Identification of Gastric Lesions in a Pacific Walrus (Odobenus rosmarus divergens) Presenting with Chronic Regurgitations via a Capsule Endoscopy (ALICAM®)
IAAAM 2021

Caroline Gingras-Harvey1*+; Marilyn Dunn1; Joseph Bisignano2; Jean-François St-Cyr3; Claire Vergneau-Grosset1,3

1Service de Sciences Cliniques, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, QC, Canada; 2Infiniti Medical, Palo Alto, CA, USA; 3SEPAQ Aquarium du Québec, Québec, QC, Canada

Abstract

Few techniques are available to evaluate the digestive tract of walruses. The large size and high anesthetic risk of these animals limit the use of radiography, fluoroscopy, computed tomography and endoscopy. The ALICAM® (Infiniti Medical), which stands for Ambulatory Light-based Imaging CAMera, is a single-use ingestible device generating images of the digestive system without sedation or anesthesia. This 11x31-mm size device contains four high-resolution cameras, produces light and acquires images of the digestive tract, which are downloaded when the ALICAM® is retrieved from the feces. Capsule endoscopy is used in humans, dogs and horses.1-3 The purpose of this study was to evaluate the use of capsule endoscopy as an alternative technique to investigate regurgitations in a male walrus.

A 14-year-old, captive-born, male Pacific walrus (Odobenus rosmarus divergens) presented with chronic regurgitations. Medical management consisted of oral administration of sucralfate (0.008 mg/kg q 12 h) for four months and omeprazole 0.5 mg/kg q 24 h for eight days. Partial improvement of the clinical signs was noted. After fasting the walrus for 24 hours, the capsule was administered orally with a handful of shrimp and vitamins, and recovered from the feces after 43 hours. Gastric images showed multifocal sections displaying mildly irregular gastric mucosa. These regions had a cobblestone and mildly proliferative appearance, compatible with resolving, current, or emerging inflammatory lesions. No evidence of neoplasia, foreign body, nor hemorrhagic lesions were found in the esophagus nor stomach. Medical and supportive care was continued in this walrus.

Overall, detailed images from the esophagus, gastric fundus and pylorus were obtained for 20 hours. However, no images of the small intestine nor colon could be obtained with the ALICAM®, as the capsule remained in the stomach past 20 hours. Gastric retention of the capsule may be physiologic in walruses or secondary to gastric hypomotility. Limitations of the technique include battery capacity of the device, its single use and price. Capsule endoscopy can be used in walruses as an alternative to traditional endoscopy to investigate esophageal and gastric lesions.

Acknowledgements

The authors wish to thank the animal health technicians and marine mammal trainers at the Aquarium du Québec who have been involved with the care of this marine mammal.

*Presenting author
+Student presenter

Literature Cited

1.  Appleyard M, Fireman Z, Glukhovsky A, Jacob H, Shreiver R, Kadirkamanathan S, Lavy A, Lewkowicz S, Scapa E, Shofti R, Swain P, Zaretsky A. 2000. A randomized trial comparing wireless capsule endoscopy with push enteroscopy for the detection of small-bowel lesions. Gastroenterol. 119:1431–1438.

2.  Davignon DI, Lee ACY, Johnston AN, Bowman DD, Simpson KW. 2016. Evaluation of capsule endoscopy to detect mucosal lesions associated with gastrointestinal bleeding in dogs. J Small Anim Pract. 57:148–158.

3.  Leguillette R, Steinmann M, Bezugley R, Pomrantz JS. 2017. Capsule endoscopy (ALICAM) in horses: assessing gastrointestinal tract transit time, image quality and lesions. J Vet Intern Med. 31(5):1596.

 

Speaker Information
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Caroline Gingras-Harvey
Service de Sciences Cliniques
Faculté de médecine vétérinaire
Université de Montréal
St-Hyacinthe, QC, Canada


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