Horse Health Veterinary Consults with Dr Gustafson

Horse Health Veterinary Consults with Dr Gustafson
California, New York
Showing posts with label Salix. Show all posts
Showing posts with label Salix. Show all posts

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.

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.

Monday, April 30, 2012


April 29, 2012, 9:58 AM

New Model Needed for Race-Day Treatments

The white horse emerged late last year representing promise to restore a limping game; a new age of clean racing, race-day-medication-free racing; but the white horse hung coming down the lane. Too much Lasix, it seems; resulting in an inability to hold sway.
American trainers and their attending veterinarians remain unwilling to sacrifice their race-day needles just yet. They are reluctant to give up medicating racehorses before the runners head over to the paddock. Rather than educating trainers how to appropriately care for racehorse lungs and limbs as attending veterinarians should, the race-day vets continue to inject drugs, and more drugs. The more drugs attending veterinarians administer, the more they are paid. The only fees attending veterinarians generate are fees for administering medication. Attending veterinarians are paid in direct proportion to the drugs they administer.
One can easily see how that may sway their opinion regarding drugs, and their decisions to administer drugs to racehorses. There are no veterinary fees for consults or advice on the backside. Herein lies a significant part of the medication problem. Attending veterinarians have failed to learn how to charge for medical consults. To give the advice to let a horse run clean is to not be paid for anything, although it is often the best advice a veterinarian could give to a trainer regarding a champion runner. To be able to deliver sound horsemanship advice and be eligible to be willingly paid for his knowledge and professional acumen, an attending vet needs to appreciate the true nature of horses and learn how to manage bleeding and unsoundness in more appropriate, less pharmaceutical, fashions. When attending veterinarians come to understand as much about equine behavior and welfare as they know about manipulating horses with drugs, life will begin to improve for horses.
It is simply not good form to go after horses with needles and drugs before they race. It is not fair. It is not right. It is not medically or morally appropriate. It has been demonstrated to be a practice that is harmful to horses, a practice that when allowed is applied to virtually all horses rather than horses in need, regardless of their limb and lung health. To medicate nearly every horse who races in America with bute and Lasix is not the practice of veterinary medicine, but rather some sort of medication sham. Veterinarians should know better. As has long been suspected in ethical racing jurisdictions around the world, medicating racehorses on race day has proved to be an inappropriate and unethical practice, not to be allowed, much less tolerated. The regulators of racing in the 1960s had it right. No drugs allowed, no doping whatsoever permitted, regardless of the dope or the doper. The results of race-day medication will always be the same: rogue winners, rogue losers, more medical issues incited than resolved, more deterioration of the horses and the sport, shorter careers, more fragility, and more breakdowns. More public concern and scrutiny.
It has long been public knowledge that horse racing requires strident antidoping regulations and enforcement. It is becoming increasingly evident that the attending veterinarians are the people who require intense monitoring. Once entrusted with the health and welfare of racehorses afforded by their professional standing and education, they can no longer be counted upon to practice right by the horse. Racehorses and drugs have had a long, albeit dangerous, marriage, and the attending veterinarians have been the ministers of the nefarious relationship.
To relentlessly medicate racehorses, rather than to nurture and care for them properly in accord with their long-evolved nature, has resulted in tragedy reaching to the very top of the American horseracing game. The more medication horses are given, the less carefully their natural needs and tendencies are tended to, and the more fragile they become.
Rather than drugs, appropriate care and horsemanship are the keys to appropriately manage bleeding and unsoundness in horses. Racing was originally designed to be drug free, and that clean-running notion of ethical regulation holds to this day. It is generally accepted by most welfare-progressive societies around the world that trainers and their attending veterinarians cannot be relied upon to represent the health and welfare of their horses when money and fame are to be gained by pharmaceutical manipulation of their charges. Permissible race-day drug injections have deteriorated the game considerably.
All of this year’s Derby runners are scheduled to race on Lasix, and most all of them will also get injected with the adjunct bleeder medication which the Kentucky Horse Racing Commission allows to be injected into horses before the race, the drug known as Kentucky Red, or carbazochrome. Good stuff, that Kentucky Red. If one drug is good, two must be better, or so goes the veterinary reasoning and fee structure of attending veterinarians.
In addition to pushing drugs into the Derby runners’ veins shortly before they race, the veterinarians will also be very busy injecting the horses the day before they race. Never enough vetting has become the backside mantra. In addition to the race-day cocktail the Derby runners and all the other runners on the card will be receiving before they run, most of the runners will be medicated with phenylbutazone 24 hours before the Derby, along with various other additionally permitted nonsteroidal, anti-inflammatory drugs, as well as a surfeit of other permissible medications. Most Derby horses will have a cornucopia of drugs circulating through their systems by the time they reach the starting gate, enough drugs to float a battleship, as the saying goes, drugs that allow trainers to exceed the adaptability of their racehorses.
The reality, now demonstrated worldwide, is that horses and their riders are best served to race clean. The fewer drugs the better as far as the horses’ health and welfare are concerned. The public prefers an even field, and a fair horse race. Clean racing evens the field and protects horses, riders, and horseplayers. Clean racing selects for the best horse; the most durable, soundest, best developed, best bred, and fastest horse. Clean racing allows horses to persevere and prevail over a long career of running. Clean racing allows the best horses to prevail time and again, to win the Triple Crown.
Across the oceans, clean runners are currently competing more safely than the drug-addled American horses. Foreign runners break down less, and bleed little, if any, more than the heavily medicated American horses. Everywhere but in America, bleeding and soundness are managed with horsemanship and appropriate husbandry as bleeding and unsoundness should be managed. The correlation between race-day drug use and breakdowns has become painfully evident. The more drugs a jurisdiction permits to be administered to horses, the more breakdowns the horses racing in the jurisdiction experience. The time to ban race-day drugs is now. Horses cannot speak, file lawsuits, or tweet, therefore much of the medication abuse of racehorses in veterinary hands goes unnoticed as unreported, excepting, of course those abuses so prevalent and overwhelming that they require reporting by those news outlets genuinely concerned about the health and welfare of racehorses.
Next time, I’ll deliver another rousing sermon from my rabbit hole in the infield: how to race and win without Lasix, and to race and win again, and then win one more time. It is no coincidence that there has not been a Triple Crown winner since Lasix started sapping the vigor and durability out of champion runners in America. The times they are a changin’ for the better for horses, thanks to those who have the creative cause to step forth and take a stand for the health and welfare of Equus caballus.


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.

Thursday, April 5, 2012

Racehorse Advocacy, The End of Raceday Medications




Racehorse Advocacy
The End of Raceday Medications 


Sid Gustafson DVM
Equine veterinary behaviorist representing the health and welfare of horses

Thanks to a wide and diverse variety of racehorse advocacy efforts, a review of racehorse raceday medication practices by a variety of racing jurisdictions and organizations is making advancements to support the drug-free welfare and humane care of racehorses. Raceday medications are in the process of being rescinded, as are the indiscriminate and abusive use of drugs in racehorses in general. It has become clear to many that current racehorse medication practices in the United States and Canada exceed the adaptability of the racehorse, resulting in unnecessary breakdowns and injuries and death to both horses and jockeys. Rather than drugs, it is the humane care of racehorses that supports soundness of wind and limb.
A variety of groups have responded to the call by the HSVMA and HSUS to better care for racehorses. The Kentucky Horse Racing Commission invited the HSUS to testify at its raceday medication hearing, and I provided a version of the racehorse advocacy that follows. The Interstate Horse Racing Improvement Act is making its way through the United States Congress, and is supported by several congressional representatives. Make sure your representative supports this important Act. Governor Cuomo has called for an investigation of the New York Racing Association breakdowns. The New York Times is running a series of articles exposing the medication charade that has endangered horses and riders for decades in America. The Breeder’s Cup committee has banned raceday Lasix for two-year-olds racing in this year’s Breeder’ Cup.
Drug-free racing will improve stabling, conditioning, and husbandry practices for racehorses. Medication has long been a crutch that facilitates the improper care of stabled horses. Rather than alleviate medical conditions, recent data clearly demonstrates that racing medications allow people to exceed racehorse adaptability.  Drug use perpetuates fragility in racehorses.[1] Fragility is dangerous for both horses and riders. To appreciate the principles of equine behavior is to understand what is required to maintain pulmonary health in horses confined to stalls being conditioned to race, and it is not drugs. The solution to managing Exercise-Induced-Pulmonary-Hemorrhage and preventing breakdowns is appropriate breeding, development, horsemanship, training, and husbandry rather than drugs. The care that establishes and enhances pulmonary health and endurance in horses is the same care that enriches stabled horses’ lives. It is the same care that keeps racehorses’ musculoskeletal systems sound. It is humane care that keeps horses on their feet during races.
Horses with healthy lungs and sound limbs are content and fulfilled horses whose lives their caretakers adequately and extensively enrich. Lung health is supported by limb health. Appropriate husbandry and training maintains and establishes soundness of both wind and limb. 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. Limb soundness and pulmonary soundness are physiologically entwined.
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 EIPH while racing. They are more apt to stay sound of limb. Humane care of the horse prevents bleeding, my friends. Humane care of the horse prevents breakdowns. 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. Drugs and raceday medications perpetuate substandard horsemanship, artificially suppressing the untoward result (bleeding and breakdowns) of inadequate preparation of the thoroughbred. Drugs are no longer the solution. Humane care of the horse based on evolved behavioral needs is the solution to safe horseracing.
The solution to manage bleeding and prevent breakdowns in racehorses is to breed, develop, teach, train, and care for horses in a horse-sensitive fashion. Horses evolved as social grazers of the plains, group survivalists moving and grazing together much of the time. Horses require near-constant forage, friends, and locomotion to maintain health of wind and limb, even if they are stabled. Racehorses are no exception. The last place a horse evolved to live is in a stall, alone, with a limited view and uncirculated air. Training and husbandry need to be a good deal for horses in order for horses to maintain healthy partnerships with people. Pulmonary health is reflective of overall health and soundness in horses. Pulmonary health is reflective of limb soundness.
In order to maintain pulmonary health, natural conditions need to be re-created in the stable. The solution to managing racehorse health is proper horsemanship and husbandry, which is sadly lacking at today’s racetracks. Horses prefer to graze together and move nearly constantly in natural settings, and to race without drugs, natural has to be re-created in the stable. The equine requirement for near-constant grazing and moving is essential for joint and bone health, hoof health, metabolic health, and pulmonary health. In order for lungs to stay healthy, horses need more movement than they are currently provided. Abundant on track and off-track locomotion is necessary to condition a horse’s lungs. Lungs deteriorate when movement is restricted by excessive confinement in a stall. Horses breath all day long, and trainers need to appreciate abundant movement is required through much of the day to maintain pulmonary strength and health.
To enhance pulmonary health is to enhance the horse’s entire life and outlook. Not only do properly stabled and trained horses’ lungs hold bleeding in abeyance, they hold sway and win. Pulmonary health and bleeding prevention are dependent on smooth running and biomechanically sound locomotion.
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 inadequate in providing healthy air horse require. Appropriate barn design and stabling practices maintain pulmonary health. Bedding is critical. Clean straw provides stall 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. This is not enough. For healthy lungs, horses need to get out of their stalls for hours each afternoon. Horses need near-constant 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 support, and maintain lung and limb health without drugs is to enhance the overall health and soundness of the horse.
Sid Gustafson DVM



http://therail.blogs.nytimes.com/2011/10/28/goodbye-lasix-and-good-riddance/



[1] http://www.nytimes.com/2012/03/25/us/death-and-disarray-at-americas-racetracks.html?pagewanted=all


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. 

Tuesday, February 7, 2012

Kentucky Horse Racing Commission RaceDay Medication Transcript

Dr Gustafson's testimony begins on Page 169, Arthur Hancock's testimony begins on page 220, Bill Casner's begins on 137.

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

Dr Gustafson is an equine veterinarian, veterinary behaviorist, and novelist. DrSid provides equine behavior consultations to help recreate the needs and preferences of horses in training and competition. He advises owners and trainers how to manage bleeding without drugs.


MR. FARMER: Dr. Gustafson with the Humane Society of the United States.
DR. GUSTAFSON: Thank you commissioners for having this hearing to address this important issue.
My name is Sid Gustafson. A brief biography for those of you who would like to know. In the '60s, I started catching urine in Montana. I was catching urine in 1968 when Dancer's Image number was taken down. And so I put a lot of thought into raceday medication through the years.
I represent the Humane Society of the United States today as well as the Humane Society Veterinary Medical Association. I teach veterinary behavior at the University of Guelph and, in addition, I am a regulatory veterinarian in 4 states; California, New York, Montana, and Washington.
So I have been around as both an attending and regulatory veterinarian.
We do not oppose horse racing. But we do oppose race day medication. Hearing the information that exercise induced pulmonary hemorrhage is present in nearly 100 percent of the horses, some people would conclude that that is somewhat of a normal occurrence rather than an abnormal pathology.
However, certain degrees of it can be quite problematic. And I feel that part of this is due to exceeding the adaptability of the racehorse. So in my talk, I am going to present some solutions other than medication to exercise induced pulmonary hemorrhage.
Apparently all of these other jurisdictions in Hong Kong and Europe and places they don't use race day medication went through this process. And I assume the process they went to -- the collusions they came to will somewhat reflect what happens here. But I guess that remains to be seen.
To appreciate the nature of the thoroughbred, I would like to briefly review the evolution of the horse and the domestication process. Of all of the human equine pursuits, horse racing is perhaps the most natural equine pursuit of all. More natural, for example, than polo or stadium jumping or cutting. Horses have evolved for 60 million years to run at speed in close company. Running at speed in close company is the horse's long evolved group survival mechanism.
This is the nature which is nurtured in thoroughbred lines and thoroughbred development and training.
Racing comes natural to a horse.
To appreciate how horses develop the athletic endurance to run at speed together and connected in close company, veterinary behaviorists observe horses in natural settings to assess how horses naturally prepare themselves to race. We study horses prepare younger horses to develop strong limbs and strong lungs and musculoskeletal systems to achieve success evading prey.
Knowledge of the horse's nature is abundantly applied here in Kentucky. Farm after farm I drove through coming here had large pastures where bands of mares and foals and later bands of cohorts run and play and learn to travel closely together at speed. They learn to communicate together, change leads together and move in a safe and synchronous organized fashion while running in large circles around the pasture.
It is this essential experience with other horses in a heard that a growing thoroughbred gains the confident to run by and through horses later in life in a race. The herd conditions growing horses. Running with the herd facilitates the physical development of the lungs and musculoskeletal system.
The reproduction and recreation of these natural behaviors are essential for the healthy, mental, and physical development of the thoroughbred as is evident everywhere here in the Bluegrass. In order to later prevail in a horse race, growing thoroughbreds need to be conditioned to develop the ability, coordination, stamina, pulmonary capacity, and strength, confidence and experience needed to endure training and racing.
It is this knowledge that elucidates how race day Lasix impoverishes the welfare of horses. To
appreciate the principles of equine behavior is to understand what is required to maintain pulmonary health in horses confined to stalls being conditioned to race.
The solution to managing exercise induced pulmonary hemorrhage is appropriate breeding development, horsemanship, training, and husbandry. The care that establishes and enhances pulmonary health and endurance in horses is the same care that enriches stabled horse's lives. It is the same care that keeps racehorses' musculoskeletal systems sound. It is the care that keeps horses on their feet during races.
One point is clear about all of this data. The data from non-Lasix, non-race day medication jurisdictions indicates to me, at least, that clean running horses suffer significantly fewer breakdowns than horses running on Lasix in America.
Over the last 2 years, if I am reading the data from Encompass correctly, we watched 2 horses break down for every 1,000 starts. Meanwhile, the Hong Kong Jockey Club, which has been discussed here quite a bit, has set an example of clean and racing without race day medication. And their data indicates that they have less than 1 breakdown for every 2000 starts.
So on that basis, we find the use of Lasix and race day medication to be a welfare issue. 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. Appropriate husbandry and training maintains and establishes the soundness of both wind and limb.
Breeding and running are biologically intertwined on the racetrack, a breath per stride. To stride correctly is to breathe correctly. To breathe correctly is to breathe soundly and to 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 equine induced pulmonary hemorrhage -- exercise induced pulmonary hemorrhage while racing. They are more apt to stay sound.
Humane my friends. appropriate
care of the horse prevents bleeding, Pulmonary health is reflective of
husbandry, breeding, training, nutrition, and the abundant provisions of forage, friends, and perhaps most importantly locomotion.
Lasix perpetuates substandard horsemanship, artificially suppressing the untoward result, which is bleeding, to impair performance of inadequate preparation of the thoroughbred.
Performance medication on race day leads to fragility. Rather than alleviate medical conditions, the data from several jurisdictions and studies indicates that racing medications administered on race day exceed racehorse adaptability and perpetuate fragility in race horses. Fragility is dangerous for both horses and riders.
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.
Lasix manages a wide variety of unsoundnesses, as do the cortisone and the non-steroidal anti-inflammatory drugs. Running sore can cause horses to bleed. Anti-inflammatory drugs aggravate coagulation processes.
Please appropriate that horses running on pharmaceutical scrims are 4 times more likely to
break down than horses running free of race day medication.
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 husbandry are the keys to racehorse soundness, stamina, and durability.
Horses evolved as social grazers of the plains, group survivalists moving and grazing together much of the time. Horses require near constant forage, friends, and locomotion to maintain health of wind and limb. Racehorses are no exception. The last place a horse evolved to live is in a stall alone. The solution to manage bleeding in racehorses is to develop, teach, train, and care for horses in a horse-sensitive fashion.
Training and husbandry need to be a good deal for horses in order for horses to maintain healthy partnerships with people. Pulmonary health is
reflective of overall health and soundness in horses.

order to maintain pulmonary health, natural conditions need to be recreated in the stable. 
Horses prefer to graze together and move nearly constantly. This constant grazing and moving are essential for joint and bone health, hoof health, metabolic health, and pulmonary health. In order for lungs to stay healthy, horses need movement, often more movement than trainers provide.
Walking enhances and maintains horse health. Stabled horses need a lot more walking than most are currently afforded. Abundant on track and on track locomotion is necessary to condition a horse's lungs. Lungs deteriorate when movement is restricted. Horse breath all day long and walking is part of the way that assists their health.
Walking and movement enhance breathing and lung health. Development and conditioning of pulmonary health throughout growth and while training are the answers to prevent and manage bleeding as they have always been.
To enhance pulmonary health is to enhance the horse's entire life and outlook. Not only do
properly stabled and trained horses' lungs hold bleeding in abeyance, they hold sway and win.
Pulmonary health and bleeding prevention are dependent on smooth running and biomechanically sound locomotions.
Horse evolved in the open spaces of the northern hemisphere and require the cleanest, purest air to thrive and develop health 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 must be addressed to maintain pulmonary health. Bedding is critical. Clear straw provides the moves
movement by simulating Horses stalled on about with their heads
grazing. straw are noted to move down nibbling and exploring
for hours, recreating natural, keeping their lungs healthy with movement.
Their respiratory tracts drained by all the head-down nibbling and grazing. Horses need near constant 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 horse.
Racing has proven to be safer in Lasix-free and race day medication free jurisdictions where the drug crutch is not allowed.
Drugs are not allowed to replace appropriate care and training in Hong Kong and Europe. And race day drugs should not be allowed in America.
The stabled race horses has to be carefully and humanely cared for and nourished, both physically and behaviorally to win and stay healthy. Lasix has weekend the breed, and weakened the American horse racing game considerably as the numbers across the board reveal.
The horse has brought us all here today. If racing is to flourish as a sport in Kentucky and subsequently in the rest of the world, horse racing must come clean of drugs and replace its race day medication attitudes with appropriate horse sensitive breeding, development, horsemanship, behavior, training, and husbandry programs.

To honorably share this great Commonwealth with our friend the horse, we must learn to use the resources of the land and people to nurture Kentucky horses and rid the heart of the sport of its dependence on race day drugs.
Respectfully submitted. MR. FARMER: Thank you very much, doctor. Any questions from the panel? Commissioners?
Thank you very much. DR. GUSTAFSON: Thank you.

Wednesday, December 7, 2011

Racehorse Advocacy


Racehorse Advocacy
The Trouble with Lasix

Testimony before the Kentucky Horse Racing Commission hearing on raceday medication. November 14, 2011, Frankfort, KY, on behalf of the Humane Society Veterinary Medical Association and the Humane Society of the United States.

Sid Gustafson DVM
Equine veterinary behaviorist representing the health and welfare of horses

11-11-11


To appreciate the nature of the thoroughbred, I would like to briefly review the evolution of the horse and the domestication process. Of all human/equine pursuits, horse racing is perhaps the most natural equine pursuit of all, more natural than polo or stadium jumping or cutting, for example. Horses have evolved for 60 million years to run at speed in close company. Running at speed is the horse’s long-evolved group survival mechanism. This is the nature which is nurtured in thoroughbred lines and thoroughbred development and training. Racing comes natural to a horse.
To appreciate how horses develop the athletic endurance to run at speed together in connected and close company, veterinary behaviorists observe horses in natural settings to assess how horses naturally prepare themselves to race. They study how horses prepare younger horses to develop strong limbs and lungs and musculoskeletal systems to achieve success in evading prey. Knowledge of the horse’s nature is abundantly applied here in Kentucky. Farm after farm has large pastures where bands of mares and foals, and later bands of cohorts, run and play and learn to travel closely together at running at speed. They learn to communicate together, to change leads together, to move in a safe and synchronous organized fashion while running in large circles. It is this essential experience with other horses in a herd that a growing thoroughbred gains the confidence to run by and through horses later in life in a race.
The goal of a harem is to teach the foal to run with the herd. The mare and band are the long-evolved teachers of this process. The herd conditions growing horses. Running with the herd facilitates the physical development of the lungs and musculoskeltal system. The reproduction and re-creation of these natural behaviors are essential for the healthy mental and physical development of the thoroughbred, as is evident everywhere in the Bluegrass. In order to later prevail in a horserace, growing thoroughbreds need to be conditioned by the herd to develop the ability, coordination, stamina, pulmonary capacity and strength, confidence, and experience needed to endure training and racing. 
It is this knowledge that elucidates how raceday medication impoverishes the welfare of racehorses. To appreciate the principles of equine behavior is to understand what is required to maintain pulmonary health in horses confined to stalls being conditioned to race. The solution to managing Exercise-Induced-Pulmonary-Hemorrhage is appropriate breeding, development, horsemanship, training, and husbandry. The care that establishes and enhances pulmonary health and endurance in horses is the same care that enriches stabled horses’ lives. It is the same care that keeps racehorses’ musculoskeletal systems sound. It is the care that keeps horses on their feet during races.
One point is clear; the data from non-Lasix, non-raceday medication jurisdictions indicates clean-running horses suffer significantly fewer breakdowns than horses running on Lasix in America. Over the last two years, we watched two horses break down for every 1000 starts. Meanwhile, the clean running Hong Kong Jockey Club has less than one breakdown for every 2000 starts. They have no apparent or significant problems with bleeding. They have clearly demonstrated that clean racing is four times safer than medicated racing.
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. Appropriate husbandry and training maintains and establishes soundness of both wind and limb. 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 EIPH while racing. They are more apt to stay sound. Humane care of the horse prevents bleeding, my friends. 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. Peformance medication leads to fragility. Rather than alleviate medical conditions, this data indicates racing medications exceed racehorse adaptability and perpetuate fragility in racehorses. Fragility is dangerous for both horses and riders. To grasp how Lasix impoverishes the welfare of the racehorse, one needs to understand the long-evolved nature and behavior of the racehorse.
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. Lasix manages a wide variety of unsoundness’s, as do the cortisones and NSAIDs. Running sore causes lungs to bleed. Anti-inflammatory drugs aggravate coagulation processes. Please appreciate that horses running on pharmaceutical scrims are 4X more likely to break down. 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 husbandry are the keys to racehorse soundness, stamina, and durability.
The causes of EIPH are clear. Horses prone to bleed are those horses that are mistakenly bred, inadequately developed, and inappropriately stabled and trained. To allow drugs to cover conditions reflective of horsemen failing to attend to the basic needs of the horse in training impoverishes thoroughbred and standardbred welfare. To administer Lasix, the adjunct drugs, and phenylbutazone to virtually every horse before he or she races is an inappropriate application of veterinary medicine. The en masse drugging of racehorses has been demonstrated to be unethical, unnecessary, and untoward. In the case of contemporary American racing, Lasix is the drug that allows horsemen to abuse horses, to use a plethora of performance enhancing drugs, to cut corners on the proper care, conditioning, development, and husbandry of their racehorses, to develop an ideology that relies on drugs rather than talent. Drugs should not be allowed to alleviate conditions reflective of improper care. The first rule of veterinary medicine is; First, Do No Harm.
Horses evolved as social grazers of the plains, group survivalists moving and grazing together much of the time. Horses require near-constant forage, friends, and locomotion to maintain health of wind and limb. Racehorses are no exception. The last place a horse evolved to live is in a stall, alone. The solution to manage bleeding in racehorses is to develop, teach, train, and care for horses in a horse-sensitive fashion. Training and husbandry need to be a good deal for horses in order for horses to maintain healthy partnerships with people. Pulmonary health is reflective of overall health and soundness in horses.
In order to maintain pulmonary health, natural conditions need to be recreated in the stable. Horses prefer to graze together and move nearly constantly. This constant grazing and moving are essential for joint and bone health, hoof health, metabolic health, and pulmonary health. In order for lungs to stay healthy, horses need movement, often more movement than trainers provide. Walking enhances and maintains horse health. Stabled horses need a lot more walking than most are currently afforded. Abundant on track and off-track locomotion is necessary to condition a horse’s lungs. Lungs deteriorate when movement is restricted. Horses breath all day long, and movement is required much of the day to maintain pulmonary strength and health. Walking and movement enhance breathing and lung health. Drugs are not the answer. 
Development and conditioning of pulmonary health throughout growth and while training are the answers to preventing bleeding, as they have always been. To enhance pulmonary health is to enhance the horse’s entire life and outlook. Not only do properly stabled and trained horses’ lungs hold bleeding in abeyance, they hold sway and win. Pulmonary health and bleeding prevention are dependent on smooth running and biomechanically sound locomotion.
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 addressed to maintain pulmonary health. 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 natural 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 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 horse. Racing is safer in Lasix-free jurisdictions where the drug crutch is not allowed. Drugs are not allowed to replace appropriate care and training in Hong Kong and Europe, and raceday drugs should not be allowed in America. The stabled racehorse has to be carefully and humanely cared for and nourished, both physically and behaviorally, to win and stay healthy. Lasix has weakened the breed, and weakened the American horseracing game considerably as the numbers across the board clearly reveal.
The horse has brought us all here today. If racing is to flourish as a sport in Kentucky, horseracing must come clean of drugs and replace its raceday medication attitudes with appropriate horse-sensitive breeding, development, horsemanship, behavior, training, and husbandry programs. To honorably share this great Commonwealth with our friend the horse, we must learn to use the resources of the land and people to nurture Kentucky horses, and rid the heart of the sport of its dependence on raceday drugs.

Respectfully submitted,
Sid Gustafson DVM





Dr Gustafson's novels, books, and stories