Gagliano: Moving Lasix debate from ‘hyperbole and fear-mongering’ to facts about competition

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Lasix (Furosemide, Salix) Lasix (Furosemide, Salix)

The following letter to the editor was sent by Jim Gagliano, president and chief operating officer of the Jockey Club, in response to a Thoroughbred Daily News report on a panel earlier this month in California.  The scientists invited to speak on the panel issued a consensus statement saying that “the only treatment that has been shown to prevent the occurrence and decrease the severity of E.I.P.H. (Exercise Induced Pulmonary Hemorrhage) in Thoroughbred racehorses is furosemide (also known as Lasix).

The Thoroughbred Owners of California issued a press release summarizing the TDN report, which said the panelists agreed the Thoroughbred industry needs to develop funding for research on EIPH. 

Below is Gagliano’s response.


Dear Editor:
 
We read with great interest the article published in the January 24, 2014 edition of Thoroughbred Daily News (“EIPH Takes Center Stage”).
 
The article detailed a closed two-day meeting of the Thoroughbred Owners of California this past weekend, wherein Dr. Mark Dedomenico and Dr. Wayne McIlwraith co-chaired an impressive assembly of panelists to discuss Exercise Induced Pulmonary Hemorrhaging, among other topics.

From reading the article, it seems that those in attendance agreed that additional basic research on the matter of EIPH is necessary. Again, we commend those industry leaders willing to undertake a serious review of this issue, and for the ongoing commitment to equine research.
 
For the record, The Jockey Club’s Grayson-Jockey Club Research Foundation was one of the funding organizations of the well-known South African study mentioned in the article, and fully supports its findings. (In fact, Grayson has also funded many other equine health-related research projects on this topic, including those authored by several of the presenters at the TOC conference).
 
The South African study was conducted on a population of racehorses in that country in 2007 by an international team of veterinarians: Dr. Paul Morley of Colorado State; Dr. Kenneth Hinchcliff of the University of Melbourne in Australia; and Dr. Alan J. Guthrie of the University of Pretoria in South Africa.
 
There was one finding in the study that was not mentioned in the TDN story: namely, that the study demonstrated that Lasix reduced signs of EIPH by an average score of 0.63 on a scale from 0 to 4. Even then, the majority of horses — 57.2% — still had EIPH, and one-in-five received no benefit as they showed no signs in the first place.
 
In addition, missing from the analysis is the answer to the question important to all industry stakeholders and regulators: what is the effect of the small reduction in EIPH on competition? As important, is it in the best interest of the clinically problematic horse (those with EIPH) that it be treated with Lasix, just so it can race?
 
The South African study is good science but it also underscores the perils of exclusively relying upon science when promulgating rules in competition.
 
Rules, and medication rules specifically, must consider the effects on athletes and the effects on competition, especially in horse racing when our customers expect and deserve a level playing field while wagering.
 
With a medication like Lasix, which these same authors believe produces powerful effects on performance, and which, according to other authors, cannot be fully explained by the reduction in signs of EIPH alone, the work is only half complete.
 
Since the completion of the South African study, representatives of The Jockey Club have asked the researchers to dig deeper into the data to determine the effects of Lasix on competition. The researchers have steadfastly declined to do so on the basis that a study, conducted over a period of two years with 152 racehorses in races, was not adequately designed to study competition.

We note that not one international jurisdiction with rules preventing the use of Lasix in competition sought to change its medication policies since the paper was published.
 
Our analysis on the matter of EIPH has concluded that to-date there are likely thousands of research papers on cardio-pulmonary physiology of the horse; and likely hundreds involving the administration of Lasix.
 
It is inarguable that understanding the source of any health issue affecting horses is to our advantage. Further studies that fail to address the fundamentals of competition however, will continue to confound all of us, as they have for decades now.

Moreover, when signs of EIPH are masked, any breeding strategy based upon selection of superior traits may be confounded.
 
However, we submit that there is one “study” that has not yet been conducted. One that The Jockey Club supported back in 2011, when it was first proposed at the International Summit on Raceday Medication, EIPH and the Racehorse at Belmont Park — and one we continue to support to this day.
 
That proposal was that the industry consider temporary regulations that would allow comprehensive, controlled research beginning with our young racehorses — two-year-olds. A study based upon a substantial part of a foal crop could yield real, practical answers on the effects of EIPH on competition, and provide valuable answers to many of our lingering questions.
 
The study should include a regimen of regular endoscopic examinations during the training and racing of these equine athletes, provided the examinations are suitably controlled to yield meaningful results and supervised by an independent board of researchers, funded by all segments of the industry.
 
Besides illuminating the effects of EIPH on competition, the study would show us what effect, if any, a ban on Lasix would have on the lifeblood of our sport: wagering.
 
The data derived from such a study could yield real results, moving this industry debate from hyperbole and fear-mongering into the establishment of a real database of facts from which we can develop appropriate policies.
 
Let’s now end the rhetoric, and instead continue to work together on a constructive solution.
 
Our competitors – and our customers – deserve nothing less.
 
James L. Gagliano
President and Chief Operating Officer
The Jockey Club
New York, NY

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  • http://www.facebook.com/ben.vandenbrink.52 Ben van den Brink

    That,s a lot better than the so called california horseman group.
    Notice for the Breeders Cup either race without the stuff, or ban the complete breeders cup series.

  • Tinky

    “The study should include a regimen of regular endoscopic examinations during the training and racing of these equine athletes”

    This will be problematic, as very few owners or trainers would want scoping to be done for research. There are risks associated with scoping, and, however small, few will choose to accept them.

  • Bonniemcdo

    Perhaps they can have an ongoing study. Identify true bleeders and let them be treated but make note that they are being treated to prevent bleeding. This goes for fillies and colts. It would also be valuable for anyone wanting to purchase these horses in the future. How many people buy a broodmare not knowing she is a bleeding because everyone gets lasix. And what about sires.  

  • Pwaz16

    you can make a study show anything you want afterthe fact. lets do a study on the looks on peoples faces after watching a horse bleed to death because lasix is outlawed. lets see their faces he a jock is disabled because his horse just dropped dead. lasix does not mask anything is doesnt make tem run faster it just helps prevent bleeding and its the only drug that works. we dont prevent humans frm taking prescription drugs why stop an equine?   

  • SteveG

    Brilliant.  Many thanks.

  • jorge

    You have to love it. Six years later the Jockey Club is working to undermine the results of its own study

  • Marshall Cassidy

    Mr. Gagliano writes persuasively and constructively about one of the most important and divisive subjects in horse racing, both Thoroughbred and Harness. Lasix is perceived to be both saviour and destroyer of our games by people of all walks of racing life, and this argumentative schism contains the potential to be as destructive to our businesses as the threat of federal oversight.

    If we can’t get back to a natural order – that of a non-drug-related culture, and begin to breed healthier animals that don’t require artificial support – I ask why we should continue to put on speed exhibitions that risk the safety of horses and jockeys in the first place. Just to make money? Consequences be damned? 

  • Stanley inman

    Talk, talk, talk
    Till the cows come home;
    The jockey club can simple
    edict
    …”no foals eligible for registration
    If sire or dam
    raced on lassie …starting …”
    The jockey club can end raceday meds
    All by themselves;
    Why all this need to join up.

  • Randyp

    As the rest of the world races without lasix, what a hypocritical statement for you to make?your statement about humans taking prescription drugs is irrelevant as race horses are being asked to perform for a wagering public not recover from a predetermined illness with prescribed drugs from their doctor.

  • http://www.facebook.com/ben.vandenbrink.52 Ben van den Brink

    I did have an severe bleeder myself, and it is not a pretty sight, so I gave her away as a pet horse. It is an inherited weakness of the breed that should be culled at once.
    And yeh it cost me a lot of money.

  • http://profile.yahoo.com/GM4MKOH3SRM3GAZLMIKOOOAI74 jttf

    can tomlinson or someone else put out some ratings on which breeds are more apt to bleed ?   breeders dont seem to care about keeping track of which breeds bleed more often.  dont we want the horses to be less reliant on meds ?   if someone makes this info available to the public.   trainers would be more aware of which breeds to show caution to.      

  • http://www.facebook.com/ben.vandenbrink.52 Ben van den Brink

    Lasix is an powerful diurectic, and there is not one country in the world except the US and Canada where it is allowed in competion, not humane not equine

  • PNkt

    Would you like to show us your evidence of horses bleeding to death in the rest of the world?  I’ve worked in racing in Great Britain for over 10 years (not long in the grand scheme of things, I know) and I have never seen a horse bleed to death through EIPH.

  • wabstat

    Kentucky breeders have ruined the sport. 

  • McGov

    Well said…I completely agree.  IMO, horses and jockeys are considered collateral damage in the pursuit of greed and notoriety.

  • Sue M. Chapman

    Good information.  As is that shared by Barry Irwin stating that his 2YO’s were scoped regularly after morning training, and post race.  His conclusion:  it is rare to find even traces of blood after endoscopic exam. 
    So, if the baseline number of horses who Bleed Through the Nose is very low, why the insistence on raceday Lasix?  Yes, it is effective in horses that actually bleed. 
    The only other reason for it’s use is Performance Enhancement.

  • Circusticket

    The humans who take Lasix are not healthy.  They have high blood pressure and are not athletes.  Horses used for racing should be healthy to begin with.  Are you proposing we use unhealthy horses, with high blood pressure, drug them and have them compete?  We don’t do it to humans and we shouldn’t do it to horses.

    And, why does nobody EVER mention this, that the South African study used lasix only once on each horse and compared it to the placebo.  How can any scientist claim any results from testing a drug only once, without using it for a longer period to determine if there are any side effects.  Would you take a drug yourself that wasn’t tested more than once?  Why do we do this to the horses?  IMO, that study is flawed.

  • bob hope

    an excellent piece although without mention that field sizes have shrunk dramatically in the lasix era and horses are making less starts per annum.  when we speak of economics, these factor should prevail.

  • Turftoe

    Get a copy of “speed in the racehorse:the air flow factors” by W. Robert Clark FRCVS PHD.  People have been using this info. for several years to cut down on the chance of buying a “Bleeder” at yearling sales with a high degree of success…………

  • RayPaulick

    I believe it is Dr. Cook, not Clark, who wrote that book.

  • Bob Cook

    An excess of water in the system does not cause bleeding and a pre-race diuretic does not prevent it. My thoughts on the cause and prevention of bleeding can be read in a two-part article, the link for which is provided below.  But to start the ball rolling, here are a few lines from the Abstract  ‘Bleeding’ is only
    one sign of a larger problem, waterlogging (edema) of the lung; this, in turn,
    is caused by asphyxia.  The most common
    cause of asphyxia is elevation and dorsal displacement of the soft palate and
    this, in turn, is caused by the bit. 
     

    http://www.bitlessbridle.com/W

  • Kim Howell (Anita Xanax)

    My God, finally the voice of reason.

  • John McEvoy

    With all due respect to Mr. Gagliano, waving the flag of a six-year-old study conducted thousands of miles from the U. S. doesn’t mean much to many of our owners whose horses compete on dirt of various qualities, on synthetic, on grass, on muddy tracks, in winter weather, at night, under conditions completely unlike pristine foreign racing. If the Jockey Club could fund a “definitive” study in South Africa, how about doing the same here in the U. S.?

  • Bob Cook

    As bleeding (pulmonary edema) is IMO caused by asphyxia, this is not a problem that can be blamed on any particular breed.  A plough horse with a paralyzed voice box (laryngeal hemiplegia) will bleed at the walk, as will a timber-hauling horse. A horse of any breed that gets cast in its stable and suffers asphyxia may bleed and die without ever having been exercised.  A Thoroughbred will bleed frequently, not because it is a Thoroughbred but because it is is being asphyxiated.  Standardbreds may bleed more fiercely because they have more metal in their mouths and the pressure on the bit is greater – hence the greater frequency of soft palate ‘choking’ (asphyxia).  Any breed, type or age of horse will bleed if their upper airway is obstructed. 
      

  • Roisin

    You are right.
    Of course they would never bleed to death. If the bleeder did die because of pulmonary hemorrhage it would be from “drowning” in their own blood because the blood would not allow the normal gas exchange in the alvioli, the lung air sacs.

    The death would not be from hypovolemia and shock due to the blood loss.

  • Jim Gagliano

    Ed Bowen
    10 hours ago
    There were numerous reasons why South Africa was a proper venue
    for the Lasix study supported by Grayson-Jockey Club Research Foundation and referenced in some of these comments. The horses there had not been exposed to racing on Lasix
    in the past, because of the country’s rules, so they would have begun the study
    on even ground. Also, in order to make the study scientifically valid, a great
    many logistical issues had to be solved, and the economics of South African
    racing were conducive. For example, owners had to be compensated for letting
    their horses participate and to ensure that all horses were driven to their
    best efforts. The racing authorities condoned what were not official races but
    were run under the exact conditions of races. The jockeys, of course, had to be
    paid as well, and purse money had to be provided. While we are not suggesting
    that it would have been impossible to replicate true racing conditions in an
    experiment in any other country, the whole combination of logistics, including
    the cost of incentives, were practical in South Africa. The participating
    scientists represent various countries and did not regard the results as
    scientifically diminished because of differences in racing from one
    country to another.

    Edward L. Bowen
    President
    Grayson-Jockey Club Research Foundation

    reply

  • Sue M. Chapman

    How many needless surgeries have been done on horses with a “slow flap”?  Previously surgery that briefly stopped the horse from training.  Now, Laser Surgery on the soft palate.  The problem is far bigger than a paralyzed flap. 

  • Sue M. Chapman

    I’ve been writing it for months.  Today Phipps and Janney admit Lasix is performance enhancing.

  • Sue M. Chapman

    I have posted, as has Barry Irwin:  he scoped after AM training and post race and admittedly saw very few with even traces of blood.  And yesterday, Janney and OMP admitted Lasix is performance enhancing.   Maybe scoping in sale horses is iffy.  That’s what the repository is for.  But horses in full training; everybody scopes.

  • Sue M. Chapman

    It now appears that there is a large schism between the Jockey Club and Breeders’ Cup.

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