Barium-impregnated Polyethylene Spheres Research Articles

Gastrointestinal release site for delayed release and gelatin capsules in healthy dogs.

Gelatin capsules deliver their contents to the stomach, while delayed-release (DR) capsules are designed to allow delivery to the small intestine. This study evaluated the gastrointestinal release site of DR capsules in six healthy adult dogs compared to gelatin capsules. Both gelatin and DR capsules were filled with barium-impregnated polyethylene spheres (BIPS™), and following enteral administration, release site was assessed using abdominal radiographs at baseline, immediately after ingestion, 15 min post-ingestion, 30 min post-ingestion, and then every 30 min thereafter. The evaluated phases included fasted conditions (phase 1, n = 6), increased meal size (phase 2, n = 2), double encapsulation (phase 3, n = 2), and altered capsule size (phase 4, n = 1). The released site was the stomach in all phases for both capsule types. In phase 1, DR capsules had a significantly prolonged time (median 60 min, range 60-90) to release BIPS™ compared to gelatin capsules (15 min, range 15-30; p = .03). In phase 2 (full meal size), 3 (double encapsulation), and 4 (smaller capsule size) pilot studies, release time was prolonged but still occurred in the stomach. This is similar to the release site for gelatin capsules but differs from the release site for DR capsules in people. This has implications for pharmacologic outcomes for products that are affected by gastric physiology (e.g. fecal microbiota transplantation). Based on this pilot data, clinicians and researchers should not assume DR capsules will allow for intestinal delivery of contents in dogs. Future studies should be conducted on larger and varied populations of dogs.

Diagnosis and Management of Marine Debris Ingestion and Entanglement by Using Advanced Imaging and Endoscopy in Sea Turtles

Marine debris ingestion and entanglement have caused morbidity and mortality in multiple marine species, including all seven species of sea turtles. This case series outlines six cases in which advanced imaging modalities were used to diagnose marine debris–induced foreign body obstructions and to aid in the treatment of wounds caused by marine debris entanglement. Prefemoral ultrasonography was used to correctly diagnose a monofilament fishing line linear foreign body obstruction in a juvenile female Kemp's Ridley sea turtle (Lepidochelys kempii) and a subadult female loggerhead sea turtle (Caretta caretta). Administration of iodinated contrast confirmed a complete upper gastrointestinal obstruction in a juvenile green sea turtle (Chelonia mydas). Traditional radiographs were nondiagnostic in all three animals. Barium-impregnated polyethylene spheres were used to identify a partial gastrointestinal foreign body obstruction in a juvenile green sea turtle. Endoscopy was used in multiple cases as both a diagnostic and a therapeutic tool. This case series demonstrates that contrast radiography, ultrasonography, and endoscopy are accurate diagnostic tools for the identification of marine debris–induced foreign body obstructions in sea turtles.

Effects of acupuncture at Pericardium-6 and Stomach-36 on nausea, sedation and gastrointestinal motility in healthy dogs administered intravenous lidocaine infusions.

The objectives of this study were to assess gastrointestinal transit times, sedation, and signs of nausea associated with intravenous lidocaine infusions in dogs following targeted acupuncture at Pericardium-6 (PC6) and Stomach-36 (ST36). In a randomized, blind crossover design, 6 healthy, adult Beagles were fed thirty 1.5 mm barium-impregnated polyethylene spheres (BIPS), then were subject to 30 minutes of: 1) no acupuncture, 2) bilateral targeted acupuncture at PC6 and ST36, or 3) bilateral non-target acupuncture at Lung-5 (LU5) and Bladder-55 (BL55). Lidocaine was immediately administered at 1 mg/kg intravenously followed by 50 μg/kg/min. BIPS were tracked radiographically; sedation and nausea were scored at baseline (Time 0) and for 11 hours during lidocaine infusions. Transit times and sedation and nausea scores were analyzed with a linear mixed-effects model; the number of BIPS at defined time points was analyzed with a piecewise linear mixed-effects model. All P values were two-sided and P < 0.05 was considered significant. Sedation and nausea scores did not differ between treatments at any time point (all P > 0.05). However, nausea scores in all groups were significantly greater at Times 5 through 7 and at Time 11 compared to Time 0 whereas sedation scores in all groups were significantly greater at Times 2 through 11 compared to Time 0 (all P < 0.05). The number of BIPs found out of the stomach, the number found in the large intestine, gastric emptying and gastrointestinal transit times did not differ between treatments (all P > 0.05). Acupuncture at PC6 and ST36 did not alleviate nausea and sedation associated with lidocaine infusions in clinically normal animals or affect gastric emptying and gastrointestinal transit.

Effect of Tailored Perigastric Lymph Node Dissection on Gastric Motility in a Canine Model

BackgroundCombination laparoscopic lymph node (LN) dissection and endoscopic resection is a promising treatment for early gastric cancer. However, LN dissection could cause nerve injury and deterioration of motility in the preserved stomach. This experimental study aims to evaluate changes in gastric motility after tailored perigastric regional lymph node dissection without gastrectomy. Materials and methodsWe identified four most frequently involved LN combinations considering tumor location from retrospective reviews of 4697 gastrectomy patients. We randomly assigned 55 dogs to five groups: control (laparotomy only) and four experimental groups with LN dissection without gastrectomy: group 1 (LNs 3, 7, and 8), group 2 (LNs 3, 4, and 6), group 3 (LNs 1, 3, and 7), and group 4 (LNs 3, 4, and 11). Gastric emptying time (GET) was measured using barium-impregnated polyethylene spheres. GET50 and GET75 were the time points when 50% and 75% of the markers, respectively, had emptied from the stomach. ResultsOn postoperative days (PODs) 2 and 3, GET50, GET75, and proportion of GET50 <4 h in groups 1 and 2 were comparable with controls. However, group 3 showed delayed GET50 and GET75, and groups 3 and 4 demonstrated significantly smaller proportions of GET50 <4 h compared with controls on PODs 2 and 3. This effect resolved by POD 6 and there were no significant differences in GET50, GET75, or proportion of GET50 <4 h between the groups. ConclusionsTailored perigastric LN resection without gastrectomy was feasible and acceptable in terms of postoperative motility in the preserved stomach.

Gastrointestinal effects following acupuncture at Pericardium-6 and Stomach-36 in healthy dogs: a pilot study.

To quantify changes in gastric and intestinal emptying times in the conscious dog following gastrointestinal acupoint stimulation. In a randomised, blinded crossover study, six dogs were fed 30×1.5 mm barium-impregnated polyethylene spheres and underwent: (1) no acupuncture (Control); (2) stimulation of target points PC6 and ST36 (Target) and (3) stimulation of non-target points LU7 and BL55 (Sham). Abdominal radiographs were assessed immediately after feeding the spheres and every hour for 12 hours and their number in the stomach and large intestines was counted. The number of barium-impregnated polyethylene spheres found distal to the stomach was less in the Target group compared to the Control and Sham groups between hours 2 and 4, but no differences between groups were seen for the remainder of the treatment period. The number of spheres found within the colon/rectum was less in the Target group compared to the Control and Sham groups between hours 4 and 6, and compared to the Sham group only at hour 7 but no differences between groups were seen after hour 8. Acupuncture targeted at the gastrointestinal tract of dogs was associated briefly with slowed gastric emptying and gastrointestinal transit time. This foundational study lays the groundwork for additional studies of acupuncture effects associated with altered physiologic states.

Relationship between gastrointestinal transit time and anesthetic fasting protocols in the captive chimpanzee, Pan troglodytes

Lengthy social separation and prolonged fasting time contribute to increased risks associated with anesthesia in captive primates. This study is an initial attempt to identify a safe pre-anesthetic fasting procedure by identifying gastric emptying time (GET) and gastrointestinal transit time (GTT) of captive chimpanzees, Pan troglodytes. Seven adult chimpanzees at the North Carolina Zoo immobilized for annual physical examinations were fed barium-impregnated polyethylene spheres to measure GET. Eleven animals were individually fed a color dye marker and fecal passage was observed to determine GTT. Gastric emptying time (GET) was approximated to be >3 hours but <16 hours. The mean GTT was 16.5 hours. This study indicates that a fasting time of 3 hours would allow for complete gastric emptying and could potentially replace the current overnight fast (≥16 hour) to help minimize complications associated with pre-anesthetic fasting in captive primates.

In this issue - May 2010

Flea-associated infectious agents in cats in Eastern Australia · Complications of barium-impregnated polyethylene spheres · Reproductive efficiency of Thoroughbred and Standardbred horses · GPS tracking collars to monitor horses · Correction of vesicovaginal reflux in mares · Antibodies to Lawsonia intracellularis in Australian pig herds · Mucormycosis in the platypus · Panniculitis from Mycobacterium mageritense in a Tasmanian devil

Aspiration of barium‐impregnated polyethylene spheres by a dog

This case report describes an 11-year-old Belgian Malinois dog with acute onset of cough caused by aspiration of barium-impregnated polyethylene spheres (BIPS) and pneumonia following an episode of suspected gastric dilation. Although bronchoscopic retrieval of the BIPS was largely unsuccessful, the dog recovered uneventfully, with most of the BIPS being coughed out and swallowed over a 1-month period. Aspiration of BIPS should be considered a potential complication of their administration. Furthermore, endoscopic removal of aspirated BIPS is challenging and may not be indicated because of their inert nature and possible self-clearance.

Evaluation of Gastrointestinal Tract Transit Times Using Barium-Impregnated Polyethylene Spheres and Barium Sulfate Suspension in a Domestic Pigeon (Columba livia) Model

Barium impregnated polyethylene spheres (BIPS) are used in small animal medicine as an alternative to barium sulfate for radiographic studies of the gastrointestinal tract. To determine the usefulness of BIPS as an alternative to barium suspension in measuring gastrointestinal (GI) transit time for avian species, ventrodorsal radiographs were used to follow the passage of BIPS and 30% barium sulfate suspension through the GI tracts of domestic pigeons (Columba livia). Gastrointestinal transit times of thirty 1.5-mm BIPS administered in moistened gelatin capsules and 30% barium sulfate suspension gavaged into the crop were compared in 6 pigeons. Although the barium suspension passed out of the GI tract of all pigeons within 24 hours, the 1.5-mm BIPS remained in the ventriculus for 368.0 +/- 176.8 hours and did not clear the GI tract for 424.0 +/- 204.6 hours. Although the times for passage of BIPS and 30% barium sulfate suspension from the crop into the ventriculus were not significantly different (P = .14), the times for passage of BIPS from the ventriculus into the large intestine-cloaca and for clearance from the GI tract of the pigeons were significantly longer (P < .001) than for the 30% barium sulfate suspension. From the results of this study, we conclude that BIPS are not useful for radiographically evaluating GI transit times in pigeons and are unlikely to be useful in other avian species that have a muscular ventriculus. BIPS may or may not be useful for evaluating GI transit times in species that lack a muscular ventriculus.

Ingesta passage and gastric emptying times in loggerhead sea turtles ( Caretta caretta)

Ingesta passage times of soft flat foam dishes and gastric emptying time of barium-impregnated polyethylene spheres (BIPS ®) were measured in 22 and 8 loggerhead sea turtles ( Caretta caretta), respectively. Transit time ( T 1) was considered as the time between ingestion and first elimination, and retention time ( T 50) and total transit time ( T 85) the expulsion time of 50% and 85% of the markers, respectively. The experiments were carried out at different times of the year and water temperature was recorded. A set of dorso-ventral radiographs was taken to locate the BIPS ®, and the gastrointestinal anatomy of 5 dead turtles was studied to help with interpretation of the radiographs. No significant correlation was observed between T 1, T 50, T 85 and minimum straight carapace length (SCLmin) or body mass and no statistical difference was found in ingesta passage transit times between juvenile ( n = 6) and sub-adult turtles ( n = 16). Mean passage times of the dishes (in days) were: T 1 = 9.05, T 50 = 12.00 and T 85 = 13.19. Gastric emptying time using BIPS ® was 24–48 h. The transit time ( T 1) for the BIPS ® was longer (13.25 ± 4.86 days) than the foam markers (8.5 ± 2.73 days) in 8 turtles studied simultaneously. Although the total transit time tended to be faster in turtles submitted to water temperatures between 20 °C and 23.6 °C no significant correlation was observed between T 1, T 50 and T 85 and the temperature.

Characterizing gastrointestinal transit time in four lemur species using barium‐impregnated polyethylene spheres (BIPS)

Differences in dietary profiles and gastrointestinal (GI) morphologies observed across lemur species suggest that there may be variation in patterns of digesta flow through the GI tract related to the method of digesta processing. Using radio-opaque barium-impregnated polyethylene spheres (BIPS), we characterized such patterns in four lemur species: Varecia variegata (VV), Eulemur fulvus (EF), Propithecus verreauxi (PV), and Hapalemur griseus (HG) (n = 2 per species). After an initial radiograph was taken under light sedation, the animals were fed the BIPS together with a small meal. A combination of 30 small (1.5 mm) and 10 large (5 mm) BIPS was administered. Radiographs were then taken on a species-dependent basis up to 48 hr post-dosage. For small BIPS, the gastric transit time (GTT; time of first exit of BIPS from stomach) was 0.25-2 hr for VV, EF, and HG, and approximately 10 hr for PV. The oro-rectal transit time (ORTT; time of first appearance in the rectum) was < 2 hr for VV and EF, and 24.0 hr for PV and HG. The intestinal transit time (ITT, measured as ORTT - GTT) was < 1.5 hr for VV and EF, and approximately 14 hr and 22 hr for PV and HG, respectively. These data suggest that the GTT of digesta as measured with BIPS was rapid for VV, EF, and HG. For VV and EF, the ORTT and ITT were also rapid, while for HG they were much slower. PV was characterized by delayed GTT, and a more rapid ITT compared to HG. Thus, patterns of flow for PV and HG, despite similar ORTT, differed in that HG emptied BIPS more rapidly and ITT was slower. The flow of BIPS did not differ for VV and EF. These data reveal new information in addition to the total tract transit time, and complement existing knowledge regarding anatomy and diet.

Gastric emptying as assessed by barium-impregnated polyethylene spheres in healthy dogs consuming a commercial kibble ration.

Barium-impregnated polyethylene spheres (BIPS) were used to assess gastric emptying in medium-sized dogs consuming a commercial kibble ration. Two sizes of spheres were used: 1.5 mm and 5.0 mm in diameter. Ventrodorsal and right lateral recumbent radiographs were taken immediately before and after consumption of the test meal, and then hourly. The lag phase and the time to 25% (GET25), 50% (GET50), and 75% (GET75) gastric emptying of each sized marker were calculated. There was no significant difference between the lag phases of the small and large BIPS. There was a significant difference between the 1.5 and 5.0 markers at GET25, GET50, and GET75 in these medium-sized dogs. In a majority (70%) of the dogs in this study, GET25 of the 1.5-mm marker occurred at 4.73+/-1.44 hours; GET50 (1.5 mm) occurred at 8.29+/-1.62 hours, and GET75 (1.5 mm) occurred at 10.82+/-1.35 hours. The 5.0-mm markers tended to empty erratically and slowly. Four of the eight dogs retained some of the large markers in their stomachs at the end of the study period (24 hours).

Pros and cons of Barium-Impregnated Polyethylene Spheres in Gastrointestinal Disease

Barium-impregnated polyethylene spheres are an alternative contrast agent for radiographic studies of the gastrointestinal tract. The spheres are a practical, efficient, and relatively inexpensive way to diagnose a number of relatively common gastrointestinal conditions. They are most useful in the diagnosis of chronic conditions. Radiographic interpretation relies on a thorough understanding of the pathophysiology of gastrointestinal disease and how various disease states influence gastrointestinal function.

Enteroplication in cats, using suture of N-butyl cyanocrylate adhesive

Enteroplication has been recommended to prevent recurrence of intussusception in dogs and cats. This study investigated the impact of enteroplication on subsequent function of the plicated small intestine as measured by transit time of barium impregnated polyethylene spheres (BIDS) and compared two methods of achieving enteroplication - sutures using polydioxanone and cyanoacrylate tissue adhesive. Twenty-two healthy young cats were used - four controls, nine sutured and nine glued. The mean ±SD transit times before, one week after and four weeks after enteroplication were respectively 2·0±0·80 hours, 1·6±0·80 hours, 2·2±1·18 hours. There was no significant difference in transit time or in the time to create enteroplication in the two plicated groups. Maintenance of intestinal adhesion was greater for the sutured plications. There was no significant change in internal diameter with either technique. Adverse clinical signs after enteroplication were not severe, however, they were more prevalent in cats which had glued plication. The inflammation associated with the suture was of a greater depth initially but that associated with the adhesive was more widespread and persisted for the four weeks of the experiments. Enteroplication in cats was a relatively benign procedure which did not cause significant alterations in small intestinal function. However, cyanoacrylate tissue adhesive cannot be recommended for this clinical procedure.

Reference ranges for gastrointestinal transit of barium-impregnated polyethylene spheres in healthy cats.

Commercial barium-impregnated polyethylene spheres (BIPS) were administered to 12 healthy adult cats according to the manufacturer's instructions (30 small BIPS and 10 large BIPS to each cat) together with 60 g of a canned food. Radiographs were taken at hourly intervals until seven hours after feeding, and then at eight, 10, 12, 14, 17, 23 and 30 hours or until all the BIPS had left the stomach and at least 50 per cent had entered the colon. Six cats were sedated immediately after being fed the BIPS and six cats remained unsedated. For small BIPS (1.5 mm diameter), the gastric transit time (first exit of BIPS from the stomach) in the sedated cats had a median of 6 hours (range 3 to 8) and in the unsedated cats a median of 2.5 hours (range 2 to 6). Values for other transit times were not significantly different between the two groups, and the pooled data revealed a median 50 per cent gastric emptying time of 6.4 hours (range 2.5 to 10.9), a complete gastric emptying time of 12 hours (range 6 to 27), an orocaecal transit time (first appearance of BIPS in the colon) of 6.5 hours (range 4.0 to 12.0) and a 50 per cent orocaecal transit time of 8.8 hours (range 4.6 to 12.8). The gastrointestinal transit of large BIPS (5 mm diameter) was significantly correlated with the passage of small BIPS but, except for the complete gastric emptying time, was significantly slower.