Viagra Suspension: A Trail From China to New Mexico

by | 02.13.2014 | 5:33pm

Quarter horse trainer John Stinebaugh said contamination of cinnamon ginseng powder – imported from China into Canada, then sent to a compounding pharmacy in Texas, made into a paste sold to veterinarians and given to horses he trained in New Mexico – may put him out of business.

“Trainers beware,” he told the Paulick Report two days after being fined $40,000 and having his licensed suspended 16 years by the New Mexico Racing Commission. Last July, four horses in his care tested positive for Sildenafil, the active ingredient in the erectile dysfunction drug Viagra. He said trace amounts of the drug showed up as a result of contaminated raw materials used by a compounding pharmacy. “If I can't trust the vets and the vets can't trust the companies they buy their products from, where does it end?”

Because Stinebaugh plans to appeal the suspension and $40,000 fine he received from Sunland Park stewards on Monday, it's unclear where this story ends.  But the trail began, apparently, somewhere in China with an herbal ingredient that was shipped to Attix Pharmaceuticals in Toronto, Canada, continued south to Weatherford Compounding Pharmacy in Texas, and eventually crossed the border to New Mexico's Ruidoso Downs, where the four horses raced in Futurity and Derby Trails last July 5 and 6.


Along the line, a compounded product named Tourniquet, which purportedly is used to treat exercise-induced pulmonary hemorrhage, allegedly became contaminated with a trace amount of the Viagra drug. Stewards and the New Mexico Racing Commission ruled Stinebaugh was ultimately responsible as the absolute insurer of his horses after tests from the Maddy Laboratory at the University of California-Davis came back positive for Sildenafil.

New Mexico horse racing has been ground zero for drug cheating since the New York Times exposed lax regulations with a series of articles in the spring of 2012. Its commission, under executive director Vince Mares, has sought help from New Mexico legislators, getting an expanded budget for improved drug testing, tighter security and tougher penalties.

“I'm almost collateral damage to the commission,” said Stinebaugh.

The players in this drama, in addition to Stinebaugh, who worked under Quarter horse legend training legend Blane Schvaneveldt before going off on his own 30 years ago, are:

—Boyd Clement, DVM, a longtime racetrack practitioner associated with the Equine Sports Medicine & Surgery headquartered in Weatherford, Texas. Stinebaugh has been one of his clients.

—Joe Landers, owner of the Weatherford Compounding Pharmacy in Weatherford, the subject of an in-depth article by Frank Angst of Bloodhorse.com last November that listed some of the pharmacy's products by name, including Tourniquet, Equine Growth Hormone, Game Changer, Exacta, and Race Ready.

—Attix Pharmaceuticals, a company founded in Toronto in 2000 by Syveon D. Liu, a graduate of the School of Pharmaceutical Sciences at the Beijing Medical University and who later studied in Australia and Canada.

According to Stinebaugh, testimony was provided to stewards from representatives of Attix and Weatherford Compounding Pharmacy that materials sent to the compounder from Canada were contaminated with Sildenafil. The trainer said the owners of the four horses were reimbursed for purse money they had to forfeit because of the positive tests.

Tourniquet is the name of an injectable product available from Weatherford Compounding Pharmacy. A similar product, apparently under the same Tourniquet name, was developed last year as a paste and sold by Landers as an herbal treatment for EIPH. Stinebaugh said Tourniquet contains vitamins, amino acids and a cinnamon ginseng extract. “What part of that am I supposed to be nervous about?” he said.

Among those Landers sold this paste to was Clement, the veterinarian for Stinebaugh, shortly before the Rainbow Derby and Futurity Trials were held last July. Clement recalls talking with Landers about the product that he now insists was contaminated with Sildenafil.

“I asked the compounder (Landers), ‘Did this have any Viagra or Viagra-like substances?'” Clement said. “People who were privy to the conversation said I asked him six times. Each time he replied ‘no.'”

Why, Clement was asked by the Paulick Report, would he be so specific in asking about a prohibited drug being in an herbal treatment?

“I know by word of mouth and through the grapevine that Viagra in the past had been used to treat bleeders,” Clement said, “but I also knew it would test, so we didn't want to take any chances. These horses were going in the Trials.

“I've been a racetrack vet 40 years,” Clement added. “I'm dotting the i's and crossing the t's for the clients that I work for.”

Clement, who said “most racetrack practices have done business with Joe Landers and umpteen other” compounding pharmacies, admitted that he prescribed the paste product without having any scientific or clinical evidence of its efficacy.

“It was sent to us and we tried it in horses that were working,” Clement said. “For whatever reason the horses didn't bleed that much. This all happened in a very compressed time frame. This stuff was not dramatic enough of an advantage for anyone to continue on with it. It was not that kind of thing.

“Nobody made any covert effort to give Viagra to any horses,” Clement added.

“I haven't read all the details, but it was a cinnamon ginseng powder that was contaminated. It's my understanding the stuff was shipped from China to some company in Canada (Attix), and this company distributes to human and animal compounders in the United States.”

Stinebaugh said he was not the only trainer with horses running in the Trials on July 5 and 6 who used the product, which he said was a paste version of the injectable Tourniquet. “The contamination wasn't in every single tube,” he said. “But I was the only trainer that got positives, and only on four horses.”

Similar cases were heard in Iowa when positive tests for trace amounts of Sildenafil came back on four horses racing at Prairie Meadows. An official with the Iowa Racing and Gaming Commission said convincing evidence was presented that the positive tests were a result of contamination in the paste version of Tourniquet around the same time as the Rainbow Trials at Ruidoso. Those cases resulted in one trainer being suspended 15 days and two others getting $1,000 fines.

Landers could not be reached and did not respond to a message left at the Weatherford Compounding Pharmacy.

Last year, in the Bloodhorse profile, which ran under the headline “Texas Compounder Draws Industry Scrutiny,” Landers defended his operation. “Anything we make, it's at the request of veterinarians and how they want to put them together, and what they want to do. The owners, the trainers, and the veterinarians are the ones that control what goes into their horse, not the pharmacy. We don't go in there and give them anything.”

Asked specifically about some of the products, Landers added: “There's not been a horse yet that's had a bad test on Race Ready. There's not been a horse yet that's had a bad test on Tourniquet. If there was, this would have surfaced a long time ago.”

Compounders serve an important role in human and veterinary medicine, but some compounders have, as the Bloodhorse.com piece indicated, been under the watchful eye of racing regulators – though there seemingly is little they can do to regulate them. Compounding pharmacies are believed to have been the source of the powerful and dangerous illegal drug dermorphin, also known as frog juice, that was used rampantly in Quarter horse racing in New Mexico until a test was developed two years ago. To date, no compounders have been identified.

Many compounding pharmacies, like Hagyards and Rood & Riddle in Kentucky or Wedgewood Pharmacy in New Jersey, are members of the Pharmacy Compounding Accreditation Board. PCAB accreditation assures consumers that the pharmacy complies with nationally accepted quality control, quality assurance and quality improvement standards. According to the PCAB website, Weatherford Compounding Pharmacy is not a member of the organization.

There is some question about whether a compounded product like Tourniquet is, technically, a legal drug. According to an FDA official, speaking to the American Association of Equine Practitioners in December, when a compounded product's name or labeling may imply or give the impression of certain claims (i.e. Tourniquet could be interpreted as “stops bleeding”), and the product has not gone through the FDA approval process, that product is not legal.

None of that matters to Stinebaugh, who said using the Tourniquet product “wasn't about cheating. It was all about the health of the horse.” Internal bleeding, especially in the high altitude of Ruidoso Downs is a major problem, Stinebaugh insisted. “I know for a fact that Tourniquet is used coast to coast and there has never been a problem with it,” Stinebaugh said. “The only problem was when it was made into a paste. They made that change last summer, and that's when I got in trouble.

“I am responsible for the health and welfare of those horses,” Stinebaugh said. “I am glad to be the insuror of that, and I think I've done a very good job. I can not be responsible for things that happened thousands of miles away and weeks and months before.”

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