Commentary: The Problem Of The Inject Now, Ask Questions Later (Maybe) Mentality

by | 12.16.2015 | 4:19pm

This year marked my third trip to the annual convention of the American Association of Equine Practitioners, where I had the opportunity to sit in on a “rounds” meeting of the AAEP Racing Committee. The convention is a great opportunity to listen to both formally-presented new research and casual shop talk among veterinarians in open forums like this one, where some of the discussion focused on Thoroughbred soundness.

Regulators have the often thankless and ever-more complex job of trying to stay a step ahead of horsemen misusing drugs to gain some kind of edge or to patch up some kind of problem. One of the latest drugs of concern is the family known as bisphosphonates, sold on the equine market under the trade names Osphos and Tildren. These medications are used in humans to prevent osteoporosis. The drugs make bone denser by getting rid of osteoclasts, the cells that prompt new bone density by destroying old bone. Some practitioners believe that farm managers are using bisphosphonates to erase the signs of sesamoiditis in young sale horses.

Although some veterinarians say they have found useful clinical applications for bisphosphonates in their practices, there are concerns that the drugs live and work in the horse's bone tissue for a startling amount of time (the best guess is several years). That continued action can make young bones too dense and predispose horses to fractures. They're also useful as analgesics, which many experts believe makes them an irresistible go-to for farm managers who have sales yearlings suffering from developmental orthopedic diseases and want a sound product with clear radiographs. 

Committee members couldn't agree on how prevalent misuse of the drugs are in young horses because there is no test for them currently. Some veterinarians had not seen any interest in the drugs from clients, while others were aware of them being doled out like candy at certain farms and sales preparation facilities.

What struck me is that the use of bisphosphonates seems to be one more example of a bizarre strain of ignorance afflicting some horsemen. Dr. Larry Bramlage, equine surgeon at Rood and Riddle Equine Hospital, voiced skepticism that bisphosphonates are even effective at clearing up sesamoiditis, which can manifest with localized areas of bone loss around the sesamoids.

“[Bisphosphonates] kill cells, the osteoclasts,” said Bramlage. “Those cells are not the primary cause of bone absorption in sesamoiditis.”

Whether it's a matter of misunderstanding how bisphosphonates work, or failing to ask questions about what the drug called Osphos actually contains, it wouldn't be the first time horsemen have gotten it wrong—we've seen this pattern of ‘inject first, ask questions later' before. My favorite still has to be the trainers who tried to cheat using dermorphin and turned out to have used a version of the drug that couldn't survive in biologic fluid, rendering it useless. Earlier this month, trainer Roy Sedlacek admitted to illegally injecting two of his horses with AH-7921, a synthetic opioid, thinking it was ITTP—a different illegal substance that's supposed to boost blood oxygen.  

“The racing population has been very quick to jump on new treatments, especially if they see them work,” said Dr. Scott Hay, member of the committee and clinician with Teigland, Franklin, and Brokken in Florida. In Hay's experience, the philosophy seems to be that if something is good for one horse, it's good for all horses.

If that were true, there would be very little need for veterinarians at all.

The committee also brought up another point about keeping racehorses sound that I'd heard before. Several practitioners agreed that they can only work with what they're given, and it seems they are experiencing some déjà vu of their own. They see horses from the same sire lines, with the same penchant for the same injuries based on conformation and other factors. This takes away a lot of the ‘longevity' of Thoroughbreds that so many people pine for, but that doesn't stop breeders from reproducing the problem.

“We used to select stallions for longevity because the old-time breeders bred horses that were good to each other over a long period of time. We don't select for longevity at all anymore, so why do we expect it?” said Bramlage.

“If they're fast, we'll breed to them.”

  • G. Rarick

    Tildren stops the formation of both osteoclasts AND osteoblasts, helping stabilize the overall bone structure during periods of intense effort, especially if the horse is still growing (as most racehorses are). Because of this, it also prevents the formation of cysts that can form within remodeling bone, which weaken the structure. As such, it helps prevent catastrophic injury rather than contribute to it. Tildren has been in wide use in France for several years. It is not at all used in an “inject now and ask questions later” context – the efficacity of the drug is up to 18 months, so you don’t use it lightly or often, but it can be a very useful tool.

    • Natalie Voss

      It would appear both racing regulators here and the FDA have a different impression as to its means of action.

      • G. Rarick

        Natalie – I edited my response above – it does act on both osteoblasts and osteoclasts, in opposite ways. I think the FDA sheet is a little misleading, and it is also worth noting that it discusses risks with extreme high doses, which one would never do. It’s been quite a good product for us for many years now – and the difference in breakdown rates between Europe and America speak for themselves.

        • Two dollar bettor

          Lightning fast racing surfaces aren’t helping the situation.

        • Janet delcastillo

          No one would use high doses??? Have you seen the misuse of Clenbuteral? and other meds? I have found a great lack of respect for the potential effect of medications…Attitude is if a little is good, more is better.

          • G. Rarick

            It can’t work this way with Tildren, Janet. You administer it once over a 90 minute drip with a tranquilizer because of the colic risk. You can’t use it repeatedly over a short period – there is no added benefit after the initial treatment, and only risk. You can’t inject it into joints, etc. It takes two weeks to a month to start seeing benefits from it. It’s really a one-time, long-term treatment. I’ve used it on a few horses over the years, but you only do it once every two years or so. Most American horses don’t run careers long enough to make this interesting for them apart from maybe one initial treatment. In any case, putting it in the same breath as demorphin, as this article does, is a real disservice. (It’s also hideously expensive, but I suppose that wouldn’t be offputting to American clients used to monster vet bills….)

  • Tinky

    I don’t always agree with LB, but this is certainly a salient question:

    “We don’t select for longevity at all anymore, so why do we expect it?” said Bramlage.

    • Old Timer

      Its the sad sad truth, of all the things that bothers me most, this is in fact the worst. Drugs use has been around forever, it won’t change. Breeding…yes breeding has changed and not for the better.

      • Tinky

        The problem in a nutshell is that when horses became more valuable to breed than to race, the emphasis on soundness dissipated.

        • It is called commercialization. When this replaced sport, the game took a downward spiral. Based on what I see today, I am more comfortable breeding than buying to race.

        • The whole thing is becoming reminiscent of the comedy WW2 sketch:
          First spiv “oy, you, those sardines I had off you nearly killed me!”
          Second spiv “Wot!, You never ate them ? They was for buying and selling!”

    • Concerned Observer

      Just did a number of starts check for the top 10 stallions in USA YTD.

      2,6,6,9,10,13,14,16,16,17 Hardly a longevity focus. Likely represents 1500 foals this year alone.

      I like stallions with proven durability for my mares. But, it is really hard to find one with race proven soundness that made 20 starts.

      • Tinky

        When I was getting into the game in the ’70s, there were plenty. One of my favorites was Mr. Leader, whose runners averaged 27 starts. Averaged!

        • Concerned Observer

          I think there are also subtle unintended consequences as well. Racing secretaries write shorter and shorter races to match the aptitudes of the horses. Owners of lesser horses (claimers) with less breeding potential are hurt when the horses are unable to sustain longer earning careers as race horses. So the cheaper horses have less marketability for the breeders. Fields are shorter because there are simply fewer total races available in the horse population. etc. etc.

          In my opinion, lots of bad consequences have been a result of the “breed for speed and ignore soundness” mentality.

          • Add to that the fact that trainers will always enter a race that is shortened up (6 to 5 1/2, etc.) rather than a longer one (8 1/2 to 9).

          • Phil Schoenthal

            That’s a rather broad stroke of the pen. Trainers enter in the races offered to them. How’d you like to get a phone call from your trainer saying, “Well I know you’ve been paying me training bills on your horse for 3 months and I know I told you he is ready to run, but I’m going to skip this 5.5 furlong race in the book in protest of the distance and wait for one going 6 furlongs next month, but please keep paying your bills promptly…” lol

          • Agreed Phil, but this is less of a “what came first, the chicken or the egg” situation than it may appear. Racing secretaries write the races they think have the best chance of filling, so they cater to their horsemen. Horsemen are the ones that prefer to run shorter rather than longer under the mistaken notion that it requires less fitness.

          • Concerned Observer

            True. I have seen it happen over and over. Trainers know their horse can go 6, but not sure about 8. They almost always opt for 6.

            Over time it changes the sport/breed.

            i was recently keeping track of a filly I bred and raced, that after being claimed was running for another owner. Since I owned the brood mare I wanted the filly to do well on the track. I saw the trainer on occasion and told him the filly should do well at longer distances…..but he showed no interest on his part. He kept running her short, usually finishing 2nd or 3rd. Finally he put her in at a mile and she won easily. Next, 7f, fast close, won by a nose, next longer 1 1/16 at CD won going away. 3 quick wins at longer distances after 20 races at 6f or less.

          • Funnily enough in Britain the reverse is true, certainly as far as 2yo races are concerned. There has been less and less opportunity for precocious horses at shorter trips in recent years. Those allowance races have been transferred to maiden races over a mile – and even up to 10 f. – in order make life easier for the bigger establishment trainers. A welcome partial reversal to normality was mooted 2 years ago, but that initiative was strangled at the 11th hour by trainers with friends in high places. The change has been promised again for next year, but on a trial basis until August 1st. On August 2nd we will likely go back to supporting slower [or less trained] horses.

          • Bein

            I’m not sure if it’s because they think it requires less fitness. It does require more skill. The horse has to be taught something about racing. Running short kind of transforms horse racing into dog racing. All speed and luck, little brains.

          • Bein

            Your example of passing up a 5.5 sprint to wait for a 6 sprint next month most likely never happens, Phil.

            In fact, trainers don’t enter the longer races. The mile or more races don’t fill with regularity.

            It’s frustrating to listen to the concern over short fields when an entire class of runner is being underutilized. Stamina is a talent too.

          • Except that the”old” Aga Khan did say that speed was the only thing to concentrate upon. Obviously he meant tractable speed.

        • gls

          Amen, I loved that SOB , made of iron. One of the biggest problems with soundness is Agents and greed.Nobody takes pride in what they breed any more, its all about the sale. All the old time gentlemen are just about gone from the game. Now we have wall street wonders rolling the dice and their agents don’t care what they breed as long as it brings lots of money. Remember every time money changes hands they get a piece. God bless capitalism.

        • Concerned Observer

          Tinky, The Grayson-Jockey Club Research Today website publishes an annual list under “stallion statistics, Durability and soundness” it ranks ave. number of starts and % of runners in the foal crop of major stallions. I find it very helpful in selecting stallions.

      • But these figures of themselves don’t demonstrate lack of soundness – and certainly not a genetic predisposition to fail physically. The earning capacity of a stud horse often far outweighs the most optimistic estimate of his future earnings on the track – added to which a poor campaign may reveal his feet to be of clay. At the very least it will mean that time has dimmed the brilliance of his earlier achievements and new stars will have flashed across the firmament: in a sales based environment, why risk it? IMO[!], mechanical failures in racehorses are much more likely due to care and maintenance issues than to underlying design faults [in their genetic makeup].

        • Tinky

          The remarkable decline in the U.S. from runners averaging 30+ career races to half that number over a mere 40 years cannot be explained without a genetic component.

          We can argue about the size of that component, and the degrees to which training styles and drugs have contributed, but there is no possibility that the wholesale change from breeding to race to breeding to sell hasn’t adversely impacted soundness.

          • Tink, I’m still not at all sure. In the first place I don’t think that there was ever a golden age when the racecourse test was strictly applied to breeding stock. Secondly, although you might reasonably argue that far more mares are bred nowadays, and so far more undesirable ones, the fact is that new methods of stallion management result in lowly mares going to better horses than would once have been the case – the net result ought logically to be [some] upgrade in the offspring. The shortened careers of so many American horses are almost certainly the result of nurture rather than nature, as evidenced for example by the fact that American bred [and even raised] horses do appear to be more durable in Europe than had they stayed at home. Also the fact that horses are retired to stud on financial grounds may only imply common sense rather than fragility. The start of this particular discussion centered upon medical intervention in order to augment bone formation. It is well accepted that the best bone results from progressive exercise [I think Tom Ivers remarked that the most solid bone in nature is the tennis player’s forearm] and in view of that protocol being generally abandoned it seems illogical to attribute the lack of solid bone to genetic degeneration – the comparison of the-and-now cannot be like-for-like.

          • Concerned Observer

            Skim through the Keeneland Sale catalogs and note the number of fashionably pedigreed but “unraced” mares bred to hot new stallions…..that is what most would call a “crap shoot”.

          • And how does that effect my argument? Some of those unraced but fashionably bred mares [perhaps the only “mistake” under their own dam] will breed good horses to a good covering; when that happens it seems to me likely that someone made a mistake and bollixed up a mare that -as proven by the successful offspring – must have had “the right stuff”. That is not an advocacy of unraced mares in general.

          • Concerned Observer

            Old saying…”breed the best, to the best,and hope for the best”

            Very different than “breed the unproven to the unproven and pray for proof”.

            I fear your arguments do not factor in the last 30 years commercial breeding strategy shifts which may have completely changed the concentration of horses. 1. Huge books to a limited number of stallions. 2. Focus on totally unproven new stallions (ads brag 450 foals in his first 3 crops). 3. Many foals out of unproven/unraced mares.

            Those 3 items alone used to account for maybe 10% of the population, but now may account for 30%??????. that could change a breed pretty fast. Then….What happens to all the foals by failed “new” stallions and failed “unraced mares”….why they get bred of course.

          • I still don’t follow. How does any of this mean that the breed is getting weaker? Horses with no ability don’t get 450 foals from 3 crops – and lots of mares that would have gone to lesser horses get a better covering than they would have done years ago: that might be for better or for worse – how do you know? Actually it probably doesn’t matter too much – Cunningham and others have estimated that the eventual results are likely governed 70% by nurture and only 30% by nature. Which is where I came in: what happens to a horse after he is conceived has much more bearing on his soundness or otherwise than do his genes.

          • Concerned Observer

            If you are trying to confuse me, you have succeeded.

            Let me put it in auto racing terms. It is easy to build a race car that will go 500 miles reliably. It is also fairly easy to build a race car that will qualify for the race with a very fast 4 lap average. What is most difficult is building a race car that is BOTH, fast enough to qualify for the race and durable enough to finish it……that is the challenge.

            That balance is much harder to assess in horses, especially when so many excuses can be made for the early stallion retirements.

          • If I’ve confused you then I’m sorry. Please read what I’ve said again. Then try and find Cunningham’s work. You might like to refer to Ivers on bone density. I’m sure you can find the Aga’s remarks on speed somewhere. I would say that I give them all credence based upon what I have experienced myself. I don’t know anything about cars, but your analogy doesn’t make much sense – after all if the mechanic puts on the wrong tyres or lets it run out of oil the design won’t matter.

          • Tinky

            Bill –

            There were obviously butchers disguised as trainers in the U.S. during the ’50s through early ’70s, and yet racehorses averaged over 30 career starts.

            That wasn’t because the good trainers’ stock was averaging 50 races, and the bad 10 – it was largely a function of breeding for soundness.

            The disparity between American-breds racing in America and Europe is too small to buttress your broader argument. And again, if it were primarily a matter of training methods, then anachronisms like Allen Jerkens would have been getting far more average starts from their runners in recent decades, yet they didn’t.

            Soundness was a point of emphasis when owners and breeders were earning their returns primarily through racing. That has changed dramatically, and the overwhelming evidence suggests that breeding to fragile stallions has greatly reduced the durability of the average runner.

            As I have mentioned more than once previously, I agree that there are other contributing factors. But I would rank year-round racing well ahead of the different training methods employed nowadays in terms of importance.

          • Tink, I have no idea whether or not Allen Jerkens trained hard or easy – and it really doesn’t effect my argument. The simple fact is that after, say, 30 or 40 generations the breed will not have altered in 2 or 3. All sorts of things may be conspiring to the fall off in starts but the cause is most unlikely to be a genetic change. I’m well aware that I am in a minority here, but the fragility narrative is universally accepted only because it makes a fortune for all sorts of interventionists and, even more important, it effectively exonerates everyone involved from blame: what’s not to like? To paraphrase Mandy Rice-Davies “they would say that, wouldn’t they?”.

          • Tinky

            Bill, breeding to a stallion like Unbridled’s Song, which was clearly unsound as a racehorse, and passed that trait on to a high percentage of his offspring, was clearly going to produce a very different result than breeding to a horse which raced 30 times and typically got sound stock, and did.

            Were particularly sound mares bred to the former, it would likely have had a mitigating effect, but the market didn’t care at all, so neither did most breeders.

            Then, when you compound that problem with many sons of stallions like US, Storm Cat, and other high-fashion sires which got relatively fragile runners, it becomes easy to understand why the geneticists’ argument falls flat.

            No one is arguing that the whole breed has become significantly more fragile (i.e. that there aren’t exceptions), nor that it couldn’t again turn around in a few decades of selecting for soundness. But to ignore the genetic component flies in the face of the available evidence.

            Again, I challenge you or any skeptic to offer an explain for how it would be possible for the number of career starts to have been cut in half without there being a genetic component.

            Your oversimplification above is not helpful, either. I have repeatedly argued that there are multiple variables, so I am neither exonerating trainers and their methods, nor drugs, etc.

            The reason t6hat you are in such a tiny minority is because you are entirely excluding a variable which, for reasons that I have outlined, appears certain to have played some kind of role.

          • Right you are then, here’s my answer. [I have again explained further down that the accepted wisdom is that the result of a horserace is 70% nurture and just 30% nature]. To examine the 70%: most horses are trained by people who have no real interest or aptitude for the task – or if they once had it they have realised that the more horses they have the more money they make. They delude themselves that they can safely delegate the horse work while they train the owners and the media. The veterinary profession – including early onset farriery – is running out of control. Most of the morning riders ought probably not to be allowed near a food animal. All in all, and however weak or strong the genetic aspect is, the environmental influences are often very negative. It’s surprising that most horses run at all, yet blaming it on genetics is a feeble excuse. Sorry to offend, however I have to call ’em as I see ’em.

          • Tinky

            You’re not offending me, Bill.

            Again, though, there were plenty of bad trainers here in the U.S. when horses were averaging 30 starts – plenty!. And yet their runners somehow overcame their lack of sensitivity, to put it kindly.

            So how is it possible that horses were tough enough to overcome bad trainers 40 years ago, yet today average significantly fewer starts even while in the hands of good trainers? (As a related aside, it would be nice to see a list of average starts for each trainer, though of course the claiming game would skew many of them.)

            My primary answers are:

            1) breeding to sell rather than to race

            2) increasing dependence on vets and drugs

            3) year-round racing (no natural break to allow minor issues to heal)

            Now, I don’t claim to know the degree to which each variable has impacted the numbers, but I believe them all to be meaningfully large.

            I don’t disagree with your harsh assessment of trainers or veterinarians, and they have both played significant roles. But for the benefit of those who may be following this thread, let me propose the following hypothetical.

            100 mares are bred to Unbridled’s Song, while 100 of the same basic profile (in terms of soundness) are bred to Concordes’s Tune. I chose the latter because he, like US, also typically gets sprinters and milers.

            Those 200 foals are raised similarly, and given to the likes of Mott, Motion or Clement to train throughout their careers.

            Your position is that there would be little if any difference in terms of durability. My position is that even under such controlled circumstances, genetics would create a notable disparity between the two sires’ offspring.

            Unbridled’s Song’s offspring raced around 11 times on average during his career at stud. Concorde’s Tune is around 25.

          • We do agree upon points 2 and 3. Also I’m sure that you may be right about comparing those 2 stallions. What I am fulminating against is the catch-all excuse that the breed has deteriorated as a whole. I say what has deteriorated is the preparation of horses for battle, which in itself creates a vicious circle because a hard race takes a lot more out of an unfit horse than out of a battle hardened one: you know that I have some experience of that. When Martin Pipe started training he knew nothing about horses but had read some books on athletics. Eventually everyone adopted his 3 or 4 short repeat training and the 2 mile jumping races now go 20 seconds faster than they did before he arrived. What we are talking about is the reverse situation – fragility is a self fulfilling prophesy. The starting point for this discussion was the use of medicinal intervention to fit bone for combat:that appears to me ridiculous.

          • Tink,

            I’ve just had another thought!! Could “retro genetics” be at play here? Might something in the programming department be recognising the drop off in daily work load and deciding there may be no longer a need to over-strengthen. This is not entirely tongue in cheek – some people feel that Darwin may not have had all the answers with his natural selection theory. It certainly works for bacteria, and I was reading something the other day about the genetic difference between town and country swans [ of course it may have been that only swans that are programmed to be less fearful come to town, rather than that urban swans have developed a genetic tolerance of humans].

          • Tinky

            Now that’s a creative thought!

            I don’t rule anything out, as new science continually supersedes what was previously thought to have been fact.

          • 7Cents

            I won’t deny that I believe some of the blame for lower starts can be laid on genetics. Some responsibility certainly falls to those overusing medications. I am also seeing another variable, from a trainer’s angle.
            Even 10-12 years ago you had maiden and maiden claiming races, the N2 Alw, and N3 Alw, then it was wide open, be it claiming prices or allowances. Now we have this plethora of conditioned claiming races – N2 at 2-3 different prices, same for N3, even N4 (sometimes coupled with dates). The allowances now offer 1X, 2X, even 3X, Non since date, Non winners of $ “X” other than (and $ “X” other than since date), etc, etc. As a trainer, it’s your job to put your charges in the best spots, so you have trainers shooting for the conditions that best fit their horses, but it dilutes the pool of available horses and races don’t fill. Meanwhile, without a plethora of conditions available, one might have otherwise entered in the open claimer or allowance and filled a race. A lot of us are running about 50% starters vs entries. Now, I am talking about average, Thursday-afternoon-card horses, not the ones breathing the rarefied air of stakes, graded or otherwise, but that is the bulk of horses running, so have a huge influence on the overall numbers. The rarefied air horses are worth so much residual money that they are judiciously managed to run only in the easiest spots with the best money, so fewer opportunities as well. Not unusual to have a horse ready to run and only run 1 time a month. Not because you are “trying to get him sound,” but because races are not filling and getting used. Constantly training for races and being unable to run when ready is harder on most horses than running every 10-14 days like we could do in the good old days. My 2cents only.

          • That’s interesting and, unlike much of what we see here, it’s opinion from someone in the front line. Based upon the British experience I wonder whether there might be a secret island somewhere breeding a special race of mental pygmies to staff the political and race programme industries!

          • Concerned Observer

            Getting horses into races is a real challenge here too. It is not unusual to enter 3 or 4 races and go a week or 2 or 3 before a race fills. It is very frustrating for owners, trainers…..and tough on horses too.

            That is one reason I am against the old practice of forcing a trainer to run only at the track where he is stabled. If he enters twice and the races don’t fill he should be allowed to race off the grounds without penalty.

            As for the durability discussion, for every stallion that is retired early for breeding value, there are 10,000 left over (of no value in the breeding shed) that could be racing 30 or 40 starts (but are not). Simple mathematics. A few early retirements for breeding purposes simply does not explain the decline in number of starts for the breed.

          • Janet delcastillo

            In the “old days” Trainers would use races and put them in not the most ideal spot to give them the experience and keep them ready. Today everyone is so aware of statistics that many trainers won’t “darken their form” and wait for the ideal spot.

  • Ronald W

    Well, in my opinion Dr. Bramlage and Dr. Hay are the “good guys” here. LB very super smart and on top of stuff, and SH being then same, but also being in “the trenches”, that is to say practicing at the race tracks, on a daily basis.

  • Natalie, thanks for writing about something real. We don’t get enough of it. Keep up the good work.

  • People will always pay for magic. The idea that the TB is increasingly fragile is a winner from everyone’s point of view – plenty of scope for expensive intervention and no-one’s fault if they break! The fact is that most TBs are pretty resilient as long as a certain amount of Common Sense is applied to their preparation, and if the warning lights are heeded rather than being disconnected by NSAIDs.

    • Bill, of course they always paid for magic, but a lot of them paid for bird as well.

      • Tinky

        And to think that they were Michigan and Indiana-breds…

    • Bein

      Perfect, perfect, perfect.

  • Cyndi Robertson

    There is no research to support the use, safety, or efficacy of Osphos in young horses since it is labeled specifically for horses 4 YEARS of age and older to treat navicular syndrome…

    • Larry Ensor

      As a person who does re-hab and has used both Tiltdren and Osphos both are used for a number of things navicular issues being just one.

      • Cyndi Robertson

        I understand that Tildren & Osphos are being used and possibly overused for a number of issues, but please site the research to support the safety & efficacy in young racehorses.

        • Larry Ensor

          Sorry, I should have acknowledged that I agree with the “science” behind it being used on horses 4 and up. What I do not agree with is saying that it is specifically labeled for treating navicular. I work with some very respected vets. Vets that do a lot or are involved in a lot of “research and studies”. We don[‘t “experiment”.

  • Marlaine Meeker

    Are they horses or pincushions? Good article.

  • Larry Ensor

    Tildren has been available and used for a number of years in Europe. In this country it has been under review by the FDA for use in horses in a trial bases. It is/was not widely available because a license issued by the FDA had to be approved and granted to import and use legally.This made the per-dose cost at around $1,000. It is not “injected” it is given by way of a slow IV drip it done correctly. A number of horses do not “handle it” well and can develop severe Gastro issues. It does not give “instant” results like certain meds used for joint injections. It can take several weeks to months to see if it of any benefit.A re-hab program should be used also.

    It is my understanding that Tildren was given FDA approval last year for use on horses. Which will make it widely available to are vets. The cost would drop to under $500.

    It is my understanding Osphos is a “domestic” variation of Tildren and has only been on the market a short time. It does not seem to have the same Gastro side effect issues that Tiltdren does. The benifits are still under review/study. The per-dose cost is around $300.

    IMO and limited experience the cost/benefit is still VERY subjective. In short, like a lot of horse “treatments, therapy” the horses are guinea pigs and the owners are paying for the “research”.

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