131ST BELMONT STAKES

June 5, 1999

Larry Bramlage

DR. BRAMLAGE: Sure. I just got off the phone from Dr. Selway. He's the attending veterinarian. The x-rays are back. He has a lateral condylar fracture, bottom of the cannon bone right into the ankle. Unfortunately, he displaced it. He has a crack in the sesamoid bone. That means he's through as a racehorse. The fracture, it's urgent but not an emergency, not like he'll go right to surgery. The horse will be able to settle down. The splint will take care of him. In a day or two, two or three screws will be put in the condyle. We expect him to be fine as a stallion. But, unfortunately, this is the end of his career. When they get that fracture, it usually means that it happened and they continued on before you get them pulled up. The horse tries to run on through it and, you know, it's pure speculation as to when it could have happened. But it's likely it happened right near the wire. So Chris knew pretty soon after the wire, you could see him looking around to see who was coming behind him, so he knew pretty soon after the wire that the horse wasn't smooth anymore.

DR. BRAMLAGE: He handled it fine, considering he's going from running 35 miles an hour to an ambulance. The horse showed a lot of class, walked into the stall, they x-rayed him.

DR. BRAMLAGE: One that was a little less severe, Acceptable from just before the Derby. In fact, last year he won three or four stakes in a row for coming back after the injury, probably the closest injury to the type of injury that he had that I can remember off the top of my head are Flanders in a Breeder's Cup a couple years ago. Exactly the same thing, displaced condylar fracture, fracture of the sesamoid.

DR. BRAMLAGE: That's the reason why he won't go immediately to the surgery table. They become a better patient if you give them a little bit of a chance to settle down from the race. He was at a fine-tuned pitch with his level of fitness, so, that's why you let them get calmed down and they go in and out of surgery better. There's always the concern of a horse going in and out of surgery. As you know, it used to be much more of a problem than it is now. Now we do it fairly routine.

DR. BRAMLAGE: Left front.

DR. BRAMLAGE: The horse will tell them. It will be in the next day or two. If he's settled down and quiet and calm they may do it Tuesday, maybe Wednesday. It wouldn't be a problem if the horse needed to wait to the end of the week. But it needs to be stabilized at some point.

DR. BRAMLAGE: The people from -- I mean, I'm not doing this just to blow wind up your shirt, John, but the people from Belmont are the very best at getting to the injury, letting us know what they've got, where the injury location is. They took him right back to the barn, Dr. Selway was waiting. They radiographed him. Within 20 minutes they had the diagnosis. That's better than you do with most football players.

DR. BRAMLAGE: Yes. Go For Wand was one of the stimulus for us getting together with the on-call program for the AAEP, which is what I'm doing here today, actually having or practicing in Lexington, Kentucky. The people on the ambulance have to be able to do their job and the primary job is to stabilize the horse and take care of him. As soon as that's done, they call us on television and come down here. I'm sorry I'm late getting here. ESP and CNN had to split right at 6 o'clock. We had to do an update for them. As part of the Association of Equine Practitioners to get this information to these guys quickly and as accurately as we can.

DR. BRAMLAGE: The horse ambulance waits in the gap right off the track. As soon as the veterinarian stationed in the stands at the Winner's Circle saw that Chris Antley was pulling the horse up, by radio he contacts the horse ambulance. The outrider can also contact the horse ambulance. So as soon as any one of them sees there is a problem, then the horse ambulance rolls to pick up the horse.

DR. BRAMLAGE: Yes, but the person with the splint to do the First Aid was in the Winner's Circle and he was there within a minute of whenever Chris got off and picked up the horse's leg.

DR. BRAMLAGE: Dr. Kunz right here gave me the preliminary diagnosis on her examination of the horse. She was the one there. Maybe she should be the one to respond to that. By the location of the swelling and her experience with taking care of these horses on a daily basis when they're racing, she knew what the likely diagnosis was and then went with the horse and when the radiographs were done, passed it up to us.

DR. BRAMLAGE: The response for First Aid, absolutely. That's here for any race. The response as far as getting the word to television and news media is only done when there's a nationally televised race.

DR. BRAMLAGE: We're all in the business of -- we all have a sort of love of horse racing and the part of the problem with speculation is it may or may not be accurate and it's always the first news that gets read. When you come back and correct an error, it's -- a lot of people don't even know it. So it's very important for us in horse racing as well as for us in the veterinary profession to get you the information as quickly and accurately as we can so that first news story has got the right stuff in it.

DR. BRAMLAGE: Absolutely. Advances in the ability to anesthetize and recover a horse. There are advances in knowledge in surgical techniques. You know, we now know that we have better splints. We know that this kind of fracture is not an emergency. Ten years ago these were kind of uncommon, where this is a pretty common fracture for us now, so it's something that we routinely repair. I mentioned Acceptable. This fracture is a little less severe. He's back running stakes races the next year. But Charismatic, in addition to fracturing the cannon bone fractured a sesamoid behind it. We won't go into the discussion of the biomechanics of that. That means when the fractured happened, he went on a little bit before he showed it and before they could get him pulled up. And you know, the top class athletes, whether they're people or horses, they can play with pain and so a horse becomes his own enemy when he's trying to keep running, yet he's got a problem that's getting worse with every stride.

DR. BRAMLAGE: No. Tranquilizer were given, antiinflammatories, settle him down. Normally a horse cools out for some period of time after the race. You know, it's the process that takes a half hour, 45 minutes or an hour, depending on the length of the race and the horse. Now you got one who's just finished a mile and a half. He can't even be walked and has to go right to his stall. So you know you have to take care of the horse as well. You can imagine if you just finished a race and they put you in bed, the next morning you're going to be pretty stiff. That's why it's better not to take him to surgery until he's back to normal.

DR. BRAMLAGE: No indication. He had gone a mile and almost a half and he was right with the leaders. If he had had some ongoing problem that, you know, he's not going to be doing that. So this is something that happened right at the end. We struggle this with every day, because bones fracture a lot like porcelain in that they may get a little bit of a crack right in the midst of the race and all of a sudden like a coffee cup that splits apart. Unfortunately, we find some they have when they look like your cup with a crack in it and everything is together they know something is wrong with the horse. They show it in the morning. Common scenario. They come off the track fine. They get the bath as they walk off, stiff and sore. Those are the cracks that happen before they displaced. This horse's crack happened in the middle of, the end of the race, as he's trying to go with those horses. It's going to propagate and it cracks free. So there's no indication and I think you can be confident that this horse didn't have some ongoing problem that then resulted in this. This is something he did in the race.

DR. BRAMLAGE: Well, I'm the American Association of Equine Practitioners' on-call veterinarian. On-call is the word we've given to the situation of providing someone to give accurate information by taking someone out of the midst of the care of the horse and having them available by radio to talk to initially television and then print. And then with the help of Dr. Celeste Kunz from here and Dr. Steve Selway, the horse's attending veterinarian, now we know the extent of the injury, the prognosis and the required treatment.

DR. BRAMLAGE: It's already done on all the nationally televised racing. Not only the thoroughbred, but for the standardbred races the races at the Meadowlands. The Little Brown Jug. It's being done as part of your veterinary responsibility to the racing community. Everybody has taken a new hold in their responsibility with the NTRA and the cooperation of all the racetracks and the fractures of the industry. This is our part.

DR. BRAMLAGE: We know the incidents of very serious injuries in racehorses from statistical study that have been done in the past that the incidents of injury, for instance, in Kentucky where I practice is point one percent. And you know this, that's not to say that that includes all injuries where the horse is going to have little chip fractures and those sort of things ordinary routine everyday. These are horses that get injured on the racetrack and have to have an ambulance take them off. You know many of those end up being fatal injuries because they're horses, they're not people. You can't put them in bed. The difficulty of treating them is magnified by their size and temperament, and those things we know about. So the incidents, as I said, is somewhere just above one-tenth of one percent in horses. And you know horses are pretty fragile animals to be that big and that fast and run on those small legs.

DR. BRAMLAGE: Yes.

DR. BRAMLAGE: Yes.

DR. BRAMLAGE: The horse was blooming with the injury -- I mean, I'm sorry the horse was blooming with the training and, you know, it's unusual for a horse running in the stakes races to be able to maintain their class at this level for this period of time, but horses certainly can race every two weeks. You go to the horses that are racing in the stables that are lesser class than they're racing in claiming races. They'll be going out every two weeks and some places even more often that that. It was very hard to make the case the horse was raced too heavily. He was thriving on the way he was raced. This is just an unfortunate accident. You know, we joke in the veterinary community that slow horses don't hurt themselves. Obviously, the force being the mass times the velocity is going to be a lot bigger in a horse with talent. So they're kind of running on the edge of their physiology all the time.

DR. BRAMLAGE: It's not a compound fracture now. I don't mind explaining the biomechanics. I didn't know how interested you guys were. What happens with a condylar fracture is -- do you have those pictures?

DR. BRAMLAGE: C-O-N-D-Y-L-A-R. The guys in the press box aren't going to be able to see this probably. But this is a drawing of the bottom of the cannon bone and the reason it's called a condylar fracture is these two flat places on both sides of the bone are anatomically called condyles, so that's -- I mean, it's as simple as that, is that a condylar fracture is a fracture of that part of the bone.

DR. BRAMLAGE: The reason it's called a condylar fracture is that the anatomic part of the bone that he fractured is called a condyle, and that's the flat area. There's one on each side of the bone with a ridge in the middle. So he broke from here and his ankle up at an angle up through the side of the bone. You mentioned compound fracture before. Actually, compound fracture is an antiquated term. It's stuck in kind of the lexicon, but that would properly be called an open fracture, meaning it went to the skin, which he does not have. He does not have an open fracture. That's the next thing that happens if Chris Antley isn't aware that something is wrong and they pull him up, sometimes the bone, the sharp end of the bone, will actually go out through the skin.

DR. BRAMLAGE: No, no, much worse off to race on. If he races on that little, you know, fractured bones have little pointed ends and horse's skin is very thin. You know, people get the concept that horses have, because they're big animals, they have real thick skin. It's thinner than ours. And certainly thinner than, for instance, the leather we have on our shoes which is cowhide for the most part. They have thin skin. Doesn't take much for those bones to poke through the skin. If it does, it immediately becomes a more serious injury. Then you have to worry about infection. But he does not have a compound fracture or the correct term would be open fracture. That's not part of his diagnosis.

DR. BRAMLAGE: He loved what he was doing out there today. He wanted to run on. And so it's -- I think if you just look at those animals running and how they thrive on that sort of athletic competition, you get some idea. If you want to know further, come visit us in Lexington. You'll see it everyday. They race among themselves in the field. All the colts will be out and they're seeing who's the fastest. Horses are made and are physiologically and psychologically running animals. They probably do it better than any animal that there is. We, a few years ago had a stallion fracture his cannon bone spontaneously in the paddock racing a car. Now, if you think they don't like to run. He didn't have any -- stallions can't be turned out with other horses. He didn't have any other horses to race. He's racing a car along the road and spontaneously cracked his cannon bone. It wasn't from too much training with him. It's just -- they're going so fast, you load that bone a bit unevenly and you know they can break it. And what probably is being referred to in the back of the room is that some of the horse -- we know now that some horse injuries the bone cycles through weaknesses and strengths during the process of training and that some injuries are the result of multiple cycling loading which creates a weak spot and if you load it unevenly that something will happen. That's mostly in younger horses that are adapting to racing and training.

DR. BRAMLAGE: Dr. Selway did them here in the horse's stall, took him to his clinic, and the horse is still in his stall.