Page 330 - Feline diagnostic imaging

338 21 Normal Gastrointestinal Anatomy

(a) (b)

(c)

Figure 21.6 (a–c) Fluoroscopy was done during esophagography in a 3-year-old castrated domestic shorthair cat with history of
chronic intermittent regurgitation. Barium was given as a paste and mixed with wet and dry food with the patient standing. A normal
bolus was formed and traveled normally into the stomach. No strictures or other abnormalities were apparent.

21.2.3 Videofluoroscopy for Evaluation expelled from the colon. Water should be withheld for 1–2
of Swallowing hours before the study so that the stomach will not be fluid
filled. Survey radiography should be done immediately
If fluoroscopy is available, esophagography can be per- before contrast administration to ensure that there is no
formed during videofluoroscopy to evaluate swallowing. ingesta or other material in or on the patient that might
The video is examined frame by frame to determine the interfere with the study. Most upper GI series are elective
time from the beginning of swallowing to the maximal and should not proceed until preparation is adequate.
pharyngeal contraction, upper esophageal sphincter Occasionally, the final survey radiography reveals
opening and closing, and epiglottic reopening [13,14]. The new diagnostic information, making a contrast study
procedure is more difficult in cats than in dogs because of unnecessary.
poor patient compliance [14].
Commercially prepared microfine barium suspension is
the contrast medium of choice for an upper GI series. A
stomach tube can be passed but care should be taken to
21.2.4 Upper Gastrointestinal Series
ensure that the tube is within the esophagus and the tip has
Unlike esophagography, an upper GI series requires thor- entered the stomach. Alternatively, barium can be given
ough preparation of the GIT. Dependent on the condition slowly with a syringe. Barium is given orally at a dosage of
of the patient and the situation, the patient should be fasted 5–6 cc per pound. Administering less than a full dose can
for 12–24 hours. Antiemetic and antidiarrheal drugs mark- result in insufficient gastric distension and poor gastric
edly alter GI motility and should be withdrawn 48–72 hours emptying. The standard abdominal technique should be
before the study if possible. Laxatives should be adminis- increased by 6–8 kVp to provide maximum contrast
tered and enemas should be given at least 1–2 hours before between the barium and soft tissues. The study should be
the contrast study to allow time for gas and fluid to be continued until barium has reached the colon or a diagnosis