Blood Money: Salix and Beyond – Part 2, the Money

by JANE ALLIN
Int’l Fund for Horses Special Report

PART 2, THE MONEY

THE primary intent of this article was not to expound on the pros and cons of Salix but rather to focus on the aspect of greed and money that is synonymous with the North American racing industry.

A South African project undertaken by the University of Pretoria to study the effect of Salix on EIPH says it all.

“Why are you doing the study of furosemide in horses?

The study is being conducted to provide scientific evidence of the effect of the treatment on EIPH, or not, in order to justify the widespread and expensive use of the drug in race horses (costing over $30,000,000 US per annum in the United States).” [1]

Ah yes – money and greed – more gullible than innocence, but deadly for the horses.

So exactly how much money is involved here?

We’re not simply talking Salix but also the plethora of medications routinely administered to every Thoroughbred racehorse in the country. But let’s start with the race-day medication Salix.

The following racing statistics are taken from The Jockey Club website for 2011. [2]

In the United States and Canada there was a total of 64,625 starters (horses that ran in a race), in a total of 49,794 races, with a total of 400,408 starts. The average field size was 8.04 (average number of horses in a race). The key here is the total number of starts (440,408) or the total number of times any of the 64,626 starters raced.

Several sources show that the average cost of a pre-race injection for Salix in NA is about $20-$30 and in many cases this is accompanied by a shot of Premarin (conjugated equine estrogens or CEEs) or another adjunct bleeder medication for a fee of anywhere from $25-$50.

Some may query “Premarin?”

Pfizer are making millions off the exploitation of pregnant mares for their estrogen rich urine to produce the menopausal drug Premarin, killing countless by-product foals in the process. Now we find that the pharma giant are raking in millions from the medication of innocent racehorses with the same drug.

Yes, the evil PMU (pregnant mare’s urine) industry gives back to the equally sordid racing industry.

Premarin is often used in conjunction with Salix as a means of restoring or strengthening vascular integrity which in theory will shorten the bleeding time. Premarin is not a classified drug nor is it necessary to report the use of it on race day in some jurisdictions.

Often a horse will run either on Premarin or Salix or a combination of both without disclosure to the public potentially putting the bettors at a disadvantage. [3]

In any case, it is estimated that 95% of the horses in North America run on Salix on race day and that the average cost of that injection is $25.

The total number of starts in 2011 = 440,408
If 95% of the starts ran on Salix:
The total number of injections = 440,408 x 0.95 = 418,388
At $25 per injection:
The total cost passed on to the owners = 418,388 x $25 = $10,459,700

This is only the tip of the iceberg. Before getting into the cost of Premarin and other routinely administered drugs we can extrapolate further with respect to the use of Salix leading up to a race.

Salix is typically administered before each “breeze”, admittedly at somewhat lower cost as a result of no requirement by the attending veterinarians to complete paperwork. Most sources indicate that the cost per workout is between $15 and $20. If the midpoint of $17.50 is used as the cost per breeze at an average of 3 breezes prior to the race the cost of Salix during training can be estimated.

The total number of starts in 2011 = 440,408
Assuming that 95% of the starts also trained on Salix:
The total number of injections = 440,408 x 0.95 = 418,388
At $17.50 per injection per breeze:
Total cost passed on to the owners = 418,388 x $17.50 x 3 = $21,965,370

Racehorses jump out the gate at the start of a race. — Racehorses jump out of the gate at the start of a race.

Hence, from a rudimentary mathematical approach, for the 400,408 starts in 2011 the take out on Salix alone is over $32,000,000.

Note that this is likely to be a conservative estimate as it has been reported that many trainers administer Salix on a weekly basis throughout the racehorse’s entire career.

If this is the case the actual cost per annum, at $17.50 per injection for the 64,625 starters in 2011, would be $58,808,750 – almost twofold. No need to point out the sizable disparity in the conservative approach compared to what might be and probably is closer to reality.

Let’s also calculate the cost of adjunct bleeding medications that are used in conjunction with Salix to alleviate the effects of EIPH.

These include medications such as Premarin or alternatively carbazochrome, transexamic acid, or aminocaproic acid for example. It is not clear how many horses actually race or train on these medications given that it is more expensive than Salix and may be relegated to race day and then only in some jurisdictions. Accordingly an arbitrary percentage will be assigned to this calculation simply for illustrative purposes.

Assume 75% of horses on race day are administered an adjunct bleeding medication at $25 per injection (at the low end of the cost).

The total number of starts in 2011 = 440,408
If 75% of the starts ran on the medication:
The total number of injections = 440,408 x 0.75 = 330,306
At $25 per injection:
The total cost passed on to the owners = 330,306 x $25 = $8,257,650

Similarly assume that only 25% of these horses breeze (3 times) on these meds at $25 per dose.

The total number of starts in 2011 = 440,408
Assuming that 25% of the starts also trained on adjunct bleeder medication:
The total number of injections = 440.408 x 0.25 = 110,102
At $25 per injection per breeze:
Total cost passed on to the owners = 110,102 x $25 x 3 = $8,257,650

This brings the total cost of the administration of adjunct bleeder medication to $16,515,300 with a grand total of close to $50,000,000 when administering the dual drug regimen (Salix and adjunct medication) to help mitigate the effects of EIPH for which only 2%-5% of racehorses actually truly suffer from in any serious way.

But it doesn’t stop here.

“Lasix begets a plethora of additional drug use. Wherever pre-race Lasix is permitted, additional drugs are administered to most all of the diuretically-infused racing horses by their trainers and attending veterinarians. Lasix allows and encourages a lot of drug use. It legitimized the stage for the medication mentality that has haunted racing in recent years with all the notable breakdowns, sudden deaths and wrecks.” [4]

It has been estimated that the accompanying drug regimen before and after the Salix injection on race day can exceed $200 and is frequently as high as $300 or more in some cases, all at the discretion of the trainer. [5], [6]

Sample diet of just a few racehorse drugs.

A compilation of several conventional medications included in race-day regimens is shown in Table 1.

Table 1. Common Race-Day Medications

MEDICATION	PURPOSE
Banamine	NSAID – anti-inflammatory
Robaxin	Muscle relaxant
Bute	NSAID – anti-inflammatory
Asium	Cortisone – anti-inflammatory)
Acetylcystiene	Breaks up lung mucuous
Salix	Diuretic for the alleviation of EIPH
Premarin/Estrogens	Adjunct bleeder medication
Calcium	Attempt to increase Calcium after leaching from bones due to Salix
Vitamin C and K	C (blood vessel repair), K (anti-coagulant) for bleeding
Jugs	Concentrated electrolytes and fluids to replenish loss due to Salix

Clearly the statement “Lasix begets a plethora of additional drug use” epitomizes the hedonism of drug culture in North American racing.

Once more, some basic math will shed some insight on the economic component of race day in North America. It’s not simply the little innocuous $25 shot of Salix that the pro-Salix camp would have you believe but rather a much more significant chunk of change involved to off-set the effects of Salix and keep these horses running as deemed necessary to stay on a competitive level.

$200 per race day per 440.408 starts in 2011 = $200 x 440,480 = $88,096,000
$300 per race day per 440.408 starts in 2011 = $300 x 440,480 = $132,114,000

Wow, anywhere from $88 to $132 million just on race day.

Truth be told these estimates are not far off the mark. As Tracy Farmer points out in his article “U.S. Horses Losing Value, Respect in Foreign Markets”:

“My understanding is that bute is an anti-inflammatory designed to offset the impact of furosemide. Together with the electrolytes and other supplements used in an attempt to compensate the horse for the dramatic loss of fluids caused by furosemide, the direct cost is more than $100 million annually to owners.” [7]

But the buck doesn’t stop there. What about training regimens and routine medications and the like? Gotta’ keep those profits coming in.

It is common knowledge that the cost of keeping an average horse in training is on the order of $200 to $300 dollars per month. [8], [9] This is over and above race-day costs and many horses will be administered even more medications dependent on their overall “condition”. Much to the horror of racing fans, this ugly reality was sadly illustrated in the New York Times series Breakdown Death and Disarray at America’s Race Tracks.

Syringes with Racehorse Meds — Mock up of syringes containing racehorse medications.

In one instance (One Horse, One Week of Injections); a disturbing inventory of the drugs dispensed over a period of a week to Coronado Heights, a 4-year-old thoroughbred who received a diagnosis of early degenerative joint disease serves to illustrate the severity of the drug problem in North America.

Ten different drugs administered, often in multiple doses (see New York Times illustration, to quell his unsoundness, the only reason being that his ethically challenged owner and trainer could not bear the thought of losing out on the prospect of winning.

Unthinkable and unscrupulous to say the least.

Sadly Coronado Heights broke down and was euthanized on the track at Aqueduct on February 25th. [10]

Is this the norm and not the exception? Presumably – yes, it happens all the time.

“In a 69-day period in 2008, one well-known track vet administered $4,264.50 worth of drugs to my 3-year-old filly, including antibleeder medicine, clenbuterol, muscle relaxers and a spate of antibiotics so powerful the horse had to be treated for ulcers and digestive tract damage. There were also four tissue damaging joint injections — for a total of $225.

What the horse really needed was some rest and a $90 session with a good equine chiropractor to realign her spine.” [11]

Is there no shame?

As with race-day medications there is no scarcity of drugs administered routinely to horses in training. The common training medications list as shown in Table 2 is not an exhaustive one as there are myriad medications that can and are used to “manage” the North American Thoroughbred.

Table 2. Common Training Medications

MEDICATION	PURPOSE
NSAIDs	Anti-inflammatory (e.g. Bute, Bamamine, Naproxine, Azium)
Muscle Relaxants	Robaxin
Sulfa Drugs	Colds, Coughs (e.g. Tribrissen)
Ulcer Therapy	Treatment of ulcers caused by NSAIDs etc. (e.g. Tagamet)
Bleeder Medication	Treatment of EIPH (e.g. Salix, Premarin)
Hormones	Stimulate muscle development, repress ovulatory cycle (e.g. Winstrol, Testosterone, Progesterone
Vitamins and Fluids	Muscle soreness, vitamin deficiencies, electrolyte balance (e.g. Vitamin E & Selenium “Jugs”)
Joint Therapy	Short term relief of joint pain and inflammation (e.g. Corticosteroids, Hyaluronic acid, Adequan)

Once more this amount can be added to the escalating costs attributed to medications doled out on a dedicated basis to these hapless Thoroughbreds at the mercy of their trainers and veterinarians driven to win by any means possible.

$200 per month per 64,625 starters x 12 months in 2011
= $200 x 64,625 x 12 = $155,100,100
$300 per month per 64,625 starters x 12 months in 2011
= $300 x 64,625 x 12 = $232,650,000

As a summary of rough estimates based on evidence taken from several sources for the costs, and obvious profiteering, of those involved in the North American drug “culture”, the upper limit of these “admitted” practices is likely to be closer to the truth. This is purely in light of the very real and chilling speculation that what we read and what is documented is conceivably far removed from certainty as evidenced from anecdotal hearsay. Clandestine drug use is indiscriminate and widespread.

That said it serves as a tool to illustrate the unfounded abuse of “legal” medications and the haunting prospect of how far North American racing will go to satisfy their insatiable appetite to win.

Salix Injections Only = $32,000,000
Race Day (Including Pre and Post) = $132,000,000
Medications for Training Purposes = $155,000,000 to $233,000,000
Total estimate = $319,000,000 to $397,000,000

As you can see, the result is over a quarter of a billion dollars and approaching the half billion mark.

Racing Plate with Blood Money — When morality comes up against profit, it is seldom that profit loses. ~ Shirley Chisholm

There are no words, only a distinct feeling of disgust and sadness. And to think that this figure has the potential of being even higher is even more revolting. Moreover in the end it is not really the money that is flowing into these greedy pockets that is bothersome but rather the devastation and premature deaths of these innocent creatures. Greed is one thing, but where is the shame that should accompany it?

This criminal economic conspiracy is basically comprised of a three-tiered system with interplay between each contender. At the top is the omnipotent pharmaceutical industry without whose interaction the vile nature of the beast would be less so, no doubt. It’s no secret that unprincipled Big Pharma’s tentacles are intricately entangled in the matrix of Thoroughbred racing and have been instrumental in the introduction of patented and expensive medications to the game.

Some time ago the analogy of marketing drugs to consumers was applied to the horse racing industry wherein the relationship with the equine consumer soon flourished with expedient and profitable returns. Since then it has only gotten worse particularly given the unrelenting desire to win and the lust for money inside the North American racing abyss.

While there is no doubt that Big Pharma and the attending veterinarians are those that line their pockets with the proceeds, it is nonetheless the trainers and owners who drive the drug culture from the bottom up; the owners by way of their choice of trainer and knowledge of that trainer’s ethics or lack thereof. If their horse doesn’t win, neither do they nor do their bank accounts –- their passion for economic gain is simply too tempting and without empathy for the welfare of the horse. In actuality it is a vicious cycle replete with acts and deeds that come full circle and risk the lives of the innocent – the innocents whose very life blood sustains the industry.

Indeed, rumor has it that there is no shortage of complicity amongst the three levels in the arena where bribery and back-scratching are commonplace. When it comes to horse racing, the lust for money is the root of all evil where greed has no boundaries –- a bottomless chasm in a perpetual effort to satisfy the need without ever realizing satisfaction.

Can anyone question the fact that the drug trade inside the North American racing industry is indeed a multi-million dollar industry in itself? And how did it evolve?

What is so different about North America that compels these individuals to literally rape this sport’s integrity at every opportunity and at all costs? It has evolved into a game of money with a labyrinth of players all out to the same end –- to line their pockets with wealth, no more, no less.

What happened to veracity, honesty and horsemanship?

While there are, without doubt, good people within the industry there exists the fact, for whatever reason, that these benefactors have no capacity to sway the movement when it comes to medication abuse. And, in as much as the North American racing world would have you believe there are only 1.5% who are responsible for the carnage, it is difficult to swallow this argument.

Drugs are not just at the top tiers of racing where all the money is they are also decidedly ubiquitous at the low end, especially on the level of claiming races. And it is not just the illegal drugs we are talking about here it is also the superfluous and disproportionate use of the therapeutics as well.

Despite the fact that for well over a year North American horse racing and its race-day drug-related issues have been conspicuously under the microscope, little has been done to address and resolve these issues in any definitive way. All talk and no action it seems. Even with the proposed new rules and principled intentions communicated by The Jockey Club and championed by the Thoroughbred Owners and Breeders Association (TOBA) it is clear that the overwhelming majority of players in the industry have serious reservations about banning race-day Salix medication.

Whether this refusal to accept these initiatives stems from the welfare issue of preserving the respiratory health of the horse or whether it is related to performance enhancement is irrelevant. The fact is the conflict is there and will no doubt remain for some time to come. After all Salix has been a central element of the North American racing industry for 40 years and the majority of trainers are simply not familiar with any other way. The Water, Hay and Oats approach is entirely foreign and they want to keep it that way.

Regardless of the rhetoric that continues to beleaguer the Salix and Bute race-day debate one thing is clear. There is a dire need, once and for all, to determine what is best for the horse in keeping with the goal of preserving the quality and integrity of racing based entirely on the athletic ability of the horse without medication band-aids.

First and foremost are the physiological effects on the equine patient.

While the pro-Salix circle will have you believe that it alleviates the symptoms of EIPH and benefits respiratory health, it certainly does not cure EIPH. What this side of the equation repeatedly overlooks are the deleterious effects attributed to this powerful diuretic as a result of dehydration and electrolyte imbalance – most notably the risk of cardiac failure (potassium depletion) and heat stroke but more insidiously perhaps, the unremitting loss of calcium and deterioration of bone structure which establishes a scenario conducive to increased fracture risk.

Which is more detrimental to the horse? Can it be any clearer? EIPH rarely kills a horse. Can the same be said of cardiac arrest, heat stroke or catastrophic breakdowns? You be the judge.

Eight Belles is euthanized on the track at the 2008 Ky Derby — Eight Belles dies in the dirt at Churchill Downs. She was euthanized after breaking both front ankles, after finishing second in the 2008 Kentucky Derby.

Secondly, it has long been theorized that Salix is indeed a performance-enhancing drug and is recognized as such everywhere else in the world whether equine-related or not. Diuretics have long been classified as performance enhancers due to weight loss. It is based on the scientific principles of work, energy and velocity as a function of mass. Simply put, it takes less energy and work to move a lighter object hence the ability to move faster over the same distance.

As for race-day Bute allowances, it masks pain. Enough said.

While it is true that some semblance of change is on the horizon, what will it take to truly reform this broken industry and its broken athletes? Or can it even be “reformed”?

Undeniably, the difficulties inherent to reform are in a large way a function of the fragmented organization of the industry here in North America where all 38 jurisdictions in the United States have their own set of rules and empower themselves to enforce them. Nothing even remotely resembling uniformity with respect to rules and regulations exists, drug violations are undisciplined, penalties are insignificant where the punishment doesn’t fit the crime and recidivism is widespread. Basically it’s a joke.

Rep. Ed Whitfield (R-KY-01) has introduced legislation in Washingdon amending the Horse Racing Improvement Act that, if enacted, would ban all race-day medication throughout the U.S.

In fact, the drug topic, or at least talk of change and reform, has escalated to the point that efforts have been initiated in Washington, D.C. to regulate the issue. Whether this intervention is good or bad remains to be seen. However, without a doubt if the North American Thoroughbred horse racing industry wants to clean itself up a serious effort will be required to eliminate the current organization of separate racing jurisdictions and overall divergent policies.

What’s more, if the racing industry wants to operate within its own precinct rather than be manipulated by government edict it must unify itself and elect a single authority to govern the entire enterprise with implementation of explicit standardized rules and regulations. Moreover these strict policies will require enforcement of accountability on the part of owners, trainers and racetracks via the execution of stiff penalties and fines for any and all infractions. Let’s face it the current system simply does not work.

While there has been much in the media of late, a special mention is warranted for the actions taken by Governor Beshear of Kentucky – the horse capital of North America.

“In a highly anticipated move, Kentucky Democratic Gov. Steve Beshear said he is overriding the vote taken earlier this week by the state legislature’s Interim Joint Committee of Licensing and Occupations that rejected three key changes in medication rules approved earlier this year by the Kentucky Horse Racing Commission.” [12]

“The regulations, scheduled to take effect Sept. 6, opening day of the Turfway Park meet, ban adjunct bleeder drugs on race day; mandate regulatory administration of the anti-bleeding drug furosemide, also called Salix or Lasix; and lower the permitted amount of phenylbutazone, also known as Bute, that can be administered 24 hours before a race.” [13]

Hats off to Governor Beshear for such a commendable and courageous decision –- one that few in the racing world are willing to commit to.

Sadly the North American racing consortium is in the throes of an abusive addiction and has been for some time; the insidious addiction to money, where drugs, both illegal and therapeutic, are the engine that drives it –- a means to an end. This addiction presents itself as a vicious cycle somewhat analogous to that of the opium-morphine-heroin-methadone conundrum; a cycle of addiction that telescopes into the depths of chaos with ever-increasing risk and ruin.

The opium to methadone regimen was the attempt to replace an addictive drug with a purportedly “non-addictive” one derived from the same source. Unfortunately, the morphine substitute for opium became equally if not more of a problem, so in due time the purportedly “non-addictive” heroin became the substitute which begat methodone and unfortunately became even more addictive than heroin.

So how is this analogous to the situation in the North American horse racing world?

Just as the lust for opium and its euphoric effect is the root of all evil in the human drug paradigm, so is the gluttony for money in the North American racing world and the power it brings with it. Opium addiction is “treated” with morphine which in turn is “treated” with heroin and finally heroin with methadone but without resolve of the underlying issue of drug addiction.

In North American racing illegal drugs are clandestinely used to “treat” the money addiction through the vehicle of performance enhancement just as the opium addiction was treated with morphine yet ultimately achieved the same addictive end effect. But there is a catch to the illegal medication with risk of discovery which brings with it a need to find a suitable alternative, just as there is the issue with morphine and its ability to achieve the same effect as opium and the need to find a substitute for the morphine.

Enter the therapeutic medications such as Salix and Bute, for example. As the pro-raceday medication proponents would have you believe these drugs are inconsequential in terms of performance enhancing and of much benefit to the welfare of the horse – so they proclaim. Yet just as the morphine, heroin, methadone chain of events illustrates, the end result is unequivocally interconnected with the fundamental addiction.

It is really the search for that innocuous “fix” with the intent of fueling the addiction.

Frightened horse held and injected. — A clearly frightened horse is held while he is being injected. Those in the horse racing industry who are addicted to drugging horses to cheat and win have a choice; the horses do not.

Regardless of what the pro-Salix, Bute and other enthusiasts want to believe, these drugs, although theoretically therapeutic in nature, are not being employed to this end. In North America they are feeding the primary addiction – money – at any and all costs.

Perhaps this is a caustic and unsavory analysis, but the unscrupulous and unnecessary over-use of both illegal and therapeutic medications currently rampant in North America is ugly, without justification and destructive. In the end, the human drug addict has a choice, regrettably the horse doesn’t.

All the pretty horses, all in a row . . . . “Ashes, Ashes” They all fall down!