Bronchoalveolar Lavage of Adults and Foals

Bronchoalveolar lavage (BAL) can be performed via a BAL catheter/tube or via endoscopy. Due to this procedure, a sample from the lower airways is obtained for cytologic characterization, particularly when a non-infectious cause of lower airway disease is suspected. It is used to evaluate the airway anatomic structures such as the larynx, trachea, and larger bronchi and collect sample via bronchoscopy of a specific area of the tracheobronchial tree where more inflammation or discharge is noted. The degree of physical and chemical restraint will depend on the age, training, and disposition of the horse. Foals are often restrained in sternal recumbency under heavy sedation on a foal table with the thoracic limbs over the leading edge of the table, facing the endoscopist. Moderate sedation will facilitate the procedure and decrease coughing. Care during withdrawal of the endoscope is necessary to avoid bumping the ethmoid and causing epitaxis.