Liver biopsy is indicated when clinical signs, biochemical markers, and/or diagnostic imaging suggest hepatic disease. Biopsy allows definitive diagnosis of neoplastic, infectious, inflammatory, vascular, and mineral storage disease processes. With careful attention to patient evaluation and preparation, it can be performed safely in most animals. Complete blood count, serum chemistry panel, coagulation panel, urinalysis, and abdominal ultrasonography are often performed before biopsy.
In addition to general systemic health, coagulation ability should be evaluated. Although many animals with liver disease may have primary and/or secondary hemostatic abnormalities, liver biopsy can usually be performed safely, provided the clinician uses sound judgment and methodology.
Patients with significant coagulation abnormalities may benefit from plasma administration immediately before or the night before the surgical procedure. Dogs with von Willebrand factor deficiency should be pretreated with cryoprecipitate, plasma, or arginine vasopressin. Vitamin K can also be administered before the procedure. Medical textbooks may provide specific recommendations.