Does periosteal scraping of the third metacarpal bone reduce the incidence of 'bucked shins' in young Thoroughbred racehorses?

REASONS FOR PERFORMING STUDY: The occurrence of bucked shins in young Thoroughbred racehorses in North America is high. Although an altered training regime has demonstrated a significant decrease in this condition, trainers can be opposed to altering something as fundamental as their training routine. Periosteal scraping of the third metacarpal bone (McIII) is a putative prophylactic technique used to prevent bucked shins; therefore, a study to investigate the validity of the procedure is warranted. OBJECTIVES: To investigate whether prophylactic McIII scraping: 1) reduces the incidence of bucked shins in juvenile Thoroughbred horses at race speeds (breeze); and 2) allows increased cumulative breeze miles before the onset of disease. STUDY DESIGN: Nonrandomised prospective clinical study. METHODS: One hundred and seventy yearling Thoroughbreds from one farm, under one trainer, were enrolled in this study over one training season; 85 horses were treated and 85 horses were control animals. Horses were observed for bucked shins over 5 cumulative breeze miles. The objectives were evaluated by comparing incidence rates and Kaplan-Meier plots. RESULTS: The incidence rate for bucked shins was 0.059 cases per breezed mile in the treatment group, compared with 0.103 cases per breezed mile in the control group. Comparison of Kaplan-Meier plots of breeze miles for the 2 groups demonstrated a significant difference between groups (P = 0.035). Horses that developed bucked shins following periosteal shin scraping breezed an average of 3.52 miles before the onset of disease, compared to 2.50 miles for horses not prophylactically treated (P = 0.005). CONCLUSIONS: Periosteal McIII scraping reduced the incidence rate of bucked shins. The procedure allowed treated horses to breeze greater cumulative distances before an incident but failed to prevent the disease over the long term. Further investigation into this commonly used prophylactic technique is required.

Acute mastoiditis: Increase of incidence and controversies in antibiotic treatment

An important complication of acute otitis media is acute mastoiditis which responds to antibiotic therapy and myringotomy. Patients with acute mastoiditis were reviewed during 1996-2005 in the tertiary University Children’s Hospital in Madrid. The number of patients with acute mastoiditis increased by about 2-fold during this period. Of 205 children with mastoiditis, ranging from 0.6-17 years of age, surgical treatment was needed in about 4.3% in 1996 and in 70% in 2005. In spite of 80% of the children having received antibiotics at the pediatric visit, the number of complications increased (periostitis, subperiosteal abscess), and the number of surgical interventions increased by 8-fold. Etiological agents were Streptococcus pneumoniae (28.5%) and Staphylococcus aureus (16.3%). Negative cultures were obtained in 53.6% of cases. Lack of response to conventional therapy may require more tympanocentesis procedures for a middle ear culture, and surgical therapy may be necessary more often, as is the tendency in our hospital

La mastoiditis aguda es una complicación importante de la otitis media aguda que responde al tratamiento antibiótico y la miringotomía. Se realizó un estudio de revisión de los pacientes con mastoiditis aguda que acudieron al Hospital Infantil Universitario Niño Jesús de Madrid, de nivel terciario, durante 1996-2005. El número de pacientes con mastoiditis aguda aumentó aproximadamente dos veces durante este periodo. De los 205 niños registrados con mastoiditis, con una edad de 0,6 a 17 años, se requirió tratamiento quirúrgico en cerca del 4,3% en 1996 y en el 70% en 2005. A pesar de que el 80% de los niños recibieron antibióticos al visitar al pediatra, el número de complicaciones aumentó (periostitis, absceso subperióstico) y el número de intervenciones quirúrgicas fue hasta ocho veces superior. Los agentes etiológicos identificados fueron Streptococcus pneumoniae (28,5%) y Staphylococcus aureus (16,3%). Los cultivos fueron negativos en el 53,6% de los casos. Según la tendencia observada en nuestro hospital, la falta de respuesta a un tratamiento convencional puede requerir un mayor número de procedimientos de timpanocentesis para los cultivos de oído medio y la necesidad de realizar un tratamiento quirúrgico con mayor frecuencia

[Acute mastoiditis: increase of incidence and controversies in antibiotic treatment].

An important complication of acute otitis media is acute mastoiditis which responds to antibiotic therapy and myringotomy. Patients with acute mastoiditis were reviewed during 1996-2005 in the tertiary University Children's Hospital in Madrid. The number of patients with acute mastoiditis increased by about 2-fold during this period. Of 205 children with mastoiditis, ranging from 0.6-17 years of age, surgical treatment was needed in about 4.3% in 1996 and in 70% in 2005. In spite of 80% of the children having received antibiotics at the pediatric visit, the number of complications increased (periostitis, subperiosteal abscess), and the number of surgical interventions increased by 8-fold. Etiological agents were Streptococcus pneumoniae (28.5%) and Staphylococcus aureus (16.3%). Negative cultures were obtained in 53.6% of cases. Lack of response to conventional therapy may require more tympanocentesis procedures for a middle ear culture, and surgical therapy may be necessary more often, as is the tendency in our hospital.

Periostite metacarpiana dorsal: incidência e fatores pré-disponentes / Dorsal metacarpal disease: incidence and predisposing factors

Quarenta e dois potros Puro Sangue de Corrida, de 2 anos de idade, foram acompanhados clinicamente a cada 15 dias, durante o treinamento para sua primeira corrida, para determinar a incidência e possíveis fatores pré-disponentes da periostite metacarpiana dorsal. Durante dois meses no primeiro ano (n=25) e quatro meses (n=17) no segundo ano em que foi realizado o acompanhamento dos potros eles foram submetidos a exames físicos para a identificação de sinais clínicos de periostite metacarpiana dorsal. Dados como sexo, velocidade média, distância dos exercícios de velocidade e treinador foram tabulados. No primeiro ano 28% dos potros manifestaram periostite metacarpiana dorsal e no segundo ano este índice foi de 70,6%. Considerando-se todo o periodo de estudo a incidência foi de 45%. Não houve diferença entre os sexos na manifestação de periostite metacarpiana e velocidade média alcançada. A velocidade média desenvolvida pelos potros que permaneceram sadios e dos que apresentaram periostite metacarpiana se manteve entre 16 e 18 m/s. Nos 500 e 700m a velocidade média dos animais com periostite metacarpiana foi maior (p<0,05). A periostite metacarpiana se manifestou em 10 de 19 potros na distância de 700 m. Houve diferença na incidência de periostite metacarpiana e velocidade média atingida pelos potros de acordo com o treinador. Os potros treinados pelos treinadores que apresentaram maior incidência de periostite metacarpiana foram os mais rápidos. Portanto, fatores que favoreceram a manifestação de periostite metacarpiana foram velocidade média elevada sobre distâncias maiores como os 700m e regime de treinamento preconizado pelos diferentes treinadores.

Forty two 2-year-old thoroughbreds were examined clinically at intervals of 15 days during their training for the flrst race to determine the incidence and the predisposing factors of dorsal metacarpal disease. During the flrst year 25 horses were followed during 2 months and in the second year the follow up was done for 4 months in 17. Horses' data like gender, average speed, speed exercise work and trainer were also collected. Dorsal metacarpal disease was diagnosed in 28% and 70,6% of the 2 year-old thoroughbreds in the flrst and second year of the study, respectively. Total incidence was 45%. The incidence and average speed was not affected by gender. The average speed achieved by affected and none affected horses remained between 16 and 18m/ s. On 500 and 700m speed exercise, the average speed of affected horses was higher than of none affected ones (p<0,05). Ten out of 19 horses showed dorsal metacarpal disease signs at the distance of 700m. There was signiflcant difference between trainers regarding the incidence of dorsal metacarpal disease and average speed of their horses. 2-year-olds under care of trainers whose horses had the highest incidence o dorsal metacarpal disease also were the fastest one's. Therefore, fast speed associated with longer distances (700m) and trainer are factors that predispose young horses to dorsal metacarpal disease.

Gait and speed as exercise components of risk factors associated with onset of fatigue injury of the third metacarpal bone in 2-year-old Thoroughbred racehorses.

OBJECTIVE: To determine the degree to which components of the training program of 2-year-old Thoroughbred racehorses influence their susceptibility to fatigue injury of the third metacarpal bone (bucked shins). ANIMALS: 226 two-year-old Thoroughbred racehorses. PROCEDURE: Daily training information and health reports on 2-year-old Thoroughbreds were compiled from records provided from 5 commercial stables. For each horse, data (exercise variables) were collected that comprised distance jogged (approx speed of 5 m/s), galloped (approx 11 m/s), and breezed (approx 15 to 16 m/s) until a single instance of bucked shins was reported. Data were coded for analysis using cross-tabulation, graphic, and survival techniques. RESULTS: Of 226 horses, 56 had bucked shins, 9 completed the observation period without bucked shins, and 161 were lost to follow-up. Distinct training strategies were used at stables resulting in significantly different survival profiles among stables. Mean (+/- SD) allocation of exercise to breezing was 0.15 +/- 0.13 miles/wk (maximum, 0.64 miles/wk), to galloping was 4.47 +/- 1.52 miles/wk (maximum, 9.56 miles/wk), and to jogging was 2.34 +/- 1.70 miles/wk (maximum, 8.53 miles/wk). Survival (ie, lack of bucked shins during 1 year of monitoring) was found to be significantly reduced by exercise allocation to breezing, significantly increased by exercise allocation to galloping, and uninfluenced by exercise allocation to jogging. The log of the hazard ratio was reduced by 4.2 +/- 1.5/mile breezed and increased by 0.3 +/- 0.1/mile galloped. CONCLUSIONS AND CLINICAL RELEVANCE: Relationships between different gaits and speeds in the training regimen influence the incidence of bucked shins. To reduce the incidence of bucked shins, trainers should consider allocating more training effort to regular short-distance breezing and less to long-distance galloping.