Research: Does the Unshod Dressage Horse Really Bear a Competitive Disadvantage?

Irish researcher Richard Mott writes: "This photo is an example of some of the gait analysis work I’m doing for my dissertation comparing the stride patterns of shod and unshod horses. Most previous research has measured shod horses then taken their shoes off and measured them again straight away. The result? 'Look how badly they go without shoes!' To my knowledge, this is the only study that has compared shod and unshod horses that are conditioned to that state."

At the recent International Society for Equitation Science (ISES) Conference in Denmark, a Warwickshire College (UK) abstract covered research by distance-learning student Richard Mott from Ireland: He studied the potential difference in movement between shod and unshod horses in dressage.

To be fair to the researchers, this abstract is something like a snapshot from a moving car, compared to the author's much larger research effort. Richard Mott's thesis will actually be about 12,000 words when we finally get to read it.

On the Case: Combined Contracture and Laxity Complicate Limb Deformity in an Irish Thoroughbred Foal

Kevin Corley, BVM&S, PhD. DACVIM, DACVECC, DECEIM, MRCVS of the Anglesey Lodge Equine Hospital in County Kildare, Ireland shared photos of a recent case. A 12-hour-old Thoroughbred foal intended for future racing needed a treatment or management plan for an unusual hind limb deformity.

The foal’s foot was flat on the ground, but the pastern was vertical and the fetlock knuckled forward.

Were Ancient Horses' Fetlocks Less Susceptible to Breakdown Injury?

  

As Saturday's 2013 Grand National approaches, the possibility of some news from the University of Liverpool's vet school has been high. Each year, injured racehorses find expert care at the nearby vet hospital, and the vet school is proud of its long association with the race and its role in helping prevent and treat injuries in racehorses.

Foal Defomity: SPANA's Video Postcard from a Developing World Clinic

This video is provided to give you an idea of the type of challenges that a charity like SPANA faces at its clinics. We do not have medical records or radiographs of this foal to document the severity of the injury. We all know that this type of deformity would be a challenge to any veterinary practice, and yet the treatment seems very simple and straightforward and the effect was almost immediate on this foal.

Far away in Morocco, a mule called Amina was born with a painful deformity to her fetlock joints which meant she was unable to straighten her front legs. Her worried owner, Bouishak, brought the foal, aged two weeks, to the Society for the Protection of Animals Abroad (SPANA) veterinary center.

In developing countries like Morocco, most donkeys, mules, horses and camels support the families who own them: they carry goods or produce to market, they plow land for crops or they transport people and their belongings.

Amina arrived at the clinic unable to stand on her hooves.

If an animal is born with a condition that means they can’t work, they’re of little use. Their impoverished owners simply can’t afford to look after a lame animal, so if they're unable to work, they are usually abandoned or put down.

Without veterinary treatment, the wounds to Amina's fetlocks would soon have become infected and the owner may well have had no choice but to put Amina out of her misery.

The wounds were cleaned with antiseptic cream, and then carefully wrapped with soft padding and bandages. Head SPANA vet Dr Hinnach then applied splints to keep Amina's legs in the correct, extended position while they strengthened.

The foal's pressure sores from "standing" on her fetlocks were at risk of infection.

Over the next few days SPANA's dedicated team of vets closely monitored Amina’s care and her incredible recovery surprised everyone. Amazingly, Amina was able to walk a week later, but the splints were kept on for a few more weeks to allow the legs to fully strengthen.

Dr Hinnach filmed Amina’s first steps--Amina’s joy at being able to walk is clear to see.

SPANA vets gave this foal a future.

The low-tech treatment on this young foal used simple splints over bandages.

We all know how expensive a treatment like this would be for a foal in a developed nation. The radiography, antiseptics, medication and orthopedic devices would run into the thousands of dollars. The foal would have to have a high potential value and it would need a good prognosis for an athletic future.

SPANA, however, estimated that it could offer this treatment for less than $50US to pay for splints, padded bandages, antiseptic cream, three rolls of cotton and penicillin.

Visit SPANA's donation page to see how a relatively small donation can be put to work by vets and farriers in developing nations.

Hopefully, you will donate to SPANA. That's the point of this article. But maybe it is a good idea to look beyond just donating some money to support SPANA and organizations like it.

Farrier and vet innovators are climbing a high-tech ladder that towers high above the simple tenets of basic health and care of horses' and donkeys' hooves. We have reached a point where tech-based treatments and products are available to anyone with enough open credit on their cards to purchase them.

But what if the same brain power could be used to de-engineer hoof treatments? The world needs some simple low-cost solutions to the needs of working equids in less-advantaged nations. We also need low-cost ideas for hoof protection when natural disasters hit and hooves are in danger of heat or puncture damage.

The same low-tech, low-cost solutions could be put to good use by horse rescue and wild horse sanctuaries right here in the developed world, as well.

Please, don't stop thinking high-tech, but maybe some little part of your brain power can think about the horses and donkeys in need out there, wherever they are. I'm sure that groups like SPANA would love to hear your ideas, or invite you to be part of their programs.

I would, too...and I'll tell the world what you've developed for them.

Followup: Amina's treatment was done in July 2011. Dr Hinnich recently visited the family and was pleased that she was walking normally. If Amina needs any care in the future, it will be provided free by SPANA.

To learn more:  

SPANA web site 

British newspaper (Guardian) article about vets going to Morocco to work for SPANA

 

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© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

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Racehorse Fetlock Screening Via Standing MRI Could Identify Horses at Risk for Condylar Fractures of the Fetlock

If there is one thing that we all learned by watching the Kentucky Derby this year, it was the term "condylar fracture". Watching first Battle of Hastings and then Archarcharch load into the horse ambulance was the low point of the day.

Are you one of the people who just shrugs and says, "That's racing!" or are you one of the people who asks, "Why? Why? Why?"

Maybe this article will raise the eyebrows of people in both camps and get them both saying, "What if..."

So what if...

What if a standing MRI could help identify horses with potential fetlock problems before any injury ever even happens? It's possible, and that's the prospect that equine practitioner John Peloso of Equine Medical Associates of Ocala, Florida put forward in March in an article in Thoroughbred Times.

Little did he know how timely the article would be six weeks later!

Let's start with the injury. Condylar fracture means that the portion of the long bone that was broken was the condyle. When you look at the end of the cannon bone, you see a ridge in the middle, between two rounded bulbs, called condyles.

The fetlock joint surface can be subject to a lot of wear and tear, as well as evidence of a degenerative condition, that might now show on a radiograph but might be visible via MRI. (John Peloso DVM photo)

The condyles sit in the fetlock joint and rotate within it, like balls in a socket, as the horse flexes his lower leg. Battle of Hastings' fracture was the medial (rough translation: inner side of the limb) condyle, whereas Archarcharch's injury involved the lateral  (rough translation: outer side of the limb) condyle.

Racehorses are especially prone to condylar fractures. Something (trainers like to call it "a bad step") causes increased pressure on the condyles in the fetlock joint. Normally a horse is fine but sometimes the condyle fractures, to varying degrees. A radiograph will show what looks like a crack in the cannon bone in the condyle area.

Thoroughbreds "Make It or Break It"

In his article, Dr Peloso reminds us that the process of building and creating an equine athlete is dependent on the horse's ability to "remodel" his bones.

The rigors of training cause a horse to continually lose bone and then replace it. In a healthy normal horse, the resulting replacement is more dense than the original.

But in some horses, the lost bone is not adequately replaced or fortified. This is called non-adaptive bone modeling. The effects of training may actually weaken the bone rather than fortify it.

If you have looked at a good radiograph of a horse's fetlock and cannon bone, you know that bone has different density values, and yet the inadequate bone modeling syndrome is deep in the bone and difficult for a radiograph to show. The depth of the problem means that the tissue around the joint doesn't swell, either. It's invisible.

MRI scans the fetlock in 3-D

Which horse would you bet on? The horse on the left had not begun training; the horse on the right shows mild thickening of the subchondral bone in the condyle region. (John Peloso photo)

Dr Peloso recommends the use of standing MRI to evaluate racehorses. MRI scans the fetlock in three dimensions and shows what's going on with the soft tissue in and around the joint as well as the architecture of the bony column itself. And with standing MRI, the horse does not need general anesthesia; trainers are reluctant to schedule their horses in training for anesthesia.

Standing MRI allows the horse to stand in a natural position while the scanning goes on. The horse is sedated but does not need general anesthesia. (Hallmarq Veterinary Imaging photo)

Certainly there is no way to know how many injuries can be prevented by monitoring fetlocks for non-adaptive bone remodeling. But in human medicine, MRI is the modality of choice to routinely detect almost-invisible stress fractures in athletes.

Dr Peloso noted that standing MRI screening of the fetlock is commonly performed in England, Ireland, France and Dubai, where many vet clinics are equipped with standing MRI units and may screen as many as two to three racehorses per day.

What veterinarians like Dr. Peloso hope to help trainers avoid: two examples of the early stages of condylar fracture of the fetlock. The red arrows are pointing to white crack-like lines that indicate a fracture has begun. (John Peloso photo)

Of course, you have to wonder why this happens at all: why are some horses normal? Why is it that the bones in other horses--horses who look and act perfectly healthy--just don't adapt properly?

Those are big questions. MRI can't answer those but a racehorse monitoring protocol of standing MRI sounds like a hopeful proposal that could possibly save some American horses' lives, careers or months lost from training. It could be that famous "ounce of prevention" that is worth many pounds of surgery, layup and rehabilitative cure.

Thanks to the kindness of our friends at Thoroughbred Times, we're able to post the entire article by Dr Peloso here on the Hoof Blog. You'll find an interactive window at the end of this article. Use the controls at the bottom of the document window to enlarge the text or scroll through the pages.

To contact Dr Peloso about his work on bone remodeling in Thoroughbreds, please contact John G. Peloso, DVM, MS, Diplomate ACVS, Equine Medical Center of Ocala, 7107 West Highway 326, Ocala, Florida 34482.

To learn more about standing MRI, visit Hallmarq Veterinary Imaging on the web.

Also on the Hoof Blog:

• Hallmarq Veterinary Imaging Presents Dr Sue Dyson's Patient, A Showjumper Who Wanted to Stay on the Left Lead
• No Farrier, No MRI: Diagnostic Imaging Sessions Begin With Careful Un-Shoeing
• Hallmarq Veterinary Imaging Looks at the Statistics of Equine Foot Lameness: New Diagnostics Document More Precise Damage to the Feet of Sport Horses
• More information and images appear regularly on Hallmarq's Facebook page
• Follow Hallmarq on Twitter: @HallmarqMRI

Thoroughbred Times 032511 Hallmarq Benefits of MRI Peloso

Article reprinted with permission from
Thoroughbred Times
 

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Disclosure of Material Connection: Hoofcare Publishing contracted to receive compensation for compiling this post but the veterinary expertise and opinions in the article were provided by John Peloso DVM and Hallmarq Veterinary Imaging.  The information contained in this article is for informational purposes only, and should not be used to replace professional veterinary advice for your horse. Visitors to the website are responsible for how they choose to utilize this content. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Global Hunter Takes a Detour to the Winner's Circle, Via Surgery at Alamo Pintado

It was a game finish to the American Handicap at California's Hollywood Park on the Fourth of July. While the rest of us were on the barbeque and fireworks circuit, a nice racehorse was being pulled up after winning the race by a neck. They called it a "bad step" in the racing press. In spite of the win, a nice horse became a statistic, and almost a fatality.

Global Hunter never made it to the winner's circle. The veterinarians took over and the Grade 1 stakes winner was vanned that night to Dr. Doug Herthel's Alamo Pintado Equine Medical Center in Los Olivos, California. That's a long van ride; Los Olivos is north of Santa Barbara. But it was worth the trip.

Radiographs apparently showed that the horse dislocated his fetlock but did not actually fracture his leg, although I am sure more detailed images have been taken now, and the surgeons may have found some damage. Virtually all the racing publications, web sites and TVG reported that the horse went into surgery at Alamo Pintado under the care of Dr Carter Judy, and that he seemed to recover well afterwards and was standing on all four legs. Dr Carter's surgical repairs used plates and screws to realign and stabilize the lower limb.

Now begins the vigil. A Global Hunter Facebook page immediately popped up and will hopefully keep a flow of news available to those who care about the horse

Global Hunter is a seven-year-old Argentine-bred son of Jade Hunter who has done well racing in California. The Grade II American Handicap was a turf race.

About the joint: The fetlock, or metacarpophalangeal joint,  is a relatively straightforward joint that flexes and extends with the changing segments of the horse's stride. The cannon (third metacarpal) bone meets the long pastern bone (proximal phalanx) and the knob-like proximal sesamoids to form this joint. A small sagittal ridge between the condyles (rounded ends) of the cannon bone creates a sort of stabilizing bar within the joint so that it only opens and closes in a flex-extend acceptable range of motion. This ridge and the condyles of the cannon bone sit perfectly into the joint cavity created by the long pastern bone. Such a nicely designed joint architecture is held in place by a network of short, tight ligaments that prevent both side-to-side motion and dangerous knuckling forward of the joint. In addition, the two proximal sesamoid bones are points of attachment for the branches of the suspensory ligament (interosseous) and the deep digital flexor tendon rides across the back of the two sesamoids. In summary, the fetlock is much more than a mere joint: it is an intersection of both soft and bony tissue and one of the most critical structures for both weightbearing and locomotion.

Global Hunter will no doubt remain at Alamo Pintado for the time being. The hospital made this video available about its fracture repair services. While Global Hunter's injury may not technically not a long-bone fracture, the process to repair it is similar to the fracture repair and surgical processes detailed in this video, so I thought I would share this. He is a lucky horse, but we will find out in the weeks to come just how lucky. Maybe someday he'll make it back to the winner's circle at Hollywood Park for his win photo from the Fourth of July.

To learn more: An excellent paper on the structure and function of the fetlock joint and the how-and-why of injuries in racehorses is Articular Fetlock Injuries in Exercising Horses by Elizabeth M. Santschi DVM of the College of Veterinary Medicine at The Ohio State University. It is published in Performance Horse Lameness and Orthopedics, Volume 24 No. 1 (April 2008) of Veterinary Clinics of North America: Equine Practice.

Video courtesy of Alamo Pintado Equine Medical Center in Los Olivos, California

Fran Jurga's Hoof Blog at Hoofcare.com
© Fran Jurga and Hoofcare Publishing


Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.