Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement.
Abstract: Published studies of exercise-induced pulmonary hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations. Objective: Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses. Methods: None. Methods: Systematic review. A panel of 7 experts was formed to assess evidence in the peer reviewed literature addressing each of the 4 objectives. Methodology followed that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Publications were assessed for quality of evidence by working groups of the panel, and a summary of findings was presented in tables. Recommendations were based on quality of evidence and were determined by a vote of the panel. Results: Much of the evidence was of low to very low quality. Experimental studies frequently lacked adequate statistical power. There was moderate to high quality evidence that EIPH is progressive, is associated with lung lesions, that it adversely affects racing performance, that severe EIPH (Grade 4) is associated with a shorter career duration, that furosemide is efficacious in decreasing the incidence and severity of EIPH, and that administration of furosemide is associated with superior race performance. Conclusions: Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.
Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2015-05-23 PubMed ID: 25996660PubMed Central: PMC4895427DOI: 10.1111/jvim.12593Google Scholar: Lookup
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Summary
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The research article discusses the team’s findings on the impact of Exercise-Induced Pulmonary Hemorrhage (EIPH) on horses’ health, welfare, and athletic capacity based on a systematic review of various studies. Additionally, the efficacy of prophylactic interventions and the effect of the drug Furosemide on equine athletic performance are discussed.
Review and Methodology
- The researchers performed a systematic review of various individual studies addressing four main objectives – if EIPH affects horses’ health/welfare, if it impacts their athletic capacity, the efficacy of prophylactic interventions for EIPH, and the effects of Furosemide on a horse’s athletic capacity.
- A panel of seven experts was convened to scrutinize evidence in the peer-reviewed literature pertaining to these four objectives. The methodology followed was that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).
- The quality of evidence from various publications was examined by working groups from the panel, and the findings were tabulated.
- Recommendations were made based on the quality of evidence after a vote by the panel.
Key Findings
- The research concluded a large amount of the evidence examined was of low to very low quality. Many of the reviewed experimental studies did not have adequate statistical power to give reliable results.
- The team found moderate to high-quality evidence suggesting that EIPH is progressive, associated with lung lesions, and negatively impacts racing performance.
- There was also substantial evidence to suggest that severe EIPH (Grade 4) leads to a shorter career duration for racehorses.
- The drug Furosemide was found effective in reducing the incidence and severity of EIPH, and its administration was associated with better race performance.
Conclusions and Recommendations
- Based on the findings, the team made a strong recommendation for considering EIPH a disease in horse, given its negative impacts on horse health and performance.
- A weaker recommendation was made for the use of the drug Furosemide in managing racehorses affected by EIPH.
Cite This Article
APA
Hinchcliff KW, Couetil LL, Knight PK, Morley PS, Robinson NE, Sweeney CR, van Erck E.
(2015).
Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement.
J Vet Intern Med, 29(3), 743-758.
https://doi.org/10.1111/jvim.12593 Publication
Researcher Affiliations
- University of Melbourne, Werribee, Vic., Australia.
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN.
- University of Sydney, Sydney, NSW, Australia.
- Clinical Sciences, Colorado State University, Fort Collins, CO.
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI.
- University of Pennsylvania, New Bolton Center, Kennett Square, PA.
- Equine Sports Medicine Practice, Waterloo, Belgium.
MeSH Terms
- Animals
- Consensus
- Female
- Furosemide / therapeutic use
- Hemorrhage / etiology
- Hemorrhage / prevention & control
- Hemorrhage / veterinary
- Horse Diseases / etiology
- Horse Diseases / prevention & control
- Horses
- Lung Diseases / etiology
- Lung Diseases / prevention & control
- Lung Diseases / veterinary
- Male
- Physical Conditioning, Animal / adverse effects
- Veterinary Sports Medicine
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