I read an interesting piece by Bob Pandolfo in HRU on the use of Lasix in the sport. Many of you have probably read it already. His argument was that perhaps the medication Lasix is unnecessary. Some of the points included that many jurisdictions outside of North America don’t permit the use of the medication, that the sport survived without the medication for years, that Lasix could mask other harmful drugs, that the drug is a performance enhancer and is overused, and finally that the drug could have side effects. Do any of these arguments hold water? Is Lasix truly an evil that must be eradicated from harness racing? If I had a dollar for every trainer that told me their horse bled during a race, I’d be at the yearling sales buying six-figure babies since my bank account would be quite large. Like it or not, many horses bleed during races. The only difference between today and years ago is that technology has improved and trainers are more aware of what is causing each bad performance. The same goes for Atrial Fibrillation or any other ailment. Science has advanced and now when a horse races poorly we have more answers. Decades ago, the answer was simply to move on to the next horse. Every person reading this editorial is either taking medication or knows a plethora of people who take medication. In all cases, it is decided that the positive effects simply outweigh the bad. Nearly every Monday night during the Fall/Spring I bowl in a league. In order to compete without discomfort, I stretch and take two Advil. I could bowl without the medication, just like a horse could race without Lasix, but the experience is less of an ordeal with the drug than without it. Quite simply, without the pain reliever, I wouldn’t bowl. Similarly, without Lasix some horses wouldn’t be able to race. That fact alone doesn’t mean that the Advil or Lasix is doing any harm. “It is no more dangerous than any commonly used therapeutic medication. To me it is an excellent medication when used properly,” said John Reichert, D.V.M. “The idea that every horse needs 5cc of Lasix is a farce. Every horse is an individual and you have to address the condition of each horse to assess the level that should be used.” Now of course the difference with the Advil is that I can communicate with my doctor and make personal decisions as to whether I want to take medication. Maybe the answer is that we need more oversight in terms of the administering of Lasix. Each state has slightly different rules when it comes to the medication, which is mind-boggling to say the least. While it is common practice that a vet must examine and scope a horse to confirm bleeding in order for the drug to be used, the decision as to how much Lasix can be administered and who makes that call depends on where the horse is racing. Often the ultimate decision as to the amount is up to the trainer and not the vet. “The trainers that I deal with regularly are smart enough to know that this isn’t one of those medications where more is better,” said Reichert. “It is definitely one of those medications where the less you give to get the desired effect of not bleeding, the better off you are. The smaller the dose that achieves the effects of inhibiting bleeding, that’s the optimal dose.” One point I think most of us can agree upon is that there is no sense using medication unless it is 100% necessary. To that means, shouldn’t a licensed vet make the final call in all states? Just like a doctor would prescribe how much medication a human patient would consume after an examination, wouldn’t it make sense for the vet to decide the exact dose of Lasix? Making matters worse is that in some states you can’t give a lower dose even if you want to. One day I was in the barn when a trainer asked to give 2cc of Lasix to a horse and he was told the minimum amount was 3cc. Here is the perfect example of a trainer trying to take the best course of action for the horse and the state guidelines standing in the way. Digging deeper into the effects of Lasix, Dr. Reichert was kind enough to provide his opinion on some of the concerns that typically surround the medication. On whether Lasix can mask other potentially harmful performance enhancing drugs, Reichert admitted it was possible but only if standard state guidelines for when the medication can be administered are not followed. “Yes, it is a possibility but not provided if Lasix is given four hours out,” said Reichert. “The diuretic effect in the urine passes if given four hours out. So the benefits are still there of its usage, but it is not masking other medications or drugs at that point. That is why there is such a hard and fast rule that Lasix must be given at a certain time.” The key to the four-hour timeframe is to ensure that a horse’s urine isn’t too dilute. When that happens it can potentially mask other agents in the horse’s system according to Reichert. A common practice from those outside of harness racing is to point to horses that race better once Lasix is given and cry bloody murder that the medication is a performance enhancer. According to Reichert, in reality taking Lasix is no different from a human taking a preventative medication to reduce cholesterol. “It is not a performance enhancing medication,” said Reichert. “I believe that it stops horses from bleeding and leading up to that is what makes a horses’ performance less than optimal. Once the horse is on Lasix and the horse is stopped from bleeding, they are back to where they are capable. “There are other medications out there that are the same way. It is not just Lasix. There are other issues related to a horses’ health that if you treat those issues the horse will be better. If you don’t, he would not.” Anyone who has watched a live television program has certainly viewed countless commercials promoting various medications. They all have side effects, even something as simple as Advil can cause a stomachache. Lasix is no different. “Potentially in higher doses, horses get dehydrated and there are a host of potential side effects if a horse does get dehydrated,” said Reichert about the downside of Lasix. “A horse that gets dehydrated tends to not perform as well. If a horse tends to tie-up, exertion could lead to myolysis (muscle cramping). Horses tend to tie-up if they get too much Lasix and the horse will go backwards. It does deplete potassium, so there is the potential for heart-related issues. That is why you tend to see horses that go into Atrial Fibrillation if too much Lasix is given. Those are a few potential side effects.” Going back to my Advil stomachache, the key is to have something to eat prior to taking the medication to avoid any discomfort. The same thought applies to Lasix. Horses on Lasix are typically given additional fluids before and after they race to prevent dehydration. The bottom line is that Lasix is not perfect, but like countless other medications we all take on a daily basis, it makes the day-to-day activities for horses more comfortable. I wouldn’t stop a human from taking blood thinners to prevent heart issues despite the fact that side effects could be severe bleeding, joint pain and headaches. So why exactly should horses stop using Lasix?