Laminitis Research Videos: Advances in endocrinopathic laminitis diagnosis, treatment and science

Last week,  31 laminitis research articles, collected from recent editions of the prestigious Equine Veterinary Journal, were made freely available to the public. All 31 articles may be read and downloaded without charge for the next year.

What could make this better? A summary--or three of them, in fact. Today we offer an overview of the research, in the form of three short, concise videos by three of the authors. Each provides an overview of the articles in his or her area of research.

The Helpful Farrier: Dimpled Laminitis Treatment Stirs Facebook Furor and Charitable Shoeing

This foot was probably the most viewed, shared and commented on hoof in the world in June 2013.  The only problem was that the people doing all the viewing, sharing and commenting didn't bother to read the details of the case posted by farrier RT Goodrich in California, who found the horse with this unusual hoof wall treatment. (RT Goodrich photo)

It appeared on Facebook on June 7 and it went viral: 422 people left comments and 233 shared it all over Facebook. Then others shared it. It took on a life of its own. Who didn't see it?

“It” was a photo posted by California farrier RT Goodrich. "It" was a hoof that had been dimpled all over with holes. It looked for all the world like a hoof made of Swiss cheese.

On the Case: California Wrap, British Style, for White Line Disease

One of the best things about the Hoof Blog is hearing from people  inspired to share how they would use different materials or methods to achieve the same thing.

Laminitis Treatment: UC Davis Experimental Anti-Inflammatory Shows Promise in Test Case

Can an anti-inflammatory medication have curative power over a disease like laminitis? Researchers at the University of California at Davis are beginning clinical testing of a new medication that might be an outside-the-box hope for relieving horses suffering with the disease. Here's a report from UC Davis School of Veterinary Medicine:

Four horses suffering from laminitis have been treated with the investigational anti-inflammatory drug so far. One experienced a complete remission that has lasted for more than a year, and three others have shown some improvement.

A paper on the first laminitis case has been accepted for publication by the peer-reviewed Journal of Veterinary Anaesthesia and Analgesia. The paper is expected to be published in the journal’s February issue, but journal editors authorized the authors to disclose their findings ahead of publication.

Alonso Guedes, an assistant professor of veterinary medicine, treated this four-year-old Thoroughbred mare by administering an experimental anti-inflammatory drug to treat laminitis. (Don Preisler/UC Davis photo)

“This is an unusual step for us to announce this so far in advance, but because euthanasia is often the only way to alleviate pain in severe laminitis, we felt that it was important to let the veterinarians and horse owners know that this compound has shown potential as a treatment,” said Alonso Guedes, an assistant professor in the School of Veterinary Medicine.

The horses were treated under a “compassionate use” protocol approved by the UC Davis Institutional Animal Care and Use Committee. That protocol allows animals to be treated with an experimental drug if no approved alternative treatment exists.

A clinical trial to assess the drug’s safety and establish a tolerable dose for the compound is expected to begin in the spring. Further clinical trials would be needed to establish the drug’s effectiveness as a laminitis treatment.

The experimental compound, known as t-TUCB, belongs to a group of anti-inflammatory compounds called sEH (soluble epoxide hydrolases) inhibitors. It stems from a discovery made more than 40 years ago by UC Davis entomology professor Bruce Hammock while doing basic insect biology research.

The "cure" for laminitis is
the rehabilitation of the
horse's foot and the
elimination of the triggering
cause. (Plastination model
of advanced laminitis by
Christoph von Horst DVM PhD)

 

 

Originally interested in finding biological insect control methods, Hammock has since broadened his research to also search for biomedical applications. He and colleagues have identified a group of anti-inflammatory compounds, including the sEH inhibitors, that have proven to be effective in relieving inflammatory discomfort and pain related to nervous system disorders in mice and rats. Their work has been published in scientific journals including the Proceedings of the National Academy of Sciences and the Journal of Medicinal Chemistry.

Guedes noted that the safe management of laminitis-related pain is one of the biggest challenges for equine veterinarians. Often, euthanasia is the only humane alternative for alleviating pain and suffering in horses afflicted with the condition.

Consequently, according to UC Davis, the survival rate for laminitis is estimated to be only 25 percent. Very few surviving horses return to their previous levels of activity, and laminitis often reappears.

In his upcoming paper, Guedes reports the case of a four-year old Thoroughbred mare named Hulahalla. The horse had been retired from racing following a tendon injury and donated to the UC Davis School of Veterinary Medicine, where it was participating in a study focused on healing tendon injuries using stem cell treatments. She developed laminitis.

Veterinarians from UC Davis’ William R. Pritchard Veterinary Medical Teaching Hospital treated the laminitis with conventional therapies including cold immersion, antibiotics, leg wraps, and two commonly-used nonsteroidal drugs intended to reduce inflammation and relieve pain — but the horse only got worse. At the point that the mare was spending most of the day lying down, Guedes got involved.

Before resorting to euthanasia, Guedes and the veterinary team decided to try one last treatment, t-TUCB.

The veterinarians administered the experimental compound intravenously early on the eighth day of Hulahalla’s illness. After receiving the first dose, the horse remained standing in the stall most of the day, became interested in her surroundings and walked voluntarily.

The mare’s demeanor, posture and mobility continued to improve over four days of treatment, and her high blood pressure gradually returned to normal. No adverse affects from t-TUCB were observed, and Hulahalla has remained laminitis-free for a full year.

The sEH inhibitors, including t-TUCB, are currently available from the Hammock lab, which has provided the experimental compounds to more than 100 academic scientists around the world for basic investigation into their role in treating disease.

Hammock said that work aimed at moving t-TUCB and related compounds toward clinical use is advancing in several areas. He and Guedes are working on compounds with potential for targeting pain and arthritis in companion animals. And they are working with UC Davis to move the intellectual property from this research into a company to develop medications for difficult-to-manage neuropathic pain associated with diabetes and nerve injury.

Funding was provided by the National Institute of Environmental Health Sciences and the UC Davis Center for Equine Health.

The University of California at Davis provided this article.

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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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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. 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.

Prascend® PPID (Equine Cushings Disease) Treatment Approved by FDA for US Horses

Maybe I'm biased, but I thought that the CSI (Cushings Scene Investigation) ad run by Boehringer-Ingelheim Vetmedica in British horse magazines was the most clever horse ad so far this year. It heralded the introduction of Prascend to treat Cushings-suffering horses; Prascend will soon be available in the USA.

The following press release is not an ad, it is published here as a "heads up". Anyone involved in the world of Hoofcare + Lameness is going to hear about this. Farriers and veterinarians will be asked questions by horseowners about this medication, and you need to know about how pergolide has evolved into Prascend®.

Prascend has been available in the United Kingdom for a few months, and Boehringer-Ingelheim Vetmedica has launched an awareness campaign there to urge horse owners to have their horses tested for PPID. I don't know yet what B-I has planned in the USA, but I feel confident in saying that "this is news".

In 2007, this blog reported that a potential crisis loomed for horseowners who were treating the symptoms of their horses' PPID condition with Permax (pergolide). (See links at end of this blog post.) The medication was taken from the market temporarily because of problems with human prescriptions. Before long, it became available again in the compounded form, which many horse owners ordered directly and in different forms.

Compounding pharmacies have been at the center of a controversy in the veterinary industry. At this time, it is too early to give a reliable answer whether compounded (and less expensive) pergolide will remain an option for horseowners as pill-only Prascend enters the marketplace. Ideally, horseowners will have safe and multiple alternatives to keep their horses comfortable.

Much more information will be available at or following the AAEP Convention in San Antonio later this month. 

Everyone can recognize the advanced PPID (Cushing disease) horse. But laminitis and stretched white lines in younger horses may not seem to be related to PPID until much later, when a definitive diagnosis is made. Only careful testing will discern if horses without obvious signs suffer from PPID. (photo provided by Dr. Christian A. Bingold)

Boehringer Ingelheim’s Prascend^® Approved for PPID in Horses

Product is the first and only FDA-approved treatment for the management of PPID.

ST. JOSEPH, Mo. (November 2, 2011) – Boehringer Ingelheim Vetmedica, Inc. (BIVI), has received approval from the Food and Drug Administration (FDA) to market Prascend® (pergolide mesylate), for treatment of clinical signs associated with pituitary pars intermedia dysfunction (PPID), also known as equine Cushing’s disease.

PRASCEND is the first and only FDA-approved product for the management of PPID in horses. (1) Administered in tablet form, treatment with PRASCEND can improve the quality of life for PPID-affected horses by managing clinical signs and decreasing the risk of complications of the disease, including those that have the potential to be life-threatening.

It is estimated that one in seven horses over the age of 15 has PPID (2) and horses as young as seven years of age have been diagnosed with the disease (3). In addition, up to 70 percent of clinical laminitis cases also may be affected with underlying PPID4. The most common clinical signs of advanced-stage PPID that occur in horses are hirsutism (hypertrichosis) or an abnormal amount of hair growth, abnormal sweating, weight loss, muscle wasting, abnormal fat distribution, lethargy, laminitis, polyuria/polydipsia and chronic/recurrent infections.

“Unfortunately, PPID is not a curable disease,” says Dr. John Tuttle, BIVI equine technical services veterinarian. “However, PRASCEND does offer a safe and efficacious treatment option to veterinarians and horse owners that can help reduce the clinical signs of the disease and effectively improve the quality of life of infected horses.”

While PPID is typically considered a late-stage-of-life disease in the horse, Tuttle adds that with horse owner vigilance and regular veterinary care, the disease may be detected earlier.

“Because the early symptoms of PPID may be difficult to recognize, some horses with PPID may go undiagnosed until the disease becomes more advanced,” says Tuttle. “Through regular veterinary wellness exams, oftentimes the disease can be caught earlier. By beginning treatment in the earlier stages of the disease, we are able to reduce the risk of some of the potential complications associated with PPID, such as laminitis, recurring infections, dental disease and other potential issues of uncontrolled PPID.”

Farriers often notice the early signs of PPID in horses' feet while trimming. As Cushings diseases advances, farriers are challenged to keep PPID sufferers comfortable and manage any flare-ups of chronic lamiitis. (Massachusetts farrier Allie Hayes trimming a Cushings-affected pony, photo © Hoofcare Publishing)

Not only can PRASCEND aid in the management of clinical signs of disease, the FDA approval also assures the product has been thoroughly evaluated for safety and efficacy. In addition, PRASCEND has met the standards set forth by the FDA in regard to production to preserve its identity, strength, quality, purity and consistency from batch to batch, and the product has demonstrated stability and effectiveness over time through a variety of environmental conditions.

“We are excited to offer a treatment option for horses suffering from PPID,” says Tuttle. “We encourage horse owners to continue to work with their veterinarians to find the best treatment for their horse and are confident that PRASCEND can help make a difference in the lives of horses suffering from this disease.”

PPID horses may be quite thin under all that hair. Cushings sufferers are also believed to be more highly perceptible to worms than non-sufferers. Many people clip their long-haired horses to be more aware of body condition. (photo © Hoofcare Publishing)

PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Refer to the package insert for complete product information or contact Boehringer Ingelheim Vetmedica at 800-325-9167.

(Hoof Blog note: A web address should be available soon.)

Reference:

1.  PRASCEND^® (pergolide mesylate) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
2. McGowan TW, Hodgson DR, McGowan CM. The prevalence of equine Cushing’s syndrome in aged horses. In: Proceedings from the 25th American College of Veterinary Internal Medicine Forum; June 6–9, 2007; Seattle, WA. Abstract 603.
3. Schott HC. Pars pituitary intermedia dysfunction: challenges of diagnosis and treatment. In: Proceedings from the 52nd American Association of Equine Practitioners Annual Convention; December 2–6, 2006; San Antonio, TX.
4. Donaldson MT. Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis. J Am Vet Med Assoc. 2004;224(7):1123–1127.

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 TO LEARN MORE

AAEP Statement on FDA Withdrawal of Pergolide for Human Use: Will It Still Be Available for Horses?

Pergolide Cleared for Equine Veterinary Use by FDA

Laminitis Research: Australian Breakthrough on Insulin Function in Equine Foot

Too Fat? Too Thin? British Court Faces Conflict Over "Abused" Horse with Cushings Disease

Cornell Laminitis Research Beneficiary of Arabian Horse Foundation Grant to Study Genetic Markers in Equine Metabolic Syndrome and Cushings Disease

Equine Pituitary Dysfunction Test Choices Analyzed by New Bolton Center's Jill Beech VMD

Three Chimneys Farm Works to Help Slew 'o Gold Keep His Cool

© 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.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines on Facebook

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. 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.

Umbilical Stem Cells Show Promise in Pilot Study at Rood and Riddle Equine Hospital Podiatry Center

What's underneath that hoof cast? The latest laminitis therapy is virtually invisible to the observer, and may often covered with a foot cast.

The following article is provided by the Rood and Riddle Equine Hospital Podiatry Clinic in Lexington, Kentucky.

Background

Laminitis can be a devastating and expensive disease to treat. Today there is no true cure for the disease. However cases can often be rehabilitated back to varying degrees with the aid of therapeutic shoeing, foot management, and medical therapies. Although special foot management can in some cases return horses back to previous athletic use, others remain severely compromised and lame. Once the lamina detaches and the pedal bone displaces, each case heals back with varying degrees of stability. The tissue that heals the separated lamina is a combination of scar tissue, dysfunctional disorganized horn tissue (epithelial cells) and healthy lamina.

Additionally, these cases can suffer permanent damage to the growth centers of the foot such as the coronary band and the sensitive sole, further limiting their ability to heal. The degree of future stability most likely is dependent upon the type of tissue that heals the diseased region.

What are stem cells? What is regenerative medicine?

Stem cells are cells that have the ability to replicate themselves and regenerate tissue. They play an important role in embryonic and fetal development as well as repairing damaged tissue. Isolating these cells and using them for a targeted treatment with the intention to heal a specific area is the principle behind their potential use.

Stem cell therapy or regenerative medicine is an exciting, but relatively new area which has sparked great interest. Its potential use to influence the type of tissue that heals a diseased or damaged area is a great interest to the veterinary community.

How is Rood and Riddle approaching stem cell therapy for laminitis patients?

Rood and Riddle Equine Hospital is currently working on clinical-based research using stem cells on severe laminitic patients which have proven unresponsive to other treatments. The clinical use of stem cells is still in its early stages, but results appear promising and worth further investigation.

Since many laminitis cases can be rehabilitated with other modalities, it was determined to limit our clinical study to those cases which have been unresponsive to all other treatments. These cases failed to show sole or wall growth after shoeing, foot casting, slinging and, in many cases, after deep digital flexor tenotomy.

Stem cell therapy is an adjunctive therapy, used in conjunction with extensive medical and mechanical treatments. To date, Rood and Riddle's laminitis-specialist veterinarians selected cases based on poor response to the disease's normal treatment protocols at the clinic. (Fran Jurga photo)

To date we have used stem cell therapy on twelve cases as an adjunctive treatment. All but one case has responded with significant sole and wall growth in the affected feet. Typically signs of growth were evident within two weeks.

The one case that did not respond was a severe acute “sinker” (lamellar failure or detachment occurs around the entire hoof capsule causing the coffin bone to “sink”) ; the horse was sloughing the hoof and had severe soft tissue necrosis before treatment.

It is important to note that stem cell therapy alone will most likely offer little benefit in the unstable cases. As with all therapies these feet will require special management (shoeing, casting, sling, and DDF tenotomy) to help stabilize and support the foot while it is healing.

The stem cells used in Rood and Riddle's clinical laminitis research are harvested and cultured from the blood in umbilical cords of foals. (Joanna8555 photo)

Umbilical stem cells from newborn foals

Rood and Riddle's Stem Cell Lab is currently harvesting cells from the umbilical cord blood of newborn foals. Umbilical cord blood is collected at the time of birth, which provides a pool of stem cell which can be cultured and expanded for clinical use.

When these cells are used as a treatment on another horse, they are considered allogenic (from a donor) with the possible risk of rejection. However, no reactions in our cases have been noticed.

Stem cells can also be collected from fat or bone marrow and used specifically for that horse if needed. The best source of cells, timing, dose, administration, and route still need to be determined.

Case Study from Rood and Riddle Equine Hospital's Podiatry Clinic

The following case is a severe bilateral front foot sinker. This case had a deep digital flexor tenotomy, foot cast, and partial hoof wall resection. She failed to show any signs of wall or sole growth over a two-month period of time.

Stem cell therapy and foot casts were applied on both front feet as a last effort to save her. Within two weeks she showed signs of healthy wall and sole growth and improving her comfort level. Currently this mare is doing well; it has now been six months since treatment and she is turned out in a small paddock.

Left and right foot radiographs before treatment. Stem cell therapy was begun at this time along with foot casts and antibiotics.  Two weeks later the coronary band and sole began to show healthy growth.(Scott Morrison images)

These are radiographic images of a 10 year old thoroughbred mare with severe sinking of both front feet before and after stem cell therapy. The mare was treated with deep digital flexor tenotomy, foot casts and partial wall resections. The foot did not show any signs of improvement for over 2 months.

 This photo was taken at six weeks post stem cell treatment. Note the new, healthy wall growing from the coronary band. (Scott Morrison image)

Left and right feet six months after therapy with umbilical stem cells. (Scott Morrison images)

Watch for more news about the use of umbilical and other stem cells in horse foot problems.

Rood and Riddle Podiatry Clinic veterinarians working on the stem cell treatment cases mentioned in this article are (from left to right) clinic director Dr Scott Morrison, Dr Vern Dryden and Dr Raul Bras.

TO LEARN MORE: The Second Annual North American Veterinary Regenerative Medicine Conference (NAVRMC) is scheduled for June 2-4, 2011, at the Marriott Griffin Gate Resort in Lexington, Kentucky.  Held in collaboration with the University of California at Davis Center for Equine Health, Alamo Pintado Equine Medical Center and Rood & Riddle Equine Hospital, the NAVRMC is a three-day working meeting consisting of scientific presentations and discussion sessions on all aspects of stem cell therapy and regenerative medicine in horses and small animals.

The conference will bring together researchers and practitioners to discuss and apply this promising area of veterinary medicine. Topics will be a blend of research and practical application discussions.

New to the NAVRMC in 2011 is a special session for horsemen. The half-day forum, set for June 4, is open to all horse owners, trainers, and equine professionals who are interested in learning more about this rapidly growing area of veterinary science.

For complete NAVRMA sponsorship information, membership fees, and conference registration please visit www.navrma.org.

© 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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Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. 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.

IRAP Equine Lameness Therapy: Two Veterinarians, Two Videos to Show and Tell the Treatment's Story

Interleukin-1 Receptor Antagonist Protein therapy (IRAP™) for equine lameness came on the scene a few years ago and seemed to be the province of university and referral hospitals. It was first discussed on this blog back in May of 2007, in New Lameness Treatments: IRAP™ Therapy.

Fast forward to 2011 and IRAP has become a word you'll overhear trainers using at the racetrack, and dressage riders quipping about as they compare notes on their horses' injuries. IRAP may not be an overnight sensation, but it would be close to the equivalent and if you haven't had first-hand experience with a case yet, just hang on--you will. Or, you may even be around horses that have undergone IRAP therapy and you didn't even know it: there are no scars, no bandages, no clipped hair.

But horse owners still call here and ask for advice: what is it? what can go wrong? who's had it done? It's true; some owners can't quite catch the name or the concept, and think of IRAP as just a very expensive joint injection. But they are usually pretty happy with the results.

IRAP isn't a treatment with a lot of drama or big equipment or flashing lights. It is simply a treatment of a sample of the horse's own blood, creating an enriched serum which contains anti-inflammatory proteins. These proteins are very specifically targeted to block the harmful effects of interleukin-1, an inflammatory mediator that accelerates the destruction of cartilage.

Will IRAP help every horse? Will it reverse the degenerative effects of years of arthritis? As the numbers of treatments increase, veterinarians are becoming more specific about ideal cases and potential benefits.

For the horse, the treatment consists of just two injections: first the drawing of a vial of blood, then the enriched serum is injected back into the horse at the site of the injury. Because the serum is autologous, or derived from the horse’s own blood, there is only a minimal risk of an adverse reaction.

When I went looking for a video about IRAP, I thought I would share two instead of one, because together they tell a good deal about IRAP. The two videos are similar, but show a lot of details about the process. Dr. McKee of McKee Pownall Equine Services has a Standardbred racehorse on hand as a patient, while Dr. Charlene Cook of Central Georgia Equine Services has a pleasure horse on the cross ties.

This may seem like too much information...until the day comes when you need to know about IRAP. 

Melissa McKee DVM of McKee Pownall Equine Services in Ontario, Canada leads the horse world through the demystification of many horse diseases and problems through her practice's YouTube channel. In this video, Dr McKee's straightforward explanation of IRAP should put horseowners at ease when their vets recommend the treatment. Thanks to McKee Pownall for their ongoing excellence in client education. Via YouTube and Facebook, they are educating many more of us than just their clients!

If you or one of your clients would like to read more about IRAP on paper, we have a link to an excellent document download, IRAP Therapy for Equine Osteoarthritis, created by Amanda House DVM of the University of Florida's College of Veterinary Medicine's Extension Service.

© 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 Performance "Not Significantly Affected by Tendon Injury", According to Horse Trust Research

This horse has "bowed" it superficial digital flexor tendon; the tendon protrudes, or bows out, at the back of the leg. This is the most common debilitating tendon injury suffered by racehorses and requires a long layoff for recovery, although new treatments are shortening the time lost from training. (Photo: Dr. Barak Amram/VetMoves)

Data compiled and analyzed in a research project in Great Britain funded by The Horse Trust found that racehorses who recovered from tendon injuries did not have inferior racing performance records compared to horses that had not had tendon injuries.

The research was led by Bryan O'Meara, who is in the final year of a three year clinical training scholarship funded by The Horse Trust. O'Meara carried out the research at Donnington Grove Veterinary Surgery in Newbury, under the supervision of epidemiologist Dr Tim Parkin from University of Glasgow.

Tendonitis is one of the most common musculoskeletal injuries in racehorses, with a prevalence of 11-30%, according to earlier research.

O'Meara examined the clinical records and racing histories of 400 racehorses who had been treated for superficial digital flexor (SDF) tendonitis injuries over a five year period from 2003 to 2008.

The race records of horses affected by tendon injury were compared with 400 matched control horses that had never suffered SDF tendon injuries. The controls were horses training in the same establishment at the time of injury and of the same age and sex as the case horse.

The Horse Trust-funded research looked at the performance of the racehorses in races before and after treatment for the injury, and at the performance of the control horses before and after the treatment date. The Racing Post Rating (RPR), which is published by the Racing Post (a British racing newspaper with charts) after every race, was used as a measure of performance.

O'Meara found that there was no significant difference in RPR before and after the treatment date in case and control horses.

This result is unexpected as in vitro studies have found that healed tendon tissue has reduced elasticity properties due to the presence of scar tissue. This suggests that a horse with a healed SDF tendon would need to work its muscles harder to compensate and would therefore be expected to have lower performance.

O'Meara said more research is needed to back-up his finding that performance isn't significantly affected by tendon injury.

"It could be that using Racing Post Rating to measure performance isn't sensitive enough to pick up a change in the horse's performance," said O'Meara. "However, it's encouraging that there's no marked change in performance after a horse has recovered from a tendon injury. These findings show that there's no need to give up on a horse that has a tendon injury--they can still come back and perform well, or can be used for other, less demanding riding activities."

The Horse Trust-funded research also found that there was no significant difference between case and control horses when returning to racing and completing three races. Only after completing five races, or three years post treatment, was a significant difference found between case and control horses. This finding is a step towards developing a more accurate assessment of tendon-treatment outcome after five races or three years post-treatment is a better indicator of the outcome of treatment.

"At the moment, some tendon treatments state their success as the percentage of horses that return to racing after treatment. However, we've shown that there's no significant difference between case and control horses at this time," said O'Meara. "At the moment, there are a myriad of treatments available to treat tendonitis. Hopefully this finding will be used in further research to learn which treatments are most effective."

O'Meara's research also found a link between SDF tendon injury and the racehorse competing at its maximum performance level: the case horses were significantly nearer to their pre-injury maximum performance level in the race immediately before injury (compared to matched controls), suggesting that they were competing nearer their individual maximum performance level when the SDF tendon injury occurred. (Note: this statement is not explained but would seem to suggest that either the level/class of the race or the distance perhaps was the best the horse had done in its career when the injury occurred.)

Editor's note: Information in this article was provided by The Horse Trust, a British charity that funds equine research and promotes education about horse health and welfare. Hoofcare Publishing likes to support The Horse Trust whenever possible. The research described in this article was published in the May 2010 edition of the Equine Veterinary Journal and is available online as a downloadable PDF file: "An investigation of the relationship between race performance and superficial digital flexor tendonitis in the Thoroughbred racehorse".

Readers should keep in mind that the study included only British racehorses and that the majority of British racing is done on grass. Race distances, conditioning schedules and training methods also vary in Great Britain from methods used in North America and some other countries. But the results are interesting, no matter where you live!

© 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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