Principles and diagnostic use of Endoscopy in canines

Endoscopy means ‘looking inside’ and typically refers to the technique of looking inside the body for medical reasons using an endoscope.

1. Principles and diagnostic use of Endoscopy in canines Presented by Dr Ajith Y. MVSc Division of Medicine IVRI, Izatnagar , UP, India

2. Endoscopy means ‘looking inside’ and typically refers to the technique of looking inside the body for medical reasons using an endoscope. Endoscope is an instrument used to examine the interior of a hollow organ or cavity of the body.

3. 1806: First Endoscope- Philipp Bozzini  - light conductor 1879: Electric bulb discovered 1908: Light fitted hysteroscopy by Charles David  1911: Georg Wolf- Flexible gastroscope 1945: Karl Storz started making endoscope 1950: Harold Hopkins- Optical fibre 1957: First fiber optic endoscope History of endoscope

4. An endoscope may consist of: A rigid or flexible tube. A light delivery system A lens system An eyepiece or video screen An additional channel to allow entry of medical instruments or manipulators.

5. Rigid type endoscope

6. Flexible type endoscope

7. Modern endoscope unit

8. ACCESSORY USES Biopsy needle For biopsy Foreign body retrievals For grasping Cytology brushes For sampling Aspiration tubing For aspiration Injection needles For fluid infusion Polypectomy snares For removing polyps Coagulating electrodes Electro-surgery or laser surgery

9. Oesophagus , stomach and duodenum ( Esophago -gastro- duodenoscopy ) Small intestine ( enteroscopy ) Large intestine/colon (colonoscopy) Bile duct Endoscopic retrograde cholangio-pancreatography (ERCP) Duodenoscope -assisted cholangio-pancreatoscopy Intra-operative cholangioscopy Rectum ( rectoscopy / proctoscopy ) Anus ( anoscopy ) Application of endoscopy

10. The respiratory tract Nose ( rhinoscopy ) Lower respiratory tract ( bronchoscopy ) The ear ( otoscope ) The urinary tract ( cystoscopy ) The female reproductive system ( gynoscopy ) Cervix ( colposcopy ) Uterus (hysteroscopy) Fallopian tubes ( falloposcopy ) Application of endoscopy

11. Closed body cavities (through a small incision): The abdominal or pelvic cavity (laparoscopy) The interior of a joint (arthroscopy) Organs of the chest ( thoracoscopy ) Application of endoscopy

12. Endoscopy of a dog

13. Diagnostic indications- Regurgitiation , dysphagia , odynophagia and excessive salivation Definitive diagnosis – Oesophagitis , neoplasia , gastro- oesophagial intussusception , stricture, megaoesophagus , diverticulam , hiatel hernia Evaluation and removal of foreign body Application of Oesophagoscopy

14. Withheld food for mini. 12 hrs General anaesthesia Mouth gag in place Left lateral recumbency Confirm no evidence of perforation by radiography Avoid medication which alter GI motility Barium contrast radiography 24 hrs before Procedure for Oesophagoscopy

15. Gastroscope with less than 9 mm diameter and 130 cm length for both upper and lower GI endoscopy The tip of the endoscope is lubricated, passed blindly into the proximal oesophagus and then advanced down the 0esophagus under direct visualisation whilst insufflating air. Procedure for Oesophagoscopy

16. Normal oesophagus Oesophagitis Oesophageal stricture Megaoesophagus Oesophageal diverticulam Oesophageal perforation Oesophageal neoplasm Oesophageal foreign body

17. REMOVAL OF FOREIGN BODY

18. For evaluating gastric disorders: observation of gastric mucosa Major indication : chronic vomiting (intermittent or persistent), haematemesis and melena Gastroscopy

19. Flexible- 9.8 mm dia. or less Cat, dog (<5 kg) : < 7.8 mm diameter Gastro-esophageal sphincter (which is usually closed) and advancing whilst insufflating air. Retroflexing the scope and pulling it back to visualize the cardia & fundus ( J maneuver ) Pyloric sphincter and pylorus are inspected . Procedure of Gastroscopy

20. Normal stomach Angulus J maneuver cardia Punctuate erosions Gastric lymphoma Gastroesophageal intussusception Peptic ulcer Stomach worms- Physaloptera

21. Small intestine Detects diffuse submucosal small bowel disease Distal limit- proximal jejunum Disadv : Entire small intestine examination-not possible Major indications- Small bowel diarrhea, protein losing enteropathies , chronic vomiting and melena Enteroscopy

22. Insertion depth : 287 ± 36 cm Average duration of the exploration: 84 ± 8 min. No complications or relevant adverse clinical effects Diagnosis and treatment of gastrointestinal diseases deep in the small intestine to an extent that has not been possible using conventional endoscopy. Double balloon Enteroscopy

23. Duodenal mucosa and papilla Peyer’s patches in the lateral wall  IBD Hook worms in duodenum Duodenal ulcer Duodenal a denocarcinoma Erosive duodenitis

24. Indications : Dyschezia , tenesmus,constipation chronic diarrhoea containing fresh blood and/or mucus Multiple enemas and oral cleansing agents before colonoscopy Colonoscopy

25. a Normal colon Ulcerative colitis Whip worms in colon Ulcerative colitis Rectal adenoma Colonic tuberculosis

26. Record images of the digestive tract The capsule contains a tiny camera. Patient swallows the capsule It takes pictures of the inside of the gastrointestinal tract. To examine areas of the small intestine that cannot be seen by other types of endoscopy such as colonoscopy or esophago-gastroduodenoscopy . Pass through feces within 24–48 hours. Capsule endoscopy

27. Capsule endoscopy

28. Laparoscopy

29. Arthroscopy