An assessment of intra- and interobserver agreement of reporting orthopaedic findings on presale radiographs of Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: Radiography is commonly used in clinical practice but agreement of reporting of radiographically detected orthopaedic findings in horses has rarely been studied. OBJECTIVES: To assess agreement within and between observers for reporting of orthopaedic findings on presale radiographs of Thoroughbred yearlings. STUDY DESIGN: Retrospective analysis of archived radiographs. METHODS: Four veterinary radiology specialists each twice examined 167 sets of radiographs for orthopaedic findings in the fore feet, fore and hind fetlocks, carpi, tarsi and stifles. There were 27 findings analysed for agreement. Kappa statistic (κ), percentage of positive agreement (Ppos) and percentage of negative agreement are reported. RESULTS: An excellent percentage of negative agreement was observed for all findings, with the exception of regular vascular channels of the proximal sesamoid bones. Ppos and κ results were variable. The presence of extra carpal bones, osseous cyst-like lesions of the ulnar carpal bone, sagittal ridge defects of the third metacarpus, fracture of the fore and hind proximal sesamoid bones, regular vascular channels in the hind proximal sesamoids, osteochondrosis lesions of the distal intermediate ridge and/or medial malleoli of the tibia, and osseous cyst-like lesions in the medial femoral condyle was consistently observed with an intra- and interagreement κ≥0.5 and Ppos≥50%. Lucency within the proximal sesamoids consistently had an observed intra- and interagreement κ<0.4 and Ppos<40%. CONCLUSIONS: Observation of orthopaedic findings on yearling repository radiographs showed generally excellent agreement on the absence of findings, but variable agreement on the presence of findings. Agreement was good for larger and easy to categorise radiographic findings. More accurate definitions and training need to be developed to improve agreement within and between observers for orthopaedic findings with poor or fair to good agreement.

Risk factors for exercise-induced pulmonary haemorrhage in Thoroughbred racehorses.

REASONS FOR PERFORMING STUDY: Risk factors for occult exercise-induced pulmonary haemorrhage (EIPH) are poorly defined or quantified. OBJECTIVES: To investigate the importance of putative risk factors for EIPH amongst Thoroughbred racehorses in Australia. METHODS: Tracheobronchoscopy was used to determine EIPH status of 744 Thoroughbred racehorses after flat racing in Melbourne, Australia. Horses were identified for study before racing, and over 50% of horses racing during the study period were examined. Statistical analysis included use of bivariate and multivariate logistic regression analysis to account for simultaneous effects of a large number of variables. RESULTS: The only risk factor identified as associated with both EIPH ≥ 1 or ≥ 2 was ambient temperature, with horses racing at temperatures <20 °C being at ∼ 2 times risk of occult EIPH. There was no association of EIPH with age, sex, weight carried, track hardness, speed of racing, or air quality. CONCLUSIONS: There do not appear to be individual risk factors, amongst those examined in this study, that are strongly associated with EIPH. POTENTIAL RELEVANCE: The risk of developing EIPH cannot be readily determined from a combination of age, race speed, race distance, track hardness or air quality. This study does not provide support for the hypotheses that racing on hard surfaces or in polluted air contributes to the development of EIPH.

Risk factors for Thoroughbred racehorse fatality in jump starts in Victoria, Australia (1989-2004).

REASONS FOR PERFORMING STUDY: The risk of fatality is greater in jump than in flat racing in Victoria, Australia. This is the first study to identify risk factors specific to jump starts in Victoria. OBJECTIVE: To identify risk factors for fatality of Thoroughbred racehorses in jump starts on all racecourses in Victoria, Australia between 1989 and 2004. METHODS: Fatalities comprised all horses that died during or immediately after a jump (hurdle or steeplechase) race or official jump trial and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 191 case starts and 2324 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. A multiple level model was used with racecourse included as a random effect. RESULTS: In the final multivariable model, the duration of the racing career of the horse, the number of flat, hurdle and steeple starts accumulated in the 60 days prior to the case or control start, the number of flat and jump starts accumulated over the racing career, if the horse had had a start between 1 and 14 days prior to the case or control start, the type of jump race (hurdle or steeple), the calendar year of the start and the location of the racecourse were associated with fatality. CONCLUSIONS: The findings highlight the need to investigate further the differences between hurdle and steeplechase events and the adverse effect of prolonged prior flat racing careers on the risk of fatality in jump starts. POTENTIAL RELEVANCE: This is the first study to examine risk factors for fatality in jump starts in Victoria. The results should shape the development of interventions to reduce the risk in jump starts in the future.

Risk factors for Thoroughbred racehorse fatality in flat starts in Victoria, Australia (1989-2004).

REASONS FOR PERFORMING STUDY: Research into risk factors specific for fatality in flat racing should be focused at a regional level as the risk factors may differ among countries and even regions within countries. OBJECTIVE: To identify risk factors for fatality of Thoroughbred racehorses in flat starts on all racecourses in Victoria, Australia between 1989 and 2004. METHODS: Fatalities comprised all horses that died during or immediately after a flat race or official flat trial, and all horses that were subjected to euthanasia within 24 h of an event in which an injury was sustained. The retrospective study involved 283 case starts and 3307 control starts. Univariable and multivariable backward stepwise logistic regression was used to identify risk factors for fatality at any one start. RESULTS: In the final multivariable model, horse gender, prior racing history, race length, racing year, racecourse location and track rating were associated with fatality. CONCLUSIONS: This study identified specific risk factors for fatality. The findings are consistent with the hypothesis that horses accumulating high speed exercise are predisposed to catastrophic injury. The study has also highlighted the need to investigate further the adverse effects of different track ratings on the incidence of injury and subsequent fatality. RELEVANCE: The results will facilitate the development of effective strategies to improve overall safety of horses and jockeys in flat racing in Victoria, Australia.

Risk of fatality and causes of death of Thoroughbred horses associated with racing in Victoria, Australia: 1989-2004.

REASONS FOR PERFORMING STUDY: Determining the risk of fatality of Thoroughbred horses while racing is essential to assess the impact of intervention measures designed to minimise such fatalities. OBJECTIVES: To measure the risk of racehorse fatality in jump and flat starts on racecourses in Victoria, Australia, over a 15 year period and to determine proportional mortality rates for specific causes of death. METHODS: All fatalities of Thoroughbred horses that occurred during or within 24 h of a race were identified from a database. The risk of a start resulting in a racehorse fatality in all races and within flat and jump races, proportional mortality rates, population attributable risk, population attributable fraction and risk ratios were calculated along with 95% confidence intervals. Poisson regression was also performed to estimate risk ratios. RESULTS: There were 514 fatalities over the 15 year period; 316 in flat races and 198 in jump races. The risk of fatality was 0.44 per 1000 flat starts and 8.3 per 1000 jump starts (18.9 x greater). The risk of fatality on city tracks was 1.1 per 1000 starts whereas on country tracks it was 0.57 per 1000 starts. Of the 316 fatalities in flat races, 73.4% were due to limb injury, 2.5% to cranial or vertebral injury and 19.0% were sudden deaths. Of the 198 fatalities in jump races, 68.7% were due to limb injury, 16.2% to cranial or vertebral injury and 3.5% were sudden deaths. The risk of fatality in flat starts increased between 1989 and 2004 but the risk in jump starts remained unchanged over the 15 year period. CONCLUSIONS: The risk of fatality in flat starts was lower in Victoria than North America and the UK but the risk in jump starts was greater. Catastrophic limb injury was the major reason for racehorse fatality in Victoria but there was a larger percentage of sudden deaths than has been reported overseas. The risk of fatality in jump starts remained constant over the study period despite jump racing reviews that recommended changes to hurdle and steeple races to improve safety. POTENTIAL RELEVANCE: This study provides important benchmarks for the racing industry to monitor racetrack fatalities and evaluate intervention strategies.

Prevalence of pharyngeal and laryngeal abnormalities in Thoroughbreds racing in Australia, and their association with performance.

REASONS FOR PERFORMING STUDY: Little information is available regarding the prevalence of abnormalities of the upper airway and their association with performance in the general population of Thoroughbred racehorses. OBJECTIVES: To describe the prevalence of selected abnormalities of the upper airway and their association with performance in Thoroughbred racehorses in Australia. HYPOTHESIS: That abnormalities of the upper airway of Thoroughbred racehorses are associated with poor race performance. METHODS: Rhinolaryngoscopy was performed after racing and presence and characteristics of abnormalities of the larynx and pharynx were recorded in a prospective cross-sectional study of Thoroughbred horses racing in Victoria, Australia. RESULTS: Rhinolaryngoscopy was performed once on each of 744 horses over 35 months. Fifty abnormalities of the upper airway were detected in 47 horses (6.3%, 95% confidence interval [CI] 4.7-83%). Epiglottic entrapment was detected in 7 horses (0.9%, 95% CI 0.4-1.9%) and was significantly (P = 0.015) associated with superior performance. Grade 2 asymmetry (4 grade scale) of the left arytenoid cartilage was detected in 9 horses (1.2%, 95% CI 0.5-2.4%) and was also associated with superior performance (P<0.001). Ulceration or erosion of the mucosa of the axial surface of one or both arytenoids was detected in 18 horses (2.4%, 95% CI 13-3.8%) and was not associated with alterations in exercise performance (P = 0.31). CONCLUSIONS: Epiglottic entrapment, Grade 2 laryngeal asymmetry and mucosal erosions detected in Thoroughbred racehorses were not associated with impaired performance; therefore, surgical correction and concern over laryngeal function in horses with Grade 2 asymmetry may not be necessary in individuals performing to expectation.

Outbreak of equine herpesvirus type 1 myeloencephalitis: new insights from virus identification by PCR and the application of an EHV-1-specific antibody detection ELISA.

Five of 10 pregnant, lactating mares, each with a foal at foot, developed neurological disease. Three of them became recumbent, developed complications and were euthanased; of the two that survived, one aborted an equine herpesvirus type 1 (EHV-1)-positive fetus 68 days after the first signs were observed in the index case and the other gave birth to a healthy foal on day 283 but remained ataxic and incontinent. The diagnosis of EHV-1 myeloencephalitis was supported by postmortem findings, PCR identification of the virus and by serological tests with an EHV-1-specific ELISA. At the time of the index case, the 10 foals all had a heavy mucopurulent nasal discharge, and PCR and the ELISA were used to detect and monitor EHV-1 infection in them. The status of EHV-1 infection in the five in-contact mares was similarly monitored. Sera from three of the affected mares, taken seven days after the index case were negative or had borderline EHV-1-specific antibody titres. In later serum samples there was an increase in the titres of EHV-1-specific antibody in two of the affected mares. In contrast, sera from the five unaffected in-contact mares were all EHV-1-antibody positive when they were first tested seven or 13 days after the index case.

Immunological and haematinic consequences of feeding a standardised Echinacea (Echinacea angustifolia) extract to healthy horses.

This study was undertaken to compile new data on the efficacy of Echinacea in stimulating the immune system of the horse. Use of Echinacea is becoming widespread in horses, despite an absence of controlled laboratory research into its effectiveness or safety. This paper documents results of a double-blind, placebo-controlled, cross-over trial investigating the effect of standardised Echinacea extract on 8 horses. Animals were supplemented with Echinacea or placebo for 42 days, and their response to supplements recorded. Treatment with Echinacea increased phagocytic ability of isolated neutrophils, boosted peripheral lymphocyte counts and appeared to stimulate neutrophil migration from peripheral circulation into the tissues. Echinacea supplement also increased the size and concentration of peripheral red blood cells, and the concentration of haemoglobin and packed cell volume. It was concluded that Echinacea effectively stimulates equine immunocompetence, and the plant extract behaves, in equine subjects, as a haematinic agent, i.e. one which improves the quality of blood by increasing haemoglobin levels and the number of erythrocytes and which, by virtue of their effects on oxygen transport cells, are considered to improve parameters of exercise physiology and performance.

Chromatographic and immunochemical approaches to the analysis of the HIV protease inhibitor saquinavir in plasma.

The development of the HIV protease inhibitor saquinavir (Ro 31-8959) required a range of analytical methods for its measurement in biological fluids. This paper describes the development of isocratic, reverse-phase HPLC/UV methods for the routine measurement of plasma levels of the drug together with a more sensitive radioimmunoassay. The performance of the two assays is compared with that of an HPLC/MS/MS method previously published and has been shown to be satisfactory, with coefficients of variation of calibration standards and quality control samples within the usual outside limits of +/- 15%. The HPLC/UV method can be routinely applied for concentrations down to 10-20 ng/ml and a lower limit of quantification of 1 ng/ml from 1 ml of human plasma is possible. The radioimmunoassay was developed for the specific measurement of saquinavir concentrations in human, HIV-positive plasma samples and has a lower limit of quantification of 0.5-1.0 ng/ml. Some preliminary findings suggested that it might not be specific in rat plasma and no attempts have been made to quantify any nonclinical samples with this technique. If still greater sensitivity is required, recourse can be made to the HPLC/MS/MS assay.

Prevalence of serum precipitating antibodies in horses to fungal and thermophilic actinomycete antigens: effects of environmental challenge.

Sera from 54 two- to three-year-old Thoroughbred horses from an English racing stable were examined for precipitins to antigen extracts prepared from 18 species of moulds (fungi and thermophilic actinomycetes) isolated from the same stable. Twenty-seven horses exhibited serum precipitins to one or more antigens; sixteen of the mould antigens elicited positive reactions in sera from one or more horses. Significantly more precipitins occurred in sera of those horses stabled in a barn than among those stabled in individual boxes. This indicated a possible association between type of housing, level of exposure to airborne moulds and presence of serum precipitins. None of the horses had overt respiratory disease. This study agrees with reports of the presence of serum precipitating antibodies to mould antigens in clinically healthy horses and confirms that serological tests, therefore, are of little value in the diagnosis of chronic obstructive pulmonary disease (COPD) or 'heaves'.

The relationship of air hygiene in stables to lower airway disease and pharyngeal lymphoid hyperplasia in two groups of Thoroughbred horses.

The relationship between air hygiene within two types of identically managed horse housing and the incidence of covert respiratory disease (as revealed by endoscopic examination) of their inhabitants was assessed. The horses were all under the supervision of the same trainer. In one yard the design ensured the boxes were well ventilated in still air conditions. In the other yard the boxes were insulated and there was little provision for natural ventilation in still air conditions. There was heavy fungal and actinomycete contamination of wood shavings in the heavily insulated, poorly ventilated housing but not in the shavings of better ventilated boxes. There was increased incidence and severity of mucopus in the tracheas of horses stabled in the contaminated environment over that seen in the other group. There was no such association between the incidence or degree of pharyngeal lymphoid hyperplasia and the two environments or between the degree of tracheal mucopus and PLH found in the 72 horses examined in this study.

Technique for assessing respiratory health hazards from hay and other source materials.

This paper describes and compares three techniques of categorisation of hay, straw and other feeds and beddings collected from stables. A hand-held sampler was used to categorise samples according to the presence of plant material, fungal spores and dust mites. An Andersen sampler was used to categorise samples according to the thermotolerances of fungi and actinomycetes. An aerodynamic particle sizer was used to categorise samples according to respirable particle release rates. The highest burden of respirable particles was associated with the presence of thermophilic and thermotolerant actinomycetes and fungi. The portable slit sampler proved to be an accurate, quick and simple semiquantitative method of assessing the mould contamination of source materials. This latter technique requires only a microscope and the sampler, and is thus ideal for veterinary practices and small diagnostic laboratories.

Air hygiene in stables. 1: Effects of stable design, ventilation and management on the concentration of respirable dust.

The concentration of fungal spores, the main constituents of respirable dust in stables, is determined by rates of release from fodder and bedding and rate of clearance, principally by ventilation. This paper outlines the principles that govern the application of natural ventilation to the control of air hygiene in barns and individual boxes for horses. When release rates are low, ventilation rates over four air changes per hour are satisfactory. Ventilation was satisfactory in individual boxes but usually unsatisfactory in barns and specific recommendations are made for improvement. Preliminary observations in stables with clean, well-managed bedding revealed only small differences between straw, wood shavings and paper. In these circumstances hay tended to be the major source of respirable spores.

Survey of the designs of racehorse stables in the south west of England.

The design of 96 racehorse stables in the south west of England were surveyed. The 'typical' racehorse is kept in a loose box, bedded on straw and remains indoors while the stable is cleaned. It is given a floor area of 12 m2 and shares its airspace of 39 m3 with seven other horses. Overall, the predicted minimum rate of air change by natural convection in calm winds is 6.6 air changes/h but this is reduced to 2.2 if the top door of the stable is closed. On balance, racehorse stables in use today are based on designs which are worse overall than the best available in the 19th century.

A review of environmental and host factors in relation to equine respiratory disease.

This paper reviews the environmental and host factors which interact to affect the incidence and severity of episodes of respiratory disease in stabled horses. The folly of accepting housing criteria and management practices for the horse, based on direct extrapolations from intensive housing of meat producing animals, is discussed. The factors which affect air hygiene and physical environment of stables are considered in terms of short-term athletic performance and long-term welfare.

The pharmacokinetics of oral and intravenous prenalterol in young, healthy volunteers.

The pharmacokinetics of prenalterol in healthy young volunteers after i.v. and oral dosing has been studied. There is evidence of non-linearity following the i.v. dosing. Evidence of dose-dependent pharmacokinetics following i.v. dosing has been obtained. The sustained-release formulation is very effective: almost 12 h were needed to achieve 50 per cent of the total AUC.

Review of exercise induced pulmonary haemorrhage and its possible relationship with mechanical stress.

Exercise induced pulmonary haemorrhage (EIPH) is a condition of uncertain aetiology. This article reviews the evidence relating to its incidence, clinical findings, radiological observations, histopathology and certain aspects of respiratory physiology. It is proposed that EIPH is primarily caused by mechanical stress in the dorsocaudal region of the lung.