Championship care

Two eminent veterinarians discuss how advances in the management and care of top racehorses have ultimately improved the lives of all horses.
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Two eminent veterinarians discuss how advances in the management and care of top racehorses have ultimately improved the lives of all horses.

You might not think that your horse has much in common with American Pharoah or the other 11 horses who’ve won the Triple Crown. And in the most obvious ways you’d be right.

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But where it matters most, the daily care that keeps your horse healthy closely parallels the management practices that help elite equine athletes perform their best. That’s because, for the most part, “racehorses are a unique population, but they are still horses,” says Reynolds Cowles, DVM, a Virginia veterinarian who has spent much of his nearly 50-year career serving racehorses both in the barn and on a myriad of safety and research advisory committees. Through every era, from Sir Barton’s Triple Crown in 1919 to American Pharoah’s this year, race-horses have had the same basic needs: a balanced diet, ample fresh water, proper conditioning, expert farriery care---the very same things we all strive to provide our horses.

And while your horse won’t be competing for million dollar purses or logging thousands of miles of transport across the country, if he becomes ill or injured he is likely to benefit from treatment advances originally devised for equine athletes who do. “We will talk about these great innovations coming from the racetrack, but they quickly filter out to benefit horses in all occupations,” says Cowles. After all, the bulk of research dollars and efforts are targeted toward the needs of racehorses---and nearly all innovations move beyond that sport to benefit horses far and wide.

Renowned equine orthopedic surgeon Larry Bramlage, DVM, has seen this firsthand. “Improvements in the care of racehorses ultimately translate into improvement for all horses,” says Bramlage, who has helped care for many top racehorses throughout his 40-year career.

With this in mind, we commemorate American Pharoah’s Triple Crown victory by sharing insights from Cowles and Bramlage on how veterinary care for racehorses---and by extension all horses---has progressed since Sir Barton won the first crown in 1919. It’s an interesting perspective on how far we’ve come in all corners of the horse world.

Progress in injury care

The primary health concern for racehorses 100 years ago was musculo-skeletal injury, and it still is today. Just as in the past, tendon, ligament and bone injuries are the most common reason for the premature end of racing careers. How those injuries are identified and managed, however, has changed dramatically over time.

“In the early Triple Crown years you could rely only on a very attentive groom to notice when a joint was swollen or a horse was a bit ‘off’; then you’d get the veterinarian, who had limited options,” say Bramlage.

What was missing in the first few decades of the 20th century was, for starters, diagnostic tools. “Before the end of World War II, you couldn’t x-ray a horse in the shedrow,” says Bramlage. “X-ray machines were available for horses, but nothing was both mobile and sturdy enough for any type of practical use at the track itself. Portable x-ray machines were developed for use in wartime, and that technology, like a lot of things, eventually spun off into horse care. Today we regard an x-ray as basic care when a horse has a swollen joint. We use it early in the diagnostic process, and it allows us to identify problems and get ahead of them. But before 1946, the year Assault won the Triple Crown, that was an impossibility.”

Treatment options for musculoskeletal injuries were also limited in the first few decades of the 20th century. Even icing horses was challenging in the 1920s and 1930s because that most ubiquitous of modern appliances---the freezer---wasn’t in widespread use until the 1940s. Trainers and veterinarian instead turned to methods we’d consider barbaric today.

“They ended up using a firing iron and blisters for a lot of things,” says Bramlage. “They had nothing better to use.” “Pin firing” involved pressing a hot iron against the tendon area. Blistering was done by applying an irritant chemical on the area. Both were intended to trigger massive inflammation and jump start the healing response.

These practices did have some foundation in physiology, says Bramlage. “The idea was to increase blood flow to an area by irritating it. It’s not without any basis because that will happen, but we have become so much more sophisticated today and know there are better ways to accomplish the same thing. Trainers will still use liniments but rarely to the point of blistering that damages tissue. Pin firing horses has steadily declined since the mid-1970s because better methods are available.”

Medications have also made a significant difference in the management of musculoskeletal injuries in racehorses. “In the late 1960s, anti-inflammatories came along,” says Bramlage. “Phenylbutazone0 was a huge advancement. Then came corticosteroids0, injected systemically and intra-articularly. Horses in the first half of the Triple Crown era never had a joint injected, and then suddenly we had a way to halt inflammation in its tracks. It seemed like magic.”

There was a downside to these innovations, however. “Used wisely, all of these medications are great for the horses,” continues Bramlage. “But of course, with them came the potential for abuse, which I think happened in the early 1980s. Too much of anything can be a bad thing. More recently we’ve realized this and I think we are approaching a point where we are using them more sensibly and appropriately.”

Advances in managing respiratory disease

The second biggest health concern in racehorses of any era has been res-piratory illness. “Most racehorses are going to get respiratory disease at some point in their life,” says Cowles. “That’s been true for decades. The difference today is how we treat them.” In the first decades of the 20th century, a racehorse who contracted a respiratory illness would receive supportive care and be given a layoff to allow his immune system to do its work. “Essentially, you turned the horse out and hoped for the best,” says Bramlage.

Today, an arsenal of drugs is available to tackle infection head-on. “Antibiotics were another significant veterinary innovation to come out of World War II,” says Bramlage. “Prior to the war, there were sulfa antibiotics, and they were effective in horses but prohibitively expensive. Only after the war did they become a more common option for a sick horse.”

Laboratory work has also been a major advancement, allowing positive identification of pathogens for careful selection of appropriate and effective drugs. “We do a much better job at treating bacterial infections thanks to vastly superior laboratory capabilities and monitoring,” says Cowles. “This is literally a lifesaving difference for many racehorses.”

Of course, preventing disease is easier than treating it, but that wasn’t an easy proposition either until relatively recently. “Vaccines against many of these diseases weren’t even available until the early 1960s,” says Cowles. In other words, the first Triple Crown winner to be given anywhere near the same slate of vaccines your own horse receives was Secretariat.

Considering the profound difference antibiotics and vaccines have made on the health of racing horses, you might wonder how horses in the early 20th century stayed healthy enough to make two or three times as many starts as today’s racehorses. Cowles explains: “Back then you had more dilution of the population, fewer horses and less concentration of them in specific areas. As a result, the spread of infections was not as fast as it is today.”

The approach to another significant respiratory concern of racehorses changed even more recently, thanks to developments in imaging technology. “It wasn’t until the late 1970s that the endoscope0 came along,” says Bramlage. This, he says, allowed for investigation of “bleeding” (exercise-induced pulmonary hemorrhage), which is the presence of blood in the airways of horses after intense exercise: “Years ago, there was no understanding of what the blood meant or even where it originated from. Grooms carried a red towel and just wiped it off.”

The invention of the cold light source in the 1970s led to the development of the endoscope, a flexible tube carrying fiber optics that can be passed down a horse’s airway to view the inside of his lungs. Now there are tiny cameras that transmit images back to a screen in real time, even as the horse is worked. Using these advances, researchers discovered that the blood was coming from deep in the lungs and related to changes in pressure as the horse exerted himself. “We also learned that it’s a fact of life with hardworking horses,” says Bramlage, “but something we need to monitor.”

A more mobile population

The life of a modern-day racehorse includes extensive travel. This wasn’t always the case, and that change had a ripple effect on the sport and the health care of the horses in it.

“You didn’t ship horses that much in the early days of the Triple Crown,” says Bramlage. “Horses moved principally by railcar and not all that often. They tended to stay in one place for an entire racing season.” The weight handicapping system of Thoroughbred racing was developed of necessity to keep up bettor interest in a static population of horses.

“For instance,” says Bramlage, “you’d have a group of horses who went to Chicago to race for the summer, and they spent the entire summer there as a group, with few new horses coming in. It was likely that one of those horses was going to be the best and consistently beat the other horses. That would make for a very boring and predictable summer for all the bettors. So they would handicap the better horses by having them carry more weight. That way the other horses had a shot at beating them, and the races were more interesting.”

Less transport back then meant more time for horses to rest. “Racing wasn’t year-round, and the horses had planned breaks, which in some ways was good for the horse, but also had drawbacks,” says Bramlage. “Two months doesn’t cause much concern for a fit horse’s skeleton. But, a horse can lose a lot of fitness once you go beyond three months of total break, and you have to work to bring him back to that level to race again. Prolonged breaks with no exercise lead to more injuries and illness. In some ways you could argue that it’s better to keep a horse in some level of fitness throughout his career.”

The semi tractor-trailer came along in the 1950s, making it easier to move horses to tracks around the country. “I took my first load of horses from Kentucky to Virginia in 1963,” says Cowles. “The development and evolution of the gooseneck since then has revolutionized a lot of horse shipping, making it much easier on the hauler, and in some cases the horses, particularly for small loads.” By the 1980s, shipping horses via airplane became practical.

“Today, the ease of transportation for the elite racehorses assures that if you are the best horse in Chicago and a big race comes up, horses are going to be flown in from around the country and Canada to run against you for that prize,” says Bramlage. “Handicapping is still done, but the span of the weights has narrowed considerably with the ability to move horses easily and create competitive fields.”

As far as the health of the highly traveled modern racehorses is concerned, Cowles says a focus on preventive medicine is key. “Horsemen across the board today have an increased awareness and desire to prevent problems and not just treat them. I’ve seen this increase over the course of my career. We are more attentive as far as husbandry is concerned and the horses, on and off the track, are better off for it.”

Improvements big and small

You don’t have to look far to find even more positive advances in the care of elite equine athletes of any sport.

“One of the most dramatic changes in veterinary care over the last 40 years, I think, is advances in anesthesia,” says Cowles. “Four decade ago horses didn’t recover very well at all. The development of inhalation anesthesia and other agents have allowed surgeons to do dramatically better work. Procedures that would have been very tough on horses can now be done easily and safely. That means we can fix and prevent things we couldn’t even address before and do a lot of fine surgery.”

Bramlage includes nutrition in the advancements in racehorse care that have made a difference. “Feeds are much better than they used to be,” says Bramlage. “Back in the early years, horses were fed straight oats and hay. Those were the only options, and the horses did well enough on those. It’s important to understand that changes in agriculture have altered grains. Oats used to be slow growing, and they absorbed more trace minerals as they grew. Today, oats are cultivated to have more energy per bushel, but the vitamin and mineral content is lower than it used to be.” As a result, he says, many modern trainers opt for commercial grain mixes, often adding supplements to create customized mixes. “Each trainer has their own feeding program and each one will tell you that theirs is the best.”

Hoof care, says Cowles, has also undergone considerable improvement. “Horses are shod similarly to how they were in the early Triple Crown years, but we’ve seen advances in farrier science. Horses today have more balanced feet. We know the extreme long-toe, low-heel conformation that was popular is a risk factor for injuries. I’ve also seen an increase in cooperation between farriers and veterinarians over the course of my career. We’re working together now more than ever.”

Some advances in the management of racehorses aren’t medical, per se, but still have had a profound effect on their well-being. “We handle horses differently today,” says Cowles. “Natural horsemanship techniques have been adopted from many Western trainers who have made their way to the track. Trainers use them to teach horses to settle into the starting gate or load calmly into vans and trailers. With these techniques they are trying to understand the horses better and responding to their needs. The horses are happier, and ultimately healthier, as a result.”

Your own horse may never gallop down the home stretch as thousands of fans roar in excitement and joy, but that doesn’t mean he’s not worth the best veterinary care available. And chances are, he’ll get it. Many of the advances in care that “average” horses benefit from have, in fact, come from the racetrack, co-opted and pursued by owners who will never make headlines or millions but instead find their payday in a field of healthy, happy horses.

This article first appeared in EQUUS issue #458, November 2015.