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.
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...
Morrison KE, Slocombe RF, McKane SA, Dargaville PA.Pulmonary surfactant from bronchoalveolar lavages was obtained from 2 groups of horses. A control group consisting of 6 healthy racehorses that were paddock-rested and lavaged weekly for 6 consecutive weeks were compared with an experimental group of 10 healthy racehorses, lavaged weekly the same period, consisting of a 5 week incremental-intensity treadmill training programme and one week post training paddock rest. Phospholipid content of lavage fluid was determined indirectly by phosphorus assay, and surfactant functional activity was determined by bubble surfactometry. Total cell counts an...
McKane SA, Slocombe RF.Six horses, free of recent exercise-induced pulmonary haemorrhage (EIPH), each had 8 bronchial segments inoculated with 40 ml of autologous blood lavaged on Days 3, 5, 7, 10, 14 and 21 after inoculation. The bronchoalveolar lavage (BAL) fluid samples were analysed, and total leucocyte counts and differential cell percentages determined. Statistical analysis of the differences between the 8 post inoculation and 1 pre-inoculation (control) lavage sites demonstrated an early neutrophilic response, rising from < 5% of alveolar leucocytes to 10% by 24-48 h post inoculation. As this response wane...
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...
Couëtil LL, Denicola DB.The purpose of this study was to evaluate the relationship between bronchoalveolar lavage (BAL) cytology, arterial blood gases and plasma lactate concentration during a standardised treadmill test (STT) in racehorses with small-airway inflammation (SAI), or exercise-induced pulmonary haemorrhage (EIPH). Sixteen Thoroughbred and 20 Standardbred actively racing racehorses, were divided into a control group (n = 10), EIPH group (n = 13) and SAI group (n = 13). Each STT consisted of a 2 min trot at 4 m/s followed by 5 x 1 min, incremental speed steps (6, 8, 10, 11 and 12 m/s) at 10% incline for Th...
Votion DM, Roberts CA, Marlin DJ, Lekeux PM.We hypothesised that scintigraphic imaging of the lungs following injection of 99mTc labelled red blood cells (99mTc-RBC) in the exercising horse might enable exercise-induced pulmonary haemorrhage (EIPH) quantification. Ideally, to favour detection of bleeding, circulating 99mTc-RBC not involved in the haemorrhage should be removed from the circulation quickly. Altering RBC during labelling to stimulate splenic uptake of 99mTc-RBC may encourage this. In order to investigate this hypothesis, 99mTc-RBC distribution was followed for 1 h in 2 groups of horses. Group 1 was injected i.v., at rest, ...
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....
Nagata S, Takeda F, Kurosawa M, Mima K, Hiraga A, Kai M, Taya K.The responses of plasma adrenocorticotropin (ACTH), cortisol, noradrenaline and adrenaline in 5 Thoroughbred horses to an incremental exercise and 2 relative workload exercises, at 105 and 80% maximal oxygen consumption (VO2max), on a treadmill were examined. These hormone concentrations increased (P < 0.05) with each exercise and the maximal plasma concentrations of ACTH, cortisol were observed between 5 and 30 min after the end of the exercise, while maximal catecholamine concentrations occurred just at exhaustion time. The plasma ACTH, noradrenaline and adrenaline responses during exerci...
Foreman JH.Differentiation of diseases of the equine respiratory tract is based on history, clinical signs, auscultation, endoscopy, imaging, and sampling of airway exudate. Upper respiratory therapies include surgical correction of airway obstructions; flushing of localized abscesses (strangles), guttural pouch disease, or sinusitis; and oral or parenteral antibiotic and anti-inflammatory therapy if deemed necessary. Pneumonia usually is treated with antimicrobials, anti-inflammatories, and bronchodilators. Pleural drainage is indicated if significant pleural effusion is present. The most commonly used ...
Manohar M, Goetz TE.To determine whether intravenous infusion of nitroglycerin would modify pulmonary arterial, capillary, or venous hypertension in strenuously exercising Thoroughbreds. Methods: 5 healthy Thoroughbred horses. Methods: Right atrial, right ventricular, and pulmonary vascular pressures were measured. Each horse was used in a control treatment (not medicated) and a nitroglycerin infusion (20 microg/kg of body weight/min) at rest and during exercise on a treadmill. Sequence of treatments was randomized for each horse, and treatments were separated by a 7-day interval. Galloping at 14.2 m/s on a 5% up...
Oikawa M.The dorsocaudal extremities of the caudal lobes of the lungs of racehorses are vulnerable to exercise-induced pulmonary haemorrhage (EIPH). The morphology of the lungs at these sites was studied in 13 Thoroughbred horses aged 18 to 22 months. These animals, which had been performing low-intensity exercise on a track at maximum running speeds of approximately 5-8.5 metres/second (m/s), were withdrawn from the racehorse training programme for reasons of unsuitability. Lung lesions observed in the dorsocaudal lung extremities in 10 of the 13 horses were not found in the craniodorsal or craniovent...
Hackett RP, Ducharme NG, Ainsworth DM, Erickson BK, Erb HN, Soderholm LV, Thorson LM.To determine whether dorsal displacement of the soft palate (DDSP) results in pulmonary artery hypertension and leads to increases in transmural pulmonary artery pressure (TPAP); to determine whether pulmonary hypertension can be prevented by prior administration of furosemide; and to determine whether tracheostomy reduces pulmonary hypertension. Methods: 7 healthy horses. Methods: Horses were subjected to 3 conditions (control conditions, conditions after induction of DDSP, and conditions after tracheostomy). Horses were evaluated during exercise after being given saline (0.9% NaCl) solution ...
Martin BB, Beech J, Parente EJ.To evaluate results of cytologic examination of specimens obtained by means of tracheal washes (TW) in 42 horses with a history of poor performance. Methods: Cross-sectional case series. Methods: 42 horses with a history of poor performance. Methods: A TW was performed via endoscopy before and after horses exercised on a high-speed treadmill, and specimens were evaluated microscopically and graded. Results: Ten (24%) horses were considered to be clinically normal before and after exercise. Pulmonary hemorrhage was diagnosed in 8 (19%) horses. One horse had evidence of exercise-induced pulmonar...
Lester G, Clark C, Rice B, Steible-Hartless C, Vetro-Widenhouse T.To examine effect of pre-exercise administration of furosemide (FUR) on mean pulmonary arterial pressure (PAP) during work and RBC concentration in bronchoalveolar lavage fluid (BALF) collected 40 minutes after exercise. Methods: 10 adult Thoroughbreds. Methods: A modified 10 X 10 crossover design comprising 10 horses during 10 weeks was used. Each horse received each of 5 treatments twice. Treatment structure included a control plus a 2 X 2 factorial and consisted of the following: A, control; B, FUR, 250 mg, IV, 30 minutes before exercise; C, FUR, 250 mg, IV, 240 minutes before exercise; D, ...
Savage CJ, Traub-Dargatz JL, Mumford EL.A survey designed to obtain information on the indications, contraindications, complications, and methodology of percutaneous lung biopsy in the horse was sent to large animal diplomates of the American College of Veterinary Internal Medicine. Sixty-five of 190 diplomates returned the survey (response rate: 34%) and 59 of these 65 respondents (91%) indicated that they worked with horses. Forty-four diplomates had performed a percutaneous lung biopsy in 1 or more horses (i.e. 75% of those diplomates working with horses and 68% of total respondents). Clinical and radiologic diagnoses that prompt...
Meyer TS, Fedde MR, Gaughan EM, Langsetmo I, Erickson HH.Exercise-induced pulmonary haemorrhage (EIPH) causes serious economic losses in the horse racing industry. Endoscopic examination indicates that 40-90% of horses exhibit EIPH following sprint exercise, but the limitations of the endoscope prevent diagnosis in many horses. Bronchoalveolar lavage (BAL) was utilised to detect red blood cells (RBCs) in the terminal airways in 6 horses. Two lavages were performed at weekly intervals prior to exercise, one within 90 min after exercise, and 5 at weekly intervals after exercise. The horses were exercised strenuously at 12.5-14.6 m/s on a treadmill (3 ...
Soma LR, Uboh CE.Furosemide has been used empirically and has been legally approved for many years by the US racing industry for the control of exercise-induced pulmonary haemorrhage (EIPH) or bleeding. Its use in horses for this purpose is highly controversial and has been criticized by organizations outside and inside of the racing industry. This review concentrates on its renal and extra-renal actions and the possible relationship of these actions to the modification of EIPH and changes in performance of horses. The existing literature references suggest that furosemide has the potential of increasing perfo...
Schroter RC, Marlin DJ, Denny E.Exercise-induced pulmonary haemorrhage (EIPH) in horses, although of major welfare and economic importance worldwide, is of uncertain cause. It is accepted that the dorsocaudal region of the lung is particularly prone to the condition, but present theories of causation cannot satisfactorily explain the mechanism or pattern of occurrence. We propose that EIPH results from locomotory impact induced trauma; the mechanism being similar to that producing lung tissue damage following thoracic impact injury. In impact injury, the localised impulsive load on the chest wall is transmitted by pressure w...
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...
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...
Manohar M.High-intensity exercise results in a dramatic increase in mean pulmonary capillary blood pressure of horses, and administration of furosemide 4 hours before exertion significantly attenuates this exercise-induced increment. To test whether this effect of furosemide is mediated via release of prostaglandins, right atrial and pulmonary vascular pressures were measured in 8 healthy, sound, exercise-trained Thoroughbreds at rest and during incremental-step exercise on a treadmill. Horses were studied on 3 separate occasions: after i.v. administration of saline (0.9% NaCl) solution, after administr...
Dixon PM, Railton DI, McGorum BC, Tothill S.One-hundred and forty-seven of 270 (54.4%) horses suffering from pulmonary disorders were given at least one re-examination including, clinical, bronchoscopic, pulmonary function and cytological examinations after treatment and a further 83 of these horses (30.7%) had their clinical progress assessed by verbal or written reports. These examinations and progress reports showed high levels of partial or total recovery for most pulmonary disease categories, including chronic obstructive pulmonary disease, infectious, S. zooepidemicus and undifferentiated pulmonary disease and lungworm infection g...
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...
Johnson JE, Beech J, Saik JE.A 6.5-year-old horse with a history of exercise-induced pulmonary hemorrhage was admitted because of acute onset of epistaxis, dyspnea, high respiratory rate, pale mucous membranes, and dark feces. There was no clinical or laboratory evidence of a bleeding disorder, and the horse's anemia was considered to be secondary to pulmonary hemorrhage. The cause of the hemorrhage was not found on thoracic sonograms or from cytologic examination of transtracheal aspirates. Despite supportive care, the horse's health deteriorated, and it was euthanatized. Necropsy revealed blood in the thoracic and perit...
Heffron B, Taddei L, Benoit M, Negrusz A.The use of nonsteroidal antiinflammatory drugs in racehorses is allowed under most jurisdictions. Furosemide is administered to treat exercise-induced pulmonary hemorrhage. To help distinguish between therapeutic and illegal uses, racing regulatory bodies have set thresholds in serum for several drugs. The method for the simultaneous detection and quantification of furosemide, flunixin, ketoprofen, phenylbutazone and oxyphenbutazone using 500 µL of serum, and liquid extraction using diethyl ether : hexanes : dichloromethane followed by liquid chromatography tandem mass spectrometry quantitati...
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...
Harris P, Snow DH.To investigate the effect of moderate to high intensity exercise of up to 6 min duration on plasma potassium and lactate concentrations, 6 Thoroughbred horses were studied using a treadmill at a 5 degree incline. Each test consisted of an 8-min standardised warm-up followed by an exercise bout at 8, 9, 10 or 12 m/sec. The horses were galloped at each speed for up to a maximum of 6 min or until signs of fatigue were present. The horses were then walked at 0 degree incline. Carotid arterial blood samples were taken during and after the exercise. At 8, 9 and 10 m/sec there was a general pattern o...
Littlejohn A, Howell W, Killeen V.In ten Thoroughbred racehorses which suffered epistaxis during a race, the mean pulmonary arterial diastolic pressure (PADP) was significantly higher, and the mean pulmonary arterial oxygen tension (PaO2) was significantly lower, than the corresponding mean values of a sample of fourteen clinically normal Thoroughbreds in training. The authors conclude that in horses with epistaxis during a race, pulmonary dysfunction may persist for up to two months after the episode, and that the results indicate a need for pulmonary function studies before and after racing, in order to resolve problems conc...
Boudreaux MK, Koehler J, Habecker PL, Del Piero F.Exercise-induced pulmonary hemorrhage (EIPH) is a common disorder of equine athletes. The role of polymorphisms in genes encoding hemostasis-regulatory proteins in horses with abnormal hemorrhage is unknown. Objective: The goal of this study was to evaluate the genes encoding 2 ectonucleotidases, CD39/NTPDase-1 and CD39L1/NTPDase-2, and one ecto-5' nucleotidase, CD73, in horses with abnormal hemorrhage or pathologic changes consistent with EIPH. Methods: Twenty-three horses with histories of abnormal hemorrhage, 8 horses with gastrointestinal signs, and 45 healthy horses were evaluated using p...
Walker HJ, Evans DL, Slocombe RF, Hodgson JL, Hodgson DR.Intrapulmonary blood causes an inflammatory response. Modifying this inflammatory response may be useful in the treatment of exercise induced pulmonary haemorrhage (EIPH). Objective: To evaluate the efficacy of 3 treatments, an oral bronchodilator, inhaled steroid and oral steroid in modifying the cellular response to intrapulmonary blood inoculation. Methods: Experimental design was a randomised block divided into 4 experimental segments of 2 weeks. Eight normal horses were randomly assigned to pairs and treatments. Autologous blood was inoculated into the lungs on 4 occasions over an 8 week ...
Knych HK, Vale A, Wilson WD, Kass PH, Arthur RM, Jones JH.Furosemide is a diuretic agent used commonly in racehorses to attenuate the bleeding associated with exercise-induced pulmonary hemorrhage (EIPH). The current study describes serum and urine concentrations and the pharmacokinetics of furosemide following administration at 4 and 24 hrs prior to maximal exercise. Eight exercised adult Thoroughbred horses received a single IV administration of 250 mg of furosemide at 4 and 24 hrs prior to maximal exercise on a high-speed treadmill. Blood and urine samples were collected at time 0 and at various times for up to 72 hrs and furosemide concentrat...
Votion DM, Roberts CA, Marlin DJ, Lekeux PM.We hypothesised that scintigraphic imaging of the lungs following injection of 99mTc labelled red blood cells (99mTc-RBC) in the exercising horse might enable exercise-induced pulmonary haemorrhage (EIPH) quantification. Ideally, to favour detection of bleeding, circulating 99mTc-RBC not involved in the haemorrhage should be removed from the circulation quickly. Altering RBC during labelling to stimulate splenic uptake of 99mTc-RBC may encourage this. In order to investigate this hypothesis, 99mTc-RBC distribution was followed for 1 h in 2 groups of horses. Group 1 was injected i.v., at rest, ...
Hansen S, Otten ND, Nissen SD, Carstensen H, Hopster-Iversen C, Fjeldborg J, Staun SH, Fenner M, Hesselkilde EM, Buhl R.Atrial fibrillation (AF) has been proposed as a risk factor for exercise-induced pulmonary haemorrhage (EIPH) due to increased pressure in the left atrium. Objective: To evaluate if AF was associated with EIPH following a standardised exercise test (SET) to fatigue. Methods: Two-arm controlled experiment. Methods: Ten untrained Standardbred mares mean (standard deviation [SD]) age 6 (2) years performed a SET on the treadmill in sinus rhythm (SR) (SET1) and 25-44 days after induction of self-sustained AF (SET2). AF was induced by tachypacing using a pacing device. Endoscopy, including trachea...
Nath LC, Elliott A, La Gerche A, Weir J, Forbes G, Thomas G, Franklin S.Atrial fibrillation (AF) is the most common performance limiting arrhythmia in racehorses. High dose exercise and airway disease promote AF in humans. Few studies have investigated epidemiological factors associated with AF in horses. Objective: Explore variables relating to performance, exercise volume and postrace endoscopic findings in horses with AF. Methods: A total of 164 horses with poor race performance and postrace AF were compared to 321 horses with poor performance without AF (PP) and 314 horses performing to expectation (TE). Methods: Horse-level and race-level variables for horses...
Shoemaker S, Wang Y, Sellon D, Gold J, Fisher A, Bagshaw J, Leguillette R, Sanz M, Bayly W.Little has been reported regarding the prevalence and severity of exercise-induced pulmonary hemorrhage (EIPH) in 2-year-old Thoroughbred racehorses. Objective: Evaluate EIPH prevalence and severity and its association with performance, speed index, furosemide administration, race distance, and track surface. Methods: A total of 830 2-year-old Thoroughbreds. Methods: Prospective blinded observational study. Videoendoscopy was performed 30 to 60 minutes postrace at 15 American racetracks. Three blinded observers independently assigned an EIPH grade (0-4) to each video, and prevalence and seve...
