A dog liver biopsy procedure may have been recommended for your dog and you may be wondering about the what the procedure entails and its associated costs. There are actually several techniques veterinarians rely on in order to obtain a liver biopsy. The choice of one technique over the other is based on several factors such as the veterinarian’s preference, the overall health of the dog, the size of the liver, the size of the dog and the owner’s finances, considering that certain medical procedures are more costly than others.
Dog Liver Biopsy Procedure
A dog liver biopsy procedure may be suggested when the vet suspects some type of liver disease. Affected dogs may have increased liver enzymes on their serum biochemistry profile, abnormal bile acid concentrations, or their ultrasound may have shown changes that require investigation.
A biopsy is indicated when such results were not adequate enough to establish a definite diagnosis. A dog liver biopsy procedure can help pinpoint potential underlying conditions such as inflammation, infection, cancer and other conditions affecting the dog’s liver.
The biopsy, which consists of obtaining a tissue sample from the liver, can provide information on whether there is presence of abnormal cells in the liver, such as cancer cells, or whether there may be some ongoing disease processes at play.
“Although our diagnostic techniques continue to improve, in most instances imaging and biochemical testing cannot replace a liver biopsy. This is by far the best examination for a definitive determination of the nature and extent of hepatic damage and to appropriately direct the course of treatment.”~Dr. David Twedt, board-certified veterinarian
Dog Liver Biopsy Techniques
There are several techniques used to obtain a liver sample in dogs. Examples include fine needle aspiration, ultrasound-guided biopsy, laparoscopy and laparotomy.
Fine-needle aspiration (percutaneous) may be the method of choice for dogs who are not in stable conditions or for dogs who are affected by some type of severe bleeding disorder. This procedure simply requires inserting a thin needle through the abdomen and into the liver. Sedation is typically not needed for this. The sample is then looked at under a microscope (cytology). While less invasive, a fine needle aspirate offers the disadvantage of not providing accurate results as a wedge biopsy may.
Ultrasound-guided biopsy is also prone to variables in the quality of samples obtained. The issue is that the sample obtained by a biopsy needle is small compared to that obtained by a wedge-biopsy. However, this type of biopsy method offers the advantage of identifying the exact location of any troublesome areas via ultrasound prior to obtaining the biopsy.
Laparascopy has it place when it comes to dog liver biopsy procedures. The advantage of using laparoscopy (a minimally invasive technique, often referred to as “keyhole surgery”) is less pain after surgery and a faster recovery time compared to traditional open surgical techniques.
In this procedure, tube-like instruments collect the biopsy sample through small incisions (ports) in the abdomen. Since small instruments are used, there is no need for the vet to make an incision that is large enough to insert his hands to get a sample. Usually, the procedure lasts anywhere between 15 minutes to half hour and the small incisions will need only two to three sutures. Laparoscopic liver biopsy offers a better visual of the location, but still the volume of the sample collected is inferior to the samples collected through surgical wedge biopsy.
Traditional abdominal surgery, known as laparotomy or celiotomy, offers the best option for a definitive diagnosis. It’s indeed, considered the gold standard method. In this procedure, a wedge-shaped sample of tissue from the liver is obtained. However, it’s also the most invasive method.
What Happens at the Vet
- DVM360: Surgery STAT: The finer points of laparoscopic liver biopsies
- DVM360: How to perform a surgical hepatic biopsy
- Tufts University: Minimally Invasive Surgery Reaches the Veterinary Operating Room