What is an endoscopy?
Endoscopy is the process of examining a body cavity or organ using a medical camera, known as an endoscope. Endoscopes are long, slim and waterproof so they can be passed into narrow openings and will not be damaged by stomach contents or urine. Endoscopes can be rigid or flexible, and come in different sizes. Some endoscopes have a channel, meaning fine instruments can be passed down the endoscope to retrieve foreign items or take biopsies. High quality endoscopes can be very expensive and require skill to use.
What is endoscopy used for?
Endoscopy is very good for examining inside areas that we cannot otherwise see. Common uses include:
- the nasal cavity (known as rhinoscopy)
- the stomach and upper intestine (known as gastroscopy)
- the large intestine and rectum (known as colonoscopy)
- the bladder (known as cystoscopy)
- the airways (known as bronchoscopy).
Different types of endoscopes are used for different areas to get the best access and image quality. Sometimes air is inserted to inflate the organ, such as in the stomach, or water is used to flush the area during examination, such as up the nose.
Endoscopy can also be used to retrieve foreign bodies that have been ingested by pets depending on their location and size, and may sometimes be offered instead of surgical retrieval, or attempted before surgical retrieval.
Endoscopy is performed under anaesthetic, as the patient needs to be still, and the exam may be uncomfortable. You will typically be asked to leave your pet at the practice for the day and be asked to withhold food the night before, so the stomach is empty. If your pet is undergoing a colonoscopy, it is likely that they will need an enema to completely empty the colon of its contents. Depending on the reason for the endoscopy, other tests may also be carried out on the same day. This could be imaging, such as ultrasound, x-ray or CT scan, or surgery.
Endoscopy only shows us the surface of the organs or tissues. Although some conditions cause distinctive changes, the tissues may look normal despite a deeper problem. Often, several conditions look similar from the outside. It may be advised to take biopsy samples during the endoscopy to get more information. This is simple to perform but can cause some bleeding. This can cause a small amount of blood in the stools or urine, or rhinoscopy of the nose may lead to nosebleeds. These are not dangerous, but your pet may be advised to stay in the practice longer until they are controlled. Occasionally, bleeding may occur even without biopsies due to the endoscope itself irritating the tissues.
Endoscope images are created instantly during the examination. Often, your vet will be able to report the results the same day. If biopsies have been taken these will be sent to a specialist laboratory for processing, which can take up to a week. In this case, your vet may report all results together when they have the biopsy report for context.
As vets, we never recommend any test unless we think there is a good chance that it will give us a diagnosis. Unfortunately, not every problem can be identified with an endoscopy, and sometimes the procedure is more useful for ruling things out than providing a positive answer.
Depending on what is seen on the endoscopy this may be enough to decide a treatment plan. If not, we will need to gather more information. This may include additional imaging (such as x-ray, ultrasound or CT), taking a surgical biopsy, performing specific blood tests, or even exploratory surgery. Sometimes advanced imaging such as a CT scan is required. This is significantly more expensive, and may require referral to another centre, but gives a much more detailed image.