[en] [en] BACKGROUND: Cytology of airway samples is sensitive for diagnosis of exercise-induced pulmonary haemorrhage (EIPH), but the association between tracheal wash (TW) and bronchoalveolar lavage fluid (BALF) is unknown. The objective of this study was to determine whether diagnosis of EIPH, using haemosiderophages/macrophages (H/M) ratio, differs when based on TW or BALF.
METHODS: A prospective cross-sectional study was conducted on 102 standardbred horses in training. TW and BALF were collected concomitantly from all horses at rest (at least 24 hours after their last training or race), and their H/M ratios were calculated. Spearman's correlation, Cohen's kappa and Gwet's coefficient tests were performed to evaluate the association between TW and BALF samples.
RESULTS: With BALF, 21 horses met the cytological inclusion criteria for an EIPH diagnosis from individual and/or pooled samples. With TW, 20 horses had occasional (H/M < 10%) haemosiderophages, and nine, one and three horses had small (10%-25%), moderate (25%-50%) and large (>50%) proportions, respectively. Poor correlations and inconsistent concordances between TW and BALF were found for H/M ratio.
LIMITATIONS: Limitations include the use of a single staining method and the absence of a total haemosiderin score.
CONCLUSION: No association between TW and BALF was found for the cytological diagnosis of EIPH. Based on H/M ratio, BALF remains the sample type of choice for cytological diagnosis of EIPH.
Disciplines :
Veterinary medicine & animal health
Author, co-author :
Barbazanges, Pauline ; Department of Equine Internal Medicine, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
Richard, Eric A; LABÉO (Frank Duncombe), Caen, France ; Université de Caen Normandie, BIOTARGEN UR7450, Caen, France
Lemonnier, Louise C ; Department of Equine Internal Medicine, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France
Wouters, Clovis ; Université de Liège - ULiège > Fundamental and Applied Research for Animals and Health (FARAH) > FARAH: Médecine vétérinaire comparée
Toquet, Marie-Pierre; LABÉO (Frank Duncombe), Caen, France ; Université de Caen Normandie, BIOTARGEN UR7450, Caen, France
Couroucé, Anne; Department of Equine Internal Medicine, Equine Clinic, ONIRIS, National College of Veterinary Medicine, Food Science and Engineering, Nantes, France ; Université de Caen Normandie, BIOTARGEN UR7450, Caen, France
Language :
English
Title :
Cytological diagnosis of exercise-induced pulmonary haemorrhage: Comparison of tracheal wash and bronchoalveolar lavage in standardbred racehorses.
Publication date :
30 January 2024
Journal title :
Veterinary Record
ISSN :
0042-4900
eISSN :
2042-7670
Publisher :
Wiley, England
Pages :
e3826
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
Fonds Eperon IFCE - Institut Français du Cheval et de l'Équitation
Hinchcliff KW, Couetil LL, Knight PK, Morley PS, Robinson NE, Sweeney CR, et al. Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine Consensus Statement. J Vet Intern Med. 2015;29(3):743–758.
Crispe EJ, Lester GD. Exercise-induced pulmonary hemorrhage. Vet Clin North Am Equine Pract. 2019;35(2):339–350.
Poole D, Erickson H. Exercise-induced pulmonary hemorrhage: where are we now? Vet Med. 2016;7:133–148.
McGilvray TA, Cardwell JM. Training related risk factors for exercise induced pulmonary haemorrhage in British National Hunt racehorses. Equine Vet J. 2022;54(2):283–289.
Hinchcliff KW, Jackson MA, Brown JA, Dredge AF, O'Callaghan PA, McCaffrey JP, et al. Tracheobronchoscopic assessment of exercise-induced pulmonary hemorrhage in horses. Am J Vet Res. 2005;66(4):596–598.
Cian F, Monti P, Durham A. Cytology of the lower respiratory tract in horses: an updated review. Equine Vet Educ. 2015;27(10):544–553.
Depecker M, Couroucé-Malblanc A, Leleu C, Genneviève V, Pitel PH, Richard EA. Comparison of two cytological methods for detecting pulmonary haemorrhage in horses. Vet Rec. 2015;177(12):305–305.
Van Erck-Westergren E, Franklin SH, Bayly WM. Respiratory diseases and their effects on respiratory function and exercise capacity: responses of horses with respiratory disease to exercise. Equine Vet J. 2013;45(3):376–387.
Sullivan S, Hinchcliff K. Update on exercise-induced pulmonary hemorrhage. Vet Clin North Am Equine Pract. 2015;31(1):187–198.
McKane S, Canfield P, Rose R. Equine bronchoalveolar lavage cytology: survey of Thoroughbred racehorses in training. Aust Vet J. 1993;70(11):401–404.
McKane SA, Slocombe RF. Sequential changes in bronchoalveolar cytology after autologous blood inoculation. Equine Vet J. 1999;31(S30):126–130.
Fogarty U, Buckley T. Bronchoalveolar lavage findings in horses with exercise intolerance. Equine Vet J. 1991;23(6):434–437.
Step DL, Freeman KP, Gleed RD, Hackett RP. Cytologic and endoscopic findings after intrapulmonary blood inoculation in horses. J Equine Vet Sci. 1991;11(6):340–345.
Mahalingam-Dhingra A, Bedenice D, Mazan MR. Bronchoalveolar lavage hemosiderosis in lightly active or sedentary horses. J Vet Intern Med. 2023;37(3):1243-1249
Ghio AJ, Roggli VL. Perls’ Prussian Blue stains of lung tissue, bronchoalveolar lavage, and sputum. J Environ Pathol Toxicol Oncol. 2021;40(1):1–15.
Kinnison T, Cardwell JM. Conflict between direct experience and research-based evidence is a key challenge to evidence-based respiratory medicine on British Racing Yards. Front Vet Sci. 2020;7:266.
Newton JR, Wood JLN. Evidence of an association between inflammatory airway disease and EIPH in young Thoroughbreds during training. Equine Vet J. 2010;34(S34):417–424.
Cascardo B, Bernardes C, de Souza GN, Silva KM, Pires NR, de Alencar NX, et al. Diagnostic value of tracheal wash cytology for monitoring exercise-induced pulmonary hemorrhage in Thoroughbred racehorses. J Equine Vet Sci. 2022;118:104128.
Richard EA, Fortier GD, Lekeux PM, Erck EV. Laboratory findings in respiratory fluids of the poorly-performing horse. Vet J. 2010;185(2):115–122.
Doucet MY, Viel L. Alveolar macrophage graded hemosiderin score from bronchoalveolar lavage in horses with exercise-induced pulmonary hemorrhage and controls. J Vet Intern Med. 2002;16(3):281–286.
Hermange T, Le Corre S, Bizon C, Richard EA, Couroucé A. Bronchoalveolar lavage fluid from both lungs in horses: diagnostic reliability of cytology from pooled samples. Vet J. 2019;244:28–33.
Depecker M, Richard EA, Pitel PH, Fortier G, Leleu C, Couroucé-Malblanc A. Bronchoalveolar lavage fluid in Standardbred racehorses: influence of unilateral/bilateral profiles and cut-off values on lower airway disease diagnosis. Vet J. 2014;199(1):150–156.
Gerber V, Straub R, Marti E, Hauptman J, Herholz C, King M, et al. Endoscopic scoring of mucus quantity and quality: observer and horse variance and relationship to inflammation, mucus viscoelasticity and volume. Equine Vet J. 2010;36(7):576–582.
Di Terlizzi R, English K, Cowell RL, Tyler RD, Meinkoth JH. Transtracheal and bronchoalveolar washes. In: Cowell and Tyler's diagnostic cytology and hematology of the dog and cat. Elsevier; 2020. p. 247–268.
DeHeer HL, McManus P. Frequency and severity of tracheal wash hemosiderosis and association with underlying disease in 96 cats: 2002–2003. Vet Clin Pathol. 2005;34(1):17–22.
Rocchigiani G, Verin R, Uzal FA, Singer ER, Pregel P, Ressel L, et al. Pulmonary bleeding in racehorses: a gross, histologic, and ultrastructural comparison of exercise-induced pulmonary hemorrhage and exercise-associated fatal pulmonary hemorrhage. Vet Pathol. 2022;59(6):973–982.
Couëtil LL, Cardwell JM, Gerber V, Lavoie J-P, Léguillette R, Richard EA. Inflammatory airway disease of horses—revised consensus statement. J Vet Intern Med. 2016;30(2):503–515.
Derksen FJ, Brown CM, Sonea I, Darien BJ, Robinson NE. Comparison of transtracheal aspirate and bronchoalveolar lavage cytology in 50 horses with chronic lung disease. Equine Vet J. 1989;21(1):23–26.
Malikides N, Hughes K, Hodgson D, Hodgson J. Comparison of tracheal aspirates and bronchoalveolar lavage in racehorses. 2. Evaluation of the diagnostic significance of neutrophil percentage. Aust Vet J. 2003;81(11):685–687.
Vach W, Gerke O. Gwet's AC1 is not a substitute for Cohen's kappa—a comparison of basic properties. MethodsX. 2023;10:102212.
Deniau V, Jaillardon L, Fortier G, Couroucé-Malblanc A. Comparison of cytological profiles of bronchoalveolar lavage fluid obtained from left and right lungs according to conditions of conservation and preparation. Proceedings of the Conference on Equine Sports Medicine and Science, Sigtuna, Sweden. 2010.
Varegg MS, Kløverød KM, Austnes MK, Siwinska N, Słowikowska M, Zak A, et al. Fatal pulmonary hemorrhage in a horse during bronchoalveolar lavage—single case report. BMC Vet Res. 2019;15(1):169.
Lopez Sanchez CM, Kogan C, Gold JR, Sellon DC, Bayly WM. Relationship between tracheobronchoscopic score and bronchoalveolar lavage red blood cell numbers in the diagnosis of exercise-induced pulmonary hemorrhage in horses. J Vet Intern Med. 2020;34(1):322–329.
Gold JR, Knowles DP, Coffey T, Bayly WM. Exercise-induced pulmonary hemorrhage in barrel racing horses in the Pacific Northwest region of the United States. J Vet Intern Med. 2018;32(2):839–845.
Langsetmo I, Fedde MR, Meyer TS, Erickson HH. Relationship of pulmonary arterial pressure to pulmonary haemorrhage in exercising horses. Equine Vet J. 2010;32(5):379–384.
Derkse FJ, Slocombe RF, Gray PR, Robinson NE. Exercise-induced pulmonary hemorrhage in horses with experimentally induced allergic lung disease. Am J Vet Res. 1992;53(1):15–21.
Meyer TS, Fedde MR, Gaughan EM, Langsetmo I, Erickson HH. Quantification of exercise-induced pulmonary haemorrhage with bronchoalveolar lavage. Equine Vet J. 1998;30(4):284–288.
