The unpalatable truth: Bits are linked to a host of behavioral and breathing issues

The use of the bit can be linked to a host of behavioral and breathing-related problems in horses, writes Bob Cook, Professor Emeritus of Surgery at the Cummings School of Veterinary Medicine at Tufts University in Massachusetts. And, he suggests, racing authorities who assign catastrophic breakdowns to problems with the musculoskeletal system might be missing the root cause.

The growth of knowledge in any field of study is a never-ending process.

In equine medicine it is unsurprising that there is uncertainty and no consensus on the cause of some diseases.

As removal of the cause is crucial to treatment, such diseases are difficult to cure or prevent and there is often a confusing abundance of options for their management.

On the other hand, there is consensus that the cause of many respiratory diseases of the horse is unknown.

Ironically, recognition of a pattern of unknown cause in a group of diseases can be a stepping-stone to understanding.

The family likeness of these “breathlessness-at-exercise” diseases of unknown cause include palatal instability, collapse of the floor of the throat airway (dorsal displacement of the soft palate), collapse of the roof of the throat airway, obstruction of the voice box at one or more cardinal points (e.g., epiglottis, vocal cord, ‘flapper’ cartilage), collapse of the roof of the windpipe, cartilaginous deformity of the windpipe (‘scabbard’ trachea), inflammatory airway disease (equine asthma), exercise-induced pulmonary haemorrhage (negative pressure pulmonary oedema), and sudden death (Cook 2015).

All these are referred to in veterinary textbooks as “idiopathic” – a medical term for diseases of unknown cause [sic].

In the last 20 years, my research has led me to conclude that they are linked by a common cause – the bit.

Two mechanisms explain how the bit obstructs the throat airway, operating singly or together.  First, by preventing maximum head and neck extension at fast exercise. Secondly, by disrupting the lip seal that — in the wild horse — maintains a sub-atmospheric pressure in the digestive part of the throat and firmly approximates the soft palate to an immobile root of tongue when a horse is running.

In so doing, the size of the digestive part of the throat is minimized in order to maximize the size of the respiratory part – the airway. The likelihood of such a causal link has been recently reviewed by Mellor and Beausoleil (2017).

A conservative respiratory rate for a galloping horse is 120 breaths a minute – that is, two full breaths every second. An uninterrupted and maximum flow of air is critical, not just for running but for life itself.

A bullet to the brain or a lethal intravenous injection might kill faster than an obstructed airway but an obstructed airway can be equally lethal.

If the asphyxia is not fatal it will, nevertheless, rapidly cause fatigue of leg muscles and handicap performance.

Exhaustion and lack of muscle tone can be followed by falls and fractures/dislocations or these same problems can arise first and falls follow.

The point is that when racehorse accidents are classified on a systems basis (as a guide for the direction of future research), an assignment to “musculoskeletal system” does not necessarily pin-point the root cause.

Failure of the musculoskeletal system may be secondary to failure of the respiratory system (Cook 2014).

When reading a report that a racehorse incurred a long-bone fracture, by all means consider that a pre-existing microfracture could conceivably have been present that led to a complete fracture during a race.

But consider also that the fracture could have been secondary to asphyxia-induced muscle fatigue.

Whereas microfractures may well occur, they are not as ubiquitous as a bit.

As ‘common things, commonly occur,’ it is appropriate to ask which is the most likely cause – a pre-existing microfracture or a bit?

Furthermore, with regard to future studies on accidents in general, the latter hypothetical explanation lends itself most readily to testing.

In addition to respiratory disease, there are many behavioral problems of the ridden and driven horse that horsemen are all too familiar with and yet are listed as of unknown or uncertain cause and for which effective treatment is elusive, e.g., headshaking.

Other problems, like an open mouth (which leads to a throttled throat – see above), lack of head and neck extension at exercise (another cause of a throttled throat), “bit lameness”, excessive salivation, spookiness, bolting, bucking, rearing and general resistance to training are also common and difficult to treat because their cause is not recognized.

They are often incorrectly attributed to some psychological deficiency of the horse or even accepted as “normal.”

Admittedly, there may be more than one cause of these problems but we should ask, is there one cause that is overwhelmingly more common than any other?  A recent study suggests that there may be.

Sixty-nine behavioural problems in 66 horses were shown to be statistically correctable by removing the bit (Cook and Kibler, 2018).

My hypothesis is that bit-induced airway obstruction causes a family of respiratory diseases and that bit-induced pain causes a family of behavioral problems. To test this idea I recommend a simple therapeutic trial.

When any of the above diseases or behavioural problems are encountered, first remove the bit. For recreational riders this is really simple. They can wake-up one morning and just do it. By the end of the day they will have a happier horse and be on a path to a true partnership, safer riding, enhanced performance and ethical equitation.

Showjumpers can make the same decision, as showjumping rules do not require a bit.

For racing, dressage, Pony Club and other events, use of a bit is mandated.

Yet there is no evidence to support the opinion that bits are necessary for control and safety.

On the contrary, there is ample evidence that a bit endangers the life of both horse and rider.

To retain the social licence and sustainability of horse sports in general, the causes of accidents, injuries and deaths of both horse and rider, have to be addressed.

Bit-free training and racing trials are needed. Bits do not have to be banned. All that is required is that riders and drivers should have the option of choosing between a rein-aid that causes pain, disease and accidents and one that does not.

Once the option becomes available and bit-free benefits are recognized, bits will quickly become obsolete.

References

Cook (2014): A hypothetical, aetiological relationship between the horse’s bit, nasopharyngeal asphyxia and negative pressure pulmonary oedema. Equine Veterinary Education, 26, 381-389

Cook, W.R, (2015): Bit-induced asphyxia in the racehorse as a cause of sudden death.  Equine Veterinary Education. 28, 405-409 https://doi.org/10.1111/eve.12455

Cook, WR. and Kibler, M (2018). Behavioural assessment of pain in 66 horses, with and without a bit. Equine Veterinary. Education. https://doi.org/10.1111/eve.12916

Mellor, D.J. and Beausoleil, N.J. (2017).  Equine welfare during exercise: An evaluation of breathing, breathlessness and bridles Animals. 7, 41 https://doi.org/10.3390/ani.7060041