title: Training-related factors associated with dorsometacarpal disease in young Thoroughbred racehorses in the UK.
abstract: BACKGROUND
  Dorsometacarpal disease (DMD) is common in young Thoroughbred (TB) racehorses, often interfering with their training programme. No reports exist on incidence rate or associated risk factors in the UK.
  
  
  OBJECTIVE
  To estimate the incidence rate of DMD in TB horses in training for flat racing in the UK and identify associated risk factors, particularly in relation to training regimens.
  
  
  METHODS
  Data were drawn from a large prospective study in which TB horses in 13 training yards were monitored for a period of up to 2 years, recording daily training information and details of musculoskeletal injury, including DMD. The incidence of DMD was calculated and survival analysis performed to determine features of the training regimen related to the risk of disease.
  
  
  RESULTS
  A total of 335 horses provided 4235 months at risk of DMD. Seventy-nine first episodes were recorded, resulting in an incidence rate of 1.87/100 horse months (95% confidence interval 1.50-2.33). Increasing exercise distances at canter and high speed in short periods (up to 1 month) were associated with an increasing risk of DMD. However, increasing cumulative exercise distances since entering training were associated with a decreasing risk of the disease.
  
  
  CONCLUSIONS
  The risk of DMD in young TBs decreases with accumulation of distances exercised at canter and high speed; this reflects the adaptive response of the third metacarpal bone to the loads placed upon it. However, increasing exercise distances in short periods (up to 1 month) increases the risk of DMD, probably as a consequence of microdamage and its associated remodelling response, and should therefore be avoided.
  
  
  CONCLUSIONS
  Training regimens for young TBs can be adjusted to prevent the occurrence of DMD. Early but gradual introduction of small amounts of high-speed exercise may be beneficial. Canter exercise should be kept minimal on high-speed work days and large amounts of both cantering and high-speed work per week, 2 weeks or per month should be avoided, particularly during the early stages of training, in order to minimise the risk of DMD.
authors.affiliation: Epidemiology Unit, Animal Health Trust, Lanwades Park, Kentford, Suffolk CB8 7UU, UK.
authors.forename: K L P
authors.initials: KL
authors.lastname: Verheyen
authors.forename: W E
authors.initials: WE
authors.lastname: Henley
authors.forename: J S
authors.initials: JS
authors.lastname: Price
authors.forename: J L N
authors.initials: JL
authors.lastname: Wood
mesh_terms: D000818:Animals; D001947:Breeding; D005260:Female; D006734:Horse Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006736:Horses; D015994:Incidence; D007592:Joint Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control / Q000662:veterinary*; D007794:Lameness, Animal / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008663:Metacarpus / Q000293:injuries*; D010805:Physical Conditioning, Animal / Q000009:adverse effects* / Q000502:physiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology