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The influence of bronchoalveolar lavage on thoracic radiography in the horse
Ann Kristin Barton1,*, Thorben Schulze1, Marcus G. Doherr2, Heidrun Gehlen1
1Equine Clinic and 2Institute for Veterinary Epidemiology & Biostatistics, Freie Universitaet Berlin, 14163 Berlin, Germany
Correspondence to: Tel: +49-30-83862299; Fax: +49-30-838462529; E-mail: Ann-Kristin.Barton@fu-berlin.de
Received: August 24, 2017; Revised: February 19, 2018; Accepted: February 20, 2018; Published online: February 27, 2018.
Bronchoalveolar lavage (BAL) and thoracic radiography are routinely performed diagnostic procedures. We hypothesized that the BAL increases the interstitial opacity of caudoventral and caudodorsal thoracic radiographs. 53 horses, including 12 clinic owned and 41 horses of a referral-hospital population, were classified as healthy controls (n=12), severe (RAO, n=12) or mild-to-moderate equine asthma (IAD, n=21) according to the results of a clinical scoring system. 4 blinded and randomized thoracic radiographs of each horse were scored by two observers, who were also asked to identify the image as obtained before or after the BAL procedure. In severe equine asthma, the chance (adjusted odds) of misinterpretation of the correct time point was about 5 times higher in comparison to controls (OR = 5.373, P = 0.028). The chance of misinterpretation was about 4 times less in caudodorsal compared to caudoventral projections (OR = 0.241, P = 0.004). Identification of the correct time point was highly correlated with an increase in interstitial opacity (OR = 9.976, P < 0.0001). In conclusion, we recommend to perform BAL after thoracic radiography to avoid misinterpretation.
Keywords: horse, lung, respiratory disease, bronchoalveolar lavage, thoracic radiography

© 2018 The Korean Society of Veterinary Science.