Microsoft word - csteel-updatebleederseiph-june07-edited.doc
An update on “Bleeders” and that reported in Japan, Britain and South Africa, and less than that reported in Singapore, Hong Kong Defining a “bleeder”. and the USA.
definition of a “bleeder” in various
world. In Australia, bleeding is defined as the appearance of blood
indicate that some degree of EIPH at both nostrils, irrespective of the may occur in up to 75% of runners. quantity, after exercise, unless in the opinion of the Stewards such bleeding was caused by external trauma (AR53A (1) ). In some racing
bleeding from one nostril after exercise
How common is bleeding from the lungs in racehorses and how is it diagnosed? What risk factors have been identified for this condition?
The prevalence of epistaxis is higher in
nostrils (referred to as ‘epistaxis’) in
racing increases the risk), in hurdle or
Victoria, the prevalence of horses bleeding for the first-time as defined as the appearance of blood at both nostrils after exercise is Singapore the prevalence of bleeding approximately 1.5 per 1000 starters
(epistaxis) is higher on fiber-sand than
(or 0.15%). This is comparable to
turf. The effect of ‘going’ is variable
identified as a risk in one study but not
hemiplegia/‘roaring’) or airway disease
potentially at least, contribute further
Why do horses bleed from their lungs?
the smallest vessels (the capillaries) in
unlikely to be central to the problem is
capillary stress failure. The interface of
Consequences of EIPH
specialized cells lining the respiratory
macrophages) that ‘ingest’ blood over
cumulative, ultimately leading to significant decreases in performance. This is likely because
sample and are called following each episode), red cells are haemosiderophages. The presence and
Therefore, EIPH is a serious Blood in the air spaces is irritant and condition in racehorses and stimulates an inflammatory response prevention or reduction of its in the lung. In areas where persistent incidence is an important issue. The safety and welfare issues and review of the bleeding rule.
from repeated episodes of several centres in Australia and the haemorrhage and the development of
(‘bleeding’), a small percentage are
Does EIPH affect performance?
the majority of fatalities are as a result
most horses with blood at both nostrils finish worse than mid-field, and about half of these horses finish
and stumble before they ‘pull up’ or
are likely to be progressive and lung Rules regarding “bleeders” vary
There is to the author’s knowledge, no
world wide from no or limited action
apparent explanation as to the rationale
to banning horses from racing after the second episode. Although
individuals may differ slightly in their
opinions, overall, the parties concerned
bleeder rules. Also, they appear to vary
In South Africa the rule stipulates: 1st
for 2 months, or start in any race for 3
training tracks for 2 months or start in
a race for 6 months, and only then after
is permanently banned if it suffers a 3rd
The regulations for bleeders are stricter
horses on the ‘bleeder list’ (a list of
nostrils or in the trachea on enodscopic
If the horse is observed by officials to
episode-placed on ‘bleeder list’ and
satisfactory gallop of at least 1,000m in
If the incidence of a fatal episode of bleeding is so low, why ban bleeders from racing? Can bleeding be prevented or managed?
In 1998-1999 an extensive review of the bleeding rule was under-taken in
pathological reactions, it is well worth
rule was too harsh in light of ‘softer’
can assist in reducing the severity of haemorrhage and therefore reduce the
requires collection of a ‘lung wash’
Australian Equine Veterinary (BAL), which is probably best Association provided an extensive
scientific and statistical review of this
blood and to heal. A minimum time of 1 month is likely to be needed to recover from a single acute episode of EIPH. A longer period is required in many cases where chronic lesions are present. Despite months of rest and treatment, some horses do continue to bleed when faster exercise resumes. These horses should be and usually are retired.
the lung. Because of its diuretic effect,
effects on detection of other drugs and,
the fact that frusemide is not effective
authorities do not allow the use of this
Equine Nasal Strips have been shown
consideration of their use in training in
is not currently permitted on raceday in
‘treatments’ that claim to treat bleeding
alternative drugs will be developed that
This article was prepared by Dr Cate Steel, BVSc FACVSc.
Drug Companies & Doctors: A Story of Corruption Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial by Alison Bass Algonquin Books of Chapel Hill, 260 pp., $24.95 Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drugs by Melody Petersen Sara
Hypothalamic Hamartoma with Precocious Puberty in infant girl: Case Report By: Prof. Dr. Abdel-Wahab M. Ibrahim, MD, FRCS, LRCP, and Ibrahim Abdel-Aal MSc, Mansoura Neurosurgery Department, Manoura University, Egypt. Email: awibrahem@esns.org.eg Introduction: Sexual precocity can result from primary dysfunction of the neuroendocrine system within the brain. Various entities are im