Affiliated Veterinary Specialists : Clinical Insights from AVS

Please call us at any time if you have questions about AVS or if you are concerned about your pet.

During regular business hours an assistant may be able to answer your questions. If you need the advice of a specialist, a doctor will receive your message and will return your call as soon as possible.

Phone calls received after hours on weekdays and on the weekend will be returned the following business day.

Clinical Insights

The Pros and Cons of Gastrointestinal Endoscopy

Indications for a patient referral to AVS for GI endoscopy include regurgitation, chronic vomiting, hematemesis (without coagulation problems) melena, chronic small and large bowel diarrhea, removal of esophageal/gastric foreign objects, feeding tube placement and dilation of esophageal/colonic strictures. Generally endoscopy is a very safe procedure with the major risk being possible complications associated with anesthesia. It is not a replacement for but used in conjunction with a complete history and physical examination as well as other diagnostics such as blood work, fecal examination, radiography and ultrasound.

PROS

Minimally invasive
Animals undergoing endoscopy require anesthesia and some preparation – fasting (12-36 hrs), warm water only enemas, and possibly oral osmotic solutions

Low morbidity and mortality

Sensitive for diagnosing mucosal diseases
Esophageal, gastric, duodenal, distal ileal (possibly), colonic mucosa only

Allows for descriptive and photographic documentation of lesions

CONS

Cannot assess functional disease, luminal diameter, wall thickness

Cannot identify disease in most of the small intestine

Cannot detect disease in the deep submucosa, muscularis or serosa

Not appropriate if bowel perforation is suspected

Not ideal if pet not adequately prepared or barium/sucralfate present

Cannot assess or biopsy lymph nodes

Biopsy samples are very small, need multiple

COMPLICATIONS – rare with an experienced endoscopist

GI perforation possible

Laceration of major blood vessels or major organs adj to GI tract

Decreased venous return or hypoxia if stomach over inflated

Bradycardia due to vasovagal reflex from over distention/traction

GDV from inadequate removal of air as endoscope is removed

Mucosal bleeding usually minor unless ulcerations, neoplasia

Bacteremia post-endoscopy, noted in humans, likely in animals