Tuesday, October 23, 2012

Drugs and Racehorses


Drugs and Racehorses

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.

http://therail.blogs.nytimes.com/2008/06/04/drugs-and-racehorses/?smid=pl-share

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. Applied veterinary behavior enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Natural approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance. Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses. DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition.

Wednesday, October 17, 2012

Welfare and Safety of the Racehorse Summit


Dr McIlwraith gave a fine presentation on intra-articular steroids. He failed to mention the effect of corticosteroids on the circulatory system and coagulation, and subsequently their contribution to contributing to increased incidences of EIPH. Side effects of fluid retention, catabolic breakdown of membranes and tissues, and alteration of the clotting processes are side effects that need to be explored and studied. Both corticosteroids and NSAID alter normal coagulation and contribute to an increased incidence of EIPH. Their extensive use is one of the many significant reasons American racehorses are prone to experience EIPH. Many medications, especially those utilized regularly in training, create the tendency to bleed. For this reason, many contemporary trainers feel they cannot race without Lasix. Lasix has become a cover for the overzealous use of performance medications, as most performance medications aggravate the clotting and pulmonary circulation process. Aggressive use of corticosteroids, bloodbuilders, and NSAIDs contribute to EIPH. This combined with inappropriate stabling and the failure to enrich the stabled racehorse's wellbeing with abundant forage, friends, and locomotion has created the illusion that drugs are needed to race horses.
Thank Dr Bramalage for the fine conditioning presentation. It seems Dr Bramalage did not mention the critical need to exercise horses throughout the day to sustain and maintain musculoskeletal and pulmonary health. Abundant locomotion beyond the training regimen is what American racehorses lack but need to promote soundness of wind and limb. Horses locked down in stalls all but an hour or two a day are not receiving adequate movement required to enhance the soundness of lungs and legs. Racehorses require movement throughout the day to adequately develop and sustain soundness of wind and limb. 


Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist.  Natural approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance. Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses. DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition.

Thursday, October 4, 2012

Racehorse Advocacy: The Trouble with Raceday Medications

Racehorse Advocacy: The Trouble with Raceday Medications

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. Natural approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance. Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses.DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition.

Lasix-free Horseracing

The simplest and most logical solution that favors the health and welfare of the horse is to ban raceday Lasix and the administration of all other drugs after entry. No medication should be allowed to be administered whatsoever after a horse is entered and the post positions are drawn. This policy would make racing not only safer, but more enticing to the general public, as the playing field would be evened, and the betting would be fairer. 
Lasix use has engendered the dangerous drug culture horseracing is experiencing. Lasix facilitates substandard horsemanship. Lasix promotes the medication mentality. Most horses that bleed are those horses cared for and conditioned in a substandard fashion. Pulmonary health is reflective of appropriate horsemanship. Drugging horses to race demonstrates a lack of consideration for the health and welfare of horses, as has come clearly evident.
Rather than establish appropriate ventilation and provide horses with abundant locomotion which enhances the soundness of wind and limb, trainers lock their horses down in the stalls, feed them drugs, inject their joints, harpoon their jugulars with Lasix and whatever other drugs they can get away with before heading to the paddock, and race. These people are not horsemen, they are sham pharmacists. This drug-addled behavior, my friends, causes breakdowns. Lasix is the root of the problem, and Lasix and all other drugs, whatever their nature, should be forbidden after entry, as the rules once stipulated back in the 1960s before the pharmaceutical veterinary lobby. Doping has and always will be a problem, but a problem that will be much easier addressed and minimized when permitted drugs are taken out of the picture after post positions are drawn. The standard procedure that resulted in the Aqueduct breakdowns was this: Enter the questionably sound horse. When the race fills and entries are drawn, get the vet over to inject all the troubled joints. Don't stop with the joints. After all that joint work, best make sure everything else that needs doping is doped. Dope the horse thoroughly, with everything and anything that may help and will not test. Race the horse; hope he or she wins to cover the vet bills, and cross your fingers the horse doesn't breakdown and pray the jockey survives if the horse does.


Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. Natural approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance. Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses. DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition.

Wednesday, October 3, 2012

The Snaffle Connection

More communication can be relayed between a horse and rider with a snaffle bit than with most other headgear. A snaffle allows sophisticated connection in trained, knowing, and familiar hands. In progressive relationships, the horse and rider each knows and feels the other constantly and intimately. The slightest tongue move the horse makes is felt by the rider, and responded to appropriately. The tiniest finger touch to the rein, likewise, can relay the most timely and specific information. Headstalls without bits, or bridles with heavy curbs and shanks cannot detail refined communication like a snaffle can. Snaffles allow refined requests and responses to be taught. In the end, all can be cued from the seat, bridleless, after the teaching process with the snaffle and other headgear has reached ultimate fulfillment. These taught aids can later be overlain with classically conditioned seat and leg cues, and the snaffle can then be replaced with a bride-less contraption, or no head gear at all. Snaffles facilitate refined cue teaching and delicate responsiveness. Horses come to admire sophisticated, timely fingers. Here is an example of snaffle connection. The reins on Rachel are white, and Calvin's fingers, voice, and seat do the talking, and listening. Rachel tells Calvin when rein pressure is necessary, and Calvin listens. This is also an ultimate example of utilizing the horse's proclivity for flight.
www.youtube.com/watch?v=37TaDAMDIkw

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. Behavioral approaches to development, training, nutrition, and conditioning sustain equine health and enhance performance. Behavioral and nutritional enrichment strategies enhance the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses. DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition.