Friday, May 25, 2012

May 25, 2012, 10:09 PM

Alkalinization, Lasix and Milkshaking: A Veterinarian’s View

The Kentucky Horse Racing Commission’s hearing on race-day medication last November revealed that Lasix alkalinizes horses, elevating their racing TCO2 values.
The more Lasix, and the closer it is administered to the race, the more intense the alkalinization effect of Lasix, according to the science presented at the K.H.R.C. race-day medication hearing. Lasix alkalinizes horses, creating a competitive metabolic advantage similar to milkshaking, rendering the drug Lasix a clear and present doping agent. Human athletic regulators have deemed Lasix a doping agent, and horseracing regulators will eventually have to come to that appropriate conclusion. Lasix has significant potential to alter and enhance racehorse performance.
As well, in my experience as both an attending veterinarian and a regulatory veterinarian, the attending veterinarians administering Lasix are often requested (as long as they are in the stall with the horse before the race to give the Lasix) to administer intravenous sodium bicarbonate, calcium and wide variety of other substances, including adjunct bleeder medications and undetectable performance-enhancers to stimulate or calm horses while sustaining added endurance. By pharmaceutically altering and manipulating a variety of physiological and neurological parameters for competitive advantage, medicating veterinarians influence the outcome of horse races and racehorse performance. In addition, these race-day medicators put horses at increased risk to break down. The statistics presented at the hearing clearly show horses medicated on race day break down more often than clean racing runners. The connection is indisputable.
There are a wide variety of pharmaceutical and nutritional manipulations veterinarians and trainers apply to gain competitive advantages, especially when veterinarians are allowed to medicate horses on race day, and the day before. Intubation (passing a tube up the nose and down the esophagus to administer a gallon or so of a sodium bicarbonate, crystalline sugar, and whatever else doesn’t test but may help move a horse up) is one method to milkshake a horse. Intravenous, intramuscular, sublingual, and oral administration of drugs are other racing-vet approaches to alkalinize racehorses to buffer the metabolic acidosis they experience as they enter the anaerobic acidotic state in the later stages of the horse race.
The historical method to curb veterinary doping has always been to bar veterinarians with needles from being around horses on raceday. When I started collecting racehorse urine in the ’60s, veterinarians were not allowed to be around horses with their needles and drugs on raceday in America. Initially, racing regulators barred trainers from possessing drugs and needles. Next thing they knew, veterinarians were slinking around from stall to stall before the races injecting horses as if they were sick. When I practiced on standardbreds in New York in the late ’70s and early ’80s, racing veterinarians were not allowed to be on the grounds hours before the races at Batavia Downs and Buffalo Raceway.
Horses are notoriously vulnerable to pharmaceutical manipulation, and these days with all the permissive medication policies, trainers and their veterinarians remain notoriously tempted to pursue every pharmaceutical ploy they can devise to move a horse up. Alkalinization comes in a variety of bottles and can be achieved by utilizing a variety of methods. It is the nature of many trainers to take whatever pharmaceutical measures they feel they can get away with to get their horse across the finish line first.
To allow racing veterinarians in a stall with a horse before a race is to permit doping, as it has turned out in America. I have witnessed veterinary doping first hand from California to New York. The solution to prevent doping and render an even field is to keep medicating veterinarians away from horses in the days before they race, as is the policy in Europe and Asia, where racing is approximately four times safer than in America. There, veterinarians can attend horses, but they are forbidden to medicate them, as is the appropriate ethical standard. Horses are never denied appropriate veterinary care, but when horses do require medication, they are declared unfit to race, as should be the policy in America.
Certain bodywork, massages, and physical therapies are appropriate as the race approaches, but doping is not. Drugs and medications are to treat ailing and lame horses, and ailing or lame horses are not permitted to race in ethical racing jurisdictions. Horses deemed to require medication are horses unfit to race by current international ethical standards. The universal standard through horse racing time has been to bar administration of any and all medications before a horse competes. Racehorses and riders are best served to run with no drugs in their systems. The clean racing standard is the standard that has effectively and appropriately protected the health and welfare of horses through time.
There are a variety of conditioning, husbandry and nutritional strategies that can be used that do not include or involve drugs and medications to prepare horses to withstand the rigors of a race. Tapering down the digestive tract, appropriate nutritional supplementation, appropriate exercise routines, appropriate hydration and metabolic preparations, and an endless variety of other holistic and physiologic preparatory approaches are more wholesome medication-free approaches for horse, rider and horseplayer.
It should be noted here, as well, that California allows trainers to take horses on and off Lasix without public knowledge. The attending veterinarians are allowed to use the steroidal estrogen hormone Premarin instead of Lasix. The California attending veterinarians are at liberty to switch out established race-day Lasix administration for race-day Premarin without the public disclosure of the change. All the while the horse is listed on the program as a Lasix horse race after race, despite differing medication regimens from race to race. This can result in significant variations in the type and dosage of administered medications from race to race, with associated alterations in performance. A horse listed as a Lasix horse may legally receive Premarin instead of Lasix. Next race the horse may receive Lasix, or Lasix plus Premarin, or only Premarin. The betting public is not made aware of these medication switches. Potential performance variations because of medication changes are hidden from the public by the C.H.R.B. Their regulatory veterinarians are forbidden to disclose the information to anyone but the testing laboratory, so the lab knows why certain Lasix horses do not have Lasix in their urine. The race-to-race medication choices are orchestrated and controlled by the racing veterinarians administering the race-day medications.
The Breeders’ Cup is in California this fall. Oversight by the Breeders’ Cup or reconsideration of the medication rules is in order there to protect the health and welfare of those champion runners and to assure medication consistency from race to race and horse to horse. The betting public deserves to be accurately informed about which horses are receiving what drugs, and for which race, and what changes to the medication routine occur from race to race.
The journey to establish clean horse racing continues. Soon, the horses shall prevail as horses have prevailed through time. Trainers will soon be required to utilize horsemanship rather than drugs to chalk up a win.

Sid Gustafson, D.V.M., is a novelist and equine veterinarian specializing in thoroughbred sports medicine and equine behavior. He currently practices regulatory veterinary medicine, representing the safety and welfare of thoroughbred racehorses.

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