Video Proof of Why Thoroughbreds Bleed in the US and not in Japan

Click ‘play’ on both of the above videos simultaneously, and watch six horses in the post parade 5min prior to loading in Japan (top clip) and in the United States (bottom clip) over dirt last night on TVG – quite a difference, eh?

I have argued for years that an appropriate pre-race warmup prior to loading in the gate will eliminate or decrease the severity of bleeding in most racing stock without the use of a pharmaceutical diuretic such as Salix/Lasix.

The mechanism behind this concept is twofold: A single furlong at a 15sec clip (or a bit quicker) will cause the spleen to contract and shoot 30% more red blood cells into the bloodstream, thickening the blood and stressing the capillary walls. Slowing to a jog/walk soon afterwards allows these blood vessels time to stretch and dilate in order to decrease blood pressure, naturally. Otherwise this happens in the first few strides from the gate – albeit with no rest period to accomodate the newly thickened bloodflow. Bleeding ensues.

Briefly, EIPH or bleeding from the lungs in an exercising thoroughbred is the result of high blood pressures overwhelming the pulmonary capillaries and causing them to burst, leaking blood into the lungs themselves. There are two variables at play here: the viscosity of the blood itself, and the volume of capillaries present in lung tissues.

Firstly, as described above – the equine spleen is unlike the human version and serves as a reservoir of oxygen carrying red blood cells in horses, this is but one catalyst of the ‘fight or flight’ response found in animals of prey. Secondly, capillaries are tiny straw-like tubes that connect arteries and veins. Genetics determines how many a horse is born with, but conditioning determines how dense that capillary bed becomes: a horse’s arteries and veins are unaffected by the training environment, but exercise at 60-70% of maximum heart rate increases the number of capillaries.

Lasix works by inducing increased urination in a horse, resulting in a lower volume of water within the plasma component of the blood: lower blood volume then equals lower pressures throughout the circulatory system. However, as with any drug (human or equine) there are side effects.

Often enemies of Lasix cite the fact that Europeans do not allow the drug in their racing programs. However, this is not comparing apples to apples. Euros run overwhelmingly on turf or synthetic – and a relaxing 54sec half mile from the gate has little in common with the US style of 45sec in the first half mile over an unforgiving dirt surface.

Finally, with the above videos I am able to confirm what I have always suspected: in jurisdictions that prohibit raceday Lasix AND race on dirt – other interventions such as an extensive warm up are utilized to control the effects of EIPH.

Horses in Japan are trained trackside just like in the US – they don’t have access to hundreds of acres of rolling hillside to train over between efforts, as do the Euros. Yet, you see no lead ponies in the above post parade at Kyoto Racecourse as trainers have conditioned their horses in the mornings to behave appropriately during the big events even with this pre-race blowout.

A common, and valid, reason given by US trainers as to why they don’t practice such a pre-race warmup is that they cannot find riders who are able to consistently pull up the horse after a quick furlong, not in the mornings and not on raceday.

That is a lack of horsemanship on the part of the exercise rider that the trainer overcomes by veterinary intervention – yet opponents of Lasix are touted as ‘cruel to racehorses’ – what a crock.

Trainers out there unwilling to overcome ego and apply some science to the conditioning process be warned: if Lasix is ruled off – you are going to have to do what I just described in order to remain competitive. I recommend you do some experimentation now, practicing the above warm-up protocol before a training breeze – and you will be shocked how well your horse finishes up that breeze after a spleen-contracting furlong 3min before the real work begins.

Stretching and warming up in humans in order to prevent injury has been exposed as a fallacy, the real value in warming up aggressively is to improve performance during competition – this practice WILL buy you a few tenths of a second if you implement it correctly, even in the slowest horse in your barn, provided he is reasonably sound.

If you are based at KEE or CD give me a shout and I’ll come with my HR/GPS equipment, free of charge, and show you with numbers how this practice consistently improves performance.

Good luck!-


About bpressey

Equine Exercise Physiologist

Posted on November 13, 2011, in Uncategorized. Bookmark the permalink. 41 Comments.

  1. Makes sense … If you have a bleeder and your in europe .. Lasix is a no-no as you say

    So I have a filly who bleeds do you sugest I ask the jockey to give her a fast 200m on the way to the start ?


    • Yes Pete, that would be my recommendation, completing the quick 200m burst at least 5min prior to loading. But unfortunately my experience is ‘once a bleeder, always a bleeder.’ Regardless, continuing to pump her full of Lasix which she is now dependent upon, and adding the pre-race blowout will improve her a bit – assuming she is fairly sound. Please come back and report your experiences….

  2. Where do your jockeys learn their craft- on the Subway? Are they jockeys or passengers?

  3. There is no evidence that EIPH occurs less frequently in Japan as opposed to the United States. If warming up prior to racing reduced the incidence of EIPH you would expect harness horses to have a low incidence since a significant warmup ( brush) occurs prior to the race. The frequency of EIPH in harness horses is comparable to Thoroughbreds in the United States.

    James C Meyer

    • James, Japan reports a 0.2% incidence of EIPH in their horses – yet US needle happy vets are proud to proclaim “every horse bleeds”. Japan also runs thousands of races each year on dirt with full fields and no raceday diuretic use, while US runners use the drug 98% of the time. When Lasix was introduced to the US, horses averaged 12 starts per year, now the number is 6.

      Harness horses don’t use Lasix to prevent bleeding, they use it because it is a performance enhancing drug and gives them a 30lb weight drop prior to post. The same reason the Euros use it when running here in the BC.

      On that topic, I am a huge fan of the conditioning and warmup regimens of sulky trainers, that is true horsemanship. I may be mistaken, but I don’t believe raceday Lasix use is permitted in the Hambletonian these days.

      You are more than welcome to come back and show me the ‘proof’ behind your statements, otherwise you come off as a drug apologist, in my opinion. Still, I very much welcome your input.

      • I am not a drug apologist. However the facts you state are misleading the 0.2 % that is reported by Japan is epistaxis as evidenced by hemorraghe at the nostrils. This represents a small proportion of horses that “bleed” from the lungs as evidenced by endoscopy. Therefore comparing the incidence of EIPH between jurisdiction is fraught with problems. I do not disagree that it makes sense for any athlete to warmup properly prior to competition I have not seen evidence that it lessens the incidence of EIPH. The more likely benefit of the prerace exercise in the horse is the natural “blood doping” induced by splenic contraction prior to the race, and perhaps the increased blood flow to the large muscles of the hindquarters.

      • True enough, the definition of EIPH differs considerably. But back to your initial point: If all horses around the world bleed equally, why can Japan fill races on dirt without Lasix and America cannot?

        I assume you are in the camp that views Lasix as a humane intervention in order to keep horses from suffering unnecessary discomfort, but do you believe that Lasix is the only drug in the world with zero side effects, especially in a still developing 2yo? Why could my family’s horses, and many others, start 80, 90, 120+ times in a career on dirt in 1975 without this diuretic?

        Why can trotters compete in the Hambletonian and Oaks without Lasix, yet vets propose that our Kentucky Derby entrants cannot? Why is the Hambo run on average 10sec faster now than in 1950 while Ky Derby times have only improved 2sec?

        Why do our Lasix addled turf runners breakdown 300% more often than those in Australia who race clean? (and we are slower as well…)

        I’m sorry for all the questions, but its finally nice to have a DVM viewpoint in this space…

    • Ah James, I see you are a vet. Color me surprised. I will certainly agree with you that there is no proof that such a warmup prevents or lessens EIPH.

      I, for one, will never waste time and resources in an attempt to prove it as any findings would be ignored by the veterinary community anyway – and I view the practice as an edge for my clients.
      Can I at least get you to admit that the practice of a scoredown/brush is beneficial to racing performance in a (sound) thoroughbred?

      Please follow this blog as I have a post upcoming from a young vet student in Germany who hit the board in his first 8 starts with a horse running drug-free, and even though I can be a jerk sometimes I truly value the opinions of the veterinary community.

      On another subject, my next door neighbor here in Louisville is a top cardiovascular surgeon. He can fix holes in hearts, but he has no concept of exercise physiology. Don’t get me wrong, he could learn it in a weekend if he wishes – but the education behind becoming a surgeon/vet doesn’t necessarily cover the science of equine exercise physiology.

  4. And again James I will also readily admit that if thoroughbred trainers limit the gallop distance of their charges to 1.5miles daily, they likely will not build a dense enough bed of capillaries to avoid significant pulmonary bleeding either.

  5. most of the tracks i’ve been add, lack of pre-race warm up is more an out rider problem than a jock problem. the out riders simply won’t let you warm up. To do a burst, u first have to do a slow warm up. by the time the slow warm up is done the out rider has already contracted the warm up area that to do a burst is difficult. For warm up to start happening in the USA there first needs to be an HBPA awareness and then change the track culture to permit it, both in the morning and afts. I think more it’s that inappropriate warm up contributes to EIPH than that warm up prevents it–for the reason that appropriately warmed up horses bleed. I think the biggest culprit in EIPH is surface, although to watch a jock in the morning walk a horse to the gate and do a 5f breeze, or to see a jock warm up and the horse stands behind the gate for 10 min–how many EIPH have been created that way?


    • First, I always warmed my horses up in a race with a blow out, no pony attached and was able to pull the horse up every time. Yes, I had to warn the outrider of what I was going to do and they prepared themselves by going to the far turn incase I could not pull my horse up. I did this at tracks like Churhill, Keenland, Turfway, Ellis, KY Downs, the tracks in Indiana and Ohio as well.
      Second, all horses bleed, but a spleen dumping warm up definately decreases the chances of the blood coming into the esophagus and out the nostrils most of the time. It causes the stored 1/3 of the blood supply to become oxiginated before reaching the gates.
      Third, as an advocate and pactitioner of interval training, the second interval is ALWAYS performed better than the first one on any given day.
      Thank you and that is all.

  6. just watched video. makes u sick to ur stomach, eh?

  7. Yes RR – I had to make the title a bit dramatic in order to gain some attention. I do believe that some horses will bleed regardless of what you do, and that extensive warmups won’t help them all. I also believe that once one is an established bleeder dependent upon Lasix, it’s too late to turn back.

    In Japan, and also in Argentina where I went in 2010, it seems the accepted post parade involves this sprint down the lane in front of the grandstand – certainly in the US major ‘system’ changes would need to be made to accomodate my ‘radical’ ideas.

    On the flip side, giving a 2yo Lasix before each time he works fast down in FL over the winter means he gets the drug roughly 30 times in a 4 month period, and just before a bone-straining piece of exercise. This just can’t be good long term for skeletal health during such a crucial phase of development.

    Remember, it’s a proven fact that US turf runners breakdown 300% more often that do those in Australia:

    So we must be doing something wrong here.

  8. Bill, you are absolutely right, as usual. But if the U.S. ever saw the light, the jockeys would have to actually learn to ride! Imagine the carnage if they were actually asked to control their horses through a proper warmup!

  9. First off, showing horses actually warming up in Japan, Thoroughbreds with NO ponies as is typical, and then showing a QH race from Los Alamitos in the warm up (not actually warming up yet) is so very slanted it’s absurd. Completely biased and proves nothing.

    It’s the trainer’s choice how to warm up a horse, not the hired pony person. If the trainer doesn’t care then it’s the jock’s choice. Usually the reason a pony person won’t blow out with a racehorse is pretty obvious: they can’t keep up AND it’s too hard on the pony whose been warming up horses all day. It’s not an argument about how strong US jockeys are opposed to Euro’s or Asian. Get real. A pony huffing and puffing next to a racehorse might just make the racehorse too hard to handle. Granted, we’ve (in America) made them that way, because they are trained to go with a pony, they are less warmed up. You wouldn’t see a track and field athlete warm up like our racehorses, typically. I agree we don’t warm them up like they do in Europe but that does NOT explain or confirm if it eliminates bleeding. If only!!

    Shameless ploy at cheap advertising.

  10. Los Alamitos QH horses were the only ones I could get off my TVG feed that evening, I could have waited for a TB race, but 5min prior to post they are all the same in the US regardless. I’ll be at CD all week watching the process in real life.

    A pony should be nowhere near a TB warming up for a race, that is the whole point of the post. I’m not advertising a damn thing Lisa J, how the hell can I ‘sell’ the concept of warming up your horse aggressively and it’s effect on EIPH? Who exactly is going to compensate me for this opinion?

    As a matter of fact it’s the opposite: I am freely giving advice that can help performance, you can call it ‘crap’ if you wish – as many do.

    It is indeed the trainer’s choice, and without the crutch of a drug a trainer needs to choose differently.

    I take it you are a long time racetracker, if you cannot discern the action and effects of the equine spleen on exercise performance – well, that is part of the overall problem and I’m not surprised by your vitriolic repsonse.

  11. I know this is a complete longshot, but you’d think the idea of better warm ups could be addressed if a racing jurisdiction allowed horses to warm up with their training yokes. Sure you’d need to get creative in creating a rig or girth system that could easily be removed at the gate, and of course there are likely rules, regs and even laws that would make it a difficult proposition, but this seems like it might be something one of the B tracks could experiment with. With the yoke, at least the ham fisted jock might be able to wrestle one back vs. the freight train you get when one gets above the bit.
    Just a suggestion to the powers that be….

  12. Great lively conversation, I’m with Mr.ressey, I have for years practiced and preached the concept of a sprightly warm up, and have had the results confirmed, we had fewer bleeders (pre lasix in NY) fewer break downs, and more wins,and more starts, a few years later with Lasix allowed in NY more breakdowns, more bleeders and fewer wins

    • Thanks for the perspective Rick, I have yet to see an owner/trainer come online and claim the opposite: that since the advent of Lasix his horses win more, start more, and breakdown less.

  13. Anonymous trainer:

    I came on the track in 1963 at the age of 15 and left in 1979. The last six years I trained a stable of mostly claimers. During that time, states one by one started permitting the usage of phenylbutazone or Bute. Lasix had more limited approval and could only be used if a state veterinarian witnessed an overt bleed post-race.
    Virtually all trainers during this time had their horses on a one- or two-week race schedule. Horses were expected to run 20-plus times a year. If horses weren’t running, they weren’t earning their way.
    Horses worked one or two days before a race. All of the historical data shows that horses of this era raced more often and had longer racing careers. There are several arguments cited to blame or support this shift.
    One fact is absolutely crystal clear: The diminished number of starts per horse started to decline with the advent of permitted medications and has continued to decline. Is this coincidental?

  14. I train Standardbreds and all the study material I have seen shows Standardbreds bleed less and fewer race on lasix/salix than TBs. I seldom had bleeders and I do believe it is from the conditioning we put in on our horses as compared to TBs. Univ of PA did a study over the summer at Poconos and found that pacers improved their times on lasix by .67

    Most pacers race on lasix for that over half second advantage not because of bleeding.

    • EIPH has been reported utilizing tracheobronchoscopy from various controlled studies and has shown an incidence of (42-75%) in Thoroughbreds, (26-86%) in Standardbreds, and (62.3%) in racing Quarterhorses it has also been noted in racing camels and greyhounds. There are no controlled studies to evaluate the effect of conditioning or prerace warmup on the incidence. Anecdotal comments regarding the effect of weather, pedigree etc are to be taken with a grain of salt. Much is to be learned about the cause and prevention of this condition and only controlled statisticlly significant studies should be consulted to elucidate this information.

      • In this study you cite James, can I assume even the smallest drop of blood is considered ‘bleeding’, even if it’s not enough to be performance crippling? I have no issue with a racehorse streaming blood from the nostrils to be given relief via Lasix, but it’s the cheats who will find a workaround to get the drug when its not needed that kill the concept for me. I continue to be amazed that a vet requires evidence or proof that Lasix improves performance when it is accompanied by a 20lb weight drop – yet we formally handicap horses with a 2lb weight allowance.

  15. Bill part of the problem with statistics quoted on bleeding is the definition. Epistaxis (blood at the nostrils) is exceedingly rare compared with horses that have evidence of blood in the trachea or bronchii after racing. There certainly is some correlation between performance and degree of bleeding. Other factors such as inflammatory lower airway disease which is quite common in stabled horses contribute to the poor performance. You are absolutely correct that furosemide enhaces performance through mechanisms not associated with its affect on EIPH. Also as you most certainly are aware loop diuretics like furosemide induce a significant hypokalemia(decrease in potassium) which could impair performance. I do not disagree that when so many animals require medication to perform there is a problem. I am just not convinced that there is evidence that conditioning impacts the occurence of bleeding. Unfortunately until the advent of the fiberoptic endoscope the only evidence of bleeding had to be external. By the way I laud you on your efforts to introduce science to the conditioning of racehorses, I know that equine exercise physiology and its research have been much more advanced in Australia than in North America, but anything that can be done to objectively monitor and improve fitness has to be beneficial for both the equine athlete and their owners.

  16. Thanks for the kind words James, your points here are well received (even if I was a bit of a jerk at first – my apologies, but I don’t often get a veterinary opinion such as yours given with so much class!).

    Some horses don’t bleed enough to require intervention, even at fast speeds on dirt. I cannot believe that those lucky ones are identical physiologically to the severe bleeders.

    If EIPH is primarily due to high blood pressures overwhelming pulmonary capillaries – it would stand to reason that increasing the number of capillaries via aerobic conditioning would lessen, albeit not cure, the problem. Although the number of arteries and veins is genetically pre-determined, I’m not sure the racing public understands the effects of appropriate exercise on increasing capillary density.

    Similarly, if an extensive warm up can lead to splenic contraction and the corresponding increase in blood volume – and then be followed by a walking rest period to allow the capillaries time to dilate, again it stands to reason this can’t be anything but beneficial.

    I’m not sure this theory is able to be proven via study, even so I doubt anyone would pay it much attention. I prefer to concentrate on the process, rather than the result.

    Countries like Australia offer medical degrees in Equine Exercise Physiology, yet in the US the concept is often referred to as ‘mumbo jumbo’ – quite frustrating.

    If every vet, namely Foster Northrup, was as thoughtful as yourself, there would be much less vitriol in this discussion.

  17. Let me get back on track here for a second, back to interventions in the conditioning process to alleviate bleeding from the lungs. What hasn’t been discussed is the frequency and/or volume of intense breezing exercise. When you have a horse that has been conditioned to breeze 4F and then you race him 6F+ – HE IS GOING TO BLEED, and it’s your fault as the conditioner – not the horse itself. .

    Only during intense exercise do the lungs recruit alveoli found deep within the lung tissue in order to aid in respiration. If these regions of the lungs are untested until racetime, well – that’s not a pretty picture as the endoscope suggests.

    I didn’t mean to insinuate that you could gallop your horse 10 miles a day and never, ever bleed – that is not the case whatsoever.

  18. Drp stirrup irons to a sane level and not only would most jockeys miraculously be competent enough for warmups, the number of lame or destroyed colts caused by riders ruining their balance while at a gallop would be greatly reduced.

  19. i second the motion that Pressey the lone exercise physiologist equine type I’m aware of should efforts should be lauded. unnecessary in my world to train TBs to be an exercise physiologist, and txs. to the standard bred lady. every little bit of info helps. I’ll add one more to Dr. Meyer. there is evidence that exercise reduces EIPH, at least in my little stable there is. My one serious bleeder gradually reduced the severity off his EIPH as training, and particularly speed training progressed. The physiological explanation I am uncertain, but there was a definite noticeable correlation between where the horse was on the exercise spectrum and his EIPH. This horse incidentally is also living proof that a logically trained, appropriately warmed up horse can develop severe EIPH. I am pretty sure it’s a surface thing with other factors contributing or ameliorating. Same animal never bled breezing on soft grass. First day on dirt–coughing. One rat.

    • Horses are elite athletes, in 2011 nearly every elite athlete employs a conditioning specialist in addition to a regular coach.

      Just watch the 24×7 series on HBO, boxer Manny Pacquiao uses a man named Alex and has for years – now this year we see his competition (Marquez) do the same. A horse trainer has many, many jobs that are extremely time consuming, meaning individual attention to conditioning often takes a back seat. Phil Jackson of the Lakers is possibly the greatest coach ever, but he has ZERO input on training his players to be explosively powerful, he leaves that up to a guy named Chip Schaefer.

      Horsemanship is developed by using your collective subjective experience to train horses. I would never endeavor to tell a trainer how to choose a bit or feel heat in legs, but I am uniquely qualified to consult on equine physiological conditioning. Both Alex, Chip and myself share similar if not identical backgrounds in education. As stated in Moneyball; subjective experience in any sport helps a great deal, but also hinders some aspects of the game – an outside perspective can contribute valuable insight that most ignore.

      One cannot condition a horse like a human, they are different athletes, each with specific needs – but the tools used and the overall principles are similar.

      Aidan O’Brien and Mike de Kock are the two biggest ‘name’ trainers that employ these concepts, they do not let their egos get in the way of doing their jobs to the fullest.

  20. Over here (Germany), raceday lasix is prohibited. When a horse bleeds visually and it affected his performance it’s reported in the official results. I think in about 1 in 10-20 results, such a report is made concerning a single horse. Obviously, pre-race warm-ups in Germany racing are like the one in the video of Japanese racing.

  21. The horses posted on in the bottom video link are quarter horses.

    • Yes Adam those are QHs as that was all TVG had on at midnight, please see the comments above where this is addressed.

      I attend hundreds of races in the US every year, and 95% of the time the thoroughbreds are walking next to the pony 5min to post as in this video. Before this, you see the pony-led jog to the backside, which in my opinion is insufficient. I have seen Calvin Borel be a bit more aggressive when riding for his trainer brother Cecil, and I have seen DW Lukas horses warm up ‘Japanese-style’ on a few occasions.

      Other countries like JPN and HK race on dirt with full fields and no raceday Lasix, and this is one of the easily observable differences in their routine. Similarly, harness horses are not allowed Lasix on raceday either, and they warm up even more aggressively.

  22. Forgot to mention, in the winter, German racing is on dirt. No more incidences of bleeding seem to occur in comparison to turf.

  23. would this bleeding condition show up in a thoroughbred that is training for racing

    • Certainly Don, many will bleed during training breezes – a scope is required to determine to what extent, Grade 1-4. Grade 1 and 2 bleeds are no big deal, while Grade 4 results in blood coming out of the nostrils. It is the Grade 3 bleeds we endeavor to avoid through conditioning, or Lasix. Training a horse to breeze only 4F then racing him 8F is likely to result in a Grade 3 episode, I have found.

  1. Pingback: Video Proof of Why Thoroughbreds Bleed in the US and not in Japan » New Mexico Horse Racing News

  2. Pingback: My Kingdom for an Appropriate Pre-Race Warmup | ThoroEdge Equine Performance

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