Artificial sphincter to the rescue!

Yesterday I participated in my first canine colonoscopy (okay, my first colonoscopy with any species) and debuted in the role of "artificial sphincter."

To explain: a colonoscopy is a small camera on an approximately 1/2-inch diameter cable placed into the rectum and advanced through the colon, and into the small intestine if possible.

Normally, the colon and intestines are pretty collapsed down on themselves, not just sitting wide open. So in order to be able to look around and visualize the inner surfaces of the bowel, it's necessary to blow a substantial quantity of air into the colon using the endoscope, to inflate everything.

The patient receives multiple enemas before the procedure to help clean things out, since it's a lot harder to see what the intestine looks like if there's poop all over it, but there is invariably a small amount of fecal material left, which is remedied by rinsing with water or saline through the endoscope.

Under the influence of general anesthesia, sphincters relax. It's possible to have spontaneous release of bladder and bowels. This makes it easier to pass the endoscope through the anus, but it also means that the water and air that are being infused into the colon through the endoscope have an easy means of escape through the loosened sphincter.

This is where I come in: artificial sphincter to the rescue!

No, it's not as exciting as it sounds.

Yes, it is absolutely as disgusting as it sounds.

Step #1: Wear your clinic smock over your nice clothes. Remove watch. Don latex gloves.

Step #2: Use your fingers to pinch the anus closed around the endoscope cable.

Step #3: Ignore the vibrations and farting sounds as small amounts of air leak out from the anus. Ignore the liquid fecal matter dripping out onto your (gloved) fingers.

Step #4: Smile idiotically as your rotation-mate, who is going to do her grand rounds presentation on this patient, snaps photos.

Step #5: Blog about it. (Oops, forgot Step #4a: remove gloves, wash hands.)

Yes, it was a once-in-a-lifetime experience, which is just fine, because it's not an experience that I ever need to have again. That was just a little more intimate with a dog's anal sphincter than I usually prefer to be.

(As an aside: this dog has been my patient since his arrival in hospital on Wednesday, and I'm hoping he can go home tomorrow. He is my favorite patient so far in senior year, and by far my most interesting and involved case. I'm hoping to have some time this weekend to blog about the cute little fellow!)