Bronchoalveolar lavage changes the ultrasonographic and radiographic appearances of lungs in adult horses.

BAL induces significant imaging changes; clinicians should account for these artifacts when interpreting thoracic images.

This prospective observational study evaluated 32 adult horses to determine how bronchoalveolar lavage (BAL) affects the ultrasonographic and radiographic appearance of lungs in horses suspected of having equine asthma syndrome (EAS). Thoracic imaging was performed before and within 3 hours after BAL procedure. Both ultrasonographic and radiographic scores increased significantly following BAL, with notable changes on the right side ultrasonographically and in the caudoventral and caudodorsal lung regions radiographically. Importantly, no correlation was found between the magnitude of imaging score increases and either the percent recovery of BAL fluid or the percentage of neutrophils in cytology. These findings indicate that clinicians must recognize BAL-induced imaging artifacts when evaluating horses for EAS, as these procedurally-related changes could potentially be misinterpreted as disease findings. This is critical for accurate diagnosis and exclusion of differential diagnoses in horses with suspected lower airway disease.

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