Clarity and Cooperation - by Eric Mitchell

(Originally published in the April 20, 2013 issue of The Blood-Horse magazine. Feel free to share your own thoughts and opinions at the bottom of the column.)

By Eric Mitchell - @BH_EMitchell on Twitter

By Eric Mitchell A couple of issues have surfaced related to cases of sudden death in California racehorses.

One, the state could do a better job in how it presents its plethora of statistics on racehorse injuries, and second, horsemen clearly have an opportunity to help the equine medical community narrow down the potential causes behind these sudden deaths.

California certainly has no shortage of statistics on equine injuries and is the nation’s indisputable leader in this area. The Postmortem Examination Program was established at UC-Davis in 1990 to further enhance the ability to analyze and prevent racing injuries. Because of this program, all horses that die at California tracks are examined at one of the California Animal Health and Food Safety Laboratories.

A compilation of the injury statistics is published annually. In the latest report for fiscal year 2012, the report noted a rise in the number of sudden deaths attributed to cardiac failure. A summary paragraph in a section titled “Other Organ Systems Affected by Injuries” states: “During this period there were 11 cases of sudden death due to cardiac failure. This represents an increase from four horses with this diagnosis during 2008-09 and six with the same diagnosis in 2010-11.”

Certainly, it appears significant when the number of cardiac failures is about double of what has been reported in previous years.

Except, apparently, it isn’t.

“Any variation is really magnified but all these numbers average out over time,” said Dr. Rick Arthur, equine medical director for the California Horse Racing Board. “Here is what the problem is…this is a very technical area. It is not black and white. For years, these postmortem annual reports were not published because there was concern they would cause more problems. The subtleties go over most people’s heads.”

No one will question that medical forensics is a challenging field because of the complex nature of intertwined biological systems that are influenced by a lot of variables—time, temperature, legal and illegal medications, and physiological peculiarities among individual horses.

But isn’t the purpose of any annual report to distill complex issues and statistics into their essence so the state leaders—who are not pathologists, toxicologists, or veterinarians—can make educated decisions based on what’s presented? So if an annual report goes out of its way to note an increase in a certain area, it should also note if the increase is statistically meaningful. Data should always be presented in context, and not just for racing commissioners. Horsemen and owners should also have the benefit of understanding the trends that affect their livelihoods and their investments, respectively.

This leads us to the second point.

Dr. Francisco Uzal, a professor of clinical diagnostic pathology at UC-Davis, said in a presentation before the CHRB Medication and Track Safety Committee Feb. 20 that the most recent cases of sudden death were particularly puzzling.

“Without an explanation we don’t know why this happens, but these are horses that are healthy...and they fall dead,” Uzal said. “And we’ve done extensive work; more than diagnostic work, we’ve done research. And we still don’t know exactly what’s happening.”

One piece of the puzzle missing, however, is consistently getting a list of any medications or supplements these deceased horses had been receiving.

“One of the issues that we, the pathologists, have (is) we are not clinicians. We see the horses when they are dead. So if anybody has any idea or anybody thinks, ‘Hey, what do you think about this drug or about this medication?’ Talk to us,” Uzal told the committee members. “The information on medication we get is still sketchy.”

Uzal later added that acquiring medication histories is “critical” in identifying the causes of sudden deaths.

Expecting state agencies to change how they produce annual reports is probably a longshot, but clearly California horsemen have an opportunity to step up. Disclosing medications and supplements could help solve the mystery shrouding these sudden death cases. The result could be fewer horses dying, fewer riders injured, and a better image for the sport. So what’s holding them back?

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