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Future of Injury Prevention - by Dr. Wayne McIlwraith

I testified as part of the “Breeding, Drugs, and Breakdowns: The State of Thoroughbred Horseracing and the Welfare of the Thoroughbred Racehorse” Congressional hearing June 19. It was both disillusioning and enlightening. I naïvely thought I was invited along with three other veterinarians to talk about all the issues influencing fatal injuries in racehorses. I expected some tough questions and was looking forward to getting the facts as we know them out in the open, including the use of medication from a veterinarian’s perspective.

However, the positive work taking place wasn’t fully explored that day, and it is important that everyone with a stake in the racing industry understand the key research that is underway to significantly reduce the injury rate in racehorses. 

A tremendous amount of study is being done by researchers on the factors that predispose a horse to injury. It is becoming clear that detecting the presence of existing damage to the horse’s musculoskeletal structure through early recognition techniques is critical to fracture prevention.

Our research group at Colorado State University, along with our collaborators, has demonstrated that the presence of “microdamage” in the bone can lead to the catastrophic fractures that we see in the fetlock joint (these include condylar and biaxial sesamoid fractures).

Researchers at the University of California, Davis have shown that stress fractures can be a precursor to catastrophic injury. Nuclear scintigraphy is effective in detecting these stress fractures, and early recognition has prevented numerous catastrophic injuries. The challenge is to identify the horse that shows no signs of lameness but has microdamage, which is essentially a fracture present in the earliest stages of development.

Getting horses routinely screened is the key to early detection. While CT scans and MRI are not practical for screening large groups of horses, the use of blood biomarkers and analysis offers the greatest potential for identifying at-risk horses. The principle behind biomarker testing is very straightforward: When cartilage and bone begin to break down early in the disease process, these products are released and can be measured by a laboratory test. An elevated test result indicates that the horse is potentially at risk for an injury.

At that point the horse can undergo a thorough diagnostic examination that involves nuclear scintigraphy or a CT scan.

In our most recent study funded by the Grayson-Jockey Club Research Foundation and done in racing Thoroughbreds in Southern California, we found that with sequential blood samples we could pick up changes in biomarkers six weeks before an injury occurred. Our accuracy rate in the study was approximately 70%, and we are striving to reach 100% accuracy.

The future vision is that we could identify a horse at risk through monthly samples of blood biomarkers. The idea is that the horse would be taken out of training, the microdamage could heal, and a catastrophic fracture would be prevented.

Reducing catastrophic injuries is the most important issue facing the racing industry, and we are hopeful that the biomarker test will soon be commercially available for use by the equine industry. We must protect the health of our equine athletes, and advances in veterinary research and technology are hopefully going to allow us to see a day when most horses receive care and treatment before a severe injury occurs. Other factors, such as racing surfaces and training regimens, must be evaluated for their roles in catastrophic injury, and a screening test is no substitute for proper horse management. We also must examine other purported injury factors, such as durability, 2-year-old racing, and medication. But an easy-to-use test is a significant step toward an injury-free horse.

Those are the positive developments that didn’t make the headlines from the Congressional hearing. There is good reason to be optimistic about efforts underway to protect the health and welfare of the horse. As a veterinarian, I am proud to be a part of these advances.

Dr. Wayne McIlwraith is professor of surgery and director of the Gail Holmes Equine Orthopaedic Research Center at Colorado State University

15 Comments:

dr. mcillwraith is talking biomarkers and training protocol while the NTRA is talking whips and toe grabs.  is there a disconnect somewhere? Finally the Blood Horse decides to publish something with the real injury issues.  Finally!

fb0252 03 Sep 2008 2:29 PM

Thank you sir for speaking out and your close up knowledge of the problems facing racing today. Thank you also for showing us that there is hope and that a large group of committed people are helping to bring about positive developments to the sport.

Wanda 03 Sep 2008 4:58 PM

Dr. mcillwraith ties in the correllation of testing before the excessive use of toe grabs and/or whipping a horse with bio-markers indicating an iminent breakdown...it's all related and it's all important.

da3hoss 03 Sep 2008 6:48 PM

That is great that there is now a test to determine a potential breakdown, but how is that testing going to be enforced?  Do you think trainers that want and NEED a race are going to scratch a horse because a blood test comes back indicating a "potential" breakdown?   Was there any discussion how such a test would become policy in order to make sure horses facing "potential" breakdowns won't be jeaopardized?

LCM 03 Sep 2008 8:24 PM

I am so suprised how quick most want to go back to business as usual. Great job! What really helps the horse is always going to be the hardest job. Its difficult,takes massive energy and time to change, but always will make the industry better, stronger, and obtain the growth and support that is missing. You have my total respect.

russell maiers 03 Sep 2008 9:05 PM

Dear Dr. McIllwraith..I have profound empathy for you regarding your somewhat frustrating and  inconclusive testimony before this House Committee..Sounds like typical political chicanery..Somethings in life just do not change and this is one of them..My suggestion to you Dr.is since you are so fervently  committed and dedicated to your work and research is to continue this dialog via the American Horse Council..headquarted in Washington, D.C. Their mission is simply to lobby to the inside of the beltwayers the thoughts of all of those involved in the equine industry..transcending all breeds..including thoroughbreds and couch documentation and germane research such as yours to the members of Congress sitting on both sides of the aisle..I would not let it evaporate because some member of the committee was running late to board an plane an campaign out in the hustings for someone else.. Your work is entirely to valuable and intrinsic to be dismissed so lightly....You have to be in control..not these politicans..After all..we do indeed elect them.. They don't elect themselves..Thank goodness...Thank you always for the window and continued success in your work.. Steve Stone..East Hanover..New Jersey...

STEVE STONE 03 Sep 2008 10:57 PM

It would  be great if all owners, trainers, track and state officials, veterinarians, jockeys and all were most concerned about injury prevention. Unfortunately, too many want to maximize profits from horses at all costs. So many sore horses are galloping in the morning, yet most of them will run. Horses drop to lower and lower claiming levels, everyone knows why: they have problems and their owners don't want to rest or retire them. They prefer trying to get that final check as they will if their horses are claimed but don't survive the race. Not many owners are willing to rest their cheaper horses and some send them to slaughter auctions right from the track. Examining vets are not equipped to do a thorough job by design, because they must fill races. Their pre-race exams are  done after horses have been thoroughly medicated, blocked and iced. Most jockeys are willing to jump on anything that is still standing up. Veterinarians are too happy to sell truck loads of drugs.

Dr. Wayne, aside of owners of very valuable horses, your wonderful preventive technology will not be used as long as racing lack moral, has an insane number of cheap races to fill each year. Horses most in need of such preventive measures are the claiming horses and as these horses get worse and cheaper, the least protection is devoted to them. Even old stakes winners of $500,000+ are fair game to race for $4,000 claiming! Anything which will show that horses need rest or retirement will not be good news to many in this crowd.

Most serious equine injuries are man-made and came with warnings which are being ignored and overridden with drugs. Only when such preventive measures along with rest, retirement and no drugs on race day are mandatory, will honorable, caring owners be in the majority and such preventive measures will be fully embraced.

josy 04 Sep 2008 2:40 PM

I find it very discouraging that The Horse and/or Bloodhorse has never reported on Dr. Christine Ross' study demonstrating that heart rate variability screening (as described in the May 2008 issue of Equus Magazine), which unlike the biomarker tests, is non-invasive and has shown the promise to be much more accurate than any of the tests described by Dr. McIllwraith.  Until Dr. Ross' study and invention are fairly reported in media concerned with horse racing, no fair evaluation of current research can be done.

Dyane Smith 04 Sep 2008 3:25 PM

Dr. Mcllwraith:  Please keep trying as there is a lot at stake.  Consider . . .  

For racing, two areas of comfort amid monumental concern are the pre-emptive advantage accorded by ADW and the sustained growth and popularity of the Triple Crown.  

The problem with ADW is, of course, that intramurals have served to constrict this new and efficient delivery system.  Of greater concern, however, is the circumstance surrounding two of the past three Triple Crown series.  

The heart wrenching demise of BARBARO was all too fresh when EIGHT BELLS languished into Churchill’s clubhouse turn.  Although understandably subdued considering historical implication, a legitimate Triple Crown shot appeared to be a measure of much needed tonic.   Then on a beautiful spring Saturday in New York the bravado of “colorful” connections and public anticipation came crashing down faster than the congressional approval rating.  

Our son’s then-fiancée, now wife, were in the stands when BARBARO ran the most impressive Derby in recent memory.  She is an accomplished horsewoman, competing successfully in the ring.  The fact that a noted former dressage horsemen trained this magnificant animal made her first racing experience even more memorable.  Among friends convening in Sedona for four days of hiking and relaxation last month was another horsewoman.  She and her husband have a small farm in Versailles.

Only by accident did I learn these two women shared something in common.  When asked if our son and daughter-in-law were going to swing by Louisville for the ’09 Derby the tactful response was “. . . no, losing the filly was too much”.   When queried as to whether the aforementioned Versailles resident was involved in the 2010 World Equestrian Games, the alarming response was “I’m through with racing, jumping, show or anything other than caring for my horses”.

I was involved in thoroughbred racing for over 20 years and remain up to speed on issues confronting the industry.  The perception and opinion (about racing) now held by these two intelligent women has shaken me to the core.  

It would be wonderful to miraculously wake up tomorrow to safer surfaces, uniform rules and regulations, secure tote systems and integrity in the auction ring.  The problem is that even with solutions, it may no longer be enough.

David 04 Sep 2008 3:45 PM

i too am frustrated with the superficial manner in which the health of the horse is being handled by everyone from congress down through the jockey club to the state racing commissioners. as the good doctor says, there are things going inside the equine structure we don't fully understand and cannot yet detect on a regular basis. HOWEVER, there is less likelihood of understanding or detecting these decects while horses are given so much legal (and illegal) medication. let's start with what is legal right now: everyone is obsessed with steroids as of this nanosecond, but there is little mention of lasix and bute and other legal drugs which hide illegal drugs. it surely is no coincidence that while handles are plummeting here, they are rising in hong kong, where punters have greater faith in the integrity of the sport. let's start in this country by banning all race-day medication, something many in the veterinary community are dead-set against, naturally. until we do that, all this talk about is really going on in a horse's body is just so much horse manure.

pa male 04 Sep 2008 8:18 PM

Doctor, thank you for your dedication and please continue your research.

Bernie 05 Sep 2008 11:52 AM

Dr. McIlwraith:

With regards the June 19 Congressional hearing, your letter appears to suggest that your main (?only) complaint is that "the positive work taking place..." wasn't fully aired. Do you wish us to infer that had more time been devoted to this topic Congress ( and all of us) would see less reason for concern on the issue of racehorse welfare? For years I have been disappointed with the equine veterinary profession's lack of leadership, and insufficient voice on this subject. For example, Dr. Bramlege, and Dr. Richardson have had recently many opportunities to expose the plight of the racehorse, but have essentially neglected to do so. They, and perhaps, you (as one might infer from your comments/subject of this forum) seem far more protective of the sport than of its equine participants.

Dr. Robert Fishman 07 Sep 2008 12:34 PM

waiting on the 2yo's to mature will help BIG TIME...pushing em to early is part of the problem...Long Live The King!!!

Bellwether 07 Sep 2008 6:48 PM

Thanks for getting the word out.  Discouraging that the hearings impeded this meaningful information.

Jane 08 Sep 2008 6:43 AM

Good news.  Anything implemented to help make it safer for the race horse would be a good thing.  They give their all in a horse race.  They deserve no less from us to make it safer for them when racing.

Joan 08 Sep 2008 11:58 PM

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