September 8, 2007
Case Study - Bleeders - EIPH - Pulmon-EZ

1995 Thoroughbred gelding
Owner: Carole Letarte
Pulmon EZ™ for EIPH (exercise induced pulmonary hemorrhage)
"YOUR FIRST" is a 1995 Florida bred and raced TB gelding by "You made your point" and out of "First Paula" by "First Dawn." He has suffered from EIPH, (exercise induced pulmonary hemorrhage) since he started racing as a 3 year old. EIPH is a condition characterized by bleeding from the pulmonary vasculature as a result of the cardiopulmonary changes that occur during intense exercise. Race horses with this condition are commonly called "bleeders".
There are several different hypothesis regarding possible causes of EIPH. The most consistent is that "stress failure," or a breakdown of the pulmonary capillaries occurs, when high transmural capillary pressures are generated. This hypothesis supports a possible mechanism, but there are other possible causes.
These include chronic lung disease, partial airway obstruction, defects in hemostasis, abnormalities in red cell deformability, and blood borne pathogens to name a few. Bronchial arterial neovascularization and small airway disease (bronchiolitis) were found consistently in the lung tissues of horses with severe EIPH. These inflammatory events appear to precede the onset of EIPH. Another theory is that partial airway obstructions and breath holding causes secondary partial asphyxia and also produces EIPH.
The first time "YOUR FIRST" bled was after a workout, as a 3 year old. The track veterinarian prescribed Furosemide (brand name Lasix). Lasix is a commonly prescribed drug for EIPH that acts as a diuretic and causes the body to lose water, essential electrolytes, potassium and calcium. As he got older his dosage was increased to try and stop the bleeding. Also additional other medications were prescribed to try and halt his EIPH. His bleeding was so severe; he even had to be given Lasix for his morning works.
In January 2003 this race horse’s owner/trainer suffered from an illness, and in May of 2003 "Your First" was sent north to another trainer. Due to the inability to control his bleeding, he was sent to a farm and turned out while his owner/trainer was still recovering from her illness. In August, 2003 his owner began looking for an alternative treatment for EIPH instead of Lasix.
She found the Nitric Oxide delivering product Pulmon EZ™, specially formulated to support lung function in the horse. "YOUR FIRST" began the product Pulmon EZ™ on November 3, 2003, and was taken off of the drug Lasix, and the Lasix list at the race track. For the first 10 days he received doses AM and PM, and then he was backed down to 1 dose per day. On race day, a double dose 2 hours before race time, and a single dose following the race.
Since beginning Pulmon EZ™, "YOUR FIRST" has not bled at all during his works or races, and he has raced 3 times since beginning Pulmon EZ™. He is coming close to retirement due to his age and because he has a few other problems. But "YOUR FIRST" has had a wonderful successful career as a race horse for his owner and trainer Carole Letarte. His race record is 13 wins, 13 seconds, 7 thirds. His owner Carole says she wishes "YOUR FIRST" had been on Pulmon EZ™ much earlier in his career, and wonders how he may have been even more successful if he had not had to suffer from the bleeding and Lasix.



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