TECHNIQUE

Bronchoalveolar Lavage in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description Based on the description given in Ward (2006) (B601.2.w2).

Note: the following procedure can be performed using a bronchoscope if there is one available and this will have the advantage of permitting direct visualisation of the airway that is to be sampled. (B601.2.w2)

  • Restraint:
    • The rabbit must be anaesthetised for this procedure. (B601.2.w2)
  • Preparation:
    • Apply sterile lidocaine (lignocaine) topically to the laryngeal mucosa. (B601.2.w2)
    • Intubate, using a sterile endotracheal tube. See: Endotracheal Intubation of Rabbits
      • To minimise oral contamination, the tube must be passed through the larynx as cleanly as possible (ideally using mouth gags and a long-bladed laryngoscope to aid placement). (B601.2.w2)
  • Positioning:
    • Place the rabbit in lateral recumbency making sure the most severely affected side is next to the table (the degree of severity is determined on the results of physical examination and radiography). (B601.2.w2)
  • Technique:
    • Pass a sterile catheter through the endotracheal tube, blindly.
      • If a bronchoscope is available, perform this procedure via the bronchoscope. (B601.2.w2)
      • The bronchoscope allows the operator to directly visualise the sampling site.
    • Gently advance the catheter until it lodges in a distal airway. (B601.2.w2)
    • Using a syringe, instil a bolus of warm (body temperature) sterile saline (1 - 2 mL/kg) into the catheter over about three seconds. (B601.2.w2)
    • To recover the fluid, apply gentle suction
      • Briefly elevating the rabbit's caudal half a few inches off the table may facilitate this. (B601.2.w2)
    • Make several attempts to aspirate fluid until no further fluid can be obtained. (B601.2.w2)
      • Note: it is only possible to retrieve a portion of the instilled fluid. (B601.2.w2)
    • Provide 100% oxygen for at least ten to fifteen minutes after the procedure, and expand the lungs with several "sighs" whilst the rabbit is still intubated. (B601.2.w2)
Appropriate Use (?)
Indications
  • Investigation of lower respiratory disease of unknown origin. (B601.2.w2)
Appropriate restraint
  • Anaesthesia is necessary for this procedure. (B601.2.w2)
Bronchoscope
  • This piece of equipment is very useful for this procedure as it will permit direct visualisation of the airway that is to be sampled. (B601.2.w2)
Notes
  • Sterile equipment
    • Catheters, endotracheal tubes, syringes etc. must remain sterile during the procedure. 
  • Disposal of used equipment
    • Used disposable equipment needs to be put into the appropriate clinical waste container and needles should be disposed of in a sharps container.
Complications/ Limitations / Risk
  • Restraint:
    • Anaesthesia is necessary for this procedure. (B601.2.w2)
  • Maintaining sterility:
    • To minimise oral contamination, the sterile endotracheal tube must be passed through the larynx as cleanly as possible (ideally using mouth gags and a long-bladed laryngoscope to aid placement). (B601.2.w2)
  • Providing adequate oxygen after the procedure:
    • The patient should receive 100 % oxygen for at least ten to fifteen minutes and the lungs should be expanded with several "sighs" whilst the rabbit is still intubated. (B601.2.w2)
Equipment / Chemicals required and Suppliers
  • A bronchoscope is very useful but not essential.
  • Sterile lidocaine (lignocaine)
  • Sterile endotracheal tube 
  • Mouth gags and a long-bladed laryngoscope are useful. 
  • Sterile catheter
  • Sterile syringe
  • Sterile saline

(B601.2.w2)

Expertise level / Ease of Use This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost / Availability
  • Equipment is relatively inexpensive.
  • Cost of equipment for in-house testing
  • Cost of external laboratory fees.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Nikki Fox BVSc MRCVS (V.w103)
Referee Debra Bourne MA VetMB PhD MRCVS (V.w5); Brigitte Reusch BVet Med (Hons) CertZooMed MRCVS (V.w127)
References B601.2.w2

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