Therapeutic Medications in Spotlight Once Again

As the National Thoroughbred Racing Association Racing Integrity and Drug Testing Task Force prepared to release the results of round two of its super-testing program, the University of Florida appropriately kicked off its first Equine Medical Symposium March 14 with discussion on some therapeutic medications.

Though the two aren't necessarily linked, they put the spotlight on therapeutics, Class 4 and 5 medications that fall within a gray area of sorts in equine treatment. Their use has caused a rift between some factions in Kentucky, where many are legal on race day, and other states that allow them two or three days out.

Dr. Scot Waterman, who will take over as executive director of the NTRA task force from Jim Gallagher effective April 1, indicated the hard part has just begun. It was easy, he said, to identify Class 1, 2, and 3 drugs that aren't supposed to be found in a horse's system.

"To interpret what we're finding with the Class 4s is really tough," said Waterman, who took in presentations during opening day of the medical symposium held in Hollywood Beach, Fla. "It really becomes more of a veterinarian issue than an analytical issue. There are so many different methodologies, and one jurisdiction isn't testing for them at all.

"It will make it tough to draw conclusions. With Class 4s, more than anything it's a sort of survey -- let's see what the incidence is."

Waterman acknowledged the results of the second round of super-testing produced more positive calls. The results could be released by the end of March.

"You'd absolutely expect (there to be more positives)," Waterman said. "If the number wasn't higher, I think I would have fallen out of my chair."

Super-testing has been performed on blind samples, and jurisdictions with positives haven't been identified by name. That makes interpretation of the second round of testing difficult, because many calls may come from Kentucky, a state where their use is legal.

During the symposium, Dr. Steeve Giguere, assistant professor for large animal medicine at the University of Florida, mentioned dexamethesone, triamcinalone, prednisone, fluticasone, and beclomethasone (all Class 4) as medications used to treat equine respiratory disease. Giguere discussed strangles and heaves, and the more common "exercise induced pulmonary hemorrhage," which is characterized by the presence of blood in a horse's airway after exercise.

About 90% of performance horses suffer from it, but Giguere said "most studies have failed to identify a relationship between EIPH and poor performance."

Dr. Al Merritt, also a professor at the University of Florida, discussed gastric ulcer syndrome in equines. He called animals in training "an ulcer factory," and said the type of training really doesn't matter.

Merritt said a recent experiment produced a hypothesis that increased pressure (exertion) pushes acidic gastric contents into a region of the stomach that has squamous mucosa and promotes formation of lesions. Treatment, or "antacid therapy," as he called it, can be treated with omeprazole, or GastroGard by trade name. One similar generic compound was somewhat successful in treatment, but two others were not, Merritt said.

Another remedy is removing the underlying cause. "That's pretty hard to do," Merritt said. "We want to keep these animals in training."

The March 14 program included a discussion on equine disease outbreaks, including mare reproductive loss syndrome. Dr. Eleanor Green of the University of Florida's College of Veterinary Medicine said Florida, a leading breeding state, was and is ready to respond to a threat like MRLS because of the working relationship between the state, the Florida Thoroughbred Breeders' and Owners' Association, the Florida Quarter Horse Association, other breed organizations, and the University of Florida.

On March 15, the symposium will close with a panel discussion on medication and drug testing. According to symposium information, Ken McPeek, trainer of top 3-year-olds Harlan's Holiday, Repent, and Take Charge Lady, is among those expected to participate.

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