"Particularly in the Thoroughbred racehorse, catastrophic injury is a potential," says Martin. Thoroughbreds can get stress
fractures in their shins, tibia or humerus. "The horses may be quite lame one day and the next they're fine, so one of the
big advantages of using the bone scan is that you can figure that out, without putting the horse or the rider at risk," Martin
'We're looking for America'
'With the bone scan, as opposed to MRI, one can check the whole leg, back or pelvis, while an MRI only can check from the
knee down. Things happen in the rest of the horse's body that can't be accessed with MRI, one of the key advantages of nuclear
"Basically, like Columbus was looking for America, we're looking for America in the horse's body essentially," Martin says.
"We're looking for that dark spot or spots that may be clinically applicable."
Horses also have hot spots that are not clinically meaningful, so part of the clinician's job is to figure out what's real
and what's artifact.
"It's not a big deal for someone to refer a horse for scintigraphy," says Martin. The next step for Rags to Riches was further
imaging that might locate an area that doctors might want to radiograph or look at with ultrasound, or perhaps an MRI.
"If it's her foot, you might want to look at it with an MRI, if you don't see anything on radiograph," explains Martin. "It's
kind of a stepwise search."
If a horse is lame and has never been "blocked," one would proceed forward and start blocking. It often occurs that horses
come to New Bolton fairly lame, get a bone scan with basically poor results, then must go back to the sort of basics performed
10 to 20 years ago — blocking the horse see where, or if, it is lame.
A decision to make
In the case of Rags to Riches, if the horse looked fine and the bone scan was totally negative, then her owners would have
to decide what they wanted to do.
"I could say physically she's perfect and she's sound and she's happy, etc. Then they'd need to decide, do they want to keep
training and racing her, do they want to give her the rest of the year off and run her next year or send her to the breeding
shed? Those are all fairly common choices," Martin explains.
On the other hand, if they found something they could address, they would form a plan to do so. The three most likely outcomes
are (A) she goes back to the racetrack, (B) she gets retired or (C) she has a period of rehabbing.
"Even though she supposedly didn't show any obvious signs of lameness and her veterinary exam at Belmont Park was fine, I
never say it's good. I always say it's guarded, because you just never know," says Martin. "They're so fragile. Hopefully
she's healthy and she'll be running at Saratoga (in the Alabama) in a few weeks, knock on wood."
On July 28, Rags to Riches' trainer, Todd Pletcher, said Dr. Paul Thorpe, DVM, of Lexington, Ky., attending veterinarian for
owners Michael Tabor and Derrick Smith, was returning from a prior commitment in Ireland and would also inspect the filly.
Everyone had been waiting on Thorpe's input. "He's going to process all the information — the scan results, the X-ray, the
complete physical workup that they did on her," said Pletcher. "He'll examine the filly himself and hopefully give us a clean
bill of health, and we can move forward."