Unraveling the mystery of poor performance

As a former racetrack practitioner, I am far too familiar with the frustrations of evaluating unrealized athletic potential in the horse. In a game based on hope, disappointment is often a heavyhanded opposition player. As the saying goes, “there are a thousand ways to lose a horse race,” and each is usually accompanied by a veterinary examination the following day. The causes of poor performance vary from orthopedic injury, to illness, to respiratory or cardiac insufficiencies, and sometimes even to emotional disturbances. The practicing sport horse veterinarian usually is charged with the task of sorting through this list of endless possibilities to find the means by which all parties—the horse, the trainer, the owner, and the $2 dollar better—can be made well. He/she calls on their training, intellect, experience, and existential powers to find the true solution. This process can vary from an obvious and quick diagnosis of lameness to a long and arduous task akin to unraveling a murder mystery. Fortunately, today’s modern veterinary practitioner has a widening array of diagnostic tools at his/her disposal. These new tools make finding the cause of lameness or determining the source of a respiratory noise much easier. Innovations such as ultrasound, nuclear scintigraphy, and even computed tomography scanning technologies have been combined with the tried and true methods of diagnostic nerve blocks and radiographs to greatly facilitate the conduct of a lameness examination. Each technical innovation brings with it the expansion of medical knowledge and treatment for previously unexplained maladies. The fiberoptic endoscope is an example of a technical innovation that completely changed, not only the diagnostic methodology but also the total understanding of upper respiratory disease in the horse. Although these new and not-so-new innovations have greatly facilitated the practitioner’s ability to find the answer as to why a horse is not performing up to expectations, there are still some causes that elude the normal diagnostic net. As a result, clinicians at several veterinary medical schools around the country have combined with medical research specialists to develop the art and science of equine performance evaluation. They are employed on a referral basis from equine practitioners to attempt to solve that small percentage of cases in which a diagnosis cannot be achieved through standard medical assessment procedures. A recent issue of our Horse Report described in detail the performance evaluation process that is currently being conducted at the University of California (UC), Davis Veterinary Medical Teaching Hospital. Our approach employs the participation of several equine clinicians and researchers with varying areas of expertise working together as a team to expedite the process of diagnosis. Our veterinary faculty often uses this team approach to expedite and ensure the successful solution of complicated problems. The diagnostic process described is the result of a careful melding of available technical methodology and sound medical knowledge. The performance testing techniques used here at UC Davis have been thoroughly tested in the research laboratory to ensure their applicability, once again, showing the contribution quality scientific research makes to the clinical conduct of equine medicine. We at the UC Davis Center for Equine Health are glad to have our report reprinted in this issue of JEVS in an edited format. From the University of California, Davis Center for Equine Health, Address reprint requests to Gregory L. Ferraro, DVM, UC Davis Center for Equine Health, Copyright 2002, Elsevier Science (USA). All rights reserved. 0737-0806/02/2208-0002$35.00/0 doi:10.1053/jevs.2002.37101