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What is “Bled For the First Time?”

16 August 2011 No Comment

What is “Bled For the First Time?”
Laura Phelps-Bell has over 25 years experience in the equine industry as a trainer and instructor. Her background includes successfully competing in dressage, on the “A” Open circuit in hunter/jumpers, showing in many western events, management of several large training/boarding facilities and teaching equine management courses at the college level. More about Laura

Hi, I recently purchased an ‘Off the Track’ TB that I plan to retrain to eventing. I did a search for his race record on the internet and found his last race. In the stewards report they said my horse had ‘bled for the first time’.
I don’t know anything about racing so could you explain what this means and if there are any long term consequences?
Hi Emma, What your horse probably experienced while at the racetrack is called Exercise Induced Pulmonary Hemorrhage (EIPH). This is a condition that is much debated and has many different theories regarding its possible causes and treatment. Bleeding from the lungs, or pulmonary hemorrhage, is a condition that is found in most performance horses, even lower level performance horses (as many as 10% may experience bleeding). However, it is most often associated with Thoroughbred and Quarter Horse racehorses, Standardbred harness racers and those used in high performance barrel racing, cutting and roping competitions (there are some researchers that say that 100% of these horses experience “bleeding”, but the degree to which they bleed varies). It mostly occurs during strenuous sprint exercise and may be accentuated by pathologic changes in the lungs. There are also schools-of-thought that propose that from an evolutionary standpoint, horses were designed to graze and travel for miles and miles at a walking pace and only would sprint if trying to escape a predator. Their heart and lungs were not designed for extended periods of hard running, or for repeated sprints. What we as humans may be asking them to do goes completely against how evolution has designed them.

Horses may develop very high blood pressure within the pulmonary capillaries in the lungs. The high pressure causes the capillaries to break (pulmonary hemorrhage) and allows blood to flow into the animal’s airways. In the more severe cases, the blood flows up the trachea and out of the horse’s nostrils. While many high-powered performance horses may bleed in and from the lungs, only a small percentage bleed from the nostrils (about 3-5%). In order to view the interior of the airways and see if bleeding has occurred, an endoscopy needs to be performed.

Some veterinarians believe that there are three areas that influence the high pulmonary blood pressure: the pulmonary blood vessels, the heart and the spleen. These veterinarians are concerned that there is not enough time for the heart to contract, relax and fill during vigorous exercise such as racing. They are doing research to find out if the problem occurs because of something that isn’t happening properly within the heart, or whether it is a problem that really has its origin within the lungs. Some veterinarians are also not ruling out that a contributing factor for bleeding in performance horses may be because they are fed diets high in protein in the form of alfalfa hay. The excess protein (that fed above the horses requirement) is broken down into energy (calories) and a nitrogen by-product called urea, that is then expelled in the urine. By being kept confined to a box stall for several hours per day, possibly breathing in ammonia fumes from the urine in their bedding, these horses may develop irritation to their airways and lungs, causing the horse to bleed when vigorously exercised.

EIPH is rarely fatal, but the ailment can be very serious in some cases and also costly to treat. The current method of treatment is to give horses that have a bleeding episode a diuretic called furosemide (Lasix) before they race. This reduces the high blood pressure, but does not eliminate the problem completely. Another concern is that if Lasix is over-used, the horse may become dehydrated, develop electrolyte imbalances and also experience low potassium levels, which may require that the horse be supplemented.

Complete recovery from an episode of bleeding may take four to six weeks, so for many horses, their training comes to a standstill while they recover. In many states and countries, a horse cannot race for 10 days after a first bleeding episode. In some countries, if a horse bleeds a second time, they can never race again, so for this reason, many horses such as yours, will be trained for other careers.

There are a few things that you can do to help prevent a repeat episode of “bleeding” with your horse. First, if your horse is housed in a barn, make sure that there is plenty of ventilation. Exposure to fungus, mold spores and other potential allergens should be avoided, so only provide hay that is free from dust, mold and weeds. Make sure that your horses stall is kept mucked-out to avoid possible exposure and irritation from the ammonia in his urine in the bedding. If at all possible, your horse should live outside, or be turned out, for as many hours a day as possible. Second, try to feed your horse in a more natural grazing position with his head and neck lowered to eat. When fed from feeders that are above eye-level, horses inhale spores and dust from their hay which can irritant their airways and lungs. Third, design an efficient conditioning and training program geared toward your horse as an individual. Utilize various approaches and build his fitness in a step-by-step way so as to avoid over-doing it and perhaps having him bleed.

Bleeding may be tied up with the structural efficiency of the lungs, the physical fitness and conditioning of your horse and the amount of scarring from previous bleeding episodes. For these reasons, be sure and structure your horses living conditions and training/conditioning program toward the individual that he is and in this way, you will be helping to prevent future bleeding episodes.


Laura Phelps-Bell

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