How new techniques for racing emergencies could make equestrian sport safer *H&H Plus*

The latest statistics from the British Horseracing Authority (BHA) show that the five-year rolling average fatality rate for horses racing in the UK now stands at the lowest on record — at 0.19%. Not only has there been a significant drop in fatality figures, but an overall decrease of 36% in the rate of long-term injuries sustained on the track. Reasons for these ongoing reductions range from improvement in the methods and standards of racehorse training to more sophisticated practices for preparing racetracks. However, one of the key factors has been the heightened expertise of the veterinary teams on duty. [subscriber-content]The BHA stipulates that a racecourse vet must attend a casualty management training course once every five years, run by the Association of Racecourse Veterinary Surgeons (ARVS) and underpinned by the BHA. Both societies now recognise the need for more training, however, on an annual basis, to ensure vets have the necessary skills and equipment to respond appropriately. And that training should involve not just the vets but the whole racecourse team — the doctors, paramedics, ground staff, horse ambulance and screens teams, stewards and the clerk of the course. This training is being carried out by the ARVS in association with the British Animal Rescue and Trauma Care Association (BARTA). As part of the new BHA initiative, an appraisal system will also be in place to ensure all racecourses meet minimum standards of veterinary care, protocols and equipment. While the training is geared to the racetrack, these skills and techniques can be used in everyday emergency practice and are transferable to event cover in a range of equestrian sports. Race against time An important part of the training deals with how to work safely around the recumbent horse. It is never acceptable to expect a point-to point fence judge to grab the leg of a fallen horse to help him roll over. The thrashing head and limbs of a struggling horse can be extremely dangerous to the assisting team or an injured jockey in close proximity. If a jockey is trapped under a horse, doctors, vets, ground staff and the person controlling the incident must work together as the situation unfolds. The vets use clear protocols to respond rapidly, working with the medical team to ascertain the best method and direction in which to move the horse. This type of incident can be life-threatening for the jockey and has occurred on occasion in both racing and eventing. Following a relatively recent racing incident, vets are aware that the situation may require giving the horse general anaesthesia and fully assessing his injuries only once the rider has been safely removed. The quickest, safest method of moving a horse away from an injured or trapped jockey involves the use of strops. Trained groundstaff using a specially designed metal “introducer” will place these webbing straps in specific positions under the horse’s body, according to which way he needs to be moved. There may not be time to wait for a tractor to arrive to help move the horse. With two or three people on the end of each strop, a horse can be moved quickly. These techniques rarely need to be used, thankfully, but when they are required the whole operation must be very slick. Training must, therefore, be repeated at intervals throughout the year. Another useful piece of equipment is a glide, a type of drag mat used to transfer an anaesthetised horse up the ramp into an ambulance and to an area for veterinary assessment. Injury assessment On occasion, there may be uncertainty about the type and severity of injury a horse has sustained. Vets are now trained to obtain a second opinion as necessary while the horse is in situ, or to apply a support system to an affected limb so that he can be transported off the course to the veterinary treatment room to be reassessed. Modern digital radiography (DR) and scanning equipment allows immediate email or WhatsApp communication to a specialist orthopaedic surgeon, for guidance as to whether a fracture is repairable and the long-term prognosis. Many more lower limb fractures can now be repaired, but welfare of the horse has to be the top priority throughout Better support systems for travelling horses with limb fractures to referral centres are also more widely and effectively used — for example, a cast or a Robert Jones bandage, or a variety of splinting techniques. Screens erected around an incident do not necessarily indicate that a serious injury has occurred. They are used primarily to provide a quiet, safe and private place for the vet or doctor to carry out their assessments. Regular training for the screens team is essential, so they know how to position them correctly. Euthanasia on the racetrack is a sensitive issue, but it is sometimes essential for the welfare of a horse who has suffered a fatal injury. The method of choice is no longer a firearm, but intravenous chemical euthanasia. Sedatives and euthanasia solution should be ready, as this facilitates the procedure when it is required. Major incident management also forms part of annual training. If a fire breaks out in the stables, for example, the racecourse team must assess the direction in which it is progressing before starting to move the horses to safety in an appropriate order. This requires a lot of manpower; there may be more than 100 horses attending the meeting, with each travelling groom in charge of more than one horse. Opening the stable doors might be the first reaction, but loose horses galloping around — and possibly in the dark — would be a danger to themselves and others. Each needs to be led out individually and may require veterinary sedation, hence the need for a large volume of sedative to be available. A contingency plan must also be in place for the treatment of injuries and burns. Beating the heat The provision of improved cooling facilities at racetracks across the UK has been a focal point of the new appraisal system. Factors that contribute to heat stress include sub-optimal fitness, high ambient temperature, high humidity and longer-distance jump races over undulating tracks. Some horses seem to be more at risk than others and are now flagged up to the on-course vets at each race meeting by the BHA veterinary officer. Heat stress can be life-threatening. Signs typically develop some minutes after racing, as the heat in the horse’s body builds up, and include rapid breathing that fails to recover, agitation, incoordination, kicking out and drooping of the head with the ears held to the sides. Treatment involves applying large volumes of cold (iced, if possible) water to the horse’s whole body, to promote heat conduction through the skin. The vet may administer anti-inflammatory agents and sometimes intravenous fluids as emergency treatment. Believe it or not, we occasionally experience warm weather conditions for the four-mile-long Eider Chase, which is held each February at Newcastle Racecourse and considered by some as a trial for the Grand National. Last year, a horse began to show signs of heat stress upon arriving in the parade ring after the race. The management of this case required a large number of people to erect and hold screens and to administer veterinary treatment. At the same time, more people provided a continual supply of buckets of cold water to apply to the horse for around 20 minutes, until he recovered sufficiently to be walked safely back to the stables. About this author: Lesley Barwise-Munro MRCVS, from Alnorthumbria Veterinary Group, Northumberland, is the senior vet at Newcastle Racecourse, and attended the London and Rio Olympics and World Equestrian Games as an FEI treating vet. Visit: alnorthumbriavets.co.uk, 01670 897597 [/subscriber-content]