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Taking the Inside View:
Clinic Has Equipment and Expertise in Endoscopy

When the patient isn't responding to treatment for the initial diagnosis or when radiographs and ultrasound don't give the full picture, a little fiber-optic camera and tiny forceps on long leashes could be the way to get to the heart of the problem--without cutting open the patient.

"In many situations, endoscopy is a very useful, minimally invasive way to obtain samples for histopathology," explains Dr. Rhonda Schulman, visiting clinical assistant professor in small animal medicine.

[Dr. Rhonda Schulman, technician Kristi Staci and students Di Short and Craig Miller] Dr. Schulman watches a video screen while manipulating the controls of the camera; technician Kristi Staci and students Di Short and Craig Miller assist. More than 750 endoscopic procedures are performed each year on small animal patients at the teaching hospital.

"For example, anorexia is the most common sign of gastrointestinal disease in companion animals, but it could indicate a host of problems, from inflammatory bowel disease to neoplasia. Without a biopsy, you can't make an accurate diagnosis," she says.

For 20 years, the Small Animal Clinic has been offering endoscopy services to its clients as well as conducting a stringent training program in use of the equipment for its residents in internal medicine. Dr. Schulman, who completed a residency at Illinois in 1998, is now back as a faculty member after practicing in Mesa, Arizona.

Before residents at Illinois are allowed to perform the technique on their patients, they attend lectures by faculty, practice on dried lungs, and must pass oral and practical examinations. For the first year they perform endoscopies only under faculty supervision.

The Small Animal Clinic has equipment for viewing the lungs and nasal passages, gastrointestinal tract, bladder, and colon for patients ranging from little cats to very large dogs.

For about 2 years the Small Animal Clinic has also had laparoscopic equipment, which is similar to an endoscope except it is used within the body cavity rather than within an organ. It allows clinicians to, for example, take a larger biopsy of a liver than could be sampled with an ultrasound-guided needle.

While typically used for diagnostic purposes, endoscopes have other uses. Some nasal fungal infections benefit from having medication delivered directly to the site of infection. With a snare attachment instead of the forceps, endoscopes offer a handy alternative to surgery for the removal of foreign objects.

"One poor patient had a burr up his nose for a year before his owners brought him in for an investigation of the problem," recalls Dr. Schulman. "We've extracted everything from a pork chop bone in the esophagus to a GI Joe toy in the small intestine."

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