Szintigrafie zur Bestimmung der Magenentleerungszeit beim Kleintier

Zusammenfassung

Eine verzögerte Magenentleerung ist als primäre Erkrankung sowie als Sekundärerscheinung bei unterschiedlichen Krankheitsprozessen bei Hund und Katze bekannt. Dabei ist die Diagnose einer Magenentleerungsstörung in der Veterinärmedizin schwierig; die szintigrafische Untersuchung gilt jedoch als Goldstandardmethode. Allerdings ist die Bestimmung von Referenzwerten nicht unproblematisch und die Signifikanz alimentärer sowie physiologischer Einflüsse, Rasse oder Gewicht ungeklärt. Weiterhin ist der routinemäßige Einsatz durch gesetzliche Regularien, die Verfügbarkeit der Methode sowie Probleme in der Interpretation eingeschränkt. Dieser Artikel soll einen Überblick über die bisher beim Kleintier angewandten szintigrafischen Techniken zur Bestimmung der Magenentleerungszeit geben und Vor- und Nachteile der Methode aufzeigen.

Abstract

Gastric emptying disorders are known in the dog and cat as a primary process as well as a secondary phenomenon to different underlying diseases. Diagnosing gastric emptying disorders remains difficult in veterinary medicine; however, gastric scintigraphy is considered the gold standard method. Unfortunately, determination of reference values is problematic and the significance of alimentary or physiological influences, breed or weight remains largely unknown. In addition, performance of scintigraphy in routine-diagnostics is limited by law restrictions, availability and difficulties in interpretation of results.This article gives an overview of scintigraphic techniques used in small animals so far to assess gastric emptying times and discusses advantages and disadvantages of this method.

Schlüsselwörter

Magenmotilität - Magenhalbentleerungszeit - Technetium - Gammakamera

Key words

gastric motility - gastric emptying time - technetium - gamma camera

Literatur

• 1 Armbrust LJ, Hoskinson JJ, Lora-Michiels M. et al . Gastric emptying in cats using foods varying in fiber content and kibble shapes.  Vet Radiol Ultrasound. 2003;  44 339-343
• 2 Bennink RJ, De Jonge WJ, Symonds EL. et al . Validation of gastric-emptying scintigraphy of solids and liquids in mice using dedicated animal pinhole scintigraphy.  J Nucl Med. 2003;  44 1099-1104
• 3 Blat S, Guerin S, Chauvin A. et al . Role of vagal innervation on intragastric distribution and emptying of liquid and semisolid meals in conscious pigs.  Neurogastroenterol Motil. 2001;  13 73-80
• 4 Bourreau J, Hernot D, Bailhache E. et al . Gastric emptying rate is inversely related to body weight in dog breeds of different sizes.  J Nutr. 2004;  134 2039S-2041S
• 5 Brockman DJ, Washabau RJ, Drobatz KJ. Canine gastric dilatation/volvulus syndrome in a veterinary critical care unit: 295 cases (1986–1992).  J Am Vet Med Assoc. 1995;  207 460-464
• 6 Bruley des Varannes S, Mizrahi M, Dubois A. Relation between postprandial gastric emptying and cutaneous electrogastrogram in primates.  Am J Physiol. 1991;  261 G248-255
• 7 Canton DD, Sharp NJ, Aguirre GD. Dysautonomia in a cat.  J Am Vet Med Assoc. 1988;  192 1293-1296
• 8 Chaudhuri TK. Use of 99mTc-DTPA for measuring gastric emptying time.  J Nucl Med. 1974;  15 391-395
• 9 Costello M, Papasouliotis K, Barr FJ. et al . Determination of solid- and liquid-phase gastric emptying half times in cats by use of nuclear scintigraphy.  Am J Vet Res. 1999;  60 1222-1226
• 10 Cullen JJ, Titler S, Ephgrave KS. et al . Gastric emptying of liquids and postprandial pancreatobiliary secretion are temporarily impaired during endotoxemia.  Dig Dis Sci. 1999;  44 2172-2177
• 11 Dormehl IC, du Plessis M, Maree M. et al . A comparison of 111In-labelled polymer beads and 99mTc-Sn-colloid as solid food and semi-solid food tracers for scintigraphic gastric emptying studies.  Nuklearmedizin. 1986;  25 50-54
• 12 Duval-Araujo I, De Magal-Aes Queiroz DM, Magnago AG. et al . Increased gastric emptying induced by Helicobacter heilmannii type 1 infection in rats.  J Med Microbio. 2000;  49 627-634
• 13 Fioramonti J, Bueno L. Gastrointestinal myoelectric activity disturbances in gastric ulcer disease in rats and dogs.  Dig Dis Sci. 1980;  25 575-580
• 14 Glickman LT, Glickman NW, Perez CM. et al . Analysis of risk factors for gastric dilatation and dilatation-volvulus in dogs.  J Am Vet Med Assoc. 1994;  204 1465-1471
• 15 Goggin JM, Hoskinson JJ, Kirk CA. et al . Comparison of gastric emptying times in healthy cats simultaneously evaluated with radiopaque markers and nuclear scintigraphy.  Vet Radiol Ultrasound. 1999;  40 89-95
• 16 Gould RJ, Fioravanti C, Cook PG. et al . A model of gastric emptying in cats shows solid emptying is promoted by MK-329: a CCK antagonist.  J Nucl Med. 1990;  31 1494-1499
• 17 Griffith GH, Owen GM, Kirkman S. et al . Measurement of rate of gastric emptying using chromium-51.  Lancet. 1996;  1 1244-1245
• 18 Hall JA, Willer RL, Seim HB. et al . Gastric emptying of nondigestible radiopaque markers after circumcostal gastropexy in clinically normal dogs and dogs with gastric dilatation-volvulus.  Am J Vet Res. 1992;  53 1961-1965
• 19 Hinder RA, Kelly KA. Canine gastric emptying of solids and liquids.  Am J Physiol. 1977;  233 E335-E340
• 20 Hornof WJ, Koblik PD, Strombeck DR. et al . Scintigraphic Evaluation of Solid-Phase Gastric-Emptying in the Dog.  Veterinary Radiology. 1989;  30 242-248
• 21 Hoskinson JJ, Goggin JM, Butine MD. Evaluation of solid-phase labels for gastric emptying studies in cats.  J Nucl Med. 1997;  38 495-499
• 22 Hotokezaka M, Combs MJ, Schirmer BD. Recovery of gastrointestinal motility following open versus laparoscopic colon resection in dogs.  Dig Dis Sci. 1996;  41 705-710
• 23 Itoh Z, Sekiguchi T. Interdigestive motor activity in health and disease.  Scand J Gastroenterol Suppl. 1983;  82 121-134
• 24 Iwanaga YJ, Wen J, Thollander MS. et al . Scintigraphic measurement of regional gastrointestinal transit in the dog.  Am J Phys Gastr Liv Phys. 1998;  38 G904-G910
• 25 Johnson CS, Fales-Williams AJ, Reimer SB. et al . Fibrosing gastrointestinal leiomyositis as a cause of chronic intestinal pseudo-obstruction in an 8-month-old dog.  Vet Pathol. 2007;  44 106-109
• 26 Lester NV, Roberts GD, Newell SM. et al . Assessment of barium impregnated polyethylene spheres (BIPS) as a measure of solid-phase gastric emptying in normal dogs-comparison to scintigraphy.  Vet Radiol Ultrasound. 1999;  40 465-471
• 27 McLellan J, Wyse CA, Dickie A. et al . Comparison of the carbon 13-labeled octanoic acid breath test and ultrasonography for assessment of gastric emptying of a semisolid meal in dogs.  Am J Vet Res. 2004;  65 1557-1562
• 28 Meyer JH, Thomson JB, Cohen MB. et al . Sieving of solid food by the canine stomach and sieving after gastric surgery.  Gastroenterology. 1979;  76 804-813
• 29 Mistiaen W, Blockx P, Van Hee R. et al . Comparison of anterior and geometric mean liquid and solid gastric emptying rates in dogs and in patients after partial gastrectomy.  J Nucl Med Techno. 2000;  28 165-170
• 30 Parkman HP, Harris AD, Krevsky B. et al . Gastroduodenal motility and dysmotility: an update on techniques available for evaluation.  Am J Gastroenterol. 1995;  90 869-892
• 31 Pearson H, Gaskell CJ, Gibbs C. et al . Pyloric and oesophageal dysfunction in the cat.  J Small Anim Pract. 1974;  15 487-501
• 32 Roche M, Bueno L. et al . Patterns of electrical activity in the digestive tract of the conscious cat.  Br J Nutr. 1982;  48 129-135
• 33 Schmitz S. Validation of the 13C-sodium-acetate breath test for the measurement of gastric emptying in dogs in comparison to 99mTechnetium radioscintigraphy.  Dissertation. 7;  http://geb.uni-giessen.de/geb/volltexte/2007/5101/
• 34 Steyn PF, Twedt DC, Toombs WK. The effect of intravenous diazepam on solid phase gastric emptying in normal cats.  Vet Radiol Ultrasound. 1997;  38 469-473
• 35 Sutton DG, Bahr A, Preston T. et al . Validation of the 13C-octanoic acid breath test for measurement of equine gastric emptying rate of solids using radioscintigraphy.  Equine Vet J. 2003;  35 27-33
• 36 Szarka LA, Camilleri M. Methods for measurement of gastric motility.  Am J Phys Gastr Liv. 2009;  296 G461-G475
• 37 Szurszewski JH. A migrating electric complex of canine small intestine.  Am J Physiol. 1969;  217 1757-1763
• 38 Takeda M, Mizutani Y, Yamano M. et al . Gastric emptying in diabetic gastroparetic dogs: ffects of SK-951,a novel prokinetic agent.  Pharmacology. 2001;  62 23-28
• 39 Theodorakis MC. External Scintigraphy in Measuring Rate of Gastric-Emptying in Beagles.  Am J Phys. 1980;  239 G39-G43
• 40 Vandenbrom WE, Happe RP. Gastric-emptying of a radionuclide-labeled test meal in healthy dogs – a new mathematical analysis and reference values.  Am J Vet Res. 1986;  47 2170-2174
• 41 Vogel SB, Vair DB, Woodward ER. Alterations in gastrointestinal emptying of 99m-technetium-labeled solids following sequential antrectomy, truncal vagotomy and Roux-Y gastroenterostomy.  Ann Surg. 1983;  982 506-515
• 42 Wallden J. The influence of opioids on gastric function: experimental and clinical studies.  Acta Anaesthesiol Scand. 2008;  52 1432
• 43 Walter MC, Goldschmidt MH, Stone EA. et al . Chronic hypertrophic pyloric gastropathy as a cause of pyloric obstruction in the dog.  J Am Vet Med Assoc. 1985;  186 157-161
• 44 Washabau RJ. Gastrointestinal motility disorders and gastrointestinal prokinetic therapy.  Vet Clin North Am Small Anim Pract. 2003;  33 1007-1028
• 45 Willson CA, Bushnell D, Keshavarzian A. The effect of acute and chronic ethanol administration on gastric emptying in cats.  Dig Dis Sci. 1990;  35 444-448
• 46 Wyse CA, McLellan J, Dickie AM. et al . A review of methods for assessment of the rate of gastric emptying in the dog and cat: 1898-2002.  J Vet Intern Med. 2003;  17 609-621
• 47 Wyse CA, Preston T, Love S. et al . Use of the 13C-octanoic acid breath test for assessment of solid-phase gastric emptying in dogs.  Am J Vet Res. 2001;  62 1939-1944
• 48 Yam PS, McLellan J, Wyse CA. et al . Effect of body size on gastric emptying using the 13C-octanoic acid breath test.  J Small Anim Pract. 2004;  45 386-389

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