Biopsy
Liver
Basic Information 
Indications
• To provide diagnostic and prognostic information in horses with liver disease
• To obtain a representative liver sample for bacterial culture
• In horses with clinical and ultrasonographic findings consistent with metastatic neoplasia (focal or multifocal masses), a liver biopsy sample may be more easily obtained than a sample at the primary tumor site and thus may aid in diagnosis and characterization of neoplastic disease if hepatic metastases are present.
Contraindications
• A liver biopsy should be performed with caution in horses with documented coagulopathies; hemorrhage is a potential complication even when clotting function is normal.
• Percutaneous liver biopsy is also discouraged in horses in which the liver cannot be visualized ultrasonographically; the risk of penetration of other structures (right kidney, pancreas, large colon, diaphragm, spleen) is increased in these cases.
Equipment, Anesthesia
• Appropriate sedation and/or a twitch
• Clippers with a No. 40 blade
• Disinfectant scrub material and sterile gauze for sterile preparation of the skin
• 2% lidocaine or another local-acting anesthetic
• One 5 to 10 mL syringe and several 22 or 25 gauge needles
• No. 15 scalpel blade, sterile
• Sterile gauze pads (3 × 3 or 4 × 4 inches)
• A 14 gauge, 15 to 16 cm biopsy instrument, such as one of the following:
• If using ultrasound assistance or guidance:
• Nonabsorbable suture material and needle drivers
• 10% formalin to preserve samples for histopathologic evaluation
• Transport media for aerobic and anaerobic bacterial culture of biopsy samples
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