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Monday, February 19, 2018

Racing Research: Can ultrasound predict whether an injured Thoroughbred will return to racing?

Arrogate during training at 2017 Dubai World Cup

"Will he race again, Doc?" That's the question you hear trainers ask their veterinarians when a racehorse is sidelined with a tendon injury.

Veterinarians don't carry crystal balls in their trucks. Advances in equine imaging have made it possible to be much more accurate in diagnosing the severity of an injury, but it's often a matter of wait-and-see.

But now, a new tendon injury scoring system utilizes diagnostic ultrasound technology to predict a racehorse’s likelihood to return to racing. It was developed by veterinarians at Great Britain's University of Nottingham and Oakham Veterinary Hospital in Leicestershire, England in conjunction with the Hong Kong Jockey Club in China.

The system grades tendon injuries in racehorses when they first occur. The researchers used this system in a large study to determine which ultrasound features will predict whether or not the horse will successfully race again after rehabilitation.

The new system may significantly improve racehorse welfare in both the short and long term. It will enable veterinarians and racehorse trainers to make early and informed decisions on a horse’s future, including whether to prescribe rest and recovery before racing again, rehabilitation for another career or immediate retirement.

While only a relatively small percentage of all racehorses will suffer a tendon injury, a high proportion of these will not be fit to race again and will have to be retrained for an alternative career.

In this video, University of Nottingham Vet School equine surgery resident Rafael Alzola Domingo, BVMS, MSc, GPCert(EqP), Cert AVP, MRCVS, who is also an equine vet at Oakham Veterinary Hospital and first author on the published paper, explains the importance of this study and how it was carried out:

The researchers have also been working with a leading veterinary ultrasound company, BCF Technology, to develop a mobile app veterinarians can use to record their ultrasound findings using the new scoring system. 

In the new study, published last month in the Equine Veterinary Journal, the researchers developed a statistical model which related ultrasound changes in 469 racehorses when the  tendon injury first occurred to the likelihood of that horse making a successful return to racing (defined as completing at least five races after rehabilitation).

The data used in the study are unique in that the Hong Kong Jockey Club has standardized recording of clinical records for all racehorses over many years. All racehorses in Hong Kong train and race on the same track, live together in the same racing yard, and are attended to by the same vets. These uniform characteristics enabled the researchers to perform a large-scale cohort study with long-term followup of each injured racehorse. 
Equine lameness app for tendon injury evaluation
BCF's "Visits ToDo" app for
racehorse tendon injuries.

The study's predictive model found that clinicians should concentrate on two main characteristics of the tendon injury, each easily assessed by ultrasound at first presentation: 1) the cross-sectional area of the lesion and 2) the extent of disruption to the normally highly-ordered pattern of tendon fibers. 

Professor Chris Riggs, BVSc, PhD, DEO, DipECVS, MRCVS, Head of Veterinary Clinical Services at the Hong Kong Jockey Club commented: “Decisions on future careers for racehorses have to be carefully considered by the horse’s owner, trainer, and vet working together. This study is important from a welfare perspective, as it provides the information to help them make decisions which are best for the horse’s long term welfare, as soon as the injury occurs.” 

The Visits ToDo App produced by BCF gives veterinary surgeons and technicians the tool to record animal health and diagnostics in one place while they are out in the field. 

• • • • • 

Click here to download the 27-page PDF file of the full Open Access article. (Note: The article is still in pre-publication manuscript format.) It will appear in a future edition of Equine Veterinary Journal.

More on the Hong Kong Jockey Club's equine hospital and Professor Chris Riggs.

Citation for this study:
Alzola, R., Easter, C., Riggs, C. M., Gardner, D. S. and Freeman, S. L., Ultrasonographic-based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong. Equine Vet J. Accepted Author Manuscript. doi:10.1111/evj.12810

This study is indexed in the January 2018 edition of HoofSearch, the international report on equine hoof science and lameness papers, proceedings, and patents.

The University of Nottingham and BCF Technologies provided material used in this article. Hoof Blog file photo of Arrogate's very sound legs in 2017 courtesy of Dubai Racing Club and Mathea Kelley.

Click here to learn more about HoofSearch. Or: Click here to purchase your 12-issue subscription.

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