Liver biopsy in horses

Due to the liver's large reserve capacity, clinical signs of hepatopathy in horses do not usually become apparent until 60 per cent of hepatic function is lost, so subclinical disease is common. The signs are frequently vague, with abnormal serum biochemistry results often being the first indicator of liver dysfunction. Hepatic insults may be self‐limiting or secondary to other conditions so it can be difficult to determine those cases that warrant further investigation. Non‐invasive tests are less reliable in predicting the severity of hepatic disease compared with histopathology, which provides valuable information about aetiology, treatment and prognosis. This article describes how to conduct a liver biopsy in horses and hopefully provides reassurance that it is a safe procedure that should be considered early on in the investigation of hepatic disease.