The Centurion Transpirator II - an INTRODUCTION
Based on over eight years of clinical experience with treatment of human obstructive
airway disease, Centurion Systems has developed the Transpirator II. This device is
designed to provide heated water vapour therapy to promote the clearance of airway
mucous obstructions that can lead to exercise-induced pulmonary haemorrhage (EIPH)
and poor racing performance.
The Transpirator filters and preconditions the horse's entire inhalation with heat
and droplet-free water vapour, which thins the mucous blanket, dissolves mucous plugs,
and promotes mucocilliary clearance. The resulting removal of airway obstructions
reduces the potential for EIPH without drugs.
The soothing output from the Transpirator is delivered to the horse by muzzle mask.
All breeds and all ages seem to enjoy the treatments - standing unattended for hours,
even during hot, humid weather. Foals with pneumonia have voluntarily put their head
in the mask.
In cooperation with the University of Pennsylvania, New Bolton Centre, Centurion
Systems has demonstrated the prevention of exercise-induced pulmonary haemorrhage
(EIPH) with heated humidity therapy. The studies were conducted at six eastern
thoroughbred and harness tracks.
Dr. Lawrence Soma and Dr. Corinne Sweeney of the University of Pennsylvania's New
Bolton Centre coordinated the EIPH study. The study consisted of scoping a horse
after racing, and rating the severity of bleeding. The horse then received five
two-hour Transpirator treatments, one each of the four days preceding the race
and race day. The horse was scoped after that race and the severity of bleeding
was again recorded. The results obtained from 33 known bleeders after 60
Transpirator-treated races are summarised in the following chart.
Of the 27 horses treated with the Transpirator without Lasix, 14(52%) stopped bleeding,
10(37%) bled less and only 3(11%) showed no change. Of the six horses that were known
to bleed through Lasix, 2(33%) stopped bleeding, 2(33%) bled less and 2(33%) showed no
change. Overall, 85% of the horses treated bled less and no adverse effects were observed.
Respiratory disease is second only to bone and muscle problems in limiting a racehorse's
ability to perform.
Improving a horse's pulmonary function by removing airway obstructions reduces the work
of breathing and improves oxygenation; two major factors in allowing the equine athlete
to race at his full potential.
Improving mucocilliary clearance can lead to shorter recovery times for horses with
respiratory complications, getting the animal back on the track faster for training
In our EIPH Study, each of the 19 trainers involved were asked to rate their horse's
racing performance after Transpirator treatments: 65% of the races were rated as improved.
Many trainers commented that the horse's recovery time after a race was markedly improved:
less blowing, and back to feed and water in a shorter period of time. At least 9 of the
33 horses turned in the best performances of their careers.
Doctor Soma at the University of Pennsylvania is in the process of statistical analysis
of racing performance. In the interim, we can report the following manner:
As you can see from the above chart, the win ratio for these 33 horses in treatment
and the Win, Place, Show average increased from 28% to a very respectable 42%. This
is especially note worthy considering that all 33 horses had exercise-induced pulmonary
haemorrhage before treatment.
OBSTRUCTIVE CAUSES OF EIPH
Airway obstruction is now proven to be a major cause of exercise-induced pulmonary
haemorrhage, more widely known as "bleeding". Horses have been observed bleeding
from the nose for centuries. However, it was not until fibre-optic bronchoscope
development in the early seventies, that the blood was found to originate from the
lungs, not the nose.
Leading veterinary researchers postulate that there are two basic types of EIPH and
they both occur during maximum inspiration.
Type I: Pressure Rupture Of Arterial Capillaries:
Excessive negative alveolar air pressure caused by airway obstructions, combined with
the increased pulmonary arterial pressure during maximum ex~, can cause capillary walls
to seep or haemorrhage. This type of EIPH may be relatively painless and bleeding will
probably stop soon after exercise.
Type II: Over-expansion Rupture Of Unobstructed Alveoli:
If a number of alveoli become obstructed and cannot inflate during maximum inhalation,
the surrounding unobstructed alveoli must over inflate to fill the expanded chest cavity.
Tearing of alveolar walls by over-expansion may be painful and bleeding may be more severe
Relatively minor airway obstruction can increase alveolar vacuum and cause capillary
haemorrhaging. Three major causes of airway obstruction are (a) secretions (dehydrated
mucous and infection); (b) inflamed, swollen airways (bronchitis); and (c) reactive
airways (asthma bronchospasm).
EIPH PREVENTION WITH WATER VAPOUR
The Transpirator filers and preconditions the horse's entire inhalation with heat and
droplet-free water vapour to just above body temperature saturation. This prevents
airway water loss and upon cooling produces a thin film of condensation on the walls
of the entire respiratory tract - from the nasal sinus to the alveoli. Retained and
absorbed water thins the mucous blanket, dissolves mucous plugs, and promotes
mucocilliary clearance. The resulting removal of airway obstructions reduces the
potential for EIPH.
TRANSPIRATOR VS. NEBULIZER
The Transpirator is not a nebulizer. Nebulizers are designed to break down medications
and water into small airborne droplets for treatment of the upper airways. The upper
airways remove airborne particles, including nebulized water droplets, to protect the
small lower airways and alveoli in the lung. As a result, nebulized water is of no
value in preventing EIPH.
The Transpirator in contrast heats and humidifies the horses inhalation in much the
same manner as the horses upper respiratory tract. This heated humidity can penetrate
the lungs all the way to the bronchioles and alveoli. It is in the small air-ways
where obstructions are most prevalent. The resulting hydration and removal of mucous
airway obstruction reduces the potential for EIPH.
LASIX TREATMENT OF EIPH
A previous EIPH Study1 conducted by Drs. Soma and Sweeney at New Bolton Centre,
revealed that up to 75 percent of racing horses suffer from exercise-induced pulmonary
haemorrhage. Currently, the only approved race day treatment for a bleeder is injection
of the diuretic furosemide. Right now, 10 of 16 states with harness racing allow the
use of furosemide. In thoroughbred racing, 20 of 23 states permit its use.
Our demonstration that airway mucous clearance reduces EIPH, supports the edema-reduction
theory for the efficacy of Lasix. Airway obstruction caused by inflammation and swelling
of mucosal membranes, causes similar airflow restriction to secretion obstructions. If
Lasix reduces the swelling through duretic dehydration, then airway resistance and negative
inspiratory air pressure should be reduced. However, there are increasing doubts about
the efficacy of Lasix. Dr. Pascoe of the University of California at Davis is quoted in
an article on Lasix in the July 1985 issue of The Blood Horse., "Based on the evidence
we have ... furosemide seems to reduce the amount of haemorrhage, but it does not stop it."
Our own experience is limited to only eight horses that were on Lasix. However, we
found that six were bleeding through. According to their trainers, most of these
horses had been on Lasix for more than one year. Unfortunately, none of them were
scoped after initial Lasix injections, so it is not known whether any of them ever
stopped bleeding. We broncho-scoped these eight Lasix horses after racing. The
six that were bleeding through were left on Lasix and included in our Transpirator
treatment program: two stopped bleeding, two bled less and two showed no change.
Although the sample is small, it appears that mucous clearance helps Lasix bleeders
as well as it helps untreated bleeders.
1 Raphel C.F., Soma L.R., Exercise-Induced Pulmonary Haemorrhage in Thoroughbreds
After Racing and Breezing. American Journal of Veterinary Research July 1982 pp. 1123-1127.
Clinical evaluation of Transpirator treatment has been primarily focused on EIPH,
however, there has also been success in treating equine bronchitis, sinus infections,
allergies, and foal pneumonia. The dramatic early results with foal pneumonia have
accelerated plans for controlled clinical studies of this most serious breeding farm
Mucous clearance by cilia motion and coughing are the primary mechanisms for removing
airway obstructions. Prevention of airway water loss by administration of warm air
saturated with water vapour is a natural, drug-free method for promoting mucous clearance.
Improved mucous clearance reduces residence time of bacteria and allergens, minimizes
bronchitis and helps maintain the natural humidification function of the upper airways.
Improved natural humidification, in turn, reduces the potential for dry-air-induced