Case-control study of high-speed exercise history of Thoroughbred and Quarter Horse racehorses that died related to a complete scapular fracture

Linkage of jockey falls and injuries with racehorse injuries and fatalities in Thoroughbred flat racing in Victoria, Australia

Introduction

Racehorse and jockey incidents on race-days frequently occur together, yet risk factors for their occurrence have historically been investigated separately. Consideration of both horses and humans in tandem is required for a One Health approach to risk reduction. Our objectives were to therefore identify modifiable risk factors for adverse outcomes that are common or conflicting to both horses and their jockeys in Thoroughbred racing.

Methods

Australian Single National System records for the 2004/05 to 2018/19 flat racing season were merged with the corresponding Australian Racing Incident Database records. Incidence rate ratios (IRR) with 95% confidence intervals (CI) were estimated for the outcomes of racehorse musculoskeletal injury (MSI), racehorse fatality, jockey falls and jockey injury using Poisson regression. Horse-level, race-level, jockey-level and trainer-level factors associated with each adverse outcome during or post-race were identified using multivariable logistic regression.

Results

The incidence of MSI was 21.21 (20.84, 21.59), racehorse fatalities 0.55 (0.50, 0.61), jockey falls was 3.01 (2.80, 3.24), and jockey injuries 1.79 (1.63, 1.97) per 1000 flat race starts. There was a decrease in racehorse MSI and jockey falls over the study period but no change in racehorse fatality or jockey injury incidence. In multivariable analysis, longer race distances and higher caliber races were associated with horse (p < 0.01), but not jockey, incidents. Firmer turf surfaces were associated with greater risk of both horse incidents and jockey falls (p < 0.05). Racehorses that were of older age at their first start, and/or had prior race-day injuries had a greater risk of injury and fatality (p < 0.001, p < 0.01, respectively). The most prominent risk factor for jockey fall or injury was a racehorse incident, although overall contributing to a relatively small proportion; 8.6% (n = 42/489) of jockey falls and 15.3% (n = 24/147) of injuries. Jockeys with fewer career starts were at greater risk of falling, and those with a higher percentage of last place finishing positions were at greater risk of injury (p < 0.001).

Discussion

As there were no conflicting risk factors identified between racehorse and jockey injury, policies aimed at reducing horse injury risk are also expected to benefit their riders.

A machine learning approach to identify stride characteristics predictive of musculoskeletal injury, enforced rest and retirement in Thoroughbred racehorses

Decreasing speed and stride length over successive races have been shown to be associated with musculoskeletal injury (MSI) in racehorses, demonstrating the potential for early detection of MSI through longitudinal monitoring of changes in stride characteristics. A machine learning (ML) approach for early detection of MSI, enforced rest, and retirement events using this same horse-level, race-level, and stride characteristic data across all race sectionals was investigated. A CatBoost model using features from the two races prior to an event had the highest classification performance (sensitivity score for MSI, enforced rest and retirement equal to 0.00, 0.58, 0.76, respectively and balanced accuracy score corresponding to 0.44), with scores decreasing for models incorporating windows that included additional races further from the event. Feature importance analysis of ML models demonstrated that retirement was predicted by older age, poor performance, and longer racing career, enforced rest was predicted by younger age and better performance, but was less likely to occur when the stride length is increasing, and MSI predicted by increased number of starters, greater variation in speed and lower percentage of career time at rest. A relatively low classification performance highlights the difficulties in discerning MSI from alternate events using ML. Improved data recording through more thorough assessment and annotation of adverse events is expected to improve the predictability of MSI.

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.

The association between Thoroughbred racehorse training practices and musculoskeletal injuries in Victoria, Australia

Catastrophic musculoskeletal injuries (CMI) in horses are associated with both too little and too much high-speed exercise. In order to advise trainers on training and management strategies that minimize the risk of musculoskeletal injury (MSI), a better understanding of how training practices affect MSI in racehorses is needed. Data from prospective studies relating training data and MSI are complicated by the gradual development of pathology and the effect of this on the ability of horses to train consistently prior to the identification of an injury. To circumvent this, 66 Australian Thoroughbred trainers were surveyed on their intended training practices, including rest, pre-training, and race-fit practices. Associations between intended training practices and catastrophic and non-catastrophic race day MSI outcomes in two-year-old and mature (≥three-year-old) horses were assessed using multivariable negative binomial regression models. The incidence of two-year-old race day MSI was lower for trainers who preferred shorter times (weeks) to trial, less time in fast work pre-trial (p = 0.003), shorter, more frequent rest periods (p < 0.01) and higher amounts of fast work at 15.5-16.7 m/s once race-fit (p = 0.001). The incidence of mature horse race day MSI was lower for trainers who preferred longer rest periods (p = 0.026) and a high-volume pre-trial training strategy comprising a high volume of slower speed gallop training and longer times to trial compared to fast and light training programs (p = 0.004) for their mature horses, in addition to higher amounts of fast work at 15.5-16.7 m/s for their race-fit two-year-olds (p = 0.012). Race day CMI incidence was lower for trainers who preferred lower volumes of fast gallop work for their race-fit mature horses (p < 0.05). These results suggest that two-year-old training practices could affect MSI risk later in a horse's career, and that age and stage in training (pre-trial, race-fit) are important considerations when developing training practices to minimize the risk of MSI.

A Bioeconomic Model for the Thoroughbred Racing Industry-Optimisation of the Production Cycle with a Horse Centric Welfare Perspective

The Thoroughbred racing industry faces new and competing pressures to operate within a modern, changing society. Three major moderators drive the focus and productivity of the industry worldwide: economic sustainability, horse biology and social licence to operate. This review proposes that despite the apparent homogeneity in the structure of racing across jurisdictions due to international regulation of the sport, there are significant differences within each jurisdiction in each of the three moderators. This creates challenges for the comparison of injury risk factors for racehorses within the industry across different jurisdictions. Comparison of the relative distribution of racing and gambling metrics internationally indicates that the Asian jurisdictions have a high focus on gambling efficiency and high economic return of the product, with a high number of starts per horse and the highest relative betting turnover. In contrast, the racing metrics from the USA have proportionally low racing stakes and fewer horses per race. These differences provide insight into the sociology of horse ownership, with a shift from the long-term return on investment held by most jurisdictions to a short-term transitional view and immediate return on investment in others. Wastage studies identify varying risks influenced by the predominant racing culture, training methods, production focus and environment within individual jurisdictions. Increasing societal pressure to maintain high racehorse welfare and reduce the negative impact of gambling poses fluctuating risks to each jurisdiction's social licence to operate. Based on the data presented within this review, the authors propose that the use of a bioeconomic model would permit consideration of all three moderators on industry practice and optimisation of the jurisdiction-specific production cycle with a horse-centric welfare perspective.

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.

Association of Thoroughbred Racehorse Workloads and Rest Practices with Trainer Success

Understanding the relationship between the training practices of Thoroughbred racehorses and race performance is important to ensure advice given to trainers for injury prevention or management is practical and consistent. We assessed associations between intended volume and speed of gallop training (i.e., typical workloads for horses free of injury or other performance limiting conditions) and rest practices on official trainer career and previous season success rates (rate of wins and places, prizemoney per start). Sixty-six Australian Thoroughbred trainers were surveyed. Multivariable negative binomial regression models were employed for the outcomes career and previous season wins and places, and linear regression models for prizemoney per start. Intended training workload was not associated with prizemoney. Pre-trial total galloping distances (≥13.3 m/s) between 7500 m and 15,000 m were associated with a higher rate of career wins, and previous season wins and places per start (p < 0.05). Slow-speed (13.3-14.3 m/s) galloping distance to trial between 5000 m to 12,500 m was associated with higher rate of career placings per start, with reduced performance over 12,500 m (p = 0.003). Greater time between race starts was associated with a greater rate of previous season wins and prizemoney per start until three weeks between starts, with decline in performance thereafter (p < 0.05). Greater frequency of rest breaks was associated with greater prizemoney per start earnt in the previous season (p ≤ 0.01). These results suggest that modifications to training programs aimed at injury prevention, such as avoiding long galloping distances, should not adversely affect trainer success.

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.

A Prospective Study of Training Methods for Two-Year-Old Thoroughbred Racehorses in Queensland, Australia, and Analysis of the Differences in Training Methods between Trainers of Varying Stable Sizes

Simple Summary

Musculoskeletal injuries present significant concerns for the global Thoroughbred racing industry. The development of training and management strategies to reduce injuries has been challenging due to conflicting findings about the risk factors for injury, and limited understanding of the role of different training methodologies. There is little published data on patterns of rest periods and exercise data and how these vary between trainers and between different racing jurisdictions. We describe training methodologies for 535 two-year-old horses providing 1258 training preparations and 7512 weeks of exercise. We investigated the variation in training methodologies between trainers from small, medium and large stable sizes. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume, attaining training milestones more frequently and taking less time to reach their training milestones. We also highlight similarities and differences in training methods used in Queensland, Australia, and those previously reported from other geographic locations. A better understanding of training methods is an essential step towards reducing the impact of injuries.

Abstract

Worldwide, musculoskeletal injuries remain a major problem for the Thoroughbred racing industry. There is a strong interest in developing training and management strategies to reduce the impact of musculoskeletal injuries, however, progress has been limited by studies reporting conflicting findings, and a limited understanding of the role of different training methods in preventing injury. There is little data on patterns of rest periods and exercise data and how these vary between trainers. This prospective study of two-year-old racehorses was conducted in Queensland, Australia and involved weekly personal structured interviews with 26 trainers over 56 weeks. Detailed daily exercise data for 535 horses providing 1258 training preparations and 7512 weeks at risk were collected. Trainers were categorised into three groups by the mean number of two-year-old horses that they had in work each week over the study duration: (1) Small stables with five or less, (2) Medium stables with 6 to 15 and (3) Large stables with greater than 15 horses in training. Differences between trainers with small, medium and large stable sizes were evaluated using linear regression, Kruskal–Wallis equality-of-populations rank test if linear models were mis-specified or Chi-squared tests for categorical variables. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume (p < 0.001), attaining training milestones more frequently (p = 0.01) and taking less time to reach their training milestones (p = 0.001). This study provides detailed data to which training practices from other locations can be compared. Presenting actual training data rather than trainers’ estimation of a typical program provides a more accurate assessment of training practices. Understanding how training practices vary between regions improves comparability of studies investigating risk factors and is an important step towards reducing the impact of musculoskeletal injuries.

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.

Expression of select mRNA in Thoroughbreds with catastrophic racing injuries

BACKGROUND

The ability to identify horses at risk for catastrophic injuries continues to be a pressing issue for the racing industry, especially given recent events in North America.

OBJECTIVES

Since most catastrophic injuries occur in areas of existing pathology and this pathology is likely to elicit an inflammatory response, it was hypothesised that analysis of messenger RNA (mRNA) expression would detect significant changes in select genes in horses at risk for a catastrophic injury.

STUDY DESIGN

Prospective cohort study.

METHODS

Five racing jurisdictions across the United States participated in this study. A total of 686 Tempus^® RNA Blood Tube samples were collected for mRNA analysis from 107 catastrophically injured horses, as well as from noninjured horses sampled either prerace (n = 374) or postrace (n = 205). A subset of horses (n = 37) were sampled both prerace and postrace for analysis of expression changes during the postrace period.

RESULTS

Of 21 genes analysed via RT-qPCR, the expression of 12 genes (ALOX5AP, CD14, IL-10, IL-1β, IL-6, IL-8, MMP1, PTGS2, TLR4, TNFα, TNFSF13B and VEGFA) changed significantly within 45 minutes after a race and were excluded. Of the remaining nine genes (BMP-2, IGF-1, IL1RN, MMP2, MMP9, Osteoprotegrin, RANKL, SAA1 and TGFβ), three genes (IGF-1, IL1RN and MMP2) were found to be significantly different between catastrophically injured and noninjured horses using multiple logistic regression modelling. Receiver operating characteristic analysis of models, which included mRNA expression, demonstrated sensitivities from 76%-82% (95% CI: 67%-93%) and specificities from 84%-88% (95% CI: 71%-94%) at the Youden Index.

MAIN LIMITATIONS

Samples were collected as soon as possible postinjury (within 30 minutes).

CONCLUSIONS

Analysis of mRNA expression of specific genes in the future may be considered as an economical, accessible and noninvasive means by which horses at risk for catastrophic injury can be identified.

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.

A prospective cohort study on the acute:chronic workload ratio in relation to injuries in high level eventing horses: A comprehensive 3-year study

In human sport science, the acute:chronic workload (ACWR) ratio is used to monitor an athlete's preparedness for competition and to assess injury risks. The aim of this study was to investigate whether acute and chronic workload calculations for external and internal loads (e.g. high-speed work distance and associated exertional effort) were associated with injury risk in elite eventing horses and to identify workloads performed by horses competing in different competition and at different fitness levels. Training load and injury data were collected from 58 international eventing horses (CCI2*-CCI5* level) over 1-3 years. A total of 94 individual competition seasons were monitored. During this period, heart rate (HR; beat/min) and GPS data were collected of all their conditional training sessions and competitions. External load was determined as the distance (m) covered at high speed (HS¹ ; velocity between 6.6 and 9.5 m/s), and sprint speed (SS² ; velocity>9.5 m/s). Internal load was calculated for HS and SS, using individualized training impulses (TRIMP³ ;AU). For internal and external workload HS and SS the acute (1-week) and chronic (4-week) workloads were calculated and ACWR⁴ determined. The injury data in relation to ACWR was modelled with a multilevel logistic regression. Akaike's information criterion was used for model reduction. Sixty-four soft tissue injuries were registered from a total of 2300 training sessions and competitions. External and internal workload at HS and SS were significantly affected by the year and fitness level of horses. Competition level and year significantly affected the distances covered at SS. The ACWR of high-speed distance of the present week (OR; 0.133, 95 % CI; 0.032, 0.484) and the previous week (OR 3.951, 95 % CI; 1.390, 12.498) were significantly associated with injury risk. Competition level and chronic workload had no significant effect on injuries. In agreement with findings in human athletes, acute spikes of workload in eventing horses increased the risk of injury. Evaluation of horses' workload can be used to design and effectively monitor training programs and can help to improve equine welfare by reducing injury risk.

Training practices, speed and distances undertaken by Thoroughbred racehorses in Victoria, Australia

BACKGROUND

Musculoskeletal injuries (MSI) in racehorses are commonly due to bone fatigue, a function of the number of cycles (strides) and the magnitude of load applied to the limb. These parameters can be estimated using speed and distance, with greater than 6000 m/month at a gallop (>14 m/s), in combination with canter distances greater than 44,000 m/month, reported to increase fracture risk. Despite their importance, there are limited data on the distances and speeds horses are exposed to during training.

OBJECTIVES

Estimate training volume at different speeds undertaken by Australian Thoroughbred racehorses.

STUDY DESIGN

Cross-sectional study.

METHODS

Registered trainers (n = 66) in Victoria, Australia were surveyed. Questions were designed to assess the full training workload from initial pre-training to training performed to achieve and maintain race fitness, as well as information on rest periods. Descriptive analyses were stratified by trainer- and horse-level factors, with assessment of variance within and between groups. Cluster analyses were used to identify similar workload intensity groups.

RESULTS

Horse-level factors (age, targeted race distance) were associated with workload (younger<older, sprinters<stayers). Trainer categorisation did not influence workload, but there was significant variation in volume of total gallop exercise between trainers (median gallop distance 8000 m/month [IQR 6400-12,000]). Cluster analyses identified four workload programmes (medians): low-intensity (4800 m/month), medium-volume (8000 m/month), medium-volume with a higher proportion of high-speed workouts (12,800 m/month) and high-volume programmes (19,200 m/month), with 23, 50, 17 and 9% of trainers predominately training racehorses under each of the respective programmes. Horses 3-years and older were rested twice yearly for 6.3 (95% CI 5.7, 6.8) weeks, with more experienced trainers resting horses for shorter periods (P = 0.03).

MAIN LIMITATIONS

Possible selection bias, subjective reporting of workloads by trainers.

CONCLUSIONS

Australian Thoroughbred training programmes include high volumes of galloping with more than half exceeding previously reported risk levels for MSI.

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.

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.