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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.
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...
Clinical and endoscopic study to estimate the incidence of distal respiratory tract infection in thoroughbred foals on Ontario breeding farms. Respiratory tract infections are prevalent in foals, yet the frequency with which the distal airways are affected in clinical episodes of respiratory tract disease has not been evaluated to our knowledge. The objective of the study was to determine the incidence of distal respiratory tract infection (DRTI) in foals on a sample of Thoroughbred breeding farms (n = 10) in Ontario. In a pilot study, clinical criteria commonly used to select foals for antimicrobial treatment (detection of abnormal lung sounds, plus nasal discharge, cough, fever, tachypnea, and/or lethargy) were found to segregate f...
Association of microbiologic flora with clinical, endoscopic, and pulmonary cytologic findings in foals with distal respiratory tract infection. Undifferentiated distal respiratory tract disease (nasal discharge, cough, pneumonia) in foals (1 to 8 months old) is a burdensome economic problem on breeding farms; yet, the infective agents associated with these episodes have not been well described. Possible causes of these episodes of illness were investigated by culturing specimens of proximal and distal airways of clinically diseased foals (n = 101), prior to any treatment, for aerobic and anaerobic bacteria and viruses (rhinoviruses, equine arteritis virus, equine herpesvirus subtype 1 [EHV-1], influenza virus, and adenovirus). Pairs o...
Effects of triamcinolone acetonide on pulmonary function and bronchoalveolar lavage cytologic features in horses with chronic obstructive pulmonary disease. Effects of triamcinolone acetonide (TA) on pulmonary function, bronchoalveolar lavage cytologic features and serum cortisol concentration, were studied in 5 control horses and 5 horses with chronic obstructive pulmonary disease (COPD). In experiment 1, horses were brought in from pasture 3 weeks before administration of 1 injection of TA (0.09 mg/kg of body weight, IM), and were stabled in dusty conditions throughout the experimental period. Measurements of respiratory rate (f), tidal volume, minute ventilation, expiratory-to-inspiratory time ratio, maximal change in transpulmonary pressure (d...
Comparison of cellular and molecular components of bronchoalveolar lavage fluid harvested from different segments of the equine lung. A comparison was made of the cellular and molecular components of bronchoalveolar lavage fluid (BALF) harvested from the left and right diaphragmatic lobes, the accessory lobe of the right lung and the apical lobe of the left lung, of seven control horses and six horses with symptomatic chronic obstructive pulmonary disease (COPD). Neither control nor symptomatic COPD affected horses showed significant regional differences in BALF recovery volumes, total and differential BALF cell counts, albumen adjusted total and absolute BALF cell counts, total and absolute pulmonary epithelial lining fluid...
Evaluation of urea and albumen as endogenous markers of dilution of equine bronchoalveolar lavage fluid. The urea and albumen dilution techniques for standardising the variable concentrations of pulmonary epithelial lining fluid (PELF) in bronchoalveolar lavage fluid (BALF) samples were evaluated in horses. Both techniques proved satisfactory and were of equal accuracy. Albumen adjusted BALF cell counts were significantly higher than PELF cell counts. BALF from normal horses contained, on average, 0.4 per cent PELF (range 0.1 to 1.0 per cent), as determined by the urea dilution technique.
Evaluation of local endobronchial antigen challenges in the investigation of equine chronic obstructive pulmonary disease. Local transendoscopic endobronchial antigen challenge, which has proved to be a valuable clinical and research technique in the study of human pulmonary hypersensitivity, was evaluated in control and asymptomatic COPD--affected horses. Transendoscopic endobronchial challenges with phosphate-buffered saline (PBS), Micropolyspora faeni extract at 60 and 600 micrograms/ml and mouldy hay extract elicited neutrophilic airway inflammatory responses in control (N = 5-7) and asymptomatic COPD-affected (N = 5-7) horses, as determined by cytological examinations of bronchoalveolar lavage fluid (BALF) ha...
Responses of horses affected with chronic obstructive pulmonary disease to inhalation challenges with mould antigens. Eight control and 8 asymptomatic COPD-affected horses were given, on separate occasions, inhalation challenges with extracts of Micropolyspora faeni, Aspergillus fumigatus and Thermoactinomyces vulgaris. All horses were also given nebulised phosphate-buffered saline (PBS) challenges and 'natural challenges' (NCs), i.e. exposure to hay and straw, as control challenges. Responses were assessed by clinical, pulmonary mechanics, arterial blood gas tensions, arterial blood pH and bronchoalveolar lavage fluid cytological examinations. PBS challenges had no effect on control or COPD-affected horses, ...
