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Exercise-induced pulmonary hemorrhage, or EIPH, is a condition in which small blood vessels in a horse’s lungs rupture during exercise. Blood may enter the pharynx, larynx, trachea, or bronchial tubes, and blood may be seen dripping from the nostrils of some horses during and after races. Large amounts of blood can block the free flow of air into and out of the horse’s lungs.

In a study led by researchers from the Gluck Equine Research Center’s Equine Soundness and Sports Medicine Program at the University of Kentucky, 822 Thoroughbred geldings were examined endoscopically to determine EIPH status. Records for the horses’ racing careers in Hong Kong between 2007 and 2012 were also reviewed.

At racetracks in Hong Kong, trainers can request endoscopic examinations at any time. Horses are given an EIPH score of 0 (no blood observed) to 4 (visible bleeding from the nostrils). Horses with a grade of 4 could also have blood covering the tracheal surface and possibly pooling at the thoracic inlet. Lasix (furosemide), a medication commonly used in the United States and other countries to prevent EIPH, cannot be administered to horses on the days they race in Hong Kong.

Of the 822 horses in the study, endoscopy was performed on 732 horses, with many of these having the procedure more than once. Researchers found some level of EIPH in 55% of the horses examined. Only 4% of the horses showed grade 4 EIPH.

A review of race records showed no statistically significant difference in the number of starts between horses with and without EIPH. Horses that showed some level of EIPH at any time had a median of 3 races in which EIPH was found. These horses had a median number of 18 lifetime race starts.

Horses with EIPH tended to run somewhat more often than EIPH-negative horses, but there was no difference in the length of racing careers of horses in the two groups. However, horses that showed grade 4 EIPH had somewhat shorter careers (average of 699 days) compared to horses that had lower levels of EIPH (average of 842 days).

Results of the study indicated that low-level EIPH did not significantly impact number of starts, ability to stay in race training, or length of a horse’s racing career among the horses in this study.

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