Before a biopsy is taken, an ultrasound or x-ray will be needed to locate the inflamed area and any growths in the stomach or intestines. Blood work will be used prior to the biopsy harvest to help determine if the dog is healthy enough to receive general anesthesia. The dog will be required to fast for some time prior to the procedure, to limit complications with the anesthesia and to leave the stomach and intestines as empty as possible. If an incisional biopsy is being performed, the area of entrance on the abdomen will be shaved and disinfected. An IV will be placed to administer the sedative.
For a full-thickness biopsy, an incision must be made in the dog's abdomen. Once the affected area of the stomach or intestines has been located, it will be secured using stay sutures. The tissue or growths can then be removed using scissors, a scalpel, or a Keyes biopsy punch. This tissue will be placed in an airtight container and sent to a laboratory for histopathological examination. The stay sutures can then be removed and the incision closed and sewn shut using regular sutures.
If the biopsies are being taken endoscopically, the endoscopic tube will be inserted through the mouth and down the esophagus for stomach biopsies, and through the rectum and up the bowels for intestinal biopsies. Surface tissue may then be clipped off and removed from the body for evaluation. Percutaneous biopsies may be taken using a long needle inserted through the skin into the affected stomach or intestinal tissue. Ultrasonic imaging is used to guide the needle to the correct location.