Is improved high speed performance following frusemide administration due to diuresis‐induced weight loss or reduced severity of exercise‐induced pulmonary haemorrhage?

Zawadzkas, X. A.; Sides, R. H.; Bayly, W. M.

doi:10.1111/j.2042-3306.2006.tb05555.x

Cited by 14 publications

(11 citation statements)

References 10 publications

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“…It has been speculated that furosemide-induced reductions in body weight are indicative of reductions in body water and intravascular fluid volume and that these reductions in body water and intravascular fluid volume attenuate the exercise-induced increase in pulmonary arterial blood pressure typically associated with exercise, with a consequent reduction in the incidence of alveolar capillary rupture and decreased hemorrhage. [13][14][15] The amount of weight lost by horses in the present study after furosemide administration was consistent with the amount of weight loss in horses administered furosemide under experimental conditions. [16][17][18] However, weight loss does not appear to be directly related to the mechanism by which furosemide prevents EIPH, in that we did not identify an association between amount of weight lost and prevention of EIPH in the present study.…”

supporting

confidence: 69%

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Hinchcliff

Morley²,

Guthrie³

2009

javma

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EQUINE Horse racing is a popular, multimillion-dollar industry worldwide, but reports of injuries and other physical disorders in racehorses have harmed public perceptions of the sport and challenged the economic viability of the racing industry. In addition, controversy has been generated by use of medications that are perceived to affect the performance or well-being of racehorses. One of the foremost concerns in this regard is the occurrence of EIPH and the use of medications in an attempt to prevent it. Factors that make this an important issue include the frequency of EIPH, the importance of the disease in terms of the performance and well-being of horses, and the common use of prophylactic treatments. At least 80% of racehorses can be expected to develop the condition at some time during their career, 1,2 approximately 60% of sudden deaths during racing have been attributed to pulmonary hemorrhage, 2 severe EIPH has been shown to adversely affect race performance, 3 and EIPH is believed to adversely affect the overall health of racehorses. 4 Beyond this, Objective-To evaluate the efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage (EIPH) in Thoroughbred racehorses under typical racing conditions. Design-Randomized, placebo-controlled, blinded, crossover field trial. Animals-167 Thoroughbred racehorses. Procedures-Horses were allocated to race fields of 9 to 16 horses each and raced twice, 1 week apart, with each of the 2 races consisting of the same race field and distance. Each horse received furosemide (500 mg, IV) before one race and a placebo (saline solution) before the other, with the order of treatments randomly determined. Severity of EIPH was scored on a scale from 0 to 4 after each race by means of tracheobronchoscopy. Data were analyzed by means of various methods of multivariable logistic regression.Results-Horses were substantially more likely to develop EIPH (severity score ≥ 1; odds ratio, 3.3 to 4.4) or moderate to severe EIPH (severity score ≥ 2; odds ratio, 6.9 to 11.0) following administration of saline solution than following administration of furosemide. In addition, 81 of the 120 (67.5%) horses that had EIPH after administration of saline solution had a reduction in EIPH severity score of at least 1 when treated with furosemide. Furosemide is the drug most widely used to prevent EIPH in racehorses and is administered on the day of racing to > 92% of Thoroughbred racehorses in North America (approx 400,000 doses/y). 4,5 However, few studies have examined whether furosemide is effective in preventing the development of EIPH, and the studies that have been performed were not conducted Conclusions and Clinical Relevance-Results

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supporting

confidence: 69%

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Hinchcliff

Morley²,

Guthrie³

2009

javma

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“…In total, 5653 horses were enrolled in the 17 studies included in this review . The number of horses in each study ranged from 3 to 3539 horses.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of the efficacy of furosemide for exercise‐induced pulmonary haemorrhage inThoroughbred andStandardbred racehorses

Sullivan

Whittem

Morley

et al. 2015

Equine Veterinary Journal

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SummaryReasons for performing study: Furosemide is the most commonly used medication for exercise-induced pulmonary haemorrhage (EIPH); however, critical evaluation of the strength of evidence for efficacy of furosemide is lacking and is warranted so that evidence-based treatment decisions can be made. Objectives: To evaluate the efficacy of furosemide to reduce the severity or frequency of detection of EIPH in Thoroughbred and Standardbred racehorses. Study design: Systematic review with meta-analyses. Methods: Primary studies were identified via searches of electronic databases, relevant texts and reference lists of published articles. Studies were not restricted by date or publication status. Only studies published in English were eligible for inclusion. Searches were performed using a predetermined search string. Randomised controlled trials, nonrandomised trials and observational studies were included. Three authors independently assessed each study using the Cochrane collaboration guidelines and Grading of Recommendations Assessment, Development and Evaluation recommendations for rating quality of evidence. Meta-analysis of studies was performed with pooled data to determine whether furosemide reduced the frequency of detection of EIPH (yes or no) as evaluated by tracheobronchoscopy or bronchoalveolar lavage fluid red blood cell number, or if furosemide reduced the severity of EIPH by at least one tracheobronchoscopic grade. Results: Seventeen studies fulfilled the inclusion criteria. The relative risk of detecting any EIPH by tracheobronchoscopy after administration of furosemide was 0.88 (pooled data from 11 studies, n = 5780; 95% confidence interval 0.79-0.97, P = 0.01). When data from only high-quality randomised controlled trials (2 studies, n = 405) were used, the relative risk of detecting endoscopically evident EIPH was 0.68 (95% confidence interval 0.58-0.79, P<0.001). The proportion of horses previously diagnosed with EIPH having a reduction of at least one EIPH grade after furosemide was 68% (2 studies, n = 405; 95% confidence interval 61-78%). Conclusions: There is high-quality evidence, albeit limited, that administration of furosemide reduces the incidence and severity of EIPH in Thoroughbred or Standardbred racehorses.

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“…A later study by the same group testing fluid administration after furosemide but before exercise found BW losses ranging from 5.9 ± 0.9 to 11.5 ± 0.8 kg (Hinchcliff & Mckeever, 1998). Horses in an earlier study by Tobin et al (1978) produced 10.5 L of urine at the end of 4 hr after furosemide administration, and even more studies have found an average 2%–4% BW loss with furosemide administration (Butudom et al, 2004; Forro & Lindinger, 2006; Freestone et al, 1988; Pritchard et al, 2017; Warren, Lawrence, Brewster‐Barnes, & Powell, 1999; Zawadzkas et al, 2006). As BW for horses in the current study averaged around 530 kg, post‐furosemide administration expected BW losses should be around 10.6–21.2 kg or around 10–20 L of urine.…”

Section: Discussionmentioning

confidence: 99%

“…While veterinarians and trainers use the diuretic to reduce the incidence or lessen the severity of exercise‐induced pulmonary haemorrhage (EIPH), its efficacy is mixed (Hinchcliff, Morley, & Guthrie, 2009; Knych et al, 2018; Pascoe, McCabe, Franti, & Arthur, 1985; Sullivan, Whittem, Morley, & Hinchcliff, 2015). Additionally, administration can enhance performance (Hinchcliff, McKeever, Muir, & Sams, 1993; Sweeney et al, 1990; Zawadzkas, Sides, & Bayly, 2006), but whether this benefit is from the reduced EIPH severity or short‐term weight loss (Hinchcliff et al, 1993; Pritchard, Spooner, & Hoffman, 2017) is unclear.…”

Section: Introductionmentioning

confidence: 99%

Furosemide administration results in a transient alteration in calcium balance in mature horses

Pritchard

Nielsen

Robison

et al. 2020

Animal Physiology Nutrition

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Previous research documented that furosemide negatively impacted calcium balance for 3 days but did not determine when calcium balance returned to baseline. This study hypothesized that furosemide's impact on calcium would return to control values before 7 days post‐administration. Ten mature geldings were assigned to either control (CON, n = 5) or treatment (FUR, n = 5) for the first of two 8‐day total collections in crossover design. Treatment horses received one administration of furosemide (1 mg/kg, IV). A 10% sample of pooled faeces and urine from each day was kept. Calcium concentrations in hay, faeces and urine were determined by an atomic absorption spectrophotometer. Data were analysed using mixed‐model‐repeated measures ANOVA to determine influence of day and treatment. For urine output, FUR urinated twice as much during the 24 hr after administration than CON (p < .001). Horses in FUR excreted more urinary calcium 24‐hr post‐administration as compared to CON (9.3 ± 1.0 and 4.2 ± 1.0 g, respectively; p < .001). Calcium balance in FUR was more negative on day 1 than day 3 (p < .05). Faecal calcium concentrations remained the same from day 1 to day 7 in CON (6.3 ± 1.3 and 5.5 ± 1.3 g/kg, respectively; p > .10) but were lower in FUR on day 7 as compared to day 1 (4.8 ± 1.3 and 7.3 ± 1.3 g/kg, respectively; p < .001), indicating a potential mechanism to restore calcium balance. These findings corroborate previous studies on furosemide and calcium balance and provide evidence for a possible mechanism to recover net calcium losses after furosemide administration. Since calcium balance returns to baseline in 3 days and previous results have examined frequent, long‐term use, furosemide may not negatively impact bone mineral content even if used over long periods.

show abstract

Is improved high speed performance following frusemide administration due to diuresis‐induced weight loss or reduced severity of exercise‐induced pulmonary haemorrhage?

Cited by 14 publications

References 10 publications

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses

A systematic review and meta‐analysis of the efficacy of furosemide for exercise‐induced pulmonary haemorrhage inThoroughbred andStandardbred racehorses

Furosemide administration results in a transient alteration in calcium balance in mature horses

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