Is a feline liver biopsy for lesions necessary if my cat isn’t showing symptoms?

Original Question: I took Snickers for an annual physical and they discovered a growth on his abdomen. After blood tests which showed one liver enzyme slightly elevated and an ultrasound which showed more than one growth in the liver, they are suggesting a biopsy (with camera attachment) to see if the lesion(s) are cancerous and if they can safely be removed. This will be an additional $1,300 on top of the $600 already paid. Does this seem like a reasonable cost? It seems like a logical next step. He is showing no symptoms - no change in appetite, bowel or urine. We lost our other cat earlier this year. - Eleanor

Jun 18, 2018

Hi Eleanor,

Thanks for your question. I’m sorry to hear that you’re going through this.

I find this question intriguing. My initial response is to go ahead and investigate the lesions on the liver. Any lesion in the body should be investigated and I support the recommendation that your veterinarian has offered. I’ll tell you quite frankly that I am truly surprised at the price that they are presenting. It is much lower than I would have expected. Furthermore, the money you’ve already spent is also lower than I would have expected. An abdominal ultrasound alone is typically in excess of $600. This seems like a very reasonably priced clinic.

There is one thing that comes to mind that I believe is either missing in your question or it hasn’t been brought up yet. I’m curious what the growth is on the abdomen. I would assume they have sampled and determined the name of it. This is a significant piece of information missing from your question. If the growth is benign, like a lipoma, it would be near impossible for it to have spread to the liver. If it were something more serious that typically does spread to another area of the body, then the value and urgency of investigating a liver lesion becomes much more important. I assume the ultrasound was performed to evaluate whether there was spread of the primary mass on the abdomen, but regardless of what the growth on the abdomen is, they have now found something in the liver and I agree it should be explored even if it is unlikely to be linked to the growth on the abdomen.

You mention as well that your cat is not having any symptoms of illness. This is not a reason to not go through with the feline liver biopsy and examination. There are many cancers that won’t cause symptoms until they are extremely advanced, especially when it involves the liver. You can have normal function with 20% of your liver so it is great at masking a disease that is actually impairing even half of your liver.

The rational reason to not perform the recommended procedure is the risk it holds. If they sample the liver there could be bleeding and if it’s performed laparoscopically (as you say ‘with cameras’), then the ability to surgically repair any bleeding is a little more limited than if you did a standard abdominal surgery. I would recommend you have a blood-clotting panel performed prior to the procedure. This is a test to determine if there are any deficiencies in your cat’s ability to clot its blood and stop bleeding when it occurs. Sampling the liver does carry a risk of bleeding so the value of determining the diagnosis needs to outweigh the risk and I believe it does in this case, especially if the growth on the abdomen is something that could spread to the liver. If it is a growth that is benign and rarely spreads, you could decide to avoid sampling the liver and just repeat the ultrasound in 2-3 months and see if the liver lesions have changed at all. I would discuss this option with your veterinarian and the answer would all be based on the type of lesion present on the abdomen and its potential to spread to the liver.