What’s missing in the racing medication debate? by Ray Paulick|10.04.201210.05.2012|7:08am1:38pm Racing from Oaklawn Park returns to TVG If the medication issue in horse racing were easy, it would have been resolved a long time ago. It isn't easy, however, largely because we don't have consensus on what direction to take, even within the same constituency groups. Example: Veterinarians, including some very well known and respected equine practitioners, can't agree on whether certain therapeutic medications can be harmful to a horse or mask lameness, a situation that can lead to catastrophic injury. Among owners, you have a vocal minority that wants to put American medication rules in line with those followed by the rest of the world. Other owners (many of them mimicking the positions of their trainers) insist that American racing is different, that our horses race primarily on dirt, are stuck 22 hours a day in dirty stalls with polluted air, and are incapable of competing without an array of drugs in their system to help them breathe more easily and loosen up their stiff joints. Breeders are the one group that seems to be most insistent on racing horses in their natural state. They worry that drugs are altering performance and polluting the gene pool with runners whose best races were chemically enhanced. But many of those breeders who produce Thoroughbreds for the commercial market cycle their mares with lights and medication, straighten the limbs of their foals with corrective surgeries, and bulk up their yearlings with food additives that can have the same effect as anabolic steroids. So let's start by acknowledging that hardly anyone in this business lays exclusive claim to high moral ground. That goes for New York, where some believe a circular firing squad actually might be a good idea. We have a governor who is a bully, a legislature that is filled with political opportunists, a State Racing and Wagering Board that is out of step and in denial, and a New York Racing Association that is tone deaf. Oh, yes, and a horseman's organization, if I can borrow a phrase from a former Speaker of the U.S. House of Representatives, that is full of “pious baloney.” The report from the New York Task Force on Racehorse Health and Safety, through its lengthy series of recommendations, found plenty of blame to spread around. The politically appointed State Racing and Wagering Board is far behind other states in things like requiring necropsies of horses that die on racetrack premises. The task force found New York's medication rules are far too lax in the administration of corticosteroids and clenbuterol, to cite two examples. That the NYSRWB has no regulation of Extracorporeal Shockwave Therapy is, well, shocking. (NYRA regulates the treatments with a house rule, which is problematic.) The absence of an Equine Medical Director is another example of New York being behind the times. And the fact that the NYSRWB has allowed veterinarians to ignore existing rules that require reporting of certain drug treatments suggests the regulatory body is going through the motions. Missing from the task force report was any kind of assessment of the statement's drug testing program, which is long overdue. Drug testing has been in the hands of one person, Dr. George Maylin, for far too long. This poor record of regulation by the NYSRWB overshadows whatever shortcomings the New York Racing Associated was cited for having. NYRA's biggest problem, it seems, was having the team of track veterinarians reporting to the racing office – an obvious potential conflict of interest. A veterinarian's job is to assess the soundness of horses before racing, and scratch them if necessary. A racing office priority is for larger fields. That is a bad recipe. The task force consisted of veterinary surgeon Scott Palmer, regulatory veterinarian Mary Scollay (Kentucky's Equine Medical Director), attorney and horseman's association head Alan Foreman, and retired Hall of Fame jockey Jerry Bailey. Their report, among other things, examined past performances of all horses euthanized at Aqueduct from late November 2011 through mid-March of this year, and also looked at medical treatments of those horses prior to their races. The report found, in many cases, that horses were administered intra-articular injections of different corticosteroids and given non-steroidal anti-inflammatories within days of their races. The task force concluded in several fatal breakdowns that the administration of multiple drugs “may have represented a missed opportunity” to prevent the injuries. The task force singled out what it called Eclipse Award-winning trainer Todd Pletcher's “aggressive pre-race medication protocol” and said it may have masked unsoundness. The protocol, which the report quoted Pletcher as saying was routine, included intra-articular joint injections of hyaluronic acid and Depo-Medrol five days before a race, administration of two non-steroidal anti-inflammatories (which the report called “controversial”), and treatment with the joint health products Legend and Adequan. But two racetrack veterinarians contacted by the Paulick Report said there was nothing controversial or aggressive about Pletcher's pre-race routine, which they insisted was designed to help horses avoid injury by insuring more fluidity, particularly in the hind limbs. Another vet said pushing clenbuterol use back to 21 days out, as recommended by the task force, was a mistake. “Many of the Aqueduct barns have no ventilation, they're filthy, with birds flying around and dust everywhere,” he said. “These horses have airway problems caused by this environment. Clenbuterol is a very effective treatment for that.” But it does not sit well with many people that horses need to be on multiple medications when they race: injections of corticosteroids or cortisone, administration of anti-inflammatories, and the almost obligatory race-day treatment with furosemide to reduce exercise-induced pulmonary hemorrhage. I know many racetrack veterinarians, and I don't think a single one of them believes they are doing anything but helping the horse when they treat them with therapeutic medication. Most vets I know believed anabolic steroids were useful and therapeutic, too. But the vast majority of veterinarians, along with most of the trainers who hire them to treat their horses, are clueless when it comes to understanding how their routine drug administrations are viewed by the public. They are as tone deaf as a racing association struggling to make ends meet spending $250,000 for a vanity art mural. I am confused over whether the use of therapeutic medication, including furosemide, is in the best interest of the horse. But I am certain the general public views it far differently than the vets and trainers do. Veterinarians have done a lousy job explaining to the public why they feel therapeutic drugs are necessary. Until recently, the medication protocol for horses has been kept secret, many fans thinking Bute and Lasix were all that were given to horses. However, when drug treatment sheets are made public, as they were earlier this year before the Belmont Stakes and more recently in the Travers, people were shocked to see how many different kinds of drugs were given to horses before they race. Likewise, until Rick Dutrow spilled the beans about giving anabolic steroids to all his horses routinely, most people had no idea steroids were then legal. Perhaps one reason vets have not told their story very well is the division within their own profession. Several years ago one vet told me he would not want medication records made public because groups like PETA would have a field day. But if you can't defend those treatments, to PETA or anyone else, should we be doing them? Make no mistake about it: calls for medication transparency are not going away. It's clear the veterinary community is on the defensive right now, and in my opinion they should be. This is not “their” game, it is a game supported by the public, which has a right to know whether the horses they wager on are medicated and how much. If the veterinarians feel these treatments are justified, they need to inform and educate us exactly why. If they can't, the sport needs to phase out the use of these drugs so close to a race.