Hemorrhage in horses refers to the escape of blood from blood vessels into surrounding tissues or outside the body, which can occur due to trauma, surgical procedures, or underlying health conditions. It presents in various forms, such as internal bleeding, external bleeding, or bleeding into body cavities. Hemorrhage can affect different systems within the horse, including the respiratory, gastrointestinal, and musculoskeletal systems, depending on the location and severity of the bleeding. The management of hemorrhage involves identifying the source of bleeding, controlling blood loss, and providing supportive care to maintain the horse's physiological stability. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, mechanisms, and management strategies of hemorrhage in equine medicine.
McConnico RS, Copedge K, Bischoff KL.Increased popularity during the past decade of brodifacoum, an anticoagulant rodenticide, has led to an increase in cases of accidental poisoning in nontarget species, including pets and farm animals. Pharmacokinetics of second-generation anticoagulant rodenticides such as brodifacoum are substantially different from those of first-generation anticoagulant rodenticides such as warfarin. This difference dramatically influences management of exposure in terms of duration and cost of treatment and may affect outcome. The National Poison Control Center reports that approximately 50 cases of brodif...
Nie GJ, Pope KC.Prolonged penile prolapse in horses has been reported in association with administration of phenothiazine tranquilizers, trauma, neuropathies, severe general debilitation or exhaustion, starvation, rabies, herpes myeloencephalitis, equine infectious anemia, and purpura hemorrhagica. A 5-year-old gelding was admitted for treatment of prolonged penile prolapse of 12 days' duration that developed after acepromazine maleate was administered to allow examination of a laceration that had resulted in severe blood loss. The horse was sedated, and the penis was replaced in the preputial cavity by use o...
Colbourne CM, Rosenstein DS, Steficek BA, Yovich JV, Stick JA.A progressive ethmoidal hematoma (PEH) was treated successfully in a 4-week-old Belgian filly by surgical removal, using a frontonasal bone flap. The filly had respiratory stridor, epistaxis, and facial enlargement over the left paranasal sinuses, which had progressively increased in size since birth. Computed tomographic images of the head obtained with the foal under general anesthesia were useful in determining the extent and nature of the soft-tissue mass and planning surgical intervention. On the basis of the histologic appearance of the mass, a diagnosis of PEH was made. Twelve months af...
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, ...
Hooper PT, Ketterer PJ, Hyatt AD, Russell GM.Laboratory examinations of equine morbillivirus included experimental reproductions of the disease caused by the virus by transmission of mixed lung and spleen taken from two field equine cases into two horses and by inoculating tissue culture virus into a further two horses. The most distinctive gross lesions of the diseases that developed in three of the horses was that of pulmonary edema characterized by gelatinous distension of subpleural lymphatics. Histologically, the lesions in the lungs were those of serofibrinous alveolar edema, alveolar macrophages, hemorrhage, thrombosis of capillar...
Yarbrough TB, Carr EA, Snyder JR, Hornof WJ.This article reports an alternative to septal resection in nasal septal deviations involving the rostral 7 to 10 cm of the nasal septum. Methods: Case report. Methods: One client-owned foal. Methods: A nasal approach with mucosal elevation was used to gain access to the cartilaginous portion of the nasal septum. Once exposed, a series of parasagittal incisions in the cartilage allowed the septum to be repositioned while providing some intrinsic stabilization. Results: The nasal approach provided good access to the rostral 7 cm of the nasal septum. The technique resulted in minimal hemorrhage f...
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...
Carr EA, Carlson GP, Wilson WD, Read DH.To characterize history, clinical signs, and pathologic findings in horses with histologically confirmed acute hemorrhagic pulmonary infarction and necrotizing pneumonia. Methods: Retrospective study. Methods: 21 horses. Results: 19 of the 21 horses were Thoroughbred racehorses in training. Eighteen horses had had strenuous exercise immediately prior to onset of illness. Fifteen horses had a serosanguineous nasal discharge during hospitalization. Seventeen horses had radiographic evidence of pulmonary consolidation and pleural effusion. Nine of 14 horses had ultrasonographic evidence of large ...
Foster RA, Gartley CJ, Newman S.Cervical and uterine varices with thrombosis were observed at the necropsy of a virgin 16-year-old Peruvian Paso that had previous episodes of hemorrhage from the uterus. Practitioners and pathologists should be alert to the possibility of ruptured varices in mares with hemorrhage into the uterus or from the vulva.
Trim CM, Eaton SA, Parks AH.An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indi...
Birks EK, Mathieu-Costello O, Fu Z, Tyler WS, West JB.Thoroughbred horses develop extremely high pulmonary vascular pressures during galloping, all horses in training develop exercise-induced pulmonary hemorrhage, and we have shown that this is caused by stress failure of pulmonary capillaries. It is known that the capillary transmural pressure (Ptm) necessary for stress failure is higher in dogs than in rabbits. The present study was designed to determine this value in horses. The lungs from 15 Thoroughbred horses were perfused with autologous blood at Ptm values (midlung) of 25, 50, 75, 100 and 150 mmHg, and then perfusion fixed, and samples (d...
Pace LW, Turnquist SE, Casteel SW, Johnson PJ, Frankeny RL.Five adult horses presented with acute clinical signs of watery diarrhea, excessive salivation, muscle tremors, ataxia, and depression. Four died within 24 hours and the fifth was euthanatized approximately 48 hours after onset of clinical signs. Necropsy finds in two of the horses included hyperemia of gastric mucosa, intestines filled with green to black watery fluid, and multifocal to coalescing, hemorrhagic 1.0-2.0-cm-diameter ulcers of the mucosa of the cecum and large colon. Histopathologic changes in the cecum and large colon consisted of mucosal necrosis and ulceration, vascular thromb...
Mills PC, Higgins AJ.The athletic ability of the horse is facilitated by vital physiological adaptations to high-intensity exercise, including a thin (but strong) pulmonary blood-gas barrier, a large pulmonary functional reserve capacity and a consequent maximum oxygen uptake (VO2max) far higher than in other species. A high pulmonary artery pressure also serves to enhance pulmonary function, although stress failure of lung capillaries at high pulmonary transmural pressures, and the contribution of other factors which act in the exercising horse to increase pulmonary vascular tone, may lead to pathological or path...
Tute AS, Wilkins PA, Gleed RD, Credille KM, Murphy DJ, Ducharme NG.An 8-year-old Trakehner mare developed fulminant pulmonary edema following suspected upper airway obstruction 50 minutes into an otherwise unremarkable anesthetic recovery after surgery for left cricoarytenoideus dorsalis muscle reinnervation and ventriculocordectomy. Establishing a patent airway by orotracheal reintubation and cardiopulmonary resuscitation attempts were unsuccessful. Gross, histological, and electron microscopic postmortem examination showed severe hemorrhagic pulmonary edema. Laryngeal swelling or hemorrhage were not evident, suggesting laryngospasm or functional airway coll...
Van Hoogmoed L, Snyder JR.Four horses were evaluated for clinical signs consistent with small intestinal disease. During exploratory surgery, primary hematomas in the mesentery were found in 2 horses. The third horse developed a hematoma secondary to a mesenteric rent, whereas in the fourth horse, a hematoma developed secondary to strangulation of the bowel by a mesenteric lipoma. Two horses were euthanatized at surgery, because the extensive nature of the hematoma precluded ligation and there was substantial risk of continued hemorrhage postoperatively. The remaining horses recovered from surgery but developed complic...
McAbee GN, Ciminera PF.Intracranial hematoma in pediatric equestrians is rare, notwithstanding the lack of uniform standards and requirements for the use of protective headgear during equestrian events. We report two teenage helmeted equestrians who sustained severe head trauma with intracranial hematoma due to falls during equestrian events. Current recommendations for the use of equestrian headgear are reviewed.
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...
Dickinson CE, Traub-Dargatz JL, Dargatz DA, Bennett DG, Knight AP.To determine the clinical manifestations, morbidity, mortality, and treatment methods for rattlesnake venom poisoning in horses. Methods: Retrospective analysis of medical records. Methods: 27 horses with acute venom poisoning attributable to prairie rattlesnakes, and 5 with chronic problems subsequent to a rattlesnake bite. Results: Most horses were bitten on or near the muzzle while on pasture, resulting in head swelling, dyspnea, and epistaxis. Additional manifestations of acute poisoning included fever, tachycardia, tachypnea, cardiac arrhythmia, hemolytic anemia, thrombocytopenia, hemorrh...
Weiss DJ, Geor RJ, Burger K.To determine whether furosemide treatment altered the blood flow properties and serum and RBC electrolyte concentrations of Thoroughbreds during submaximal treadmill exercise. Methods: Thoroughbreds were subjected to submaximal treadmill exercise with and without treatment with furosemide (1 mg/kg of body weight, IV). Methods: 5 healthy Throughbreds that had raced within the past year and had no history of exercise-induced pulmonary hemorrhage. Methods: Venous blood samples were obtained before exercise, at treadmill speeds of 9 and 13 m/s, and 10 minutes after exercise, and hemorheologic and ...
Weiss DJ, Richwagen K, Evanson OA.To evaluate the contribution of hematocrit and RBC deformability to pulmonary vascular pressures of racehorses. Methods: Pony lungs were isolated and right and left lungs were perfused separately with blood. The effects of changing hematocrit and of pentoxifylline treatment were evaluated. Methods: 11 healthy mixed-breed ponies. Methods: Ponies were anesthesized, blood was collected, and lungs were removed and perfused with blood at constant flow rate. Results: Increasing the hematocrit from 35% to 65% resulted in increases in pulmonary arterial pressure (53%, 45%), capillary shear stress (45%...
Bucci TJ, Hansen DK, LaBorde JB.Two of five pregnant rabbits gavaged with purified fumonisin B1 at 1.75 mg/kg/day died, one after 9 and one after 13 doses. Microscopic examination revealed focal small hemorrhages in cerebral white matter in both animals, with malacia and hemorrhage also present in the hippocampus of one. The lesions were bilateral. Both animals also had marked degeneration of renal tubule epithelium and of hepatocytes. Apoptosis was the dominant degenerative change in kidney and liver. Fumonisin is known to cause leukoencephalomalacia and hemorrhage in equines, but CNS changes associated with exposure to fum...
Hogan PM, Bramlage LR, Pierce SW.A 14-year-old Thoroughbred broodmare was evaluated for signs of mild to moderate abdominal pain of 5 hours' duration. Exploratory celiotomy revealed a 20 x 8-cm subserosal hematoma associated with a focal serosal perforation overlying a muscular tear along the parietal surface of the stomach. The odor of intestinal tract gas was detected, but gross contamination of the abdomen was not evident. Concurrent partial volvulus of the small intestine was evident. Removal of the large colon from the abdomen appeared to coincide with propagation of the serosal perforation to a full-thickness gastric re...
Moore EH, Shelton DK, Wisner ER, Richardson ML, Bishop DM, Brock JM.To reexamine the blood patch technique in a laboratory model of lung biopsy free of confounding clinical variables. Methods: An equine model of lung biopsy was developed with an excised lobe connected to an insufflation bulb and pressure monitor. Patched and control unpatched punctures were made in the lung surface, and the pressure within the lung was raised to the maximum achievable. Whether air leakage from the puncture sites could be induced was determined and, if so, at what pressure it occurred. Results: At statistical analysis with the Kaplan-Meier test and the Cox proportional hazards ...
Rampazzo A, Eule C, Speier S, Grest P, Spiess B.The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. Results: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% present...
Nelson BB, Kawcak CE, Ehrhart EJ, Goodrich LR.To compare intra and postoperative clinical features of desmotomy of the accessory ligament of the superficial digital flexor tendon (ALSDFT) using the Saber radiofrequency (SaberRF) electrosurgical probe versus sharp transection with a tenotomy knife. Methods: Randomized, controlled, blocked (horse) design. Methods: Adult horses (n = 6). Methods: Each horse received bilateral, tenoscopic-guided ALSDFT desmotomy with a SaberRF and tenotomy knife, randomly assigned to left, or right limb. The desmotomy duration and intraoperative hemorrhage grades were recorded. Postoperatively, the grades ...
Kemper T, Spier S, Barratt-Boyes SM, Hoffman R.Five horses were admitted for treatment of smoke-inhalation injuries sustained in a barn fire. Three of the horses were mildly affected, with high respiratory rates (24 to 36 breaths/min) and normal to low arterial oxygen tensions (77.0 to 94.1 mm of Hg), and responded well to administration of diuretics, bronchodilators, corticosteroids, and antibiotics. The 2 remaining horses were severely affected. Both were in respiratory distress, with markedly low arterial oxygen tensions (50.4 and 57.1 mm of Hg) and cyanosis. These 2 horses required fluid resuscitation in addition to the treatments give...
Shull RM.Hemolytic or blood loss anemia was induce in six ponies and red blood cell concentrations of creatine, glucose-6-phosphate dehydrogenase (G-6-PD), lactate dehydrogenase (LDH), and aspartate transaminase (AST) were measured during the ensuing regenerative period. Creatine and G-6-PD levels correlated well and increased concentration of either was good indication of increased erythrogenesis. Erythrocyte LDH levels were of value in assessing the response to hemolytic anemia but not to blood loss anemia. The difference may be, at least in part, the result of differing degrees of regenerative effor...
Wyn-Jones G, Jones RS, Church S.One of the major obstacles to successful intranasal surgery in the horse is haemorrhage, even minor interferences causing profuse bleeding. Conventional techniques for haemostasis are ineffective or inhibit the progress of the surgery. Temporary bilateral occlusion of the common carotid artery resulted in a substantial reduction in haemorrhage during intranasal surgery in five horses, with much improved visibility and facility of operation. The large contribution to the circle of Willis by the ventral spinal artery is believed to prevent cerebral ischaemia during this procedure. This paper des...
Erickson HH, Lowe BS.This article discusses exercise-induced pulmonary hemorrhage (EIPH), a pathophysiological syndrome which occurs worldwide in the equine athlete. It reviews the history of EIPH, the incidence in performance horses, the etiology, studies performed on the treadmill to determine the mechanisms of EIPH, and the most likely causes of stress failure of the pulmonary capillaries.
Sarin EL, Moore JB, Moore EE, Sheppard FR.The majority of blunt aortic injuries (BAIs) are related to "rapid deceleration"mechanisms with motor vehicle crashes (MVCs) and falls accounting for the majority of these injuries. However, in recent years improved understanding of the mechanisms behind blunt aortic injury has led
to an expansion of the "usual suspects" when evaluating blunt thoracic injury. Compression of the thoracic cage has proven to have a significant potential for blunt aortic injury, even in
instances without "high-speed" mechanisms commonly sought when explaining the history for BAI risk factors. In this we report, ...
Mehl ML, Ragle CA, Mealey RH, Whooten TL.A 5-year-old Quarter Horse was examined after it developed signs of abdominal discomfort as a result of a training accident. Oral mucous membranes were pale, and capillary refill time was > 3 seconds. Hematologically, the PCV was low, and abdominocentesis yielded a serosanguineous fluid. Abdominal ultrasonography was performed and revealed a large hypoechoic mass associated with the cranial margin of the spleen. Because differentiation between subcapsular hematoma and extracapsular hematoma could not be made with certainty, further evaluation of the spleen was indicated. Abdominal laparosco...
Speirs VC, van Veenendaal JC, Christie BA, Lavelle RB, Gay CC.Three cases of intramural haematoma of the small colon of horses are presented. In all cases the haematoma obstructed the lumen and caused an accumulation of faeces and gas. The horses were in shock and had acute abdominal pain. Exploratory abdominal surgery revealed the haematomas and showed them to be associated with chronic infection and terminal rupture in one animal which was subsequently killed, and an iatrogenic perforation of the terminal small colon in another which survived after intestinal resection. In the remaining horse, which died without recovering after intestinal resection, n...
Dahlgren AR, Tablin F, Finno CJ.Genetic bleeding disorders can have a profound impact on a horse's health and athletic career. As such, it is important to understand the mechanisms of these diseases and how they are diagnosed. These diseases include haemophilia A, von Willebrand disease, prekallikrein deficiency, Glanzmann's Thrombasthenia and Atypical Equine Thrombasthenia. Exercise-induced pulmonary haemorrhage also has a proposed genetic component. Genetic mutations have been identified for haemophilia A and Glanzmann's Thrombasthenia in the horse. Mutations are known for von Willebrand disease and prekallikrein deficienc...
Angsubhakorn S, Poomvises P, Romruen K, Newberne PM.Two episodes of acute aflatoxin poisoning in horses suggest that horses are susceptible to the toxic effects of this mycotoxin. Lesions associated with exposure to aflatoxin included encephalomalacia of cerebral hemispheres, fatty degeneration, necrosis, bile duct hyperplasia, fibrosis of the liver, fatty infiltration of the kidney, hemorrhagic enteritis, and myocardial degeneration. Hypoglycemia, hyperlipidemia, and depletion of lymphocytes accompanied these lesions. The diagnosis was based on gross and histopathologic observations, consistent with observations of other species poisoned with ...
Pusterla N, Fecteau ME, Madigan JE, Wilson WD, Magdesian KG.The medical records of 19 horses with acute hemoperitoneum were reviewed. The causes for the hemoperitoneum were idiopathic (8 horses), splenic hematoma with capsular tear (7), bleeding from the reproductive tract (3), multicentric hemangiosarcoma (1), and systemic amyloidosis (1). The affected horses were between 4 and 32 years of age (median 11.5 years). The most consistent findings on initial examination were depression, tachycardia, tachypnea, pale mucous membranes, prolonged capillary refill time, colic, and abdominal discomfort. Less common clinical signs included abdominal distention, p...
Knych HK, Wilson WD, Vale A, Kass PH, Arthur RM, Jones JH.Due to the high prevalence of EIPH in racehorses and its potential impact on the horse's health, furosemide administration is permitted up to 4-h prior to post time in most North American racing jurisdictions. Anecdotal reports suggest that administration of furosemide 24-h prior to strenuous exercise may be equally effective in decreasing the severity of EIPH. Objective: To 1) compare the efficacy of furosemide in reducing the presence and severity of EIPH when administered 4- or 24-h prior to strenuous exercise 2) characterise electrolyte and blood parameters following administration of furo...