Horsemen, veterinarians, racing officials, and regulators in Kentucky have been working behind the scenes to develop a new medication policy for the state that figures to greatly influence the debate over a uniform medication policy for the United States.The Kentucky Racing Commission could discuss the proposal at its next meeting Sept. 24. The number of medications permitted in a horse on race days in Kentucky would drop from 16 to five, according to a working document. No changes in state regulations are required.Kentucky has been the lightning rod in the debate over development of uniform medication rules because it allows the most race-day medications of any jurisdiction. In the nine months since the first Racehorse Medication Summit in Tucson, Ariz., the only race-day medication a national committee has endorsed is furosemide (Salix, formerly Lasix).Research into the use and affect of other substances continues under the Racing Medication and Testing Consortium. No decisions have been made to seek bans on any therapeutic medications. Under the Kentucky proposal, the race-day therapeutics on the approved list are: - No more than two NSAIDs, namely phenylbutazone (Butazolidin) and flunixin meclofenamic acid (Banamine), naproxen, or ketoprofen. - No more than one steroidal anti-inflammatory agent such as prednisolone, dexamethasone, prednisone, or triamcinolone. - Furosemide and aminocaproic acid (amicar), both of which can be used to treat exercise-induced pulmonary hemorrhage.Stimulants, local anesthetics, depressants, tranquilizers, masking and interfering agents, milkshakes, and possession or use of erythropoietin (EPO) and related substances would be prohibited, as they are now. "It's a good step in the right direction, and something that is desperately needed," said Alice Chandler, a Thoroughbred breeder and member of the racing commission. "My hat is off to (racing commission chairman) Frank Shoop for getting this done. Horses that need all this stuff really don't need to be racing."Chandler acknowledged the proposal is a compromise in that it may not have been realistic to go from 16 race-day medications to a Salix-only policy. She said that as the country moves toward uniformity, the Kentucky policy could be even more conservative."I'm just happy that everyone went along with it," Chandler said.Shoop could not be reached immediately for comment, but last year he formed an equine medication review committee whose goal was to design a model for drug testing and therapeutic medication in Kentucky. At the time, Shoop said the commission wanted to be "proactive," and that Kentucky, as the "premier horse racing state in the country...should be setting the standard for others to follow."Marty Maline, executive director of the Kentucky Horsemen's Benevolent and Protective Association, said the organization would ask its adviser, Dr. Thomas Tobin, to review the proposal. Maline said one trainer who heard about it said it was "something he thought he could live with," but the HBPA board would have no official comment until it studies the document.Dr. Alex Harthill, the Louisville veterinarian, said he sat in on a meeting on the topic. His initial impression was favorable, he said, but that he couldn't comment further."I do believe horses need permissive medication," Harthill said. "I don't know which way it's going to go. I'm not at liberty to divulge anything. It's not my position to announce anything."There has also been discussion about reducing the race-day window for Salix administration to no later than three hours before a race, but it would remain at four hours under the proposed regulation.Meanwhile, the National HBPA, which has taken a proactive role in the national uniformity debate, has decided to survey its affiliates a second time because of some confusion over its first race-day medication survey. The results could be ready at the organization's next convention in January 2003."We pretty much realized it was a flawed survey," said Kent Stirling, executive director of the Florida HBPA and chairman of the National HBPA medication committee. "We tweaked a few of the words, and will use a listing of all members so each person can vote only once."The survey choices are: - Salix only. - Any number of undeclared Class 4 therapeutic NSAIDs and anti-bleeding remedies. - Declared use of Class 4 NSAIDs and corticosteroids at time of entry, and those to be administered after time of entry and prior to race day. On race day, the declared use of Salix, adjunct bleeder medications, and any other approved medication, all of which must be under the regulatory threshold level."We'll probably come up with a compromise," Stirling said. "We're not looking to get boxed in."In the first survey, there was some support for the current Kentucky model, though not necessarily a belief that 16 substances are necessary on race day. The support stemmed from a belief that the model allowed room for compromise when compared with a Salix-only policy.