Details Emerge On Maryland Study Tracking EIPH In Lasix-Free 2-Year-Old Runners

A survey study of all 2-year-olds that race in Maryland this year to determine the extent of exercise-induced pulmonary hemorrhage is set to begin Friday, Aug. 7, at Laurel Park.

The Maryland Equine Safety, Health and Welfare Advisory Committee, which falls under the Maryland Racing Commission, on July 31 approved the plan for post-race video endoscopies of all starters in all 2-year-old races. The first 2-year-old races of the year in the state have been carded as extras for the Friday, Aug. 7 program.

Under an emergency regulation approved Aug. 2, all 2-year-old races through Dec. 31 will be run Lasix-free with a 48-hour cut-off of the therapeutic medication. The survey study is part of a broader agreement between the Maryland Thoroughbred Horsemen's Association and The Stronach Group for the Lasix-free pilot program that runs through 2023 for 2-year-old races and graded stakes only. Graded stakes in 2020 are not part of the pilot program.

Private veterinarians who practice at Laurel will conduct the video endoscopies and complete information forms for each horse that will include the horse's name, its EIPH score, any related comments, and whether the horse trains on Lasix. Additional useful data from each race and race day will be added to the information forms, which will be transferred to an online database.


The MRC will maintain all records from the survey study, and only a horse's owner and trainer will be given the results of a scope to maintain anonymity. Horses will be scored using a range from 0 to 3—none, mild, moderate or severe bleeding—for the purpose of simplification.

Dr. John Sivick, a Laurel-based veterinarian who is a member of the Equine Safety, Health and Welfare Advisory Committee, said endoscopies are usually performed 30 minutes to 90 minutes after a race, but the goal will be a window of 40 minutes to 70 minutes post-race to keep the scores as consistent as possible.

All horsemen who enter 2-year-olds in Maryland for the rest of this year can expect the horses to be scoped. The Maryland Jockey Club Racing office will notify horsemen when entries are made and also the morning of the race. Grooms must wait with a horse until it is scoped.

Owners and trainers do not have to pay for the video endoscopies however, they will be entitled to the results.

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Maryland 2-Year-Old Racing Set To Commence With Lasix

The Maryland Administrative, Executive and Legislative Review Committee Aug. 2 said it has approved the Maryland Racing Commission's emergency regulation on use of race-day Lasix in 2-year-olds, a decision that will facilitate the carding of races for 2-year-olds at Laurel Park.

No 2-year-old races have been run in Maryland so far this year. There are no such races in the current Laurel condition book, which runs through Aug. 22, so the races will be listed as extras on overnights. Maryland Jockey Club President Sal Sinatra said that there will be two late breaking extras for Friday, August 7th: X7 Lasix-free 2-year-old MSW five furlongs; X8 Lasix-free Filly 2-year-old MSW five furlongs.

The MRC on July 16 approved—subject to adoption of an emergency rule—an agreement between the Maryland Thoroughbred Horsemen's Association and The Stronach Group/Maryland Jockey Club for a Lasix-free pilot program through 2023. The pilot program was subject to the approval by the AELR Committee of the revised Lasix regulation, which states that no 2-year-old can be administered Lasix within 48 hours of a race; the remainder of the regulation will not be changed.

In a related matter, the MRC Equine Safety, Health and Welfare Advisory Committee July 31 authorized a veterinary survey study of all 2-year-olds that race in Maryland through Dec. 31 of this year. The objective, as directed by the MRC, is to track the incidence of exercise-induced pulmonary hemorrhage in 2-year-olds racing without Lasix.

Under the survey study, veterinarians will take video endoscopies of all starters in 2-year-old races through Dec. 31, 2020. The MRC emergency regulation was approved for the standard six-month period—July 31, 2020, through Jan. 26, 2021.

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2YO Racing Stalemate in Maryland Ends

The Maryland Administrative, Executive and Legislative Review Committee has approved the Maryland Racing Commission’s emergency regulation that will facilitate Lasix-free 2-year-old races, it was announced Sunday evening. No races for juveniles have been held in Maryland this year due to a stalemate between the state’s racing factions over the use of the anti-bleeder medication. It was announced on July 16 that The Maryland Jockey Club, The Stronach Group and the Maryland Thoroughbred Horsemen’s Association had reached an agreement for a Lasix-free pilot program through 2023.

While no 2-year-old races are listed in the current Laurel Park condition book, Maryland Jockey Club President Sal Sinatra said there would be two extra races offered for Friday, Aug. 7: a Lasix-free 2-year-old maiden special weight and Lasix-free 2-year-old maiden special weight for fillies, both at five furlongs.

Relatedly, the MRC Equine Safety, Health and Welfare Advisory Committee July 31 authorized a veterinary survey study of all 2-year-olds that race in Maryland through Dec. 31 of 2020. The objective of the study is to track the incidence of exercise-induced pulmonary hemorrhage in 2-year-olds racing without Lasix using video scopes.

The emergency regulation was approved for the standard six-month period, from July 31, 2020 through Jan. 26, 2021.

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Open Letter to the Industry: Bentley Combs

Last week I was disheartened to read the Maryland horsemen had relented to outside pressure to hold 2-year-old racing without Lasix. However, I saw a silver lining in the mentioning of a possible three-year study. No matter what side of the debate you fall on, we can all agree that the race-day administration of Lasix might be the most divisive issue in an industry full of divides.

In the back and forth debate over Lasix and its need, I have heard differing numbers. I have heard anti-Lasix people say between five and 10 percent of horses experience Exercise Induced Pulmonary Hemorrhaging (EIPH), commonly known as bleeding. On the pro-Lasix side I’ve heard over 50 percent. This three-year study gives us the chance to answer that debate.

We have decades of anecdotal evidence through experience at the track and through studies such as the South African study partially funded by the Grayson Jockey Club Research Foundation. That landmark study demonstrated the effectiveness of Lasix and, also importantly, showed no harm with its usage. Knowing this, the prevalence of EIPH should be the deciding factor in the administration of race-day Lasix. What if we had a large comprehensive study answering the question of prevalence of EIPH under real-world racing conditions in horses running in the United States that have not been administered Lasix on race day?

Vital to truly understanding the extent of EIPH, we must determine the numbers of horses who might not bleed through the nostrils, to where it can be observed by the naked eye, but who experience blood in the airways that is detected only by endoscopic exam. Whether visible or not, bleeding is damaging to a horse and often is progressive.

Not having the expertise to come up with the conceptual framework of a peer-reviewed study, this just seems like the most common-sense approach to me: We scope all 2-year-olds that run in a race in Maryland for the next three years. Scope them all 45 minutes to an hour post race. This would be for the simple binary ruling of yes or no. Other things will need to be recorded as well such as sex, surface, distance, weather conditions and track conditions as these things could be contributing factors.

Certainly any such study will face hurdles, including owners and trainers objecting to participation for fear of their horses being put on some sort of bleeder list. Submitting to the study would be a condition of entry. Also people’s minds can be put to rest with the condition of anonymity for the horse. The only purpose for identifying the horse post race is to confirm that the horse was in fact one that ran in that race.

Also: who will do the scoping and who will pay for this study? I think it should be the veterinarians currently working at Maryland tracks doing the endoscopic exams. Vets aren’t going to scope horses for free, so who will pay for the scoping and compiling of the data? This might be pie in the sky, but I think every industry stakeholder should make an effort to chip in for such a study because it benefits everybody and most of all our horses. This issue of prevalence of EIPH brings us to a new starting point in a conversation over Lasix based in science.

I think any owner, trainer, breeder or stakeholder who is genuinely curious and willing to learn would contribute. Such a study would give the world as a whole a chance to learn and grow.

So many decisions in this industry seem to be emotionally based. A study like this gives the industry a chance to base policy-making on Lasix on science rather than emotion.

Given the importance of such a study, the industry shouldn’t limit the scope to just Maryland. Every racing jurisdiction that has adopted a no-Lasix policy for 2-year-old racing–whether by regulatory authority or utilizing a track’s “house rules”–should launch a parallel project.

I sincerely hope the anti-Lasix camp with their numbers of between 5 and 10 percent are correct. Given my own experiences, I don’t believe the anti-Lasix camp’s numbers to be accurate (or they’re only counting horses who visibly bleed), but I don’t know for sure. A study like this would give us a clear view moving forward in our policy-making rather than the emotionally blinded view it seems we’ve been using thus far.

Kentucky-based Bentley Combs began training horses in late 2017 after serving as assistant trainer to Dallas Stewart. The Lexington product graduated from the University of Louisville’s Equine Industry Program in the College of Business and received an MBA from the University of Mississippi.

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