Topic:Bronchoalveolar Lavage
Bronchoalveolar lavage (BAL) is a diagnostic procedure used to collect samples from the lower respiratory tract of horses. The technique involves the introduction of a sterile fluid into the bronchi and alveoli, which is then retrieved for analysis. BAL is utilized to assess the cellular and microbiological composition of the lower airways, aiding in the diagnosis of respiratory conditions such as inflammatory airway disease, recurrent airway obstruction, and infections. The procedure provides valuable insights into the type and extent of inflammation or infection present in the respiratory system. This page compiles peer-reviewed research studies and scholarly articles that explore the methodology, applications, and clinical relevance of bronchoalveolar lavage in equine respiratory health.
Effect of treatment with erythromycin on bronchoalveolar lavage fluid cell populations in foals. To determine whether oral administration of erythromycin alters the inflammatory response to bronchoalveolar lavage (BAL) in young horses. Methods: 12 healthy, unweaned, mixed-breed foals of either sex, between 2 and 4 months old. Methods: BAL was performed; 250 ml of phosphate-buffered saline solution (300 mOsm, pH 7.4) was administered in 50-ml aliquots. Foals were carefully monitored for 4 days, then erythromycin base (25 mg/kg of body weight, PO, q 12 h) was given to foals of the treated group. After 4 days, foals were reanesthetized, and the same lung was relavaged. Cytologic examination ...
Lower respiratory tract disease. Lower respiratory tract disease is an important source of poor performance and exercise intolerance in racehorses and middle-aged sport horses. Horses that perform high-intensity exercise are predisposed to development of infectious and noninfectious respiratory disease. Diagnostic aids for investigation of lower respiratory tract disease include thorough thoracic auscultation with rebreathing, endoscopic examination, bronchoalveolar lavage (BAL), and thoracic radiographic examination. The therapeutic approach for horses with lower respiratory tract diseases often can be directed by cytologic ...
Diagnostic approach to exercise intolerance in racehorses. The diagnostic approach to the exercise intolerant racehorse depends on sound, fundamental steps to allow complete examination of the entire horse in a logical, time-efficient fashion. Availability of referral diagnostic modalities should not overshadow the need for collecting a clinical history or performing a complete physical examination. The diagnostic approach to exercise intolerance can be divided into a few basic steps. The first step, conducted without the horse, is a thorough discussion about the horse with the trainer and/or owner. Many clinical histories are complex and therefore fo...
Effects of ozone and airway inflammation on glutathione status and iron homeostasis in the lungs of horses. To investigate the effects of ozone and airway inflammation on indices of oxidant injury in horses. Methods: 5 clinically normal horses and 25 horses referred for poor performance. Methods: Blood, tracheal wash, and bronchoalveolar lavage fluid samples were collected before and after ozone exposure (n = 5) or from clinical cases (n = 25), and were analyzed for reduced glutathione (GSH), glutathione disulfide (GSSG), and free and total iron (Fe) values. A scoring system (0 to 5) was used to assess airway inflammation on the basis of clinical signs and cytologic analysis of the tracheal wash and...
Residence and recruitment of leucocytes to the equine lung after EHV-1 infection. This study characterised bronchoalveolar leucocytes collected by lavage from five susceptible and two immune ponies before and after nebulised aerosol infection with equid herpesvirus-1 (EHV-1). Leucocyte counts and lymphocyte phenotypic analyses were performed using either differential staining or an indirect immunofluorescence assay with monoclonal antibodies specific for equine (Eq) CD4, CD5, CD8 and B lymphocytes. After EHV-1 infection, significant changes developed: a transient neutrophilia occurred on Day 2, coincident with a reduction in macrophage numbers and an EqCD5+, EqCD4+ and EqCD...
Quantitative characterization of lymphocyte populations in bronchoalveolar lavage fluid and peripheral blood of normal adult Arabian horses. Bronchoalveolar lavage fluid (BALF) and peripheral blood were obtained from each of 17 adult Arabian mares and absolute numbers and relative lymphocyte proportions were determined for total T lymphocytes, using CD2 as a marker, CD4 + T lymphocytes, CD8 + T lymphocytes, CD5 + lymphocytes, and sIgM + B lymphocytes. The marked variation in BALF cell recovery resulted in wide variation in absolute values for each lymphocyte subset. The relative proportions of gated BALF lymphocytes were much less variable and provided a basis for comparison of lymphocyte subsets between the BALF and peripheral blo...
Obstructive pulmonary disease in 18 horses at summer pasture. The clinical features of 18 cases of summer pasture associated obstructive pulmonary disease were reviewed. The horses had signs of obstructive pulmonary disease (expiratory dyspnoea, wheezing and crackling lung sounds and coughing) during the spring, summer or autumn while they were kept permanently at grass with no access to hay or straw, for at least two consecutive years. In nine cases there was a seasonal incidence with the disease occurring during April and May. Eleven of the horses were affected by bouts of severe dyspnoea. Eleven of the horses also suffered from chronic obstructive pul...
Changes in airway inflammatory cell populations in standardbred racehorses after interferon-alpha administration. Natural human interferon-alpha (nHuIFN alpha) was administered to actively training Standardbred racehorses with inflammatory airway disease (IAD). Inflammatory airway disease was characterized by poor exercise performance and inflammation and exudate in the upper and lower airway. Placebo, 50, 150, or 450 units(U) of nHuIFN alpha was administered orally for 5 consecutive days to eight horses per treatment group in a double-blind, randomized block design. Response to nHuIFN alpha was monitored by semiquantitative endoscopic examination score and cytologic examination of bronchoalveolar lavage ...
Equine pulmonary disease: a case control study of 300 referred cases. Part 3: Ancillary diagnostic findings. The majority of 270 adult horses with chronic pulmonary diseases had excessive volumes of respiratory secretions (RS) present in their trachea, elevated tracheal RS neutrophil ratios and lowered arterial oxygen partial pressures. Some control horses, had inexplicably elevated trachael RS neutrophil ratios. Only the chronic obstructive pulmonary disease (COPD) affected group had significantly elevated bronchoalveolar lavage fluid (BALF) neutrophil ratios. Maximal intrapleural pressure changes (max dPpl) were raised in 48% of COPD cases and rarely with other pulmonary disorders. Arterial pH or c...
Equine pulmonary disease: a case control study of 300 referred cases. Part 1: Examination techniques, diagnostic criteria and diagnoses. Three-hundred adult horses, referred from 1990 to 1993 inclusively, for pulmonary examination were assessed using standardised history taking and clinical, intrapleural pressure, arterial blood gases and pH, bronchoscopic and tracheal and broncho-alveolar lavage fluid (BALF) cytological examinations. Two-hundred and thirty-five cases were referred with overt signs of pulmonary disease and the remaining 65 cases were referred for pulmonary examination because of reduced exercise (usually racing) performance or prolonged dyspnoea after racing. No pulmonary disease was detected in 30 cases. The 2...
Comparison of bronchoalveolar lavage findings and measurements of gas exchange during exercise in horses with poor racing performance. Twenty-four Thoroughbred and twelve Standardbred racehorses aged between 2 and 6 years, presented for reported poor racing performance, underwent clinical exercise testing. During the last 10 s of exercise at each speed throughout an incremental speed exercise test on a treadmill inclined at a 10% slope, samples of arterial blood and expired gases were collected. Maximum oxygen uptake and the partial pressures of oxygen and carbon dioxide in arterial blood were determined. These values were compared between the two breeds of horses and also with reference to cytological findings of bronchoalve...
Bronchoalveolar lavage in horses: effect of exercise and repeated sampling on cytology. Bronchoalveolar lavage (BAL) was performed at weekly intervals in 10 Thoroughbred horses in race training (group 1) and in 4 rested horses (group 2) for 10 weeks. Lavages were continued on a weekly basis in 4 group 1 horses for an additional 9 weeks (group 3). Cytological analysis of samples included leukocyte counts, erythrocyte counts, differential leukocyte counts, and haemosiderophage score. The mean leukocyte concentration was significantly lower in group 1 (92.1 +/- 4.6 cells/microL) when compared with group 2 (133.5 +/- 8.2 cells/microL), P = 0.037. The differential leukocyte data were ...
Equine herpesvirus 2 in pulmonary macrophages of horses. In a search of viral agents in pulmonary macrophages of horses with chronic pulmonary disease, equine herpesvirus 2 was found to be unique. In 8 of 9 horses with chronic pulmonary disease, antigens of equine herpesvirus 2 were detected by indirect immunofluorescence staining of scattered foamy macrophages immediately after harvesting by bronchoalveolar lavage and fractionation on metrizamide gradients. In a healthy horse, antigens were not found. After 1 week of cultivation of bronchoalveolar lavage cells from a second group of 9 horses with chronic pulmonary disease, viral antigens were detec...
Cytologic evaluation of bronchoalveolar lavage fluid obtained from standardbred racehorses with inflammatory airway disease. Cytologic examination of bronchoalveolar lavage fluid (BALF), including phenotypic analysis of lymphocytes, was performed on 32 Standardbreds with poor race performance and endoscopic examination findings characteristic of inflammatory airway disease (IAD). Nucleated cell counts in BALF from IAD-affected horses were higher than those in control horses; the cytologic profile of BALF in affected horses included mixed inflammation, characterized by mild neutrophilia, lymphocytosis, and monocytosis. Eosinophil and mast cell counts were not higher in the IAD-affected group, compared with those in t...
[Demonstration of two trimethoprim/sulfonamide combinations in bronchoalveolar lavage fluid of horses and determination of blood levels]. Five healthy horses were given a sulfadoxine/trimethoprim combination (Borgal, Hoechst AG) i.v. on day 1. The next ten days the horses got once a day a sulfadimethoxine/trimethoprim combination orally (Trafigal, Hoechst AG). The doses were given as recommended. One horse received no medicaments for control. On each horse six bronchoalveolar lavages were performed. Blood samples were taken to calculate blood levels and elimination half lives. To determine the amount of substances in lavage fluid and plasma the high performance liquid chromatography (HPLC) was used. Regularly low quantities of s...
Effect of prior lavage on bronchoalveolar lavage fluid cell population of lavaged and unlavaged lung segments in horses. Bronchoalveolar lavage (BAL) was performed on 16 horses to determine whether it caused local or diffuse inflammation in the lungs. In 7 horses, BAL was performed in both lungs twice, 48 hours apart. Although total cell counts of the BAL samples did not change significantly, there were increased numbers and percentage of neutrophils in the second lavage fluid samples. In 5 horses, BAL was performed in 1 lung and repeated 48 hours later in the same lung and in the corresponding airway in the contralateral lung. The absolute cell count and percentage of neutrophils were significantly (P = < 0....
Decrease in the alpha 1-proteinase inhibitor Spi3 in equine bronchoalveolar lavage fluid. The alpha 1-proteinase inhibitors of trypsin, Spi1, Spi3A, and Spi3B, in bronchoalveolar lavage fluid (BALF) and serum of horses were separated by electrophoresis, and their proportions were quantified in 12 control horses and 12 with chronic obstructive pulmonary disease (COPD). A significantly lower proportion of Spi3B (P < 0.05) and higher proportion of Spi1 (P < 0.02 to P < 0.01) were detected in BALF, compared with serum, in control and COPD-affected horses and appeared to be attributable to reduced Spi3 activity in BALF. There was no significant difference between the control an...
Phagocytic activity of polymorphonuclear leukocytes lavaged from the lungs of horses with clinically diagnosed chronic pulmonary disease. The aim of this study was to compare phagocytic activity of polymorphonuclear cells (PMNs) from the bronchoalveolar lavage of clinically healthy horses and those with severe chronic bronchiolitis. Research was carried out on 28 horses. Chronic inflammation of the lower airways was diagnosed in nine horses. Cells from the respiratory tract were lavaged according to accepted methods. For comparison, PMNs were isolated from peripheral blood of all investigated horses. The phagocytic activity of PMNs was determined in relation to two standard strains of Staphylococcus aureus, Staph, aureus Smith w...
Molecular weight alterations of alpha-1 proteinase inhibitor in equine bronchoalveolar lavage fluid. The equine alpha-1 proteinase inhibitor (alpha 1PI) system differs from that of man in that the equine system consists of four closely-linked genes (Spi1-Spi4) whereas in man, a single gene encodes for alpha 1PI. We have previously found differences in the proportion of the Spi proteins in equine serum and bronchoalveolar lavage fluid (BALF). We therefore wished to determine whether, as reported in man, there was any molecular weight difference between the Spi proteins in serum and BALF. alpha 1PI and albumin from equine BALF migrated further towards the anode compared with serum alpha 1PI on ...
Effect of sodium cromoglycate on light racehorses with elevated metachromatic cell numbers on bronchoalveolar lavage and reduced exercise tolerance. Some young horses with clinical signs of small airway disease demonstrate increased metachromatic cell numbers on bronchoalveolar lavage. The purpose of this study was to determine the effect of sodium cromoglycate treatment on clinical signs, bronchoalveolar lavage cytology and bronchoalveolar lavage histamine parameters in these horses. Twelve racehorses (age: 3.4 +/- 1.6 years) with a history of respiratory embarrassment at exercise, clinical signs of obstructive airway disease and bronchoalveolar lavage metachromatic cell differential greater than 2% were selected. Horses were randomly ass...
Effects of centrifugation and specimen preparation technique on bronchoalveolar lavage analysis in horses. Bronchoalveolar lavages (BAL) were performed for 6 healthy horses and 8 horses with lower airway diseases (LAD). Total cell and differential counts were performed before and after centrifugation and resuspension of the BAL cells in a small volume of fluid; there was no difference in the total cell counts, but mast cell percentages were significantly (P < 0.05) lower, after centrifugation, in the LAD group. The two specimen preparation techniques compared were cytocentrifugation and centrifugation on microscope glass covers. For both groups of horses, lymphocyte percentages were significantl...
Pneumocystis carinii pneumonia in foals. Pneumocystis carinii pneumonia was diagnosed in 3 foals. In 2 foals (No. 1 and 2), diagnosis was by histologic evaluation of pulmonary tissue. On retrospective evaluation, P carinii cysts were found on sediment smears of bronchoalveolar lavage fluid in 1 foal (No. 1). A different foal (No. 3) was diagnosed as having pneumocytosis by finding P carinii cysts in bronchoalveolar lavage fluid, and was treated successfully. Definitive diagnosis of pneumocytosis in animals is usually made at necropsy. However, careful cytologic evaluation in bronchoalveolar lavage fluid sediment can provide a diagnos...
Lack of residual lung damage in horses in which Rhodococcus equi-induced pneumonia had been diagnosed. The effect of prior Rhodococcus equi-induced pneumonia on pulmonary health was investigated in 5 horses (< 24 months old) using endoscopy, radiography, hematologic and bronchoalveolar lavage analyses, and pulmonary function testing. Rhodococcus equi-induced pneumonia had been diagnosed in principal horses when they were foals. Diagnosis was based on positive results of transtracheal aspiration and thoracic radiography at the time of initial clinical examination. Results of reevaluation of the respiratory system of these horses (R+) were compared with those of 5 age-matched healthy horses (R...
Sensitivity and specificity of bronchoalveolar lavage and protected catheter brush methods for isolating bacteria from foals with experimentally induced pneumonia caused by Klebsiella pneumoniae. One indication for referral of horses to veterinary hospitals is for diagnosis of the microbiologic cause of pneumonia, particularly when the initial treatment fails. Although endoscopic methods have long been available for microbiologic sample collection, accuracy of these methods under these conditions have not been studied in detail. We compared the bacteria isolated from samples obtained by bronchoalveolar lavage (BAL) with those obtained by protected catheter brush (PCB) from foals with unilateral pneumonia induced by inoculation with Klebsiella pneumoniae. As part of previously described...
Equine bronchoalveolar lavage cytology: survey of thoroughbred racehorses in training. Sixty-two Thoroughbred horses aged between 1 and 7 years in training in Sydney had bronchoalveolar lavage (BAL) samples collected for cytological examination. All horses, except the yearlings and those with a cough, had raced at the time of the examination and the trainers reported satisfactory performance. Free erythrocytes were found in 73% of samples and haemosiderophages in 90% of the samples, indicating immediate or past occurrences of exercise-induced pulmonary haemorrhage (EIPH). Bronchoalveolar fluid from the yearlings contained significantly less (P < 0.05) erythrocytes and haemosi...
A review of cytological specimens from horses with and without clinical signs of respiratory disease. Thirty-six transtracheal washing (TTW) and 12 bronchoalveolar lavage (BAL) specimens collected in clinical practice from horses with and without respiratory disease were reviewed. Cytological features were considered in accordance with the presenting complaint, clinical signs, clinical diagnoses, microbiological, radiographic and/or endoscopic findings, therapy, and response to therapy. The trichrome-stained TTW and BAL specimens were useful in interpreting the results of concurrent microbiological cultures, and determining whether a condition was present based on occurrence of typical cytolog...
Local and systemic antibody production in horses affected with chronic obstructive pulmonary disease. An enzyme-linked immunosorbent assay (ELISA) was used to quantify isotype-specific antibody to Micropolyspora faeni and to Aspergillus fumigatus in the sera and bronchoalveolar lavage fluid (BALF) of normal horses, horses with chronic obstructive pulmonary disease (COPD) and horses with other chronic respiratory diseases. Elevated antibody levels were not detected in the sera of affected horses. However, both IgE and IgA antibody to both allergens was significantly elevated in BALF in COPD affected horses sampled both when symptomatic and asymptomatic. Elevated levels were also found in animal...
Microbiologic changes during antimicrobial treatment and rate of relapse of distal respiratory tract infections in foals. Despite the high incidence of distal respiratory tract infection of undetermined cause on farms, to our knowledge, the microbiologic effects of conventional antimicrobial treatment for this condition have not been studied. We evaluated the possible pathogenic role of bacterial isolates from the distal airways of foals with clinical respiratory tract disease, by correlating changes in their numbers (increase or decrease) with clinical, endoscopic, and pulmonary cytologic signs of disease resolution during treatment with antimicrobial drugs. We also determined qualitative changes in in vitro ant...
Early neutrophil but not eosinophil or platelet recruitment to the lungs of allergic horses following antigen exposure. Previous studies have shown that bronchoalveolar lavage fluid from horses with allergic respiratory disease and showing clinical symptoms contains increased numbers of neutrophils. In some cases, the eosinophil count is also increased. In this study the time course of changes in lung function and the accumulation of radiolabelled leucocytes and platelets in the lungs of allergic and normal horses has been examined during a 7 hr allergen exposure. Antigen challenge had no effect on pleural pressure or the distribution of radiolabelled neutrophils, eosinophils or platelets in normal horses. In c...