Respiratory System e.g. chronic cough, nasal discharge
Bronchoalveolar lavage (BAL or lungwash)
A BAL involves passing a special tube or endoscope down into the airways of a horse as far as the tube will go until it “wedges” in an airway. A volume of sterile saline solution is infused through the tube or endoscope. This fluid is then immediately retrieved and submitted for analysis. Various analyses can be performed on the fluid including looking at cells microscopically and assessment for bacteria.
A BAL helps determine if abnormal cells, fluid, fungi or bacteria are present within the airways and air sacs of the lung. The results of the BAL can help determine the best course of treatment.
A BAL can be performed on a conscious standing horse, however sedation is required to minimise discomfort for the horse. Local anaesthetic is also often used to reduce the coughing response while the tube is being passed.
Transtracheal wash
This procedure is designed to recover fluid samples containing respiratory secretions from the lower airways for evaluation of cells or for bacterial or fungal culture. It differs from the BAL in that the transtracheal wash does not sample as deeply as a BAL.
A sample of fluid is collected from the trachea (wind pipe) either through an endoscope or via a catheter passed through the skin in the lower third of the horse’s neck. This procedure is performed with sedation and local anaesthetic with minimal discomfort to the horse.
Rhinoscopy/Bronchoscopy
A special endoscope is used to examine a horse’s nasal passages, sinus openings, larynx, pharynx and large airways. This enables the clinician to look for the source of a nasal discharge and to assess the extent of airway inflammation in a coughing horse.
X-rays
Our high-powered X-ray machine enables us to obtain high quality images of a hors's skull for assessment of sinuses and other potential sources of a nasal discharge. We are also able to obtain good quality X-rays of a horse's lungs, which can enable us to detect inflammation, abscesses, pneumonia, and we can determine if a horse is a "bleeder".
Ultrasound
Thoracic ultrasound (ultrasound of the chest region) can provide useful information about the surface of the lungs and will detect lung that is not inflated (such as in pneumonia) and if there is fluid accumulation around the lungs (pleuritis or pleurisy). In many instances, ultrasound is a better diagnostic modality than X-rays for conditions affecting the lungs.
Arterial blood gases
In horses showing an increased breathing effort or respiratory distress, it is important to know how severe that problem may be. Along with our other respiratory diagnostic modalities, assessing the amount of oxygen and carbon dioxide in the arterial blood provides vital information about lung function. We have a portable blood gas machine that enables us to evaluate arterial blood samples patient side.