Derby Decisions

Every competitive horse has normal wear and tear, just like human athletes. Horses on the road to the Kentucky Derby in Thoroughbred racing receive more media attention than probably any other equine athletes. So, when a spring season arrives, and when there is attrition in the upper ranks of 3-year-olds, it is seen and commented on by millions of people, many of whom don't know much about equine athletes.

There also are many horse owners, however, who don't know about the inner workings of Thoroughbred, Quarter Horse, Standardbred, and steeplechase racing, not to mention barrel racing in the Western discipline. Those horses undergo rigorous training from a young age geared toward helping them be as fast as their genetic and physical makeup allows.

Larry Bramlage, DVM, Diplomate ACVS, one of the leading equine orthopedic surgeons in the world, also has been a member of the American Association of Equine Practitioners' On-Call team at the Triple Crown events since the inception of the program in 1991. (Bramlage also is a member of the AAEP Editorial Advisory Board to The Horse.)

"This is the usual wear-and-tear," said Bramlage of the horses which did not make the Run for the Roses because of physical problems. "There is stress accumulation, and there are problems that aren't related."

He pointed out that not all the injuries were life- or career-ending. Pulpit, who was one of the favorites for the Derby, had a fracture last year that was painful, but not unstable, and it required nothing but rest for complete healing. Following the Derby, it was discovered that Pulpit had a displaced chip in his left knee. Bramlage performed surgery to remove the chip.

Accelerator, Acceptable, Inexcessivelygood, Pacificbounty...all were top 3-year-olds lost from the competitive ranks shortly before the Derby. Their problems ranged from Inexcessivelygood's catastrophic injury in the Jim Beam Stakes, to Pacificbounty's quarter crack that didn't come together in time for the Derby.

The use of scintigraphy has become common-place in screening racehorses for microfractures that can lead to more severe injuries. Bramlage said that even though trainers have embraced the use of scintigraphy, the diagnostic tool is not available everywhere there is racing and training. Also, since scintigraphy requires the use of radioactive material and trained personnel, there has to be a facility available within a short distance from the track, which isn't the case in areas where there is racing.

"It isn't a lameness meter," noted Bramlage. "Someone has to interpret the information. And a third of the time scintigraphy doesn't show the answer because it (the problem) is in soft tissue, which is not visualized as well. It has to be combined with a lameness exam to tell you what it means."

Injuries such as the one suffered by Inexcessivelygood bring up the question of saving catastrophically injured horses. These are animals which not only are stressed from severe injury, but are athletes who were stopped in the midst of all-out exercise.

"It takes twice the amount to anesthetize a horse when (they are injured) racing as when they are calm," said Bramlage. "We'll never be able to save every horse that has an injury because of poor blood supply and the tenuous skin of the limbs, and because we can't put them in bed.

"In a few years," predicted Bramlage, "we will see horses with those same injuries given an injection, but they will be anesthetized rather than euthanized."

The search for answers of how to anesthetize horses safely with high respiratory and cardiac rates resulting from exercise is ongoing. Washington State University and The Ohio State University each have projects underway, which are being funded by the American Quarter Horse Association and the Grayson-Jockey Club Research Foundation.

Bramlage said there is a need for a short-acting anesthesia so the horse becomes unconscious quickly, and an anesthesia that can work on horses which are stressed. An equine ambulance is necessary at each track or training facility, as well as a padded stall for recovery of the anesthetized animal.

There also is the question of whether horses are more likely to tie-up (suffer from rhabdomyolysis, see page 16) if they are anesthetized during strenuous activity, pointed out Bramlage. He also noted that only about one-tenth of one percent of horses racing face euthanasia.

"We should be able to take some gray areas to white, and push some of the black areas to gray," he said of research into anesthetizing horses suffering catastrophic injuries while racing.

George Mundy, DVM, chief veterinarian of the Kentucky Racing Commission and team leader of the Derby and Breeders' Cup veterinary inspection teams, said that management of these horses injured during racing becomes very complex.

"When we get to a horse seconds after an incident, his heart rate is 160 and he's in shock," Mundy said. "It's like that extreme emergency in human medicine when they call in the Medivac helicopter."

He said if there is a fracture, but the skin is not broken, then there usually is a good chance of getting the horse braced, sta-bilized, and moved off the track where a private practitioner can take over. When there is contamination of a severe injury, the outlook in most cases is grim.

There is a push by some practitioners--particularly veterinarian/farrier Ric Redden--to use a prosthesis on horses with no other chance to save a limb. This is a controversial, and expensive, alternative, but it is an alternative that Redden wants more owners and trainers to know about.

"In some cases, it is best to stop the suffering (on the track)," said Mundy. "Our job is to get to them, stabilize them if possible, and get them off the track to their own private veterinarians."

But, he pointed out, being able to do something for the horse once it is anesthetized and off the track is just as key as getting them off the track alive and in the best shape possible. He gave the example of a mare who was pregnant and entered in a race at Keeneland racecourse in Lexington. She flipped over in the paddock, suffered a severe head injury, and could not rise. Fortunately for her, there was a Kimzey ambulance available that can load a "down" horse, and there was a surgical hospital within minutes of the track that had the equipment to stabilize and sling the mare, which ended up recovering.

On the other hand, if the track is 90 miles from the nearest surgical facility, the horse not only has to be anesthetized on the track and loaded in a van, but has to be maintained during the long trailer ride, and there has to be a team waiting to handle that type of emergency once the horse arrives.

"We need a way to anesthetize and maintain a horse for that period of time," stressed Mundy.

Bramlage agreed, saying that it is a tough decision for a track veterinarian to make the call to euthanize a horse on the track. "But his prime concern is to take care of the horse at the time," he added, "and sometimes it's more humane to end the horse's suffering."

The answers to these and other questions regarding catastrophic injuries in competitive horses are being researched, and horse owners and organizations are supporting institutions that are leading in the search for insight.

About the Author

Kimberly S. Brown

Kimberly S. Brown was the Publisher/Editor of The Horse: Your Guide To Equine Health Care from June 2008 to March 2010, and she served in various positions at Blood-Horse Publications since 1980.

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