For most of us, the amputation process is a trial-by-fire experience that leaves our heads spinning. If cancer is suspected, it's critical for us to advocate for our dog's treatments, even if our vets seem to be on the ball.

One of the ways we can ensure that all treatment options are presented to us is by ensuring that a biopsy is performed on our dog's affected limb, before and/or after amputation.

Recently we were saddened to hear that a member's vet did not send the dog's amputated limb to a pathology lab for a post-op biopsy. This wasn't the pawrent's fault, they trusted their vet to follow standard cancer diagnosis protocols. Sadly, the vet didn't.

Being angry about this error doesn't serve a purpose, but we thought we could turn a regrettable situation into an educational one, by reviewing the importance of this procedure for new members who haven't gone through surgery.

Why Are Biopsies Useful?

In "The Dog Cancer Survival Guide," (one of the best dog cancer resources available) Dr. Susan Ettinger DVM, Dip. ACVIM (oncology) says:

“Biopsy reports are extremely useful because they give the diagnosis and a detailed description of the cancer cells. They will also often report the tumor type, grade and sometimes a margin evaluation (which tells you if the entire tumor was likely removed). The lab may also include comments about the cancer's likely prognosis, but these comments, unfortunately, could be viewed as facts. Keep in mind that the biopsy report is only one part of the story, and your dog's prognosis is not based solely on this one item.

For a more complete and reliable prognosis for your dog, it's best to have a discussion with an oncologist who has examined him, reviewed his medical history and stated his cancer for spread. Putting that information together with the biopsy report creates a more complete picture.”

Biopsy Types

Biopsies can be performed before or after amputation. Before amputation, a fine needle aspirate can detect up to 94 percent of bone cancers. When a diagnosis can't be confirmed with this painless, in-office procedure, an open incisional biopsy may be suggested.

An open incisional biopsy is a general anesthesia procedure that takes several large bone samples from the affected area. It is a painful procedure and one that usually isn't done unless an exact diagnosis isn't achieved from a fine needle aspirate. It's roughly $300 and complications can range from infection to a pathological fracture of the bone.

Why Biopsy?

Bone biopsies are not necessary before amputation if you are certain that you will amputate. While bone biopsies will help determine what kind of cancer your dog has, and what kind of treatment is best if you are considering chemotherapy, bone biopsies are not necessary if you know you will not pursue chemotherapy.

If you are leaning toward amputation and your dog's diagnosis is up in the air, spare your dog the agony of this expensive bone biopsy procedure and ask your vet to conduct the bone biopsy after the leg is removed.

Recommended Reading

The Dog Cancer Survival Guide by Dr. Demian Dressler, DVM and Dr. Susan Ettinger, DVM, Dip. ACVIM (Oncology)
Three Legs & a Spare, a Canine Amputation Handbook from Tripawds
Tripawds Discussion Forum: Soft Tissue Sarcoma: Final Diagnosis?