In the Shadow of Horse

In the Shadow of Horse
In the Shadow of Horse

Thursday, June 12, 2008

Horsemanship and Horse Racing

June 11, 2008, New York Times, The Rail
Horsemanship and Horse Racing
By SID GUSTAFSON
I have to be careful writing about jockeys and riding as I still do veterinary regulatory racetrack work from time to time representing the horses and jockeys safety and welfare on race day. I try to stay out of debates involving riding strategy, so as not to have jockeys lose confidence in me should I happen to perform regulatory work at their track in the future. In order to effectively carry out regulatory duties, veterinarians have to maintain trusting working relationships with the jockeys. On the other hand, proper horsemanship is essential for horse racing safety, and regulatory veterinarians are certainly responsible for that.
I teach natural horsemanship at the University of Montana Western, where I have the good fortune to ride in all of the horsemanship classes. We study the nature and behavior of horses and base our training on this understanding of horses.
After the gate opened in the Belmont Stakes, Kent was dealing with a Big Brown anxious to sprint to the lead. Brown seemed to shy sideways to the right away from the starter standing in the track after he slipped out of the gate. Kent reacted and Brown did not respond to the rider’s initial reaction and instruction like Kent had anticipated, and the rider had to apply a large amount pressure to the reins, repeatedly, wrestling the horse in one direction then the other. The early issues between horse and rider cascaded, and the partnership between horse and rider deteriorated out of the gate well into the first turn.
It seemed that the Brown team knew that a deficit in the connection between Kent and Brown existed when they last observed Kent gallop Big Brown. It was reported by the trainer through the media that the horse was all over the place on a morning gallop with Kent aboard.
The general horsemanship belief is that once a horse gets his way with an unassertive rider through the course of a gallop, the horse will attempt to have its way with the rider on future rides by ignoring the cues the rider gives with the reins and legs. According to the news media and Dutrow, Brown got the best of Kent the last time Kent galloped him. Kent was not able to get Brown to respond to his cues on the gallop.
Apparently, the trainer observed the horse get his way with Kent on the last gallop and did not take measures to correct the racehorse’s relationship with the rider before the race. Subsequently, the horse did not respond to Kent in the race. In essence, Kent had to retrain the horse to respond to his cues through the first quarter mile.
If Brown understood he could get away with refusing to answer to Kent’s cues appropriately on gallops, Brown is not going to react any better to Kent’s cues in a race.
Dutrow’s description of Kent’s last gallop of Big Brown seemed to match the subsequent race ride Kent gave Brown, which is what horsemanship studies would expect, and even predict. In trying to find answers as to what might be done differently to prepare Big Brown for future races with Kent up, the horsemanship issues between horse and rider regarding response, connection, and communication need refined before the race.
Nothing is simple in horseracing, and most race finishes are the result of many, many factors and sequences of factors. Horses’ reaction times are lightning quick. However practiced, a human’s reaction to a horse’s reaction is not always a rhythmic thing when extenuating pressures and surprises arise, or when preparation has been lacking. In retrospect, it now seems that it may have been inappropriate to let Brown get away with a disobedient gallop with Kent up before the race. Brown also could have been better prepared mentally for the race, so to have been in a partnering mood with his rider. This is of course all very complex, and horses regularly fool horsemen. Developing a better understanding of equine behavior is the goal of all horsemen, but much of our learning is trial and error.
I do not share these horse behavior observations to place blame, but to clarify an aspect of horse training and memory. Certainly, losing the race was not Big Brown’s fault. He is in the hands of people, the training, the riding, the conditioning, the medication; everything the horse does is at the hand of man.
In natural horsemanship, we teach that the horse is never wrong. Riders have to develop partnerships of confidence, respect, and connection with each horse they ride, and consistently maintain all aspects of those partnerships to ensure a responsive partnership. If people are not consistent with horses, horses will not be consistent for people.
Not only was Big Brown unwilling to respond evenly for his rider, Desormeaux, Big Brown did not work as evenly as hoped for his regular exercise rider, Michelle Nevin, before the race. Horsetraining is in order for Big Brown, refinement of the basics of confidence, respect, and connection going both ways between horse and rider, all Brown’s riders. The owner and trainer’s idea to resume medicating Big Brown with Winstrol is a mistake, as anabolic steroids are notorious for making horses less trainable and responsive. Big Brown needs to get more connected with his riders, and anabolic steroids can contradict that goal.
If Desormeaux rides Big Brown in the coming races, the horsemanship issues between the horse and rider should be refined so that the horse and rider connection is more secure when the Haskell or Travers roll around.
Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

About Those Steroids and Big Brown

June 10, 2008, 8:02 am
About Those Steroids and Big Brown
By SID GUSTAFSON
Lack of steroids did not appear to be the reason Big Brown tanked the Belmont. I went over the reasons I thought were significant in my last article. Big Brown is a stallion. Horses are seasonal breeders. Anabolic steroids are naturally occurring. As days lengthen the endogenous anabolic steroids, those produced internally by intact male horses, are increasingly secreted into their bloodstream.
The days have lengthened considerably since April. Whatever Winstrol was excreted or metabolized by Big Brown before the Belmont Stakes had by and large been replaced by race time with his increased secretion of seasonal anabolic steroids. By this time of year most stallions have established higher levels of androgenic steroids in their bloodstreams by secreting their own endogenous hormones in response to the lengthening days.
Although steroids can improve performance in horses, steroid administration in itself does not assure enhanced performance. Generally speaking, horses are adequately big, strong, and fast enough. Steroid administration is not always a beneficial thing, especially over the long run. There are adverse reactions and side effects aplenty. When the dosage is excessive, or sometimes even with small dosages, difficult behavioral issues often arise. The biggest problem is that horses become hard to manage and handle. They act rank. With horses control is essential to safety and performance. It seemed Big Brown was plenty frisky as he broke out of the gate for the Belmont. Behaviorally and physically, there appeared to be little appearance of a lack of steroids in the big horse’s system.
Since steroids can indeed at times improve performance for some horses, they should be banned. There is little doubt that life will be healthier and safer for racehorses when steroid use is restricted. Artificially enhanced performance means that some medicated horses will exert themselves more than they might without steroids, putting added stress on their legs and muscles, leading to more injuries than would be the case without the added juice. Additionally, there are significant deleterious side effects due to the injudicious use of anabolic steroids: subsequent sterility, cancer, heart disease, unhandleabilty, psychological confusion, and other troubles.
Are there justified medical uses for anabolic steroids in racehorses? Yes, but justified medical use does not include enhancement of performance beyond what would normally be a horse’s inherent ability. What then are anabolic steroids used to appropriately treat? Anabolic steroids are given to help horses recover from certain medical conditions involving weight loss, reduced appetite, and loss of muscle mass. There are also valid medical uses for anabolic steroids to help horses recover more quickly and heal stronger after undergoing arduous surgical procedures, prolonged stress, and racing and training injuries. Anabolic (building up the protein) steroids induce metabolic protein retention, resulting in the incorporation of additional protein into the muscular and other structural tissues, bulking up the horses and athletes on the stuff.
Any other uses? Well, yes. Horses that are given significant amounts of catabolic steroids may need anabolic steroids to allay the protein loss the catabolic steroids induce. Catabolic steroids or cortisone (those steroids that break down protein and cause it to be excreted) are often administered to race horses to reduce joint, bone, tendon, ligament, and muscle inflammation, as well as to treat a plethora of other medical, immune, and metabolic conditions (pulmonary disease, hypoglycemia, tying-up, allergies, and many other medical issues).
Joints are injected with cortisone, and cortisone is also given systemically (intravenously, intramuscularly) to be absorbed into the bloodstream. Anabolic steroids compensate for the deleterious side effects of cortisone injections. If the use of catabolic steroids is limited, this will eliminate the medical indication to use anabolic steroids to compensate. If the industry is going to move forward in the best interests of race horses, they should significantly limit the use of cortisone as well. This will level out the drug-playing field, and bring our medical racehorse morals up to the standard of the rest of the civilized world.
Are there other examples of where one drug needs another follow-up drug to compensate for the side effects of the original drug? Yes. Phenylbutazone (bute), in addition to its vaunted non-steroidal, anti-inflammatory effect, thins the blood, increases the clotting time, and can increase the potential for bleeding into the lungs during racing (exercise-induced pulmonary hemorrhage, EIPH). If we ban the bute, the horses hopefully won’t bleed as much, and we can then reduce the need for Lasix.
Without bute and other NSAIDs in the horse’s system, the racehorse will be less likely to bleed. Both anabolic and catabolic steroids cause fluid retention, which also increases the possibilities to bleed with the increased blood volume. Lasix, a diuretic and lung-blood-pressure reducer, is used to eliminate this excess fluid.
The horse racing industry could begin to restrict the original allowed drugs bute and cortisone, thus reducing the need for Lasix, anabolic steroids, antibiotics (steroids impair immunity) and other drugs which tend to be needed to mitigate the side effects of the original drugs.
The preference of many is that race horses should run clean. Drug-free racing is safer. It favors sound horses. Fewer drugs, then, allow horses to race sounder and longer, and drug-free racing might protect the horseplayers a bit. If horses are treated with the drugs veterinarians determine they need to be treated with, then the patients should not be allowed to race until the resultant therapeutic drug levels have subsided to insignificant levels.
Will this no-drug policy then push trainers to use drugs that cannot be detected? Yes again, but then attempts to gain advantage with drugs have always been problematic in horseracing. Legalizing the use of bute and Lasix drugs did not curtail this activity, it simply enhanced it. Allowable drugs “clouded” the tests, hiding other drugs. Lasix diluted illicit drugs in the urine, making them harder to detect.
The 35-year-old raceday-drug horseracing experiment has failed, or is failing. Too many fractures. Too many wrecks. Too many injured jocks. Too many down, dead horses. It is time to start running American racehorses clean like horsemen do in the rest of the world. The cleaner, the better. Racing jurisdictions gave veterinarians and trainers the go-ahead to use drugs liberally in the 70s. And, as is apt to happen with drugs, some individuals abused the dosages and administration of those drugs. They topped allowable drugs off with more drugs, and in doing so did their horses and patients and the thoroughbred industry a significant disfavor.
The ethical rule of equine veterinary medicine is this: First, do no harm. When drugs are implicated with harm, then it is time to re-evaluate their use. The argument that legal drugs somehow help horse racing is getting weaker and weaker. Legal drugs engender the use of more drugs. Some drugs may have their place in racing horses, but we need more evidence to overcome the contradictory evidence that drug use is diminishing the public’s confidence in horseracing.
We’ll never forget those images of Eight Belles trying to rise on two broken legs. None of those who witnessed that misfortune will, not even Big Brown. But that image will fade and be less-likely to be repeated if we all get together to make racing a more reasonable sport for the horses’ sake, for everyone’s sake. It is a good feeling to win a horse race with a thoroughbred, but the ultimate good feeling in horseracing comes when a horse runs clean, wins, and returns to the barn fit and sound. Let’s get that feeling going, now.
Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

Belmont Stakes, 2008

June 8, 2008, 5:10 pm
Horse Racing Prevails
By SID GUSTAFSON
Big Brown burst from the gate fresh and fast. He immediately veered out, causing some concern that he was getting off the left front hoof (or was he just shying a bit from the starter in light of his freshness?). Despite his best efforts, Kent couldn’t contain his horse’s energy and settle him in. Checking can take the timing, balance, and rhythm out of a horse, disordering their physiology, expending their energy.
The heat, Brown’s rankness, the rough-going in tight company early, the necessity of having to rein heavily, the lost conditioning due to the quarter crack, the quarter crack itself, three races in five weeks, one mile and a half in the heat; all adequate reasons for the altered performance from the veterinary view. No surprises in the realm of equine medicine, at least.
The day was very hot; Brown was washing and foaming between the thighs. All the trouble the horse had to contend with early in the race expended needed energy not later available at the top of the homestretch. Down the backstretch Brown’s head was bobbing significantly more than the other racing horses, suggesting the onset of exhaustion.
Medically, the media and veterinary consensus thus far is that Big Brown is fine. Kent Desormeaux’s decision to pull the horse was commendable in light of the knowledge that a medical problem existed in his foot. No one wanted to risk the horse injury, especially his rider. The pressure was on to bring the horse home sound, and Kent did that. Big Brown expressed his displeasure at being held back, fighting with Kent, unfamiliar with having a herd of horses leave ahead of him, wanting to go on as Kent was bringing him to a stop in front of the grandstand. It appears our fallen hero was more likely exhausted than injured, for which we are all grateful.
Big Brown had a bad day, but things have could have turned out worse, as we all know. Horses humble men on a regular basis. Here is to the smooth and steady Da’ Tara, the sweet-riding Alan Garcia, and a superb conditioning job by Nick Zito.
The beauty of horse racing is overcoming great odds to win, rising out of the dust to prevail in the big race. The Da’ Tara team did just that, especially impressive in Saturday’s hot weather.
Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

Racehorse Heat

June 7, 2008, 7:45 am
It’s Hot Out Here for a Horse
By SID GUSTAFSON
Horses don’t like heat. They evolved in cool, even sub-arctic climates and are generally poorly-suited to deal with hot, humid weather. Heat makes horses sweat. Horses dissipate 75 percent of excess heat by sweating. The remainder of the heat is blown off by respiration. High humidity reduces the horse’s ability to dissipate heat by sweating, making it more difficult to keep the body temperature normal.
Hydration and electrolyte balance are critical in the racing thoroughbred. Muscle, nervous, pulmonary, cardiac, and joint function are vulnerable to electrolyte imbalances. Most electrolyte imbalances in thoroughbreds are caused by excessive pre-race anxiety and perspiration (washing out), which can be exacerbated by the use of race-day Lasix.
Potassium is one of the critical electrolytes depleted by washing out, as are sodium and chloride. Lasix depletes calcium and magnesium. These electrolytes are all essential for proper nerve, muscle, and circulatory function, and they all must be balanced in relation to one another.
When electrolyte dysfunction begins, wobbliness and weakness ensue, stressing the musculoskeletal system. After electrolyte imbalance becomes marked, the syndrome can move into thermoregulatory dysfunction, and the core temperature of the horse becomes elevated, causing further and more serious consequences. Although, high temperatures cause exercising horses to sweat heavily to dissipate the internal heat, susceptibility to heat stress is not solely influenced by ambient temperature alone. Excitable temperaments are the biggest culprit. Calm horses can generally maintain a normal body temperature and minimize sweating utilizing their ability to remain quiet and relaxed. In hot weather, anxiety-riddled horses can become electrolyte imbalanced before the race begins.
Other factors that may make horses vulnerable to heat include failure to be acclimated to hot temperatures and high humidity, tendency to sweat, and withdrawal of drinking water before racing. Racehorses may lose to 10-20L of sweat in a one-mile race. Fluid loss thickens the blood, making it flow more slowly, delivering less needed oxygen as the race perseveres. Additionally, hot horses redistribute blood flow to the skin in attempt to cool the blood off. This combination results in less blood being available for critical racing muscles, resulting in muscle weakness and cramping, weakness that may become especially noticeable in the last half mile of a one and a half mile race.
Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

Eight Bells, continued from the NYTimes the Rail

By SID GUSTAFSON

Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

There are medical and cultural human-animal issues in the thoroughbred industry that warrant exploration and acknowledgment.

A prudent horseman could begin with the essential topic of stabling: how do we move forward to best recreate the natural preferences and tendencies of stabled racehorses? More intense issues such as racing age, medication, track surfaces, and breeding can be better addressed in subsequent articles after the nature of the horse and the implications of racetrack confinement are addressed.

The Fetlock Epidemic: When horses break their legs in races and have to be euthanized on the track, we have clearly exceeded the adaptability of the horse. Racetrack breakdowns are endemic, if not epidemic, in America, an undeniable veterinary reality of which I have first-hand experience. There are at least 60 identified factors which contribute to breakdowns, the leading one of which is a lack of prerace scrutiny by the trainer, his veterinarian, and the regulatory veterinarians. There are accidents, bumps, missteps, and bad luck, yes, but in my experience the vast majority of breakdowns are predictable, and most breakdowns are a result of running horses with fetlock lamenesses. Fetlocks are among the thoroughbred racehorse’s most vulnerable and complex joints. The fetlock gathers a vortex of anatomical structures that are intricately interdependent and essential. Inflammation, pain, or swelling in any one of the structures alters the essential biomechanical synchronicity for proper function and support of the critical joint.

As a professor equine studies, I attempt to teach my students appropriate moral reasoning regarding the well-being of the horse. Acquiring an academic and intuitive understanding of the horse’s nature enhances moral reasoning. Time spent with horses combined with intellectual academic pursuit helps us realize when equine welfare standards are exceeded by our competitive pursuits. This is not an easy task, as horses have been utilized intensely and harshly, assertively and aggressively through time, a cultural ideology that does not fade easily, although significant progress is taking place. In situations involving the welfare of animals progress is sometimes all we can ask.

Understanding horse behavior is necessary to refine our contemporary relationship with the horse. I attempt to engage my natural horsemanship students in analytical thinking regarding the management of confined horses in the context of the well-being of the horse, and in consideration of the intimately connected physical and mental needs of horses, especially the mental. Thoroughbreds are one of the most intensely stabled breeds. Mental and physical health become challenging to manage in confinement scenarios. After their yearling year, many thoroughbreds spend the rest of their performance life stalled, contrary to their nature. To restore confidence in thoroughbred racing, we could begin by trying to modify stabling practices to better accommodate horses’ nature, allowing the horses to develop stronger and more durable physiques in a natural fashion; to become more psychologically content and physically sound athletes, to become less dependent on drugs and surgeons. We need to place more focus on the horses’ racetrack environment and take steps to design appropriate stables and training facilities to accommodate the horses’ sociobehavioral, nutritional, and physiological requirements and preferences. To make horseracing a safer sport for horses and riders the industry could best be served by attempting to improve racetrack stabling practices, a topic on which most horsemen should find common ground in which to contribute appropriate practices and facility ideas to improve the horses’ racetrack life.

The contemporary racetrack-stabling scenario significantly displaces the horse from its natural preferences. Little semblance of a horse grazing the plains with its herdmates is apparent in a shedrow stall, where today’s racehorse spends over 90 percent of its time, depending on the trainer and his or her regimen of training and enrichment. Somehow, certain effective trainers recreate enough natural preferences for racing success despite this restrictive stabling. Their horses train sound and win races and return sound and uninjured in the best circumstances. These trainers create success for their horses; make it easy for the horses to succeed by fulfilling their inherent needs. Other trainers fail to adequately fulfill their horses’ needs. Adaptation is exceeded. Their horses become injured, sometimes because of inappropriate conditioning, and subsequently become prone to break down, as certain conditions really never return to normal function. An injury in one location, or two or three as can be the case, significantly disrupts the synchronous movement of the horse, stressing multiple joints and legs, an interdependence demonstrated so unfortunately by Eight Belles, fracturing not one, but two fetlocks.

How do we strengthen legs? Improved husbandry and stabling practices can offer remedy when the horses’ adaptability is exceeded. How can we better recreate the natural needs and conditions of stabled racehorses? All horsemen have ideas about recreating natural circumstances to fulfill natural tendencies of horses, like friendship and play, sleep and grazing and walking together. If we design the stable and manage horses in a more horse sensitive manner, horses have the potential to race stronger and safer. Many trainers adequately fulfill these needs in horses. Certain individual horses require more fulfillment than others, they are less adaptable to stabled life, require more patience and understanding to facilitate gate relaxation and acceptance.

What improvements in stabling facilities and exercise paddocks can be implemented to improve the horses’ mental health and physical endurance? Let’s ask the horsemen. Let’s ask those who study horses. Let’s attend The Horse display at the Museum of Natural History. Let us look to many venues to understand the horse. Can natural approaches improve the durability and safety of thoroughbreds? Can we create stabling conditions that promote the need for less medication while creating increased physiologic durability and mental health? Yes. Educational, informative articles make a difference for racehorses, literarily, medically, and journalistically.

Drugs and Horseracing

June 4, 2008, 3:42 pm
Drugs and Racehorses
By SID GUSTAFSON
Phenylbutazone seemed a miracle drug when the stuff began entering the bloodstreams of racehorses in the 1960s. I was collecting the post-race urine that concentrated the metabolites of that drug during the ’60s, and as a teenager I became acutely aware of drugs and racehorses.
What a soothing anti-inflammatory effect bute brought to racehorses in those simpler days when its use first became widespread. The alleviation of certain lamenesses was dramatic. “Really sweet stuff,” I remember Wright Haggerty’s Kentucky groom telling me on the Shelby, Montana, backside in 1965 as he pestelled up tiny white 100-milligram dog pills he had received from my father, the attending and regulatory veterinarian (thus my job as urine catcher). The original medical plan, being that most racing jurisdictions back then prohibited the use of any and all drugs, was to use bute for training. The groom mixed the white powder into a mash, and fed his eager and waiting racehorse, who trained like Seabiscuit the next morning.
Bute cools hot joints and quiets inflamed tendons to desirable medical effect, allowing horses to return to training and racing sooner than otherwise, allowing them to maintain their conditioning. Tight, cool legs and hooves are necessary to continue conditioning the racehorse. If there is excess fluid in a joint, or swelling within a hoof, conditioning is generally counterproductive as further inflammation and damage follow exercise.
Bute was first used to facilitate continued training by quieting certain injuries or inflammations, and was especially effective when used conscientiously and conservatively. In a certain sense and in compassionate, knowing hands the drug provided humane relief to the rigors of racehorse life. The question quickly became: Could bute enhance performance? It was not a question for long. The answer was yes. Bute was and is the cleanest boost ever for a horse with mild inflammation in need of relief. The stuff could move a horse up, as they say, without a mental, or stimulant effect, but with an anti-inflammatory effect.
Two horses being equal, however, bute generally won’t make a horse with quieted inflammation run faster than a horse without joint, bone, or tendon inflammation. In a sense, bute restores normal overall biomechanical function. The nonsteroidal anti-inflammatory drug takes the heat out of mildly inflamed legs, feet, and joints, and this can be good in considerate hands.
Bute also became useful in the sense that it was diagnostic, or so the mind-set went at the time. If you administered bute and your horse went back to training and eating and being a sound horse after laming up a bit, then it was concluded that the condition was not significant enough to warrant rest, only to warrant bute. Bute, then, could be used to assess the severity of the lameness in racehorses. Some did not consider bute-responsive conditions serious, and this is one line of reasoning that eventually allowed the legalization of bute. There were medical arguments for its use in racing horses, medical arguments made by veterinarians and drug companies.
The conditions that bute administration does not resolve or effectively manage are considered problematic, and those conditions generally warrant rest, rather than more intensive treatment. Today, however, if bute does not manage the condition, more intense treatments are used, and more intense drugs are used.
Rest is the oldest and most effective treatment for lameness. In the history of horse doctoring, no treatment is more effective. The horse has a tremendous potential to heal musculoskeletal injuries if returned to natural pasture conditions, grazing the plains with herdmates. The problem is that it takes a full year of rest to cure many conditions racehorses develop, and at least months for others. No one has time to rest racehorses, to wait a year, and then take eight months to recondition the horse. With racehorses the clock is ticking, fast. If drugs can save time with racehorses, they are used for just that. And that is the case these days. The industry has transcended bute. The monthly veterinary bills at Belmont and Aqueduct often exceed the monthly training fee. Ask any owner.
If conditions are diagnosed accurately and thoroughly, and drugs are dosed properly and administered in a timely manner, doctors can reduce problematic inflammation in a given leg or joint, which in turn protects the rest of the horse by minimizing the risk of extra strain on other joints and limbs to compensate for the painful injured joint. However carefully dosed and administered, however, this brand of racehorse sports medicine puts more pressure on the weakened, and now treated joint, and herein lies the danger. In addition to systemic medication given intravenously to treat joint inflammation, cortisone is injected directly into joints and tendon sheaths to get a significant anti-inflammatory effect. Cortisone is in a different class of drugs called steroids, which can be used more specifically than bute to reduce the inflammation in a specific joint.
When there is swelling in a joint or tendon sheath, excess synovial fluid is secreted, distending the joint structures, and in some cases, deforming them, making for irregular movement. The reason for excess fluid in a joint is most often damage to the sensitive joint structures; damage to the synovial membranes, articular cartilages, ligaments, tendons, and underlying bone, any or all of the above. Damaged joints are weakened joints. They are inflamed joints, and in racehorses, many become cortisone-injected joints: weakened joints that are quieted down with cortisone. Why? Horse joints need to flow smoothly. Imagine an abraded joint surface, or a tendon that loses its lubrication as is passes over a running, moving joint, the resultant pain, swelling, inflammation, increased friction, and impaired function. If there is rough movement in one joint, the roughness is relayed throughout the horse’s musculoskeletal system, increasing the burden on the other legs and joints.
Intra-articular injection of a joint with cortisone is a potent treatment. In certain veterinarians hands it can be used beautifully. The most commonly injected joint is the fetlock, which is also the most commonly fractured joint. The reality is that most of fractured joints were cortisoned joints, although this information is inaccessible because of medical confidentiality. Bute is less intense, less potent, and a more conservative, safer remedy. The original idea was that legalized bute would replace joint injections, or that was part of the intent. That has not been the case.
Phenylbutazone, or bute, abbreviated from the early popular brand Butazolodin, is a nonsteroidal anti-inflammatory drug very similar to aspirin. Those who understand the pharmaceutical principles of aspirin understand phenylbutazone. Bute reduces inflammation, and subsequent to that, pain. That is the sequence, anti-inflammatory first, with subsequent pain relief. As a result of reduced inflammation, there is restoration of function accompanying relief of the joint pain.
If you consider aspirin a painkiller, then I suppose you can consider bute one, as well. Bute lasts longer, a day or two, while aspirin is more quickly metabolized in the horse, a matter of hours. The sustained anti-inflammatory effect of bute is especially therapeutic to horses. Prolonged anti-inflammatory relief allows the interdependent musculoskeletal system of the horse to redistribute weight appropriately. Lameness anywhere imbalances the horse. In a sense, bute can improve the balance by providing anti-inflammatory relief of the inflamed parts.
Initially, drugs for racehorses being illegal, bute was used to facilitate training and not so much enhance racing. That came next. The medication got to working pretty darn good, and in time trainers began administering bute to their horses closer and closer to racing, and soon the testing folk started picking it up. Matt Lytle was one trainer who taught me about bute, the smile it put on his face until Croff Lake, one of his horses, suffered a bad test after winning the Oilfield Handicap in Shelby, Montana, one of those years in the mid-’60s. Lost his purse and sort of soiled his reputation all because of a shade of bute in the urine.
Later, I heard him defend the drug, and his use of it: he gave it for the horses well-being, he claimed, and knowing Matt and his connection to his horses, I did not doubt his intent and compassion. Pain relief is compassionate, especially the sort of racehorse pain relief bute provided. The problem today is that a good thing, bute, or medication in general, has been taken too far. In the passion of competition and in a world of big money, horses have become victims of a misguided pharmaceutical culture.
My dad, having dispensed the bute, sampled Matt’s horse after it won the Oilfield Handicap. I was the one who caught Croff Lake’s urine, which tested positive. Then the next spring a winning horse tested positive in the Kentucky Derby. Rather than further restrict drug use to remedy the situation, the industry legalized drugs. From that time, horse racing shifted from a covert medication culture to an overt medication culture, which has been recently brought to its knees.
After hundreds of other doping incidents, there came a general consensus that if so many felt the need to use bute, maybe it should be O.K. to run on. After all, it was only a type of aspirin. And perhaps its legalization would eliminate the need for other more abrasive medications, such as opiates and amphetamines, and local anesthetics. Some even thought it would reduce the urge to administer intra-articular injections of cortisone. Not the case.
By the time I graduated from vet school and began practicing at Playfair Racecourse in the late ’70s, I could legally treat racehorses with nearly everything except stimulants, opiates or depressants. That left a lot of anti-inflammatory drugs, antihistamines, hormones, steroids and bleeding medications to administer to running racehorses, not to mention a multitude of vitamins, amino acids and minerals thought to help a horse endure the rigors of confinement training and racing.
Now virtually all racehorses run on bute and Lasix, and now with too many fractured fetlocks the medication has to be reduced. Bute wasn’t enough. No drug is. Legal bute engendered a drug culture. The ideology that more conservative use of potent medications would follow legalization of bute did not prove up. More intense drugs and medical treatments followed, rather than less. The pharmaceutical adaptability of the racehorse has been exceeded. Horse racing has to wean itself from its addiction to drugs that no longer help, but instead weaken horses. Racing jurisdictions are in the process of rolling back drug use. The trend should continue as a part of the remedy to reduce breakdowns. Foreign horse racing jurisdictions run without medication, and their safety records are better than the United States’. Horses running clean are less likely to break down than those running on medication.
Sid Gustafson is a novelist, social commentator, and former thoroughbred attending and examining veterinarian licensed in New York, Washington, and Montana, where he has had significant experience in the regulation of racehorses, especially as it pertains to soundness and breakdowns.

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