Barium study question

Re: Barium study question

bob lehner — Tue, 17 Jul 2012 15:38:43 GMT

I think it's fair to say that whether you favour BIPs or liquid, barium studies are notoriously difficult to interpret for the non-expert, unless it is something pretty damn obvious. For which reason ultrasound +/- endoscopy has superseded barium studies in many cases these day.

Re: Barium study question

Rob Davis — Tue, 17 Jul 2012 12:37:30 GMT

[quote user="Nicola Lawlor"]May have access to an endoscope tomorrow too which will be good to check with before an ex-lap is done, assuming there is still barium in the stomach in the morning. [/quote]

My experience with endoscopy following barium is not good - unable to see anything other than barium, though I guess if there was a large FB it ought to be visible. No good for looking at mucosa as will all be coated in barium.

Re: Barium study question

Evelyn Barbour-Hill — Mon, 16 Jul 2012 21:37:08 GMT

[quote user="bob lehner"]Well, in my very humble opinion BIPS are a complete waste of space in cases where I have watched colleagues messing about with them. [/quote]

In my very humble opinion, BIPS are great in appropriate cases.

Re: Barium study question

Nicola Lawlor — Mon, 16 Jul 2012 20:15:16 GMT

Well, no movement out of the stomach at all by the end of the day but the dog is clearly feeling better for rehydration on an iv at least. Will re-radiograph in the morning and see what happens. May have access to an endoscope tomorrow too which will be good to check with before an ex-lap is done, assuming there is still barium in the stomach in the morning.

Re: Barium study question

bob lehner — Mon, 16 Jul 2012 16:10:56 GMT

[quote user="Martin Atkinson"]You could try BIPS given concious [/quote]

Well, in my very humble opinion BIPS are a complete waste of space in cases where I have watched colleagues messing about with them. Can be retained in the stomach for ages even in un-sedated dog and then their progress down the gi tract seems to be unpredictable and they obviously can't show filling defects. A good slug of liquid barium does the job much more effectively.

With regard to retention of barium in the stomach I have seen many cases where it is retained whilst the dog is in hospital, only to move on quite happily when the dog is more relaxed at home. I think it is a good idea to give the barium, then send home if possible and have back the next day to repeat rads. Have seen a number of cases where animals have had expl laps on the strength of barium retained in the stomach over night in hosp, with embarrassingly negative findings.

Re: Barium study question

Martin Atkinson — Mon, 16 Jul 2012 15:42:50 GMT

I would have thought that you would have some sort of filling defect if there was a gastric FB regardless of slowing of transit time due to sedation. You could try BIPS given concious then sedate to X-ray 12 hrs later.

Re: Barium study question

Nicola Lawlor — Mon, 16 Jul 2012 14:49:17 GMT

Thank you

Re: Barium study question

David Mills — Mon, 16 Jul 2012 14:48:29 GMT

There is a fair bit of work on this in rats.

Medetomidine does significantly slow gastric emptying/GI transit:

http://www.ncbi.nlm.nih.gov/pubmed/9135310

http://www.ncbi.nlm.nih.gov/pubmed/9505780

http://www.ncbi.nlm.nih.gov/pubmed/9280369

but this is obliterated by reversal with atipamezole:

http://www.ncbi.nlm.nih.gov/pubmed/8095034

Would likely give it 4 hours after barium re-sedate and X-ray.

Re: Barium study question

Michael Woodhouse — Mon, 16 Jul 2012 14:24:48 GMT

I don't know the answer. I do know that alpha 2's stop all gut sounds in colicing horses so I'd postulate a similar effect in the dog.