Management of fractures in endurance horses

This paper provides relevant information for veterinarians responsible for treatment of endurance horses, including a retrospective study of fractures in endurance horses presenting to one referral hospital and to treatment clinics at 3 different race venues. Treatment and case outcome were also noted. The information presented provides clinicians working with high level endurance horses increased awareness of common sites of fractures, of prefracture stress related bone injury within this population of athletes and guidelines in order to manage them more effectively. The most common fractures involve the metacarpo‐(tarso‐)phalangeal joint. Most distal limb fractures can be diagnosed radiographically, but magnetic resonance imaging or scintigraphy may be required in some cases.     

Surgical colic in racing endurance horses

A retrospective study was performed of horses that developed colic during endurance racing, and subsequently required surgery. Fifteen horses met the inclusion criteria, of which 13 (87%) had small intestinal volvulus. Nine of the 15 horses (60%) had a small intestinal resection and anastomosis performed. Post operative ileus, particularly in those horses that had a resection performed, was a common complication. Eleven of the 15 (73%) survived, and 4 (27%) have since raced.     

Prevalence of gastric ulcer syndrome in high-level endurance horses

Reasons for performing the study: Equine gastric ulcers syndrome (EGUS) prevalence studies are rare in the endurance horse and none has been carried out to date in horses competing at high level. Objectives: To determine the prevalence of EGUS in high‐level endurance horses. Methods: Thirty endurance horses competing at high level were selected and submitted to 2 gastroscopic examinations. The first gastroscopy was performed during the interseason period, and the second during the competition season within 2–3 days following a ride of 90–160 km. Data related to housing, feeding, training system as well as age, breed and gender were recorded for each horse. Results: The prevalence of squamous gastric ulcers was 48% during the interseason period (mean score 0.85 ± 0.13 on a scale from 0–4) and 93% during the competition season (mean score 1.60 ± 1.15) with a highly significant difference between the seasons (P = 0.001). Most of the lesions were situated in the squamous portion of the stomach but 33.3% of horses showed also glandular lesions. Significant influence of training and performance level on the gastric score (according to the distance of the ride preceding the second gastroscopy) was shown (P = 0.038). There was also a significant influence of housing on the gastric score (P = 0.002) showing higher scores in the horses kept totally on pasture (mean score: 2.14 ± 0.14) vs. horses housed in a mixed environment (stable + pasture, mean score: 1.43 ± 0.17). Both the pastured and (stabled + pastured) groups were receiving a grain supplement but the pastured group received a higher daily starch intake, which might explain the higher ulcer prevalence. There was no influence of age, breed or gender on the gastric scores. Conclusions: The high prevalence of gastric lesions observed in this study is probably related to the high level of training and performance of the horses examined compared to the population of horses included in the prior study. Potential relevance: This prevalence of EGUS in high‐level endurance horses is comparable to the prevalence established in racing horses. The equine veterinarians may take into consideration EGUS as a potential cause of poor performance.     

Plantar fasciitis in 19 endurance horses: Diagnosis,treatment and follow-up

Lesions of the peritendinous–periligamentous soft tissues of the tarsus (plantar fasciitis) commonly result in a curb-like appearance and are considered overrepresented in Standardbred racehorses; however, plantar fasciitis is also quite common in endurance horses. Nineteen endurance horses of different ages (median: 7 years; range: 3–13) and athletic activity level comprising a total number of 25 plantar fasciitis cases were described in this study. In nine cases, injury developed during a training session, and in 16 cases, it developed during competition. In 18 cases, there was swelling, heat and pain on palpation, and in six cases, only swelling was detected. Eight cases were not lame at the time of examination, while in 17 cases, lameness ranged from grades 1–3 on the American Association of Equine Practitioners modified grading scale. The degree of swelling was significantly related to the lameness grade. Ultrasonography revealed differing amounts of thickening of the plantar fascia plantar to the superficial digital flexor tendon and peritendinous–periligamentous oedema of heterogeneous appearance. Horses were treated conservatively with several combinations of rest, controlled exercise, ice-therapy, corticosteroids, local application of working counterirritants and therapeutic shoeing. Seventeen of 25 cases (68%) did not develop re-injury after treatment and rehabilitation, whilst eight of 25 (32%) developed one or more re-injury/injuries. Overall, 21 of 25 cases (84%) returned to the previous or a higher level of competition; in one case (4%), the injury was the cause of retirement from athletic activity. Plantar fasciitis can be considered a sport-related injury in endurance horses of all ages and athletic activity level. Re-injury rate is low; however, adequate rest and rehabilitation protocols are important. Plantar fasciitis rarely leads to retirement from athletic activity, but it can result in 2–5 months out of training and competition.     

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.     

Effects of two training protocols on Angiotensin I-converting enzyme (ACE) activity in horses

Reasons for performing study: Studies in man have shown a correlation between Angiotensin I‐converting enzyme (ACE) genetic polymorphisms, ACE activity in the blood and superior athletic performance in sports requiring endurance. It has been hypothesised that the same correlation occurs in horses. There is no information in the literature concerning the effects of training on ACE activity in equine plasma. Hypothesis: Exercise training influences the activity of circulating ACE and the response observed is dependent on the exercise protocol. Methods: Thirteen horses of mixed breeds were randomly allocated 2 different training protocols to be carried out for a period of 15 weeks. Blood samples were collected from each horse before the beginning of training to determine baseline values. Subsequent sampling took place every 15 days throughout the training phase and for 8 weeks of paddock rest. Angiotensin I‐converting enzyme activity was determined by automated spectrophotometry. Results: Training for 15 weeks significantly increased plasma ACE activity, irrespective of training protocol. Differences observed in ACE activity pattern between the 2 training protocols were not statistically significant. Increase in ACE activity peaked with maximum workload. As soon as training was interrupted, ACE levels significantly decreased. Conclusions and discussion: Exercise training affects levels of ACE activity in equine plasma. The mechanism for this is not yet elucidated, but cardiovascular adaptation to exercise and blood pressure changes might be involved in this regulation. Potential relevance: Exercise training produced a gradual increase in enzymatic activity and might warrant the use of ACE as a tool for fitness monitoring. Angiotensin I‐converting enzyme enzymatic activity in the plasma might be directly correlated to a change in genetic expression and that variability must be taken into account when evaluating results from horses undergoing a physical training programme.     

Computed tomographic diagnosis of incomplete palmar cortical (fatigue) fracture of the third metacarpal bone in two young adult endurance horses

Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. In both cases, scintigraphic examination was suggested, but was declined by the owner, and the lameness had significantly improved after local infiltration of 3 mL of anaesthetic solution in the proximal suspensory region. Radiographic and ultrasonographic examinations of the carpus and proximal suspensory region were unremarkable in Case 2. Case 1 had increased thickness of the medial lobe of the proximal aspect of the suspensory ligament. A computed tomographic examination was performed and an incomplete longitudinal (fatigue) fracture of the proximal third metacarpal bone was detected. After 8 months of box rest and rehabilitation, re-examination revealed resolution of the lameness in both cases. Advanced diagnostic imaging should be considered in young endurance horses with severe lameness during competition or training, in which radiographic and ultrasonographic examinations are unremarkable or do not explain the severity of the lameness. Computed tomography imaging is considered a useful diagnostic imaging technique to detect incomplete longitudinal palmar metacarpal cortical (fatigue) fractures due to its ability to provide excellent bone detail.     

Cardiovascular variables in eventing and endurance horses over a season

IntroductionThe objectives of this study were to describe the changes in clinical cardiovascular examination variables over a competition season in groups of competitive eventing and endurance horses and to compare these findings to non-competitive controls of the same breeds.AnimalsThis study included two eventing horses, 11 endurance horses, and 13 eventing and seven endurance control breed-matched horses.Materials and methodsCardiovascular examinations were performed before starting the competition season, in the middle and at the peak/end of the competition season. Examinations included auscultation of the heart; M-mode echocardiographic measurements and calculated values; left atrial, pulmonary artery, and aortic diameters; color flow Doppler; exercise electrocardiograms (ECG) measuring peak heart rates and quantifying premature complexes; and 24-h continuous ECGs quantifying premature complexes per hour.ResultsAuscultation, echocardiograms, arrhythmias during exercise, and 24-h continuous ECGs did not change significantly throughout the season (p > 0.05 for all variables).ConclusionCardiovascular examination variables of eventing and endurance horses throughout a competition season are reported here for the first time. Although the present study did not reveal significant changes, data should be interpreted carefully as only a small number of horses were examined.     

The relationship of muscle perfusion and metabolism with cardiovascular variables before and after detomidine injection during propofol–ketamine anaesthesia in horses

Objectives To study in horses (1) the relationship between cardiovascular variables and muscle perfusion during propofol–ketamine anaesthesia, (2) the physiological effects of a single intravenous (IV) detomidine injection, (3) the metabolic response of muscle to anaesthesia, and (4) the effects of propofol–ketamine infusion on respiratory function. Study design Prospective experimental study. Animals Seven standardbred trotters, 5–12 years old, 416–581 kg. Methods Anaesthesia was induced with intravenous (IV) guaifenesin and propofol (2 mg kg^?1) and maintained with a continuous IV infusion of propofol (0.15 mg kg^?1 minute^?1) and ketamine (0.05 mg kg^?1 minute^?1) with horses positioned in left lateral recumbency. After 1 hour, detomidine (0.01 mg kg^?1) was administered IV and 40–50 minutes later anaesthesia was discontinued. Cardiovascular and respiratory variables (heart rate, cardiac output, systemic and pulmonary artery blood pressures, respiratory rate, tidal volume, and inspiratory and expiratory O₂ and CO₂) and muscle temperature were measured at pre‐determined times. Peripheral perfusion was measured continuously in the gluteal muscles and skin using laser Doppler flowmetry (LDF). Muscle biopsy samples from the left and right gluteal muscles were analysed for glycogen, creatine phosphate, creatine, adenine nucleotides, inosine monophosphate and lactate. Arterial blood was analysed for PO₂, PCO₂, pH, oxygen saturation and HCO₃. Mixed venous blood was analysed for PO₂, PCO₂, pH, oxygen saturation, HCO₃, cortisol, lactate, uric acid, hypoxanthine, xanthine, creatine kinase, creatinine, aspartate aminotransferase, electrolytes, total protein, haemoglobin, haematocrit and white blood cell count. Results Circulatory function was preserved during propofol–ketamine anaesthesia. Detomidine caused profound hypertension and bradycardia and decreased cardiac output and muscle perfusion. Ten minutes after detomidine injection muscle perfusion had recovered to pre‐injection levels, although heart rate and cardiac output had not. No difference in indices of muscle metabolism was found between dependent and independent muscles. Anaerobic muscle metabolism, indicated by decreased muscle and creatine phosphate levels was evident after anaesthesia. Conclusion Muscle perfusion was closely related to cardiac output but not arterial blood pressure. Total intravenous anaesthesia with propofol–ketamine deserves further study despite its respiratory depression effects, as the combination preserves cardiovascular function. Decreases in high‐energy phosphate stores during recovery show that muscle is vulnerable after anaesthesia. Continued research is required to clarify the course of muscle metabolic events during recovery.     

Electromyographic evaluation of masseter muscle activity in horses fed (i) different types of roughage and (ii) maize after different hay allocations

The aims of this study were to monitor electromyographic (EMG) activity of masseter muscle in healthy horses fed (i) different types of roughage and (ii) maize after different hay allocations. Four horses were offered the following three diets ad libitum: hay, haylage or straw/alfalfa chaff (SAC). In a second trial, four horses were fed cracked maize (CM) and hay in three different orders: (i) CM after a 12‐h overnight fast; (ii) CM immediately after restricted hay intake (0.6 kg hay/100 kg BW); or 3) CM after hay intake ad libitum. The activity of the masseter muscle was determined by EMG (IED^®), and the following were measured: amplitude (muscle action potential = MAP, maximum voltage) and duration of MAP (s). The intake of hay or haylage was associated with intense masseter muscle activity (MAP: hay, 10 ± 1.7 V; haylage, 11 ± 3.3 V; and duration of MAP: hay, 0.31 ± 0.04 s; haylage, 0.30 ± 0.04 s). Similar intense chewing was measured for SAC (MAP 13 ± 3.8 V), although duration of the chewing cycle was relatively short (0.22 ± 0.03 s, diet p < 0.05), which is possibly related to the shorter fibre length. CM was consumed rapidly, with less intense masseter muscle activity (MAP 6.0 ± 1.5 V). Hay intake before CM did not affect chewing force of CM, but duration of chewing cycle was significantly prolonged by feeding hay ad libitum before CM was fed. The consumption of hay, haylage or SAC was associated with intensive masseter muscle activity that was likely to stimulate salivary flow rate. In contrast to roughage, concentrates like CM are consumed rapidly with less intensive masseter muscle activity. This situation is associated with a low salivary flow that may have an adverse effect on gastric function.     

Effects of exercise on skeletal muscle and serum enzyme activities in pigs

In order to determine skeletal muscle and serum enzyme activities following exercise, six adult Landrace pigs were submitted to 10 min running on a treadmill (0.5 m/s, on a 12% gradient) and compared to six controls. Blood samples were obtained just before the exercise, immediately after, and 24 h, 48 h and 144 h after exercise. Muscle biopsies were taken from the longissimus dorsi and biceps femoris 24 h after exercise. Total lactic dehydrogenase (LDH) and LDH isoenzymes in muscle and serum were unchanged. In muscle homogenates, there was no difference in total creatine phosphokinase (CK) activity between the two groups. Total CK activity in the biceps femoris muscle represented only 59% of that observed in the longissimus dorsi muscle. A mean CK-MB value of 2.5% was found in the control group for both muscles but after exercise it was 9.5% (p<0.05) for the biceps femoris and 12.2% (p<0.01) of the longissimus dorsi muscle. In serum, the total CK (p<0.05), CK-MM (p<0.05) and CK-BB (p<0.05) increased immediately after the exercise, followed by a progressive decrease.