Frequency and severity of tracheal wash hemosiderosis and association with underlying disease in 96 cats: 2002-2003

BACKGROUND: Hemosiderophages may be found in feline tracheal wash specimens in association with various disease conditions, including heart failure, trauma, infection, foreign body migration, lung lobe torsion, pulmonary embolism or infarction, neoplasia, and bleeding diathesis. Based on observations in our laboratory, we hypothesized that tracheal wash specimens from cats with asthma also frequently contain hemosiderophages, even in the absence of other known causes of pulmonary hemorrhage. OBJECTIVES: The purpose of this study was to determine the frequency and severity of hemosiderosis in tracheal wash fluid from cats with various diseases, including asthma. METHODS: Feline tracheal wash fluid specimens submitted for cytologic evaluation between March 2002 and August 2003 were included in the study. One hundred and one specimens from 96 cats were examined with both Wright's-Giemsa and Prussian blue stains. Cats were assigned to 6 disease categories: feline asthma, pneumonia, pulmonary neoplasia, rhinitis, heart disease, and other disorders. Based on the percentage of Prussian blue-positive macrophages, hemosiderosis was categorized as negative (0%), mild (<20%), moderate (21-50%), or marked (>50%). RESULTS: The frequency of tracheal wash hemosiderosis in the study population was 63.5% (61/96); hemosiderosis was mild (29/96, 30.2%), moderate (22/96, 22.9%), or marked (10/96, 10.4%). Hemosiderosis was found in 85.7% (6/7) of cats with rhinitis, 78.6% (11/14) of cats with pulmonary neoplasia, 75.0% (27/36) of cats with asthma, 71.4% (5/7) of cats with primary or concurrent heart disease, 25.0% (5/20) of cats with pneumonia, and 66.7% (12/18) of cats with other disorders. In cats with asthma, hemosiderosis was usually mild to moderate and frequently was accompanied by increased eosinophils. CONCLUSIONS: The results of this study confirm that hemosiderosis is a common finding in tracheal wash specimens collected from cats with diverse disease conditions, including feline asthma syndrome.