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.”
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