Everyone at a racetrack holds their breath when a horse pulls up. It was true before the fatality spike at Santa Anita Park in 2018-19, and it's even more true now that every on-track injury feels like a liability for the sport. Veteran horsemen have long felt they could guess, as they get closer to the solemn scene, whether they think the injured horse is going to make it or not. In those moments when they believe there is no salvation to be had, most of them say the kindest thing to do is to end the horse's suffering as quickly as possible.
A recent initiative at The Stronach Group racetracks has been pushing the boundaries of that assumption – but not everyone is happy about it.
Taking the finances out of the equation
Two years ago, Stronach Group management was looking for whatever solutions it could find to the breakdown problem at Santa Anita. Facing what was an enormous public relations crisis, the company needed fewer dead horses. Its executives implemented a flurry of new protocols, including rolling back administration times for various therapeutic drugs, increasing veterinary oversight, and reducing whip use. Around that time, the company also began exploring the idea of funding surgeries on injured horses.
“As we looked around, we said, 'If we take the financial piece out of it, what decisions do people make?'” said Dr. Dionne Benson, chief veterinarian for 1/ST Racing, The Stronach Group's racing brand. “You look at a horse like ArchArchArch, who broke down in the Derby, got a fetlock arthrodesis and [became] a breeding stallion. Those are no-brainers for people because they want the residual value of the stallion. But often if you've got a gelding that's running for $5,000, there's an economic decision that's made. We wanted to allow people to make the decision for the horse while taking some of the economic burden away.”
Orthopedic surgery and subsequent care can cost thousands of dollars, and costs increase exponentially based on the complexity of the injury and the smoothness of recovery. Benson and others worried that there were cases of owners or trainers looking at the prospect of operating on an injured horse as a money-loser, and choosing to euthanize – even in cases where the horse might have had a productive life in retirement. She also wondered how many horses were euthanized without significant diagnostics to even find out if they could be saved. Benson said she heard of one case – not at a Stronach track – where a horse was euthanized after pulling up lame with a sizable bump in the leg, which veterinarians assumed was a serious fracture. Only upon conducting a necropsy did they learn it was a hematoma.
Santa Anita is unique in that it has a fully equipped equine hospital on-site, so it's logistically easy to assess and operate on a horse with an orthopedic injury. Benson consulted the best orthopedic surgeons in the country, including Dr. Larry Bramlage at Rood and Riddle Equine Hospital in Kentucky and Dr. Ryan Carpenter, who operates at Santa Anita, looking for guidance on what makes for a good surgical candidate and what doesn't.
Then, the racetrack began funding veterinary care in cases where owners wouldn't or couldn't. In the past year and a half, Benson said The Stronach Group has paid for veterinary care on a variety of injuries, including some serious wounds, a bilateral condylar fracture, cannon bone fractures, and sesamoid fractures. The track was willing to pay for surgery even in cases where a referring veterinarian may have suggested euthanasia. So far, it has paid for surgery for 17 Santa Anita-based runners since the start of 2020, and 13 are alive and well – which Benson considers a solid success rate, assuming those horses may have otherwise been euthanized by their connections. From those 17, there were 11 fetlock arthrodesis surgeries, where a serious sesamoid fracture is repaired by fusing the bones in the ankle joint. Eight of those horses are still alive and doing well. For horses who would otherwise be dead, Benson said she's comfortable with those outcomes.
That early success rate prompted The Stronach Group to expand its surgical assistance program to its tracks in Maryland and Florida. In lieu of on-site surgery suites at the racetracks there, The Stronach Group has implemented partnerships with Rood and Riddle and the University of Pennsylvania to refer surgical candidates.
Currently, Benson said if a horse sustains an injury on track, the horse's treating veterinarian and trainer will typically put a splint on the injured limb, administer sedation and pain relief, and take the horse back to its stall for evaluation. Someone from The Stronach Group veterinary team will reach out and ask for diagnostic images on any horse who does not have a fracture coming through the skin and does not have injuries to more than one limb (with one exception in California). Horses with those injuries are not considered good surgical candidates. The track then offers to send those images to Drs. Carpenter, Bramlage, or Rood and Riddle surgeon Scott Hopper for a consult. If the surgeon tells the racetrack and connections they think the horse has better than a 50/50 chance at eventual pasture soundness with surgery and the horse's owner doesn't want to proceed, they are offered the opportunity to sign the horse over to The Stronach Group.
Dr. Ryan Carpenter
All of this takes time, but it's time Carpenter says he would normally give a horse anyway before deciding whether to proceed with surgery. Perhaps surprisingly, he says that the main indicator of whether a horse will do well with surgery isn't a matter of how gnarly their radiographs look – it's about the amount of swelling and blood supply they have to the area. Independent of this program, he often waits until the day after an injury before assessing a horse's fitness for surgery because that's when it'll be most clear how the blood supply responded to the injury.
Carpenter said he has learned from the past two years of the track-funded surgery in California that the responsiveness of on-track emergency personnel is key to a horse's chances. While a horse with a fracture wears a Kimzey splint in the trailer ride from the track to the barn, Carpenter prefers to remove it at the barn, take the necessary images, then wrap the leg and put the Kimzey back on as quickly as possible. That extra compression and support from the bandage can significantly reduce swelling, and even a few minutes' difference can have a massive impact on how the horse's blood supply reacts to the injury later.
While the program has been going full strength in California for a year and a half, it was implemented much more recently at Stronach Group facilities in Florida and Maryland. In Maryland, three horses have been sent to surgery at New Bolton Center by the track, and all three have lived. One was a spiraling medial condylar fracture on a hind limb that needed a plate. The referring veterinarian suggested euthanasia, but the surgeon said the horse had a 50 to 60 percent chance to return to racing. After seeing the surgeon's report, Benson said the horse's connections decided to proceed with the surgery themselves.
In Florida, Benson admits the results haven't been as strong; surgical success rate is at about 50 percent.
Not everyone is on board
The Paulick Report has interviewed a number of horsemen and veterinarians with direct and indirect knowledge of The Stronach Group's program to fund surgeries. All declined to speak on the record for fear of retribution from racetrack management, and most expressed serious concerns about the ethics of the program.
For horsemen who had not had a horse injured on track since the program came to their state, there seemed to be little concrete information provided by the racetrack about how it would work. Many had the impression the track was strong-arming trainers into signing over ownership of the injured horses (an allegation Benson denies), playing on their fears of losing stalls. They also had no access to information about the outcomes of injuries they'd witnessed and believed or assumed all or most horses trailered to nearby clinics for surgery had died.
People who had been involved with an on-track injury confirmed the track is not exerting pressure on connections to sign horses over, but did say they had serious concerns about whether the decision to send particular horses to surgery had been fair on the animal.
For horses that go through a complex surgery and long recovery from a procedure like a fetlock arthrodesis, many people questioned those horses' short- and long-term quality of life, along with the associated cost to care for them. Benson said that horses who had been saved by track-funded surgeries in California were placed via the California Retirement Management Account (CARMA) if they were only pasture sound. The track has committed to following those horses throughout their lives to ensure that, given the relatively limited vocational options for some, they didn't fall into a bad situation.
Carpenter said skepticism of the program in the case of serious injuries like sesamoid trauma likely comes from an outdated notion of what a surgical repair, like a fetlock arthrodesis, entails. Dr. Dean Richardson at New Bolton has perfected the procedure in recent years with new materials, cables and locking plates, and new approaches to the incision sites that make the surgery shorter, less complicated, and more likely to achieve a positive outcome than it did a decade ago.
“You have to acknowledge that just because we're done things a certain way for a long time, that doesn't mean that's the way we will continue to do them or should continue to do them,” said Carpenter. “An arthrodesis done today has a far better chance of survival than an arthrodesis done 10 years ago. but the perceptions of people today are often based on the perceptions of the past.”
This horse suffered serious wounds in a freak accident at Laurel when he reared and fell onto an iron fence. The Stronach Group funded his care, and he is ready to leave the hospital and begin rehabilitation.
He's also troubled by the number of people who seem intent on euthanasia in cases he thinks don't warrant it, including career-ending sesamoid fractures on horses without residual value in the breeding shed. While the critics of the program believe they are coming from a place of kindness, Carpenter believes he is, too.
“This is one where if it was American Pharoah, everyone would be cheering 'Give this horse a chance,' but when it's a $10,000 claimer, everyone's cheering 'Put it down,'” he said. “That, I don't understand. A horse is a horse. If it's good enough for American Pharoah and humane enough for American Pharoah, then it's good and humane enough for the $10,000 claimer that no one knows their name.”
But as the program expands to other states and continues over a period of years, a greater success rate will mean there will be more horses that need that kind of care and monitoring. Some have wondered whether it's fair to salvage a horse for pasture soundness, only to pass on the costs for the remainder of its 15 to 20 years of life to a non-profit or a well-meaning adopter. Private home placements for pasture ornaments are hard to come by, which is why there are so many retired horses in sanctuary facilities already.
The question asked independently by nearly everyone who expressed concerns to this publication was also – is The Stronach Group doing this out of the kindness of its corporate heart, or to reduce fatality numbers? Horses are considered racing or training fatalities for the purposes of the Equine Injury Database (EID) if they are euthanized due to injury within 72 hours of incurring the injury.
Benson said this isn't the motivation behind the program, and that horses vanned off and euthanized in the 72-hour window are reported by The Stronach Group to the EID as racing or training fatalities. In California, the horse racing board keeps its own records on racing and training fatalities and follows up with necropsies and post-mortem reports as part of state regulations. In Florida, on-track deaths are supposed to be reported to the Division of Pari-Mutuel Wagering, but it seems from public records as though those reports are made voluntarily by a trainer or treating veterinarian, not a state representative keeping independent track of deaths.
It's also true that the track's desire to give an injured horse a chance does, by default, create the opportunity to reduce fatality numbers – and those numbers are better in all three states since the surgical program and other reforms were implemented.
“We have reduced the number of racing related fatalities in Florida and they are consistent year over year in Maryland to date,” said Benson. “In training, we have reduced horse fatalities (on-track musculoskeletal and sudden deaths) by about half in both Maryland and Florida year over year. Additionally, while I cannot speak for Florida generally, we enter all fatalities and injuries to horses in the EID for our tracks and training facilities located there. Moreover, every horse that dies or is euthanized at Gulfstream Park or Palm Meadows is sent to necropsy at our expense. This has been the case for over a year.”
Benson and Carpenter agreed that those concerns voiced by horsemen in Florida and Maryland are nothing new – they heard them when they launched the program in California. Both now say that referring veterinarians and horsemen in California are on board with the program, largely because they've seen horses move on to second careers or achieve pasture soundness. They remain confident that eventually, their success at other facilities will convince the naysayers.
“I acknowledge the fact that what we're doing here in California is not going to be widely accepted in other states,” said Carpenter. “I think we're a little bit ahead of the curve and part of that is because of what we endured in 2019.
“What I saw very quickly in interacting with people who don't know anything about racing, is that every single fatality is significant. When you make the comment that 'This year we've only had 30 [fatalities]' — which from an industry standpoint is amazing — the people are still appalled because that's still a very, very big number.”
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