by JANE ALLIN
Int’l Fund for Horses Special Report
PART 1, THE BLOOD
THE North American Thoroughbred racing industry is rife with the natter of race day and other medications where polarized delegations continue to vehemently argue in defense of their convictions one way or another.
Lasix (furosemide), now renamed Salix for use in animals, is central to the debate, a debate solely North American in nature, foreign to the global racing world and a contentious issue that seems without resolve.
Nonetheless the debate and tentative solutions to it seem to be, at a snail’s pace, moving forward, albeit mired in rhetoric and with many impediments much to the chagrin of the anti-Salix crowd.
As much as pro-Salix individuals and organizations have fervently defended the use of Salix for the relief of EIPH (Exercise Induced Pulmonary Hemorrhage) the problem is that the rest of the world doesn’t race on it and none of these “foreign” horses suffer in its absence. It is considered performance enhancing and unnecessary unless the horse is experiencing symptoms that limit his or her performance in which case that horse is retired.
In fact, contrary to claims from the pro-Salix crowd that continues to use the pitiful “sour grapes” approach that the rest of the racing world are hypocrites because they use Salix during training just not on race day, this is pure fiction. In a recent New York Times article, “Race-Day Medication: the View from Overseas” authored by Gina Rarick, Christiane “Criquette” Head, president of the European Trainers Association, sets the record straight:
“This is completely, 100 percent false,” said Christiane “Criquette” Head, president of the European Trainers Association and a top name in French racing for years. “I don’t use Lasix in training and no one I know uses Lasix in training.” 
Head goes on to say:
“If the horse has a true bleeding problem that impacts performance, it is retired — or moved to the United States to race.” 
At first glance the statement “moved to the United States to race” seems somewhat acerbic in nature however this has apparently been going on for some time.
“It is well-known that in recent years foreign owners and trainers have sent their few horses diagnosed as bleeders to race in America permanently. And then they send horses that do not bleed over to compete in the Triple Crown, Breeders’ Cup and other big purse stakes, giving them what ever trainer domestic and foreign believes to be an advantage of first-time furosemide. They are beating us at our own game, not only on the track.” 
This makes North America look like a disposal ground for spent goods. Long gone are the glory days for the “Old Kentucky Home” of born and bred champions of the “Sport of Kings”. Nowadays it’s more akin to the “Old Kentucky Crack House” of junkies.
“Racing is about natural selection. In the United States, there are stallions that shouldn’t be stallions, but you never know because the performance was achieved with medication. It is seriously affecting the breed.” 
Similarly in Great Britain the use of Salix in training is virtually non-existent.
“Over the last 10 years 5275 samples have been taken from racehorses in training by the regulator of horseracing. Medications have been detected in around 15% of these samples (some horses will be receiving more than one medication). The prevalence of findings of furosemide was 0.11%, i.e. it was detected in 6 horses. Furosemide is not allowed on raceday in Great Britain. Recent studies of all cases of visible bleeding from the nose after racing over the last 10 years by the University of Nottingham showed a prevalence of such epistaxis of 0.13% in flat racehorses, and that British trainers consistently chose to electively rest affected horses for longer that the statutory rest periods mandated in other racing jurisdictions.” 
These are examples of “clean racing” unlike in the United States where Salix is nothing more than a drug crutch; a crutch that that serves as an expedient; a means to an end – not necessarily a principled or ethical one – and suggestive of substandard or inappropriate care.
In the end, drug use is simply not the answer to the management of bleeding as has been proven time and again in European and other racing nations. When will the United States realize that the addiction to race-day and other medications has cast a shadow on the North American Thoroughbred, once lauded as the world’s best and now portrayed as the inferior species.
Overall, foreign racehorses are sounder as evidenced by significantly lower breakdown rates. The high breakdown rates in the United States are considered to be an unmistakable consequence of the misguided and needless use of both therapeutic and illegal drugs, including Salix and the ubiquitous “Bute”. Back in the pre-Salix days some horses ran 30 times a year. And let’s face it, North America’s racing reputation is overtly tarnished as far as the global racing circuit is concerned – a culture of drugs and lax regulation.
But it is far worse than just Salix.
One need only recall the recent spate of positives in several states with the drug Dermorphin, a powerful painkiller isolated from the skin of South American frogs which is 30-40 times more potent than morphine; clearly unethical abuse and a diabolical exemplar of cheating. Nonetheless it will continue. The addiction is so powerful that it will override any sense of morality and a new potion will arrive on the scene; one that will stealthily go undetected only because it will be novel and without a procedure in place to test for it. Always one step ahead of the law.
And so it seems Salix is merely a distraction.
Why then is Salix the primary focus in North American racing these days?
First and foremost because the rest of the world prohibits the administration of Salix on race day but secondly, and perhaps more importantly, because it is legal, it generates lots of money and it is not the worst of what is really happening in drug-dependent North America.
Without a doubt the key word in this list of reasons is “MONEY” in very big capital letters.
It is easy to focus on this glaring discrepancy between the North American racing industry and the rest of the world and with it the level of visibility it gains from an international perspective. It is also easy to defend it, which has been done since its introduction in the 1970’s.
Interestingly enough the first Kentucky Derby horse to race on furosemide was none other than Northern Dancer in 1964. How fitting given that the inbred Northern Dancer’s pedigree is infused with the stained genes of unsound Native Dancer, both of whose bloodlines coarse through the veins of so many modern Thoroughbreds. And by the way, Northern Dancer, touted as the “most influential stallion in Thoroughbred racing”, won the Kentucky Derby that year but only by inching out Hill Rise by a neck.
Did Salix and the corresponding weight loss give him the estimated extra 3 to 5 length advantage allegedly conferred by the drug and would he have won it if he hadn’t raced on it? After all, none of the other horses ran on Salix and therefore hypothetically all at a recognized disadvantage. Isn’t that why the vast majority of trainers in North America insist their horses run on it even if unnecessary?
This was the beginning, the beginning of the end for North American racing.
Now after 40 years of use in North America, it is “routine”, an accepted and legal practice that most trainers and veterinarians will vouch for in its effectiveness regardless of the discrepancies and lack of consistent scientific evidence to wholly back its advantage. As Sheila Lyons, DVM and Founder and Director, ACVSMR (American College of Veterinary Sports Medicine and Rehabilitation) emphasizes:
“It is time for an extensive study of the lasix effect on horse physiology- one that was done nearly thirty years ago in human medicine and until my recent study, has not been conducted in horses by any veterinary researcher.”  pdf
One need only look at the effects of furosemide on bone growth to see that the disadvantages of its use in the horse far outweigh any advantage conferred. Moreover does any trainer in North America know how to train a horse without it? It is a case where these so-called “horsemen” put their own economic interest before the horse.
It is also clearly “The North American Way” – ergo, it will be. The rest of the world is wrong, simple as that, can’t anyone see? And in consequence of this allegation the rest of the racing world is inhumane, the common and droning catchphrase cited for its use, regardless of the fact that prior to the advent of this “miracle” drug all North American horses ran without it. Doesn’t it follow then that North America was once inhumane as well? That’s a lot to swallow.
All bets have it that the current state of Thoroughbred racing in North America is vastly more inhumane than it was prior to the introduction of Salix. All one has to do is look at the decline in the number of starts the average horse makes and the unmistakable escalation in catastrophic breakdowns which, by the way, are far in excess of other racing jurisdictions on a global basis.
“Extensive studies clearly indicate that drugs cause more trouble for racehorses and their riders than they alleviate. Lasix jurisdictions have significantly more breakdowns than jurisdictions where Lasix is not allowed . . . . Equine veterinarians have long lobbied for drugs to enhance racing, but the science continues to demonstrate that chronic use of raceday drugs degrades the quality and safety of racing while impoverishing the welfare of racehorses. Raceday medications increase the breakdown rate.” 
Nevertheless the omnipresent mantra of the pro-Salix contingent is that all horses experience bleeding to some degree and therefore it is inhumane to withhold Salix for the purpose of mitigating EIPH.
“Studies suggest that less than 5 percent of racehorses bleed in the lungs significantly enough to impair performance; more than 95 percent of all horses race on it in the United States and Canada.” 
In spite of this, these alleged “altruists” want the public to believe that if horses are not given an injection of Salix on race day a blood bath on the race track will prevail. A post on Tuesday’s Horse in June of this year “Blood will spurt from horse’s noses if you ban Lasix they cry in Kentucky” reports this ludicrous claim.
“Thoroughbred owners and trainers voiced dire warnings Tuesday about the potential of blood spurting from horses’ noses if the Kentucky Horse Racing Commission institutes a race-day ban on the anti-bleeding drug furosemide.
“What will the public perception be when horses pull up in front of the grandstand with blood running out of their nostrils, down their chests and legs and the jockeys’ silks covered in blood? This will make the betting public sick to their stomachs,” horse owner Billy Ashabraner said.” 
Incredible; this declaration is enough to render one speechless.
And so North America predictably continues to pay no heed to the transparent reality that Salix is banned in every racing jurisdiction around the globe without any evidence of blood spewing forth from the nostrils of the horses – deaf ears and closed minds. In fact many North American horses have competed successfully without Lasix in foreign racing events without incidence.
One example is Curlin and his record-setting 7-3/4–length victory in the Dubai World Cup in 2008 – the world’s richest race at Nad al Sheba racetrack – competing against the world’s best horses from around the globe.
Now, however, the proof is in the pudding.
On July 19, 2012 forty-two prominent Thoroughbred owners and partnerships upheld their opposition to race-day medication and made a praiseworthy commitment not to run their 2-year-olds this year on Salix. So far no issues reported, no bloody disasters or any catastrophic events related to EIPH. Moreover, the recently created Jockey Club website “Clean Horse Racing” (http://cleanhorseracing.org/) maintains a daily update of the most current performers in North America winning without Salix; there appear to be no shortage of winners and miraculously no blood. What a concept.
No Salix, no problem.
Add to this the comments of owner Bill Casner who runs all of his horses without Salix or Bute:
“The fact is, when you dehydrate before an athletic performance, it is counterintuitive to proper physiology or optimum physiology for a horse to perform at its best. I think any competitive advantage is negated. Horses experience extreme potassium loss when they are given a diuretic. Trainers in this day and age understand that it takes anywhere from four weeks to seven or eight weeks to recover from a race. In earlier days, horses ran every two weeks. That was ideal and that was because they didn’t have to deal with the metabolic stress of dehydration combined with the stress of a race.”  pdf
Casner goes on to say:
“We’ve scoped our horses after they run and only a small percentage have bled. About 10% of our horses have bled after running without Lasix. One of the contributing factors, and I don’t have any science or data to support this, but we have seen with the horses that have bled is that a common factor is that we have administered butazolidin the day before. Now, we don’t run with bute either. Bute is a very caustic drug. It’s not even used in human medicine much anymore. It is a drug that has whole litany of side effects. We have found that by removing both meds that our horses are not bleeding and are running very well.”  pdf
North America’s legal race day meds – Salix and Bute – synergistically working to enfeeble the race horse all in the name of greed and ego.
But that’s not all. To add insult to injury, the pro-Salix delegation, enmeshed in paradoxical rhetoric, are adamant that Salix is not performance enhancing. It is simply incredulous that they fanatically deny this.
“Furosemide is a powerful diuretic that can flush out upwards of 2% of a horse’s weight in water. The loss of such large volumes of water (up to several gallons) can confer a weight advantage of as many as 20 pounds and often more. Given that the typical imposts carried by different horses as a handicapping tactic only vary between 5 to 10 pounds, the loss of 20 to 30 pounds is indeed significant. While this in itself is shameless deceit, it is also believed that the excessive urination also has the ability to flush out trace amounts of illicit drugs to the extent that on post-race testing, they go undetected – a two-fold effect on achieving performance advantage.” 
Furthermore, in a New York Times article “Alkalization, Lasix and Milkshaking: A Veterinarian’s View” author Sid Gustafson, D.V.M., an equine veterinarian specializing in Thoroughbred sports medicine explains:
“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.” 
That said, how can performance enhancement be completely ruled out? Who is kidding who?
The issue of weight is recognized on an international level and is fundamental to handicapping as a means of balancing a race on a competitive level depending on the perceived racing abilities and past performance of the individual horses in the field — the purpose being to make the outcome more difficult to predict. Any means of reducing the weight the horse carries will decidedly provide an advantage. This is no doubt the very reason that the vast majority of horses in North America race on Salix regardless of whether it is genuinely a necessity, otherwise they may be at a disadvantage compared to those horses that receive the injection.
What is especially appalling is the glut of physiological issues that accompany the obligatory injection of North America’s golden racing elixir.
“Lasix or Salix is furosemide, a potent diuretic that dilutes the urine and lowers the pulmonary blood pressure. The drug alters the electrolyte balance of racing horses and makes them vulnerable to heat stroke and metabolic dysfunction. As well, chronic diuretic use interferes with locomotory abilities required to run biomechanically sound by altering cardiac function, muscle function, nerve function, and most every other physiologic function. Diuretics weaken horses”.  pdf
A most insightful comment made by Tracy Farmer, vice chairman of the Kentucky Racing Commission, in his recent article: “Horse Racing’s Medication Choices” hits the nail on the head when it comes to the destructive relationship between Salix and chronic breakdown issues observed in North American racing.
“In my opinion it is no coincidence that the decline in the image of the sport and the horse perfectly parallels the introduction and spread of furosemide as a race-day medication. While those who oppose its discontinuance may do so believing it to be in the best interest of the sport, all you have to do is read about the drug’s side-effects on the bones of humans for which it was originally intended. A drug that routinely results in the disruption of bone growth in immature animals cannot possibly be in the horse’s best interest. In my mind the trauma caused by regular doses of a powerful diuretic, results in a bone-weakening process that inevitably increases the number of breakdowns and shortens the careers of American racehorses.” 
It is well known that the chronic administration of furosemide is considered a high risk factor for the development of osteoporosis and decreased bone mineral density in humans primarily due to increased urinary excretion of calcium.  pdf
However, this is not restricted to human bone health but rather pertains to the bones of any animal as well, horses included. Calcium, along with phosphorous, are precursors required for bone development, strength and repair as well as other vital functions related to muscular and nervous system activity.  pdf
The regulation of calcium levels in the blood is tightly controlled to maintain normal calcium homeostasis (i.e. equilibrium, balance) since innumerable processes are dependent upon it. When the level drastically plummets, which happens in consequence of disproportionate urinary excretion once furosemide is administered, the body will sustain that level in the blood through resorption of calcium from bone reservoirs.  pdf
Unfortunately a shot of calcium, often prescribed post-race, will not stop the leaching of calcium from the bone or increase the amount of calcium stored but will simply be flushed out of the system. Calcium levels in the blood are regulated by a feedback looping system via specific hormones that act as chemical messengers. With the influx of calcium from an injection, these hormones recognize this as excess blood calcium and activate the appropriate calcium-sensing receptors such that much of it is quickly eliminated to maintain blood calcium homeostasis. Therefore this is not a quick fix for the losses incurred as a direct result of Salix usage.
With chronic use, such as that occurring in the North American Thoroughbred due to the abusive use of Salix, a persistent state of calcium deficiency can potentially be established. With continuous resorption of calcium from the bone this invariably leads to chronically reduced calcium supplies and in turn reduced bone density, abnormal bone formations and susceptibility to fractures. It is much more complicated than this but you get the picture. Salix is literally killing the North American Thoroughbred.
The science is there but no one is listening.
How long can the pro-Salix crowd run away from the truth? They are unfailingly taciturn in response to the real arguments.
But I digress.
THAT’S THE BLOOD. READ PART 2: THE MONEY
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