Exercise-induced pulmonary hemorrhage in barrel racing horses in the Pacific Northwest region of the United States

BackgroundExercise-induced pulmonary hemorrhage (EIPH) refers to bleeding from the lungs in association with strenuous exercise. It has been documented in race horses but little information exists on EIPH in barrel racing horses. Hypothesis/ObjectivesOur goals were to evaluate the presence of EIPH in barrel racing horses and estimate its prevalence in the Pacific Northwest. Animals149 barrel racing horses enrolled at events in WA (11), ID (3), and MT (33). MethodsObservational cross-sectional study. Data collected included signalment, history of illness, respiratory disease, race division, and pre-race medications. Endoscopy was performed and tracheobronchoscopic (TBE) EIPH score was assigned based on quantity of blood in the trachea (0=no blood to 4=abundance of blood within the trachea). After TBE, bronchoalveolar lavage (BAL) was performed. Erythrocyte (red blood cell, RBC) counts were obtained from bronchoalveolar lavage fluid (BALF). Statistical analysis included linear and logistic regression, Fisher's exact t test, and calculation of correlation coefficient. Significance was set at P<.05. ResultsThe prevalence of EIPH based on TBE EIPH score was 54%. When based on BALF RBC count >1,000 cells, EIPH prevalence was 66%. Race time did not significantly affect the presence of EIPH. A significant (P<.0001) positive linear relationship between the TBE and BAL erythrocyte count was identified, but its strength was poor (r(2)=.15). Conclusions and Clinical ImportanceEIPH occurs in over 50% of barrel racing horses in the Pacific Northwest. Precise determination of the impact of EIPH on health of barrel racers requires further study.