equis - Articles
Kidney: biopsy
Synonym(s): Renal biopsy
Introduction
- Renal disease Kidney: disease - overview is uncommon in horses compared to other species.
- Functional reserve of kidneys implies that bilateral severe disease must occur before outward signs of organ failure Kidney: renal failure occur (>70% nephron loss).
- Ultrasound examination Ultrasonography: abdomen and guidance are obligate pre-requisites for renal biopsy.
Uses
- Renal biopsy best indicated for histologic diagnosis of renal masses or investigation of azotemia or massive proteinuria with diffuse bilateral disease.
- Biopsy can help target medical and surgical therapy of renal disease, eg steroidal anti-inflammatory drugs for glomerulonephritis, or nephrectomy for unilateral neoplasia Kidney: renal carcinoma or hydronephrosis.
Advantages
- Can provide histologic diagnosis for targeted therapy.
- Can be performed standing under sedation Anesthesia: standing chemical restraint .
Disadvantages
- Invasive procedure, which carries risk of renal hemorrhage or inadvertent gut penetration, hence the need for ultrasound guidance.
- Assumes diffuse disease, although this is often the case for bilateral disease. For focal lesion(s), risk of false-negative result.
- Biopsy of left kidney more challenging than right due to anatomy - right kidney is adjacent to body wall, left kidney frequently only accessible through spleen.
- Advisable to check clotting function prior to procedure (PT and PTT) Blood: hemostasis .
- Ensure recent tetanus prophylaxis Tetanus antitoxin .
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Tyner G A et al (2009) Renal biopsies in horse; a retrospective study of 71 cases. J Vet Intern Med 23 (3), 703.
- Barratt-Boyes S M et al (1991) Ultrasound localization and guidance for renal biopsy in the horse. Vet Radiol 32 (3), 121-126 VetMedResource.