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3 METER EQUINE GASTROSCOPY INFORMATION!
Equine Gastroscopy
 
Patient Preparation:
Patient needs to be starved for at least 12 hours and water for 6 hours if horse can tolerate water deprivation
Set Up:
Leak check the endoscope before procedure
Connect endoscope to light source and turn on
Connect water bottle to endoscope, completely depress the blue piston to prime scope with water and check air flow
Connect aspiration unit to endoscope, may be required to aspirate fluid from stomach, take care as channel can become blocked
Prepare syringes with saline, may be required to wash feed matter from stomach walls, introduce through catheter or directly through the biopsy channel or via roller pump
Lubricate bending section of scope to assist in transition of scope, avoid lenses
 
 
 
 
 What Causes Gastric Ulcers in Horses?



The following are the primary causes of gastric ulcers in horses. In every situation, the concentration of stomach acid increases, thereby causing ulceration.



Failure to Chew Feed

A horse MUST chew their feed in order to salivate. They do not have the ability, as we do, to “salivate upon sight”. Production of saliva assists in establishing buffering capacity in the digestive tract, and saliva works directly to neutralize the extremely acidic characteristics of the digestive tract, particularly in the stomach.



Stressed and/or Nervous Horses

There is no question that stress in horses and horses that tend to be “nervous by nature” are prone to gastric ulcers. Stress can and does come from many areas, including moderate to intense levels of work associated with training, being hauled extensively and exposed to constantly changing environments, and horses that naturally tend to be “high strung”.



Nutrition

High grain/low roughage diets tend to contribute to the incidence of gastric ulcers, as high levels of grain dramatically increase concentration of acid in the stomach, due to high levels of starch in grains. Also, horses that are held off a diet (fasted) prior to training or being showed tend to have increased levels of acid, which contribute to gastric ulcers.



Can We Recognize Horses that Have Gastric Ulcers?



Changes in physical appearance can be an initial indicator of the problem. Changes includes loss of hair coat, loss of body condition, and changes in eating patterns. Horses with gastric ulcers typically become very picky eaters, performance levels decrease, and these horses have been seen to have dramatic changes in behavior, acting much as a “sour” horse would.



The only definite way to determine if a horse has gastric ulcers is with an endoscope. Many veterinarians utilize an endoscope; however, we must be sure that, for an accurate diagnosis that the endoscope is at least 3 meters in length. Some veterinarians have shorter scopes for use in observing the respiratory tract.



From a Management Perspective, What Can We Do?



We must ensure that the horse chews their feed to stimulate production of saliva. This can be accomplished by providing a diet that is in a form which forces the horse to chew. Particle size and type should be taken into account to accomplish this objective.



Dealing with issues that contribute to stress in horses is very difficult. Horses that are hauled frequently and “shown hard” must be managed in such a way as to alleviate the stress as much as possible. Some horses tend to adapt to this stress over time, as we typically see less stress, to some degree, in older horses as opposed to young horses on the road. Providing additional time at a show or event can aid in reducing stress and the horse’s response to it, in contrast to the situation where someone arrives at the show, unloads and goes into the show immediately.



Nutritionally, the best way to minimize the incidence of gastric ulcers is to decrease the amount of grain fed, while concomitantly increasing the amount of forage fed. This will decrease the amount of acid secreted in the stomach and should help in preventing the problem. Also, keeping hay in front of a horse at all times will help to keep concentrations of acid in the stomach to a minimum. There are several products in the market today which are used to treat ulcers, and work very well in cases where ulceration is moderate to severe. These products tend to be very expensive as opposed to making changes in the feeding program, which can and should be the primary approach from a preventative standpoint.

January 30th, 2007 in Agriculture & Food: Animal Agriculture


By Barry Foushee, Livestock Extension Agent
 
 
 
 
 
 
 
 
 Triple Crown Consulting Group is a boutique consulting and marketing management firm that brings Irish horsemanship and a global expertise of over 20 years’ experience in the equine industry to specialty Pharma and Biotech Companies.
 
 
 
 
 
 
 
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Equine Gastroscopy Procedure:
 
Pass endoscope ventrally via either left or right nostril into the pharynx, take care that the endoscope does not pass via the middle meatus, potentially causing trauma to the ethmoid turbinates
To aid passage of the endoscope, the horse should be encouraged to swallow by passing approximately 2-3 millilitres of water by de-pressing the blue piston towards the lateral food channel. The endoscopist should not attempt to aid passage by manipulating the tip as this usually prevents rather than promotes the passage of the endoscope. The lining of the oesophagus should be positively identified before inserting the endoscope further. Take care that the endoscope does not retroflex and become crushed by teeth, a mouth guard is often used to protect the scope.
Inflate the oesophagus by covering the blue piston and advance the endoscope, try and keep the centre of the oesophagus in the centre of the field of view.
On entry to the stomach cover the blue piston to inflate.
As the stomach is inflated the rugul folds that are usually present are obliterated, once the stomach is inflated, both the greater curvature opposite the cardiac orifice and the right side of the stomach can be seen. It is easier to conceptualize the image through the scope if the squamous portion of the stomach is positioned in the top section and the glandular portion in the lower section of the image.
Once the correct orientation is obtained the stomach should be systematically examined. The tip of the endoscope should be elevated to visualize the saccus cecus and lowered to observe the glandular region of the stomach. To view the lesser curvature the scope may be advanced with the tip directed to the right. This is an area where severe gastric ulceration may be found.
To enter the duodenum the endoscope is directed ventrally after the cardia orifice is identified so as to visualise the pyloric antrum. The endoscope is then advanced through the pylorus into the duodenum.
A visual inspection of the stomach is often easier when retracting the endoscope
At the end of the procedure excess air can be aspirated by turning on the aspirator unit and de-pressing the red piston, the stomach will collapse and assist in patient recovery
A visual inspection of the oesophagus is often easier when withdrawing the endoscope ensure that the tip of the endoscope is straight
 
Cleaning & Disinfection:
 
A large tray or cleaning station is required for cold soaking endoscope and associated instruments and water bottle

Endoscopes should be cleaned and disinfected immediately following the endoscopy to avoid contamination solidifying in the channels of the scope, channel irrigators or flushing adapters can be used to assist this process an aspiration unit may also be used to aspirate detergent and disinfectant through scope
Remove gross contamination from patient tube on withdrawal by wiping patient tube with tissue or soft cloth soaked in enzymatic detergent
LEAK CHECK THE ENDOSCOPE BEFORE SCOPE IS PLACED IN FLUID
Refer to manual for leak checking procedure
Place the tip of the scope in enzymatic detergent and de-press the blue piston to blow water through the channel, cover the blue piston to blow bubbles, this will remove contamination from the outlet pipe and avoid air water blockages
Clean the control body and insertion tube taking care to remove contamination from lenses on the eyepiece and distal end of the scope
Cold soak any instruments that have been used, biopsy forceps should be placed in enzymatic detergent as soon as possible to avoid jaws sticking
Remove red and blue pistons and biopsy cap, there are two holes located under the red piston
Pass the cleaning brush through the hole located directly in front of you, the cleaning brush will emerge at the aspiration connector on the light guide plug, you may feel some resistance as the brush turns the corner but you should not feel any resistance whilst passing the brush through the channel, if you do, stop and contact your service provider, this process may be required several times to ensure gross contamination is removed from channel
Pass the cleaning brush through the hole located at approx 6.00 o clock, the cleaning brush will emerge at the distal tip of the scope, ensure that the bending section is straight, again you should fell no resistance as the cleaning brush is passed through the channel, if so contact your service provider for assistance, this process may be required several times to remove gross contamination from channels of scope
Pass the cleaning brush through the biopsy port and the cleaning brush will again emerge at the distal tip, repeat as necessary.
Attach the channel irrigators to the red and blue piston ports and re-attach the biopsy cap to aid flushing
Flush enzymatic detergent through the channels of the scope, fluid will be seen at the water bottle connector on the light guide probe, the aspiration connector on the light guide probe and the distal tip of the scope
Leave instrument to soak for approx 20-30 minutes or according to your soak times, manufactures times will differ.
Discard enzymatic detergent and cold soak instrument in disinfectant, again flush disinfectant through the channels of the scope via flushing adapters, ensure that disinfectant emerges at the water bottle connector, aspiration connector and distal tip
Leave to cold soak according to your manufactures recommended times
Discard disinfectant and flush with distilled water or sanitizer through the channels of the scope via flushing adapters, this will remove trace elements of disinfectant from the scope and sanitise the instrument
Wipe instrument with tissue to dry, pay particular attention to the light guide probe
Remove flushing adapters and replace air water and aspiration pistons
Re-connect endoscope to the light source and turn on pump
De-press the blue piston to evacuate excess water from channel
Cover the blue piston to pass air through channels
Endoscope should be stored hanging up and not in transportation case

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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