Panel Examines Possible Research Paths for EIPH Treatment

As part of its strategic initiative to protect the health and welfare of the racehorse, the American Association of Equine Practitioners (AAEP) has released a list of research topics identified by a panel as central to the goal of understanding exercise-induced pulmonary hemorrhage (EIPH).

The identified topics will help determine future research priorities in the investigation of alternative management strategies for EIPH.

The panel, assembled for an AAEP-hosted meeting in November 2015, included experts in the fields of equine EIPH, pulmonary and cardiac physiology, lung pathology, and human sports medicine. Their focus was a review of current scientific knowledge and the identification of future research priorities.

Examined topics included epidemiology, vascular physiology, pathology, venous remodeling, role of the heart, pathophysiology of blood flow, efficacy of furosemide and regenerative medicine in the lung.

“The racehorse is a superb athlete bred for maximal performance and the panel recognized the physiological challenges of eliminating all occurrences of EIPH,” said Kathy Anderson, DVM, the 2016 AAEP president. “It is clear, however, that our body of existing research has not yielded the information needed to develop more effective treatment options. The questions far outweigh the answers.”

The following research topics were considered by the panel as important to the goal of understanding EIPH:

  • Experimentally validate the contributions of pulmonary arterial and venous pressures and decreased alveolar pressures to EIPH and to subsequent lung lesions;
  • Characterize the venous remodeling and fibrosis found in chronic bleeders;
  • Define the long-term progression of lung lesions from the early days of training throughout the racing career;
  • Determine the acute and chronic effects of EIPH on horse health;
  • Determine the incidence of EIPH during training, including galloping;
  • Understand how furosemide decreases EIPH, including possible effects on the vasculature;
  • Define the benefit of nasal strips through further testing; and
  • Investigate phenotypic traits that represent genetic susceptibility to EIPH.

The panel currently is outlining specific research projects and the funding required to conduct the projects. The report about the November 2015 AAEP-hosted panel—including an overview of EIPH—is available online. Funding for the panel was provided by the AAEP Foundation.

“The AAEP is committed to finding solutions for EIPH and we will need the support and resources of industry stakeholders to achieve the research outcomes we’ve all been seeking,” added Anderson.

The panel was chaired by noted researcher and AAEP Past-President Nat White, DVM, MS, Dipl. ACVS. Panel participants included:

  • Warwick Bayly, BVSc, MS, PhD, Dipl. ACVIM, of Washington State University;
  • Jeff Blea, DVM, a private racetrack practitioner from Sierra Madre, California;
  • Kent Carter, DVM, MS, Dipl. ACVIM, of Texas A&M University;
  • Gordon Cohen, MD, PhD, MBA, of the University of California, San Francisco;
  • Paul Morley, DVM, PhD, Dipl. ACVIM, of Colorado State University;
  • David Poole, PhD, DSc, of Kansas State University;
  • Ed Robinson, BVetMed, MRCVS, PhD, of Michigan State University;
  • Corinne Sweeney, DVM, Dipl. ACVIM, of the University of Pennsylvania;
  • Dan Weiss, MD, PhD, of the University of Vermont; and
  • Kurt Williams, DVM, PhD, Dipl. ACVP, of Michigan State University.

The AAEP announced its “Prescription for Racing Reform” last July. In addition to investigating EIPH treatments which do not require race-day administration, the key points of the initiative include banning anabolic steroids in horses in training and restricting the administration of non-steroidal anti-inflammatory drugs to 48 hours before racing. 

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