Open Renal Biopsy in Dogs

Open renal biopsy is a surgical procedure used to collect tissue samples from the kidney. Open biopsy is not generally recommended for all dogs that require renal biopsy. This procedure is more invasive than the percutaneous, or non-surgical, approach. Open renal biopsy will be recommended if increased visualization is vital for diagnosing the condition, if no other biopsy techniques can be used, or if hemorrhage is a major concern.

Open renal biopsy is achieved using a procedure known as laparotomy. The approach to biopsy through laparotomy is outlined below.

1. Before surgery begins, a blood sample will be evaluated to make sure it is safe for the dog to be anesthetized.
2. General anesthesia is administered before the skin is cleaned.
3. The surgeon will make the initial incision into the skin and incise the abdominal cavity.
4. Specialized forceps and a scalpel will be used to obtain tissue samples from the renal cortex.
5. The surgeon will take as many tissue samples as needed before suturing the incision site.

Open renal biopsy is considered incredibly effective in retrieving tissue samples. It is considered more effective than closed renal biopsy techniques because it provides direct visualization of the kidney. However, open renal biopsy is more expensive compared to other forms of biopsy because laparoscopic equipment is more expensive for the practice to operate.

Dogs will be allowed to return home the same day of their biopsy. Owners should follow their veterinarian’s recovery instructions carefully. Analgesics will be prescribed to manage postoperative pain. Dogs may need to wear an Elizabethan cone to avoid irritating the surgery site until the sutures are removed. If any swelling, discharge, or bleeding occurs near the surgery site, owners should contact their veterinarian immediately. A follow-up appointment will be scheduled within fourteen days of the procedure so the sutures can be removed. Until the sutures are removed, exercise should be restricted to minimize the risk of wound rupture and infection. Additional appointments will be made to administer treatment for the underlying condition.

The cost of open renal biopsy in dogs may vary depending on standards of living and additional treatment costs. The cost of open renal biopsy typically ranges from $500 to $1,000.

Open renal biopsy is a relatively safe procedure. It provides the surgeon with enhanced visualization and an increased chance of controlling possible hemorrhage. However, since it is a surgical procedure, complications are possible. These include, but may not be limited to:

• Severe hemorrhage
• Trauma
• Hydronephrosis: Occurs when water or urine builds up inside the kidney
• Infection
• Anesthetic death

For most laparoscopic procedures, the risk of complication is generally low, and typically correlates with the experience of the surgeon. Severe hemorrhage is one of the primary complications of renal biopsy, although it occurs in less than 3% of animals undergoing the procedure. Surgeons may be able to control or minimize the risk of hemorrhage using the open surgical approach. Anesthetic death is rare in animals that have been evaluated for anesthetization prior to surgery.

Open renal biopsy should not be performed in dogs that are unstable or have:

• Abnormal blood clotting
• Only one kidney
• Severe high-blood pressure
• Renal masses associated with effusion (fluid accumulation)
• Polycystic kidney disease
• Hydronephrosis
• Severe anemia

It is difficult to prevent most kidney conditions that require biopsy. Owners should make sure their dogs attend routine veterinary checkups so that renal conditions can be diagnosed and treated quickly should they arise.