Although veterinary medicine has come a long way in understanding the bleeding horse, there is still a great deal of work to be done in this area. Researchers estimate that 75% of animals that bleed show no outward signs. By this, we mean that only a small percentage of affected animals bleed through their nostrils during or after a performance event.
Typically, when winter comes, the bleeders come with it (though some animals will bleed any time of year). The outward bleeder poses no difficulty in diagnosis; the problem is self-evident. It is those animals that are bleeding internally only, that make diagnosis difficult. Again the silent bleeder can take on characteristics of a lameness. Usually, the animal will die out around the 3/4 or 7/8 pole in a race. Many horses will come back to the barn/paddock blowing excessively and may even cough but this is not always the case. Only by scoping these animals immediately following the performance event /race will the story be told.
Most animals bleed from their lungs and therefore the problem lies well down in the respiratory tract. It seems that the more the horse bleeds, the worse the problem gets. The condition will become increasingly more difficult to treat with each bleeding session. Laying the horse off for a period of time (a month) helps many animals as the rest allows broken vessels to repair themselves. Others will simply have to be controlled through the dictates of the individual state commissions. Lasix (furosemide), a drug permitted in most states, seems to work by lowering the blood pressure of the horse.
Estrogens and Vitamin K work by quickly coagulating the blood once the bleeding has started. The important thing to remember when dealing with a bleeding horse is firstly to treat the condition whether it be a race, a training mile, or any other type of performance event. The more an animal bleeds, the more he will continue to bleed. Secondly, do not administer substances which tend to increase the blood pressure of the animal. Heavy vitamin feeding, especially B-12, will only tend to exacerbate the situation. Thirdly, if the horse has lower respiratory disease, find the cause. For example, if the animal has allergies, it would most likely trigger bronchoconstriction of the lower lungs and cause bleeding. The treatment choices consist of corticosteroids (dexamethasone), bronchodilators(clenbuterol), and/or nebulizing with a mast cell stabilizer (cromolyn sodium) as a prophylaxis to exercise or allergy-induced bronchospasm.
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