# Some facts about the Skin Punch Biopsy



## peluitohavanese (Nov 8, 2006)

Good afternoon,

I have seen some define the the skin punch biopsy procedure as being "not much worse than getting a microchip".

With all due respect, this could be further from the truth, and those Hav owners (pet or show) who wish to submit their affected and non-affected dogs' samples to this study, should know what to expect. It would not be very nice for a pet owner to go in thinking that this is just like inserting a microchip, only to have their dog come back with multiple 6mm incisions that are sutured with anywhere from 1 to 3 stitches. We all know that no sutures OR local anesthetic (lidocane) are required for microchipping. Personally, I would not be a happy camper if full disclosure is not made about how this procedure is conducted, and we are all about full disclosure of everything health related, right??

So, in this regard, I'd like all of those who are being so generous and offering their puppers to participate in this study to know exactly what to expect- no surprises.

Here us a link to a report with pictures, http://www.rottweilerhealth.org/pdfs..._castle_02.pdf and also attached is an excerpt from a newsletter:

Commonly Asked Questions

About Skin Biopsies

by Kelly M. Credille, D.V.M., D.A.C.V.P.

The skin punch biopsy is a useful tool in the diagnosis of skin

problems when used as part of a thorough workup. It can be

used to aid in the diagnose of autoimmune diseases, hair loss

diseases, infections, and sometimes allergies, as well as other conditions.

Sometimes the biopsy is nondiagnostic too.

1. How much discomfort does a skin biopsy cause and will there be

a scar?

Other than the discomfort your dog feels when given the local

anesthetic, a skin biopsy is a painless procedure. Most biopsies,

including the 6 mm diameter biopsies needed for SA screening, are

taken using a local anesthetic very similar to that used in your

dentist's office. For each biopsy needed, a small amount (at most a

quarter of a teaspoon) of anesthetic will be injected under the skin at

the site to be sampled.

As you probably know from the dentist, the anesthetic can sting

while being injected, but soon afterwards the site is numb for hours.

The needle used to inject the anesthetic is small and causes only a

small pinprick when inserted into the skin. Once the skin is numbed,

your dog should not feel any discomfort for the rest of the procedure.

To take the biopsy, a simple instrument called a biopsy "punch" is

used. The "punch" consists of a hollow, cylindrical blade attached to

a plastic handle. The blade is placed on the skin and with pressure

and a circular wrist motion, it is used like a cookie cutter to remove a

core of skin. The biopsied site will bleed a small amount but this

usually stops after a few minutes.

After the cylindrical plug of skin has been removed, one or two

skin sutures will be placed to close the biopsy site. Again, because of

the local anesthetic, your dog will not feel the suturing. Once the

biopsy site is closed, it should not be painful to your dog. After seven

to 10 days the site should be healed and the sutures will need to be

removed - a process that only takes a few seconds. Because the

biopsy punch is so sharp, the edges of the biopsied site will heal

together quickly and leave only a very small scar that is completely

hidden by the hair coat.

2. Are there any complications of a skin biopsy?

Because a skin biopsy is such a simple procedure, complications

are rare. The most common is bleeding from the site after the dog is

home. If this happens, applying pressure to the site for a few minutes

with gauze from your home first aid kit should stop the bleeding.

Some dogs will remove their own sutures prematurely, and in these

cases the site will have to heal on its own. This will slow the healing

process and may result in a slightly larger scar, but even here, any

scar is very hard to detect after the coat re-grows, even in shortcoated

breeds.

An unusual side effect of skin biopsies that we see occasionally

and your vet may mention, is that hairs may grow back a different

color at the biopsy site. Usually if the coat is light, the new hair will

be darker. In dark or black dogs, the re-growth may be white. Often

the hair color will correct itself but this may take some time.

Because the skin heals so well, skin biopsies do not need to be

taken using the same measures to ensure sterility as more invasive

procedures. This means the site does not need to be scrubbed vigorously

prior to the biopsy, but just gently cleaned with alcohol. Very

rarely, perhaps one in several hundred cases, an infection can develop

at a biopsy site. If an infection occurs, the biopsy site will feel

hard, appear red and may drain. This will slow healing and may

result in a slightly larger scar at the site. If you think this is occurring,

contact your veterinarian, as antibiotics may be needed to clear the

infection.

Finally, veterinarians are always careful about the total amount of

local anesthetic injected. If given in excess, and if enough is absorbed

into the dog's system, the anesthetic can depress the heart

rate and induce seizures. This is virtually never a problem in an adult

dog, but must be kept in mind on the rare occasions when many

biopsies are taken from a small puppy.

3. How much of my dog's show coat will have to be clipped in

order to perform the biopsy?

As we have discussed above, skin biopsies are not sterile procedures

and extensive and close clipping of the hair does not have to

be done. In order to maximize the cleanliness of the biopsy site, it is

optimal to clip long hair out of the way before taking the biopsies

and if your dog is being biopsied as part of a work-up for a skin

disease, we would recommend allowing your vet to clip the coat as

much as they think necessary.

For dogs in show coat, biopsies can be taken with no or minimal

clipping at the biopsy site; however this will slightly increase the risk

of infection, as hair may be brought into the surgical site. We have

found that some veterinarians are willing to take punch biopsies for

SA screening without clipping when the dog is in full show coat. If

this is important to you, this should be discussed with your vet before

taking the biopsy specimens. ■

Note: The dermatologists listed below have agreed to a diagnostic protocol

for evaluating skin biopsies for the presence of sebaceous adenitis:

Dept. of Vet. Pathobiology, Texas A&M University, c/o Robert Dunstan,

DVM, MS, Diplomate, ACVP, SA Research Project, or Kelly M. Credille,

DVM, Diplomate ACVP; 210 B Texas Veterinary Medical Center, College

Station, TX 77848-4467; Phone (409) 845-2651

Ann M. Hargis, DVM, MS, Diplomate ACVP, Dermato-Diagnostics, c/o

HCS, 85 SE Eighth Ave., P.O. Box 1109, Oak Harbor, WA 98277; Phone

(425) 775-6903

Maron B. Calderwood Mays, VMD, PhD, Florida Animal Resources,

13703 Millhopper Rd., Gainesville, FL 32653; Phone/Fax (352) 331-8032.

Brian Wilcock, DVM, PhD, 21 Vardon Dr., Guelph, ON, Canada, N1G

1WB; Phone/Fax (800) 853-PATH

Yager-Best, c/o Vitatech, 151 Esna Park Dr., Unit 13, Markham, ON,

Canada, L3R 3B1; Phone (800) 667-3411; Fax (905) 475-7309 (Susan J.

Best, DVM, DVSc and Julie Yager, BVSc, PhD)


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## Jill in Mich (Feb 24, 2008)

Thanks Arlene,

I had pretty well decided I've put Tess (and myself) through enough in the past few months and that I didn't want to go through the skin punch. This confirms it for me - I'm going to trust the allergy/dermatology specialist I'm seeing right now that we're dealing with allergies and not SA.


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## Janizona (Oct 17, 2006)

*First hand experience on a skin punch for SA*

Here are some messages on another list about what a bunch biopsy is like for 2 folks that have had it done:

_I have had several dogs tested for SA and all did get a local anesthetic - which made it less painful that a microchip. Two of the dogs had no stitches, all the rest had one stitch - none had more than one. There are always risks for any procedure - from annual shots, to microchips, to this procedure - although I have heard of more complications with annual shots than I have with the skin punch biopsy procedure. Each person has to weigh the risks to the benefits. The benefits of this study could save many dogs the suffering of SA, many owners the heart ache of dealing with it and many breeders the agony of producing it. Is it worth it??? It's up to you.

In an effort to help you know what to expect, this has been my experience:

1. The dog is giving a local anesthetic to avoid any discomfort
2. A small skin sample, about the size of the very tip of your pinky finger, is taken - usually from two different locations - usually at the base of the neck and an area on the back, near the rump.
3. In some cases, the vet applies a stitch - in some cases they don't
4. The dog doesn't cry or complain one bit

MaryEllen_
_________________________________________________

_Years ago, I had 2 of my Havs skin punched for test for SA. Thankfully, all was well. You can search my dogs on OFA to see who was tested. For this study, I will have them punched again, and gladly do so. Anyway, there were no stitches, and there is usually only one punch done in the most likely spot to show SA. My girls didn't care, they went right on with their daily lives, 1 inch equals 2.54 centimeters. So 6 centimeters is around 2 3/8 inches. Now, divide the 2 3/8 by 10 to get the millimeters, and you get less than a quarter inch. It is not an incision, it is a punch biopsy, much like many of us have had done to our cervix (sorry guys) without antibiotics afterwards, and without subsequent problems (and for us humans, not a lot of anesthetic, either). As in the test of the cervix, the answers you get from the test far outweigh any slight discomfort. IMO nona_
__________________


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## peluitohavanese (Nov 8, 2006)

This is good information Jan. I wanted to include pictures and articles written by experienced veterinarians for all to read and be informed.
This is not meant in any way to discourage anyone from participating. As in any procedure (i.e. a colonoscopy for example), your physician discusses the prep and steps taken in the procedure and what to expect before, during and after. I think anyone who is generously submitting samples of their Havs, should know what to expect and not be mislead into thinking this is the same as inserting a microchip.
Arlene


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## Janizona (Oct 17, 2006)

peluitohavanese said:


> This is good information Jan. I wanted to include pictures and articles written by experienced veterinarians for all to read and be informed.
> This is not meant in any way to discourage anyone from participating. As in any procedure (i.e. a colonoscopy for example), your physician discusses the prep and steps taken in the procedure and what to expect before, during and after. I think anyone who is generously submitting samples of their Havs, should know what to expect and not be mislead into thinking this is the same as inserting a microchip.
> Arlene


Thanks for saying that Arlene. I sometimes get the impression that you are not in favor of this study - based upon conversations on some other lists. So its good to hear you are backing it also. We need all the help we can get to find a test for this terrible disease.

And its Janet...not Jan :biggrin1: but YOU know that! Wanted to make sure others got my name right.

Will you be at the Nationals this year? Aren't you in IL?


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## peluitohavanese (Nov 8, 2006)

I am not backing or against the study. If someone wants to have their dogs tested, then more power to them. I just want people to know what to expect and not think it's as simple as placing a microchip in. 
I am forthright with my puppy buyers and believe that being truthful and honest is the best policy.
I was going to have my Bogie biopsied as he will be 7 in December, but I have decided against putting him through that. 
I will be at National  I am from Minnesota.


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## Havtahava (Aug 20, 2006)

I'm just getting around to the skin punch biopsy topics. Have any of you (humans) had a skin punch biopsy? I have. I go to see my dermatolgist for other matters on a regular basis and I pointed out an area on my skin that I had noticed had changed. Without any warning (she is a great doctor, but communication is not her strong suit), she pulled out a needle, gave me a local anesthetic and then did a skin punch biopsy as if it was no big deal. It was freaky to see her scoop out a section of skin. (The "cookie cutter" comment above is pretty accurate to what it seemed like to me.) It left a hole as wide as a pencil eraser that was so deep it was just white flesh below that seeped a little blood through the pores, but she covered it and that was that. I was shocked because I had no idea she was going to do it and I watched her scoop out a chunk of my skin, but it was very simple and it was all done in less than two minutes.

The procedure for the dogs sounds like it is similar except for those with long coats and that's pretty easy to remedy.

By the way, for me, there is NO indication at all on where this was done at all. I'd be curious to know if it is the same for the dogs after the skin grows back.


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