What type of endoscopy is used for diagnosing Gastrointestinal (GI) issues in pets?

Endoscopic Procedures for Diagnosing GI Issues in Pets

Flexible endoscopy is the primary diagnostic tool for evaluating gastrointestinal issues in pets, with upper GI endoscopy being particularly valuable for diagnosing diseases with luminal or mucosal involvement. 1

Types of Endoscopy Used in Veterinary Medicine

Upper GI Endoscopy

• Primary diagnostic tool for examining the esophagus, stomach, and proximal duodenum
• Allows direct visualization of the mucosa and collection of biopsy samples
• Particularly useful for diagnosing:
  • Esophagitis
  • Gastritis
  • Gastric/duodenal ulcers
  • Foreign bodies
  • Neoplastic lesions 1, 2

Lower GI Endoscopy (Colonoscopy)

• Used to examine the colon and rectum
• Often combined with upper GI endoscopy for comprehensive evaluation 2

Ileal Endoscopy

• Recent studies have demonstrated significant value in ileal biopsies for diagnosing chronic enteropathies in both dogs and cats 3

Technical Considerations

Equipment Selection

• Appropriately sized endoscopes are crucial for cats and small dogs:
  • Pediatric endoscopes (5-6 mm diameter) are often ideal for cats
  • Standard adult endoscopes (9-10 mm) may be suitable for medium to large dogs 2

Biopsy Techniques

• Multiple biopsies should be collected from each region:
  • Minimum of 6-8 samples per region for adequate diagnostic yield
  • Samples should be taken from both normal and abnormal appearing mucosa
  • Ileal biopsies are particularly important in chronic enteropathy cases 3

Proper Preparation

• Fasting for 12-24 hours before the procedure
• Colonic cleansing for lower GI endoscopy
• General anesthesia is required for proper examination and biopsy collection 2, 4

Diagnostic Applications

Chronic GI Disease

• Allows for direct visualization of mucosal changes:
  • Inflammation
  • Ulceration
  • Erosions
  • Mass lesions
• Provides tissue samples for histopathology, which is essential for definitive diagnosis of:
  • Inflammatory bowel disease
  • Lymphoma
  • Other neoplastic conditions 3, 4

Foreign Body Retrieval

• Direct visualization and removal of ingested objects
• Less invasive than surgical intervention 1, 4

Therapeutic Applications

• Stricture dilation (particularly esophageal)
• Percutaneous endoscopic gastrostomy (PEG) tube placement
• Polypectomy 4

Advantages Over Other Diagnostic Methods

• Direct visualization of the mucosa
• Ability to obtain targeted tissue samples
• Less invasive than exploratory surgery
• Can be both diagnostic and therapeutic in the same procedure 1, 4

Common Pitfalls and Limitations

• Equipment limitations: Inadequate endoscope size can limit examination, particularly in cats and small dogs
• Operator experience: Significant training is required to differentiate normal from abnormal findings
• Sampling errors: Superficial biopsies may miss deeper lesions
• Inability to access all intestinal segments: Standard endoscopy cannot reach the jejunum and proximal ileum
• Discordance between endoscopic appearance and histopathology: Visual assessment alone is insufficient 1, 3, 2

Best Practices

• Always perform endoscopy in conjunction with thorough history, physical examination, laboratory evaluation, and imaging studies
• Use standardized protocols for biopsy collection
• Process samples appropriately for histopathology
• Consider additional testing on biopsy samples (immunohistochemistry, microbiology, molecular studies) when indicated 3, 4

Endoscopy should be considered an essential diagnostic tool for pets with persistent GI signs, particularly when non-invasive diagnostics have failed to yield a definitive diagnosis or when tissue samples are needed for proper disease characterization.