Hello from Cleveland Equine Clinic! I have been here two weeks and there are many interesting things to share. I spent the last couple mornings on the backside of a thoroughbred racetrack. I am convinced that racetrack medicine is completely unique in equine practice.

We get to the track pretty early, while horses are still being worked. The first challenge is staying out of everyone’s way. Jockeys are taking horses to and from the track, grooms are hand walking horses in the barn aisle. If you don’t get out of the way you’re liable to get run over; if you get too close to a stall door an ornery horse might reach out and bite you, which happened to me this morning. It’s craziness until around 10:30am when the track closes and most of the horses are back in their stalls.

The laws regarding horses racing while under the influence of drugs are strict. To prevent administration of illicit substances, the only persons allowed to possess syringes or needles at the track are veterinarians. We have to be careful to take all our syringes back to the truck; it’s illegal to leave them at the track, even in the trash. There are a lot of prohibited drugs, and the drugs that are allowed have withholding times before the horse can race and limits on how much drug can be present in their blood or urine post-race. It’s important to find out when the horse is going to race next before using sedation, local anesthetics, injecting joints, or even administering parenteral vitamins.  The only drugs that can be given to a racehorse within 24 hours of a race in Ohio are furosemide and aminocaproic acid, and they must be given at least 4 hours prior to the race. These two drugs are used to reduce the severity of exercise induced pulmonary hemorrhage (EIPH).  

So in the mornings at the track, we administer IV furosemide and aminocaproic acid to horses that will be racing that day. We also have to do treatments for horses that aren’t racing if they require any injectable drugs. We check in with all the trainers we service and see if they need anything. Frequently they ask us to do lameness exams or to inject joints. Yesterday, we examined a horse with a grade 3/5 front leg lameness. The horse was lame with a palmar distal nerve block, but sound when blocked with carbocaine at the buttons of the splint bones, indicating the problem was most likely in the fetlock. Radiographs revealed no significant findings in either the foot or ankle. The veterinarian was worried that there may be a fracture in one of the sesamoids or in the distal cannon bone, or that a fracture may occur if the horse continues to be ridden. The problem with radiographs is that they lag behind actual changes in the bone. Until osteoclasts begin to resorb the bone along a fracture line, you may not see a fracture on radiographs.  The recommendation was to do an MRI of the ankle, which could identify changes that indicate a fracture is imminent.