Characteristics of Thoroughbred and Quarter Horse racehorses that sustained a complete scapular fracture

Fractures in Thoroughbred racing and the potential for pre-race identification of horses at risk

Risk rates for and predisposing factors to fractures occurring in Thoroughbred racing that have been published in peer reviewed journals are documented. The potential for currently available techniques to identify horses at increased risk for fracture is discussed on the bases of principles, practicalities, advantages, disadvantages and current data. All are reviewed in light of justifiable decision making and importance of fractures to horseracing's social license.

Fifteen risk factors associated with sudden death in Thoroughbred racehorses in North America (2009-2021)

OBJECTIVE

To identify risk factors associated with race-related sudden death in Thoroughbred racehorses in the US and Canada.

ANIMALS

4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the US and Canada between 2009 and 2021.

PROCEDURES

Study data were extracted from the Equine Injury Database, which contains detailed records of 92.2% of all official race starts made in the US and Canada during the study period. Forty-nine potential risk factors were analyzed using univariable and multivariable logistic regression. Cases were defined as race starts that resulted in fatality within 3 days of racing, in which at least 1 of 5 codes relating to sudden death was recorded. Fatalities due to catastrophic musculoskeletal injury were omitted from the study cohort.

RESULTS

536 race starts resulted in sudden death, an incidence rate of 0.13/1,000 starts. Fifteen risk factors were significantly associated with sudden death, including horse age and sex, season and purse of race, race distance, and horses' recent history of injury and lay-up. Horses racing while on furosemide medication were at 62% increased odds of sudden death.

CLINICAL RELEVANCE

Associations found between previous injury and sudden death suggests preexisting pathology could contribute in some cases. The association between furosemide and sudden death prompts further study to understand which biological processes could contribute to this result.

Catastrophic musculoskeletal injuries in Thoroughbred racehorses in Uruguay, 2011-2017

Catastrophic musculoskeletal injuries (CMI) pose a major welfare concern to horses and their riders, yet limited data is available describing their occurrence in South America. Using a retrospective cohort and case-control design, the objective of the study was to determine the incidence of CMI for Thoroughbreds in training and racing, and associated horse-level risk factors in Uruguay. Seventy-seven Thoroughbreds sustained a CMI; 37 of which were age- and sex-matched to 111 control horses in the same race. Training and racing data from 2011-2017 were collected. Incidence of race day CMI per 1000 race starts and training CMI incidence per 100 horse months were calculated using Poisson regression. Univariable logistic regression was used to assess relationships between race history and occurrence of CMI by fracture location, and multivariably for all fracture locations. Overall race day incidence of CMI was 0.42 per 1000 race starts (95% CI 0.29, 0.60). The incidence of CMI in training was 0.059 per 100 horse months. Most fractures were of the forelimbs (80.3%). There were 32 (41.5%) distal and 39 (50.6%) proximal limb fractures. The risk of CMI was greater for horses with fewer places (P = 0.001), and greater time between the previous race and the race in which CMI occurred (P = 0.020). The rate of race day CMI was low, despite Uruguay being a racing jurisdiction with policies and risk factors associated with higher CMI rates compared to other jurisdictions. Lightly raced horses with long periods since their previous race start should be monitored closely.

Survival Analysis of Training Methodologies and Other Risk Factors for Musculoskeletal Injury in 2-Year-Old Thoroughbred Racehorses in Queensland, Australia

Musculoskeletal injuries remain a global problem for the Thoroughbred racing industry and there is conflicting evidence regarding the effect of age on the incidence of injuries. The ideal time to commence race training is strongly debated, with limited supporting literature. There is also conflicting evidence regarding the effect of high-speed exercise on musculoskeletal injuries. There is a strong interest in developing training and management strategies to reduce the frequency of injuries. The types of musculoskeletal injuries vary between 2-year-old and older horses, with dorsal metacarpal disease the most common injury in 2-year-old horses. It is likely that risk factors for injury in 2-year-old horses are different than those for older horses. It is also likely that the risk factors may vary between types of injury. This study aimed to determine the risk factors for musculoskeletal injuries and dorsal metacarpal disease. We report the findings of a large scale, prospective observational study of 2-year-old horses in Queensland, Australia. Data were collected weekly for 56-weeks, from 26 trainers, involving 535 2-year-old Thoroughbred racehorses, 1, 258 training preparations and 7, 512-weeks of exercise data. A causal approach was used to develop our statistical models, to build on the existing literature surrounding injury risk, by incorporating the previously established causal links into our analyses. Where previous data were not available, industry experts were consulted. Survival analyses were performed using Cox proportional hazards or Weibull regression models. Analysis of musculoskeletal injuries overall revealed the hazard was reduced with increased exposure to high-speed exercise [Hazard ratio (HR) 0.89, 95% Confidence Interval (CI) 0.84, 0.94, p < 0.001], increased number of training preparations (HR 0.58, 95% CI 0.50, 0.67, p < 0.001), increased rest before the training preparation (HR 0.89, 95% CI 0.83, 0.96, p = 0.003) and increased dam parity (HR 0.86, 95% CI 0.77, 0.97, p = 0.01). The hazard of injury was increased with increasing age that training commenced (HR 1.13, 95% CI 1.06, 1.19, p < 0.001). Analyses were then repeated with the outcome of interest dorsal metacarpal disease. Factors that were protective against dorsal metacarpal disease and musculoskeletal injuries overall included: increased total cumulative distance (HR 0.89, 95% CI 0.82, 0.97, p = 0.001) and total cumulative days exercised as a gallop (HR 0.96, 95% CI 0.92, 0.99, p = 0.03), the number of the training preparations (HR 0.43, 95% CI 0.30, 0.61, p < 0.001). The age that training commenced was harmful for both dorsal metacarpal disease (HR 1.17, 95% CI 1.07, 1.28, p < 0.001 and overall musculoskeletal injuries.). The use of non-ridden training modalities was protective for dorsal metacarpal disease (HR 0.89, 95% CI 0.81, 0.97, p = 0.008), but not musculoskeletal injuries overall. The male sex increased the hazard of DMD compared to females (HR 2.58, 95% CI 1.20, 5.56, p = 0.02), but not MSI overall. In summary, the hazard of musculoskeletal injury is greatest for 2-year-old horses that are born from uniparous mares, commence training at a later age, are in their first training preparation, have undertaken little high-speed exercise or had limited rest before their training preparation. The hazard of dorsal metacarpal disease is greatest for 2-year-old horses that are males, commence training at a later age, are in their first training preparation, have undertaken little high-speed exercise or had limited use of non-ridden training modalities. Close monitoring of these high-risk horses during their training program could substantially reduce the impact of MSI. Furthermore, an understanding of how training methodologies affect the hazard of MSI facilitates modification of training programs to mitigate the risk impact of injury. The strengths of this study include a large sample size, a well-defined study protocol and direct trainer interviews. The main limitation is the inherent susceptibility to survival bias.

Factors Associated with Fatality in Ontario Thoroughbred Racehorses: 2003-2015

Simple Summary

Ontario’s Alcohol and Gaming Commission records equine racing fatalities through its Equine Health Program. This study examines the 695 Thoroughbred occurrences from 2003 to 2015 with the aim of identifying associations. Deaths occurred within 60 days of a horse racing or being entered or qualified to race. Calculated on the most commonly adopted basis, rates for Ontario Thoroughbreds are high—2.94/1000 starts (all fatalities) and 1.96/1000 (breakdowns only), compared with a global industry breakdown range of 0.29–2.36/1000 starts. The study revealed several significant risk factors, including workload, stage of training, age, sex, stage of career, finish position, race field size, and day of week. Among fatalities were groups where combinations of these risk factors were important, such as being a two-year-old male, un-castrated, and in early training. Probability of fatality fell over the study period in response to increasing awareness through existence of the Program and adoption of new regulations, but remains of concern. All identified associations represent aspects of management and industry structure that are amenable to change with a view to reducing fatalities. A link between fatality and cumulative, non-fatal outcomes should also be considered. An overall approach might view associated factors as sources of physical and psychological stress that, acutely and cumulatively, may influence the liability for adverse outcomes in training and racing.

Abstract

Ontario’s Alcohol and Gaming Commission records equine racing fatalities through its Equine Health Program. The present study examined all Thoroughbred fatalities from 2003 to 2015, inclusive, to identify associations. Official records and details of fatalities were combined in multivariable logistic regression modelling of 236,386 race work-events (433 fatalities), and 459,013 workout work-events (252 fatalities). Fatality rates were 2.94/1000 race starts (all fatalities) and 1.96/1000 (breakdowns only) with an overall rate of 2.61% or 26.1 fatalities/1000 horses. Comparison with published reports reveals rates to be high. Musculoskeletal injury was the predominant complaint and there was a high incidence of horses dying suddenly. Liability was high for young horses early in the season with a differential according to sex and whether a male horse was gelded. Horses undertaking repeated workouts had a higher liability and liability was higher in workouts for horses switching from dirt/synthetic to turf racing and for young horses in sprints. Race distance was not significant but high fatality rates in some large field, distance races combined with effects of age and workload identified groups at particular risk. As field size increased, fatality liability increased for early-finishing horses. Findings suggest jockey strategy could be an important factor influencing fatalities. Probability of fatality declined over the study period. Findings indicate that rapid accumulation of workload in animals early in their preparation is likely to be damaging. Fatality fell toward the end of a season and for horses with a long career history of successful performance; however, horses not exhibiting this robustness and staying power represent the population of greatest concern. Associations may be characterised as representing sources of stress, current or cumulative, and identifying at-risk animals on this basis may be as productive as targeting specific, discrete mechanisms suspected to contribute to individual fatalities.

Sudden death caused by spinal cord injury associated with vertebral fractures and fetlock failure in a Thoroughbred racehorse

The most prevalent causes of death in racehorses are musculoskeletal injuries, causing ~83% of deaths within the racing industry in California and elsewhere. The vast majority of these injuries have preexisting lesions that predispose to fatal injury. A 4-y-old Thoroughbred colt suffered an acute suspensory apparatus failure, including biaxial proximal sesamoid bone fractures of the right front fetlock, causing loss of support of the fetlock joint and consequent fall with fractures of the cervical and sacral spine. Cervical fracture caused spinal cord damage that resulted in sudden death. A preexisting lesion in the medial proximal sesamoid bone likely predisposed to complete fracture of this bone and fetlock breakdown. Interestingly, a comparable osteopenic lesion was present in the intact medial proximal sesamoid bone of the left forelimb, which is consistent with bilateral repetitive overuse injury in racehorses. The morphologic features of the cervical and sacral spine fractures were compatible with acute injury; no evidence of preexisting lesions was seen. Most likely, these acute vertebral fractures occurred as a result of the horse falling. This case emphasizes the importance of performing a detailed autopsy in horses that suffer an appendicular musculoskeletal injury, particularly in fatal cases when the horse dies following a leg injury.

The Risk Factors for Musculoskeletal Injuries in Thoroughbred Racehorses in Queensland, Australia: How These Vary for Two-Year-Old and Older Horses and with Type of Injury

Simple Summary

Musculoskeletal injuries (MSI) continue to affect Thoroughbred racehorses internationally, despite over thirty years of research into this problem. Studies of risk factors for musculoskeletal injuries report inconsistent findings. Consequently, developing training strategies to mitigate the risk of MSI is difficult. We identified factors associated with particularly high odds of injury in this population of racehorses. Two-year-old horses from primiparous mares (first foals born) are at increased odds of MSI, particularly dorsal metacarpal disease (“shinsoreness”). Two-year-old horses that have had a total preparation length of between 10 and 14 weeks also have increased odds of injury. Horses of all ages that travelled a total distance of 2.4–3.8 km (12–19 furlongs) at a gallop (faster than 15 m/s; 13 s/furlong; 900 m/min; 55 km/h) in the last four weeks and horses three years and older that travelled 3.0–4.8 km (15–24 furlongs) at three-quarter pace and above (faster than 13 m/s; 15 s/furlong; 800 m/min; 48 km/h) also have increased odds of injury. We recommend that these horses should be monitored closely for impending signs of injury. We also observed a non-linear relationship between high-speed exercise and musculoskeletal injuries. This highlights the importance of high-speed exercise to enable tissue adaptation to training. Finally, in some situations, increasing the number of days worked at a slow pace may be more effective for preventing MSI, if horses are perceived at a higher risk, than resting the horse altogether. Early identification of horses at increased risk of injury and appropriate intervention could substantially reduce the impact of musculoskeletal injuries in Thoroughbred racehorses.

Abstract

Musculoskeletal injuries (MSI) continue to affect Thoroughbred racehorses internationally. There is a strong interest in developing training and management strategies to reduce their impact, however, studies of risk factors report inconsistent findings. Furthermore, many injuries and fatalities occur during training rather than during racing, yet most studies report racing data only. By combining racing and training data a larger exposure to risk factors and a larger number of musculoskeletal injuries are captured and the true effect of risk factors may be more accurately represented. Furthermore, modifications to reduce the impact of MSI are more readily implemented at the training level. Our study aimed to: (1) determine the risk factors for musculoskeletal injuries and whether these are different for two-year-old and older horses and (2) determine whether risk factors vary with type of injury. This was performed by repeating analyses by age category and injury type. Data from 202 cases and 202 matched controls were collected through weekly interviews with trainers and analysed using conditional logistic regression. Increasing dam parity significantly reduced the odds of injury in horses of all age groups because of the effect in two-year-old horses (odds ratio (OR) 0.08; 95% confidence interval (CI) 0.02, 0.36; p < 0.001). Increasing total preparation length is associated with higher odds of injury in horses of all ages (OR 5.56; 95% CI 1.59, 19.46; p = 0.01), but particularly in two-year-old horses (OR 8.05; 95% CI 1.92, 33.76; p = 0.004). Increasing number of days exercised at a slow pace decreased the odds of injury in horses of all ages (OR 0.09; 95% CI 0.03, 0.28; p < 0.001). The distance travelled at three-quarter pace and above (faster than 13 m/s; 15 s/furlong; 800 m/min; 48 km/h) and the total distance travelled at a gallop (faster than 15 m/s; 13 s/furlong; 900 m/min; 55 km/h) in the past four weeks significantly affected the odds of injury. There was a non-linear association between high-speed exercise and injury whereby the odds of injury initially increased and subsequently decreased as accumulated high-speed exercise distance increased. None of the racing career and performance indices affected the odds of injury. We identified horses in this population that have particularly high odds of injury. Two-year-old horses from primiparous mares are at increased odds of injury, particularly dorsal metacarpal disease. Two-year-old horses that have had a total preparation length of between 10 and 14 weeks also have increased odds of injury. Horses of all ages that travelled a total distance of 2.4–3.8 km (12–19 furlongs) at a gallop in the last four weeks and horses three years and older that travelled 3.0–4.8 km (15–24 furlongs) at three-quarter pace and above also have increased odds of injury. We recommend that these horses should be monitored closely for impending signs of injury. Increasing the number of days worked at a slow pace may be more effective for preventing injury, if horses are perceived at a higher risk, than resting the horse altogether. Early identification of horses at increased risk and appropriate intervention could substantially reduce the impact of musculoskeletal injuries in Thoroughbred racehorses.

Characteristics of complete tibial fractures in California racehorses

BACKGROUND

Tibial fractures cause ~3% of racehorse deaths. Pre-existing stress fractures have been associated with multiple racing and training fractures, but not complete tibial fractures.

OBJECTIVES

To describe racehorse tibial fractures and compare signalment and exercise histories of affected and control racehorses.

STUDY DESIGN

Retrospective analysis of necropsy reports.

METHODS

Racehorses that had a complete tibial fracture (1990-2018) were retrospectively reviewed. Signalment and exercise histories of affected horses were compared to 1) racehorses that died because of non-tibial musculoskeletal injuries or 2) non-musculoskeletal cause and 3) age, sex, event-matched control racehorses. Tibial fracture prevalence was described relative to California racehorses that had at least one official work or race. Age, sex and limb distributions were compared between affected and control horses (Chi-square, Fisher's Exact test). Exercise history data were reduced to counts and rates of official high speed works, races and layups (periods without an official high speed work or race >60 days). Variables were compared among groups using matched logistic regression (P ≤ .05).

RESULTS

Tibial fractures in 115 horses (97% unilateral; 50% left, 47% right) occurred most commonly during training (68%) and in 2- to 3-year-old horses (73%). Fractures were predominantly comminuted (93%), diaphyseal (44%) and oblique (40%). Of 61 cases examined for callus, 64% had periosteal callus associated with fracture, most commonly in proximal (65%) and distal diaphyseal (27%) locations. Of 28 racehorses with known exercise history, 57% never raced and 36% had a layup. Affected horses had fewer official-timed works and events (official high speed works and races), number of active days and accumulated less distance in events and works (P < .05) than control horses.

MAIN LIMITATIONS

Retrospective review of necropsy reports by multiple pathologists over 28 years.

CONCLUSIONS

Tibial fractures were associated with pre-existing stress fracture early in career. Most fractures were associated with proximolateral stress fractures.

The Effect of Combined Training and Racing High-Speed Exercise History on Musculoskeletal Injuries in Thoroughbred Racehorses: A Systematic Review and Meta-Analysis of the Current Literature

Simple Summary

Despite extensive international research, musculoskeletal injuries remain a key problem for the Thoroughbred racing industry, with multiple welfare and ethical consequences. High-speed exercise (HSE) history is an important risk factor for injury. However, studies report conflicting findings concerning the effect of HSE on the risk of injury. Although most injuries and fatalities occur during training rather than racing, many research studies only evaluate injuries reported on race day, which likely underrepresents the injuries acquired by these horses. This study aimed to determine the effect of combined training and racing HSE on injuries in racehorses. We performed a systematic search of the relevant literature and evaluated the effect of seven measures of HSE on injury through meta-analyses. The total career HSE distance significantly affected the odds of musculoskeletal injuries (MSI). With every 5-furlong (1 km) increase in career HSE distance, the odds of MSI increased by 2%. The average HSE distance per day also affected the odds of MSI. With every additional furlong (200 m) of average HSE per day, the odds of MSI increased by 73%. However, the strength of the available evidence is restricted by methodological limitations, which will need to be addressed in the future, to explore the level of risk and mechanisms for injury in more detail.

Abstract

Despite over three decades of active research, musculoskeletal injuries (MSI) remain a global problem for the Thoroughbred (TB) racing industry. High-speed exercise history (HSEH) has been identified as an important risk factor for MSI. However, the nature of this relationship remains unclear, with an apparent protective effect of HSE against injury, before it becomes potentially harmful. Many MSI cases and fatalities occur during training rather than during racing, resulting in an underestimation of injury from studies focused on race day. The objective of this study was to examine the current evidence of the effect of combined training and racing HSEH on MSI in TB flat racehorses, through a systematic review and meta-analysis. A systematic search of the relevant literature was performed using PubMed^®, Scopus^®, Web of Science^®, and Embase^® online databases and the gray literature using sites containing “.edu” or “.edu.au”. Studies included in the review had explored seven different measures of HSE, including total career HSE distance, cumulative HSE distance in the 30 and 60 days before MSI, average HSE distance per day, per event and per 30 days, and the total number of HSE events. The total cumulative career HSE distance significantly affected the odds of MSI, with every 5-furlong increase, the odds of MSI increased by 2% (OR = 1.02; 95% CI 1.01, 1.03; p = 0.004). The average HSE distance per day also affected the odds of MSI, with every additional furlong increasing the odds of MSI by 73% (OR = 1.73; 95% CI 1.29, 2.31; p < 0.001). Other measures of HSE were not found to be consistently associated with risk of MSI, but these results should be interpreted with caution. Significant methodological limitations were identified and influence the comparability of studies. Standardizing the measures of HSE in studies of MSI, and describing training conditions in more detail, would support a more thorough investigation of the relationship between HSE and MSI. An improved understanding of this relationship is critical to mitigating the impact of MSI in the Thoroughbred racehorse.

Appraising the Welfare of Thoroughbred Racehorses in Training in Queensland, Australia: The Incidence and Type of Musculoskeletal Injuries Vary between Two-Year-Old and Older Thoroughbred Racehorses

Simple Summary

Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with serious ethical and welfare consequences. Previous research examining risk factors for injuries report inconsistent findings. Age is thought to affect the risk of injury, but, to date, there have been no prospective studies specifically comparing injuries between two-year-old versus older horses. We aimed to: (1) determine the incidence of injuries for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of injuries affecting two-year-old and older horses, and whether horses trialled or raced after injury. Data were collected through personal structured weekly interviews with participating trainers over a 13-month period. Data were analysed using Poisson regression. The incidence of MSI in the current study was low (0.6%). The incidence of MSI in two-year-old horses was higher than older horses. Types of MSI varied between two-year-old and older horses and affected whether horses subsequently trialled or raced from 11 to 23 months after injury. A larger proportion of two-year-old horses had dorsal metacarpal disease and traumatic lacerations. A smaller proportion of two-year-old horses had suspensory desmitis, superficial digital flexor tendonitis, proximal sesamoid bone fractures, and fetlock joint injuries than older horses. Training track and rainfall did not affect the incidence of injuries. The season affected the incidence of injuries in two-year-old horses but not in older horses.

Abstract

Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with important ethical and welfare consequences. Previous research examining risk factors for MSI report inconsistent findings. Age is thought to affect MSI risk, but, to date, there have been no prospective studies comparing MSI in two-year-old versus older horses. This study aimed to: (1) determine the incidence of MSI for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of MSI affecting two-year-old and older horses, and whether horses trialled or raced after injury. A prospective survey was conducted with data collected through personal structured weekly interviews with participating trainers over a 13-month period. Data were analysed using Poisson regression. The incidence of MSI in the current study was low (0.6%). The incidence of MSI in two-year-old horses was higher than older horses (p < 0.001). Types of MSI varied between two-year-old and older horses (p < 0.001) and affected whether horses subsequently trailed or raced from 11 to 23 months after injury (p < 0.001). A larger proportion of two-year-old horses had dorsal metacarpal disease and traumatic lacerations. A smaller proportion of two-year-old horses had suspensory ligament desmitis, superficial digital flexor tendonitis, proximal sesamoid bone fractures, and fetlock joint injuries than older horses. Training track and rainfall did not affect MSI. The season affected MSI in two-year-old horses (p < 0.001) but not older horses. The major limitation was that trainers in this study were metropolitan (city) and our findings may not be generalisable to racehorses in regional (country) areas. Another significant limitation was the assumption that MSI was the reason for failure to trial or race after injury. In conclusion, the incidence of MSI was low in the current study and the types and the risk factors for MSI are different for two-year-old and older horses.

Subchondral focal osteopenia associated with proximal sesamoid bone fracture in Thoroughbred racehorses

BACKGROUND

Proximal sesamoid bone (PSB) fracture is the most common fatal injury in Thoroughbred (TB) racehorses in the United States. Epidemiological and pathological evidence indicates PSB fracture is likely the acute culmination of a chronic stress-related process. However, the aetiopathogenesis of PSB fracture is poorly understood.

OBJECTIVE

To characterise bone abnormalities that precede PSB fracture.

STUDY DESIGN

Two retrospective case-control groups of PSBs from TB racehorses with, and without, unilateral biaxial PSB fracture.

METHODS

Proximal sesamoid bones were harvested post-mortem from TB racehorses subjected to euthanasia for unilateral biaxial PSB fracture (cases) or causes unrelated to PSB fracture (controls) while racing or training. The fractured medial PSB (FX-PSB) and contralateral intact medial PSB (CLI-PSB) from racehorses that sustained PSB fracture, and an intact medial PSB (CTRL-PSB) from racehorses that did not have a PSB fracture were collected as case and control specimens. Study 1 distributions of morphological features were compared among case and control groups using visual examination, photographs, radiographs and histology of whole PSBs and serial sagittal sections (10 FX-PSB, 10 CLI-PSB and 10 CTRL-PSB). Study 2 local bone volume fraction and mineral densities were compared among case and control PSBs using microcomputed tomography (9 FX-PSB, 9 CLI-PSB and 9 CTRL-PSB).

RESULTS

A focal subchondral lesion characterised by colocalised focal discoloration, radiolucency, osteopenia, low tissue mineral density and a surrounding region of dense cancellous bone was identified in most case horses but not in controls. This subchondral lesion was found in a slightly abaxial mid-body location and was bilaterally present in most case horses.

MAIN LIMITATIONS

The post-mortem samples may not represent the spectrum of abnormalities that occur throughout the development of the subchondral lesion. Lateral PSBs were not examined, so their contribution to biaxial PSB fracture pathogenesis is unknown.

CONCLUSION

Abaxial subchondral lesions are consistent with pre-existing injury and likely associated with PSB fracture.

Meta-analysis of risk factors for racehorse catastrophic musculoskeletal injury in flat racing

Studies of racehorse injury or fatality in various countries have identified common, and in some cases conflicting, risk factors. We conducted a systematic search of the relevant literature published from 1990 to 2017. Peer-reviewed articles were included if they reported the incidence of fatal or catastrophic musculoskeletal injury (CMI) in Thoroughbred flat races (n=21) or risk factors for CMI (n=65). Pooled effect sizes were estimated using the random-effects DerSimonian-Laird model. The pooled incidence of CMI was 1.17 (95% confidence interval 0.90, 1.44) per 1000 race starts. Almost 300 factors have been investigated in epidemiological studies for potential associations with CMI. Factors found to have consistent evidence of increasing risk of CMI are: (1) Horse-level factors such as older horse age and age at first start, male sex, and higher race class or lower claiming price; (2) Race-level factors such as firmer track conditions on turf and wetter conditions on dirt, longer race distance, and a greater number of starters; and (3) Management-related factors including more time since previous start, greater number of starts, longer career length, issues identified at pre-race examination, previous injury, and recent administration of medication or injections. Studies investigating recent cumulative distance of high-speed exercise were conflicting and suggestive of at least two mechanisms of injury related to the accumulation of bone damage: (1) In well adapted bone following a period of intense training; and (2) In poorly adapted bone at relatively low levels of training intensity. Future studies should evaluate success of interventions and mechanisms for injury.

Relationship Between Historical Lameness, Medication Usage, Surgery, and Exercise With Catastrophic Musculoskeletal Injury in Racehorses

Background: The rate of catastrophic musculoskeletal injuries (CMI) in racehorses is high in the United States compared to other countries. Few modifiable risk factors related to lameness, medication, and surgery history have been identified.

Objective: To detect management factors that increase risk of CMI by comparing medical histories between horses that sustained, and horses that did not sustain, a CMI.

Study design: Case-control.

Methods: Racehorse necropsy data (May 2012-June 2013) were obtained through the California Horse Racing Board Postmortem Program. Attending veterinarians of Thoroughbreds (TB) and Quarter Horses (QH) that experienced CMI, and of three matched control horses, were invited to complete an online veterinary medical history survey. We investigated associations between CMI and lameness, medication, surgery, and exercise history using multivariable logistic regression.

Results: There were 146 TB (45 cases, 101 controls) and 17 QH (11 cases, 6 controls) surveys completed. TB cases were more likely to show signs of lameness within the 3 months prior to death compared to controls. A high proportion of both cases (64.3%) and controls (76.8%) were administered medications, but unraced TB case horses were more likely to have been administered systemic medications compared to those that previously raced. TB cases were more likely to have raced with greater intensity during their career, but had eased off in the month preceding CMI. For QHs, there was insufficient power to detect significant differences between cases and controls that showed signs of lameness, or that were administered medications. Surgery history was not associated with CMI.

Main limitation: Insufficient power to detect small effect sizes.

Conclusions: The study provides information that can be used to aid in identification of horses at high risk for catastrophic injury, and management factors that can be modified to reduce the risk for all horses.

Ontario Racehorse Death Registry, 2003-2015: Descriptive analysis and rates of mortality

BACKGROUND

The Province of Ontario maintains a registry of racehorse deaths occurring within 60 days of a race or trial entry that provides insight into mortality rates and costs of competition.

OBJECTIVES

To characterise and quantify mortality and identify breed differences.

STUDY DESIGN

Retrospective annualised cohort study.

METHODS

The Ontario Death Registry for 2003-2015, containing 1713 cases, was audited and information on the relationship between death and official work added. Race and trial data from industry performance databases were used to determine mortality rates according to breed, year, age, sex and circumstances of death.

RESULTS

Breed differences in mortality rate and individual risk were found. Thoroughbreds (Tb) had the greatest exercise-associated mortality (EAM) rate and risk by all measures (2.27 deaths/1000 race starts, 0.95-1.0% annual individual risk), followed by Quarter horses (Qh, 1.49, 0.60-0.69%). Rate and risk were lowest for Standardbreds (Sb, 0.28, 0.23-0.24%). Nonexercise annual individual risk was highest for the Sb (0.45%, vs. Tb 0.33%, and Qh 0.32%). Pattern and type of EAM mirrored the characteristics of competitive activity in each industry, with high Tb and Qh mortality being associated with exercise and involving musculoskeletal injuries, dying suddenly and accidents. Low Sb EAM reflected the more extensive nature of training preparation and racing for this breed.

MAIN LIMITATIONS

Available data provided no information on morbidity, mortality beyond the 60-day horizon or for horses not racing. Numbers for the Qh were low.

CONCLUSIONS

Race-intensity exercise is clearly hazardous for horses, with hazards varying widely between breeds and showing parallels with industry cultural and management norms. Breed differences provide insights concerning strategies that could reduce mortality, while improving welfare and reducing costs of participation. For all breeds, musculoskeletal injury was the major contributing cause of mortality.

Diagnostic approach to catastrophic musculoskeletal injuries in racehorses

Catastrophic musculoskeletal injuries are the most common cause of euthanasia or spontaneous death in racehorses, and the most common cause of jockey falls with potential for serious human injury. Horses are predisposed to the vast majority of these injuries by preexisting lesions that can be prevented by early diagnosis and adequate bone injury management. A thorough examination of the musculoskeletal system in racehorses often determines the cause of these injuries and generates data to develop injury prevention strategies. We describe the diagnostic approach to musculoskeletal injury, review the methodology for the examination of racehorse limbs, and provide anatomy and pathology tools to perform an organized and thorough postmortem examination of the musculoskeletal system in equine athletes.

The role of catastrophic injury or sudden death of the horse in race-day jockey falls and injuries in California, 2007-2012

REASONS FOR PERFORMING STUDY

If equine conditions with high likelihood of jockey injury can be determined and subsequently prevented, jockey safety can be enhanced.

OBJECTIVES

To identify racehorse injuries or conditions with greatest risk for jockey falls and injuries.

STUDY DESIGN

Retrospective correlation of race-day jockey fall and injury data with racehorse fatality data.

METHODS

Thoroughbred (TB) and Quarter Horse (QH) racehorse cause of death and jockey fall and injury data for California flat races were reviewed for a 6-year period. Race and jockey race ride population data were used to determine jockey fall and injury incidence rates relative to cause of racehorse death, and were assessed using Poisson regression. Differences in proportions were assessed using Fisher's exact, Pearson's χ(2), and Cochran-Mantel-Haenszel tests.

RESULTS

707 racehorses experienced race-related catastrophic injury or sudden death. 199 jockeys had 601 falls with 325 injuries. Jockeys were 162 times more likely to fall (95% confidence interval 137-192; P<0.001) and 171 times more likely to be injured (95% confidence interval 140-208; P<0.001) when they rode a horse that died in a race. We infer that jockeys were more likely to fall or be injured when riding in QH races than in TB races because of a higher incidence of horse fatalities in QH races. Jockey falls occurred with 24% of TB and 36% of QH race-related horse fatalities, and jockey injury occurred in 64% of falls. Jockey falls were most common with TB fetlock injuries and QH carpal, metacarpal and fetlock injuries; and with axial, bilateral and multiple injuries compared with appendicular, unilateral and singular injuries, respectively.

CONCLUSIONS

Prevention of the most common catastrophic injuries and conditions of the racehorse, e.g. fetlock injuries, may be most effective at decreasing rates of falls and injuries to horseracing jockeys during racing.

Jockey Falls, Injuries, and Fatalities Associated With Thoroughbred and Quarter Horse Racing in California, 2007-2011

BACKGROUND

Despite the popularity of the horse racing industry in the United States and the wide recognition that horse racing is one of the most hazardous occupations, little focused research into the prevention of falls by and injuries to jockeys has been conducted.

PURPOSE

To describe the incidence rates and characteristics of falls and injuries to Thoroughbred and Quarter Horse racing jockeys in the state of California.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Data on race-day falls and injuries were extracted from jockey accident reports submitted to the California Horse Racing Board from January 2007 to December 2011. Denominator data, number of jockey race rides, were obtained from commercial and industry databases. Jockey fall, injury, and fatality incidence rates and ratios in Thoroughbred and Quarter Horse flat races were estimated using Poisson regression. Characteristics of falls and injuries are described and compared.

RESULTS

In Thoroughbred races, 184 jockey injuries occurred from 360 reported jockey falls, 180,646 race rides, 23,500 races, and 3350 race meetings. In Quarter Horse races, 85 jockey injuries occurred from 145 jockey falls, 46,106 race rides, 6320 races, and 1053 race meetings. Jockey falls occurred at a rate of 1.99 falls per 1000 rides in Thoroughbred races, with 51% of falls resulting in jockey injury, and 3.14 falls per 1000 rides in Quarter Horse races, with 59% of falls resulting in jockey injury. The majority of falls occurred during a race, with catastrophic injury or sudden death of the horse reported as the most common cause in both Thoroughbred (29%) and Quarter Horse (44%) races. During the period studied, 1 jockey fatality resulted from a fall. Jockey fall rates were lower but injury rates were comparable to those reported internationally.

CONCLUSION

On average, a licensed jockey in California can expect to have a fall every 502 rides in Thoroughbred races and every 318 rides in Quarter Horse races. While jockey fall rates were lower, injury rates were similar to those in other racing jurisdictions. The high proportion of jockey falls caused by horse fatalities should be further investigated.