Transcript: Talkin' Horses with Dr. Larry Bramlage, Part 2

Many readers' questions remained unanswered following the most recent chat with equine surgeon Larry Bramlage, DVM, Dipl. ACVS. As a favor to Bloodhorse.com, Bramlage graciously agreed to answer the remaining questions as a special Part 2 installment of his session.

You can read the transcript of his Dec. 13 chat at www.TheHorse.com/ViewArticle.aspx?ID=10983.  

For more information on BloodHorse.com's interactive "Talkin' Horses" chats, see www.BloodHorse.com/talkinhorses.  


Arcadia,CA:

Do you feel you are doing more corrective surgery on foals today then maybe ten years ago?

Bramlage:

Yes, we have more stallions that produce conformational faults. Unfortunately some of those stallions also produce exceptional athletes as well. That is why the industry tolerates them.


Chicago, IL:

Thank you for taking our questions. We recently had a horse that received the tie forward surgery from Dr. Woodie at R&R. Before the surgery we consulted with a few successful trainers, and they did not recommend surgery. Do you have any data on success/failure of post surgery cases at your clinic?

Bramlage:

Normally for discussions I should not answer questions that start, "I had a horse", but Dr. Woodie has published on this surgery. You can do a search and find the papers.


Lexington, KY:

What do you think of chiropractors for horses?

Bramlage:

I believe they can make some horses feel better.


Boise, ID:

I admire your ability to deal with breakdowns and tragedies on the tract. Where does your strength come from to deal with these happenings?

Bramlage:

Information and understanding make people comfortable with reality. That is how I approach my day to day work, and how I try to portray the reality of sports injury when I am doing the On Call telecasts.


Milaca, MN:

As an expert in the field of equine medicine what are your thoughts regarding the health of thoroughbreds used in racing? By this I mean what is done to the horses physically by subjecting them to a grueling campaign at such young ages, and what is done to a horse psychologically when they spend the majority of their time confined to a stall? What can be done to improve the overall physical and mental well-being of these animals?

Bramlage:

It seems your premise is that horses are unhappy. If you spend any time around the racehorse you come to understand that they are so fit, and so healthy, and they have so much energy they just do what the horsemen describe as "jump out of their skin". Each day I do lameness exams I marvel at them as physical specimens. I wish that at some time in my life I would have ever felt that good. Maybe I did and just can't remember. When they are sick, or when they become sore, they begin to lose that glow, but most of the time those horses are sent for a break, because they are not competitive in the racing venue. If you stand by the rail, and watch hundreds of horses train each morning at the track, you begin to understand how good they feel about what they are doing. So I don't accept your premise that horses are unhappy. If they are sick or injured they need care, and they shouldn't be kept in training, but for most thoroughbred horses, I believe they are happier training and getting all that attention than at any other time in their life. Why do human athletes like to perform?


Springfield PA:

Larry , in a claiming race in the paddock before the race I always see the trainers intently staring at the horses legs is there something that just sticks out with a horse with bad legs?

Bramlage:

No, but since the training of a horse is always limited by the musculoskeletal system, they have wonderful heart and lungs, the trainers are continually watching their limbs.


Nottingham, NH:

I understand how Barbaro developed Laminitis, but I have always wondered how Secretariat and Foolish Pleasure became victims of this awful condition well after they were retired to stud.

Bramlage:

Laminitis is the end result of many systemic and local diseases. That is why it is so difficult to deal with. Virtually any sick horse is at risk, and many horses with no signs of disease come down with it, though they may have had some unidentifiable subclinical problem.


Charleston, SC:

From a percentage perspective, it seems that geldings suffer fewer catastrophic breakdowns on the track than other horses. Is this a valid observation in your experience? If so, what factors could account for this?

Bramlage:

I don't think the numbers bear this out.


St. Louis, MO:

If a decision is made to euthanize a horse on the track, is it because the horse is unable to be loaded onto the van alive?

Bramlage:

That would be one situation; we try to load all horses that are able to walk and take them for a thorough examination.


Lexington, KY:

I've heard that if you had not been a vet---you were headed to the NFL ---you were compared to DICK BUTKUS!

Bramlage:

Only in my dreams.


St. Croix, US Virgin Islands:

Do you feel there is an increased risk for injury to a horse who trains and races on one surface and then switches to another?

Bramlage:

When horses move from track to track during the year they will often get minor soreness after they train on the new surface for a while. The adaptation of the skeleton is work specific, and therefore they adapt to the type of stress they see in training. When they switch tracks, they see different stresses. This only happens after a while, not when they just change tracks for a race. The majority of the time it is not serious injury, just various overstress problems they are not adapted for.


Palatine, IL:

Can you tell me the differences in the roles performed by the state vets vs. the track vets on both racing and dark days. Their names are both listed in the horse racing program inside cover at least in Illinois. Just wondering as a racing fan.

Bramlage:

The veterinarians and their jobs are laid out differently state to state. I am not informed in all racing jurisdictions. I don't know the answer to your question in Illinois.


Christiana, TN:

How prevalent is OCD in racehorses? Are there particular dam/sire lines that have a higher incidence in offspring (without naming names)? Does anyone keep track of this type of information or are most accounts anecdotal? In your opinion, is OCD a contributing factor in TB breakdown?

Bramlage:

OCD's are more common in big fast growing colts, but so are the fastest racehorses. There is no central clearing house, but there are various studies on a smaller scale that verify this fact. OCD's usually cause degenerative arthritis, not catastrophic failure, so the answer to your last question is no. We normally say that we like to see the bone formation problems on a farm under 15%.


Saratoga Springs, NY:

Do you believe if toe grabs, caulks, and bends were banned that it would have a positive impact on lessening the number of breakdowns?

Bramlage:

As with most things this is neither black nor white. An absence of stability or traction is bad, as is excess traction. A stable confident foot plant is a good thing for a horse. Tendon and ligamentous injuries tend to go up with slipping and sliding foot plants because muscles dampen the load when they can anticipate the forces that will be seen. When surprise loads are encountered they tend to create excess loads, or uneven load application. This results in sprains and tears in supporting ligaments such as the suspensory branches, sesamoidean ligaments, and the cruciate ligaments of the stifles. Excess traction devices increase the jarring forces, and torsion forces when the foot plant is too stable. Recent data shows the stopping action of the foot hitting the ground is the excess force, rather than the force generated by the push off. I would favor elimination of all excess traction devices such as caulks and stickers. I would allow very low toe grabs, queens plates, and bends, but not turn-downs.


Scottsburg, IN:

What rules do you feel need to be changed or enforced, for example ,Lasix, steroids. Also, do you race or breed horses of your own? Thank you for your time.

Bramlage:

I happen to favor Lasix and phenylbutazone in therapeutic doses. I think they protect horses from more serious injuries, and more aggressive treatments. I think we spend too much time, get too much bad press, and waste our resources on honest mistakes such as slight overages of these medications and therefore rob the resources from finding the people who are trying to cheat. I happen to think the owner, and the veterinarian who gave the illegal drugs should join the trainer in the responsibility for violations, and I think they should have penalties that are stiff enough that they can't be circumvented. We are trying to move this way as an industry.

I do own and raise horses in a limited fashion. Last year I had a broodmare, a yearling, and her foal as well as a race mare, and a part of a racing colt. The race mare was claimed. The mare did not get in foal, her yearling did not sell, and we gave the racing colt away because I could out run him. Therefore, next year I will have a broodmare, hopefully a new foal, and a colt who I will be racing if he ever starts. Dr. Gabel, one of my mentors, used to tell us that "clients like you to be involved as long as you are not too successful." I have to say that so far I am strong in that category.


Auburn, WA:

Hello Dr. Bramlage, My question is about one of my favorite horses...Teuflesberg. I was wondering about the problems with his white cell count when he was first admitted. Isn't that the reason you had to wait to do his surgery? I was wondering what caused that spike in his cell count and if it can be attributed to shock or stress in any way.

Bramlage:

Teuflesberg's surgery was delayed because he had lost the blood flow to his distal limb when he ran on after losing his jockey, and it was cold and in danger of not having enough blood supply to survive. Fortunately, that responded to treatment and the blood supply issues resolved with about a week of treatment and we were able to go to surgery. There were some cell count changes that accompany the injury, but nothing that would have stopped us if he had not needed the treatment for his circulation. He has now begun his walking program, and with some luck we will be able to turn him out after the first of the year.


Versailles, KY:

What do you think has been the greatest advancement in equine orthopedic surgery in your career?

Bramlage:

If you asked me for only one, I would say the realization that we could not take human techniques and just apply them to horses. When we started developing techniques of treatment, and then eventually implants, designed specifically for horses, we began to make great strides. That of course was aided and paralleled by advancements in general anesthesia for horses, better understanding and availability of antibiotics, advancements in first aid, and others that all moved along with the advancement of veterinary medicine.


Ashland, OR:

Since the synthetic track installations and the perceived future health of our thoroughbreds will improve on the track surfaces, do you feel that Triple Crown tracks will be reluctant to change in spite of the health of the horse for the History of the event?

Bramlage:

I don't think anything will over-rule the health and welfare of the horse. But, I think we should realize that synthetic surfaces as we know them are not an insurance policy preventing injury. They have some good aspects, and some warts. I remain skeptical that we should make wholesale changes until we understand them a little better. In instances where they negate the huge variability in weather conditions, I think they were rightly installed.


Washington, NC:

Are there any publicly available stats on training and/or race track injuries or fatalities?

Bramlage:

Yes and No, yes there are published studies in the veterinary literature that detail injuries over time in individual states. The trouble with these studies is that the entry points were defined differently, the results were tabulated differently, even the description of what is an injury was different. This means they can't reasonably be compared. That is why the injury reporting system that grew out of the Racetrack Injury Summit, sponsored by the Grayson-Jockey Club, is so important. Headed by Dr. Mary Scollay, this system will allow direct comparison of data for the first time.


Eddyville, KY:

What has been your most challenging surgical procedure in your career and why?

Bramlage:

Alydar's hind limb fracture, complicated situation, bad patient, bankers and lawyers everywhere. It was not the toughest individual surgery, but the toughest situation.


Crestwood, KY:

I realize racehorses have always broken down and been injured in races, it just seems that it happens more often now. Is it because there are just more horses out there or have we gone wrong in our breeding practices?

Bramlage:

Injuries appear to have gone up some, but the press has gone up exponentially, and the game has become national. Combine that with the instant news mentality and the desire to show the wrecks, not the fantastic finishes in the popular press with the fact that there are three views of each inch of every race on video tape or digital media and the injuries make prime time viewing. Every station wants to be bigger and better than the other in what they show. When was the last time that you saw the cleanest lap of the Indianapolis 500, vs. the one with the wreck.


(Originally published at www.BloodHorse.com.)  

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