Thankfully not a large part of a racetrack veterinarian's job, severe injury of a racehorse nevertheless is one of the most visible and critical situations these practitioners must handle. Two experienced racetrack veterinarians, Mary Scollay, DVM, senior association veterinarian for Gulfstream Park and Calder Racecourses; and Celeste Kunz, VMD, chief examining veterinarian of the New York Racing Association, moderated a Sunrise Session discussion on triage of acute racing injuries during the 2003 American Association of Equine Practitioners convention. The session covered triage of many specific injuries, as well as more general recommendations and discussion of the relationships between practitioners, jockeys, trainers, and track management.

"The emergency treatment of catastrophic injuries on the racetrack can influence or even determine their prognosis," stated a paper handed out by Kunz during the session.

However, "While injury management guidelines exist in the AAEP Guide to Racetrack practice, there are not really established protocols for much of the stuff we do out on the track in emergency situations," said Scollay. "There can't be one simple protocol because each situation is different. If you have a checklist-type approach, you will get it wrong."

One of the biggest topics was when and how much to sedate an injured horse, and using what agents. Scollay mentioned research done by John Hubbell, DVM, MS, Dipl. ACVA, of The Ohio State University, in which he put horses on treadmills to simulate racing exercise, then abruptly stopped exercise, sedated the horses with various agents and amounts, and splinted the horses as if they were injured to evaluate response to sedation. He found that sedating a horse which has been racing might require double the dose one would use for a calm, quiet horse.

Scollay cautioned, "Any time you put a needle in a horse, you're asking for a lawsuit. I try to put as little on board as possible. But you have to do what's needed."

Kunz added that it is important to keep yohimbine on hand to reverse the sedation if it is too much for that particular horse, and she noted that sedative effects in a horse which is revved up from racing might be much shorter-lived than in a calm horse.

One attendee asked what was recommended for handling a horse caught in the gate. Kunz said to sedate them to unconsciousness to remove him from the gate.

Stunned From the Fall
The down horse isn't always a down horse, said Scollay. Sometimes he might have hit the ground hard and be stunned, but not severely injured. "Their wind might be knocked out of them," she said. "If you give these stunned horses a minute, they'll be OK.”

There are many types of fractures and various ways of handling them. Much of the session was spent discussing splint options, compression boots, splint padding, etc.

"Your job as the veterinarian at the scene is to assess, report, and restrain the horse," Scollay said. "How you stabilize that horse also depends on where he's going--there's a way to prep a horse for transport to the nearest hospital, and a different way to ship him several states over to a specialty hospital."

There was some discussion of stabilizing hind limb injuries, as they are much more difficult than injuries to forelimbs. "You see more P1 (long pastern bone) fractures in the hinds than in the fronts," Kunz said. But these aren't the only injuries a track veterinarian might see in the hind leg. "I watched one horse who had a complete fracture of the tibia continue to run three-legged," related Kunz. "Not only can they walk three-legged, they can run! But that horse calmed down a lot once his leg was splinted and stabilized, even without sedation. David Nunamaker (VMD, Dipl. ACVS, Jacques Jenny Orthopedic Research Chair at the University of Pennsylvania’s New Bolton Center) has been using an air compression boot that you pump up to stabilize lower leg fractures."

Scollay added, "Stabilizing bad lower fractures can help stop the horse from trying to 'shake off the foot.' Don't feel like if you don't have all the expensive toys that you can't do this. PVC makes a wonderful stabilizer. And it's essential to have attending veterinarians on the grounds when their clients' horses are running," she asserted. "You can do the best triage in the world, but if no one's there to get the horse, then it's not good for him."

Kunz noted that apprentice riders might inadvertently worsen injuries by not recognizing them as quickly as more experienced riders. Also, while treating the injury is the veterinarian's responsibility, the jockey is "first on the scene" and will often play a role in the severity of the injury.

When to Pull the Horse?
The best way to avoid injury, of course, is time spent on pre-race inspections. This can be a difficult and thankless part of the job.

"Any groom can make a horse lame," said Scollay. "Especially a lame groom! A horse also can look lame when restrained by the pony. If the jockey says he feels something's 'off,' give the horse a chance to warm up away from the pony and then evaluate the horse."

This touched off a discussion on how a veterinarian works with a jockey to handle a possible unsoundness issue, with some instances where a jockey might want to call a horse unsound rather than ride it for whatever reason. "If the horse is older and moves funny all the time, that's the trainer's issue," Scollay said. "But I won't say the horse is lame if I don't see it.

"But there's also things the jockey might be able to feel that I can't see," she stated. "I have made it clear to riders that they <I>have<I> to tell me if they feel something subtle."

When the horse has trouble in the gate, both veterinarians recommended backing the horse out (if he isn't caught), checking him over, and giving him a few minutes to "reset," jog, and re-enter the gate if he's not hurt so he doesn't run his race in the gate.

"If it's not an injury situation, the stewards make the call," Scollay said.

Risk and liability are big concerns in racing, particularly in very visible situations with thousands of spectators. Some attendees strongly recommended that track veterinarians keep their own malpractice insurance in addition to the track's policy.

"As soon as the horse is off the track, it's the attending veterinarian's responsibility," said Scollay. During emergency treatment/stabilization, she said, the veterinarian is responsible for anyone getting hurt. "The horse's value might be high, but it's set. There is an increased risk of human injury when working with an injured horse and as the veterinarian on scene, I may not have the opportunity to choose who will be assisting me in these situations. You may be training people while you are addressing the needs of the horse," she said.

"When I have an overheated horse, I'll usually check on him the next day and talk to the trainer about prevention (i.e., running the horse at night or in cooler regions), but keep him off the vet's unsoundness list," Scollay said.

Kunz described light-weight sheets commonly used to treat burn victims that she has used with great success in overheated horses. "Often the horse looks crampy first, kicking out a bit. You put these sheets in cold water, then on the horse. They work really quickly and stay cold for a long time."

About the Author

Christy M. West

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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