Physiologic effects of furosemide in combination with water restriction when administered at 4 and 24 hours prior to high-intensity treadmill training.
Abstract: Although controversial, due to its reported effectiveness in attenuating bleeding associated with exercise-induced pulmonary hemorrhage (EIPH), furosemide is currently a permitted race day medication in most North American racing jurisdictions. The objective of this study was to assess the efficacy of furosemide in reducing the presence and severity of EIPH when administered 24 hr prior to strenuous treadmill exercise. Eight exercised Thoroughbred horses received saline or 250 mg of furosemide either 4 or 24 hr prior to high-speed treadmill exercise in a balanced 3-way cross-over design. Blood samples were collected for determination of furosemide, lactate, hemoglobin, blood gas, and electrolyte concentrations. Heart rate and pulmonary arterial pressure were measured throughout the run and endoscopic examination and bronchoalveolar lavage (BAL) performed. Horses were assigned an EIPH score and the number of red blood cells in BAL fluid determined. Although not significantly different, endoscopic EIPH scores were lower in the 4-hr versus the 24-hr and saline groups. RBC counts were not significantly different between the treatment groups. Pulmonary arterial pressures were significantly increased at higher speeds; however, there were no significant differences between dose groups when controlling for speed. A small sample size and unknown bleeding history warrant a larger-scale study.
© 2020 John Wiley & Sons Ltd.
Publication Date: 2020-06-01 PubMed ID: 32483865DOI: 10.1111/jvp.12881Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
Summary
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This study investigates the effects of administering furosemide, a drug used to reduce bleeding induced by strenuous exercise in horses, at different time periods before intense training. The efficacy of furosemide in decreasing the presence and severity of the condition, exercise-induced pulmonary hemorrhage (EIPH), when administered 24 hours before high-intensity treadmill exercise, was assessed.
Experimental Design
- Eight exercised Thoroughbred horses were involved in the experiment. These horses were given either saline (a placebo) or furosemide (a dose of 250 mg).
- The drug or placebo was administered at two different intervals, either 4 hours or 24 hours prior to strenuous treadmill exercise. This experiment was conducted in a balanced 3-way cross-over design, meaning each horse had an opportunity to receive each treatment in a random order with periods of rest in between.
- Blood samples were collected from the horses to measure furosemide levels, lactate (a measure of workload), hemoglobin (a measure of oxygen-carrying capacity), and measures of blood gas and electrolyte concentration, all potential indicators of EIPH.
- Heart rate and pulmonary arterial pressure of the horses were measured throughout the run and post-run, the horses underwent an endoscopic examination and a bronchoalveolar lavage (a procedure that involves flushing lung fluid).
- The horses were then given an EIPH score and the number of red blood cells found in the lung fluid was counted as another indicator of EIPH.
Results and Conclusion
- The study reported that, though not significantly, endoscopic EIPH scores were lower when furosemide was administered 4 hours prior to exercise compared to when it was administered 24 hours prior or when saline was administered.
- The count of red blood cells in the fluid from the horses’ lungs (which could indicate the extent of EIPH), was not significantly different between the groups who received furosemide at different periods before exercise and the group who received placebo.
- Pulmonary arterial pressures for the horses rose significantly at higher running speeds. However, there were no significant differences in pulmonary arterial pressures between the groups who received furosemide at different periods prior to exercise when the running speed was taken into account (controlled for speed).
The small sample size and the horses’ unknown bleeding history may affect the overall conclusions and wider applicability of these results. Therefore, a larger-scale study is recommended to draw firm conclusions on the effectiveness of furosemide in reducing EIPH when administered 24 hours before strenuous exercise.
Cite This Article
APA
Knych HK, Wilson WD, Vale A, Kass PH, Steffey EP, Jones JH, Arthur RM.
(2020).
Physiologic effects of furosemide in combination with water restriction when administered at 4 and 24 hours prior to high-intensity treadmill training.
J Vet Pharmacol Ther, 43(6), 565-576.
https://doi.org/10.1111/jvp.12881 Publication
Researcher Affiliations
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- Department of Veterinary Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- Private Practitioner, San Diego, CA, USA.
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
- School of Veterinary Medicine, University of California, Davis, Davis, CA, USA.
MeSH Terms
- Animals
- Blood Pressure / drug effects
- Cross-Over Studies
- Diuretics / administration & dosage
- Diuretics / pharmacology
- Drug Administration Schedule
- Female
- Furosemide / administration & dosage
- Furosemide / pharmacology
- Horses
- Lactic Acid / blood
- Male
- Physical Conditioning, Animal
- Water Deprivation
Grant Funding
- Churchill Downs
- New York Racing Association
- Grayson Jockey Club Research Foundation
- Oaklawn Park
- and The Thoroughbred Horseman's Association
- Keeneland Association, Kentucky Downs
- The Stronach Group
- Del Mar Thoroughbred Club
- Oak Tree Racing Association
- American Association of Equine Practitioners Foundation
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