Tragedy on the track

OCEANPORT, N.J. — When an equine injury or death occurs at a racetrack, especially during a high-profile event like the Breeders' Cup Championships, accurate reporting of health-status issues to the public is critical — perhaps as important as dealing with the injury itself, says one of the nation's leading equine veterinarians.

Tense moment: George Washington, a 4-year-old colt, is restrained after suffering a leg injury. (Photo: A-Z Communications)

Larry Bramlage, DVM , MS, Dipl. ACVS and a partner in Rood & Riddle Equine Hospital in Lexington, Ky., was one of two experts serving as American Association of Equine Practitioners (AAEP) "On Call" veterinarians at this year's Breeders' Cup races at New Jersey's Monmouth Park racetrack Oct. 26 and 27.

He and the other AAEP "On Call" expert, Dr. C. Wayne McIlwraith, BVSc, PhD, FRCVS, DSc, Dr. med vet (hc), Dipl. ACVS, a professor of surgery and director of the Orthopaedic Research Center at Colorado State University's College of Veterinary Medicine & Biological Sciences, were there to provide accurate veterinary information to broadcast and print media during the live-network races.

That role thrust them to the forefront of a huge media event near the end of the $5 million Breeders' Cup Classic — the featured final race on the second day of the rain-soaked event — when George Washington, a 4-year-old Irish-bred colt, pulled up in the stretch with a severe injury to the right front leg and was immediately euthanized behind a curtain, as Preakness winner Curlin continued on to win the race by 4.5 lengths.

Raising the curtain: Breeders' Cup track workers hurriedly set up a screen to block the view of spectators while the injured horse, George Washington, was euthanized and taken away by ambulance. (Photo: A-Z Communications)

The horse suffered a lateral condylar fracture of the distal metacarpus, with a dislocated fetlock joint and biaxial proximal sesamoid bone fractures, and the wound was open, McIlwraith tells DVM Newsmagazine.

"Before the horse could get pulled up, his fetlock dislocated and destroyed the soft tissue on the back, which destroyed the blood supply, so there was no oxygen for repair. It was open into the dirt, so it's contaminated, and you can't get antibiotics there because you don't have a blood supply, and you don't have blood to support repair," Bramlage explains. "It has to do with the horse's anatomy and how really little blood supply they have in the lower part of the leg."

Veterinary expertise: AAEP "On Call" veterinarians Larry Bramlage, center, and Wayne McIlwraith, right, with Breeders' Cup Panel observer George Mundy, DVM. (Photo: A-Z Communications)

As the colt, bred by Barbaro owners Roy and Gretchen Jackson, held up its injured leg, workers set up screens to block the view of nearly 42,000 stunned spectators and managed to load the horse into an ambulance behind the screens.

George Washington had dropped from fifth place at the half-mile point to seventh at the time of his injury.

"Typically, these injuries occur in the last part of the race," McIlwraith says. "The horses are more fatigued, so have less support to the joint."

The horse was used to running mostly on grass in Europe and had earned more than $1.4 million racing there for owners Susan Magnier of Ireland and Michael Tabor and Derrick Smith of England.

The Monmouth Park track was a sea of mud during both race days.

But "data over many years show there are no more ambulance runs or catastrophic injuries on muddy tracks," Bramlage says, so that was not cited as a contributing factor to the horse's injury.

"Our most visible function (as On Call veterinarians) is to address the media if there's an injury that occurs on national television," says Bramlage.

"Of course, you can't make an instant diagnosis, you don't have radiographs, you don't have a complete exam, but you can give them (media and public) a general idea of the probability of what that injury means — whether it's career-ending, how life-threatening it is and what the general approach to treatment is going to be."

Answering reporters' questions, providing expert information behind the scenes, is "in the long run ... maybe an equally if not more important aspect of the On Call program than is the immediate triage of injury," Bramlage says.

How On Call program was born

The AAEP started the On Call program in 1991, providing media-trained equine veterinarians to respond to crisis situations and answer questions, after the death of three horses in the 1990 Breeders' Cup at New York's Belmont Park. There was no expert veterinary commentary during that telecast, leaving reporters mostly to fend for themselves. The AAEP worked with the Thoroughbred racing industry to improve future live coverage of major races, and the On Call program was born.

Before the accident: Irish-bred colt George Washington is walked in the paddock before the Breeders' Cup Classic race, during which he pulled up in the stretch with a severe leg injury and was euthanized. (Photo: Ed Kane)

Since then, more than 30 AAEP veterinarians have committed their time and expertise as On Call experts, having received media training to educate reporters and the public about the care of racehorses and the specifics of racing injuries when they occur.

They include surgeons, racetrack veterinarians or DVMs who work for racing commissions.

More than 100 events each year, including Olympic events, rodeos and major shows in addition to races, are supported by one or two AAEP On Call veterinarians.

For some races, only one expert is available, but for the Breeders' Cup, McIlwraith and Bramlage have been a two-man team for some time and say it's necessary to have more than one expert present. "First, we could have two incidents going on at the same time," says McIlwraith. That happened in 2006. "Generally Larry (Bramlage) goes on television and I go to the press room, so that hopefully the press gets the correct story all at once. It has helped the reporting of these things significantly."

14-member DVM staff

At this year's Breeders' Cup, besides Bramlage and McIlwraith, a 14-member veterinary team was at the track to observe, examine and, if necessary, treat more than 125 U. S. and foreign Breeders' Cup horses, plus 100 more horses that participated in 21 races over two days.

On the final day, everything seemed to have gone smoothly, until the final race. That's when George Washington broke down 100 yards short of finishing. Jockey Mick Kinane dismounted, and the veterinary staff responded. Among the first on the scene with the ambulance were Dr. Deborah Lamparter, chief veterinarian for the New Jersey Racing Commission (NJRC) and four members of her group, Drs. Michael Fugaro, Nancy Vutz, Richard Carbone and Cathy Ball, along with Dr. Anthony Verderosa (New York Racing Authority), one of the Breeders' Cup Panel veterinarians who handled radio communications with Bramlage and McIlwraith.

Drs. Scott Palmer and Jennifer Smith, of the nearby New Jersey Equine Clinic — the Breeders' Cup's designated emergency clinic — also came to the scene with members of the track crew.

Dr. John Halley, veterinarian for trainer Aiden O'Brien, requested that the horse be euthanized and the screen was set up.

"There wasn't any point in going on, so rather than even trying to splint him and load him, they just euthanized him immediately," Bramlage says.

Desensitizing the public to the injury was one of Bramlage's and McIlwraith's objectives in describing to reporters what was taking place.

"If you give them the information and the prognosis, they don't leave the telecast with those vivid pictures as they did at the 1990 Breeders' Cup where there was no one officially to talk about the injuries or the horses. All they could do was show the pictures over and over, talking to people who were not very well equipped to discuss that scenario," Bramlage says.

"Our whole job is to have people leave the telecast remembering it for the races, not the injuries," he adds. "I think we accomplished that. The right information puts people's minds at ease and sometimes even if the news is bad, they can feel bad but don't continue to agonize over it."

Need for accurate reporting

Over time, Bramlage and McIlwraith say they've come to a better understanding of what the media need and that the press has learned to trust them. "One thing we veterinarians never talk to each other about is which leg got injured," Bramlage notes. Because the On Call doctors usually are not at the scene, but communicate by radio with those in the horse ambulance, they discuss only the type of injury, what structures are likely to have been involved, giving them a basis to offer a prognosis and probable treatment.

"When you go to the reporters, the first thing they ask you is which leg?" says Bramlage.

"We are reliant on getting good information from the track and must have it quickly, because we've got reporters there, especially TV," says McIlwraith. "We don't want to go on television and say that it was a fixable injury and everything's fine and two days later they find out that it wasn't."

During the several races, the On Call veterinarians have to watch for injuries, and with the Breeders' Cup that means a fast turnaround, with another race occurring about every 30 minutes. "Sometimes you don't finish reporting on one injury before the next race is going off," says Bramlage.

"We've gotten quicker at this scenario, but as we get quicker television demands that we get quicker still. We still have to inform the media and above all be accurate. It's a system we can't foul up."

"That's part of our success," adds McIlwraith. "When we first started this program, we had to become accepted and achieve credibility with the press. Now that we've got that, they look for us as soon as there's an incident. That's good because it means the program has become well recognized and people want to hear from the veterinarians. We just have to be accurate."

Earlier at this year's Breeders' Cup, the NJRC veterinarians jogged and examined entrants prior to all races. Post-race drug testing was done on the first four finishers in each race, along with certain others selected by the track stewards. There were extensive procedures at the quarantine barn for foreign horses.

Two other Breeders' Cup Panel veterinarians on duty besides Verderosa were Dr. Robin White, from England, and Dr. Tim Connor, of California. The panel is set up to have doctors representing both the east and west coasts, and the European Union.

Other NJRC veterinarians working were Dr. SueAnn Bennett, Dr. Barbara Greene, Dr. Diane Simoncini and Dr. Kathy Picciano.

Lamparter, the NJRC chief veterinarian, went to last year's Breeders' Cup in Kentucky to plan for this year's event in New Jersey. "I started my game plan from that point," she says. "It helped me decide how much planning I needed to do, how much coverage I'd need for my staff and to gain cooperation with all the groups that were going to be here."

For all equine practitioners

The AAEP On Call program sets an example for what equine veterinarians at local events around the country can do, even when there's no live telecast coverage, Bramlage says.

"If something happens, they can be of real service in the same way we are formally," even if it's nothing more than explaining what happened to the local or regional newspaper, in medical terms couched in language the public can follow.

"I would say the general practitioner should look for opportunities at the local level, in the same way we plan for them at the Breeders' Cup," Bramlage explains.

"It works as the model for better communication with the industry," says McIlwraith, "whether it's clients, owners or people involved with horse racing."

"Make yourself available to the media for whatever information they might need. Don't hesitate to step up," Bramlage says.

Kane is a Seattle author, researcher and consultant in animal nutrition, physiology and veterinary medicine, with a background in horses, pets and livestock.