Exercise-induced pulmonary haemorrhage in Thoroughbred racehorses: a longitudinal study

E. J. Crispe, C. J. Secombe, D. I. Perera, A. A. Manderson, B. A. Turlach, G. D. Lester

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Exercise-induced pulmonary haemorrhage (EIPH) is considered a progressive disease based on histopathology, but it is unknown if tracheobronchoscopic EIPH severity worsens over time. Objectives Study design The aim of this study was to examine tracheobronchoscopic EIPH changes over time in a population of Thoroughbred racehorses. A secondary aim was to identify factors that affect changes in tracheobronchoscopic EIPH severity between observations. Prospective, longitudinal, observational cross-sectional study. Methods Results Thoroughbred racehorses were examined with tracheobronchoscopy no earlier than 30 min after racing. Examinations were recorded and graded blindly by experienced veterinarians using a 0-4 scale. Horses with 2 or more observations were included in the analysis. The association between the previous and current EIPH score was investigated using a linear mixed effect model. Factors associated with transitioning from a lower to a high EIPH grade and vice versa were examined using multiple ordinal regression. A semi-parametric regression model was used to examine progression using the number of career starts as a marker for time. Models were adjusted for potential confounding variables. There were 2974 tracheobronchoscopic examinations performed on 747 horses. Blood was detected in over half of all examinations (55.6%). The population prevalence of EIPH increased as the number of examinations for each horse increased. The preceding EIPH score was significantly associated with the current EIPH score. Significant variables associated with moving between EIPH grades were the number of days since last racing, ambient temperature and weight carried. Tracheobronchoscopic EIPH is mildly progressive over the first thirty career starts. Main limitations Conclusion Enrolment was voluntary. Horses were not followed for their entire career. Limiting the number of days in the current racing preparation and spacing races for horses with moderate to severe EIPH may be beneficial for reducing tracheobronchoscopic EIPH severity. The association between ambient temperature and EIPH warrants further investigation.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalEquine Veterinary Journal
Volume51
Issue number1
Early online date20 Apr 2018
DOIs
Publication statusPublished - Jan 2019

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racehorses
longitudinal studies
hemorrhage
Longitudinal Studies
exercise
lungs
Exercise
Hemorrhage
Lung
Horses
horses
ambient temperature
Temperature
Confounding Factors (Epidemiology)
Veterinarians
cross-sectional studies
histopathology
Population
veterinarians

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Crispe, E. J. ; Secombe, C. J. ; Perera, D. I. ; Manderson, A. A. ; Turlach, B. A. ; Lester, G. D. / Exercise-induced pulmonary haemorrhage in Thoroughbred racehorses : a longitudinal study. In: Equine Veterinary Journal. 2019 ; Vol. 51, No. 1. pp. 45-51.
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abstract = "Background Exercise-induced pulmonary haemorrhage (EIPH) is considered a progressive disease based on histopathology, but it is unknown if tracheobronchoscopic EIPH severity worsens over time. Objectives Study design The aim of this study was to examine tracheobronchoscopic EIPH changes over time in a population of Thoroughbred racehorses. A secondary aim was to identify factors that affect changes in tracheobronchoscopic EIPH severity between observations. Prospective, longitudinal, observational cross-sectional study. Methods Results Thoroughbred racehorses were examined with tracheobronchoscopy no earlier than 30 min after racing. Examinations were recorded and graded blindly by experienced veterinarians using a 0-4 scale. Horses with 2 or more observations were included in the analysis. The association between the previous and current EIPH score was investigated using a linear mixed effect model. Factors associated with transitioning from a lower to a high EIPH grade and vice versa were examined using multiple ordinal regression. A semi-parametric regression model was used to examine progression using the number of career starts as a marker for time. Models were adjusted for potential confounding variables. There were 2974 tracheobronchoscopic examinations performed on 747 horses. Blood was detected in over half of all examinations (55.6{\%}). The population prevalence of EIPH increased as the number of examinations for each horse increased. The preceding EIPH score was significantly associated with the current EIPH score. Significant variables associated with moving between EIPH grades were the number of days since last racing, ambient temperature and weight carried. Tracheobronchoscopic EIPH is mildly progressive over the first thirty career starts. Main limitations Conclusion Enrolment was voluntary. Horses were not followed for their entire career. Limiting the number of days in the current racing preparation and spacing races for horses with moderate to severe EIPH may be beneficial for reducing tracheobronchoscopic EIPH severity. The association between ambient temperature and EIPH warrants further investigation.",
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Exercise-induced pulmonary haemorrhage in Thoroughbred racehorses : a longitudinal study. / Crispe, E. J.; Secombe, C. J.; Perera, D. I.; Manderson, A. A.; Turlach, B. A.; Lester, G. D.

In: Equine Veterinary Journal, Vol. 51, No. 1, 01.2019, p. 45-51.

Research output: Contribution to journalArticle

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T1 - Exercise-induced pulmonary haemorrhage in Thoroughbred racehorses

T2 - a longitudinal study

AU - Crispe, E. J.

AU - Secombe, C. J.

AU - Perera, D. I.

AU - Manderson, A. A.

AU - Turlach, B. A.

AU - Lester, G. D.

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/1

Y1 - 2019/1

N2 - Background Exercise-induced pulmonary haemorrhage (EIPH) is considered a progressive disease based on histopathology, but it is unknown if tracheobronchoscopic EIPH severity worsens over time. Objectives Study design The aim of this study was to examine tracheobronchoscopic EIPH changes over time in a population of Thoroughbred racehorses. A secondary aim was to identify factors that affect changes in tracheobronchoscopic EIPH severity between observations. Prospective, longitudinal, observational cross-sectional study. Methods Results Thoroughbred racehorses were examined with tracheobronchoscopy no earlier than 30 min after racing. Examinations were recorded and graded blindly by experienced veterinarians using a 0-4 scale. Horses with 2 or more observations were included in the analysis. The association between the previous and current EIPH score was investigated using a linear mixed effect model. Factors associated with transitioning from a lower to a high EIPH grade and vice versa were examined using multiple ordinal regression. A semi-parametric regression model was used to examine progression using the number of career starts as a marker for time. Models were adjusted for potential confounding variables. There were 2974 tracheobronchoscopic examinations performed on 747 horses. Blood was detected in over half of all examinations (55.6%). The population prevalence of EIPH increased as the number of examinations for each horse increased. The preceding EIPH score was significantly associated with the current EIPH score. Significant variables associated with moving between EIPH grades were the number of days since last racing, ambient temperature and weight carried. Tracheobronchoscopic EIPH is mildly progressive over the first thirty career starts. Main limitations Conclusion Enrolment was voluntary. Horses were not followed for their entire career. Limiting the number of days in the current racing preparation and spacing races for horses with moderate to severe EIPH may be beneficial for reducing tracheobronchoscopic EIPH severity. The association between ambient temperature and EIPH warrants further investigation.

AB - Background Exercise-induced pulmonary haemorrhage (EIPH) is considered a progressive disease based on histopathology, but it is unknown if tracheobronchoscopic EIPH severity worsens over time. Objectives Study design The aim of this study was to examine tracheobronchoscopic EIPH changes over time in a population of Thoroughbred racehorses. A secondary aim was to identify factors that affect changes in tracheobronchoscopic EIPH severity between observations. Prospective, longitudinal, observational cross-sectional study. Methods Results Thoroughbred racehorses were examined with tracheobronchoscopy no earlier than 30 min after racing. Examinations were recorded and graded blindly by experienced veterinarians using a 0-4 scale. Horses with 2 or more observations were included in the analysis. The association between the previous and current EIPH score was investigated using a linear mixed effect model. Factors associated with transitioning from a lower to a high EIPH grade and vice versa were examined using multiple ordinal regression. A semi-parametric regression model was used to examine progression using the number of career starts as a marker for time. Models were adjusted for potential confounding variables. There were 2974 tracheobronchoscopic examinations performed on 747 horses. Blood was detected in over half of all examinations (55.6%). The population prevalence of EIPH increased as the number of examinations for each horse increased. The preceding EIPH score was significantly associated with the current EIPH score. Significant variables associated with moving between EIPH grades were the number of days since last racing, ambient temperature and weight carried. Tracheobronchoscopic EIPH is mildly progressive over the first thirty career starts. Main limitations Conclusion Enrolment was voluntary. Horses were not followed for their entire career. Limiting the number of days in the current racing preparation and spacing races for horses with moderate to severe EIPH may be beneficial for reducing tracheobronchoscopic EIPH severity. The association between ambient temperature and EIPH warrants further investigation.

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KW - Thoroughbred

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KW - progression

KW - longitudinal

KW - INFLAMMATORY AIRWAY DISEASE

KW - RISK-FACTORS

KW - HORSES

KW - ASSOCIATION

KW - POSTMORTEM

KW - PERFORMANCE

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