Exercise Induced Pulmonary Hemorrhage in Horses: American College of Veterinary Internal Medicine Consensus Statement. (May 2015)

• Record Type: Journal Article
• Authors: Hinchcliff, K.W.; Couetil, L.L.; Knight, P.K.; Morley, P.S.; Robinson, N.E.; Sweeney, C.R.; van Erck, E.
• Is Part Of: Journal of veterinary internal medicine. Volume 29:Number 3(2015:May/Jun.)
• Page Start: 743
• Page End: 758
• Publication Date: 2015-05
• Subjects: Veterinary medicine -- Periodicals; 636.0896
• DOI: 10.1111/jvim.12593
• Languages: English
• ISSNs: 0891-6640

Abstract

<abstract abstract-type="main" id="jvim12593-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jvim12593-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="jvim12593-sec-0002" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="jvim12593-sec-0003" sec-type="section"> <title>Animals</title> <p>None.</p> </sec> <sec id="jvim12593-sec-0004" sec-type="section"> <title>Materials and Methods</title> <p> <italic>Systematic review</italic>. 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.</p> </sec> <sec id="jvim12593-sec-0005" sec-type="section"> <title>Results</title> <p>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.</p> </sec> <sec id="jvim12593-sec-0006" sec-type="section"> <title>Conclusions and clinical significance</title> <p>Strong recommendation that EIPH be considered a disease and a weak recommendation for use of furosemide in management of racehorses with EIPH.</p> </sec> </abstract>