Exercise Induced Pulmonary Hemorrhage - Prevalence of EIPH in Horses

Prevalence of EIPH in Horses

Based on surveys of horses examined endoscopically following racing, around 40 to 70% of horses have been reported to have blood in the trachea following a single post-race examination. One of the more recent and larger studies found an overall prevalence of just under 60%. The time at which the examination is carried out can determine whether or not blood is seen. The usual time for examination is 30–40 minutes following exercise. If examination is carried out too soon after exercise then blood may not have progressed from the dorso-caudal (top and back) of the lung into the trachea. If the examination is carried out too long after exercise then any blood may have moved up the trachea and been swallowed and therefore not be visible at the time of examination. In one study (Birks et al. 2002), when horses were endoscoped on at least three separate occasions following racing, all horses had blood in the trachea on at least one occasion.

Epistaxis (blood coming from one or both nostrils) is much less common. In a survey of over 220,000 horse starts in UK Flat and National Hunt (jump) racing, 185 cases of epistaxis were identified giving a frequency of 0.83/1000 starts. Similar frequencies have been reported for epistaxis in Japan (1.5 per 1000 starts) and South Africa (1.65 per 1000 starts). However a study of racehorses in Korea reported a much higher frequency (8.4 per 1000 starts).

It is believed that nearly all horses experience EIPH when exposed to strenuous exercise, and it has the potential to decrease lung function over time. However, there are no documented cases of bleeding in wild horses when rounded up with helicopters from mountain tops in pens miles away.

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