How to perform a transtracheal aspirate in horses for diagnosis of lower respiratory tract disease

Rebecca C. Bishop College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL

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 DVM, MS, DACVS https://orcid.org/0000-0002-9660-732X
,
Ana D. Nobrega College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL

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Ina Mersich College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL

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 Mag med vet
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Pamela A. Wilkins College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL

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 DVM, PhD, DACVIM, DACVECC
DOI:
https://doi.org/10.2460/javma.24.11.0697
Volume/Issue:
Volume 263: Issue 3
Received:
02 Nov 2024
|
Accepted:
25 Nov 2024
|
Online Publication Date:
18 Dec 2024
Open access
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Abstract

OBJECTIVE

To describe indications for and demonstrate the technique to perform a transtracheal aspirate in horses. Transtracheal aspirate is indicated to collect samples for cytology and bacteriologic culture in cases of suspected pneumonia or other lower respiratory tract disease.

ANIMALS

1 healthy university-owned horse was used for demonstration purposes. Images of clinical case samples from the University of Illinois Veterinary Teaching Hospital are shown.

METHODS

The horse is restrained and sedated with detomidine or xylazine to facilitate restraint and butorphanol to minimize coughing. The ventral neck is clipped and aseptically prepared. The site of planned puncture proximal to the bifurcation of the sternocephalicus is anesthetized with lidocaine. Two to three 30-mL syringes are filled with saline aseptically. A stab incision is made with a No. 15 blade to the depth of the trachea. The trocar is advanced between tracheal rings on midline, the stylet removed, and the aspiration catheter advanced through the trocar to the level of the proximal horizontal trachea. Sterile saline (30 mL) is infused rapidly, and suction is applied to the syringe while slowly withdrawing the catheter until fluid is retrieved. The catheter and trocar are withdrawn and the puncture site covered with antimicrobial ointment or a light bandage.

RESULTS

Samples are collected in a plain tube for bacteriologic culture and EDTA for cytology. The visual appearance of purulent effluent confirms severe pneumonia.

CLINICAL RELEVANCE

Transtracheal aspirate is minimally invasive and simple to perform with available kits. Samples provide valuable information to guide treatment decisions and selection of antimicrobials for horses with suspected lower respiratory tract disease.

Abstract

OBJECTIVE

To describe indications for and demonstrate the technique to perform a transtracheal aspirate in horses. Transtracheal aspirate is indicated to collect samples for cytology and bacteriologic culture in cases of suspected pneumonia or other lower respiratory tract disease.

ANIMALS

1 healthy university-owned horse was used for demonstration purposes. Images of clinical case samples from the University of Illinois Veterinary Teaching Hospital are shown.

METHODS

The horse is restrained and sedated with detomidine or xylazine to facilitate restraint and butorphanol to minimize coughing. The ventral neck is clipped and aseptically prepared. The site of planned puncture proximal to the bifurcation of the sternocephalicus is anesthetized with lidocaine. Two to three 30-mL syringes are filled with saline aseptically. A stab incision is made with a No. 15 blade to the depth of the trachea. The trocar is advanced between tracheal rings on midline, the stylet removed, and the aspiration catheter advanced through the trocar to the level of the proximal horizontal trachea. Sterile saline (30 mL) is infused rapidly, and suction is applied to the syringe while slowly withdrawing the catheter until fluid is retrieved. The catheter and trocar are withdrawn and the puncture site covered with antimicrobial ointment or a light bandage.

RESULTS

Samples are collected in a plain tube for bacteriologic culture and EDTA for cytology. The visual appearance of purulent effluent confirms severe pneumonia.

CLINICAL RELEVANCE

Transtracheal aspirate is minimally invasive and simple to perform with available kits. Samples provide valuable information to guide treatment decisions and selection of antimicrobials for horses with suspected lower respiratory tract disease.

Keywords: equine; transtracheal wash; pneumonia; aspiration; lung

Acknowledgments

The background music featured in this Technical Tutorial Video, titled “The Lounge,” by Ben Tissot, was acquired from Bensound.com (license code S7DB4OIXE3FRVICR).

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this abstract or video.

Funding

None reported.

ORCID

R. C. Bishop https://orcid.org/0000-0002-9660-732X

References

  • 1.

    Gerard MP, Wilkins PA. Respiratory tract. In: Southwood LL, Wilkins PA, eds. Equine Emergency and Critical Care Medicine. CRC Press; 2014. doi:10.1201/b17486-5

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  • 2.

    Sponseller B, Sponseller B. Transtracheal aspiration of adults and foals. In: Costa LRR, Paradis MR, eds. Manual of Clinical Procedures in the Horse. John Wiley & Sons Inc; 2017:255-259. doi:10.1002/9781118939956.ch26

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Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
01 Mar 2025
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