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New Study Finds Horses Racing On Lasix At 62 Percent Increased Risk Of Sudden Death

by Paulick Report Staff

 

A new study of data from the Equine Injury Database has revealed that horses medicated with furosemide (Lasix) on race day were at 62 percent increased odds of sudden death compared to horses that were not racing on furosemide.

Funded by the Grayson Jockey Club Foundation, the study was published by Dr. Euan Bennet and Dr. Tim Parkin on Oct. 20, 2022, in the Journal of the American Veterinary Medical Association. It examined the 4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the United States and Canada between 2009 and 2021; those numbers represent 92.2 percent of all official race starts during that period.

Of those nearly 4.2 million starts, 536 resulted in a horse’s sudden death, an incidence rate of 0.13/1,000 starts. Sudden death was defined as any horse that was recorded as a fatality within three days of racing, along with one or more of the following fatal injury descriptions or (presumptive) diagnosis, as provided by each participating track to the EID: (1) sudden death (recorded as “SUD” in the EID), (2) pulmonary hemorrhage, (3) exercise-induced pulmonary hemorrhage (EIPH), (4) postexertional distress/heatstroke (PED), and (5) cardiac arrhythmia.

 

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WELFARE AND SAFETY OF THE RACEHORSE SUMMIT TO BE AVAILABLE VIA LIVE STREAM

The 10th Welfare and Safety of the Racehorse Summit, scheduled to be held on Wednesday, June 22, in the Keeneland sales pavilion, will be available via livestream through links at grayson-jockeyclub.org/ and on jockeyclub.com. The event is co-hosted by The Jockey Club. The previous summit was held in June 2020 as a virtual webinar series due to COVID-19.

The event will start at 8:20 a.m. ET and last until approximately 5 p.m. ET; it is free and open to the public. Topics on the agenda include an update on the Equine Injury Database, presentations about preparing the 2-year-old Thoroughbred for racing, jockey weights, wearable technologies for horses, and the use of positron emission tomography scans. The full agenda is available at grayson-jockeyclub.org/WelfareSafety/pdfs/2022/WSS_bios.pdf.

Previous editions of the summit can be viewed on Grayson’s YouTube page and have received nearly 16,000 views. Among the major accomplishments that have evolved from the previous nine summits are the Equine Injury Database; the Jockey Injury Database; the Racing Surfaces Testing Laboratory; a uniform trainer test and study guide; the racing surfaces white paper and publication of educational bulletins for track maintenance; the publication of stallion durability statistics; the Hoof: Inside and Out DVD, available in English and Spanish; protocols for horses working off of the veterinarian’s list; recommended regulations that void the claim of horses suffering injuries during a race; and inclement weather protocols.

Grayson-Jockey Club Research Foundation is traditionally the nation’s leading source of private funding for equine medical research that benefits all breeds of horses. Since 1983, the foundation has provided more than $32.1 million to fund 412 projects at 45 universities in North America and overseas. Additional information about the foundation is available at grayson-jockeyclub.org.
Contact: Jamie Haydon
(859) 224-2750

Study Links Bone Loss to Proximal Sesamoid Bone Fractures in California Racehorses

A recent study by Sarah Shaffer, Dr. Susan Stover and colleagues at the J.D. Wheat Orthopedic Laboratory at the UC Davis School of Veterinary Medicine sought to characterize bone abnormalities that precede proximal sesamoid bone (PSB) fractures and determine if pre-existing abnormalities are associated with these fractures. The group retrospectively studied cases from California Thoroughbred racehorses that died from PSB fractures, and controls that died for other reasons.

The most common fatal injury in racehorses in the United States, PSB fractures account for 45-50 percent of such injuries in Thoroughbreds, and 37-40 percent in racing Quarter Horses. The PSBs are two comparatively small bones located in the fetlock that act as part of the suspensory apparatus. Fractures in these bones are likely due to the accumulation of repeated, stress-related processes. This is supported by evidence that racehorses in intensive training are at higher risk for PSB fractures, but the exact causes are not well understood.

Other repetitive overuse injuries in horses are known to be bilateral in nature, meaning that they are similar on both sides of the horse, with the more severely affected limb usually incurring the fracture. With this in mind, the study looked at both the fractured PSB and the intact PSB from the opposing limb of the same horse for all of the cases. The researchers hypothesized that horses with PSB fractures would also show evidence of stress in the PSB of the opposite limb and that the bone that sustained the break would show more severe changes than the intact bone.

The results showed that 90 percent of fractured PSBs from the cases had visible discoloration on the surface of the fracture, most commonly (70 percent of the time) in a characteristic crescent pattern. Directly below the cartilage, evidence of bone loss was noted in 70 percent of cases. This bone loss was located in the same region as the discolorations. Fractured PSBs had lower bone volume fraction and tissue mineral density within the lesion sites than comparable locations in opposing limbs and controls. These regions were contiguous with the fracture lines. Evidence of microdamage was also observed in fractured PSBs.

Overall, changes identified in the bones were more numerous in case horses than control horses and more severe in the fractured limbs than the opposing limbs in cases. Sampling from areas of bone distant from the lesions noted no significant differences in bones from case and control horses other than the presence of a lesion.

This data supports the role of microdamage and tissue remodeling in the formation of lesions in PSBs. It is important to note that all of the horses in this study were California racehorses, so it is currently unknown if the results will apply equally to racehorses in other areas. Future studies with larger sample sizes may provide further information.

Understanding the mechanism of PSB fracture is necessary in order to determine risk factors and prevent fractures. Combining this information with advanced technology, such as the recent introduction of positron emission tomography (PET scan) may facilitate identification of horses at risk for PSB fracture and inform management alterations to avoid injury.

* This work was supported with funding from the Grayson Jockey Club Research Foundation, Inc., the UC Davis Center for Equine Health, the Maury Hull Fellowship, and the Louis R. Rowan Fellowship.

Virtual Welfare & Safety of the Racehorse Summit Concludes with Update on the Equine Injury Database

June 9, 2020

 

The ninth Welfare and Safety of the Racehorse Summit, held this year as a series of weekly webinars due to the impact of the COVID-19 pandemic, concluded today with a presentation on findings from the Equine Injury Database. The webinars were hosted by Grayson-Jockey Club Research Foundation, which had previously hosted eight in-person summits.

This week’s presentation was delivered by Dr. Tim Parkin, professor of Veterinary Epidemiology at the University of Glasgow, and the webinar was moderated by Dr. Mary Scollay, executive director and chief operating officer of the Racing Medication & Testing Consortium. Parkin described risk factors for fatal injury in Thoroughbred racehorses based on data from the Equine Injury Database. Risk factors included history of previous industry, time spent on the vet’s list, increased age at first start, changing trainers and time spent with a trainer, track surface and condition, race distance, and racing in claiming races.

“Even though we were unable to host an in-person Welfare and Safety of the Racehorse Summit, we felt it was important to offer these webinars to inform industry stakeholders and the public on the work being done to protect our equine athletes and enhance equine welfare,” said Jamie Haydon, president of Grayson. “We thank our presenters and moderators for taking the time to discuss the important work they are doing to protect equine athletes.”

Today’s webinar will be uploaded to Grayson’s YouTube channel at bit.ly/graysonchannel. All presentations from the virtual Welfare and Safety of the Racehorse Summit can be found on this page.

The virtual Welfare and Safety of the Racehorse Summit kicked off May 12 with a presentation by Dr. Katherine Garrett of Rood & Riddle Equine Hospital, who discussed the uses and advantages of different imaging modalities. She also highlighted common injuries to the fetlock.

On May 19, Dr. Dionne Benson, chief veterinary officer of The Stronach Group, moderated a panel consisting of Dr. Ryan Carpenter, a private veterinarian in California; Dr. William Farmer, the equine medical director for Churchill Downs Incorporated; and Dr. Scott Palmer, the equine medical director for the New York State Gaming Commission. The group emphasized the importance of transparency in medical records throughout a horse’s racing career.

The May 26 webinar featured Dr. Mick Peterson, executive director of the Racing Surfaces Testing Laboratory and professor of Biosystems and Agricultural Engineering at the University of Kentucky. Dr. Peterson focused on the Maintenance Quality System, which monitors track conditions. His presentation also included interviews with Glen Kozak, the New York Racing Association’s (NYRA) senior vice president of Operations & Capital Projects; Jim Pendergest, general manager of The Thoroughbred Center and director of Surfaces at Keeneland; Dr. Stephanie Bonin, biomedical engineer at MEA Forensic; and Dennis Moore, track superintendent at Del Mar and Santa Anita.

The fourth webinar was moderated by Dr. Jennifer Durenberger, The Jockey Club steward for NYRA, on June 2. This session featured a presentation by Dr. Sue Stover, professor of Surgical and Radiological Sciences at UC Davis School of Veterinary Medicine. She delved into findings from the California Horse Racing Board’s postmortem program. Stover noted that catastrophic injuries are the result of pre-existing conditions and tend to occur in predictable locations.

Among the major accomplishments that have evolved from the previous eight summits are the Equine Injury Database; the Jockey Injury Database; the Racing Surfaces Testing Laboratory; a uniform trainer test and study guide; the racing surfaces white paper and publication of educational bulletins for track maintenance; the publication of stallion durability statistics; the Hoof: Inside and Out DVD, available in English and Spanish; protocols for horses working off of the veterinarian’s list; recommended regulations that void the claim of horses suffering injuries during a race; and inclement weather protocols.

Grayson-Jockey Club Research Foundation is traditionally the nation’s leading source of private funding for equine medical research that benefits all breeds of horses. Since 1983, the foundation has provided more than $28.8 million to fund 383 projects at 45 universities in North America and overseas. Additional information about the foundation is available at grayson-jockeyclub.org.

Grayson-Jockey Club Research Foundation to hold Photo Contest to Celebrate Healthy Horses

Grayson-Jockey Club Research Foundation announced today an online photo contest for horse lovers to celebrate their equine companions.

The contest opens February 1, and entries will be accepted through February 29. Horse enthusiasts are encouraged to submit original photos of horses representing all breeds, backgrounds, and disciplines on Grayson’s website at grayson-jockeyclub.org/default.asp?section=2&area=PHOTOINFO&menu=1.

Finalists will be selected by the Grayson team, and the winning photo will be chosen by votes from the public on Grayson’s Facebook page. The winner will receive a Grayson “swag bag,” and each finalist will also receive a prize. Selected photos submitted to the contest will be shared on Grayson’s social media accounts using the hashtag #ilovehealthyhorses.

“Grayson’s mission is to improve the wellness of all horses, and we are excited to see images of people showing off the healthy horses in their lives to increase awareness of the importance of equine veterinary research,” said Jamie Haydon, president of Grayson-Jockey Club Research Foundation.

For the contest’s official rules, please visit grayson-jockeyclub.org/default.asp?section=2&area=PHOTORULES&menu=1

Grayson-Jockey Club Research Foundation is traditionally the nation’s leading source of private funding for equine medical research that benefits all breeds of horses. Since 1983, the foundation has provided more than $27.5 million to fund 366 projects at 44 universities in North America and overseas. Additional information about the foundation is available at grayson-jockeyclub.org.

EIPH Research Unveils Possible 24-Hour Furosemide Dose

Emphasis placed on strategies to control EIPH without race-day medication

Two research projects on Exercise Induced Pulmonary Hemorrhage solicited by The Grayson-Jockey Club Research Foundation and funded in cooperation with The Jockey Club, the AAEP Foundation, Keeneland Association, Oak Tree Racing Association, The Stronach Group, Churchill Downs, Kentucky Downs, New York Racing Association, The Del Mar Thoroughbred Club, Oaklawn Park, and The Thoroughbred Horseman’s Association have now appeared in peer-reviewed journals.

Knych HK, Wilson WD, Vale A, et al.
Effectiveness of furosemide in attenuating exercise-induced pulmonary haemorrhage in horses when administered 4- and 24-h prior to high speed training. Equine Vet J. 2017;50:350-355.

Bayly W, Lopez C, Sides R, et al.
Effect of different protocols on the mitigation of exercise induced pulmonary hemorrhage in horses when administered 24 hours before strenuous exercise. J Vet Intern Med. 2019; 1–8. https://doi.org/10.1111/jvim.15574

In March 2015, a special call for research on exercise induced pulmonary hemorrhage was issued by The Grayson-Jockey Club Research Foundation. Emphasis was placed on strategies to control EIPH without race-day medication. Two projects were selected. The premise of the research was to look at the post-treatment effect of furosemide (Salix, or Lasix) if it had been given 24 hours before exercise with water intake limited to maintenance water levels (which are known).

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INDUSTRY GROUPS ISSUE CALL FOR BISPHOSPHONATE RESEARCH PROPOSALS

LEXINGTON, Ky. (June 13, 2019) – Three organizations dedicated to the improvement of horse health today announced a call for research proposals to investigate bisphosphonate administration in racehorses and in young racing prospects intended for sale at public auction.

The initiative by the Racing Medication and Testing Consortium (RMTC), the Grayson-Jockey Club Research Foundation and the American Association of Equine Practitioners Foundation seeks to understand how bisphosphonates affect the long-term health and soundness of equine athletes. No research exists regarding the medication’s influence on horses under four years of age.

“The expeditious development, funding and execution of targeted tactical research will be critical to our industry’s efforts to effectively regulate the use of bisphosphonates and prevent their abuse,” said RMTC Chair Alex Waldrop.

The areas of requested research are:

  • Improving existing detection methodologies, including the potential use of alternative matrices such as hair and biomarkers in addition to the traditional testing matrices of urine and blood.
  • Understanding the effects of bisphosphonate administration on bone healing and remodeling.
  • Assessing the analgesic properties of bisphosphonates in the horse.

The complete Request for Proposals can be read here. The deadline for submission is Oct. 1, 2019.

For more information about submitting a proposal for consideration, please contact Johnny Mac Smith, DVM, Grayson-Jockey Club Research Foundation, at (859) 224-2850.

More than $1 Million in Funding Approved for Equine Research by Grayson-Jockey Club Board

New York, NY – April 22, 2019 – The board of directors of Grayson-Jockey Club Research Foundation announced that it has authorized expenditure of $1,338,858 to fund eight new projects at seven universities, nine continuing projects, and three career development awards to fund veterinary research to benefit all horses. This is the fifth straight year that more than $1 million has been approved.

“We thank our generous donors who recognize the value of veterinary research for enhancing equine health and wellness,” said Jamie Haydon, president of the foundation. “From studying a racehorse’s stride to predict injury, to testing an intrauterine antibiotic treatment, we are excited to see the results of these studies and how they may help horses of all breeds in the future.”

The 2019 slate of research brings Grayson-Jockey Club Research Foundation’s totals since 1983 to more than $27.5 million to underwrite 366 projects at 44 universities.

“Grayson’s goal has always been to support the most relevant and impactful research on behalf of the horse, and the past year has seen an increased focus on the musculoskeletal system of the racehorse,” said Dr. Larry Bramlage, partner, Rood & Riddle Equine Hospital and a member of Grayson’s Research Advisory Committee. “We are very happy to have three quality musculoskeletal projects focused on better understanding why injuries occur and how to detect and prevent them before they manifest themselves as injuries to the bones and joints of the racehorse.”

Additionally, Oaklawn Park and WinStar Farm will each be donating $50,000 in 2019 to sponsor research projects pertaining to health in racehorses. They are participants in Grayson’s new corporate membership program, whereby organizations can contribute to Grayson-funded projects. Those interested in the program should contact the foundation.

The new projects are listed alphabetically by university below:

Antimicrobial Properties of Equine MSCs 
Laurie Goodrich, Colorado State University
This study is expected to impact the equine industry by validating TLR activated equine mesenchymal stem cells as an effective, novel therapy in treating multi-drug resistant infections.

Uncovering the Blood B Cell Immune Response to EHV-1 
Tracy Stokol, Cornell University
By sequencing individual blood B cells, this research will identify changes in B cell immunity after EHV-1 vaccination and will generate a sequencing database that will uncover new antibodies against EHV-1.

Intrauterine Antibiotics may Augment Placentitis Therapy
Scott Bailey, North Carolina State University
This proposal will explore the potential for intrauterine antibiotic treatment to improve foal survival and health in mares with ascending placentitis.

Non-Invasive Evaluation of Host-Microbiota Interactions 
Canaan Whitfield-Cargile, Texas A&M
This study aims to develop a non-invasive platform to serve as a diagnostic test for gastrointestinal inflammation prior to severe disease and to reveal how bacteria in the gut influence horse health.

Standing PET of the Racehorse Fetlock 
Mathieu Spriet, University of California-Davis
This research involves validation of a PET technology for early detection of fetlock lesions in standing horses to prevent catastrophic breakdowns in racehorses.

Training Programs for Prevention of Fetlock Injury
Sue Stover, University of California-Davis
This study is designed to predict proximal sesamoid bone fracture in racehorses from a calibrated computational model that incorporates training programs, track surface properties, and bone’s reparative processes.

Racehorse Stride Characteristics, Injury and Performance
Chris Whitton, University of Melbourne
By identifying changes in stride characteristics of racehorses over time, researchers can identify those parameters that can be used as an early indicator of injury or that are key to injury development.
*Sponsored by WinStar Farm*

Robotic CT for Assessing of Bone Morphology
Kyla Ortved, University of Pennsylvania
This study strives to prevent catastrophic injuries in the Thoroughbred racehorse by screening fetlock joints using standing robotic CT and biomarker analysis.
*Sponsored by Oaklawn Park*

Kline Award Recipient

Sian Durward-Akhurst, University of Minnesota
Dr. Akhurt’s project looks at using whole genome sequencing (WGS) to create a catalog of genetic variation in the horse and quantify the number of variants predicted to have a detrimental effect on phenotype. Understanding of the genetic burden in the diverse population of the equine will help in diagnosing, determining prevalence, and lead to ways of dealing with mutation-caused diseases.

Storm Cat Award Recipients

Lynn Pezzanite, Colorado State University
Dr. Pezzanite’s project looks at the possible benefits of combining mesenchymal stem cells, known to secrete antimicrobial peptides, into traditional antibiotic therapy for control of joint infections.  If successful, this improves outcomes and reduces reliance on antibiotics to which infections are becoming increasingly resistant.

Holly Stewart, Colorado State University
Bone marrow lesions are known to be early indicators of structural deterioration of the fetlock joint.  Dr Stewart’s project looks to develop a dual energy cone beam CT scan of this area of maladaptive changes with the advantages of reduced scan times, reduced cost, and improved spatial resolution compared to conventional MRI.

Details on the new projects are available here.

Grayson-Jockey Club Research Foundation is traditionally the nation’s leading source of equine research funding. The projects it supports enhance the health and safety of horses of all breeds. Additional information about the foundation is available at grayson.jockeyclub.org.

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Lasix Study Backs Four-Hour Administration Time

Pair of Lasix studies of interest outline results.

A study that has some potential to reshape the timing of Salix administration ahead of racing determined that the current four-hour timeframe is more effective than administering 24 hours out in reducing the severity of exercise-induced pulmonary hemorrhage.

The study, led by Dr. Heather Knych, was one of two studies on Salix (furosemide, commonly referred to as Lasix) with results outlined at the American Association of Equine Practitioners convention in late November. The other study, led by Dr. Warwick Bayly, found some potential for a low dosage of Salix 24 hours out combined with controlled access to water in reducing EIPH in racing.

The Paulick Report first posted a story on the results of both studies Jan. 30.

According to the AAEP’s 2017 Convention Proceedings document, the study by Dr. Knych of the Ken L. Maddy Equine Analytical Chemistry Laboratory looked at the efficacy of administering Lasix 24 hours out, instead of the current four hours out called for in racing’s model rules. The study concluded that administering furosemide four hours before a race was more effective in reducing the severity of EIPH than going to 24 hours out.

The Knych study saw 15 Thoroughbreds administered furosemide either four or 24 hours prior to a five-furlong simulated race. Blood samples were collected before and after the simulated race for determination of furosemide, lactate, hemoglobin, and electrolyte concentrations.

One hour after the race, an endoscopic exam and bronchoalveolar lavage (BAL) was performed. Horses were assigned an EIPH score based on previously published criteria. The number of red blood cells in in BAL fluid was also determined.

“There was a statistically significant difference in EIPH scores between the four-hour and 24-hour furosemide administrations,” the study determined. The study noted that none of the treatments prevented EIPH in the horses but that reducted red blood cell counts in bronchoalveolar fluid post-race indicated that administering furesomide four hours before a race was the most effective.

According to its introduction, the study came together following anecdotal reports that suggested furosemide administration 24 hours prior to strenuous exercise could be equally effective at decreasing EIPH.

The United States is one of the few countries that allows the raceday administration of Lasix. A study showing efficacy in preventing EIPH at 24 hours or beyond had potential to reshape current raceday policy of administration four hours before the race.

In the study led by Bayly, it was determined that a 0.5 mg/kg administration of furosemide 24 hours before strenuous exercise combined with controlled access to water shows potential for reducing the severity of EIPH.

The study used six horses who underwent treadmill exercise to fatigue after seven different protocols that adjusted the dosage amount of the Lasix and timing of the administration. The study concluded that, “Furosemide, 0.5 mg/kg, combined with controlled access to water, significantly reduced the severity of EIPH,” adding that, “No ill effects were detected in the horses.”

In its AAEP presentation outline, the study noted that “Although the findings were promising, the number of horses used was small. The effects of furosemide on water and ion excretion were evident for 24 hours but did not adversely affect the horses, likely because of increased absorption of wager and ions from the colon.”

In September 2015, Grayson Jockey Club Foundation announced it had launched funding of the two projects. The AAEP also played a prominent role in funding the projects, along with a number of racetracks.

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