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Bronchoalveolar lavage
Synonym(s): BAL
Introduction
- Broncho-alveolar lavage (BAL) is a valuable diagnostic tool when investigating respiratory disease in individual animals or during a group outbreak of disease.
- Culture and sensitivity of BAL samples provides information relating to bacterial colonisation of the lower respiratory tract and appropriate antibiotic selection.
- Cytology of fluids from the lower respiratory tract can be informative when pre-patent lungworm infection or non-infectious etiologies such as Farmers’ lung (allergic alveolitis) are suspected.
- Whilst many clinicians seem reluctant to perform a BAL, the technique is safe, quick, cheap and easy to perform.
- Full analysis of 5 BAL samples will cost in the region of £250-300 (SAC 2018), which is insignificant in comparison to the total cost of disease (UK 2018).
- Depending on laboratory turnaround, Polymerase Chain Reaction (PCR) and culture and sensitivity results will be available from 1-3 days after submission.
Alternative techniques
- Transtracheal aspiration Transtracheal wash.
- Tracheal wash via endoscope Transtracheal wash.
- Naso-pharyngeal swabs (not for cytology and will sample upper respiratory tract commensals) Nasopharyngeal swab.
Decision taking
- If investigating an outbreak of bovine respiratory disease Bovine respiratory disease: approach to an outbreak, the author advocates taking a clotted blood sample, to demonstrate a rising titer upon taking a second sample 2-3 weeks later, and BAL sample from at least 5 acutely affected animals.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Referred papers
- Recent references from PubMed and VetMedResource.
- Caldow G (1997) Broncho Alveolar Lavage in the Investigation of Bovine Respiratory Disease. Cattle Practice 1 (5), 39.
Organisation(s)
- Edinburgh University, UK.