Necropsy

Necropsy

The article "Teaching the Living" by Dr Richard Jakowski, DVM, PhD, (which appeared in the SCBDFC Bulletin, sometime in 2001 if I recall correctly) was absolutely superb. The subjects of death and autopsy or necropsy are ones few of us want to think about until we are forced to do so, but the advantages of thinking and planning ahead of necessity are considerable.

Last year (2001) when I was working up additions to the VMTH Tour notes for tours of the Vet Med Teaching Hospital (VMTH) at UC Davis, I added a section on the Necropsy facilities. I did so with some worries that it might not be well received, but with strong feeling that people need to think about this calmly and rationally -- and the best time to do so is while the need is still comfortably distant and hypothetical. I will paste in my tour notes below. (Update note : this was written before "CSI" , "CSI Miami" , and "Crossing Jordan" came along ; pathology and forensics are a very "hot ticket" right now !)

About the one thing that might be added is that if one is planning for an autopsy / necropsy , that will also affect one's plans for burial, cremation, etc. Basically, a full (extensive, complete) autopsy means that there cannot be an "open casket" event -- ie the body will not be something one wants to look at and remember. The vet profession and animal mortuary profession have not had incentive to develop the arts of making a damaged body viewable that the human mortuary profession has developed. But a closed casket burial is still a reasonable choice and likewise cremation. One also has the option of a "cosmetic" or limited autopsy, in which only one or two selected aspects of the body are examined and the corpse is then sewn up and restored to an acceptable appearance. The problem however is that this limited autopsy may fail to answer the questions to which answers are sought.

My precious Bonesy took leave of me on Easter Sunday 2000 after more than a year of living in style and grace with cancer. His oncologists and I had long planned for autopsy to evaluate treatment as well as to provide a legacy to students. In the form of slides and other tissue preps, including DNA samples, my beloved Bonesy's blood and body will continue to confer the sacrament of knowledge on generations of future veterinarians. (The VMTH never throws anything away, so many retrospective research projects yield valuable knowledge based on samples from the "archives".) And finally , a sacrament for me, was the irrefutable proof that his body was so badly ravaged by innumerable metastases that not even his indomitable spirit could have continued to ignore or endure the damage any longer. It took away any potential for self-doubt over whether I had done the right thing at the right time in letting him go then.

(Update note : Since this was first written, my dear Sweetie was a subject in the trial of a very promising new cancer drug that targets specific receptor molecules on cancer cells. This drug gave her about 6 months of excellent quality of life survival that she would not have otherwise had. Her necropsy was of extreme value to this research, helping to answer important questions about possible side effects. For me there was some comfort in knowing that we had contributed this knowledge to benefit future patients. And , again, I received the solace of proof that her sweet spirit needed to be set free of the burdens of her badly diseased body. )

VMTH tour notes : PATHOLOGY & NECROPSY LABS

Pathology labs examine tissue samples from living patients and from dead ones. Many diseases can only be definitively diagnosed from such tissue samples. Samples from a living patient are called "biopsy" samples, those from the dead are "necropsy" samples.

Necropsy (called autopsy in humans) is the study of the dead patient. I don't know how many of you watched the old "Quincy ME" TV show or saw the 1999-2000 season's "60 Minutes" episode bewailing the lack of use of autopsies in human medicine. But as Quincy was fond of saying "every dead body has a secret to tell us". this last precious bit of knowledge is the patient's final legacy to the world and payback to the medical profession for all the knowledge and care that went into the treatment that was given. Necropsies may be limited, perhaps looking only at one organ or tissue, or may be extensive.

Most people don't care to think about a necropsy while their loved pet is alive and well, and then find it too painful to consider when a pet dies -- and often the vet is afraid to ask permission, for fear that to do so will be painful for the grieving owner/guardian. But there are so many benefits and so few detriments that necropsy should be considered in many cases. By the way the VMTH long-standing policy has been that there is no charge for necropsy on those who have been in care here.

Reasons to do a necropsy include

• (1) when the cause of death is unknown or the death was unexpected,
• (2) when there is possibility of contagious disease that could affect others,
• (3) to further evaluate effects of treatment, especially when a new treatment was involved or a reaction to a drug suspected,
• (4) legal (eg suspected poisoning, suspected abuse, possible malpractice),
• (5) to benefit the students who participate (it is a great learning experience) or to provide material for use in teaching or research,

and finally
• (6) to give peace of mind to the grieving owner and the vet that indeed there was nothing more that could have reasonably been done to keep this patient comfortable.

footnote : terminology "necropsy" vs "autopsy"

The word "necropsy" from its Greek roots means "study of the dead" and thus is appropriate to any form of post-mortem examination. The term "autopsy", which is usually preferred when referring to a post-mortem examination on human remains, comes from Greek roots meaning "self-study". Now since it is quite patently  impossible  to perform a post-mortem study upon one's own self, the literal appropriateness fo the term seems to me very dubious. The real reason why many prefer to use a separate term for post-mortems on human remains as opposed to on non-human animal remains is simply the need some humans have to obscure or forget that we too are animals, ie we are "non-non-human animals", the "hairless primates", and so on. (I have been known to jocularly refer to the UC Davis Med Center as the HPMTH (Hairless Primate Medical Teaching Hospital) or as the HPTH (Hairless Primate Teaching Hospital, since the word Hospital tends to make the word Medical redundant) and I have been known to refer to some person's human domestic partner as being his or her "non-non-human animal companion." Guess I've been living in Davis too long.)