Biopsy

Question 1

What is the first step before undertaking biopsy?

Answer 1

Complete coagulation profile and measure von Willebrand factor in predisposed breeds (does not affect normal coags)

Question 2

If coagulation profile is unavailable what is the next best option?

Answer 2

Platelet examination and clotting time in a glass tube

Question 3

What results indicate a high likelihood of bleeding?

Answer 3

Prolonged OSPT 🐕
Or APTT 🐈

And less than 80,000 platelets

Question 4

When should a biopsy be delayed?

Answer 4

Clinical evidence of bleeding

Or

Markedly abnormal coagulation results

Question 5

What can be done to improve clotting?

Answer 5

Vitamin K injections for 2 days pre-op (for EBDO)

Fresh frozen plasma transfusion

Question 6

When is FNA used?

Answer 6

It has a poor correlation except for hepatic lipidosis in cats 🐈
lymphoma in dogs 🐕
14g needle recommended

Question 7

What samples should be taken at biopsy?

Answer 7

“normal” and “abnormal” liver

Aspirate gall bladder
Biopsy pancreas

Place feeding tube

Question 8

What should be done if a large volume effusion is present?

Answer 8

Disperse with diuretics first to avoid marked decrease in blood albumin