Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999

REASONS FOR PERFORMING STUDY: Overstrain injuries to the superficial digital flexor tendon (SDFT) and suspensory ligament (SI) are among the most common musculoskeletal injuries which contribute to the considerable wastage of racing Thoroughbreds. Many epidemiological studies have demonstrated the prevalence of and risk factors for tendon injury when racing but have not included those injuries sustained during training. However, since tendon injury during training is seen commonly in clinical practice, it is appropriate to determine the overall prevalence of tendon injury sustained during both training and racing. OBJECTIVE: To determine the prevalence of overstrain injury to the SDFT and SL during training and racing among Thoroughbred flat racehorses in Japan in 1999. METHODS: A retrospective study was performed using a sample population of 10,262 Thoroughbred racehorses. The medical information database of Thoroughbred racehorses registered by the Japan Racing Association (JRA) in 1999 was analysed for SDFT and SL overstrain injury diagnosed by a veterinarian employed by JRA during training and racing. Jump racehorses were excluded from this study. RESULTS: The prevalence of forelimb SDFT tendonitis and SL desmitis was 11.1% (1130 cases) and 3.61% (370 cases) of the population, respectively. In the hindlimb, there were 0.06% (6 cases) and 0.14% (14 cases), respectively. Risks of SDF tendonitis in the forelimb in 3-year-olds or older horses were significantly higher than in 2-year-olds. In contrast, the risk of SL desmitis in the forelimb at age 3 and 4 years was 2.23 and 2.11 times higher, respectively, than in 2-year-olds, but this increased to 5.07 times in those age > or = 5 years. Entire males were at greater risk in comparison to females and geldings. CONCLUSIONS: The results suggest that the prevalence of SDF tendonitis and SL desmitis in the forelimb was associated with the horse's age and sex. The prevalence of SL desmitis increased further with age compared with SDF tendonitis, possibly reflecting a more rapid accumulation of degeneration in this structure. POTENTIAL RELEVANCE: The age-related risk demonstrated in this study provides further support that overstrain injuries are associated with accumulated degeneration. These data provide a valuable resource for further research into the aetiology of tendon injury in the racehorse.     

Ophthalmic examination findings of Thoroughbred racehorses in Australia

OBJECTIVE: To record the prevalence and document the types of eye disease in population of Thoroughbred racehorses in Victoria, Australia. DESIGN: Prospective study. ANIMALS: Two hundred four Thoroughbred racehorses. PROCEDURE: All horses and both eyes were examined at four metropolitan and two country racing stable complexes. Ophthalmic exam was performed following dark adaptation with a transilluminator, biomicroscope, and direct ophthalmoscope. Intraocular pressures were measured when indicated. Both pupils were dilated with tropicamide when indicated. RESULTS: One hundred eighty-two (89.2%) flat-racing and 22 (10.8%) jump-racing (hurdle or steeple) horses were examined. Age range: 2-9 years (mean 3.7 years, median 3); 97 (47.5%) male-neuter, 74 (36. 3%) female, 33 (16.2%) male. Potential vision-threatening eye disease was present in 15 (7.4%) different horses: complete lenticular cataracts 3, posterior lens luxation and cataract 1, large peripapillary 'butterfly' inactive lesions 3, large peripapillary 'butterfly' active lesions 2, peripapillary focal inactive 'bullet hole' chorioretinal lesions (> 20) 5, optic nerve atrophy 1. Non-vision threatening eye disease was present in 117 (57.4%) different horses, involving one or more ocular structures: lower eyelid scars 3; periocular fibropapillomatous disease 1; third eyelid squamous cell carcinoma 1; corneal scars 6; corneal band opacity 2; anterior iris synechia 1; developmental cataracts 36 (17.2%); peripapillary focal inactive 'bullet hole' chorioretinal lesions (< 20) 103 (50.0%); linear peripapillary hyperpigmentation bands 16 (7.9%). Unusual variations of normal ocular anatomy and colobomata was recorded in 11 (5.4%) different horses: granular iridica hypoplasia 3, granular iridica hyperplasia 2, multilobular granular iridica cyst 1, microcornea 1, hyaloid remnant 1, rotated optic nerve head 1, coloboma of the lens 1, atypical coloboma of the retina 1. CONCLUSIONS: This survey demonstrates that the prevalence of vision-threatening eye disease in racing horses may be greater than previously perceived, and highlights the importance of ocular examination within any routine physical examination of horses.     

Heritability of recurrent exertional rhabdomyolysis in Thoroughbred racehorses

OBJECTIVE: To determine the likely mode of inheritance and identify probable foundation horses for recurrent exertional rhabdomyolysis (RER) in Thoroughbred (TB) racehorses. ANIMALS: 4 families of TB racehorses with a high prevalence of RER, consisting of 3 to 53 horses/family, were used to determine mode of inheritance. Sixty-two TB horses with RER and 34 control TB racehorses without RER were used to identify probable foundation horses for the RER trait. PROCEDURE: RER was diagnosed by a veterinarian and verified by detecting high serum creatine kinase activity. Pedigrees dating from 1930 for all horses were entered into a database. Pedigrees of horses in 4 families were visually inspected for a pattern of inheritance and used for calculation of foundation horse contributions and inbreeding coefficients. The Markov chain Monte Carlo technique was used to analyze pedigrees of the 62 affected and 34 control horses for the conditional probability of foundation genotypes. A dominant mode of inheritance with variable expression model was used. RESULTS: Pedigree analysis supported an autosomal dominant mode of inheritance with variable expression. All affected horses from the 4 families shared a common ancestor. This ancestor and 5 other stallions had a conditional probability of 1.00 for being affected. All 6 stallions shared a common male ancestor within 3 to 5 generations. CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of this study, the RER trait has been in TB racehorses for more than 70 years and may be inherited as an autosomal dominant trait with variable expression.     

Epidemiologic characteristics of catastrophic musculoskeletal injuries in Thoroughbred racehorses

OBJECTIVE: To determine characteristics, incidence rate, and possible associations with selected demographic characteristics of catastrophic musculoskeletal injuries (CMIs) in Thoroughbred racehorses. ANIMALS: 76 Thoroughbreds with CMIs. PROCEDURES: Incidence rates of CMIs during racing or training were calculated with number of CMIs as the numerator and overall numbers of races or training events during 2004 and 2005 as the denominators. Exact 95% confidence intervals were calculated. Associations between incidence and dichotomous exposure factors, nominal factors, and ordinal factors were determined. Only univariable associations were examined. RESULTS: 76 horses were euthanized because of CMI and represented 2.36 and 1.69 deaths/1,000 racing starts in 2004 and 2005, respectively. Of these, 57 were euthanized within 60 days before or after a race, which yielded a point incidence of 1.05/1,000 racing starts and 0.39/1,000 training starts. CONCLUSIONS AND CLINICAL RELEVANCE: Incidence rate of CMIs at 2 Ontario racetracks was similar to that at other North American racetracks. A cumulative death rate of 1 to 2 deaths/wk should be considered typical when designing prevention strategies and offers a baseline value for measuring improvement.     

Descriptive epidemiology of joint injuries in Thoroughbred racehorses in training

Reasons for performing study: No large scale epidemiological studies have previously quantified the occurrence of carpal, metacarpo‐ and metatarsophalangeal (MCP/MTP) joint injuries in Thoroughbred racehorses. Objectives: To develop an objective classification system for carpal and MCP/MTP joint injuries and estimate the incidence of these injuries in young Thoroughbreds in flat race training. Methods: In a prospective cohort study, data on daily exercise and veterinary‐diagnosed carpal and MCP/MTP joint injuries were collected from Thoroughbreds monitored since starting training as yearlings, for up to 2 years. Cases were classified in one of 4 categories: 1) localised to a carpal or MCP/MTP joint based on clinical examination and/or diagnostic analgesia; no diagnostic imaging performed; 2) localised to a carpal or MCP/MTP joint based on clinical examination and/or diagnostic analgesia; radiographs taken but no abnormalities detected; 3) evidence of abnormality of subchondral bone and/or articular margin(s) on diagnostic imaging and 4) evidence of discontinuity of the articular surface on diagnostic imaging. Incidence rates and rate ratios were estimated using Poisson regression, adjusting for trainer‐level clustering. Results: A total of 647 horses from 13 trainers throughout England contributed 7785 months at risk of joint injury. One‐hundred‐and‐eighty‐four cases of carpal (n = 82) or MCP/MTP (n = 102) joint injury were reported in 165 horses and classified in Category 1 (n = 21), Category 2 (n = 21), Category 3 (n = 72) or Category 4 (n = 70). The overall joint injury rate was 1.8 per 100 horse months (95% CI = 1.2, 2.8); rates did not differ significantly between 2‐ and 3‐year‐olds but females sustained Category 1 injuries at triple the rate of males (P = 0.03). Joint injury rates differed significantly between trainers (P<0.001) and there was trainer variation in anatomical site and severity of injury. Conclusions and potential relevance: Carpal and MCP/MTP joint injuries are an important cause of morbidity in Thoroughbred racehorses. Identification of modifiable risk factors for these injuries may reduce their incidence.     

Observer variation in visual assessment of forelimb horseshoe characteristics on Thoroughbred racehorses

OBJECTIVE: To assess the accuracy and reliability of a visual method of evaluating horseshoe characteristics. ANIMALS: 1,199 Thoroughbred racehorses. PROCEDURE: Characteristics of 1 forelimb horseshoe were visually assessed on horses immediately prior to racing by 5 field observers at 5 major racetracks in California. Characteristics evaluated included horseshoe type; toe grab height; and the presence of a rim, pad, and heel traction devices. Sensitivity and specificity for observer assessment of horseshoe characteristics were calculated by comparing observer assessments to a postmortem laboratory standard for horses that died within 48 hours of a race. Intraobserver agreement was assessed in a subset of horses by comparing horseshoe observations made before and after the horse's race. Interobserver agreement was evaluated by comparing horseshoe assessment among observers who examined the same subset of horses prior to racing on select days. RESULTS: The sensitivity and specificity of this visual method of evaluating horseshoe characteristics were good and ranged from 0.75 to 1 and 0.67 to 1, respectively. Agreement beyond chance (weighted kappa values) between observers and the laboratory standard for toe grab height was fair (0.60 to 0.62). Intraobserver and interobserver agreements (kappa values) were high (0.86 to 0.99 and 0.71 to 1, respectively). CONCLUSIONS AND CLINICAL RELEVANCE: Visual observation of horseshoes can be a feasible and reproducible method for assessing horseshoe characteristics prospectively in a large cohort of horses under racing conditions.     

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.     

Fractures sustained by racehorses in Japan during flat racing with special reference to track condition and racing time

The purpose of this report is to describe the results of epidemiological surveys of racing-related fractures in Thoroughbred horses in Japan. In the period 1987-2000, a total of 10,203 fractures were diagnosed in 556,705 runners, resulting in an overall incidence of 1.83%. The annual incidence of fractures in flat racing during the 14-year period fluctuated between 1.44% and 2.19%. The majority of fractures affected the forelimbs. We found significant effects of track condition on injury incidence. The incidence of fractures decreased as track conditions on turf became softer and increased as track conditions on dirt became muddier. Because of the general trend for the incidence of fractures to vary with track condition, we examined the relationship between track conditions and racing times for winning horses in 4117 races and for 50,564 overall runners for the period 1990-1994 on two tracks. For turf courses, racing times became longer as track conditions became softer. In contrast, for dirt courses, racing time tended to become shorter in muddier conditions. The variation in the incidence of fracture with track condition might be due to the corresponding difference in racing time.     

Effect of tracheal mucus and tracheal cytology on racing performance in Thoroughbred racehorses

REASON FOR PERFORMING STUDY: Accumulations of mucus within the trachea are often found during endoscopic examinations of the airways of poorly performing racehorses, but the clinical importance of this finding is unknown. OBJECTIVES: To determine the effect of tracheal mucus, pharyngeal lymphoid hyperplasia (PLH) and cytological indices of tracheal aspirate on racing performance in Thoroughbred horses assessed by race place and whether the horse was raced. METHODS: Endoscopic examination of the nasopharynx, larynx and trachea was performed, and a tracheal aspirate obtained monthly at Thistledown racetrack from April to December, 2002 and 2003. Horses received a score of 0-4 for the degree of PLH and 0-4 for the amount of mucus visible in the trachea. The tracheal aspirate was assessed for turbidity, and total and differential cell counts. Generalised estimating equations models were used as repeated measures models for each risk factor and the level of association assessed through the risk factor's P value in the model. RESULTS: Moderate to severe tracheal mucus (2-4) was a risk factor for poor racing performance. There was no association between degree of PLH, cell counts or turbidity of tracheal wash fluid and racing performance. However, horses that raced had higher total neutrophil counts in tracheal wash aspirates than horses that did not race. CONCLUSIONS: Grades 2-4 tracheal mucus should be considered a potential cause of poor racing performance in Thoroughbred horses. CLINICAL RELEVANCE: Because moderate to severe tracheal mucus accumulation, and not increased tracheal neutrophils, was a risk factor for poor racing performance, functionally significant airway inflammation may best be confirmed by the presence of mucus rather than increased number of neutrophils in the trachea.     

Development of equine upper airway fluid mechanics model for Thoroughbred racehorses

REASON FOR PERFORMING STUDY: Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments. HYPOTHESIS: The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated. Methods: Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse. RESULTS: The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx. CONCLUSIONS AND CLINICAL RELEVANCE: In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis.     

Endoscopic findings in the upper respiratory tract of 678 Thoroughbred racehorses

The frequency of upper respiratory tract abnormalities was determined in a selected population of racing Thoroughbreds. The prevalence of pharyngeal lymphoid hyperplasia was 34.2%; left laryngeal hemiplegia was 1.8%; and epiglottic entrapment was 0.74%. Excluding pharyngeal lymphoid hyperplasia and tracheal exudate, 3.7% of the population examined had upper respiratory tract abnormalities.     

Prevalence and treatment of gastric ulcers in Thoroughbred racehorses of Korea

BackgroundGastric ulcer is one of the prevalent diseases in racehorses. However, it has not been recognized as important in Korea, and drugs used to treat gastric ulcers are included in the doping test list, so they are not allowed to be administered to racehorses in training.ObjectivesThis study was performed 1) to investigate the prevalence and the severity of gastric ulcers in Thoroughbred racehorses in Korea, 2) to confirm the therapeutic effect of ranitidine and omeprazole, and 3) to compare the efficacy between ranitidine and omeprazole.MethodsForty-nine horses were randomly recruited, and gastroscopy was performed within two days after racing. Twelve horses with a sum grade of five or higher were randomly assigned to two treatment groups. Seven horses were administered ranitidine, and five horses were administered omeprazole. Follow-up gastroscopy was scheduled within one to five days after finishing the treatment.ResultsThe prevalence of gastric ulcer in Korean Thoroughbred racehorses after racing was 100%, and the grade was more severe in the non-glandular region than in the pyloric region. There was no correlation between the severity of gastric ulcer in the two regions. Omeprazole had a greater therapeutic effect than ranitidine.ConclusionsThis study shows the importance of recognizing gastric ulcers as an important factor, and omeprazole as a possible treatment option in Korea, as it has been removed from the list of prohibited substances for racehorses. Thus, the use of omeprazole is currently recommended until one day before the race.     

Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training

REASONS FOR PERFORMING STUDY: Musculoskeletal injury is the major cause of days lost from training and wastage in Thoroughbred racehorses. Little scientific information is available on the majority of injuries occurring in training. OBJECTIVES: To estimate the incidence of fractures in British racehorses in training and describe the occurrence of different fracture types and bones involved. METHODS: Thirteen UK racehorse trainers participated in a prospective study, providing data on horses in their care for 2 years. Details on horses, their daily exercise and fracture occurrence were recorded. RESULTS: A total of 1178 horses provided 12,893 months at risk. Nontraumatic fracture incidence was 1.15/100 horse months (95% CI = 0.98, 1.35) and 78% of fractures occurred during training. A wide variety of fracture types and bones were involved, although at least 57% were stress fractures. Pelvic and tibial stress injuries accounted for 28% of fractures diagnosed. CONCLUSIONS: It is important to study injuries in training as well as in racing. The number of stress fractures suggests that training regimes for young Thoroughbreds could often be improved to create a more robust skeleton, able to withstand injury. POTENTIAL RELEVANCE: Studying injuries in racehorses in training can provide a scientific basis for the design of safer training regimes.