New Targets for Medication Regulation

Corticosteroids and Salix will be closely examined by racing officials this year.

Though most racing jurisdictions in North America have greatly curtailed the use of race-day medication, two drugs commonly used in racehorses are getting a hard look from industry officials.

Corticosteroids, usually injected into joints and not currently regulated, are being studied by the Racing Medication and Testing Consortium, the broad-based national group that makes recommendations to regulators for use in model rules. And the results of a South African study could determine whether U.S. racing officials consider limiting use of the therapeutic drug Salix, an anti-bleeding agent used by most Thoroughbreds on race day.

Medication issues dominated the April 23 sessions of the Association of Racing Commissioners International annual conference in Lexington. They dovetailed with an overall look at the status of equine health and welfare initiatives.

RMTC executive director Scot Waterman said nine corticosteroids have been identified for development of threshold testing levels. That means they would be treated like anabolic steroids — permitted for therapeutic non-racing use but banned on race days.

Industry officials and veterinarians have indicated joint injections are commonplace at racetracks. Over time, they could have debilitating effects.

Dr. Larry Soma of the University of Pennsylvania School of Veterinary Medicine, which developed the definitive test for blood-doping agents in horses, said corticosteroids are “potent drugs that have multiple actions on the body,” and are effective at low concentrations. He said they are mostly used as anti-inflammatory agents.

The drugs effect glucose metabolism, endogenous stress hormones, and electrolyte balance, and could cause behavioral changes, Soma said. “Just because you inject into the joint doesn’t mean you’re not going to have all these effects,” he said.

Used properly, corticosteroids can be beneficial at lower doses about six to seven days before a race, Soma said. But they often are administered “improperly” — 48-72 hours before a race, in multiple joints, and perhaps weekly, he said.

Some said the Pennsylvania Horse Racing Commission could recommend a cut-off of seven days for use of corticosteroids.

“Veterinarians believe they need guidelines to practice good medicine,” Soma said. “We still have effects (in racehorses) way beyond the time we can (quantify) the drug in plasma.”

Dr. Tom David, equine medical director for the Louisiana State Racing Commission, said regulation of corticosteroids would aid pre-race equine exams, which he said are “essential” in the effort to protect horses and jockeys. David said the seven-day cut-off is realistic at this time.

David said such therapeutic medications, if given even 24 hours before a race, can mask problems that otherwise might be detected in pre-race exams. He said cut-offs of 48 to 72 hours would aid in the pre-race exam process.

“To some degree, we can pick these things up and fortunately save a rider or a horse,” David said. “There’s no question every horse should receive a pre-race exam. It’s being demanded by the public supporting our sport.

“The public gives us a license to have racing, and they can take that license away. We need to protect the welfare of the horse.”

As for Salix, the results of an efficacy study in South Africa to determine whether it alleviates exercise-induced pulmonary hemorrhaging is greatly anticipated in the U.S., officials said.

Salix, formerly known as Lasix, is widely used on race day. The RMTC, after much consideration, agreed several years ago to allow limited use of adjunct bleeder medications that were prevalent at Mid-Atlantic racetracks. Horses that race on both will have the "(LA)" designation next to their names in programs.

The American Association of Equine Practitioners, which earlier this year released a white paper on equine health and welfare issues, only supports use of Salix on race day. But Dr. Foster Northrop, vice chairman of the AAEP Racing Committee and a member of the Kentucky Horse Racing Commission, said bleeder medications need more research.

“Medication is being blamed for the majority of problems in racing,” Northrop said. “We need scientific evidence to support the benefit of Salix and adjunct bleeder medications.”

If Salix and the adjunct medications ever were banned, no drugs would be permitted on race day.