Gastrointestinal Endoscopy in Dogs

Gastrointestinal Endoscopy in Dogs

Introduction

Endoscopy is a Greek word comprising of “Endo” for Inner and “Skopein” to view or observe with a purpose and Fiberoptic endoscopy is a noninvasive technique for evaluating the lumen and mucosa of the gastrointestinal tract of dogs. It is a fundamental method for investigation of the digestive tract, and is important in the diagnosis and prognosis of a variety of gastrointestinal disorders.

It is indicated mainly if history and physical examination of a patient reveals abnormalities in the area of the gastrointestinal tract. In addition to this further investigations like plan and contrast radiography, ultrasonography and functional tests may permit tentative diagnosis. Until recently clinician had been limited in their ability to diagnose GI diseases morphologically because of the need to carry out an exploratory laparotomy in order to obtain biopsy samples and has been largely replaced by endoscopy.

THORACOCENTESIS AS DIAGNOSTIC AND THERAPEUTIC TOOL IN DOGS

THORACOCENTESIS

Introduction

Thoracocentesis is the name given to the clinical technique where by fluid or air is removed from thoracic cavity.

1. Thoracocentesis may be diagnostic to determine whether air or fluid is present and to characterize the nature of the fluid obtained.

2. Thoracocentesis also can be therapeutic when removing large volumes of air or fluid to allow pulmonary re-expansion and correction of hypoxemia  and orthopnea.

3. Rapid stabilization in immediate respiratory distress due to the accumulation of air or fluid in the pleural space.

When the findings of the thoracic auscultation or percussion are suggestive of pleural effusion then thoracocentesis is  performed  to -

Ø  To Confirm the presence of pleural effusion.

Ø  Provide a specimen for examination which provide a diagnosis or guide the therapeutic plan .

Ø  Therapeutically drain a large of pleural fluid is present.

 THORACOCENTESIS IN DOGS

Materials needed:

Ø  Sterile Needle

Ø  Cat, 18-23 gauge

Ø  Dog, 18-21 gauge

Ø  Scalp Vein

Ø  A flexible polythene catheter with removable needle

Ø  Syringe- Usually 10-30ml so that large volumes of fluid/air can be collected.

Technique

1. Clip the hair and clean the skin at the proper location and each rib marked with an overlay of red ink.

2. Palpate the 13^th rib, and then the 12^th interspace immediately in front of it.‘Walk’ your fingers cranial ly from one interspace to the next, counting 11-10-9-8-7 as you go, to identify the 7^th and 8^th interspaces.

3. Once you’ve identified the desired location, advance the needle through the skin. As soon as the needle enters the subcutaneous space, pull back on the plunger to apply 1-2 cc’s of vaccum. You should be able to feel the plunger tugging against your fingers.

4. Never advance the needle deeper than you think the pleural space is your main goal is to avoid lacerating the lung in animals that in fact have no pleural space fluid or air.

5.Withdraw the needle as soon as you get a positive tap (loss of  vacuum observation of fluid), and proceed to a therapeutic tap.

6. While maintaining a strong suction, advance the needle through the chest wall at the leading (cranial) edge of the rib behind it. The instant the needle enters the pleural cavity , you will either lose the vacuum (in the case of pneumothorax as shown here) or observe the entry of fluid into the needle barrel (in the case of pleural fluid accumulation).

     Fluid Analysis

EDTA tube
a. Total protein concentration
b. Specific gravity
c.Total nucleated and red cell counts, and cytology.

Plain tube
a. Bacteriological examination
b. Other biochemical tests e,g,  triglycerides and cholesterol
c.  Smears should be prepared immediately after collection.

 Type of effusion

1. Pure transudate
a. Low protein level in the plasma (hypoproteinemia)

b. Congestive cardiac failure 

2. Modified transudate

a. High venous and capillary hydrostatic presure

b. Congestive heart failure

c. Obstruction of vein and/or lymphatics –intrathoracic mass 

3. Chylous effusions

a. Thorax –rupture of the thoracic duct

b. Intrathoracic lymphagiectasia

c. Obstruction or trauma

4. Haemorrhagic exudates

a. Thoracic trauma

b. Intrathoracic tumour

5. Exudates

1. Septic
a. Foreign body
b. Penetratign wound of the thorax, oesophagus or airway

2. Non-septic
a. Negative culture 
b. Immune-mediated process
c. Parasitic or neoplastic process

Thoracocentesis is very effective and safe procedure  in diagnosing conditions of the thoracic cavity in dogs and requires no special equipment. Thoracocentesis often makes the difference between life and death in dogs with severe disease.