Anyone who?s dealt with an unsound horse, probably battled the decision on whether it’s OK to continue using that horse, keeping him sound with the help of drugs and other therapies, or to retire him. You likely consulted your trainer and veterinarian, weighing the pros and cons of various treatments, the effects on and risks to the horse, and the wisdom of using
a pain-masking drug.
Along the same lines, you may have wondered about the integrity of an international competitor who was eliminated due to a positive drug test. Sometimes, the drug clearly made a difference in the horse’s performance and that competitor ?cheated.?
Other times, though, the amount of the forbidden substance found was far too tiny to have any effect on the horse, a leftover from a legitimate therapy. But this is what happens with zero-tolerance drug rules, and it can be heartbreaking. Clearly, sensible rules were needed, but whether or not we’re going to get them is debatable.
The FEI Vote
On Nov. 19, the General Assembly of the Federation Equestre Internationale (FEI) passed regulations including a new ?progressive list? of permitted medications for horses competing in FEI-sanctioned international events. These drugs include phenylbutazone (?bute?), salicylic acid (aspirin) and flunixin meglumine (Banamine).
The new list passed the vote by a narrow margin, although it appeared that some members felt it was presented in an obscure way, stating they didn’t fully realize what they were voting for. Requests for a second vote were refused. A sharp divide in the member countries ensued and spilled over into the equine community in general.
The U.S. Equestrian Federation (USEF) supports the move, which isn?t surprising as they have an even more liberal policy toward these drugs. The British Equine Veterinary Association (BEVA) condemned the action, as did Leo B. Jeffcott, the former chair of the FEI Veterinary Committee and an internationally renowned veterinary researcher. Jeffcott?s letter was cosigned by 15 other prominent veterinarians and current and past FEI officials.
Even supporting associations, such as our USEF, expressed concerns about the January start date, stating issues such as need to standardize laboratory procedures.
The passage also produces problems for competitions within nations that have a no-drug policy. Some have expressed concerns that sponsorships may be jeopardized by the change, while others worried about the image of the FEI as a result of this change. In response to the firestorm, the FEI issued a decision to postpone implementation from January 1, 2010, to at least April 2010.
The Horse?s Welfare
Money and sponsorships aside, the overriding point of contention is the use of pain-killing drugs in competing horses and the welfare of the horses. Proponents of the drug-rule change claim the allowed levels wouldn?t mask a severe lameness. Jeffcott, though, points out the proposed limit of 8 ug/mL is four times what the permissible level was before the FEI moved to their zero-tolerance policy in 1993.
Proponents of the rule say the zero-tolerance policy prevents them from using necessary drugs in legitimate circumstances. The definition of ?zero tolerance? is that the horse may not test positive for any level of any drug found. Of course, a negative test doesn’t necessarily mean there are no drugs in the horse. It just means the test can’t detect any.
Exactly how much drug might go undetected depends on the sensitivity of the test. For a drug like phenylbutazone, used at fairly large doses compared to some other drug classes and readily detectable on screening, zero-tolerance translates to the horse not having received bute in the three to five days prior to competition, if the testing method used is chromatography.
For us, the disturbing part of this controversy surrounds the NSAIDs (non-steroidal anti-inflammatory drugs, like aspirin and bute) that were included in the list with the idea that these drugs were somehow therapeutic or ?restorative.? However, any vet will tell you that NSAIDs aren?t healing. They do little more than mask pain.
A growing body of evidence has found negative effects of NSAIDs on joint cartilage and bone metabolism, to the point that human orthopedic surgeons routinely advise against their use prior to and following surgery because of the negative effects on healing. Preliminary work on equine tissue has confirmed these findings (May 2000, December 2001 American Journal of Veterinary Research). Their use by human athletes is under scrutiny because of these issues.
The dosage of phenylbutazone doesn’t determine the potency of its pain-relieving effects. The blood level does. The blood-level ceiling being suggested by the FEI is well within the level
known to effectively mask pain. If the drug was administered according to guidelines, 1 gram at 12 or more hours before competition, the blood level would be much lower.
it’s ridiculous to expect athletes of any species to be fully injury- or arthritis-free. If a human athlete feels pain and chooses to take a pain-relieving drug and continue on, then so be it. Hopefully, he or she has sense enough to get a firm diagnosis and ask about the consequences of continuing the exercise. With our horses, there’s much more involved than how much pain-masking effect the defined dosage would provide on that day.
Competitors who are concerned about zero-tolerance policies that result in positive tests on non-therapeutic tiny amounts have a point, but the solution isn?t to permit therapeutic levels of drugs during competition. Ultrasensitive ELISA tests are needed for drugs that don’t produce high circulating blood levels and for drugs whose effect is still present even when circulating levels are low, like the long-acting tranquilizers. These aren?t the drugs we think are at the crux of this controversy. it’s those pain-masking NSAIDs.
We believe a sensible middle ground would be to return to thresholds that clearly aren?t in the known therapeutic range for these drugs. The high ceiling this new FEI rule allows leaves the door wide open for abuse. We believe this rule has the potential to lead to escalated use of NSAIDs between competitions and the use of higher levels much closer to competition. The FEI needs to reconsider their stand and the horse welfare issue.
Editor?s Note: We will keep you up-to-date in Horse Journal as this controversy continues. For even more timely news, check out Performance Editor John Strassburger?s weekly blog at: www.myhorse.com/blogs.
Article by Horse Journal staff.