A Thoroughbred racehorse with a unicortical palmar lateral condylar fracture returned to training 14 days after surgery: a hypothesis on the role of a single bone screw on crack propagation.

A 2-year-old Thoroughbred racehorse had LF lameness that began post high-speed exercise and persisted for two days before the horse once again became sound. Diagnostic analgesia localized the lameness to the LF distal metacarpus, and a standing MRI identified a unicortical condylar fracture. A single 5.5 mm cortical screw was placed in lag fashion. The horse began hand walking at 14 days, racetrack jogging at 30 days, and racing at 5 months after the day of surgery. Placement of a single lag screw ahead of the tip of the crack in unicortical condylar fracture may be useful for reducing the recovery period for horses returning to training and racing.

Comparison of the racing performance of Thoroughbreds with versus without osteochondral fragmentation of the accessory carpal bone identified on yearling sales repository radiographs.

OBJECTIVE To evaluate 2- and 3-year-old and career race performance of Thoroughbred racehorse prospects with and without osteochondral fragmentation of the accessory carpal bone (ACB) identified on yearling presale radiographs. DESIGN Retrospective, matched cohort study. ANIMALS 47 nonlame Thoroughbreds with (exposed cohort) and 94 nonlame Thoroughbreds without (unexposed cohort) osteochondral fragmentation of ACB facture identified on yearling sales repository radiographs. PROCEDURES Repository radiographic interpretation reports for September yearling sales of a large Kentucky auction house from 2005 through 2012 were reviewed, and race records were collected and analyzed. Race performance was compared between horses with and without ACB fracture chosen from the same sale to identify associations between racing performance and ACB fracture. RESULTS No significant differences were identified between horses with or without ACB fracture in their incidence of starting a race as a 2- or 3-year-old and the number of races started, earnings, or earnings per start for 2- or 3-year-old or career race performance. There was no significant difference in performance between horses with or without concurrent carpal osteoarthritis, nor did performance differ between horses with ACB fracture alone and those with ACB fracture and other radiographic abnormalities found to be associated with poorer performance in previous studies. CONCLUSIONS AND CLINICAL RELEVANCE ACB fracture with or without carpal osteoarthritic changes identified on repository radiographs of Thoroughbred yearlings was not associated with poorer racing performance or lower likelihood of starting a race as a 2- or 3-year-old, compared with outcomes for unaffected horses.

Association of catastrophic condylar fracture with bony changes of the third metacarpal bone identified by use of standing magnetic resonance imaging in forelimbs from cadavers of Thoroughbred racehorses in the United States.

OBJECTIVE To compare bony changes of the third metacarpal bone (MC3) of Thoroughbred racehorse cadavers with (cases) or without (controls) catastrophic condylar fracture by use of standing MRI. SAMPLE 140 forelimbs from 26 case horses (both forelimbs) and 88 control horses (single forelimb). PROCEDURES Bone marrow lesions (BMLs), identified as a decrease in T1-weighted (T1W) signal and increases in T2*-weighted (T2*W) and short tau inversion recovery (STIR) signals, and dense bone volume percentage (DBVP), identified as decreases in T1W, T2*W, and STIR signals, in the distopalmar aspect of MC3 were recorded. Logistic regression was used to compare fractured and nonfractured limbs of cases and fractured limbs of cases with randomly selected limbs of controls. RESULTS Among cases, fractured limbs were significantly more likely to have BMLs (26/26 [100%]) than were nonfractured limbs (7/26 [27%]). Fractured limbs of cases were significantly more likely to have BMLs (26/26 [100%]) than were limbs of controls (6/88 [7%]). Among cases, there was no significant difference in DBVP between fractured and nonfractured limbs in lateral (26% vs 21%, respectively) or medial (25% vs 20%, respectively) condyles. However, DBVP was significantly greater in fractured limbs of cases than in limbs of controls for lateral (26% vs 16%, respectively) and medial (25% vs 18%, respectively) condyles. CONCLUSIONS AND CLINICAL RELEVANCE Standing MRI revealed a significantly greater degree of bone change in racehorses with condylar fracture when comparing fractured and nonfractured limbs of case horses and fractured limbs of case horses with randomly selected limbs of control horses.

Association of catastrophic biaxial fracture of the proximal sesamoid bones with bony changes of the metacarpophalangeal joint identified by standing magnetic resonance imaging in cadaveric forelimbs of Thoroughbred racehorses.

OBJECTIVE: To compare bony changes in the metacarpophalangeal joint (MCPJ) of racehorses with (cases) and without (controls) biaxial proximal sesamoid bone (PSB) fracture as determined by 2 grading scales applied to images of cadaveric forelimbs obtained by means of standing MRI (sMRI). DESIGN: Case-control study. SAMPLE: Forelimbs from 74 Thoroughbred racehorses (21 cases and 53 controls) that were euthanized at a Florida racetrack. PROCEDURES: Both forelimbs were harvested from cases and controls. Each forelimb underwent sMRI to obtain images of the MCPJ. Two grading scales were described and used for image evaluation; one assessed the density of the PSBs, and the other assessed the integrity of the subchondral bone (SCB) plate at the distopalmar aspect of the third metacarpal bone (MC3). Logistic regression was used to compare the grades between case and control limbs. RESULTS: Biaxial PSB fracture was associated with a total PSB grade (sum of lateral and medial PSB grades) ≥ 5 for the fractured limb, total MC3 SCB grade (sum of lateral and medial MC3 SCB grades) ≥ 5 for the contralateral limb, and the presence of orthopedic disease in the contralateral MC3. CONCLUSIONS AND CLINICAL RELEVANCE: For cases with biaxial PSB fracture, the density of the PSBs in the affected limb was greater and the MC3 of the contralateral limb was more likely to have orthopedic disease, compared with those for controls. Further evaluation of sMRI as a screening tool for identification of racehorses at risk of biaxial PSB fracture is warranted.

Comparison of phenylephrine administration and exercise versus phenylephrine administration and a rolling procedure for the correction of nephrosplenic entrapment of the large colon in horses: 88 cases (2004-2010).

OBJECTIVE: To compare the outcome of horses with nephrosplenic entrapment of the large colon (NSELC) that were treated nonsurgically by IV administration of phenylephrine and exercise with that of horses treated by IV administration of phenylephrine and a rolling procedure under general anesthesia. DESIGN: Retrospective case series. ANIMALS: 88 horses with NSELC. PROCEDURES: Horses examined between 2004 and 2010 because of acute abdominal pain that had NSELC on the basis of findings on abdominal palpation per rectum, abdominal ultrasonography, or both were included. Medical records were reviewed to obtain information on treatment (IV administration of phenylephrine and exercise vs IV administration of phenylephrine and a rolling procedure) and outcome. RESULTS: Overall, 85% (75/88) of horses with NSELC responded to exercise or rolling under general anesthesia. The success rate of rolling under general anesthesia (42/50 [84%]) was significantly higher than the success rate of exercise after IV administration of phenylephrine (24/38 [63.2%]). Resolution of NSELC was achieved by rolling under general anesthesia in 8 of 14 horses that initially failed to resolve with exercise. CONCLUSIONS AND CLINICAL RELEVANCE: A rolling procedure performed under general anesthesia had a higher success rate than exercise after IV phenylephrine administration for resolution of NSELC in horses, suggesting that rolling could be considered as the initial medical treatment. The rolling procedure may be labor intensive and should only be attempted in a surgical facility in the event that exploratory laparotomy is required.

Use of serial measurements of peritoneal fluid lactate concentration to identify strangulating intestinal lesions in referred horses with signs of colic.

OBJECTIVE: To determine the value of serial measurements of peritoneal fluid lactate concentration (PFL) for detecting strangulating intestinal lesions (SLs) in referred horses with signs of colic. DESIGN: Retrospective cohort study. ANIMALS: 94 horses with signs of colic. PROCEDURES: Medical records of horses evaluated between September 2006 and February 2010 because of signs of colic were reviewed. All included horses had ≥ 2 peritoneal fluid samples collected, including one at admission and another within 1 to 6 hours after admission. Of the 94 horses, 26 were assigned to the SL group on the basis of findings at surgery or necropsy and 68 were assigned to the nonstrangulating intestinal lesion group because their signs of colic resolved with medical management. Peritoneal fluid lactate concentration was measured by use of a handheld lactate monitor. Data were analyzed by use of univariable and multivariable logistic regression analysis. RESULTS: PFL at admission > 4 mmol/L, an increase in PFL over time, and especially an increase in PFL over time in horses with a PFL < 4 mmol/L at admission (OR, 62; sensitivity, 95%; specificity, 77%) were significant predictors of horses with an SL. CONCLUSIONS AND CLINICAL RELEVANCE: Serially determined PFL was a strong predictor for differentiating horses with SLs from horses with nonstrangulating intestinal lesions. Given the high OR, sensitivity, and specificity of these tests, serially determined PFL may have potential as a screening test for identifying horses with SLs. Further evaluation of the clinical value of PFL for predicting SLs in a prospective, multicenter study is warranted.

Cardiac troponin I in pastured and race-training Thoroughbred horses.

Cardiac troponin I (cTnI), a myocardial polypeptide, is a highly sensitive and specific biomarker of myocardial injury in people and dogs. The structure of cTnI is highly conserved across species, and equine myocardium has high reactivity with human immunoassays. The purpose of this study was to describe cTnI concentrations in normal pastured and race-training Thoroughbred horses. Ten horses on pasture and 10 horses in race training were studied. Horses were considered normal on the basis of physical examination, training performance, electrocardiography (ECG), and echocardiography. Serum cTnI concentrations were determined with a colorimetric immunoassay. The assay has an analytical sensitivity of 0.04 ng/mL. Serum cTnI concentrations in race-training horses were not significantly different from those of pastured horses. When groups were combined, mean cTnI concentration (+/- SD) was 0.047 +/- 0.085 ng/mL. and the median was 0 (range, 0-0.35 ng/mL). The 90th percentile for both groups combined was 0.11 ng/mL. This study establishes a preliminary reference range for serum cTnI in normal Thoroughbred horses.