Training vs. racing: A comparison of arrhythmias and the repeatability of findings in Thoroughbred Chuckwagon racehorses.

Arrhythmias are commonly reported in exercising horses, however due to regulatory constraints electrocardiograms (ECGs) are acquired during training but not competition, raising questions about the repeatability of findings. The aims were (1) compare training and competition arrhythmias and (2) describe the repeatability of arrhythmias during maximal-intensity exercise. A convenience sample of 52 healthy Thoroughbreds (aged 8.7 ± 2.5 years) competing in the World Professional Chuckwagon Association were obtained, totaling 152 training or competition ECGs (2-7 ECGs/horse). Speed, heart rate (HR) and arrhythmias (supraventricular premature complex, SVPC; ventricular premature complex, VPC) were examined. Pre- and post-recovery (approximately 6 min) blood samples measured lactate and high-sensitivity troponin-T. Training and competition arrythmias were compared (Friedman's test) and reliability of repeated ECGs assessed (intraclass correlation; P < 0.05). Training vs. competition: Forty horses had clean tracing from training and competition (n = 80 ECGs); the number and type of arrhythmias were not different. In training, VPCs were present in 7/40 horses (median [interquartile range, IQR]/ECG; range; 0 [0,0]; 0-4) and 9/40 horses (0 [0,0]; 0-5) in active-recovery. In competition, VPCs were present in 7/40 horses (0 [0,0]; 0-8) and 8/40 horses (0 [0,0]; 0-5) in active-recovery. Arrhythmias were primarily single premature complexes. Training and competition speed, HR, lactate and troponin-T did not differ however, sampling was too early for peak serum Troponin-T levels. Repeatability: total arrhythmias between serial ECGs did not differ. The reliability to detect SVPCs and VPCs was poor to moderate, and poor, respectively. Overall, the total number of arrhythmias was repeatable, but the reliability of arrhythmia type was poor to moderate.

Upper airway endoscopy in exercising horses: Findings in 164 barrel racing horses with respiratory clinical signs and/or poor performance.

Barrel racing involves sprinting through a cloverleaf pattern in under 20 s. The prevalence of upper airway obstructions (UAO) in barrel racers is unknown, thus a retrospective analysis of 164 client-owned horses referred for overground endoscopy (OGE) between 2014 and 2022 was performed. Referring complaints included respiratory noise, cough, epistaxis, behaviour (owner reported stress/anxiety, refusal to enter arena, excessive head shaking), and/or poor performance. Horses performed a standardized exercise test with low and high-speed components. Videoendoscopic recordings were systematically scored by one experienced clinician. Exercising abnormalities included palatal instability (PI), intermittent dorsal displacement of the soft palate (iDDSP), nasopharyngeal collapse (NPC), recurrent laryngeal neuropathy (RLN), ventro-medial luxation of the apex of the corniculate process of the arytenoid (VLAC), medial deviation of the aryepiglottic fold (MDAF), vocal fold collapse (VFC), and cricotracheal ligament collapse. Associations between co-existing UAOs, age and sex were examined (McNemar's test; logistic regression; P < 0.05). During exercise, 24/164 (15%) horses had no UAO. In the remaining 140 horses, 56% had two or more. NPC was observed in 68/140 (49%), PI in 59/140 (42%), iDDSP in 55/140 (39%), VFC in 38/140 (27%), RLN in 27/140 (19%), VLAC in 14/140 (10%), MDAF in 8/140 (6%) and cricotracheal ligament collapse in 8/140 (6%). Nasopharyngeal collapse and RLN were primarily Grade 3 and Grade B, respectively. Associations exist between several co-existing UAOs, but not age or sex. Abnormalities were more frequent at low-speed (55%) than high-speed (22%), highlighting the importance of OGEs at different exercise intensities. Multiple UAOs appear common in barrel racers with clinical presentations.

Prevalence of cardiac arrhythmias and R-R interval variation in healthy Thoroughbred horses during official Chuckwagon races and recovery.

The prevalence and severity of cardiac arrhythmias in healthy racehorses undergoing competition is not well defined. The aim was to characterize arrhythmias in Thoroughbreds participating in official Chuckwagon races and to determine normal beat-to-beat (R-R) variability during supramaximal exercise. Electrocardiograph (ECG) recordings were obtained during pre-race, race, and active-recovery from 82 clinically healthy Thoroughbreds. ECG recordings were analyzed for arrhythmias and mean percent R-R deviation. Plasma lactate and high-sensitivity troponin (hs-cTnT) were also measured. Fifty-two ECGs were included in the analysis. Arrhythmias were seen in 48/52 horses (92%) and were predominantly isolated events. No complex rhythms were observed. During the race, 92% of horses had arrhythmias (81% supraventricular premature complex [SVPC]; 33% ventricular premature complex [VPC]). Eleven percent of racing arrhythmias were VPCs (all singlets except for two couplets). During active-recovery, 58% of horses had arrhythmias (56% SVPC; 15% VPCs): Three horses had VPC couplets and one horse had a VPC triplet. All plasma hs-cTnT were within normal limits. The measured lactate was 28.5 ± 4.5 mmol/L, confirming supramaximal exercise. R-R variation ranged between -9.5 to +18.8% during pre-race (mean heart rate [HR], 155 ± 22 beats per min [bpm]), -27.8 to +45.3% during racing (mean HR, 200 ± 9 bpm) and -16.4 to +40.1% during active-recovery (mean HR, 165 ± 14 bpm). Maximal and 1st percentile R-R shortening and lengthening were significantly greater at race than pre-race and active-recovery (P < 0.0001). Racing and active-recovery maximal R-R lengthening were significantly greater than pre-race (P = 0.0003). Supraventricular premature complexes and VPCs are prevalent in healthy horses undergoing Chuckwagon racing. R-R variation is greater during racing than has previously been described.

24-Hour Kinetics of Cardiac Troponin-T Using a "High-Sensitivity" Assay in Thoroughbred Chuckwagon Racing Geldings after Race and Associated Clinical Sampling Guidelines.

BACKGROUND: A "high-sensitivity" cardiac troponin-T (hscTnT) assay recently has been validated for use in horses and is a specific biomarker of myocardial damage. Postexercise release kinetics of cTnT utilizing the hscTnT assay have yet to be established in horses. OBJECTIVES: To determine: (1) cTnT release kinetics in racing Thoroughbreds after a high-intensity 5/8th mile Chuckwagon race; (2) the effects of age on pre- and postrace cTnT concentrations; and (3) sampling guidelines for clinicians evaluating horses presenting after exercise. ANIMALS: Samples were obtained from 38 Thoroughbred geldings aged 5-16 years before racing and immediately, 2, 3, 4, 6, 12, and 24 hour postrace. METHODS: Prospective, observational study with convenience sampling. A fifth-generation hscTnT assay was used for plasma sample analysis, and concentrations were compared at all time-points. Correlations were determined between cTnT concentrations and age. Biochemistry analysis was performed to assess rhabdomyolysis, renal failure, and exercise-induced dehydration. RESULTS: All horses with measureable cTnT concentrations had significant postexercise increases in cTnT with a median peak (8.0 ng/L) at 3-hour postrace. All horses had peak postexercise cTnT concentrations 2- to 6-hour postrace ≤ the 99th percentile upper reference limit of 23.2 ng/L, after which all cTnT concentrations decreased until returning to baseline by 12-24 hours. There was no correlation over time between cTnT concentrations and age. CONCLUSIONS AND CLINICAL IMPORTANCE: In racing Thoroughbreds completing short-duration, high-intensity Chuckwagon races, cTnT concentrations are expected to be increased 2- to 6-hour postrace and to decrease by 12-24 hours while remaining ≤23.2 ng/L throughout. This study contributes to establishing guidelines for clinical use of the hscTnT assay in exercising horses.

Prognostic Value and Development of a Scoring System in Horses With Systemic Inflammatory Response Syndrome.

BACKGROUND: Despite its widespread use in equine medicine, the clinical value of the systemic inflammatory response syndrome (SIRS) concept in horses remains unknown. OBJECTIVES: To study the prognostic value of measures of SIRS in horses and identify the best model of severe SIRS to predict outcome. ANIMALS: A total of 479 consecutive adult horse emergency admissions to a private primary referral practice. METHODS: Prospective observational study. All adult horses admitted for emergency treatment over the study period were included. Multivariate logistic regression and stepwise model selection were used. RESULTS: Each of the 4 SIRS criteria was associated with outcome in this population. Thirty-one percent of emergency cases had 2 or more abnormal SIRS criteria on admission and were defined as SIRS cases. SIRS was associated with increased odds of death (odds ratio [OR] = 8.22; 95% CI, 4.61-15.18; P < .001), an effect mainly found for acute gastrointestinal cases. SIRS cases were assigned a SIRS score of 2, 3, or 4, according to the number of abnormal SIRS criteria fulfilled on admission, and SIRS3 and SIRS4 cases had increased odds of death compared to SIRS2 cases (OR = 4.45; 95% CI, 1.78-11.15; P = .002). A model of severe SIRS including the SIRS score, blood lactate concentration, and color of the mucous membranes best predicted outcome in this population of horses. CONCLUSIONS AND CLINICAL IMPORTANCE: Systemic inflammatory response syndrome is associated with an increased risk of death in adult horses presenting with acute gastrointestinal illnesses. The model of severe SIRS proposed in this study could be used to assess the status and prognosis of adult equine emergency admissions.

Analytical validation and establishment of reference intervals for a 'high-sensitivity' cardiac troponin-T assay in horses.

BACKGROUND: Cardiac troponin-I assays have been validated in horses.'High-sensitivity' cardiac troponin assays are now the standard in human cardiology. OBJECTIVE: Appropriately validate the'high-sensitivity' cardiac Troponin-T (hscTnT) assay for clinical use in horses, establish reference intervals, determine the biological variation, and demonstrate assay utility in selected clinical cases. METHODS: Analytical validation of the Roche hscTnT assay included within- and between-run precision, linear dose response, limit of quantitation (LoQ), stability, and comparison with cTn-I (iSTAT). Reference intervals and biological variation were determined using adult, healthy, Non-Competition Horses (N = 125) and Racing-Thoroughbreds (N = 178). HscTnT levels were measured in two horses with cardiac pathology. RESULTS: The hscTnT demonstrates acceptable within-run (L1 = 6.5 ng/L, CV 14.9 %, L2 = 10.1 ng/L, CV 8.7 %, L3 = 15.3 ng/L, CV 5.4 %) and between-run precision (L1 = 12.2 ng/L, CV 8.4 %, L2 = 57.0 ng/L, CV 8.4 %, L3 = 256.0 ng/L, CV 9.0 %). The assay was linear from 3 to 391 ng/L. The LoQ was validated at 3 ng/L. Samples demonstrated insignificant decay over freeze-thaw cycle. Comparison with cTnI assay showed excellent correlation (range: 8.0-3535.0 ng/L, R(2) = 0.9996). Reference intervals: The upper 95(th) and 99(th) percentile of the hscTnT population distribution were 6.8 and 16.2 ng/L in Non-Competition Horses, and 14.0 and 23.2 ng/L in Racing-Thoroughbreds. Between-breed, diurnal effect, and between-day variation was below LoQ. Two clinical cases with presumed cardiac pathology had hscTnT levels of 220.9 ng/L and 5723.0 ng/L. CONCLUSIONS: This benchmark study is the first to comply with CLSI guidelines, thus further establishing the performance characteristics of the hscTnT assay, and reference intervals in healthy horses. Two clinical cases demonstrated further the clinical utility of the assay.