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19-03-2013 | Veterinary medicine | Article

Double-balloon endoscopy shows promise in dogs

Abstract

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medwireNews: Oral double-balloon endoscopy (DBE) is an effective and low-risk procedure for dogs and could prove useful in the diagnosis of disease in the deep portion of the canine small intestine, report Spanish researchers.

Traditional endoscopy does not allow the veterinarian to progress further than a few centimeters into the jejunum using the oral approach, explains the team, while DBE - which involves a "push and pull" technique - allows treatment as well as exploration.

A total of 10 of the 12 dogs (10-34 kg) in the study received DBE, giving an overall success rate of 83%. The size of the dogs was the most important veterinary limitation, write the study authors in The Veterinary Journal, since a minimum intestinal diameter of 2 cm was needed for smooth passage of the endoscope and overtube.

"Future studies which describe DBE by the anal route in the dog would allow portions of the distal jejunum to be explored, enabling a complete exploration of the small intestine by combining both oral and anal routes, as is practiced in human medicine," suggest Rafael Latorre (University of Murcia, Spain) and colleagues.

The DBE procedure involved a 200 cm endoscope and 145 cm overtube, both of which have a latex balloon attached to the tip. The balloons are alternately inflated and deflated to allow the endoscope to progress ("push") or fold the intestine behind the balloons to allow exploration ("pull"), explain the researchers.

The two animals that did not undergo the full procedure had it terminated after the endoscope did not progress.

Overall, the average insertion depth was 287 cm and the average procedure duration was 84 minutes.

The first "push" maneuver was the most effective, observed Latorre et al, progressing the endoscope by an average of 35 cm. Efficiency decreased progressively after that, by more than 10 cm at the end of the DBE procedure.

In total, 1 meter of insertion required 20 minutes DBE, and 3 meters' insertion was reached after 50 minutes. No significant alterations or adverse effects were noted in the dogs' blood pressure, heart rate, respiratory rate, or oxygen saturation, and their food intake was normal 1 day after the procedure,

"Similarly, regarding the potential risk of post-procedure pancreatitis, there was no clinical suspicion or any adverse serological evidence," conclude the authors.

By Sarah Guy, medwireNews Reporter