What is a kidney biopsy?
A kidney biopsy is the process of taking a small piece of kidney tissue to look at under the microscope. This microscopic evaluation is performed by a veterinary pathologist. It allows for special stains to be applied to the tissue, which can help identify disease. For example, when Congo Red Stain is applied to the kidney, it stains a peach color when amyloid fibrils are present. The kidney biopsy works best when both kidneys are diffusely affected by disease (in other words – the whole kidney is affected). Otherwise, you may get a sample that doesn’t accurately represent the kidney’s health. Generally, amyloidosis affects both kidneys in this manner.
How is a kidney biopsy performed?
Kidney tissue can be evaluated while a dog is alive in order to obtain a specific diagnosis to guide therapy. This can be done surgically, laparoscopically, or ultrasound guided. The kidney tissue can also be evaluated post-mortem as part of a necropsy (animal autopsy). While the diagnosis will obviously not change the outcome for the deceased animal, it is helpful to obtain information for the breed and especially that dog’s close relatives who may be at an increased risk of kidney disease if a hereditary condition is found.
What are the benefits of kidney biopsy?
A kidney biopsy is the only way to evaluate the kidneys on a cellular level. It is generally the only way to reach a definitive diagnosis. This can provide information on the prognosis, treatment, and familial implications of disease.
What are the risks of kidney biopsy?
When performed by an experienced veterinarian, the risks of kidney biopsy are generally low. There is risk of bleeding from the biopsy site, obtaining a non-diagnostic or non-representative sample, and causing worsening of kidney disease. There is the standard risk associated with general anesthesia. It is important to discuss the risks/benefits of kidney biopsy with your veterinarian.
What is the associated cost?
Depending on the laboratory performing the testing and what tests are being run, the cost can vary significantly. In some labs, a single stain for Congo Red to screen for amyloidosis is less than $50. I generally recommend full evaluation of kidney tissue (which is can be $300-700, depending on the level of diagnostics needed, recommended lab is the International Veterinary Renal Pathology Service). There is also the cost to obtain the kidney tissue, which will be at the discretion of your veterinarian. Post-mortem evaluation generally costs less than pre-mortem evaluation (due to the costs associated with anesthesia, monitoring, imaging, and tissue collection).
Who can perform a kidney biopsy?
Post mortem kidney tissue can be collected by your local veterinarian and sent for evaluation. Ultrasound guided, surgical, or laparoscopic kidney biopsy often requires treatment with a veterinary specialist. The biopsy itself may be performed by an Internal Medicine, Surgery, or Radiology Specialist, among others – depending on the hospital protocols and what method is used for biopsy.
Who can evaluate a kidney biopsy?
The microscopic evaluation is performed by a board certified veterinary pathologist. I generally recommend the International Veterinary Renal Pathology Service. They provide excellent comprehensive and detailed reports with photos, and they are familiar with evaluating Bracco tissue for amyloidosis.
How do I plan for a post-mortem kidney evaluation?
Having a post-mortem kidney tissue evaluation can be a heart-wrenching and complicated process if not planned for. I recommend discussing your wishes with your veterinarian in advance. This allows them to have the materials needed to perform kidney tissue collection in a timely manner post-mortem. When faced with the loss of a beloved companion, the last thing we want to think about are the logistics and costs associated with kidney tissue evaluation. Planning ahead of time when your dog is diagnosed with kidney disease can help to streamline the process. Sometimes, our dogs get sick very rapidly and we cannot plan ahead. This is when I hope this website is helpful, to be a single source for resources and information. Your veterinarian will help you understand your options for post-mortem evaluation and guide you through the process.
More information on kidney biopsy is available on the Resources page.