how much does an intestinal biopsy cost?

shebaa

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my cat hasnt been eating well since monday. she has a history of vomiting and sometimes being constipated. i started her on her new food trail (natural balance venision) on sunday. i thought it was her being picky about dry food (she gets wet food too) and figured though love. but today being the 3rd day, i decided to skip dry. i gave her half a can of wet of her old wet food (friskies) after she refused venison wet food. she barely ate that. after multiple vet visits, one thing the vet brought up was a intestine biopsy, which im thinking now maybe thats the next thing i should do, im just worried about the cost. has anyone gotten their cat one before?
for now her food trail is on hold and will just feed her friskies
also, ive been giving her hairball gel everyday for 2 1/2weeks. after vet recommended increasing to help with constipation. is it normal to be still somewhat constipated every now and then and for her to throw up hairballs?

AND please do not recommend giving her only wet food for now on, i know wet food is better but if i have to keep her on the novel diet, i did the math and it would cost me $90 a month if i only give her wet food. if a novel diet / lid or whatever wasnt the solution, where i can feed her friskies then yeah, i can do that but this new food trail is expensive
 

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I wish that there was some hard and fast rule about the cost for this, but it varies, and sometimes widely, from place to place, sometimes even from vet to vet, depending on what lab they use, and how much that particular lab may charge. There just isn't one answer here. What you would expect to pay in Arizona could be hundreds of dollars more or less than someone in New York or North Carolina. The best you can do is call and ask about the costs.
 

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As @Mamany1953 said, it varies by area. It also varies by method and extent of biopsy. There is an Endoscopic biopsy where the vet runs a lighted scope from the mouth down to the stomach and beginning of small intestines, and/or runs the scope up the rectum looking at the large intestines, taking samples This is a less expensive, and less invasive biopsy option. Whether the upper GI or lower GI, or both is done, depends upon results from an ultrasound locating the area, or areas of inflammation.

Sometimes vets can also do a needle biopsy which is less expensive.

Then there is the more invasive, and more expensive, surgical option where the cat is opened up and biopsy samples taken.

I would first discuss with your vet about getting an ultrasound. Results of this will guide the need for and extent and cost of any biopsy.
 
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shebaa

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As @Mamany1953 said, it varies by area. It also varies by method and extent of biopsy. There is an Endoscopic biopsy where the vet runs a lighted scope from the mouth down to the stomach and beginning of small intestines, and/or runs the scope up the rectum looking at the large intestines, taking samples This is a less expensive, and less invasive biopsy option. Whether the upper GI or lower GI, or both is done, depends upon results from an ultrasound locating the area, or areas of inflammation.

Sometimes vets can also do a needle biopsy which is less expensive.

Then there is the more invasive, and more expensive, surgical option where the cat is opened up and biopsy samples taken.

I would first discuss with your vet about getting an ultrasound. Results of this will guide the need for and extent and cost of any biopsy.
good to know. i didnt know there were different ways of doing a biopsy, i only heard of the needle biopsy.
 

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Is the vet thinking maybe IBD? Leroy's endoscopy with needle biopsy cost almost $1500 with all the miscellaneous fees included.

Non-chicken canned foods are helpful to cats with various gastrointestinal issues. I think Friskies might have a few varieties? Prescription food and expensive LID type commercial foods aren't necessary.
 
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shebaa

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Is the vet thinking maybe IBD? Leroy's endoscopy with needle biopsy cost almost $1500 with all the miscellaneous fees included.

Non-chicken canned foods are helpful to cats with various gastrointestinal issues. I think Friskies might have a few varieties? Prescription food and expensive LID type commercial foods aren't necessary.
vet brought up ibd once. but wanted me to try a novel protein diet first. shes been on turkey and still had the same problem. and now her newest problem is being constipated, i think thats whats going on this week. happened 2x in 3 weeks, first time she meowed (obviously being uncomfortable) and tried to go in the kitchen floor. and now its her not eating well. been giving her hairball gel everyday but obviously it isnt working.
 
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shebaa

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Have you tried pumpkin puree or Miralax for the constipation?
no i havent. i was just looking into those 2 and i think i will try the pumpkin, i read some reviews of miralax making things worse. im assuming pumpkin that us humans eat is what i give my cat..? is there a special type for cats?
good news is that my cat is getting her appetite back. i just gave her some more food after she was begging. i hate when she begs but in this case im so happy!
 

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There isn't a special type for cats. Just make sure it is plain pumpkin and not some type of ready to use pie filling. I would start with the ultrasound which will need to be done whether you go to a biopsy or not. With my IBD cat I didn't go to the biopsy. Someone experienced with reading ultrasounds can tell a lot from that alone. I personally try not to go to more invasive diagnostics unless they are really needed.
 

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no i havent. i was just looking into those 2 and i think i will try the pumpkin, i read some reviews of miralax making things worse. im assuming pumpkin that us humans eat is what i give my cat..? is there a special type for cats?
good news is that my cat is getting her appetite back. i just gave her some more food after she was begging. i hate when she begs but in this case im so happy!
Pumpkin means the plain canned pumpkin, not the pie filling with added spices. Another option is plain pumpkin that comes in small pouch specifically for cats. I see it at Petco. I think it is by Weruva or Soulistic. They also have blended pouches like "chicken and pumpkin", "tuna and pumpkin"; again by Weruva or Soulistic. You might want to check these out. At least you could try a small pouch, not a big can of pumpkin.
 

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no i havent. i was just looking into those 2 and i think i will try the pumpkin, i read some reviews of miralax making things worse. im assuming pumpkin that us humans eat is what i give my cat..? is there a special type for cats?
I posted info on canned pumpkin for cats here:

How relieve constipation in cats?

Store brand of 100% pumpkin puree works just as well as brand name. Or buy pouches of pumpkin puree from the pet store.
 

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My cat had an abdominal ultrasound- that showed intestinal thickening suggestive of either severe IBD or cancer. I went ahead and started him on treatment with Chlorambucil and prednisolone and am crossing my fingers and hoping for the best. I am considering the TK-1 test, but at this point we are $1000 in diagnostics, and treatment is expensive. With Chlorambucil you need lots of repeated bloodwork. I opted not to do the Biopsy. I don't know if that was the right choice.

I don't know if anything is the right choice if you dealing with cancer. My last cat had breast cancer (very very aggressive). She made it about 9 months, we did two surgeries. The last surgery wasn't really worth it, as the cancer returned at the surgical site. I had her put down within about 9 weeks of the last surgery, as she wasn't eating and was clearly in pain. After she had passed, I was able to palpate her belly, and you could feel a large mass inside her abdomen (golf ball sized). Usually it spreads to the lungs. In her case it didn't do that, thankfully.

My cat right now seems to be doing okay on the medications but I won't know for sure until Monday (and our next bloodwork draw). As chlorambucil can suppress bone marrow and cause anemia or low WBC counts. His counts were low to begin with, so I'm not sure what to expect. He's eating and going to the bathroom. He's not vomiting anymore, and he appears to be putting on weight (but he's getting like 270 calories a day). He sleeps a lot more than normal. It's clear that he isn't feeling great. He just seems tired.

Here are your options:

With a situation like you describe you could have Pancreatitis, Inflammatory bowel disease, or lymphoma.

The problem is inflammatory bowel disease or lymphoma both look very nearly identical. Even if you go in and do biopsies, it's hard to tell the two diseases apart.

This is the most helpful site: IBD or Cancer? – IBDKitties
Read everything and read it a second or third time.

Recognizing that GI inflammation can morph into cancer, more vets are willing to treat cats for small cell lymphoma with chlorambucil when the symptoms of IBD become intractable with diet and steroid therapies, (8) despite no biopsy having been performed.

With the new TK-1 test, pet parents have an option to rule cancer in. Although the TK-1 test cannot identify whether the cancer is large or small cell (and a negative test does not mean your cat does NOT have cancer), if the test indicates a cancer is present, based on the probability of small cell versus large cell, some vets are willing to prescribe chlorambucil and prednisolone. If your cat responds, you can be reasonably assured you have the right treatment on board. The TK-1 test can be falsely positive as well, especially in pancreatitis cases.

Read this one as well:
Inflammatory Bowel Disease in Small Animals - Digestive System - Merck Veterinary Manual
 

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You could get an abdominal ultrasound done by an internal medicine specialist- costs about $600 for the consult and ultrasound.
You could go ahead and do biopsies- if you do surgical biospies they will be more accurate (but high risk and longer recovery time)
If you do endoscopic biopsies, they may not be able to reach the affected area, so biopsy results won't be as accurate.
You could jump straight to medications, and try treating to see if there is improvement.

Nothing in this is straight forward. No matter what you choose, you will probably second guess yourself. I don't think I slept for a week, as I was completely stressed out about whether I was doing the right thing. If you are a person who requires certainty- and wants to know exactly what you are dealing with- and if your cat is healthy enough for surgery, then a surgical biopsy is the best bet. PCR (PARR) testing, can improve your diagnostic certainty if done in conjunction with the biopsies.

PCR for Antigen Receptor Rearrangements (PARR)

Obviously, financial constraints are a big consideration. I could spend $2000 on diagnositics, but what about the necessary repeated bloodwork, medication costs etc? If I spend $2000 on diagnostics and he has Large cell lymphoma, survival times are low unless I spend thousands on chemotherapy, and do I want to put my cat through that? If he has IBD or small cell lymphoma, he should respond well to medications. It may be better to treat as if this IS cancer.
 
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shebaa

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I posted info on canned pumpkin for cats here:

How relieve constipation in cats?

Store brand of 100% pumpkin puree works just as well as brand name. Or buy pouches of pumpkin puree from the pet store.
i just came from the store and bought the name brand just to be safe, but next time i will buy the store brand.

My cat had an abdominal ultrasound- that showed intestinal thickening suggestive of either severe IBD or cancer. I went ahead and started him on treatment with Chlorambucil and prednisolone and am crossing my fingers and hoping for the best. I am considering the TK-1 test, but at this point we are $1000 in diagnostics, and treatment is expensive. With Chlorambucil you need lots of repeated bloodwork. I opted not to do the Biopsy. I don't know if that was the right choice.

I don't know if anything is the right choice if you dealing with cancer. My last cat had breast cancer (very very aggressive). She made it about 9 months, we did two surgeries. The last surgery wasn't really worth it, as the cancer returned at the surgical site. I had her put down within about 9 weeks of the last surgery, as she wasn't eating and was clearly in pain. After she had passed, I was able to palpate her belly, and you could feel a large mass inside her abdomen (golf ball sized). Usually it spreads to the lungs. In her case it didn't do that, thankfully.

My cat right now seems to be doing okay on the medications but I won't know for sure until Monday (and our next bloodwork draw). As chlorambucil can suppress bone marrow and cause anemia or low WBC counts. His counts were low to begin with, so I'm not sure what to expect. He's eating and going to the bathroom. He's not vomiting anymore, and he appears to be putting on weight (but he's getting like 270 calories a day). He sleeps a lot more than normal. It's clear that he isn't feeling great. He just seems tired.

Here are your options:

With a situation like you describe you could have Pancreatitis, Inflammatory bowel disease, or lymphoma.

The problem is inflammatory bowel disease or lymphoma both look very nearly identical. Even if you go in and do biopsies, it's hard to tell the two diseases apart.

This is the most helpful site: IBD or Cancer? – IBDKitties
Read everything and read it a second or third time.

Recognizing that GI inflammation can morph into cancer, more vets are willing to treat cats for small cell lymphoma with chlorambucil when the symptoms of IBD become intractable with diet and steroid therapies, (8) despite no biopsy having been performed.

With the new TK-1 test, pet parents have an option to rule cancer in. Although the TK-1 test cannot identify whether the cancer is large or small cell (and a negative test does not mean your cat does NOT have cancer), if the test indicates a cancer is present, based on the probability of small cell versus large cell, some vets are willing to prescribe chlorambucil and prednisolone. If your cat responds, you can be reasonably assured you have the right treatment on board. The TK-1 test can be falsely positive as well, especially in pancreatitis cases.

Read this one as well:
Inflammatory Bowel Disease in Small Animals - Digestive System - Merck Veterinary Manual
how much did the ultrasound cost alone? if she does have something going on will it show up on the ultrasound no matter what or just when shes having symptoms (so like right now).? shes been throwing up all her life, shes 6 years old now. it just gotten worse over the last 2 years.
 
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shebaa

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You could get an abdominal ultrasound done by an internal medicine specialist- costs about $600 for the consult and ultrasound.
You could go ahead and do biopsies- if you do surgical biospies they will be more accurate (but high risk and longer recovery time)
If you do endoscopic biopsies, they may not be able to reach the affected area, so biopsy results won't be as accurate.
You could jump straight to medications, and try treating to see if there is improvement.

Nothing in this is straight forward. No matter what you choose, you will probably second guess yourself. I don't think I slept for a week, as I was completely stressed out about whether I was doing the right thing. If you are a person who requires certainty- and wants to know exactly what you are dealing with- and if your cat is healthy enough for surgery, then a surgical biopsy is the best bet. PCR (PARR) testing, can improve your diagnostic certainty if done in conjunction with the biopsies.

PCR for Antigen Receptor Rearrangements (PARR)

Obviously, financial constraints are a big consideration. I could spend $2000 on diagnositics, but what about the necessary repeated bloodwork, medication costs etc? If I spend $2000 on diagnostics and he has Large cell lymphoma, survival times are low unless I spend thousands on chemotherapy, and do I want to put my cat through that? If he has IBD or small cell lymphoma, he should respond well to medications. It may be better to treat as if this IS cancer.
so much for an ultrasound! if it was cancer, would it show up in blood work? my cat gets blood work done yearly and each time shows everythings good
 

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I think it was $140 for the consult and a little less than $460 or so for the ultrasound. My bill was slightly under $600.

Yes it is very expensive but the only places that do ultrasounds around here are either Blue Pearl or the University. Both are similarly priced. A regular vet is not a specialist and they would not be able to do that kind of ultrasound, nor would they be able to read it. Nor would I trust them to read it.

Other things cause vomiting and constipation. So I would start with the treatment plan on the Merck vet website I sent you the link too. See if any of those things helps. My cat with breast cancer was a chronic vomiter long before her diagnosis of breast cancer. When we did x rays for the breast cancer, there was an object of some sort in her stomach, that had probably been in there for years. Couldn't tell what it was, and never did find out. But it was definitely a foreign body. She had pica and would eat anything- pieces of paper, tissues, chewed holes in the shower curtain etc. So not exactly surprising that she had foreign matter in her stomach.

Bloodwork will not show cancer. I wish it would.
 

Pouncecat1

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Ultrasound is very good at picking up foreign bodies if your cat did eat something weird. Unfortunately it can't tell the difference between inflammatory bowel disease or lymphoma.
 
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shebaa

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what about xray? would ibd show in xrays? i take her to banfield, i dont know if they do ultrasounds and i hate to have to take her to more visits. she has such anxiety at the vet, i have to give her gabapentin but that barely helps.
 

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Do be aware that a significant number of cats who have issues with chicken also have issues with turkey. Try looking for something like rabbit, or bison, something totally unrelated to fowl.
 
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shebaa

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Do be aware that a significant number of cats who have issues with chicken also have issues with turkey. Try looking for something like rabbit, or bison, something totally unrelated to fowl.
i started her on venison on sunday. but with her lost of appetite, thats on hold as shes back on her old food, (science diet indoor and friskies wet food) until everything is back to normal. then i will transition her into her new food again
 
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