On Sunday morning, trainer Bob Baffert shocked the racing world with his announcement that Kentucky Derby winner Medina Spirit's post-race test had returned a positive result for 21 picograms of betamethasone. During his press conference, Baffert went on to say that Medina Spirit has never been administered betamethasone.
During the ensuing social media storm, questions have arisen about what exactly betamethasone is, the legitimacy of testing for substances in concentrations as low as a picogram (one trillionth of a gram), and how it got into the horse's system in the first place.
Dr. Mary Scollay, executive director of the Lexington, Ky.-based Racing Medication and Testing Consortium, answered some of those questions in a series with Horse Racing Nation.
Betamethasone is a corticosteriod used to reduce inflammation. It can be utilized in four ways: direct injection into a horse's joint, injection into the bloodstream, subcutaneous injection near soft tissues that may be inflamed, or via topical applications.
Betamethasone “is a medication that has legitimate applications in the care of race horses,” Scollay told HRN. “It's not a heinous substance. But it is a substance that we want to control in proximity to a race, largely to protect the safety and welfare, of course, because anti-inflammatories have the ability to mask inflammation, signs of inflammation, that can be warning signs either to the horse's connections or the horse itself that there is an injury present that could escalate into something far worse if pressured.”
Read more about corticosteroids in the Paulick Report archives here and here.
The recommended withdrawal period in Kentucky for a betamethasone joint injection is 14 days, so no closer than two weeks before a race. The allowable threshold for betamethasone in a post-race test used to be 10 picograms, but that was changed last fall. Now, no trace amount is allowed.
When used as a joint injection, a typical dose of betamethasone would be nine milligrams, Scollay said.
“But then that drug leaves the joint, enters the bloodstream and is distributed throughout the body,” she told HRN. “And remember that a racehorse has upwards of 50,000 mls (milliliters) of blood. So you're not talking about 21 picograms in that entire horse's body. You're talking about 21 picograms in one ml of blood. And there's 49,999 other mls of blood, not to mention all the other tissues, the muscles, the organs, the brain, the skin, all the other tissues of the body. That drug distributes throughout the entire body. So 21 picograms, you know, you can be a little overly reductive and say that's nothing. But when you can contemplate the total sum of medication that may be in the body at that time point? It's a different story.”
If 21 picograms (remember, 21 trillionths of a gram) were found in a single milliliter of blood, that means upwards of 1,050,000 picograms of betamethasone was circulating through the horse's bloodstream at the time of the test. (That translates to 1.05 micrograms, or 0.00105 milligrams.)
Again, that doesn't include the amount of the medication remaining in the horse's tissues.
All of the above leads to the following question: if Medina Spirit was never administered this medication, how did it get into his system?
Scollay doubts that intentional sabotage is a factor in this case for two reasons. First, horses are under 24-hour security beginning on Tuesday of Kentucky Derby week. Second, the choice of a therapeutic medication to sabotage a horse just doesn't make sense.
Read more at Horse Racing Nation here and here
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