Exercise-induced pulmonary hemorrhage.
Abstract: EIPH is a condition affecting virtually all horses during intense exercise worldwide. The hemorrhage originates from the pulmonary vasculature and is distributed predominantly bilaterally in the dorsocaudal lung lobes. As the condition progresses, the lung abnormalities extend cranially along the dorsal portions of the lung. An inflammatory response occurs in association with the hemorrhage and may contribute to the chronic sequela. Although conflicting opinions exist as to its affect on performance, it is a syndrome that is thought to increase in severity with age. The most commonly performed method to diagnose EIPH at the present time is endoscopy of the upper airway alone or in combination with tracheal wash analysis for the presence of erythrocytes and hemosiderophages. Because horses may not bleed to the same extent every time and the bleeding may originate from slightly different locations, these diagnostic procedures may not be extremely sensitive or quantitative. At this time, there is no treatment that is considered a panacea, and the currently allowed treatments have not proven to be effective in preventing EIPH. Future directions for therapeutic intervention may need to include limiting inflammatory responses to blood remaining within the lungs after EIPH.
Publication Date: 2003-05-16 PubMed ID: 12747663DOI: 10.1016/s0749-0739(02)00068-8Google Scholar: Lookup
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- Journal Article
- Review
- Age Factors
- Clinical Examination
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Disease Etiology
- Disease Treatment
- Endoscopy
- Equine Diseases
- Equine Health
- Equine Science
- Exercise-Induced Pulmonary Hemorrhage
- Hemorrhage
- Horses
- Inflammatory Response
- Pathophysiology
- Pulmonary Health
- Respiratory Health
- Veterinary Care
- Veterinary Medicine
- Veterinary Research
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.
The research focuses on Exercise-Induced Pulmonary Hemorrhage (EIPH), a condition common among horses during intense physical activity. It explores the diagnosis, effects on performance, and potential therapies for the condition.
Background on EIPH
- Exercise-induced pulmonary hemorrhage (EIPH) is a condition that affects virtually all horses during intense exercise globally. This condition originates from the animal’s pulmonary vasculature and is primarily found in the dorsocaudal lung lobes.
- The issue advances over time, with lung abnormalities extending along the dorsal portions of the lung. An inflammatory response by the body occurs in association with this hemorrhage, potentially contributing to chronic outcomes of the condition.
Effects on Performance
- Despite varying opinions on the condition’s effects on performance, researchers believe EIPH severity increases with the horse’s age, thus affecting its ability to perform intense exercises over time.
Diagnosing EIPH
- Currently, the most common method for diagnosing EIPH is endoscopy of the upper airway, sometimes combined with an analysis of a tracheal wash for the presence of erythrocytes and hemosiderophages, cells associated with blood and iron breakdown.
- The varying extent and differing origins of bleeding in each incident can make these diagnostic methods neither extremely sensitive nor quantitative.
Therapy for EIPH
- The research notes that presently, there is no universally effective treatment for the condition. Existing treatments have not been proven conclusively to prevent EIPH.
- The future directions for therapeutic intervention may need to focus on controlling the inflammatory response to the presence of blood within the lungs following EIPH events.
Cite This Article
APA
Birks EK, Durando MM, McBride S.
(2003).
Exercise-induced pulmonary hemorrhage.
Vet Clin North Am Equine Pract, 19(1), 87-100.
https://doi.org/10.1016/s0749-0739(02)00068-8 Publication
Researcher Affiliations
- Sports Medicine and Imaging, Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348-1692, USA. ebirks@vet.upenn.edu
MeSH Terms
- Animals
- Diuretics / therapeutic use
- Furosemide / therapeutic use
- Hemorrhage / diagnosis
- Hemorrhage / drug therapy
- Hemorrhage / etiology
- Hemorrhage / veterinary
- Horse Diseases / diagnosis
- Horse Diseases / drug therapy
- Horse Diseases / etiology
- Horses
- Lung Diseases / diagnosis
- Lung Diseases / drug therapy
- Lung Diseases / etiology
- Lung Diseases / veterinary
- Physical Exertion
- Treatment Outcome
Citations
This article has been cited 6 times.- Marzahl C, Hill J, Stayt J, Bienzle D, Welker L, Wilm F, Voigt J, Aubreville M, Maier A, Klopfleisch R, Breininger K, Bertram CA. Inter-species cell detection - datasets on pulmonary hemosiderophages in equine, human and feline specimens. Sci Data 2022 Jun 3;9(1):269.
- Hohmann E, Glatt V, Tetsworth K. Swimming induced pulmonary oedema in athletes - a systematic review and best evidence synthesis. BMC Sports Sci Med Rehabil 2018;10:18.
- Giordano A, Meazza C, Salvadori M, Paltrinieri S. Thromboelastometric profiles of horses affected by exercise-induced pulmonary hemorrhages. Vet Med Int 2010 Sep 30;2010.
- Manning H, Sampson S. Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital. Equine Vet J 2025 May;57(3):666-673.
- Shawaf T. Jugular venous thrombosis as a risk factor for exercise-induced pulmonary hemorrhage in thoroughbred racehorses. Open Vet J 2024 May;14(5):1111-1116.
- Marzahl C, Aubreville M, Bertram CA, Stayt J, Jasensky AK, Bartenschlager F, Fragoso-Garcia M, Barton AK, Elsemann S, Jabari S, Krauth J, Madhu P, Voigt J, Hill J, Klopfleisch R, Maier A. Deep Learning-Based Quantification of Pulmonary Hemosiderophages in Cytology Slides. Sci Rep 2020 Aug 3;10(1):9795.
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