Palmer: 'PET Scan Not Appropriate As Initial Screening Tool'

Dr. Scott Palmer | AAEP

New York State Equine Medical Director Dr. Scott Palmer has described Positron Emission Tomography (PET) scan as a “fantastic diagnostic tool” and that “it can play a very important role” in helping to identify and pinpoint subtle musculoskeletal injuries in horses, but that the scan is not the best initial screening tool in singling out horses at risk for catastrophic injuries.

Palmer addressed the issue during an equine health and safety briefing held at Tuesday's meeting of the New York State Gaming Commission and also offered some preliminary findings  on the 17 equine fatalities recorded during this summer's Saratoga meeting.

“Identification of horses at risk for catastrophic injury must begin with a screening protocol that can be scalable, practical, affordable, and can be used by every horse while training or racing without regard to any clinical indication of injury,” Palmer said in revised comments issued Wednesday. “Wearable biometric sensors are best suited to accomplish this first level of screening. These sensors detect subtle abnormalities in a horse's gait that are not detectable with the human eye. They serve as a 'check engine' light that alerts us to the possibility that there is something wrong with the horse and that the horse should be examined by a veterinarian.

“The veterinary examination is the second level of screening for an abnormality that might predispose a horse to injury. The goal is to reach a diagnosis of musculoskeletal abnormalities and typically will include use of diagnostic nerve blocks and digital radiography. If lameness is detected in a limb during this examination and digital radiographs are inconclusive, then advanced imaging such as PET can be employed as a final screening step in this process.

“In summary, PET can play a very important role in the diagnosis of subtle musculoskeletal injuries in horses, but it is not useful at the initial screening level,” he concluded.

Palmer added that biometric sensors placed in horses' saddlecloths that can help identify at-risk animals, are “not quite ready for 'prime time' use” at this time.

In referencing the 17 Saratoga fatalities–a number that is approximately 1% of the 2000 horses stabled at the track but three times higher than 2021 and 2022–Palmer noted that the incidents were clustered around Whitney and Travers weekends. He added that fetlock injuries, typically responsible for 48-50% of fatal musculoskeletal injuries in New York and California over the last decade, represented 92% of all the exercise-associated fatal musculoskeletal injuries at Saratoga, a “significant finding” in Palmer's estimation.

Twelve of the 13 exercise-associated injuries occurred either during the final furlongs of the race or during the gallop out, suggesting that fatigue was also a contributing factor.

Palmer explained that the unprecedented 11 inches of rain that fell during the meet–compared to nine inches in 2021 and 8 inches in 2022–had a material impact on the consistency of the racing surfaces. During the meet, there were 65 surface changes (16%) compared to just 17 (4%) in 2022. With those facts in mind, “increased moisture in the Saratoga main dirt track and spatial and temporal variation of the moisture content of the track during the meet were likely contributing factors to the increase in the number of racing fatalities.”

A comprehensive report of the investigation will be made available to the public as soon as the investigation is complete.

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