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What is Biopsy of the Thorax?

The equine thoracic cavity consists of the chest cavity of your horse between the neck and abdomen and contains the heart and lungs. It is enclosed by the ribs, breastbone and dorsal vertebrae. When serious disorder of organs or tissues in the thorax occurs, requiring definitive diagnosis, a biopsy of tissues in this cavity can be performed by your veterinarian. A biopsy is a surgical procedure to obtain tissue samples for analysis to identify the types of cells present. Biopsies may be performed by fine needle aspiration, to collect fluid samples, or by tissue biopsy, which preserves the tissue cell structure and yields better identification results, although it requires a more invasive procedure. 

As the risks associated with biopsying respiratory organs are substantial, and prognosis for disease requiring such a biopsy of thoracic organs and tissues is poor, this procedure is usually performed only when other diagnostic procedures have failed and a diagnosis is required. If required, biopsy of the thorax can be performed by your veterinarian in a standing horse under sedation and local anesthetic. 

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Biopsy of the Thorax Procedure in Horses

Biopsy of the thorax is usually performed using minimally invasive techniques in a standing horse under sedation and with local anesthetic. Your horse will be carefully sedated and the area through which biopsy is to be harvested will be shaved and prepared antiseptically. This area is usually on the thorax wall, a hand’s breadth above the olecranon and just caudal to the heart. Due to the delicacy of the procedure it should be guided by ultrasound or with the use of a specialized surgical camera, pleuroscopy or thoracoscope, inserted to visually aid the biopsy procedure. Small incisions are made for the camera and for the biopsy tool to be inserted. Biopsy may occur by:

  • Thoracoscopy guided pulmonary wedge resection
  • Fine needle aspiration
  • Biopsy instruments such as a true cut, spring loaded biopsy tool
  • Endoscopic biopsy forceps

After the sample is extracted, the area is observed for signs of hemorrhage before closing incisions with sutures. The tissue sample is sent for analysis and identification of cells present.

Efficacy of Biopsy of the Thorax in Horses

Biopsy is the best procedure available for the identification of cells, however in horses affected with severe disease of thoracic tissues, such as the lungs, the procedure may be risky, and options for treatment limited. Biopsy of the thorax is therefore usually done only in situations where a diagnosis is required. If performed standing, under sedation, with minimally invasive techniques such as by thoracoscopy, risks are much less than if performed under general anaesthetic by open surgery.

Biopsy of the Thorax Recovery in Horses

Horses having undergone biopsy of the thorax should be monitored for complications immediately after the procedure and on an ongoing basis. As other complications from disease may be present, extra care should be taken with horses having undergone this procedure. Incision sites should be observed for signs of infection or bleeding. In addition, your horse's breathing should be carefully checked along with other vital signs. If signs of hemorrhage, infection, or respiratory distress occur, veterinary care will be required immediately.

Cost of Biopsy of the Thorax in Horses

The cost of a standing thorax biopsy performed in your horse will vary depending on the procedure used. The use of fine needle aspiration to collect samples versus tissue recovery, or sedation versus general anesthetic, will affect the cost of the procedure, as will your location and mileage charges incurred by your veterinarian. Cost therefore can range from $500 to $2,000 or more if open surgery and general anesthesia are required, although open surgery is used less often to obtain thoracic tissue samples.

Horse Biopsy of the Thorax Considerations

Because prognosis is poor for diseases of the thoracic organs and there are risks associated with the procedure, biopsy of the thorax in horses is only performed when a diagnosis is required and other methods of diagnosis are unavailable or ineffective.

Risks include, pneumothorax, epistaxis, hemorrhage, hemothorax, lung puncture and infection. In addition, biopsy of the thorax is contraindicated where lung infection is present.

Biopsy of the Thorax Prevention in Horses

Severe respiratory and cardiac disorder may not be easily preventable, however intervention in respiratory disorders at an early stage may allow treatment to be more effective. Respiratory disorders such as heaves, if caught at an early stage, can be mitigated with medication and changes to environmental factors. Regular veterinary care, good diet and an anti-parasite program will decrease your horse's chances of developing severe disease of organs and tissues located in the thorax.