The effects of frusemide on racing times of Standardbred pacers

Total Carbon Dioxide (TCO2) Concentrations in Thoroughbred and Quarter Racehorses in Louisiana

The TCO₂ (total carbon dioxide) test is performed on the blood of racehorses as a means of combatting the practice of administering alkalizing agents. This study evaluated serum TCO₂ concentrations and factors influencing concentration of TCO₂ in Thoroughbred and Quarter Horses. The normality of data were evaluated with a Shapiro-Wilk test. Mann-Whitney tests and Kruskal-Wallis tests were used against different effects. When a fixed effect was detected, Dunn's post-hoc comparisons were performed. The median pre-race serum TCO₂ concentration (32.20 mmol/L (interquartile range (IQR): 30.80-33.50)) was higher than that of post-race samples (26.70 mmol/L (IQR: 24.55-29.25)) (P < .0001). The median TCO₂ concentrations in pre-race samples were different between Thoroughbred (32.40 mmol/L (IQR: 30.90-33.60)) and Quarter Horses (31.30 mmol/L (IQR: 30.00-32.50)) (P < .0001). The median pre-race TCO₂ concentrations were 32.75 (IQR: 31.40-33.90), 31.40 (IQR: 29.80-32.80), 32.50 (IQR: 31.20-33.88), and 31.60 (IQR 30.00-32.70) mmol/L in racehorses at Fair Grounds, Louisiana Downs, Delta Downs, and Evangeline Downs racetracks, respectively (P < .0001). The total serum TCO₂ concentrations in Thoroughbred and Quarter Horse racehorses were affected by seasonal temperature variation (P < .0001). A smaller sample size was available for post-race samples (n = 205) and Quarter Horse pre-race samples (n = 351). The results of this study indicated that the breed, seasonal temperature variation, pre-race or post-race sampling, and track location are strongly correlated to total TCO₂ concentrations. It was not clear whether the statistically significant differences in TCO₂ levels among racetracks in Louisiana were due to location of racetracks and/or seasonal temperature variation.

Total Carbon Dioxide in Adult Standardbred and Thoroughbred Horses

The TCO2 (total carbon dioxide) test is performed on the blood of racehorses as a means of combatting the practice of administering alkalizing agents for the purpose of enhancing performance. The purposes of this review are to present an overview of the factors contributing to TCO2 and to review the literature regarding TCO2 in adult Standardbred and Thoroughbred horses to demonstrate the range of variability of TCO2 in horses. Most of the research published on the topic of TCO2 or bicarbonate measurement in racehorses was accessed and reviewed. PubMed and Google Scholar were the primary search engines used to source the relevant literature. The main physicochemical factors that contribute to changes in TCO2 in horses at rest are changes in strong ions concentration, followed by changes in weak acid (i.e. plasma albumin) concentrations. There is a wide normal distribution of TCO2 in horses ranging from 23 mmol/L to 38 mmol/L. Independent of administration of alkalizing agents, blood TCO2 is affected mainly by feeding, time of day (diurnal variation), season and exercise. There are few studies that have reported hour-by-hour changes in TCO2. Racehorse population studies suffer from lack of validation regarding whether or not a horse was administered an alkalizing agent. It is concluded that the normal range of TCO2 in non-alkalized Standardbred and Thoroughbred horses is significantly wider than has been appreciated, that periods of elevated TCO2 appear to be normal for many horses at rest, and that a TCO2 test alone is not definitive for the purposes of determining of an alkalizing agent has been administered to a horse.

Foundations of performance – factors that contribute to excellence in equine exercise

Horses are renowned for their incredible capacity for a range of athletic activities, and participation in athletic events arguably represents the most critical strut of the equine industry. Successful performance is typically a primary focus during participation in competitive athletic events, and relies upon a variety of innate physiological and structural factors of the athlete. However, a wide range of external factors also influence performance, and many of these can be readily manipulated. Therefore, thorough assessment of the individual’s inherent capacity for a specific athletic discipline must be combined with optimisation of external factors including nutrition and training to promote excellent performance. Recent progress in methods of athlete selection and monitoring of training responses are assisting continued improvements in equine performance.

Exercise induced pulmonary hemorrhage in horses: American College of Veterinary Internal Medicine consensus statement

Background

Published studies of exercise‐induced pulmonary hemorrhage (EIPH), when assessed individually, often provide equivocal or conflicting results. Systematic reviews aggregate evidence from individual studies to provide a global assessment of the quality of evidence and to inform recommendations.

Objectives

Evaluate evidence to determine: if EIPH adversely affects the health, welfare or both of horses; if EIPH affects the athletic capacity of horses; the efficacy of prophylactic interventions for EIPH; and if furosemide affects the athletic capacity of horses.

Animals

None.

Materials and Methods

Systematic review. A panel of 7 experts was formed to assess evidence in the peer reviewed literature addressing each of the 4 objectives. Methodology followed that of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Publications were assessed for quality of evidence by working groups of the panel, and a summary of findings was presented in tables. Recommendations were based on quality of evidence and were determined by a vote of the panel.

Results

Much of the evidence was of low to very low quality. Experimental studies frequently lacked adequate statistical power. There was moderate to high quality evidence that EIPH is progressive, is associated with lung lesions, that it adversely affects racing performance, that severe EIPH (Grade 4) is associated with a shorter career duration, that furosemide is efficacious in decreasing the incidence and severity of EIPH, and that administration of furosemide is associated with superior race performance.

Conclusions and clinical significance

Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.

Intra- and inter-day variability in plasma tCO2 concentration in sedentary horses

Sodium bicarbonate and other alkalinising solutions (‘milkshakes’) have been given to horses surreptitiously before exercise to provide exogenous buffering effects. After an initial positive blood test, some accused horse trainers claim that their horses ‘naturally test high’, so some jurisdictions allow a secured quarantine in which the horse is tested multiple times. The objective of this experiment was to determine the intra- and inter-day variability of plasma total CO2 (tCO2) and other plasma strong ions in a group of sedentary horses housed similarly to a quarantine period. The hypothesis was that plasma tCO2 would not remain constant over a multi-day monitoring interval, but would vary measurably during that interval. Eight sedentary (unconditioned) horses were studied for 2 weeks. Horses were acclimated to a climate-controlled indoor environment and an alfalfa-only diet for a minimum of 10 days prior to sampling. Horses were sampled 3 times daily for 5 consecutive days at 7:00, 11:00 and 15:00 h. Blood samples were collected directly into 10 ml heparinised evacuated glass tubes by jugular venipuncture using a double-ended 0.91 mm needle. Samples were chilled until concentrations of plasma tCO2, Na+, K+, and Cl-, were determined within 1-3 h of sampling using an automated serum chemistry analyzer which was calibrated daily using commercial reagents obtained from the manufacturer as well as externally-obtained NIST-traceable calibrating solutions. Mean results documented mild variations in mean plasma tCO2 (range 28.9-31.6 mmol/l), but individual horses’ plasma tCO2 ranged over 4-7 units. Results showed that there was considerable intra- and inter-individual variability in plasma tCO2. Mean pooled tCO2 and measured strong ion difference (SIDm) differed by time-of-day, with both late morning and early afternoon values lower than early morning values (P<0.001). There was a strong positive linear relationship between plasma SIDm and tCO2 (r=0.75, P<0.001).

Exercise-induced pulmonary haemorrhage in horses – review

Exercise-induced pulmonary haemorrhage is a major cause of poor performance in the equine athlete. It is an important cause of exercise intolerance and results from strenuous exercise and pathophysiological changes in the equine lung and possibly in the airways. Endoscopic surveys of the respiratory tracts of horses after competitive events have shown that many horses experience exercise-induced pulmonary haemorrhage. The reported incidence of exercise-induced pulmonary haemorrhage in different breeds varies between 40–85%. The cause of bleeding in exercising horses has fostered considerable debate over the past three centuries, but currently, the most accepted hypothesis is that the source of haemorrhage is disruption of the pulmonary capillaries during exercise. Furosemide is the medication used most widely for the treatment and prevention of exercise-induced pulmonary haemorrhage. This review provides an update on the aetiology, clinical signs, physiopathology, diagnosis and treatment of exercise-induced pulmonary haemorrhage.

Laboratory findings in respiratory fluids of the poorly-performing horse

Any disorder impairing a performance horse's ability to ventilate its lungs and exchange oxygen compromises exercise performance in any discipline. Since bronchoalveolar lavage was described in horses in the early 1980s, laboratory evaluation of respiratory fluids, along with clinical and functional assessment of the respiratory system, has become a relevant step in the diagnosis of respiratory disease affecting performance. The aim of this review is to provide objective information to assist clinicians in interpreting laboratory findings by (1) summarising published cytological references values in both clinically healthy horses and those with various airway diseases, (2) assessing the influence of physiological circumstances, such as exercise, on the cytological evaluation, (3) discussing the relationship between cytological and microbiological analyses, clinical signs and respiratory function, and (4) suggesting how this latter relationship may affect performance.

Effect of omeprazole on markers of performance in gastric ulcer-free Standardbred horses

REASONS FOR PERFORMING STUDY

A large percentage of performance horses develop gastric ulcers and many of those horses are treated with omeprazole. Unfortunately, no data have been published on the effects of the drug on markers of performance in animals without ulcers.

HYPOTHESIS

Omeprazole would alter markers of aerobic and anaerobic performance.

METHODS

Ten unfit, healthy, ulcer free, Standardbred mares were administered either control (CON; oral apple sauce, 20 ml) or omeprazole (OP; oral paste, 4 mg/kg bwt s.i.d.) in a random crossover fashion with the investigators blind to the treatment. Treatments were administered for 7 days prior to performing an incremental exercise test (GXT) on a high-speed treadmill. Endoscopic examinations were performed just prior to the trial to verify that the mares were ulcer-free. During the GXT, the mares ran on a treadmill up a 6% grade to measure maximal oxygen consumption (VO2max), run time (RT), velocity at VO2max, maximal velocity (Vmax), packed cell volume (PCV), plasma lactate concentration (LA) and plasma protein concentration (TP). Measurements were recorded at rest, at the end of each 1 min step of the GXT and at 2 and 5 min post GXT. Data were analysed using ANOVA for repeated measures and t tests for paired comparisons.

RESULTS

There was no effect (P>0.05) of omeprazole on VO2max; velocity at VO2max; RT; Vmax; 2 min recovery plasma LA. Nor were there any changes (P>0.05) in the relationship between treadmill speed and VO2, PCV, TP, or plasma LA.

CONCLUSIONS

Omeprazole does not appear to improve physiological markers of performance in healthy, ulcer free horses.

POTENTIAL RELEVANCE

These data may benefit various authorities responsible for deciding administration and timing policies of omeprazole as well as clinicians and horse owners.

Evaluation of race distance, track surface and season of the year on exercise-induced pulmonary haemorrhage in flat racing Thoroughbreds in Brazil

REASONS FOR PERFORMING STUDY

To our knowledge no studies evaluating risk factors to EIPH have been undertaken with such a population of horses in Brazil, which is one of the few countries in the racing community to accept the use of frusemide (FUR) as a prerace medication for bleeders. We also compared national results with those already in the literature.

OBJECTIVES

To verify the influence of variables such as distance of the race, racetrack surface, going and season of the year in the recurrence and severity of EIPH and its effect on the finishing position of flat racing Thoroughbreds in Brazil.

METHODS

2118 post race respiratory endoscopies were recorded, in a total of 1003 individual horses. All horses in the study were certified bleeders (deemed positive by registered veterinarians following one or more endoscopies) and were administered FUR prior to each race. Data was analysed using both ordinary logistic regression and multiple logistic regression.

RESULTS

The results suggest that race distance, season of the year and racetrack surface affect the recurrence of EIPH. Also, despite the use of FUR, the majority (62%) of horses continued to display some degree of haemorrhage.

CONCLUSIONS

There was a tendency for horses that remained positive despite the use of FUR to finish unplaced in a race. Horses which had a significant reduction in bleeding and became HPIE negative after the use of FUR, tended to finish in top positions. It was not possible to determine a pattern of severity of EIPH in horses with more than one endoscopy. Further studies are required to improve our understanding of this syndrome and its correlations to performance in the racing Thoroughbred, together with the role of FUR and its possible enhancing performance effects and efficacy in consistently diminishing EIPH.

POTENTIAL RELEVANCE

This study enabled a better understanding of the use of FUR in Brazilian Thoroughbred racehorses and showed there was a tendency towards improvement in performance after administrion of FUR in bleeders. The fact that a large number of horses remained positive for EIPH despite the use of FUR should encourage the scientific community to search for better ways of reducing, or preventing, this syndrome.

Evidence-based respiratory medicine in horses

It is clear from a review of the current scientific literature that an evidence-based approach to medical treatment of equine respiratory disease can be applied, at least in the instance of common lower respiratory diseases. In particular, there is clear evidence for efficacious treatments for recurrent airway obstruction and exercise-induced pulmonary hemorrhage, and with the recognition of this evidence, these treatments should be the first to be considered by a practitioner when treating these conditions. The purpose of this article is not only to identify the existence of relevant high-quality studies for incorporation into an evidence-based veterinary medicine approach to patient care, but to highlight the features of those studies that should be considered when evaluating their value in individual situations.

Exercise-induced pulmonary hemorrhage

EIPH is a condition affecting virtually all horses during intense exercise worldwide. The hemorrhage originates from the pulmonary vasculature and is distributed predominantly bilaterally in the dorsocaudal lung lobes. As the condition progresses, the lung abnormalities extend cranially along the dorsal portions of the lung. An inflammatory response occurs in association with the hemorrhage and may contribute to the chronic sequela. Although conflicting opinions exist as to its affect on performance, it is a syndrome that is thought to increase in severity with age. The most commonly performed method to diagnose EIPH at the present time is endoscopy of the upper airway alone or in combination with tracheal wash analysis for the presence of erythrocytes and hemosiderophages. Because horses may not bleed to the same extent every time and the bleeding may originate from slightly different locations, these diagnostic procedures may not be extremely sensitive or quantitative. At this time, there is no treatment that is considered a panacea, and the currently allowed treatments have not proven to be effective in preventing EIPH. Future directions for therapeutic intervention may need to include limiting inflammatory responses to blood remaining within the lungs after EIPH.

Effects of an external nasal strip and frusemide on pulmonary haemorrhage in Thoroughbreds following high-intensity exercise

The purpose of this study was to examine the effects of an external nasal strip (NS), frusemide (FR) and a combination of the 2 treatments (NS + FR) on exercise-induced pulmonary haemorrhage (EIPH) in Thoroughbred horses. It was hypothesised that both the NS and FR would attenuate EIPH as assessed by red blood cell count in bronchoalveolar lavage fluid. In random order, 8 horses completed each of 4 sprint exercise tests on a treadmill: 1) NS; 2) FR (0.5 mg/kg bwt i.v., 4 h pre-exercise); 3) NS + FR; and 4) control (C; no treatment). After a 5 min warm-up (4.5 m/s), horses completed 2 min running at 120% maximum oxygen consumption (VO2max) with the treadmill set at 3 degrees incline. Mean +/- s.d. running speed was 14.2+/-0.2 m/s. In the FR and NS + FR trials, horses carried weight equal to that lost as a result of frusemide administration. During exercise at 120% Vo2max, oxygen consumption (Vo2) and carbon dioxide production (Vco2) were measured at 15 s intervals. Plasma lactate concentration was measured in samples collected before exercise, at the end of the sprint and after 5 min cool-down at the trot. Thirty minutes after the run, bronchoalveolar lavage (BAL) was performed and the red cell count in the fluid quantified. Vo2 and Vco2 were significantly lower in NS and NS + FR trials than in the C and FR trials at the end of the sprint exercise protocol. However, plasma lactate concentrations did not differ among treatments. Compared with the C trial (61.1+/-30.5 x 10(6) red blood cells/ml BAL fluid), pulmonary haemorrhage was significantly (P<0.05) decreased in both the NS (15.9+/-4.0 x 106 RBC/ml) and FR (12.2+/-5.8 x 10(6) RBC/ml) trials. EIPH in the NS + FR trial (7.9+/-1.0 x 10(6) RBC/ml) was further diminished (P<0.05) compared to the NS trial, but not different from the FR trial. We conclude that both the external nasal strip and frusemide attenuate pulmonary haemorrhage in Thoroughbred horses during high-speed sprint exercise. The external nasal strip appears to lower the metabolic cost of supramaximal exertion in horses. Given the purported ergogenic effects of frusemide, the external nasal strip is a valuable alternative for the attenuation of EIPH.