advances in diagnostics: the abc’s of bronchoscopy
We’ve talked about endoscopy in general, and about more specific types of endoscopies called laparoscopy and arthroscopy. Today we’ll discuss another “scopy” called bronchoscopy.
Bronchoscopy is the use of a flexible endoscope to examine and sample the upper and lower respiratory tracts. As you recall, an endoscope generally consists of a flexible or rigid tube (in the case of bronchoscopy, it’s a flexible tube) with a camera and a light source, and we use these endoscopes to visualize different body cavities.
A huge advantage that endoscopy has in most cases is that it is non-invasive. In the cases of laparoscopy and arthroscopy, only a few small incisions need to be made rather than a large incision that opens the whole joint or abdomen. This makes for easier and faster patient recovery. But in bronchoscopy, this is really a moot point, as we can’t generally access the respiratory tract surgically to investigate lung tissue!
And that’s what makes bronchoscopy so amazing; now, when we have a patient with a respiratory problem that we cannot seem to pin down, we can actually visualize the tissues at hand to see what’s causing the problem. When visualization isn’t enough, we can sample the cells of the respiratory tract by performing a bronchoalveolar lavage (BAL) or tissue biopsy. And bronchoscopy can be therapeutic as well, as foreign bodies can be sought out and removed during the procedure.
Pets with many conditions can benefit from bronchoscopy, including those with:
Suspected lung infections (bacterial or fungal)
Feline bronchial disease (asthma)
Chronic aspiration pneumonia
Prior to bronchoscopy, patients must be deemed healthy enough for anesthesia, which is necessary to perform the procedure. Unstable patients have increased anesthetic risks, so pre-anesthetic testing should be performed before the procedure. Your veterinarian will also want to measure your pet’s oxygen levels prior to and during the procedure to make sure that your pet’s blood is adequately oxygenated.
Once safely anesthetized, the endoscope will be passed through your pet’s mouth, down the trachea, and into the lungs. The veterinarian will be able to visualize the actual walls of the trachea and bronchi to look for swelling, redness, bleeding, or pus that may explain your pet’s symptoms. Foreign bodies can be revealed, as can masses. As I said before, masses can be biopsied and foreign bodies removed with tools that fit through the endoscope.
Bronchoscopy can show us tissues that we are unable to see otherwise, and can help us treat stubborn respiratory cases by giving us an accurate diagnosis. And that, dear pet owners, is a breath of fresh air!