tag:blogger.com,1999:blog-76429355469861867222024-03-13T11:56:53.110-07:00Sound VetPath BlogUnknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-7642935546986186722.post-44264306933924883782014-11-18T08:21:00.002-08:002014-12-17T09:37:53.979-08:00<div class="MsoNormal">
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<span style="font-family: Times, Times New Roman, serif; font-size: large;"><b>The Significance of A Necropsy</b><o:p></o:p></span><br />
<span style="font-family: Times, Times New Roman, serif; font-size: x-small;"><b>Barry Rickman, VMD, PhD, DACVP</b></span></div>
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<span style="font-size: large;">A necropsy is postmortem examination, which is defined as a
thorough, orderly dissection of a deceased pet or animal.<span style="mso-spacerun: yes;"> </span>At the time of an animal’s death, especially
a pet, an owner often does not want to consider a necropsy.<span style="mso-spacerun: yes;"> </span>This is definitely understandable however
there are times that a necropsy is worth considering and this article explains
the importance of a necropsy.<o:p></o:p></span></div>
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<span style="font-size: large;">The most common reason to perform a necropsy is to determine
the cause and manner of death.<span style="mso-spacerun: yes;"> </span>In some
cases, we might already know the disease that is contributing to an animal’s
death, but a necropsy can reveal additional information regarding the disease
process, the extent of disease, as well as the presence of other underlying
conditions.<span style="mso-spacerun: yes;"> </span>Often veterinarians might
want to perform a necropsy to learn and understand how treatment (i.e. surgery,
radiation, and chemotherapy for cancer) played a role in the disease
course.<span style="mso-spacerun: yes;"> </span>In some cases animals do not
respond to treatment and only the necropsy can explain why.<span style="mso-spacerun: yes;"> </span>In some cases the necropsy can explain a
completely different disease process occurring, or it might reveal other
contributing factors to the illness or death of the animal.<span style="mso-spacerun: yes;"> </span>Other reasons for performing a necropsy
include medicolegal cases (forensic necropsy), public health concerns, new and
emerging diseases, herd health, shelter health, zoo health, breeding animals
and genetics, insurance and/or malpractice, and anesthetic death.<span style="mso-spacerun: yes;"> </span>It can also provide closure for the animal owner
and family.<o:p></o:p></span></div>
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<span style="font-size: large;">Determining the cause of death without a complete necropsy
provides the animal owner only with an educated guess to why the animal died in
many cases.<span style="mso-spacerun: yes;"> </span>A multitude of diseases
leading to death can manifest with similar clinical signs, and a veterinarian
might rule out only the most common causes of death, without considering less
common disease processes, that if found, might have important
implications.<span style="mso-spacerun: yes;"> </span>For example, a seizing
middle-aged dog might be due to epilepsy, a brain tumor, trauma, emboli,
toxins, diabetes or infection (such as bacterial infection or viruses such as
distemper or rabies), to name a few.<span style="mso-spacerun: yes;"> </span>If
the dog died from the seizure without previously being examined in the clinic,
only the clinician’s best educated guess would help with a presumptive
diagnosis.<span style="mso-spacerun: yes;"> </span>If that dog was exposed to a
certain toxin that caused the seizures and it was not suspected or diagnosed,
then there might be a risk to other pets or wildlife in the vicinity. <o:p></o:p></span></div>
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<span style="font-size: large;">Another significant example is with West Nile Virus, a
recently emergent viral disease transmitted by mosquitos that was not present
in the United States 20 years ago.<span style="mso-spacerun: yes;"> </span>It
was only diagnosed by a veterinary pathologist that was aware of a die off of
birds in the NYC area, and linking it with critically neurologically ill people
in NYC.<span style="mso-spacerun: yes;"> </span>It was not on the radar of
public health officials at the time.<span style="mso-spacerun: yes;">
</span>Since then, it has become a public health concern for people across the
country, as well as for animals - ranging from horses to wildlife.<o:p></o:p></span></div>
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<span style="font-size: large;">One necropsy review discusses that although new technological
tools have diminished the differences between clinical diagnosis of disease and
necropsy findings, major diagnostic discrepancies were found in 14 – 39% of
cases (Gutierrez 2009).<span style="mso-spacerun: yes;"> </span>In another study
in human hospitals, it cites that at least 1/3 of death certificates to be
incorrect and 50% of autopsies produce findings unsuspected before death
(Roulson 2005).<span style="mso-spacerun: yes;"> </span>This article also states
that over 20% of clinically unexpected autopsy findings, including 5% of major
findings, can be correctly diagnosed only by histological examination.<span style="mso-spacerun: yes;"> </span>Another goal of the necropsy is to understand
the disease process and mechanism in order to improve the quality of patient
care.<o:p></o:p></span></div>
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<span style="font-size: large;">A complete necropsy consists of a few components.<span style="mso-spacerun: yes;"> </span>A thorough history and diagnostic tests (
i.e. bloodwork, radiographs) can aid the pathologist in evaluating the cause of
death.<span style="mso-spacerun: yes;"> </span>In some cases sudden death occurs
and there are no diagnostic tests involved - this alone is an important piece
of the history.<span style="mso-spacerun: yes;"> </span>A gross necropsy is a
systemic, complete examination of the deceased animal, both externally and
internally, with the naked eye.<span style="mso-spacerun: yes;"> </span>Every
tissue and organ is grossly evaluated.<span style="mso-spacerun: yes;">
</span>Tissues and organs are surgically sampled in order to further examine
microscopically.<span style="mso-spacerun: yes;"> </span>Additional testing for
microbiology, parasitology, toxicology, and genetic testing are sampled and
performed when needed.<span style="mso-spacerun: yes;"> </span>A formal report
is then written with photodocumentation. <o:p></o:p></span></div>
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<span style="font-size: large;">There are a small percentage of cases where necropsy does
not reveal the cause of death grossly or histologically.<span style="mso-spacerun: yes;"> </span>These can include idiosyncratic drug
reaction, metabolic/electrolyte disturbances and abnormalities, electrical
instability related to neurohumoral and central nervous system influences,
electrophysiologic abnormalities, and certain toxin exposures.<o:p></o:p></span></div>
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<span style="font-size: large;">In summary, the animal necropsy and histologic examination
are the gold standard to accurately determine the manner and cause of death and
to correlate the accuracy of clinical diagnosis and diagnostic tests.<span style="mso-spacerun: yes;"> </span>Improved accuracy of new diagnostic methods
could be achieved through closer collaboration between veterinarians,
radiologists, and clinical and anatomic pathologists (Gutierrez 2009).<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif; font-size: x-small;">Ermenc B. Comparison of the clinical and postmortem
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</span>Forensic Sci Int. 2000 Nov 13;114(2):117-9.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif; font-size: x-small;">Gutierrez PS, de Brito T, Sampaio Lopes MB, Ferreira Alves
VA.<span style="mso-spacerun: yes;"> </span>The value of necropsy in quality
control of medical diagnosis – the gold standard for years to come.<span style="mso-spacerun: yes;"> </span>Clinics 2009;64(3):161-2<o:p></o:p></span></div>
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diagnosis and the value of post mortem histology; a meta-analysis and review.
Histopathology 2005 Dec;47(6):551-9.<o:p></o:p></span></div>
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<span style="font-family: Times, Times New Roman, serif; font-size: x-small;">Thomas HS. A necropsy: when is it important?<span style="mso-spacerun: yes;"> </span>California Thoroughbred 2006 Nov; 87.<span style="mso-spacerun: yes;"> </span></span><o:p></o:p></div>
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