Friday, June 17, 2011

Lasix: What Is To Be Done?

My previous two posts (here and here) dealt with the scientific evidence regarding Lasix use in thoroughbreds and with the policies of the racing world outside North America. Here’s a brief summary of what we know, as presented at the open-to-the-public Monday session of the NTRA.AAEP/RMTC “Summit” on Lasix:

Most horses bleed.

Very few horses (less than 1%) bleed at a level that seriously impairs their racing ability.

Lasix works; it reduces both the incidence and the severity of bleeding, though it doesn’t eliminate low-grade bleeding.

Horses run better with Lasix than without it; whether you call the drug a “performance enhancer,” “performance enabler,” or “performance optimizer,” horses that get Lasix run faster.

Lasix does not appear to interfere with testing for other drugs.

The rest of this post discusses what the US and Canada, the principal holdouts that allow race-day use of Lasix, should do. Two principal camps have emerged. One, led by the Jockey Club and a number of prominent owners, is calling for the rapid elimination of race-day Lasix. The other, probably representing the majority of US trainers and horsemen’s associations, contends that North America should continue to permit race-day Lasix or even that other countries should also permit it.

(Before going on, I should probably note that my views don’t necessarily – in fact I’m sure they don’t – represent the official views of the New York Thoroughbred Horsemen’s Association, even though I ‘m a member of the NYTHA Board of Directors.)

The horsemen’s case for Lasix appears to have two basic elements. First, they argue, Lasix is actually good for the horse. By reducing the incidence and the severity of bleeding, Lasix spares horses from the pain that severe bleeding inflicts and enables a racehorse to perform up to its potential. Second, the racing environment is so much different in the US, as compared to most of the rest of the world, that’s it’s a case of comparing apples and oranges . In this view, the fact that the rest of the world eschews Lasix has no bearing on what’s right for the US.

What are the merits of these arguments? Of course, all (or almost all) of us in the game want to spare horses unnecessary pain. Most of us are in racing because we love horses; if we were in it solely for the money, there’d be serious cause to question our sanity, as most owners, and some trainers, actually lose money. And the use of Lasix apparently does spare horses some pain, particularly by reducing what would otherwise be painful Class 3 or 4 bleeding, or the even more severe bleeding that’s visible at the nostrils (bilateral epitaxis, in vet-speak) to a milder Class 1 or 2 smattering of blood in the trachea after a race. But if sparing some horses – fewer than 1% show Class 3 or 4 bleeding or bilateral epitaxis in a strict no-Lasix jurisdiction like Hong Kong – then the logical question to ask is why 95% or more of US starters race with Lasix? In most countries that ban the drug, repeated bleeders are simply banned from racing. And in most of those jurisdictions where racing is allowed in training, but not on race day, trainers report that they treat fewer than 10% of their horses with the drug.

As for the argument that racing permits horses to run to their potential, that all depends on how one defines “potential.” In the days before anti-bleeding medication, “bleeders” were shunned by owners and systematically removed from the gene pool. (Of course, not all bleeders were so identified; the great trainer Woody Stephens had his grooms carry a red towel, so they could wipe away the evidence of bleeding before anyone noticed.) And the argument is a slippery one; what about the use of painkillers to permit a horse to run to its potential despite internal warnings that something’s amiss? Bute and other pain meds aren’t permitted on race day in most US jurisdictions, though they're frequently used in training. If Lasix reduces pain in the lungs from bleeding, why not allow drugs that reduce pain elsewhere?

And the gene pool inevitably suffers. As Denis Egan, head of the Irish racing authority, noted at Monday’s drug summit, many foreign buyers and breeders view US-bred thoroughbreds as suspect, and not as sound as their foreign-bred counterparts, despite figures that show that the number of starts per horse per year is pretty much the same all over. There’s also a concern, as yet not proven by scientific research, that long-term Lasix use reduces calcium and therefore leads to more brittle bones. Many US trainers acknowledge a decline in soundness and durability as well. My conversations with Allen Jerkens at the rail of the Belmont training track certainly bear this out; the “Chief” says most current US race horses couldn’t stand up to the intensity of training that he used to give all his charges in decades past. On the other hand, repeated bleeding episodes, which might be avoided with widespread Lasix use, have been proven to produce scarring of the lungs and remodeling of the pulmonary blood vessels, both of which reduce lung function and make a horse prone to even more bleeding.

Regardless of what’s happening elsewhere, horses in the US do run less often and have shorter careers than they used to. Not all, or even most, of this decline can be blamed solely on Lasix. Breeding to sire lines prone to unsoundness (especially Mr. Prospector and Northern Dancer); corrective surgery on foals that don’t look good enough for the sale ring; kid-glove treatment of babies, denying them the opportunity to run around in the field as much as they used to; and trainers’ concerns for a high win percentage to attract owners, thus largely eliminating the old practice of racing a horse into shape, all play a part. And the rapid expansion of the foal crop in response to the boom market of the 1970s and 1980s meant that many more questionable mares were kept in production. But Lasix also enters into the equation. According to data presented at the Summit, bleeding is to some degree an inherited trait, and the more horses whose bleeding was controlled by Lasix go to the breeding shed, the more that trait will tend to appear in subsequent generation.

Despite all those negatives, US trainers’ argument that racing here differs from the rest of the world has some merit. Our industry differs significantly from other countries'. First, we run many more races per year – too many -- with (necessarily) shorter fields. We run much more on dirt, and less on turf, than other countries; it’s plausible that horses’ inhaling dirt and blowback from synthetic tracks leads to more lung problems than racing on grass. We have many more minor-league tracks, where the horse population consists disproportionately of older horses with an accumulation of infirmities; see the all-too-true description of the barely-fictionalized Mountaineer in Jaimy Gordon’s National Book Award-winning novel, Lord of Misrule. We have a lot more owners who don’t have inherited or self-made real wealth and therefore can’t afford to make a small fortune in racing by starting out with a big fortune. The local building contractor who, with a few pals, owns a couple of claimers, or the partnerships that appeal to average race fans, don’t like to see their horses shipped out to the farm for R&R; that means bills to pay with no purse money coming in. We have too many horses, even with the recent reduction in matings and foals crops following the 2008 financial crisis. And, three decades into the legal Lasix era, we have too many trainers and too many vets who’ve never had to manage bleeding without chemical assistance; a lot of lore in the heads of old-time trainers and vets has simply been lost.

For all these reasons, Lasix makes a good bit of sense in US racing.

But we have a problem of political and public perception that seems to me more important than a narrow balancing of the day-to-day pluses and minuses of Lasix. Even though, as reported by the NTRA’s pollster at the Summit, more racing fans today perceive the game as fair, and drug use under control, than was true three years ago, before the elimination of some steroids and the increased concern for track safety in the wake of Eight Belles’ collapse at the end of that year’s Kentucky Derby, drug use is still a huge perception problem. While most sports are seen as relatively clean, horse racing and cycling still carry a stigma, facts notwithstanding.

And the perception can lead to huge over-reaction. The bill currently before Congress that would require horses to race “drug-free,” whatever that means, and impose draconian penalties on even inadvertent violations, is a case in point. If racing doesn’t act, the public will continue to act, by betting ever-less on US racing, and the political system will impose its own over-the-top solutions. What a leader does in this situation is figure out where the followers (in this case the public that still cares about racing) is going and get out in front of them.

Part of the perception problem is that the public and politicians see vets entering horses’ stalls with a Lasix injection and assume that the vet could be giving a whole lot of other meds as well. The New York Racing Association has actually solved that problem by requiring that Lasix shots be given only by the official track vets, and not letting private vets in the stall before a race, but that’s an initiative no one knows about and is hardly likely to change the views who have weak knowledge and strong opinions.

Even if Lasix is good for horses, human athletes run or play through pain all the time; in fact, being able to do that is part of the definition of a great athlete. Humans, as contrasted to horses, are supposed to have some choice in the matter (though try telling that to an NFL lineman trying to hang onto his roster spot). Not all thoroughbreds are great athletes, and maybe some just shouldn’t be racing.

At the Summit, a variety of trainers and vets described training regimens that seemed to reduce the incidence of bleeding without resorting to race-day Lasix. These ranged from training horses away from the race track to at least giving them periodic breaks, both of which reduced the stress induced by full-time residence at the track. Stress levels do seem to be correlated with bleeding. Also, training patterns in most countries appear to involve more stamina work and less high-speed sprint breezes, in which a horse is performing at close to 100% of its potential. Even where horses are stabled at the track, the use of dust-free bedding and other similar management techniques can help ease the problem.

Given the current state of US racing, it’s not economically feasible for all owners and trainers to adopt such measures immediately. Owners at tracks where the win purse is $5,000 can’t afford to take their horses out of training, and trainers whose horses are primarily low-level claimers face the same pressure. Abolition of race-day Lasix might work for the upper end of the business, where owners either make a lot of money with their horses or have a lot of money to take care of them. That’s why the suggestion that graded stakes in the US become Lasix-free isn’t a bad starting point. Trainer Richard Mandella, one of the Summit participants, said he could live with such a ban. So that’s one place to begin. Another is with new two-year-olds. Two-year-old racing has already begun this year, but perhaps, starting with next year’s crop, Lasix could be banned in any race restricted to horses of a particular age: two-year-olds beginning in 2012, three-year-olds in 2013, etc. , for a phase-in period of perhaps five years, by which time most of the Lasix habitu├ęs would be retired. Or perhaps that ban would take effect only at, say, major league and “Triple A”-level tracks, perhaps those offering $125,000 and up in average overnight purses.

Whatever good Lasix does, we’re prisoners of public and politicians’ opinions. If we can’t change them, and the last decade suggests that we’ve had only limited success in that endeavor, than we need to adjust to save the industry. Trainers will need to develop new methods of dealing with bleeding, owners will have to adjust to new patterns for a horse’s career. The status quo regarding Lasix, no matter how justifiable it is in scientific terms, just can’t be maintained.

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