Veterinary Clinical Medicine-I (General and Systemic)

EXERCISE INDUCED PULMONARY HEMORRHAGE

• Blood from lungs (caudodorsal lung field) as consequence of exercise.

• Horses with a history of repeated bouts of severe EIPH have extensive bronchiolitis in the dorsal regions of the caudal lobe with concurrent bronchial arterial neovascularization, interstitial fibrosis, and sequestration of macrophages containing hemosiderin (hemosiderophages). 
• Endoscopy (60-90 min after exercise), see blood in airways . If you suspect EIPH but can not do endoscopy, examine TB asp for hemosidin containing macrophages.
• Differential Diagnosis: Guttural pouch mycosis and ethmoidal hematoma.
• Therapy: ineffective. Symptomatic. Frusemide, conjugated estrogens, vitamin K, and vitamin C used for prevention but not very effective.