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Drug reform or business as usual?
Little has changed on Kentucky backstretches since the passage late last month of what was supposed to be a sweeping change in the state's medication rules, said prominent trainers and veterinarians on the Kentucky circuit.
The new policy, which cut back the maximum number of raceday medications from 16 to five, went into effect on Oct. 4, opening day of Keeneland's fall meet. Since then, many Kentucky horsemen have continued to administer combinations of analgesics and anti-bleeding medications to horses four hours before post time, just as they did before the new rules.
"We do have a few more guidelines that we have to be aware of," said Jerry Johnson, a racetrack veterinarian based in Kentucky who supports liberal medication rules. "And there's always a breaking-in period to get used to. But it really hasn't changed my practice at all."
For supporters of the new policy, which was approved by the Kentucky Racing Commission on Sept. 24 with the backing of every major racing organization in the state, the rule changes were said to be a significant step for Kentucky, which has come under fire for having the most liberal medication rules in the country.
But according to recent conversations with four veterinarians and five trainers, the biggest effect has been to mute criticism of the state's rules rather than to change the behavior of horsemen.
According to the trainers, the new policy eliminated drugs that horsemen never really used while still allowing them to treat horses with preferred combinations of potent drugs.
"I think any horseman is going to find that there is going to be very little difference living under the new rules, and absolutely no difference in how their horses perform," said John Ward, a trainer who supports more restrictive rules. "It wasn't that someone was using all these drugs before, that this was being done routinely. It was that if someone wished to do it, then they could. The law would back them up. That's not so anymore."
Before the policy change, criticism of Kentucky's rules was led by a wide-ranging group that has attempted to reform and standardize medication policies, an effort that Kentucky's horsemen have resisted. The national group recommended 10 months ago that only one medication - Lasix, the popular diuretic used to treat bleeding from the lungs - be allowed on race day.
Under the new Kentucky policy, horses can receive up to five drugs on race day from a list of 11. The drugs are arranged in three categories, allowing trainers to pick and choose to create their own ideal, five-drug raceday combination.
The policy allows trainers to administer two non-steroidal anti-inflammatory drugs, or NSAID's, on race day by permitting the mild analgesic phenylbutazone and one other painkiller from a list of four. The policy also permits one corticosteroid, a powerful anti-inflammatory, from a list of four, as well as two anti-bleeding medications, Lasix and the blood-clotter Amicar.
The new policy is still the most liberal in the country, and combinations of the drugs allowed in Kentucky are forbidden in all other states. Opponents of the state's liberal practices explained their support for the policy by pointing out that the rule change was a step toward even more restrictive policies.
"It's a lot easier to go from five to one than to go from 16 to one," said one Kentucky racing official, referring to the national group's Lasix-only recommendation.
Some trainers, however, said that any further effort to restrict medications will be met with resistance. The trainers, who have watched the Kentucky racing circuit rise from mediocrity in the late 1980's to its current position as one of the strongest in the country, complain that regulators are pushing politically correct rules and accuse the reformers of forcing trainers to treat their horses inhumanely.
"If you want an animal to perform, you have to take care of him," said Bernie Flint, a leading Kentucky trainer. "Why deprive a horse, one that works for a living, of drugs that can help him do his job? Would that be fair to do because some do-gooder says they can't? Do-gooders don't understand what they are doing to these animals. You'd have to be a complete idiot to sit on one of these medication boards with grown men and women and tell people that you can't use medication."
Kentucky racing commission chairman Frank Shoop defended the effectiveness of the new rules. "I feel very strongly about this, and I know a lot of other people do, too," Shoop said. "I think we are doing the right thing."
But some trainers and veterinarians said they supported the rule change principally because they never used the full range of 16 legal drugs anyway.
"I pretty much stick with Bute and Lasix," said William Fires, a leading trainer in Kentucky. "I got a brother who's a rider and a brother-in-law who's a rider, and if the horses are bad enough, they don't need to be riding them. I got other things to think about."
Even with the rollback, parts of the Kentucky policy remain the subject of debate, inside and outside the state, largely because of the continued tolerance of the use of painkillers on race day.
Whether in support of or in opposition to the changes, Kentucky racing officials and trainers said the rule allowing for the combination of two NSAID's was intended to protect the practice of administering the mixture of Bute and Banamine on race day, a controversial practice in other states and other sports. Banamine is generally regarded as one of the most powerful painkillers on the market, trainers said.
"A lot of people swear by that Bute-Banamine combination, because a lot of people believe that Banamine is a lot better for those soft tissue injuries, and that Bute is best for hard-tissue injuries," said Scott Waterman, the director of the National Thoroughbred Racing Association's Drug Testing and Medication Task Force. "That way they are covering all the bases, so to speak."
Debate over the use of the Bute-Banamine combination stems from concern over the cocktail's ability to mask injuries, the reason nearly all racing commissions ban the use of any NSAID, including Bute, on race day.
USA Equestrian, the governing body for nonracing competitions, whose rules are accepted annually at 2,700 horse shows, specifically banned the Bute-Banamine combination when it rewrote its rules in the late 1980's, even though the rules allow a combination of two NSAID's.
"It's based on the belief that the combination of Bute and Banamine has a much stronger analgesic effect than the combination of any two other NSAID's," said John Lengel, a veterinarian who is the director of USA Equestrian's drugs and medications department.
Many Kentucky veterinarians refused to speak publicly about their use of medications. Others referred all questions to Jerry Johnson, the veterinarian, who spoke on behalf of Kentucky racetrack practitioners at racing commission meetings where the rules changes were discussed and who played a role in drafting the new rules.
Johnson said that perhaps 50 percent of horses in Kentucky receive a combination of NSAID's on race day. He said that most horses, however, receive Bute the night before a race rather than on race day. Banamine is then regularly administered at the four-hour threshold, Johnson said.
Johnson said Bute allows the horse to relax.
"It just makes sense," Johnson said. "If you had something big you had to do the next day, like a race, wouldn't you want to get a good night's rest?"
Like NSAID's, corticosteroids are anti-inflammatory drugs, but they are more potent than Bute or Banamine and are either injected directly into joints, applied to the skin, or injested orally. Because of their ability to ease pain - and because of a side effect that spikes blood-sugar levels, which trainers believe can give a horse an energy boost - corticosteroids were widely believed to be abused before sensitive tests were developed in the 1980's to detect them.
Only one state other than Kentucky - Florida - allows a corticosteroid to be administered on race day, and the use is limited to prednisolone, one of the least potent drugs in the class. Kentucky's rule allows for prednisolone, the related drug prednisone, triamclinolone, and dexamethasone, one of the most powerful corticosteroids available.
Johnson said that perhaps 25 percent of horses in Kentucky receive a corticosteroid on race day. He said that the administrations were frequently in oral or topical form, and that trainers rarely injected joints, a practice that can lead to long-term damage, according to studies.
"Just because it's on the list doesn't mean we give it to them," Johnson said. "That's the public perception - that if it's on there, they get it. That's just not so, and never has been."
Daryl Easley, a Kentucky veterinarian who favors more restrictive rules, criticized the use of NSAID's and corticosteroids on raceday, saying that trainers had other options.
"If they need a whole lot of drugs on race day, then we need to reevaluate how that horse is being treated, just because of all the things we have available to us that we can do on the day before or farther out," Easley said.
Johnson, however, praised the new Kentucky rule for allowing each veterinarian or trainer to make his or her own decisions.
"It gets to be a personal preference as to which medication is working best, and thankfully in Kentucky, that's been left up to the practitioner," Johnson said. "That's the way it should be. We know what we're doing."