Inflammatory airway disease: When, how to perform a bronchoalveolar lavage - DVM
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Inflammatory airway disease: When, how to perform a bronchoalveolar lavage
This diagnostic test for IAD is relatively easy for practitioners to perform in the field


DVM360 MAGAZINE


Curschmann's spirals (Figure 4) are coiled plugs of mucus and cellular casts extruded from obstructed small airways and are a classic cytologic finding of chronic inflammatory small-airway disease.

Hemosiderophages may be present in horses with exercise-induced pulmonary hemorrhage. If the BAL cytology does not yield a diagnosis or yields equivocal findings, the addition of pulmonary function testing may provide further insight.

Summary

Bronchoalveolar lavage is relatively easy to perform in the field. It is the preferred means of evaluating small-airway disease, but should not be performed on patients with severe respiratory compromise.

When sepsis is suspected, a transtracheal aspirate would be the preferred diagnostic methodology.

Bronchoalveolar lavages should be promptly submitted for evaluation by a clinical pathologist.

The hallmarks of inflammatory disease of the small airways are increased mucus and an increased percentage of neutrophils, mast cells or eosinophils.

Barton is the Josiah Meigs Distinguished Teaching Professor at the University of Georgia's College of Veterinary Medicine, where she is a large-animal internist in academic practice. She received her DVM from the University of Illinois in 1985, her PhD in physiology at the University of Georgia in 1990 and became an ACVIM diplomate in 1990.

Suggested Reading

•Couetil LL et al. Inflammatory airway disease of the horse: ACVIM consensus statement. JVIM 21: 356-361, 2007. •Viel L and Hewson J. Bronchoalveolar lavage in current therapy in equine medicine 5, Robsinson NE (ed). Saunders, Philadelphia, Pa. p 407-411, 2003.


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Source: DVM360 MAGAZINE,
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