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. 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."