The old adage says "you don't know where you're going if you don't know where you've been."
So at the 2013 American Association of Equine Practitioners' (AAEP) convention, held Dec. 7-11 in Nashville, Tenn., several of the organization’s past presidents covered controversial industry topics in a “Lessons Learned” session from. Tom Brokken, DVM, AAEP’s president in 2006, reviewed evolving medication regulations in horse racing. Brokken is a partner with Teigland, Franklin & Brokken, DVMs, P.A., in Ft. Lauderdale, Fla.
Brokken began by outlining the AAEP-sponsored Racehorse Medication Summit which took place in 2001. The goal of that first meeting was to create overall uniformity within the racing industry, Brokken said. At that meeting the group agreed on a need for:
- Medication regulation uniformity;
- Medication policies that considered the integrity of racing, health and welfare of horse and human participants, and long-term interest of the breeds;
- The creation of a national advisory body to develop medication policies;
- Education; and
- Broad-based funding to support these initiatives.
In 2002 the Racing Medication and Testing Consortium was formed (RMTC) with AAEP as a founding member. The Consortium’s mission was “to develop, promote, and coordinate, at the national level, policies, research, and educational programs that seek to ensure the fairness and integrity of racing and the health and welfare of racehorses and participants, and to protect the interests of the racing public.”
That same year, the industry adopted regulations prohibiting erythropoietin (EPO, a human medication designed to increase the concentration of red blood cells) and darbepoetin-? (DPO, a synthetic form of erythropoietin), two drugs used in blood doping.
In 2003 the RMTC awarded grants for researchers to study the use of procaine (a short-acting local anesthetic), EPO, clenbuterol (a bronchodilator), and morphine (an opioid analgesic, or pain-killing drug) in racehorses. The RMTC also adopted an initial model medication policy (known as the “Model Rules”) and sent it to the Association of Racing Commissioners International (RCI) for approval. The RCI approved the Model Rules in 2004 and Kansas became the first state to adopt the policy, with California following suit two months later. The next year, the RCI adopted penalty guidelines for medication rules violations.
The RMTC approved a plan for setting therapeutic medication levels in response to requests from industry in 2006. “Therapeutic levels determine when a medication is no longer … effective,” Brokken explained.
That year also saw the “Out of Competition Model Rule” (testing for drugs that might not be detected at race time but could still have a performance-enhancing effect) drafted and pilot projects for therapeutic levels on acepromazine (a tranquilizer), lidocaine and mepivacaine ( local anesthetics), pyrilamine (an antihistamine), glycopyrrolate (a bronchodilator), butorphanol (a morphine-derivative analgesic), methocarbamol (a muscle relaxant), and detomidine (a sedative).
By 2008 the Drug Testing Initiative was created to attain consistency among racing laboratories, with five of 18 labs receiving ISO accreditation. That year the Model Rule banning AAS (anabolic-androgenic steroids) had passed in 16 states. It expanded to 33 states by 2009, which is the same year the RMTC laboratory accreditation program began.
The RMTC also approved a A 2-microgram (mcg)/mL of plasma/serum threshold (down from 5 mcg/mL, Brokken noted) for the non-steroidal anti-inflammatory drug (NSAID) phenylbutazone in 2010, and additional thresholds were approved for glycopyrrolate and methocarbamol.
In 2011 the AAEP, RMTC, and National Thoroughbred Racing Association joined forces to host the International Summit on Race Day Medication. The same year, the RMTC recommended a rule permitting only third-party furosemide administration (in this case, only permitting regulatory veterinarians to administer the medication) on race day, and the RCI, implementing RMTC’s recommendations, adopted the model rule.
In 2012 the RMTC launched its External Quality Assurance Program, which it designed to determine "if laboratories have the capabilities required to detect substances of concern at the concentrations that are mandated by the RMTC model rule recommendations," the group's website said. Additionally, the RMTC approved a withdrawal threshold for firocoxib (a COX-2 inhibitor), acepromazine, butorphanol, clenbuterol, dantrolene, detomidine, and mepivacaine, also lending its support to the concept of an approved therapeutic medication list.
In advance of the 2012 AAEP Convention in Anaheim, Calif., the RMTC hosted a conference on corticosteroid use. “The resulting recommendations for long- and short-acting corticosteroid thresholds and withdrawal guidelines were adopted by the industry in early 2013,” Brokken said.
Where We Are Today
Today, Brokken explained, the Uniform National Medication Program has four parts:
- Laboratory accreditation, with 10 of 14 labs ISO-accredited;
- A multiple medication violation penalty approved by RMTC and RCI that addresses the issue of repeat offenders;
- Third party/supervised furosemide administration to help ensure integrity; and
- An approved, living therapeutic medication list that provides research-based information on administration route, dose, and a guideline for withdrawal, as well as a threshold designed to consider the welfare of the horse, the integrity of the sport, and the safety of the human and horse athletes.
Six jurisdictions, led by the mid-Atlantic states, have now adopted the National Uniform Medication Policy, nine jurisdictions are currently working toward adopting the policy, and eight are reviewing it.
“If all of these jurisdictions adopt the National Uniform Medication Policy, this will represent 86% of all pari-mutuel horse racing in the United States,” Brokken said.
Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.