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