Ill PROCEEDINGS OF THE FIRST INTERNATIONAL CONFERENCE ON EQUINE RESCUE

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SAFETY IN THREE-DAY EVENTING

Catherine W. Kohn, VMD

Introduction

Three-day eventing is a strenuous sport that requires a fit, well-trained equine athlete and a rider who is an excellent horseperson. The horse must compete in Dressage on day 1, the Speed and Endurance test on day 2, and Stadium Jumping on day 3. Distances, speeds and number and difficulty of jumping efforts vary with the level, (degree of difficulty) of the competition. Horses must qualify to be allowed to compete at each level. This system ensures that only horses which are ready to take on the more difficult levels are allowed entry.

In order t o compete safely, the rider must have conditioned his horse very well, must know his horse's abilities and must be particularly sensitive to the responses of the horse to the intense exercise during the Speed and Endurance Test. To successfully complete Phases A and C (Roads and Tracks, 7920-16060 meters at 240 m/min) the horse must be fit for endurance work, while Phase B (Steeplechase, 2240-2760 meters with 7-9 jumping efforts) requires that the horse be able to gallop and jump fences at speed (640-690 meters/minute). During Phase D (Cross Country) the horse must cover 4500 to 6500 meters with 24 to 36 jumping efforts. Optimum speeds for Phase D range from 520 to 570 meters/minute. Thus the 3-day event horse must be conditioned for endurance, speed and jumping work and the sport is therefore aptly known as Combined Training.

The sport was developed in northern Europe where cool, wet weather is the rule during the competition season. The calendar for 3-day events in the USA has been adjusted so that competitions occur primarily during cool weather. A notable exception will be the Atlanta Olympic event in 1996. When hot and humid weather does prevail, certain adaptations in the sport are necessary to assure safety of horse and rider.

Three-day eventing is sanctioned in the USA by the American Horse Shows Association and the United States Combined Training Association, and internationally by the

Author's address: Department of Veterinary Clinical Sciences, The Ohio State University, 601 Vernon L. Tharp St., Columbus, OH 43210.

Federation Equestre Intemationale (FEI). Although the rules governing national and international competitions are somewhat different, both stipulate that veterinarians be involved in the regulation of all events. The official veterinarian, called the Veterinarian Delegate (VD), works closely with the judges and is responsible for the welfare of the equine athletes.

In this sport every effort is made first to prevent problems for competition horses and secondly to be well prepared to deal with emergencies should they arise. A system of repetitive examinations of the horses is used to ensure that the equine athletes are fit and sound before, during and after the competition. The VD assesses the ambient conditions at the competition site and discusses with the judges alterations in the course which might be necessary if conditions are inclement. By rule the VD is required to a assess the safety of Phase D (Cross Country). The Veterinary Delegate is also responsible for assuring that Treating Veterinarians (TVS) are always available in the event of medical need. The purpose of the following discussion is to review these preventive measures and to summarize strategies employed to deal with medical emergencies.

Compulsory Examinations and Inspections of Horses for Health and Fitness.

A health record is established for each horse when it arrives at the competition site. The health record identifies the horse by name, age, breed, sex, color, passport number (FEI competitions) and rider's name. All details of the horse's experiences at the competition are recorded in the health record including results of all examinations and inspections, treatments for illness or injury, and whether or not the horse was subjected to Medication Control. The health record follows the horse through the competition and is available at all times to the VD, the judges and the competitor.

First (Arrival) Examination All horses competing in National and FEI events must be

examined for general health and to assure freedom from infectious diseases upon arrival at the competition and before being allowed access to the stables. At FEI competitions, the rider must have documentation that his horse has been vaccinated for influenza in a manner which complies with the minimum standards of the FEI before entry into the competition stables is permitted. Improperly vaccinated, unvaccinated, or potentially ill horses (cough, fever, diarrhea) must be housed in an isolation facility.

During the Arrival Examination, the VD records the temperature, pulse and respiratory rate of the horse and gains

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an impression of the animal's "fitness to compete" by performing a rapid but reasonably thorough physical examination. A quick ophthalmic exam rules out bilateral compromise to vision (cataracts, uveitis). The heart is carefully ausculated and any murmurs or arrhythmias are noted. If a horse with a potentially exercise limited heart murmur or arrhythmia (most commonly atrial fibrillation) is identified, the VD makes arrangements for an EKG to be performed and a consultation with a veterinary cardiologist if possible. The judges are informed of the horse's potentially disqualifying problem, and when results of all examinations are available, a joint decision is made as to whether the horse should be allowed to compete. Competitors who are aware that their horses have an unusual heart rhythm or murmur may bring documentation of a recent cardiac examination. Some murmurs and arrhythmias are benign, and this information is helpful in assuring that horses which may safely compete are not eliminated unnecessarily.

The Arrival Examination is used to obtain a baseline assessment of the horse's museuloskeletal status. It should be noted that the rules do not specifically state that this examination should include evaluation of the museuloskeletal system. All 4 legs are palpated briefly, paying particular attention to the supporting leg structures (check ligaments, flexor tendons and suspensories). Any injury to these structures is recorded on the health form. If an acutely inflamed structure is found (a bowed tendon, a painful splint, a sensitive heel grab or painful dermatitis in the pastern region for example), its presence is also noted. An ultrasound examination is recommended for a questionable tendon, suspensory or check ligament. Corrective shoeing is described on the health form. At National competitions, the competitor is asked if the horse is being given allowed medicat ions (Phenylbutazone or Banamine). This information is used to help evaluate severity of lameness in a treated horse.

The Arrival Examination affords an excellent opportunity for the VD to establish a good working relationship with competitors and coaches. Such a relationship fosters free exchange of information during the competition and facilitates accurate assessment of the horses.

First Horse Inspection This Inspection usually occurs the afternoon or morning

before Dressage begins. The Inspection is carded out by the judges and theVD and its purpose is primarily to identify lame horses. Horses are examined in hand on hard, level surface, standing, at the walk and at the trot. The VD refers to notes made at the Arrival Examination, evaluates soundness in the

context of results of that examination, and answers any questions the judges may have. A joint decision is then made and the horse is either Accepted (passed to compete), Not Accepted (eliminated) or questioned and Held for re- inspection. Questionable horses are detained in a supervised "Holding Area" where they are examined by the Associate Veterinarian (AV) who has the health form on which are noted the VD and judges' observations. The AV discusses the lameness seen at the inspection with the rider and coach, and tries to ascertain the cause of the problem. The AV reports his findings to the judges and VD. After discussion, the horse is reinspected andAccepted or NotAccepted. The HoldingArea procedure gives questionable homes the benefit of the doubt while facilitating elimination of horses with potentially dangerous musculoskeletal problems.

After the First Inspection, horses are not formally evaluated again untilafter completing Dressage and PhasesA, B and C of the Speed and Endurance tests. Since Roads and Tracks and Steeplechase are strenuous tests, every effort is made during the Arrival Examination and the First Inspection to be sure that horses allowed to start in Phase A are fit and sound. It should be noted that the senior judge has "the right and the duty" to eliminate any horse which is unfit to continue at any time during the competition. For example, the senior judge may eliminate a lame horse during the dressage test.

Second Horse Inspection The Second Horse Inspection is performed by the VD,

the AV, and a judge at the end of Phase C of the Speed and Endurance test. The rules specify that a mandatory 10-minute pause in the Speed and Endurance Test occur at this point. Horses enter a controlled area, the 10 Minute Box, for inspection, cooling if necessary, and tack adjustments. The method for performing the Second Horse Inspection described here was developed jointly by Dr. Denys Frappier of Montreal, Quebec, Canada; Dr. John Mayo of Middleburg Virginia and the author. The rules for eventing do not specify the use of this method; however, it is in relatively wide use in North America and we have found it to be reliable, efficient, safe and fair for the horses.

The AV watches horses finish Phase C (the finish is usually in or near the 10 Minute Box).

The AV takes a heart rate (again listening carefully for arrhythmias) and a respiratory rate. The horse's overall attitude is assessed as the AV walks around the horse looking for injuries such as a stifle rub from hitting a steeplechase fence. Missing shoes are noted so that the competitor can get them replaced by the blacksmith in the 10 Minute Box. The AV refers to the health record to see if any previously

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questioned areas should be rechecked. The AV's exam takes about 45 seconds.

While the AV is working, a knowledgeable horseperson places a thermometer in the horse's rectum and clips the attached string to the horse's tail. The temperature taker notes whether anal sphincter tone is good. The horse is then allowed to walk off for further attention by grooms and rider and the temperature taker follows to remove the thermometer after 90 seconds. The rectal temperature is recorded together with the AV's comments on the health form. The form is then transferred to the VD who, together with a judge, will re- examine the horse after it has been in the Box for about 7 minutes. The VD dispatches a second temperature taker to replace a rectal thermometer in the horse after the horse has been in the Box for 6 minutes. At 7 minutes the VD auscults the horse's heart, counts the respiratory rate and then notes the rectal temperature. Temperature, pulse and respiratory rates should decrease during the pause. The horse is then jogged in hand to evaluate soundness. The VD evaluates the horse's recovery based on ambient conditions and in the context of recoveries noted in previous horses. The horse's fitness to continue is then evaluated overall by the VD and the judge. Inadequate recover and/or lameness results in elimination of the horse. All findings are recorded on the health record which is then transferred to the veterinarian at the end of Phase D.

Second Horse Examination This examination takes place at the end of the Speed and

Endurance Test. A veterinarian who has had experience with event horses, and preferably at events, is stationed by the VD at the end of Phase D with a judge. At this examination, a competitor may be eliminated by the judge for cruelty, should the horse be exhausted or injured at the end of Phase D. The veterinarian records temperature, pulse and respiratory rate in each horse as soon as possible after it finishes the course. The horse is quickly examined for injuries and signs of exhaustion. The horse is then walked and cooled for 10 minutes and re-examined by the vet. Further re-evaluations occur at 10-minute intervals until recovery is assured (generally, temperature less than 103 ° F and heart rate less than 60). During hot and humid weather it is especially important to monitor rectal temperatures. Before excusing the horses, each is jogged for lameness. Lame, injured or ill horses are transported back to the barn. All information is recorded on the health form.

Third Horse Inspection This inspection is performed the morning of the Stadium

Jumping test and follows the same format as the First Horse Inspection. Elimination at this inspection disqualified the

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horse from the Stadium Jumping test and from completing the competition.

Other Safety Precautions during the Speed and Endurance Test Veterinary Safety Officer

During the Speed and Endurance Test, the AV is the Veterinary Safety Officer. The AV is in radio contact with the TVs stationed on the course, with the TV in the stables, with the Control Officer, with the horse ambulance drivers and with the stable manager. TheAV makes certain that any horse in difficulty on the course is promptly attended by a TV. The AV coordinates transport of ill or injured horses to the barn, makes certain the TV in the barn attends such horses, and maintains a list of horses which required emergency care so that the VD can follow up on the cases at the end of the day. Should horses require referral to a hospital, the AV facilitates referral and transport.

Control Officer for the Speed and Endurance Test The Control Officer is responsible for monitoring all

horses during the entire Speed. and Endurance test from a centrally located Control Center. The Control Center is usually positioned to provide maximum view of the cross country course. The Control Officer is in radio contact with all fence Judges and Area Stewards. Area Stewards are knowledgeable horsepersons assigned to specific sectors of the Cross Country course. The Area Steward supervises the fence judges and carries out emergency procedures when needed. Should a problem occur on course, the Control Officer can stop any horse on course immediately. A Safety Officer works with the Control Officer and the Veterinary Safety Officer. Should a medical or veterinary emergency arise, the Safety Officer directs all efforts to deal with the situation. Aseparate frequency on the radio net is designated for emergency use only, and emergency personnel are well- briefed on procedures before the Speed and Endurance test starts.

Elimination of Horses on Course Judges maintain careful surveillance of the entire

Speed and Endurance test. Judges have the "right and the duty" to eliminate at any time any horse in difficulty. One judge remains at the Control Center. In Europe, Control is supplied with television surveillance of the entire cross country course. The control officer and the judge can monitor each horse 's progress and can stop any questionable horse. In America, TV monitors are not available. Horses are monitored on course by judges and

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judges' delegates in communication via an extensive radio network.

Emergency Care The VD is responsible for directing recruitment of

knowledgeable equine practitioners to work during the competition and especially during the Speed and Endurance test. Deployment of TV during the Speed and Endurance test is arranged so that maximum accessibility oftheTVs to horses is assured. One TV is stationed at Steeplechase, and several (2 to 5) are stationed on the cross country course so that aTV can reach any fence quickly. All TVs are in radio contact with the control officer and with the AV in the 10 Minute BOx. At least 1 TV is stationed in the stables. Two TVs may be required in the barn to efficiently respond to horse needs.

All TVs are well-equipped to supply emergency services. All carry IV fluids, sedatives, bandages, splints and euthanasia solution. Every effort is made to stabilize an injured horse and move it by ambulance as rapidly as possible to the barn or to a referral hospital if necessary. Emergency care is thus centralized as much as possible. The VD makes certain that the event organizer stocks at least 100 liters of balanced electrolyte solution (usually lactated Ringer's solution) for use during the competition.

Treating Veterinarians Throughout the competition, TVs are available. There is

always aTV on the grounds while any horse is competing, and TVs are otherwise on call. ATV remains in the stable area the evening following the Speed and Endurance Test for as long as necessary to supervise all treatments. The TV returns as often as necessary through the night to monitor patients. The TVin conjunction with theVD arranges for referralofpatients to a hospital if necessary.

Ambulances At least 2 ambulances are required during the Speed and

Endurance test. A large trailer with a tailgate, hitched to a 4- wheel drive vehicle is acceptable when a horse ambulance trailer is not available. Drivers are briefed to be knowledgeable about the course so that horses in difficulty can be reached expediently. Ambulance drivers are in radio communication with control and with theAVin the 10 Minute Box. When Steeplechase is not centrally located, one ambulance should be stationed there. Asecond ambulance is stationed at the 10 Minute Box, and a third, if available, on course. The number of ambulances required depends on the site and course layout. All parts of the Speed and Endurance tests (including Roads and Tracks) must be accessible.

Water and Ice Water and ice are always made available in the

Authorized Assistance Area after Steeplechase, in the 10 Minute Box and in the Stables. In hot and humid weather, large supplies of both may be needed and arrangements for resupply as necessary are made by the organizer.

Course Safety The VD is required by the rules to inspect the cross

country course prior to the start of the competition. This inspection is to assure safety of the footing and fences. TheVD brings all concerns to the Course Designer and the judges. Unsafe obstacles or footing should be altered or eliminated from the course.

Assessment of Ambient Conditions The VD must consider the possibility that ambient

conditions for the competition may not be optimal. Extremes of temperature and humidity (especially in combination), heavy rain, or unexpectedly hard ground may make the competition as planned unsafe. The VD and the judges formulate a contingency plan at the start of the competition. For example, they may agree to assess weather and footing conditions the morning of the Speed and Endurance Test and alter the test as indicated. They may elect to watch the first few horses through the test, and make changes based on the performance of these fast competitors. The VD has the duty to strongly state his opinion on if or how the course should be altered. Appropriate course alterations might include increasing the time on Phase C, decreasing the distance of B, C or D, lengthening the time in the 10 Minute Box, removing a fence or fences from Phase D, or, in extreme cases, running a horse trial instead of a three-day event (eliminating Phases A, B and C ).

Conclusion

The VD is the official advocate for the equine at a three- day event and as such is responsible for all aspects of horse safety. The rules of the sport mandate that this responsibility be shared by judges, other officials (course designer, technical delegate, organizer) and by riders and coaches. The VD makes certain that all useful strategies for ensuring horse safety are employed and that veterinary medical services are well organized. The VD bases all decisions concerning fitness to continue on an objective assessment of the horse's soundness and physical well being: horse safety is the primary consideration.

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