Background: Poor performance is a multifactorial syndrome of racehorses, commonly associated with subclinical disorders, which can be diagnosed by exercise testing. Objectives: Describe the prevalence of medical causes of poor performance in Standardbreds unassociated with lameness, and evaluate their relationships with fitness variables measured by exercise treadmill test. Animals: Hospital population of 259 nonlame Standardbred trotters referred for poor performance. Methods: The horses' medical records were retrospectively reviewed. Horses underwent a diagnostic protocol including resting examination, plasma lactate concentration, treadmill test with continuous ECG and assessment of fitness variables, creatine kinase activity, treadmill endoscopy, postexercise tracheobronchoscopy, bronchoalveolar lavage (BAL), and gastroscopy. The prevalence of different disorders was evaluated, including cardiac arrhythmias, exertional myopathies, dynamic upper airway obstructions (DUAOs), exercise-induced pulmonary hemorrhage (EIPH), moderate equine asthma (MEA), and gastric ulcers (EGUS). The associations of these disorders with fitness variables were investigated individually and using multivariable models. Results: Moderate equine asthma and EGUS were the most common disorders, followed by EIPH, DUAOs, cardiac arrhythmias, and exertional myopathies. Hemosiderin score was positively correlated with BAL neutrophils, eosinophils, and mast cells; increased creatine kinase activity was associated with BAL neutrophilia, DUAOs, premature complexes, and squamous gastric disease. Treadmill velocity at a plasma lactate concentration of 4 mmol/L and at heart rate of 200 beats per minute was negatively affected by BAL neutrophilia, multiple DUAOs, exertional myopathies, and squamous gastric disease. Conclusions: The multifactorial nature of poor performance was confirmed, with MEA, DUAOs, myopathies and EGUS representing the main diseases involved in fitness impairment.

Background Due to compactness and cheapness, smartphone ECG (sECG) could be very useful to equine practitioners. However, previous studies have evaluated the accuracy of sECG in hospitalised horses only. Different conditions in the field could influence the accuracy of the device. The aim of this study is to compare the accuracy of sECG in field and in hospital conditions. Methods This is a prospective study. Paired standard base-apex ECG (stECG) and sECG were recorded in hospitalised horses and in subjects examined in field conditions. ECGs were analysed for heart rate and rhythm, presence/type of arrhythmias, presence/duration of artefacts, electrocardiographic waves and interval parameters by a blinded clinician. Statistical analysis evaluated the agreement between stECG and sECG and the differences in the prevalence of artefact in field and hospital conditions. Results Nineteen (hospital) and 40 (field) paired ECGs were analysed. Agreement between stECG and sECG was found for heart rate and rhythm, evaluation of atrioventricular block and premature complexes, P wave and PQ interval duration, and QRS complex duration and polarity. No differences were found between artefacts recorded in hospital and in field conditions. Conclusion sECG is a feasible tool for evaluation of rhythm in horses and is as accurate in field as in ambulatory conditions.

Mild–moderate equine asthma (MEA) is a common disease of young racehorses characterized by inflammation of the lower airways diagnosed by cytological examination of bronchoalveolar lavage fluid (BALF), and it is considered an important cause of poor performance. The most common parameter of athletic capacity associated with horse performance is the speed at 4 mmol/L of lactate (VLA4). The aim of the present work was to evaluate the relation between the different BALF inflammatory cells and VLA4 in racehorses affected by MEA. A population of Standardbred racehorses that underwent an accurate protocol for poor performance evaluation was collected for a retrospective study. Horses with any other alteration potentially influencing performance were excluded, thus considering only subjects with BALF cytology consistent with MEA. A sample of 30 horses (3.4 ± 1.0 years old) was selected. The relationship between BALF inflammatory cell differential count and VLA4 was evaluated by means of linear regression. Statistical analysis showed a significant relation (p = 0.015, r² = 0.19) between the increase in the differential count of neutrophils in BALF and the decrease in VLA4. The results obtained suggested that the accumulation of neutrophils in the airways of MEA horses may have a direct impact on athletic capacity, possibly due to impaired alveolar blood-gas exchanges during strenuous exercise.

Mild-moderate (MEA), severe (SEA) equine asthma and exercise-induced pulmonary hemorrhage (EIPH) are common respiratory disorders in horses. The present retrospective study aims to evaluate the role of ultrasonography and endoscopy in the diagnosis of these conditions. Three hundred and three horses were included and divided into SEA, MEA and MEA + EIPH groups, on the basis of history, clinical examination and bronchoalveolar lavage fluid (BALf) cytology; scores were assigned to lung ultrasonography, pharyngeal lymphoid hyperplasia (PLH), tracheal mucus (TM) and tracheal bifurcation edema (TB). These scores were compared between groups, and their associations with age, BALf cytology, tracheal wash microbiology and between endoscopic and ultrasonographic scores were statistically analyzed. Ultrasonographic scores were higher in the SEA and MEA + EIPH groups and associated with increased BALf neutrophils and hemosiderophages. The PLH score was higher in younger horses affected by MEA and EIPH and associated with increased eosinophils and hemosiderophages. TM and TB scores were greater in older horses affected by SEA, associated with increased neutrophils and inversely correlated with hemosiderophages. Moreover, TM grade was negatively correlated with mast cells. Thoracic ultrasonography and airway endoscopy can provide useful information about the inflammatory status of upper and lower airways in the horse.