Inhalation injury in 11 Thoroughbred racehorses: Clinical course on bronchoscopy, treatment and postinjury racing performance

Inhalation injury is a serious and potentially fatal consequence of a fire or explosion. Bronchoscopy is recommended for rapid assessment of inhalation injury in humans; however, descriptions of bronchoscopic observation of inhalation injury in horses are lacking. We describe the clinical course of inhalation injury observed by bronchoscopy, treatment, and racing performance in 26 Thoroughbred racehorses that had been exposed to a fire. On initial bronchoscopy, 11 were diagnosed with inhalation injury (3 of Grade 1 [mild]; 3 of Grade 2 [moderate]; 4 of Grade 3 [severe]; and 1 of Grade 4 [massive]); 11 had no injury (Grade 0); and 4 were found dead. Treatment was based on inhalation injury grade and mainly involved airway lavage via bronchoscopy for soot removal and exudate recovery. Of the 11 horses with inhalation injury, 10 survived and 9 returned to racing. No effects in terms of racing performance (number of starts, finishing position, and earnings) were observed. Prompt and repeated bronchoscopy may be useful for evaluating the severity of inhalation injury, and airway lavage via bronchoscopy may be an effective treatment. If diagnosed and treated early and appropriately, even severe inhalation injury will not necessarily hinder postinjury racing performance in Thoroughbred racehorses.