Regulatory administration of race-day anti-bleeding medication in Kentucky has provided a clearer picture of drug testing and produced added security benefits, officials said.

Kentucky Horse Racing Commission-authorized veterinarians began administering furosemide, also known as Salix or Lasix, on race day during the Keeneland fall meet in 2012. The policy was enacted as part of a broader medication-related executive order signed by Gov. Steve Beshear.

After several gaffes–horses receiving or not receiving Salix as listed in the program–at the Keeneland and Churchill Downs fall meets, the system has worked well, said Dr. Mary Scollay, equine medical director for the KHRC. And commission officials, after about nine months, have testing data for comparative purposes, she said.

Scollay and Dr. Rick Sams, who runs the HFL Sport Science drug testing lab, recently reviewed the program with The Blood-Horse. They showed test results that clearly indicate not only lower levels of Salix almost across the board, but a major reduction in "static"–other substances in the samples.

"In every case the distribution of the furosemide level was lower," Sams said. "There were no high values or outliers. I'm surprised the distribution (of values) is such a narrow range.

"This also has had an effect on TCO2 levels, because we know furosemide does affect TCO2. The values have been lower since regulatory vets began administering furosemide. It wasn't a big difference, but it's highly significant."

In post-race samples the Salix concentration dropped by about 30% at the Keeneland and Churchill meets this spring and summer. Officials said that could mean Salix was being administered up to an hour later by private vets, perhaps unintentionally because of busy work schedules.

Scollay noted the standard dose of Salix–a minimum of 3 ccs and a high of 10 ccs–hasn't changed since the policy was enacted last year. But regulatory vets encountered some trainers that requested the Salix shot be given in muscle, or they inquired about having other substances injected.

"Some of the things we have learned are some horsemen requested to have it in the muscle because the drug has a prolonged effect–but that's a violation of our regulations," Scollay said. "We also were asked for other things clearly not permitted by the regulations, such as vitamins. This all appeared to be standard procedure (before the policy change)."

"My seat-of-the-pants impression is there is less 'background' in the urine samples," Sams said. "That's probably a reflection of commission vets not administering stuff other vets were administering."

Scollay said an investigation last year at Ellis Park into race-day administration of substances other than Salix led regulators to find "profligate administration by injection of other substances such as magnesium sulfate and "Carolina Gold." The latter is trade name for gamma-aminobutyric acid, or GABA, which is a relaxant that produces optimum results when given to a horse a few hours before a race.

GABA is banned by the United States Equestrian Federation. Like magnesium sulfate and hydrocortisone, also calming agents, GABA occurs naturally in horses and is rapidly eliminated. The industry continues to study the substances in the hope of eventually determining levels at which they naturally occur.

"One could argue these substances are performance-enhancing based on indirect effects such as calming a horse before it races," Scollay said. "But it's a very complex question. That's why we're not regulating them until we're confident a threshold has been established that is fair and safe."

"Not all drug samples fit nicely into the post-race sampling package," Scollay said, noting regulators may need to adjust sampling times to target specific substances.

The 2012 updated equine drug policy also brought to an end use of race-day adjunct bleeder medications such as aminocaproic acid and conjugated estrogens. Sams said the effect on test results has been noticeable.

"The drugs were given in huge doses about four hours before a race," he said. "We've seen these in urine sample extract. They created a broad peak that made it very difficult to see other stuff. That's all gone now."

Scollay said the KHRC also uses the testing information to identify "horses of interest," or those whose tests may show traces of multiple non-steroidal anti-inflammatory drugs. As for increased security, Scollay said just having more regulatory vets in or near stalls has provided another avenue for intelligence-gathering.

Dr. Dionne Benson, the Racing Medication and Testing Consortium executive director who has given race-day Salix to horses when needed in Kentucky, said the policy does have added benefits.

Benson said when she was a vet technician she would see private vets walk into stalls with four or five syringes per horse.

"If vets are really paying attention on the backside, you do have an extra level of security," Benson said. "They could spend eight or nine hours just walking around to administer (Salix). You have people around to know what horses are being injected. I was very skeptical before I saw it in action."

Kentucky is one of several states that require Salix administration by regulatory vets; the others are New York, Nevada, and North Dakota, according to the RMTC. Of other states, Delaware requires an agent of the racing commission to give the shots; Indiana, Minnesota, and Wyoming allow private vets to do so but only under security supervision; and New Jersey, at Monmouth Park at least, requires third-party administration of the drug.

There is a recommendation in California for association or non-practicing vets to administer Salix, while Maryland could have a regulatory vet rule in place later this year. Pennsylvania is considering the policy, but one track–Hollywood Casino at Penn National Race Course–already used a third-party service to administer Salix.

Chris McErlean, corporate vice president of racing for Penn National owner Penn National Gaming Inc., said the Pennsylvania track has employed a third-party service headed by Dr. Jay Baldwin for about a year. Baldwin services other tracks in the Mid-Atlantic region, including Delaware Park.

The policy came about as a byproduct of the track's agreement with local horsemen, McErlean said. Horsemen were unable to find private vets to stay at the track for race nights, so they struck a deal with management on a solution for Salix administration and regular vet services.

"We did it on our own," McErlean said. "The (Pennsylvania State Racing Commission) didn't have an issue with it as long as the rules were being followed. The private vets weren't necessarily happy about it but the horsemen saw it as a benefit.

"We've had a couple of hiccups here and there but nothing major; there have been a few tweaks to make it more efficient. And from the perception point of view, we were able to fall into the new national standards."

Major racing organizations that develop equine drug policy have said regulatory administration of Salix is a major part of medication reform.

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