Risk factors for being an unsuccessful two-year old race horse Student: Studentnr.: Address: Phone-nr: E-mail: Sanne Willemien Steenhuisen 0249084 Hoogdorperweg 17D 1965NB Heemskerk The Netherlands 0031(0)6-27530273 the_only_sanne@hotmail.com Location of project: Local supervisor: Supervisor at UU: Planned initial date: Duration: Massey University, Palmerston North, New Zealand Dr. C.W. Rogers Prof. P.R. van Weeren 17-7-2008 12 weeks Abstract Background The primary reason for the loss of horses from training and racing is musculoskeletal injury, especially dorsal metacarpal disease. Research has shown that the occurrence of injuries is related to the intensity of the exercise programme. Short periods of high speed exercise in the training seem to be beneficial, as especially bones can adapt to the high speed, so horses are better prepared for racing speeds. Aims To describe the differences between horses who go straight through training as a twoyear-old and horse who have interruptions in their training. Methods The data, containing 597 two-year-horses, were obtained by Perkins over a 34-months period from October 1997 until July 2000. For every horse the training activity score (TAS) was recorded, as well as the amount of days it had spent in that TAS. Different TAS were: TAS 1= spell, TAS 2= walk/trot, TAS 3= canter, TAS 4= gallop/high speed exercise, TAS 5= starting in a race or trial. Also recorded were the reasons why horses were put on a spell; voluntary or injury related. Results The two-year-olds were divided in three different groups: “Good” horses (n=279, no spells), “Voluntary” horses (n=144, just voluntary spells) and “Involuntary” horses (n=132, at least one injury-related spell). There was a significant difference between the good group and the voluntary/involuntary group in TAS already at the start. The voluntary and involuntary groups both had a big dip in TAS at the beginning of training, but after that the voluntary group went significantly faster to reach TAS 5 than the involuntary group (p<0.05). Of the voluntary group 50% of the horses reached TAS 5. Of the involuntary horses only 30% reached TAS 5. Of all the horses that reached TAS 5, the good horses (median=114 days) were significantly faster (p<0.01) to reach TAS 5 than the voluntary/involuntary horses. There was no difference between the voluntary (median=244 days) and involuntary groups (median=244 days). Voluntary horses were faster to reach their first spell than involuntary horses (p<0.01). Both groups had their first spell early in the training. Involuntary horses had more than one spell more often than voluntary horses. In the good group, older two-year-olds were faster to reach TAS 5 than the youngest (p<0.01) and middle (p=0.028) groups of two-year-olds. In the voluntary group, the middle group of two-year olds were faster to reach TAS 5 than the early two-yearolds (p=0.014). Horses that were born in the year 1995 were faster to reach TAS 5 than horses born in the year 1996 (p=0.013) and the year 1997 (p=0.003). 2 Conclusions The critical point of horses ending up in a group is early on in the training. Trainers may have a good view on whether a horse is going to be a good one and they will train such a horse quickly up to TAS 5. Voluntary horses might be the horses that are obviously not ready to cope with the training and are put on a spell by their trainer. Involuntary horses could be the horses that the trainers were in doubt about whether to put them on a spell or not, then were trained further and subsequently sustained an injury. When in doubt it would therefore be wise to put the horse on a voluntary spell, as horses in this group have a much higher chance of reaching TAS 5 and a lower chance of being put on another spell, than horses in the involuntary group. Late two-year-olds have an advantage on younger two-year-olds. This could be due to these horses being stronger and more developed or having received more pre-training. There is an effect in the year of birth the horses were born in. This shows that factors such as weather and track conditions have their influence. 3 Table of contents INTRODUCTION ..................................................................................................................................... 5 Wastage in general ......................................................................................................................... 5 DMD ............................................................................................................................................... 5 Fractures ......................................................................................................................................... 5 CMSI ............................................................................................................................................... 6 Tendon / soft tissue.......................................................................................................................... 6 MSI general..................................................................................................................................... 6 Hypothesis: ..................................................................................................................................... 6 MATERIALS AND METHODS .................................................................................................................. 7 Statistical analysis .......................................................................................................................... 7 RESULTS ............................................................................................................................................... 8 Parameters ...................................................................................................................................... 8 Differences between Good, Voluntary and Involuntary groups ...................................................... 8 Successful/unsuccessful horses ..................................................................................................... 10 Timing of spells ............................................................................................................................. 11 Difference in age ........................................................................................................................... 12 Difference in years of birth ........................................................................................................... 14 Differences between districts ........................................................................................................ 15 DISCUSSION ........................................................................................................................................ 15 Two groups ................................................................................................................................... 15 Good vs. bad horses ...................................................................................................................... 15 Voluntary horses ........................................................................................................................... 16 Involuntary horses ........................................................................................................................ 16 Comparing involuntary and voluntary horses .............................................................................. 16 Risk factors ................................................................................................................................... 17 REFERENCES....................................................................................................................................... 18 4 Introduction Wastage in general The primary reason for the loss of horses from training and racing, often termed wastage, is musculoskeletal injury (Bailey et al. 1997; Jeffcott et al. 1982) However, the relationship between training exposure and risk is not straightforward. The risk and nature of the musculoskeletal injury changes as a training programme progresses and with increasing age (Perkins et al. 2005b). It is therefore important to examine the reasons for wastage either according to injury type, or by age and class of the horse. In the interest of clarity, risk of injury will be presented according to injury category within this review. DMD Dorsal metacarpal disease is the single largest reason for wastage in young (2-yearold racehorses). Estimates of the percentage of horses affected differs between racing regions with estimates ranging from 20 – 70% of all 2 year olds in work (Bailey et al. 1998; Norwood 1978; Perkins et al. 2005a). A possible reason for the variation between populations could be due to differences in early preparation, surfaces worked on and the structure of the racing or training programme. Research has shown that cortical and especially cancellous bone responds rapidly to training exercise (Firth and Rogers 2005). Training for prolonged intervals at slower speeds will induce a modelling response, which is inappropriate for racing speeds (Nunamaker et al. 1990). Nunamaker actually designed a training schedule aimed at reducing the incidence of fatigue damage to the third metacarpal bone by cutting the extent of the low speed work and increasing the frequency of short interval high speed work. This stimulates an appropriate modelling response, with minimal risk of fatigue damage.(Boston and Nunamaker 2000). Verheyen found that the risk of dorsal metacarpal disease (DMD) decreases with accumulation of distances at canter and gallop. However, accumulation of exercise distances in short periods increases the risk of dorsal metacarpal disease (Verheyen et al. 2005). The incidence of DMD in two-year-old race horses is high. However, the incidence in three-year-olds is a lot lower (Bailey et al. 1998), which could also be due to the modelling response of the bone, as three year-olds have had a year more training exposure, so the bone has had time to adapt to the exercise. Fractures Research has shown that in previously untrained bones, there was an increased risk of fracture with an accumulation in canter exercise. Accumulation of high-speed gallop exercise seemed to have a protective effect, as the risk of fractures decreased with more exercise at the gallop. Horses doing no gallop work at all during training were at an increased risk of fracture on the racecourse (Parkin et al. 2004) However, when accumulation of canter and gallop exercise increases in a short time period, the risk of fractures is increased (Verheyen et al. 2006). A large proportion of fractures occur in the absence of a specific event and show typical signs of stress fractures. They are often associated with pre-existing pathology and frequently share the same locations as incomplete cracks. Intense training before the adaptive response is completed increases the risk of fatigue damage. Fatigue damage is associated with progressive micro damage. However, the biological repair 5 mechanism of bone (remodelling) is also important. Horses exercised before bone repair is complete are likely to be at greater risk for catastrophic stress fracture (Riggs 2002). CMSI Studies reported that the total distance accumulated during a two-month period was positively associated with the risk of catastrophic musculoskeletal injury (Estberg et al. 1996). It was also reported that the risk of catastrophic MSI was greatest within 30 days of a period of above average high-intensity exercise (Estberg et al. 1998) Tendon / soft tissue Hill found that suspensory apparatus failure was related to a higher intensity of recent exercise. It was also found that the longer the interval was since the last period of 60 or more days without a race or timed workout, the higher the risk of suspensory apparatus failure (Hill et al. 2004). MSI general Research indicated that increasing cumulative racing distances were associated with an initial reduction in the odds of MSI, that then levelled out and finally increased again as the cumulative racing distance was increased further (Perkins et al. 2005b) Another study showed an association between increasing the average distance at high speeds and an increased risk of injury. It also showed a correlation between the amount of fast days within the fast intervals and musculoskeletal injuries (Cogger et al. 2006). In this project, we focus on the differences between successful and unsuccessful horses. We further look at the differences in training between “good” and “bad” horses and try to identify the risk factors for horses having an unsuccessful two-yearold racing campaign. It is hypothesised that: The median number of days until the first race (or trial) start will be higher in ‘setback’ horses compared to healthy horses. Horses in the ‘setback’ group are significantly less likely to start in a race than healthy horses. Horses accumulating a higher number of training days at TAS 2 or 3 will be at an increased risk of having ‘setbacks’. The risk of further ‘setbacks’ increases as the number of days spelling increases. Horses with involuntary “setbacks” are less likely to start in a race than horses with voluntary “setbacks”. The number of days until the first start will be higher in involuntary “setback” horses, than in voluntary “setback” horses. Late two-year-olds are less likely to be in the “setback” group. The relative proportion of “setback” horses in each year of birth will be the same. The relative proportion of “setback” horses will be the same in different NewZealand districts. 6 Materials and methods The data were initially obtained during a longitudinal study conducted by Perkins et al. (2004) over a period of 34 months, starting in October 1997 and ending in July 2000. The initial dataset was meant for only 2 year old horses and represents data from twenty different trainers located in either the central and northern North Island region of New Zealand. The trainers were a sample of licensed professional Thoroughbred trainers and were training at 5 different regional training venues. The data contain a total of 597 twoyear old Thoroughbred race horses. Daily records of the training and injury status of the horse were collected. At the end of each data collection period (usually 2 – 3 weeks) a summarising training activity score was allocated to best describe the training level of the horse during the observation period. The Training activity scores (TAS) were allocated using the following criteria, TAS = 1: Spell TAS = 2: Walk or trot TAS = 3: Activity up to but not exceeding a canter TAS = 4: Galop/fast work but not yet started in a trial or race TAS = 5: Horses that have started in at least one trial or race For analysis the sequence in which the horses were trained at a particular TAS and the numbers of days spent in that TAS were examined. One sequence equals the time the horse spent in one particular TAS. The number of sequences a horse went through depends on the number of times it received a set back, i.e. it was put back on a lower TAS. A spell was recorded if the horse was put on a spell for more than 7 days. The reasons for putting a horse on a spell were recorded as being voluntary, immaturity or injury related (involuntary). Injuries were classified according to the body system involved; musculoskeletal, respiratory, etc and are described in detail in Perkins et al (2004). Specific information about anatomic location and diagnosis by a veterinarian were also collected. Statistical analysis The statistical analysis and data processing were performed using SPSS version 16.0 (SPSS Inc, Chicago, Il, USA). To examine the relative representation of the horses in the different age, year of birth and region categories Chi-square tests were used. To examine the effect of variables on the time until event (TAS5 or first spell) Kaplan-Meier survival analysis was used with a log rank test to compare between groups. To examine the differences in the relative ranking of variables the KruskalWallis test was used. For all analysis the significance level was set to p<0.05. 7 Results Parameters Within the dataset there were 597 two-year-old horses, divided almost equally into groups of male and female. The horses were trained by twenty different trainers, who were training at five different tracks. The central districts region consisted of the Awapuni, Foxton and Levin training centres / tracks and the Northern region consisted of the Cambridge and Matamata training centres. The horses were not equally divided between districts. More horses were trained in the northern district (table xyz). The horses in the dataset were born in 1995, 1996, 1997 or 1998. The majority of the horses in this dataset were born in 1996 and 1997. Table 1: Parameters of the dataset Parameter Sex Female Male District Central North Year of birth 1995 1996 1997 1998 Group “Good” “Involuntary” “Voluntary” Number of horses 282 315 259 338 58 241 265 33 279 132 144 Differences between Good, Voluntary and Involuntary groups Within the dataset there were 279 horses that had an uninterrupted training schedule from entry into the stable until they reached TAS 5 (having a trial or race start). These were identified as “good” (G) horses. On the other side there were horses with at least one injury-related spell, they were identified as “involuntary” (I) horses. A third group was identified as “voluntary” (V), as they did have spells, but these were only voluntary spells (horses on a spell because of immaturity were also put in this category, because it still was the discission of the trainer to put the horse on a spell). The horses were not equally distributed between the different categories. Half of the population belonged to the good horses and the remaining half were equally divided into involuntary and voluntary horses (p<0.05). From an administrator’s view this demonstrated that 50% of the horses are successful in reaching TAS 5 without any spells. 8 6 5 4 TAS Good 3 Voluntary Involuntary 2 1 0 0 50 100 150 200 250 300 350 400 450 days Figure 1: The median TAS and median days spent in that TAS, for three different groups; good horses, involuntary horses and voluntary horses Table 2: Parameters of training for three different groups Sequences Parameter 1 2 3 4 5 No. of horses “Good” 279 224 107 20 1 “Voluntary” 144 144 108 85 43 “Involuntary” 132 132 103 82 57 Median TAS 3 5 5 5 5 “Good” 2 1 2 4 4 “Voluntary” 2 1 2 2 3 “Involuntary” Median cum. days 35 86 146 223 276 “Good” 38 103 126.5 178.5 234.5 “Voluntary” 44 99 135 176 217 “Involuntary” 6 7 8 9 20 38 8 22 6 7 3 2 - - - - 5 2 2.5 3 3.5 4 4 5 - - - - 277 252 307.5 285.5 361.5 327.5 410.5 392 The median TAS of the Good group is in sequence 1 to 4 significantly higher than the median TAS of the Voluntary group (p<0.01). In the 5th sequence there is no significant difference. The median TAS of the Voluntary group has no significant difference with the Involuntary group in the first sequence. In the second sequence the Involuntary group has a significantly higher median TAS than the Voluntary group (p=0.004). In sequence 3 to 6 the Voluntary group has a significantly higher median TAS than the Involuntary group (p<0.05). In sequence 7 to 9 there were no significant differences, possibly due to the small number of horses remaining. 9 Figure 2: Kaplan-Meier survival function of good, involuntary and voluntary horses. Table 3: Median days till TAS 5 for three different groups. n Median (95% CI ) days to TAS 5 Good 279 114 (109-119)a1 Involuntary 42 244 (225-263)b Voluntary 77 244 (233-255)b For the amount of days it took each group to reach TAS 5, significant differences were found between the good horses and the voluntary horses (p<0.01) and between the good horses and the involuntary horses (p<0.01). There was no significant difference between the groups of voluntary and involuntary horses. Successful/unsuccessful horses Within the groups of voluntary and involuntary horses there were a number of horses that after one or more spells reached TAS 5; they were called successful involuntary or voluntary horses. Horses that never reached TAS 5 were called failure horses. “Involuntary”- “failure”= 90 horses “successful” = 42 horses “voluntary”- “failure”= 67 “successful”= 77 horses 1 Different superscripts show significant difference (p<0.05) 10 Table 4: Days spent at different TAS for five different groups Median days spent at TAS TAS 1 TAS 2/3 TAS 4 Group Good 0 16 0 Involuntary failure 110,5 57,5 38,5 Involuntary successful 59,5 84 24,5 Voluntary failure 109 32 0 Voluntary successful 85 55 0 TAS 5 66 0 50 0 62 Table 4 shows the total number of days spent at a particular group for all five groups. In the good group the horses spent a small amount of time in TAS 2 or 3 and went quickly on to TAS 5. In the involuntary group the failure horses spent almost twice as much time in TAS 1 than the successful horses did. In the voluntary group the failure horses spent most of their time in TAS 1. Successful horses did spend a bit of time in TAS 1 but then went quickly on to TAS 5. Timing of spells Figure 3: Kaplan-Meier survival function of days until the first spell for involuntary and voluntary horses. 11 If a horse had a spell it would have the spell earlier in the training programme if it was in the voluntary group (p<0.01). In both groups the median number of days until a spell occurred within the first 2 months of training (for discussion note that this is before the median race start date for horses in New-Zealand) Table 5: Days to first spell for two different groups n Median (95% CI ) days to first spell Involuntary 42 67 (60-74)a Voluntary 77 48 (43-53)b Table 6: Number of spells in the three groups No. of spells Good Involuntary 0 279 0 1 0 81 More than 1 0 51 Voluntary 0 129 15 It can be seen that the voluntary horses often have just one spell, where the involuntary horses have more than one spell. Difference in age The age when two-year-olds starting training was not equally distributed; the majority of the horses started training between 20 -25 months (p<0.01). Figure 4: Kaplan-Meier survival function of 3 age groups within the good horses. 12 In the group of “good” horses, the horses older than 25 months reached TAS 5 significantly earlier than horses within the group of 20-25 months (p=0.028) and horses within the group younger than 25 months (p<0.01) Table 7: Good horses divided into age groups n Median (95% CI ) days to TAS 5 Younger than 20 months 66 131 (118-144) b Between 20-25 months 138 114 (104-124)b Older than 25 months 75 107 (98-116)a Figure 5: Kaplan-Meier survival function of 3 age groups within the voluntary horses. In the voluntary group, horses within the group of 20-25 months were significantly (p=0.014) earlier to reach TAS 5 than the horses younger than 20 months. Table 8: Voluntary horses divided into age groups n Median (95% CI ) days to TAS 5 Younger than 20 months 33 266 (243-289) a Between 20-25 months 42 236 (219-253)b Older than 25 months 2 173 In the involuntary group there was no significant difference between the age groups 13 Table 9:Involuntary horses divided into age groups n Median (95% CI ) days to TAS 5 Younger than 20 months 14 228 (204-251) Between 20-25 months 24 245 (227-263) Older than 25 months 4 210 (121-299) Difference in years of birth Figure 6: Kaplan-Meier survival function of three different years of birth. A significant difference in reaching TAS 5 was found between the horses born in 1995 and 1996 (p=0.013). A significant difference was also found between horses born in 1995 and 1997 (p=0.003). No significant difference was found between horses born in 1996 and 1997. Table 10: Days to TAS 5 for different years of birth Year of birth n Median (95% CI ) days to TAS 5 1995 41 138 (125-151)a 1996 165 138 (119-257)b 1997 192 140 (126-149)b No horse from the year 1998 had reached TAS 5. 14 Differences between districts No significant difference in reaching TAS 5 was found between different districts. Table 11: Days to TAS 5 for different districts n Median (95% CI ) days to TAS 5 Central district 142 133 (124-142)a North district 256 147 (129-165)a Discussion Two groups The results clearly identify two distinct populations of two-year-old racehorses. There is an obvious successful group among the two-year-old racehorses, which proceeds straight through to TAS 5 without any spells or injuries. The other group consists of horses that had spells, either voluntary or involuntary. The good horses make up about 50% of the population, which means half of the horses in training had at least one spell during their two-year old campaign. If the horses had a spell there is just a 40% chance of them reaching TAS 5 as a two-year-old. It’s obvious that everybody wants a good horse. They reach TAS 5 earlier than the horses in the other groups and therefore provide a better return on investment. Also, the export / trading market is focused around two-year-olds, so therefore it is important to have them in a trial or race a soon as possible. From there they can be sold to, for example, Asia, or raced to try to win back the investment in purchase price and costs of training. Good vs. bad horses Figure one, which shows the median TAS against median days spent in that TAS, clearly shows the progression in training of the good group. After training for one sequence, their TAS was already significantly higher than for the horses in the involuntary or voluntary groups. The good horse had achieved a TAS 5 after a median of 86 days training. These are the horses a trainer wants, because they are ready to race or trial after a relatively short training period. The results show that these horses start out at a higher TAS. This means the trainer must have a good idea in the beginning of training if the horse is a good horse or not. Good horses spend little time at a lower TAS and then spend most of their time on a higher TAS. This means that if a trainer is convinced that the horse falls in this category, he or she can quickly progress to high speed exercise, instead of spending a lot of time at lower speeds. Figure two also shows a clear difference between the good horses and the involuntary/voluntary group. The median of the good horses versus the other horses differed by130 days, but the pattern of survival was similar. This shows that the 130 day difference between the groups is due to a delay at the beginning of training of the voluntary/involuntary groups. These results also show that the delay happens in the first part of the training. 15 Voluntary horses In the pattern of the voluntary group it can be seen that they start out at lower TAS. They then make one dip in TAS, which is probably related to the timing of their spell period. After this dip they go straight to TAS 5. The median of horses in this group reached TAS 5 after 277 days. The obvious big dip in TAS in the beginning of the training of voluntary horses could be related to the fact that voluntary horses are put on spells because the trainer makes the decision to put them out for a spell. Apparently most trainers make a quick decision in the beginning of training that some horses are not yet ready to be trained further, deeming it better to wait with the training until the horse is ready. Half of the horses that are voluntary actually make it to TAS 5, so the chance that a horse on a voluntary spell is going to end up racing is not big. It can be seen that the successful horses spend time in TAS 1, but otherwise they have the same pattern of days spent at different TAS as the good horses. Although the successful voluntary take more time to reach TAS 5 because of their spell at the beginning, they are still worth putting time in as they will reach TAS 5. Unsuccessful voluntary horses just spend a lot of time in the lower TAS categories, so if it would be possible to identify these horses early on, that would be a big benefit for the owner of the horse. Involuntary horses The group of involuntary horses also has the dip in sequence two although they don’t go down as much as the voluntary group. After that they don’t go straight through to TAS 5, but keep having dips in their TAS. The median of the horses in this group does not reach TAS 5 until after 400 days. In the chart it can be seen that the involuntary horses not only go up slower than the voluntary after the initial dip, but have more dips in their TAS later on. This is probably due to the fact that a lot of involuntary horses have more than one spell. One could question if it is worthwhile to put more money in a horse that had an involuntary spell, as only a third of the horses actually make it to TAS 5, it takes them almost 300 days more than the good horses to reach it, and they have a big chance of re-injury or having a spell again. In table 4 it can be seen that the successful involuntary horses spent almost two months less in TAS 1 than the unsuccessful horses. This could mean that the successful ones have just one spell or spent a lot less time to recover in their first spell. This means it might not be worthwhile to spend more time and money training a horse that has been on a spell for more than two months. Comparing involuntary and voluntary horses Figure 3 shows the survival curve until the first spell for both the voluntary and involuntary group. It shows that the median time until the first spell for the voluntary group is just 48 days. The median time until the first spell for the involuntary group is 67 days, significantly later than the voluntary group. Both survival curves show that the first spells do indeed occur in the first two months of training. This shows that the critical point of a horse becoming a good or involuntary/voluntary horse might lie in the first two months. That the voluntary horses have their first spell significantly earlier than the involuntary is probably a result of the different ways horses end up in these groups. The voluntary group is a result of the choice of a trainer to put the horse on a spell. If 16 the horse was too immature or could obviously not cope with the work it was doing it would be put on a spell. Therefore, these horses were put on a spell before they had reached their limit. Involuntary horses are put on a spell because of an injury and had therefore already passed their limit. An explanation for the higher amount of days until the first spell of involuntary horses might be that the involuntary horses were the horses were it was doubtful whether they were too immature or could cope with the work. These horses then may have continued training and subsequently sustained an injury requiring a spell for recovery. This means that it could be preferable to put a horse on a spell when in doubt, rather than continuing training it until it possibly breaks down. The advantage of this approach could be that the horses will have a bigger chance of competing in a race, as significantly more horses in the voluntary group than the involuntary group eventually reach TAS 5. Risk factors Figure 4 shows the difference between the different ages within the two-year-old horses. The older horses are significantly faster to reach TAS 5 than the younger horses. It can also be seen that there are hardly any older horses in the voluntary or involuntary group, so the older horses (older than 25 months) are not only the fastest to reach TAS 5, but they also hardly have any spell periods. The reason for this could be that older horses are stronger and more developed, so they are less likely to get an injury or to be regarded as not ready for training (thus ending up in the voluntary group). It could also be that these horses did have a bit of pre-training before and were therefore already stronger and more adapted to the exercise. This shows that it’s not advantageous for owners and trainers to try to have a young two-year-old as quickly as possible ready to race, as they have a bigger risk of injury during training and in the end take a longer time to eventually start in a race. As shown by figure 6, a significant difference can be found between different years. 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Equine Veterinary Journal 37, 442-448. 19