A day at the races

ELMONT, N.Y. — She's no stranger to track trauma. She was instrumental in saving Charismatic's life in 1999 as the horse battled for the first Triple Crown since Affirmed in 1978. Dr. Celeste Kunz, DVM, New York Racing Association (NYRA) chief examining veterinarian, was the first to treat Charismatic when he pulled up abruptly in the stretch. The diagnosis of a displaced condylar fracture was made on the scene, and Charismatic was fitted with a compression boot. Kunz loaded him into the horse ambulance, medicated him and delivered him to the safety of his stall. Radiographs confirmed the diagnosis minutes later, and the compression boot successfully prevented further displacement prior to his surgery.

Dr. Celeste Kunz (above and below on left) pauses to examine Afleet Alex after the race. The Preakness winner drew deserved attention as he ran the fastest final quarter mile since Arts and Letters in 1969 to win by seven lengths.

She recalls the experience while busy tending to her pre-race routines for the 137th Belmont Stakes, which took place June 11.

"I served as the Triple Crown Veterinarian and joined Dr. Mitzi Fisher, Kentucky Racing Commission Chief Veterinarian at Churchill Downs, to examine him before the Derby," Kunz remembered of her 1999 experience. "Two weeks later at the Preakness, I saw a horse that was evolving into a champion, both physically and mentally. When I examined him before the 1999 Belmont Stakes, I believed that I was in the presence of a Triple Crown winner. During the race, I was positioned in the chase vehicle and could see a horse pulling up shortly past the wire. When I arrived on the scene, I said to myself in disbelief, 'It's Charismatic! This cannot be happening.' But there is no time for emotions with the responsibility that the track veterinarians have. Instinct and experience dictate your actions. Our emergency response procedures are the same for every horse, no matter the value of its value nor the profile of the race."

On this day, another champion, Afleet Alex, third in the Kentucky Derby and winner of the Preakness, unruffled and calmly walked off the van as he arrived from Pimlico, Md., before settling into Barn 14 without incident. Conversely, hearts jumped during the May 21 Preakness when he clipped heels with Scrappy T, went to his knees, but miraculously collected himself and elevated to full flight to win the second jewel of the Triple Crown.

Dr. Larry Bramlage, dipl. ACVS, Rood & Riddle Equine Hospital in Lexington, Ky., and immediate past president of the American Association of Equine Practitioners (AAEP), was an on-call veterinarian at the Preakness, as well as this year's Belmont. AAEP's On-Call Program began 12 years ago to assist track veterinarians with trauma and to explain injuries to the media during live broadcasts and simulcasts.

"It scared me to death having to do the on-call (at Pimlico Racecourse), realizing that we might have two horses fall with 12 horses right behind them," Bramlage recalls. "There could have been four or five horses that could have stumbled and fell; It's one thing if one horse goes down and they can scramble toward the rail, but where do they go if they're in the middle of track like that? Luckily Afleet Alex caught his balance, went on and hardly missed a stride."

Maybe it was in part a miracle performed by Alex's namesake, Alexandra Scott (See sidebar, this page) or trainer Tim Ritchey's unorthodox training regimen that helped him.

The heart of a champion

"His athletic ability is so fine-tuned at this point that his reflexes had to be quicker than any magician with a slight-of-hand trick," Ritchey says. "For him to be able to put those legs out, save himself, get back up and within a stride be back in full flight, I've never seen a horse do that, nor think it was possible to do."

Kunz is hoping for decidedly less drama during her most-demanding race of the year, but she has all the bases covered and works the magic of any Houdini as she keeps tabs on 2,000 Thoroughbreds in 63 barns at the park.

Pre-race physical exam

Whether it was Belmont Stakes Day or any other race day, the pre-race physical inspection is similar, though a new policy had been instituted by NYRA May 4. Two barns were converted to security barns, in which horses must be taken to approximately seven hours prior to their race time.

Dr. Celeste Kunz confers with on-call veterinarian Dr. Mike Gotchey at the starting gate prior to the Belmont Stakes to make sure all the horses are able to run 111/42 miles.

"We perform the same pre-race physical examination as we have done in the past, when we would go to their own barn," Kunz says as she examines a horse. "Our approach is a little different in that we'll examine them in shifts to reduce the amount of activity in the shed row. Before the security barns were implemented, there was a lot of anxiety amongst the trainers concerning possible effects on their horse's temperaments. But it was easy for the horses to move to the security barns, just like shipping in from other tracks."

Strict attention is paid to cleanliness and disinfection in the security barn, too. Managed like an equine hospital, security barns are on the lookout for signs of communicable disease. "We're going to identify the horse by lip tattoo," she says as she continues with an exam. "We don't handle the mouth as a precaution to avoid transmission of bacteria between horses; the handler does that. This is just one of the biosecurity measures we have instituted. We start the exam by checking the head and eyes, we then palpate the legs feeling for any joint effusion or puffiness, heat or sensitivity indicating inflammation, range of motion while flexing the joints, etc. We finish by jogging for soundness as we've been doing for years."

After the hands-on exam, Kunz requests the horse be walked in a direction away from her.

Dr. Celeste Kunz, far left, monitors one of the racers in the paddock. Horses are assessed continually from the time they enter the grounds until the time they leave for their home barn after the race.

"I'm watching the symmetry of his gait. Okay, gracias, no mas," she tells the handler. "If I like what I see, I only have the horse go in one direction because again, that is less activity in the shed row."

Between exams, Kunz monitors each horse's health and orthopedic history, including previous examination findings, pre-existing pathology, race-related injuries, surgeries and even conformational flaws.

"We have a medical record for every horse, so we know what we've seen in the past and what we should expect. Sometimes our exam history conflicts with the horse's presentation on race day, though. The purpose of the pre-race inspection is to reduce the risk of catastrophic injuries on the racetrack. If an ankle is warm and puffy and sensitive to flexion, that's something I would then make a recommendation on."

As each horse approaches the saddling enclosure at the paddock before each race, the NYRA Horse Identifier verifies its identification with a photograph. Before a horse races for the first time at an NYRA track, they must be matched against its original foal papers and photograph to generate an identification card. When a horse arrives at the paddock, the identifier uses the ID card to circumvent the lip tattoo.

Dr. Celeste Kunz, far left, monitors one of the racers in the paddock. Horses are assessed continually from the time they enter the grounds until the time they leave for their home barn after the race.

"We look at markings (coat coloration), and the chestnuts (the oval plates of horny epithelium)," explains Jim Zito, chief horse identifier. "What I'm doing is comparing the photo identification of the horse to the horse as it appears prior to the race, and we treat a $10,000 claimer the same as a horse in a Grade 1 stakes winner."

Kunz has a set routine, too, before and after each race, though a slight change was made for Belmont Stakes Day. Veterinary escorts walk with the horses to make sure they are not startled or interfered with by the gaggle of photographers trying to capture a potentially lucrative image of the possible winner.

Leveling the field

In addition to physical exams and horse monitoring on the track, urine and blood are taken selectively to check for illegal substances. The racing stewards also select certain races for blood gas testing. For this purpose, blood samples are taken approximately one hour prior to the race and analyzed for elevated CO2 levels, which correspond to excessive alkalinizing agents.

The New York State Racing and Wagering Board requests post-race blood and urine tests for illegal substances, and they request blood gas analysis for randomly selected horses and races as well.

"The most efficient blood gas analysis we've found is pre-race," Kunz says. "That is because after exercise, the horse blows off CO2, and it takes more than an hour for a Thoroughbred's blood to return to baseline for accurate assessment. It is difficult to keep them in the detention barn for that length of time, especially since they've already cooled out. We are still gathering information as to the benefit of post-race blood gas testing. Theoretically, testing close to race time would display the highest level if an alkalinizing agent was given, because the rationale is to raise CO2/bicarbonate levels to their highest before they exercise to combat lactic acidosis, which in turn would combat fatigue."

Dr. Fisher's position in Kentucky is parallel to Dr. Kunz's for NYRA. She too was at Belmont Park for Belmont Stakes Day as an AAEP On-Call veterinarian.

"All the horses are basically tested and treated the same. On Derby Day, we previously used to have the horses come to a holding barn 45 minutes prior to post, and we drew blood samples. Since this year there were 20 horses in the race, we did pre-race sampling at their own barn," Fisher explains. "Other than that, the horses are tested and treated like any other race on any other day, though for the Kentucky Derby post-race, we tested a few extra horses."

Scratch to race another day

On top of race-day responsibilities, Kunz often must determine whether an animal should bow out of a race.

If a horse is deemed unfit to race, the trainer must prove to the veterinary staff that the horse has recovered from whatever issues he had before he can race again. Often it entails a timed workout (sometimes with jockey instead of an exercise rider), to the veterinarian's satisfaction.

"These horses post-injury are monitored quite closely to ensure their good health before returning to run," Kunz says. "We'll follow-up on their diagnostics, whether it be X-rays, ultrasound, surgery etc, and their return to good health prior to their running again. We involve ourselves with these cases as if they were our own patients, and communicate with the trainer and their veterinarian. Once we feel comfortable that they've recovered, we release them to enter again."

A horse can be scratched if it becomes agitated, stumbles or falls within the paddock or gets caught in the starting gate. The veterinarian uses discretion to determine if the horse is OK to run. The veterinarian and the racing stewards have a dual hand in making those determinations. The veterinarian determines soundness and extent of an injury, but the racing stewards might scratch a horse if it gets loose and has already run too fast and too far to race that day.

"A horse will be scratched 99 percent of the time not because of a serious injury, Kunz says. Sometimes, a simple misstep could signal it not be in the horse's best interest to run that day.

"Once in while we'll have a horse fall in the paddock, we'll scratch the horse, and the trainer and owners are disappointed because the horse looks fine walking back to his barn. We'll get a call later thanking us for scratching the horse because they've actually fractured their ribs or withers. There are many things to take into consideration, and experience helps our immediate response. Horses can be unpredictable, and that's one of the reasons why there needs to be a vet present everywhere the horses are."

Gearing up for the bell

Kunz observes the racers in the paddock as they are walked and saddled and then follows them out to the racetrack. There is a veterinarian at the starting gate, finish and in a chase vehicle, manned by Kunz, or one of her staff, Drs. Jennifer Durenberger, Anthony Verderosa, Barbara Greene or Jamie Motler. They observe the horses in the post parade to ensure they warm up properly and as they load into the starting gate. The veterinarian at the "wire" watches for each horse to gallop out after the race and canter back sound. A veterinarian is driven in the chase car to monitor and respond to any incident or injury that occurs during the race.

Kunz will be assisted by an EMS group with human ambulance in case of jockey injury. Kunz is driven to the starting gate to observe the horses as they approach and enter the gate, and as the race begins, the chase car follows behind the horses to the finish line to monitor the horses for soundness after the race.

But her day doesn't slow at he finish line; she observes the horses as they canter back to the finish line after the race. She observes them as they are unsaddled and walked back to the barns.

As a precaution at the ready, there are three Kimzey Horse Ambulances stationed around the racetrack. They are equipped with medical equipment, including compression boots and splints, pharmaceuticals, oxygen, alcohol and ice water, and "ArcticHorse" blankets. These blankets, created from material originally designed for human burn victims, are placed on horses to avoid heat exhaustion. The ambulances are hydraulic, powered electrically, and can maneuver over any surface. There is no rear axle, so the floor can be lowered to facilitate the loading of an injured horse. There are skylights that make the interior brighter and less threatening to the horse, and a movable partition restricts the horse while the ambulance is in motion. The NYRA owns five horse ambulances, which are distributed among its three racetracks, Belmont Park, Aqueduct Racetrack and Saratoga. For Belmont Stakes day, one from Aqueduct was borrowed to make three available.

"It is very, very rare, that we need two ambulances in a single race, but the precaution is taken just in case," she says.

Home stretch

Luckily, the Belmont Stakes ended without incident, though it likely had little to do with luck and much to do with the care and expertise exhibited by Kunz and her veterinary staff. Lost in the Fog, the nation's leading sprinter, won his seventh-consecutive race in the $200,000 Riva Ridge, a Grade II for 3-year olds at seven furlongs.

Afleet Alex romped by seven lengths to win the $1-million Belmont Stakes to the joy and enthusiasm of 62,274 cheering fans. He passed the entire field at the quarter pole, running the final quarter mile in a record 24.5, not done since 1969 by Arts and Letters. Was it the patience of his jockey, Jeremy Rose, the 411/42 miles he jogged and galloped the Monday before, the heart of a champion racehorse or a lift from Alexandra Scott, the little girl that seemed to have buoyed horse, jockey and trainer? Maybe all of the above, but for Dr. Kunz and her staff, it was just another day at the races.

Dr. Kane earned his doctorate in equine nutrition and physiology from the University of Kentucky in 1978. He works within the animal-feed industry with a specialty in horses.