Fédération Equestre Internationale (FEI) eventing: Fence-level risk factors for falls during the cross-country phase (2008-2018)

BACKGROUND

The equestrian discipline of eventing tests athletes' and horses' skill over three phases: dressage, jumping, and cross-country. Falls during cross-country can be particularly serious and result in serious or fatal injury for both horse and athlete. Cross-country course and fence design are crucial contributory factors to safety.

OBJECTIVES

To provide descriptive statistics and identify fence-level risk factors for horses competing in Fédération Equestre Internationale (FEI) events worldwide.

STUDY DESIGN

Retrospective cohort study.

METHODS

Data were collected for every horse start worldwide in all international (CI), championship (CH), Olympics (OG), and World Equestrian Games (WEG) eventing competitions between January 2008 and December 2018 and univariable logistic regression, followed by multivariable logistic regression were applied. The final model was built in a stepwise bi-directional process, with each step assessed by the Akaike information criterion.

RESULTS

Risk factors were identified at fence level covering aspects of fence design and course design. Ten fence types were at increased odds of a fall occurring compared to square spread fences, and seven types were at reduced odds. Fences with an approach downhill (odds ratio 1.35, 95% confidence interval 1.19-1.52), with landing into water (OR 1.82, CI 1.62-2.01), frangible devices (OR 1.28, CI 1.15-1.41), and later elements of combined obstacles (OR 1.33 CI 1.25-1.42 for the second element, OR 1.21 CI 1.10-1.32 for later elements) were associated with increased risk of falls occurring.

MAIN LIMITATIONS

Although the data set covers every international competition worldwide, it does not include national-level competitions.

CONCLUSIONS

It is recommended that the most challenging fences are placed near the beginning of the course, and not in downhill or water settings. The complexity of individual elements in combined fences should be reduced. Adopting evidence-based course design is a crucial intervention for reducing the incidence of horse falls and associated serious and fatal injuries to horse and human athletes. This article is protected by copyright. All rights reserved.

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.

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.

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.

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.

Catastrophic biaxial proximal sesamoid bone fractures in UK Thoroughbred races (1999-2004): horse characteristics and racing history

REASON FOR PERFORMING STUDY

Catastrophic biaxial proximal sesamoid bone fractures (PSBF) have not yet been described in detail in the UK racing population.

OBJECTIVES

To determine the incidence and relative risk (RR) of PSBF in different types of racing in the UK; and to describe horse-level characteristics and racing histories of horses sustaining these injuries.

METHODS

Distal limbs were collected from all racehorses suffering catastrophic fractures during racing at all 59 racecourses in the UK, in a prospective study from February 1999 to December 2004. Post mortem investigation identified the anatomical location and type of fracture. Horse, racing history, race and racecourse details were obtained. Characteristics of the horses that sustained PSBF were described. The incidence and RR of PSBF in the different types of racing in the UK were calculated.

RESULTS

Thirty-one horses suffered PSBF during the study period. The incidence of PSBF in all types of race was 0.63 per 10,000 starts (31/494,744). The incidence was highest in flat races on all weather surfaces (1.63 per 10,000 starts: 12/73,467; RR = 4.4 when compared to turf flat racing). Affected horses had an average age of 5.6 years and had started a mean of 28 races at the time of fracture.

CONCLUSION AND POTENTIAL RELEVANCE

There is a strong association between type of racing surface and PSBF. Horses competing in flat races on all weather surfaces have an increased risk of PSBF. These fractures appear to happen in experienced horses with several starts, with few fractures occurring within the first season of racing. Further research should focus on identification of underlying pathology of these fractures. Epidemiological studies aimed at the identification of risk factors for PSBF in the UK racing population would require a large number of cases acquired over many years given the relatively low incidence of PSBF.

An investigation of the relationship between race performance and superficial digital flexor tendonitis in the Thoroughbred racehorse

REASONS FOR PERFORMING STUDY

There is limited information regarding the number of races and the period for evaluation of outcome which is critical for assessment of SDF tendonitis treatments.

OBJECTIVE

To evaluate the re-injury rate and racing performance of Thoroughbred racehorses that sustain SDF tendonitis in relation to matched controls in terms of number of races post treatment and maximum racing performance ratings before and after injury.

STUDY DESIGN

Clinical records and racing histories of 401 racehorses with a first occurrence of SDF tendonitis diagnosed by ultrasonography. Controls were of the same age, sex and were horses training in the same establishment at the time of injury as the case horses and where the trainer reported that the horse had not had a previous SDF tendon injury or treatment.

RESULTS

Eighty percent of both case and control horses returned to racing after the date of injury, and the re-injury proportion within 3 years of treatment was 53%. The difference in Racing Post Rating((max)) (RPR((max))) and the Racing Post Rating in the race immediately before the treatment date was significantly smaller in case horses (mean = 9.6 lbs; range = 0-75) compared to control horses (mean = 17.0 lbs; range = 0-79). No significant decrease in RPR((max)) was noted post injury. No difference between case and control horses was found for return to racing and racing 3 times, but control horses were significantly more likely to compete 5 races post treatment date than case horses.

CONCLUSION AND CLINICAL RELEVANCE

Injury was associated with an individual's pre-injury maximum performance level and return to racing and completion of 3 races are not useful indicator of the outcome of horses with SDF tendonitis. The assessment of the outcome of horses with an SDF injury in a population of racehorses using the number of races post injury requires a minimum of 5 races post injury to be a useful indicator. Further, a re-injury proportion in a population of horses in training for 3 years post treatment.

Horse-level risk factors for fatal distal limb fracture in racing Thoroughbreds in the UK

REASONS FOR PERFORMING STUDY

Fractures below the level of the radius or tibia (distal limb fractures) are the most common cause of equine fatality on UK racecourses; however, little is known about their epidemiology or aetiology. Identification of risk factors could enable intervention strategies to be designed to reduce the number of fatalities.

OBJECTIVES

To identify horse-level risk factors for fatal distal limb fracture in Thoroughbreds on UK racecourses.

METHODS

A case-control study design was used. Fractures in case horses were confirmed by post mortem examination and 3 matched uninjured controls were selected from the race in which the case horse was running. One hundred and nine cases were included and information was collected about previous racing history, horse characteristics and training schedules. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture.

RESULTS

Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have trained on a sand gallop, i.e. a gallop described by trainers as being primarily composed of sand.

CONCLUSIONS

Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal distal limb fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 805-2012 m (4-10 furlongs)/week.

POTENTIAL RELEVANCE

The information from this study can be used to alter training schedules in an attempt to reduce the incidence of fatal distal limb fracture in Thoroughbred racehorses. Training should include some gallop work, and further studies, recording the exact level of work, will help to identify an optimum range of training speeds and distances which will reduce the liklihood of catastrophic fracture on the racecourse.

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 fatal lateral condylar fracture of the third metacarpus/metatarsus in UK racing

REASONS FOR PERFORMING STUDY

Lateral condylar fractures of the third metacarpus/metatarsus are the most common cause of equine fatality on UK racecourses. Identification of risk factors for such injuries and the subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities.

OBJECTIVES

To identify horse-, race- and course-level risk factors for fatal lateral condylar fracture in Thoroughbreds on UK racecourses.

METHODS

Case-control study designs were used. Case horses were defined as those that were subjected to euthanasia having sustained an irreparable lateral condylar fracture while racing at any of the 59 UK racecourses. Case races were defined as those in which one or more horses sustained a fatal lateral condylar fracture. Three controls for each case horse were selected at random from the race in which the case was running. Three controls for each case race were selected at random from all races of the same type held in the same year. Ninety-eight cases were included in the study. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture.

RESULTS

Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have started racing as 3- or 4-year-olds. Fractures were found to be more likely in longer races with a larger number of runners, races in which professional jockeys were not permitted to ride and races in which the going was described as firm or hard.

CONCLUSIONS AND POTENTIAL RELEVANCE

Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal lateral condylar fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 201 m (1 furlong) and 1609 m (8 furlongs) per week. The association with age at first race requires further investigation for flat and National Hunt racing separately. A reduction in the number of races taking place on very firm going could have an impact on the number of lateral condylar fractures.

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.

Exhaled breath condensate hydrogen peroxide and pH for the assessment of lower airway inflammation in the horse

Measurement of hydrogen peroxide (H(2)O(2)) concentration and pH in exhaled breath condensate (EBC) is useful for detection and monitoring of asthma in humans. In contrast, limited information on the use of these parameters for the investigation of lower airway inflammation (LAI) is available for horses. Aims of the current study were to investigate the intra- and inter-day variations of EBC H(2)O(2) concentration and pH in horses and establish any relationship(s) with LAI. Both intra- and inter-day variability of EBC H(2)O(2) concentration were large, while those of pH were small. No significant difference in the intra-day or inter-day H(2)O(2) concentrations or pH measurements were found in control or LAI horses, except for inter-day H(2)O(2) concentration in horses with LAI (p=0.019). There was no significant difference in EBC pH or H(2)O(2) concentration between control and LAI horses, however a trend for a reduced pH in horses with LAI was observed.

Lower respiratory tract disease in Thoroughbred racehorses: analysis of endoscopic data from a UK training yard

REASON FOR PERFORMING STUDY

There has been much research directed at potential causative agents and the epidemiology of lower respiratory tract disease (LRTD), but few reports of the clinical progression and outcome.

OBJECTIVES

To define clinical features of LRTD in racehorses, including association with age and average duration of disease, through the analysis of endoscopic data.

METHODS

A retrospective analysis of records from a single training yard of endoscopic examinations undertaken over a 2-year period was performed. Horses were subjected to regular endoscopic examination for a variety of reasons, and all horses placed on antibiotic therapy for lower respiratory tract disease were rescoped following treatment. Data analysed included a 0-8 tracheal mucus score based on visible endoscopic mucus and gross tracheal lavage turbidity, as well as age and treatment duration and type.

RESULTS

A total of 522 endoscopic examinations undertaken on 123 horses and tracking 169 episodes of lower respiratory tract disease were recorded. Mean duration of disease episode was 15.5 days (median = 11 days, range = 4-61 days). Horses age 2 years were significantly more likely than those age > or=3 years to have at least one episode of respiratory disease (P<0.001). There was a direct association between initial tracheal mucus score and rescope score after treatment.

CONCLUSIONS

Lower respiratory tract disease was more common in 2-year-olds than in older horses. Affected horses had endoscopic evidence of increased tracheal mucus accumulation for an average of 15.5 days per episode, a considerably shorter period than that suggested by previous studies.

POTENTIAL RELEVANCE

Endoscopic examinations permit longitudinal tracking of lower respiratory tract disease in Thoroughbred racehorses. A prolonged duration of disease, sometimes extending for months, can be expected in a small proportion of cases, some of which appear to be refractory to treatment. There is a clear need for evidence-based analysis of treatment regimes to assist clinicians in decision making when managing disease in both individual and group situations.

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.

How does exercise intensity and type affect equine distal tarsal subchondral bone thickness?

Adaptation of osteochondral tissues is based on the strains experienced during exercise at each location within the joint. Different exercise intensities and types may induce particular site-specific strains, influencing osteochondral adaptation and potentially predisposing to injury. Our hypotheses were that patterns of equine distal tarsal subchondral bone (SCB) thickness relate to the type and intensity of exercise, and that high-intensity exercise leads to site-specific increases in thickness. SCB thickness was measured at defined dorsal and plantar locations on magnetic resonance images of cadaver tarsi collected from horses with a history of low [general purpose ( n = 20) and horse walker ( n = 6)] or high [elite competition ( n = 12), race training ( n = 15), and treadmill training ( n = 4)] exercise intensity. SCB thickness was compared between sites within each exercise group and between exercise groups. SCB thickness in elite competition and race training, but not treadmill training, was greater than low-intensity exercise. For general purpose horses, lateral SCB thickness was greater than medial throughout. Horse walker exercise led to relatively thicker lateral and medial SCB compared with the midline. Elite competition was associated with increased SCB thickness of the proximal small tarsal bones medially and the distal bones laterally. For race training and treadmill training, there were minimal differences between sites overall, although the lateral aspect was greater than medial, and medial greater than midline at a few sites for race training. In conclusion, different types of high-intensity exercise were associated with different patterns of SCB thickness across the joints from medial to lateral and proximal to distal, indicating that both exercise intensity and type of exercise affect the SCB response at any particular site within the equine distal tarsal joints.

Descriptive analysis of retirement of Thoroughbred racehorses due to tendon injuries at the Hong Kong Jockey Club (1992-2004)

REASONS FOR PERFORMING STUDY

This study was part of a programme to optimise the longevity and maximise the health and welfare of the Thoroughbred racehorses in Hong Kong. Injuries to the superficial digital flexor (SDF) tendon are the most common veterinary reason for premature retirement in this population.

OBJECTIVE

To describe the frequency and pattern of retirements associated with SDF tendon injuries in Thoroughbred racehorses and to compare the characteristics of these horses with those that retired for other reasons.

METHODS

A retrospective analysis of retirement records documented in the Hong Kong Jockey Club clinical database between 1992 and 2004 was conducted. As this is complete census data, no statistical inference to the population is necessary.

RESULTS

The mean annual cumulative incidence of retirements due to tendon injury was 3.2% accounting for 14% of all retirements. The risk of tendon injury increased over the 12 year period from 23-4.2%. The racing career, number of starts and earnings of horses retired with tendon injuries were reduced by 25.6, 41.2 and 53.3%, respectively. Thirteen percent of these horses never raced in Hong Kong. A greater proportion of 3- and 4-year-olds and entire males were retired because of tendon injuries. Ninety-seven percent of injuries affected the forelimb, the right more frequently than the left. Only 19.7% of retired horses that had received ultrasound examination for SDF tendon injury retired for this reason.

CONCLUSIONS

This study provides population based data on the frequency, career and economic losses associated with tendon injury induced retirement.

POTENTIAL RELEVANCE

This descriptive study has provided a useful resource for further case-control studies to investigate risk factors for retirement from racing due to tendon injury. This is the first step toward the development of management tools to reduce the incidence of tendon injury related retirement in Hong Kong.

Analysis of horse race videos to identify intra-race risk factors for fatal distal limb fracture

The objective of this study was to identify risk factors, during racing, associated with imminent fatal distal limb fracture in Thoroughbreds. One hundred and nine cases of fatal distal limb fracture were identified from all 59 UK racecourses over a 2-year period (February 1999-January 2001). Three uninjured control horses were randomly selected from the same race as the case horse. Videos of races in which fractures occurred were viewed using a defined protocol. Fractures in flat races occurred at any time during the race, whereas 74% (45/61) of cases in national hunt type races occurred in the second half of races. More than 75% (79/103) of cases were spontaneous, i.e. there was no obvious external influence such as a fall at a fence or collision with another horse. Sixty-six percent (44/67) of horses, sustaining a forelimb fracture, fractured the forelimb they were using as lead leg at the time of fracture. When case and control horses were compared, horses that were: (a) making good progress through the race, (b) reluctant to start and (c) received encouragement in the final 10s before the time of fracture, were more likely to sustain a fracture.

Catastrophic fracture of the lateral condyle of the third metacarpus/metatarsus in UK racehorses – fracture descriptions and pre-existing pathology

The characteristics of, and pre-existing pathology associated with 75 cases of fatal lateral condylar fracture sustained by Thoroughbreds while racing in the UK were described. Cases were identified from 220 cases of fatal distal limb fracture submitted as part of studies designed to identify risk factors for all fatal distal limb fractures. Fractures were most common in hurdle races and affected the right forelimb twice as often as the left forelimb. Fracture dimensions were similar to previous reports, however there was a much greater prevalence of articular and diaphyseal comminution and of concurrent fractures in the current report. Pre-existing pathology was particularly common in the medial and lateral parasagittal grooves of the distal articular surfaces of the third metacarpus/metatarsus. The degree of this pathology was not associated with horse age, length of career or number of career starts.

Race- and course-level risk factors for fatal distal limb fracture in racing Thoroughbreds

REASONS FOR PERFORMING STUDY

Considerable variation in the rates of equine fatality at different racecourses draws attention to probable risk factors at the level of course or race that might be partly responsible. Distal limb fractures are the most common cause of equine fatality on UK racecourses and identification of risk factors for such injuries and subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities.

OBJECTIVES

To identify race- and course-level risk factors for fatal distal limb fracture in Thoroughbreds on UK racecourses.

METHODS

A case-control study design was used. Case races were defined as those in which one or more horses sustained fatal fracture of the distal limb. Controls were selected in 2 different ways. Firstly, 3 races in which no fracture occurred were selected from all races of the same type held within 5 days of the case race (Analysis 1). Secondly, 3 control races were selected for each case race from all races of the same type held in the same year (Analysis 2). One hundred and nine cases were included in the study. Information about the race and the racecourses was collected from Computer Raceform. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture in a race.

RESULTS

Longer races with a larger number of runners were more likely to contain a fracture. Firmer going and fewer days since the last race on the same course were associated with an increased risk of fracture. The going at the course at the previous race meeting was also associated with the likelihood of fracture.

CONCLUSIONS

Modifications to the going on the day of a race and greater emphasis on ground maintenance between race meetings may have an impact on the risk of fatal distal limb fracture during racing.

POTENTIAL RELEVANCE

Modification of risk factors such as the going and number of days since the last race meeting could reduce the number of equine fatalities on UK racecourses. The condition of the racecourse may be an important risk factor and future research should focus on the identification of course maintenance techniques that produce the safest possible racing surfaces.

Risk of fatal distal limb fractures among thoroughbreds involved in the five tpes of racing in the United Kingdom

The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the third metacarpus were the most common, and they were also the most common in national hunt-type races (hurdle, steeplechase and national hunt flat races). In all-weather flat racing biaxial proximal sesamoid fractures were most common, and in turf flat racing fractures of the first phalanx were most common. The risk of fractures of more than one bone was greater in national hunt-type races.

Factors related to the risk of neonatal mortality, birth-weight and serum immunoglobulin concentration in lambs in the UK

Neonatal-lamb mortality represents an economic loss and welfare concern. Two factors often associated with the risk of mortality are birth-weight and serum immunoglobulin concentration. We used data from two studies to investigate risk factors for mortality between 2 and 14 days of age and factors affecting birth-weight and serum immunoglobulin concentration at 48h of age. Dataset 1 included 1339 lambs born on eight farms during the 1995 spring lambing season; dataset 2 included 3172 lambs on seven farms during the 1991 spring lambing season. To account for some of the potential clustering within the data, multilevel models were used. Most (>75%) of the variation in the risk of mortality was at the lamb level. In dataset 1, factors significantly associated with increased odds of lamb mortality included low birth-weight and low serum immunoglobulin concentration. In dataset 2, significant risk factors for mortality included low birth-weight, ewe body-condition score, being born late in the season (relative to other lambs on the farm) and being born in multiple litters. There was a significant interaction between the effects of litter size and birth-weight. (Serum immunoglobulin concentration was not available for dataset 2.) More than half of the variation in birth-weight was at the ewe level, 27% at the lamb level, and 18% at the farm level (dataset 1). Single birth and being male were associated with increased birth-weight in both datasets. In dataset 2 only, increasing ewe condition score and birth early in the study period were also associated with increased birth-weight. Fifty-six percent of the variation in immunoglobulin concentration was at the lamb level, 36% at the ewe level and only 7% at the farm level. Factors associated with reduced serum immunoglobulin concentration included early or late birth in the lambing season, being born later than 14 days after the first lamb born on the farm, multiple-birth litters and maternal mastitis.