Race Day Medication Summit: Overview of EIPH and its treatment

I don’t know a lot about medication in horses. I’m neither a vet, nor a scientist, nor a horsewoman. For these reasons, I haven’t had much of an opinion on race day medications in horses, leaving those decisions to those better informed than I.

And for these reasons, I spent the first day of my summer vacation – nine straight hours of it – listening to vets, scientists, and horsemen talk about use of furosemide on exercise-induced pulmonary hemorrhage. Or: What are the effects of Lasix/Salix on bleeding in horses?

It would be impossible to summarize everything that was said (though I did my damndest as I live-tweeted for Thoroughbred Times, to the horror of some and approval of many), so over a series of posts, I’m going to share some of what I learned and some impressions of the day.  This post will focus on the presentations that took place in the first part of the day.

Rob Manfred, Jr., an executive Vice President of Major League Baseball, opened the day, explaining how MLB dealt with its “performance-enhancing substance” problem (though Manfred sometimes said “performance-enhancing drug,” he more often used the word “substance”).  While interesting enough from a theoretical standpoint, the MLB situation didn’t seem analogous to the subject at hand: the summit was about the regulated use of a legal drug widely considered therapeutic, while baseball’s big problem was with steroids, a substance already banned in the game.

Alex Waldrop of the NTRA posed a series of questions, explicitly or by inference:

  • How many horses would bleed without Lasix?
  • Is Salix performance enhancing or optimizing?
  • Should we move to international uniformity? Should the rest of the world adjust to North America?
  • Is Salix a masking agent?
  • Has Salix weakened the Thoroughbred breed?

Few of those questions were answered on Monday; Dr. Rick Sams, director of the HFL Sport Science, Inc. laboratory, which is the official lab of the Kentucky Horse Racing Commission, did speak about furosemide as a masking agent, concluding that its uncontrolled use had “profound effects” on drug concentrations in urine and “negligible effects” on drug concentrations in blood, indicating that the uncontrolled use of furosemide could well pose problems for detecting other medications in a horse’s urine. He pointed out that furosemide use in racing is tightly controlled in terms of dose, route of administration, and time of administration and that under those conditions, the effects of the medication on drug detection are “largely limited.”

Monday’s second panel featured vets offering various perspectives on EIPH: its effect on a horse’s health; treatment options; race day medication and its effects on drug testing. Dr. Ed Robinson, a faculty member of the College of Veterinary Medicine at Michigan State University, explained the physiological causes and effects of EIPH, indicating that repeated bleeding causes the walls of the blood vessels in the lungs to thicken, which can then lead to fibrosis, which can, according to a 2007 study conducted in part by Dr. Robinson, “enhance the severity of bleeding during exercise.”

Dr. Steve Reed, a veterinarian who has long worked at universities and who now works at Rood and Riddle Equine Hospital, spoke about treatment of EIPH, concluding that furosemide and Flair Nasal Strips offer the most evidence of benefit; Reed said furosemide was the most effective treatment for bleeding.

Some of the presentations, including Dr. Robinson’s and Dr. Reed’s, are archived at the NTRA site; video of the whole day is expected to be up next week. Below is the coverage from Thoroughbred Times and Daily Racing Form. The next post will offer perspectives on regulating race day medications and managing EIPH from vets and horsemen in Ireland, the United States, Hong Kong, and the United Kingdom.

Thoroughbred Times

Trainers, vets on summit panels support use of race-day Salix

RMTC to take industry lead on race day medication issues

Daily Racing Form

Foreign racing officials urge U.S., Canada to ban furosemide

Belmont Lasix summit weighs pros and cons

Lasix talks to resume in July

4 thoughts on “Race Day Medication Summit: Overview of EIPH and its treatment

  1. Steve Byk noted today that while European trainers don’t use lasix for horses on the day they race they frequently train on it. I’m in favor of medication if needed but the underlying physical condition should be treated. Perhaps the real problem is horses not 100 per cent healthy are asked to race instead of being given time off to recuperate and heal.

  2. Pam – I agree. Seems if the horse ‘needs’ the Lasix to race, it shouldn’t be racing at all…

    Teresa – Did they discuss the possible long-term effects of Lasix on bone health?

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