What is Intestinal Biopsy?
There are many different reasons for a cat to undergo an intestinal biopsy, in which intestinal tissue will be collected for examination and testing. Often a biopsy will be recommended if a cat has experienced an extended period of diarrhea or vomiting. An ultrasound will generally be requested first, and may reveal masses in the intestines. There are multiple ways of collecting an intestinal biopsy, some being more invasive than others.
Endoscopic examinations and percutaneous biopsies may be performed without surgery but may result in less accurate diagnoses. Laparotomic or laparoscopic biopsies to remove full-thickness cuts result in the best diagnoses but require an ACVS board-certified veterinary surgeon to complete the procedure. These biopsies are needed prior to many different abdominal surgeries and treatments.
Intestinal Biopsy Procedure in Cats
Blood work will be run to determine if the cat will be able to handle general anesthesia for a surgical biopsy, or if a less invasive method of diagnosis is needed. Ultrasounds may be used to locate masses or lesions from which the biopsies will be taken. At this point the veterinarian will determine which type of biopsy procedure will best suit the patient. A percutaneous biopsy may be taken using an automated biopsy needle. For this method to be effective, the intestinal wall being sampled must be at least 2 cm thick.
If the cat is stable enough for it, a coliotomy to collect a full-thickness biopsy cut will be performed. This biopsy requires general anesthesia to be completed. An abdominal incision will need to be made, and then a further incision into the lumen of the intestines. Tissue will be removed from the intestines using a scalpel, scissors, or a Keyes biopsy punch and placed in a sealed container to be sent to a pathologist. Multiple samples are often taken. The intestinal opening will then be closed with sutures, followed by the abdominal opening.
Efficacy of Intestinal Biopsy in Cats
Depending on the method used, varying success rates are seen. If they can be safely obtained, full-thickness biopsies result in the highest percentage of accurate diagnoses. While this method is the most invasive, it is performed routinely and is relatively safe. It also limits the need for further testing and helps determine the best course for treatment.
Endoscopy, while not invasive at all, fails to provide any information on tissue below the mucosa, missing many cancers and other lesions that dwell within the intestinal wall. Percutaneous biopsies collected in this way may provide enough tissue for a diagnosis, but only carry an accuracy rate of 69%.
Intestinal Biopsy Recovery in Cats
After the biopsy has been taken, the cat will need to be monitored to ensure no adverse reactions occur while coming off of the anesthetic. Pain relief will be administered at this time, along with intravenous fluids and electrolytes. Regular eating and drinking will be resumed slowly over several days. The cat may need to be coaxed to eat with aromatic, warmed foods. Prophylactic antibiotics will be given to the cat, along with sucralfate to ease internal irritation. This may continue for a few days. A follow-up appointment will be needed one to two weeks after the procedure to assess how the cat is healing and to discuss test results if they have returned from the lab. Once a diagnosis has been made, a treatment regime may be started.
Cost of Intestinal Biopsy in Cats
Having an intestinal biopsy taken from your cat can greatly range in cost depending on the type of biopsy and the medications needed for recovery. The procedure can cost as low as $500 for needle aspirations or up to $5,000 if exploratory surgery is required to locate all masses to sample. Endoscopy is a less costly option, but offers much less information on the actual condition of the cat, and may result in further testing being needed.
Cat Intestinal Biopsy Considerations
Complications from intestinal biopsies are rare, and are most often associated with problems involving general anesthesia. Having a surgical wound rupture or leak into the abdomen can happen and is life-threatening, however it occurs in less than 2% of all procedures. There is also a risk of septic peritonitis, but this too is low. If the cat is in good overall condition, obtaining an intestinal biopsy is generally a safe and effective procedure. Non-invasive options may be chosen for cost reasons or if the animal is not well enough for surgery, but generally are less accurate.
Intestinal Biopsy Prevention in Cats
To prevent the health problems that result in a cat needing an intestinal biopsy, certain measures may be taken throughout the cat's life. Inflammatory bowel disease can be managed with a species-appropriate customized diet. Hypoallergenic diets have been found to be effective also.
To prevent your cat from contracting a feline virus, keep it indoors and do not allow it to interact with infected cats. There are some vaccines that have been shown to reduce the chance of infection. When bringing a new cat home, it is always best to quarantine the animal until it has been fully checked by a vet. Keep all litter boxes and food dishes clean. Cancer of the intestines is rare in cats, and may be prevented by the avoidance of toxins and carcinogens. Many cancers are genetic and may not be prevented.
Intestinal Biopsy Questions and Advice from Veterinary Professionals
Hi, I have a 4,5 month old kitten that has, according to ultrasound and blood sample, an inflammation in his small intestine and also in his pancreas. His ESR was high on the day when they did the ultrasound and took the blood sample, but two days later without any treatment it had gone down to a much better level, (perhaps even normal but I'm not sure). Next step is to do a new ultrasound and new blood test later this week, and the vet said that I should make up my mind if I want them to do a biopsy if it still doesn't look good, or start cortisone treatment.
The thing is, that my kitten is showing no symptoms what so ever. He is active, has good appetite, is drinking, and his poop is "healthy" looking.
Is it really necessary to do a biopsy if he's doing well? Is it more or less risky to do this procedure when it's just a kitten?
The reason for us going to the vet in the first place was because he had an eye problem.
Hope you understand me even if I'm not very good at medical terms in English :)
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My cat will be 11 in April and has just been dx'ed with likely IBD, possible pancreatitis and/or small cell lymphoma. Nothing striking showed up in the ultrasound, and we did a GI panel as well. The next step would be endoscopy, but I'm thinking it might be prudent to go for the biopsy now, rather than wait more time, as she is feeling pretty good, and likely strong enough for a surgery of this nature. Is it worth it, treatment wise? If she has cancer, I imagine I'd want to start treatment for that sooner rather than later? Does it let them have a better quality of life?
Just trying to weight my options here.
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My 7 year old orange tabby dropped from 9.7 lbs to 9.04 lbs.
I took him to the vet, had an abdominal x-ray done. Results dictated an ultrasound be done. I had the ultrasound done yesterday. Results indicated "mild diffuse small intestinal small intestinal luminal dilation, prominent rugae and mild mesenteric lymphandenopathy - highly suggestive of underlying inflammation with lesser consideration to infection or early infiltration. Suspect mild chronic pancreatitis."
I am leaning towards having the surgical biopsy done but want to know if this procedure is routinely done by a general practitioner or should I only allow a board surgeon perform the procedure?
Also, my vet only plans to sample the intestine and lymph node but not the pancreas. I am confused and don't know what to do. I want to do what is best for my cat. Thank you.
Danny, are you happy you did it? Did it provide necessary answers which you were able to plan for, treatment-wise?
Thank you for your comments. I decided to have a surgeon perform the biopsy which was done today. I pick him up tomorrow; hoping for a fast recovery. Thanks again.
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