Effect of different protocols on the mitigation of exercise-induced pulmonary hemorrhage in horses when administered 24 hours before strenuous exercise.
Abstract: 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 supramaximally to fatigue 24 hours after initiating 5 EIPH prophylaxis protocols: 0.5 and 1.0 mg/kg furosemide IV 24 hours pre-exercise with and without controlled access to water, and 24 hour controlled access to water. Effects were compared to those measured after giving a placebo 24 hours pre-exercise, and 0.5 mg/kg furosemide IV 4 hours pre-exercise. Bronchoalveolar lavage (BAL) erythrocyte count was determined 45-60 minutes postexercise after endoscopy to assign an EIPH score. Data were analyzed using linear mixed effects models. The most promising protocol from the treadmill study was further evaluated in 6 horses using endoscopy and BAL after 1100 m simulated races. Results: Intravenous furosemide (0.5 mg/kg) administered 24 hours pre-exercise combined with controlled access to water decreased the severity of EIPH on the treadmill and at the racetrack. Conclusions: Administering 0.5 mg/kg furosemide 24 hours pre-racing combined with controlling water intake may be a strategy to replace race-day furosemide administration for the management of EIPH. A larger study is indicated to further evaluate whether this protocol significantly mitigates EIPH severity.
© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2019-08-09 PubMed ID: 31397944PubMed Central: PMC6766505DOI: 10.1111/jvim.15574Google Scholar: Lookup
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- Journal Article
Summary
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The research study overviews the examination of various protocols, notably an injection of furosemide 24 hours prior to exercise combined with controlled water intake, as potential alternatives to race-day furosemide administration for the mitigation of exercise-induced pulmonary hemorrhage (EIPH) in horses.
Objectives and Methods
- The main objective of this study was to explore alternatives to race-day administration of furosemide, a drug known to reduce the severity of EIPH in horses, in light of public pressure in the U.S. against its use on race days.
- To achieve this, researchers carried out a double-blind placebo-controlled Latin square crossover study using a treadmill, followed by a blinded placebo-controlled crossover study at a racetrack.
- The subjects of these studies were seven fit Thoroughbred horses with recent incidences of EIPH.
- Researchers began five different EIPH prevention protocols 24 hours before subjecting the horses to extreme exercise. Protocols included administering 0.5 and 1.0 mg/kg of furosemide intravenously with and without controlled access to water, and controlling water access specifically for 24 hours.
- The researchers also applied a placebo 24 hours before exercise, and 0.5 mg/kg of furosemide administered intravenously 4 hours pre-exercise, for comparative purposes.
- The effectiveness of the protocols on EIPH mitigation was assessed after conducting bronchoalveolar lavage (BAL) to count erythrocytes (red blood cells) 45-60 minutes post-exercise, with the EIPH score being assigned post-endoscopy.
Results
- The results showed that administering 0.5 mg/kg of furosemide intravenously 24 hours before exercise along with controlled water intake decreased EIPH severity both on the treadmill and at the racetrack.
Conclusions
- The findings suggest that administering 0.5 mg/kg of furosemide 24 hours before racing, in combination with controlling water intake, can be employed as an alternative strategy to race-day furosemide administration in managing EIPH.
- The researchers opined that a larger study should be conducted to evaluate whether this protocol indeed substantially weakens EIPH severity.
Cite This Article
APA
Bayly W, Lopez C, Sides R, Bergsma G, Bergsma J, Gold J, Sellon D.
(2019).
Effect of different protocols on the mitigation of exercise-induced pulmonary hemorrhage in horses when administered 24 hours before strenuous exercise.
J Vet Intern Med, 33(5), 2319-2326.
https://doi.org/10.1111/jvim.15574 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
- Cavalli Equine Veterinary Services, Auburn, Washington.
- Cavalli Equine Veterinary Services, Auburn, Washington.
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
MeSH Terms
- Animals
- Bronchoalveolar Lavage Fluid / cytology
- Cross-Over Studies
- Diuretics / administration & dosage
- Diuretics / pharmacology
- Erythrocyte Count
- Female
- Furosemide / administration & dosage
- Furosemide / pharmacology
- Hemorrhage / prevention & control
- Hemorrhage / veterinary
- Horse Diseases / prevention & control
- Horses
- Lung Diseases / prevention & control
- Lung Diseases / veterinary
- Male
Grant Funding
- American Association of Equine Practitioners Foundation
- Churchill Downs
- Del Mar Thoroughbred Club
- Grayson-Jockey Club Research Foundation
- Keeneland Racetrack
- Kentucky Downs
- New York Racing Association
- Oak Tree Racing Association
- Oaklawn Racetrack
- The Stronach Group
- Thoroughbred Horseman's Association
Conflict of Interest Statement
Bayly and Sellon are former members of the Board of Directors of the American Association of Equine Practitioners (AAEP) but were not at the time of funding. Bayly is currently a member of the Grayson‐Jockey Club Research Advisory Committee, but was not at the time of funding. Sellon is currently a member of the AAEP Foundation Advisory Committee, but was not at the time of funding. The other authors have no conflicts of interest.
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Citations
This article has been cited 3 times.- Darbandi H, Munsters C, Parmentier J, Havinga P. Detecting fatigue of sport horses with biomechanical gait features using inertial sensors. PLoS One 2023;18(4):e0284554.
- Maśko M, Lewczuk D, Szarska E, Domino M. Successive approximation of horses to their first work on a treadmill: The effect of previous loading into a trailer. Anim Sci J 2022 Jan-Dec;93(1):e13687.
- Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
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