Descriptive epidemiology of fracture,tendon and suspensory ligament injuries in National Hunt racehorses in training

Reasons for performing study: While fractures and tendon injuries are known to be important diseases in National Hunt (NH) racehorses during racing, there are no accurate estimates of their incidence in NH training yards. Objectives: To estimate the incidence of fractures and tendon and suspensory ligament injuries (TLIs) in NH racehorses in training; to describe the injuries incurred and to compare injury incidence rates by horse age, trainer, gender and background (ex‐flat vs. ex‐store horses). Methods: Cohort data were collected from 14 UK NH training yards for 2 racing seasons. Daily exercise regimens and details of fractures and TLIs occurring in study horses were recorded. Results: Data were gathered from 1223 horses that spent 9466 months at risk of injury. The fracture incidence rate was 1.1/100 horse months and varied significantly by trainer (P<0.001) but not by gender, age or background. The pelvis and third metacarpal bone (MCIII) were the most common fracture sites, although this varied between racing and training. The TLI incidence rate was 1.9/100 horse months and varied significantly by trainer (P = 0.05) and age (P<0.001) but not by gender or background. However, exstore horses were significantly more likely to have a TLI on the racecourse than ex‐flat horses (P = 0.01). Superficial digital flexor injuries accounted for 89% of all TLIs, the remainder being suspensory ligament injuries. Conclusions and potential relevance: Fractures and TLIs are important causes of morbidity and mortality in NH racehorses in training in England. This study provides accurate estimates of their incidence in this population and provides a baseline against which to monitor the effect of future interventions.     

Horse injuries and racing practices in National Hunt racehorses in the UK: the results of a prospective cohort study

A prospective cohort study was conducted on horses starting in hurdle and steeplechase races on six UK racecourses in 2000 and 2001. Trainers or carers were questioned on the horses' pre-race routine and observational data were collected in the stables and parade ring. Some practices were common to many starters, such as withholding food and water before racing whereas other practices, such as schooling frequency, were more variable. There was a total of 2879 starts and a total of 83 injuries or medical events (28.8/1000 starts). The commonest types of injury were tendon/suspensory injuries and lacerations/wounds. Multivariable logistic regression models were used to identify the relationship between predictor variables and the risk of injury. Risk of injury or medical event was associated with distance of the race and weight carried. The risk of injury, excluding medical events, was associated with the speed of the race and foot conformation.     

The effect of training on stride parameters in a cohort of National Hunt racing Thoroughbreds: A preliminary study

Reasons for performing study: The influence of training on stride parameters is controversial and to date there is no information on how training influences stride parameters during high‐speed locomotion in the field. Objective: To determine the influence of training on stride variables during high‐speed locomotion in Thoroughbred racehorses. Methods: Speed, stride frequency, stance and protraction times were quantified in 8 Thoroughbreds with foot mounted accelerometers and GPS sensors during their first week of canter after the summer break and 6 months into training. Results: At a speed of 11 m/s, stride frequency was (mean ± s.d.) 2.160 ± 0.120 strides/s pre‐ and 2.167 ± 0.083 strides/s post training; mean stance time was 125.3 ± 9 ms pre‐ and 125.9 ± 7 ms post training; protraction time was 340.7 ± 20.4 ms pre‐ and 337.2 ± 14.3 ms post training. The increase in stride frequency and the decrease in protraction time after training were significant. There was no statistically significant difference in the maximum speed reached by each horse pre‐ and post training. Conclusions: Stance time stayed constant throughout the training season in the tested horses. A significant decrease in protraction time and a corresponding significant increase in stride frequency were observed after training. Potential relevance: Training of racehorses could be adapted to maximise the effect on modifiable parameters and reduce the risk of training‐induced pathologies. Further research will be conducted to investigate the effect of different training protocols on a large number of horses.     

Bee pollen product supplementation to horses in training seems to improve feed intake: A pilot study

The objective of this study was to determine the efficacy of supplementation of Dynamic Trio 50/50, a bee pollen-based product, to improve physical fitness, blood leukocyte profiles, and nutritional variables in exercised horses. Ten Arabian horses underwent a standardised exercise test (SET), then were pair-matched by sex and fitness and randomly assigned to BP (receiving 118 g of Dynamic Trio 50/50 daily) or CO (receiving 73 g of a placebo) for a period of 42 days. A total collection was conducted from days 18 to 21 on six geldings to determine nutrient retention and neutral detergent fibre (NDF) and acid detergent fibre (ADF) digestibility. Horses were exercise conditioned and completed another SET on day 42. V160 and V200 were calculated from SET heart rates (HR). Lactate, glucose, haematocrit (HT) and haemoglobin (HB) concentrations were determined from SET blood samples. Total leukocyte count, and circulating numbers of various leukocytes and IgG, IgM and IgA concentrations were determined in rest and recovery blood samples from both SETs. Geldings on BP (n = 3) ate more feed than CO. BP had less phosphorus excretion, and tended to retain more nitrogen. BP tended to digest more NDF and ADF while having lower NDF digestibility and tending to have lower ADF digestibility. No treatment differences existed for V160 and V200, HR, lactate, HT and HB. There was a trend for lymphocyte counts to be lower in BP than CO on day 42. Dynamic Trio 50/50 supplementation may have a positive effect on performance by helping horses in training meet their potentially increased nutrient demands by increasing feed intake and thus nutrient retention.     

Laparoscopic intestinal exploration and full-thickness intestinal biopsy in standing horses: a pilot study

OBJECTIVE: To assess a laparoscopic technique for equine intestinal biopsy. STUDY DESIGN: Experimental study. ANIMALS: Seven adult horses. METHODS: Food but not water was withheld for 36 hours before laparoscopy. In 3 horses (group A) standing, right laparoscopic access to different small intestinal segments was compared with ventral median celiotomy access. Inaccessible segments were identified at necropsy. In 4 horses (group B), the feasibility of obtaining full-thickness duodenal and cecal biopsies and any associated morbidity were evaluated. Biopsy specimens were collected during standing right laparoscopy using a 2-step procedure and intracorporeal suturing technique, and abdominal lavage was performed. Horses were monitored clinically and by abdominal fluid cytology and microbial culture, and repeat laparoscopy was performed on day 6. RESULTS: Standing right flank laparoscopy provided good observation of small intestinal segments and enabled manipulation of all but 15-20 cm of the duodenum and approximately 40 cm more ileum compared with ventral median celiotomy. Group B horses had no complications, no adhesions, and no bacterial growth from peritoneal fluid samples. None of the horses had signs of abdominal pain. CONCLUSION: A 2-stage intestinal biopsy technique performed during standing, right flank laparoscopy may be a safe alternative to exploratory celiotomy and biopsy in normal horses. CLINICAL RELEVANCE: Right flank laparoscopy allows biopsy of intestinal segments including duodenum and 50% more of the ileum than is accessible by ventral median celiotomy. This technique should be evaluated in clinical patients.     

Constant rate infusion for topical ocular delivery in horses: a pilot study

OBJECTIVE: To assess the efficacy and kinetics of a continuous infusion modality for topical ophthalmic drug delivery via subpalpebral lavage in horses. ANIMALS STUDIED: Five ophthalmically normal horses PROCEDURES: A constant-rate continuous delivery pump was used to apply 0.01% fluorescein solution to the eyes of five ophthalmically normal horses via subpalpebral lavage. Fluorescein was applied at a rate of 0.14 mL/h for 72 h. Tear samples were collected from the ventral conjunctival fornix at regular intervals via capillary tube and tear fluorescein concentrations were determined via spectral assay. Laboratory studies to evaluate the procedures used in the study also were performed. RESULTS: Overall mean tear film fluorescein concentration was approximately 20% of the applied concentration of fluorescein. However, tear film fluorescein concentrations varied considerably between horses and over time. Dilution varied from 0.62% to 60% of the applied concentration. Air pockets sporadically appeared in subpalpebral lavage tubing lines, resulting in discontinuous topical application of fluorescein. CONCLUSIONS: Constant-rate delivery of ophthalmic medications using a continuous infusion pump may provide a valuable method of topical drug delivery if tear film dilution of drugs is taken into account.     

Relationship between the ultrasonographic findings of suspected superficial digital flexor tendon injury and the prevalence of subsequent severe superficial digital flexor tendon injuries in Thoroughbred horses: a retrospective study

The onset of severe injury to the superficial digital flexor tendon (SDFT) is extremely difficult to predict from slight changes in ultrasonographic findings in cases with no apparent clinical signs. This study investigated the relationship between an increased cross-sectional area (CSA) or edema in the subcutaneous tissue around the tendon and the subsequent onset of severe SDFT injury in Thoroughbred racehorses. Horses were classified into three groups based on ultrasound diagnosis (USD) findings: Group A included cases with enlarged tendons; Group B included cases with tendons of normal size but with prominent edema in the peritendinous tissue; and Group C (control group) included cases with no abnormal USD findings. The incidence of subsequent severe tendon injury was significantly higher in the horses in Groups A (25.7%, 28/101) and B (28.3%, 65/212) than in those in Group C (4.9%, 2/41). There were no significant differences in the median period and the median number of races from the first examination to the subsequent tendon injury between Groups A (140 days, 1 race) and B (120 days, 1 race). The results of this study revealed that horses with increased CSA and peritendinous edema are likely to suffer a subsequent severe tendon injury. Also, these two USD findings, i.e., increased CSA and peritendinous edema, indicate the risk of onset of severe SDFT injury.     

Fractures of the withers in horses

The objective was to determine the prognostic features and long‐term outcome of withers fractures in horses. Medical records and radiographs of 14 horses with withers fractures from 2 veterinary teaching hospitals were reviewed. Case details, presentation, clinical signs, radiographs, treatment and outcome were assessed. In all cases, withers fractures were found to occur following a fall on the back. Although horses were often presented with severe acute clinical signs, the long‐term prognosis was good, in the absence of neurological signs, and following extended conservative management (an approximate 6 month rest period).     

Photodynamic therapy for the treatment of periocular squamous cell carcinoma in horses: a pilot study

Objective  Local photodynamic therapy (PDT) is a novel cancer therapy in veterinary ophthalmology. A prospective pilot study seeking to demonstrate proof of principle and safety for the treatment of equine periocular squamous cell carcinoma (PSCC) was therefore conducted. We hypothesized that surgical excision with adjunctive local PDT is an effective and safe treatment for equine PSCC.
Procedures  Nine horses (10 eyes) with PSCC were treated with surgical resection, local infiltration of resulting wound beds with 2-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and irradiation with 665-nm wavelength diode laser. Regular follow-up ophthalmic examinations were performed.
Results  Surgical resection and PDT yielded disease-free intervals of 25–68 months in our study horses as of January, 2008. These results were obtained following a single treatment in seven horses and two treatments in one horse. In one horse, carcinoma in situ developed 2.5 months after partial surgical excision and PDT, requiring local excision under standing sedation.
Conclusions  Preliminary results suggest that surgical resection and adjunctive local PDT is a safe and effective novel treatment for PSCC in horses. More research is needed before PDT for the treatment of equine PSCC can be adequately compared with other current modalities. Important to future investigations regarding PDT, tumor recurrence rate, length of hospitalization, number of treatment episodes required to effect tumor remission, and total treatment costs should be examined in a controlled manner. Our present results and experiences suggest that this treatment may be useful in the treatment of equine PSCC.     

Kick injuries of veterinarians during examination and treatment of horses: a retrospective study in Switzerland

The risk of injury to veterinarians treating horses is high, particularly when performing painful procedures. The present retrospective study investigated this risk, including the frequency and severity of kick injuries, by submitting questionnaires to 700 veterinary practitioners in Switzerland. Evaluation of 216 completed questionnaires revealed that the frequency of kick injuries was affected by the professional experience of the veterinarian, veterinarians being an owner of a horse, the season, the type of procedure, the percentage of equine patients in the practice population, the treatment location (stall, pasture) and chemical restraint of the patient. Severe injuries incurred by veterinarians in recent years were few in number and the result of a number of unfortunate circumstances, which included hurried procedures due to time restraints and unforeseen events that frightened the patient. The risk factors derived from the full statistical model are the percentage of equine patients in the practice population, the treatment location, the type of procedure and chemical restraint of the patient. Using this information, it should be feasible to reduce the risk of injuries. Sedation of horses undergoing painful procedures, choosing a safe treatment location and caution on the part of the veterinarian are advised to reduce the number of injuries.     

Descriptive results from a longitudinal study of airway inflammation in British National Hunt racehorses

Reasons for performing study: Rates of airway inflammation in young racehorses decrease with time but it is not clear whether this is associated with increasing age or time exposed to the training environment. The structure of the British National Hunt (NH) population allowed closer examination of this relationship. Objectives: To compare rates of inflammatory airway disease diagnosed by tracheal sampling (trIAD), and its components, in NH racehorses by age and training history and with published rates in young racehorses. Methods: A prospective, longitudinal study was conducted on 5 NH yards over 2 years. Period sample prevalences of nasal discharge, tracheal mucus, airway neutrophilia and trIAD (defined by a combination of tracheal mucus and airway neutrophilia) were estimated and compared between horses with different ages and time in training. Results: Horses new to training had twice the odds of visible tracheal mucus as ex‐flat trained horses (OR 2.0; 95% CI: 1.4–2.8; P<0.001) but no significantly increased odds of airway neutrophilia (OR 1.3; 95% CI: 0.8–1.9; P = 0.3) and inconclusive evidence of increased odds of trIAD (OR 1.8; CI: 0.9–3.5; P = 0.08). However, a lower median time in training was significantly associated with the presence of visible mucus (P<0.001), increased mucus (P = 0.005) and trIAD (P = 0.03). No disease measure varied significantly with age. Conclusions: Tracheal mucus and trIAD, but not neutrophilia detected in tracheal wash samples, were less prevalent in horses that had been exposed to the training environment for longer, explaining previously reported associations with age. Potential relevance: Neutrophil proportion in tracheal wash samples is not as useful a clinical tool as measures of visible tracheal mucus for identifying horses requiring treatment or changes in management. The inclusion of tracheal wash neutrophils in the assessment of equine airways, or at least their relative weighting in definitions of trIAD, should be re‐evaluated.     

Fractures of the distal phalanx in horses

Summary. Nineteen cases of fracture of the distal phalanx in horses are reviewed. This represented 1.1% of the total number of horses seen at Murdoch University Veterinary Hospital (MUVH) over a 32-month period. All horses were managed conservatively. Eight horses made a complete recovery. Three are being trained again and are not lame. Four horses made a limited recovery. Two horses are still resting and one horse was killed humanely when it still showed lameness after 2 years. One horse was killed humanely after the fracture was first diagnosed.     

Variation in conformation in a cohort of National Hunt racehorses

REASONS FOR PERFORMING THE STUDY: Assessment of conformation is commonly used in the selection of horses for performance purposes. Little information is available on the normal range of conformational traits within the Thoroughbred population. OBJECTIVES: To describe variations in conformation in a cohort of racing Thoroughbreds in order to provide a set of baseline standards within which conformational traits can be considered normal. MATERIALS AND METHODS: Ninety-eight conformational parameters were measured in a cohort of 108 National Hunt racehorses using a digital motion analysis system. The measurements consisted of segment lengths, joint angles in 2D and 3D, inclinations, deviations and circumference measurements. The differences between left and right sides were determined to obtain a measure of asymmetry. Conformational parameters were related to each horse's country of origin, preferred race distance and race type. RESULTS: The majority of parameters followed a normal distribution with the biggest relative variation in hoof related measurements and in stifle and coxal angle. All circumference measurements and the majority of the length measurements were significantly correlated with the height of the horse at the withers. No underlying pattern of combinations of conformational parameters was identified. Twenty-five per cent of the parameters showed a significant difference between left and right-sided measurements. A significant difference in girth and intermandibular width was observed between Irish and French horses. CONCLUSIONS: Thoroughbreds differ from other breeds, not only with regard to segment lengths but also with regard to joint angles and deviations. Variation in conformational parameters was relatively small and no distinct pattern of combinations of conformational traits identified. CLINICAL RELEVANCE: The variation in conformational measurements in Thoroughbred racehorses establishes a set of baseline measurements of conformational range against which individual horses can be assessed.     

Comparative ingestive mastication in domestic horses and cattle: a pilot investigation

It is often assumed that horses chew food more intensively during ingestion than cattle, which ‐ as ruminants ‐ complete part of the mastication during rumination. This has been proposed as a reason for more robust mandibles, larger masseter insertion areas and larger masseter muscles in horses as compared to cattle and other grazing ruminants. In this study, we evaluate results of comparative feeding trials with three horses (338–629 kg) and three cows (404–786 kg), on four different roughages. Ingestion time (s/g dry matter) and chewing intensity (chews/g dry matter) differed among animals within a species, indicating an influence of body mass, and differed significantly between different forages. However, although numerical differences clearly suggest that horses have longer ingestion times and higher chewing intensities on high‐fibre roughage than do cattle, this could not be proven in this dataset, most likely because of the small number of individuals sampled. Further studies are required to corroborate the suspected ingestive behaviour difference between equids and ruminants.     

Growth factor and receptor mRNA expression in the intestine of horses with large colon volvulus: a pilot study

REASONS FOR PERFORMING STUDY: Growth factors (GF) are important for maintenance and repair of intestinal mucosal structure and function, but there have been no studies investigating growth factor (GF) or growth factor receptor (GF-R) mRNA expression in the intestine of horses with large colon volvulus (LCV). OBJECTIVES: (1) To determine mRNA expression for epidermal growth factor (EGF), EGF receptor (EGF-R), insulin-like growth factor-I (IGF), IGF receptor (IGF-R), vascular endothelial growth factor (VEGF) and VEGF receptor (VEGF-R) in the intestine of horses with an LCV compared to normal intestine. (2) To measure the correlation between histological intestinal injury and mRNA expression. METHODS: In 5 horses, samples were collected from the mid-jejunum (small intestine, SI), pelvic flexure (PF) and right dorsal colon (RDC) prior to creation of the LCV (NORM), 1 h following creation of the LCV (ISCH) and 1 h following correction of the LCV (REPER). In 2 clinical cases of LCV, samples were collected from the PF and RDC. Samples were assessed histologically for the amount of intestinal injury. The mRNA expressions of growth factors and receptors were determined using qRT-PCR. RESULTS: VEGF and VEGF-R mRNA expression was greater in horses with an LCV compared to NORM. Expression of IGF-R mRNA increased in the SI during ISCH and REPER. CONCLUSION AND POTENTIAL RELEVANCE: The increase compared to NORM in VEGF and VEGF-R mRNA expression in horses with LCV may be important in early intestinal healing and may also explain, in part, the increase in vascular permeability in horses with a LCV. Expression of IGF and IGF-R in the SI warrants further investigation and may be important for understanding post operative complications in horses with SI lesions.     

Scoring of sweat losses in exercised horses – a pilot study

Based on a series of exercise tests which included the estimation of sweat losses, this article proposes a novel sweat scoring system for exercising horses. This provides a practical estimate of individual animal exercise‐induced sweat losses, based on visible appearance of sweat on the coat after work, which takes into account the effect of various influencing factors. In terms of accuracy and flexibility, the score seems to provide advantages over estimates based on current general recommendations from reference books. Additional studies are needed to validate this scoring system and its use under more diverse situations.     

Muscle and tendon injuries in dogs

The conditions described fall into three categories: (1) muscle contractures (mm. infraspinatus, gracilis and quadriceps); (2) avulsion and displacement of muscles and tendons; and (3) severance of tendons (Achilles, digital flexors).
The clinical features and treatment are outlined for each condition mentioned, and aspects of aetiology are discussed.
The approach essential to the satisfactory repair of severed tendons is presented and the techniques employed for primary and secondary suturing are described.
An account is also given of the use being made of carbon fibre implants in the repair of tendon injuries.