Innovative Tools to Detect Lameness and Pre-existing Injury in Racehorses

Mongolian Groom. Sports Illustrated image.

By JANE ALLIN


LAMENESS LOCATOR

Lameness is a term used to describe a horse’s change in gait, usually in response to pain in a limb that can occur due to a wide variety of causes (e.g. degenerative joint disease, laminitis, infection). Some conditions are more easily diagnosed and treated than others, which may only cause a subtle change in gait, or even just a decreased ability or willingness to perform.

Lameness is a clinical symptom not a diagnosis, which requires careful consideration by the veterinarian to determine the root cause. This will include the medical history of the horse, observation and appraisal of the horse at rest, a hands-on examination, application of hoof testers to the feet, evaluation of the horse in motion and joint flexion tests. To isolate the location and cause of lameness other diagnostic tests may also be required (i.e. diagnostic nerve and joint blocks, radiographs, ultrasound, and more).

Enter the Equinosis Q with Lameness Locator

The Equinosis Q with Lameness Locator is a veterinary diagnostic system used to objectively measure a horse’s movement. Although the Equinosis Q cannot diagnose a lameness problem independently of a thorough evaluation, its inertial sensors and algorithms help veterinarians detect early or mild lameness with high confidence. [1]

The algorithms in the Lameness Locator were created specifically to assess lameness in horses and were developed by University of Missouri’s Dr. Kevin Keegan and Dr. Frank Pai. [2]

The objective of the device is not to be used as a stand-alone diagnostic but rather to add a resource to the veterinarian’s toolbox that uses advanced technology to supplement the hands-on evaluation. This would aid in diagnosing lameness that is difficult to perceive by the naked eye.

How does it work?

The Lameness Locator measures the movement of the horse’s head and pelvis, two areas most closely associated with decreased weight-bearing on their limbs that suggests lameness in one of their legs. 

The device is equipped with three wireless motion sensors that are attached to three distinct positions on the horse; the head, the pelvis and the right front pastern. The head and pelvis sensors contain an accelerometer while the front right pastern contains a gyroscope.[3]

  • An accelerometer measures the acceleration, which is the rate of change of the velocity of an object, which in turn is the speed of the object (distance covered in time) moving in a certain direction. Consequently, the acceleration can be converted to a position with changes recorded as the horse is jogged back and forth while the veterinarian observes the movement.
  • A gyroscope is a device that measures orientation and is used to measure rotational motion. This is used as a reference point for the right forelimb stance.

A tablet with the Lameness Locator software collects the data the sensors generate through a long-range Bluetooth receiver.

“Acceleration is converted to position and differences in head and pelvic heights between right and left halves of stride [over many strides] are calculated,” said Dr. Laurie Tyrrell-Schroeder, director of veterinary services for Equinosis LLC. “[It is] essentially measuring the symmetry of movement between the two halves of stride. Shifting load off a limb will manifest as asymmetric head or pelvic movement.”

The program generates measurements that indicate the amplitude of head and or pelvic movement asymmetry, which tends to correlate with the degree of lameness. Negative numbers indicate left-sided lameness and positive numbers indicate right-sided lameness.”[4]

The following diagram illustrates the setup (the source provides a video as well).

Dr. Rhodes Bell DMV, who practices veterinary medicine at Park Equine Hospital in Versailles, KY, was introduced to this technology during his Masters studies where he studied the technology to determine the effectiveness in quantifying equine lameness.[5] Bell now advocates for its use on most, if not all, lameness cases and is sought out expressly by individuals who need advice on how to proceed with their horse’s lameness.  

It is also invaluable as a tool for “baseline wellness exams” where a horse may be monitored over time to determine how a horse develops over the course of their racing or sporting career.  

“A nice feature of the software is it is able to store a horse’s evaluation forever,” he said. “It would be nice to follow horses along through their season, comparing their current form back to their earlier evaluations. If something is changing, then some additional investigation may be warranted.”[6]

It also provides a relatively cost-effective means of supplying important information that may preclude expensive imaging techniques. 

So, what is stopping equine veterinarians from using this on a regular basis? Commercially, it has been available since 2009.

As always, resistance to change.

“I think many veterinarians question spending money for a piece of equipment that does something they think they can already do themselves,” Bell said. “A similar mindset was present when the new technology of ultrasonography was introduced–those palpating the reproductive tracts of mares and those palpating musculoskeletal structures of equine athletes thought, ‘What possible additional information could I derive from this machine that is so costly?’ I think you would be hard pressed to find either a reproduction or lameness veterinarian without access to an ultrasound machine in this day and age.

The sport of racing has long held on to its historical roots, reluctantly utilizing new technologies (Keeneland didn’t have a public address system for a track announcer until 1997). Bell feels that the transition to using the objective lameness evaluation a regular basis for racing Thoroughbreds is a matter of time.”[7]

Time will tell. But it seems like a no-brainer to use such a diagnostic tool to rule out a compromised horse “before” they break down. Would this have saved Mongolian Groom? No doubt it would have.

NEW BLOOD TEST

A New Blood Test Has the Potential to Detect Imminent Injury in Racehorses

Researchers at the University of Kentucky’s Gluck Equine Research Center have shown promising results using a novel blood test that has the potential to detect an impending injury prior to a horse exhibiting any signs of lameness or atypical imaging.[1]

The majority (85%) of fatal injuries in racehorses result from pre-existing pathology in the same location that the fracture occurs. It is also recognised that many types of damage (e.g. pre-existing stress fractures) rarely cause lameness and may go undetected by radiographic analysis.

Earlier research has shown that biomarkers may provide veterinarians with more means to identify problems prior to experiencing a serious bone or soft tissue injury.[2]

What is a biomarker?

Biomarkers, short for biological markers, are distinct biological indicators of a process, event or condition that can be accurately measured to detect normal or abnormal processes taking place in the body that may be a sign of an underlying condition or disease, including inflammation. Various types of molecules, such as DNA (genes), proteins or hormones, can serve as biomarkers, since they all indicate something about the health of an individual. An example of a human biomarker is blood cholesterol, which is a well-known biomarker for coronary heart disease. 

Since, more often than not, biomarkers that are proteins are typically discovered after an injury, the researchers took the approach of looking at an intermediary step prior to the formation of the protein. The starting material for the manufacture of a protein is DNA, which makes RNA which makes protein. Without going into detail, a simple schematic illustrates the concept.[3]

The researchers, Drs. Allen Page and David Horohov, decided to use mRNA (messenger RNA) as the biomarker which, as the schematic shows, is a set of instructions from genes made of DNA to produce a given protein.  In medicine, mRNA biomarkers have been developed as a common technique that offers early and more accurate prediction and diagnosis of disease and disease progression, and the ability to identify individuals at risk. 

Of note, is that for inflammation a horse may be experiencing, the set of instructions (gene copies) change with different levels of inflammation (gene expression) and hence serve as a marker for any potential underlying condition.[4]

Study method and preliminary results

Although the study has yet to be completed, Page and Horohov have collected more than 800 samples, half of which suffered fatal injuries and the other half of uninjured horses as control samples (that’s over 400 dead horses). Blood samples were taken both before and after racing. To date the study has shown that out of 23 genes, two have been measured to have tested consistently higher in the horses that died. The study is expected to be complete before the end of the year, after which it will be published in a peer-reviewed journal.

“My view of where you are now is that we’re a lot farther down the road than we once were,” said Dr. Johnny Mac Smith, EDRC member and veterinary consultant to the Grayson-Jockey Club Research Foundation, during the council meeting. “Although it may be a road with a few more curves than you anticipate, I think it’s a worthwhile effort to pursue this. Who’s to say, if your work was finished and we had a screening test, we might still have Mongolian Groom.”[5]

The second phase of the project will use the same blood samples to analyze thousands of genes. It is generally believed that there are over 20,000 genes that are responsible for the creation of different proteins in horses. The hope is that more of the genes that are increased are identified in horses who have been fatally-injured. This would be a novel technique for the racing industry in identifying those horses who are at an increased risk prior to breaking down, hence preventing, or greatly minimizing, the incidence of catastrophic injuries. Both phases of the project have been funded to the tune of $300,000 by the Equine Drug research Council (EDCR).[6]

“I think anybody who’s involved in the industry realizes we’re at a pretty significant crossroads. We all need to be doing whatever we can to provide not only opinions but solutions. Based on the first year and a half’s worth of data, we’re definitely excited about the potential that this research holds.”[7]

AS TECHNOLOGY MOVES FORWARD THE RACING INDUSTRY FESTERS IN CHAOS

I don’t think it’s too radical to say that the US racing industry is in crisis. After decades of talk, chronic resistance to change and heated debate, the implementation of uniform racing medication policies by the industry has been an epic failure.

The time for talk is over. 

It is not only the general public, but also the core fans of racing, who are losing their confidence in the industry’s ability of its insiders to promote the health and safety of racehorses. 

Self-regulation has not worked and will not work. If the sport is to survive, it must, at the very least, adopt an independent entity to establish uniform rules, regulations and testing protocols across all 38 racing jurisdictions. This, of course, is the focus of The Horseracing Integrity Act.

Until then, it will continue to spiral downwards into the abyss. 

As Maryland Jockey Club racetrack owner Joe De Francis, now chairman of the National Horseracing Advisory Council of the Humane Society of the United States sums up the racing’s credibility problems on equine safety and integrity issues . . .

“a growing tsunami . . . about to crest and destroy us.”[8]

TYGART TELLS CONGRESS: DON’T ENCOURAGE FOX TO GUARD HENHOUSE

Travis Tygart, the CEO of the U.S. Anti-Doping Agency (USADA), makes some powerful points in this article about the parallels between issues facing the U.S. horse industry and the Olympics when it comes to ensuring the integrity of those sports, specifically with regard to oversight on medications.[1]

Travis Tygart became USADA’s Chief Executive Officer in September of 2007.

The USADA, the official anti-doping agency in the United States for the Olympics, Paralympic, Pan American and Parapan American sport, is the independent non-governmental agency that would oversee horse racing’s medication policies under the proposed Horseracing Integrity Act (HIA).

“In his prepared statement, Tygart said that the ‘most vital principle of an effective anti-doping system is that it must be free from the influence of sport governing bodies. … Since our founding in late 2000, we at USADA have advocated for a clear separation between those who promote sport and those who police it. To do so otherwise, we believe, is to encourage the fox to guard the henhouse. No matter how well intended it might begin, it simply does not work.’”[2]

During the question and answer period after the hearing, there were several comments made as to how this kind of independent authority would benefit the racing industry.

Tygart, after an inquiry from Sen. Tom Udall of New Mexico as to how independence will bring about genuinely needed reform, went on to discuss how the U.S. Olympic and Paralympic Committee (USOPC) finally, in 1999, committed to outsourcing and making the USOPC totally independent from its board and staff by creating the USADA in 2000. He concluded that its effectiveness and success in curtailing drug use and the ability to identify cheaters has transformed the human sports world. 

The same would apply to horseracing if adopted by all those involved in the racing community.  

“The USADA was a result of the recommendations made by the USOP’s Select Task Force on Externalization to bring credibility and independence to the anti-doping movement in the U.S. The USADA was given full authority to execute a comprehensive national anti-doping program that encompassed testing, results management, education and research while also developing programs, policies and procedures in each of those areas.”[3

The key to its effectiveness is that the USADA is an independent legal entity not subject to the control of the USOC and staff, whereby none can have any financial interest or serve in any capacity for an organization they provide services to. 

This is precisely what the racing industry is up against.  Currently, it is a rogue organization with no central body of control or uniform regulations to prevent the abuses, particularly the rampant drug use, that are intrinsic to NA horseracing.  

In response to Sen. Richard Blumenthal’s (Connecticut) question “as to whether he was extending the jurisdiction of your agency to include horse racing to prevent doping and substance in that sport.” Tygart was confident that independent models that do not rely on economic interests or other advantageous positives for those directly involved in making decisions, eliminate the self-interest awards that go hand in hand with nepotism. 

Tygart was presented with two questions; (1) whether he was interested in “extending the jurisdiction of the USADA to include horse racing to prevent doping and substance abuse in that sport”, and (2) how the USADA had evolved to improve the effectiveness of anti-doping programs

He responded with three concrete reasons why it would be in the best interests of a sports industry suffering from public scrutiny.[4]

  • The ability to stay abreast of new designer drugs that are emerging everyday from places outside of the US that are not intended for human consumption and the ability to test for them.
  • To profile testing of an individual/athlete over time (e.g. blood and urine markers)
  • The ability to encourage “whistle blowers” to speak up and hold those accountable who break the rules. 

While these are only three of the benefits about independence, they provide a transparency that does not currently exist, nor ever existed, in the horseracing industry. 

Triple Crown Winner Justify, a pawn in the chess match of doping in the Chemical Age of American Racing, wears a tarnished crown.

We have seen the cover-ups (e.g. Baffert’s Justify drug cover-up by the CHRB which would have cost him the Triple Crown); the blatant ability to allow disqualified horses in one jurisdiction from racing in another jurisdiction or under a new “trainer”, the classic case being Steve Asmussen turning his horses over to his assistant Blasi, who won another 198 races as the stable finished the year with more than $14 million in earnings; the overuse of therapeutics to mask pain; and of course, the reluctance of racing insiders to speak of their knowledge, which would ostracise them forever from the racing mafia.  

And although the HIA may not be perfect in every sense, as long as it completely partitions the racing industry from the oversight of it, there is a valuable opportunity to clean up the sport and regain the confidence of the general public and racing fans.  Particularly if the testing is done outside of racing’s jurisdiction – the only equitable way to implement a level playing field and without tampering from the insiders. 

While cynicism of the government’s involvement can be rationalized, the industry has shown that it simply cannot function properly on its own after decades wasted trying to justify the failure of the less than stellar attempts to “solve” their problems. For far too long, racing authorities have allowed cheaters to repeatedly cheat by either dismissing the charges or applying insufficient penalties. 

There are, of course, many nay-sayers, and one of the principal controversies is the suspension of race-day Lasix (a topic on its own) but the HIA has the support of much of the industry as well as leading animal welfare groups. Ironically, it is the very people who argue they can reform the sport, without intervention from outside sources, who have navigated the “ship of racing” into the current crisis.  

The time for change is now. Without change the racing industry won’t need to worry about remedies, the confidence of not only the general public but of its core customers in the basic product they offer will be lost and the invisible hand of the marketplace will drive the business into oblivion.[5]

Retired Hall of Fame Jockey, Chris McCarron

The most powerful traditions are those that adapt. Change cannot wait.” — Testimony of Christopher J. McCarron, Hall of Fame Jockey, Retired.


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FEATURED IMAGE: Mongolian Groom / Sports Illustrated

Top 5 Horse Health Hacks for Winter

By JAMES HARRIS

Unless you’re a hardcore rider that saddles up even it’s raining sideways, you will take a look out of the window at the torrents of wind, rain, and snow and think about giving your horse a brush rather than a hack out into the unknown – it’s nothing to be ashamed about; we all do it.

This little intro probably rings true with a lot of riders, giving the wet winter months a miss as far as saddle time and obviously, events. So what has giving your horse a break and keeping them all snug during the winter months got to do with health?

From experience and a particularly bad period during which my wife and I moved our two horses to an entirely different property, we started to notice how a horse’s environment (or change of) affects their health, predominantly their hooves and the perpetual vicious circle we experienced trying to cure the ill effects from a change in environment.

Ironically, our winter troubles started because of a hot summer – despite using a track system, our horses were free to chomp on sugar-rich grass, which led to laminitis. We quickly learnt our new area was prone to sugar-rich rich grass over the costal land we came from.

Not being one to entirely trust a phone app, it did get to a point where we downloaded one specifically for laminitis and the results only backed up what we’d heard from our equine podiatrist.

So with this in mind, we fought off and treated the laminitis through the summer, but because the horse’s white line had deteriorated and the weather took a turn for the worst, we battled a series of abscesses.

For a horse to maintain a healthy hoof, he needs to exercise, work and put pressure through his hooves, but because of water-logged fields, abscesses and the combination of deteriorating white line and loose gravel roads, we faced this vicious circle I mentioned – if we’d caught the laminitis earlier, we may have avoided all the problems that followed.

Hindsight is always 20/20, but with all the above taken on board, here are 5 hacks I’d recommend during the cold and wet months to maintain optimal equine health.

1. Exercise

Whether your horse is 100% fit or hopping lame, varying degrees of exercise will help your horse maintain some sort of health and fitness, whether it’s general fitness or healthy hooves and joints.

Despite our horses suffering laminitis and abscesses, exercise was still vital. Even a gentle amble up and down a lane or road will both help you visually pick up on problem(s) and the speed in which the problem(s) subside or get worse. Gentle exercise also provides the equine digit with much-needed movement and internal pressures, all of which contribute towards healing and growth.

2. Sole Cleanse

Sole Cleanse

This antimicrobial Sole Cleanse hoof spray played a vital role in at least keeping germs and the threat of infection at bay. Because our horses’ hooves experienced a series of abscesses, liberally spraying this after picking out and treating gives you peace of mind you are managing the potential for those germs that find cracks, crevices (and in our case) gaps in the white line.

Even if your horses’ hooves are healthy, Sole Cleanse is good to spray on to maintain health in both the horny outer layers and preventing fungal growth or thrush on the softer tissues like the frog.

3. Epson Salts

Salts are a great way to soak a horse’s hoof to both clean and soften any bad tissues infected, as in our case, abscesses. Adding Epson Salts to warm/hot water and soaking the horse’s hoof for 20 – 30 minutes softens infected tissue – giving our horses a walk afterwards sometimes helped tease out any infection and pus.

Epson Salts can also be fed to a horse (25-gms per 100-KG bodyweight) as a temporary magnesium supplement for laminitis and pollen allergies.

4. Hoof Stuff

Like the Sole Cleanse, Hoof Stuff is an antimicrobial product. Once an infected or cracked hoof has been suitably cleaned out and treated, this thick paste can be pushed into any cracks and crevices, preventing further intruding infection. We found packing this into a treated hoof was both satisfying and also gave peace of mind concerning any dirt getting back into any infected areas.

5. Knowledge

Most horse owners understand the fundamental biology behind their animals, but believe it or not, the equine digit is a highly complex piece of kit. After listening to our podiatrist and spending hours on google, I quickly established the internal combustion engine was more basic than the internal
functions of a horse’s hoof.

Because the hoof often holds the answer to many other aspects of a horse’s health (environmental changes, malnutrition, skeletal problems and even psychological disorders), understanding the equine digits’ components and functions will open a door to a whole new way of questioning any potential problems.

Whether all of the above is old hat to seasoned owner or it’s all fascinating to the newbie owner, I hope these winter hacks prevent or intercept an ailment before it gets out of hand like it did for my wife and I.