In 2020, the Southern California Equine Foundation and its research arm, the Dolly Green Research Foundation, funded the development of the world's first standing PET scanner. Standing PET showed potential to allow the detection of specific pre-existing injuries which hitherto escaped recognition by either clinical exam or diagnostic technique. That investment has proved invaluable to the safety of California racing. Standing PET technology is now deployed in racing venues ranging from Australia to Europe.The Board of Directors of the SCEF/DGRF is composed of industry representatives, veterinarians and trainers. From the outset, the board saw the potential for PET screening of the entire racing pool to detect injuries which predispose to breakdown. After all, conventional means were clearly inadequate.Anticipating the future, the SCEF/DGRF consistently expanded its imaging facility to accommodate screening of the larger racehorse population. Infrastructure was upgraded, and the latest PET updates now provide quicker scans and complete distal limb imaging.Recent national safety numbers, despite all efforts, are not overly impressive. The graph below shows racing fatalities by number of starts and the data is derived from the EID database overseen by The Jockey Club.Graph courtesy of Dr. Tim Parkin, Bristol Veterinary School, Scotland, UKThe graph appears to validate some improvement since 2019, coincident with the establishment of numerous industry-wide safety measures. It is also apparent from the numbers that current efforts will not be sufficient to take us where we need to go in the time we need to arrive there. More technological intervention is needed.To that end, several additional technologies are advancing into our industry. Collectively termed “wearables”, these devices collect critical data about well-being and are worn by the horse during exercise and racing. All these new technologies will be critical to further reduction of racing fatalities. And fatalities are not the end game. Injury also needs to be addressed, for both ethical and economic reasons.The development of a PET screening protocol will certainly play a major role in further reducing fatalities. SCEF performs PET scans on more than 250 patients each year, but its daily PET scan capacity is far from being fully utilized. Is PET screening of large defined portions of the racing pool the wrong approach?Recent push back at academic meetings and in the racing press has suggested as much. Logistical and cost/benefit reasons have been among the most cited excuses. The fact of the matter is the horse has left the barn. Screening has been a growing portion of SCEF PET cases for years now.Trainers have been the biggest drivers of this segment. Horses with no medical diagnosis are commonly screened at the behest of their connections. Some trainers state that PET allows them to sleep better at night. Trainers note that common fetlock-related pathologies, which generally present with no symptoms on clinical exam, are initially identified by observing gradual changes in a horse's daily gallops over time. Regulatory veterinarians also frequently exercise pre-emptive caution by ordering PET screenings for horses exhibiting vague concerns absent any diagnosis. Both instances represent legitimate examples of PET screening.Regarding breakdown prevention, the hard work was developing standing PET imaging which allows visualization of the long-recognized sesamoid lesion which predisposes to fetlock failure. The hard work is done. Less difficult is raising funding and selling jurisdictions on PET's benefits to the horse and the entire racing industry. Likely the easiest hurdle is designing a PET screening protocol to effectively reduce current fatalities.A common inquiry is, “How do we determine which horses to screen?” Ironically, perhaps the easiest part is all that remains ahead of us. Regulatory attending, and academic veterinarians can sit down and devise a reasonable initial scheme for screening a portion of the racehorse population. Once screened and found satisfactory, those horses will likely be safe for a prolonged period before needing to be re-scanned. Another often asked question is, “who will make decisions on which horses are unsafe.Fortunately, PET results are quite clear-cut. Someone or some committee of experts can easily accomplish the decision-making. Of those horses with predisposing lesions will need to be removed from the racing pool and provided rehabilitation. False positives? One could argue they don't exist. False negatives? Maybe, but we've yet to identify any. The good news is most injured horses will eventually re-enter the racing pool to help fill fields in the future.In our experience, PET scanning horses exhibiting clinical signs of lameness, most are not suffering acutely life-threatening injury. We can reasonably estimate critical injury to be a relatively uncommon finding across the population of all horses in training. But horses with critical injury must be identified preemptively to reduce catastrophic failure. This underscores the importance of proactive screening, specifically PET scans, which enable early detection of injuries that may not yet be apparent through clinical examination or traditional diagnostics.It's past time to employ PET screening to drive down racing and training deaths and reduce costly injuries. Furthermore, the industry should also be embracing existing wearable devices to further this goal. We need to improve safety today. The tools exist. Employ these tools now. Experience and competition will shape wearable technology and its effectiveness. PET screening is immediately essential, with no foreseeable alternatives.–Joseph Dowd, DVM, MA, PhDPrivate practitionerPresident, Southern California Equine FoundationPresident, Dolly Green Research FoundationThe post Letter To The Editor: Preventive PET Screening Arrives In U.S. appeared first on TDN | Thoroughbred Daily News | Horse Racing News, Results and Video | Thoroughbred Breeding and Auctions.