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What is Intestinal Biopsy?

Intestinal biopsy is a technique used to help diagnose the cause of long-term vomiting or diarrhea. It involves harvesting a small sample of the intestinal wall, which is then preserved, and sent to a laboratory where the cell types are identified. 

Typically full-thickness intestinal biopsies are collected during a laparotomy procedure, in which the dog's abdomen is surgically opened to allow inspection of the internal organs. When intestinal biopsy goes well and heals uneventfully, it gives a definitive diagnosis in many cases. Unfortunately, healing doesn't always go smoothly and complications can occur, the most serious being peritonitis (infection within the abdominal cavity) due to leakage from the biopsy site.

Intestinal Biopsy Procedure in Dogs

The dog is prepped for surgery with intravenous fluids, pain relief, and antibiotics. The patient is given a general anesthetic and their abdomen shaved and scrubbed ready for surgery. 

The surgeon makes a surgical incision through the body wall. They systematically inspect all the organs in the abdomen, and every inch of the gut whilst being alert for abnormalities. The surgeon then selects which parts of the intestine to biopsy that are most likely to yield interesting pathology, for the histologist to analyse. 

A small, full thickness tissue is removed and the hole in the bowel wall repaired with absorbable sutures. The biopsy site is checked for leaks, and then the abdomen closed. 

In the immediate postoperative period, the dog is maintained on intravenous fluids and given pain relief. Once the dog is fully awake and eating unaided, the supportive fluids can be withdrawn. 

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Efficacy of Intestinal Biopsy in Dogs

Intestinal biopsy is an effective way of getting answers about bowel related disease. The method that yields most information is a full-thickness biopsy obtained via surgery. However, at specialist centers a partial thickness biopsy can be obtained via endoscopy. The latter has its uses, but can miss evidence of disease if pathology is located in the deeper layers of the gut wall. 

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Intestinal Biopsy Recovery in Dogs

After surgery, the dog is encouraged to eat within 24 hours. A low fat, easy-to-digest food is ideal. Most patients are able to go home the day after surgery, provided the clinician has no concerns about leakage from the biopsy site and the dog is eating. 

The dog has a follow-up appointment one to two days later, where blood may be taken to check for signs of leakage. If all is well, the dog is maintained on a bland, easy-to-digest diet until the skin sutures are removed at the ten day point. 

During the recovery period, the dog must rest and not partake in any vigorous exercise. They must also leave the abdominal incision alone and not lick at the wound, which may mean wearing a cone. Once the biopsy results are back, the clinician can then prescribe a treatment course to address the underlying problem that meant biopsy was needed. If this involves immunosuppressive drugs then these are not started until after the bowel has fully healed (because they can interfere with healing), at around two weeks out. 

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Cost of Intestinal Biopsy in Dogs

Bowel biopsy is commonly undertaken in first opinion practice. The cost of anesthetic and harvesting the samples is often $800 upwards, with $1,300 being the lower threshold when other procedures are undertaken at the same time, such as removing a foreign body. 

Ironically, obtaining an endoscopic intestinal biopsy, although less invasive, is unlikely to be any cheaper because the equipment itself is costly.

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Dog Intestinal Biopsy Considerations

Intestinal biopsy is often reserved as a procedure undertaken when all other diagnostic avenues have been explored. Whilst the information gained is very useful, there is a risk of complications. Chief of these is wound breakdown in the bowel wall, leading to spillage of gut contents into the abdomen, and peritonitis. 

The risk can be reduced (but not completely eliminated) with good surgical technique, so the owner needs to be aware of the life-threatening consequences should the worst happen. This may then necessitate repeat abdominal surgery to flush out the abdomen and repair the hole in the gut wall. 

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Intestinal Biopsy Prevention in Dogs

Intestinal biopsy is a diagnostic process and one only pursued when other avenues have been explored. Thus before proceeding, the clinician must have a strong argument that bowel biopsy with the associated risks is going to be beneficial to the patient. 

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Intestinal Biopsy Questions and Advice from Veterinary Professionals

Need pet health advice? Ask a vet

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Ask a Vet

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Gunner

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Staffordshire Bull Terrier

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6 Years

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Not Eating, Latargic, Bloated,

our dog stopped eating two weeks ago, on the third day we took him to the vet, his Creatine levels were high they suspected pancreatitis, treated with medication and IV to flush the kidneys, xrays and a ultrasound showed nothing suspicious to inflame the pancreas CREA levels have been as high as 37 and in the normal range, white cells normal, red cells were not too good and there was low absorption of fluids and was given a blood volumizer? (albumen?) to help this, now they want to do a biopsy and I am worried. I should add that he is eating now not as much as usual but eating Gunner's dad

March 15, 2018

Gunner's Owner


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Dr. Michele K. DVM

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1611 Recommendations

Thank you for your email. Pancreatitis is a somewhat common problem, and typically occurs when dogs eat fatty foods. If he is responding to therapy, I'm not sure that a biopsy would be necessary. Signs of improvement include his appetite improving, no vomiting or diarrhea, and an improved CPL test. Without knowing the details of his situation, I can't comment on the right way to handle it, but those things might be worth discussing with your veterinarian before having an invasive procedure like a biopsy done. I hope that he is okay.

March 15, 2018

I should add that Gunner has not vomited food only a couple of times and it was bile (small amount)and no diarrhea,his feces are soft and mostly formed. Gunners dad

March 15, 2018

Gunner's Owner

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Kookoo

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English Bulldog

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7 Years

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Moderate severity

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0 found helpful

pill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filledpill-rating-filled

Moderate severity

Has Symptoms

Diarrhea

Dog with chronic diarrhea for 2 months. It completely goes away while on medicine but comes back once off. Was on metro, Tylan and now prednisone and once she get off the meds it is back. Vet recommends biopsy but I read a lot about EPI yet the vet won’t test for it. Advice?

Jan. 18, 2018

Kookoo's Owner

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3320 Recommendations

There are various causes for chronic diarrhoea in dogs and you should speak with your Veterinarian about why they don’t want to test for exocrine pancreatic insufficiency and they can take you through the symptoms; exocrine pancreatic insufficiency can be checked by the addition of digestive enzymes into the diet or fresh pancreas which should make improvements in the faeces. But, you should discuss with your Veterinarian and also have faecal tests done for bacteria and parasites to see if this is the cause. Regards Dr Callum Turner DVM

Jan. 18, 2018

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Ride

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Golden Retriever

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2 Years

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Moderate severity

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0 found helpful

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Moderate severity

Has Symptoms

Diarrhea

I have a 2 1/2 yr old Golden with chronic diarrhea for 3 months. Been on hydrolyzed diet. Meds were metro, then Baytril. Fairly consistent poops twice a day fluctuating from slightly formed to cow patty type. Just finished last round of meds and his poops turned to liquid several times a night. Had ultrasound, ACTH test - all negative. Biopsy is being recommended as the next step but is there anything else I could try first? He is a very healthy boy and I hate to put him through that with diarrhea being the only symptom.

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Petal

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Pomeranian

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9 Years

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Serious severity

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0 found helpful

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Serious severity

Has Symptoms

Swollen Abdomen
Weight Loss
Excessive Panting
Vomiting, Lethargy

I have a 9 year old Pomeranian who began to throw up everything she ate. Thinking she was just sick, I let it go on until it was obviously serious. She was licking her lips, I could hear her stomach making loud noises and she was unable to lie down comfortably. After many vet visits and test, everyone thought she had serious, chronic Pancreatitis. So I fed her a low fat diet. It didn't seem to help much and after her 3rd time being hospitalized for 4 days, we did an ultrasound. Her pancreas was fine. What it showed was a thickening of the small intestinal wall. Could be GI lymphoma. Could be IBD. Now we try a hypoallergenic diet and see if that helps. Then comes the biopsy. I'm destroyed.