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Veterinary research communications1991; 15(3); 211-226; doi: 10.1007/BF00343226

A review of the pathophysiology of exercise-induced pulmonary haemorrhage in the equine athlete.

Abstract: In the United States, more than 75% of equine athletes are reported to suffer from exercise-related haemorrhage of the respiratory tract (Voynick and Sweeney, 1986; Sweeney et al., 1990). Fiberoptic endoscopy has traced the source of blood to beyond the bifurcation of the trachea. In 1981, the term exercise-induced pulmonary haemorrhage (EIPH) was introduced (Pascoe et al., 1981). Racehorses of all breeds, polo ponies and three-day event horses of mixed heritage, even foxhunters, may 'bleed' (Voynick and Sweeney, 1986; Pascoe et al., 1981; Sweeney and Soma, 1983; Hillidge, 1986). Any horse working at speeds greater than 240 m/min is at risk (Voynick and Sweeney, 1986). The impact of exercise-induced pulmonary haemorrhage is difficult to assess. Most attempts to demonstrate statistically a negative correlation between EIPH and performance have been unrewarding, largely due to the number of uncontrollable variables (Pascoe et al., 1981; Raphel and Soma, 1982). In racing thoroughbreds (Mason et al., 1983) and standard breeds (MacNamara et al., 1990) approximately half as many EIPH-positive as EIPH-negative horses were placed in their races. Based on extensive intrapulmonary haemorrhage, a 3-year prospective study of sudden deaths in exercising thoroughbreds concluded that 9 out of 11 deaths were attributable to EIPH (Gunson et al., 1988). By correlation of clinical signs, thoracic radiographs, ventilation/perfusion scintigraphy, gross and subgross pathology and histopathology in 26 affected thoroughbreds, EIPH has been associated with chronic small airway inflammation, proliferation of subpleural, peribronchial and septal bronchial arterioles, interstitial connective tissue fibrosis and alveolar septal disruption in the dorsocaudal lung lobes (O'Callaghan et al., 1987). From this work it was proposed that the initial insult of EIPH started as focal, dorsocaudal pulmonary peribronchial inflammation which resulted in bronchial arterial neovascularization. Haemorrhage then occurred when, during exercise, bronchial blood pressure increased in fragile capillary buds. The incidence of bronchitis/bronchiolitis, regardless of aetiology, has been estimated to be 30% in non-racing equine athletes and close to 100% in one group of racing thoroughbreds (Sweeney et al., 1989). Histological study of lungs from horses with mild, moderate and severe chronic small airway disease consistently revealed a greater density of lesions in the diaphragmatic lobes (Winder and von Fellenberg, 1988). To understand further the aetiology and/or pathophysiology of EIPH, we will first explore some aspects of general mammalian and specific equine pulmonary and bronchial vascular anatomy and physiology. Exercise-related changes in these systems in normal and EIPH-positive horses will be briefly reviewed.(ABSTRACT TRUNCATED AT 400 WORDS)
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Publication Date: 1991-01-01 PubMed ID: 1882515DOI: 10.1007/BF00343226Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article is a comprehensive examination of Exercise-Induced Pulmonary Haemorrhage (EIPH) in horses, retrieving data on its pathophysiology, causes, and how it impacts equine performance. EIPH is a widespread issue affecting various breed of horses and its impact on performance and health is significant, yet variable which makes the condition intriguing for further exploration.

Defining Exercise-Induced Pulmonary Haemorrhage (EIPH)

  • This condition is observed in numerous breeds of horses, including racehorses, polo ponies, and three-day event horses. Even during activities like fox hunting, EIPH can occur.
  • The study states that any horse working at speeds exceeding 240 m/min could potentially develop EIPH.

The Impact of EIPH

  • The effects of EIPH are hard to quantify due to its variable nature and the numerous variables that can influence its severity and its impact on performance.
  • The polarity in performance of EIPH-positive and EIPH-negative horses in races is noted by the authors. Racehorses positive with EIPH have been observed to perform at around 50% less efficiency.
  • The reports from a prospective study suggested that EIPH could be linked to 9 out of 11 sudden deaths in exercising thoroughbreds.

Associated Medical Findings

  • EIPH was found related to chronic small airway inflammation, proliferation of certain arterioles, connective tissue fibrosis, and disruption in certain parts of the lungs of the horses.
  • It’s suggested that the initial occurrence of EIPH begins as focal inflammation that evolves into bronchial arterial neovascularization, with hemorrhage occurring when blood pressure increases in fragile capillary buds during exercise.
  • It was revealed in studies that bronchitis/bronchiolitis seems to be a common ailment in non-racing equine athletes (approx. 30%), while being practically universal in racing Thoroughbreds (close to 100%).

Further research and investigation

  • The study then suggests further exploration into the cause and pathophysiology of EIPH, including looking into general mammalian and specific equine pulmonary and bronchial vascular anatomy and physiology.
  • Another area of research includes investigating the changes in these systems in normal and EIPH-positive horses during exercise.

Cite This Article

APA
Donaldson LL. (1991). A review of the pathophysiology of exercise-induced pulmonary haemorrhage in the equine athlete. Vet Res Commun, 15(3), 211-226. https://doi.org/10.1007/BF00343226

Publication

Veterinary research communications
ISSN: 0165-7380
NlmUniqueID: 8100520
Country: Switzerland
Language: English
Volume: 15
Issue: 3
Pages: 211-226

Researcher Affiliations

Donaldson, L L
  • Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg 22075.

MeSH Terms

  • Animals
  • Hemorrhage / drug therapy
  • Hemorrhage / physiopathology
  • Hemorrhage / veterinary
  • Horse Diseases / drug therapy
  • Horse Diseases / physiopathology
  • Horses
  • Lung / anatomy & histology
  • Lung / blood supply
  • Lung / physiology
  • Lung Diseases / physiopathology
  • Lung Diseases / veterinary
  • Physical Exertion

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Citations

This article has been cited 1 times.
  1. Dumont R, Touzet C, Gomes E, Le Boedec K. Treatment of recurrent hunting-associated respiratory distress episodes in 2 dogs. J Vet Intern Med 2023 Nov-Dec;37(6):2514-2519.
    doi: 10.1111/jvim.16665pubmed: 37878243google scholar: lookup
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