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Shoemaker S, Wang Y, Sellon D, Gold J, Fisher A, Bagshaw J, Leguillette R, Sanz M, Bayly W. Prevalence and severity of exercise-induced pulmonary hemorrhage in 2-year-old Thoroughbred racehorses and its relationship to performance. J Vet Intern Med 2024; 38:1167-1176. [PMID: 38363079 PMCID: PMC10937470 DOI: 10.1111/jvim.17003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 01/22/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Little has been reported regarding the prevalence and severity of exercise-induced pulmonary hemorrhage (EIPH) in 2-year-old Thoroughbred racehorses. OBJECTIVES Evaluate EIPH prevalence and severity and its association with performance, speed index, furosemide administration, race distance, and track surface. ANIMALS A total of 830 2-year-old Thoroughbreds. METHODS Prospective blinded observational study. Videoendoscopy was performed 30 to 60 minutes postrace at 15 American racetracks. Three blinded observers independently assigned an EIPH grade (0-4) to each video, and prevalence and severity of EIPH were determined. Relationships of EIPH grade to performance, speed index, race distance, track surface, and prerace administration of furosemide were evaluated using Pearson's chi-squared test for categorical variables and analysis of variance (ANOVA) for numerical variables. Multivariable logistic regression assessed relationships between EIPH prevalence and severity, respectively, and the aforementioned independent variables. A P < .05 was considered significant. RESULTS A total of 1071 tracheoendoscopies were recorded. The EIPH prevalence was 74% and for EIPH grade ≥3 was 8%. Speed index (P = .02) and finishing place (P = .004) were lower with EIPH ≥3. The EIPH prevalence and severity were lower at 2 tracks where postrace tracheoendoscopy was mandatory rather than voluntary (P < .001). Probability of observing EIPH was negatively associated with speed index (P = .01) at tracks where postrace tracheoendoscopy was mandatory. Prerace furosemide administration decreased the probability of EIPH occurrence (P = .007) and severity (P = .01) where study participation was voluntary. CONCLUSIONS AND CLINICAL IMPORTANCE Prevalence and severity of EIPH in 2-year-old racehorses were consistent with that of older racehorses. An EIPH grade ≥3 was associated with decreased performance. Prerace furosemide administration was associated with a decreased likelihood, but not severity, of EIPH at most tracks.
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Affiliation(s)
- Sierra Shoemaker
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
| | - Yuan Wang
- Center for Interdisciplinary Statistical Education and ResearchWashington State UniversityPullmanWashingtonUSA
| | - Debra Sellon
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
| | - Jenifer Gold
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
| | - Allison Fisher
- Center for Interdisciplinary Statistical Education and ResearchWashington State UniversityPullmanWashingtonUSA
| | - Julia Bagshaw
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
| | - Renaud Leguillette
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary MedicineUniversity of CalgaryCalgaryAlbertaCanada
| | - Macarena Sanz
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
| | - Warwick Bayly
- Department of Veterinary Clinical SciencesWashington State UniversityPullmanWashingtonUSA
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Lo Feudo CM, Stucchi L, Stancari G, Conturba B, Bozzola C, Zucca E, Ferrucci F. Associations between Medical Disorders and Racing Outcomes in Poorly Performing Standardbred Trotter Racehorses: A Retrospective Study. Animals (Basel) 2023; 13:2569. [PMID: 37627359 PMCID: PMC10451774 DOI: 10.3390/ani13162569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/13/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Poor performance in racehorses is commonly associated with subclinical diseases. This study aims to evaluate the associations between medical disorders and racing results in Standardbred trotters. The clinical records of 248 poorly performing Standardbreds were retrospectively reviewed, and their racing results were extracted from an online database, concerning the periods 3 months before and 6 months after hospitalization and the entire lifetime. Generalized linear models were used to evaluate the effects of different disorders on racing outcomes. Airway neutrophilia was associated with limiting lifetime starts and wins pre- and post-hospitalization, while mastocytosis was associated with less wins in the post-hospitalization period. Therefore, lower airway inflammation showed both short- and long-term impacts on racing performance. Severe upper airway obstructions and gastric ulcers showed associations with less placings in the post-discharge period but no long-term influence on performance. The significance of exertional rhabdomyolysis was indeterminable, yet interference with the number of starts in the post-discharge period was reported and associated with lower total career earnings. Exercise-induced pulmonary hemorrhage and cardiac arrhythmias were not associated with worse racing outcomes: therefore, their role in poor performance remains unclear.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.)
| | - Luca Stucchi
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.)
| | - Giovanni Stancari
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy
| | - Bianca Conturba
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy
| | - Chiara Bozzola
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.)
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.)
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.)
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Lo Feudo CM, Stucchi L, Conturba B, Stancari G, Zucca E, Ferrucci F. Medical causes of poor performance and their associations with fitness in Standardbred racehorses. J Vet Intern Med 2023; 37:1514-1527. [PMID: 37148147 PMCID: PMC10365054 DOI: 10.1111/jvim.16734] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/21/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Poor performance is a multifactorial syndrome of racehorses, commonly associated with subclinical disorders, which can be diagnosed by exercise testing. OBJECTIVES Describe the prevalence of medical causes of poor performance in Standardbreds unassociated with lameness, and evaluate their relationships with fitness variables measured by exercise treadmill test. ANIMALS Hospital population of 259 nonlame Standardbred trotters referred for poor performance. METHODS The horses' medical records were retrospectively reviewed. Horses underwent a diagnostic protocol including resting examination, plasma lactate concentration, treadmill test with continuous ECG and assessment of fitness variables, creatine kinase activity, treadmill endoscopy, postexercise tracheobronchoscopy, bronchoalveolar lavage (BAL), and gastroscopy. The prevalence of different disorders was evaluated, including cardiac arrhythmias, exertional myopathies, dynamic upper airway obstructions (DUAOs), exercise-induced pulmonary hemorrhage (EIPH), moderate equine asthma (MEA), and gastric ulcers (EGUS). The associations of these disorders with fitness variables were investigated individually and using multivariable models. RESULTS Moderate equine asthma and EGUS were the most common disorders, followed by EIPH, DUAOs, cardiac arrhythmias, and exertional myopathies. Hemosiderin score was positively correlated with BAL neutrophils, eosinophils, and mast cells; increased creatine kinase activity was associated with BAL neutrophilia, DUAOs, premature complexes, and squamous gastric disease. Treadmill velocity at a plasma lactate concentration of 4 mmol/L and at heart rate of 200 beats per minute was negatively affected by BAL neutrophilia, multiple DUAOs, exertional myopathies, and squamous gastric disease. CONCLUSIONS The multifactorial nature of poor performance was confirmed, with MEA, DUAOs, myopathies and EGUS representing the main diseases involved in fitness impairment.
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Affiliation(s)
- Chiara M. Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
| | - Luca Stucchi
- Equine Unit, Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
| | - Bianca Conturba
- Equine Unit, Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
| | - Giovanni Stancari
- Equine Unit, Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal SciencesUniversità degli Studi di MilanoLodiItaly
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Sugiyama F, Takahashi Y, Nomura M, Ebisuda Y, Mukai K, Yoshida T. Risk Factors for Epistaxis in Thoroughbred Flat Races in Japan (2001-2020). Animals (Basel) 2023; 13:ani13081348. [PMID: 37106911 PMCID: PMC10135158 DOI: 10.3390/ani13081348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
We investigated the risk factors for epistaxis in Japanese flat races over a 20-year period. The veterinary records of horses identified as having epistaxis by endoscopy on the race day, and the official racing records of all flat races from April to September between 2001 and 2020, were reviewed. The racecourses (n = 10), surface type, surface condition, race class, race distance, race year, sex, age, two training centers, ambient temperature, and body weight on race days were assessed using multivariable logistic regression (p < 0.05). Of 475,709 race starts, 616 (1.30 cases per 1000 starts; 95% confidence interval [CI], 1.20-1.40) included an epistaxis event. Nine variables were significantly associated with epistaxis. Seven of the variables have been reported in previous studies: lower ambient temperature, soft surface conditions, shorter racing distances (≤1400 m), increasing age, females and geldings compared to males, training center, and race year. However, two novel variables were identified as significantly associated with epistaxis, increasing body weight per 20 kg (p < 0.001, odds ratio [OR], 1.33; 95% CI, 1.25-1.41) and the racecourses that the horses were running at (p < 0.001, especially Sapporo [OR; 4.74, 95% CI, 3.07-7.31], Hakodate [OR, 4.66; 95% CI, 3.05-7.11], and Kokura [OR, 4.14; 95% CI, 2.65-6.48] compared to the reference racecourse [Kyoto]). These results can facilitate developing interventions to reduce epistaxis in flat racing.
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Affiliation(s)
- Fumi Sugiyama
- Sports Science Division, Equine Research Institute, Japan Racing Association, 1400-4, Shiba, Shimotsuke 329-0412, Tochigi, Japan
| | - Yuji Takahashi
- Sports Science Division, Equine Research Institute, Japan Racing Association, 1400-4, Shiba, Shimotsuke 329-0412, Tochigi, Japan
| | - Motoi Nomura
- Equine Department, Japan Racing Association, 1-1-1, Nishi-Shinbashi, Minato 105-0003, Tokyo, Japan
| | - Yusaku Ebisuda
- Sports Science Division, Equine Research Institute, Japan Racing Association, 1400-4, Shiba, Shimotsuke 329-0412, Tochigi, Japan
| | - Kazutaka Mukai
- Sports Science Division, Equine Research Institute, Japan Racing Association, 1400-4, Shiba, Shimotsuke 329-0412, Tochigi, Japan
| | - Toshinobu Yoshida
- Sports Science Division, Equine Research Institute, Japan Racing Association, 1400-4, Shiba, Shimotsuke 329-0412, Tochigi, Japan
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Cullinane A, Garvey M, Walsh C, Gibbons J, Creighton A. A Scoping Review of Non-Structural Airway Disease as a Cause of Poor Performance in Racehorses. Animals (Basel) 2023; 13:ani13030429. [PMID: 36766318 PMCID: PMC9913315 DOI: 10.3390/ani13030429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/02/2023] Open
Abstract
The association between poor performance and respiratory disease in Thoroughbred racehorses that do not have a structural abnormality of the respiratory tract, is often based on anecdotal evidence. The objective of this scoping review was to examine the scientific evidence for such associations. Publications were selected based on a search of three databases (PubMed, Scopus, and CAB Direct), in English and without date restriction, followed by a screening process to exclude non-relevant papers, duplicates, and reviews. This process identified 996 publications of which 20 were analysed using the Quality in Prognosis Studies (QUIPS) tool. The results indicated that the evidence supporting the relationship between proposed diagnostic indicators and poor performance is variable. There is a need for better quality evidence. In particular, there are conflicting reports relating to the impact of equine asthma and EIPH on athletic performance. Furthermore, a lack of standardisation in the measurement of racehorse performance makes it difficult to compare findings from different studies. The industry would benefit from high-level guidance concerning the design of controlled performance studies in Thoroughbred racehorses to collect comprehensive data and facilitate targeted interventions.
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Affiliation(s)
- Ann Cullinane
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
- Correspondence: ; Tel.: +353-45-866266; Fax: +353-45-866273
| | - Marie Garvey
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
| | - Cathal Walsh
- Department of Mathematics and Statistics, University of Limerick, V94 T9PX Limerick, Ireland
| | - James Gibbons
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
| | - Alan Creighton
- The Irish Equine Centre, Johnstown, Naas, Co., W91 RH93 Kildare, Ireland
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Lo Feudo CM, Stucchi L, Stancari G, Alberti E, Conturba B, Zucca E, Ferrucci F. Associations between Exercise-Induced Pulmonary Hemorrhage (EIPH) and Fitness Parameters Measured by Incremental Treadmill Test in Standardbred Racehorses. Animals (Basel) 2022; 12:ani12040449. [PMID: 35203157 PMCID: PMC8868235 DOI: 10.3390/ani12040449] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Exercise-induced pulmonary hemorrhage (EIPH) frequently affects racehorses worldwide and has been widely associated with poor performance; however, scientific evidence supporting this observation is low. The present retrospective study aims to evaluate objectively whether the presence and grade of EIPH could affect some fitness parameters, measured during an incremental treadmill test, in poorly performing Standardbred racehorses. For this purpose, the association between EIPH and the results of a treadmill metabolic test (including blood lactate analysis and venous blood gas analysis) were evaluated in 81 Standardbred racehorses. No relationship between EIPH and aerobic/anaerobic capacity was observed, suggesting that EIPH may affect performance in a different manner. However, EIPH-affected horses were shown to reach higher hematocrit values during exercise compared to EIPH-negative horses; therefore, it may be hypothesized that hemoconcentration may take part in the pathogenesis of EIPH by increasing the pulmonary capillary pressure. Abstract Exercise-induced pulmonary hemorrhage (EIPH) is a condition affecting up to 95% of racehorses, diagnosed by detecting blood in the trachea after exercise and/or the presence of hemosiderophages in the bronchoalveolar lavage fluid (BALf). Although EIPH is commonly associated with poor performance, scientific evidence is scarce. The athletic capacity of racehorses can be quantified through some parameters obtained during an incremental treadmill test; in particular, the speed at a heart rate of 200 bpm (V200), and the speed (VLa4) and the heart rate (HRLa4) at which the blood lactate concentration reaches 4 mmol/L are considered good fitness indicators. The present retrospective study aims to evaluate whether EIPH could influence fitness parameters in poorly performing Standardbreds. For this purpose, data from 81 patients regarding their V200, VLa4, HRLa4, peak lactate, maximum speed, minimum pH, and maximum hematocrit were reviewed; EIPH scores were assigned based on tracheobronchoscopy and BALf cytology. The association between the fitness parameters and EIPH was evaluated through Spearman’s correlation analysis. No relationship between EIPH and V200, VLa4, and HRLa4 was observed. Interestingly, EIPH-positive horses showed higher hematocrit values (p = 0.0072, r = 0.47), suggesting the possible influence of the hemoconcentration on the increase of pulmonary capillary pressure as a part of the pathogenesis of EIPH.
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Affiliation(s)
- Chiara Maria Lo Feudo
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Luca Stucchi
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Giovanni Stancari
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Elena Alberti
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Bianca Conturba
- Veterinary Teaching Hospital, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (L.S.); (G.S.); (B.C.)
| | - Enrica Zucca
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
| | - Francesco Ferrucci
- Equine Sports Medicine Laboratory “Franco Tradati”, Department of Veterinary Medicine and Animal Sciences, Università Degli Studi di Milano, 26900 Lodi, Italy; (C.M.L.F.); (E.A.); (E.Z.)
- Correspondence: ; Tel.: +39-0250334146
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Pires NR, Miranda S, Costa M, Ramos M, Bernardes C, Alencar N, Lessa D. Effect of intrabronchial platelet rich plasma on the exercise-induced pulmonary hemorrhage endoscopic score in thoroughbred racehorses using furosemide: a preliminary study. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-12212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The high prevalence of exercise-induced pulmonary hemorrhage (EIPH) in athletic horses constitutes to be a challenge to the racing industry and a source of major concern to animal welfare. Both experimental and clinical evidence indicate that the use of autologous platelet-rich plasma (PRP) is a promising effector of repair in a variety of pulmonary conditions. The present study evaluated the effect of intrabronchial instillation of PRP on EIPH endoscopic scores from 37 Thoroughbred racehorses. Inclusion criteria were for animals to be EIPH-positive in, at least, two consecutive post-exercise endoscopic exams and to receive 250mg of furosemide IV four hours before racing. Animals were randomly assigned into 3 groups: placebo, control, and PRP instillation. All 37 Thoroughbred racehorses included had EIPH endoscopic scores pre- and post- treatment compared by statistical analysis. The bleeding score from the group receiving PRP was significantly lower than in the control and placebo groups. No adverse effects were observed in any animal during or after the experiment. It was possible to conclude that the intrabronchial instillation of autologous PRP was effective in reducing EIPH scores in racehorses receiving furosemide and that this bioproduct can be considered as a promising coadjuvant in controlling EIPH in athletic horses.
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Affiliation(s)
| | | | | | - M.T. Ramos
- Universidade do Grande Rio “Professor José de Souza Herdy”, Brazil
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McGilvray TA, Cardwell JM. Training related risk factors for exercise induced pulmonary haemorrhage in British National Hunt racehorses. Equine Vet J 2021; 54:283-289. [PMID: 33843093 DOI: 10.1111/evj.13448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/25/2021] [Accepted: 04/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exercise induced pulmonary haemorrhage (EIPH) is an important condition of horses performing high intensity exercise, with reported prevalence among racehorses of up to 95%, based on the detection of blood on tracheobronchoscopy. Previously identified risk factors include age, sex, season, race type, years spent in racing and lower airway inflammation. OBJECTIVES To estimate the prevalence of EIPH in British National Hunt racehorses as indicated by two outcome measures: presence of tracheal blood on tracheobronchoscopy, and presence of moderate-large (significant) proportions of haemosiderophages in tracheal wash (TW) fluid; and to identify training-related risk factors for these indicators of EIPH. STUDY DESIGN Prospective longitudinal study. METHODS Data from tracheobronchoscopy and TW cytology were analysed using univariable and multivariable mixed-effects logistic regression. RESULTS 1184 observations, from 177 horses, were analysed. The prevalence of tracheal blood was 7.2% (95%CI: 5.8, 8.8) and significant haemosiderophages in TW fluid was 36% (95%CI: 33.3, 38.8). Increased time in training was significantly associated with increased odds of EIPH. For each additional year spent in training the odds of tracheal blood and presence of significant proportions haemosiderophages increased approximately 1.5-fold (OR = 1.5; 95%CI: 1.1-2.0; P = .005; and OR = 1.5; 95%CI: 1.3, 1.8; P < .001, respectively). Current inflammation was associated with previous haemorrhage, but not current haemorrhage. MAIN LIMITATIONS There are no standardised measures for quantification of TW cytological parameters for EIPH diagnosis. Few horses were examined following jumping. Recent racing dates were not included in analysis. CONCLUSIONS Increasing time in training was a risk factor for both indicators of EIPH. Current inflammation was associated with previous haemorrhage, but not current or future haemorrhage, suggesting that haemorrhage leads to inflammation but not that inflammation leads to haemorrhage. Overall, our findings are consistent with the capillary stress failure theory of EIPH. The development of standardised measures for TW cytological diagnosis of EIPH is warranted.
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9
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Crispe EJ, Lester GD. Exercise-induced Pulmonary Hemorrhage: Is It Important and Can It Be Prevented? Vet Clin North Am Equine Pract 2019; 35:339-350. [PMID: 31084976 DOI: 10.1016/j.cveq.2019.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Exercise-induced pulmonary hemorrhage (EIPH) occurs commonly in horses undergoing strenuous exercise. Reported risk factors include racing in cold temperatures and wearing of bar shoes. In horses with documented moderate to severe EIPH, increasing the interval between races and adopting a negative race pace strategy may reduce the severity of EIPH in subsequent races. EIPH seems to have an impact on performance only when moderate to severe. This occurs in a small number of starters, approximately 6%. EIPH often is erratic in severity from race to race, although across a population it is weakly progressive over increasing race starts.
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Affiliation(s)
- Eleanor J Crispe
- Simon Miller Racing, PO Box 7298, Shenton Park, Western Australia 6008, Australia
| | - Guy D Lester
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Box 100136, Gainesville, FL 32610-0136, USA.
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10
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De Mello Costa M, Ronchi F, Yoonsuh J, Ivanow A, Braga J, Ramos M, Casarini D, Slocombe R. ACE activity post-race is influenced by furosemide administration. COMPARATIVE EXERCISE PHYSIOLOGY 2018. [DOI: 10.3920/cep170032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Exercise induced pulmonary haemorrhage (EIPH) affecting racehorses continues to raise questions regarding animal welfare and to-date no effective treatment has been identified. The mode of action of furosemide on EIPH, the only medication for the condition accepted in some racing jurisdictions, has not been completely elucidated. This research investigated the interaction between furosemide on angiotensin converting enzyme (ACE) as a potential pathway for future investigation of EIPH treatment options in a prospective case-control analytical study. ACE is a potent vasoconstrictor and substances reducing its activity could potentially contribute to decreasing blood pressure and EIPH. Horses racing on 8 official race days at Gávea Racetrack, Brazil had respiratory endoscopy data and blood samples collected after the race and were grouped into furosemide medicated and non-furosemide medicated horses. ACE measurement was conducted using fluorescence in a previously validated method. Environmental, race and haematological data were also recorded. A multiple regression model was used to analyse the data collected, with further analysis including Fisher’s exact test and Pearson’s chi-squared test with Yates’ continuity correction; a Welch two sample t-test and a simple linear regression model. 73 horses were included in the study. ACE activity between horses not medicated and medicated with furosemide was significantly different. Pre-race furosemide significantly influenced ACE activity post-race, while distance raced, temperature, humidity, and haematocrit did not. Horses medicated with pre-race furosemide still demonstrated some degree of bleeding after the race and were at higher risk of presenting EIPH than non-medicated horses. Horses medicated with furosemide have lower circulating ACE activity which might indicate a protective effect of furosemide. Furosemide might reduce EIPH severity after a single bout of exercise, but it does not abolish or reduce its occurrence.
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Affiliation(s)
- M.F. De Mello Costa
- Waikato Institute of Technology, Centre for Science and Primary Industries, A Block, Gate 3, Tristram Street, Hamilton, New Zealand
- Universidade Severino Sombra, Veterinary Medicine School, Av. Expedicionário Oswaldo de Almeida Ramos 280 Centro, Vassouras, RJ 27700-000, Brazil
| | - F.A. Ronchi
- Escola Paulista de Medicina, Departamento de Medicina, Disciplina de Nefrologia, UNIFESP, Rua Botucatu, 591, Vila Clementino, SP, Brazil
| | - J. Yoonsuh
- University of Waikato, Hillcrest, Hamilton 3216, New Zealand
- Department of Statistics, Korea University, 145 Anam-ro, Anam-dong, Seongbuk-gu, Seoul, South Korea
| | - A. Ivanow
- Centaur Equine Research Consortium, Auckland, New Zealand
| | - J.V. Braga
- Jockey Club Brasileiro, F e G, Rua Djalma Ulrich 110, Copacabana, Rio de Janeiro 22071-020, Brazil
| | - M.T. Ramos
- Universidade Severino Sombra, Veterinary Medicine School, Av. Expedicionário Oswaldo de Almeida Ramos 280 Centro, Vassouras, RJ 27700-000, Brazil
- Universidade Federal Rural do Rio de Janeiro, BR 465, Km 07. Seropédica, RJ 23897-97, Brazil
| | - D.E. Casarini
- Escola Paulista de Medicina, Departamento de Medicina, Disciplina de Nefrologia, UNIFESP, Rua Pedro de Toledo 669, Sao Paulo, Brazil
| | - R.F. Slocombe
- Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee, Victoria 3030, Australia
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11
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Crispe EJ, Lester GD, Secombe CJ, Perera DI. The association between exercise‐induced pulmonary haemorrhage and race‐day performance in Thoroughbred racehorses. Equine Vet J 2017; 49:584-589. [DOI: 10.1111/evj.12671] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 01/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- E. J. Crispe
- College of Veterinary Medicine School of Veterinary and Life Sciences Murdoch University Murdoch Western Australia Australia
| | - G. D. Lester
- College of Veterinary Medicine School of Veterinary and Life Sciences Murdoch University Murdoch Western Australia Australia
| | - C. J. Secombe
- College of Veterinary Medicine School of Veterinary and Life Sciences Murdoch University Murdoch Western Australia Australia
| | - D. I. Perera
- College of Veterinary Medicine School of Veterinary and Life Sciences Murdoch University Murdoch Western Australia Australia
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Hinchcliff KW, Couetil LL, Knight PK, Morley PS, Robinson NE, Sweeney CR, van Erck E. Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement. J Vet Intern Med 2016; 29:743-58. [PMID: 25996660 PMCID: PMC4895427 DOI: 10.1111/jvim.12593] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 03/08/2015] [Accepted: 03/10/2015] [Indexed: 12/02/2022] Open
Abstract
Background 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. Objectives 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. Animals None. Materials and 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 and clinical significance Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.
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Affiliation(s)
| | - L L Couetil
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN
| | - P K Knight
- University of Sydney, Sydney, NSW, Australia
| | - P S Morley
- Clinical Sciences, Colorado State University, Fort Collins, CO
| | - N E Robinson
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - C R Sweeney
- University of Pennsylvania, New Bolton Center, Kennett Square, PA
| | - E van Erck
- Equine Sports Medicine Practice, Waterloo, Belgium
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Crispe EJ, Lester GD, Robertson ID, Secombe CJ. Bar shoes and ambient temperature are risk factors for exercise-induced pulmonary haemorrhage in Thoroughbred racehorses. Equine Vet J 2015; 48:438-41. [DOI: 10.1111/evj.12458] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 05/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- E. J. Crispe
- College of Veterinary Medicine; School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - G. D. Lester
- College of Veterinary Medicine; School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - I. D. Robertson
- College of Veterinary Medicine; School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
| | - C. J. Secombe
- College of Veterinary Medicine; School of Veterinary and Life Sciences; Murdoch University; Murdoch Western Australia Australia
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Sullivan S, Hinchcliff K. Update on Exercise-Induced Pulmonary Hemorrhage. Vet Clin North Am Equine Pract 2015; 31:187-98. [DOI: 10.1016/j.cveq.2014.11.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Morley PS, Bromberek JL, Saulez MN, Hinchcliff KW, Guthrie AJ. Exercise-induced pulmonary haemorrhage impairs racing performance in Thoroughbred racehorses. Equine Vet J 2014; 47:358-65. [PMID: 25290262 DOI: 10.1111/evj.12368] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 09/26/2014] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING STUDY Exercise-induced pulmonary haemorrhage (EIPH) occurs commonly in Thoroughbred racehorses worldwide. While EIPH is believed to be an important cause of impaired performance in these horses, there is limited evidence from sufficiently powered studies to evaluate this association. OBJECTIVES To evaluate whether EIPH is associated with finishing position, distance finished behind race winners and differences in race earning among Thoroughbred horses racing in South Africa. STUDY DESIGN Prospective cross-sectional study. METHODS One thousand Thoroughbred horses racing in South Africa were enrolled prior to a single race and underwent tracheobronchoscopic examination within 2 h of racing. Three observers, blinded to the horses' identity and race performance, independently evaluated EIPH occurrence and severity using video recordings of the examination. Data were analysed using multivariable logistic and linear regression while controlling for important horse and race factors as potential confounding variables. RESULTS Overall, 68% of horses had evidence of EIPH (grade ≥1). Horses without evidence of EIPH (severity grade 0), when compared with horses with any evidence of EIPH (grade ≥1), were >2 times more likely to win races (odds ratio = 2.3; 95% confidence interval 1.4-3.7; P = 0.001), finished an average of one length ahead of horses with EIPH (P = 0.03), and were 2.5 times more likely to be in the highest decile in race earnings (odds ratio = 2.5, 95% CI 1.5-4.1, P<0.001). However, no association was identified regarding finishing in the top 3 positions or earning money when analysed as a continuous variable or analysed as any winnings vs. none. CONCLUSIONS Exercise-induced pulmonary haemorrhage was associated with impaired performance in Thoroughbred racehorses not medicated with furosemide and not using nasal dilator strips. These findings provide strong corroboration of previous research indicating that the occurrence of EIPH has a major impact on the ability of Thoroughbred racehorses to compete successfully as elite athletes.
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Affiliation(s)
- P S Morley
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA
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Sullivan SL, Anderson GA, Morley PS, Hinchcliff KW. Prospective study of the association between exercise-induced pulmonary haemorrhage and long-term performance in Thoroughbred racehorses. Equine Vet J 2014; 47:350-7. [PMID: 24617564 DOI: 10.1111/evj.12263] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 02/26/2014] [Indexed: 11/28/2022]
Abstract
REASONS FOR PERFORMING STUDY Exercise-induced pulmonary haemorrhage (EIPH) is associated with impaired short-term race performance but consequences to long-term race performance of Thoroughbred racehorses are unknown. Knowledge of effects of EIPH on performance over a prolonged time would inform the need for management and treatment of this disorder. OBJECTIVES To determine the relationship between EIPH detected on a single occasion and long-term athletic performance in Thoroughbred racehorses. STUDY DESIGN Prospective, longitudinal, observational epidemiological study conducted from 2003 to 2012. METHODS Seven hundred and forty-four Thoroughbred racehorses underwent a single tracheobronchoscopic examination to determine presence and severity of EIPH in 2003. Following retirement of all the horses from racing, career after examination and lifetime performance data (including career duration, earnings, starts, wins and placings) were abstracted from a commercial database. The association between presence and severity of EIPH and individual performance variables were analysed using survival analysis, linear regression and negative binomial regression. RESULTS No association was detected between the presence of any EIPH (grade ≥1) and all measures of long-term performance examined except that horses with EIPH (grade ≥2) had fewer earnings after endoscopic examination than did horses with mild EIPH or no EIPH (grades ≤1). Multiple associations were detected between the most severe form of EIPH (grade 4) and measures of long-term performance suggesting that the severity of EIPH commonly associated with epistaxis adversely affects either the horse's opportunity to race or physiologic capacity to race. CONCLUSIONS We conclude that there is no association between EIPH grades 0, 1, 2 and 3 and long-term racing performance of Thoroughbred racehorses. These results are based on a single endoscopic evaluation of EIPH grade made during a horse's career. Further studies are required to determine the reasons for an association of severe (grade 4) EIPH with impaired long-term race performance.
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Affiliation(s)
- S L Sullivan
- Faculty of Veterinary Science, University of Melbourne, Werribee, Victoria, Australia
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Van Erck-Westergren E, Franklin SH, Bayly WM. Respiratory diseases and their effects on respiratory function and exercise capacity. Equine Vet J 2013; 45:376-87. [PMID: 23368813 DOI: 10.1111/evj.12028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 12/02/2012] [Indexed: 12/26/2022]
Abstract
Given that aerobic metabolism is the predominant energy pathway for most sports, the respiratory system can be a rate-limiting factor in the exercise capacity of fit and healthy horses. Consequently, respiratory diseases, even in mild forms, are potentially deleterious to any athletic performance. The functional impairment associated with a respiratory condition depends on the degree of severity of the disease and the equestrian discipline involved. Respiratory abnormalities generally result in an increase in respiratory impedance and work of breathing and a reduced level of ventilation that can be detected objectively by deterioration in breathing mechanics and arterial blood gas tensions and/or lactataemia. The overall prevalence of airway diseases is comparatively high in equine athletes and may affect the upper airways, lower airways or both. Diseases of the airways have been associated with a wide variety of anatomical and/or inflammatory conditions. In some instances, the diagnosis is challenging because conditions can be subclinical in horses at rest and become clinically relevant only during exercise. In such cases, an exercise test may be warranted in the evaluation of the patient. The design of the exercise test is critical to inducing the clinical signs of the problem and establishing an accurate diagnosis. Additional diagnostic techniques, such as airway sampling, can be valuable in the diagnosis of subclinical lower airway problems that have the capacity to impair performance. As all these techniques become more widely used in practice, they should inevitably enhance veterinarians' diagnostic capabilities and improve their assessment of treatment effectiveness and the long-term management of equine athletes.
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