High complication rate of an automatic Tru-Cut biopsy gun device for liver biopsy in cats

Liver biopsies taken with an automatic Tru-Cut biopsy gun device caused unexpected fatal shock reactions in cats. The goal of the present study was to determine if this biopsy device caused more frequent fatal complications than did a semiautomatic device.

All cats referred to the Utrecht University, between October 1, 2002, and October 31, 2004, in which ultrasound-guided Tru-Cut liver biopsies were taken. The indications for liver biopsy were increased liver enzyme activity, increased bile acid concentrations, ultrasonographic abnormalities of the liver, ultrasonographic abnormalities of the bile ducts, or some combination of these findings. Coagulation parameters were normal.

From October 1, 2002, until October 31, 2003, 26 cats were biopsied with an automatic biopsy device. Between November 1, 2003, and October 31, 2004, 19 cats underwent liver biopsy with a semiautomatic biopsy device.

In the first period. 5 of the 26 cats (19%) developed severe shock within 15 minutes. Resuscitation was not successful. In the second period, none of the 19 cats experienced any major adverse effect. There were no significant differences between the 2 groups with respect to diagnosis, clinical signs, clinicopathologic findings, or the use of anesthetics.

We conclude that the difference in complication rate is explained by the biopsy technique used. The pressure wave, which occurs when firing the automatic device, may have caused intense vagotonia and shock. Use of this automatic biopsy device should be avoided in cats because of the high risk of fatal complications.