Ultrasound-guided liver biopsy in birds

In this study, 30 pigeons (Columba livia forma domestica) and 30 quails (Coturnix coturnix) were used to evaluate the diagnostic practicability and relevance of an ultrasound-conducted liver biopsy. Their body weight ranged between 144 and 603g. Considering anatomical peculiarities, the lateral (pigeons) or ventro-median (quails) access was chosen. In the case of the pigeons, 29 (96.7%) biopsies proved clearly to be liver tissue, while in the case of the smaller quails, 19 (63.3%) samples could be clearly identified as liver tissue. All animals but one quail survived the intervention. The blood chemical parameters varied before and after the biopsy within the physiological range. These results show that ultrasound-guided liver biopsy in avian patients is generally possible and with strict indication and conscientious application can be considered as a relatively risk free and diagnostically sensible addition to liver diagnostic in birds. An aimed collection of focal hepatic alterations is conceivable depending on the size of the patient.     

Needle biopsy for hepatic vitamin A levels in lions (Panthera leo)

Hypovitaminosis A (HA)-related skull malformations resulting in neurologic abnormalities and death have been, and still are, reported in captive lions (Panthera leo) worldwide. Liver vitamin A (VA) concentration is the most reliable indicator of animals' VA status, and its assessment is essential in prevention and treatment of HA in lions. A percutaneous needle liver biopsy using high-performance liquid chromatography ultraviolet retinoid analysis for VA concentration measurement was validated. It was first assessed in vitro using chicken liver. Later, the safety and feasibility of ultrasound-guided percutaneous needle liver biopsy was assessed in living lions. Hepatic VA concentrations in lion liver were measured using the above laboratory method. Mean chicken hepatic VA concentration in needle biopsy (NB) and wedge biopsy (WB) of the same liver lobes were 108.66 and 60.89 microg/g wet tissue, respectively, and were significantly (P = 0.03) correlated (r = 0.74). The calculated linear regression for predicting VA concentration in WB using NB VA for chicken liver was 25.194 + 0.3234x NB (microg/g). Four ultrasound-guided percutaneous needle liver biopsies were obtained from each of the four lions under general anesthesia. Mean hepatic VA concentration was 8.25 microg/g wet tissue (range 1.43-25.29 microg/g). Mean serum VA concentration, measured in these four lions was 1,011.1 nmol/L with a standard deviation of 337.91 nmol/L (range 590.26-1,077.2 nmol/L). The lions recovered uneventfully, and no complications were observed during a 4-yr follow-up period. In conclusion, the percutaneous needle liver biopsy technique is a reliable, practical, safe tool for obtaining liver tissue samples antemortem for assessment of the VA status in lions and can be used in future studies.     

High complication rate of an automatic Tru-Cut biopsy gun device for liver biopsy in cats

BACKGROUND: Liver biopsies taken with an automatic Tru-Cut biopsy gun device caused unexpected fatal shock reactions in cats. The goal of the present study was to determine if this biopsy device caused more frequent fatal complications than did a semiautomatic device. ANIMALS: All cats referred to the Utrecht University, between October 1, 2002, and October 31, 2004, in which ultrasound-guided Tru-Cut liver biopsies were taken. The indications for liver biopsy were increased liver enzyme activity, increased bile acid concentrations, ultrasonographic abnormalities of the liver, ultrasonographic abnormalities of the bile ducts, or some combination of these findings. Coagulation parameters were normal. METHODS: From October 1, 2002, until October 31, 2003, 26 cats were biopsied with an automatic biopsy device. Between November 1, 2003, and October 31, 2004, 19 cats underwent liver biopsy with a semiautomatic biopsy device. RESULTS: In the first period. 5 of the 26 cats (19%) developed severe shock within 15 minutes. Resuscitation was not successful. In the second period, none of the 19 cats experienced any major adverse effect. There were no significant differences between the 2 groups with respect to diagnosis, clinical signs, clinicopathologic findings, or the use of anesthetics. CONCLUSIONS AND CLINICAL IMPORTANCE: We conclude that the difference in complication rate is explained by the biopsy technique used. The pressure wave, which occurs when firing the automatic device, may have caused intense vagotonia and shock. Use of this automatic biopsy device should be avoided in cats because of the high risk of fatal complications.     

Effects of percutaneous liver biopsy in alpacas and llamas

OBJECTIVE: To determine changes in results of selected serum biochemical tests after a single percutaneous liver biopsy and changes in results of hematologic and selected serum biochemical tests after multiple percutaneous liver biopsies in alpacas and llamas. ANIMALS: 5 llamas and 10 alpacas. PROCEDURE: A single percutaneous liver biopsy was performed in 5 llamas and 6 alpacas. Blood samples were collected before and 1, 2, and 3 days after liver biopsy, and submitted for serum biochemical analysis. In the other 4 alpacas, liver biopsy was performed on day 0 and then weekly for 4 weeks. Blood samples were collected at the time of each biopsy, and CBC and serum biochemical analyses were performed. Attitude and appetite of all animals were evaluated daily. RESULTS: None of the animals developed clinically apparent adverse effects. A mild decrease in sorbitol dehydrogenase activity was detected in animals that underwent a single liver biopsy, and mild decreases in plasma protein and albumin concentrations were detected in animals that underwent multiple biopsies. Other significant changes were not detected. CONCLUSIONS: Results of this study suggest that liver biopsy is safe in healthy llamas and alpacas and that, if necessary, multiple weekly liver biopsies can be performed safely in healthy alpacas.     

Interpretation of canine liver biopsy. A clinician's perspective

Proper evaluation of hepatic biopsies is essential for the proper management of dogs with liver disease. The clinician must have some basic knowledge of hepatic anatomy and histopathologic nomenclature in order to establish an accurate prognosis and therapeutic plan.     

Remifentanil/isoflurane anesthesia in five dogs with liver disease undergoing liver biopsy

Remifentanil is a synthetic opioid with direct action on μ opioid receptors. It has an ultrashort duration of action, and its elimination is independent of hepatic or renal function. The anesthetic management of five dogs with nonuniform liver disease and requiring liver biopsy via celiotomy is described. Remifentanil and isoflurane were used for induction and maintenance of anesthesia. Intraoperative analgesia was provided by a constant rate infusion of remifentanil. Remifentanil, in combination with isoflurane, was safely and successfully used in five cases for the balanced anesthesia of dogs with hepatic diseases requiring liver biopsy via celiotomy.     

Measurement of the status of trace elements in cattle using liver biopsy samples

Serum, plasma, or urine samples are usually used for the measurement of the trace elements copper; zinc, iron, selenium, because these samples are easy to obtain; however; these samples are not always appropriate. For example, it is not possible to measure molybdenum, the major antagonist of copper; in blood or urine. Therefore measurement of trace elements in liver tissue is considered the gold standard. For the assessment of selenium the method of choice remains determination of glutathion peroxidase in erythrocytes and for the assessment of magnesium determination of magnesium in urine. We determined the accuracy and repeatability of measuring trace elements in liver biopsies and whole liver homogenates. The levels of trace elements measured were similar in both preparations (92% agreement). Liver biopsy in live animals is a relatively simple procedure but not common in The Netherlands. Reference levels of trace elements, classified as too low, low, adequate, high, and too high, were established on the basis of our research and information in the literature. In a second study we investigated the practical aspects of obtaining liver tissue samples and their use. Samples were collected from cattle on a commercial dairy farm. Liver biopsy provided additional information to that obtained from serum and urine samples. We prepared a biopsy protocol and a test package, which we tested on 14 farms where an imbalance of trace minerals was suspected. Biopsy samples taken from 4 to 6 animals revealed extreme levels of trace elements.     

Diagnostic value of tissue biopsy in gastrointestinal and liver disease

Methods are described for the endoscopic examination and biopsy of the gastrointestinal tract and liver of the dog, cat, ox and horse. The results of the examination of 41 biopsy samples are shown, followed by a discussion of the value of biopsy in the diagnosis of diseases of the digestive tract.     

Effects of percutaneous needle liver biopsy on dairy cow behaviour

In cattle, percutaneous needle liver biopsy is used for scientific examination of liver metabolism. The impact of the biopsy procedure is, however, poorly investigated. Our aim was to examine the behaviour of dairy cows during and after liver biopsy. Data were collected from 18 dry cows. Percutaneous needle liver biopsies (after administration of local anaesthesia (2% Procaine)) and blood samples were taken during restraining. During the control treatment, animals were restrained and blood sampled. During the biopsy procedure, cows showed increased restlessness (P=0.008), frequency of head shaking (P=0.016), and decreased rumination (P=0.064). After biopsies, tail pressing (P=0.016) and time spent perching (P=0.058) increased. Time spent upright (P=0.10) and number of leg movements (P=0.033) increased during the night as compared to controls. Thus, liver biopsy induced behavioural changes for up to 19h - and particularly for behaviour previously associated with pain. Even though the exact welfare impact of percutaneous needle liver biopsies in cows is not known, and the magnitude of the behavioural changes was limited, pain always has negative effects on animal welfare. Therefore, if the present biopsy procedure - involving several biopsy passes - is to be used, improvement of the anaesthetic protocol as well as the inclusion of analgesics should be considered.     

Evaluation of an endoscopic liver biopsy technique in green iguanas

OBJECTIVE: To establish a safe and effective endoscopic technique for collection of liver biopsy specimens from lizards by use of a 2.7-mm rigid endoscope system that is commonly available in zoologic veterinary practice. DESIGN: Prospective study. ANIMALS: 11 subadult male green iguanas (Iguana iguana). PROCEDURES: Each lizard was anesthetized, and right-sided coelioscopic examination of the right liver lobe and gallbladder was performed. Three liver biopsy specimens were collected from each lizard by use of a 2.7-mm rigid endoscope and 1.7-mm (5-F) biopsy forceps. Biopsy samples were evaluated histologically for quality and crush artifact. Ten days following surgery, all iguanas were euthanatized and underwent full necropsy examination. RESULTS: For all 11 iguanas, the right liver lobe and gallbladder were successfully examined endoscopically, and 3 biopsy specimens of the liver were collected without complications. Mean +/- SD durations of anesthesia and surgery were 24 +/- 7 minutes and 6.8 +/- 1.0 minutes, respectively. At necropsy, there was no evidence of trauma or disease associated with the skin or muscle entry sites, liver, or any visceral structures in any iguana. All 33 biopsy specimens were considered acceptable for histologic interpretation; in most samples, the extent of crush artifact was considered minimal. CONCLUSIONS AND CLINICAL RELEVANCE: By use of a 2.7-mm rigid endoscope, liver biopsy procedures can be performed safely, swiftly, and easily in green iguanas. Biopsy specimens obtained by this technique are suitable for histologic examination. For evaluation of the liver and biopsy specimen collection in lizards, endoscopy is recommended.     

Hepatic emphysema associated with ultrasound-guided liver biopsy in a dog

An eleven-year-old Chinese Crested Powder Puff dog presented with polydipsia/polyuria, inappetence, diarrhea and vomiting underwent an ultrasound-guided percutaneous liver biopsy. Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema. Radiographs and ultrasound showed focal severe hepatic emphysema in the region of the previous liver biopsy. Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis. Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature. We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.     

Partial lobectomy of bovine liver: a new biopsy technique.

A surgical technique has been developed for partial lobectomy of the bovine liver to obtain greater than 25 gram liver samples. Vertical mattress sutures, backed with plastic tubing, were replaced in the liver near the incision line to provide hemostasis. Hemostasis of the cut surface of the liver was adequate in each case. Postoperative recovery was uneventful and only minor adhesions were found later by laparotomy and at necropsy.