Competition Horse Medication Ethics

Competition Horse Medication Ethics

Sid Gustafson, DVM, practitioner/equine behaviour educator, Bozeman, MT

Appreciation of the evolved nature and behavior of horses provides the foundation for the ethical veterinary care of equine athletes. The establishment of a veterinary patient client relationship (VCPR) is instrumental in providing ethical care for the competition horse. Ethical veterinary practice supports the horse’s long-term health, therapy, and welfare interests while avoiding pharmaceutical intervention in the days before competition.

Horses evolved as social grazers of the plains, moving and grazing in a mutually connected and communicative fashion on a near-constant basis. Contemporary equine health and prosperity remains dependent on providing an acceptable degree of this continual movement, foraging, and socialization that sustain equine health. When horses are confined to fulfill convenience and performance interests, the horse’s natural preferences need be re-created to a suitable degree to avoid exceeding the adaptability of the stabled horse. When adaptability is exceeded, welfare is diminished and the need for medical intervention to remedy behavioral, health, and soundness deficiencies becomes complex. Contemporary husbandry and conditioning practices regularly exceed the competition horse’s adaptability, resulting in the need for extensive veterinary intervention to sustain health and competitiveness. Ethics need to be improved to protect the future health and welfare of competition horses. Pre-competition medication strategies should not supplant or replace the appropriate fulfillment of the horse’s long-evolved survival requirements.

The more medical care and pharmaceutical intervention required to sustain a population of horses, the lower the population’s welfare. Ethical veterinary care supports the horse’s best welfare interests, as well as the safety of horse and rider. Veterinary caregivers are required to provide equine athletes with appropriate medical and surgical therapy for a wide variety of infirmities. To properly support the health and welfare of equine athletes, the practitioner must deviate from pharmaceutical pre-competition intervention to providing for their patients’ inherent and individual long-term conditioning and husbandry essentials. While necessary therapies are being instituted by the practitioner, socialization, constant foraging, and abundant daily locomotion need to be initiated. Providing the long-evolved requirements to promote and sustain optimal soundness, behavioral health, performance, is essential to promote healing in competition horses. Once most injuries are stabilized, stall rest is not the correct ameliorative approach to resolve lameness. 

Healthy horses are best-served to perform naturally in an unmedicated state. Due to a lack of cultural appreciation of the nature of the horse, medication is heavily regulated in jurisdictions worldwide to protect the horse. It has been demonstrated—in Hong Kong and Great Britain, for example—that fewer pre-race medications allow for safer horseracing. All competitive equine pursuits require medication policies due to the potential of unscrupulous medication practices to gain competitive advantage. Polo, endurance, cutting, reining, rodeo, and all unmentioned performance horse pursuits are required to follow the same ethical approach. Medication should not influence performance. The equine practitioner best serves the horse and client by focusing on post-performance evaluations and therapeutic approaches. Appropriate treatments and protocols to sustain horse health can be implemented on an enduring basis when conditions are identified during post-competition examinations. The performance horse veterinarian needs to change their work schedule from pre- performance to post-performance. There, the doctor can do right by the horse.

A behavioral emphasis on fulfilling the medical, physical, nutritional, metabolic, and behavioral needs of the horse to prepare for future competitions provides a solid platform for the ethical veterinary care of the competition horse. Horses so served prevail at the competitions. The pre-competition veterinary role is to guide the client to prepare a strong horse who is sound and able to compete safely, willingly, and efficiently in a natural fashion. Pre-competition pharmaceutical scrims have little place in the ethical practice of competition horse medicine. Pre-competition practices that replace or supplant appropriate health care are not in accord with the AVMA Principles of Veterinary Ethics. The AVMA Principles of Veterinary Ethics state that it is unethical for veterinarians to medicate or treat horses without a VCPR. The use of itinerant veterinarians to inject Lasix into nearly all horses racing in America hours before they race is an example of the unethical practice of veterinary medicine. The result is horses breaking down three to four times more often in America than in overseas jurisdictions where horses are prevented from being medicated before racing. The medical and pharmaceutical practices that support equine competitive pursuits enhance the health and soundness of the horse on a long-term basis. Pre-competition medical influence should not enhance performance nor be intended to enhance performance. When performance is enhanced, the adaptability of the competition horse is exceeded and catastrophic results ensue. Pre-competition practices should not mask lameness of any sort.

All sensation, behaviour, cognition, and proprioception should remain uninfluenced by medication during competitions. Treatments should not effect normal physiologic function or behavior of the horse. Senses should not be dulled, masked or stimulated. Performance horses should not perform under the influence of medications that are capable of initiating an action or effect upon the nervous, cardiovascular, respiratory, digestive, urinary, reproductive, musculoskeletal, blood, immune (save approved vaccines), or endocrine systems. Endocrine secretions or their synthetic substitutes, masking agents, oxygen carriers, or chemicals that directly or indirectly affect or manipulate blood physiology or gene expression are not appropriate for use in competing equine athletes. Horses are vulnerable to performance manipulation via pharmaceutical influence. The only fair competition is a competition for non-medicated horses.

Sound horses properly prepared have little need for pre-competition medication. Unsound or behaviorally dysfunctional horses require rehabilitation that restores soundness before training and competition are resumed. All horses need to be professionally prepared physically and behaviorally to endure the task asked of them. Musculoskeletal development requires lifelong, constant attention, most notably in the stable. Horses are born to move most all the time, and move they must to maintain health and soundness, especially in preparation for competitive pursuits. 

Horses who require medication to compete become unfit to compete safely. Rather than therapeutic intent, pre-competition medication practices have become performance enhancing at the expense and safety of horse and rider. When the adaptability of the horse is exceeded, horses become unsound and require veterinary attention, treatment, and care. Assessment of stabling conditions and athletic preparation practices are essential components of ethical equine care. When horses are injured or impaired by competitive pursuits, healing must be allowed to progress before competition and training are resumed. Client education is essential to create a husbandry situation conducive to equine healing. Restoration strategies that re-create the horse's social grazing and locomotion preferences facilitate and potentiate horse healing. Appropriate healing of many equine maladies is encouraged when the veterinarian provides appropriate medical care and carefully facilitates a scenario to provide the horse with appropriate physical rehabilitation and behavioral fulfillment. 

Interdependence exists between horse health and locomotion. Deprivations of abundant daily locomotion are the most common underlying cause of infirmity and fragility in competition horses. Metabolic, pulmonary, circulatory, digestive, musculoskeletal, and behavioral health are all dependent upon abundant daily locomotion. Stabled horses require miles of daily walking to maintain health and vigor. Horses evolved to be near-constant walkers and grazers. With domestication and selective breeding for performance, horse health remains dependent on locomotion. Horses deprived of socialization, constant foraging, and abundant daily locomotion are at risk to develop stereotypies. The more stereotypies present in a population of equine athletes, the lower their level of care and welfare.

Solutions and alternative approaches to pre-race medication. 

Establish a viable VCPR. Appreciate the nature of the horse. Understand how to fulfill the nature of the horse from a medical and soundness perspective. Appreciate behavioral need.

Examine and consult. Question medication protocols that are not supported by a VCPR. Question stabling and care protocols that do not support equine welfare or sustain long-term soundness and vigor. Observe and assess the environment and hour-to-hour daily care of the horse. Promote abundant enrichment activities that get the horse out of the stall for significant periods of locomotory fulfillment each day, morning and afternoon. Explore the history and temperament of the individual horse. Offer wholesome solutions to sustained soundness and behavior. Appreciate that all horse behavior, both welcome and unwelcome, is primarily a result of human management (or mismanagement) of the horse. Know the client. Know the stabling, conditioning, training, nutrition, travel, and preparation of the horses by your client. Establish yourself to offer professional consultations in these essential areas. Utilize physical and exercise therapies in preference to pharmaceutical solutions when appropriate. Teach your clients that horses do not need medication to compete. When horses are stabled, manual therapy needs to be applied for hours at a time to replace the essential movement horses require for vigor. Time spent outside the stall walking and hand-grazing enhances health, welfare, fitness to compete, and soundness. 

Specific solutions:

Diminished performance; lameness must be resolved and soundness restored, medical conditions identified and alleviated with developmental approaches that lead to medication-free competition.

The nervous horse; appropriate fulfillment, socialization, training, and husbandry.

The metabolically disabled horse; nutrition, foraging, locomotion, and husbandry. Keeping metabolism on an even keel 24/7/365. 

The bleeder; daily conditioning which promotes, develops, and sustains pulmonary health, abundant ventilation, clean air and bedding, daily exercise routines to develop pulmonary resilience, extensive time spent in open air while moving. For horses, to move is to breathe, and to breathe is to move. Breathing exercises are locomotion exercises. Every stride is a breath, every breath a stride. 

Electrolytes. Hydration. Salt. 

Performance preparation. Pre-race exercise and behavioral fulfillment.

Building endurance. Blood cell management.

Ethical care of the horse is dependent on ethical veterinary practitioners. Education of future veterinarians in the area of equine behavior promotes the development of ethical veterinarians. 

Horses require abundant daily locomotion. Miles of daily walking support all aspects of equine health and soundness. Veterinarians require abundant animal behavior education and multidisciplinary experience to establish themselves as ethical practitioners. Representing the health and welfare of the competition horse takes precedence in the ethical equine practice.

Recommended reading

Chyoke A, Olsen S & Grant S 2006 Horses and Humans, The Evolution of Human-Equine Relationships,  BAR International Series 1560, Archeopress, England, ISBN 1 84171 990 0

McGreevy P 2004 Equine Behavior: A Guide for Veterinarians and Equine Scientists Philadelphia: Elsevier Limited. ISBN 0 7020 2634 4

Budiansky, S. (1997). The nature of horses: Exploring equine evolution, intelligence, and behavior. New York: The Free Press.

McLean A, McGreevy P, Ethical equitation: Capping the price horses pay for human glory Journal of Veterinary Behavior: Clinical Applications and Research Volume 5, Issue 4, July–August 2010.

Goff L, Manual Therapy for the Horse—A Contemporary Perspective, Journal of Equine Veterinary Science, Vol 29, No 11 (2009) 

Gustafson S, Equine Behavior; The Nature of the Horse, Sleipnir Publishing, 2014.

Dr Gustafson is a practicing veterinarian, equine behavior educator, and novelist. The application of behavior science enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Behavioral and nutritional strategies enrich the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses who are willing to learn and perform.

In Search of Montana Horseracing

In Search of Montana Horseracing | Big Sky Journal

Link to story and photos! From Yellowstone Down to the Crow river horses of the Little Big Horn

Dr Gustafson is a practicing veterinarian, equine behavior educator, and novelist. The application of behavior science enhances optimum health, performance, soundness, contentment, and longevity in animal athletes. Behavioral and nutritional strategies enrich the lives of stabled horses. Training and husbandry from the horse's perspective result in content, cooperative horses who are willing to learn and perform.

http://bigskyjournal.com/Features/Story/in-search-of-montana-horse-racing

Conditioning and Winning, Lasix-free

Competition Horse Medication Ethics

Horses evolved as social grazers of the plains, group survivalists moving and grazing together most all of the time. During their 60-million-year evolution, horses came to require near-constant forage, friends and locomotion to maintain health and vigor of wind and limb.

http://therail.blogs.nytimes.com/2012/05/11/conditioning-and-winning-lasix-free/

Despite domestication and selective breeding, today’s racehorses are no exception. Although horses are extremely adaptable, the last place a horse evolved to live is in a stall, alone, with limited space to move and forage about with others. The solution to manage bleeding in racehorses is to breed, develop, teach, train and care for horses in a horse-sensitive fashion that provides abundant lifetime locomotion and socialization. Pulmonary health is reflective of overall health and soundness in horses.

In order to maintain pulmonary health, natural conditions need to be re-created in the stable. Horses prefer to graze together and move nearly constantly. Constant foraging, grazing, socializing and moving are essential for joint and bone health, hoof health, metabolic health and pulmonary health, and, of course, mental health. In order for lungs to stay healthy, horses need movement, more movement than American trainers currently provide the population of stabled. Horses communicate with movement and sustain physiologic and metabolic health via near-constant locomotion. Movement is what is most often missing in a racehorse’s stabled life.

Walking throughout the day enhances and maintains lung health. Stabled horses need hours of walking each day, more walking than most are currently afforded. Veterinarians who manage racehorse health need to ensure that their patients are provided with adequate daily locomotion. The movement of training and track conditioning are not adequate to condition healthy lungs throughout the rest of the day, as lung health requires 24/7 movement. For a horse, moving is breathing. Abundant on-track and off-track locomotion is necessary to condition a horse’s lungs and to provide the necessary resilience to withstand the rigors of racing.

Lungs deteriorate when movement is restricted. Horses breath all day long, and near-constant movement is required much of the day to assist their breathing to maintain pulmonary flexibility and vigor. Plentiful walking enhances breathing and lung health. Swimming and doing lunges are also appropriate lung-conditioning activities. Grazing while casually walking clears the airways. Hand grazing may be the best lung-healthy activity of all. Racetracks need to provide abundant hand-grazing opportunities for all of the stabled horses, and the green grass needs to be appropriate grazing grass. Kentucky limestone grass is always best, it seems.

Training over hills and dales, as well as walking up and down inclines helps develop and sustain pulmonary vigor. When horses are locked in a stall a large percentage of the time, their lungs deteriorate. Stabling that does not afford abundant movement and head-down grazing and foraging impairs lung health, making horses vulnerable to bleed when exerted in a race. The cause of exercise-induced pulmonary hemorrhage is insensitive and deficient stabling and husbandry practices and includes diagnostic failures to detect bleeding during training.

The care that establishes and enhances pulmonary health and endurance in horses is the same care that enriches stabled horses’ lives. Pulmonary care is providing the same near-constant movement that keeps racehorses’ musculoskeletal systems sound. It is the care that keeps horses on their feet during races. Horses must remain sound of limb to ensure lung soundness, and they must remain sound of lung to achieve and maintain limb soundness. Afternoon and evening hand walking and hand grazing are essential to develop and sustain lungs and limbs fit to race.

Horses with healthy lungs are content and fulfilled horses whose lives their caretakers adequately, if not extensively, enrich. Lung health is supported by limb health. Breathing and running are biologically intertwined on the track, a breath per stride. To stride correctly is to breathe correctly. To breathe correctly is to breathe soundly, and race sound.

Horses who are bred, socialized, and developed properly from birth, and who train while living enriched stable lives are seldom likely to experience performance-impairing E.I.P.H. while racing. They are more apt to stay sound. Humane care of the horse prevents bleeding. Pulmonary health is reflective of appropriate husbandry, breeding, training, nutrition, and the abundant provisions of forage, friends, and perhaps most importantly, locomotion. Bleeding in a race is reflective of inadequate care and preparation, of miscalculations and untoward medication practices. Lasix perpetuates substandard horsemanship, artificially suppressing the untoward result (bleeding) of inadequate preparation of the thoroughbred.

Genetics play a role in pulmonary health and physical durability. Lasix perpetuates genetic weakness by allowing ailing horses to prevail and sow their seeds of pharmaceutical dependence. Running sore causes lungs to bleed. Lasix manages a wide variety of unsoundness, as do the cortisones and NSAIDs (bute and similar drugs). These anti-inflammatory drugs aggravate coagulation processes. Rather than drugs, pulmonary health is dependent on appropriate breeding and proper development for the vigor, durability and endurance thoroughbred racing demands. Drugs are not the solution. Competent horsemanship is the solution. Genetic dosage, behavioral and physical development, socialization, training, and locomotion husbandry are the keys to racehorse soundness, lung health, stamina, and durability. The causes of E.I.P.H. are no mystery to seasoned race folk. Horses prone to bleed are those horses that are mistakenly bred, inadequately developed and inappropriately stabled and trained.

Horses evolved in the open spaces of the northern hemisphere and require the cleanest, purest air to thrive and develop healthy lungs and hearts. Stable air needs to be constantly refreshed to maintain pulmonary health. Ventilation is essential, and enclosed structures are often inappropriate. Barn design needs to provide both clean air and abundant locomotion. Bedding is critical. Clean straw provides the most movement by simulating grazing. Horses stalled on straw are noted to move about with their heads down nibbling and exploring for hours, recreating nature to some degree, keeping their lungs healthy with movement, their respiratory tracts drained by all the head-down nibbling and grazing. Horses need near-constant head-down movement to maintain optimum lung health. Long-standing horses’ lungs deteriorate quickly. Not only does near-constant movement maintain and enhance pulmonary health, abundant locomotion maintains metabolic health, joint and bone health, hoof health and digestive health.

To enhance lung health is to enhance the overall health and soundness of the racehorse. Racing appears much safer in Lasix-free jurisdictions, where the drug crutch is not allowed, because the drug crutch allows horses to be cared for in a substandard fashion. (A link to the transcript from the Kentucky Raceday Medication Committee hearing is here.) Drugs are not allowed to replace appropriate care and training in Asia and Europe, and raceday drugs should be barred in America as they are in the rest of the civilized world. The stabled racehorse has to be carefully and humanely cared for and nourished in a holistic fashion, both physically and behaviorally, to win and stay healthy to win again.

Sid Gustafson, D.V.M., is a novelist and equine veterinarian specializing in thoroughbred sports medicine and equine behavior. His talk at the upcoming AVMA annual veterinary convention in Boston is Competition Horse Medication Ethics.