Clinical evaluation of poor performance in the racehorse: the results of 275 evaluations.

A clinical sports medicine evaluation was applied to 275 racehorses with a history of poor racing performance. The poor performance evaluation included a) general physical examination and basic laboratory screening; b) respiratory examination including auscultation, thoracic radiographs, ventilation-perfusion lung scintigraphy and upper airway endoscopy at rest and during maximal treadmill exercise c) examination of the musculoskeletal system including lameness examination, video gait analysis at high speed, post exercise serum chemistry to identify obvious as well as sub-clinical myopathies, high detail radiography and nuclear scintigraphy; d) cardiac examination including auscultation, electrocardiographic analysis during strenuous exercise and when indicated, echocardiography; and e) a standardised exercise stress test entailing the measurement of oxygen consumption, carbon dioxide production, venous blood lactate concentration and heart rate during sequentially increasing running speeds on the high speed treadmill. The choice of diagnostic methodologies utilised were tailored to each individual in order to determine most efficiently the abnormalities contributing to inadequate racing performance. The results of this clinical evaluation showed that 1) many of the diagnoses were subtle requiring the use of sophisticated diagnostic equipment including scintigraphy and dynamic evaluation of the horse exercising on the high speed treadmill and 2) 84 per cent of the horses were diagnosed as suffering from more than one problem leading to the supposition that inadequate athletic performance is often caused by a constellation of abnormalities requiring a comprehensive approach to diagnosing decreased athletic capability.