Preface
The practice of gastroenterology has changed dramatically in the last decade.The not-uncommon frustration that veterinarians and their clients experienced in the past when dealing with pets afflicted with chronic gastrointestinal disorders has given way to very satisfying results in many cases.This is in large part attributable to major advances that have been made both in our diagnostic capabilities and in the availability of more effective therapeutic agents.
Most notably, with the advent of endoscopic instrumentation, it has become possible to directly examine a large portion of the gastrointestinal tract and to procure biopsy samples in a minimally invasive manner. Endoscopy has truly played a major role in enabling clinicians to diagnose many disorders that otherwise might have gone unrecognized until much later in their course. Laparoscopy is also being used much more commonly for minimally invasive procurement of liver and pancreatic tissue for histopathologic evaluation, for prophylactic gastropexy, and for other innovative techniques.Additionally, advances in imaging techniques (ultrasonography, nuclear scintigraphy) have occurred, and more specific tests of liver function (e.g., bile acids assay), exocrine pancreatic insufficiency (trypsinlike immunoreactivity), and pancreatic inflammation (pancreatic lipase immunoreactivity assay) are now in routine use. These improvements, as well as others too numerous to list here, have enhanced our ability to approach digestive system problems more accurately and less invasively. In short, we can now do a much better job for our patients and their owners.
The second edition of the Handbook of Small Animal Gastroenterology meets the original goal of the first edition—it provides a practical update on small animal clinical gastroenterology that should serve as a useful reference in any practice setting.
It is clearly recognized in veterinary practices throughout the world that digestive system disorders are among the most common reasons that pet owners seek veterinary consultation. The text is therefore directed particularly toward veterinary students, interns, residents in medicine and surgery, and primary care practitioners. Emphasis is placed on a practical diagnostic approach and development of well directed treatment plans for a majority of the gastrointestinal diseases that are encountered in practice. The second edition has been extensively revised and includes important updates throughout, and there is a new chapter, which provides a detailed review of neoplasia of the digestive system (Chapter 11).The importance of directing very careful consideration to the patient's history when presented with animals exhibiting symptoms of a digestive system disorder cannot be overemphasized.Therefore an entire chapter (Chapter 1) has once again been devoted to a discussion of important symptoms and differential diagnosis. Chapters 2 and 3 complete the overview of diagnosis of digestive system diseases with information highlighting the clinical utility of four very important diagnostic modalities in gastroenterology: radiology and ultrasonography (Chapter 2) and endoscopy and laparoscopy (Chapter 3). The remaining chapters sequentially address the various anatomic regions of the digestive system individually. Newer tests and drugs are described throughout. Chapter 12 discusses enteral nutritional support, and this chapter has been expanded for the new edition.
I am indebted to the authors who contributed to this book. They are highly experienced clinicians with demonstrated expertise in either busy private or academic practices. They all share the common thread of being excellent teachers. I have the greatest respect for their contributions to our profession. I also acknowledge the excellent assistance of the staff at Elsevier, and in particular my editors, Raymond Kersey, Denise LeMelledo, and Mary Turner, for their encouragement, advice, and professionalism.
Todd R. Tams, DVM