In the Shadow of Horse

In the Shadow of Horse
In the Shadow of Horse

Tuesday, April 28, 2015

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.

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