The Battle of Salix - By Eric Mitchell

 (Originally published in the June 4, 2011 issue of The Blood-Horse magazine. Feel free to share your own thoughts and opinions at the bottom of the column.

By Eric Mitchell - @EJMitchellKy on Twitter

By Eric Mitchell Another battle over the medication Salix is brewing. We say “another” because Thoroughbred racing has been wrestling with this drug on and off since the 1970s when there was a mixed bag of prohibition and acceptance among the racing states. New York was the last state to fall, lifting its ban in 1995.
Today, debate is heating up again over the effectiveness of the anti-bleeder medication (formerly known under the brand name Lasix) and more importantly whether it should be allowed on race day since research has shown it is a performance-enhancing drug.

We know this about Salix: It is effective in preventing exercise-induced pulmonary hemorrhaging (EIPH), which is known more commonly as bleeding. Horses with EIPH have their pulmonary systems stressed to the point where capillaries and blood vessels burst, and they bleed through the nostrils. We know from research that racehorses with EIPH do not perform as well as horses without this condition. We also know that using Salix improves performance, which is the reason a maiden claiming race for 2-year-olds June 1 at Delaware Park, shows eight of the nine horses entered are listed as running on Salix and/or an adjunct medication. Actually, for the entire race card, only five of 89 horses entered will not be racing on Salix.

We’re not picking on Delaware Park. These statistics are the same at all North American racetracks.

A study conducted in South Africa—the results of which were published in 2009—was significant because it reaffirmed the drug works to reduce EIPH and that horses on the drug perform better than those without it.

Now what does racing do with a drug that effectively treats a serious condition but is known to influence performance in a sport with legal gambling?

In Australia, all horses can be trained on Bute, Salix, and other medications provided the horses are free of any traces of the drugs on race day.

In France, no medication is allowed whatsoever, even for training. A veterinarian has to prescribe treatment and a set time is established for treating the horse. Any trace of medication found in a horse on race day triggers a disqualification. The testing in France is so good that bloodstock agent Patrick Barbe said, “If there is one drop of Bute in an Olympic-sized swimming pool, they can find it.”

The British Horseracing Authority makes a clear distinction between medication and doping. Medications are permissible during training and have definitive withdrawal times designed to ensure the medication by race-day is at such a low level that it cannot affect performance. Zero tolerance does not apply to these drugs. Doping agents, however, are not allowed in any concentration, and diuretics (Salix) are included on that list along with anabolic steroids and tranquilizers.

But it is not clear-cut, at this point, simply to state the U.S. should adopt the policies of these other racing countries because these locales don’t have any problems with drugs.

Trainer Rick Hiles, a member of the Kentucky Equine Drug Research Council, recently related a story about an individual who asked why a European country had no positives for phenylbutazone, the non-steroidal anti-inflammatory drug called Bute. The drug can be administered no later than 24 hours before a race in the U.S. The reason for the lack of positives, Hiles was told, was that the jurisdiction didn’t test for the drug.

Hopefully an international summit scheduled for June 13-14 at Belmont Park will shed plenty of light on how the U.S. can improve its medication policies and ensure the safety and well-being of racehorses. The summit is being organized by the National Thoroughbred Racing Association, the American Association of Equine Practitioners, and the Racing Medication and Testing Consortium.

The program will include presentations on the current status of medication issues in racing, an overview of EIPH and its impact upon horse health, management and treatment alternatives for EIPH, and testing issues surrounding treatment for EIPH. These topics will be followed by international panel discussions on regulatory issues surrounding race-day medication, veterinary viewpoints on the management of EIPH, and the management of EIPH from a trainer’s perspective. The second day of the summit is closed to the public and media. The agenda for day two is a facilitated discussion among RMTC members and invited guests.

Here’s hoping the summit does not drive only one side of the debate and instead is educational, filling the gaps in everyone’s knowledge about a very complicated subject.
Then, at least when the battle comes, decisions will be made after informed and passionate debate instead of ignorance and fear.

26 Comments

Leave a Comment:

Walt Gekko

This is something that is quite welcome.  In the past, I've noted my own five-year plan to phase out lasix from the sport:

2012: No lasix allowed for ALL two year old races along with the Triple Crown and Breeders' Cup events AND selected Grade 1 events that would include all such races for three year olds preceding the Kentucky Derby along with the Kentucky Oaks, Arlington Million, Jockey Club Gold Cup, Travers, Santa Anita Handicap, Pacific Classic, Joe Hirsch Turf Classic and Beldame among others.

2013: The ban on lasix expands to ALL races restricted to two and three year olds, as well as ALL Grade 1 and Grade 2 stakes events. Three year olds would only be permitted to use lasix when facing older horses in races where lasix would still be allowed.

2014: The ban on lasix expands to include ALL Graded Stakes and non-Graded stakes carrying a purse of at least $100,000. In addition, non-graded stakes where lasix is allowed would be barred from consideration for Graded status at this point.

2015: The ban on lasix expands to include all non-claiming races, including Allowance Optional Claiming and starter events.

2016: Total ban on lasix.

This to me would allow for a phase-out on lasix as well as immediately strengthen the breed and get rid of a good number of the cheaters.

01 Jun 2011 10:28 AM
Rachel NH

What about the serious side effects?

Lasix leaches calcium from the bones...

Lasix causes ulcers and other serious gastrointestinal problems.

Causes increased levels of CO2 in blood, which can cause rapid heart rates, seizures, respiratory failure.

Gee, I'm glad we don't see lots of breakdowns and no horses die from gastro related reasons or simply drop dead during or after a race...oh wait..oh, well, at least it helps bleeders...ummm...unless of course they breakdown, die from ulcer or ruptured guts or drop dead on the track.

And the best part? We get them in the gene pool!!!Yippee, we LOVE the breed!

Also

Causes massive electrolyte loss which takes weeks to recover from...oh, wait, REST for 4 weeks will help a bleeder recover! How coincidental!

Lowers blood pressure.

Can cause Pancreatitis

Jaundice

01 Jun 2011 10:44 AM
GoldenBroom

Enough already. Get rid of the drugs. Forcing a horses kidneys to work extra hard and draining them of water that should naturally be there is just selfish and mean. It doesn't "help" horses...it just allows ones  without natural constitutions strong enough to compete to make a buck or two. It's all bad for the breed. A single bleeder may get forced into pleasure horse-land or end up at the killers. Better that than the breeding shed where they make more bleeders! Same goes for horses with poor hooves, poor skeletal structures that lead to injuries and sore horses, brittle bones and weak joints.

01 Jun 2011 11:41 AM
fb0252

nice balanced post except for one thing--where do u get that lasix improves performance. is your logic because lasix is used it improves performance?  lasix is used to prevent bleeding and control bleeding, period. nobody uses lasix as a performance enhancer, and you'd be quite challenged to find any scientific evidence (other than slight weight loss) to indicate lasix does anything to enhance performance but permit a horse to breathe.

01 Jun 2011 12:13 PM
dixiebandfan

OK, so what about Karakorum Jete. She bled through Lasix, but she's alright. Even with performance enhancement, she's not going to win too many races. Should we blame her dam, Culet? and/or her sire, Dance With Ravens? She's only 3yo, likes to race and isn't likely to be a pet. Lots if not all racehorses will bleed. Fields are too small as it is. As much as it would be nice to have a squeaky clean racing game, the economics would never support it. This isn't Europe. We have to run more often and run on dirt, mud, and in the Winter just to keep the game alive. Golden Broom's comments may be both idealistic and correct, but they don't address the reality that all the horses are bleeders with structural problems, and if it weren't for our selfishness to make them run so we can bet on them and win purses and trophies, there wouldn't be any racehorses. These are not creatures of Mother Nature, they are human creations as expensive toys. Yes, they are sentient beings, and some are quite nice and gentle. But they only exist to race, and, if they qualify, to breed. The damage done by careless breeding may be difficult to undo, and it should be undone if possible. It is probably already too late, however. Lasix and Bute may be necessary evils, but they may be necessary in order to keep racing going. The problem with this argument is that it doesn't address the need to bring more people into the game. It emphasizes our dirty little secret and turns prospective fans into empty seats. We should be talking about how to get people interested. Cleaning up the sport may wind up ending the sport. Be careful what you wish for.

01 Jun 2011 12:32 PM
Steve G

It's getting very scary what people in this industry are trying to do in the way of making life very difficult for the horses.  Lasix is needed for the horses who actually bleed. They don't all bleed, and those that don't, don't need lasix, but those that do, absolutely need lasix, and should have it to race.  I trained horses for a number of years, and discovered whether or not one of my horses was a bleeder, my vet would gladly state that he scoped the horse and it is a bleeder, and get him put on the bleeders list.  He loved the additional income from the administration of the lasix...  The state vets should be the ones who qualify a horse for bleeder medication, not the practitioner who stands to make money off of administering the drug.

It seems lately, there have been some radical knee jerk reactions, in regards to what can be in a horses system when it races, and what cannot.  Two substances that have been outlawed, that should not have been are baking soda, and isoxuprine.  

The only thing baking soda does for a horse is neutralize the lactic acid build up in a horses body.  Some horses bodies do not suffer from the build up of lactic acid and do not need any help neutralizing the lactic acid, but some horses are not so fortunate, and are fatigued by the build up during the course of a race.  The substance doesn't enhance the horses ability to run faster; it only allows the horse to run to it's ability with out suffering from lactic acid build up.  

Isoxuprine is a drug that is very therapeutic for horses with navicular disease.  No way does it enhance performance.  All it does is help increase circulation to the feet.

Following is an excerpt from an equine magazine, and written by a veterinarian.

Isoxsuprine

In one study isoxsuprine was shown to be helpful in the treatment of early NS. This has not been my experience and more recent work is having trouble finding a pharmacological response at published doses. On the other hand the medication is safe and low cost. Along with proper shoeing, isoxsuprine has an overall success rate of over 60%. Proper shoeing alone has a success rate of only 30%. This drug works by increasing the circulation to the bone, so that it may repair and remodel its shape to adapt to changing stress. Dosage should start at 500 mg./1000 lbs. twice daily. The dosage is then adjusted every two weeks depending on response. If sound, the horse is reduced to once daily dosing and then weaned off the drug over the next 45 days. Remember that isoxsuprine is a forbidden substance by the American Horse Shows Association.

Why would anybody with the good welfare of the horse in mind outlaw this substance from use in race horses?!

Those calling for all of this elimination of these so called, "performance enhancing drugs", need to do a very serious gut check.  Much of what they are outlawing are actually very beneficial to the horse.  Outlawing substances like lasix, isoxuprine, and bicarb, (which are not performance enhancing)is only keeping real horsemen, who recognize the therapeutic values of these substances, from doing the best for the horses in their care.

Steve G.

01 Jun 2011 1:44 PM
GoldenBroom

dixiebandfan, I hate to say it but if the industry is in such bad shape that we HAVE to depend on medically propped up horses...I say cut it loose. Yes, cut it loose. The big players will run over seas and we'll still have a few big races here. There will be one generation of horses that takes a hit but the only ones going forward are ones that can compete. Do we really need low level claimers and racetracks that host a couple hundred to maybe a thousand people a day? It's wasted space that can be prime real-estate (whenever the economy recovers). It's meant to be the sport of kings anyway. If it's clean and without (much) scandal and really that good of entertainment (I think so) it will find a way to bounce back and survive. We are not going to attract new sponsers and fans when they can hang Ohio State's Tressel for the acts of others, yet proudly dope our own animals and parade them around like they are something to be admired when they are too fragile to run longer than a year or two anyway.

01 Jun 2011 2:05 PM
JerseyBoy

Why is the statement that Lasix prevents bleeding, repeated so often?. It sounds like a commercial.

Let us just take the efficacy of Lasix as a fact and move on to the next question, namely, is the effect of the drug, on raceday, uniform upon all horses treated? If it is not uniform, how can it be justified for use in an event in which gambling is being conducted?

Secondly, I have read in defense of raceday Lasix, some speculation that horses in Europe probably bleed less because the races there are run more slowly.

This is a fallacy which is being perpetuated to lead the blind. Anyone who knows European racing knows that the times are slower because the tracks are more demanding. They race on watered grass courses, some with an uphill finish. They often employ pacemakers to ensure that the top races are a true test of stamina. Sometimes the tracks are "heavy".

If the races were indeed "slower", American trainers would take their supposedly faster horses and cleanup in the European Group races.

Incidentally, in America, horses run on Lasix when competing over lightning fast grass courses.

01 Jun 2011 2:05 PM
big Cat

I agree with the ban on drugs at race time but only to an extent. A Complete ban with demolish the claiming horse. The people that use the strongest drugs will still get away with it because they are way ahead of the testing game. if you ban bute and lasix it will cull off half of the mid-level operations. The fight is too one sided. A horse that bleeds would be simply worthless. people can believe what they want but there is no such thing as a perfect or a 100% sound horse, and there never will be. that would be nice but it will never happen. These horses need SOME medications. Most of the sneakiest horsemen are from over seas. the grass is not always green on the other side. a 5 year phase out is asking too much too quick look at a 20 or 30 year plan. give the game and people time to adjust not just this generation of horses.

01 Jun 2011 2:09 PM
big Cat

The ones who claim that lasix is killing the horses need to get a little closer to the game. Ive watched thousands of races and never seen a horse drop dead from lasix. Ive owned approx 30 in my lifetime never seen or heard of a horse dying from lasix. The legal drugs are taking blame for what the illegal drugs are causing. Look at all the positive test for severe pain killers, i guarantee only 10% of horses on the drugs get tested, and many slip by the test because they are not thorough enough. we need more consistent and more thorough testing.  

01 Jun 2011 2:17 PM
kincsem

Dixiebandfan - No, they do not exist "just to race or breed". They make perfectly good sport-horses. How naive of you! And, no we don't HAVE to run more often. And maybe the sport needs to consolidate, so there are fewer venues, but larger fields. Gee, we wouldn't want to do anything for the benefit of the animal. Just use them up & throw them away, & in the mean time, if cobra venom makes 'em perform better, let's use that, too...

Steve G - sodium bicarbonate increases blood pressure. It is NOT benign to the horse.

01 Jun 2011 9:15 PM
Walt Gekko

Big Cat:

Personally, I would bar lasix immediately, but that would be unrealistic, hence, why I would go to a five-year phase out, which would give owners and breeders time to adjust.  Starting with the biggest races makes the most sense, especially since for instance in Harness Racing, the Hambletonian (biggest event in that sport) has NEVER allowed horses to race on lasix in that event whatsoever (eliminations or the final).  

Lasix like it or not is considered a masking agent and responsible for many of the problems we have today.  Go back to the '60s when we didn't have lasix and horses raced far more frequently, which continued even into the '80s.  That's why I phase out lasix over five years.

02 Jun 2011 2:55 AM
Rachel NH

I'm not saying it should never be used...it should not be routinely used on healthy or mild bleeders because of the proven dangerous side effects...why would you do that to a healthy animal?

Don't race or breed them....Find another vocation for the horse. Who would deliberately breed a race horse that can't breathe?

PS is dangerous when combined with many antibiotics and great care should be used.

02 Jun 2011 6:39 AM
Jenifer

Seems to me that instead of using Lasix if there are so many bleeders more work should be done on finding out why!  Here in Australia these drugs are banned.  Some trainers do use them in work but run the risk of being tested at any time.  Stewards make surprise visits to tracks & stables.  Seems to work well as racing is thriving & big fields are the order of the day here in Victoria.  They are particularly down on carbed soda.

02 Jun 2011 8:36 AM
Stephi S.

Why would anyone want to give a horse that is about to race a drug that will dehydrate them? Why ask a horse to race after having removed most of the electrolytes and trace minerals from their system? Electrolytes are critical for muscle function, without them muscles don't work properly. This is asking for a bad step, and subsequent breakdown. Why risk kidney and organ failure, or at best, colic?

I hate to be a one-note Nellie, but "back in the day" we managed bleeders with diet and exercise. Bleeders got a lot more jogging than other horses, it kept them fitter in the core which helped with bleeding. We didn't feed any clover hay, and some didn't feed timothy either, since the clover has hooks on the leaves, timothy has them on the heads of the hay, that can be inhaled when eaten and which irritate the airways. Water was pulled a bit earlier than with non-bleeders. And horses were not considered bleeders unless they bled from the nose. No scoping back then. Now if a trainer wants to put a horse on Lasix, or Salix, they have it scoped and if one or two drops of blood are seen the vet can say the horse is a "bleeder". Never mind that all athletes, horse and human, bleed in the lungs a little when highly stressed. A few drops of blood in the lungs is normal after a race and not a sign of a "bleeder". However, these days it's enough to put a horse on Salix.

I have heard trainers say they like to run on Lasix, or Salix, because the horse sheds so much water and the water weighs a lot so the horse doesn't have that weight to haul around the track. Yeah, and its muscles, and organs, are dehydrated and without needed electrolytes too. Good thing he doesn't have to haul that water around, though! Another thing about Salix, or Lasix, is that when it washes the fluids out of a horse, it can also take any illegal drugs with it out of the urine and diminish them in the blood. It used to be used by trainers to mask things they shouldn't be using. It probably still is in some barns.

If trainers would actually train the horses, individually, instead of running an assembly-line type barn, then they wouldn't need drugs to make their horses run well, they would run well off the training. More "bottom" on the horses, ie jogging and long, slow gallops, will do more to prevent bleeding than all the drugs in the world. Now all we have to do is convince the trainers that work and solid training will remove the need for drugs on race day. Good luck with that!!

02 Jun 2011 10:53 AM
Brigitte

Stop the short term thinking!

Giving Lasix to help a horse that can't race without it helps the owner of that horse short term and damages the Thoroughbred long term as more and more bleeders go the the breeding shed. Lasix is a diuretic and flushed other drugs out of the system. It's a multiple whammy for bettors.  

Other posters have mentioned the side effects of Lasix. Remeber Pletcher's comment about Life at Ten? He said she might have had a bad reaction to Lasix.... and if Lasix is bad for bettors the vet expenses of administering it plus treating side effects must be a big hit for the owners.

Stop the short term thinking - stop the race-day drugs.

02 Jun 2011 3:26 PM
papillon

mr. mitchell, can you provide a link to the 2009 article you mention, or its title and author? i would like to read the article, because i agree with fb0252 and doubt that there is any real evidence that it truly improves performance.

what it does is allows a horse with fluid leaking into its lungs to breathe somewhat easier. so yes, if a horse has chronic pulmonary hemorrhaging it will not be able to compete at all without it because it will not be able to breathe effectively. if you give it lasix, which removes the fluid by dehydrating the horse, it can temporarily breathe better and probably seems like a "new" horse, because all of a sudden a horse might like its a runner.

but this is an illusion--the horse is sick and the use of lasix combined with extreme exertion is making the horse worse, leading to scarification of the lung tissue and permanent impairment of the horse's respiratory system (which may be the real reason almost no horses today race after for more than a few years, and race so infrequently).

dehydration has a very profound effect on athletic ability. even mild dehydration greatly reduces performance. forcing horses to run and train at top capacity in a state of permanent dehydration, means that they are probably going to experience more EIPH, rather than less, over the long run, because EIPHis the result of over-exertion (in horses who do not have chronic EIPH) and dehydration makes all exertion more taxing. Chronic EIPH is probably a misnomer and should just be called PH.

My theory is that chronic use of lasix is probably making horses who are not true bleeders into bleeders overtime by forcing them to perform while chronically dehydrated.

horses with chronic EIPH, true bleeders, should never be raced or bred. lasix should be banned for training and racing, and only allowed as medical treatment for horses, who are monitored to insure they are not being forced to physically exert themselves while on it.

the real way to control EIPH is to train and prep in such away that produces horses who are fit enough to handle the exertion of a race. everything we see theses days points to the fact the horses are not ready for their races and not fit enough. maybe racing needs to learn from eventing, and allow horses to mature before forcing them to perform?

finally, jrseyboy is correct in stating that we need to question the premise that lasix cures bleeding--it doesn't. it doesn't prevent or cure the underlying cause of the hemorrhage, it simply helps alleviate one of the symptoms--the fluid build of in the chest. when you take an aspirin for a fever, your fever may go done, and you may feel better, but whatever caused your fever is still there.

dixiebandfan, i think you should be sentenced to reading black beauty once a month until the story's point sinks in--pay particular attention to ginger.

02 Jun 2011 4:47 PM
aspradling
03 Jun 2011 3:10 PM
Your Only Friend

If you cannot train/race without drugs in your horse.......you should get out of racing business. Lets give the betting public a fair shake.

04 Jun 2011 1:14 PM
Your Only Friend

If they do not use drugs of anykind in other countries....and are successful.....why do owners/trainers believe they have to use them USA.....maybe they are not as good of trainer as they want you to believe.

04 Jun 2011 6:48 PM
papillon

@aspradling--

RE: the article from the Horse entitled, "Study: Exercise-Induced Pulmonary Hemorrhage Prevented by Furosemide."

without the actual JAVMA article, it is impossible to judge the conclusions one way or the other. however, it seems probable that if a horse is on lasix, that it will be more difficult to detect if the horse bled or not via tracheal examination, since the basic test for EIPH is to look for signs of bleeding in the trachea, and lasix works precisely by removing these telltale signs from the trachea.

the only way to conclusively determine that EIPH did NOT occur in  a horse on lasix, is either by Bronchoalveolar Lavage (BAL) with Cytopathology or by autopsy. I feel confident they did not perform autopsies and am fairly confident that they did not perform BAL, because it is involved process that requires sedating the horse and because they evaluated the EIPH noticed using the 1-4 scale of a tracheal examination, and not the blood cell ratio of the chest fluid of a BAL examination.

if you don't find blood in the trachea of horse on lasix after a race, it doesn't mean the horse's lung didn't perforate, only that there was no blood present when checked. that could either be the result of prevention, or, more likely, since lasix has no pharmacological means of stopping perforation, it could be the result of the lasix, a medicinal "sponge," doing its job by removing the fluid. if that is the case, the use of lasix is doubly dangerous, because it masks hemorrhages, leading to long term damage of the horse's lung tissue.

RE: the article from "the Horse" entitled, "Furosemide (Salix) Effect on Racing Performance." this study was very poorly designed. it didn't establish proper control groups. instead, it took two groups, group 1, horses running on lasix, and group 2, horses not running on it, and compared their final times. the faster times of the lasix cohort (which were minor in any event) cannot be attributed to the medication, because the study wasn't comparing the controlled times of any individual horses before and after lasix administration.

it is just as likely that the lasix cohort were simply faster than the non-lasix cohort. you cannot conclude that performance is enhanced by comparing two different individuals, because there is no way to account for their inherent differences. moreover, the alomst egligible difference in gelding times, would seem to support my contention that horses are bleeding because they unfit--geldings have no value other than racing--it is arguable they are less "babied" and thus more fit, than breeding stock racers.

very shody, meaningless study.

here's an article for you: www.thehorse.com/ViewArticle.aspx

consider the following quotes from it:

"We are fooling ourselves if we think we can truly prevent bleeding. About the only way to do that is to force them to run more slowly so their blood pressure doesn't get as high and the pressure associated with breathing is also reduced."

"veterinarians recommend resting horses with EIPH to allow the lungs to heal, rather than running the risk of inducing more severe inflammation because of repeated bouts of EIPH."

"Previous studies suggest that EIPH affects virtually all racehorses at one time or another, with its severity varying on a horse-by-horse basis. Another study revealed that 13% of upper-level three-day event horses are bleeders"

only 13% of eventing horses bleed!!!?? so what's going? eventing is an order of magnitude more difficult for a horse than flat course racing is. the physics of lifting 1200lbs vertically over and over again requires far greater lung capacity and aerobic exertion than carrying 1200 horizontally does.

(if you don't believe me, try this--run to the end of your driveway as fast as you can; then set up 4 foot obstacles on your drive way and try run to the end of it as fast as you can while trying leaping vertically over each obstacle (and don't cheat by using the modern hurdler's position, which was created to alleviate some of the gravitational inertia)).

that so few eventers are bleeding may very well be even more evidence that they are better trained and prepared for their exertions than the moder race horse is.

05 Jun 2011 5:39 PM
Vetstudent

@ Stephi S.

While i agree with the most part of your comment i can reassure you that  diuretics DO NOT flush drugs out of the bloodstream of horses, period.

Furosemide does have some diluting effects in urine but on the other hand scientific articles suggest that if the sample is taken three to four hours after the injection, the urine sample will be concentrated with a reasonable amount of drug metabolites.

@ Mr Mitchell

According to a study that took place at Louisville downs by the Ohio State university and the university of Kentucky in the summer of 1977, it was concluded that Lasix could not improve the performance of horses. (Tobin et al. 1977)

05 Jun 2011 7:50 PM
EJMitchellKy

Vetstudent,

I stand by the comment made by Dr. Kennth Hinchcliff, one of the veterinarians involved in the South African study, regarding the ability of Salix to enhance performance.

Hinchcliff told the New York Times: “We know that furosemide is associated with improved performance, and that exercise-induced pulmonary hemorrhage markedly affects race performance. But we didn’t know the answer to the third — and most important — leg of the trifecta: whether furosemide is effective in treating E.I.P.H. We now know.”

The study was conducted on 167 racehorses in South Africa in 2007 by an international team of veterinarians: Morley, of Colorado State; Hinchcliff, of the University of Melbourne in Australia; and Dr. Alan J. Guthrie of the University of Pretoria in South Africa. Each horse in the study raced twice, once after receiving Lasix before the race and once after receiving a placebo.

Results showed that horses were 3 to 11 times as likely to suffer some bleeding while running on the placebo as they were after receiving the Lasix. About two-thirds of the horses that had some bleeding under the placebo had a reduction in its severity when treated with Lasix, the study said.

It also demonstrated how, beyond the prospect of unobstructed breathing, the medication can enhance the performance of a horse. Horses that were treated with Lasix lost an average of 27.9 pounds between injection and a weight measurement after the race, while untreated horses lost an average of 11.9 pounds.

06 Jun 2011 6:50 PM
Karen in Texas

The authors of the 2007 study established the efficacy or "effectiveness" of furosemide for treating EIPH. They apparently felt that this might be construed as an animal welfare issue. I am going to quote from a 2009 article in BH and try to link it as well. "Once the study results are widely circulated, the authors anticipate that some racing jurisdictions may reconsider their ban on the use of furosemide." The upcoming Summit should indeed be enlightening.

www.bloodhorse.com/.../study-shows-furosemide-has-beneficial-effects

06 Jun 2011 8:38 PM
Karen in Texas

papillon---The link to the actual study is inactive from the BH article. I found it by Googling the authors names and the terms "efficacy of furosemide". I'll try to get it to link here.

www.news.colostate.edu/.../4363_1.pdf

07 Jun 2011 11:26 AM
Moodygirl

Thank you Mr. Mitchell for your article, which I am late reading, and all the thoughtful comments. I was pleased that the comments were not just knee jerk reactions but based on actual experience and scientific studies, with references. Again glad someone pointed out not all studies are good science, or using good scientific methods. That's why they need to be judged by other scientists and confirmed with further study before being accepted as fact. As far as EIPH being an inherited trait, I think that has been known for decades. I like to read about the great race horses of the past. In reading Sire Lines by Abram S. Hewitt I know that some great horses were described as bleeders and were known to sire bleeders. These were horses from the early 1900s and I assume before Lasix. If it were not for the medications I am on I could probably remember which ones but I cannot unfortunately. :) No time to research it right now. It is a very complex issue as noted in these comments. It does need a through examination of all the facts and a reasonable solution established for this country and the benefit of our horses & racing. I hope the current symposium contributes a great deal for this plan. One other comment. I HATE that our horses do not have the stamina and hardiness of 50 years ago, but we cannot assume it is just Lasix or other drugs that have caused this. It may be do to many other factors such as the complete change in training methods by most trainers, exporting our best sires and who knows what else. The TB is a closed gene pool so I believe if errors have been made, through proper breeding the TB can be improved. All is certainly not lost!

15 Jun 2011 1:16 PM

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