Spike In Corticosteroid Tests Highlights Growing Pains In New Mexico

by | 02.21.2019 | 3:14pm

Change is never easy, even when it's for the better. Horsemen and officials in New Mexico have been learning that the hard way over the past few months.

In June 2018, the New Mexico Racing Commission (NMRC) began a new drug testing contract with a new laboratory and, almost immediately, saw a rise in corticosteroid overages. In the 685 days before the switch, New Mexico had 52 corticosteroid overages. In the first 73 days of the new contract, it had 34.

The New Mexico Horsemen's Association (NMHA) grew suspicious and called in experts to figure out what went wrong. At a public meeting in late November, drug testing experts Drs. Thomas Tobin and Rick Sams, together with racetrack veterinarians Drs. Clara Fenger, Clayton McCook, and Paul Jenson presented their analysis.

The spike, the group concluded, was not likely due to a change in veterinarians' protocols, and it wasn't ineptitude on the part of the previous laboratory. The answer was more complex than that, and made it difficult for anyone to decide who was at fault for the rash of positive tests.

Prior to last summer, New Mexico had contracted with the Kenneth L Maddy Equine Analytical Chemistry Laboratory at the University of California-Davis. In June, NMRC began a new contract with Industrial Laboratories in Wheat Ridge, Colo. Both are accredited by the Racing Medication and Testing Consortium, and were both among the first to do so. Theoretically then, the capabilities of the labs were the same. What changed, Sams and Tobin agreed, were the instructions in the contract NMRC signed.

NMRC's prior contract with UC-Davis had limits on how many blood and urine samples could be tested. The budget for urine sample tests was large. The budget for blood samples was small, only allowing for 1,800 or so each year. Of those, blood samples were divided into two groups: those that would be tested for phenylbutazone and banamine only, and those that would be subjected to the full range of testing required by the Thoroughbred Owners and Breeders Association's American Graded Stakes Committee.

The problem with that, Sams said, is that New Mexico's rules (and those of many other states) have some drug thresholds listed in urine, some in blood, and some in both. For a commission to call a positive, its testing lab has to provide them with the concentration of a drug in the appropriate medium. With such a small blood testing budget, Sams said UC-Davis would have been forced to hazard a guess at a horse's drug levels based on its urine sample, which in the case of corticosteroids is a poor indicator of how much of the substance is actually in the horse.

“Are they missing some that were really over the [state] threshold? Absolutely,” said Sams at a NMHA meeting held in late November. “They're missing a lot of low ones. They may be missing high ones, because the urine sample is a poor substitute for the blood sample when the threshold is in the blood.

“That was dictated, not by the choices UC-Davis made, but by the memorandum they had agreed to. They had no other options.”

Ruidoso Downs in New Mexico

The new contract requires the lab to test paired blood and urine samples, meaning both the blood and the urine for each horse selected for testing.

Corticosteroids, not to be confused with anabolic steroids, are a type of anti-inflammatory agent commonly used to reduce pain and swelling.

Corticosteroids are not the only therapeutic drugs whose thresholds are given in blood only. Cetirizine, cimetidine, dantrolene, diclofenac, DMSO, firocoxib, furosemide, glycopyrrolate, guaifenesin, isoflupredone, lidocaine, methocarbamol, omeprazole, procaine penicillin, ranitidine, and xylazine all have their thresholds given in blood only. The previous contract didn't allow for blood testing to be done for those drugs, either.

Interestingly, data provided at the NMHA meeting indicated the total number of blood samples taken in New Mexico from August 1, 2016, to May 31, 2017, was 4,556 – far above the number budgeted for testing. The number of samples actually tested in that time was 1,218. What happened to the rest of them? Sams says that remains unclear, but it's likely many, if not most, were discarded, untested.

Sams and Tobin agreed – the spike probably didn't happen because horsemen were using corticosteroids differently, but because the commission had finally allowed a lab to look for them.

“Any time you change labs you're at risk of surprises,” said Tobin, toxicology expert from the University of Kentucky's Gluck Equine Research Center. “That's just the nature of the beast. One of the ways of handling this is to have a phase-in period … the reason for these identifications is unquestionably the change in laboratory. When I look at a spike of positives, one of the things I look for is if you have independent trainers showing the same positive in the same location at the same time, it's clearly not the trainers. It's something else.”

For its part, NMRC executive director Izzy Trejo points out the overall percentage of tests showing positives for corticosteroids in 2017 was 2.5 percent, and in 2018 it dropped to 1.4 percent. Of course, Trejo said, the commission also tested a lot more samples in 2018 than it had in 2017, which could help explain the change.

“The commission has been advised by legal counsel to proceed with business as usual in adjudicating the cases and penalizing them according to ARCI recommended penalties, which we are bound to do by statute,” said Trejo.

 

All this leaves the commission between a rock and a hard place. On one hand, the recent rash of positives are most certainly positive. On the other, horsemen and veterinarians feel like the playing field shifted under them without any warning, as many of them say they did not change their programs but began getting positives after the change in labs.

“It had a tremendous effect on our practice,” said Dr. Clayton McCook, racetrack practitioner from Equine Sports Medicine and Surgery. “One of the things that keeps me up at night is therapeutic overages, particularly in these races that are worth millions of dollars … I am exceptionally careful in my practice. We work very hard to maintain a level of care.

“We started to hear about the overages, particularly with betamethosane and dexamethasone. There was almost a panic on the backstretch. There was certainly a panic within me because I have some very successful clients that spend a lot of time in the test barn. Typically when they win a big race, I don't sleep for a couple of weeks, even though I know I've done everything by the book.”

At the NMHA public meeting, McCook also alleged the administration guidelines he and his practice had been using were in line with, or even backed out slightly, from the RMTC withdrawal guidelines. He also said he was not provided with information regarding blood versus urine testing at UC-Davis or Industrial. Since the spike in positives, he has discontinued the use of dexamethasone, not wanting to risk a positive.

McCook said some of his clients had gotten corticosteroid positives in the first 73 days of the new contract.  Of those, he said there were horses who had not been treated with corticosteroids within 72 hours of race time, or indeed for months before their races. He dismissed suggestions those trainers may have given the drugs themselves.

A number of trainers were present at the NMHA meeting discussing corticosteroids. Those who spoke expressed frustration and confusion to the experts and commissioners present, several of them questioning whether the positives from this spike should be allowed to stand.

Longtime New Mexico owner/breeder Tom McKenna, chimed in.

“It looks to me like the onus is on the racing commission,” he said. “It takes a big man to admit a mistake and they have obviously made a mistake in the hasty decision they made. They need to walk it back. We all know where we start from now. We're not trying to run faster, we're trying to run safer and we're being penalized for it.”

Since that initial spike of corticosteroid positives in the first 73 days of the drug testing contract, the NMRC has issued 25 more rulings to trainers for corticosteroid overages through early February 2019.

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