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Coping with EIPH or Exercise Induced Pulmonary Haemorrhage (Bleeders)

by Robert McDowell

There are those who say that all competition horses bleed from the lungs at times and I think that this is probably true.

Nowadays I find the odd trainer who is so paranoid about this possibility that they will 'scope' their charges (that is have their vet look into the lungs with a laparoscope) after almost every run.

These trainers seem to have their worst fears confirmed and their vets then have a good steady income continuing this practice. I am not so sure how good it is for the horse to have this piece of equipment poking around in their lung cavity on a regular basis.

However, if it is true that all horses can bleed, then potentially all racers and pacers can be disqualified from any further competition if they are picked up with blood in the nostrils by the Stewards more than twice, or whatever the ruling is in each country.

Bleeding, also called EIPH or Exercise Induced Pulmonary Haemorrhage is another one of these design problems where the designer is aiming for maximum efficiency, but in order to get this degree of efficiency has to go very close to the limits.

Horses lungs are very large and powerful and they are driven by the gait where a galloper particularly as he draws his hindquarters forward will pump the air out very forcefully and will draw it in just as efficiently when he stretches out.

Of course as he hits the ground each time the whole structure of the animal suffers a significant jarring. Added to this is the effect of turbulence, where a large mass of air being drawn in and then blown out so forcefully creates a terrific amount of turbulence within the lungs and can produce localised areas of very high wind speeds like having a hurricane inside there.

All of this is happening in an area of the body where the alveoli (the little blood filled sacs in the lungs) must have a very fragile lining over them in order to allow oxygen to be drawn in directly through the lining (or the skin) covering them.

What is amazing when you look at it like this is that the designer managed to make it work at all. Imagine being asked to design a bubble bath, which will stand up to hurricane force winds.

Pacers, since their gait is not a natural one for the speeds which they are asked perform at, suffer more since they don't have the benefit of the natural pumping action of the gallop so they have shorter sharper breaths and more jarring to the lungs in their action.

Bleeding then is all tied up with the gait, the structural efficiency of the lungs themselves, the fitness, the amount of scarring from previous bleeds and the strength of the lining of the alveoli.

Herbally it is a simple matter to fine-tune the strength of the linings, which we do with the herb Rue and with Buckwheat. It is also simple to improve the reabsorption and normalisation of scarred tissue within the lungs to reduce the problem of the patch being stronger than the garment in which the weakness along the boundary of the less elastic scarred tissue and the more elastic normal tissue is very often the site of the next bleed. This can be accomplished by using demulcent and healing herbs, especially Comfrey, which has both actions within the same herb. Another approach I use combines Elecampane and Marshmallow for example where Elecampane improves the strength and efficiency of the lungs as a whole while containing allantoin as a healer and Marshmallow provides the demulcent action in soothing and softening damaged or scarred tissue within the lungs.

In my mixtures for bleeders I also include Hawthorne, Nettle, Rescue Remedy, Yarrow and sometimes Kelp. Hawthorne is particularly important for those cases where there has been a substantial and sudden bleed mid flight, which virtually stops the animal in its tracks as the lungs have partially filled with blood and cannot supply oxygen to the body. This situation produces an enormous shock and strain to the heart. Hawthorne and Rescue Remedy mitigate the effects of this sort of shock. Nettle and Yarrow work at the level of blood quality ensuring more efficient and healthy read blood cells and the Yarrow as an astringent can help also in toning up the alveoli walls.

As a maintenance program for all racers and pacers then they should have access to Rue and Hawthorne either in their feed or their hedgerow and they should be fed some Buckwheat (which is the commercial source of Rutin) in their diet. I provide to many of my pacing clients especially a complex mix containing most of the above herbs which both protects their animals against bleeds and also improves the efficiency of their lungs allowing them to 'go faster'

I also believe there are great business opportunities out there for experienced handlers to rehabilitate Bleeders by combining such treatments with training and exercise programs including perhaps gait modification and swimming for example. Such a person who specialised in this sort of rehabilitation would very quickly become expert in this field and could make a wonderful contribution to the industry by restoring valuable stock, to the humanity the whole business and of course to their own livelihood.

The difficulty faced by the industry is really the problem of distinguishing between a simple bleed, which can show in the nostril after a race and has very little significance and a severe bleed which for all the correct and humane reasons should be cause for suspension. I have no answers to this dilemma apart from the preventative measures above but I am sure that multiple scoping does more harm than good.


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