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Biomedical subjects

C J Proudman

Publications and source records attributed to C J Proudman.

At least 19 recordsLinked to original sources
PubMed2006

Analysis of horse race videos to identify intra-race risk factors for fatal distal limb fracture.

The objective of this study was to identify risk factors, during racing, associated with imminent fatal distal limb fracture in Thoroughbreds. One hundred and nine cases of fatal distal limb fracture were identified from all 59 UK racecourses over a 2-year period (February 1999-January 2001). Three uninjured control horses were randomly selected from the same race as the case horse. Videos of races in which fractures occurred were viewed using a defined protocol. Fractures in flat races occurred at any time during the race, whereas 74% (45/61) of cases in national hunt type races occurred in the second half of races. More than 75% (79/103) of cases were spontaneous, i.e. there was no obvious external influence such as a fall at a fence or collision with another horse. Sixty-six percent (44/67) of horses, sustaining a forelimb fracture, fractured the forelimb they were using as lead leg at the time of fracture. When case and control horses were compared, horses that were: (a) making good progress through the race, (b) reluctant to start and (c) received encouragement in the final 10s before the time of fracture, were more likely to sustain a fracture.

Animals↗
PubMed2006

Catastrophic fracture of the lateral condyle of the third metacarpus/metatarsus in UK racehorses - fracture descriptions and pre-existing pathology.

The characteristics of, and pre-existing pathology associated with 75 cases of fatal lateral condylar fracture sustained by Thoroughbreds while racing in the UK were described. Cases were identified from 220 cases of fatal distal limb fracture submitted as part of studies designed to identify risk factors for all fatal distal limb fractures. Fractures were most common in hurdle races and affected the right forelimb twice as often as the left forelimb. Fracture dimensions were similar to previous reports, however there was a much greater prevalence of articular and diaphyseal comminution and of concurrent fractures in the current report. Pre-existing pathology was particularly common in the medial and lateral parasagittal grooves of the distal articular surfaces of the third metacarpus/metatarsus. The degree of this pathology was not associated with horse age, length of career or number of career starts.

Animals↗
PubMed2006

The risk of a horse-and-rider partnership falling on the cross-country phase of eventing competitions.

REASONS FOR PERFORMING STUDY: Fatalities resulting from horse falls occurring during the cross-country phase of eventing competitions initiated epidemiological investigation of the risk factors associated with horse falls. OBJECTIVES: To identify variables that increased or decreased the risk of a horse fall during the cross-country phase of an eventing competition. METHODS: Data were collected from randomly selected British Eventing competitions held in Great Britain during 2001 and 2002. Data were obtained for 173 cases (jumping efforts resulting in a fall of the horse-and-rider partnership) and 503 matched controls (jumping efforts not resulting in a fall). The risk of falling was modelled using conditional logistic regression. RESULTS: An increased risk of a horse fall was associated with jumping into or out of water; taking off from good-to-soft, soft or heavy ground; fences with a drop landing; nonangled fences with a spread > or =2 m; and angled fences. Other risk factors included riders who knew that they were in the lead within the competition before the cross-country phase; an inappropriate speed of approach to the fence (too fast or too slow); horse-and-rider partnerships that had not incurred refusals at earlier fences; and riders who received cross-country tuition. CONCLUSIONS: This study has identified modifiable course- and fence-level risk factors for horse falls during the cross-country phase of eventing competitions. The risk of horse and rider injury at eventing competitions should be reduced by 3 simple measures; maintaining good to firm take-off surfaces at fences, reducing the base spread of fences to <2 m and reducing the use of fences at which horses are required to jump into or out of water. Risk reduction arising from course and fence modification needs to be confirmed by intervention studies. POTENTIAL RELEVANCE: Knowledge of factors that increase or decrease the risk of a horse fall can be used by UK governing bodies of the sport to reduce the risk of horse falls on the cross-country phase of eventing competitions, and reduce the risk of horse and rider injuries and fatalities. As one in 3 horses that fall injure themselves and one in 100 horse falls results in fatality to the horse, we suggest that immediate consideration is given to these recommendations.

Accidental Falls↗
PubMed2005

Risk factors for cross-country horse falls at one-day events and at two-/three-day events.

The cross-country phase of eventing competitions has been associated with injuries and fatalities to horses and riders. A case-control study was carried out to identify variables that were associated with increased or decreased risk of a horse fall on the cross-country phase at event competitions. After initial analysis, the dataset was split according to the categories of one-day events as compared to two- or three-day events to establish whether significant risk factors varied between the different types of eventing competitions. Data were collected for 121 cases (horse falls) at one-day events, 59 cases at two- or three-day events and for their 540 matched controls. The data were analysed using conditional logistic regression. The variables of no previous refusals on the course, fences with a landing in water and the combined variable of the angle and the spread of the fence were significantly associated with the risk of a horse fall in both datasets. Additional risk factors for one-day event falls were: fences requiring a take-off from water, a drop landing, the rider's knowledge of their position before the cross-country phase and if the rider received cross-country tuition. Three-day event risk factors in the multivariable model included: the camber of the fence and participation in non-equestrian sports by the rider. This study identified variables that were significantly associated with an increase or a decrease in the risk of a horse fall during the cross-country phase of different types of eventing competitions. Some of these variables are modifiable and the results of this study have been reported to the governing body of the sport of eventing in the UK so that possible interventions might be considered.

Accidental Falls↗
PubMed2005

Epidemiological clues to preventing colic.

Colic remains a significant problem in the horse in terms of welfare and economics; in some equine populations it is the single most common cause of death. Many causes of colic are cited in the equestrian and veterinary literature but little scientific evidence exists to substantiate these theories. Recent epidemiological investigations have confirmed that colic is complex and multi-factorial in nature. Studies have identified a number of factors that are associated with increased risk of colic including parasite burden, certain feed types, recent change in feeding practices, stabling, lack of access to pasture and water, increasing exercise and transport. These findings are reviewed together with examples of management practices that may be altered to reduce the incidence of specific types of colic. This is an opinionated, not a systematic, review focusing on those areas that are considered most relevant to the practitioner.

Animal Feed↗
PubMed2005

Cytokine responses to Cyathostominae larvae in the equine large intestinal wall.

To investigate cytokine responses in cyathostomin infection, we quantified mucosal interleukin-4 (IL-4), interleukin-10 (IL-10), tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma by reverse transcriptase-competitive polymerase chain reaction. The analysis was performed on large intestinal wall samples obtained from six anatomical sites spanning the caecum and colon of 17 naturally exposed horses. The numbers of developing larvae (DL) and early third stage larvae (EL3) were ascertained using transmural illumination and pepsin digestion techniques, respectively. Levels of each cytokine transcript were correlated with local intestinal wall burdens of Cyathostominae larvae. IL-4 and IL-10 levels showed significant correlations with EL3 and DL burdens at several sites. No significant correlations were observed with IFNgamma. A pro-inflammatory response, typified by detection of TNFalpha transcript, was observed at a few sites in some horses with inflammatory enteropathy associated with emerging or emerged larvae. However, this cytokine was measured at an insufficient number of sites to enable statistical analysis. Levels of IL-4, IL-10 and IFNgamma transcript were compared between two groups: one group consisting of horses with low to high mucosal burdens (Group A) and the other, of horses with negative/negligible mucosal burdens (Group B). Significant differences in IL-4 (P<0.001) and IL-10 (P<0.001) transcript levels were observed between the groups, with higher levels observed in Group A. No significant differences in IFNgamma were observed. Taken together, these results indicate that Th2 responses predominate in mucosal Cyathostominae infection prior to larval reactivation.

Animals↗
PubMed2005

Evaluation of the clinical efficacy of prokinetic drugs in the management of post-operative ileus: can retrospective data help us?

The objectives of the study were to determine whether retrospective data can be used to answer questions about the efficacy of prokinetic agents when used to treat horses with post-operative ileus (POI). We describe prevalence and mortality of POI with reference to treatment with four prokinetic agents. By combining data from two Hospitals a study population of 55 horses with POI following pedunculated lipoma obstruction (PLO) was established. Univariable and multivariable associations were determined between short term survival and potential explanatory variables. With death as outcome in multivariable models, breed and hospital were significantly associated with outcome but the use of prokinetic agents was not (P=0.15). However, sample size estimates indicate the low power of this study to detect differences in outcome. It was not possible definitively to evaluate the efficacy of prokinetics as treatment for POI following PLO using retrospective data. The data were suggestive of limited efficacy of prokinetics as treatment for POI. It is postulated that the identified association between hospital and survival reflects differences in clinician decision making. The study highlights the need for further prospective studies using randomised clinical trials to evaluate accurately the efficacy of prokinetic agents. This report illustrates difficulties with performing retrospective analysis of clinical data to determine the efficacy of treatment regimes.

Animals↗
PubMed2005

Clustering of equine grass sickness cases in the United Kingdom: a study considering the effect of position-dependent reporting on the space-time K-function.

Equine grass sickness (EGS) is a largely fatal, pasture-associated dysautonomia. Although the aetiology of this disease is unknown, there is increasing evidence that Clostridium botulinum type C plays an important role in this condition. The disease is widespread in the United Kingdom, with the highest incidence believed to occur in Scotland. EGS also shows strong seasonal variation (most cases are reported between April and July). Data from histologically confirmed cases of EGS from England and Wales in 1999 and 2000 were collected from UK veterinary diagnostic centres. The data did not represent a complete census of cases, and the proportion of all cases reported to the centres would have varied in space and, independently, in time. We consider the variable reporting of this condition and the appropriateness of the space-time K-function when exploring the spatial-temporal properties of a 'thinned' point process. We conclude that such position-dependent under-reporting of EGS does not invalidate the Monte Carlo test for space-time interaction, and find strong evidence for space time clustering of EGS cases (P < 0.001). This may be attributed to contagious or other spatially and temporally localized processes such as local climate and/or pasture management practices.

Animals↗
PubMed2005

Modelling long-term survival of horses following surgery for large intestinal disease.

REASONS FOR PERFORMING STUDY: Large intestinal diseases are an important cause of equine colic that require surgical management, but there is little published information about long-term survival of such cases. OBJECTIVES: To identify variables associated with post operative mortality and to develop a model for post operative survival following surgery for large intestinal disease. METHODS: Clinical data and long-term follow-up information from 275 horses undergoing surgery for large intestinal disease were used. A multivariable, Cox proportional hazards model for post operative death was developed and the fit of the model evaluated. RESULTS: The continuous variables age, heart rate and packed cell volume (PCV) were associated positively with the risk of post operative death, as were the categorical variables resection (odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2-5.1) and relaparotomy (OR 3.5, 95% CI 1.4-8.4). CONCLUSIONS: In the population studied, the probability of post operative survival following surgery for large intestinal disease was associated with the cardiovascular parameters heart rate and PCV on admission, age of the horse and whether it underwent resection or relaparotomy. POTENTIAL RELEVANCE: The prognosis for post operative survival for horses with large intestinal disease may be improved by early surgery, prior to the development of cardiovascular compromise. Surgeons should be aware that increasing age, resection of large colon and relaparotomy are all associated with a worsening prognosis for survival.

Age Factors↗
PubMed2005

Factors affecting long-term survival of horses recovering from surgery of the small intestine.

REASONS FOR PERFORMING STUDY: Epiploic foramen entrapment (EFE) has been associated with a particularly poor post operative prognosis for equine colic cases, but the reasons for this are unknown. OBJECTIVES: To identify variables associated with post operative survival following surgery for small intestinal disease; develop a model describing long-term post operative survival; and identify reasons for the poor prognosis associated with EFE. METHODS: Data from 382 horses undergoing surgery were used to identify variables associated with survival. A multivariable Cox proportional hazards model for post operative survival was developed and model fit evaluated. RESULTS: The final model included the variables total plasma protein (TP) and packed cell volume (PCV) at admission, duration of surgery and the dichotomous variable relaparotomy (yes/no). Risk of death was positively associated with increasing PCV, but negatively associated with increasing TP (which decreased the probability of death). In a univariable model, EFE cases had a significantly higher death rate than other types of small intestinal disease (hazard ratio = 1.7, P = 0.035). Multivariable modelling indicated that some of the increased risk associated with EFE cases was due to lower TP values and longer duration of surgery. CONCLUSIONS: Preoperative TP is associated negatively with the risk of post operative death in horses recovering from small intestinal surgery. Other variables associated with the probability of survival are preoperative PCV, duration of surgery and relaparotomy. The increased post operative death rate of EFE cases can be explained in part by lower TP and longer surgery times of these cases. POTENTIAL RELEVANCE: Total plasma protein may be not simply a measure of hydration status in small intestinal colic cases, but an important determinant of survival. Further investigation of this relationship is warranted. Our model for post operative survival highlights the importance of preoperative TP, PCV and duration of surgery as prognostic indicators. This information should allow a more accurate post operative prognosis following small intestinal surgery.

Animals↗
PubMed2005

Risk factors for fatal lateral condylar fracture of the third metacarpus/metatarsus in UK racing.

REASONS FOR PERFORMING STUDY: Lateral condylar fractures of the third metacarpus/metatarsus are the most common cause of equine fatality on UK racecourses. Identification of risk factors for such injuries and the subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities. OBJECTIVES: To identify horse-, race- and course-level risk factors for fatal lateral condylar fracture in Thoroughbreds on UK racecourses. METHODS: Case-control study designs were used. Case horses were defined as those that were subjected to euthanasia having sustained an irreparable lateral condylar fracture while racing at any of the 59 UK racecourses. Case races were defined as those in which one or more horses sustained a fatal lateral condylar fracture. Three controls for each case horse were selected at random from the race in which the case was running. Three controls for each case race were selected at random from all races of the same type held in the same year. Ninety-eight cases were included in the study. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture. RESULTS: Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have started racing as 3- or 4-year-olds. Fractures were found to be more likely in longer races with a larger number of runners, races in which professional jockeys were not permitted to ride and races in which the going was described as firm or hard. CONCLUSIONS AND POTENTIAL RELEVANCE: Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal lateral condylar fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 201 m (1 furlong) and 1609 m (8 furlongs) per week. The association with age at first race requires further investigation for flat and National Hunt racing separately. A reduction in the number of races taking place on very firm going could have an impact on the number of lateral condylar fractures.

Age Factors↗
PubMed2004

Pre-operative and anaesthesia-related risk factors for mortality in equine colic cases.

Mortality rates for horses that have undergone emergency abdominal surgery are higher than for other procedures. Here, multivariable modelling of data from 774 surgical colic cases is used to identify pre-operative and anaesthesia-related variables associated with intra- and post-operative mortality. Intra-operative mortality was significantly (P<0.05), and positively associated with heart rate and packed cell volume (PCV) at admission, and negatively associated with the severity of pain. Post-operative mortality increased with increasing age and PCV at admission. Draught horses, Thoroughbreds and Thoroughbred-cross horses carried a significantly worse prognosis. We detected a small but significant variability in the risk of intra-operative death amongst referring veterinary surgeons. Different anaesthetic induction agents, inhalation maintenance agents and the use, or not, of intermittent positive pressure ventilation had no significant effect on risk of death. We conclude that cardiovascular compromise, level of pain, age, and breed are all associated with the risk of mortality in equine surgical colic cases.

Age Factors↗
PubMed2004

Case-control investigation of the factors affecting the risk of horses falling during steeplechase racing in the UK.

A concurrent case-control study of 12 UK racecourses was made between March 1, 2000, and August 31, 2001, to identify and quantify the factors associated with the risk of horses falling in steeplechase races. Cases were defined as a jumping effort at a steeplechase fence that resulted in a fall and controls were defined as a successful jumping effort over any steeplechase fence at any of the 12 racecourses within 14 days before or after the case fall. Information on the horse, the jockey and the race were collected and all the fences on all the courses were surveyed. Conditional logistic regression was used to examine the relationships between the predictor variables and the risk of falling. There was one fall per 254 jumping efforts. The risk of a horse falling decreased the more times it had raced on a particular racecourse. The number of fences, the distance from the previous fence and the nature of the previous fence also affected the risk of falling. If the previous fence was a water jump the risk of falling increased; fences that were sited on flat or slight uphill gradients (up to approximately 1 in 25) were associated with a lower risk of horses falling than downhill fences, and higher takeoff boards were associated with a higher risk of falling.

Accidental Falls↗
PubMed2004

Memory decay and performance-related information bias in the reporting of scores by event riders.

We used data from a case-control study investigating risk factors for horse falls in the cross-country phase of eventing in Great Britain (GB) to examine evidence for memory decay and information bias. Responses to two questions obtained by telephone for 173 cases and 521 controls were examined for evidence of differential reporting according to the respondent's case-control status and performance in the dressage and cross-country phases of competitions. Information bias was found in the accuracy of reporting dressage penalty scores when analysed as a function of performance level (good/poor). Poor dressage performers were less likely to report accurate dressage scores than good performers. The accuracy of reporting dressage scores decreased as the time between the event and questionnaire completion increased, with no case-control interaction. Competitors who incurred cross-country jumping penalties at the event preceding the selected event reported their cross-country scores with less accuracy when compared with competitors who incurred no penalties. No information bias was found when the reporting of dressage and cross-country scores were analysed as a function of respondent category (case/control).

Accidental Falls↗
PubMed2004

Risk of fatal distal limb fractures among Thoroughbreds involved in the five types of racing in the United Kingdom.

The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the third metacarpus were the most common, and they were also the most common in national hunt-type races (hurdle, steeplechase and national hunt flat races). In all-weather flat racing biaxial proximal sesamoid fractures were most common, and in turf flat racing fractures of the first phalanx were most common. The risk of fractures of more than one bone was greater in national hunt-type races.

Animals↗