You can read Dr. Cookās journal article online for free here: https://aaep.org/sites/default/files/2018-08/Equine%20Veterinary%20Education%20July%202014.pdf (starts p381) . Iāve quoted the significant bits here but basically it is all hypothetical rather than research-based, and he has a major conflict of interest.
[B]Conclusion
Currently, the hypothesis that the bit causes pulmonary oedema is not refuted. A flow chart summarises what I believe to be the consequences of bit usage (Fig 11). In my opinion, nasopharyngeal asphyxia is the cause of exercise-induced pulmonary haemorrhage (EIPH), which is analogous to a rare but life-threatening disease in man known as negative pressure pulmonary oedema (NPPE) (Bhaskar and Fraser 2011; Cook 2014). NPPE in man is caused by upper airway obstruction and is, I submit, a model for exercise-induced pulmonary haemorrhage. It would advance the understanding and prevention of this serious problem in the horse if it too was known as NPPE.
Discussion
I propose that the bit is the predominant cause of nasopharyngeal asphyxia and that NPPE is one of its signs. Contributory factors include variations in usage, respiratory rates, rein tension, poll flexion and a horseās pain threshold. Potential relevance: Unless the hypothesis can be refuted a cause will have been suggested (the bit) and a basis for treatment indicated (its removal) for nasopharyngeal asphyxia and NPPE. As sequelae to these common diseases include hypoxaemia, exhaustion, breakdowns, falls, fractures and sudden death, the article is relevant to: ⢠the welfare and safety of horse and rider/driver ⢠the public image of racing ⢠the furosemide debate ⢠poor performance Medical and surgical interventions do not remove the cause of nasopharyngeal asphyxia. Until at least one racing jurisdiction permits the use of a bitless bridle, removal of the bit cannot be tested under racing conditions but it can be and has been tested during training.
Authorās declaration of interests W.R. Cook is Chairman and major shareholder of Bitless Bridle Inc. and owns a patent on the crossunder bitless bridle.
Source of funding Bitless Bridle Inc.[/B]