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Treating nosebleeds is a source of debate, not least because there is no single cause or treatment for exercise induced pulmonary haemorrhages (EIPH).
Rest, anti-inflammatory medication, investigation and treatment of concurrent airway disorders may be beneficial, while a change in training regime may also help. The latter can be difficult as many horses only bleed when exercised maximally.
Certainly, minimising stable dust by soaking hay, improving ventilation and possibly turn-out can benefit some sufferers.
There is evidence that nasal dilator strips can help with nosebleeds, as there is a decreased red blood cell count on lung samples taken after intense exercise when they are used.
Also the drug frusemide, known by brand names Lasix or Salix, is said to be beneficial and is widely used in some countries, especially the USA. A recent study on a group of 167 racehorses in South Africa that were given Lasix pre-racing showed a decrease in both the severity and incidence of EIPH.
Both these options are banned in the UK for racing, as they are deemed to be potentially performance-enhancing, although sport horses can compete with nasal strips under FEI rules.
EIPH remains a frustrating condition for some performance horses because, once they develop this problem, many suffer from recurrent bouts that can limit their athletic career.
The condition will only affect horses that are working at speed, so a change of career to allow them to work at a more leisurely pace will often cure the problem.
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For the full article on exercise-induced equine nosebleeds, see the current issue of Horse & Hound (4 November, ’10)