Fill out the Muscle Biopsy Submission Form. You will receive a PDF of the completed form to print and submit with the biopsy.

Fees: $300 per biopsy sample submitted.

INFORMATION ON SUBMITTING A SAMPLE

What muscle should I biopsy?

• For exertional rhabdomyolysis, polysaccharide storage myopathy, myofibrillar myopathy: semimem/tendinosus, middle gluteal muscle
• For generalized atrophy: sacrocaudalis dorsalis medialis muscle
• For focal muscle atrophy: the atrophied muscle

How do I handle the muscle sample?

• Beginning July 1, 2022, we will only accept formalin-fixed samples. We have perfected IHC stains for formalin-fixed tissue and can diagnose equine muscle diseases using these stains on a smaller sample
• Obtain a 1/2-inch cube of semimembranosus or sacrocaudalis (if atrophy)
• Leave biopsy in air while you suture
• Optional, cut the biopsy in half across with width of the muscle (not lengthwise) and place in the cassette so the two halves can be sectioned simultaneously.
• Place in at least 130 ml (4.5 oz) 10% neutral buffered formalin 3-5 min after you take the biopsy

When should we schedule a biopsy?

Biopsies can now be scheduled anytime. IHC stains work best on samples that have not been in formalin for more than 5 days.

The Process

1. Submit form online

2. Receive email with instructions and paperwork to accompany samples

3. Send samples to MSU Integrated histopathology lab for slide preparation (not the MSU Veterinary Diagnostic Laboratory as was done prior to January 2023)

4. Slides collected from histopathology lab and read by Dr. Valberg

5. Report of results for paid submissions sent by Dr. Valberg to submitting veterinarian

Kentucky Equine Research provides administrative services to the Valberg NMDL and does not receive specimens nor is it party to the results. Please do not send any samples to Kentucky Equine Research.

Percutaneous Needle Biopsy (Middle Gluteal Muscle)

• Video – Percutaneous Needle Biopsy

Please download the Percutaneous Needle Biopsy Technique PDF for reference.

Semimembranosus/Semitendinosus 

The best site for a semimembranosus biopsy is midway between the tuber ischii and the origin of the Achilles tendon at about the level of the vulvar lips. Avoid tendinous insertions. This site hides scarring under tail hairs and is easily treated if dehiscence occurs.

Sacrocaudalis

The best site for a sacrocaudalis biopsy is 1/2 inch above the origin of the tail and approximately 1/4 inch off midline. Skin retractors are highly recommended for this site.

Procedure

• Lidocaine is injected under the skin but not into the muscle belly. This area has many nerves so 5-7 ml of lidocaine may be necessary.
• A 2-inch incision is made through the skin and subcutaneous fat and fascia. The skin is not flexible in this area so a larger skin incision is needed.
• Use skin retractors for visualization.
• Parallel longitudinal incisions are made in the muscle 1/4 inch apart.
• The cranial aspect of the muscle is grasped with forceps and the muscle is dissected out 1/4 inch deep and 1/2 inch long. Don’t pull this muscle out via forceps as that squishing creates atrophy.
• This area can have a lot of subcutaneous fat. Make sure the sample is deep enough to obtain muscle tissue.

• Do not squeeze or squish as that can damage cells. Do not ship muscle in red top tubes.
• Place a ½” cube of fresh muscle in at least 130 ml (4.5 oz) of 10% buffered formalin in a hard, watertight container. Larger samples than this won’t fix well so trim them.
• Label each container with the owner’s name, horse’s name, and name of the muscle it contains (one muscle per container).
• Wrap the top with parafilm and place it in a biohazard Ziploc bag containing absorbent material such as paper towel.
• Fill out the submission form, submit and print out the PDF that you receive. Send in a separate Ziploc bag with the sample.
• Sample submissions do not have to be shipped overnight. For us to track the biopsies closely upon arrival at MSU, please DO NOT arrange for a Saturday or Sunday delivery. Samples can stay in formalin over the weekend and be shipped on Monday. 
• Ship to:
  • Michigan State University
    Departments of Physiology & Pathology
    Investigative HistoPathology Lab
    567 Wilson Road – Rm 1104
    East Lansing, MI 48824

NOTE: A permit is required when shipping originates outside the United States. If shipping samples from outside the USA, six unstained parrafin-embeded slides sent in a plastic slide container can be sent to the Valberg NMDL and will be stained here at the same cost as a muscle sample submission.

For shipments from Canada: Please email dxmuscle22@gmail.com to receive an import permit. We strongly recommend using a major carrier such as FedEx to ensure the samples clear customs.

NOTE: You must include with the formalin-fixed samples:

1. The IMPORT PERMIT
2. An ORIGINAL signed document from the producer/manufacturer that CLEARLY corresponds to the shipment by means of an invoice number or shipping marks or lot number or other identification method. This document must confirm that:
   • The exported materials are formalin fixed muscle samples derived from equine species that:
     • Originated in Canada,
     • Were not known to be or suspected of having been exposed to or infected with any specific animal pathogen.
   • The exported materials were not exposed to or commingled with any other animal derived material.

• The submitter is responsible for all fees associated with the submission.
• Turnaround time for results is 10-14 days
• The submitter is responsible for adherence to sample-shipping regulations.
• The Valberg Neuromuscular Diagnostic Laboratory no longer offers a shipping discount code for sample submissions. We apologize for any inconvenience.
• All samples and specimens submitted become the property of Valberg Neuromuscular Diagnostic Laboratory and will not be returned.
• Samples, specimens, and related test and diagnostic results may be used for teaching and research purposes.

For any questions or concerns regarding submission, please email dxmuscle22@gmail.com.