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Exercise Induced Pulmonary Hemorrhage
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= presence of blood in the airways following exertion, “bleeders”
Bleeding from the lungs, or exercise-induced pulmonary hemorrhage (EIPH), as it is more correctly known, is a very common condition in racehorses. Sometimes, its occurrence is associated with poor performance, while on other occasions it appears to have no effect. It is well known that horses winning or placing in races often bleed in these events. While a lot is known about the cause of bleeding, the circumstances under which it interferes with performance are poorly understood. Factors which may play a role in this regard probably include: (1) the amount of blood lost into the lung; (2) the time when bleeding begins in relation to the start or finish of a race or training run; (3) the site of the bleeding within the lung; and (4) the effects of repeated episodes of bleeding on lung function during exercise. Currently, little is known about the relationship between any of these factors and performance.
In view of the inadequacy of our present knowledge, the existence of EIPH is currently presumed to reduce exercise ability, and is treated accordingly. In some cases, such treatment may be unnecessary because the bleeding has had no effect on performance and is an incidental finding. Treatment may be inappropriate in other cases because the poor performance is due to the co-existence of other undetected lung diseases. In these instances, the lung disease can remain undiagnosed because its possible presence is not investigated due to the almost automatic presumption that EIPH is the cause of the problem. [...]
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