A wireless endoscopy capsule suitable for imaging of the equine stomach and small intestine.
Authors: Steinmann Mei, Bezugley Rebecca J, Bond Stephanie L, Pomrantz Jill S, Léguillette Renaud
Journal: Journal of veterinary internal medicine
Summary
Wireless capsule endoscopy represents a significant advancement for visualising the equine gastrointestinal mucosa, particularly the stomach and small intestine where conventional endoscopic reach is limited. Researchers tested this novel technology across five healthy horses using three different preparation protocols (varying fasting duration, oral fluid administration, and exercise) in a crossover design, with capsule recovery confirmed radiographically and image quality assessed objectively. The capsule successfully captured detailed mucosal images including the pylorus, duodenal papilla, individual villi, and ileocecal junction; optimal visualisation of gastric and small intestinal mucosa occurred following 24-hour feed withholding, though transit time was highly variable (median 6.5 days, range 3–8.75 days) with three of fifteen capsules not recovered. Lesions identified in these healthy horses included mucosal erosion, ulceration, haemorrhage, thickened mucosa, and parasitic evidence—findings that establish a baseline for recognising pathology in clinical cases. Whilst the capsule proved safe and practical for non-invasive small intestinal assessment, the unpredictability of excretion timing and occasional capsule retention necessitate careful client communication and follow-up protocols before widespread adoption in equine practice.
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Practical Takeaways
- •Capsule endoscopy offers a practical, safe, noninvasive alternative for visualizing equine stomach and small intestine when standard endoscopy is limited, particularly for detailed mucosal assessment distal to the proximal duodenum
- •Withhold feed for 24 hours before capsule administration to optimize mucosal visualization and reduce transit time variability for clinical applications
- •Account for variable capsule excretion times (up to 8.75 days) when planning clinical protocols, and recognize that some capsules may not be recovered
Key Findings
- •Wireless capsule endoscopy successfully visualized equine stomach and small intestine mucosa with excellent interobserver agreement on image quality
- •24-hour pre-administration fasting provided the greatest percentage of visible gastrointestinal mucosa
- •Mean capsule transit time was 6.5 days (range 3-8.75 days) with 20% capsule recovery failure rate
- •Common mucosal findings in healthy horses included erosions, ulcerations, hemorrhage, thickened mucosa, and parasitic evidence