Internal Medicine

Procedures for Gastrointestinal Disorders

Esophagoscopy

This procedure involves insertion of a camera through the esophagus. It is used when dogs or cats have difficulty swallowing, regurgitation, or a foreign body in the esophagus. Many patients have x-rays and fluoroscopy (a moving x-ray) performed prior to endoscopic evaluation of the esophagus, because general anesthesia is required for esophagoscopy.

Another condition that requires esophagoscopy is stricture formation. This circumferential narrowing of the esophagus can occur after a foreign body has been removed or when an animal has severe gastroesophageal reflux that erodes the lining of the esophagus and results in scar formation. In this case, balloon dilation is required to open the esophagus and allow food to pass. Generally multiple episodes of balloon dilation are required to restore normal swallowing function.

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This image shows stricture formation in the esophagus that narrows the opening to ~1mm

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A guidewire and esophageal balloon on a catheter system have been passed through the stricture to provide dilation

Gastroduodenoscopy

This procedure involves passage of a camera and endoscopy through the esophagus into the stomach and duodenum (the first part of the small intestine). It is used to remove foreign bodies from the stomach and to obtain biopsy samples from dog or cats with chronic vomiting with or without diarrhea and weight loss. It is the best tool that we have for evaluating the lining of the stomach, and we can provide information on the presence of ulcers with this technique.

Endoscopy revealed a fish hook in the stomach of one dog and a rubber ball in another. These foreign bodies were removed using instruments passed through the endoscope, allowing us to avoid surgery for each dog.

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Endoscopy revealed a fish hook in the stomach of one dog and a rubber ball in another. These foreign bodies were removed using instruments passed through the endoscope, allowing us to avoid surgery for each dog.

Colonoscopy

This procedure involves passage of a camera and endoscope through the rectum into the colon. It is indicated for animals that have fresh blood in the stool or excessive straining to pass stool. Dogs and cats that require this procedure are fasted for 1-2 days and are given a pill by mouth that helps evacuate the intestinal tract of feces so that we can see the lining of the colon. It is generally performed after non-invasive tests, such as stool testing and abdominal ultrasound have been performed and have failed to yield a diagnosis.

Laparoscopy

This is a minimally invasive procedure that involves insertion of cameras and instruments into the abdomen (belly) for evaluation and biopsy of the liver, spleen, intestinal tract, pancreas, and adrenal glands. It is a technique gaining popularity in veterinary medicine because it is less invasive than exploratory surgery and animals recover from the procedure more quickly. It provides larger and generally more diagnostic biopsy samples than those that can be obtained with ultrasound. Both the internal medicine service and the soft tissue surgery service are trained in laparoscopy and are at the forefront of research in diagnostic and therapeutic laparoscopic procedures.

Before laparoscopy is performed, a thorough medical evaluation is completed including lab work (complete blood count, biochemistry profile, urinalysis and coagulation panel), chest x-rays and abdominal ultrasound. We make decisions in conjunction with the surgery service to determine whether laparoscopy is the appropriate technique (compared to an exploratory surgery) and whether the procedure should be performed by internal medicine or surgery. Generally, initial evaluation is performed on the day of the appointment, and laparoscopy is performed a day later or at a time that is convenient for you. Most patients require hospitalization the night before and after their procedures.

Please contact the VMTH to arrange for an appointment and evaluation to discuss laparoscopy for your cat or dog.

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Laparoscopic liver biopsy

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Laparoscopic kidney biopsy