Bleeders the cause and what to do?

Thought this subject desrved it`s own thread and not buried away in yesterdays racing thread..

very interesting..


magiclips
Re: Saturday racing new

I believe Antonia Fraser suffered a very bad nosebleed. This has become something of a curse in our racing - bring on Lasix, or is that just a quick fix and not the answer?

Mavourneen

Registered: 5 weeks ago
Posts: 35
Magic, imho it's a short-term pseudo-solution that leads to a slow but unstoppable downhill slide "in the old end". Nice for now, but trouble's coming down the line later, when bleeders have been bred to bleeders, over and over again. Guess what you get? ... no prizes for tipping this one correctly.

The Americans have set up a huge genetic experiment (inadvertently of course) and I can't help notice how few of their horses now raid overseas, and how seldom they are successful. Part of it may be to do with the different surfaces, but part is perhaps that they don't do quite so well off their medication? I haven't any figures to back this theory so I stand under correction.

Got to wonder too about importing stallions from the USA. Perhaps its a blessing in disguise that we can't often afford it, nor really "well-bred" yearlings to race and hopefully, turn into stallions later. Maybe Barry Irwin has a comment to make here ... he's complimented SA horses on their toughness before, so the effect of raceday medication on long-term breeding is obviously a subject he's given plenty of thought to.

Seems to me Lasix muddies the waters w.r.t. breeding. One doesn't know which horses have genetic ability ... which can pass on to their offspring ... and which ones won big races because they were on something or other ... which definitely won't.

Pity there is no accessible register of bleeding incidents on the racetrack. There ought to be something that breeders can refer to when choosing a stallion, and buyers when buying a yearling.

My sympathies are with the breeders and owners who need to balance their books, but my logic is with "No Lasix".

Craig Eudey

Registered: 2 months ago
Posts: 58
In my opinion and I have spoken to Peter Gibson about it, the major reason for the increase in bleeders is the Horse sickness vaccination.
In the past before we had to vaccinate so that horses can be exported we had 2-3% bleed. This was the same % in our yard in England.
Since we started vaccinating for HS some yards are saying that up to 60% are bleeding. Magic I think you know of the 1 trainer that scoped his horses after fast work and found that that many bled to different degrees. It is a live vaccine that you injecting into the horse not like the flu vac.It is not completely effective as horses still get HS after being vaccinated anyway. Does increase chances of survival though.
In the 20 or so years before we vaccinated for HS here at Summerveld I dont remember more than 2 horses contracting it here.I hate the vaccination in the current form but Peter says they are making progress on a dead vaccine. Lasix is a quick fix but we need to use it to help in the short term.

magiclips

Registered: 4 years ago
Posts: 3,949
Interesting (and opposing) point of views. You don't have to tell me that AHS vaccines are not foolproof, I know this only too well from personal experience, and the link between AHS vaccines and the huge upsurge in bleeders has been suggested before. The problem appears to me that if you start using Lasix as a "quick fix" you end up going down a slippery slope and end up exactly where Mauvorneen says - with a horse population made up almost exclusively of the progeny of bleeders. On the other hand, if we already have 60% of horses bleeding then how much worse can it get if we do allow the use of Lasix in the stallions and broodmares of the future?

There is no right or wrong answer, I guess. For now it remains a curse for everybody involved - not least the horses themselves.

Craig, I'd be interested if you (or Peter Gibson) know what the mechanism is by which AHS vaccination could increase bleeding. Does it make the veins more fragile or what? You see, one needs to know what the mechanism is before you accept a theory ... as far as I'm aware this is just a theory at the moment? If not, I'd be seriously interested to read any published evidence.

It's a fact that there's a wide difference between co-incidence and correlation ... not always understood by people ... two things may coincide but not be caused by each other. Eg, did you know that wearing skirts causes breast cancer? ... 'S true! I can prove it and even give you the stats ...

Of course not! They just happen to both be the result of being female. A lot of things "go together" like skirts and breasts, or happen at the same time, but have no effect on each other at all. To be sure that one thing is caused by another thing, you need to eliminate what are called "other variables", in this case being a woman.

Bleeding may not actually be caused by AHS vaccination, it may just be co-incidence that both have occurred in the same population of horses at around the same time. Are there any other possible variables, ie things that have changed, increased or decreased, during that period? Diet? Training regime? Stallions? Amount of racing? Quality of the opposition?

Like I say, I'm under correction if someone has actually pinpointed a physical reason for the change. But lacking that, just correlation in time won't prove anything.

I'm not being sarky or superior, please understand. But research is my game, and I know something about how many pitfalls there are between the cup and the lip, between "it may be" and "it is proven". I'd hate to see action taken only on the basis of "it may be", and a good breed spoilt as a result.

This is a very interesting and controversial subject. My take on it for what its worth is that many very good horses never make it because they have a small problem with the strength of their capiliaries in the lungs..so f...g what..if you wanna grow the sport of horseracing let them train and race on furosemide..by the way there is a new better furosemide opposition in phase 4 clinical trials already !

As long as its use is strictly controlled by the NHRA..it will save owners millions and improve the sport.

I dont buy the fact that what they call "bleeding" a wrong and revolting term, is only genetic..show me one reasonable published clinical trial to show that..helping these horses will in NO WAY mess up the breeding profile...why should it??

As for a vaccine for AHS I have written many posts on this subject..the human world of vaccine developement has and is improving dramatically by the day and I predict that if a good research unit with some clever researchers employed a succesful vaccine could be discovered..this is definitely possible..and what would that do for the breeders and racing in SA??

I SAY STOP THE DIVIDENDS AND SET UP THIS RESEARCH FACILITY!!

We have had numerous posts on this subject, what was the outcome of the tests by Prof Alan Guthrie?

www.africanbettingclan.com/forum/phorum-...=ALL,match_threads=0

www.africanbettingclan.com/forum/phorum-...=ALL,match_threads=0

In my reply to Craig Eudey I tried to put the research case for the difference between Co-incidence and Causation, referring to the possibility that AHS vaccination caused an increase in the chances of bleeding after a race. Oscar brings another research topic to the fore: Nature vs Nurture. If it's not due to vaccination, what IS the cause?

What is it that causes heart attacks in humans? Is it Nature - genetic (Please tell me Mr Jones, do you have a history of heart attacks in your family ... your father ... brothers ... uncles ... anyone else in your family suffer from an attack?) or it it Nurture - lifestyle (HOW many drinks did you say you have per week? When you eat meat do you cut the fat off? How many kms would you say you walk per day)?

W.r.t. bleeding, it may be genetic or due to physical factor(s) like diet (adult or when still a weanling prepping for the sales), training regime, whatever. Or it could be both. From a research perspective this is a galloping nightmare. How the blikskottel would you actually set up an experiment to check out all the possible factors, without getting an impossible tangle of "maybes" and "perhapses" at the end of the day? It can be done, but it's not cheap.

As for setting up an experiment in real life, Oscar, not only would it not be cheap, it would be horribly expensive. Horses are not cheap to keep (I know I preach to the converted here!) and racehorses are not cheap to buy. You'd need several hundred animals, minimum, to get a statistically reliable result (called sample size), and they'd have to be kept under the same conditions as other racing animals, bar ONE chosen factor only. So wannabe solvers of the puzzle turn to already-existing populations of racehorses, with and without furosemide allowed, as they did a few years back here in SA. Even then the results can be inconclusive. We never did hear what Prof Guthrie found out ... but if someone can send me a link to his paper (and if I can get it online, a different matter) I'll read it and see if I can summarise it for you guys.

Lasix is double trouble ... not only does it allow success to horses that tend to bleed from the lungs after strong exertion, it also causes rapid temporary body weight loss and therefore may change the result of races. Everyone knows it causes increased urination ... I should know, I've taken it to help my blood pressure. The results were dramatic ... to put it mildly ... let's say it increased my understanding of how much weight a horse may loose, and how rapidly too. (And the fact that this was "net tydelik", sadly! But that's another story as Grandma said).

Unfortunately w.r.t racing this is NOT a side-effect. Frequent heavy peeing ... leads to loss of body fluid ... leads to a drop in blood pressure ... leads to less chance of bleeding during heavy exertion. Stopping/controlling urination would therefore also stop the effect of Lasix on bleeding, so there would be no point in giving it.

I have to disagree that using Lasix will not mess up SA's horse-breeding industry. Unless the controlling body insists, and persists in insisting, and penalises, and refuses to EVER back down because they are unpopular - that ALL cases of using Lasix be reported and recorded, with reasons for its use, where any interested party can see them, in a matter of a few months all SA horses will be declared to be bleeders and put on Lasix before racing. As happened in the USA. We will never keep the breeding industry clean of breeding from talented but flawed individuals if we allow this. The German Shepherd dog breeders had to go through it with hip displasia, and many breeders, large and small, cried salty tears because their gorgeous boy/girl had to be neutered, but the result is a better healthier breed today.

Are you sure that today's SA racing authorities can drive this particular bus on such a rough road? There's a lot to be lost, imho, if they back down and take the broad highway of popularity. No gain without pain ... but try telling that to a politician!

Here's a different spin on the problem. Not 100% practical (like loosening girths) but thought-provoking ...

Part of an article from review.barnmice.com/2581/the-dope-on-lasix/

Dr. W. Robert Cook, Professor of Surgery Emeritus at Tufts University and author of “Speed in the Racehorse: The Airflow Factors” feels racehorses can be better served by prevention than by treatment.

“We should be talking about prevention. You don’t need any treatment for bleeders – just rest,” he said.

Cook believes EIPH and the build-up of pressure in the lungs is caused most often by upper airway obstruction – not overexertion. This obstruction is so common in today’s training methods that we don’t even consider them a factor when it comes to performance.

Cook cites the following as causes of inspiratory obstruction and resistance:

1. The presence of a rider. A rider’s weight on the thorax limits the natural elevation of the forehand during the hind leg weight-bearing phase of the gallop. Because of this, the horse has to breathe in against abnormal resistance from the weight on its diaphragm.

2. A tight girth. This renders the chest more rigid and less easily expanded to admit air. The horse has to work harder to breathe in.

3. Poll flexion. Anything short of full extension of the poll constitutes an obstruction of the airway at the throat.

4. Use of a bit. This causes tongue movement, followed by dorsal displacement of the soft palate and obstruction of the throat.

5. Use of a tongue-tie. This effort to reduce tongue movement simply adds to the horse’s discomfort and neurological confusion. Tongue-ties stimulate digestive reflexes, which are diametrically opposed to the ‘flight’ reflexes necessary in racing.

6. Defects of conformation. Narrow air passages at any point in the upper airway may obstruct breathing. Deformities of the windpipe, for example, are extremely common in the Thoroughbred, according to Cook.

7. Diseases of the upper airway. All such diseases obstruct inspiration. An example is ‘roaring’ or recurrent laryngeal neuropathy, a common inherited disease of Thoroughbreds and draft horses.

“It follows from this evidence,” Cook said, “that it is not so much ‘exercise’ as ‘inspiratory difficulty’ that triggers bleeding.”

Joseph C. O’Dea, DVM, former president of the AAEP and author of “The Racing Imperative” recently wrote a guest commentary for the Thoroughbred Times. In his piece, O’Dea confirmed some of Cook’s theories.

“Most observant racetrack practitioners recognize that bleeding is most frequently caused by anatomical obstruction and/or more often inflammation with resistant swelling in the upper air passages and the reduction in the size of the air passage space,” wrote O’Dea. “Sometimes the degree of swelling is very minimal.”

O’Dea also lambasted the prevalent use of Lasix in treating EIPH: “It is my perception that Lasix diminishes performance in as many or more horses than it enhances and in the long run reduces consistency and the percentage of winning favorites. Lasix does not level the playing field. Lasix tilts the playing field but you never know in which direction.”

Bleeding in racehorses is not a disease, it is a symptom, according to Cook. And using furosemide to treat EIPH will not have a positive effect on bleeding until the cause of the bleeding is determined and remedied.

Horsemen who use Lasix as a means of keeping horses on the racetrack are buying the pound of cure instead of the ounce of prevention. That is unfortunate, but masking a symptom is easier than determining the cause of the problem.

Just chatted to my Vet and he says that the vaccination could be the problem but it is very hard to prove conclusively that it is the cause.He did say that most trainers seem to think as I do that there has been a huge increase in bleeders since we started vaccinating with this vaccine.Other factors come into it like,have we imported more stallions that have raced on Lasix that show they more than likely bled overseas? Were the sand tracks very heavy and dead to sprint up on? Was the horse straining to stay with the working companion during fast work? There are a multitude of factors to take into account but the majority of trainers I have spoken to believe it has got far worse since we started vaccinating. The way they work has not changed that much but the number of bleeders has changed enormously.

Craig, I'm reassessing my stand re breeding affecting bleeding. I've been doing more reading around and it seems that several breeds, eg Standardbreds and Quarter Horses, also suffer from a high incidence of bleeding after a hard race or workout. Haven't abandoned it completely, mind you! Just re-thinking ...

re vaccination causing it though ... the problem is just as bad in the USA, Aus and UK as here in AHS-ridden Afrika. Food for thought.

Regarding non-medical means of helping a horse ... gave a sample in my last posting ... I came across something interesting about nasal strips. Are these allowed in SA do you know? They certainly were banned a few years ago, in SA and also in the UK. They hold the nasal passages open ... I know they've been used by human athletes (and also to prevent snoring - dunno how effectively!) ... not so essential for human athletes who can mouth-breath if the airway becomes obstructed for any reason, or just to increase air intake, but then of course a horse can't breath through it's mouth. Are these the "nose patches" we've recently started seeing on some horses, notably on Mike de Kock's, but also on other trainers' runners?

What my reading around has also made clear to me (though I rather suspected it) is that there are such a multitude of reasons why a horse may suffer bleeding, that teasing them apart may be practically impossible. Low-level respiratory infection/allergy seems to be one possibility ... not infection that needs a vet, just a little cough or two after exercise and a slight drop in performance. In that regard it would be most interesting to know if horses racing at the Vaal sand/Kimberley get it worse than those that run on turf. Or those that run in winter/Cape (wet) vs winter/Turffies (dry). Or in Durban (always damp, more or less). But then oxygen content of the coast vs 6000 ft up in Jo'burg might cause harder breathing ... more damage ...

.... strewth! I'm not surprised people want to cut through all the tangle and say, "If Lasix works, never mind why it works, let's just use it". Don't approve, no, but I do understand the feeling of growing frustration. I feel it just reading up about it.

Just by the by, I read a figure of 2.4% weight loss for a horse that uses Lasix (I presume first time around). You can work out what that translates into in terms of weight carried in a race.

Mavourneen, your post in which you quoted Dr. Cook has a lot of good material in it.

This is a complex issue and could easily fill a large book.

Here are a few observations:

1. The majority of horses bleed. But only a few bleed through the nostrils. Vets grade episodes of bleeding and when the blood comes out of the nostrils, it is the worst case scenario. Use of an endoscope is the best method to determine whether a horse bleeds. In America, at major racetracks, the vast majority of horses are scoped after they arce, and several are scoped after they gallop (breeze).

2. Based on what I have encountered, I believe that there are definitely more bleeders in the current horse population in America than had existed in an earlier era, and I blame this on breeders that place speed above all else and will utilize stallions that were bleeders if they possessed enough speed. Breeding in America has gone down the tubes because of the commercialization of the entire enterprise. We used to have a lot of serious breeders that bred to race their own stock and it behooved them to get it right, since they were the end users. Over the last quarter century, there has emerged in the U. S. a group of commercial breeders that only cared about how much money they could get for their foal or yearling without regard to what happened to their product on the racetrack.

3. Management of upper airway disease...both from prevention to cure...is the single most important aspect of training a horse in America. There are a few equine practitioners that have specialized in setting up a good environment for horses that allow for the prevention of upper airway disease. Also, some vets have developed ways to deal with UAD.

4. The management and manipulation of UAD is the crucial to success for racing in America and elsewhere, because nothing will slow down an athlete than an inability to breathe.

5. The most successful cheaters in horse racing basically use two methods to get the most out of a racehorse and provide it with an edge over the competition. First, they find a way to buffer lactic acid. Secondly, they find a way to deliver more oxygen to the lungs. Buffering lactic acid is done by some form of "milkshaking," in which a bicaronate of soda mixture is introduced into the system. This method of cheating was banned 2 decades ago in Australia, but only in the last few years in America. There are a multitude of ways to increase the flow of oxygen to the lungs, many of which are medications developed by scientists to aid human patients suffering from such diseases as failure of the heart, lungs and organs such as the kidney and liver. It seems that everytime racing authorities finally figure out what medication is being used, the cheaters are on to a new one. And so it goes. Most of these drugs first appear in cycling, then go over to track and field and finally wind up in the bloodstream of our horses.

I hope South Africa never allows the use of Lasix, because a) it will tend to weaken the breed in the long run, b) it is not necessary and c) it can lead to a myriad of other problems.

I think Americans realize that Lasix sucks and there is a very strong movement afoot to reverse the decision to use it. Lasix could be a thing of the past.