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The Conscience of Thoroughbred Racing


Simulation of a CT scan for horses. photo: Dr. Sheila Lyons, DMV

Thoroughbred horse racing in the US is addicted to drugs. It runs so deep that it has become the norm. And worse, because it is legal, it is seen as beneficial. Instead of a health-first approach to the horse, veterinarians administer a kitchen sink of drugs when horses arrive at the racetrack upon command of trainers and do so against veterinary standards. However, technology has provided a pathway to safe, drug-free racing.

NBA star, Kevin Durant, suffered a season ending, and possibly a career ending Achilles tear injury in the playoffs after previously evaluated with a calf strain. It appeared that both Durant and Golden State Warriors head coach, Steve Kerr, “didn’t think he could get injured worse” by returning to play.

Durant felt mislead or possibly misdiagnosed by the Warriors’ physicians and he chose to return to his former foot & ankle surgeon, Dr. Martin O’Malley, MD, at Hospital for Special Surgery in New York, to operate on his ruptured tendon. O’Malley performed surgery on Durant’s broken foot four years ago.

Why did Durant and the Brooklyn Nets chose O’Malley? They have a successful prior relationship and O’Malley remains committed to use the most cutting-edge technology and diagnostics, a pedCAT scanner.

Kevin Durant left the Warriors and signed a four-year contract with Brooklyn.

Dr. Sheila Lyons, DVM, founder of The American College of Veterinary Sports Medicine and Rehabilitation, developed a high resolution Three-Dimensional CT scanner for horses along with Curvebeam, LLC., which is already a step ahead in the field of human CT scanning.

Curvebeam’s 2012 technology quickly became the new standard in human orthopedics and podiatry and was the first CT scanner to enable a standing examination of the patient with their limbs loaded normally. In 2017, Curvebeam made further advances with its introduction of the pedCAT scan. 

These image scanners add a significant diagnostic advantage, as traditional CT scans require the patient to lie down with the anatomy un-weighted, depriving the clinician of the ability to analyze the stressed areas of bone while under loading pressures. 

Until this equipment was developed, horses needed anesthesia in order to have a CT scan performed. The inherent risks associated with general anesthesia, the need to go to a hospital for a test, and the cost of this procedure prevented widespread use of CT in the majority of racehorses in training and eliminated its use as a screening tool by racing regulators and track practicing veterinarians.

Simulation of head-on view imaging both front legs simultaneously.
photo: Dr. Lyons

The new 3-D pedCAT scanner is unique in many important ways. It not only allows scans of the standing horse, it scans either both front or both hind limbs simultaneously in less than 48 seconds.  It is the perfect screening tool for racing regulators and practicing track veterinarians.

This allows scans of horses using light, short acting sedation, comparable to that typically used by veterinarians at the track during regular X-ray procedures.  This pedCAT scanner is capable of producing 3D CT scans from above the knee down to the bottom of the hoof. The site of most catastrophic injuries. 

We know from over two decades of necropsy data on horses which suffer fatal breakdowns that the majority, almost 90%, of these fatally injured horses had subchondral pathology pre-existing in the area that catastrophically fractured and that similar pathologies are present in the other limbs.

Preventing these fatalities requires application of more advanced diagnostic methods that can definitively identify the problem. 

Another unique feature of this new CT scanner is that it utilizes very low radiation.  This becomes important for both horse and technician safety.  The amount of radiation used is comparable to that required when taking a single human chest X-ray, whereas traditional CT scans are notorious for requiring very high radiation exposure. 

The equipment runs on standard AC electricity, making it easy to install and use in any facility.  It can even be adapted for a trailer installation, movable from site to site needing no more than a standard electric outlet for power. 

Multiple views displayed in on screen report from CT scan
photo: Curvebeam

Bilateral, weight-bearing scans of the foot & ankle give veterinarians the information they need to assess the biomechanical spatial relationships and alignment of the lower extremities. Additionally, the computer in the scanner uses Artificial Intelligence to determine bone density. 

The PETscan machine announced to deploy at Santa Anita Park is a very different device. The PETscan involves the injection of a radioisotope, requires the horse to stand still for 30 minutes, and only examines a small area. This is a good research tool for long-term studies, but it is not the machine necessary to scan horses and determine their soundness to race.

“It’s not that we don’t have the right diagnostic tools, it’s that we don’t have the right diagnostic mentality,” said Dr. Larry Bramlage, DVM, widely acknowledged as one the world’s foremost equine surgeons.

“Racehorse is not a diagnosis, and racing is not a condition to be treated with drugs,” said Dr. Lyons. “A drug, in and of itself, is not therapeutic. It is the context in which the drug is given that determines if it is therapeutic or anti-therapeutic. In some cases it not only doesn’t help, it makes things worse.”

While these two noted veterinarians are willing to step outside the opinion espoused by the American Association of Equine Practitioners (AAEP), the majority of racetrack practicing vets have skin in the game and make their living charging per injection.

A health-first veterinary practice would initially record a history of the horse. A physical exam would follow and testing might be necessary for a diagnosis. Only after the preceding steps should a vet develop a therapeutic plan, which may or may not involve drugs.

Try to get a record of the history or physical examinations of racehorses and you will come up empty. No such records exist.

Technology can replace drugs by first identifying and then eliminating the at-risk horses from the racetrack. Some may recover enough to race again, some will not.

Initially, this will lessen the eligible racing stock and through seasonal re-population will leave the entry box a bit short only during the first year of use. This is a great concern to racetracks already short of horses.

However, the short-term loss will be a long-term gain as CT scanning will help guarantee future seasons with barns full of sound horses.

Monitoring can begin when every new horse enters the racetrack and continue throughout its racing career. Early identification of minor injuries and treatment can prevent major injuries from occurring. With sounder horses, the need for drugs lessens.

Trainers like to say that they treat their horses the way they treat their kids. They do not! If you loaded up your kids with drugs and sent them to perform at the highest levels of physical competition, Child Protective Services would quickly take away your children.

Remove from serious discussion any thoughts of moving forward through drug reform with the trainers who are able to abuse the system because they have owners willing to pay the bills, and some veterinarians who abdicate their medical responsibility in order to earn a living.

Lyons is one veterinarian who, through technology, has presented a new direction of this maze of drug use as remedy. Safe, drug-free horse racing in the future will rely heavily on high tech diagnostic imaging; a screening tool that will enable regulators to ensure that only sound horses would be permitted to train and race.

© Mark Berner,, All Rights Reserved, 2019.

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6 Responses

  1. As I think you know Mark, I applaud Dr. Sheila Lyons and her efforts to get diagnostics on the right course. IMHO, this is the single most important tool we have at this time to identify horses at risk for orthopedic breakdowns.

    1. Nena-
      I was eager to interview Sheila and tell her story. She is the real deal. I like her health-first veterinary practice and so much more; her ideas, her vision and her principals. She doesn’t just talk the talk, she walks the walk. If I had horses, she’d be my vet.

  2. If I understand you correctly, MB, not every horse at SA will be scanned post-entry/pre-race.

    Is it also unlikely that no horse would be scanned twice at SA?

    Will any be scanned at DMR this year?

  3. I-
    The PETscan that will be installed at Santa Anita is not the right machine to pre-scan horses before a race. It is good for a long-term study. The machine needed there is the one I wrote about, a pedCAT scanner. It is what they need to pre-scan horses and see if they are sound enough to race.
    I know of no scanner at Del Mar.

  4. Horse racing needs sport science….accelerometers like sport science does with elite human athletes, the abilty to know and see in real time data

  5. Bily-
    Yes, indeed. Horseracing’s data collection, once superior, now lags badly behind other sports. I’ve promoted the advancement of data with info such as gate speed using accelerometers. Equibase is having trouble with the accuracy of its data collection because the GPS in use is only accurate to within a half length of the horse and that’s not nearly accurate enough.

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