Large Animal Endoscopy: The Future of Veterinary Medicine

Unlocking Veterinary Insights: The Importance of Large Animal Endoscopy

Endoscopy has been widely employed in equine veterinary hospitals for many decades, particularly in the assessment of the upper respiratory tract of competition horses.

Its use is not restricted to this area, however. As the available range of endoscopes, tools, and accessories expands, so does the availability and application of endoscopy in large animal general practice.

Alongside its use in horses, the large animal endoscope may be a valuable tool for veterinarians working with production animals (particularly those of high economic value), camelids, farm pets, and zoological species.

Reasons to Perform Large Animal Endoscopy

As with small animals, large animal endoscopy may be undertaken for both diagnostic and therapeutic purposes. Cases benefiting from endoscopy may include those with the following:

Structural abnormalities such as strictures may be identified and possibly treated endoscopically

Conditions associated with exercise intolerance or poor athletic performance

Traumatic injuries, for example, bolusing injuries of the pharynx or esophagus in production animals, rectal tears in the horse post-examination

Ingestion or inhalation of foreign material which may be identified and retrieved endoscopically in most large animal species

Neoplastic disease visualization, biopsy, and, in some cases such as ethmoid hematomas, treatment

Parasitic disease identification and sampling

Infectious diseases such as guttural pouch mycosis or sinusitis in horses 

Inflammatory disease for example Equine Asthma (EA) where bronchoalveolar lavage samples may be valuable

Gastric ulceration especially in horses

 Large animal endoscopy may be used in the following organ systems:

• Upper respiratory tract - including nasal passages, paranasal sinuses, guttural pouches, pharynx and larynx

• Lower respiratory tract - including trachea and bronchi

• Oral/dental assessment in all species

• Upper gastrointestinal tract - including esophagus, stomach, and proximal small intestine

• Lower gastrointestinal tract including the rectum and colon 

• Urinary tract 

• Reproductive tract

Large animal endoscopes

Large animal endoscopy most often employs a flexible endoscope (either a fiberscope or video endoscope) of diameter and length appropriate for the patient and organ system under investigation. Dynamic endoscopy is also now available, using a portable, wireless, flexible endoscope to assess an animal during exercise.

Large animal endoscopes require a light source, an air pump for insufflation, irrigation, and suction, as well as a monitor to receive the image in the case of video endoscopes. Fiberscopes and rigid endoscopes may be connected via a camera system to a display monitor. 

Instrumentation for large animal endoscopy

Instruments used in large animal endoscopy may include the following, some of which are available either as single-use or reusable items:

• Biopsy forceps – with various tips to suit the tissue to be biopsied. In this case, single-use forceps may be advantageous in gaining optimum biopsy quality as the cutting edge will always be sharp.

• Grasping forceps – including rat-toothed, alligator jaws, or multi-pronged forceps

• Retrievers, snares, or baskets – for the retrieval of foreign objects

• Polypectomy snares – with cutting wire for the removal of polyps and other small growths

• Cytology brushes – for collecting cell samples, particularly from the lower airway or gastrointestinal tract

• Catheters with injection needles - for aspiration biopsy or flushing and aspirating fluid e.g. bronchoalveolar lavage

• Guttural pouch probe – to help navigate the endoscope into the guttural pouch

• Equine laryngeal forceps – particularly useful during trans-endoscopic laser surgery

• Coagulation electrode – where hemostasis is required.

Other applications

• Rigid endoscopes (or telescopes) are also widely used in large animal veterinary clinics. Applications may include

• Dental assessment

• Arthroscopy – for diagnosis and treatment (e.g. meniscal injury)

• Thoracoscopy – for diagnosis and treatment (e.g. pleural lavage in pleuropneumonia cases)

• Laparoscopy – for diagnostics (e.g. organ visualization and biopsy), elective surgery (e.g. cryptorchid castration or ovariectomy in horses) or therapeutic surgery (e.g. abomasopexy in cattle, neoplasia in all species, inguinal ring closure in equine hernia patients or nephrogenic space ablation after entrapment colic).

Artificial insemination and embryo transfer work

• Theloresectoscopy – for diagnostics and minimally invasive teat surgery in cattle 

• Rigid endoscopes are passed through a trocar or cannula into the required space. Operating instruments for use during laparoscopy and thoracoscopy may include scissors, grasping forceps, biopsy forceps, injection cannulas, a palpation probe, needle holders, and knot tyers. Specialist instruments are available for embryo transfer in horses and cattle and for toggling procedures in cattle.

• Instruments for use during arthroscopy may include probes to assess articular cartilage and subchondral bone; curettes for debridement; osteotomes and elevators for separating bone fragments; rongeurs; grasping forceps; arthroscopy punch for resection of cartilage, synovium or soft tissue masses; chisels; scissors; and drainage cannulas.

Conclusion

Large animal veterinary practitioners are presented with some specific challenges when diagnosing and treating our patients.

They are often, by definition, large in size which can limit the use of some diagnostic techniques such as abdominal radiography.

Frequently our patients would be at high risk under general anesthesia both in terms of risk to the patient and potential risk to the handler(s) too. In our livestock patients, in particular, financial limitations may preclude the use of advanced imaging modalities.

Large animal endoscopy represents an accessible, practical, and economically viable solution in many of these cases, both in terms of diagnostics and therapeutics. 

Additional resources 

The Veterinary Endoscopy Society - https://veterinaryendoscopysociety.org/ 

Equine endoscopy - https://adobevetcenter.com/equine-endoscopy/

Equine gastroscopy https://www.veterinary-practice.com/article/equine-gastroscopy-a-complete-perspective 

Gastrointestinal biopsy in the horse https://journals.sagepub.com/doi/full/10.1177/10406387221085584

Transendoscopic URT laser surgery in the horse https://www.sciencedirect.com/science/article/pii/S0749073917302870

Livestock endoscopy - https://adobevetcenter.com/livestock-endoscopy/

Endoscopy in cattle https://pubmed.ncbi.nlm.nih.gov/22134601/#:~:text=Parts%20of%20the%20upper%20respiratory,prognosis%20of%20different%20pathological%20conditions. 

Theloscopy in cattle https://www.sciencedirect.com/science/article/abs/pii/S0749072004000854?via%3Dihub

Explore Endoscopy in Veterinary Medicine

In recent years, endoscopy has become increasingly prevalent in veterinary medicine, offering a minimally invasive approach to diagnosing and treating a wide range of conditions. Just like other advanced imaging modalities, such as veterinary CT systems and fluoroscopy, endoscopy is becoming more commonplace for use by general practitioners.

This article aims to provide an overview of endoscopy in veterinary medicine, exploring its various applications, benefits, and considerations for implementation in veterinary practices.

What is Endoscopy?

An endoscope is a specialized instrument that allows veterinarians to visualize and examine internal organs and structures without the need for surgery.

This versatile tool consists of a thin, flexible tube equipped with a light source and a camera. The endoscope is inserted into the body through a natural orifice, such as the mouth, esophagus, or anus, to provide a real-time view of the internal environment.

Common Uses of Endoscopy in Veterinary Medicine

Endoscopy offers a range of valuable applications in veterinary medicine, including:

• Non-invasive assessment of anatomy: Endoscopy allows veterinarians to examine the internal surfaces of organs and structures without making incisions. This provides a detailed view of the anatomy, enabling the detection of abnormalities, such as inflammation, masses, and foreign objects.

• Obtaining biopsy samples: Biopsy samples are crucial for the definitive diagnosis of many conditions, including inflammatory and neoplastic diseases. Endoscopes can be equipped with biopsy forceps, allowing veterinarians to collect tissue samples from the areas of interest without the need for surgical intervention.
  
  

• Removal of foreign objects: Foreign bodies can pose a significant risk to animal health. Endoscopy facilitates the visualization, localization, and removal of foreign objects from various parts of the body, including the gastrointestinal tract, respiratory tract, and urinary tract.

• Minor surgical procedures: Endoscopy can be used to perform a variety of minor surgical procedures, such as balloon dilation of strictures, hemostasis, and nasopharyngeal polyp removal.

• Exotic animal care: Endoscopy plays a valuable role in the care of exotic species, such as birds and reptiles. It can be used for gender determination, diagnostic evaluation, and minor surgical procedures.

Benefits of Endoscopy

Endoscopy offers several distinct advantages over traditional diagnostic methods, including:

• Minimally invasive: Endoscopic procedures are minimally invasive, causing minimal discomfort and tissue damage compared to open surgery. This reduces recovery time and allows animals to return to their normal activities more quickly.

• Real-time visualization: Endoscopy provides real-time visualization of internal structures, enabling veterinarians to identify abnormalities promptly and accurately.
  
  

• Versatility: Endoscopy can be used to examine a wide range of body systems, including the gastrointestinal, respiratory, urinary, and reproductive systems.

Considerations for Implementing Endoscopy in Veterinary Practices

While endoscopy offers numerous benefits, its implementation in veterinary practices requires careful consideration of several factors:

• Training and experience: Veterinarians should undergo appropriate training and gain hands-on experience in endoscopic procedures before performing them independently.

• Equipment selection: The choice of endoscopic equipment depends on the specific needs of the practice and the types of patients it serves.

• Cost-benefit analysis: Endoscopic equipment can be a significant investment, so practices should carefully assess the cost-benefit ratio before making a purchase.
  
  

• Referral options: It is important to have a referral network in place for cases that require specialized endoscopic expertise.

Conclusion

Endoscopy has become an invaluable tool in veterinary medicine, offering a minimally invasive and versatile approach to diagnosing and treating a wide range of conditions.

By expanding their diagnostic capabilities with endoscopy, veterinary practices can enhance patient care and provide comprehensive, high-quality services.

Additional Resources:

• * American Veterinary Medical Association: [https://www.avma.org/](https://www.avma.org/)

• * World Small Animal Veterinary Association: [https://www.wsava.org/](https://www.wsava.org/)

• * European Society of Veterinary Endoscopy: [https://www.esve.org/](https://www.esve.org/)

Uncover the Advantages of Endoscopes in Veterinary Medicine

Shrinking Surgeries: The Advantages of Minimally Invasive Endoscopic Procedures

Endoscopy is a fantastic, minimally invasive tool that is now widely used throughout the veterinary field, both in small- and large animal medicine. You may or may not have access to endoscopy in your current veterinary clinic but even so, it is really handy to know when to reach or refer for this modality!

What is endoscopy?

Let’s begin by reviewing how endoscopy actually works. Endoscopes are often described as “cameras'' which are used to view internal organs.

In reality, of course, we do not routinely place a camera into the patient; instead, we use an optical waveguide, typically in the form of fiber optics, which transmits light from the insertion tube and umbilical cord into the patient. The reflected light is sent back to the processor for image visualization

These optical devices rely on the principle of total internal reflection, a phenomenon whereby light can be reflected continually along an optical fiber or rod lens. The image can then either be viewed directly or projected onto a camera and displayed on a screen (as is increasingly common). 

There are two major types of endoscope: rigid vs flexible

These are selected based on the area of interest. For example, if you wanted to examine the colon, bronchioles, oesophagus, or stomach then you would opt to use the flexible endoscope.

Flexible endoscopes are made up of moveable and easy-to-manipulate insertion tubes, containing one or more bundles of optical fibers.

Whereas fixed rigid endoscopes are better suited to procedures such as arthroscopy and laparoscopy, and comprise a steel sheath containing delicate rod lenses.

In either case, the insertion tube must be connected to an umbilical cord, which supplies light (it’s dark inside a patient, remember!), distilled water (for cleaning the lens), and in many cases the camera mount and other mechanisms.

In the case of flexible endoscopes, there will usually also be a handpiece on the end of the insertion tube that mounts the control wheels, for lateral and vertical flexion and extension of the scope. In many scopes, there is an instrument channel through which instruments can be passed such as surgical instruments, biopsy forceps, or grasping instruments.

The benefits:

There are many benefits of endoscopy in small animal procedures in particular which can enhance your clinical practice, improve patient outcomes, and reduce the requirements for referral to alternative or secondary providers.

Diagnostics:

Endoscopy is now a well-recognized diagnostic tool in the management of gastrointestinal disorders in dogs and cats (Rychlik and Kaczmar, 2020). Endoscopy and endoscopically guided biopsy have a high sensitivity to diagnosing mucosal disorders within the gastrointestinal tract.

Additionally, the endoscopic biopsy of the intestine is regarded as the gold standard in the diagnosis of IBD in dogs and cats in veterinary hospitals (Rychlik et al, 2007).

As well as gastrointestinal diseases being explored via endoscopy, the respiratory system can also be explored in this way too.

Rhinoscopy, bronchoscopy, and tracheostomy can all be performed to investigate pathology associated with these areas. Focusing on rhinoscopy, this technique allows direct visualization of the nasal mucosa, allowing samples to be obtained in a less traumatic way than direct surgery.

This is particularly relevant when nasal masses are present and require diagnosis (neoplasm or mycosis, for example)  or where tumors require staging with minimal destruction of the overlying bony structures. 

Minimally invasive surgery:

Whatever it is used for, endoscopy is always described as ‘minimally invasive.’ This is due to the small incision size and minimal exposure of the body cavity.

Consequently, because of the smaller surgical wounds with endoscopy compared to conventional surgical approaches, the healing process is quicker than with traditional surgical wounds.

Quicker healing times are of particular importance in dogs with working, competition or service duties, because of their rapid return to normal function. 

Many clinics are now offering laparoscopic (keyhole) ovariohysterectomies or ovariectomies as an alternative to the traditional ventral median celiotomy technique.

As stated above, this spay technique is not only less invasive but it has also been associated with fewer postoperative complications (William et al, 2009).

Post-operative pain scores in dogs were found to be significantly higher in cases using the traditional technique versus the laparoscopic technique (Devitt et al, 2005). Other surgeries which can now be performed via endoscopy include gastropexy, cryptorchidectomy, and abdominal organ biopsy. 

Foreign bodies:

Unfortunately, as we are all well aware, foreign bodies are common presentations in small animal practices. Whether endoscopy can be offered is dependent on the nature of the foreign body and its location within the gastrointestinal tract.

Endoscopy is currently the superior treatment of choice for the majority of gastric or oesophageal foreign bodies (Poggiani et al, 2020). Without the aid of endoscopy, in most circumstances, the alternative option is invasive surgery to physically remove the foreign object.

Endoscopy is greatly beneficial in the majority of these cases because it offers a less invasive and less costly option to the pet owner.

Additionally, endoscopy is associated with a much shorter hospitalization time which is beneficial for the patient. 

To summarise, endoscopy has many benefits in small animal Veterinary medicine.

Whether you’re already a pro at endoscopy or a budding novice endoscopist, the movement is happening, and it is becoming widely available within the veterinary field worldwide. 

Advancing Veterinary surgery: Exploring the benefits of endoscopes in small animal procedures

References

Devitt, C, M. Cox, R, E. Hailey, J, J. 2005. Duration, complications, stress and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. Journal of American Veterinary Medicine Association. 227: 921- 927. 

Rychlik, A. Kaczmar, E. 2020. Endoscopic biopsies and histopathological findings in diagnosing chronic gastrointestinal disorders in dogs and cats. Vet Med Int. 9. Rychlik and Kaczmar

Rychlik, A. Nieradka, R. Kander, M. Depta, A. Nowicki, M. Sarti, K. 2007. Usefulness of endoscopic examination for the diagnosis of inflammatory bowel disease in the dog. Polish Journal of Veterinary Sciences. 10: 113-118. 

Poggiani, F, M. Duarte, R, P. Santana, M, S. Galera, P, D. 2020. Endoscopic removal of foreign body in upper gastrointestinal tract in dogs: Success rate and complications. Sci Vet. 48: 1735.

William, T, N, C. Mayhew, P, D. Brown, D, C. 2009. The effect of laparoscopic versus open ovariectomy on postsurgical activity in small dogs. Veterinary Surgeon. 38: 811-817. 

Veterinary Endoscopy: The Importance of Training

Training Opportunities in Veterinary Endoscopy

Veterinary endoscopy can be a great way to add value to a veterinary practice and help a lot of patients. But there is a learning curve when it comes to mastering diagnostic and therapeutic endoscopy procedures.

Here are a few ways to maximize the return on investment in a new veterinary endoscopy system by promoting training for veterinarians and veterinary team members…

Invest In Training as Early as Possible

Veterinary continuing education and training have many benefits when it comes to any new piece of veterinary equipment. Training should be required for any new treatment or diagnostic equipment at the practice to ensure it’s used properly and to its full potential. 

For vets who will be using the scope, training increases confidence, efficiency, and accuracy. This means the practitioner will not only have more confidence in recommending the procedure to clients but also more confidence in the accuracy of their diagnosis.

It becomes less likely that anything will be missed due to inexperience. And vets will become faster over time, which is good for efficiency and profitability in the daily clinic schedule.

It’s probably never too early to invest in training. That way, veterinarians who will be using endoscopy will feel better prepared to start right away. Even though expertise will take time and practice, there’s a lot to be said for having a solid educational foundation in endoscopy driving, interpretation, and procedures as soon as the new scope arrives. 

Plus, being proficient at endoscope functions can also help a veterinarian better evaluate machines prior to a purchase, to make the best choice when buying a scope for the hospital.

Offer Discounted Endoscopy Studies at First

Although there are excellent training courses and resources available, hands-on practice is always required to truly master any new clinical skill. Endoscopy is no exception.

Sometimes, it’s helpful for a veterinary practice to come up with a mutually beneficial solution for themselves and their clients. This might mean offering discounted studies in the beginning. Honesty is important, so clients should understand the pros, cons, and limitations based on the vet’s current skill level. Not all clients will be interested, but it’s likely that some will jump at the opportunity to help their pet while receiving a great deal on pricing.

Many vets also practice using new equipment on their own pets, staff pets, or local shelter animals who could benefit from an endoscopy study. 

Invest in Staff Training

Training is crucial for anyone who will be involved in endoscopy at the practice, not just the veterinarian operating the endoscope.

Veterinary team members play a vital role in setting up the equipment, assisting the vet during a procedure, and maintaining and cleaning the equipment. Some staff members are also involved in discussing endoscopy with clients, conveying value when presenting price estimates, or calling tech support for the equipment when needed.

Appropriate training on how an endoscope can help patients, as well as proper use and upkeep of the equipment, has many benefits. It may help more clients say “yes” to a procedure. It can help prevent damage to the endoscope and its components and make procedures more efficient. It may even help the new endoscope last longer through proper maintenance.

Choose One New Service at a Time

Trying to learn everything at once can be challenging and inefficient since veterinary endoscopy has so many potential uses. It may be more practical for a veterinarian to pick one (or just a few) procedures to focus on at first, then add more once they feel comfortable with those.

The initial choice can be based on the type of endoscope (rigid or flexible) and its capabilities, as well as clinical interests and clinical demand. For example, a vet could start with laparoscopic procedures including surgeries and biopsies. Or, they might choose to jump right into upper GI studies, since that is a service that can benefit a lot of veterinary patients.

Resources for Veterinary Endoscopy Training

Here are a few suggestions for how and where to get started with veterinary endoscopy training…

• Speak to colleagues and specialists who are already using endoscopy. Ask for their opinions, and if possible, see if you can shadow them on a few procedures.

• Look for hands-on training at conferences, universities, and other CE providers.

• See if the vendor of the endoscope you wish to purchase offers training. This can be a nice option because it’s specific to the machine you’ll be using.

• Send out studies for consultation and interpretation with a specialist, if available. Be sure to interpret the studies yourself first, then compare it to the official report as a learning opportunity.

• Join the Veterinary Endoscopy Society (Home - Become a Member | Veterinary Endoscopy Society), which offers resources, education, and networking opportunities for veterinarians interested in endoscopy.

Budgeting for training—on top of budgeting for the equipment itself—can feel expensive or overwhelming. However, it’s truly an investment. 

Written by: Dr. Tammy Powell, DVM 

Practice makes perfect, and training will help a veterinary practice offer the best patient care while also maximizing the return on investment in their new veterinary endoscopy system.

Choosing the Right Veterinary Endoscope System

How Much Do Veterinary Endoscopes Cost?

Veterinary endoscopy is valuable for a variety of diagnostic, therapeutic, and surgical procedures that can help patients. 

However, different types of scopes serve different purposes. It’s important for a veterinary practice to ensure they’re investing in the right type and size of the endoscope, not to mention the entire system used for performing endoscopy procedures.

Here are some important factors to consider prior to a veterinary endoscope purchase…

How to Evaluate a Veterinary Endoscopy Purchase

The endoscope itself is, of course, central to the purchase consideration. However, a veterinary practice probably won’t just be investing in scope alone, but rather in a system or package with all the necessary components for performing endoscopy studies.

This could potentially include the scope, a high-definition monitor for viewing images and videos, accessories like biopsy forceps, and more. So, when comparing prices, it’s important to compare what’s included in the price.

Also, not all endoscopes are created equal. Different types of scopes have different uses. A veterinary practice must research exactly what they need in terms of the type of endoscope (rigid or flexible) for the types of studies they plan to perform, as well as the size of the scope (based on the species and size of patients seen, and the type of procedures to be performed).

Some practices might want to incorporate more than one endoscope to accommodate different sizes of patients and types of procedures. In that case, it’s necessary to plan for the total cost of both scopes, plus all additional equipment or accessories for one of both of them.

How Much Does a Veterinary Endoscopy System Cost?

Keeping in mind the above factors, it’s still helpful to have a ballpark figure in mind when shopping for endoscopes. In a search of vendors, average prices ranged from about $7,000-$30,000, depending on the type of scope and what was included in the system. 

But prices are variable and may run higher or lower than this. Used veterinary endoscopes may also be a good option for some practices.

Additional Costs and Financial Considerations

The system’s price tag is an important factor. But it’s not the only factor in the total financial picture when purchasing an endoscopy system.

Here are some examples to consider…

• Warranty, maintenance, and repairs. Everyone wants their investment to last for years and years. But all veterinary equipment needs maintenance—as well as occasional repairs or replacement parts—to keep running at its best. There should be a plan in place for this. 

For new or refurbished equipment, this might mean a warranty or service agreement. Without a maintenance plan, a clinic should set aside funds for when repairs or technical support are needed.

Also, find out if loaner equipment is available to use while your equipment is being repaired.

• Hardware and software. Endoscopy studies require a system on which to view and store the collected images and videos. 

• Components and accessories. Common features include a light source, water flow, suction, and gas insufflation. Common accessories include biopsy forceps and various attachments for retrieving foreign bodies. 

Accessories are typically passed through the scope channel, so they must be appropriately sized based on the scope channel diameter and how many channels there are. The cost of these accessories can add up quickly. But it is possible to add these on over time rather than purchasing all of them upfront.

• Financing. A veterinary practice should decide whether to purchase their equipment outright or to get a loan or financing. Financing is a popular option, which helps with monthly cash flow since potential profits can help support the monthly payments. But interest and other charges must be factored in.

• Tax breaks. Speak to a tax professional to learn about tax advantages and deductions available with the purchase of new business equipment.

• Training. It’s necessary to invest in training to ensure the equipment is used properly and to its full potential. This helps maximize a practice’s return on its financial investment. It also helps avoid equipment damage due to improper usage and cleaning.

Purchasing the Best Veterinary Endoscopy System for Your Practice

Prior to a purchase decision, general practitioners may find it useful to speak to a specialist who regularly performs endoscopy studies. Specialists can provide a lot of insight into the best scope, system, and components to purchase. 

Try out equipment from vendors prior to purchasing, if possible. But do a basic endoscopy training course first. Having some comfort and familiarity with driving a scope will allow a veterinarian to better evaluate the systems they are testing.

All of this information will help a veterinary practice choose the best endoscopy system for their needs, to provide excellent patient care, and keep the practice financially healthy.

 Written by: Dr. Tammy Powell, DVM 

https://newvetequipment.com/endoscope

Choosing the Best Veterinary Endoscope for Your Practice

What to Look for in a Veterinary Endoscope

Veterinary endoscopes are an amazing tool that can help with diagnostics and therapeutic procedures in several body systems. However, because of their wide range of uses, there are many different options to choose from when purchasing an endoscope.

The previous article covered key features such as endoscope sizes, whether the scope should be rigid or flexible, and the importance of high-quality images and video. 

Below, read on for more information on specific features, tools, and other considerations for purchasing the right endoscope for your practice’s needs.

Features, Tools, and Accessories

Tools can really boost an endoscope’s functionality and expand the number of services a veterinary hospital offers. 

Some tools may come as part of the endoscope, while others are added on. The good news is, more tools can be added over time. However, if there is a specific type of procedure a veterinarian knows they want to offer, it’s important to check that the scope being purchased will accommodate a tool or attachment for that purpose.

Here are some frequently used features and tools in veterinary endoscopy…

• Light source. Typically included as part of the endoscope system, a good light source such as LED is important for seeing and assessing things clearly. 

• Air and water. These allow for the cleaning of debris from the lens or area of interest, as well as air insufflation when necessary.

• Suction. Suction can be useful for removing excessive fluids or secretions in the area being evaluated, removal of saline or air insufflation administered during the procedure, or for aspirating fluid samples for testing (for example, bronchoalveolar lavage). It can also be helpful for cleaning the endoscope after a procedure.

• Biopsy forceps. This is probably one of the most commonly used endoscopy tools that would be passed through the working channel of the instrument. These small forceps can obtain “pinch biopsies” for histopathology evaluation. Biopsy cups and other instruments might also be used for this purpose. The largest biopsy tool that can fit into the channel is the best option to obtain large enough tissue samples for analysis.

• Foreign object retrievers. These can come in a variety of shapes and sizes, including rat tooth or alligator forceps, snares, baskets, or nets. The variety of options makes it possible for veterinarians to remove many different types of foreign bodies from the digestive or respiratory tracts, without the need for more invasive surgery.

• Balloon dilation. A set of catheters for balloon dilation can be used in the treatment of strictures.

While not a complete list of all possible tools, features, and functions, this list gives an idea of some of the most common accessories that a veterinarian may want to look for when purchasing an endoscopy system.

As a general rule, make sure the working channel is wide enough to accommodate the tools you plan to purchase. And use tools that are longer than the endoscope so it will be easy to advance them into the channel and use them in a controlled manner.

User Friendliness and Learning Curve

Adequate training, including hands-on experience and practice, is crucial for any practitioner planning to use endoscopy. This allows for accurate and safe patient evaluation.

Team members also need to be trained on their endoscopy roles, which may include setup, assisting the vet during a procedure, and keeping the equipment clean and well-maintained.

Courses are available at some conferences and other continuing education events. Some veterinary endoscopy systems even come with training, whether in person or remotely. Personal guidance and instruction, as well as hands-on practice, are important.

Other Considerations

A veterinary practice will want their investment to last. Factors such as the durability of the equipment itself, as well as what a warranty and service plan look like and cost, should be considered.

Compatible hardware and software are necessary for viewing, storing, and sharing endoscopy studies. 

Speaking to a specialist who frequently uses endoscopy is a smart way to ensure the practice is purchasing a scope that meets their clinical needs and has a good recommendation.

Finally, a veterinary practice should have a financial or business plan incorporating financing and budget for the purchase, tax benefits, and a plan of use for the equipment (expected usage, how much to charge, marketing and talking to clients about endoscopy, etc.) to maximize the return on investment for this equipment. 

While this can all require a lot of research, the time will be well spent because it helps a veterinary practice determine the best endoscope for them, and then maximize their ROI on that investment while providing great patient care.

 Written by: Dr. Tammy Powell, DVM 

Choosing the Right Tools for Veterinary Endoscopy

What to Look for in a Veterinary Endoscope

Endoscopy has a wide variety of useful applications in veterinary medicine—especially GI studies, but also including rhinoscopy, evaluation of the airways and genitourinary systems, laparoscopic surgeries and biopsies, and more.

However, like any diagnostic or surgical procedure, it’s important to have the right tools for veterinary endoscopy. 

For some practices, especially busy referral centers, having a range of endoscopes with different sizes and uses may be a realistic option. However, for most general practices, the budget and expected usage would probably mean it’s more practical to have just one or two “all-around” endoscopes that can be used on many different-sized patients.

Here are some things to think about that can help narrow down the choices, so a veterinary practice can choose the endoscope that best suits their needs…

Rigid or Flexible Endoscopes

One of the most basic categorizations of veterinary endoscopes is whether they are rigid or flexible. This is exactly what it sounds like (i.e., whether the scope can bend or not), and it determines which types of procedures they would be appropriate for.

Here are some of the key differences…

• Images and Views. Rigid endoscopes only allow visual evaluation in one direction—the direction that the end of the scope is facing. To view a new angle or direction, the operator must maneuver the entire scope around. Flexible scopes, on the other hand, have the ability to bend or rotate to obtain a 360-degree view of the area being evaluated.

• Maneuverability. As you might expect, flexible endoscopes have a greater capability to maneuver around corners and follow the natural contours inside of organs like the stomach and intestines. This makes them well-suited to upper GI studies and colonoscopies, which are some of the most common indications for endoscopy. It also means there are some studies in which a flexible endoscope is the only option.

• Types of Studies. As a general rule, rigid endoscopes may be used for studies in which the distance the scope needs to travel is shorter and doesn’t require curving or bending (examples: laparoscopic evaluation and surgery, thoracoscopy, and maybe cystoscopy), while flexible endoscopes can facilitate studies where the scope needs to travel further and bend around curves (examples: upper GI studies, rhinoscopy, and bronchoscopy).

• Learning Curve. Although the functionality of flexible veterinary endoscopes is pretty amazing, it also means there are more functions to learn—thus, potentially a longer learning curve. Rigid endoscopes can be a great option to start with if it suits the types of procedures a veterinarian plans to perform.

Scope Sizes

When deciding which endoscope size to purchase, it’s important to look at both the length and the width/diameter of the tube.

As with so many instruments in veterinary medicine, purchasing decisions are largely based on which sizes of patients are seen. A feline-only practice could probably get away with just having a smaller size scope, whereas a practice that sees everything from small kittens to giant dog breeds might want to have a couple of different sizes of scopes available.

Length is important because it determines how much a veterinarian will be able to see in certain endoscopy studies—particularly GI studies, which might be the most common use for these tools. For example, a longer scope could potentially allow a practitioner to see not only the esophagus and stomach but also pass the instrument through the pyloric sphincter to evaluate the proximal duodenum.

Diameter is important for a couple of reasons. The most obvious is probably the limitations of size, such as the inability to pass a larger scope through a narrow cat nostril or urethra. However, that doesn’t necessarily mean a thinner veterinary endoscope is the best choice. There’s also the matter of passing tools through the channel. A wider diameter makes this easier and may even allow more than one tool to be threaded through and used at once.

Imaging Technology

Video technology has advanced over the years, from fiber optics to HD digital imaging. 

This is important because the better the image and video quality, the more a practitioner will be able to see. Accurate colors mean subtle lesions or inflammation can be better visualized. Accurate video orientation also makes it easier for a veterinarian to see where they are going in order to manipulate tools and obtain biopsies.

A veterinary practice should also consider the hardware and software that will be used not only for viewing during an endoscopy procedure but also for storing and sharing images and videos in the patient’s medical record.

What Else to Look For?

These features provide a great start and foundation when shopping for veterinary endoscopes. In the next article, we’ll cover some additional tools and features to consider prior to an endoscope purchase.

 Written by: Dr. Tammy Powell, DVM 

Benefits: Endoscopy to Remove Dog Bladder Stones (Video)

Stones in the bladder of a dog can cause a lot of discomfort and pain, and if left untreated, it can lead to severe complications such as blockages and infections.

The conventional method of removing bladder stones involves surgery, but with the advent of endoscopic technology, veterinarians can now remove stones non-invasively using an endoscope.

In this report, we will discuss the benefits of using an endoscope to remove bladder stones in dogs.

Non-invasive Procedure

The use of an endoscope in removing bladder stones is a non-invasive procedure. The endoscope is a thin, flexible tube equipped with a camera and light source that allows the veterinarian to see inside the bladder without making large incisions.

With the help of an endoscope, the veterinarian can locate the stones and remove them using special instruments that are passed through the endoscope.

Unlike surgery, endoscopy does not require the use of general anesthesia or extensive recovery time, making it a safer and less stressful option for both the dog and its owner.

Better Visualization

The use of an endoscope allows for better visualization of the bladder and surrounding tissue. The camera attached to the endoscope sends real-time images to a monitor, giving the veterinarian a clear view of the bladder's interior.

This makes it easier for the veterinarian to locate stones and other abnormalities in the bladder, making the removal process more efficient and precise.

Additionally, the endoscope can be used to assess the condition of the bladder's walls and detect any signs of inflammation, infection, or tumors that may require further treatment.

Cost-effective compared to surgery, the use of an endoscope to remove bladder stones in dogs is a cost-effective option.

While surgery requires general anesthesia, hospitalization, and post-operative care, endoscopy can be performed on an outpatient basis, reducing the cost of the procedure significantly.

Additionally, the use of an endoscope reduces the risk of complications, such as bleeding or infection, which can result in additional costs associated with surgery.

Conclusion:

The use of an endoscope in removing bladder stones in dogs is a safe, efficient, and cost-effective option for veterinarians.

The procedure is non-invasive, allowing for a quicker recovery time and reducing the risk of complications associated with surgery.

The better visualization provided by the endoscope makes the removal process more precise, and the procedure's cost is significantly lower than surgery.

Overall, the use of an endoscope is a valuable tool for veterinary practices, allowing them to provide better care to their patients while reducing the cost and stress associated with traditional surgical procedures.

Veterinary Endoscopy: Uses and Benefits for Patient Care

Minimally Invasive Procedures: The Benefits of Veterinary Endoscopy

Just like other advanced imaging modalities—such as veterinary CT systems, fluoroscopy, and more—endoscopy is becoming more common for use by general practitioners.

Is an endoscope a good value to add to a veterinary practice? How is it used, and how does it improve patient care? 

In the next few articles, we’ll cover common uses and purchasing questions when it comes to veterinary endoscopy.

What Is an Endoscope?

An endoscope is a rigid or flexible tube that is used for imaging, diagnostic testing, and/or certain surgeries and procedures on veterinary patients. 

The scope provides light and visibility (which may include high-resolution video on some models) to help the veterinarian better assess the patient’s anatomy and look for abnormalities. This veterinary equipment is typically hollow to allow the passage of tools and accessories—such as biopsy and retrieval forceps—to the area of interest.

Uses for Endoscopy in Veterinary Medicine

Standard uses may include non-invasively assessing anatomy, obtaining biopsy samples, and removing foreign objects. 

A very common use of endoscopy in veterinary medicine is the evaluation of the GI tract, including the esophagus, stomach, and proximal duodenum. The scope would be inserted through the mouth and passed through the esophagus to visualize the inner portions of these organs without the need to perform surgery. 

While evaluating the GI tract, a veterinarian might take note of abnormalities like inflammation, wounds or bleeding (examples: esophageal trauma or gastric ulcers), masses, strictures, foreign bodies, or other issues. 

This visual exam can help with diagnosis, but biopsies are usually needed for a definitive diagnosis of many conditions, including inflammatory or neoplastic conditions. These biopsies can typically be obtained via the scope, so long as a full-thickness surgical biopsy isn’t required. 

Tools or attachments can be used to retrieve and remove many types of foreign bodies. For a stricture, endoscopy can help facilitate balloon dilation therapy. It’s even possible to provide hemostasis with some scope accessories.

The colon, cecum, and parts of the ileum may also be evaluated via a colonoscopy. In addition to the GI tract, endoscopes may be used to evaluate other body systems such as the respiratory tract (examples: rhinoscopy or bronchoscopy) or urinary tract. 

Similar to the upper GI tract, uses of the scope include visual assessment, biopsies, and minor procedures. For example, the tool can assist with traction and removal of nasopharyngeal polyps, or with biopsies of the bladder without the need to perform a cystostomy.

Additionally, laparoscopic-assisted surgery may be performed, especially for routine procedures like spays or even gastropexy. Scopes may also assist with feeding tube placements.

For exotic species like birds or reptiles, veterinary endoscopy can aid with gender determination, in addition to helping with diagnostic and minor surgical procedures.

Should a Veterinarian Refer to a Specialist for Endoscopy?

It’s probably never “wrong” to offer clients a referral—both for the best interest of the patient when indicated, as well as for liability purposes. If a general practitioner doesn’t have the right equipment or feels confident using the equipment, a referral is usually best.

However, it’s also true that endoscopy isn’t strictly limited to specialists like surgeons or internists anymore. It’s possible for general practitioners to gain experience using this modality and expand their offerings to their own patients.

That being said, a general practitioner shouldn’t simply order an endoscope and set up shop immediately. It’s important to research the equipment prior to purchase and then to gain lots of knowledge and hands-on experience on how to safely and effectively use it.

Consulting with a veterinary specialist who frequently uses endoscopy can be helpful. They can guide you on which types of scopes (there are many options out there) might be the best investment for your budget, for the widest range of uses on the types/sizes of patients your practice sees.

Then, pursue hands-on, guided instruction in the use of the new equipment. Some endoscopy systems include training, which is nice because it’s geared toward the specific model your practice purchased. There are also in-depth courses—many with guided, in-person instruction from a knowledgeable teacher—available at conferences, universities, or other continuing education venues.

With some due diligence and training, adding veterinary endoscopy can potentially be exciting and profitable to a practice that wants to provide a high level of care to its patients.

 Written by: Dr. Tammy Powell, DVM 

The Complete Small Animal Endoscope System

The Complete Small Animal Endoscope System$16,995 or $295 a month.

Are you looking for a reliable and affordable small animal endoscope system?

Look no further than our complete system, priced at only $16,995 or $295 a month.

With shipping included and a 3-year parts warranty, you can rest assured that your investment is protected.

Versatility: Important Uses Of The Endoscope In Small Animal Diagnostics

Our small animal endoscope system is an essential tool for the evaluation of animals with a variety of symptoms such as vomiting, diarrhea, and difficulty defecating.

It is also useful for obtaining biopsies of the stomach, intestines, and potentially esophagus. With the ability to remove foreign material and place feeding tubes, this system is an invaluable asset to any veterinary practice.

LED Light Source: Excellent Visualization And Sampling

Our system comes equipped with an LED light source generating a vivid, vibrant image. Accompanied by both a water and air pump, our scope provides excellent visualization and sampling of the gastrointestinal tract from the inside.

The scope can be easily plugged into a standard 110 outlet, making it easy to use in any practice.

Training Included: Endoscope Training Program

We understand that mastering the use of an endoscope can be challenging, which is why our Endoscope Training Program is designed to help you take your endoscopy skills to the next level. Our comprehensive program offers a step-by-step guide to building, setting up, and using an endoscope and its accessories with ease.

With live remote training using Team Viewer, you can learn from the comfort of your own practice.

Suction: Schuco Aspirators

Our small animal endoscope system is also equipped with a reliable and durable Schuco aspirator. The entire family of Schuco aspirators has evolved to meet the changes in standards and provide just the right aspirator for your suction requirements. With improved scratch and flake resistance, high vacuum range, and a vibration-free gauge, this aspirator is a must-have for any veterinary practice.

In conclusion, our Complete Small Animal Endoscope System is a versatile, reliable, and affordable tool for any veterinary practice. With its LED light source, Schuco aspirator, and comprehensive Endoscope Training Program, you can take your endoscopy skills to the next level.

Contact us today at 530-722-4977 to learn more.