Tracheoscopy is the endoscopic study of the trachea and bronchoscopy is the endoscopic evaluation of the primary airways in the lungs. In most cases a small, short flexible scope is used to perform the study. Samples for culture and analysis can be obtained through the bronchoscope using either a fluid lavage technique (the flushing and retrieval of sterile fluid) or a sterile brush.
Foreign matter can be identified and often removed. Samples of airway growths can be obtained with biopsy instruments. In larger dogs, the scope can be passed down the throat without disruption of anesthesia or oxygen. Bronchoscopy requires little patient preparation outside of withholding food the morning of the scheduled procedure. Most patients are discharged the same day that the procedure is performed.
The major symptoms and reasons to perform a bronchoscopy/tracheoscopy are:
1. Persistent coughing
2. Study and removal of foreign matter in the trachea and lungs
3. To obtain biopsies from the trachea or major airways
4. To aid in the diagnosis of a collapsed trachea or lung
5. To obtain samples for testing and sensitivity when pneumonia is suspected
6. To determine the location of a tear in the trachea
BAL (bronchoalveolar lavage) is necessary to diagnose diseases such as chronic bronchitis, bacterial pneumonia (type and susceptibility of bacteria), eosinophilic bronchopneumopathy, lung worms (when not detected on feces), feline asthma, and useful in the diagnosis of foreign bodies that were not visible during bronchoscopy. Foreign body is suspected depending on the type of bacteria present in the sample.
BAL done via bronchoscopy offers the opportunity to choose the most affected area for sampling. This eliminates the possibility of not acquiring a representative sample during airway wash.
Endotracheal wash or transtracheal wash is a procedure to evaluate lungs for infection (pneumonia), inflammation, or cancer. In smaller patients (cats and small dogs) an endotracheal tube is inserted from the mouth into the trachea. In larger dogs a needle catheter is passed directly into the trachea. Sterile saline is inserted into the lungs and a sample is then retrieved for analysis (cytology and culture).
Our Internal Medicine team
Besides Dr. Otoni and Dr. Galvao, Dr. Julie Danner is also part of our internal medicine team and she also does this procedure.