A wireless endoscopy capsule suitable for imaging of the equine stomach and small intestine

Background Capsule endoscopy offers a new method for visualization of the gastrointestinal mucosa in horses where other imaging technologies have diagnostic limitations. Objectives To (1) test the feasibility of using this novel endoscopy capsule to visualize intestinal mucosa in horses, including an objective assessment of image quality, (2) assess how changes in preadministration preparation affect the transit time and the amount of gastrointestinal mucosa visualized, and (3) describe intestinal mucosa lesions in healthy horses. Animals Five healthy adult horses. Methods Three protocols were used in a crossover study design. Protocols varied in time fasted, amount of oral fluid administered, and exercise. Manure was radiographically inspected for capsule recovery. Percentage of visible gastrointestinal mucosa was objectively assessed. Results Detailed images of the gastrointestinal mucosa were recorded with all 3 protocols, including images of the pylorus, major duodenal papilla, individual villi, and ileocecal junction. Visualization of large intestinal mucosa was poor. Interobserver agreement on image quality was excellent. Capsule administration after feed withholding for 24 hours provided the greatest percentage of visible mucosa in the stomach and small intestine. Total transit time to capsule excretion was 6.5 (3-8.75) days. Of 15 capsules administered, 3 were not recovered. Lesions visualized included mucosal erosion, ulceration and hemorrhage, areas of thickened mucosa, and evidence of parasitism. Conclusions This novel endoscopic capsule appears safe, practical, and noninvasive in horses; however, variability in capsule excretion time must be taken into account for clinical application.