08/27/2009 11:00PM

More questions than answers in Lasix debate

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NEW YORK - When the New York Racing Association threw in the towel on permitting furosemide (better known as Lasix or Salix) at its tracks 15 years ago, the battle over the use of the anti-bleeding medication appeared to be over after a generation of acrimonious debate.

New York had been the last state to forbid the drug, which currently is administered on race-day to well over 90 percent of the starters at all levels of racing in the United States. No one really believes that such a high percentage of horses actually needs the drug to race, but it has gained general acceptance as a necessity for real bleeders and somewhere between a prophylactic and a harmless placebo for everyone else.

While the issue has virtually disappeared from the American agenda, it has remained a hotter topic internationally. With the exception of Canada, Brazil, and a few obscure pockets, furosemide is forbidden in every other major international racing jurisdiction, including Europe, Dubai, Asia, and Australia. This remains a troubling fact to those who are uneasy about the drug's prevalence in American racing: Is it really possible that only the United States has adopted the correct and humane stance on furosemide and that the rest of the world is wrong?

The debate, and the seeming hopelessness of ever resolving it, was revived last Sunday at the Jockey Club Round Table in Saratoga. The morning's keynote address came from Louis Romanet, chairman of the International Federation of Horseracing Authorities, the closest thing the sport has to a global high commission. Romanet's address ended with an impassioned call, complete with comparisons to D-Day and the Moon landing, for the United States to ban furosemide and other medications from its graded stakes and listed races by the end of the 2012 racing season. Romanet argued that furosemide, a powerful diuretic, is not only unnecessary and unethical but has the nefarious side effect of diluting urine samples and potentially masking other drugs for which the IFHA is attempting to establish international testing thresholds.

"How can we still recognize as world champions horses who run under medication?" he asked. "What sport today would accept that situation?"

There were a few whoops from the veterans of the anti-Lasix brigade, but the overall reaction was only polite and subdued. Within 24 hours, officials of most American racing and regulatory organizations had made it clear that they had no interest in implementing Romanet's suggestions. In fact, several of them suggested, maybe it was time instead for the rest of the world to adopt the American position.

Proponents of furosemide have been buoyed by a South African study published last month, funded in part by the Jockey Club and referred to earlier at the Round Table, saying that Lasix is 3 to 11 times more effective than a placebo in preventing bleeding. That study is being widely cited by furosemide advocates as proof that they have been right all along.

There already was plenty of evidence that Lasix helps serious bleeders, and the study didn't answer the biggest questions that have always been at the heart of the discussion:

* Perhaps it's an unanswerable question, but no one seems to know whether bleeding truly affects closer to 20 or 80 percent of horses. The low end represents the estimated number who bleed profusely from the lungs under exercise-induced stress, while the higher one reflects clinical evidence of any hemorrhaging at all, at levels that may or may not affect performance.

* How exactly does the rest of the world get along without Lasix? And why have American horses seemed to run perfectly well without it in international events where it is prohibited, such as the Dubai World Cup races?

* Conversely, if furosemide is an unnecessary and an unethical performance-enhancer spurned by foreign horsemen, why does virtually every foreign-based horse who runs in the Breeders' Cup on American soil suddenly add furosemide to his race-day regimen?

* Perhaps most important, to what extent if any is bleeding a genetic rather than environmental affliction?

Romanet said his call for a ban at only the very top end of American racing is designed to keep bleeders out of the breeding shed, but no one seems to know whether or not bleeders sire bleeders - and of course it's almost impossible to study that when more than 90 percent of all the horses racing in this country are being "treated" for a condition they may or may not have.

Until these questions get answered more conclusively, there's simply no way of telling whether American racing is doing a better job than the rest of the world at protecting the short-term health of its horses, or jeopardizing the long-term health of the breed.