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Topic:Hemorrhage
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.
Equine herpesvirus 2 in pulmonary macrophages of horses. In a search of viral agents in pulmonary macrophages of horses with chronic pulmonary disease, equine herpesvirus 2 was found to be unique. In 8 of 9 horses with chronic pulmonary disease, antigens of equine herpesvirus 2 were detected by indirect immunofluorescence staining of scattered foamy macrophages immediately after harvesting by bronchoalveolar lavage and fractionation on metrizamide gradients. In a healthy horse, antigens were not found. After 1 week of cultivation of bronchoalveolar lavage cells from a second group of 9 horses with chronic pulmonary disease, viral antigens were detec...
Traumatic carotid and vertebral artery dissection in a professional jockey: a cautionary tale. Jockeys accept bony fractures and soft tissue injuries as occupational hazards. An average National Hunt jockey falls once in ten races with an injury rate of 4.25%. Head injury is a common cause of morbidity and the benefit of helmets is well recognized. Neck injuries are also common and usually musculoskeletal. Although rare, trauma to the neck arteries may go unnoticed yet have catastrophic consequences. Internal tears can allow arterial blood to dissect the layers of the arterial wall and obstruct the lumen. Severe obstruction may lead to cerebral ischaemia and infarction. An appreciation ...
Kinetics, dose response, tachyphylaxis and cross-tachyphylaxis of vascular leakage induced by endotoxin, zymosan-activated plasma and platelet-activating factor in the horse. Vascular leakage induced by intradermal injection of endotoxin, zymosan-activated plasma (ZAP) and platelet-activating factor (PAF) was measured in nine Thoroughbreds using 125-iodine human serum albumin (125I-HSA) as a marker in the blood. ZAP and PAF produced dose-dependent increases in vascular permeability with the maximum occurring within the first 15 min after injection. The vascular leakage induced by endotoxin was also dose-dependent, but the maximum occurred 2 h after intradermal injection. Intradermal sites previously injected with endotoxin were refractory to a second injection of e...
Morphologic changes of the ascending colon during experimental ischemia and reperfusion in ponies. The morphologic changes following ascending colon volvulus result from the interaction of inflammatory and coagulation mediators. The objective of this study was to establish a quantifiable histopathologic scoring system to evaluate the serial pathomorphologic changes during ischemia and reperfusion. Such a scoring system could then be applied to subsequent studies designed to attenuate bowel lesions by regulating activity of individual mediators. Ten normal, healthy adult ponies were randomly divided into two equal groups. Following anesthesia and a 30-minute stabilization period, the colon o...
Pheochromocytoma in two horses. A 12-year-old Standard-bred mare and a 21-year-old Quarter Horse gelding were treated for signs of abdominal pain and sweating. The mare also had muscle fasciculations, azotemia, and ataxia, and was euthanatized after signs of pain became refractory to analgesics. The gelding died when ventricular tachycardia developed during general anesthesia for exploratory celiotomy. Adrenal pheochromocytomas (bilateral in the mare), associated with retroperitoneal and intra-abdominal hemorrhage, were found on postmortem examination. Pheochromocytoma should be considered in older horses with signs of abdom...
Endoscopy of the upper respiratory tract during treadmill exercise: a clinical study of 100 horses. Endoscopy of the upper respiratory tract was performed in 100 horses during high speed treadmill exercise. Reasons for endoscopy were a history of an abnormal noise during exercise in 75 horses, poor performance in 17 horses and to evaluate the results of upper respiratory tract surgery in 8 horses. Of the 75 horses with a history of an abnormal noise during exercise the cause was determined in 67 (89%). Endoscopic abnormalities were detected at rest in 40 of these 75 horses (53%). In these 40 horses, a similar diagnosis as to the cause of the abnormal noise was made at rest and during exercis...
Ovariohysterectomy in six mares. Six mares had ovariohysterectomy performed for chronic pyometra associated with cervical abnormalities, uterine neoplasia, or removal of a macerated fetus. Ovariohysterectomy was performed through a ventral midline incision with access to the ovarian and uterine vessels aided by traction on the uterus and retraction of abdominal viscera. Abdominal pain, the most common complication after surgery, occurred in four mares but resolved within 36 hours. Peritonitis occurred in two mares; one mare was subsequently euthanatized. Other complications that resolved with treatment included infection of t...
Autologous blood instillation alters respiratory mechanics in horses. To investigate physiological consequences of autologous blood instillation in the lungs of healthy horses, respiratory mechanics and bronchial response to histamine were studied in 8 Thoroughbreds before and after introducing autologous blood (n = 5) and sterile saline solution (n = 3) into their lungs. Blood instillation resulted in a decrease in dynamic compliance (Cdyn) and increased respiratory resistance (R). Bronchial sensitivity and reactivity were unchanged after blood introduction. There were no significant changes in pulmonary mechanics or bronchial response after saline instillation...
Stress failure of pulmonary capillaries as a limiting factor for maximal exercise. The pulmonary blood-gas barrier has a basic physiological dilemma. On the one hand it needs to be extremely thin for efficient gas exchange. On the other hand it also needs to be immensely strong because the stresses on the pulmonary capillary wall become extremely high when the capillary pressure rises on exercise. Maximal hydrostatic pressures in human pulmonary capillaries during exercise are not accurately known but must exceed 30 mmHg. In some animals, for example thoroughbred horses, the capillary pressure rises to about 100 mmHg. These pressures cause stresses in the capillary wall of 5...
Pleural effusion associated with acute and chronic pleuropneumonia and pleuritis secondary to thoracic wounds in horses: 43 cases (1982-1992). Case records of 43 horses with pleural effusion associated with acute pleuropneumonia, chronic pleuropneumonia, or pleuritis secondary to a penetrating thoracic wound were reviewed to determine the predisposing factors, diagnosis, and treatment of this condition. Acute pleuropneumonia was diagnosed in 36 horses, the majority of which were Thoroughbreds (89%). Of 22 (61%) horses that were in race training at the onset of illness, 11 (31%) had been recently transported a long distance and 4 (11%) had evidence of exercise-induced pulmonary hemorrhage. Physical examination findings and hematologic...
Management of orthopedic emergencies. Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, a...
Stress failure of pulmonary capillaries as a mechanism for exercise induced pulmonary haemorrhage in the horse. Exercise induced pulmonary haemorrhage (EIPH) is a serious problem in the Thoroughbred industry. The condition apparently occurs essentially in all Thoroughbreds in training but the mechanism has proved elusive. There is now strong evidence that the condition is caused by mechanical failure of the walls of the pulmonary capillaries when the pressure inside them rises to very high levels. It is well known that pulmonary capillaries have extremely thin walls to allow rapid exchange of respiratory gases across them. Recently we have shown that the wall stresses are very large when the capillary t...
A survey of exercise-induced pulmonary haemorrhage in Quebec standardbred racehorses. Sixty Standardbred horses, aged 3 to 10 years, were examined endoscopically for exercise-induced pulmonary haemorrhage (EIPH) 1 h after racing, on at least 3 occasions. Racing time, finishing position and post exercise venous lactate concentrations were also recorded. Horses positive for tracheal blood on endoscopy were classified as having either grade 1 EIPH (one or a few spots of blood in the trachea), or grade 2 (stream of blood). Air temperature, relative humidity and air pollutant levels were recorded on each examination day. Of the 60 horses, 52 (87%) were EIPH-positive on at least one ...
Neurological manifestation of cholesterinic granulomas in three horses. Cholesterinic granulomas have been previously reported as an incidental post mortem in horses. Three adult horses with diencephalic dysfunction due to cholesterinic granulomas are described. All the horses exhibited profound depression, somnolence and reluctance to move. One horse experienced generalised seizures. Cerebrosinal fluid was xanthochromic with an elevated total protein in two of the cases evaluated. The large cholesterinic granulomas caused expansion of the lateral ventricle and secondary hydrocephalus due to the build up of cerebrospinal fluid behind the mass. Cholesterinic granul...
Pathology of equine pneumonia associated with transport and isolation of Streptococcus equi subsp. zooepidemicus. Seven horses that died of pneumonia associated with transport yielded Streptococcus equi subsp. zooepidemicus (S.z.) from their pulmonary lesions. These lesions were divisible roughly into two types, serous haemorrhagic pneumonia and multiple foci of coagulative necrosis, which were considered to reflect a temporal difference in the process of lesion formation. Immunohistologically, S.z. antigen was detected in both types of lesion. Acute necrotic lacunar tonsillitis was considered to play an important role in the onset of the pneumonia.
Comparative aspects of the strength of pulmonary capillaries in rabbit, dog, and horse. In previous studies of rabbit and dog lung, we demonstrated stress failure of pulmonary capillaries at high transmural pressures (Ptm). The Ptm necessary to elicit stress failure was 40 cmH2O higher in dog than rabbit, and the total blood-gas barrier (BGB) thickness was greater in dog than rabbit. This suggests that stress failure may be related to BGB thickness, and is consistent with the Laplace relationship which states that wall stress is proportional to capillary radius but inversely proportional to wall thickness. In the present studies, we compared BGB thickness and an index of capillar...
Evaluation of a technique for detection of pulmonary hemorrhage in horses, using carbon monoxide uptake. The diffusing capacity for carbon monoxide (DLCO) and the functional residual capacity (FRC) of the lung were measured in 5 healthy Thoroughbreds before and after instillation of autologous blood into their lungs, in an attempt to develop a method to quantitate extravascular blood in the lungs of horses with exercise-induced pulmonary hemorrhage. Mean (+/- SD) baseline values of DLCO and FRC were 333.8 +/- 61.9 ml/min/mm of Hg and 21.464 +/- 4.156 L, respectively. Blood instillation resulted in decreases in DLCO and FRC. The paradoxic decrease in DLCO (we were expecting to find an increase owi...
Effect of ligation on internal carotid artery blood pressure in horses. The effect of a single ligature on back pressure in the internal carotid artery was studied in nine horses. In six anesthetized horses, one internal carotid artery was catheterized 2 cm from its origin and blood pressure was recorded continuously. Then the artery was ligated, pressure was recorded again, and the horses were euthanatized. In another three anesthetized horses, indwelling catheters were placed in both internal carotid arteries and a loose ligature was placed proximal to one catheter. After horses recovered from anesthesia, the ligature was tied and blood pressure was recorded in ...
Monitoring furosemide in racehorses participating in an EIPH program. Analytical procedures were developed to monitor furosemide concentrations in post-race serum and urine samples obtained from horses participating in an exercise-induced pulmonary haemorrhage (EIPH) program. High performance liquid chromatography with ultraviolet light detection proved a reliable, sensitive method for measuring urinary furosemide concentrations up to 12 h after administration of either 150 or 250 mg of the drug to race horses. However, this method was unreliable for determination of serum furosemide concentration. High performance liquid chromatography with fluorescence detecti...
Anesthesia and sedation of foals. Physiologic similarities and differences between foals and adult horses, including response to pain, cardiopulmonary function, ability to compensate for dehydration and hemorrhage, and response to anesthetic drugs, are considered in this article. Preanesthetic evaluation, choice of anesthetic drugs, technique, and monitoring support requirements through to anesthetic recovery are based on these physiologic considerations. Anesthetic techniques discussed include drugs for premedication, parenteral or inhalational anesthetic induction, and maintenance using inhalational and parenteral anesthesia...
Pneumocystis carinii pneumonia in a thoroughbred foal. Typical Pneumocystis carinii pneumonia was found in a male thoroughbred foal (46 days old) suffering from diarrhea and hypogammaglobulinemia after birth. The characteristics of the organisms were demonstrated by Grocott methenamine silver staining, and scanning and transmission electron microscopy. The present focal had no histological lesions suggesting immunodeficiency. However, he could not get adequate colostrum from his dam, because she died of hemorrhagic shock due to immuno-mediated thrombocytopenia at delivery. This condition was considered to have predisposed the foal to the pneumonia...
Prevalence and factors associated with development of laminitis in horses with duodenitis/proximal jejunitis: 33 cases (1985-1991). Medical records of 116 horses admitted to the Texas Veterinary Medical Center between Jan 1, 1984 and Dec 31, 1991 with duodenitis/proximal jejunitis (DPJ) were reviewed. The prevalence of laminitis was 28.4% (33/116; 95% confidence interval: 20.2 to 36.6%). The prevalence of DPJ and DPJ-associated laminitis did not appear to vary significantly by year during the study period. Anamnesis, physical examination, clinicopathologic data, and initial treatment recorded at the time of admission were reviewed to determine risk factors associated with development of laminitis associated with DPJ. A tre...
Mechanisms of exercise-induced pulmonary hemorrhage in the equine athlete. 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.
Heparin: a review of its pharmacology and therapeutic use in horses. Heparin is used clinically in horses to treat hemostatic abnormalities associated with severe gastrointestinal disease, septicemia, and endotoxemia. The primary anticoagulant effect of heparin is through the suppression of thrombin-dependent amplification of the coagulation cascade, and inhibition of thrombin-mediated conversion of fibrinogen to fibrin. Heparin may be of benefit in preventing the complications associated with hypercoagulable states such as jugular vein thrombosis, laminitis, and organ failure. Heparin may also be beneficial in the prevention of intraabdominal adhesions after g...
Ischemia/reperfusion injury of the ascending colon in ponies: a correlative study utilizing microvascular histopathology and corrosion casting. Volvulus of the ascending colon (ACV) in the horse results in microvascular injury and necrosis of the intestinal mucosa. This study investigated the site and type of microvascular injury which occurs within the mucosa and submucosa following ACV. Histopathology of volvulus treated ponies demonstrated mucosal necrosis with microvascular hemorrhage and thrombosis. Thrombi occurred within the subepithelial capillaries and edema and hemorrhage developed throughout the mucosa and submucosa. Vascular casts allowed 3-D viewing of samples obtained from the entire pelvic flexure and demonstrated two d...
Rheological characteristics of horse blood: significance during exercise. When horses maximally exercise, splenic contraction and fluid movement out of the vascular compartment greatly increase the hematocrit (up to 0.70). We studied the in vitro rheological characteristics of blood from Thoroughbreds and Quarter Horses to determine the interaction of hematocrit and shear rate on apparent viscosity. We also compared the rheological characteristics of the blood before and after horses received furosemide, a drug commonly used to prevent exercise-induced pulmonary hemorrhage. Although the apparent viscosity of blood with a high hematocrit was high at low shear rates, ...
Equine bronchoalveolar lavage cytology: survey of thoroughbred racehorses in training. Sixty-two Thoroughbred horses aged between 1 and 7 years in training in Sydney had bronchoalveolar lavage (BAL) samples collected for cytological examination. All horses, except the yearlings and those with a cough, had raced at the time of the examination and the trainers reported satisfactory performance. Free erythrocytes were found in 73% of samples and haemosiderophages in 90% of the samples, indicating immediate or past occurrences of exercise-induced pulmonary haemorrhage (EIPH). Bronchoalveolar fluid from the yearlings contained significantly less (P < 0.05) erythrocytes and haemosi...
Unusual internal carotid artery branching that prevented arterial occlusion with a balloon-tipped catheter in a horse. A mare with hemorrhage caused by guttural pouch mycosis was treated by insertion of a balloon-tipped catheter into the left internal carotid artery. During recovery from general anesthesia, the mare had profuse epistaxis, and was anesthetized again to determine the site of hemorrhage. The affected guttural pouch was opened to confirm that hemorrhage was from the left internal carotid artery. The mare was euthanatized, and, at necropsy, the balloon catheter was found in an aberrant branch that arose from the internal carotid artery and joined the basilar artery. The mycotic plaque was on the le...
