12/16/2013 2:25PM

Breeders' Cup furosemide study raises questions


A study examining juveniles that raced on the Nov. 1 and 2 Breeders’ Cup cards at Santa Anita has contradicted a previous study showing that the legal raceday medication furosemide is effective in mitigating the incidence and severity of bleeding.

The study last month, which entailed the endoscopic examination of 41 horses that raced without furosemide and 14 horses that raced on the medication, showed that horses treated with the drug had a statistically significant higher incidence and severity of bleeding than the untreated horses. A 2009 study on horses running in South Africa, which was conducted in a more scientifically rigid manner, showed just the opposite, confirming what some horsemen see as anecdotal evidence for the efficacy of the drug in mitigating bleeding.

Though the authors of last month’s study cautioned that the study’s limitations make the interpretation of the results difficult, the findings are sure to inflame an already contentious debate on the use of raceday furosemide, which is legal in all North American racing jurisdictions but prohibited in most other major racing countries worldwide. Supporters of furosemide use have said that the drug is an effective treatment for bleeding in the lungs, while critics have said the drug’s efficacy is vastly overstated and that the use of the drug on raceday in North America is exacerbating the sport’s public-perception problems.

The study, which was paid for by Breeders’ Cup, examined a total of 55 horses that raced during the two Breeders’ Cup cards. Juveniles running in the five Breeders’ Cup races for 2-year-olds were prohibited from running on furosemide under a rule that was allowed to expire this year, while horses in two non-Breeders’ Cup races, for California-bred juveniles, were allowed to race on the drug.

According to the study, 15 of the 41 untreated horses showed evidence of bleeding, or 37 percent, while 10 of the 14 treated horses, or 71 percent, showed evidence of bleeding (any fleck of blood visible on endoscopic examination of the trachea, the tube running from the lungs to the nose and mouth).

The study also found that five of the 14 horses, or 36 percent, treated with Lasix were scored as having bled in the higher ranges of the scale, compared with only three of the 44 untreated horses, or 7 percent. That result strongly contradicted the South Africa study, which found that horses treated with furosemide were far less likely to suffer “severe episodes of bleeding” than those injected with a saline solution.

Veterinarian Nathan Slovis, who oversaw last month’s study, said on a conference call that he had expected to find that the treated horses had lower incidences of bleeding, along the lines of the South Africa study. He cautioned that the Breeders’ Cup study looked only at “the best of the best,” and said that the South Africa study and the Breeders’ Cup study were “apples and oranges.”

“You cannot correlate our study to the South Africa one,” he said, acknowledging that the South Africa study had far fewer limitations. “You cannot compare the two.”

When asked why the result appeared to so strongly contradict the South Africa study, Slovis said that the Breeders’ Cup study had a built-in selection bias because owners of the horses that raced without furosemide knew beforehand the drug would be prohibited in the Breeders’ Cup races and may not have run horses that were bleeders.

Alternately, the horses running in the two Cal-bred stakes races included in the study “may be the horses that needed it,” Slovis said.
“It may be the caliber of the horse, different training methods, different environmental factors, it could be any number of factors,” Slovis said.

Breeders’ Cup decided to undertake the study after the Breeders’ Cup board, in a controversial vote, decided earlier in the year to suspend the ban on the drug because of concerns that horsemen would withhold approval of wagering on the Breeders’ Cup simulcast signal if the ban was not rescinded for 2014. Horsemen’s groups are the most ardent supporters of raceday use of the drug.

Craig Fravel, the chief executive of Breeders’ Cup, said the results “pose more questions than answers” and he said that the issue of raceday furosemide requires more study. He called on other industry organizations to support more research.

The question of whether furosemide is truly effective in mitigating bleeding is not the only mystery surrounding the drug. While some have theorized that the drug, a diuretic most commonly known by its former trade name, Lasix, could be effective by decreasing blood pressure in the lungs, the means of its efficacy is unknown.

“We really don’t have any data on how Lasix works,” said David Richardson, a Breeders’ Cup director and the chief of surgery at the University of Louisville. “You can also argue that we need a little more basic science … and what the side effects are.”

Gaye Goodwin More than 1 year ago
Just look at who always jumps at the opportunity to sue the BC for banning the stuff... we all know who the cheaters are! When the heck are we gonna get rid of them?
Robert Smith More than 1 year ago
It does raise a question. Why would someone need a study to know the results for lightly raced 2yr old would be different from seasoned veterans. If you read some of the below quotes you will realize this has only distorted the picture.
not impressed More than 1 year ago
Lasix is joke and so is the industry. NO horse NEEDS medication, industry members are just blind to the vets who want extra money in their pockets. Horses races for hundreds of years without stuff so why they need it now suddenly is beyond me. You will never convince me a horse needs anything other than hay, oats, and water. If they can't run without medication they're a cull pure and simple and have NO business being used in the breeding shed. I don't care who they are or what their bloodlines are. over 85% of the horses in this country I'd never breed to because they race on medication or were unsound. Had I options of money like the Sheiks, I'd be buying stock from Germany, Japan, and Australia, not from the States. USA breeders have lost the idea behind the breeding aspect and now only breed to garner quick turnarounds. They don't breed to race, they breed to sell. Until ideals change we won't be seeing any more Triple Crown winners. Our horses are simply not bred to handle racing much anymore, they're treated more like show horses. It's really hard to get excited about anything in this sport when horses retire after 5-8 race career. A true "career" is a 25 plus race career. At least then you have some idea of the type of horse you have. A "glimpse" of a campaign does not a career or champion make.
david More than 1 year ago
Very well said
Charles Williams More than 1 year ago
You are a rare bird, one who I assumes, bets on horse, but is not blind by self interest in trying to cash a bet. You have stated the absolute truth..Any other opinion is usually based on someone or a groups self interest in getting something in return for having there opinion...That of course means they are probably not being honest....Thanks, I hopefully I may stumble across another of your comments in the future...Thanks for speaking the truth.
TEDK215 More than 1 year ago
Agrarian u, look up eqb.
TEDK215 More than 1 year ago
KUDOS to the drf for keeping the ntra under the microscope with these stories they have been doing! their at least trying to keep the person buying the ticket informed of all the different types of bs that's going on. cause at the end of the day its all about INTEGRITY!
Thomas Cook More than 1 year ago
How many were treated with adjunct meds more powerful than lasix. How many of these had lasix also? Then there is climate conditions. Dry. Humid. Coastal...wtc. Just learn how to train and acclimate the horse. One reason why you see foljs ship and stable weeks before a big race usually have better success. Example..Derby colts. Also Breeders Cup Classic winner Mucho Macho Man. Etc...
Bob More than 1 year ago
Suggesting that it might be used more to mask the presence of other drugs than to mitigate the effects of bleeding during a trace?
Eric Singer More than 1 year ago
whether the sample size of the current study is significant is not the issue. what is the issue - more testing can only be useful. especially given the fact that no one knows how it works on horses. I am totally in the corner of all the people writing in to say if the whole world can race without it we can too. to my mind Lasix is part of the weakening of the breed in North America. horses with physical issues can race on race day with the medication. these same horses are bred and pass their infirmities on to their offspring. how many years of seeing 50 - 75% of the top three year old sidelined before the end of the year do you need to see before you get there is something wrong. this is not the case with Euro and Japanese 3 year olds. yes transitioning to Lasix free racing would be difficult and in the long run the future of the sport and the integrity of the breed demand it. leave things how they are and see what you have in another 20 years ...
Elliott Factor More than 1 year ago
sample size is much too small to be significant
MKKelly513 More than 1 year ago
Lies, Lies and Statistics! As I work with Probability & Statistics every day in my job, sample sizes have no meaning when less than 32. The 14 sample size is much too small to have any ability for projections. Throw out these results and increase your sample size before making any conclusions!! Hire a Probability & Statistics Professor to do your Statistical Analysis and you will see.
nick More than 1 year ago
Dear Mr. Statistician, Maybe you should read the FULL article, they did not make any conclusions. They just quoted the study results. And while.you are right in that a sample size of 14 is very small, after having 10 out of 14 Lasix horses bleed, you would have to go 0 for 27 to even tie the results of the other sample in question, and after going 10 for 14, you really think that will happen?
Joe Rockhold More than 1 year ago
Totally agree. Can't believe such a limited study would even receive press coverage. Moving on!
The Baron More than 1 year ago
Ban Lasix and you will have 4 horse fields period and the already failing business of Horse Racing will be done!! They will be turning Belmont Park in to Condos and Stores like Hollywood Park!!
Darrin More than 1 year ago
I have been saying the same thing all along.Also,the banning of steroids has done more harm for racing than good.When they could use steroids,horses could recouperate much faster,and were running back in 2 weeks,thus creating bigger fields.....just allow whatever you want to give the horses,and let everyone use whatever,and fields will be full again.....just saying.
jttf More than 1 year ago
If you need research and results with the use of lasix. I have all sorts of information on the subject. Unfortunately, the negatives outweigh the positives. It would have been a much better world if new York state would have stayed a lasix free state. Remember skip away, cigar and holy bull ? They all were stabled in new York when you couldn't use lasix. These horses were the best in the nation. This is just one example of many. Why are male horses more effected by lasix use, than the females ? Does it have something to do with dehydration ?