Liver biopsy is a procedure we perform when we suspect a horse may have a problem with their liver. It is very rare to suspect liver disease simply based on clinical signs, the vast majority of liver disease cases we see are diagnosed following blood tests (see section on blood testing).
Although blood tests will identify that a horse may have a problem with their liver, unfortunately they are unable to give us much more information than that. As you can imagine, if we want to identify what the problem is and how bad it is, the best thing to do is to examine a piece of liver!
The way this is done is by taking a tiny piece (approx. 3mm x 15mm) under ultrasound guidance from the right side of the liver. We do occasionally take some from the left side but more commonly from the right side.
The procedure is performed under standing sedation and as an outpatient, so we will normally perform it at your yard, unless there are limitations with electricity etc.
After a sedative has been given the right side of the abdomen is clipped and ultrasound used to identify the liver and examine it for any obvious abnormalities- size/ shape/ masses etc. Once a suitable site has been identified, local anaesthetic is injected and a tiny incision made in the skin. A biopsy needle is then advanced through the skin and muscle into the liver and a tiny piece of liver collected. We normally collect about 4 pieces in order for the laboratory to assess fully for the cause of the problem and identify how severe the changes are and hence what the prognosis will be.
Antibiotics and pain relief are given at the time, however the procedure presents a minimally invasive technique, allowing us to identify much more information regarding the cause and severity of the problem.
After the procedure we will often place a skin staple at the site of the biopsy which is removed after approximately 10 days. We normally recommend box rest for approximately 12 hours after the procedure, however after this the horse may resume normal activity.