Furosemide is a diuretic medication commonly administered to horses to prevent or reduce exercise-induced pulmonary hemorrhage (EIPH), a condition where blood enters the airways during intense physical activity. It functions by promoting the excretion of water and electrolytes through the kidneys, leading to a decrease in blood volume and pressure. This reduction is thought to alleviate the stress on pulmonary capillaries during exertion, thereby minimizing the occurrence of bleeding. Furosemide is frequently used in the context of horse racing and competitive equine sports. This page compiles peer-reviewed research studies and scholarly articles that investigate the effects, mechanisms, and regulatory aspects of furosemide use in equine athletes.
Kaartinen MJ, Pang DS, Cuvelliez SG.CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were ...
Pearson W.Standardbred trainers from 1 racetrack and 7 off-track training facilities were surveyed to determine the most common drugs, and prevalence of concurrent herb administration. Furosemide (on-track) and anti-inflammatory drugs (off-track) were the most common drugs administered. Among horses on-track, 9.8% received herbs compared with 13.8% off-track horses; 67% and 58% of these horses, respectively, received concurrent drugs. Les soigneurs de Standardbreds de 1 piste de course et de 7 installations d’entraînement hors piste ont été interrogés afin de déterminer les médicaments les plus...
Perez-Moreno CI, Couëtil LL, Pratt SM, Ochoa-Acuña HG, Raskin RE, Russell MA.The objective was to quantify the effect of furosemide and carbazochrome on exercise-induced pulmonary hemorrhage (EIPH) in Standardbred horses using red blood cell count and hemoglobin concentration in bronchoalveolar lavage (BAL) fluid. Six healthy Standardbred horses with prior evidence of EIPH performed a standardized treadmill test 4 h after administration of placebo, furosemide, or furosemide-carbazochrome combination. Red blood cell (RBC) counts and hemoglobin concentrations were determined on the BAL fluid. The RBC count in BAL ranges were (2903-26,025 cells/microL), (45-24,060 cells/m...
Hinchcliff KW, Morley PS, Guthrie AJ.To evaluate the efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions. Methods: Randomized, placebo-controlled, blinded, crossover field trial. Methods: 167 Thoroughbred racehorses. Methods: Horses were allocated to race fields of 9 to 16 horses each and raced twice, 1 week apart, with each of the 2 races consisting of the same race field and distance. Each horse received furosemide (500 mg, IV) before one race and a placebo (saline solution) before the other, with the order of treatments randomly determ...
Fielding CL, Magdesian KG, Carlson GP, Rhodes DM, Ruby RE.To apply the principle of sodium dilution to calculate the changes in the extracellular fluid (ECF) volume (ECFV) and intracellular fluid volume (ICFV) that occur during dehydration and rehydration in horses. Methods: 8 healthy horses of various breeds. Methods: Horses were dehydrated over 4 hours by withholding water and administering furosemide. Saline (0.9% NaCl) solution was administered IV during the next 2 hours (20 mL/kg/h; total 40 mL/kg). Horses were monitored for an additional hour following IV fluid administration. Initial ECFV was determined by use of multifrequency bioelectrical i...
Holbrook TC, Dechant JE, Crowson CL.A 523 kg Quarter Horse was anesthetized for unilateral eye enucleation. The anesthetic period was unremarkable. During anesthetic recovery the cap on the jugular venous catheter became dislodged. Clinical signs of pulmonary edema associated with moderate arterial hypoxemia subsequently developed. Although pulmonary edema resolved with medical therapy, the day following anesthetic recovery, clinical signs of vestibular disease and blindness developed. Treatment included nasal oxygen insufflation, flunixin meglumine, furosemide, dexamethasone, thiamine, dimethylsulfoxide, antimicrobials, and phe...
Nagata S, Kurosawa M, Kuwajima M.A new enzyme immunoassay (EIA) for the measurement of furosemide in horse plasma is described. The lower limit of detection of this EIA method was 7.8 ng/ml. The intra-and inter-assay coefficients of variation ranged from 2.5% to 4.9% and 7.5% to 9.8%, respectively. Cross-reactivity with other compounds was not observed. There was a high correlation (r2=0.987) between the high-performance liquid chromatography and EIA results obtained for furosemide concentrations in horse plasma. These results indicate that the newly developed EIA method is useful for the quantitative analysis of furosemide i...
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...
Costa MF, Thomassian A.To our knowledge no studies evaluating risk factors to EIPH have been undertaken with such a population of horses in Brazil, which is one of the few countries in the racing community to accept the use of frusemide (FUR) as a prerace medication for bleeders. We also compared national results with those already in the literature. Objective: To verify the influence of variables such as distance of the race, racetrack surface, going and season of the year in the recurrence and severity of EIPH and its effect on the finishing position of flat racing Thoroughbreds in Brazil. Methods: 2118 post race ...
Forro M, Lindinger MI.Frusemide (Lasix) is commonly used diuretic in horse racing and equine clinical practice. While pharmacology, pharmacodynamics, renal and haematological effects of frusemide have been studied in horses, its effects on the distribution of fluid within the horse remain unknown. Objective: To quantify the effects of frusemide on extracellular and intracellular fluid shifts. Methods: Horses were infused with 1 mg/kg body mass (n = 7) or 2 mg/kg (n = 9) i.v. frusemide. Total body water (TBW), extracellular fluid volume (ECFV) and plasma volume (PV) were measured using D2O, NaSCN and Evans blue dilu...
Fielding CL, Magdesian KG, Carlson GP, Ruby RE, Rhodes DM.Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. Objective: The purpose of this study was to evaluate the ability of MF-BIA to detect acute fluid compartment changes in horses. We hypothesized that MF-BIA would detect clinically relevant (10-20%) changes in ECFV. Methods: Six healthy mares were used in the study. Methods: This is an original ...
Cohen ND, Stanley SD, Arthur RM, Wang N.Many racing jurisdictions monitor pre-race serum concentration of total carbon dioxide (TCO2) among racing horses. To our knowledge, factors influencing concentration of TCO2 among horses participating in racing have not been systematically evaluated and reported. Objective: To determine if characteristics of horses and racing conditions routinely recorded were significantly associated with pre-race concentration of TCO2, while accounting for and estimating effects of trainer and horse. Methods: Pre-race serum TCO2 concentrations from 5028 starts made by 2,349 horses trained by 287 trainers at...
Schott HC, Axiak SM, Woody KA, Eberhart SW.To determine whether the composition of electrolyte pastes formulated for oral administration influences voluntary water intake (WI) by horses recovering from furosemide-induced dehydration. Methods: 6 horses. Methods: Voluntary WI, body weight, and blood and urine constituents were measured before and after induction of dehydration by furosemide administration and overnight withholding of water; these same variables also were measured during a 36-hour rehydration period. Each horse was evaluated 4 times with random application of 4 treatments (electrolyte pastes) that provided 0.5 g of KCl/kg...
Hinchcliff KW, Jackson MA, Morley PS, Brown JA, Dredge AE, O'Callaghan PA, McCaffrey JP, Slocombe RE, Clarke AE.To determine whether exercise-induced pulmonary hemorrhage (EIPH) was associated with racing performance inThoroughbred horses not medicated with furosemide and not using nasal dilator strips. Methods: Observational cross-sectional study. Methods: 744 two- to 10-year-old Thoroughbred horses racing in Melbourne, Australia. Methods: Horses were enrolled prior to racing, and a tracheobronchoscopic examination was performed after 1 race. Examinations were recorded on videotape, and presence and severity (grade 0 to 4) of EIPH were subsequently determined by 3 observers blinded to the horses' ident...
Borer KE.A 506 kg Warmblood horse with colic was anaesthetized for exploratory celiotomy. Anaesthesia was complicated by arterial hypoxaemia which persisted throughout surgery from the induction of anaesthesia. After endotracheal extubation in the recovery box, a degree of airway obstruction probably occurred during a brief delay in naso-tracheal intubation. Signs of pulmonary oedema were seen shortly afterwards. Furosemide and oxygen were given. Arterial hypoxaemia was present [PaO2: 6.5 kPa (49 mmHg)] when FIO2 was an estimated 0.3. The horse recovered and stood after 45 minutes. It was re-anaestheti...
Johansson AM, Gardner SY, Levine JF, Papich MG, Lafevers DH, Goldman RB, Sheets MK, Atkins CE.Furosemide is the most common diuretic drug used in horses. Furosemide is routinely administered as IV or IM bolus doses 3-4 times a day. Administration PO is often suggested as an alternative, even though documentation of absorption and efficacy in horses is lacking. This study was carried out in a randomized, crossover design and compared 8-hour urine volume among control horses that received placebo, horses that received furosemide at 1 mg/kg PO, and horses that received furosemide at 1 mg/kg IV. Blood samples for analysis of plasma furosemide concentrations, PCV, and total solids were obta...
Bosken JM, Tobin T, Mundy GD, Fisher M, Gantz MG, Banks RO.Postrace urine samples from thoroughbred horses were examined to compare osmolality and specific gravity between horses treated with furosemide and those not treated. Samples were assigned to groups in relation to reported medication (furosemide) status, race finish position, and distance of race. Urine osmolality was significantly (P <.05) lower in samples from horses treated with furosemide when compared with untreated horses. Specific gravity determinations are less precise at measuring urine osmolality at lower levels (1.01 g/ml or less). The measurement of osmolality is a superior meth...
Dirikolu L, Lehner AF, Hughes C, Karpiesiuk W, Camargo FC, Harkins JD, Woods WE, Bosken JM, Boyles J, Troppmann A, Fisher M, Tobin T.Furosemide is a potent loop diuretic used for the prevention of exercise-induced pulmonary hemorrhage in horses. This drug may interfere with the detection of other substances by reducing urinary concentrations, so its use is strictly regulated. The regulation of furosemide in many racing jurisdictions is based on paired limits of urinary SG (100 ng/ml). To validate this regulatory mechanism, a liquid chromatography/mass spectrometry/mass spectrometry method employing a solid-phase extraction procedure and furosemide-d5 as an internal standard was developed. The method was used to determine th...
Johansson AM, Gardner SY, Levine JF, Papich MG, LaFevers DH, Fuquay LR, Reagan VH, Atkins CE.Continuous rate infusion (CRI) of furosemide in humans is considered superior to intermittent administration (IA). This study examined whether furosemide CRI, compared with IA, would increase diuretic efficacy with decreased fluid and electrolyte fluctuations and activation of the renin-angiotensin-aldosterone system (RAAS) in the horse. Five mares were used in a crossover-design study. During a 24-hour period, each horse received a total of 3 mg/kg furosemide by either CRI (0.12 mg/kg/h preceded by a loading dose of 0.12 mg/kg IV) or IA (1 mg/kg IV q8h). There was not a statistically signific...
Butudom P, Barnes DJ, Davis MW, Nielsen BD, Eberhart SW, Schott HC.To determine whether temperature of rehydration fluid influences voluntary rehydration by horses, six 2-3-year-old horses were dehydrated (4-5% body weight loss) by a combination of furosemide administration and 30 km of treadmill exercise. For the initial 5 min following exercise, horses were offered a 0.9% NaCl solution at 10, 20, or 30 degrees C. Subsequently, after washing and cooling out, voluntary intake of water at 10, 20, or 30 degrees C from 20 to 60 min after exercise was measured. Fluid intake (FI) during the first 5 min of recovery was 9.8+/-2.5,12.3+/-2.1 and 9.7+/-2.0L (p>0.05) f...
Cohen ND, Hu Z, Stanley SD, Wang N.Furosemide is frequently used to control or prevent exercise-induced pulmonary hemorrhage in performance horses. The bronchodilating agent clenbuterol is also commonly used as a treatment for inflammatory airway disease in performance horses. Use of both medications is regulated by many racing authorities. The effects of concomitant administration of furosemide and clenbuterol on the pharmacokinetics of clenbuterol have not been well characterized. A study was designed to evaluate the influence of furosemide on serum and urine concentrations of clenbuterol after oral administration of clenbute...
Butudom P, Schott HC, Davis MW, Kobe CA, Nielsen BD, Eberhart SW.Because the primary stimulus for thirst is an increase in plasma tonicity, we hypothesised that dehydrated horses would drink a greater total volume of fluid voluntarily during the first hour of recovery when they were initially offered salt water. To test this hypothesis, bodyweight (bwt), fluid intake (FI) and [Na+] were measured in 6 Arabian horses offered 3 rehydration solutions. After dehydration was induced by frusemide administration (1 mg/kg bwt, i.v.) followed by 45 km treadmill exercise, water (W), 0.45% NaCl and 0.9% NaCl were offered, in a randomised order, during the initial 5 min...
Coleman RJ, St Lawrence AC, Lawrence LM, Roberts AM.This study was conducted to compare bodyweight (bwt) loss and recovery in Standardbred horses receiving frusemide compared to controls. Thirty Standardbred horses from 7 training stables that were racing at the Red Mile in Lexington, Kentucky, during the spring 2001 pari-mutuel meeting were studied. Fourteen horses (FRU) received frusemide (250 mg/horse i.v.) 4 h prior to racing, while 16 horses (NFRU) did not received frusemide. Horses were weighed on the morning of race day, prior to warm-up, after racing and the next day. Changes in bwt were calculated as percentage increase or decrease fro...
Birks EK, Shuler KM, Soma LR, Martin BB, Marconato L, Del Piero F, Teleis DC, Schar D, Hessinger AE, Uboh CE.The incidence and severity of exercise-induced pulmonary haemorrhage (EIPH) in the 2 most commonly raced horse breeds, Thoroughbreds (TB) and Standardbreds (STD), were studied, with particular interest in the possible influence of frusemide (F) and/or the breed (or running gait) on EIPH. The appearance of blood within the trachea was semi-quantified using a published 5-point system, with zero assigned when no blood was observed, and numbers 1-4 assigned with increasing amounts of blood. Considering each endoscopic examination as a separate event, approximately 75% of the postrace endoscopic ex...
Hubbell JA, Hinchcliff KW, Grosenbaugh DA, Beard WL, Beard LA.Frusemide reduces pulmonary vascular pressures in resting horses and attenuates exercise-induced increases in these pressures in exercising horses. The mechanism underlying these effects of frusemide is unclear. We tested the hypothesis that the haemodynamic effects of frusemide are dependent on diuresis by examining the effect of frusemide in anaesthetised horses in which diuresis was prevented by ligation of ureters. Twenty four horses were assigned randomly to one of 4 treatments: 1) frusemide (1 mg/kg bwt i.v.) and intact ureters; 2) frusemide and ligated ureters; 3) saline placebo and lig...
Cohen ND, Peck KE, Smith SA, Ray AC.The distribution of specific gravity values for 2,599 urine samples collected from racing Thoroughbred horses that were known to have received furosemide prior to racing was compared with that for 1,669 urine samples from racing Thoroughbred horses that reportedly had not received furosemide. Values of specific gravity for furosemide-treated horses were significantly lower (P < 0.001) than those for horses that had not received furosemide, and the proportion of horses with urine specific gravity either <1.010 or <1.012 was significantly greater (P < 0.001) among the furosemide-trea...
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...
Chu KK, Cohen ND, Stanley SD, Wang N.To estimate the probability of concurrently exceeding thresholds for plasma concentration of furosemide and urine specific gravity after IV administration of furosemide in horses. Methods: 12 mature healthy Thoroughbred (n = 6) or Quarter Horse (6) mares. Methods: Venous blood was collected from each horse prior to and 0.25, 0.5, 0.75, 1, 2, 3, 4, 4.5, 5, and 6 hours after IV administration of 250 mg (first experiment) or 500 mg (second experiment) of furosemide. Urine was collected hourly between 1 and 6 hours after administration of furosemide at both doses. Concentrations of furosemide were...
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...
Fielding CL, Magdesian KG, Carlson GP, Ruby RE, Rhodes DM.Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. Objective: The purpose of this study was to evaluate the ability of MF-BIA to detect acute fluid compartment changes in horses. We hypothesized that MF-BIA would detect clinically relevant (10-20%) changes in ECFV. Methods: Six healthy mares were used in the study. Methods: This is an original ...
Olsen SC, Coyne CP, Lowe BS, Pelletier N, Raub EM, Erickson HH.Four hours prior to exercise on a high-speed treadmill, 4 dosages of furosemide (0.25, 0.50, 1.0, and 2.0 mg/kg of body weight) and a control treatment (10 ml of 0.9% NaCl) were administered IV to 6 horses. Carotid arterial pressure (CAP), pulmonary arterial pressure (PAP), and heart rate were not different in resting horses before and 4 hours after furosemide administration. Furosemide at dosage of 2 mg/kg reduced resting right atrial pressure (RAP) 4 hours after furosemide injection. During exercise, increases in treadmill speed were associated with increases in RAP, CAP, PAP, and heart rate...
Erickson BK, Erickson HH, Coffman JR.Intravenous frusemide (1.0 mg/kg bwt) or phentolamine (0.33 mg/kg bwt) was given to 7 horses 1 h before exercise and their effects on pulmonary artery and aortic pressure changes during strenuous exercise were examined. Short-term near-maximal treadmill exercise (10 m/sec, 3 degrees incline) produced increases in heart rate, mean pulmonary artery pressure (PAP), mean aortic pressure (AP), and packed cell volume (PCV). Frusemide did not affect heart rate, PAP or PCV during exercise. Frusemide significantly decreased mean AP by 10 to 15 mmHg during exercise. Phentolamine produced an increase in ...
Divers TJ, Whitlock RH, Byars TD, Leitch M, Crowell WA.Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses t...
Gross DK, Morley PS, Hinchcliff KW, Wittum TE.To determine the effect of furosemide on performance of Thoroughbreds racing on dirt surfaces at tracks in the United States and Canada. Methods: Cross-sectional study. Methods: All Thoroughbreds (n = 22,589) that finished a race on dirt surfaces at tracks in the United States and Canada between June 28 and July 13, 1997 in jurisdictions that allowed the use of furosemide. Methods: Race records were analyzed by use of multivariable ANOVA procedures and logistic regression analyses to determine the effect of furosemide on estimated 6-furlong race time, estimated racing speed, race earnings, and...
Freestone JF, Carlson GP, Harrold DR, Church G.Alterations in electrolyte and acid-base balance were studied in 6 horses for 8 hours after furosemide administration (1 mg/kg of body weight, IM), and the results were compared with those for 5 healthy untreated horses (controls) kept under identical environmental conditions. In the treated group, decreases in plasma potassium, chloride, and calcium concentrations and increases in total plasma protein content persisted for the 8-hour observation period, whereas there was no change in plasma sodium concentration, osmolality, or packed cell volume. Plasma bicarbonate concentration and PCO2 rema...
Sweeney CR, Soma LR, Bucan CA, Ray SG.Thoroughbreds with a confirmed history of exercise-induced pulmonary hemorrhage (EIPH) were treated pre-exercise with atropine sulfate, cromolyn, ipratropium or furosemide. Atropine prevented EIPH in 3 of 3 trials in 1 horse, while having no significant effect on bleeding status in the other 2 horses. Pre-exercise treatment with cromolyn had no significant effects in the 3 horses. Pre-exercise treatment of ipratropium was apparently responsible for preventing EIPH in 17 out of 18 trials in 2 horses. The pharmacologic properties of ipratropium in the horse have not been studied, but based on hu...
Sosa León LA, Hodgson DR, Carlson GP, Rose RJ.To test effectiveness of an electrolyte paste in correcting fluid, electrolyte and acid base alterations in response to furosemide administration. Methods: 6 Standardbreds. Methods: Horses received electrolyte paste or water only (control). The paste was given orally 3 hours after furosemide administration (1 mg/kg of body weight, IM). Water was given ad libitum soon after the paste and 3 hours after furosemide administration to treated and control groups, respectively. Paste Na+, K+, and Cl- composition was approximately 2,220, 620, and 2,840 mmol, respectively. The PCV and plasma concentrati...
Warren LK, Lawrence LM, Brewster-Barnes T, Powell DM.Three diets were fed to 6 horses in a 3 x 6 Latin rectangle experiment to determine if dietary fibre could improve hydration status in response to dehydration with frusemide. Frusemide was used to simulate dehydration from exercise-induced sweat loss. Diets contained similar dry matter (DM), energy, protein and electrolyte content, but differed in total dietary fibre (TDF) and/or soluble fibre (SDF). The 3 diets were: 1) HIGH-HIGH (high TDF, high SDF); 2) HIGH-LOW (high TDF, low SDF); and 3) LOW-LOW (low TDF, low SDF). In each 10 day period, water intake and faecal moisture content were assess...
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...
Jackson JA, Ducharme NG, Hackett RP, Rehder RS, Ainsworth DM, Shannon KJ, Erickson BK, Erb HN, Jansson N, Soderholm LV, Thorson LM.To determine whether laryngeal hemiplegia would increase transmural pulmonary artery pressure (TPAP). Methods: 6 horses. Methods: Horses were studied under 5 conditions: control conditions, after induction of left laryngeal hemiplegia, during obstruction of the left nostril, after placement of an instrumented tracheostomy, and after placement of an open tracheostomy. Horses were evaluated after being given saline solution and after being given furosemide. Methods: Horses were exercised on a high speed treadmill, using a maximum speed of 13 m/s. During each exercise, airway pressures, airflow, ...
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...
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, ...
Manohar M, Goetz TE, Sullivan E, Griffin R.The frusemide dose-response for attenuation of exercise-induced pulmonary capillary hypertension was studied in 7 healthy, exercise-conditioned Thoroughbred horses using previously described haemodynamic procedures. Four different doses of frusemide were tested: 250 mg regardless of bodyweight (amounting to 0.56 +/- 0.03 mg/kg bwt), 1.0 mg/kg bwt, 1.5 mg/kg bwt and 2.0 mg/kg bwt. Frusemide was administered i.v., 4 h before exercise. Haemodynamic data were obtained at rest and during treadmill exercise performed at 14.2 m/s on a 3.5% uphill grade; this workload elicited maximal heart rate of ho...
Schott HC, Axiak SM, Woody KA, Eberhart SW.To determine whether the composition of electrolyte pastes formulated for oral administration influences voluntary water intake (WI) by horses recovering from furosemide-induced dehydration. Methods: 6 horses. Methods: Voluntary WI, body weight, and blood and urine constituents were measured before and after induction of dehydration by furosemide administration and overnight withholding of water; these same variables also were measured during a 36-hour rehydration period. Each horse was evaluated 4 times with random application of 4 treatments (electrolyte pastes) that provided 0.5 g of KCl/kg...
Forro M, Lindinger MI.Frusemide (Lasix) is commonly used diuretic in horse racing and equine clinical practice. While pharmacology, pharmacodynamics, renal and haematological effects of frusemide have been studied in horses, its effects on the distribution of fluid within the horse remain unknown. Objective: To quantify the effects of frusemide on extracellular and intracellular fluid shifts. Methods: Horses were infused with 1 mg/kg body mass (n = 7) or 2 mg/kg (n = 9) i.v. frusemide. Total body water (TBW), extracellular fluid volume (ECFV) and plasma volume (PV) were measured using D2O, NaSCN and Evans blue dilu...
Bayly WM, Slocombe RF, Schott HC, Hodgson DR.To determine whether i.v. administration of furosemide (250 mg) to horses before maximal exercise affected maximal oxygen consumption (VO2max), breathing mechanics, or gas exchange during exercise. Methods: 7 healthy, well-conditioned Thoroughbred horses. Methods: 5 horses initially performed an incremental treadmill exercise test to determine VO2max 4 hours after i.v. administration of furosemide (250 mg i.v.) or placebo (saline [0.9% NaCl] solution). Time to fatigue and distance run were recorded. All 7 horses were then used to determine the effects of furosemide on gas exchange and breathin...
Hyyppä S, Pösö AR.During both high-intensity and short-distance exercise, the high rate of expended energy is met by anaerobic oxidation of glucose to lactic acid; this is the main cause of metabolic acidosis observed during racing. In addition, plasma volume decreases because water moves from the vasculature to the intracellular and interstitial spaces at the onset of intense exercise. These fluid shifts, together with active ion-exchange between blood and tissue, cause marked changes in electrolyte concentrations. This article reviews the mechanisms of acid-base disturbances, fluid shifts, and electrolyte cha...
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...
Freestone JF, Carlson GP, Harrold DR, Church G.Metabolic alkalosis was induced in 10 clinically normal horses by administration of furosemide (1 mg/kg of body weight, IM) followed 4.5 hours later by sodium bicarbonate (NaHCO3; 500 g in 8 L water) via nasogastric tube. Furosemide diuresis resulted in a mean weight loss of 21.1 kg, which was associated with small, but significant, increases in venous blood pH, bicarbonate, and plasma protein concentrations (P less than 0.001), while plasma potassium, chloride, and calcium concentrations declined significantly (P less than 0.001). Oral administration of the hypertonic NaHCO3 solution resulted...
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...
Johansson AM, Gardner SY, Levine JF, Papich MG, Lafevers DH, Goldman RB, Sheets MK, Atkins CE.Furosemide is the most common diuretic drug used in horses. Furosemide is routinely administered as IV or IM bolus doses 3-4 times a day. Administration PO is often suggested as an alternative, even though documentation of absorption and efficacy in horses is lacking. This study was carried out in a randomized, crossover design and compared 8-hour urine volume among control horses that received placebo, horses that received furosemide at 1 mg/kg PO, and horses that received furosemide at 1 mg/kg IV. Blood samples for analysis of plasma furosemide concentrations, PCV, and total solids were obta...
Clarke LL, Argenzio RA.In contrast to in vivo findings, the equine proximal colon fails to demonstrate significant net absorption of Na+ and Cl- under in vitro conditions. The present study was undertaken to determine if endogenous prostanoids are responsible for this apparent lack of ion transport. Proximal colonic tissues from ponies were preincubated in either normal Ringer solution or in Ringer containing 1 microM indomethacin and studied in Ussing chambers containing these solutions. Untreated colonic mucosa demonstrated negligible Na(+)-Cl- absorption in the basal state. In contrast, indomethacin-treated colon...
Johansson AM, Gardner SY, Levine JF, Papich MG, LaFevers DH, Fuquay LR, Reagan VH, Atkins CE.Continuous rate infusion (CRI) of furosemide in humans is considered superior to intermittent administration (IA). This study examined whether furosemide CRI, compared with IA, would increase diuretic efficacy with decreased fluid and electrolyte fluctuations and activation of the renin-angiotensin-aldosterone system (RAAS) in the horse. Five mares were used in a crossover-design study. During a 24-hour period, each horse received a total of 3 mg/kg furosemide by either CRI (0.12 mg/kg/h preceded by a loading dose of 0.12 mg/kg IV) or IA (1 mg/kg IV q8h). There was not a statistically signific...
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....
Weiss DJ, Geor RJ, Smith CM.Effects of echinocytosis on blood rheology and exercise performance were evaluated for 5 Thoroughbreds. Echinocytosis was induced by administration of furosemide (1 mg/kg of body weight, IM, q 12 h) for 4 days. Furosemide treatment resulted in decreases in serum sodium and serum chloride concentrations and in RBC chloride and potassium concentrations. Echinocytosis was associated with increased RBC density as determined by RBC density gradient centrifugation. However, samples containing echinocytes were more filterable than control samples, indicating that echinocytes were not rigid cells. Ery...
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 ...
Muir WW, McGuirk S.Knowledge of the dosage, rate and route of administration, and potential side effects of drugs used to treat cardiac disease in horses has been refined. The judicious use of these drugs can increase exercise capacity, improve health, and potentially prolong life. Currently, antiarrhythmics (quinidine, lidocaine), positive inotropies (digoxin), and diuretics (furosemide) are the primary agents used to treat cardiovascular disease in horses. The development of newer drugs (verapamil, milrinone, bumetanide) and their usefulness in therapy for horses with cardiovascular disease require further inv...
Kollias-Baker CA, Pipers FS, Heard D, Seeherman H.Pulmonary edema associated with transient airway obstruction was detected in 3 horses. The cause of obstruction was different in each horse, but after relief of the obstruction, clinical signs and radiographic abnormalities were indicative of pulmonary edema. In 2 of the 3 horses, pink frothy fluid was evident in the airways. The horses were treated with furosemide, nasal insufflation of O2, anti-inflammatory agents, and anti-biotics. Of the 3 horses examined, 1 horse died acutely, 1 horse recovered fully, and 1 developed pleuritis and was subsequently euthanatized.
Carlson GP, Jones JH.This study was undertaken to evaluate the effects of frusemide on the concentration of plasma electrolytes and the relationship between changes in electrolyte concentration and the simultaneous changes in acid-base balance in arterial and venous blood during intense exercise. Five exercise-conditioned Thoroughbred horses were exercised on a high-speed treadmill at a slope of 10% at speeds known to exceed VO2max. Horses participated in 3 randomised exercise trials in which they received either placebo (control), low-dose frusemide (0.5 mg/kg bwt), or high-dose frusemide (1.0 mg/kg) 4 h prior to...
