Renewed focus on race-day medications
Race-day medication use has long been a controversial topic in Thoroughbred and Standardbred horse racing, but it's starting to make headlines again. That's because some in the industry are calling for an outright ban, and so is newly introduced federal legislation.
The only medications that currently can be given on race day are furosemide and other medications used to treat exercise-induced pulmonary hemorrhage, one of the most common medical problems affecting racehorses.
Although furosemide is widely used in the United States, a national and international debate has continued for decades over its effectiveness in preventing EIPH. Except for the U.S., some South American countries, and parts of Canada, most countries have prohibited the use of furosemide on race day. This has been largely due to public backlash against the use of any and all drugs in the sport.
U.S. horse-racing industry groups banned steroids from the sport after it was revealed that 2008 Kentucky Derby winner Big Brown ran legally on the drugs.
Now, the issue is whether to go further.
At the end of March, leaders of the Association of Racing Commissioners International called for the industry to develop a five-year plan to eliminate all race-day medications. That sentiment was soon echoed by the Thoroughbred Owners and Breeders Association, the Thoroughbred Racing Associations of North America, and the Jockey Club, among others.
Other horse-racing organizations urged caution, including the National Horsemen's Benevolent & Protective Association, which represents local affiliates. The group pointed to Jockey Club statistics that show approximately 99.5 percent of all horses tested in North America for nontherapeutic medications and 98 percent of trainers are in compliance with existing, scientifically proven medication standards with regard to threshold levels and withdrawals times.
"While concerns over the negative public perception are legitimate, they are in many regards an emotional one. Moreover, indirectly defaming all trainers as 'needle' pushers because they use an approved and scientifically proven therapy for EIPH will not help matters. While we address the public perception, it is equally important to correct the public's misconception," according to an NHBPA press release.
Such public opposition was on display May 4 when two congressmen introduced the Interstate Horseracing Improvement Act of 2011, which seeks "to end the use of performance-enhancing drugs in the sport of horseracing."
Under the House legislation by New Mexico Sen. Tom Udall and Kentucky Rep. Ed Whitfield, any person with three violations of the prohibition would be permanently banned from horse racing. A horse that tested positive for performance-enhancing drugs three times would receive a ban of at least two years. And the legislation would require that the winner of each race be tested for performance-enhancing drugs.
The bill would update the Interstate Horseracing Act of 1978, which grants simulcasting rights that now account for much of the industry's profits. If tracks did not comply with the legislation's stipulations, they would risk losing their ability to export and import simulcast signals. The bill also would require stiff penalties for violations.
Udall said in a statement, "The unfortunate reality is that not all is well with the sport of horse racing. Too many racehorses are overmedicated and doped, and I believe the sport of kings is no place for such a drug problem."
The American Association of Equine Practitioners issued a statement saying it supports the responsible use and regulation of valid therapeutic medications in horse racing as well as the concept of a national, uniform medication policy.
"Racehorses currently compete in a heavily regulated environment with very clear distinctions between illegal drugs and valid medications that provide therapeutic benefit. The very broad language of the bill could eliminate, as written, beneficial treatment of active equine athletes at any time—not just on the day of competition. We urge Congress to work with the horse racing industry to learn more about the health care implications of this bill as it is written and stand ready to assist in that process," according to the statement.
Even before the legislation was introduced, the AAEP, the National Thoroughbred Racing Association, and the Racing Medication and Testing Consortium announced that they would host the International Summit on Race Day Medication, Exercised-Induced Pulmonary Hemorrhage, and the Racehorse June 13-14 in New York City.
The summit would include participation by representatives from major racing jurisdictions around the world, including Europe, the Middle East, Asia, and Australia, along with the U.S. and Canada.
To the best of our knowledge, there is no published information that indicates giving furosemide in these prescribed means has any negative effect on the horse at all.
—Dr. William A. Moyer,AAEP president
Summit panels would offer discussions on topics such as regulatory issues surrounding race-day medication and veterinary viewpoints on EIPH management.
This meeting would mark the second time the industry has come together in a major way to address this issue. The AAEP organized the first effort, the Racehorse Medication Summit, in 2001. It brought together more than 20 industry stakeholder groups for a facilitated closed-door meeting to determine potential consensus points on basic elements of a uniform national medication policy for racehorses.
The summit led to the formation of the Racing Medication and Testing Consortium.
Among the consortium's accomplishments has been developing model policies on prohibited practices, drug classifications, permitted therapeutics, and uniform penalties for illegal and prohibited performance-enhancing drugs as well as rules for the regulation of anabolic steroids. Most of the 38 racing jurisdictions have incorporated these policies in their laws or rules, or anticipate doing so.
One of the consortium's leaders, Dr. Rick M. Arthur, RMTC officer and equine medical director for the California Horse Racing Board, said of this year's summit, "With our scientific research and our Drug Testing Initiative, we have the infrastructure to help the industry administer, in a uniform and effective manner, any medication program it chooses to pursue."
Dr. William A. Moyer, AAEP president, said he sees his association's role in the 2011 summit as "determining what is best for the health and welfare of the racehorse, which is our expertise."
He acknowledged that often, public perception becomes reality, but that in many instances, the public is reasonably unaware of the physiology and science that are behind what happens at the racetrack. For example, news articles have brought up concerns that furosemide masks other drugs that are given to horses before a race, but Dr. Moyer argues that isn't true.
"The reason for that is the new and sensitive technology out there takes care of those problems. Secondly, that medication is given four hours before a given event, so the effects that might have to do with dilution of urine are negated," Dr. Moyer said.
He added, "To the best of our knowledge, there is no published information that indicates giving furosemide in these prescribed means has any negative effect on the horse at all."
In fact, recent research on the subject reveals that furosemide plays an important role in maintaining the health of racehorses.
As an example, a study on "Efficacy of furosemide for prevention of exercise-induced pulmonary hemorrhage in Thoroughbred racehorses" (JAVMA 2009;235:76–82) indicated that prerace administration of furosemide decreased both the incidence and the severity of EIPH.
The study included 167 Thoroughbred horses studied under racing conditions in South Africa during 2007. In the study, each horse raced twice, with each of the two races consisting of the same race field and distance. Horses received furosemide before one race and a placebo before the other. The results showed that horses were three to 11 times as likely to have EIPH after placebo administration as they were after administration of furosemide. In addition, about two-thirds of the horses that had EIPH after administration of the placebo had a reduction in EIPH severity when treated with furosemide.
According to the study's authors, "Results of the present study provide strong evidence that furosemide can help prevent the development of EIPH in Thoroughbred racehorses. As such, its use in racehorses might be justifiable, assuming that other regulatory and policy issues important to the integrity of the sport are adequately addressed."
The AAEP recently issued clinical guidelines for practitioners who treat racehorses (see JAVMA, Dec. 15, 2010). The association anticipates providing more advice and expertise as the race-day medication conversation persists.
"I suspect that there's going to be a lot of really good discussion at this point, and whether it leads to change remains to be seen," Dr. Moyer said. "It's kind of like betting on the (Kentucky) Derby."