Can Sensors Predict Potential Injury?

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Sensor technology combined with AI algorithms could change the way that we interpret and diagnose lameness in multiple species. Here is an example of one system being developed for horses.

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Mitral Disease in Large Breed Dogs

Myxomatous mitral valve disease (MMVD) is the most common acquired cardiovascular disease in dogs, predominantly affecting small breeds but also occurring in large breeds. In a study of 455 large-breed dogs, MMVD was found to be the most prevalent cardiac disease. Most research has focused on small breeds, with limited data on large breeds like German Shepherd Dogs (GSDs), which show distinct MMVD characteristics. For instance, GSDs are more prone to systolic dysfunction and atrial fibrillation (AF) but less likely to exhibit mitral valve (MV) thickening and prolapse (MVP).

This study aimed to describe MMVD in Labrador Retrievers (LRs) and Golden Retrievers (GRs), documenting disease prevalence and clinical features. Both breeds, with significant genetic similarities and high popularity in the US, presented late-onset MMVD more commonly in males, with prevalence rates of 14.3% for LRs and 14.8% for GRs. MMVD was predominantly mild, with the majority in stage B1, aligning with previous research. Median survival times for stage B1 LRs and GRs were 898 and 489 days, respectively, similar to large-breed mixed samples and consistent with their typical life expectancy.

In the subset of LRs and GRs with stage B2 or C MMVD, additional cardiac abnormalities such as AF, ventricular arrhythmias, systolic dysfunction, and pulmonary hypertension (PH) were common. AF prevalence was higher in GRs (15.0%) compared to LRs (3.8%) and previous mixed-breed studies. In advanced MMVD stages, AF and PH were significant prognostic factors, often associated with CHF.

Ventricular arrhythmias were more frequent in LRs, with the most common being single ventricular premature complexes (VPCs). Systolic dysfunction was noted in both breeds, particularly in stage B2 or C, with diet potentially influencing GRs more than LRs. MV leaflet thickening was prevalent in both breeds, differing from GSDs, with a higher prevalence of MVP in LRs compared to GRs. Chordae tendineae rupture was uncommon but possible, associated with moderate to severe mitral regurgitation (MR).

The study's retrospective nature, incomplete data, and reliance on stored echocardiographic images were limitations. Breed-specific reference ranges for cardiac enlargement and non-standardized treatment impacted the results. Despite these limitations, the study provided novel insights into MMVD in LRs and GRs, highlighting that most cases remain mild with minimal impact on life expectancy. However, for advanced cases, monitoring for AF, ventricular arrhythmias, systolic dysfunction, and PH is crucial.

Wilson, B. A., & Wesselowski, S. (2024). Myxomatous mitral valve disease in Labrador Retrievers and Golden Retrievers. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.24.05.0303 

Bottom line — Not a huge issue in most cases

Hypertension and Radioactive Iodine Treatment in Cats

Hypertension in cats is often associated with chronic kidney disease (CKD) and hyperthyroidism. The prevalence of hypertension in untreated hyperthyroid cats varies widely, ranging from 6.7% to 47.6%. Comparatively, human hyperthyroid patients also develop secondary systolic hypertension, with a prevalence of 20% to 30%, which usually resolves after euthyroidism is reestablished. 

In cats, blood pressure changes post-treatment for hyperthyroidism are minimal, with only small or undetectable decreases in systolic blood pressure (SBP). Some cats may even develop hypertension only after becoming euthyroid. Situational or stress-induced hypertension (white coat hypertension) is common in hyperthyroid cats, leading to potentially overestimated prevalence rates of true hypertension. This was observed in a multicenter study involving over 400 hyperthyroid cats treated with radioiodine (131I). Around 25% of these cats were hypertensive at presentation, with about half normalizing their blood pressure post-treatment. Persistent or new hypertension after treatment was not linked to azotemia or iatrogenic hypothyroidism, suggesting situational factors. 

The study revealed a notable effect of treatment center on hypertension prevalence, with higher rates reported in European centers compared to the U.S. center. European centers also reported more nervous or anxious cats, implying that reported hypertension rates might be site-specific. No significant association was found between hypertension and azotemia, and plasma creatinine levels were similar between normotensive and hypertensive cats. 

While successful treatment of hyperthyroidism in humans typically resolves hypertension, only half of the hypertensive hyperthyroid cats in this study normalized blood pressure after 131I treatment. The study observed lower rates of post-treatment hypertension compared to earlier reports, suggesting situational rather than pathological hypertension. The high likelihood of situational hypertension due to stress and behavior was supported by the study's findings. 

The study had some limitations, including multiple operators and lack of blinding in demeanor scoring. Hypertension diagnosis was based on a single blood pressure measurement session, though 80% of initially hypertensive cats were re-evaluated post-treatment, aligning with diagnostic guidelines. 

In conclusion, hyperthyroid cats seem predisposed to situational hypertension rather than true pathological hypertension. Severe hypertension and new hypertension development post-131I treatment are rare, with situational factors playing a significant role in blood pressure measurements. 

Stammeleer L, Xifra P, Serrano SI, Rishniw M, Daminet S, Peterson ME. Blood pressure in hyperthyroid cats before and after radioiodine treatment. J Vet Intern Med. 2024; 38(3): 1359-1369. doi:10.1111/jvim.17032 

Bottom line — Seems to control this issue.

Sensors to Predict Musculoskeletal Injury in Horses

Musculoskeletal injuries in racehorses result in significant attrition, affecting income, field numbers, and horse careers, and can lead to severe outcomes, including the death of horses and injuries to jockeys. Catastrophic injuries often stem from preexisting pathologies rather than sudden missteps. The California Postmortem Study identified consistent lesion characteristics in injured horses, supporting the theory that such injuries result from ongoing disease processes. 

These preexisting pathologies often go unnoticed, leading to horses being deemed fit to race until a severe injury occurs. Despite a reduction in race-day fatalities from 2.0 to 1.25 per 1,000 starts between 2009 and 2022, the Thoroughbred racing industry still faces pressure to identify at-risk horses before catastrophic injuries happen. 

Human athletes use biometric sensors to monitor performance, but Thoroughbred racing has lagged in adopting similar technologies. Recent advancements involve accelerometer-based inertial measurement unit (IMU) sensors (StrideSAFE) that record the locomotion of horses at high frequencies during races. These sensors help identify horses at high risk of musculoskeletal injuries. From April to July 2023, these sensors were used at Churchill Downs and Ellis Park, identifying high-risk horses for further evaluation. 

The IMU sensors differentiate from GPS devices by measuring acceleration and deceleration forces, providing a detailed depiction of a horse's locomotion. These sensors categorize risk levels from 2 to 5, aiding in risk assessment but not serving as diagnostic tools. Horses identified at high risk require thorough veterinary evaluations and advanced imaging, such as PET scans, to diagnose underlying issues. 

The sensors identified high-risk horses that appeared sound during routine trot examinations but showed significant deviations in stride patterns at gallop speeds. The data collected facilitated targeted clinical evaluations, revealing areas of increased bone remodeling and potential injury risks. Early detection allowed for appropriate interventions, preventing severe injuries and enabling some horses to return to racing with reduced risk. 

The IMU sensor system, while not a diagnostic tool, serves as an effective risk assessment method. Its continued use, combined with veterinary follow-up, can reduce catastrophic injuries in racing Thoroughbreds. Further refinement of the sensor system and algorithm, alongside increased clinical data, will enhance its accuracy and effectiveness in preventing life- and career-ending injuries. 

Sweeney, D. M., Holmström, M., Donohue, K. D., Lambert, D. H., & Bayly, W. M. (2024). Using accelerometers to identify a high risk of catastrophic musculoskeletal injury in three racing Thoroughbreds. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.24.02.0114 

Bottom line — Exciting new system to help reduce injury.

Just putting things in perspective …