Factors associated with time until first race and career duration for Thoroughbred racehorses

OBJECTIVE: To determine whether sex or foaling period were associated with time to first race start and whether sex, age at time of first race start, or inter-race period were associated with career duration for Thoroughbred racehorses in Australia. ANIMALS: 553 Thoroughbred racehorses. PROCEDURE: Race records through to the end of the 6-year-old racing season were obtained for each horse. Product-limit survival analysis was used to determine whether sex or foaling period was associated with time to first race start and whether sex or age at first race was associated with career duration. A Cox proportional hazards model was used to determine whether sex, age at first possible race, age at first race, or inter-race period was associated with time to first race start or career duration. RESULTS: 472 horses (85.4%) raced. Time to first race start was not associated with sex or foaling period. However, males, who had their first race at a younger age and a greater mean number of rest days between races, had longer careers. The hazard ratio for career duration of males versus females, controlling for age at time of first race and inter-race period (0.27), confirmed that males had a higher probability of a long racing career. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that for Thoroughbred racehorses, sex and time of birth during the foaling season were not associated with time to first race. Male Thoroughbred racehorses that were raced less intensively or raced at a younger age were more likely to have long racing careers.     

Clinical evaluation of a titanium, headless variable-pitched tapered cannulated compression screw for repair of frontal plane slab fractures of the third carpal bone in thoroughbred racehorses

OBJECTIVE: To report clinical evaluation of third carpal bone (C3) frontal plane slab fracture repair with the Acutrak screw system. STUDY DESIGN: Prospective case series. SAMPLE POPULATION: Racing Thoroughbreds (n=17) with frontal C3 slab fractures. METHODS: C3 slab fractures in Thoroughbred racehorses (1999-2004) were repaired by use of the Acutrak screw system. Data collected were (1) preoperative variables--gender, age at injury, limb involved, injury occurrence, fracture thickness, complexity, and displacement, race starts and earnings and (2) postoperative variables were: surgical complications, days to first start, race starts, and earnings. A Wilcoxon signed-rank test was used to compare pre- and postoperative starts and earnings; significance was set at P<.05. RESULTS: Seventeen Thoroughbred racehorses (12 females, 3 males, 2 geldings) were enrolled. Mean (+/-SD) age at injury was 3.3+/-1.0 years. Right carpi (10) were affected more than left (7). Ten injuries occurred during training, 7 during racing. Twelve of 15 horses that raced before injury returned to racing. Average days to first start was 349.3+/-153.9 days. Horses that returned to racing had more starts after repair (median, 6.5 versus 3.5; P=.04) and did not have decreased earnings per start (median, $2452 versus $3061; P=.30). CONCLUSION: The Acutrak screw system is a useful repair technique for frontal C3 slab fractures in Thoroughbred racehorses. CLINICAL RELEVANCE: Adequate reduction and stability of C3 slab fractures can be achieved with the Acutrak screw system, decreasing the likelihood of fragment splitting and screw head impingement on carpal soft tissues.     

Effect of ‘tongue tie’ use on racing performance of Thoroughbreds in the United Kingdom

Reasons for performing study: There is contradictory published evidence on the potential efficacy of ‘tongue ties’ (TTs) for treatment of intermittent dorsal displacement of the soft palate (DDSP) in racehorses. Objectives: To evaluate the effect of TTs on racing performance in Thoroughbred racehorses in the UK using a retrospective cohort study. Methods: Data on individual horses' lifetime racing performance and TT use were retrieved from the Racing Post Online Database. Exposed cases were horses that ran with a TT in randomly chosen race meetings on one of 60 randomly chosen dates from 2001–2003. Unexposed (control) horses were matched to each exposed horse. Various measures of racing performance were analysed both within and between exposed and unexposed groups. Subsets of exposed horses that ran for 3 or 5 consecutive starts wearing TTs and their matched controls were analysed separately to examine the effect of repeated TT use. Results: The inclusion criteria were fulfilled by 108 horses. The odds ratio for ‘improvement’ in race earnings between exposed and unexposed horses was 1.85 for horses that ran at least once with a TT, and 3.60 and 4.24, respectively, for horses that ran in 3 or 5 consecutive races wearing a TT. After instigation of TT use, horses that ran in 3 or 5 consecutive races wearing a TT had a significant increase in earnings when they ran wearing a TT compared to their pre‐TT races. Conclusions and potential relevance: The use of a TT appears to have a beneficial effect on racing performance in a selected population of Thoroughbred racehorses.     

Race Performance After Laryngoplasty and Ventriculocordectomy in National Hunt Racehorses

Objective— To evaluate the effect of laryngoplasty (LP) on race performance in longer distance (National Hunt) Thoroughbred racehorses. Study Design— Case‐control study. Animals— National Hunt Thoroughbred racehorses (n=71) and race‐matched controls (n=126). Methods— Race records for National Hunt racehorses that had LP and ventriculocordectomy were analyzed and racing performance was compared with race‐matched controls. Results— Sixty‐three of 71 cases were matched with controls. Postoperatively, 78% of cases raced, 47% improved their individual performance and cases were as likely to start in 1 or 3 races as controls. In the 5 preoperative races, case horses earned less prize money than race‐matched controls but there was no difference in prize money earned in 5 postoperative races between groups. Cases started in significantly fewer total (lifetime) races both before and after the date of surgery compared with controls. Conclusions— LP seemingly restored short‐term postoperative racing performance of National Hunt horses to a level comparable with that of a matched control population; however, the career “longevity” of case horses appears to be shorter than that of control horses. Clinical Relevance— LP appears to be a suitable treatment for recurrent laryngeal neuropathy in National Hunt racehorses.     

Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty for treatment of dorsal displacement of the soft palate in 102 thoroughbred racehorses

Objective— To compare racing performance before and after sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty in Thoroughbred racehorses with intermittent dorsal displacement of the soft palate (DDSP).
Study Design— Retrospective study.
Animals— Thoroughbred racehorses (n=102) with DDSP.
Methods— Retrieved data included signalment, primary complaint, and upper respiratory tract endoscopic finding. Lifetime race records were compared for earnings per start before and after surgery, days to 1st start, and races won postoperatively.
Results— Comparing mean earnings per start for 3 races before ($2792) and after ($3806) surgery, racing performance improved significantly after surgery in 63% (46/73) of horses that competed in at least 1 race before and after surgery ( P =.02). Mean and median days to 1st start after surgery were 109 and 69 days, respectively. Of horses that raced postoperatively 65% (60/92) won at least 1 race, and 77% (71/92) raced in >5 races after surgery.
Conclusions— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty significantly improved racing performance in experienced Thoroughbred racehorses with performance limiting DDSP, and overall had a similar outcome to other reported surgical techniques for treatment of DDSP.
Clinical Relevance— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty should be considered as a surgical approach to correction of DDSP in Thoroughbred racehorses; however, it is possible that staphylectomy may not be necessary to achieve a desirable outcome.     

Long‐term prognosis of gastrojejunostomy in foals with gastric outflow obstruction: 16 cases (2001–2006)

Reasons for performing study: It has been suggested that the success of gastric bypass surgery in foals for the treatment of gastric outflow obstruction is poor. However, few reports exist evaluating the long‐term prognosis of these cases. Objectives: To determine the long‐term success of foals, including racing records, surgically treated for gastric outflow obstruction secondary to gastroduodenal ulceration. Methods: Medical records of foals undergoing surgical treatment of gastric outflow obstruction secondary to gastroduodenal ulceration were evaluated for clinical information. Owners, trainers and race records were evaluated regarding long‐term survival and racing success. Results and conclusions: Sixteen foals were included in the study, all treated with a gastrojejunostomy. All foals survived to immediate discharge from the hospital; 8 survived to racing age, with 7 of those entering training and 3 actually racing. Foals that did not survive to racing age had various post operative complications. The success rate for these foals appears somewhat better than that previously reported. Potential relevance: Gastrojejunostomy for the treatment of gastric outflow obstruction, secondary to gastric ulceration, is a valid treatment option for foals.     

Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses

Reasons for performing study: The effectiveness and best method to manage dorsal cortical stress fractures is not clear. This study was performed to evaluate the success of lag screw fixation of such fractures in a population of Thoroughbred racehorses. Hypothesis: Lag screw fixation of dorsal cortical stress fractures is an effective surgical procedure allowing racehorses to return to their preoperative level of performance. Methods: The records of 116 racehorses (103 Thoroughbreds) admitted to Equine Medical Centre, California between 1986 and 2008 were assessed. Information obtained from medical records included subject details, limb(s) affected, fracture configuration, length of screw used in repair and presence of concurrent surgical procedures performed. Racing performance was evaluated relative to these factors using Fisher's exact test and nonparametric methods with a level of significance of P<0.05. Results: Of 92 Thoroughbred horses, 83% raced preoperatively and 83% raced post operatively, with 63% having ≥5 starts. There was no statistically significant association between age, gender, limb affected, fracture configuration or presence of concurrent surgery and likelihood of racing post operatively or of having 5 or more starts. The mean earnings per start and the performance index for the 3 races following surgery were lower compared to the 3 races prior to surgery; however, 29 and 45% of horses either improved or did not change their earnings per start and performance index, respectively. Conclusions and potential relevance: Data show that lag screw fixation is successful at restoring ability to race in horses suffering from dorsal cortical stress fractures.     

Characteristics of Thoroughbred and Quarter Horse racehorses that sustained a complete scapular fracture

Reasons for performing study: To determine if scapular fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a scapular fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a scapular fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy‐three TB and 28 QH racehorses had a similar, complete comminuted scapular fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of scapular fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a scapular fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2‐year‐olds; most TBs (74%) were aged ≥3 years. Scapular fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race‐related scapular fracture was more likely to occur in a Maiden race than in a non‐Maiden race. Horses with a scapular fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete scapular fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic scapular fracture more frequently than TBs.     

The effect of interruptions during training on the time to the first trial and race start in Thoroughbred racehorses

Few studies have investigated the effect of having interruptions during training on future training and racing performance in Thoroughbred racehorses. The aim of this paper was to investigate the effect of having an interruption before the first trial on starting in a trial or a race. A prospective cohort study was used to record the training activity of a cohort of Thoroughbred racehorses, over two racing seasons. Fourteen racehorse trainers recorded information on the distances worked at canter and at fast speeds (<15 s/200 m) and provided reasons for horses not training, or for having interruptions (break from training). Trial and racing results were obtained from the New Zealand Thoroughbred Racing online database. A Cox proportional hazards regression model was used to investigate two outcome measures of performance: (1) time to the first trial and (2) time to the first race. The type of interruption that had occurred before the first trial was the main exposure of interest, and was grouped into: no interruption, voluntary (no known condition or disease present) and involuntary interruptions (due to the presence of a condition or disease).A total of 160/200 (80%) horses started in at least one trial and 100/205 (48%) horses started in at least one race during the study period. The median time to starting in a trial or a race differed significantly (p < 0.001) with the type of interruption. The hazard of starting in a trial was lower for horses experiencing voluntary and involuntary interruptions (p < 0.001) but there was no association with starting in a race, after adjusting for confounding variables. As age at the start of training increased the hazard of starting in a trial decreased. Horses accumulating longer distances at 15 s/200 m had a higher hazard of starting in a trial, whilst horses accumulating fewer events at high speed and fewer trials had a reduced hazard of starting in a race. There was significant clustering at the trainer level for both the outcomes investigated. Interruptions to training had an effect on the time to, and hazard of, a trial but not a race start. The timing of these interruptions may have implications for future racing success and career longevity.     

Association between race history and risk of superficial digital flexor tendon injury in Thoroughbred racehorses

OBJECTIVE: To determine whether race history, including the number of races and total race distance, was associated with risk of superficial digital flexor tendon (SDFT) injury in Thoroughbred racehorses in Japan. DESIGN: Matched case-control study. ANIMALS: 515 Thoroughbred racehorses (case horses) that sustained an SDFT injury during training or racing in Japan during 2002 and 951 horses (control horses) without SDFT injury that were matched with case horses on the basis of age and month of the latest race. PROCEDURE: Variables related to race history were compared between case and control horses by means of conditional logistic regression. RESULTS: The odds of SDFT injury increased as mean race distance and mean body weight at race time increased. Compared with females that had never competed in steeplechase races, males regardless of steeplechase race history and females that had competed in steeplechase races had higher odds of SDFT injury. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that longer mean distance per race, heavier mean body weight at race time, steeplechase experience, and sex (male) increased the risk of SDFT injury in Thoroughbred racehorses.     

Racing prognosis of horses following surgically repaired olecranon fractures

Olecranon fracture is a common orthopedic problem in juvenile horses. Prognosis for complete fracture healing when various methods of internal fixation are used is good; however, the impact of olecranon fracture stabilization on the likelihood that foals will start on a racecourse is unknown. Medical records of foals undergoing internal fixation for an olecranon fracture were reviewed. The dam's foaling records were obtained and lifetime racing records were then retrieved for both the affected foals and 1 of their siblings. Twenty-two of 24 repaired fractures healed completely, subsequently, 16 of the foals started in at least 1 race. Statistical calculations suggest that when compared with their siblings, the occurrence of olecranon factures requiring internal fixation in juvenile racehorses will not significantly reduce the likelihood that they will race; however, the siblings had significantly more lifetime race starts and higher career earnings.     

Efficacy of thermal cautery for intermittent dorsal displacement of the soft palate as compared to conservatively treated horses: Results from 78 treadmill diagnosed horses

Reasons for performing study: Previously, objective comparisons of surgical procedures to relieve dorsal displacement of the soft palate (DDSP) have been limited by the presumptive basis of the diagnostic measures applied. Objectives: To assess and compare the efficacy of thermal cautery surgery to conservatively treated controls in racehorses definitively diagnosed with idiopathic intermittent DDSP. Hypothesis: Both conservative and surgical treatments have a beneficial result on racing performance in racehorses affected with DDSP. Methods: Race records were obtained for Thoroughbred racehorses definitively diagnosed with DDSP using highspeed treadmill endoscopy. Racing performance was assessed based on prize money won. Results: Forty‐eight horses that underwent thermal cautery and 30 conservatively treated controls were included. Pretreatment earnings significantly decreased in the race immediately prior to diagnosis. A high proportion of previously raced horses returned to racing after both treatments (90–96%). Intrahorse comparison of earnings in 3 races pre‐ vs. post treatment showed that 53% of conservatively treated horses and 36% of the thermal cautery group had improved performance. Although the difference between these 2 groups may be interpreted as being clinically significant, it was not statistically significant. Conclusions and potential relevance: A higher percentage of conservatively treated controls had improved individual performance compared to horses treated with thermal cautery. Thermal cautery appears less effective than other previously published surgical treatments for DDSP. Comparison of the 2 treatment methods should be interpreted cautiously because treatments were not randomised, resulting in baseline variability between groups.     

Racing Performance in 72 Racehorses Treated with Prosthetic Laryngoplasty for Laryngeal Hemiplegia

The purpose of this study was to compare racing performance before and after prosthetic laryngoplasty for treatment of laryngeal hemiplegia in inexperienced (horses without at least one start before surgery) and experienced (horses with at least one start before surgery) Thoroughbred and Quarter Horse racehorses. Medical records of 54 Thoroughbred and 18 Quarter Horse racehorses or horses intended for racing treated with prosthetic laryngoplasty and unilateral ventriculectomy for laryngeal hemiplegia were reviewed. Signalment, age at the time of surgery, resting endoscopic grade of laryngeal function, surgical procedure, and type of suture were recorded. Median performance index (PI), earnings, distance, and Beyer speed figure (BSF) per start for three races before and after surgery were compared, and factors associated with improved postsurgical performance were evaluated. Seventy-three percent of horses that had not raced before surgery and 84% of horses that competed in at least one race before surgery were able to return to racing after surgery. Fifty-nine percent and 27% of Thoroughbreds and Quarter Horses, respectively, were able to improve their PI after surgery. Sixty-two percent and 20% of Thoroughbreds and Quarter Horses, respectively, significantly increased their distance after surgery. Additionally, 61% and 66% of racehorses were able to increase their earnings and BSF after surgery, respectively. Horses treated with laryngoplasty and unilateral ventriculectomy have a good prognosis for return to racing. Inexperienced racehorses have a better prognosis for improvement after surgery than do experienced racehorses. Thoroughbred racehorses have a better success rate than Quarter Horse racehorses.     

Heart murmurs and valvular regurgitation in thoroughbred racehorses: epidemiology and associations with athletic performance

BACKGROUND: Cardiac murmurs associated with valvular regurgitation occur commonly in conditioned performance horses, but their association with athletic performance is unknown. HYPOTHESIS: Cardiac valvular regurgitation has a negative association with race performance. ANIMALS: Five hundred and twenty-six "race fit" Thoroughbred racehorses engaged in either flat (race distance 1,000-2,500 m) or jump racing (race distance 3,200-6,400 m). METHODS: Cardiac auscultation and color flow Doppler (CFD) echocardiography were performed on 777 occasions. The associations between the presence and severity of either an audible cardiac murmur or valvular regurgitation assessed by CFD, and published, objective measures of race performance were determined using a standard regression approach. RESULTS: The prevalence of murmurs and of regurgitation varied significantly between racetypes (P<.02), generally increasing from 2-year olds to chasers. There were no consistent associations between racing performance and either grade of murmur or regurgitation, whether the presence or absence of regurgitation or murmur, or only murmurs > or =3/6 or regurgitation > or =6/9, were considered. CONCLUSIONS AND CLINICAL IMPORTANCE: There were differences in prevalence and severity of murmurs of atrioventricular and aortic valve regurgitation between racehorses in different disciplines. Data also showed that neither regurgitation nor murmurs were negatively associated with Timeform rating, an index of UK racehorse quality, in any of the groups of racehorses studied.     

Retrospective study of 108 foals with septic osteomyelitis

Objective   To determine the clinical characteristics, short-term outcome and future athletic performance of foals with septic osteomyelitis.
Design   Retrospective clinical study of 108 Thoroughbred foals with radiographic evidence of bone infection that were presented at the Scone Veterinary Hospital between August 1995 and December 2001. Medical records were reviewed and information concerning signalment, the clinical, laboratory and radiographic findings, treatment and outcome was obtained. Racing records were obtained and evaluated for surviving foals that had reached racing age.
Results   Mean age of foals at initial evaluation was 39 days (range 1–180 days); 21 foals had multiple radiographic bone lesions (19.4%), and 76 had concurrent septic arthritis (70.4%). The most frequently affected bones were the femur, tibia and distal phalanx. In total, 87 foals were discharged from the hospital (80.6%), 79 survived long-term to reach racing age and 52 raced (65.8%). Overall, 48% (52/108) of the foals treated for osteomyelitis raced. Foals less than 30 days of age at the time of diagnosis, critically ill foals and those with multiple bones or joints affected were significantly less likely to be discharged from hospital. Multiple septic joints, but not multiple bone involvement, had an unfavourable prognosis for racing.
Conclusions   The prognosis for survival of foals with septic osteomyelitis or osteitis is favourable. Multiple bone or joint involvement is an important short-term prognostic indicator; however, the involvement of multiple joints, but not multiple infected bones, is associated with an unfavourable prognosis for racing.     

Influence of different exercise regimes on the proximal hoof circumference in young Thoroughbred horses

Reasons for performing study: Most lameness in horses relates to foot problems and may be associated with changes in hoof shape, but there is a lack of information on the influence of normal exercise on hoof shape. Objectives: To investigate the effect of training on proximal hoof circumference in young Thoroughbred racehorses being prepared for racing. Methods: Thirty‐seven young Thoroughbred racehorses were included in this study. Front hoof circumference immediately below the coronary band was measured weekly with a measuring tape in all horses present at the stable. Most horses accomplished a minimum of 2 training periods at the stable separated by periods of rest on a paddock. One sample t tests were used to evaluate if the mean change per week differed from zero. To estimate the repeatability coefficient, the left proximal hoof circumference of 25 horses was measured 3 times in a random order on one day. Results: Most horses showed a similar pattern of change. The proximal hoof circumference decreased during the training periods (P<0.0001) and increased when the horse was rested (P<0.0001). The decrease of the circumference during the first training period was ?0.66 mm/week on the left and ?0.64 mm/week on the right. During the second training period, this was ?0.58 mm/week on the left and ?0.57 mm/week on the right. During the rest period, the circumference increased by 1.03 mm/week on the left and 1.12 mm/week on the right. The repeatability coefficient for the left circumference was 1.8 mm. Conclusions: Horses showed a decrease in circumference during race training that reversed when they were rested. Potential relevance: Measurement of front hoof circumference is a simple method to assess change in hoof shape. It provides an opportunity to investigate the relationships between specific training, hoof shape and soundness.     

What is the likelihood that Thoroughbred foals treated for septic arthritis will race?

REASONS FOR PERFORMING STUDY: Septic arthritis is a serious problem in the neonate, with a poor prognosis being reported for recovery. The impact of neonatal septic arthritis on the likelihood that Thoroughbred (TB) foals will start on a racecourse is not known. HYPOTHESIS: The development of septic arthritis in a TB foal significantly reduces the likelihood that it will race when compared to foals from the same dam. METHODS: Medical records of 69 foals treated for septic arthritis were reviewed. The dam's foaling records were reviewed and lifetime racing records were then retrieved for both the affected foals and at least one of their siblings (controls). Outcomes that were statistically evaluated included discharge from the hospital and whether the foal eventually raced. Univariate analyses of categorical variables were conducted for each outcome. The number of affected and unaffected foals that raced at least once were compared using regression analysis. Survival analysis was used to compare age at first race between the study and comparison groups. RESULTS: Foals with septic arthritis were less likely to start on a racecourse compared to controls (odds ratio [OR] 0.28; 95% confidence interval [CI] 0.12-0.62, P = 0.001), while those foals that were discharged from the hospital were also less likely to start on a racecourse compared to controls (OR 036; CI 0.15-0.83, P = 0.008). The presence of multisystem disease was associated with a decreased likelihood of surviving to be discharged (OR 0.13; 95% CI 0.02-0.90; P = 0.005), but did not affect the likelihood that they would start in at least one race if discharged successfully (OR 0.45; 95% CI 0.04-2.81; P = 0.34) compared to the other foals with septic arthritis. Log-rank comparison of survival curves confirmed that foals discharged following treatment for septic arthritis took significantly longer to start in their first race compared to the sibling population (mean age of study group 1757 days, CI 1604-1909; mean age of sibling group 1273 days, CI 1197-1349; P = 0.0006). CONCLUSIONS: The development of septic arthritis in a TB foal significantly reduces the likelihood that it will start on a racecourse when compared to controls. POTENTIAL RELEVANCE: Accurate figures allowing a realistic assessment of the athletic future of a foal following treatment for septic arthritis are of significance for both owner and treating veterinarian.     

Risk factors for race-associated sudden death in Thoroughbred racehorses in the UK (2000-2007)

Reasons for performing study: Sudden death adversely affects racehorse welfare, jockey safety and the public perception of horseracing. Objective: To describe the risk of racing‐associated sudden death in Thoroughbred racehorses in the UK from 2000 to 2007, to identify whether there were risk factors uniquely associated with sudden death and to improve the understanding of the pathogenesis of racing‐associated sudden death by identification of risk factors for such cases. Methods: A sudden death was defined as an acute collapse and death, in an apparently healthy Thoroughbred racehorse, during or immediately after racing, in the absence of clinical data indicative of a catastrophic orthopaedic injury. The retrospective study included 201 case race starts and 705,712 control race starts. Univariable and multivariable logistic regression were used to identify risk factors for sudden death at any one start. Results: In the multivariable model, age, distance, race type, season and number of starts in the 60 days prior to the race were associated with sudden death. Conclusions: The risk factors identified in this study are not uniquely associated with sudden death and have been also been identified in studies using all causes of fatality as the outcome. These data suggest that a generic approach to reduce fatal musculoskeletal injury and sudden death may be possible. Potential relevance: The identification of risk factors allows speculation on the underlying mechanisms of sudden death in racing. This may stimulate hypothesis‐led investigations into the pathogenesis of exercise‐related arrhythmias, exercise‐induced pulmonary haemorrhage and blood vessel rupture. See also correspondence by Cook