A Scoping Review of Non-Structural Airway Disease as a Cause of Poor Performance in Racehorses

SIMPLE SUMMARY: The association between poor performance and respiratory disease in Thoroughbred racehorses that do not have a structural abnormality of the respiratory tract is often based on anecdotal evidence. We examined peer reviewed publications to determine if there was scientific evidence to link conditions such as inflammation of the airways, asthma, tracheal mucous, and exercise-induced pulmonary haemorrhage (EIPH) with decreased athletic performance. This is a complex field and studies have yielded conflicting results as to the impact of such conditions on performance. For example, some investigators found a significant association between poor racing performance and low-grade EIPH and mild to moderate asthma. In contrast, others have suggested that they may represent a normal response to training and the stabling environment. The key outcome of the review was that there is a dearth of studies unequivocally linking non-structural airway disease with poor performance, and there is a lack of an internationally harmonised approach to the assessment of racehorse performance. Improved investigations providing better quality evidence would facilitate comparison across studies, increase our understanding of the conditions associated with poor performance, safeguard horse welfare, and assist trainers to achieve their goals. ABSTRACT: The association between poor performance and respiratory disease in Thoroughbred racehorses that do not have a structural abnormality of the respiratory tract, is often based on anecdotal evidence. The objective of this scoping review was to examine the scientific evidence for such associations. Publications were selected based on a search of three databases (PubMed, Scopus, and CAB Direct), in English and without date restriction, followed by a screening process to exclude non-relevant papers, duplicates, and reviews. This process identified 996 publications of which 20 were analysed using the Quality in Prognosis Studies (QUIPS) tool. The results indicated that the evidence supporting the relationship between proposed diagnostic indicators and poor performance is variable. There is a need for better quality evidence. In particular, there are conflicting reports relating to the impact of equine asthma and EIPH on athletic performance. Furthermore, a lack of standardisation in the measurement of racehorse performance makes it difficult to compare findings from different studies. The industry would benefit from high-level guidance concerning the design of controlled performance studies in Thoroughbred racehorses to collect comprehensive data and facilitate targeted interventions.