Treatment of EIPH Discussed at Seminar

Treatment of exercise-induced pulmonary hemorrhage by non-medicinal means was discussed April 9 during a seminar that focused on use of FLAIR Nasal Strips.

There is no cure for EIPH, or bleeding in the lungs, but it can be lessened in horses that compete through use of furosemide–also known as Salix or Lasix–and nasal strips, according to research discussed by Dr. Jim Chiapetta, a FLAIR co-inventor, at Keeneland. The results of studies vary, he said, but some show nasal strips are equally as effective as furosemide.

"I do have a vested interest in strips, but today I'm here as a messenger," Chiapetta said. "(Research shows) FLAIR Nasal Strips reduce EIPH, as does Lasix. There are some other things out there, but we have little data on them so far."

Nasal strips, which were a novelty about a decade ago, are designed to open the nasal passages of horses, thus relieving some pressure on the lungs. As Chiapetta explained, nasal strips work from the outside, while furosemide works from the inside to relieve blood pressure.

Nasal strips are legal in most North American racing jurisdictions. One exception is New York, though Chiapetta said: "We are working with regulators, hoping to get that changed." 

Darrin Miller, who trains for Kentucky-based Silverton Hill, said he uses nasal strips in conjunction with furosemide because they have an added benefit.

"We're always looking for an edge or anything that can help the horse," Miller said. "What I've noticed is a quicker post-race recovery time in horses (that wear strips). For me, that's a selling point. It would be hard to come off Lasix right now."

Though efforts to ban race-day furosemide have stalled, the issue isn't dead. In the meantime organizations such as the Thoroughbred Owners and Breeders Association, which endorsed the April 9 seminar, are looking for alternative treatments.

Dr. Nathan Slovis, director of the McGee Medical Center at Hagyard Equine Medical Institute in Lexington, said something as simple as a hay rack can lead to small airway inflammation and subsequent breathing problems. He said environmental-related airway inflammation is an overlooked caused of EIPH.

"You need a clean environment for the horse," Slovis said.

In regard to quantifying levels of bleeding in the lungs, Chiapetta said the industry should adopt a standard time to perform endoscopies on horses post-race. Otherwise, it's difficult to assess the results, he said.

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