Competition Horse Medication Ethics

COMPETITION HORSE MEDICATION ETHICS

Gustafson S, DVM

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 and welfare interests while avoiding pharmaceutical intervention in the days and weeks before competition.

Horses evolved as social grazers of the plains, moving and grazing in a mutually connected and constantly communicative fashion on a near-constant basis. Contemproary equine health and prosperity remains dependent on providing an acceptable degree of this near-constant movement, foraging, and socialization. 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 horse. As the adaptability of the horse is exceeded, welfare is dimished and the need for medical intervention to remedy behavioral, health, and soundness deficiencies is intensified. Contemporary practices regularly exceed the competition horse’s adaptability, resulting in the need for extensive veterinary intervention to sustain health and remedy training and competition injuries.[1]

The more medical care and pharmaceutical intervention required to sustain any population of animals the lower the population’s welfare.[2] Ethical veterinary care supports the horse’s best welfare interests, as well as the safety of the horse’s riders and drivers. Medical intervention of the equine athlete should be avoided in the weeks, days, and hours before competition, as pre-competition medication is associated with increased catastrophic injury vulnerability as a result of the diminished welfare it perpetuates.[3] To properly support the health and welfare of equine athletes, the practitioner must be familiar with their patients both inherently and individually. Socialization, constant foraging, and abundant daily locomotion are the long-evolved requirements to promote and sustain optimal soundness, behavioural health, performance, and healing in competition horses. 

Healthy horses function and perform more consistently and predicatbly in an unmedicated state. Contemporary pre-competition medication practices remove the horse’s ability to protect their health and sustain soundness by masking pain and suppressing symptomology. Horses who require medication to alleviate medical conditions in order to compete are rendered vulnerable to injury and physical and behavioural dysfunction imperiling the safety of both horse and horseperson. Horses requiring medication to compete are not fit to compete safely. Horses and horsefolk are best served to compete free of short-term pre-competition pharmaceutical influence. Infirmities require appropriate medical care and rehabilition before competition is considered and resumed, rather than pre-competition medication to allay active medical problems. The equine practitioner should focus on post-performance evaluations and necessary therapies to sustain horse health on a enduring basis. An emphasis on fulfilling the medical, physical, and behavioural needs of the horse to prepare for the future competitions is the essence of ethical veterinary care of the competition horse. Pre-competition medication practices that replace or supplant appropriate health care are not in accord AVMA Principles of Veterinary Ethics.[4]

For human entertainment, convenience, and revenue, horses are bred, isolated, stabled, conditioned and medicated to perform competitively. Comtemporary pre-competition medication practices are often at the expense of the horse’s health, safety, and welfare. Many current medication practices violate the AVMA Principles of Veterinary Ethics, specifically the clause that states a veterinarian shall provide veterinary medical care under the terms of a veterinarian-client-patient relationship (VCPR).

The AVMA Principles of Veterinary Ethics state that it is unethical for veterinarians to medicate horses without a VCPR. Pre-competition pharmaceutical interventions to remedy insufficient attention and preparation for the horse’s long-evolved health requirements are seldom in the best interest of the horse. The medical and pharmaceutical practices which support equine competitive pursuits should be designed to enhance the health and soundness of the horse on a long term basis and should not be intended to enhance performance or permit training on infirm legs. 

Pre-competition pharmaceutical intervention has been demonstrated to have an overall negative affect on the health and welfare of competitive horse populations. Where horses are allowed to be permissevely medicated with and without a VCPR, injuries and catastrophic injuries are more prevalent, as are jockey injuries. Horses are best served to be properly prepared to compete in a natural non-medicated state. Pharmaceutical intervention of the equine athlete should be avoided during training and in the weeks before competition, as pharmaceutical intervention impairs the innate pain barrier while increasing musculoskeletal fragility. Intense and widespread pre-competition medication practices correlate with catstrophic injury vulnerability and diminished welfare.[5]

Equine athletic pursuits have historicaly been designed to measure the natural abililty of horses and the trainer’s ability to bring out the horses’ natural ability. Performance enhancing drugs devalue and debase competetive achievements. Equine competition was designed to measure the natural abilities of horses, with trainers and riders honing those natural abilitities. Hoseracing was never intended to measure medicated ability, thus maintaining genetic integrity of the breed.[6] Pharmaceutical scrims can impair horses for generations. To suppress a condition that is induced by low welfare is unacceptable. It is imperative in animal sensitive societies that the welfare and veterinary care of the horse take precedence over economic human interests. Horses are born to socialize, communicate, locomote, move about, graze and masticate on a near-constant basis. For behavioral and physical integrity, these preferences need to be re-created to an acceptable degree in the competition stable. The ethical practice of veterinary medicine includes providing clients with the guidance to provide appropriate husbandry, nutrition, conditioning, medical management, and behavioural fulfillment of their equine athletes. Medicating and suppressing injuries with the intent to continue training to later prevail in racing constitutes the unethical and illegal practice of veterinary medicine. Furosemide is a performance enhancing drug, masking agent, and metabolic alkalinizer, and as such is forbidden in racing jurisdictions worldwide, where racing is consequently safer for horses and jockeys.

Equine welfare is best supported when horses are properly prepared, physically and mentally sound, and fit to perform in an unmedicated state. Physically or behaviourally impaired horses who require medication to compete should not compete until they are able to compete without pre-competition pharmaceutical intervention. All sensation, behaviour, and proprioception should remain physiologically normal. Sensation and cognitive awareness should not be suppressed with pre-competiton medication. This inludes the use of sedatives, stimulants, and pain relievers of all sorts. Treatments should not interefere with functional physiology.

Sound horses properly prepared for competition have little need for pre-competition medication. Unsound or behaviorally dysfunctional horses should be medically and behaviorally rehabilitated in a fashion that restores soundness before training and competition are resumed. Medication is for infirm horses, and infirm horses should not compete. Horses who require medication to compete become increasingly unfit to compete safely. Rather than therapeutic intent, many pre-competition medication practices have become performance enhancing at the expense health and welfare of horse and rider. 

It has been demonstrated through time that horses and their riders are best served to compete medication free. As a result, anti-doping laws have been established by all agencies that regualte equine competition. Veterinarians are required by both ethics and law to follow these regulations. Horseracing statisitcs support that the less medication horses receive the more favorably and safely horses compete.[7]

The safety of the competition horse is dependent on unimpaired neurological functioning. Unimpaired sensation and cognitive ability are necessary for a horse to compete safely and fairly. Any medications or procedures which negate or diminish sensation and awareness in the horse impair the ability of the horse to compete safely.[8]

The safety, longevity, and durability of the equine patient should considered before short term pre-competition medical solutions are implemented. Familiarity of the patient includes familiarity with stabling, genetics, behavior, and husbandry of the patient. Many if not most medical conditions are a result of human mismanagement of equine stabling and conditioning. When the adaptability is exceeded, horses become unsound. Assessment of stabling conditions and athletic preparation practices are essential components of ethical equine care. 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 recreate 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 behavioural fulfillment. 

Despite domestication and selective breeding for docility and captivity, horse health remains dependent on locomotion. Locomotion is inherent to digestion, to respiration, to metabolism, to hoof health and function, to joint health, to bone health and durability, to resistance to limb failure, and to behavioral fulfillment. An interdependence exists between horse health and locomotion. Horses evolved to be near-constant walkers and grazers, depending on perpetual motion to sustain health of all systems. Horses did not evolve to be confined in stalls and stables, but to move on a continuous basis. Pulmonary health is dependent on abundant daily locomotion. Deprivation of adequate locomotion results pulmonary deterioration, resulting in an abnormal incidence of EIPH. By suppressing EIPH, Lasix perpetuates the substandard American training horsemanship that causes EIPH. 

When horses are deprived of adequate and abundant locomotion, they develop strategies and unwelcome behaviors to keep themselves and their jaws in motion, as is their essential nature. Horses deprived of friends, forage, and locomotion are at risk to develop stereotypies to provide themselves with the movement they need to survive. The more stereotypies present in a population of equine athletes, the lower their welfare.

No longer is intense medical intervention prior to competetion a viable, ethical, or legal approach. It has been demonstrated that the more intensely horses are medicated to compete, the lower their welfare. The more medications required to sustain any population of animals, the further the deviation from their physical and behavioural needs. Rather than pre-race treatments, the ethical approach includes  performance of exensive post-competition examinations to address any weaknesses or unsoundness as a result of the performance. 

Alternatives to precompetition medication with non steroidal anti-inflammatory medication and steroids include fulfillment of the horse’s long-evolved nature. Musculoskeletal soundness is attained by proper breeding, development, husbandry, and conditioning practices. Management of exercise induced pulmonary hemorrhage is achieved by specific lifetime daily development of the horse’s pulmonary and cardiac function. As well, unwelcome and unsafe competition behaviors are best managed by fulfillment of the horse’s inherent behavioral needs, which include abundant daily socialization, locomotion, and grazing.[9]

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

Magner D 2004 Magner’s Classic Encyclopedia of the Horse Edison, New Jersey: Castle Books

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

Waran N, McGreevy P & Casey RA 2002 Training Methods and Horse Welfare in Waran N, ed The Welfare of Horses, Dordrecht, The Netherlands: Kluwer Academic Publishers, p151-180

Paul McGreevy BVSc, PhD, MRCVS. Equine Behavior, 2004, A Guide for Veterinarians and Equine Scientists. Second Edition, Elsevier; 2012, Chapter 13 Equitation Science

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

Hausberger M, Roche H, Henry S, and Visser E.K. “A review of the human-horse relationship” Appl Anim Behav Sci 109, 1-24. 2008

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[1] Zambruno, Teresita (2017) Epidemiological investigations of equine welfare at OSAF jurisdiction racecourses. Thesis

[2] Appleby M, Mench J, Olsson I, Hughes B (2011). Animal Welfare. CABI, Second edition; 2011.  

Fraser D (2008). Understanding Animal Welfare: The Science in its Cultural Context. Wiley-Blackwell; 2008.

[3] Slifer, Paige BMS 599 Dr. Alan Robertson 2017 A Review of Therapeutic Drugs Used for Doping of Race Horses: NSAIDs, Acepromazine, and Furosemide. Thesis

[4] The AVMA Principles of Veterinary Ethics, https://www.avma.org/About/Governance/Documents/2014S_Resolution8_Attch1.pdf

[5] Kentucky Horseracing Commission Raceday Medication Transcript, NOVEMBER 14, 2011 

 http://www.khrc.ky.gov/Documents/RaceDayMedicationTranscript.pdf

[6] Magner D 2004 Magner’s Classic Encyclopedia of the Horse Edison, New Jersey: Castle Books

[7] Kentucky Horseracing Commission Raceday Medication Transcript, NOVEMBER 14, 2011 

 http://www.khrc.ky.gov/Documents/RaceDayMedicationTranscript.pdf

[8] Furr M, Reed S editors (2007). Equine Neurology; Wiley-Blackwell

[9] Waran N, McGreevy P & Casey RA 2002 Training Methods and Horse Welfare in Waran N, ed The Welfare of Horses, Dordrecht, The Netherlands: Kluwer Academic Publishers, p151-180

Dr Gustafson graduated from Washington State University as a Doctor of Veterinary Medicine in 1979. He is a practicing veterinarian, animal welfare journalist, equine behavior educator, and novelist. The application of behavioral science to the husbandry of horses enhances optimal health, performance, soundness, contentment, and longevity. Behavioral, social, locomotory, and nutritional strategies enhance the prosperity, vigor, and health of stabled horses. Sid offers veterinary care, training, husbandry, and conditioning from the horse's perspective to achieve willing and winning equine partnerships with humans.

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.

May 25, 2012, 10:09 PM

Alkalinization, Lasix and Milkshaking: A Veterinarian’s View

By SID GUSTAFSON

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.

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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.

http://therail.blogs.nytimes.com/2012/05/25/alkalinization-lasix-and-milkshaking-a-veterinarians-view/

How to Race Horses without Lasix, Chapter 1

Chapter 1

Horses have long raced without medication the day they run, and appropriately so. Medication is for horses who are sick or unsound. Only healthy horses are qualified to race. Horses that require drugs to race should not be raced until they heal, and can race without medication. Healthy horses race safest.
Trainers who feel they cannot race horses without injecting them with raceday drugs are unqualified horsemen. The concept of fair play precludes the use of drugs to influence the outcome of a race. Horses deserve better than to be medicated on raceday, as over 90% now are. Horses have long successfully raced clean when properly cared for and appropriately conditioned, and have raced more safely than mismanaged horses that require medication to get them around the oval each race. 

Conscientious horsemanship and appropriate husbandry of stabled racehorses manages both EIPH and soundness. Horses need to get out of their stalls each afternoon for a few hours of grazing and walking about, perhaps some lungeing to lung up the lungs and flush the metabolism. Horses are born to move nearly constantly, and it is this near constant movement that appropriately conditions lungs to handle the athletic rigors of a horserace. Humane care of the horses is the answer to managing bleeding and breakdowns, not drugs, my goodness. The bleeding medication issue is entwined with the breakdown issue, as it is the horses medicated for bleeding that breakdown approximately 4X more frequently than clean running horses.

The horses will prevail soon, as the ban on raceday drugs is inevitably necessary to revive the sport and restore integrity to the game. 

Horses everywhere will breath great sighs of relief at not having to be needled with drugs hours before every race they run.

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. He helps refine horse training methods to accommodate the inherent nature and behavior of horses. 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.