Interventional Radiology and Endoscopy for the Feline Patients: outside of the Urinary Tract

Interventional Endoscopy (IE) involves the use of endoscopic equipment with other contemporary imaging modalities, such as fluoroscopy and/or ultrasound, to perform diagnostic and therapeutic procedures in virtually any part of the body accessed endoscopically (gastrointestinal, biliary, respiratory, urinary tract, etc). Interventional radiology (IR) mainly uses fluoroscopy alone (with or without ultrasound) to gain access to various regions, most commonly vascular access, but also the GI, respiratory, lymphatic and urinary tracts. Currently, an expanding investigation of the use of some novel techniques in veterinary medicine has been undertaken. The use of fluoroscopy, with or without endoscopy, allows for one to visualize and gain access into small orifices that would otherwise require more invasive surgical techniques. A good example of this is the placement of a nasopharyngeal stent through the nares for nasopharyngeal stenosis without the need for palate surgery. Many of these interventional procedures are considered the standard-of-care in human medicine, and are currently being used in veterinary medicine. The use of these techniques are expanding in our veterinary patients as these modalities are becoming more widely available. The invasiveness and morbidity associated with some traditional surgical techniques (i.e. ureterotomy for ureteral obstructions or strictures, biliary re-routing surgery, nasopharyngeal surgery for nasopharyngeal stenosis, etc) makes the use of minimally invasive alternatives using IR/IE appealing. The advantages of such procedures are not only their minimally invasive nature, but the lower morbidity, shorter hospital stays, and most importantly the lack of alternative options our patients have. The limitations are that these procedures are technically challenging, require specialized equipment, and extra training. This talk is a brief overview of some of the minimally invasive interventional radiology and endoscopic procedures actively being performed in feline patients in veterinary medicine, with focus on the respiratory, gastrointestinal, vascular and lymphatic systems. The previous talks expanded upon the large use of these techniques in the urinary tract. We will also discuss some promising future applications currently under investigation.