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.
Young DR, Richardson DW, Markel MD.A randomised, blind prospective study was performed to evaluate effects of low dose heparin therapy on complication and survival rates in 33 horses following exploratory celiotomy. Four horses had non-strangulating lesions and seven had strangulating lesions of the small intestine, 19 had non-strangulating lesions of the large intestine, and three had duodenitis-proximal jejunitis. Eighteen required an enterotomy or intestinal resection and anastomosis. Sixteen received heparin subcutaneously (66 iu/kg every 12 h) post operatively and 17 received a saline placebo for a mean of 3.7 days. There ...
Beard WL, Robertson JT, Getzy DM.To compare the effects of placing enterotomy incisions on or off the antimesenteric teniae and closing the intestinal mucosa as a separate layer, four longitudinal enterotomies were performed in the descending colon of each of six horses by the following techniques: incision through the antimesenteric teniae with one- and two-layer closure, and incision adjacent to the teniae with one- and two-layer closure. The horses were necropsied at day 33 for evidence of obstruction, adhesions, and ultrasonographic determination of the percent reduction in lumen diameter. Histologic and histomorphometric...
Henry M, Prasse K, White S.Multiple myeloma was diagnosed in a 3-month-old Quarter Horse foal with chronic weight loss, chronic bronchopneumonia, and epistaxis. The foal had pancytopenia, thrombocytopenia, and monoclonal beta-globulinemia. Bone marrow aspirates contained between 80 and 90% plasma cells.
Prater PE, Patton CS, Held JP.Pleural effusion, secondary to a metastasis from a malignant hepatoblastoma, was diagnosed in a 3-year-old Appaloosa gelding. Severe hemorrhagic transudate in both pleural cavities resulted in acute onset of labored breathing, tachypnea, tachycardia, and jugular vein pulsation. Results of ultrasonography and radiography of the ventral lung field and cranial portion of the abdomen initially were nondiagnostic, as were results of cytologic examination of peritoneal fluid and tracheal wash specimens. Moderately high serum gamma-glutamyl transferase and alkaline phosphatase activities, despite nor...
Crawley GR, Grant BD, Krpan MK, Major MD.Thirteen cases of partial limb amputation in horses were reviewed. Nine horses (69%) survived 18 to 111 months (mean, 41 months). Four unsuccessfully treated horses were euthanatized within 21 days of surgery. The horses' ages at amputation were 4 to 13 years (mean, 7.3 years). There was no predilection for the left or right limb nor for fore or hind limb involvement. Osteomyelitis in six horses (46%) was the most common cause for amputation. Severe, open, comminuted fractures of the third metacarpal bone that were impossible to stabilize by any currently available technique in four horses (31...
Winder NC, Gruenig G, Hermann M, Howald B, von Fellenberg R.Equine respiratory secretions (RS) collected before (33 horses) and after (76 horses) slaughter were evaluated cytologically and grouped according to the histological diagnosis of the lungs from which they were obtained. The histological categories included normal lungs (control; 17 horses), chronic small airway disease with mild (23 horses), moderate (13 horses) and severe lesions (25 horses), interstitial pneumonia (13 horses), pulmonary eosinophilic infiltration (13 horses) and pulmonary haemorrhage (5 horses). On a group basis there were significantly more neutrophils in RS of horses with ...
Freeman DE, Ross MW, Donawick WJ, Hamir AN.Balloon-tipped catheters were used to occlude the external carotid artery and its branches in nine horses with hemorrhage caused by guttural pouch mycosis. The internal carotid artery on the affected side was occluded simultaneously in four horses and had been occluded previously in two others. In three horses, a single balloon-tipped catheter was inserted in the external carotid artery beneath the floor of the guttural pouch and its tip was advanced blindly into distal branches. In one horse, the superficial temporal artery was occluded briefly during surgery by a balloon-tipped catheter so a...
Green SL, Specht TE, Dowling SC, Nixon AJ, Wilson JH, Carrick JB.A neonatal foal was examined because of apparent abdominal pain and distention, anemia, and hemoperitoneum. Exploratory laparotomy was performed, and a large spherical mass, which had ruptured, was found in the area of the left ovary. Left salpingo-oophorectomy was performed. The mass was determined to be a juvenile granulosa cell tumor.
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...
Kiper ML, MacAllister C, Qualls C.A cranial mesenteric arterial aneurysm with fistulous tracts to the cecum and ileum was discovered in a Missouri Fox Trotter stallion. The principal clinical sign was hematochezia, observed at 7- and 10-day intervals. The lesion may have been attributable to arteritis caused by fourth-stage larvae of Strongylus vulgaris.
Todhunter RJ, Parker JE.A recently castrated horse was examined because of preputial and ventral abdominal swelling, prolapse of the preputial fold, and serosanguinous fluid dripping from the external urethral orifice. After a poor response to initial medical management, a urethral laceration was found during exploratory surgery. Half of the ventral portion of the corpus cavernosum penis had been transected. Primary closure was followed by healing without complications.
Sweeney CR, Hall J, Fisher JR, Leary HJ, Soma LR, Spencer PA.The efficacy of water vapor-saturated air as a treatment for horses with exercise-induced pulmonary hemorrhage (EIPH) was studied. Horses selected for study (n = 14) had grade 1 or greater hemorrhage in the trachea after a minimum of 4 breezes between 0.8 and 1 km, as determined by endoscopy. Nine horses were treated with water vapor-saturated air; 5 horses were not treated. When the mean and maximal EIPH scores from the pretreatment period were compared with the mean and maximal EIPH scores from the treatment period in both treated and nontreated groups, there was no significant difference be...
Manohar M, Goetz TE, Nganwa D.Diaphragmatic O2 and lactate extraction were examined in seven healthy ponies during maximal exercise (ME) carried out without, as well as with, inspiratory resistive breathing. Arterial and diaphragmatic venous blood were sampled simultaneously at rest and at 30-s intervals during the 4 min of ME. Experiments were carried out before and after left laryngeal hemiplegia (LH) was produced. During ME, normal ponies exhibited hypocapnia, hemoconcentration, and a decrease in arterial PO2 (PaO2) with insignificant change in O2 saturation. In LH ponies, PaO2 and O2 saturation decreased well below tha...
Honnas CM, Spensley MS, Laverty S, Blanchard PC.An 18-year-old mare, 285 days pregnant, was evaluated for apparent abdominal pain of 8 hours' duration. A large volume of sanguinous fluid was obtained on abdominocentesis, and digital vaginal examination revealed a dilated cervix and blood in the uterus. Abdominal palpation per rectum revealed the uterus to be large and distended with fluid. Ultrasonography revealed a dead fetus on the floor of the cranial portion of the abdomen. The mare was euthanatized, and necropsy confirmed that the uterus had ruptured, and that the fetus, within its chorioallantois, was in the abdomen. The amniotic sac ...
Henninger RW.Severe hemorrhagic diathesis caused by hemophilia A (factor VIII:C deficiency) was diagnosed in 2 related Quarter Horse colts. Clinical signs consisted of dyspnea and dysphagia attributable to cranial cervical hematoma in one colt and to intra-abdominal hemorrhage resulting in death of the second colt. Factor VIII:C deficiency, a defect of the intrinsic coagulation pathway, is suggested by results of coagulation studies--prolonged activated partial thromboplastin time, normal prothrombin time, and normal primary bleeding time. The diagnosis was confirmed by results of factor VIII:C assays. Hem...
Jones RL, Adney WS, Alexander AF, Shideler RK, Traub-Dargatz JL.Severe hemorrhagic necrotizing enterocolitis was determined to be the cause of death for 4 foals. Toxigenic Clostridium difficile was isolated form the intestine of each foal, and large, gram-positive, rod-shaped bacteria lined the surface of necrotic villi. This finding of toxigenic C difficile associated with enteritis in foals adds another possible cause to the list of infectious agents that should be considered when evaluating foals with enteritis. Definitive diagnosis requires a thorough diagnostic evaluation, including procedures that will identify the organism and demonstrate its toxige...
Gunson DE, Sweeney CR, Soma LR.Pathologic changes are described in 11 horses that died during racing or training; 9 died of acute pulmonary hemorrhage (exercise-induced pulmonary hemorrhage), 1 died of exsanguination, and 1 died of CNS trauma. Cardiac lesions were not found in any horse. Severe engorgement of pulmonary vessels, with hemorrhage into alveoli, airways, interstitium, and subpleural tissues, was observed in all 9 horses that died of exercise-induced pulmonary hemorrhage. Infiltration of eosinophils and/or lymphocytes around vessels and airways was seen in 6 horses. Focally extensive fibrosis was observed in the ...
Freeman DE, Cimprich RE, Richardson DW, Gentile DG, Orsini JA, Tulleners EP, Fetrow JP.Strangulation obstruction was induced in anesthetized ponies for periods of 2 and 3 hours by clamping 45-cm segments of jejunum and their veins only (venous strangulation obstruction, VSO) and arteries and veins (arterial and venous strangulation obstruction, AVSO). These types of strangulation obstruction were studied in 4 segments in each of 4 ponies allowed to survive 12 hours (group 1) and in a single segment in each of 10 ponies allowed to survive 42 days (group 2) after the strangulation period ended. On visual inspection, segments subjected to VSO had hemorrhage and edema in the bowel w...
Lloyd KC, Stover SM, Pascoe JR, Pool RR.A 2.5-cm long, 0.8 mm in diameter catheter was placed percutaneously into the palmarolateral pouch of the antebrachiocarpal joint in 6 clinically normal horses. The catheter was affixed in place for 72 hours. Cytologic analysis was performed on synovial fluid specimens obtained through the catheter at postcatheterization hours (PCH) 0, 24, and 72. The horses were euthanatized at PCH 72, and macroscopic and microscopic examinations were performed on the dorsal portion of the joint capsule and the palmarolateral pouch of the catheterized and contralateral (noncatheterized) joint. Clinical, synov...
Morris DD.This article reviews normal hemostasis in order to provide the reader with the basis for understanding the pathogenesis and manifestations (both clinical and laboratory) of disseminated intravascular coagulation (DIC) in horses. DIC is subsequently discussed. The diagnosis and treatment of DIC in horses are also described.
Cohen ML, Ming RH, Gogel HK, Davis M, Pitcher JL.Phenylbutazone (PBZ) is a nonsteroidal antiinflammatory drug (NSAID) that is not commonly prescribed due to the high incidence of serious adverse reactions. However, it is still used extensively in equine medicine, and is readily available to those employed in the care and management of horses. Such persons may take the drug indiscriminately, without medical supervision. We present a 33-year-old male race horse track worker who took phenylbutazone horse pills for a chronic toothache and subsequently suffered a major hemorrhage from a gastric ulcer. Human use of phenylbutazone horse pills shoul...
Brown CM, Kaneene JB, Taylor RF.An analysis was made of the causes of death in horses and ponies over one year of age which died suddenly (Group 1) or were found dead but were considered normal when last seen (Group 2). There were 49 animals in Group 1. Thoroughbreds were overrepresented, but there were no ponies in this group. No cause of death was found in 30.6 per cent of cases and 16.3 per cent died from each of the following causes: haemorrhage in the respiratory system, central nervous system, and adverse drug reactions. Cardiovascular lesions were the cause of death in 14.4 per cent and the remaining 3.1 per cent had ...
Hayden DW, Johnson KH, Wolf CB, Westermark P.Systemic amyloidosis involving the digestive tract is described in an 11-year-old Morgan stallion. The disease was characterized clinically by weight loss, ptyalism, anaemia, persistent mature neutrophilia, hypoalbuminaemia and hypergammaglobulinaemia. The D-xylose absorption test indicated malabsorption. Necropsy revealed oral, oesophageal and gastric ulcers and reddened segments of small bowel mucosa with scant haemorrhages. Microscopically, amyloid deposits were found throughout all tissue layers of the digestive tract, except the serosa. Deposits of amyloid were most apparent in the small ...
Doran R, Allen D, Gordon B.Ovarian granulosa theca cell tumours were removed surgically in 10 mares. Stapling instruments were used to facilitate haemostasis of the ovarian pedicle in five out of 10 cases and as a sole method of haemostasis in the remaining five cases. Postoperative haemorrhage from the ovarian pedicle was suspected in only one case. All cases survived long term follow-up from six months to four years. Results from this series of cases indicate that stapling instruments provide a rapid, easy and efficient means of ligating ovarian pedicles when performing ovariectomy in the mare.
Principato M.Listed and described herein are the main macroscopic lesions produced along the whole digestive tract of free-ranging horses by larvae of the five Gasterophilus spp., occurring in Umbria, a region of central Italy: Gasterophilus intestinalis, Gasterophilus nasalis, Gasterophilus pecorum, Gasterophilus inermis, Gasterophilus haemorrhoidalis. Lesions are classified on the basis of their sizes and shapes and the host's anatomic sites infested, and they are examined in relation to the developmental stages of larvae causing them. The examination of the lesions shows that it is very difficult to dif...
Jaeschke G, Wintzer HJ.This is a review on Morbus maculosus equorum (purpura haemorrhagica) on the base of literature data and of a case report on 13 own patients. It is shown, that the clinical picture of this disease has not changed within the last 150 years. Clinical main symptoms are haemorrhagic diathesis (petechiae, ecchymosis, suggillations) as well as peripheral edema and fever. The main haematological findings are neutrophilia, mostly going along with shift to the left and lymphopenia. In the last few years thrombocytopenia was also described in some cases. Basic therapeutics are glucocorticoids and penicil...
Hart SK, Sullins KE.Results of surgical treatment of sinonasal disease in horses have been reported previously; however, this paper describes the outcome of horses in which a specific post operative treatment protocol was used. Objective: The objectives of the study were to determine: 1) short- and long-term outcome; 2) complications; and 3) recurrence rates of different disease processes, when horses were treated with a specific treatment protocol. Methods: Medical records of horses presented for surgical treatment of sinonasal disease from 1996-2007 were reviewed. Results and duration of surgical exploration we...
Temple-Wong MM, Raleigh AR, Frisbie DD, Sah RL, McIlwraith CW.To assess whether the combination of hyaluronan, sodium chondroitin sulfate, and -acetyl-d-glucosamine (HCSG) lubricates articular cartilage in vitro and modulates joint lubrication in vivo. Methods: 16 healthy adult horses. Methods: The effects of HCSG injections on SF lubricant properties and joint health, immediately after injury and 2 weeks later, were analyzed by use an equine osteochondral fracture model of post-traumatic osteoarthritis (OA). Middle carpal joints of adult horses were randomly assigned to 1 of 4 surgical treatment groups as follows: normal nonsurgical group (n = 8), norma...
Easther R, Manthorpe E, Woolford L, Kawarizadeh A, Hemmatzadeh F, Ferlini Agne G.Equine idiopathic haemorrhagic cystitis (EIHC) is a recently described form of aseptic cystitis in horses in which there is no discernible underlying cause. This case report describes a 9-year-old Thoroughbred gelding that presented with stranguria, pollakiuria, and haematuria. Cystoscopy revealed ulceration and haemorrhage of the bladder mucosa, diffuse mural hyperaemia and marked urine sedimentation. Histopathological evaluation of the bladder revealed chronic active ulcerative neutrophilic, lymphoplasmacytic, and eosinophilic cystitis. There was no bacterial or fungal growth upon culture bu...
Kamali MF, Wilson AC, Acquisto NM, Spillane L, Schneider SM.Flunexin is a nonsteroidal anti-inflammatory drug approved for veterinary use in horses and cattle. Acepromazine is a phenothiazine derivative used in horses, dogs, and cats. Human exposure to these substances is rare. Methods: We report a case of a human injection of two equine medications, flunixin and acepromazine, which resulted in altered mental status, respiratory alkalosis, gastrointestinal bleeding, and elevation of liver transaminases in a 43-year-old woman who worked as a horse trainer. The patient intentionally self-injected these medications and subsequently presented to the Emerge...
Reardon RJ, Boden LA, Mellor DJ, Love S, Newton RJ, Stirk AJ, Parkin TD.The aim of this study was to evaluate risk factors associated with developing epistaxis in jump racing in Great Britain (GB). A retrospective analysis of records from horses running in all hurdle and steeplechase races in GB between 2001 and 2009 identified diagnoses of epistaxis whilst still at the racecourse. Data were used from 603 starts resulting in epistaxis (event) and 169,065 starts resulting in no epistaxis (non-event) in hurdle racing, and from 550 event starts and 102,344 non-event starts in steeplechase racing. Two multivariable logistic regression models to evaluate risk factors a...
Young DR, Richardson DW, Markel MD.A randomised, blind prospective study was performed to evaluate effects of low dose heparin therapy on complication and survival rates in 33 horses following exploratory celiotomy. Four horses had non-strangulating lesions and seven had strangulating lesions of the small intestine, 19 had non-strangulating lesions of the large intestine, and three had duodenitis-proximal jejunitis. Eighteen required an enterotomy or intestinal resection and anastomosis. Sixteen received heparin subcutaneously (66 iu/kg every 12 h) post operatively and 17 received a saline placebo for a mean of 3.7 days. There ...
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...
McConnico RS, Stokes AM, Eades SC, Moore RM.To examine the secretory response (in the presence and absence of prostaglandin inhibition) in vitro and structural alterations of colonic mucosa in horses after intragastric administration of black walnut extract (BWE). Methods: 14 adult horses. Methods: Seven horses were administered BWE intragastrically and monitored for 11 hours. Tissue samples were obtained from the right ventral, left ventral, and right dorsal colons (RVC, LVC, and RDC, respectively) of the 7 BWE-treated and 7 control horses. Tissue samples were examined via light microscopy, and the extent of hemorrhage, edema, and gran...
Troillet A, Böttcher D, Brehm W, Scharner D.To describe the presentation, presurgical diagnostic findings, treatment, and outcome of horses with histologically confirmed, unilateral thyroid neoplasia. The complications, particularly laryngeal hemiplegia, were investigated. Retrospective case series. Client-owned horses (n=14). Medical records of horses presenting with a unilateral thyroid mass due to neoplasia from 2003-2015 were reviewed. Horses must have undergone preoperative clinical evaluations that included ultrasound examination of the mass and upper airway endoscopy. Short-term follow-up at 2 weeks after surgery and owner questi...
Stevenson AJ, Weber MP, Trudel R, Leavitt R, Woodard D, Todi F, Mendonca M, Robillo V, Young L, Kacew S.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...
Massie S, Bayly W, Ohmura H, Takahashi Y, Mukai K, Léguillette R.Comparatively little is known regarding the initial cardiorespiratory response of young racehorses to training. The objectives were to compare physiological parameters before and after introductory training and determine whether young Thoroughbreds show endoscopic signs of exercise-induced pulmonary hemorrhage (EIPH). Ten Thoroughbreds (20-23 months) underwent 12-weeks of introductory training, including weekly speed sessions. Two 600 m high-speed exercise tests (HSET) were performed following weeks 4 and 12 while wearing a validated ergospirometry facemask. Peak oxygen consumption (V̇Opk...
Gould J, Wells M, de Linde Henriksen M, Gilger BC.To determine the causes, time to resolution, effect of therapeutics, and ocular sequelae of hyphema, fibrin, and/or vitreal hemorrhage in horses. Methods: 225 horses (219 eyes) who were diagnosed with hyphema, fibrin, and/or vitreal hemorrhage. Methods: Records were retrospectively reviewed for the horses. Signalment, ophthalmic examination findings, causes, treatments, and outcomes were evaluated. Results: Common causes of intraocular fibrin or hemorrhage were equine recurrent uveitis (42/219 horses), corneal stromal abscess (32/219 horses), corneal stromal ulcer (25/219 horses), and trauma (...
Leite RO, Albertino LG, Sperandio LMS, Campos F, Campos R, Borges AS, Oliveira-Filho JP.Exercise-induced pulmonary haemorrhage (EIPH) in athletic horses is characterized by the presence of blood from the lungs in the tracheobronchial tree after intense exercise. Despite the high prevalence of EIPH in horses, the primary aetiology remains unknown. Variants in the genes encoding CD39 and CD39L1 (ENTPD1 and ENTPD2, respectively) were previously reported as potential genetic causes involved in EIPH pathogenesis. However, the role of these variants in haemostatic functions is unknown. Results: To investigate the association between EIPH and missense variants in the ENTPD1 (rs115229627...
de Sousa ALV, de Sousa DER, de Macêdo IL, de Albuquerque Cerqueira L, da Fonseca YNG, Oliveira AB, das Chagas LVS, Gonçalves GB, Veado HC....This report describes the first documented case of intracerebral hemorrhage (ICH) in a horse following Bothrops snakebite envenomation. A 3-year-old mare developed acute kidney injury, systemic hemorrhage, and neurological signs before euthanasia. Postmortem findings confirmed massive ICH with intralesional venom identified by immunohistochemistry. Delayed treatment and insufficient antivenom likely contributed to the outcome. This case highlights the potential for cerebrovascular complications following Bothrops snakebite envenomation in horses, which may present as subtle neurological signs....
Turner AS, Trotter GW.The case histories of 18 horses with hindlimb lameness attributed to fibrotic myopathy were reviewed. In 14 horses, the problem developed after trauma. In 5 others, it developed secondary to intramuscular injections. Other causes of the lameness were surgery, exertional injuries, and purpura hemorrhagica. Eleven of the horses were treated by resection of scar tissue or by semitendinosus myotenotomy. Postoperative complications included pressure necrosis under quill sutures (9 horses), acute disruption of the skin incision (2 horses), dehiscence of the wound during healing (2 horses), and prolo...
Sato F, Shibata R, Shikichi M, Ito K, Murase H, Ueno T, Furuoka H, Yamada K.Rupture of the gastrocnemius muscle is occasionally found in neonatal foals associated with dystocia and assisted delivery. In this report, 3 cases of gastrocnemius muscle disruption in newborn Thoroughbred foals (6, 5 and 2 days old) are reported. In all cases, the foals were presented with inability to rise unassisted postpartum, a dropped tarsus and swelling in the caudal aspect of the thigh accompanied by a hematoma. Ultrasonography, radiography, computerized tomography (CT) and subsequent autopsy were performed to confirm the clinical and pathological features of these cases.