Intra‐ and interobserver agreement in the interpretation of navicular bones on radiographs and computed tomography scans

Reasons for performing study: Criteria for the radiographic evaluation of navicular bones in horses have been published to standardise classification of radiographic signs. However, intra‐ and interobserver agreement have not been established. Objective: To determine intra‐ and interobserver agreement in the evaluation of radiographic and computed tomographic (CT) navicular changes. It was hypothesised that: 1) intraobserver agreement would be better than interobserver agreement; 2) agreement would be better for CT than for radiography; and 3) pathological changes would be recognised with greater certainty with CT. Methods: Radiographs and CT scans of 60 cadaver navicular bones were evaluated by 3 observers using published criteria. A subset of 30 studies was evaluated twice by one observer. Agreement was tested using the kappa statistic. Certainty about pathological changes was evaluated by giving the observers the option to choose ‘not sure’. Results: Agreement varied from poor to almost perfect for radiographic evaluation and from poor to substantial for CT evaluation. For radiographic evaluation mean interobserver agreement was fair, as it was for CT evaluation. For radiographic evaluation mean intraobserver agreement was moderate as it was for CT evaluation. Pathological changes were evaluated with greater certainty on CT scans compared to radiographs; however, this was not associated with improved agreement. Conclusions: Variations in classification of navicular lesions in radiographic and CT studies were considerable between and within observers and challenge the use of such studies for diagnostic and prognostic purposes. Potential relevance: The results of this study allowed the identification of evaluation criteria with sufficient precision to be useful for navicular bone evaluation.     

Clearance of corticosteroids following intra‐articular administration of clinical doses to racehorses

Over the last few years there has been a nationwide cooperative effort to establish threshold concentrations and withdrawal time guidelines for corticosteroid use in racehorses. As dosing regimens are specific to individual horses and highly variable, it is not possible to establish regulatory guidelines for every dosing scenario and therefore they are often based on single dose administration studies. The goal of the study described here was to assess the applicability of current regulatory recommendations for intra‐articular corticosteroids based on clinical protocols used by practitioners. A total of 58 Thoroughbred and 82 Quarter Horse racehorses received varying doses of triamcinolone acetonide, methylprednisolone acetate, isoflupredone or betamethasone intra‐articularly in various joints by the treating practitioner. Blood samples were collected at 0, 7, 10, 14, 21, 28 and 35 days post drug administration and serum samples analysed by liquid chromatography mass spectrometry for quantitation of drug concentrations. Serum elimination varied depending upon the dose and the number and specific joints treated. Serum concentrations fell below the ARCI threshold guidance by Day 7 (100 pg/ml) for both triamcinolone acetonide (2–40 mg dose) and isoflupredone acetate (4–30 mg dose) and Day 21 (100 pg/ml) for methylprednisolone acetate (20–600 mg dose). Betamethasone fell below the regulatory threshold (10 pg/ml) by 7 days for all Quarter Horses and for 7/10 Thoroughbreds studied. Drug concentrations were below the regulatory threshold by Day 10 in the remaining 3 horses receiving betamethasone.     

Association between the purchase price of Thoroughbred yearlings and their performance during the 2- and 3-year-old racing seasons

OBJECTIVES Describe the association between the purchase price of Thoroughbred yearlings sold in Australia and racing performance as 2- and 3-year-olds. METHODS Race performance data of 2773 Thoroughbred yearlings sold at auction during 2003 were collected. Associations between purchase price and the probability of starting, the number of race starts and the prize money earned were examined. RESULTS In total, 2206 (79.6%) horses started a race. The mean number of race starts was six and the mean prize money earned was A$24,420. A total of 1711 (61.5%) horses earned prize money, 402 (14.4%) earned more than their purchase price, 312 (11.2%) earned more than A$40,000, the estimated cost of training, and 142 (5.1%) earned A$40,000 more than their purchase price. There was a positive association between purchase price category and the probability of starting, number of starts, earning prize money and earning greater than A$40,000 (P < 0.001). Purchase price category was negatively associated with the probability of earning greater than the purchase price (P < 0.001). The proportion of horses earning greater than the purchase price plus $40,000 was significantly different (P = 0.03) among the five price categories. CONCLUSION Yearling purchase price was positively associated with all race performance outcomes measured and researchers examining the race performance of yearlings purchased at sales should consider including purchase price when modelling. The Thoroughbred yearling market in Australia behaves in a similar manner to the United States market; owners pay a premium to enter the sport of racing and an additional premium in the quest to own a champion.     

Haemoabdomen and colitis following a colon displacement in a 9‐year‐old Thoroughbred mare

This report describes acute haemoabdomen following phenylephrine administration in a case treated for left dorsal displacement of the large colon. The horse also subsequently developed a severe colitis which was treated with aggressive medical therapy.     

Heritability estimates of fractures in Japanese Thoroughbred racehorses using a non‐linear model

Thoroughbred racehorses are produced by mating small numbers of Arabian stallions and native British mares, and have been improved by selection of horseracing performance for about 300 years. While these improvements led to good performance as racehorses, they exposed horses to numerous medical disorders, aggravated by extensive exercise. Fractures are frequent medical disorders in Thoroughbred racehorses. In this study, fracture heritability was estimated using 3,927 Japanese Thoroughbred racehorses to elucidate the risk of racehorse fractures. The heritability estimates of all examined fractures were low (h² = 0.06), while those of fractures in carpal bone and carpus (carpal bone plus distal radius) were moderate (h² = 0.37, 0.24, respectively). Fracture occurrence age for carpal bone and distal radius was both 3.3 years old and was younger than that for other fractures. These results indicated that a larger proportion of the variation in the studied population was due to genetic factors for carpal fractures than for other fractures, while the fractures at other bones were largely affected by environmental factors, correlated with the athlete period (number year in racing). These findings contribute to develop a management plan for suppressing racehorse fractures and improving horseracing safety.     

Inter‐ and intra‐rater reliability and agreement in determining subcutaneous tumour margins in dogs

The objective of this prospective study was to evaluate agreement and reliability of calliper‐based measurements of locally invasive subcutaneous malignant tumours in dogs. Four raters measured the longest diameter of 12 subcutaneous tumours (7 soft tissue sarcomas and 5 mast cell tumours) from 11 client‐owned dogs during 3 randomized, blinded measurement trials, both pre‐ and post‐sedation. Inter‐ and intra‐rater reliability was evaluated using intra‐class correlation coefficient (ICC) and agreement was evaluated using Bland‐Altman plots. Inter‐ and intra‐rater reliability was good (ICC range of 0.8694‐0.89520) and excellent (ICC range of 0.9720‐0.9966), respectively. For agreement calculations, an a priori clinically relevant limit of agreement of 10 mm was set. Inter‐ and intra‐rater agreement was unacceptable with inter‐rater limits of agreement ranging from 15.9 to 55.6 mm and intra‐rater limit of agreement ranging from 11.9 to 28.1 mm. Review of the measurement trial photographs revealed that calliper orientation changes were frequent, occurring in 9/12 (75%) and 8/12 (67%) pre‐ and post‐sedation cases. No significant correlation was found between inter‐rater measurement standard deviations and calliper orientation changes or dog body condition score. These findings suggest veterinarians may have poor agreement in determining the gross edge of tumours, which is expected to introduce bias and inconsistency in tumour staging, assessing response to therapy, and surgical margin planning. Due to the potential consequences for veterinary cancer patients, future studies are needed to validate the present findings.     

Severe supracondylar lysis of the third metatarsal bone due to intra‐articular haemorrhage with similarities to human pigmented villonodular synovitis: A differential diagnosis to intra‐articular neoplasia

This report describes a case of severe supracondylar lysis of the third metatarsal bone of a mature Cob gelding. The gelding presented with moderate to severe lameness and soft tissue swelling in the distal metatarsal region. A mass was present plantar to the third metatarsal bone and dorsal to the suspensory ligament branches. The mass was removed surgically, and was found to be a large blood coagulum within an enlargement of the plantar pouch of the metatarsophalangeal joint. The mass was pedunculated and attached to a region of abnormal synovium. This synovium was identified histologically as being an area of villonodular synovitis. The lesion had similarities with human pigmented villonodular synovitis. Removal of the abnormal tissue resulted in resolution of the lameness and of the lysis of the third metatarsal bone. Haemarthrosis should be considered in the list of differential diagnoses for focally mineralised soft tissue masses found within an articulation, and may be associated with pigmented villonodular synovitis.     

Fibro‐osseous tumour of the second metacarpal bone in a Thoroughbred filly

A 7‐month‐old Thoroughbred filly was evaluated because of an enlarging mass present on the proximomedial aspect of the left metacarpus. The mass was first noticed at age 2 months and had continued to increase in size. The mass was firm, nonpainful to palpation, covered with normal haired skin and had never been associated with lameness. Radiographs obtained at ages 2 and 7 months revealed an enlarging and partially mineralised mass associated with the second metacarpal bone. Based on the clinical and radiographic progression, as well as the location of the mass, a poor prognosis for future athletic soundness was given and the filly was subjected to euthanasia. The mass had histological features of both an ossifying fibroma and osteoma.     

Days lost from training by two‐ and three‐year‐old Thoroughbred horses: A survey of seven UK training yards

Reasons for performing study: The first major epidemiological study of injury incidence in the UK flat racing Thoroughbred (TB), published in 1985, found lameness to be the single largest reason for days when horses failed to train. It was considered advisable to ascertain if progress has been made in reducing the problem of musculoskeletal injuries in the intervening period. Objective: To quantify injury incidence and days lost from training by 2‐ and 3‐year‐old TBs in UK training yards during 2002 and 2003. Methods: One‐hundred‐and‐eighty‐two yearling TBs were recruited at the end of 2001 and daily training and injury records maintained over the following 2 training and racing seasons. Days were defined as lost from training when a horse failed to train at a slow canter speed or faster, and could be assigned to one of 4 categories: lameness, medical, traumatic and unknown. The incidence and number of days lost due to specific injuries and medical conditions was determined by further subdividing the lameness and medical categories. Results: The study period provided a total of 52,601 2‐year‐old and 29,369 3‐year‐old days available for training, with 2‐year‐olds failing to train on a significantly greater proportion of days available than 3‐year‐olds. Lameness was the most important condition causing horses to miss training, with stress fractures being the most important cause of lameness. Medical conditions were a relatively minor cause of days lost from training, accounting for approximately 5% of untrained days in the 2 age groups. Conclusions: In UK flat racehorses there has been little change in the proportion of days lost from training due to lameness over the last 20 years. Potential relevance: This study highlights the need for further efforts to reduce the problem of lameness in the racing TB.