Joan Rivers’ tragic death last week dominated social media and made many ask questions about the safety of endoscopy, pet owners included. Joan Rivers was an unabashed dog lover. And so using one of her signature lines, “Can we talk?” this blog talks about veterinary endoscopy and how veterinarians at The Animal Medical Center safely and successfully use endoscopy every day to diagnose and treat a variety of conditions.
What is Endoscopy?
Endoscopy is a compound word created from endo, which is Greek for within, and the common suffix -scopy or -scope found on many English words: telescope, periscope and microscopy. Once again, scope comes from the Greek word ‘skopein,’ meaning to look. The word endoscopy is generic and describes multiple medical procedures, including esophagoscopy, gastroscopy, laparoscopy (WARNING: This video was taken during an actual laparoscopy where a liver biopsy was performed. Weak-kneed readers should not view this video) colonoscopy, cystoscopy, nasopharyngoscopy, and bronchoscopy. What these procedures all have in common is the use of a piece of medical equipment containing a tiny lens or video camera and specially designed minimally invasive equipment to look inside the body and correct problems with few to no surgical incisions.
What is an Endoscope?
An endoscope appears to be a simple, long tube, but it is actually a very high tech device. The endoscope requires a light source to illuminate the inside of the body. The light source is very powerful since the tip inside the patient can be two to three feet away from the scope’s other end. Endoscopes can be flexible for snaking down the twists and turns of the airways or intestines, or it can be a rigid stainless steel tube. Flexible endoscopes use fiberoptics for transmitting the internal images along the length of the scope to a video monitor for the entire medical team to view. Rigid scopes use a series of lenses and the image is viewed through an eyepiece or on a monitor. Biopsy forceps, scissors and grabbers thread down the endoscope via a separate channel to facilitate biopsy and retrieval of accidentally ingested objects or bladder stones.
Why is Anesthesia Required?
Because of the nature of our patients, anesthesia is a necessity for any endoscopic procedure in a veterinary patient. Your dog or cat must hold perfectly still to allow precise placement of the endoscopic device. Because endoscopy equipment facilitates collection of biopsy samples, general anesthesia manages any pain associated with the procedure. Bronchoscopy, esophagoscopy and gastroscopy require the endoscope to be threaded though the mouth into the lungs, esophagus or stomach. Think what your pet’s chompers do to their favorite toy. Imagine what those same chompers could do to our delicate fiberoptic endoscope. Anesthesia is a must; however many precautions are taken before and during anesthesia by your pet’s medical team to ensure a safe endoscopic procedure.
Why Would My Pet Need Endoscopy?
AMC veterinarians use endoscopy every day to diagnose and treat patients. Our internal medicine team biopsies the nose, stomach, small intestine and colon endoscopically. Ditto for the retrieval of accidently swallowed bones, balls and socks. Orthopedic surgeons use arthroscopsy to identify and repair torn cartilage inside joints. Surgeons avoid putting your pet through major surgery by using laparoscopic and thorascopic procedures in treating diseases of the abdomen and chest. Our interventional radiology team can correct misplaced ureters and remove bladder stones via minimally invasive cystoscopy.
Anytime you hear someone say your favorite fur baby has a medical problem and needs a procedure, I know your heart flutters for a moment. Now that you know more about these diverse and life saving types of endoscopy, I’m sure you realize your veterinarian has ordered a sophisticated and medically advanced procedure for your pet.
We all want to save money, but when it comes to our pets, we strive to give them the best of everything. Here are five tips to help you save money on your pet’s medical expenses and still provide your favorite fur baby with top-notch treatment.
- Be an educated pet owner.
Start by visiting your local library for a basic book on pet care. Check with your neighborhood veterinarian or animal rescue group to see if they offer classes in pet care. Familiarize yourself with the common signs of illness in your pet. For example, review this slide show about the 10 warning signs of cancer in pets and consider subscribing to our Fur the Love of Pets blog to have pet health information delivered to your inbox weekly.
- Don’t skimp on preventive care.
An annual visit to your pet’s veterinarian is worth its weight in gold. During a routine physical examination, your veterinarian can assess your pet’s risk of contracting a contagious disease, such as parvovirus or Lyme disease, and administer vaccinations or parasite preventatives to protect your pet. Subtle changes in body weight or the ability to ambulate identified during an examination may indicate the need for additional testing, medications to alleviate pain, or a diet adjustment. Without an annual examination, your pet’s undetected illness can spiral out of control and might cost much more than an annual veterinary visit.
- Don’t ignore signs of disease such as vomiting, weight loss or inactivity.
If I had dollar for every time I heard a pet owner attribute signs of disease to something other than disease, I would be rich. Here are just a few examples: “He’s not moving around much anymore, but he is older.” Diagnosis: arthritis. “I think she’s losing weight, but I am feeding her the light food.” Diagnosis: intestinal lymphoma. “He vomits every day, but that’s normal for cats, right?” Diagnosis: chronic kidney disease. Don’t miss an opportunity to be proactive and keep your pet healthy and pain-free by quickly recognizing signs of disease.
- Create a safe, but enriched environment for your pet.
One of the most common reasons for pet admissions to The AMC Emergency Service results from hazards in the home. In the month of August alone, AMC emergency and critical care veterinarians treated pets for ingestion of human foods toxic to pets, such as xylitol and chocolate; rat poison intoxication; and consumption of human prescription and recreational drugs, especially marijuana. Falls from open windows without screens commonly result in feline ER visits and hospitalization for shock and broken bones. In addition to pet-proofing your home, protect your pet by creating activities to keep Fluffy and Fido busy during the day using feeding toys, a cat tree or mechanized toys. There are many ways to create an enriched backyard for your dog. Some of these ideas can be adapted for indoor cats as well.
- Invest in pet insurance.
Purchasing the right pet insurance requires you to invest some of your time into researching the best policy for your family and your pet. The strength of some policies lies in the area of preventive care. These policies cover annual wellness visits and medications to prevent fleas, ticks and heartworms. Other policies lean towards covering catastrophic medical care, such as emergency surgery or hospitalization for diseases like heart failure or kidney disease. Purebred dog and cat aficionados should scrutinize potential policies carefully for any breed related exclusions. As you review policies, keep in mind some charge additional fees to cover expensive treatments such as chemotherapy.
So now you are an educated, proactive pet owner with a pet safe home and a well insured pet, I’ll bet that makes both you and your pet sleep better at night.
Practicing in an urban setting, we don’t see too many pets with worms, partly because the city lifestyle reduces exposure to fleas and vermin which transmit worms and partly because I follow the Companion Animal Parasite Council and recommend year round heartworm prevention. Those medications control many common intestinal parasites. Here is information about some of the less common worms veterinarians see in pets.
The photograph on the right came in with one of my patients the other day. The owner was concerned about the rice grains she was seeing on the dog’s bedding and was worried her dog was not digesting the rice in the lamb and rice dog food. What she thought were rice grains were actually tapeworm segments. Dogs become infected with tapeworms when they ingest a flea or eat a small mammal containing tapeworm eggs. Inside the dog’s intestine, a tapeworm consists of hundreds of little segments which are connected to form a worm. Segments break off and can be found moving around near the anus or on your dog’s bedding. Safe dewormers are available to eradicate tapeworms from your dog, but protecting your dog against fleas and limiting their access to vermin will also prevent them from acquiring tapeworms.
Even though NYC is urban, we have lots of raccoons. I saw three youngsters washing their hands in a Central Park pond about two weeks ago. Raccoons carry a roundworm in their intestine (Baylisascaris procyonis) and shed roundworm eggs in their feces. Raccoon roundworm eggs are very hardy and remain infective in the soil for years after being shed in the stool.
The New York City Department of Health and Mental Hygiene advises New Yorkers to avoid raccoon latrines (the area where raccoons repeatedly defecate) and to wash their hands if they come in contact with raccoon feces. Children are especially susceptible to infections with the raccoon roundworm.
Most pet owners think of worms as living in the intestine, but there are worms that live in other organs as well. Dogs can be infected with two different species of tracheal worms, Crenosoma vulpis and Filaroides osleri. F. osleri induces the formation of wart-like lesions in the trachea and bronchi of infected dogs, causing a hard, dry cough. Dr. Kelly Gisselman, an AMC trained ACVIM certified small animal internal medicine specialist, recently posted a YouTube video of a worm she spied while performing a bronchoscopy on a young dog with a cough. Deworming completely resolved the cough which had been going on for a year and a half! Since the worm did not induce the formation of wart-like lesions, we suspect it is C. vulpis.
Protecting Your Pets and Your Family Against Weird Worms
- Check out the Companion Animal Parasite Council’s website for more information on pet parasites.
- Wash hands thoroughly with soap and water after being outdoors and before eating.
- Administer year round monthly heartworm prevention. Those effective against dog roundworms will also treat raccoon roundworms.
- Use medications to prevent fleas which carry the infective form of the tapeworm.
- Clean up raccoon feces on your property, but wear gloves and wash your hands after doing so.
- Put trash in tightly covered containers and don’t put food out for wildlife that may carry weird worms.
As her name suggests, Scarlett is a pet that is red, but not a red setter, a redbone coonhound or a red Abyssinian, she’s an African grey parrot with a red tail. This 25-year-old parrot is also an artist, creating colorful abstract works of art in the bathtub. She was referred to The Animal Medical Center to see Avian and Exotic specialist Dr. Kathy Quesenberry for an egg that wasn’t being laid, an avian condition known as egg binding, putting a damper on her artistic endeavors.
Like many medical problems, egg binding occurs in overweight birds with a sedentary lifestyle or a diet lacking adequate calcium. Medical treatments can be effective in resolving a stuck egg – calcium, fluids, lubrication and keeping the bird warm may cause the egg to pass, if not, then manual or surgical removal of the egg may be necessary. These treatments had been tried in Scarlett, but they were unsuccessful.
IDing an Egg
One of the first steps in treating an egg-bound bird is to pinpoint the egg’s location within the reproductive tract. Because eggshells contain calcium, they can easily be seen using a standard x-ray. In the x-ray image on the right, you can see a thin, egg-shaped structure in Scarlett’s abdomen between her pelvic bones representing Scarlett’s stuck egg.
The inside of a bird’s vent, called the cloaca, contains multiple openings – one for the intestinal tract, one for the reproductive tract, and two small openings for the urinary tract. Dr. Quesenberry used endoscopy to view inside the vent and was planning to remove the egg at the same time. Endoscopy identified a tear at the end of the oviduct where it entered the cloaca, making surgery urgently necessary.
During the two and a half hour endoscopy and surgery, Scarlett’s torn oviduct at the cloaca was repaired, and the remainder of her oviduct was removed to prevent another egg binding episode. Unlike mammals, most birds have only a single left oviduct and ovary. Because a bird’s ovary is close to large blood vessels, it cannot be removed safely. A “bird spay,” or salpingectomy, is the procedure of removing most of the oviduct so that an actual shelled egg cannot be formed, even though the ovary still functions normally. Scarlett recovered uneventfully. Two weeks after surgery her sutures were removed and she was given a clean bill of health and she has returned to emulating Jackson Pollack-esque abstract impressionism in her bathtub. The photo seen here shows Scarlett as a component of her own artwork.
Help From an AMC Community Fund
The happy ending to Scarlett’s story would not have been possible without the generosity of those who support The AMC’s Community Funds. Scarlett’s care was covered by the Seniors’ Animal Veterinary Effort (SAVE), which provides free or subsidized general and emergency veterinary services for the pets of the indigent elderly.
Become a supporter of The AMC’s Community Funds today.
Watch Scarlett at work in her bathtub studio on The AMC’s YouTube channel.
The image on the right, is of Pongo, Perdita and their family, the iconic Dalmatians from the classic Disney movie, 101 Dalmatians. Yes, it is one of my childhood favorites, but the image is here because today I am writing about hearing loss in dogs and cats, and Dalmatians are the breed most commonly associated with an inherited form of deafness. Inherited deafness is just one type of hearing loss. Medically, veterinarians use several different classification schemes to categorize hearing loss in pets.
Inherited or Acquired Deafness
Inherited means hearing loss is due to abnormalities in the genetic material coding for hearing. In dogs, inherited deafness is associated with white haircoats, piebald (spotted) haircoats like the Dalmatian, or merle (dappled) haircoats like the Australian Shepherd. Most inherited hearing loss becomes obvious at just a few weeks of age. Acquired deafness occurs because a disease or medication destroys hearing function or because of normal aging.
Sensorineural or Conductive
While these words may not be familiar to many of my readers, the explanation of the words is quite easy to understand. In order for sound to be conducted from the ear to the brain, sound must get into the ears. Either a bad ear infection (a really common cause of hearing loss in dogs and cats) or a tumor or the ear canal (a much less common cause of hearing loss) can obstruct the ear canal. Both conditions result in conductive deafness. Sensorineural deafness results from dysfunction of the hearing structures of the ear, nerve damage to the auditory nerve or a problem in the brain’s ability to perceive sound. Sensorineural deafness is the common form of hearing loss in older animals.
Congenital or Late Onset
Congenital deafness is a condition present at birth. The majority of white cats with two blue eyes are born deaf. Less than half of white cats with one blue eye are deaf and they are usually deaf on the side with the blue eye. If we use all the classification schemes together, white cats with blue eyes have inherited congenital sensorineural deafness.
If you have an older dog who has had multiple bad ear infections and can no longer hear well, he probably has acquired late onset conductive deafness.
Hearing Tests in Pets
The Animal Medical Center’s Neurology Service uses a test called the brainstem auditory evoked response (BAER) to diagnose hearing loss in pets. The BAER machine measures brainwaves in response sound using electrodes attached to the skin.
Alterations in brainwaves indicate conductive or sensorineural deafness. BAER can be used to identify congenital deafness in puppies and kittens and exclude them from breeding programs.
Treatments for Deafness in Pets
If hearing loss is caused by an ear infection, treatment may restore hearing. Pet owners often ask about hearing aids for dogs. For pets with congenital deafness like the Dalmatian or white, blue-eyed cats, hearing aids will be of no benefit as hearing aids amplify sound, but this type of hearing loss cannot detect any sound at all, even really loud sounds. The use of hearing aids has been tried in dogs with limited success. Dogs are not always cooperative with devices placed in their ears. Many dogs (and cats) acclimate to their hearing loss. Since smell is a dog’s most highly developed sense, deaf dogs and cats can function well as indoor pets.
- Read this incredible story of how Sparky, a deaf Dachshund, learned sign language and helped deaf children at their special school.
- Resources for Deaf Pets