When Will Lasix-Free Horse Racing Come to Pass?

The Horse Racing Industry Integrity Act, or H.R. 1754, seeks to create a uniform national standard for drug testing in racehorses. Introduced by Democratic representative Paul Tonka (Sarasota Springs, NY) and Republican representative Andy Barr (Lexington, KY), the bill proposes that all animals-in-sports drug tests would be overseen by the U.S. Anti-Doping Agency – the national anti-doping organization in charge of all American Olympic, Paralympic, Pan American, and Parapan American drug testing.

Although it has yet to be approved and may not pass in its current form, the bill also aims to ban the pre-race use of furosemide in 2-year-old horses and graded stakes races beginning in 2020.

Furosemide, under the brand name Lasix, has officially been part of the North American horse racing scene since Maryland permitted its use back in the mid-1970s. Outside of North America, furosemide has faced stiffer opposition. Lasix is banned on race days in most jurisdictions and in some nations, such as Germany, horses that race on Lasix are not approved as breeding stock.

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Despite usage approval in North America, Lasix has continued to be controversial and that controversy has only grown due to the well-publicized spate of fatalities at Santa Anita. Since December, 2018, a total of 37 horses have died as a result of catastrophic injuries suffered while racing or training at the California track.

Mainstream media reporting has echoed criticisms by many in the racing industry that drug rules need to be reformed in order to prevent more deaths. In response, the Stronach Group, which manages Santa Anita, has introduced a number of measures to improve racing safety – one of which is a mandated reduction in the race-day dosage of Lasix.

The move has been heralded by some industry insiders as a step in the right direction, but critics say Lasix is being used as a scapegoat that simply satisfies the media narrative equating Lasix with illegal drugging. By reducing dosage levels or banning pre-race Lasix, they argue, more racehorses will suffer severe respiratory complications.

Furthermore, any move to reduce the use of Lasix simply confirms anti-horse racing advocates’ claims that horse racing is rife with chronic doping and animal abuse.

As Rood and Riddle Equine Hospital’s Dr. Larry Bramlage has previously stated, the American public are adamantly against drugs but can’t tell the difference between abusing street drugs like heroin and using therapeutic pharmaceuticals like Lasix.

Saviour or scapegoat; permitted or prohibited: the ongoing problem with Lasix is that it does exactly what it was designed to do.

Originally developed for human use as a treatment of hypertension and edema caused by congestive heart failure or chronic kidney disease, Lasix is used in horses to prevent respiratory bleeding.

“Bleeding” is the common term for exercise-induced pulmonary hemorrhage (EIPH). Although the condition can happen in high performance athletes of any species, in horses, EIPH is believed to occur when powerful and rapid inhalations and exhalations increases the pressure and volume of both blood and air to such a high level that blood vessels in the lungs rupture. A small number of horses with EIPH will bleed from the nostrils.

According to veterinary researchers, the condition has been documented in racing horses for over 300 hundred years and anywhere from 55 to 95 per cent of thoroughbred racehorses experience some level of EIPH during their careers.

Stallions seem to experience EIPH at a lower rate than mares and geldings, and the severity of bleeding tends to increase with a horse’s age, its racing mileage and the speed at which it is trained and raced.

Lasix works to prevent bleeding by lowering systemic blood pressure through the removal of excess fluids and salt. It does so by causing the kidney to increase urine production – effectively causing temporary dehydration. Prior to furosemide, lowering blood pressure through dehydration was achieved by taking horses off food and water for 12 to 24 hours before racing.

Whether pharmaceutically induced or the result of temporary starvation, mild dehydration can help a horse run faster. Excessive fluid loss, on the other hand, can have the exact opposite effect by depleting critical energy reserves. This means depending on the amount administered and the timing of the administration, Lasix could potentially enhance a race performance and/or cause a significant electrolyte imbalance.

Since the correlation between high speeds and catastrophic fractures in racehorses has been established by medical research, it can be argued that Lasix increases the risk of catastrophic injuries – IF administered only pre-race. By removing excess fluids for racing, a horse will theoretically be able to run faster than it has during its non-Lasix training sessions and therefore, be more prone to breaking down.

To avoid this scenario, Lasix would have to be administered prior to every workout. Unfortunately, constant Lasix use carries its own risk. Not only is there the very real possibility of kidney damage, but frequent dehydration can cause mineral and electrolyte depletion. Such depletion reduces available energy, increases fatigue and delays recovery time. Additionally, the causative link between fatigue and tendon and muscle injury is well-known, so arguably, frequent Lasix use may increase the probability of serious tissue damage and injury.

Yet EIPH remains a serious concern. So, what options is the industry left with if a full Lasix ban comes into effect?

There are studies that suggest the severity of the condition may be mitigated in young horses, or in horses that have experienced only a “light” bleeding episode through the targeted and timely use cortical steroids or medical inhalers. Such a solution might not be a viable option during a racing campaign depending on the drug rules and testing procedures in various jurisdictions.

Some trainers, such as Florida’s Stacy Lane Hendry, are advocating for a return to “old-school training methods.” By old-school, Hendry means racing the majority of his horses Lasix-free and getting each animal fit to run farther than an actual race would require. Hendry believes his 22 win per centage and 42 per cent in the money in 50 starts is also due to fewer short breezes.

Scientific research suggests that sound training practices aimed at preventing EIPH, or reducing its severity, should not only include training for ideal racing distances but limiting racing to distances and timelines according to individual development regardless of human ambition or horse pedigree.

In other words, train the horse you have, not the horse you wish you had.

Crucially, an appropriate rest period should be allowed following an episode of EIPH. Not only does this provide the opportunity for blood to clear and the lungs to heal, but over-taxing the airways after a bleeding episode only worsens the condition.

Stabling environments, dust-free feed and bedding are also important. Other environmental factors to keep in mind are temperature and humidity levels during training sessions, and since many U.S. and Canadian racetracks are located near heavy traffic corridors, ground ozone and air pollution levels.

And, if all else fails, there is the simple nasal strip. As a 2016 US study out of the College of Veterinary Medicine at Kansas State University proved, horses wearing a nasal strip achieved a 3.4 higher win percentage than their non-strip-wearing counterparts and the nasal strip reduced the between-race interval from 29 to 23 days.

Moreover, there are no current Congressional bills banning nasal strips – at the moment.