Endoscopy

What is endoscopy?

Endoscopic examination is an essential part of diagnosing diseases of the respiratory tract, digestive tract, and urinary system in small animals. Using suitable rigid and flexible optical systems, the organs in question are examined from the inside. This allows for the direct assessment of the internal structures of an organ. During endoscopies, various samples are taken (e.g., cell samples, tissue samples, samples for microbiological examinations, etc.) and are examined promptly either in our facility or in external laboratories.

At FRONTIER Veterinary Specialists we have an extensive video endoscopy setup, consisting of multiple flexible and rigid endoscopes of various sizes, as well as laryngoscopy, bronchoscopy, rhinoscopy, gastroscopy, colonoscopy, cystoscopy, and otoscopy. A specialized internist with many years of endoscopic experience is available for the endoscopies.

The use of the latest developments in digital technology, as well as high-resolution CCD chips and improved optics, enables unique image sharpness. The images are characterized by their pronounced brightness, resolution, size, and depth of field. By integrating two opposing light carriers and a digital processor, uniform image brightness is achieved even under challenging lighting conditions. This allows us to visualize and biopsy the ileum in cats, for example.

In some cases, such as rhinoscopies, it can be helpful to use an imaging technique like a CT scan before the rhinoscopy under the same anesthesia. This can help diagnose bone dissolutions (osteolysis) or visualize areas of the nasal cavities that are not accessible endoscopically.

Endoscopies can only be performed under general anesthesia, as the animals would not tolerate the examination due to defensive reactions. It is important to understand that these endoscopic examinations often represent only auxiliary tests and can only truly lead to the diagnosis of a disease after appropriate preliminary diagnostics through other examination methods. These include X-rays, possibly CT or MRI, possibly echocardiographic or sonographic diagnostics, as well as blood tests.

Through close collaboration between internists and surgeons, it is also possible to quickly make diagnoses endoscopically and then immediately address the changes surgically, such as in cases of laryngeal paralysis (laryngeal paralysis), brachycephalic syndromes, ectopic ureter treatment, etc. 

Overview of Endoscopic Examination

Tracheobronchoscopy

Tracheobronchoscopy is the endoscopic evaluation of the larynx, trachea, and bronchi. It is performed on dogs and cats using rigid or flexible endoscopes. Both systems allow penetration into smaller bronchi.

Indications for tracheobronchoscopy can include coughing, atypical respiratory noises, or shortness of breath of unclear origin, as well as a strong suspicion of a foreign body in the respiratory system. This examination method often successfully identifies various chronic inflammations, malformations such as tracheal collapse, or other serious underlying diseases in the respiratory system. It should be noted that endoscopy is a less sensitive examination method in small animals when a lung tumor is suspected, as few lung tumors show early invasion into the bronchial system and thus are often not detected with endoscopy. Other imaging techniques such as CT or thoracoscopy are more suitable for this purpose.

During a tracheobronchoscopy, samples are always collected for cytological diagnostics and bacteriological examinations. Especially with cytological diagnostics, it is often possible to specifically diagnose diseases such as feline asthma syndrome or other forms of bronchitis in dogs and cats.

Rhinoscopy

Indications for a rhinoscopy (examination of the nasal cavities) include nasal discharge, nasal breathing noises, nosebleeds, sneezing, and reverse sneezing. This examination often successfully identifies chronic inflammations, foreign bodies, tumors, or fungal infections in the nasal cavity system. As mentioned before, rhinoscopy should be regarded only as an auxiliary diagnostic tool and must be interpreted in the context of other imaging procedures such as CT, X-ray, and laboratory diagnostics. During rhinoscopy, flexible and rigid optical systems are used to directly evaluate the nasal mucosa. As with tracheobronchoscopy, collecting mucosal samples is of great importance for interpreting the rhinoscopy.

Gastroduodenoscopy or colonoscopy

Gastroduodenoscopy or colonoscopy are examinations of the gastrointestinal tract. They are performed using long, flexible video endoscopes. The animals often need to be fasted for an extended period before the examination. For a gastroduodenoscopy (examination of the stomach and small intestine), animals should not be fed for at least 12 hours. For a colonoscopy (examination of the colon), they should not be fed for 24 to 36 hours. If necessary, it may be required to prepare the patient a day before the colonoscopy for proper preparation. These gastrointestinal endoscopies are performed when there is suspicion of foreign bodies, as well as chronic vomiting, diarrhea, weight loss, recurring abdominal pain, prolonged loss of appetite, and other complaints. These examinations often help determine whether the patient has diet-related issues, chronic or possibly immune-mediated inflammations of the digestive system, ulcers, or even tumors. Treatments for these diagnoses vary greatly. During gastrointestinal endoscopies, it is essential to take numerous tissue samples. Simply observing the organs is often not sufficient for an accurate diagnosis.

Cystoscopy

The urinary system can also be evaluated endoscopically through a cystoscopy (bladder endoscopy). A significant advantage of this method is the ability to take tissue samples under visual control. This often allows for the identification of specific forms of inflammation, tumors, hard-to-detect stone diseases, or malformations. Following the procedure or during a separate appointment, malformations such as ectopic ureters can be surgically corrected in the soft tissue surgery department.

Dr. Désirée Ballhausen

Senior Physician Internal Medicine
DECVIM-CA (Internal Medicine)
EBVS European Veterinary Specialist in Small Animal Internal Medicine
Fachtierärtzin für Innere Medizin der Kleintiere

 

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e-Mail: info@frontier.vet
phone: +49 (0) 89 904 29 56-0