Browsing by Author "Kemp, Stephanie D."

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    A Comparison of Liver Biopsy Techniques in Dogs
    Kemp, Stephanie D. (Virginia Tech, 2013-05-15)
    Background: The liver biopsy technique in dogs that consistently provides samples adequate for accurate histopathologic interpretation and the variability of histopathology among lobes is unknown. Hypothesis:  Liver biopsy specimens obtained via punch, cup biopsy, and 14 gauge needle biopsy would result in similar histopathologic diagnoses to those found on deeply sectioned samples of liver obtained at necropsy and that discordant results would not differ between lobes.   Animals:  Seventy dogs undergoing necropsy. Methods: Liver specimens were obtained from the left lateral liver lobe with an 8 mm punch, a cup, and a 14 gauge needle. Two larger tissue samples were then collected near the center of the left lateral lobe and used as a histologic standard for comparison.  Samples were also obtained from all remaining lobes. Histopathologic features and numbers of portal triads in each sample were compared. Results: The mean number of portal triads were 2.9 in needle biopsies, 3.4 in cup biopsies, 12 in punch biopsies, and 30.7 in the necropsy samples. Sixty-six percent of needle biopsies,  60% of laparoscopic cup samples, and 69% of punch samples were in agreement with the necropsy samples, differences that were not significantly different. The corresponding kappa coefficient were 0.59 for needle biopsies, 0.52 for cup biopsies, and 0.62 for punch biopsies.  Discordant results did not differ between the liver lobes. Conclusions and Clinical Relevance:  A single biopsy using any of the tested techniques is insufficient for reliable diagnosis of liver disease in the dog.  Multiple biopsies from 2 lobes is recommended.
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    A Comparison of Liver Sampling Techniques in Dogs
    Kemp, Stephanie D.; Zimmerman, Kurt L.; Panciera, David L.; Monroe, William E.; Leib, Michael S.; Lanz, Otto I. (American College of Veterinary Internal Medicine, 2015-01)
    Background: The liver sampling technique in dogs that consistently provides samples adequate for accurate histopathologic interpretation is not known. Hypothesis/ Objectives: To compare histopathologic results of liver samples obtained by punch, cup, and 14 gauge needle to large wedge samples collected at necropsy. Animals: Seventy dogs undergoing necropsy. Methods: Prospective study. Liver specimens were obtained from the left lateral liver lobe with an 8 mm punch, a 5 mm cup, and a 14 gauge needle. After sample acquisition, two larger tissue samples were collected near the center of the left lateral lobe to be used as a histologic standard for comparison. Histopathologic features and numbers of portal triads in each sample were recorded. Results: The mean number of portal triads obtained by each sampling method were 2.9 in needle samples, 3.4 in cup samples, 12 in punch samples, and 30.7 in the necropsy samples. The diagnoses in 66% of needle samples, 60% of cup samples, and 69% of punch samples were in agreement with the necropsy samples, and these proportions were not significantly different from each other. The corresponding kappa coefficients were 0.59 for needle biopsies, 0.52 for cup biopsies, and 0.62 for punch biopsies. Conclusion and Clinical Importance: The histopathologic interpretation of a liver sample in the dog is unlikely to vary if the liver biopsy specimen contains at least 3- 12 portal triads. However, in comparison large necropsy samples, the accuracy of all tested methods was relatively low.
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    Histopathologic Variation between Liver Lobes in Dogs
    Kemp, Stephanie D.; Zimmerman, Kurt L.; Panciera, David L.; Monroe, William E.; Leib, Michael S. (American College of Veterinary Internal Medicine, 2015-01)
    Background: Biopsy of the liver evaluates a small portion of tissue, with inferences made to the entire organ. The method and number of biopsies obtained are tempered by consideration of the risks and benefits. Recommendations often include biopsy of more than one liver lobe, although the consistency of histopathology among lobes in dogs is unknown. Hypothesis/Objectives: To describe the distribution of histopathologic abnormalities between liver lobes. We hypothesized that discordant results would be evenly distributed among all liver lobes. Animals: Seventy dogs undergoing necropsy. Methods: Prospective study. Liver samples were obtained from all lobes. A primary diagnosis was assigned to each liver sample based on the predominant histopathologic abnormality. Results: In this population of dogs, biopsy of at least 2 liver lobes identified the predominant histologic abnormality in 98.6% of the cases. Ten ( 14%) of the dogs had = 3 lobes in agreement and could not be assigned a predominant diagnosis. The same diagnosis was present in 6/ 6 lobes in 39 ( 56.5%) dogs, 5/ 6 lobes in 10 ( 14.5%) dogs, 4/ 6 lobes in 10 ( 14.5%) dogs, 3/ 6 lobes in 7 ( 10.1%) dogs, and 2/ 6 in 3 ( 4.3%) dogs. The number of discordant results did not differ between the liver lobes. Conclusion and Clinical Importance: The likelihood of obtaining a sample that is reflective of the predominant histologic abnormality in the liver is increased when multiple liver lobes are biopsied.