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New Study Finds Horses Racing On Lasix At 62 Percent Increased Risk Of Sudden Death

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by Paulick Report Staff

 

A new study of data from the Equine Injury Database has revealed that horses medicated with furosemide (Lasix) on race day were at 62 percent increased odds of sudden death compared to horses that were not racing on furosemide.

Funded by the Grayson Jockey Club Foundation, the study was published by Dr. Euan Bennet and Dr. Tim Parkin on Oct. 20, 2022, in the Journal of the American Veterinary Medical Association. It examined the 4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the United States and Canada between 2009 and 2021; those numbers represent 92.2 percent of all official race starts during that period.

Of those nearly 4.2 million starts, 536 resulted in a horse’s sudden death, an incidence rate of 0.13/1,000 starts. Sudden death was defined as any horse that was recorded as a fatality within three days of racing, along with one or more of the following fatal injury descriptions or (presumptive) diagnosis, as provided by each participating track to the EID: (1) sudden death (recorded as “SUD” in the EID), (2) pulmonary hemorrhage, (3) exercise-induced pulmonary hemorrhage (EIPH), (4) postexertional distress/heatstroke (PED), and (5) cardiac arrhythmia.

 

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Lasix Mythbusters: Drug Masking, TCO2, And Impact On Racehorse Breakdowns

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by Natalie Voss

 

For decades now, people with an interest in horse racing have had opinions about furosemide, commonly referred to by its trade name of Lasix or Salix. Even now, as its use has been gradually pushed back farther from race time, theories abound on why trainers use it, and how (or whether) it should be used.

But floating about amongst all those opinions are sometimes misconceptions, including one we’ve heard repeatedly at the Paulick Report – that furosemide is used as a masking agent to cover up illegal drug use in post-race testing.

Dr. Rick Sams, former laboratory director at LGC Science, said that under current regulations, that just isn’t possible. Here’s why.

 

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Arkansas Commission Approves Rule Changes On Clenbuterol, Lasix

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During its regularly scheduled meeting on Thursday, Dec. 10, the Arkansas Racing Commission approved 16 rule changes originally proposed by Oaklawn Park and the Arkansas HBPA, reports the Northwest Arkansas Democrat Gazette. Key provisions include the prohibition of Clenbuterol (and other beta2-agonists) within 60 days of a race, reduction in the maximum amount of Lasix without specific veterinary approval, and the mandatory use of safety whips in races.

The Clenbuterol regulations will be confirmed through hair testing, and will also provide for claimed horses to be tested for the bronchodilator, with the ability to void a claim if the claimed horse tests positive.

Lasix administration has been cut by 50 percent, to 250 milligrams, unless the official veterinarian approves a dose up to 500 milligrams. Since the Road to the Kentucky Derby and the Road to the Kentucky Oaks will not award points to horses racing on Lasix, the commission will prohibit the use of Lasix in any 3-year-old stakes race awarding points. These include: the Smarty Jones, Southwest (G3), Rebel (G2), Arkansas Derby (G1), Martha Washington, Honeybee (G3), and Fantasy (G3).

 

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Keeneland and Churchill Downs Reinforce Commitment to Safety with Racing and Training Reforms

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Darren Rogers, Churchill Downs Communications

Keeneland and Churchill Downs today jointly announced major changes in racing and training policies to strengthen safety protocols at both race tracks. Reforms include mandatory veterinary inspections prior to workouts and race entry and enhanced reporting and transparency requirements for trainers and attending veterinarians with regard to the fitness of horses to work and race.

These reforms also apply to horses stabled at Keeneland’s The Thoroughbred Center in Lexington and the Churchill Downs Training Center in Louisville.

In a significant step to promote integrity in racing, Keeneland and Churchill Downs will ban the race-day use of Lasix in all 2-year-old races under the International Medication Protocol authority granted in 810 KAR 8:050 of the Kentucky Administrative Regulations beginning with Keeneland’s 2020 Spring Meet and following at Churchill Downs Racetrack’s 2020 Spring Meet. Kentucky’s Thoroughbred race tracks supported sweeping medication reforms, including the Lasix ban, adopted by the Kentucky Horse Racing Commission (KHRC) in late 2019.

Keeneland President and CEO Bill Thomason and Churchill Downs Racetrack President Kevin Flanery said in a joint statement: “These meaningful reforms further advance our commitment to create the safest possible environment for racing and training. Race tracks, horsemen and the veterinary community share a responsibility for the welfare of our human and equine athletes and to promote the sport for generations of fans to come.”

Changes will become effective with the opening of the stable areas at Keeneland and Churchill Downs. Trainers and attending veterinarians must agree to the following conditions in order to participate in the racing programs at either track:

A trainer is not permitted to enter a horse in any race unless the horse has been found fit to race by the attending veterinarian during the three days immediately prior to entry, and

A trainer is not permitted to work a horse unless the horse has been found fit to work by the attending veterinarian during the five days immediately before the work.

Trainers and attending veterinarians are obligated to inform the equine medical director at the appropriate race track and the KHRC of any changes in a horse’s fitness after an examination has been conducted.

Additionally, all horses at Keeneland and Churchill Downs will be subject to veterinary inspections by the tracks’ respective equine medical directors and to veterinary monitoring.

More Than 600 Stakeholders from Across the Racing Industry Sign Public Letter In Support of Protecting Lasix as a Choice on Race-Day

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LEXINGTON, KY (Friday, Sept. 20, 2019) – A unified industry group believes banning Lasix will adversely impact the health and welfare of racehorses, as well as the strength of our industry. Today, a letter (posted below) was released with more than 600 signatures in support of protecting Lasix as a choice for horsemen and veterinarians to administer on race-day for the well-being of equine and human athletes. The initial round of signatures from racing stakeholders features individuals from across the industry. Signatures will continue to be collected going forward. Click here to be added to the list.

Public Letter on Stance to NOT Eliminate the Choice to Administer Lasix on Race Day

A recent open letter proclaimed that “horse racing is at a pivotal moment in its long history in the United States.” On this we agree. We also agree all of us love and cherish the equine athletes upon which our industry is built. To that end we believe in practicing the highest standards of horsemanship, and we continually work to improve the care, health and safety of our thoroughbred racehorses.

In that regard, we support horsemen and our veterinarians having the continued option to run a horse with a race-day administration of the therapeutic and protective medication furosemide (Lasix).

We, too, are ready for change and will eagerly embrace change if the alterations are done for the greater good of equine health and welfare. We are committed to reforms emphasizing transparency and developments that will address misunderstandings from those in the non-racing public as well as ensuring our horses are treated with the highest degree of care. The eradication of our choice to administer race-day Lasix will not do any of those things.

It is our belief that banning Lasix will adversely impact the health and welfare of our racehorses as well as the strength of our industry. Research also proves an increased number of horses will bleed significantly out of their nostrils, or into in their lungs, and an increased number will die.

We understand and agree things can and should be done to improve the safety and welfare of our equine athletes. It is just as important to understand what is NOT causing catastrophic injuries, as it is understanding the underlying causes. Many continue to claim Lasix will interfere with post-race drug testing due to dilution, but this argument has long been disproven. Lasix is a short-acting diuretic and the dilution effect is gone in two hours. However, the tightly regulated administration of Lasix is required four hours before a race. Thus, Lasix has no ability to interfere with blood or urine testing after a race.

No one takes our stance on this position casually, but we believe we must not be led down a path created by perception and not facts. For this reason we must stand for what is in the best interest and safety for our equine and human athletes.

This letter includes an initial round of over 600 signatures from racing stakeholders and signatures will continue to be collected going forward. Click here to be added to the list.

Signatures include the following: Rusty Arnold; Steve Asmussen; Buff Bradley; Bret Calhoun; Anita and James Cauley; Dr. Nancy Cole; Brad Cox; Boyd Caster; Wayne Catalano, Jake Delhomme; Michael Ann Ewing; Greg Foley; Vickie Foley; Tim Glyshaw; Larry Jones; Dallas Keen; Marshall Gramm; Dr. Chuck Kidder; Mike and Penny Lauer; Mike Maker; Ron Moquett; Randy Morse; Maggi Moss; Loren Hebel Osborne; Joe Orseno; Joel Politi; Allen Poindexter; Louis J. Roussel III; Clay Sanders; Chester Thomas; Mike Tomlinson; Tom Van Berg; Kelly Von Hemel; Gary and Mary West; Ian Wilkes; Jack Wolf; Erv Woolsey.

The entire list may be viewed as a PDF file and can also be found at this link (list updated as of 9/20/19):

National HBPA Opposes Senate Introduction of the Horseracing Integrity Act (S. 1820)

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The National Horseman’s Benevolent and Protective Association (HBPA) announces its opposition to the Senate version of the Horseracing Integrity Act (S. 1820), introduced last week by Sens. Kirsten Gillibrand (D-NY) and Martha McSally (R-AZ). On behalf of Thoroughbred race horse owners and trainers, the HBPA has been steadfast in its opposition to the House companion measure introduced earlier this year by Reps. Paul Tonko (D-NY-20) and Andy Barr (R-KY-06) (H.R. 1754).

“Senator Gillibrand and Senator McSally have clearly been misguided. Banning race day Lasix will cause more equine deaths, and additional regulations will cause jobs to be lost,” stated Eric Hamelback, CEO of the HBPA.

The HBPA fully supports the veterinary community and the science on which they base their opinions. Under S. 1820, owners, trainers, and veterinarians would no longer have the choice to utilize the therapeutic, legal medication furosemide, more commonly known as Lasix. Lasix is used in horses to control or prevent Exercise Induced Pulmonary Hemorrhages (EIPH), or “bleeding” and has been used safely and humanely for the last 40 years in American horse racing. Horses often experience EIPH episodes during intense exercise, such as during races. Current industry policy endorses and strictly regulates the use of this medication on race day because it is in the best interests of the health and welfare of the horse.

“If Lasix is completely banned the number of fatalities on race tracks throughout the country will increase. While we are committed to finding answers that will prevent, reduce, and solve the occurrence of any fatality for our thoroughbred athletes, this bill is NOT the answer.” said Hamelback.

Also, the HBPA has deep concerns about the additional fees and costs that S. 1820 would place on those in the horse racing industry. For the smaller industry folks, these new fees will be the tipping point that pushes them out of the business. While wealthy owners may not feel the pinch, rural and agrarian jobs will be lost, and lives will be devastated. This loss of income will have a rippling effect on state and local economies that depend on the industry.

Hamelback believes the introduction of this legislation is a misguided attempt to address the recent equine deaths in California: “S. 1820 would not have prevented one single death. My members are as concerned as any about the recent tragedies in California, and we agree more independent research needs to be done to discover the cause of these deaths. However, implying that the racing industry is rampant with doping and that this legislation is the solution is completely wrongheaded.”

The HBPA strongly opposes the Horseracing Integrity Act and encourages industry participants to voice their opposition by contacting their representatives in Congress.

Thoroughbred Idea Foundation: Calling for a Racing Industry Compromise

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The sport which brings us together is at a turning point. We have been divided for far too long on a variety of issues that impact our business. Most notably, the “Lasix debate” has been a debilitating one, inhibiting our collective ability to move ahead. The time has come for the industry to compromise – working together with all major constituencies to establish a mutually-agreed, new way forward.

The recent announcement from a coalition of racetracks to introduce changes to their house Lasix policies was met with a series of statements from certain stakeholder groups restating their long-held positions. Compromise is essential. Absent a compromise, binding mediation should be considered.

“In my many years in this great sport, I have never seen racing more at risk than it is right now,” says B. Wayne Hughes, owner of Spendthrift Farm. “We have far too much at stake to continue being tied down in separate bunkers and not finding a way forward. The time for a compromise is now.”

As major stakeholders, we believe the only way to grow revenue for the industry’s obligations – among them, aftercare and backstretch programs, equine research, jockey insurance and prize money – is through the growth of the sport’s overall “pie.” If our industry can collectively agree to compromise, we can finally move ahead together and address other meaningful issues that have inhibited growth in the sport for far too long.

While racing has some long-standing traditions which have shaped our collective experience, nothing is set in stone. Let’s embrace that freedom to redefine the future.

Our sport has recently been challenged in a manner that requires bold, serious and innovative action. But the longer-term reality should not be ignored, either. Foal crops are at 50-year lows. Handle is down close to 50%, adjusted for inflation, over just 15 years. Though tougher to measure, the social license racing enjoys is also questioned now more than at any point in recorded history. We must adapt to this, better exhibiting to the world – not just ourselves – the outstanding care our horses receive, and their majestic, innate desire to compete.

We must unite and emerge stronger – for the horses, for our passion, for the future.

Since our organization’s launch last summer, we’ve presented four substantive white papers tackling topics related to improving our sport’s approach to pricing, transparency, product development and access to information. Now is the time to present a fresh approach to racing. We have enlisted five industry leaders to present their take on improving different segments of racing through new approaches to long-stagnant “offices.” Their ideas will be released over the next two days.

– Wagering and Innovation: Marshall Gramm (chair of Rhodes College economics department, co-founder of Ten Strike Racing)

– Racing Administration and Planning: Rick Hammerle (long-time racing official, including 20 years at Santa Anita as racing secretary and vice president of racing).

– Integrity and Welfare: Maggi Moss (attorney, major horse owner, leading aftercare advocate)

– Communications and Marketing: John Sikura (president of Hill ‘n’ Dale Farm)

– Owners’ Services and Recruitment: Brad Weisbord (founder of BSW Bloodstock, ELiTE Sales)

Presented with an opportunity to re-shape our industry and mindful of our precarious position, these suggestions should be met with open minds. Our interest in a healthy thoroughbred industry is shared. The process to achieve these much-needed improvements remains rooted in compromise, with all stakeholders understanding that once-entrenched opinions must be loosened in order to establish a modern sport.

In the recently-published words of billionaire investor and philanthropist Ray Dalio, “collective decision making works much better than fragmented individual decision making so I urge you to understand it and employ it. If you don’t, you will be left behind.” Our future, as projected by five industry leaders, could be so much brighter than our past if we can collectively move beyond that which has divided us for so long and work together. Join us in this quest!

Industry Reaction To Racetrack Coalition’s Proposed Partial Phase-Out Of Lasix

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by

 

Reaction was mixed to the announcement on Thursday by a coalition of U.S. racetracks to partially phase out race-day administration of the anti-bleeding diuretic furosemide (Lasix), beginning with 2-year-olds racing in 2020 and in stakes races beginning in 2021.

Those supporting the initiative include all tracks owned or operated by Churchill Downs Incorporated (CDI), the New York Racing Association, Inc. (NYRA) and The Stronach Group as well as Del Mar, Keeneland, Lone Star Park and Remington Park, Los Alamitos Racecourse (Thoroughbreds), Oaklawn Park and Tampa Bay Downs. Breeders’ Cup Limited, the Thoroughbred Owners and Breeders’ Association (TOBA) and its American Graded Stakes Committee and the Kentucky Thoroughbred Association also signed on in support of the proposal.

 

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Racetrack Coalition Moves Toward Lasix Ban in Stakes

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Fair Grounds among Twenty Racetracks Committed to Ending Race-day Lasix in stakes in 2021.

 

A coalition of leading Thoroughbred racing associations and organizations announced April 18 a new initiative committed to phasing out the use of the medication furosemide (Salix, commonly called Lasix) beginning in 2020 and eliminating the use of Lasix in stakes races at their tracks beginning in 2021.

Coalition racetracks that have signed on to this initiative include all tracks owned or operated by Churchill Downs Inc., the New York Racing Association and The Stronach Group as well as Del Mar, Keeneland, Lone Star Park, Remington Park, Los Alamitos Racecourse (Thoroughbred meets), Oaklawn Park, and Tampa Bay Downs. Taken together these tracks represent 86% of the stakes races assigned graded or listed status in the United States in 2018. The coalition tracks will work diligently with their respective horsemen’s associations and racing commissions toward implementing this effort.

To Read BloodHorse Article

Lasix Study Backs Four-Hour Administration Time

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Pair of Lasix studies of interest outline results.

A study that has some potential to reshape the timing of Salix administration ahead of racing determined that the current four-hour timeframe is more effective than administering 24 hours out in reducing the severity of exercise-induced pulmonary hemorrhage.

The study, led by Dr. Heather Knych, was one of two studies on Salix (furosemide, commonly referred to as Lasix) with results outlined at the American Association of Equine Practitioners convention in late November. The other study, led by Dr. Warwick Bayly, found some potential for a low dosage of Salix 24 hours out combined with controlled access to water in reducing EIPH in racing.

The Paulick Report first posted a story on the results of both studies Jan. 30.

According to the AAEP’s 2017 Convention Proceedings document, the study by Dr. Knych of the Ken L. Maddy Equine Analytical Chemistry Laboratory looked at the efficacy of administering Lasix 24 hours out, instead of the current four hours out called for in racing’s model rules. The study concluded that administering furosemide four hours before a race was more effective in reducing the severity of EIPH than going to 24 hours out.

The Knych study saw 15 Thoroughbreds administered furosemide either four or 24 hours prior to a five-furlong simulated race. Blood samples were collected before and after the simulated race for determination of furosemide, lactate, hemoglobin, and electrolyte concentrations.

One hour after the race, an endoscopic exam and bronchoalveolar lavage (BAL) was performed. Horses were assigned an EIPH score based on previously published criteria. The number of red blood cells in in BAL fluid was also determined.

“There was a statistically significant difference in EIPH scores between the four-hour and 24-hour furosemide administrations,” the study determined. The study noted that none of the treatments prevented EIPH in the horses but that reducted red blood cell counts in bronchoalveolar fluid post-race indicated that administering furesomide four hours before a race was the most effective.

According to its introduction, the study came together following anecdotal reports that suggested furosemide administration 24 hours prior to strenuous exercise could be equally effective at decreasing EIPH.

The United States is one of the few countries that allows the raceday administration of Lasix. A study showing efficacy in preventing EIPH at 24 hours or beyond had potential to reshape current raceday policy of administration four hours before the race.

In the study led by Bayly, it was determined that a 0.5 mg/kg administration of furosemide 24 hours before strenuous exercise combined with controlled access to water shows potential for reducing the severity of EIPH.

The study used six horses who underwent treadmill exercise to fatigue after seven different protocols that adjusted the dosage amount of the Lasix and timing of the administration. The study concluded that, “Furosemide, 0.5 mg/kg, combined with controlled access to water, significantly reduced the severity of EIPH,” adding that, “No ill effects were detected in the horses.”

In its AAEP presentation outline, the study noted that “Although the findings were promising, the number of horses used was small. The effects of furosemide on water and ion excretion were evident for 24 hours but did not adversely affect the horses, likely because of increased absorption of wager and ions from the colon.”

In September 2015, Grayson Jockey Club Foundation announced it had launched funding of the two projects. The AAEP also played a prominent role in funding the projects, along with a number of racetracks.

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