Incidence Of Exercise-induced Pulmonary Hemorrhage Research Articles

Relation between exercise-induced pulmonary hemorrhage and findings in upper airway and trachea in Thoroughbred racehorses

This retrospective study aimed to investigate the relationship between exercise-induced pulmonary hemorrhage (EIPH) and upper airway disorders in Thoroughbred racehorses that competed at the Sao Paulo Jockey Club between 1999 and 2005. Data were collected from 4,036 endoscopic examinations performed 30 min after a race by the same examiner. The association between upper airway disorders and EIPH was assessed using the chi-square test. In total, 2299 and 1737 horses received and did not receive furosemide before a race, respectively. The incidence of EIPH in medicated and non-medicated horses was 52.4% and 60%, respectively. Among horses with left-sided laryngeal hemiplegia or dorsal displacement of the soft palate, 61.0% and 64.1% of them had EIPH, respectively. There was no relationship between EIPH and other upper airway disorders, such as pharyngeal lymphoid hyperplasia and mucopurulent discharge draining from guttural pouch openings. Left-sided laryngeal hemiplegia and dorsal displacement of the soft palate were positively associated with EIPH, but the association was statistically significant only for dorsal displacement of the soft palate (p < 0,05).

Influence of Long-Term Furosemide Use on Bone Mineral Content, Bone Metabolism Markers, and Water Weight Loss in Horses

Furosemide is used to reduce the incidence of exercise-induced pulmonary hemorrhage in racehorses. Previous research suggests furosemide negatively impacts calcium balance, which may have long-term implications for bone health. Eleven healthy horses, either control (CON, n = 5) or treatment (FUR, n = 6), were used to test furosemide’s effects on bone mineral content (BMC), bone metabolism biomarkers, and weight loss after administration. Treatment horses received IV furosemide at 1 mg⋅kg−1 BW once weekly for seven weeks, and blood was collected before and at 24 hours after administration for biomarker analysis. All horses were weighed before and at 2, 4, 8, 24, and 48 hours after administration. Radiographs of the left third metacarpal were taken every 28 days for BMC determination using radiographic bone aluminum equivalence. After administration, FUR lost more BW than CON (P < .05 for all) as quickly as 2 hours after administration (CON: −0.4 ± 0.3%, FUR: −2.2 ± 0.3%), and these losses remained greater than CON at 4 hours (CON: −1.0 ± 0.3%, FUR: −3.3 ± 0.3%) and 8 hours (CON: 0.0 ± 0.3%, FUR: −1.2 ± 0.3%). FUR lost more BW on day 0 than CON (P = .03), but on day 28 and day 49, FUR BW losses were no greater than CON (P > .10). No treatment effects were observed for BMC nor pyridinoline and osteocalcin concentrations (P > .10). Reduced BW changes over time in FUR but not CON warrant further investigation to establish the efficacy of frequent furosemide administration over long periods of time.

Incidence of exercise-induced pulmonary hemorrhage in racehorses in Puerto Rico

Exercise-induced pulmonary hemorrhage (EIPH) is a very common condition in racehorses and is characterized by an alteration of the respiratory system. Depending on the magnitude, EIPH causes bleeding in lung passages making breathing difficult. EIPH is evaluated by endoscopies on a scale from 0 to 5, with 0 corresponding to no hemorrhage and 5 to a severe condition. In Puerto Rico, the only preventive measure used is the administration of a diuretic 4 h before the race. A data set was analyzed to determine factors associated with the incidence of EIPH and the preventive effect of the diuretic. The data was supplied by Equus PR, Center of Veterinary Medicine, and the factors considered were month of the year, sex (male or mare), distance of the race in meters (C1: 400 to 1,200; C2: 1,300 to 1,400; C3: &gt; 1600), and the use or not of a diuretic. The randomly selected data of 2,632 endoscopies of racehorses running or not that were utilized represented 20% of the total endoscopies recorded in 2014. Of this number 1,377 were from horses within 1 to 3 h after the race, representing 52% of the total. A Chi-square test analysis was performed to determine the frequency of EIPH regarding the factors of month, sex, distance of the race, and use of the diuretic. Of the 1,377 animals, 488 presented some degree of EIPH, equivalent to 35% of the total sample. The percentage of affected horses suffering EIPH severity levels from 1 to 5 was 52.8, 23.6, 13.5, 7.3 and 2.8, respectively. The frequency and severity of EIPH were similar (P = 0.435) during the 12 months of the year. Males and mares also had similar (P = 0.587) incidence. Horses running shorter races (C1 and C2) had a higher (P&lt;0.02) incidence of EIPH than those running longer races (C3). The number of healthy horses, or those suffering from the condition, was similar (P = 0.375) regardless of diuretic use. In summary, 35% of the racehorses competing presented some level of EIPH; month of year and sex did not alter the incidence. Horses running shorter distances showed a higher incidence of the condition, and use of the diuretic was not effective as a preventive method for EIPH.

Exercise-induced pulmonary haemorrhage in horses – review

Exercise-induced pulmonary haemorrhage is a major cause of poor performance in the equine athlete. It is an important cause of exercise intolerance and results from strenuous exercise and pathophysiological changes in the equine lung and possibly in the airways. Endoscopic surveys of the respiratory tracts of horses after competitive events have shown that many horses experience exercise-induced pulmonary haemorrhage. The reported incidence of exercise-induced pulmonary haemorrhage in different breeds varies between 40–85%. The cause of bleeding in exercising horses has fostered considerable debate over the past three centuries, but currently, the most accepted hypothesis is that the source of haemorrhage is disruption of the pulmonary capillaries during exercise. Furosemide is the medication used most widely for the treatment and prevention of exercise-induced pulmonary haemorrhage. This review provides an update on the aetiology, clinical signs, physiopathology, diagnosis and treatment of exercise-induced pulmonary haemorrhage.

Nasal strips do not affect pulmonary gas exchange, anaerobic metabolism, or EIPH in exercising Thoroughbreds.

The present study was carried out to examine whether nasal strip application would improve the exercise-induced arterial hypoxemia and hypercapnia, diminish anaerobic metabolism, and modify the incidence of exercise-induced pulmonary hemorrhage (EIPH) in horses. Two sets of experiments, control and nasal strip experiments, were carried out on seven healthy, sound, exercise-trained Thoroughbred horses in random order, 7 days apart. Simultaneous measurements of core temperature, arterial and mixed venous blood gases/pH, and blood lactate and ammonia concentrations were made at rest, during submaximal and near-maximal exercise, and during recovery. In both treatments, whereas submaximal exercise caused hyperventilation, near-maximal exercise induced significant arterial hypoxemia, desaturation of Hb, hypercapnia, and acidosis. However, O2 content increased significantly with exercise in both treatments, while the mixed venous blood O2 content decreased as O2 extraction increased. In both treatments, plasma ammonia and blood lactate concentrations increased significantly with exercise. Statistically significant differences between the control and the nasal strip experiments could not be discerned, however. Also, all horses experienced EIPH in both treatments. Thus our data indicated that application of an external nasal dilator strip neither improved the exercise-induced arterial hypoxemia and hypercapnia nor diminished anaerobic metabolism or the incidence of EIPH in Thoroughbred horses performing strenuous exercise.