Exercise-Induced Pulmonary Hemorrhage

Question 1

What breeds of horses most commonly are affected by EIPH? What is the most common factor?

Answer 1

1. Thoroughbreds
2. Standardbreds
3. Quarter Horses

taking part in disciplines requiring intense exercise

Question 2

What is the prevalent theory behind the pathogenesis of EIPH? What are some other theories?

Answer 2

ruptured pulmonary capillaries that were weakened by inflammatory disease +/- stress failure of pulmonary capillaries

• upper airway obstructions
• small airway disease
• coagulopathies
• redistribution of pulmonary blood flow during exercise
• trauma

Question 3

What is the prevalence of EIPH related to? What aspect of the pulmonary system is typically included?

Answer 3

intensity of exercise rather than duration of exercise, may increase with age of the horse

caudodorsal lung fields

Question 4

What clinical signs is associated with EIPH? What else is seen?

Answer 4

epistaxis after exercise, does not occur in all horses

• decreased performance
• labored breathing
• loss of speed during exercise or competition
• coughing

Question 5

What are some ways that EIPH can be diagnosed in horses not exhibiting epistaxis?

Answer 5

• endoscopy
• cytology of bronchoalveolar lavage - blood within upper airway or trachea indicated by presence of erythrocytes or hemosiderophages

Question 6

How is EIPH treated?

Answer 6

• Furosemide - permitted by racing officials if administered 4 hours before race, reduces RBCs in BALF
• procoagulants, vitamin K
• hormone therapy
• nutritional supplements