Exercise-Induced Pulmonary Hemorrhage (EIPH) is a condition observed in horses, characterized by bleeding from the blood vessels within the lungs during or shortly after intense physical activity. This phenomenon is commonly identified in racing and performance horses. The condition is associated with the rupture of pulmonary capillaries, leading to the presence of blood in the airways. EIPH can affect a horse's respiratory efficiency and overall performance. Diagnosis is typically confirmed through endoscopic examination or detection of blood in the trachea post-exercise. This page compiles peer-reviewed research studies and scholarly articles that explore the pathophysiology, diagnosis, management, and implications of EIPH in equine athletes.
Kingston JK, Bayly WM, Sides RH.Exercise-induced pulmonary haemorrhage has been associated with reduced performance in racing horses. However, it is unclear what volume of blood loss into the lungs impairs performance. The purpose of the present study was to determine the minimal volume of autologous Horses blood instilled into the airways that significantly affects performance and pulmonary function in exercising horses. Six Thoroughbred horses performed 2 exercise bouts on each of 4 treatment test days. Each exercise bout consisted of a 2 min warm-up at 4 m/s followed by running at a speed equivalent to 115% VO2max, until ...
Caillaud C, Connes P, Bouix D, Mercier J.Exercise-induced arterial hypoxemia (EIAH), i.e., a significant drop of O2 arterial partial pressure during sea level exercise, has been shown in both aerobically trained athletes and athletic animal species. The mechanisms potentially involved include ventilation/perfusion inequality and/or pulmonary diffusing capacity limitation. In thoroughbred horses, EIAH is going with pulmonary haemorrhage (EIPH). Stress failure of pulmonary capillaries leading to diffusion limitation has been proposed. Indeed, during intense exercise, the increased cardiac output and blood viscosity combine to rise capi...
Manohar M, Goetz TE, Hassan AS, Depuy T, Humphrey S.In view of the suggestion that pulmonary injury-induced release of histamine and/or other chemical mediators from airway inflammatory and mast cells contribute to the exercise-induced arterial hypoxemia (EIAH) in human athletes, we examined the effects of pretreatment with a potent anti-inflammatory agent, dexamethasone, on EIAH and desaturation of hemoglobin in horses. Seven healthy, sound, exercise-trained Thoroughbreds were studied in the control (no medications) experiments, followed in 7 days by intravenous dexamethasone (0.11 mg.kg(-1).day(-1) for 3 consecutive days) studies. Blood-gas m...
Doucet MY, Viel L.The objective of this study was to determine if a quantitative scoring system for evaluation of hemosiderin content of alveolar macrophages obtained by bronchoalevolar lavage provides a more sensitive test for the detection of exercise-induced pulmonary hemorrhage (EIPH) in horses than does endoscopy of the lower airways. A sample population composed of 74 Standardbred racehorses aged 2-5 years was used. Horses were grouped as either control (EIPH-negative) or EIPH-positive based on history and repeated postexertional endoscopic evaluation of the bronchial airways. Bronchoalveolar lavage was p...
Doucet MY, Viel L.A clinical study was performed to determine whether clinical, endoscopic, radiographic, bronchoalveolar lavage (BAL) cytological, and pulmonary biopsy findings could be correlated in horses with exercise-induced pulmonary hemorrhage (EIPH) compared with controls. Racing standardbred horses were selected as either EIPH (n = 10) or control (n = 10), based on repeated postexertional endoscopy of the lower airways. Complete physical and respiratory examinations were performed and blood samples were submitted for arterial blood gas analysis, hematologic study, and fibrinogen determination. Bilatera...
Manohar M, Goetz TE, Humphrey S, Depuy T.It has been suggested that pulmonary injury and inflammation-induced histamine release from airway mast cells may contribute to exercise-induced arterial hypoxemia (EIAH). Because stress failure of pulmonary capillaries and EIAH are routinely observed in exercising horses, we examined whether preexercise administration of an H1-receptor antagonist may mitigate EIAH. Two sets of experiments, placebo (saline) and antihistaminic (tripelennamine HCl at 1.10 mg/kg iv, 15 min preexercise) studies, were carried out on seven healthy, exercise-trained Thoroughbred horses in random order 7 days apart. A...
Geor RJ, Ommundson L, Fenton G, Pagan JD.The purpose of this study was to examine the effects of an external nasal strip (NS), frusemide (FR) and a combination of the 2 treatments (NS + FR) on exercise-induced pulmonary haemorrhage (EIPH) in Thoroughbred horses. It was hypothesised that both the NS and FR would attenuate EIPH as assessed by red blood cell count in bronchoalveolar lavage fluid. In random order, 8 horses completed each of 4 sprint exercise tests on a treadmill: 1) NS; 2) FR (0.5 mg/kg bwt i.v., 4 h pre-exercise); 3) NS + FR; and 4) control (C; no treatment). After a 5 min warm-up (4.5 m/s), horses completed 2 min runni...
Kindig CA, McDonough P, Finley MR, Behnke BJ, Richardson TE, Marlin DJ, Erickson HH, Poole DC.In horses, the exercise-induced elevation of pulmonary arterial pressure (Ppa) is thought to play a deterministic role in exercise-induced pulmonary hemorrhage (EIPH), and thus treatment designed to lower Ppa might reasonably be expected to reduce EIPH. Five Thoroughbred horses were run on a treadmill to volitional fatigue (incremental step test) under nitric oxide (NO; inhaled 80 ppm) and control (N(2), same flow rate as per NO run) conditions (2 wk between trials; order randomized) to test the hypothesis that NO inhalation would reduce maximal Ppa but that this reduction may not necessarily ...
Manohar M, Goetz TE, Hassan AS, Rothenbaum P, Humphrey S.The present study was carried out to determine whether inhibition of nitric oxide (NO) synthase promotes anaerobic metabolism in exercising horses, resulting in a significantly increased blood lactate concentration. N(omega)-nitro-L-arginine methyl ester (L-NAME) is a potent inhibitor of NO synthase that has been tested in horses and other species. Two sets of experiments, namely placebo (saline control) and L-NAME (20 mg/kg, i.v.) studies, were carried out on seven healthy, sound, exercise-trained, Thoroughbred horses in random order, 6 to 7 days apart. In both experiments, an incremental exe...
Manohar M, Goetz TE, Hassan AS.Because sensitivity of equine pulmonary vasculature to endogenous as well as exogenous nitric oxide (NO) has been demonstrated, we examined whether endogenous NO production plays a role in exercise-induced arterial hypoxemia. We hypothesized that inhibition of NO synthase may alter the distribution of ventilation-perfusion mismatching, which may affect the exercise-induced arterial hypoxemia. Arterial blood-gas variables were examined in seven healthy, sound Thoroughbred horses at rest and during incremental exercise protocol leading to galloping at maximal heart rate without (control; placebo...
Kindig CA, McDonough P, Fenton G, Poole DC, Erickson HH.The purpose of this investigation was to study the effects of an equine nasal strip (NS), furosemide (Fur), and a combination of both (NS + Fur) on exercise-induced pulmonary hemorrhage (EIPH) at speeds corresponding to near-maximal effort. Five Thoroughbreds (526 +/- 25 kg) were run on a flat treadmill from 7 to 14 m/s in 1 m x s(-1) x min(-)1 increments every 2 wk (treatment order randomized) under control (Con), Fur (1 mg/kg iv 4 h prior), NS, or NS + Fur conditions. During each run, pulmonary arterial (Ppa) and esophageal (Pes) pressures were measured. Severity of EIPH was quantified via b...
Funkquist P, Sandhagen B, Persson SG, Hedenstierna G, Essén-Gustavsson B, Nyman G.Five Standardbred trotters with red cell hypervolaemia (RCHV) were compared before and after removal of approximately 22% (36 ml/kg bwt) of the total blood volume in order to evaluate the haemodynamic responses, haemorheological alterations and oxygen transport during exercise to fatigue. Data were recorded during submaximal exercise at 4 different speeds on a treadmill and then during continued running at the highest speed step until fatigue. Oxygen uptake (VO2), pulmonary artery pressure (PAP), systemic artery pressure (SAP), heart rate (HR), haematocrit and haemoglobin concentrations (Hb) w...
Manohar M, Goetz TE, Rothenbaum P, Humphrey S.The present study was carried out to examine whether pentoxifylline administration to horses premedicated with frusemide would attenuate the exercise-induced pulmonary arterial, capillary and venous hypertension to a greater extent than frusemide alone, thereby affecting the occurrence of exercise-induced pulmonary haemorrhage (EIPH). Using established techniques, we determined right heart and pulmonary vascular pressures in 6 healthy, sound Thoroughbred horses at rest and during exercise performed at maximal heart rate at a workload of 14 m/s on 3.5% uphill grade in the control (no medication...
Goetz TE, Manohar M, Hassan AS, Baker GJ.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 subma...
Manohar M, Goetz TE, Hassan AS.Strenuously exercising horses exhibit arterial hypoxemia and exercise-induced pulmonary hemorrhage (EIPH), the latter resulting from stress failure of pulmonary capillaries. The present study was carried out to examine whether the structural changes in the blood-gas barrier caused by a prior bout of high-intensity short-term exercise capable of inducing EIPH would affect the arterial hypoxemia induced during a successive bout of exercise performed at the same workload. Two sets of experiments, double- and single-exercise-bout experiments, were carried out on seven healthy, sound Thoroughbred h...
Takahashi T, Hiraga A, Ohmura H, Kai M, Jones JH.To determine the frequency of epistaxis during or after racing among racehorses and identify factors associated with development of epistaxis. Methods: Retrospective study. Methods: 247,564 Thoroughbred and 4,045 Anglo-Arab race starts. Methods: Race start information (breed, age, sex, racing distance, and race type) was obtained for Thoroughbred and Anglo-Arab horses racing in Japan Racing Association-sanctioned races between 1992 and 1997. All horses that raced were examined by a veterinarian within 30 minutes of the conclusion of the race; any horse that had blood at the nostrils was examin...
Manohar M, Goetz TE, Rothenbaum P, Humphrey S.The stimulation of pulmonary beta2-adrenergic receptors causes a decrease in vascular resistance. Thus, the present study was carried out to examine whether concomitant administration of clenbuterol-a beta2-adrenergic receptor agonist, to horses premedicated with furosemide would attenuate the exercise-induced pulmonary capillary hypertension to a greater extent than furosemide alone, and in turn, affect the occurrence of exercise-induced pulmonary hemorrhage (EIPH). Experiments were carried out on six healthy, sound, exercise-trained Thoroughbred horses. All horses were studied in the control...
Manohar M, Goetz TE, Rothenbaum P, Humphrey S.The present study was carried out to examine whether intravenously administered pentoxifylline-a phosphodiesterase inhibitor which increases red blood cell deformability and decreases blood viscosity-would attenuate the magnitude of exercise-induced pulmonary capillary hypertension in healthy, fit Thoroughbred horses and in turn, diminish the occurrence of exercise-induced pulmonary hemorrhage (EIPH). Experiments were carried out on six healthy, sound, exercise-trained Thoroughbred horses. Hemodynamic data were collected at rest, and during exercise performed at 8 and 14 m/sec on 3.5% uphill g...
Manohar M, Goetz TE, Rothenbaum P, Humphrey S.The present study was carried out to ascertain whether beta2-adrenergic receptor stimulation with clenbuterol would attenuate the pulmonary arterial, capillary and venous hypertension in horses performing high-intensity exercise and, in turn, modify the occurrence of exercise-induced pulmonary haemorrhage (EIPH). Experiments were carried out on 6 healthy, sound, exercise-trained Thoroughbred horses. All horses were studied in the control (no medications) and the clenbuterol (0.8 pg/kg bwt, i.v.) treatments. The sequence of these treatments was randomised for every horse, and 7 days were allowe...
Langsetmo I, Meyer MR, Erickson HH.Exercise-induced pulmonary haemorrhage (EIPH) is characterised by blood in the airways after strenuous exercise and results from stress failure of the pulmonary capillaries. The purpose of this experiment was to establish a threshold value of transmural pulmonary arterial pressure at which haemorrhage occurs in the exercising horse. Five geldings, age 4-14 years, were run in random order once every 2 weeks at 1 of 4 speeds (9, 11, 13, 15 m/s); one day with no run was used as a control. Heart rate, pulmonary arterial pressure and oesophageal pressure were recorded for the duration of the run. T...
Funkquist P, Nyman G, Persson SG.In order to evaluate the haemodynamic response to exercise in Standardbred trotters with red cell hypervolaemia (RCHV), 12 trotters with RCHV were compared with 9 normovolaemic (NV) trotters. Haemodynamic data were recorded during exercise at 4 different speeds on a treadmill. Oxygen uptake was determined with an open bias flow system. Pulmonary artery pressure (PAP), systemic artery pressure (SAP), heart rate, packed cell volume (PCV) and plasma lactate and haemoglobin ([Hb]) concentrations were measured. Arteriovenous O2 content difference, cardiac output, stroke volume, pulmonary vascular r...
Soma LR, Birks EK, Uboh CE, May L, Teleis D, Martini J.Seven hundred and eighty-eight Standardbred pacers competing in 8378 races at one racetrack were analysed to determine the effects of the administration of prerace frusemide on racing times (RT). Frusemide was administered i.v. 4 h before the race to pacers diagnosed with exercise-induced pulmonary haemorrhage (EIPH). Of the pacers, starting in the 1997 racing season, 32.5% received prerace frusemide. This study demonstrated that administration of frusemide prior to racing significantly decreased RT. There was an overall significant decrease (P<0.00001) in RT of 0.67 s. The overall RT for h...
Magid JH, Manohar M, Goetz TE, Baker GJ, Ulbricht R, Bontkowski S, Ghantous S.Furosemide premedication of horses 4 h prior to exercise significantly attenuates exercise-induced pulmonary capillary hypertension which may help diminish the severity of exercise-induced pulmonary haemorrhage. As pulmonary hemodynamic effects of furosemide may be mediated via a reduction in plasma volume (which is most pronounced 15-30 min postfurosemide administration, with plasma volume recovering thereafter), we hypothesized that administration of furosemide at intervals shorter than 4 h before exertion may be more effective in attenuating the exercise-induced rise in pulmonary capillary ...
Hackett RP, Ducharme NG, Gleed RD, Erb HN, Mitchell LM, Soderholm LV.We hypothesised that 22.5 mg of oral nitroglycerin would cause pulmonary vasodilation and therefore decrease pulmonary capillary pressure in horses during strenuous exercise. Six horses were assigned to exercise twice, once with no medication (control) and once with nitroglycerin (22.5 mg orally) in random order. Horses were exercised for 3 min each at 75, 90 and 100% of maximal heart rate (HRmax) with a 2 min period of walking between each period of exertion. Pulmonary artery and oesophageal pressures were recorded continuously. Subsequent analysis was carried out on the pulmonary arterial pr...
Roberts CA, Marlin DJ, Lekeux P.The effects of training on ventilation and blood gases during exercise were investigated in 6 clinically normal, detrained Thoroughbred horses. They underwent a 16 week training programme similar to the type frequently used for Thoroughbred racehorses in Great Britain. Standardized treadmill exercise tests (2 min canter at 8 and 10 m/s C8 and C10[ and 2 min gallop at 12 m/s [G12], on a level surface) were performed prior to and after 16 weeks of training. Respiratory flow rates were measured using ultrasound flow transducers. Blood samples were drawn from a transverse facial artery and the rig...
Gleed FD, Ducharme NG, Hackett RP, Hakim TS, Erb HN, Mitchell LM, Soderholm LV.We hypothesised that frusemide would decrease pulmonary capillary pressure in horses during strenuous exercise. Seven horses were tested after receiving saline or frusemide (2 mg/kg bwt) in random order with an interval of at least one week. Measurements were made with the horses standing, exercising at 75, 90 and 100% HRmax (maximal heart rate), and then walking 2 min after cessation of 100% HRmax. The exercise tests lasted for approximately 3 min with an interval of walking between them. Pulmonary artery and oesophageal pressures were recorded continuously and subsequent analysis of the pulm...
Williams KJ, Derksen FJ, Defeijter-Rupp HL, Robinson NE.Exercise-induced pulmonary haemorrhage (EIPH) occurs in nearly all strenuously exercising horses. Recent studies have attempted to identify the role of free blood within the airspaces, in the lung fibrosis that develops within the lungs of EIPH horses. Objective: Repeated exposure of the equine lung to autologous blood results in lung fibrosis similar to that observed in spontaneous EIPH. Methods: Forty ml of autologous blood from the jugular vein was instilled into preselected lung regions of 6 horses one, 2, 3, 4 or 5 times at 2 week intervals, with 40 ml of saline instilled into the contral...
Crispe EJ, Secombe CJ, Perera DI, Manderson AA, Turlach BA, Lester GD.Exercise-induced pulmonary haemorrhage (EIPH) is considered a progressive disease based on histopathology, but it is unknown if tracheobronchoscopic EIPH severity worsens over time. Objective: The aim of this study was to examine tracheobronchoscopic EIPH changes over time in a population of Thoroughbred racehorses. A secondary aim was to identify factors that affect changes in tracheobronchoscopic EIPH severity between observations. Methods: Prospective, longitudinal, observational cross-sectional study. Methods: Thoroughbred racehorses were examined with tracheobronchoscopy no earlier than 3...
Sweeney CR, Soma LR.Of 61 horses with a history of exercise-induced pulmonary hemorrhage and treated with furosemide 4 hours prior to racing, 34 (55.7%) continued to bleed. Of 24 horses with exercise-induced pulmonary hemorrhage that were not treated with furosemide prior to racing, 17 (70.8%) still bled. There was no statistically significant difference between the treated and the nontreated groups. Of 45 horses given hesperidin-citrus bioflavinoids, 38 (84.4%) bled when exercised 90 days later. There was no statistically significant difference between the results for hesperidin-citrus bioflavinoid-treated horse...
O'Callaghan MW, Pascoe JR, Tyler WS, Mason DK.Gross post mortem examinations were performed on the lungs of 26 Thoroughbred horses of known exercise-induced pulmonary haemorrhage (EIPH) status. The most consistent finding was a variable degree of bilaterally symmetrical, dark discolouration of the dorsocaudal regions of the caudal lung lobes. In more severely affected lungs, the stained areas extended cranially along the dorsal surfaces of the lungs, and in some cases affected approximately one third of the lung surface. Discoloured areas of lung were denser than normal, collapsed less readily, often contained trapped air and were slow to...
Crispe EJ, Lester GD.Exercise-induced pulmonary hemorrhage (EIPH) occurs commonly in horses undergoing strenuous exercise. Reported risk factors include racing in cold temperatures and wearing of bar shoes. In horses with documented moderate to severe EIPH, increasing the interval between races and adopting a negative race pace strategy may reduce the severity of EIPH in subsequent races. EIPH seems to have an impact on performance only when moderate to severe. This occurs in a small number of starters, approximately 6%. EIPH often is erratic in severity from race to race, although across a population it is weakly...
Manohar M, Goetz TE, Hassan AS, Depuy T, Humphrey S.In view of the suggestion that pulmonary injury-induced release of histamine and/or other chemical mediators from airway inflammatory and mast cells contribute to the exercise-induced arterial hypoxemia (EIAH) in human athletes, we examined the effects of pretreatment with a potent anti-inflammatory agent, dexamethasone, on EIAH and desaturation of hemoglobin in horses. Seven healthy, sound, exercise-trained Thoroughbreds were studied in the control (no medications) experiments, followed in 7 days by intravenous dexamethasone (0.11 mg.kg(-1).day(-1) for 3 consecutive days) studies. Blood-gas m...
Schroter RC, Leeming A, Denny E, Bharath A, Marlin DJ.Recently we proposed that exercise-induced pulmonary haemorrhage (EIPH) results from locomotory-impact-induced trauma by impact of the scapula on the chest wall during footfall and the consequent transmission of waves through the lung. A computational model has been developed to demonstrate that wave amplification and focusing occur in the dorsocaudal tip of the lung for waves originating on the anterior subscapular surface. The propagation of an acoustic wave was investigated in a simplified 2-dimensional representation of a vertical anterio-dorsal section of horse lung. It was demonstrated t...
Preston SA, Riggs CM, Singleton MD, Troedsson MH.Exercise-induced pulmonary haemorrhage (EIPH) is reported as a performance limiting condition in racehorses, yet few longitudinal studies characterising EIPH have been reported. Objective: To characterise EIPH during training and racing in the absence of prophylactic medication with furosemide among horses imported to Hong Kong during 2007-2012. Methods: Retrospective descriptive study of clinical endoscopy, EIPH status, and racing records. Methods: Thoroughbred geldings (n = 822) imported from New Zealand between 2007 and 2012 were retrospectively assigned to 4 groups: diagnosed with EIPH via...
Goetz TE, Manohar M, Magid JH.The objective of the present study was to ascertain whether administration of a second dose of frusemide would attenuate exercise-induced pulmonary hypertension more than a single dose. Right atrial, right ventricular and pulmonary vascular pressures were determined in 7 healthy, sound, exercise-trained Thoroughbred horses at rest and during exercise (14.2 m/s + a 3.5% uphill grade) performed at maximal heart rate (217 +/- 3 beats/min [mean +/- s.e.]). Horses were studied during the following 3 treatments in random order 7 days apart: control (no medication), frusemide single dose (250 mg i.v....
Burns JJ, MacMillan KM, John E.Respiratory disease is common in the horse population and is often associated with poor performance in equine athletes. Despite their outstanding strength and aerobic capacity, little regard is given to draft horses and the respiratory disorders they may encounter when performing athletic activity. For this reason, the objectives of this study were: (1) to determine the prevalence of exercise-induced pulmonary hemorrhage (EIPH), tracheal mucus (TM) and recurrent laryngeal hemiplegia (RLH) in a population of competitive draft pulling horses, and (2) to determine if there was an association betw...
O'Callaghan MW, Pascoe JR, Tyler WS, Mason DK.The purpose of this study was to use radiographic contrast techniques and special imaging methods to identify and high-light bronchial arterial involvement in lung lesions associated with exercise-induced pulmonary haemorrhage (EIPH) in horses. The lungs from four horses with histories of EIPH were prepared for computerised tomographic scanning and microradiography by perfusing the broncho-oesophageal artery with a mixture of red latex and either barium or iodine contrast materials while the pulmonary supply received only blue latex. Computerised tomographic scan slices of the prepared inflate...
Magid JH, Manohar M, Goetz TE, Baker GJ, Ulbricht R, Bontkowski S, Ghantous S.Furosemide premedication of horses 4 h prior to exercise significantly attenuates exercise-induced pulmonary capillary hypertension which may help diminish the severity of exercise-induced pulmonary haemorrhage. As pulmonary hemodynamic effects of furosemide may be mediated via a reduction in plasma volume (which is most pronounced 15-30 min postfurosemide administration, with plasma volume recovering thereafter), we hypothesized that administration of furosemide at intervals shorter than 4 h before exertion may be more effective in attenuating the exercise-induced rise in pulmonary capillary ...
Mason BJ, Riggs CM, Cogger N.The risk of respiratory conditions, such as inflammatory airway disease (IAD) and exercise-induced pulmonary haemorrhage (EIPH), are thought to be higher in racehorses that undergo prosthetic laryngoplasty with ventriculocordectomy (PLVC) surgery to treat left-sided laryngeal hemiplegia (LLH) than in racehorses with normal laryngeal function. However, this has not been investigated formally owing to the difficulty of obtaining reliable follow-up data. Objective: To determine the incidence of respiratory conditions (IAD and EIPH), duration of racing career, number of starts and number of starts...
Manohar M.Strenuously exercising Thoroughbreds exhibit a dramatic increase in pulmonary capillary blood pressure, which contributes to stress failure of pulmonary capillaries resulting in exercise induced pulmonary haemorrhage (EIPH). One strategy to prevent EIPH is, therefore, to lower the pulmonary capillary blood pressure of exercising horses. Recent work in several species suggests that nitric oxide plays a significant role in maintaining low vascular resistance in the pulmonary circulation; however, the effects of nitrovasodilators (which work via the same mechanism as nitric oxide) on equine pulmo...
Weiss DJ, McClay CB, Smith CM, Rao GH, White JG.Platelet function was evaluated in horses with exercise-induced pulmonary hemorrhage (bleeder) and in control horses (nonbleeder). Platelet aggregation, secretion, and adhesion to rabbit aortic subendothelium were similar for bleeders and nonbleeders. Platelets readily aggregated in response to ADP, thrombin, collagen, and arachidonic acid, but platelet secretion occurred only with high concentrations of thrombin. Platelets readily adhered to rabbit aortic subendothelium and tended to form large thrombi rather than platelet monolayers or aggregates. These data suggest that horses may be predis...
Zawadzkas XA, Sides RH, Bayly WM.Prerace administration of frusemide to horses has been linked with a significant improvement in racing performance, but the basis for this improvement is unclear. Objective: To test whether improved performance with prerace administration of frusemide is due to the drug's diuresis-induced weight loss rather than its apparent alleviation of exercise-induced pulmonary haemorrhage (EIPH). Methods: Eight thoroughbred horses underwent 3 trials in a random order, 2 or 3 weeks apart: control (C), frusemide/unburdened (FU), and frusemide/burdened (FB). None of the horses were known to have exhibited p...
Manohar M, Goetz TE, Hassan AS.Because sensitivity of equine pulmonary vasculature to endogenous as well as exogenous nitric oxide (NO) has been demonstrated, we examined whether endogenous NO production plays a role in exercise-induced arterial hypoxemia. We hypothesized that inhibition of NO synthase may alter the distribution of ventilation-perfusion mismatching, which may affect the exercise-induced arterial hypoxemia. Arterial blood-gas variables were examined in seven healthy, sound Thoroughbred horses at rest and during incremental exercise protocol leading to galloping at maximal heart rate without (control; placebo...
Cascardo B, Bernardes C, de Souza GN, Silva KM, Pires NR, de Alencar NX, Lessa DAB.Lower airway cytology has been proposed as a complementary diagnostic method to confirm the presence and quantifying the severity of exercise-induced pulmonary hemorrhage (EIPH). Bronchoalveolar lavage is usually preferred over tracheal wash (TW), yet the need for sedation imposes as a limitation for active sport horses in addition to be a highly invasive technique. This study aims to evaluate the diagnostic value of TW with Total Hemosiderin Score (THS) for monitoring EIPH in active Thoroughbred racehorses. A sampling of 47 randomly selected Thoroughbreds were endoscopically examined for EIPH...
Manohar M, Goetz TE, Rothenbaum P, Humphrey S.The present study was carried out to ascertain whether beta2-adrenergic receptor stimulation with clenbuterol would attenuate the pulmonary arterial, capillary and venous hypertension in horses performing high-intensity exercise and, in turn, modify the occurrence of exercise-induced pulmonary haemorrhage (EIPH). Experiments were carried out on 6 healthy, sound, exercise-trained Thoroughbred horses. All horses were studied in the control (no medications) and the clenbuterol (0.8 pg/kg bwt, i.v.) treatments. The sequence of these treatments was randomised for every horse, and 7 days were allowe...
Weiss DJ, Geor RJ, Burger K.To determine whether pentoxifylline treatment altered hematologic, rheologic, electrolyte, or blood gas test results of Thoroughbreds during submaximal treadmill exercise. Methods: 5 healthy Thoroughbreds that had raced within the past year and had no history of exercise-induced pulmonary hemorrhage. Methods: Mixed venous blood samples were obtained before exercise, at treadmill speeds of 9 and 13 m/s, and 20 minutes after exercise; hematologic, rheologic, electrolyte, and blood gas test results were determined. Results: Pentoxifylline treatment resulted in a 45% reduction in RBC filtration pr...
O'Callaghan MW, Pascoe JR, Tyler WS, Mason DK.This paper reviews a series of clinical, post mortem and imaging studies on exercise-induced pulmonary haemorrhage (EIPH) performed on 26 Thoroughbred racehorses. Post mortem techniques included routine gross, subgross and histological examination; coloured latex perfusions of pulmonary and bronchial circulations; and microradiography and computerised tomography scans of lungs with contrast injected vasculature. The major lesions were multiple, separate and coalescing foci of moderately proliferative small airway disease accompanied by intense neovascularisation of the bronchial circulation. A...
Hackett RP, Ducharme NG, Gleed RD, Mitchell L, Soderholm LV, Erickson BK, Erb HN.To test the hypothesis that the pulmonary vascular pressures of Thoroughbred and Standardbred horses behave similarly during exertion. Measurements were made on 5 Thoroughbred and 5 Standardbred horses on a treadmill at rest and during 3-minute exercise intervals at speeds predicted to produce 75%, 90%, and 100% maximal heart rate. Left forelimb acceleration, heart rate, esophageal pressure, and pulmonary artery pressure were measured continuously. Pulmonary capillary and wedge pressures were measured during intermittent occlusion of the pulmonary artery. Breathing rate and gait frequency were...
McClay CB, Weiss DJ, Smith CM, Gordon B.Hematologic and rheologic changes were examined in 49 Thoroughbreds before and after competitive racing. Mean postrace values for RBC count, hemoglobin concentration, and PCV increased by 58 to 61%, whereas blood viscosity increased 2 to 3 times. Postrace echinocyte numbers were 162% greater than prerace values. Smaller, but statistically significant, changes were found for mean corpuscular hemoglobin concentration, red cell distribution width, plasma total protein concentration, total WBC count, neutrophil count, and lymphocyte count. Variables measured did not predict whether a horse was a b...
Hinchcliff KW, McKeever KH, Muir WW, Sams R.The effect of furosemide-induced weight loss on the energetic responses of horses to running was examined in a 3-way crossover study. Eight 2- to 3-year-old Standardbred mares received, in random order, 10 ml of saline solution 4 hours before running on a treadmill (control trial, C); or, during 2 trials, 1 mg of furosemide/kg of body weight, i.v., 4 hours before running. During one of the trials when the horses received furosemide, they carried weight equal to that lost over the 3.75 hours after furosemide administration while running (furosemide-loaded, FL), and during the other trial they d...
Catalani G, Dottavio ME, Rasia M.During acute exercise several significant cardiovascular alterations take place, along with possible physiopathological consequences, such as Exercise Inducted Pulmonary Haemorrhage (EIPH). Given the relevance of blood rheology in the determination of flow resistance and its supposed participation in the stated events, the present paper focuses on the analysis of modifications in haematocrit, blood viscosity and erythrocyte deformability in Thoroughbred horses caused by two different levels of effort (6 to 9 m/s and 13 to 16 m/s), in the same track they train in and with their own jockeys. The...
Bayly W, Lopez C, Sides R, Bergsma G, Bergsma J, Gold J, Sellon D.Public pressure exists in the United States to eliminate race-day furosemide administration despite its efficacy in decreasing the severity of equine exercise pulmonary hemorrhage (EIPH). No effective alternative prophylaxis strategies have been identified. Objective: To investigate alternative protocols to race-day furosemide that might mitigate EIPH. Methods: Seven fit Thoroughbreds with recent EIPH. Methods: Double-blinded placebo-controlled Latin square crossover using a treadmill followed by a blinded placebo-controlled crossover study at a racetrack. First, horses exercised supramaximall...
Saulez MN, Godfroid J, Bosman A, Stiltner JL, Breathnach CC, Horohov DW.To determine concentrations of cytokine mRNA in horses with exercise-induced pulmonary hemorrhage (EIPH) after racing. Methods: 97 Thoroughbreds. Methods: Following tracheobronchoscopy, the severity of EIPH was graded (scale of 0 to 4), and venous blood samples were collected from 10 horses in each grade. After RNA isolation and cDNA synthesis, real-time PCR assay was conducted to detect cytokinespecific mRNA for interleukin (IL)-1, IL-6, and IL-10; interferon (INF)-gamma; and tumor necrosis factor (TNF)-alpha. Results: Neither location nor grade of EIPH affected the expression of IL-1 and INF...
Kindig CA, Ramsel C, McDonough P, Poole DC, Erickson HH.Capillary stress failure-induced (exercise-induced) pulmonary haemorrhage (EIPH) during intense running in horses is thought to involve both intravascular (i.e. mean pulmonary arterial pressure [Ppa] > 100 mmHg) and extravascular (e.g. negative inspiratory pressure swings) mechanisms. Objective: That inclined running would reduce breathing frequency (coupled to stride frequency) and increase tidal volume thus increasing lung volume changes and intrapleural pressure swings resulting in more pronounced EIPH. Methods: Six Thoroughbred horses were run to volitional fatigue (incremental step tes...
