Veterinarians Respond To Findings Of Large-Scale Study Into Radiograph Findings At Thoroughbred Auctions

Earlier this year, the first results were published from a massive study of sale radiographs that began in 2016. Commercial consignors (and their veterinarians) have long complained that it's difficult for buyers at public Thoroughbred auctions to know how much weight to give to certain common findings on pre-sale radiographs. The popularization of consignor-furnished radiograph reports at the barn has made this particularly challenging.

Read our previous reporting on the difficulties – and liabilities — of consignor-furnished radiograph reports.

In 2016 and 2017, a group led by researchers at Colorado State University examined the sale radiographs of horses at yearling and 2-year-old sales to establish how common certain types of radiographic findings were, whether the same horses' findings changed from one year to the next, and how much of an impact those findings had on a horse's likelihood to make it to the races. The team looked at repository images for 2,508 yearlings at Keeneland September in 2016 and 436 2-year-olds at multiple juvenile auctions the following year, rating images for the presence of subchondral lucencies in stifles and sesamoiditis.

The results of that study were released earlier this year and showed that the majority of findings made no significant difference in a horse's likelihood to race. Even horses with subchondral stifle lucencies rated as Grade 3 lesions (Grade 0 being the absence of findings, and Grade 1 being the most mild findings) were not statistically less likely to race than those with Grade 0 ratings. When looking at sesamoid findings, only horses with Grade 3 sesamoid lesions saw any significant impact on performance; lower grades fared no differently than horses with zero findings in their likelihood of racing. Some 72 percent of Grade 1 vascular channel changes in yearling sesamoids had disappeared by the time the horses went to sale as 2-year-olds.

Read our previous reporting on the results of the radiograph research.

Last week, the Consignors and Commercial Breeders Association hosted a presentation at Fasig-Tipton reviewing the results of the research, followed by a veterinary panel to discuss the impact the research will have on their work.

Below are a few takeaways from the panel discussion.

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–The researchers had to construct a Grade 0 to Grade 3 scale to describe the presence or severity of sesamoiditis findings in yearling radiographs because there wasn't previously a universally-embraced system for describing this particular set of findings. Veterinarians have instead used words like “mild,” “slight,” or “moderate” when describing what they see, which may be used or received differently by vets and clients. Dr. Scott Pierce, veterinarian and shareholder at Rood and Riddle Equine Hospital, said the scale alone will make his job easier if it's adopted broadly.

“It adds a lot of clarity to what we do,” said Pierce. “We all know that sesamoiditis is way over-diagnosed. If we can have clarity, which we seem to have in this, it's easier for us to be able to describe the actual lesion and the actual disease and be able to give a prognosis for those in racing.”

Pierce noted the study found that 85 percent of horses were normal, but he sees more than 15 percent of radiograph reports suggesting a given horse may have indications of sesamoiditis, which contributes to his belief that it's over-diagnosed.

Equine Medical Associates' Dr. Jeff Berk, who moderated the panel, suggested that the usefulness of a more commonly-used scale to describe sesamoiditis was less about language choice for the radiograph report kept by the consignor in the shed row at auction and more about uniformity in the language a vet may use with a buyer when presenting their opinion of a set of images.

 

–Dr. Scott Hay of Teigland Franklin and Brokken said the study mostly aligned with his viewpoints that more minor sesamoid findings aren't likely to be an issue, but more serious lesions that would be considered a Grade 3 under this system should be approached with caution.

Hay looks forward to an additional release of data which is expected later and will look at ultrasound scans of the suspensory ligaments alongside the radiographic sesamoid findings.

“I can tell you that I've had horses that although they improved radiographically, still had suspensory sesamoid issues as 2-year-olds, so that's a little scary,” Hay said.

 

–Pierce expressed surprise about one finding from the study, which indicated the average age of first start for horses with Grade 3 sesamoiditis was still in the 2-year-old year, and only a few weeks later than horses with less severe findings.

“I basically go in with those and say they'll be 3-year-olds, so I was a little surprised about that,” he said.

 

–Dr. Nathan Mitts of Peterson & Smith wondered whether veterinarians and managers tend to handle horses with sesamoid findings too conservatively in hopes of safeguarding the bone, and is hopeful that the study data can encourage a reconsideration of that approach.

“I think I've seen too many horses have exercise restrictions because of moderate sesamoiditis that, if we can continue to follow that up, maybe that's not a significant risk factor,” said Mitts.

“I find with my clients that with horses we felt were in the stall for more days than some of their pasturemates, that's probably a risk factor as much as anything, because the soft tissue isn't allowed to develop and the bone density doesn't develop. So then, when we go to train on them in Ocala, they don't hold up for one reason or another. It may have nothing to do with the sesamoid we're looking at.”

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–Regarding the stifle portion of the study, Pierce found it encouraging that few horses saw stifle lesions worsen from their yearling sale to their appearance in 2-year-old sales, and that none with Grade 1 lesions ended up with Grade 3 lesions later.

“I think the biggest takeaway of all in this study for me was the Grade 3 stifles,” said Dr. Michael Hore of Hagyard Equine Medical Institute. “We were always kind of taught that a big medial condyle cyst was big and bad and just stay away from it. Now we can see here that the punishment doesn't fit the crime. Some of these horses are maybe at 5 to 10 percent increased risk of not making a start but those horses are getting devalued by 90 percent or 100 percent; they're just getting given away. So I think the big message from this is that it's ok if you're willing to take a little more risk to buy these horses with these cysts.”

Hore said he's seen success with horses who have undergone surgery for some cysts and gone on to racing success.

 

See a replay of the full presentation of the research and the veterinary panel here:

The post Veterinarians Respond To Findings Of Large-Scale Study Into Radiograph Findings At Thoroughbred Auctions appeared first on Horse Racing News | Paulick Report.

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