Association between exercise-induced pulmonary hemorrhage and performance in Thoroughbred racehorses

Hinchcliff, K. W.; Jackson, M. L.; Morley, Paul S.; Brown, James A.; Dredge, Anthony F.; O'Callaghan, Paul A.; McCaffrey, J. P.; Slocombe, R. F.; Clarke, AR

doi:10.2460/javma.2005.227.768

Cited by 78 publications

(127 citation statements)

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“…Factors that make this an important issue include the frequency of EIPH, the importance of the disease in terms of the performance and well-being of horses, and the common use of prophylactic treatments. At least 80% of racehorses can be expected to develop the condition at some time during their career, 1,2 approximately 60% of sudden deaths during racing have been attributed to pulmonary hemorrhage, 2 severe EIPH has been shown to adversely affect race performance, 3 and EIPH is believed to adversely affect the overall health of racehorses. 4 Beyond this, Objective-To evaluate the efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions.…”

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confidence: 99%

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Hinchcliff

Morley²,

Guthrie³

2009

javma

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EQUINE Horse racing is a popular, multimillion-dollar industry worldwide, but reports of injuries and other physical disorders in racehorses have harmed public perceptions of the sport and challenged the economic viability of the racing industry. In addition, controversy has been generated by use of medications that are perceived to affect the performance or well-being of racehorses. One of the foremost concerns in this regard is the occurrence of EIPH and the use of medications in an attempt to prevent it. Factors that make this an important issue include the frequency of EIPH, the importance of the disease in terms of the performance and well-being of horses, and the common use of prophylactic treatments. At least 80% of racehorses can be expected to develop the condition at some time during their career, 1,2 approximately 60% of sudden deaths during racing have been attributed to pulmonary hemorrhage, 2 severe EIPH has been shown to adversely affect race performance, 3 and EIPH is believed to adversely affect the overall health of racehorses. 4 Beyond this, Objective-To evaluate the efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions. Design-Randomized, placebo-controlled, blinded, crossover field trial. Animals-167 Thoroughbred racehorses. Procedures-Horses were allocated to race fields of 9 to 16 horses each and raced twice, 1 week apart, with each of the 2 races consisting of the same race field and distance. Each horse received furosemide (500 mg, IV) before one race and a placebo (saline solution) before the other, with the order of treatments randomly determined. Severity of EIPH was scored on a scale from 0 to 4 after each race by means of tracheobronchoscopy. Data were analyzed by means of various methods of multivariable logistic regression.Results-Horses were substantially more likely to develop EIPH (severity score ≥ 1; odds ratio, 3.3 to 4.4) or moderate to severe EIPH (severity score ≥ 2; odds ratio, 6.9 to 11.0) following administration of saline solution than following administration of furosemide. In addition, 81 of the 120 (67.5%) horses that had EIPH after administration of saline solution had a reduction in EIPH severity score of at least 1 when treated with furosemide. Furosemide is the drug most widely used to prevent EIPH in racehorses and is administered on the day of racing to > 92% of Thoroughbred racehorses in North America (approx 400,000 doses/y). 4,5 However, few studies have examined whether furosemide is effective in preventing the development of EIPH, and the studies that have been performed were not conducted Conclusions and Clinical Relevance-Results

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confidence: 99%

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Hinchcliff

Morley²,

Guthrie³

2009

javma

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“…Some degree of exercise-induced pulmonary haemorrhage occurs in almost all racehorses actively involved in training or racing (McKane et al 1993). According to Hinchcliff et al (2005), the low grade of EIPH is not associated with reduced athletic per-doi: 10.17221/8878-VETMED formance. We can suppose that the finding of 11% of hemosiderophages in BAL fluid is suggestive of previous mild pulmonary haemorrhage and is probably not associated with reduced athletic performance in this horse.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of poor performance in racehorses using a high-speed treadmill

Melkova¹,

Jahn²,

Bodeček³

et al. 2016

Vet. Med. - Czech

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ABSTRACT:The study reports the results of a comprehensive clinical evaluation of 18 racehorses with a history of inadequate athletic performance. The poor performance evaluation included general physical examination and laboratory screening, respiratory examination including upper airway endoscopy at rest and during maximal treadmill exercise, cardiac examination, post-exercise serum biochemistry and bronchoalveolar lavage cytology. A definitive diagnosis was established in 15 horses (83.3%). The most frequent findings were upper respiratory tract disorders, with dorsal displacement of the soft palate being most often diagnosed (eight horses) followed by axial deviation of the aryepiglottic folds (two horses) and recurrent laryngeal neuropathy (two horses). Inflammatory airway disease was diagnosed in two horses and exercise-induced pulmonary haemorrhage in one horse. Subclinical myopathy was detected in two horses. Ten horses (55.6%) had multiple concomitant problems that may have contributed to their inadequate athletic performance; therefore, a comprehensive approach is required to diagnose the cause of decreased athletic capability.Keywords: exercise testing; upper airway obstruction; endoscopy; horse List of abbreviations ADAF = axial deviation of aryepiglottic fold, BAL = bronchoalveolar lavage, CK = creatine kinase, EIPH = exerciseinduced pulmonary haemorrhage, IAD = inflammatory airway disease, PLH = pharyngeal lymphoid hyperplasia, RLN = recurrent laryngeal neuropathy, SET = standardised exercise test

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“…However, studies by Geor et al (2001) in race horses showed that the simultaneous use of nasal patches and furosemide attenuated the presentation of EIPH and diminished the presence of erythrocytes in the BALF. In addition, Hinchcliff et al (2005) suggested that EIPH is associated with impaired performance in thoroughbred racehorses that are not medicated with furosemide and do not use nasal dilator strips.…”

Section: Treatment Of Exercise-induced Pulmonary Haemorrhagementioning

confidence: 99%

“…These authors mentioned the demand that exists for prevention and treatment methods to control bleeding. Therefore, a series of manipulations and drug treatments have been researched and tested, but just few of them have demonstrated efficacy (Hinchcliff 2005). However, furosemide is the drug of choice in treating this condition (Hinchcliff et al 2009).…”

Section: Treatment Of Exercise-induced Pulmonary Haemorrhagementioning

confidence: 99%

Exercise-induced pulmonary haemorrhage in horses – review

Morán¹,

Folch²

2013

Acta Vet. Brno

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Exercise-induced pulmonary haemorrhage is a major cause of poor performance in the equine athlete. It is an important cause of exercise intolerance and results from strenuous exercise and pathophysiological changes in the equine lung and possibly in the airways. Endoscopic surveys of the respiratory tracts of horses after competitive events have shown that many horses experience exercise-induced pulmonary haemorrhage. The reported incidence of exercise-induced pulmonary haemorrhage in different breeds varies between 40-85%. The cause of bleeding in exercising horses has fostered considerable debate over the past three centuries, but currently, the most accepted hypothesis is that the source of haemorrhage is disruption of the pulmonary capillaries during exercise. Furosemide is the medication used most widely for the treatment and prevention of exercise-induced pulmonary haemorrhage. This review provides an update on the aetiology, clinical signs, physiopathology, diagnosis and treatment of exercise-induced pulmonary haemorrhage. EIPH, pulmonary pressure, equine

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Association between exercise-induced pulmonary hemorrhage and performance in Thoroughbred racehorses

Abstract: Results suggest that EIPH is associated with impaired performance in Thoroughbred racehorses not medicated with furosemide and not using nasal dilator strips.

Cited by 78 publications

References 10 publications

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Evaluation of poor performance in racehorses using a high-speed treadmill

Exercise-induced pulmonary haemorrhage in horses – review

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