This feature story ran in the April 18, 2015 issue of Blood-Horse magazine.
In contrast to North American racing's notable recent starts and stops on the race-day medication issue, owner Bill Casner hasn't wavered since his 2011 decision to race his Thoroughbreds without the widely used diuretic furosemide, or Salix (Lasix).
That commitment has come at a time when leading industry groups have waffled. A 2011 American Graded Stakes Committee decision to withhold graded status for any 2-year-old stakes that allows race-day medication did not become reality. Breeders' Cup, after running two years of juvenile races Salix-free, failed to follow through on a plan to phase out race-day medication in its races.
Some prominent North American owners have committed to run young horses without Salix, but Casner has decided to run his entire stable free of race-day medication. Now in his fifth season of racing horses medication-free, that staunchness has provided Casner and his trainer Eoin Harty with first-hand knowledge on how to campaign Thoroughbreds safely--and compete--without race-day medication.
"Bill is a very passionate person, and when he gets a hold of something, he's like a pit bull on a hot dog," Harty said. "He doesn't want to let it go, and that's not necessarily a bad thing."
Casner has become convinced healthy horses don't bleed. He believes nearly all instances of exercise induced pulmonary hemorrhage are caused by illness or infection, or by the use of other medications, specifically phenylbutazone (Bute) and other non-steroidal anti-inflammatory medications. Studies have shown Salix prevents or reduces the severity of EIPH, but Casner believes too many negative side effects come along with using the only drug permitted to be administered on race day.
"When people say most of these horses bleed, they're probably not far off. But there's a reason for that," Casner said. "It's often the environment they live in; so many of them will have some type of inflammatory disease, guttural pouches, pharyngitis; issues in their lungs. Trainers try to manage this with Salix, but that's not managing the source of the bleed; that's managing the symptom."
Surprisingly, Casner does not believe he is sacrificing performance. While he concedes a horse that goes on Salix for the first time may enjoy a boost provided by water-weight loss, Casner believes his horses fare better long-term than those that race on furosemide and deal with its side effects.
"First-time Lasix, you probably get a bump in performance," Casner said. "But after that it's the law of diminishing
Casner, a former partner with Kenny Troutt in WinStar Farm, has started 260 horses on his own since 2011. During that time through April 8, Casner's stable has registered 36 wins, for a 13.8% win percentage. In the past two seasons the stable has maintained a 12.9% win percentage.
Racing without Salix, Casner's Endorsement won the 2012 Texas Mile Stakes (gr. III) at Lone Star Park and set a track record in a 11⁄16-mile dirt race at Gulfstream Park. This year Casner's My Johnny Be Good won an allowance optional claiming race at Tampa Bay Downs by 141⁄2 lengths and then placed third in the Sam F. Davis Stakes (gr. III) and ran in the March 28 UAE Derby Sponsored by The Saeed and Mohammed Al Naboodah Group (UAE-II).
"If you have an average horse, it isn't going to matter what you do; you'll still have an average horse. If you take an average horse and give them everything in your bag of tricks, they're not going to run one-length better," Casner said. "If you have a good horse and give them Lasix, they'll run well, but they'll run just as well without it, maybe better."
Since the decision to race medication-free, Casner and Harty have worked together to ensure horses in the stable compete at a high level without bleeding. One of their first decisions was to reduce the use of Bute.
"When we first started running horses without Lasix, we were giving them Bute and no Lasix. What we observed were bleeds of two of five (on a five-point scale with five being visible bleeding through nostrils) and three of five," Casner said, noting that all his horses are examined with an endoscope after races. "We subsequently came back and ran those horses without Lasix and without Bute. Lo and behold guess what happened? They didn't bleed."
Casner already had his suspicions about Bute and its links to EIPH, an opinion that was shaped by longtime racetrack veterinarian Dr. Mark Cheney.
"You could probably eliminate half your bleeding incidents by eliminating use of Bute. These horses will perform to the optimum without it," Casner said. "Everybody gives it, 'just in case.' They'll have a horse who is tracking good, never takes a short step, is looking great, but they'll still give that horse Bute just in case."
Casner's experience with Endorsement reinforced his beliefs that Bute may cause or exacerbate EIPH. Endorsement made his first four starts on Salix while racing for WinStar. The Sunland Derby (gr. III) winner suffered a condylar fracture while preparing for the 2010 Kentucky Derby Presented by Yum! Brands (gr. I). After a layoff of more than 20 months, Endorsement made his first Salix-free start for Casner Racing, finishing second in a Gulfstream allowance optional claiming race.
Endorsement had been receiving Bute during his preparations for the return, and he registered a low-grade EIPH score after that first Salix-free start. Bute treatments were discontinued for the son of Distorted Humor. Endorsement followed with another runner-up finish before his track-record performance. He later scored his grade III win that season, all without bleeding.
"This was a horse who had a condylar fracture, but he didn't need Bute," Casner said, noting the stable now relies heavily on ice treatments for soreness.
Around the stable Harty has led the charge to reduce dust and pathogens in an effort to keep horses healthy and breathing properly. Casner noted too many barns at tracks in the U.S. have poor ventilation.
"These horses in the U.S. live in absolutely some of the worst conditions a horse can live in," said Casner, noting that in Dubai barn design and constant cleaning provide a much better atmosphere. "Virtually every racetrack here, you'll have ceilings on those stalls with the lofts up above. That's a terrible setup because it holds all of the dust, all of the ammonia, in that area. The dust carries pathogens and fungal spores into horses' lungs. In some cases you have decades of pathogens and fungal spores that have accumulated in these stalls.
"I'd challenge anybody to go live in a stall for a week. It won't be easy. You'll be hacking and sneezing. You'll have serious respiratory issues. These horses are no different."
Before a Casner horse ships to a track, a stable staff member disinfects the new stall. The stall is power-washed with Clorox and other disinfectants. After the arrival, stalls are fogged twice a week with an anti-microbial that will kill potential pathogens and viruses, but Casner said it's safe for horses.
"It takes five minutes to fog a stall. It becomes a very cost-effective tool. Those old wooden stalls always have the potential for bacteria," Casner said. "So we're putting an anti-microbial on those walls and the bedding. What we've found is the respiratory issues in the barns have all but disappeared."
Casner, who keeps 20 broodmares at WinStar, also uses the fogger with his young horses. For the past five years he has brought his weanlings to his Texas farm.
"I have a very clean barn down here, well-ventilated, but for the first three years those babies would still get what they call the 'baby crud.' They'd get to coughing; runny nose. It would go through the barn, and you'd generally have several months of it until April or May when the weather warmed up," Casner said. "Two years ago we went on this program of fogging our stalls twice a week. In two years I have not had one sick horse. It's just unbelievable."
In an effort to reduce dust at the track, horses are bedded on wood shavings instead of straw.
"Most of the straw at racetracks now is bad straw. It's really chaffy and dusty," Casner said. "If I walk down a shedrow and they're bedding on straw, my lungs will tighten up so quick. Our lungs are really no different than the horses. There's going to be different levels of sensitivity. Some horses may tolerate it better than others but there will be some that won't tolerate it."
Hay is cooked to reduce dust, eliminate pathogens, and make the meal easier to digest.
"The fact is dust is never ever good. So you manage your barn environment with simple, obvious methods; reduce the dust in that stall the best that you can. If you bed on shavings, you're going to have a lot less dust. If you cook your hay, you're going to have a lot less dust," Casner said. "There's nothing we can do about the roofs on these barns--ideally you'd not have them--but if you manage that dust and take them off the meds, these horses don't bleed."
Casner acknowledges these ideas may sound expensive and labor intensive, but he notes the cost is more than balanced out by reduced veterinary bills.
"Bedding on shavings is comparable to bedding on straw. The hay cooker is $2,500, and it will last for years," Casner said. "All of this is less than what you're paying in Lasix and Bute. All of these medications are big revenue for vets, along with all the things they give to bring a horse back, the jugs and such. I have almost zero vet bills."
Harty said the changes don't add a lot of extra work for his staff.
"Unfortunately it's difficult at some of these tracks with a very dusty environment, but you have to do everything you can to try to reduce dust and eliminate bacteria as much as you can," Harty said. "You try to eliminate pathogens as best you can; it's an uphill battle, but you do what you can. It seems like a little bit of extra work, but it's really not, once you work it into the routine."
When Casner initially studied the effects of Salix, he concluded the side effects were worse than any benefit. Especially revealing was the weight loss his horses endured following each application of the diuretic.
"It was really eye-opening. You always hear that a horse loses 25 pounds of water weight, but it goes far beyond that," Casner said. "That 25 pounds may be accurate up until race time. The fact is that Lasix continues to have its diuretic effect up to 72 hours. That horse continues to be in a diuretic state at a time when he should be in full recovery. Horses will have lost 35-55 pounds when we weighed them the morning after a race. That's even with drinking two or 21⁄2 buckets of water after the race."
Casner said his horses today lose five to seven pounds after a race and quickly regain that weight.
"We're seeing a faster recovery. At night they're in the tub; they're eating. The next morning you lead them out of the stall and they're bucking and playing. They're not dull," Casner said. "Horses on Lasix, so many of them, they won't eat at night; they're dull for two or three days after a race; that's the first thing that we see."
Casner believes the extreme flushing of fluids from the body also leads to deficiencies in calcium and potassium at the cellular level. He believes the horse's system compensates by pulling calcium from the bones. He thinks this process interferes with the normal skeletal remodeling process and leads to unsoundness.
He notes Bute use came along before Salix, and Casner suspects the bleeding problem was exacerbated by the use of Bute, fueling the need for Salix to prevent EIPH.
He believes reduced soundness and continued race-day drug use are alienating potential fans.
"The bottom line is the American public perceives it as a drug, and they do not believe any athlete should be administered a drug and compete," Casner said. "They see it as abuse."
The added recovery time Casner believes is involved with Salix has led to trainers' spreading their starts out, reducing opportunities for owners to race their horses and fans to see stars.
Casner is encouraged by plans at Keeneland to next year offer races for juveniles that in the conditions will prohibit Salix. He applauds tracks such as Oaklawn Park for awarding bonus money to horses that win races without race-day medication. He notes U.S.-based horses have enjoyed success overseas racing medication free.
Harty believes eventually U.S. racing will join most of the racing world and prohibit race-day medication.
"I think he sees where this issue is going," Harty said. "It looks like sooner or later--and it's probably going to be sooner rather than later--it's going to become the rule here." B