The impact of the mandatory rest period in Fédération Equestre Internationale endurance events.

BACKGROUND: Endurance riding competitions are increasingly popular, with a corresponding awareness of the frequency of Failure to Qualify (FTQ) due to lameness or metabolic problems. Fédération Equestre Internationale (FEI) rules require a minimum number of days between competitions, known as a mandatory rest period (MRP). OBJECTIVES: To analyse the impact on FTQ outcomes of MRPs which applied between January 2014 and December 2016, and model potential changes to MRPs to establish which rule change could lead to the largest further reduction in the number of FTQ outcomes. STUDY DESIGN: Retrospective cohort study and predictive model using a subset of data collected by the FEI of every horse start worldwide in Concours de Raid d'Endurance Internationale (CEI) competitions between 2010 and 2017. METHODS: Descriptive statistics followed by predictive/retrospective modelling of potential scenarios. Scenarios involved extended MRP for all horses and/or for only the fastest ridden horses. RESULTS: There were clear direct benefits demonstrated from the introduction of MRPs. Among directly affected horses, current MRPs could have prevented 2.3% of FTQ outcomes. Further benefits could be gained by extending MRPs. The 'best-value' impact could be found in a 1-week extension for all horses plus a 1-week extension for the fastest ridden horses - which could result in a reduction of up to 11.5% of FTQ outcomes among directly affected horses. MAIN LIMITATIONS: The data set covers all FEI competitions but no National Federation events. The data set is geographically comprehensive but it does not include every competition started by every individual horse. Training data for each horse were not available. CONCLUSIONS: Mandatory rest periods for horses between endurance competitions have had the intended impact of reducing numbers of FTQ outcomes in CEI events. Further benefits could be gained by extending rest periods for all horses and/or for horses ridden at the highest average speeds.

Overground endoscopic findings and respiratory sound analysis in horses with recurrent laryngeal neuropathy after unilateral laser ventriculocordectomy.

BACKGROUND: Unilateral ventriculocordectomy (VeC) is frequently performed, yet objective studies in horses with naturally occurring recurrent laryngeal neuropathy (RLN) are few. OBJECTIVES: To evaluate respiratory noise and exercising overground endoscopy in horses with grade B and C laryngeal function, before and after unilateral laser VeC. STUDY DESIGN: Prospective study in clinically affected client-owned horses. METHODS: Exercising endoscopy was performed and concurrent respiratory noise was recorded. A left-sided laser VeC was performed under standing sedation. Owners were asked to present the horse for re-examination 6-8 weeks post-operatively when exercising endoscopy and sound recordings were repeated. Exercising endoscopic findings were recorded, including the degree of arytenoid stability. Quantitative measurement of left-to-right quotient angle ratio (LRQ) and rima glottidis area ratio (RGA) were performed pre- and post-operatively. Sound analysis was performed, and measurements of the energy change in F1, F2 and F3 formants between pre- and post-operative recordings were made and statistically analysed. RESULTS: Three grade B and seven grade C horses were included; 6/7grade C horses preoperatively had bilateral vocal fold collapse (VFC) and 5/7 had mild right-sided medial deviation of the ary-epiglottic fold (MDAF). Right VFC and MDAF was still present in these horses post-operatively; grade B horses had no other endoscopic dynamic abnormalities post-operatively. Sound analysis showed significant reduction in energy in formant F2 (P = 0.05) after surgery. MAIN LIMITATIONS: The study sample size was small and multiple dynamic abnormalities made sound analysis challenging. CONCLUSIONS: RLN-affected horses have reduction in sound levels in F2 after unilateral laser VeC. Continuing noise may be caused by other ongoing forms of dynamic obstruction in grade C horses. Unilateral VeC is useful for grade B horses based on endoscopic images. In grade C horses, bilateral VeC, right ary-epiglottic fold resection ± laryngoplasty might be a better option than unilateral VeC alone. The Summary is available in Portuguese - see Supporting Information.

Fédération Equestre Internationale (FEI) endurance events: Riding speeds as a risk factor for failure to qualify outcomes (2012-2015).

This study examined the association between riding speed and elimination in Fédération Equestre Internationale (FEI) endurance events. A total of 35,061 horse starts from 1st July 2012 to 31st December 2015 were included in a multivariable logistic regression model containing 25 different risk factors. Riding speeds in individual stages ('loops') were included as individual risk factors in studying the progress of horses through loops 1-3 of each endurance ride. The possibility of real-time, 'mid-ride' predictive modelling was explored by modelling both riding speeds and sudden changes in speed between loops as potential risk factors. Faster riding speeds, especially during loops 1 and 2, were associated with deleterious outcomes. Furthermore, sudden drops in riding speed during loop 3 were associated with an increased likelihood of elimination.

Fédération Equestre Internationale endurance events: Risk factors for failure to qualify outcomes at the level of the horse, ride and rider (2010-2015).

An epidemiological study of elite endurance riding was conducted using data from every Fédération Equestre Internationale (FEI) endurance event from 2010 to 2015, comprising 82,917 starts. The aim of the study was to identify risk factors associated with failure to qualify outcomes for horses during FEI endurance rides. The FEI endurance rules state that, during a ride, horses must be assessed by veterinarians several times, giving veterinarians the opportunity to prevent those horses exhibiting signs of lameness or metabolic problems from continuing further. Multivariable logistic regression models were constructed to identify horse, ride and rider level risk factors associated with failure to qualify. Risk factors particularly associated with increased likelihood of failure to qualify due to lameness included age of horse≥9 years, male horse, male rider, field size≥61 horses and if the ride was held in region group II (Northern and Eastern Europe). Factors associated with increased likelihood of failure to qualify due to metabolic problems included whether the ride was held in region group VII (North Africa and the Middle East), ride distance≥100km and male rider. Some risk factors, such as field size, may be modifiable at the ride level. Other risk factors such as horse age or sex are unmodifiable, but awareness of the risk contributed by these factors can provide veterinarians with additional information while treating horses during endurance rides.

Histological Features of the Distal Third Metacarpal Bone in Thoroughbred Racehorses, With and Without Lateral Condylar Fractures.

A detailed histopathological study of the distal third metacarpal bone of Thoroughbred racehorses was undertaken to characterize lesions observed previously on magnetic resonance imaging (MRI). The bones were selected and grouped on the basis of MRI features. Representative sections in different planes were processed for histopathology. All lesions observed in the articular cartilage (AC) and subchondral bone (SCB) were recorded and graded with a scoring system, based partially on the Osteoarthritis Research Society International grading system. The scoring system included the severity of the lesion. Descriptive statistics and linear mixed effects models were performed. A positive correlation was observed between the severity of histopathological changes in the superficial and deeper osteochondral tissues, and between the number of race starts and AC score. Age was not correlated with AC or SCB score. A moderate variation in AC and SCB scores was observed between the groups; however, there were differences within individual bones. Bones with focal palmar necrosis (FPN) showed significant differences in the histological scoring of the AC compared with bones without FPN. Bones with incomplete fractures or larger areas of bone remodelling showed significant differences in SCB pathology when compared with bones with FPN. Haematoidin was detected in areas with excessive SCB and cancellous bone sclerosis and/or irregular bone density. This finding is suggestive of poor blood perfusion in these areas.

Can we use subchondral bone thickness on high-field magnetic resonance images to identify Thoroughbred racehorses at risk of catastrophic lateral condylar fracture?

REASONS FOR PERFORMING STUDY: Fractures of the lateral condyle of the third metacarpus (MC3) are a significant welfare concern in horseracing worldwide. OBJECTIVES: The primary aim of this work was to identify magnetic resonance (MR) image-detectable prefracture markers that have the potential for use as a screening tool to identify horses at significant risk of catastrophic fracture. STUDY DESIGN: Case-control study of bone-level risk factors for fracture in racehorses. METHODS: A total of 191 MC3s from horses, with and without lateral condylar fracture of MC3, were subjected to MR imaging. The depth of dense subchondral/trabecular bone was measured at several sites around the distal end of the bone and regression analyses were conducted to identify differences in this depth between horses with and without lateral condylar fracture. RESULTS: Greater depth of dense subchondral/trabecular bone in the palmar half of the lateral parasagittal groove of distal MC3 was associated with an increased likelihood of being from a horse that had sustained a fracture. Receiver operator characteristic analysis was used to identify the optimal cut-off in the depth of dense subchondral/trabecular bone at this site to best discriminate fracture status. Positive and negative predictive values were calculated using the prevalence of fracture within the current study and also a prevalence estimate for the wider racehorse population. CONCLUSIONS: There is a requirement to identify suitable prescreening test(s) to eliminate many true negative horses and increase the prevalence of prefracture pathology in the sub population that would be screened using MR imaging, in turn maximising the positive predictive value of this test.

Use of large-scale veterinary data for the investigation of antimicrobial prescribing practices in equine medicine.

BACKGROUND: As antimicrobial resistant bacterial strains continue to emerge and spread in human and animal populations, understanding prescription practices is key in benchmarking current performance and setting goals. Antimicrobial prescription (AP) in companion veterinary species is widespread, but is neither monitored nor restricted in the USA and Canada. The veterinary use of certain antimicrobial classes is discouraged in some countries, in the hope of preserving efficacy for serious human infections. OBJECTIVES: The aim of this study was to ascertain the rate of prescription of a number of 'reserved' antimicrobials in a first-opinion US and Canadian horse cohort, and identify trends in their empirical use. STUDY DESIGN: Retrospective cohort study. METHODS: A large convenience sample of electronic medical records (2006-2012) was interrogated using text mining to identify enrofloxacin, clarithromycin and ceftiofur prescriptions. Time series analysis and logistic regression were used to identify trends and risk factors for prescription. RESULTS: Prescription of these antimicrobials as a first-line intervention, without culture and sensitivity testing (CST), was common in this population. Enrofloxacin prescriptions were found to increase over the study period, and there was evidence of either a reducing, or static trend in the proportion of reserved APs informed by CST. MAIN LIMITATIONS: Dose adequacy could not be included due to the nature of the data used. CONCLUSIONS: Empirical use of reserved antimicrobials was common in this population, and further advice and guidance should be issued to first-opinion veterinarians to safeguard antimicrobial efficacy.

Repeatability and intra- and inter-observer agreement of cervical vertebral sagittal diameter ratios in horses with neurological disease.

BACKGROUND: Sagittal ratio values (SRVs) of cervical vertebrae are used for ante-mortem diagnosis of cervical vertebral stenotic myelopathy, but intraobserver and interobserver variability in measurement may influence radiographic interpretation of vertebral stenosis in horses with neurological disease. OBJECTIVES: To determine intraobserver repeatability in SRVs, intra- and interobserver agreement in SRVs and whether or not agreement was influenced by animal age. ANIMALS: Forty-two horses (>1 year old) with neurological disease from which laterolateral computed radiographic images of C2-C7 were obtained. METHODS: Four observers made measurements from C2 to C7 for each horse and interobserver agreement for intra- and intervertebral SRVs was determined using Bland-Altman analysis (acceptable agreement: limits of agreement [LOA] ≤ 0.05) on all horses and those ≤3 (n = 25) and >3 (n = 17) years old. Each observer also made repeated measurements for 10 horses and intraobserver repeatability and agreement were determined. RESULTS: Adequate intraobserver repeatability was achieved for 6 sites. Within observers, paired measurements had a median difference ≤5.7%, but a large range in differences often occurred, most frequently at intervertebral sites. For C5, C6, C7, and C3-4, LOA ≤ 0.05 were achieved by at least 1 observer. With the exception of C5 for 1 pair, LOA were >0.05 for interobserver agreement, regardless of animal age. LOA were largest at intervertebral sites. CONCLUSIONS AND CLINICAL IMPORTANCE: Within and between observers, measurement error may limit the diagnostic accuracy of SRVs and result in discrepancies of diagnosis and treatment and warrants consideration when used clinically in horses with neurological disease.

Musculoskeletal injury rates in Thoroughbred racehorses following local corticosteroid injection.

A retrospective cohort study was performed to compare the rates of musculoskeletal injury (MSI) in horses receiving local corticosteroid injection (LCI) with those that were untreated and those prior to treatment. Of the 1911 study horses, 392 had been treated. A LCI was defined as any injection of corticosteroid into or adjacent to a synovial structure, muscle, or tendon/ligament. A MSI was defined as any limb injury identified by a veterinarian, following which the horse did not race for at least 6 months, or was retired. Hazard ratios (HR) comparing hazard of injury following injection to that in non-injected horses and prior to injection were calculated using Cox proportional hazards models. At least one LCI was administered to 392 horses (20.5%; median 2, range 1-16). Most LCIs were performed bilaterally (70.9%) and intra-articularly into the carpal (49.7%) or fore fetlock (29.3%) joints. There were 219 MSIs of which carpal injuries (47%), fore fetlock (22%) and forelimb tendon injuries (16%) were the most common. The incidence rate of MSI in untreated horses and those prior to injection was 1.22 (95% CI 1.04-1.44) injuries/100 horse-months, and following LCI the hazard of MSI was greater (HR 4.83, 3.54-6.61, P<0.001). The hazard ratio returned to levels indistinguishable from before treatment after 49 days. The hazard of MSI in horses following second and subsequent LCIs in the data collection period was greater than in horses following their first LCI (HR 2.10, 1.31-3.36, P=0.002). There was a positive association between LCI and subsequent musculoskeletal injury rates which was most likely due to progression of the musculoskeletal condition which prompted treatment. Assuming horses that received LCI were at increased risk of MSI subsequently, any beneficial effects of the LCI were insufficient to counter this increased risk for at least 49 days after the injection.

Accuracy of distal limb fracture diagnosis at British racecourses 1999-2005.

Accurate diagnosis of racing injuries can be difficult. The objectives of this study were to describe the postmortem (PM) defined distribution of fatal distal limb fractures (DLF) affecting Thoroughbreds racing in Great Britain between February 1999 and August 2005 and then assess the accuracy of veterinary racecourse diagnoses and examine whether these improved following introduction of a computerised recording system. PM examinations were performed on limbs distal to radius or tibia from all cases of fatal DLF occurring on British racecourses during the study period. Results of these examinations were described and compared with the diagnoses made at the racecourses. Over the study period, fatal DLF prevalence in all race types was 0.63 per 1000 starts (344/545,335), with the lowest frequency (0.34 per 1000 starts) in flat racing on turf and the highest frequency (1.56 per 1000 starts) in national hunt flat races. The prevalence of fatal DLF in steeplechase racing had reduced from that reported previously: from 2.3 to 1 per 1000 starts. Racecourse veterinary identification of fracture presence was good (>93 per cent); however, identification of all fractured bones was poor (<55 per cent). Introduction of a computerised recording system did not significantly improve diagnostic accuracy. The prevalence of fatal DLF has not significantly altered since the 1970s. Techniques such as on course digital radiography to help improve racecourse fracture diagnoses could be introduced.

Long-term exercising video-endoscopic examination of the upper airway following laryngoplasty surgery: a prospective cross-sectional study of 41 horses.

REASONS FOR PERFORMING STUDY: To investigate upper respiratory tract function in horses, previously undergoing laryngoplasty (LP), using exercising video-endoscopy. OBJECTIVES: To evaluate arytenoid abduction and stability, diagnose any concurrent upper airway problems, and correlate these with the owners' perception of success. METHODS: Horses undergoing LP during a 6-year period at one hospital were initially included. Those available for re-examination were exercised for a duration and intensity considered maximal for their discipline using an over-ground endoscope. Resting and exercising laryngeal and pharyngeal videos were analysed blindly. Multivariable analysis was used to test associations between resting and exercising endoscopic variables, and also between endoscopic variables and owner questionnaire findings. RESULTS: Forty-one horses were included and 78% had a form of upper airway collapse at exercise, with 41% having complex forms, despite 93% of owners reporting the surgery to have been beneficial. Horses with poor abduction (grades 4 or 5/5) were 6 times more likely to make respiratory noise compared with those with good (grades 2 or 3/5) abduction (P = 0.020; 95% confidence interval [CI] 1.3-27.0), and those not having a ventriculectomy were 4.9 times more likely to produce respiratory noise post operatively (P = 0.048; 95% CI 1.0-23.9). Palatal dysfunction was observed in 24% of horses at rest, and 56% at exercise, with the diagnosis at rest and exercise significantly associated (P = 0.001). Increasing severity of pharyngeal lymphoid hyperplasia (prevalence 61%) was significantly associated with increasing arytenoid abduction (P = 0.01). Thirty-four per cent of horses had aryepiglottic fold collapse and 22% of horses had vocal fold collapse. CONCLUSIONS: Many horses that had previously had LP were diagnosed with upper airway abnormalities, despite the procedure being considered as beneficial by most owners. POTENTIAL RELEVANCE: When investigating cases of ongoing respiratory noise or poor performance following LP, exercising endoscopy must be considered. Continued respiratory noise may be associated with poor arytenoid abduction and not performing concurrent ventriculectomy.

Pulpar temperature changes during mechanical reduction of equine cheek teeth: comparison of different motorised dental instruments, duration of treatments and use of water cooling.

REASONS FOR PERFORMING STUDY: Although equine motorised dental instruments are widely used, there is limited information on their thermal effect on teeth. The recently described variation in subocclusal secondary dentine depth overlying individual pulp horns may affect heat transmission to the underlying pulps. OBJECTIVES: This study compared the effect of 3 different equine motorised dental instruments on the pulpar temperature of equine cheek teeth with and without the use of water cooling. It also evaluated the effect of subocclusal secondary dentine thickness on pulpar temperature changes. METHODS: A thermocouple probe was inserted into the pulp horns of 188 transversely sectioned maxillary cheek teeth with its tip lying subocclusally. Pulpar temperature changes were recorded during and following the continuous use of 3 different equine motorised dental instruments (A, B and C) for sequential time periods, with and without the use of water cooling. RESULTS: Using motorised dental instrument B compared with either A or C increased the likelihood that the critical temperature was reached in pulps by 8.6 times. Compared with rasping for 30 s, rasping for 45, 60 and 90 s increased the likelihood that the critical temperature would be reached in pulps by 7.3, 8.9 and 24.7 times, respectively. Thicker subocclusal secondary dentine (odds ratio [OR] = 0.75/mm) and water cooling (OR = 0.14) were both protective against the likelihood of the pulp reaching the critical temperature. CONCLUSIONS: Prolonged rasping with motorised dental instruments increased the likelihood that a pulp would be heated above the critical temperature. Increased dentinal thickness and water cooling had protective roles in reducing pulpar heating. POTENTIAL RELEVANCE: Motorised dental instruments have the potential to seriously damage equine pulp if used inappropriately. Higher speed motorised dental instruments should be used for less time and teeth should be water cooled during or immediately after instrument use to reduce the risk of thermal pulpar damage.

Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in steeplechase starts in the United Kingdom (2001-2009).

The objective of this study was to identify risk factors for superficial digital flexor (SDF) tendinopathy in Thoroughbred horses in steeplechase races in the United Kingdom. Potential risk factors for SDF tendinopathy were studied between 1st January 2001 and 31st December 2009 using a cohort study design with 648 injuries sustained in 102,894 starts. Potential risk factors were screened using univariable logistic regression prior to multivariable model building. In the final multivariable model, 12 statistically significant risk factors were identified. Variables that increased the odds of SDF tendinopathy included firmer going, increased horse age, and racing in the summer compared to other seasons. Variables that decreased the odds included having a higher official rating and the number of starts in the preceding days. Fewer and different risk factors were identified than in an equivalent model of SDF tendinopathy in hurdle racing, highlighting potential differences between these disciplines. Further collection of training and racecourse information would be beneficial and may help to explain further some of the associations identified in this study. The results will facilitate the development of strategies to improve overall safety of horses in UK steeplechase racing.

The impact of birthweight on mare health and reproductive efficiency, and foal health and subsequent racing performance.

REASONS FOR PERFORMING STUDY: Although low birthweight is a risk factor for neonatal illness, the impact of high birthweight on the health of foals and mares, and on the foals' long-term athletic capability, is unknown. OBJECTIVES: To investigate whether: 1) foals that are excessively heavy are associated with an increased prevalence of maternal illness in the first month post partum and reproductive dysfunction in the following season; 2) excessively light or heavy foals are at an increased risk of illness in the first month of life; and 3) birthweight is associated with racing success. METHODS: Veterinary records from 230 Thoroughbred mares and 409 foalings were reviewed. Data relating to foaling, foal and mare health during the first month postpartum and subsequent breeding efficiency were extracted. Foals' racing records were obtained and the association between birthweight and these outcomes examined. RESULTS: Mares with heavy foals had a higher prevalence of minor nonreproductive problems than those with light and average foals. Compared to average foals, placental weight was lower in the light group and higher in the heavy group. Light foals took longer to stand, nurse and pass meconium, whereas gestation period and duration of Stage 2 parturition were longer in heavy foals. Heavy foals were at increased risk of nonseptic musculoskeletal conditions and conformational defects. Birthweight was not associated with racing outcomes. CONCLUSIONS: High birthweight was associated with increased prevalence of neonatal musculoskeletal conditions but birthweight did not have a major impact on mares' health and reproductive efficiency, orfoals' racing success. POTENTIAL RELEVANCE: These data add to the understanding of the impact of birthweight on short- and long-term health outcomes in mares and foals.

Risk factors for superficial digital flexor tendinopathy in Thoroughbred racehorses in hurdle starts in the UK (2001-2009).

REASONS FOR PERFORMING STUDY: Superficial digital flexor (SDF) tendinopathy is a common injury in Thoroughbred horses racing over hurdles. Identification of risk factors may allow the introduction of measures to minimise the incidence of this injury. OBJECTIVE: To identify risk factors for SDF tendinopathy in Thoroughbred horses in hurdle races in the UK. METHODS: Potential risk factors for SDF tendinopathy were studied between 1 January 2001 and 31 December 2009 using a retrospective cohort study design with 1031 case starts and 168,637 control starts. Potential risk factors were screened using univariable logistic regression prior to multivariable model building. RESULTS: IN the final multivariable model, 20 statistically significant risk factors were identified. Variables found to be associated with increased odds of SDF tendinopathy included: firmer going; increased horse age at first race; having had a previous SDFT injury; and racing in the summer compared to other seasons. Variables found to be associated with decreased odds included: being trained by a more successful trainer; and having raced more frequently in the preceding 9-12 months. CONCLUSIONS: This study identified multiple risk factors associated with SDF tendinopathy, some of which are difficult to explain with the current data source. Factors resulting in increased cumulative horse and tendon fatigue (increased years in racing; carrying increased weight; and racing over longer distances), firm ground, and the presence of previous tendon injury should be considered when attempting to reduce the likelihood of sustaining SDF tendinopathy. POTENTIAL RELEVANCE: The results will facilitate the development of strategies to improve the overall safety of horses in hurdle racing in the UK.

Magnetic resonance imaging-detected adaptation and pathology in the distal condyles of the third metacarpus, associated with lateral condylar fracture in Thoroughbred racehorses.

REASONS FOR PERFORMING THE STUDY: Lateral condylar (LC) fractures of the third metacarpus (McIII) are a common reason for euthanasia in racehorses, and may be the result of repetitive overloading or cumulative pathological change. Magnetic resonance imaging (MRI) allows monitoring of bone and cartilage to detect pathological and adaptive changes that may be precursors of fracture. OBJECTIVES: To describe bone and cartilage MRI features in the distal condyles of McIII of Thoroughbred racehorses, with and without condylar fracture. HYPOTHESES: 1) A greater degree of bone and cartilage adaptation or pathology will be seen in fractured McIIIs compared with their respective contralateral McIIIs. 2) Contralateral McIIIs will have a greater degree of bone and cartilage adaptation or pathology than McIIIs from control horses that did not sustain a LC fracture. METHODS: The McIIIs from 96 horses subjected to euthanasia at racecourses were divided into 3 groups: Group 1: nonfractured bones from horses without LC fracture; Group 2: nonfractured bones from horses with unilateral LC fracture; and Group 3: fractured bones from horses with unilateral LC fracture. The MR images were examined and graded for bone and cartilage changes. RESULTS: Nine percent of Group 1 (n = 9) and 11% of Group 2 bones (n = 5) had incomplete LC fractures. Focal palmar necrosis was most frequently detected in bones from Group 1 (12%) compared with Groups 2 (9%) and 3 (4%). The prevalence of bone and/or cartilage abnormalities tended to increase from Group 1 to Group 2 to Group 3. CONCLUSIONS: Magnetic resonance imaging is able to detect cartilage and bone changes that may be associated with LC fracture. There was no significant difference in bone/cartilage changes between bones from Groups 1 and 2, despite increased pathology in Group 2 bones. POTENTIAL RELEVANCE: Periodic monitoring of bone and/or cartilage changes in distal McIII of Thoroughbred racehorses may help to prevent catastrophic LC fractures.

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.

An investigation of the relationships between angles and shapes of the hoof capsule and the distal phalanx.

REASONS FOR PERFORMING STUDY: There is little scientific evidence to support the premise that poor foot conformation predisposes to foot pain and lameness. OBJECTIVES: To determine relationships between external characteristics of the hoof capsule and angles of the distal phalanx; to determine variability in shape of the distal phalanx; and to investigate association between distal phalanx angles and the injury causing lameness. MATERIALS AND METHODS: Feet were documented photographically and radiographically. Linear and angle measurements were obtained for the hoof capsule and distal phalanx and compared statistically. Horses were categorised according to injury group, and angles and linear ratios were compared between groups. RESULTS: There was modest correlation between hoof wall and heel angles and angles of the distal phalanx. There was variation in shape of the distal phalanx. There was no significant association between injury type and angles of the distal phalanx, although there was a trend for the angle of the dorsal aspect of the distal phalanx with the horizontal to be smaller in horses with injuries of the podotrochlear apparatus or deep digital flexor tendon compared with other groups. CONCLUSIONS: There are variations in shape of the distal phalanx largely due to differences in orientation of the concave solar border and the solar border to the horizontal. Variations in shape of the distal phalanx were not accurately correlated with external characteristics of the hoof capsule. There were weak associations between injury groups and angles of the distal phalanx. CLINICAL RELEVANCE: Further work is required to elucidate risk factors for foot-related lameness.

A comparison of factors that influence survival in dogs with adrenal-dependent hyperadrenocorticism treated with mitotane or trilostane.

BACKGROUND: Trilostane is a recognized treatment for canine pituitary-dependent hyperadrenocorticism (PDH); however, its efficacy in dogs with adrenal-dependent hyperadrenocorticism (ADH) is unknown. OBJECTIVES: To examine factors that might influence survival in the medical management of ADH, with particular emphasis on treatment selection. ANIMALS: Thirty-seven animals referred to 4 centers over a period of 12 years that had been diagnosed with ADH and treated with either trilostane (22/37), mitotane (13/37), or both (2/37). METHODS: Retrospective analysis of clinical records. RESULTS: There was no statistically significant difference between the survival times of 13 dogs treated only with mitotane when compared with 22 dogs treated only with trilostane. The median survival time for animals treated with trilostane was 353 days (95% confidence interval [CI] 95-528 days), whereas it was 102 days (95% CI 43-277 days) for mitotane. Metastatic disease was detected in 8 of 37 dogs. There was a significantly lower probability of survival for dogs with metastatic disease when compared with those without metastatic disease (P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: The choice of medical treatment for ADH may not have a major effect on survival times. However, the presence of metastatic disease considerably decreases survival time regardless of the choice of medical treatment.

Quantitative evaluation of subchondral bone injury of the plantaro-lateral condyles of the third metatarsal bone in Thoroughbred horses identified using nuclear scintigraphy: 48 cases.

REASONS FOR PERFORMING STUDY: Increased radio-isotope uptake (IRU) in the subchondral bone of the plantaro-lateral condyle of the third metatarsus (MTIII) is a commonly reported scintigraphic finding and potential cause of lameness in UK Thoroughbred racehorses in training and has not been fully documented. OBJECTIVES: To characterise lameness attributable to IRU of the subchondral bone of MTIII, compare the scintigraphic findings of these horses with a normal population and evaluate the use of scintigraphy as an indicator of prognosis. HYPOTHESIS: IRU will be in significantly higher in horses with subchondral bone injury and will be related to prognosis and future racing performance. METHODS: Data were analysed from 48 horses in which subchondral bone injury of the plantaro-lateral condyle of MTIII had been diagnosed using nuclear scintigraphy and that met the inclusion criteria. Data recorded included age, sex, trainer, racing discipline, lameness assessment, treatment regimes, radiographic and scintigraphic findings, response to diagnostic analgesia where performed and racing performance pre- and post diagnosis. Region of interest (ROI) counts were obtained for the plantar condyle and the mid diaphysis from the latero-medial view, the ratio calculated and then compared with a control group of clinically unaffected horses. RESULTS: The mean condyle mid-diaphysis ROI ratio was significantly (P<0.001) higher in the affected population and with positively correlation (P = 0.024) with the level of lameness. The presence of radiographic findings had no significant effect on the ROI ratio. CONCLUSION: Subchondral bone injury of the plantar lateral condyles of MTIII is a significant cause of lameness in UK Thoroughbred racehorses. Nuclear scintigraphy is a useful diagnostic imaging modality in the detection of affected horses but is a poor indicator of prognosis for the condition. POTENTIAL RELEVANCE: Better understanding of the clinical manifestations, diagnosis of and prognosis for subchondral bone injury will benefit the Thoroughbred industry in the UK.