exercise induced pulmonary hemorrhage | Horse Racing Free Tips

View From The Eighth Pole: Lasix-Free Triple Crown A Step In Right Direction

With so much attention focused on the drug test that could lead to the disqualification of Kentucky Derby winner Medina Spirit, there's been barely a peep about how American racing managed to get through a Triple Crown season with all of its participants competing free of race-day furosemide, the anti-bleeding medication better known as Lasix.

It wasn't just the Kentucky Derby, Preakness and Belmont Stakes that were run Lasix-free. Official qualifying points races for the Derby also were run with a Lasix ban (or, in some cases, if owners and trainers chose to have the diuretic given to their horses, those horses would not qualify for points).

Grindstone was the last horse to win the Kentucky Derby without being administered Lasix four hours prior to the race. That was in 1996, when five of the 19 Derby starters raced Lasix-free. Since then, an increasing number of Derbies has been run with 100% of the starters competing on Lasix, the only recent exceptions being foreign-based runners.

The move toward Lasix-free racing of 2-year-olds in 2020 and stakes races in 2021 came about two years ago when a coalition of racetracks and industry organizations issued a statement saying they were committed to more closely aligning U.S. medication policies with international standards. Lasix is not permitted on race day in Europe, Asia, or Australia/New Zealand and is being phased out in some Latin American countries.

There was opposition to the change, led by the Kentucky Horsemen's Benevolent and Protective Association, which sued the Kentucky Horse Racing Commission, Churchill Downs and Keeneland. The horsemen's organization claimed its members would suffer “irreparable injury” if their horses were required to race without Lasix. A judge ruled against the HBPA.

Horses will experience exercise-induced pulmonary hemorrhage, whether they are treated on race-day with Lasix or not. A scientific study from South Africa published in 2009 showed that race-day administration of the drug reduced the incidence and severity of EIPH. But 57% of the horses in that study still experienced EIPH after being treated with Lasix (compared to 79% given a saline solution as a placebo).

There were warnings from some Lasix advocates that it would be inhumane to not treat a horse with the drug, that we would start seeing more horses bleeding from the nose when they come back to be unsaddled after a race.

For the most part, the protests against the change have been much ado about nothing. Horses have bled, just as before, the majority of incidents detected through a post-race endoscopic examination. Visible bleeding from the nose has not occurred with the frequency many predicted would happen. Trainers have adjusted and racing goes on. Some have said their horses bounce back more quickly after a race without Lasix because they haven't sustained the loss of fluids that result from administration of the diuretic.

This isn't a game changer. Prohibiting Lasix will not get rid of horse racing's drug problems. But it's a step in the right direction and a further sign that the liberal medication policies of the past involving anti-inflammatories, anabolic steroids, bronchodilators and other so-called therapeutic drugs were misguided and a disservice to the sport.

That's my view from the eighth pole.

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Training Time, Season, Gender May Play Role In EIPH For Steeplechasers

A study completed by the Royal Veterinary College has shown that the amount of training steeplechase horses undergo significantly increases the chance of them suffering from exercise-induced pulmonary hemorrhage (EIPH). EIPH is most frequently seen in Thoroughbred and Standardbred racehorses, and can cause significant performance issues.

The exact cause of the condition is unknown, though some believe it's a result of pulmonary capillary stress failure. This occurs when the blood-gas barrier in the alveoli is broken during intense exercise.

Drs. Tegan McGilvray and Jacqueline Cardwell used 177 racehorses in the British National Hunt to test for the prevalence of EIPH using a tracheobronchoscopy and a tracheal wash. In addition to blood, the researchers tested for the presence of hemosiderophages, which are cells that indicate previous lung bleeding.

Tracheal blood was found in 26 percent of the horses, hemosiderophages in 94 percent of the horses) and “significant” hemosiderophages in 78 percent of the horses.

The team drew these conclusions:

Each year in training increased the chances of tracheal blood and the presence of hemosiderophages by 1.5 percent.
Male horses had 85 percent less of a chance of bleeding than female horses
Tracheal blood was twice as likely to be see in winter and spring than in the fall
Horses with significant hemosiderophages were five times more likely to tracheal blood
Horses completing high-impact work were 60 times more likely to have tracheal blood

The researchers' findings support the capillary stress failure theory. Increased time in training causes “cumulative remodeling of the pulmonary vasculature, increasing susceptibility to EIPH through capillary stress failure with ongoing training.”

They note that EIPH may not be avoidable, but identifying horses at risk of the condition will be helpful in determining preventative measures in the future.

Read the article here.

Orseno: ‘Wrong And Naïve To Think No Damage Is Being Done To Horses Just Because They Didn’t Bleed Through The Nostrils’

The following statement was released by trainer Joe Orseno on Thursday, following reports from the Kentucky State Veterinarian's office earlier this week:

Published reports and social media have had some incorrect information about what did and didn't happen to my horse Imprimis, who finished second by a nose to Bound for Nowhere in Keeneland's Grade 2 Shakertown Stakes Saturday while racing without the anti-bleeder medication Lasix. I want to set the record straight:

Thank God the considerable blood coming from Imprimis' left nostril after the race was not pulmonary hemorrhaging. It also was not from what has been erroneously reported as being a cut on his nose sustained when he broke through the gate prior to the start. Imprimis does have a sizable bump on his nose – about six inches from his nostril – from where his head apparently hit the gate, but he did not sustain any cuts. The endoscopic examination that I had my private veterinarian conduct did reveal trace levels of Exercise Induced Pulmonary Hemorrhaging. I'm just so thankful that it wasn't more severe.

The bleeding episode apparently was like being punched in the nose, when you can develop a nose bleed without being cut. So Imprimis must have banged his head pretty hard and it went unnoticed.

I also don't retract what I told journalists after the race. I'll say it again right now: It's not good for the industry what they're doing forcing horses, particularly older horses, to run without Lasix in stakes races. And apparently that's not just one trainer's opinion. I didn't know so many people had my phone number, all the horsemen who called or emailed me and said, “thank you for speaking up” — trainers I don't even know. Someone in California called me out of the clear blue and said “thank you, someone had the guts to say something.” I don't look at it that way. At the time, it wasn't about guts, it was about being very upset over my horse. I've been doing this 44 years and it's not just my livelihood, it's my life.

The state vets at Keeneland did a very thorough examination on my horse in the morning. I'm sure they looked at him after he broke through the gate, saw no cuts, saw no head abrasions, no blood in his nose then. They put him back in the gate and let him run. If they had seen anything, I'm sure they would have scratched him.

The first thing I do after a race is look at their legs, and make sure everything is OK. When I subsequently saw his nose and blood just pouring off his left nostril, you have to assume the horse bled.

When the press asked me about the race, the first thing I said was, “Well, I think my horse ran a great race, got beat by a very good horse.” I said, “He beat me, I beat him (in 2019 Shakertown), only noses separated them.”

Then I started on the bleeding, because I thought my horse bled horribly. That's when I made my statement that someone has to explain to me why we're making horses bleed, older horses that have run on Lasix their whole life, and now all of a sudden you're going to penalize the best horses in the country. It's not good for the game, when we can stop it with an easy fix.

My veterinarian's endoscopic exam of Imprimis showed that most of the blood was from banging his head. He did have traces, a trickle down his throat, showing that he did bleed a little in the trachea. We were very lucky. Now he might still be on track for his next race. I was very pleased for the owners that I didn't have to put him away for four or five months. He's bright-eyed today and looks great. He just has a bump on his nose.

There are many horses that bleed significantly but not always externally. It is wrong and naive to think no damage is being done to horses just because they didn't bleed through the nostrils. It is also deceptive for those who are trying to label an EIPH episode only by visible blood from the nostrils. How are you going to tell an owner this horse is going to only run four times this year instead of eight or nine because I need more time in between to heal them up because he bleeds and we can't use Lasix? They are going to start to get disgusted, and horses will be hurt if they return at all. Owners are not going to be as excited about buying horses and racing if they can't run them more than four times a year.

I am on the board of the Florida HBPA. We are scoping stakes horses – which must run without Lasix at Gulfstream Park – and we're paying for it so we hopefully can all learn something and together make informed and intelligent policy decisions from transparent data going forward. I'd say overall that the overwhelming majority of these horses are bleeding to some degree. The numbers aren't good. Do we really want to do this to our horses? I sure don't.

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Vella: Don’t Let Public Perception Guide Lasix Policy

I would like the people who are against the use of Lasix to understand what is really going on in the horse racing industry in North America and throughout the world.

Let's start with the fact that horses in high performance sports suffer from EIPH – exercise-induced pulmonary hemorrhage. That includes all performance sports, in all parts of the world – make no mistake about it.

The question is how do you deal with the problem and what is best for the horses and what is best for the sport in question?

Before I go any further, I want to make a statement that I can't get past. It helps me personally clarify the situation: Lasix is a veterinarian-prescribed medication to treat EIPH in horses. It works well and has minimal side effects.

There is no proof that Lasix makes a horse run faster. Horses on Lasix perform more consistently than those not on Lasix. That is true because they are not bleeding internally.

Think of it this way: People suffer from high blood pressure and live longer when they take their doctor-prescribed medication. It is the same for horses who require medication to remain healthy and stop bleeding.

I'm going to do a little rant here.

As a Thoroughbred trainer in North America I'm getting tired of hearing people tell me that they race in other parts of the world without Lasix, why can't you? Well, here is the question you should be asking: If horses everywhere bleed, how is the rest of the world treating these horses? Are they giving them medication the day before? Are they depriving them of food and water for days in advance?

I personally do not know, as I do not race there, but, believe me, they are doing something to solve the problem and it is not prescribed by a veterinarian. So why are people looking down on trainers who are doing what the doctor has prescribed.

The real truth here is that people want to stop the use of Lasix because it would look good for the industry, but not because it is the best thing for the horse. Just ask our veterinarians!

Let me clarify a few things.

I am against the use of other medications on race horses and I believe that everyone in the industry has to be held more responsible for the health and welfare of these animals that we love and respect. Working in this industry is not a job; it is a way of life. Animal care is seven days a week, 52 weeks a year.

I am against stopping the use of a prescribed medication that solves a serious health problem in horses, just because it looks better for public perception.

Daniel Vella is a two-time Sovereign Award-winning trainer based in Ontario, Canada.

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