Changes

===Endoscopy===

===Endoscopy===

Oesophagogastroscopy or duodenoscopy can be performed under mild sedation in the standing horse.(Sanchez) Of these, duodenoscopy is the more specific but more technically demanding method(Sanchez).  Endoscopic examination requires preparatory starving of the patient, eliciting a certain degree of stress.  As such, it is preferable not to carry out this technique in foals.

Oesophagogastroscopy or duodenoscopy can be performed under mild sedation (e.g. 0.6-0.8mg/kg xylazine(Orsini)) in the standing horse.  Of these, duodenoscopy is the more specific but more technically demanding method(Sanchez).  Endoscopic examination requires preparatory starving of the patient for 6-8hours (Orsini), eliciting a certain degree of stress.  As such, it is preferable not to carry out this technique in foals.  In adult horses, a minimum endoscope length of two metres is essential to visualize the gastric body and fundus.(Sanchez) A 2.8-3.0 metre endoscope is needed to observe the gastric antrum, pylorus and proximal dudoenum.(Sanchez) In either case, fibreoptic or videoendoscopic equipment can be used.(EGUC)

 

 

   

Flexible endoscopes: for mature equine gastric endoscopy, a minimum working length of 200 cm is required. However, a 280-300 cm long endoscope is required to perform duodenoscopy in mature individuals. A working length of 110 cm with an outer diameter of 10 mm (human gastroscope) is sufficient to reach the stomach of foals up to age 30-40 days.

Fibreoptic endoscopic equipment uses glass-fibre bundles to transmit light to the area to be viewed and transmit this image to an eyepiece. The image is magnified by a lens system within the eyepiece. This is important in alimentary endoscopy, since 150 W lamps used in most portable light sources provide poor illumination of a horse’s stomach. More powerful light sources are available (up to 300 W) but become larger and less portable as the lamp intensity increases. The quality of the fibreoptic instrument is determined largely by its image resolution, which is related directly to the number of optical fibres.

 

 

A diagnosis can be made only by endoscopy (oesophagogastroscopy).

 

Minimum endoscope length of two metres and 2.8-3.0 metre instruments are required for duodenoscopy

A 3 mtre endoscope allows visualization of stomach, pyrlorus and proximal duodenum (Sanchez)

Shorter scopes permit investigation fo gastric body and fundus only (Sanchez)

 

Based on a consensus, the Equine Gastric Ulcer Council (EGUC) publised an EGUS Lesion Scoring System which they claimed to be simple and applicable to both regions of the equine gastric mucosa(EGUC).  This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa(Merritt).  At the time of writing however, the EGUC system appears to be the most well established and useful in practice:  

Based on a consensus, the Equine Gastric Ulcer Council (EGUC) publised an EGUS Lesion Scoring System which they claimed to be simple and applicable to both regions of the equine gastric mucosa(EGUC).  This last point has been debated, since most of the acquired data on gastric lesions refers only to the squamous mucosa(Merritt).  At the time of writing however, the EGUC system appears to be the most well established and useful in practice: