Assessing the usefulness of contrast-enhanced ultrasound and narrow-band imaging endoscopy in gut inflammation in dogs. Image Contrast-enhanced ultrasound of the small intestine. Ultrasound is a great tool to find or exclude causes for gastrointestinal problems in small animals as it allows us to “look” inside the body from the outside. We can examine internal structures for example of the gut. However, especially in chronic inflammatory or cancerous conditions, in a lot of cases the ultrasound alone cannot give us an exact picture of what is going on. Similarly, even endoscopy (looking down the inside of the gut with a camera) is known to be a very insensitive tool to differentiate between normal, inflamed or even cancerous tissue, which is why biopsies are needed in all cases. However, there are new diagnostic tools available that might help to answer the following questions: Is it inflammation or cancer? Where is the most affected part of the gut or is it everywhere? How severe are the changes? Does the severity or type of changes in the gut tell us anything about which treatment might be the “right one” and how well the patient will be doing long-term? For this study, we combine 2 new diagnostic tools to assist in answering these questions, so that maybe at some point in the future biopsies might not be necessary any longer! The first test used is a new type of ultrasound called contrast-enhanced ultrasound (CEUS). A harmless contrast medium consisting of microscopic bubbles is injected and allows the gut to “glow” for around 2 minutes, which enhances its features and gives an indication of blood flow to the tissue. The second test is a type of imaging performed during normal gut endoscopy, which involves to switch from normal white light of the endoscopic camera to a more green looking light spectrum (a narrower range of light wavelengths), as this allows to see some features of the gut mucosa more clearly (for example blood vessels that cannot normally be seen are now seen as brown/ black). This is called narrow-band imaging (NBI) and has been used to increase detection rates of certain diseases in human endoscopy for a while already. Image Endoscopical view of the inside of the small intestine: Left panel: normal view where the mucosa appears pink/ orange. Right panel: special \"narrow band imaging\" settings, where the mucosa and vessels appear pale green/ brown. We currently offer these imaging modality for every dog coming to the DIGEST clinic/ the Small Animal Internal Medicine Service with chronic gastrointestinal problems and hope to thereby better understand its utility. We are aiming to correlate the findings of the CEUS and NBI with several other parameters (severity of disease, severity and type of inflammation seen on biopsies, response to treatment, outcome) to see if they can be used as predictors. This project has been approved by the R(D)SVS ethics and welfare committee with the approval number VERC 21.17. This study is supported by a PetPlan Pump Primer. Publication date 19 Apr, 2018
