Forgotten Side of the Salix Debate: The Calcium Connection cont’d

I'll Have Another retired due to swollen left front tendon. (AP Photo/Matt Slocum)
The front legs of Kentucky Derby and Preakness winner I’ll Have Another, scratched the day before the Belmont Stakes due to a swollen left front tendon they said at the time. According to later reports, it turned out the horse had symptoms of chronic osteoarthritis that were hardly new or recent. I’ll Have Another was rushed off to stud weeks later. (AP Photo/Matt Slocum)


Drug Interactions Anyone?

This takes us to an even more insidious topic; the subject of drug interactions. As we are all aware there are always precautions associated with any medications, whether that be the so-called innocuous over-the-counter variety or more potent prescription medications. How two or more drugs interact, regardless of their harmlessness, can result in serious side-effects, sometimes life-threatening.

Besides Salix what else do horses have coursing through their veins during training or on race day that may put them at risk? Racehorses are routinely given an array of drugs known to interact unfavorably with furosemide which are more often than not concurrently circulating within the horse’s system.

The corticosteroids such as dexamethasone, prednisone or methyl prednisone are potent anti-inflammatories that are used to decrease inflammation, musculoskeletal pain, long-term joint degradation and opposite limb overload in horses with acute musculoskeletal inflammations. See

While it is acknowledged that corticosteroids pose a known risk of inducing laminitis in susceptible horses what is often overlooked is their effect on body water regulation and capacity to increase urine output (polyuria/polydipsia).

When used in combination with furosemide the corticosteroids further increase the risk of electrolyte imbalance and increased calcium losses yet are regularly used together in the horse. Moreover the combination of furosemide and prednisone is widely prescribed to reduce serum calcium levels along with the added danger of a reduction in potassium levels significant enough to require potassium supplementation. See .

Heavy sweating alone can induce serious dehydration, particularly in racehorses reaching speeds of up to 40 miles an hour with accompanying calcium and electrolyte losses. Obviously the combined use of Salix and corticosteroids significantly compounds these effects and can only be detrimental to the well-being of the horse.

Another drug administered, often on a “daily” basis, to many horses is clenbuterol, a powerful bronchodilator which works via relaxation of the muscles that line the airways to alleviate breathing problems in horses with inflammatory airway disease (IAD) and recurrent airway obstruction (RAO, more commonly known as heaves).

There has been much controversy over its use in terms of performance enhancement and despite the fact that most horses do not require it many trainers continue to use it for its muscle-building anabolic steroid effects.

Not only is it detrimental to the horse with continued use it also increases the risk of cardiac arrhythmias when used with potassium-depleting drugs such as loop diuretics – yup Salix – and corticosteroids; a triple drug interaction on the horse’s overtaxed system.

Moreover it also has vasodilator effects which can further compromise the horse particularly when given with Salix. Furosemide decreases the circulating blood volume which means that the kidneys (and most other organs) will have decreased blood flow to them. When a state of electrolyte balance is induced such as would be the case when Salix is administered, a drug with vasodilator properties such as clenbuterol should never be administered until that balance is allowed to return to equilibrium as it too will reduce blood flow to the kidney which may fail, possibly permanently.

Are these issues not serious enough to consider? Or does anyone care?

There are of course other drugs administered to horses on a regular basis that interact unfavorably with Salix many of which are related to potassium and magnesium loses (e.g. albuterol, ketoprofen, ephedrine) but the picture is pretty clear.

So much for the innocuous Salix theory.

But of course one cannot discuss drugs and the racehorse without mention of the ubiquitous phenylbutazone more commonly referred to as bute a non-steroidal anti-inflammatory drug (NSAID) used for pain relief. The Salix/bute combination is probably the most perplexing of all.

To begin with:

“A 2000 study by Ohio State University to determine the effects of bute on bone activity and bone formation in horses concluded “that the mineral apposition rate in cortical bone decreased and appeared to decrease the healing rate of cortical defects.”


So Salix leaches calcium from the bones and bute aids and abets the outcome. Great combination if you are Gumby’s sidekick Pokey, the talking red horse with rubber legs.

But more bewildering is the fact that phenylbutazone and NSAIDs in general reduce the number of platelets in the blood and block aggregation such that clotting is limited and bleeding persists.

Ergo bleeding problems will intensify.


Medically speaking this is absurd. Give these horses phenylbutazone that promotes bleeding and then administer Salix in an attempt to mitigate its effects. Talk about medical malpractice. They call this “humane”? No, this is totally unacceptable and once more exemplifies the reckless abandon with which the North American horse racing industry prides itself on.

To even consider using these two drugs together in the performance horse is inexcusable. NSAIDs are well known to cause bleeding problems and bute, a particularly potent NSAID, is no longer used in humans for this very reason. Any physician in the real world would be under medical review by his/her licensing board for reckless known interactions like this in a patient under their care.

Finally, add to this the conspicuous difference between drug regulations here in North America and elsewhere.

“Withdrawal times for other medications commonly used within 48 hours of racing in the United States are considerably longer in Europe: anti-inflammatory drugs like flunixin or phenylbutazone are three weeks, and corticosteroids are not allowed less than 18 days before racing.”


Clearly there is something amiss that inherently puts the North American Thoroughbred at increased risk of breakdown and demise.

The Future: Armageddon?

Hock Injection. Image:
Hock Injection. Image:

There seems to be no stopping this drug frenzy here in North America. The unremitting defense of the use of Salix the celebrated “miracle” drug simply adds to the pathetic state of affairs. It seems clear enough to me that Salix is far from harmless, perhaps not an instantaneous death potion, but certainly unwarranted for the most part. Why are North American horses so prone to EIPH and higher breakdown rates? Given the drug culture that has morphed North American philosophy into something that extends beyond tolerable I suppose this merely is an effect of the cause.

Cause or effect? Terminology that many misinterpret and find confusing.

Medically speaking is the cause a fundamental issue with North American horses or is it because of the persistent use of medications that has weakened the breed? To those in the industry this query may seem foreign because this is the North American way that has persisted since the seventies.

Nevertheless it seems remarkably clear that the overabundant administration of these purported therapeutic drugs has reduced the North American Thoroughbred to a drug-dependent addict at the hands of the trainers with their obsession to win and succeed at the track. That said do not forget the overzealous veterinarians, many of whom seem oblivious to horse welfare, who have, with the aid of the breeding fanatics and their syndicated enterprise conglomerate, helped turn this once majestic sport into the profiteering industry it has become. This is the cause and sadly the effect is the deterioration of the Thoroughbred.

“In general, treatments designed to repair a horse’s injuries and to alleviate its suffering are now used to get the animal out onto the track to compete – to force the animal, like some punchdrunk fighter to make just one more round. Equine veterinary medicine has been misdirected from the art of healing to the craft of portfolio management, and the business of horse racing is in the process of killing its goose with the golden egg” ~ Dr. Gregory L. Ferraro


It is difficult to imagine that the rest of the world is uninformed. The world is replete with scientists and equally intelligent people outside of North America. This persistent North American stance on the use of Salix and other therapeutic medications is arrogance that continues to be challenged and has only shamed the integrity of its racing community from a global perspective.

Today, North American Thoroughbreds are considered drug-induced and genetically challenged.

“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.”~ Christiane “Criquette” Head, president of the European Trainers Association


The world of horse racing is not contingent on North America. In fact, North America is a smear on the face of horse racing; the horses who have grandly done their part in a time-valued and honorable way to bring emotion and life to this exhilarating display of shear fortitude have not disappointed. It is human intervention that has destroyed it all.

“Mankind” directs the fate of our animal companions and North America has failed the Thoroughbred. Egos and wealth are paramount and accountability seems non-existent and laced with disconcerting measures dedicated not to the welfare of the horse but rather to the people who exploit these innocent and noble creatures.

The racing industry here in North America is a web of deceit, insulated from the rest of the world and lacking focus on the very athlete that sustains it — no lifeblood, no nurture, no compassion, no accountability, where one answers to the lure of money, greed and ego without heed to the welfare of the horse.

Everything has been passed over in favor of the bottom line; that being return on investment at all and any cost. The horses have nothing to do with it – they are simply a means to an end.

Crash and burn — totally broken.

There are no words for the sadness of it all.


© Int’l Fund for Horses

Read Part 1 >>

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