Ask a vet online – ‘Can any vet perform a liver biopsy or should my dog be seen by an expert?’

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)

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8 thoughts on “Ask a vet online – ‘Can any vet perform a liver biopsy or should my dog be seen by an expert?’

  1. Thanks Shanika, appreciate this full informative answer. Spud is having a true cut biopsy on Tuesday. He was on NSAIDs for many years (he is only 7!) and routine bloods showed elevated liver enzymes. Next, post prandial bloods taken and also elevated. coagulation tests normal, nothing obvious on ultrasound. Taken off NSaids, put on Tramadol instead, 3 mths on – rpt blds all higher levels than last time, so next step biopsy . He is booked in for a true cut biopsy on wed. I think that is the least invasive and ultrasound guided. More coagulation tests done, TTT raised (don’t know what that is). He will be kept in over night for more blood monitoring before and after. He is at a hospital and under a Cert SAM vet who has performed these previously. I think this is reassuring albeit not a referral vet who does them daily.

  2. Thanks Shanika, appreciate this full informative answer. Spud is having a true cut biopsy on Tuesday. He was on NSAIDs for many years (he is only 7!) and routine bloods showed elevated liver enzymes. Next, post prandial bloods taken and also elevated. coagulation tests normal, nothing obvious on ultrasound. Taken off NSaids, put on Tramadol instead, 3 mths on – rpt blds all higher levels than last time, so next step biopsy . He is booked in for a true cut biopsy on wed. I think that is the least invasive and ultrasound guided. More coagulation tests done, TTT raised (don’t know what that is). He will be kept in over night for more blood monitoring before and after. He is at a hospital and under a Cert SAM vet who has performed these previously. I think this is reassuring albeit not a referral vet who does them daily.

  3. Hi, hope you can advise me. I just brought our nine year old mixed breed Sadie home from having a liver biopsy. She had this performed because she had high liver enyzmes and our vet wanted to rule out certain causes. She had the type of biopsy where they insert a long needle after they did a ultrasound on her….they said they gave her a pain injection after all this, and we left Sadie there for five hours to rest. She cried pitifully in the car all the way home, seemed very upset and is just now laying down to rest by me. Do you think she is in pain and that’s why she is groaning and whimpering or is she just talking about what she went through? The vet has gone home, and when we picked her up, there was no instructions to take with us . I have some leftover Tramadol 50 mg tablets from November that she took for a bad case of kennel cough. Could she use this to quiet her down? Thank you for any input on this.

    1. Hello Judy, apologies the blog is not manned after hours. We hope that Sadie has settled, however if she is still in distress, we’d strongly suggest you speak to your vet and express your concerns.

  4. Hi, hope you can advise me. I just brought our nine year old mixed breed Sadie home from having a liver biopsy. She had this performed because she had high liver enyzmes and our vet wanted to rule out certain causes. She had the type of biopsy where they insert a long needle after they did a ultrasound on her….they said they gave her a pain injection after all this, and we left Sadie there for five hours to rest. She cried pitifully in the car all the way home, seemed very upset and is just now laying down to rest by me. Do you think she is in pain and that’s why she is groaning and whimpering or is she just talking about what she went through? The vet has gone home, and when we picked her up, there was no instructions to take with us . I have some leftover Tramadol 50 mg tablets from November that she took for a bad case of kennel cough. Could she use this to quiet her down? Thank you for any input on this.

    1. Hello Judy, apologies the blog is not manned after hours. We hope that Sadie has settled, however if she is still in distress, we’d strongly suggest you speak to your vet and express your concerns.

  5. Hi Dave – thank you for you for your reply. I’m happy to report that Sadie is settled down now this morning and seems more like herself. I received a call from the vet’s assistant as she was replying to the voice mail which I had left last night. She said had Sadie been whimpering and groaning there after she woke up, they would have given us a sedative to give her at home. Apparently, some dogs respond to sedation in the way our Sadie was doing and they can get quite vocal about it like she was. Sadie is a real “talker” on good days – I guess from what I was told, she was feeling strange inside and just wanted to let us know….Thank you again for your interest-appreciate it very much. Judith

  6. Hi Dave – thank you for you for your reply. I’m happy to report that Sadie is settled down now this morning and seems more like herself. I received a call from the vet’s assistant as she was replying to the voice mail which I had left last night. She said had Sadie been whimpering and groaning there after she woke up, they would have given us a sedative to give her at home. Apparently, some dogs respond to sedation in the way our Sadie was doing and they can get quite vocal about it like she was. Sadie is a real “talker” on good days – I guess from what I was told, she was feeling strange inside and just wanted to let us know….Thank you again for your interest-appreciate it very much. Judith

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