The influence of exercise during growth on ultrasonographic parameters of the superficial digital flexor tendon of young Thoroughbred horses

REASON FOR PERFORMING STUDY: Conditioning by early training may influence the composition of certain musculoskeletal tissues, but very few data exist on its effect during growth on tendon structure and function. OBJECTIVES: To investigate whether conditioning exercise in young foals would lead to any ultrasonographically detectable damage to the superficial digital flexor tendon or an increase in cross-sectional area (CSA). METHODS: Thirty-three Thoroughbred foals reared at pasture were allocated to 2 groups: control (PASTEX) allowed exercise freely at pasture; and CONDEX, also at pasture, began conditioning exercise from mean age 21 days over 1030 m on a purpose-built oval grass track, for 5 days/week until mean age 18 months. Foals were observed daily, and underwent orthopaedic examination monthly. Ultrasonographic images of the superficial digital flexor tendon (SDFT) at the mid-metacarpal level of both forelimbs were obtained in all foals at ages 5, 8, 12, 15 and 18 months. CSA was validated (r(2) = 0.89) by determining CSA from digital photographs of the transected SDFT surface from 12 of the horses necropsied at age 17.1 months. RESULTS: here was no clinical or ultrasonographic evidence of tendonopathy in either group and the greatest increase in mean CSA in both groups occurred between age 5 and 8 months. Across all age categories, there was no significant difference in mean CSA between the left and right limbs, or colts and fillies; there was a trend towards a larger CSA in the CONDEX group (P = 0.058). CONCLUSIONS: There was no conclusive evidence for a structural adaptive hypertrophy of the SDFT, probably because the regimen was insufficiently rigorous or because spontaneous pasture exercise may induce maximal development of energy storing tendons. POTENTIAL RELEVANCE: A moderate amount of early conditioning exercise against a background of constant exercise at pasture is not harmful to the development of the flexor tendons.     

High speed field kinematics of foot contact in elite galloping horses in training

Reasons for performing study: Mechanical characterisation of the high speed gallop has significant importance for animal welfare and basic biology. Kinematic parameters such as the velocity of each foot at contact can inform theories of why animals gallop, and supplant epidemiological investigation into the mechanisms of musculoskeletal injury. Objective: To determine the velocity at which the fore and hind hooves of elite galloping horses impact the surface. Methods: High speed videography was used to measure the horizontal and vertical velocity of the hoof immediately prior to impact, and the subsequent sink (vertical) and slip (horizontal) distances travelled by the hoof into the surface. Horse speed ranged from 11–19 m/s. In total 170 forelimb and 168 hindlimb foot falls from 89 horses were analysed. Results: Horizontal and vertical hoof velocity increased with speed (P<0.001). Horizontal hoof velocity was significantly greater in the hindlimbs compared to the forelimbs (P<0.001) and was greater in the nonlead limbs compared to the lead limbs (P<0.001). Vertical hoof velocity was significantly greater in the lead limb than the nonlead limb (P<0.001). Overall, forelimbs contacted the ground with a more acute velocity vector angle than hindlimbs (P<0.001). Lead limbs contacted the ground at more acute angles than nonlead limbs (P<0.001). Vertical and horizontal velocities were highly correlated to sink and slip distance. Conclusion: Hindlimbs impact the surface at higher velocity than forelimbs, which is likely to result in higher peak impact forces in the hindlimbs. This runs counter to the finding of lower incidence of injury in hindlimbs. Potential relevance: Explanations consistent with these findings include the hindlimbs more effectively dampening peak impact forces, or that other injury mechanisms, such as limb vibration and limb load at mid stance, play an important role in injury.     

The effect of hoof angle variations on dorsal lamellar load in the equine hoof

Reasons for performing study: In the treatment of laminitis it is believed that reducing tension in the deep digital flexor tendon by raising the palmar angle of the hoof can reduce the load on the dorsal lamellae, allowing them to heal or prevent further damage. Objective: To determine the effect of alterations in hoof angle on the load in the dorsal laminar junction. Methods: Biomechanical finite element models of equine hooves were created with palmar angles of the distal phalanx varying from 0–15°. Tissue material relations accounting for anisotropy and the effect of moisture were used. Loading conditions simulating the stages in the stance where the vertical ground reaction force, midstance joint moment and breakover joint moment were maximal, were applied to the models. The loads were adjusted to account for the reduction in joint moment caused by increasing the palmar angle. Models were compared using the stored elastic energy, an indication of load, which was sampled in the dorsal laminar junction. Results: For all loading cases, increasing the palmar angle increased the stored elastic energy in the dorsal laminar junction. The stored elastic energy near the proximal laminar junction border for a palmar angle of 15° was between 1.3 and 3.8 times that for a palmar angle of 0°. Stored elastic energy at the distal laminar junction border was small in all cases. For the breakover case, stored elastic energy at the proximal border also increased with increasing palmar angle. Conclusions and potential relevance: The models in this study predict that raising the palmar angle increases the load on the dorsal laminar junction. Therefore, hoof care interventions that raise the palmar angle in order to reduce the dorsal lamellae load may not achieve this outcome. See also correspondence by Redden See also correspondence by Curtis     

Morphological spectrum of primary epidermal laminae in the forehoof of Thoroughbred horses

Reasons for performing the study: Hoof health is a major concern of horse owners as well as the equine industry. However, many questions remain concerning regional variations of laminar junction and its potential to remodel. Hypothesis: To examine regional variations in the morphology of the laminar junction and thickness of the hoof wall in Thoroughbred horses. Methods: The forefeet of 25 Thoroughbred cadavers were examined. Each hoof was divided into 20 blocks through 4 proximodistal slices (below the coronary band, each 1 cm apart) and 5 circumferential positions (toe, medial and lateral quarters and heels). In each block, 25 central primary epidermal laminae (PEL) were considered. Orientation of each lamina in relation to the hoof wall (LO), degree of bending (IA) and the spaces between the adjacent laminae (LS) were measured. Thickness of the hoof wall and number of branched PEL were also measured. Data were analysed using a split‐block design in ANOVA. Results: There were significant differences between the 2 proximal and 2 distal slices in LO and IA data, but not in LS data. Circumferentially, toe blocks were different from heel and quarters blocks. Lateral and medial heels as well as the quarters were mostly different. The hoof wall was slightly thicker laterally than medially. There were more branched PEL on the lateral side of the left hooves and on the medial side of the right hooves. Conclusions: These data add to the circumstantial evidence supporting the hypothesis of adaptive remodelling in the laminar junction. Results of this study signify the capability of PEL to remodel in response to applied stress to the regions of the hoof. Potential relevance: A deeper understanding of the gross and cellular processes of laminar remodelling may well prove to be complementary to an understanding of their failure in laminitis.     

Skeletal forelimb measurements and hoof spread in relation to asymmetry in the bilateral forelimb of horses

Reasons for performing study: Research has highlighted a high frequency of skeletal asymmetries in horses. In addition, research into hoof asymmetries has shown that within a bilateral pair, the hoof with the smaller angle is often subjected to greater loading. There has been limited attention paid to understanding compensatory mechanisms for skeletal asymmetries in the horse; the dynamic structure of the hoof could potentially be acting in a compensatory capacity. Objectives: To investigate the relationship between morphometry of forelimb segments and hoof spread and their incidence of asymmetry. Methods: Ten bilateral measurements of the hoof and forelimb were taken from 34 leisure horses. The relationship between hoof spread and forelimb segment measurements were analysed using a generalised linear model (GLM). Results: In relation to left hoof spread, the GLM identified significant negative relationships with left side measurements (third metacarpal length, elbow height), and significant positive relationships with right side measurements (fetlock height, third metacarpal length, elbow height). In relation to right hoof spread, the GLM identified significant negative relationship with left elbow height, and significant positive relationships with right side measurements (fetlock height, point of shoulder). The difference between the number of horses larger to the left or to the right was found to be significant for point of shoulder height (X²= 4.8, P<0.05), and highly significant for heel height (X²= 9.53, P<0.01) and the third metacarpal length (X²= 7.26, P<0.01). Conclusions and clinical relevance: The study demonstrated considerable asymmetry in left‐right morphometry of the equine limb. The fact that measurements of hoof spread were significantly associated with limb segment measurements could possibly indicate that an interaction exists. Any asymmetry in hoof spread measurements may suggest unequal loading of the limbs, which in turn may contribute to injuries and reduced performance.     

Evaluation of a new strategy to modulate skeletal development in Thoroughbred performance horses by imposing track-based exercise during growth

REASON FOR PERFORMING STUDY: No data exist on the intensity of exercise required or on possible harmful effects of increasing exercise in foals over the natural level when free at pasture. OBJECTIVES: To investigate whether an increase in workload over free pasture exercise in the period from directly after birth to the start of training is tolerated by Thoroughbred (TB) foals without increasing injury rate or producing other undesired side effects. METHODS: Thirty-three TB foals were allocated to one of 2 exercise groups directly after birth. One group (PASTEX) was raised on pasture and the other (CONDEX) kept under identical circumstances, but was additionally subjected to an exercise protocol of gradually increasing intensity. Foals were monitored periodically and scored for the presence of clinical signs related to the musculoskeletal system (joint effusion, pain at flexion, occurrence of physeal swelling), and radiographs taken at the end of the conditioning phase. Also, behavioural studies were performed to detect any changes in behaviour related to the exercise programme. Cortisol levels were measured in both groups, to assess the level of stress. RESULTS: Workload in the CONDEX group was significantly higher than in the PASTEX group (approximately 30%). Conditioning increased the likelihood for joint effusion in the antebrachiocarpal joint, but reduced tarsocrural effusion and physeal swelling at the lateral distal radius, the third metacarpal bone (medial aspect) and lateral and medial aspects of the third metatarsal bone. CONCLUSIONS: The 30% increase in workload did not affect the animals' welfare, effects of conditioning exercise on clinical musculoskeletal health were few and there were no adverse effects. POTENTIAL RELEVANCE: This study supports the feasibility of imposing early conditioning exercise in horses and is a benchmark for its effects on the development of equine musculoskeletal tissues.     

Effects of different forms of exercise on post inhibitory rebound and unwanted behaviour in stabled horses

Reasons for performing study: It is unknown if different locomotor activities are equally effective at meeting the stabled horse's need for exercise and if they attenuate unwanted behaviour. Hypothesis: Alternative forms of exercise influence the intensity of locomotor activities during a period of turn‐out (the so‐called rebound effect) and the occurrence of unwanted or undesirable activities during standard handling situations. Method: Twenty‐four horses kept in stables were randomly assigned to one of 4 exercise regimes (walker, treadmill, turn‐out and riding) for 4 consecutive days. Because these forms of exercise provide additional environmental stimulation, beyond that provided by exercise, each horse served as its own control in 4 corresponding (no exercise) control treatments presented in a balanced order. Unwanted behaviour was tested by taking horses to weighing scales and loading and unloading them onto a 4‐horse float by an experienced handler and the rebound effect was tested by releasing them into a large arena for a period of 15 min at the end of the exercise and control treatments. Results: Locomotor activities made up a large part of behaviour in the large arena following control treatments and all exercise regimes were sufficient to reduce the intensity of walking (P<0.05), trotting (P<0.01) and cantering (P<0.001) on release into a large arena. Exercise regime reduced the number of bucks (P<0.01) and rolling (P<0.05) during rebound tests suggesting that turn‐out was having a stronger effect than the other 3 exercise regimes. Exercise regimes significantly reduced the amount of unwanted behaviour and the number of commands given by the handler during weighing (P<0.05) but had no effect on these behaviours during loading onto a float. Conclusion: Providing stabled horses with one hour/day of exercise on a walker, treadmill, turn‐out or by being ridden are all effective at allowing expression of locomotor activities in stabled horses. Potential relevance: Providing stabled horses with regular exercise is likely to provide positive effects on horse welfare, training ability and handler safety.     

An investigation of the shape of the hoof capsule in hindlimbs,its relationship with the orientation of the distal phalanx and comparison with forelimb hoof capsule conformation

There is limited information documenting hind foot conformation. The objectives of the study were to describe the shape of the hoof capsule of hindlimbs from the lateral aspect in horses of variable breeds, and, within horses, to compare the conformation of the hoof capsule of forelimbs and hindlimbs and determine the orientation of the distal phalanx within the hoof capsule in hindlimbs. Lateral photographs of the fore and hind feet (n = 225) and lateromedial radiographs of the hind feet (n = 29) were obtained. Differences among breed and shoeing status groups were assessed using multivariable mixed-effects linear regression models. Angular parameters and ratios of linear measurements were compared between fore and hind feet; angular radiological variables and photographic parameters of the hind feet were compared. The mean dorsal hoof wall angle for hind feet (50.9°±3.7°) was smaller than forefeet (51.8°±3.9°) (P = 0.04). The mean heel angles for hind feet (36.4°±9.6°) were smaller than forefeet (40.1°±9.3°; P < 0.001). Dorsal hoof wall (P < 0.001) and heel (P = 0.002) angles were larger in unshod than shod feet. In the hind feet, the dorsal hoof wall was parallel to the dorsal aspect of the distal phalanx. The median angle of the distal phalanx to the horizontal (angle S) was 0.6° (interquartile range: −1.4, 2.3°). There was a positive relationship between angle S and the hoof wall angle (W); each 1° increase in angle S was associated with 0.6° increase in angle W (P < 0.001). Angle S was also positively associated with photographic heel angle; each degree increase in the angle S was associated with 1.8° increase in the heel angle (P < 0.001). It was concluded that the angle of the distal phalanx to the horizontal in hindlimbs is smaller than published values for forelimbs. The orientation of the distal phalanx in hindlimbs is correlated with external characteristics of the hoof capsule.     

Consistent detection of bovine papillomavirus in lesions, intact skin and peripheral blood mononuclear cells of horses affected by hoof canker

Reasons for performing the study: Equine hoof canker is a chronic proliferative pododermatitis of as yet unknown aetiology. Like equine sarcoid disease, canker is a therapy‐resistant disorder characterised by hyperkeratosis, acanthosis and a marked tendency to recur. Hypothesis: There is an association of sarcoid‐inducing bovine papillomaviruses of types 1 and 2 (BPV‐1, BPV‐2) with hoof canker disease. Methods: Using PCR‐based techniques, we assessed canker tissue, intact skin and/or peripheral blood mononuclear cells (PBMCs) of 25 canker‐affected horses for the presence of sarcoid‐associated BPV‐1 and ‐2. Results: Conventional PCR revealed BPV‐1/‐2 DNA in 24/24 canker, 12/13 skin and 10/11 PBMC DNA isolates. Using inverse PCR, full‐length BPV episomes were detected in 1/5 canker specimens. Sequencing of viral early and late genes amplified from canker, intact skin and PBMC DNA of 2 cases revealed an overall identity of 98% to BPV‐1. Viral DNA loads amounted to ≤16 copies per cell in canker tissue and intact skin, and to ≤0.35 copies per PBMC, as determined by quantitative PCR. Using RT‐PCR, the viral major oncogene E5 was shown to be transcribed in 2/4 canker tissue specimens and 5/7 PBMC isolates. Immunocapture PCR from 7 canker and 6 skin extract supernatants revealed capsomere‐associated viral DNA in one canker and one skin sample. Hoof tissue, skin and PBMCs collected from 13 individuals with no signs of canker or BPV‐related malignancies scored negative throughout the experiments. Conclusion: These findings suggest that the observed presence of BPV‐1/‐2 in canker‐affected horses is not coincidental but indicative of an active contribution to hoof canker disease. Potential relevance: The use of antivirals and/or immune modulators may help improving canker therapy.     

Sudden death in racing Thoroughbred horses: an international multicentre study of post mortem findings

Reasons for performing study: To improve the understanding of exercise related sudden death in Thoroughbred racehorses. Objectives: To describe the post mortem findings in cases of sudden death associated with exercise in 268 Thoroughbred racehorses. Methods: Gross and histological post mortem findings of 268 cases of sudden death were collated and reviewed. Cases originated from 6 racing jurisdictions around the world. Sudden death was defined as acute collapse and death in a closely observed and previously apparently healthy Thoroughbred racehorse, during, or within one hour after, exercise. Cause of death as determined by the attending pathologist was categorised as definitive, presumptive or unexplained and compared between the different populations. Cardiopulmonary lesions recorded at post mortem examination were compared between different populations. Results: Pathologists recorded a definitive cause of death in 53% (143/268) of cases. Major definitive causes of sudden death included cardiac failure, apparent pulmonary failure, pulmonary haemorrhage, haemorrhage associated with pelvic fractures or with idiopathic blood vessel rupture, and spinal cord injury. A presumptive cause of death was made in 25% (67/268) of cases and death remained unexplained in 22% (58/268) of cases. There were several statistically significant inter‐population differences in the cause of death and in reporting of cardiopulmonary lesions. Conclusions: Sudden death can be attributed to a variety of causes. Causes of sudden death and the lesions found in cases of exercise‐related sudden death are similar in different racing jurisdictions. However, the lesions are often not specific for the cause of death and determination of the cause of death is therefore affected by interpretation by the individual pathologist.     

Locally invasive melanoma in the internal laminae of the hoof of a bay mule

An 8-year-old bay mule was presented with moderate right forelimb lameness and dark discolouration of the white line. Histopathology of the dark material indicated a melanoma. Extensive resection and debridement were not curative and the mule was subjected to euthanasia 70 days after presentation.     

The effects of limb posture on relationships between in vitro radial hoof strain,load and joint angles

Reasons for performing study: Radial strain in normal hooves has been found to vary with strain gauge location, limb posture and sample limb but reported magnitudes were considered to be low. More accurate measurement of radial strain may enhance the understanding of hoof function. Objectives: To explore in vitro radial hoof strain in relation other kinetic and kinematic variables that may be related. Methods: Five normal forelimbs were removed at the proximal articular surface of the third metacarpal bone (McIII). The limbs were loaded using a modified Instron test machine. Six calibrated infrared cameras captured movement from markers on the hoof and bone fixed markers on the second and first phalanxes and McIII, whilst radial hoof strain was measured using a calibrated instrumented plug. Change in strain, joint angle and load were found at simulated walking postures and bivariate correlations were used to compare the relationships between them. Results: Radial strain was moderately correlated with proximal interphalangeal joint (PIPJ) rotation (r =?0.519). Large reductions in radial strain were found in loading and midstance with 10° of heel lift postures. Conclusions and potential relevance: PIPJ rotation has previously been linked to the magnitude of deep digital flexor tendon (DDFT) loads and it is therefore suspected that these loads may have the greatest influence on radial strain magnitudes. Further investigation of radial strain is needed to describe the patterns fully during the stance phase in vivo.     

Thermoregulatory capacity of the Thoroughbred racehorse and its relationship to the pathogenesis of exertional heat illness

When racehorses fail to thermoregulate effectively, whether due to intrinsic or extrinsic factors, a condition called exertional heat illness (EHI) may occur, which can be life-threatening and represents a significant welfare issue. Horses usually become affected in the recovery phase soon after racing, so that a knowledge of the ‘normal’ thermoregulatory processes which operate at this time and their variations is essential to enable early detection of EHI. Racing in hot or warm and humid weather conditions represents the upper extreme of thermoregulatory variations, and observations on how horses normally recover at the racetrack may provide a clearer perspective on the physiology of that process for all sports horses. This review focuses on the post-exercise thermoregulatory capacity of the Thoroughbred racehorse, with a view to understanding the physiological mechanisms that should efficiently dissipate excess heat. The clinical manifestations of exertional heat illness are due to inadequate or harmful physiological responses, and if recognised and treated early can be effectively curtailed.     

Magnetic resonance imaging and histological findings in the proximal aspect of the suspensory ligament of forelimbs in nonlame horses

Reasons for performing study: Detailed magnetic resonance imaging (MRI) and histological appearances of the proximal aspect of the suspensory ligament (PSL) in the forelimb of nonlame horses have not been previously documented. Objectives: 1) to describe detailed anatomy of the PSL, 2) describe high‐ and low‐field MRI and histological appearances of the PSL and surrounding structures in the forelimb of horses with no carpal or proximal metacarpal pain, 3) assess the relationship between age, breed, gender, height, bodyweight and MRI findings and 4) describe the histological appearance of the PSL and compare this with MRI findings. Methods: High‐ and low‐field MR images of the PSL and related structures from 30 cadaver limbs of nonlame horses were analysed subjectively and objectively. Univariable and multivariable linear regression analyses were used to assess the association of age, breed, gender, height and bodyweight with MRI findings. Histological and MRI findings of the PSL of 9 limbs were compared subjectively. Results: The collagenous tissue of the PSL had low to intermediate signal intensity depending on the pulse sequence. There was a large variation among horses in the amount, shape and signal intensity of the muscle and adipose tissue within the PSL. Comparison of MR images with histological slides revealed that the high signal intensity areas corresponded to adipose tissue and intermediate signal intensity areas to muscle tissue. The medial lobe of the PSL had a smaller cross sectional area (CSA) than the lateral lobe; there was a positive association between CSA of the PSL and both horse height and bodyweight (P<0.001). Conclusions and potential relevance: The large variability in the MRI appearance of the PSL in nonlame horses should be borne in mind when interpreting MR images of lame horses.     

Effects of acute exercise on angiotensin I-converting enzyme (ACE) activity in horses

Angiotensin I-converting enzyme (ACE) level measurement in blood samples is an important tool in human medicine for the detection, treatment and control of diseases such as sarcoidosis and hypertension. Recently ACE has been advocated as being correlated to athletic aptitude in human athletes and a genetic polymorphism has been shown to be responsible for the enzymatic levels in the circulation. The objective of this research was to evaluate the effects of acute exercise in horses in order to increase the understanding of a possible correlation between ACE levels in plasma and performance in equine athletes. A standardised exercise test (SET) to fatigue was conducted on 8 horses and repeated venous blood collections carried out for ACE activity measurements before, during and after the SET. Our results show an increase in ACE activity up to fatigue and a return to baseline values at 30 min post exercise.