Necropsy Programs Provide Learning Opportunities To Researchers, Horsemen

by | 07.18.2017 | 1:34am

Figures released earlier this year from the Equine Injury Database suggest the number of racing fatalities in the United States is falling. For the fourth consecutive year, the rate of deaths per 1,000 starts was down, coming to 1.54 after weighing in at 2.00 when the database started recording data in 2009.

No matter where you stand at the racetrack, a catastrophic breakdown is horrendous, and the horror is compounded for people with a direct connection to the horse. But out of tragedy can come important lessons. Eight Belles' high-profile death in the gallop-out of the 2008 Kentucky Derby is referenced so often as an impetus for change we included it in our Regulatory Meeting Bingo Card last summer. At many tracks around the country, commission or track officials and trainers are attempting to use each racetrack fatality as an opportunity to learn.

The learning process
In most places, when a horse dies during a race or during morning training, its body is submitted for autopsy (called “necropsy” in animals) to gather information about possible causes of death or fatal injury. These examinations typically include both physical exam of the bones and soft tissues, as well as toxicology and histology tests on organs and, if applicable, on blood drawn before euthanasia. Radiographs may be taken of fractures as well.

The job of the veterinarian performing this process (typically a board-certified pathologist) is to be objective and thorough. The pathologist is not there to make interpretations or to speculate on the horse's medical or training history, as they are not provided with that information.

Dr. Laura Kennedy, veterinary pathologist at University of Kentucky's Veterinary Diagnostic Laboratory, says she makes sure to look both at the fracture site and the corresponding area on the opposite leg. Some pathologists take photos of any unique findings or fractures; Kennedy has taken to making sketches of what she sees to go into the horse's file.

One thing she's not there to do is recreate the scene of the breakdown.

“As a pathologist, you can only report what you see,” said Kennedy. “In comments, you might be able to provide a little more interpretation. You can only interpret, you can't make a definitive statement. I can't speculate on the cause of specific things; there's not a lot of definitive statements you can make, because you weren't there.”

In states requiring necropsies for on-track deaths, the pathologist sends a copy of their report to the commission. Then, in some places, a mortality review will take place between racing officials and horsemen.

All tracks accredited by the NTRA Safety and Integrity Alliance conduct some form of official review when a horse dies on the racetrack; the formality of the review and parties involved varies by location. In Kentucky, New York and California, the process of mortality review is mandated by the racing commission. In other states like Pennsylvania, mortality review is not mandated by state rules, but is part of “house rules” at each racetrack.

In Kentucky, the commission meets with the trainer to review the necropsy report, veterinary treatment records, workout records, and race records. Dr. Mary Scollay, equine medical director for the Kentucky Horse Racing Commission, said the tone of the meeting is not disciplinary, but as a group quest for understanding.

“It is a community problem when a horse dies,” said Scollay. “A mortality review is not about pointing fingers but is about saying, ‘What could we, as a group, have done to prevent this? What can we do going forward?' I think the people with the affected horse are grateful that there's interest in what we can do altogether.”

Dr. Jerry Pack, association veterinarian at Penn National, instituted that track's mortality review program in 2010 and agrees trainers have been receptive to the process. At Penn, Pack meets with the trainer, the racing secretary and director of racing, and administers a questionnaire to better understand the horse's medical history. He combines the trainer's answers with the necropsy report to try to arrive explanations for what happened with the horse.

“The reception to our program has been outstanding. We've been doing this since 2010 and we've had numerous trainers tell us how much they appreciate us doing this,” said Pack. “There are times when it alerts me to trainers or owners that may be a potential problem. It also alerts me to the potentials of track issues; I see certain kinds of injuries on certain kinds of surfaces. Year in, year out, the majority of our injuries will be ankle injuries, usually between the three-eighths pole and the quarter pole. That's pretty common at all racetracks, that's where they're changing leads.”

Gathering data
Besides having the benefit of giving involved trainers specific continuing education-type sessions, logging and reviewing necropsy reports also gives tracks and states localized caches of data to work with.

The Equine Injury Database records data nationally from approximately 96 percent of flat racing dates in the U.S., and has begun identifying risk factors for fatal injury based on its data. Some of the areas with longer-running necropsy and review procedures have also been keeping their own records. California officials have been gathering data on necropsies for Thoroughbreds since 1990. At Penn National, Pack has a database of 600 necropsy reports dating back to 1997.

Some of that data has already affected track policy. California's program at University of California-Davis helped identify long toe grabs on horseshoes as contributors to likelihood of fatal injury. As a result, the majority of racing states have restrictions on maximum height for toe grabs, with most being restricted to 2 millimeters.

This information has also helped researchers realize the majority of fatal orthopedic injuries take place in areas with preexisting damage (which prompted the installation of a nuclear scintigraphy machine at Santa Anita Park in the mid-1990s to help identify such damage). Just as importantly, Kennedy says, it has also taught veterinarians damage may be symmetrical in certain types of fractures.

“There are certain things where we see preexisting lesions that, with a lot of research, we've found are symmetric,” said Kennedy. “If you have a condylar fracture on one side, you're going to see in 85, 90 percent of the cases, you're going to see damage on the opposite limb. You're also going to find some other changes; you might find degenerative joint disease.”

The catch, Scollay said, is this means a horse with preexisting damage may not necessarily be what we traditionally think of as “lame” and may not bobble from one side to the other. Instead, a horse with some wear and tear damage in both front legs may simply take shorter steps, which a trainer who's unfamiliar with the horse may not recognize is unusual for the individual.

Kentucky's mortality review process has also served to remind its racing commission of the disparity sometimes existing between breaking news from the EID findings and horsemen who need that information. Scollay said although the EID has identified horses who have made a start as 2-year-olds carry a reduced risk of fatal breakdown, she still encounters trainers who waited to start oversized horses, believing they're keeping rapid growers safer.

“No matter how much we think we've gotten that word out there, people say, ‘She was a big gangly filly and I just wanted to give her a chance to grow into herself before I started training her.' The fact that we know that's not good, that doesn't mean it's getting into the hands of people who need to hear it,” said Scollay.

“And those are the people who are sobbing [in the review], because they thought they were doing the right thing. Regardless of the fact that info has been out for 20 years, if it's not getting to that person,” Kennedy agreed.

More puzzles
Then, there are the mortality reviews which show not all fatalities can be prevented.

Dr. Rick Arthur, Equine Medical Director for the California Horse Racing Board, recalled one case in which the pathologist discovered a section of bone that had been eaten away from the inside, possibly due to an old infection, but the location of the hole likely prevented it from ever showing on an x-ray because of nearby soft tissues and a joint capsule.

In Kentucky, Scollay remembered an instance from decades ago when a trainer who spoke limited English came to a review for a horse whose body had been presented to the Kentucky diagnostic lab in poor condition. It would have been easy to assume intentional neglect, but it turned out the trainer was feeding a multi-species complete feed with chopped hay in it because he couldn't read the feed tag well. He was aware the horse was losing weight, and kept increasing the horse's ration, administered wormer, and had the horse's teeth checked. The horse was eating well, and he had been distressed the animal wasn't doing better. It wasn't until the review board met with him and a translator everyone realized the horse's problem was the content of the feed, not the amount it was getting. The review process allowed the trainer to get the help and resources he needed before he was able to make the same mistake with another horse.

“It's not just enough to identify that a poor decision was made; you have to understand why it was made,” said Scollay. “I've drilled it down to ignorance, arrogance, or fear. Once you understand that, you have a path to resolving it so that the problem does not recur. You can't stand over somebody's shoulder, breathing down their neck at all times. They have to see the benefit of doing something differently. If someone made a poor decision out of fear, treating them like it was out of arrogance will not help.”

Also in the file of “troubling discoveries”: not all localities are lining up well with the risk factors identified by the EID. At Penn National, Pack said he has found no pattern in his database of necropsied horses suggesting a drop in claiming tag makes a significant difference in a horse's fatality risk. (The EID reported in 2012 horses dropping in price by $12,000 or less are 2.5 times more likely to suffer a fatal fracture; horses dropping more than $12,000 from their last start are three times more likely to break down.) He also didn't find a strong correlation between horses in his necropsy database and the veterinarian's list at Penn National, noting the crossover was only about 5 percent.

“I've been in this business for a long, long time and it blew our minds away. For the first couple of years we thought, ‘Oh it'll level out,' and then it didn't level out,” said Pack.

While this information may be puzzling, Pack said it at least gives him somewhere to start as he works to understand more about preventing fatal injuries. And information is power.

  • Bob Hope

    Information is power! While an interesting commentary here there are some logistical ingredients that could tighten up the analysis. While we are measuring the depth of toe-grabs, jar corks or other anomalies associated with racing plates in millimeters we could be looking at the depth of transitional turns, average banking generally; training conditions over the previous 6 months; interviewing the jockey following a fatal breakdown; turf banking versus dirt; rider + tack total weight for training and especially breezing. Also licensing requirements for exercise riders relative to weight. Did the accident happen in sloppy conditions? How many times did the horse race in sloppy conditions prior to the accident? Type of fabricated base of the race course where the accident took place? This type of information is vital to any conclusions.

    • Lehane

      Agree. There are many risk factors that need to be investigated. There is a high percentage of sesamoid injuries found in necropsies.

  • Figless

    I have always found that interpreting information is more difficult than gathering it.

    Regarding the stat that horses that make a start at 2 are less likely to incur a fatal breakdown, I wonder about the cause and effect? Does the fact that they started at 2 prevent fatal breakdown later in life, or does it indicate they are simply more sound to begin with?

    Scollay implies negligence on behalf of trainers letting a young gangly horse growing into its body before beginning to train. This is a tad arrogant, as I trust the individual trainers opinion more than her stats.

    • Natalie Voss

      Figless, I believe the running theory regarding horses starting at two is it may have something to do with bone remodeling, which Dr. Bramlage refers to often. The skeleton strengthens in response to the type of strain placed on it (when done so at appropriate levels and timeframes); from what I understand, the reasoning is 2 yo starters have been experiencing a greater workload than non-starters at two, so their skeletons have become stronger. Of course, they also must have held together long enough in training to make a start at two, so the soundness question is a little ‘chicken and the egg’ I guess.

      Also the stats Scollay refers to are not ‘hers’ but data from the national Equine Injury Database, collected over a period of years.

      • Guest

        Thanks, Natalie. So owners should make an effort to get their 2 yos into training and make a start unless they encounter soundness issues, and not keep them home to “let them grow up” or because they are big and immature.

        I’ve been on plenty of youngsters, and the difference in the way they carry themselves and the muscular development and coordination is very apparent within the first few months of conditioning. Some of them feel so awkward the first few weeks that you wonder if they can even gallop much less ever make it to a race, but the vast majority of them seem to come around with time.

      • Ben van den Brink

        Starting as 2 yr olds might good for prepping up bone density, but the soft tissues joints etc also need to adapt that.
        So to say, sensitive workload is good for a part of the horse, but might be worse for a different part.

        • Lehane

          In my experience in Australia, i’ve found a significant number of 2 year olds needing to be spelled for 12 months after having their first race start. The bone remodeling that takes place is the immature body going into emergency mode due to the stress of training/racing placed on very young horses.

          • Ben van den Brink

            That is absolute correct. Quite a lot of horses are rushed in order to start them as two yr olds.

            Take notice of a horse called Arrogate. If this one was pressed to early,America did not have his biggest earner of this time.

      • Figless

        Thanks. Understand the theory, believe few if any two years olds are just left in their stalls or just turned out (where they do run and play so bone remodeling can occur naturally). Agree with your chicken/egg reference, I take issue with the cause/effect conclusion drawn.

        Nonetheless the data gathering is obviously a positive for the industry and I believe has led to fewer breakdowns due to closer scrutiny if nothing else.

        • Lehane

          Agree on the issue of cause/effect conclusion drawn.
          In my view, there are so many variables.

        • Larry Ensor

          “where they do run and play so bone remodeling can occur naturally”

          Doesn’t really work that way. Dr. John Fisher DVM but was a trainer basically pioneered the detailed, well documented research a while ago.

          If I remember correctly extensive use of x-ray to “measure” bone density was used on the study group of 2 year olds in training and those with little to no work load other then that the will do “naturally” as you suggested.

          Those is training showed a much higher level of remolding and increase in density. To gain this the horses had a specific training model and were subjected to periodic short “speed drills” that puts a much high demand which in turn promotes high levels of “breakdown and remodeling”.

          The sciences behind this IMO is pretty sound. This is an objective opinion. Not subjective like most things horse.

          IMO and experience as a farm trainer. The majority of young horses are not up to the job of racing as 2 year olds. I prefer to start/break them early get a solid bottom on them and then turn back out for a couple of months work with them from time to time. Start back with them in the early to late fall and get them ready to run in the late winter early spring.

          The few i thought might have the mind and body to be “early horses” pretty much always came up with issues and set backs. A waste of a lot of money and time.

          I have have done some limited research on horses bought out of 2 year old in training sales from time to time. Quite a few don’t start until the late in their 3 year old year. Some not until 4. Haven’t taken the time to research every horse that went through the rings to see how many are the exception and what is the norm.

          Very time consuming to research several years, and a lot of horses. But I find it interesting. But IMO it would take more than just reviewing racing results. A number of other factors should be looked at and taken into consideration also.

  • Bob Hope

    Of the great many trainers that I have known it is common knowledge of most to assess the pedigree, weight, precociousness of young horses before employing a suitable program. However,
    lite training is most beneficial in the promotion of appetite, growth and experience in the initial stages. For the most part we raise “hot-house horses” in North America because of sales and “turnout” considerations that shrink the “herd tendencies” where young horses should become competitive on into the yearling stage.

  • Larry Sterne

    what were the test results on the 7 horses that was reported to have died in Bafferts care? maybe he would like to aid research by assisting in getting that info public. It may be a teachable moment

  • Bob Hope

    the addition of lasix use to breeze and race seriously complicates these discussions

  • Manefan

    Well, Dr. Scollay had rearranged my belief with regard to 2-yos in training and racing. But, the thoughtout comments here have tempered that a little. At the very least, I’m simply thankful that research has been going on and continues so that longitudinal information can be used. Good article. Good comments.

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