title: Evaluation of atropine, glucagon, and metoclopramide for facilitation of endoscopic intubation of the duodenum in dogs.
abstract: Modification of gastroduodenal motility has been proposed to aid endoscopic examination of the duodenum in dogs. The objective of this study was to evaluate the use of the following pharmacologic agents for facilitation of endoscopic intubation of the duodenum in 6 clinically normal dogs: metoclopramide HCl (0.2 mg/kg of body weight), atropine sulfate (0.045 mg/kg), glucagon (0.06 mg/kg), and isotonic saline solution. In a randomized, blinded, crossover design, the ease of endoscopic duodenal intubation was qualitatively scored by 3 endoscopists (in random order), using the following scale:  1 - immediate entry;  2 - rapid entry--moderate manipulation; 3 - difficult entry--multiple attempts; and  4 - no entry after 2 minutes [corrected]. Anesthesia was induced with thiopental and maintained with halothane. The 4 agents were diluted to a fixed volume and randomly administered. Duodenal intubation was attempted 2 minutes after IV injection of 1 of the agents. Four endoscopic procedures (1 for each agent) were performed on each dog with a minimum of 5 days between each procedure. In this study, no agent facilitated endoscopic duodenal intubation at the dose used. Instead, atropine and metoclopramide made duodenal intubation significantly more difficult, compared with use of saline solution. Difference between intubation after administration of glucagon and saline solution was not seen. On the basis of our findings, the use of these agents for facilitating endoscopic duodenal intubation is not recommended. In addition, in this study, we found that experience in endoscopic intubation is an important factor in determining the ease of duodenal intubation.
authors.affiliation: Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA 24061.
authors.forename: M E
authors.initials: ME
authors.lastname: Matz
authors.forename: M S
authors.initials: MS
authors.lastname: Leib
authors.forename: W E
authors.initials: WE
authors.lastname: Monroe
authors.forename: D J
authors.initials: DJ
authors.lastname: Davenport
authors.forename: L P
authors.initials: LP
authors.lastname: Nelson
authors.forename: J E
authors.initials: JE
authors.lastname: Kenny
mesh_terms: D000818:Animals; D001285:Atropine / Q000494:pharmacology*; D004285:Dogs / Q000502:physiology*; D004384:Duodenoscopy / Q000662:veterinary; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D005934:Glucagon / Q000494:pharmacology*; D007441:Intubation, Gastrointestinal / Q000662:veterinary; D008297:Male; D008787:Metoclopramide / Q000494:pharmacology*; D011897:Random Allocation
chemical_list: D001285:Atropine; D005934:Glucagon; D008787:Metoclopramide