Gut Check: A New View from the Inside

Researchers are trying out the use of endoscopic cameras to help diagnose hindgut problems in horses.
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Researchers are testing an endoscopic camera, contained in a small capsule and placed directly into the horse’s stomach, to gather imagery of the equine intestinal tract. The capsule sends images to an external recorder, held in place by a harness.

Researchers are testing an endoscopic camera, contained in a small capsule and placed directly into the horse’s stomach, to gather imagery of the equine intestinal tract. The capsule sends images to an external recorder, held in place by a harness.

Traditionally, veterinarians’ and researchers’ view of the equine intestinal tract has been limited. Endoscopy (inserting through the horse’s mouth a small camera attached to a flexible cable to view his insides) allows them to see only as far as the stomach. While ultrasound can sometimes provide a bigger picture, the technology can’t see through gas—and the horse’s hindgut (colon) is a highly gassy environment.

These limitations make it hard to diagnose certain internal issues and also present research challenges. But the view is now expanding, thanks to a “camera pill” being tested by a team at the University of Saskatchewan, led by Julia Montgomery, DVM, PhD, DACVIM. Dr. Montgomery worked with a multi-disciplinary group, including equine surgeon Joe Bracamonte, DVM, DVSc, DACVS, DECVS, electrical and computer engineer Khan Wahid, PhD, PEng, SMIEEE, a specialist in health informatics and imaging; veterinary undergraduate student Louisa Belgrave and engineering graduate student Shahed Khan Mohammed.

In human medicine, so-called camera pills are an accepted technology for gathering imagery of the intestinal tract. The device is basically an endoscopic camera inside a small capsule (about the size and shape of a vitamin pill). The capsule, which is clear on one end, also contains a light source and an antenna to send images to an external recording device.

The team thought: Why not try it for veterinary medicine?

They conducted a one-horse trial using off-the-shelf capsule endoscopy technology. They applied sensors to shaved patches on the horse’s abdomen, and used a harness to hold the recorder. They employed a stomach tube to send the capsule directly to the horse’s stomach, where it began a roughly eight-hour journey through the small intestine.

The results are promising. The camera was able to capture nearly continuous footage of the intestinal tract with just a few gaps where the sensors apparently lost contact with the camera. For veterinarians, this could become a powerful diagnostic aid for troubles such as inflammatory bowel disease and cancer. It could provide insight on how well internal surgical sites are healing. It may also help researchers understand normal small-intestine function and let them see the effect of drugs on the equine bowel. 

The team did identify some challenges in using a technology designed for humans. They realized that a revamp of the sensor array could help accommodate the horse’s larger size and help pinpoint the exact location of the camera at any given time. That larger size also could allow for a larger capsule, which in turn could carry more equipment—such as a double camera to ensure forward-facing footage even if the capsule flips.

With this successful trial run, the team plans additional testing on different horses. Ultimately, they hope to use the information they gather to seek funding for development of an equine-specific camera pill.

“From the engineering side, we can now look at good data,” Dr. Wahid explained. “Once we know more about the requirements, we can make it really customizable, a pill specific to the horse.”

This article was originally published in Practical Horseman's October 2016 issue. 

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