In horse racing, where opinions are a many, and frequently heated, there is perhaps no more passionate debate in the interests of the betterment of the sport than the role of medications in racing.

It’s an issue that has played out in tribunals and courtrooms in every racing jurisdiction in North America. The United States Congress has been lobbied to pass the Horse Racing Integrity Act, a push for uniform medication rules across every region of racing in the United States.

Even Buckingham Palace, the bastion of propriety, was sent off kilter when The Queen’s mare Estimate, tested positive for trace amounts of morphine after running at 2014 Royal Ascot and had to forfeit her second-place prize.

At stake is not just whether race-day and therapeutic medications are necessary, but whether testing is doing its job of weeding out the horsepeople who attempt to skirt the system to give their horses an edge. And how drug use and the industry’s on-going struggle to clamp down on cheaters affects the public’s perception of the sport.

On one side, there’s advocates for the ‘water, hay and oats’ movement, a strategy that mimics the European perspective to race-day medications, who support the ban of in-competition drugs like Lasix, and work towards zero-tolerance philosophy for therapeutic drugs.

On the other side, horsepeople and veterinarians believe equine athletes require raceday meds and therapeutic drugs to treat the rigours of racing and to perform at their best.

Other equine medicine professionals feel horsepeople compelled to ‘cheat’ are constantly on a mission to outsmart the testing laboratories, so drug testing must be hypersensitive if they want to have any chance at keeping pace with these people.

Yet it is argued, such strident testing does not take mitigating factors like contamination and anomalies in withdrawal times between horses into enough consideration, and good horsepeople are being unjustly punished for circumstances beyond their control.

Thus, while drug testing is meant to be a black or white issue, it in fact remains very grey.

Overly sensitive

Dr. Steven Barker, the former director of the Louisiana State University Equine Medication Surveillance Laboratory and state chemist for the Louisiana State Racing Commission specialized in environmental contamination throughout his career.

He says equine drug testing has evolved to catch the tiniest traces, right down to the nanogram, of substances, but many racing commissions are not clear how to interpret those results.

“This is a problem of sensitivity. The labs have gotten better and better,” he said.

“But the real problem is there’s no one between the laboratories that generate that data and the commissions, which take the data and assume it’s a positive and that someone should be punished.

“What’s really lacking is someone in between to say that is not consistent with the administration of the drug to in any way affect the performance of the horse.”

It’s important to remember that Barker practiced in the United States.

In Canada, the Canadian Pari-Mutuel Agency’s (CPMA) Equine Drug Control Program sets the protocols and conducts testing for pari-mutuel horse racing in the country. Dr. Carolyn Cooper, director of the program says that the CMPA operates in “a real partnership” with the provinces to establish baselines and enforce rules.

The CMPA does not dish out punishments: that’s up to the provincial racing commissions, she said. The agency’s job is to simply to run tests to detect the drugs, and if an illegal positive is found, they then notify the commission.

As part of the program, the CPMA published “elimination guidelines” with dosage recommendations and estimated withdrawal times, to offer trainers and veterinarians an idea of the approximate amount of time some commonly-used therapeutic drugs will be detected in the blood and urine of horses.

It is noted in the guidelines, which are available online, that “the approximate nature of the data is stressed.”

Dr. Brett Anderson, a practicing veterinarian in Port Hope, ON, and a member of the Alcohol and Gaming Commission of Ontario’s drug testing panel, considers himself “way to the left” in the debate about the need and role of medications in horse racing and feels Canada is getting it right with the stridency of its testing.

“It is my opinion that the testing protocol at the CPMA is very fair,” he said. “They allow lots of room for error… So if they establish an elimination time, they allow extra, just to ensure they don’t get false positives.”

Thresholds

Not every horse that raced on any given day is drug tested. Racing stewards and judges select horses to be tested. Those horses must immediately report to the track’s test barn where officials will draw a urine or blood sample from the horse to be sent for tests.

According to Dr. Cooper, director of the CPMA’s Equine Drug Control Program, the agency tests three ways: Qualitative testing, quantitative testing with the screening limits (i.e. buffers for ‘sensitivity’) and zero tolerance (i.e. anabolic steroids which are illegal and should not be in a horse’s system at all).

Qualitative testing has thresholds, meaning: is the drug there and does it exceed the legal amount? This type of testing is done for all drugs except for four: Lasix, cobalt, Procaine and salicylic acid. For those drugs, the CPMA has determined it’s important to know exactly how much is in a horse’s system. Cobalt and salicylic acid are naturally in a horse’s system, but higher than normal levels are considered performance enhancing. Procaine is a penicillin, and there is a rule that if a horse has been given penicillin, a trainer can declare it 30 minutes out and is given a bit of leeway in terms of testing. However, there is still a limited amount allowed, even if the horse tests over. Lasix has limits to ensure horses haven’t been topped up on it outside of what was administered by a commissioned veterinarian.

Cooper says the amount they test for is written in the rules, which are published.

“When we tests for those four drugs, we test exactly how much is in that sample and if a positive certificate is issued, that amount is listed on certificate,” she said. Those tests are performed in a special, isolated lab, which is locked, and only accessed by one person at any one time.

“That type of testing is time consuming, complicated and really expensive.”

The qualitative testing on the other hand is “more practical,” she said.

“So what we have implemented is screening limits,” she said. “(We) set a lower limit on the sensitivity of testing. We pick a level, anything below this level, we’re not calling it a positive. We know it’s there, but we’re not calling it a positive.

“Because it’s not exact, we do add a buffer.”

Environmental Contaminates

In 2008, Barker piloted a study on the barns on the backstretch of a Louisiana racetrack and found low levels of therapeutic drugs everywhere including on stall walls, in the rafters, in horse’s bedding, not to mention they also found traces of cocaine, methamphetamines, and amphetamines and blood pressure medications.

Environmental contamination, he explained, can happen in any number of ways — both from horses and humans. A major source of contamination is urine. It is possible he says for a horse to contaminate and recontaminate itself if it eats its bedding, which may contain some of its own medicine-infused urine. Or, if a human urinates in a horse’s stall (more common than you think, says Barker) and if they have drugs in their system, then they have just contaminated that horse’s environment.

“Somebody needs to review the data and look at the pharmacology of the drug and look at how it’s used and look at how people on the backside of the racetrack have been prescribed this drug, or had it in their possession and handled the horse and get all the facts before they actually accuse anyone of violating the rules,” he said, explaining that some jurisdictions only do that for certain classifications of drugs.

“That’s the biggest flaw. They need to do that for all levels of drugs. There are not enough racing jurisdictions that do.”

Anderson recognizes that contamination muddies the waters to a certain extent in drug testing, but remains cautious that the claim “environmental contamination” can be used as scapegoat, too.

“Contamination does occur, that is well supported in the literature,” he said. “The problem is that the concept of contamination is being abused by horsemen who have positive tests.”

When trainers claim contamination, he said, then that horsemen can continue to race while their case goes through the stages of having the sample re-tested and wait for a hearing.

In Barker’s mind, the new thresholds set out by racing commissions on the compounds, some of which he called “ridiculously low,” are two fold: for the industry to look “tough on drugs” and “for the industry to eliminate drugs in horse racing all together including all therapeutics,” which Barker feels is “detrimental to the health of the animal.”

He used the example of Clenbuterol, an oral drug he described as, “used the way it’s prescribed, it opens up the airways, not any more than they normally would be.” He said in some racing jurisdictions the withdrawal time is two weeks, others it’s 30 days and some places it can’t be administered at all. (According to the CPMA Elimination Guidelines for Clenbuterol is seven days for .40 mgs twice daily for five days).

“They are trying to influence the opinion of the public because they think that the biggest problem with horse racing is that it is dirty, and everybody’s cheating, so they’ve gone too far the other way,” Barker said.

Anderson disagreed. He said that drug testing needs to be strident because horsepeople are outpacing the veterinarians and laboratories in terms of finding new drugs and using already-flagged medications in different ways. He used the example of cobalt, a substance that has only recently been discovered as a performance-enhancer similar to EPO.

“Investigators became aware of cobalt by accident,” he said. It was only when they started raiding barns and noticed so many trainers with cobalt in their medicine drawers did they clue into the blue-hued metallic element.

“(The horsemen) are always ahead of the testing. So the CPMA and AGCO are doing the best they can and are very diligent in cleaning up horse racing but they are handcuffed by the fact that they are always playing catch up… because authorities don’t know what they’re using.”

As a horse breeder and a veterinarian, Anderson is emphatic that racing remain vigilant in its quest to clean up the sport.

“It’s about humane treatment of the animal, it’s about fairness and it’s about stealing of money from the betting public. When does the greater good of the industry supersede the individual?”