Question from Anita Bates
Can any vet perform a liver biopsy or should Spud Theduff dog be seen by an expert?
Answer from Shanika Winters MRCVS, Online Vet
Hi Anita and thank you for your question regarding liver biopsy. I am assuming that your dog has already undergone some tests e.g. blood tests, x-rays and or exploratory surgery which have pointed in the direction of liver disease.
So what is a liver biopsy?
A biopsy is when a small sample of a body tissue is taken to be analysed. The liver is a large organ that is found in your pets abdomen (belly) just behind the chest. The liver has many functions which include processing and filtering all the nutrients absorbed from the gut after digestion, production of bile which helps with fat digestion, production of vitamins and storage of iron.
Why would your vet advise a liver biopsy?
A liver biopsy is advised to determine the exact type of disease that might be going on in your dog’s liver. As mentioned earlier liver biopsy is usually discussed after the findings of blood tests, x-rays or ultrasound scan which suggest liver disease. Diseases of the liver include infections, tumours, inflammation and storage disease to mention a few.
How is a liver biopsy performed?
There are two main ways of collecting a liver biopsy either by opening up the dog’s abdomen and cutting a small sample directly from the liver, or, using a special biopsy needle that is inserted through the skin under the direction of an ultrasound scan.
The more invasive method of opening up your pets abdomen does have the advantage of enabling your vet to examine the whole of your pets liver and the rest of the abdominal organs however there is a greater risk of infection and a longer recovery time.
The needle method for collecting a liver biopsy is quicker to perform and recover from but does not allow the entire liver to be seen and requires specialist equipment and more experience.
What are the complications of liver biopsy?
The commonest complications after liver biopsy are haemorrhage (bleeding), infection and or pain.
We minimise the chances of your pet bleeding after liver biopsy by performing blood clotting tests before we carry out the biopsy, blood clotting tests are done on a small sample of blood collected from your pet and give us an idea of whether or not your pet has enough blood clotting factors in its body and is able to stop it self bleeding. It is important to keep in mind that the liver is responsible for making blood clotting factors and so in liver disease blood clotting can be affected.
To reduce the risk of infection good clean surgical preparation and technique plus or minus the use of antibiotics can be helpful.
Pain can be reduced again by good technique and the correct use of pain relief medications.
What actually happens to the sample from my pets liver?
The sample of liver tissue is usually preserved in a solution of formalin and saline, this fixes the tissues and makes it easier for further analysis to be performed. The sample is then usually sent to a laboratory where it is prepared into very thin sections that are stained and exmained under a microscope, a report is then written and sent to your vet. The time taken for analysis of the sample can be anything from one day to one week depending on the laboratory used and how close it is to your vets.
So in conclusion it is often the case that a liver biopsy may be performed by your regular first opinion vet, if your vet thinks it necessary they may advise the procedure to be performed by a specialist vet at a veterinary referral centre. This decision should be made after careful discussion between you and your vet, taking into consideration the individual circumstances for you and your pet. I hope that this has answered your question and helped you to make an informed decision for your dog.
Shanika Winters MRCVS (online vet)