T. D. H. Parkin

Identification of risk factors for lameness in dressage horses.

The aim of this study was to describe the prevalence of illness and lameness at different anatomical sites in registered United Kingdom dressage horses and to identify risk factors for lameness. A questionnaire was sent to all 11,363 registered members of British Dressage in 2005, with one questionnaire assigned per horse. Four multivariable logistic regression models were developed for each section of the questionnaire. A final mixed effects logistic regression model was developed which combined the results from all prior models. Owners reported that 33% of horses had been lame at some time during their career, with 24% of these within the previous 2 years. A number of factors were associated with the occurrence of lameness in the last 2 years, including age, height, indoor arenas, horse-walkers, lunging (as protective), back problems, arenas that become deeper in wet conditions and sand-based arenas. These factors were included as variables in a final model to provide information for selection of horses, development of safer arenas and more effective training regimens to minimise the onset of lameness.

Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark

REASONS FOR PERFORMING STUDY The prevalence (up to 93% in Thoroughbred racehorses) and severity of equine gastric ulceration syndrome (EGUS) has been associated with type of training and differing management practices. However, there have been few studies to confirm these findings in nonracehorses in Europe. OBJECTIVES To investigate the prevalence of EGUS in a population of Danish horses, during winter when the horses had been housed and fed for at least 8 weeks and to analyse the influence of feed, work level and environment on the risk of EGUS of > or = grade 2 in severity. METHODS A total of 201 horses, not in active race-training, were evaluated, representing 23 different stables from all 5 regions within Denmark. All horses were considered to be healthy and not on medical treatment for EGUS. Endoscopically observed ulcer lesion scores were based on the number present (0-4) and severity (0-5). Univariate and multivariable mixed effects logistic regression models were developed using EGUS score as the dependent variable. An ulceration severity score of > or = 2 was regarded as being clinically significant. Separate models were developed for horses with ulcers in either the glandular or nonglandular regions of the stomach graded > or = 2 (EGUS > or = 2) and for those horses that had nonglandular ulcers graded > or = 2 (NG > or = 2). RESULTS In this population, 53% (107/201) of horses were graded as having EGUS > or = 2 with 95 (47%) horses having NG > or = 2. Three variables were significantly (P<0.05) associated with EGUS > or = 2: straw being the only forage available; exceeding 2 g/kg bwt of starch intake/day or >1 g/kg bwt/meal; and water not being available in the turn out paddock. Risk of NG > or = 2 significantly increased when straw was the only forage available, 1 g/kg bwt of starch/meal was exceeded, water was not available in the turnout paddock and the interval between forage feeding was >6 h. CONCLUSION AND POTENTIAL RELEVANCE This study has confirmed that components of the diet, readily modifiable, may have an important impact on the risk of EGUS in the nonracehorse. Differences in the multivariable models produced for all ulcers and nonglandular ulcers support differences in the aetiology of ulcers in different locations of the stomach.

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.

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.

Risk of fatal distal limb fractures among Thoroughbreds involved in the five types 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.

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 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.

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 individuals 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.

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.

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.