## Overview Exercise-induced pulmonary hemorrhage (EIPH) is bleeding into the airways and lungs during strenuous exercise. It affects the majority of racehorses and many other horses in high-intensity sports. Visible nosebleeds occur in only a small percentage; most cases are detected by endoscopy. ## Causes Rupture of pulmonary capillaries under the high vascular pressures of intense exercise. ## Diagnosis Endoscopy after exercise showing blood in the trachea, or cytology of bronchoalveolar lavage. ## Treatment Furosemide before exercise reduces severity in many horses. Management of airway inflammation and racing schedules is supportive. Nasal strips may help some horses. ## Recovery and Prognosis Most horses continue to compete. Severe or repeated hemorrhage can affect performance and, rarely, be life-threatening. ## Prevention Furosemide use where permitted, and attention to respiratory health.
blood at the nostrils after exercise (minority of cases); poor performance; blood seen on post-exercise endoscopy
## Overview Exercise-induced pulmonary hemorrhage (EIPH) is bleeding into the airways and lungs during strenuous exercise. It affects the majority of racehorses and many other horses in high-intensity sports. Visible nosebleeds occur in only a small percentage; most cases are detected by endoscopy. ## Causes Rupture of pulmonary capillaries under the high vascular pressures of intense exercise. ## Diagnosis Endoscopy after exercise showing blood in the trachea, or cytology of bronchoalveolar lavage. ## Treatment Furosemide before exercise reduces severity in many horses. Management of airway inflammation and racing schedules is supportive. Nasal strips may help some horses. ## Recovery and Prognosis Most horses continue to compete. Severe or repeated hemorrhage can affect performance and, rarely, be life-threatening. ## Prevention Furosemide use where permitted, and attention to respiratory health.
blood at the nostrils after exercise (minority of cases); poor performance; blood seen on post-exercise endoscopy