Exploring Lung Health In Thoroughbred Racehorses
Understanding The Universal Respiratory Challenge
Exercise-Induced Pulmonary Haemorrhage (EIPH) occurs when small blood vessels in the lung tissue bleed during high-intensity exercise. It is a condition that affects virtually every horse breed, including Thoroughbreds, Arabians, and Warmbloods commonly seen across Middle East racing. Various management approaches exist, including medicinal treatments, nutritional supplements, external equipment such as nasal strips, and revolutionary biological regenerative therapy using Platelet-Rich Plasma (PRP).
Dr Luis Renato Oseliero, a distinguished veterinary specialist with 24 years of clinical experience at São Paulo's prestigious Jockey Club and current Senior Equine Ambulatory Clinician at Abu Dhabi Equine and Camel Hospital (ADECH), explains this evolving understanding. ADECH represents a pioneering venture by Rabdan Holding Ltd. in collaboration with E20 Investments and ADQ, which stands as the world's first dedicated healthcare facility for the advanced treatment of both horses and camels. The state-of-the-art facility spans 200,000 square metres in Al Wathba, Abu Dhabi.
"To be very clear, EIPH is an exercise-induced pulmonary haemorrhage that results from an increase in pressure within the small vessels inside the units responsible for the exchange of oxygen and carbon dioxide with the blood,” states Dr Renato, who graduated with honours from Universidade Paulista and completed rigorous residency training.
Modern veterinary science now recognises EIPH as a physiological alteration affecting all breeds equally. “Pulmonary haemorrhage can affect horses of any breed. What really determines how often or how severely it occurs is the intensity of exercise and the overall health of the lungs. In a horse with compromised lungs, even a light gallop may be enough to trigger bleeding. No breed can be considered consistently more or less susceptible than another”, confirms the internationally experienced specialist.
"Some authors are now considering pulmonary haemorrhage not as a disease, but as a physiological alteration caused by exercise. One hundred per cent of horses undertaking any form of exercise experience pulmonary haemorrhage at least once in their lifetime," notes the Brazilian-born specialist who also served as a UNESCO technical consultant.
Middle East Conditions Present Unique Considerations
Dr Renato, whose expertise spans international racing regulations, explains why the Gulf region requires specific management approaches.
“A common misconception about the Middle East, particularly Dubai and Abu Dhabi, is that the climate is always hot and dry. In fact, during much of the year it is hot and humid. This combination makes it harder for horses to dissipate body heat and can worsen certain clinical conditions, including exercise-induced pulmonary haemorrhage”, explains the specialist.
Regional factors also influence the condition. “In regions like the Middle East, where training tracks and the environment are sandy, horses inevitably inhale fine dust particles. But sand is not the only concern; other airborne particles, such as those coming from hay, bedding, or general stable dust, can also cause inflammation in the lungs and airways. This inflammation may predispose a horse to pulmonary haemorrhage, and it can affect any horse in the stable—from the leading performer to the most modest one.”
The economic implications are significant. "It's the most important economic loss in flat racing. As long as we keep horses out of training because of bleeding, it's money we are spending without any return," states Dr Renato.
Traditional Treatments And Their Limitations
Drawing from his extensive background, including 24 years at one of South America's leading racing venues, Dr Renato addresses conventional treatment methods and alternative approaches.
"It's hard. There is some difficulty because we don't have a specific medication or treatment to avoid this condition. Even Furosemide is not being used to avoid the bleeding. We are using it to decrease the amount of bleeding produced by this haemorrhage. So it's not a therapeutic treatment; it's a prophylactic treatment," explains the qualified surgeon.
The regulatory landscape presents ongoing challenges. "First of all, we need to know the rules of each country we are going to. In my native country, for example, in Brazil, the use of Furosemide for horses three years of age or older is permitted. But nowadays, worldwide, based on the jurisdiction of the International Federation of Horseracing Authorities, their main concern right now is to remove all medications in all countries," states Dr Renato.
Beyond pharmaceutical interventions, research has validated several alternative approaches, though their effectiveness remains debated. While some studies suggest external nasal strips may reduce EIPH by up to 50% in certain cases by stabalising nasal passages during intense exercise, Dr Oseliero notes that in his clinical experience, nasal dilators do not significantly help or improve EIPH.
Nutritional strategies are gaining prominence, with fish oil supplementation demonstrating measurable benefits in reducing EIPH episodes. Studies have shown that omega-3 fatty acids, particularly EPA and DHA, improve red blood cell membrane fluidity and support healthy tissue production. Vitamin C is crucial for collagen construction and blood vessel maintenance, while Vitamin K plays an essential role in blood clotting processes.
Emerging treatments include concentrated equine serum therapy, which has reduced EIPH by 53% and white blood cells by 32% when administered intratracheally. Hyperbaric oxygen therapy and shockwave therapy represent additional frontiers, with the former improving lung healing and the latter showing promise in promoting tissue repair.
The experienced veterinarian emphasises non-pharmaceutical approaches when medications are restricted. “Medications are the responsibility of the veterinarian, who must be fully aware of the regulations and explain them clearly to clients. The trainer’s role, which in these situations becomes even more important, is to adapt the horses’ training to the regulatory framework of each country. There are many ways to deal with these problems when therapeutic options are restricted,” explains Dr Renato.
"Of course, as much as we avoid exposing horses to this weather and environmental effects, the better it is for them. We can keep the lungs as healthy as possible, closer to the highest level of respiratory condition. Training horses in the cooler periods of the day, providing them with a very cool environment during rest time, and maintaining a very clean environment without sand and dust; all of these things make the lungs healthier and are important. But yes, we need to deal with hot environments in countries where we face these problems, and we need to deal with them as best as possible."
Prp Breakthrough Offers New Hope
Dr Renato's current practice has incorporated a newer therapeutic approach that represents an additional tool in managing this physiological condition, showing promising results in clinical application.
"PRP is one more tool and maybe the newest approach for this condition. We are having good results with the use of PRP for pulmonary haemorrhage, but it should never be considered the only alternative," explains the experienced practitioner.
"We use it intrapulmonary. It's not intravenous, it's intratracheal or intrabronchial. We inject these substances using an endoscope with a probe,” describes Dr Renato, whose diagnostic imaging training provides the technical foundation for this sophisticated procedure.
Dr Renato notes the unpredictability despite grading systems. "If they are bleeding grade one, which is a very small amount of bleeding leading to grade one haemorrhage, we almost consider it a normal finding during the exam. But we cannot say that definitively in all cases, because I have seen many horses failing with grade one, and also many horses winning races with grade four or grade five bleeding."
Success depends on numerous variables. "The track condition, the weight of the jockey, the type of racing they are in. Maybe they are running in a very low-grade quality race where they have a better chance to win. There are many things involved in flat racing," explains the specialist.
Future Outlook For Gulf Racing
The Middle East continues establishing itself as a global racing powerhouse, with the UAE and Saudi Arabia hosting the world's richest races, including the US$30.5 million Dubai World Cup and the record-breaking US$20 million Saudi Cup. With over 30 different racing jurisdictions now represented at the Dubai Racing Carnival since 2004, effective EIPH management has become increasingly critical.
Endurance racing remains particularly popular across the Gulf, where traditional 120-kilometre desert races continue ancient Bedouin traditions. As this sport grows alongside flat racing, managing the physiological challenges of intense exercise becomes ever more important.
For trainers, riders, and veterinarians managing horses in this demanding environment, understanding and effectively treating EIPH will remain a significant challenge requiring the expertise of specialists like Dr Renato, whose international background and cutting-edge approach position him at the forefront of this evolving field.
The combination of traditional knowledge, modern research, and treatments like PRP suggests that while EIPH will continue to be a physiological reality for racing horses, the tools to manage it effectively are rapidly advancing in the hands of qualified specialists throughout the Middle East's expanding racing industry.
