The dramatic click-bait headline “Horses on Lasix at Increased Risk of Sudden Death” is unwarranted by the facts. When compared to the end of the article, one becomes more frustrated with the headline since the statement “further work is required to determine which, if any, clinical signs are potential indicators and, indeed, whether such a rare outcome could be reliably predicted” provides more realistic information than the sensationalistic title.

The authors of the JAVMA paper claim no conflict of interest, but it is funded by the Grayson Jockey Club Foundation, and “help in interpreting the Equine Injury Database” was provided by two long time employees of The Jockey Club. The Jockey Club has a long history of both funding Lasix research and also pressuring the recipients of this funding to interpret findings in a manner consistent with their long-held goal of the elimination of race-day administration of Lasix in American racing.

My first concern: “Sudden death” as defined in this paper deviates from accepted definitions. Exercise associated sudden death (EASD) is typically defined as acute death in an apparently healthy animal within one hour of exercise. Bennet and Parkin define sudden death as any horse that perished from non-musculoskeletal causes within 72 hours of racing, using five “codes” unique to the Jockey Club's Equine Injury Database (EID). Left undefined are the facts behind how a horse becomes classified into one of these categories.

Even the authors of the paper agree that “it would be reasonable to assume that several of the listed codes would not be accurate.” By the authors' own admission, using the EID with undefined codes that may have very different meanings in different jurisdictions result in conclusions that are not accurate.

More importantly, only 5.6% of the horses in this study started without Lasix. No effort is made on the part of the authors to determine what, if any, other factors are associated with not using Lasix. For example, they have determined that older horses are at higher risk of EASD, and this age group also consists of almost all horses who race on Lasix. The younger age group is the only age group where any number of horses can be found that race without Lasix.

The bigger question–completely ignored by the authors and their study funded by The Jockey Club–is why do horses in North America suffer EASD at a substantially lower rate than their counterparts in other parts of the world? In this paper, EASD (with all the caveats previously mentioned about its definition) occurs at a rate of 0.13/1,000 starts, which is close to 10% of the total deaths of racehorses. In Australia, this rate is more like 25% of the total, with a whopping 37% of these EASD a result of Exercise Induced Pulmonary Hemorrhage (EIPH). In a similar study in the United Kingdom, published by the same researchers in 2011, the rate of EASD was 0.3/1,000 starts.

Bennet and Parkin–of all people, being well familiar with the principles of epidemiology–should know full well that correlation does not equal causation. Yet, they offer in the conclusions of their paper that, “The association between furosemide and sudden death prompts further study to understand which biological processes could contribute to this result.”

What we do know however, is the presentation of information can greatly impact the public's reaction, as we have seen in these recent headlines. As presented in the TDN article and others on this topic, the odds ratio was presented as furosemide increases the risk of sudden death in horses by 62%. Yet as noted by James C Meyer DVM MSc in his recent paper, if stated as an increase in the absolute risk, it would be 0.005%. That figure as you can see does not have the sensationalized purposeful negative effect as saying 62%.

I implore the readers of this letter along with the authors of the JAVMA article to consider that the biological process is simply the passage of time. The most obvious association between Lasix and EASD is that the majority of horses not racing on Lasix during the time of their study were 2-year-olds.

We know there is a mountain of evidence demonstrating that Lasix mitigates EIPH. When combined with further evidence that EIPH remains the most common cause of EASD in other countries, it is beyond irresponsible to use this Jockey Club-funded study as the basis for any policy intended to safeguard the health and welfare of our racehorses.

Dr. Doug Daniels is president of the National HBPA and an equine practitioner who owns Virginia Equine. He owns and breeds Thoroughbred racehorses.

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Published reports and social media have had some incorrect information about what did and didn't happen to my horse Imprimis, who finished second by a nose to Bound for Nowhere in Keeneland's Grade 2 Shakertown Stakes Saturday while racing without the anti-bleeder medication Lasix. I want to set the record straight:

Thank God the considerable blood coming from Imprimis' left nostril after the race was not pulmonary hemorrhaging. It also was not from what has been erroneously reported as being a cut on his nose sustained when he broke through the gate prior to the start. Imprimis does have a sizable bump on his nose – about six inches from his nostril – from where his head apparently hit the gate, but he did not sustain any cuts. The endoscopic examination that I had my private veterinarian conduct did reveal trace levels of Exercise Induced Pulmonary Hemorrhaging. I'm just so thankful that it wasn't more severe.

The bleeding episode apparently was like being punched in the nose, when you can develop a nose bleed without being cut. So Imprimis must have banged his head pretty hard and it went unnoticed.

I also don't retract what I told journalists after the race. I'll say it again right now: It's not good for the industry what they're doing forcing horses, particularly older horses, to run without Lasix in stakes races. And apparently that's not just one trainer's opinion. I didn't know so many people had my phone number, all the horsemen who called or emailed me and said, “thank you for speaking up” — trainers I don't even know. Someone in California called me out of the clear blue and said “thank you, someone had the guts to say something.” I don't look at it that way. At the time, it wasn't about guts, it was about being very upset over my horse. I've been doing this 44 years and it's not just my livelihood, it's my life.

The state vets at Keeneland did a very thorough examination on my horse in the morning. I'm sure they looked at him after he broke through the gate, saw no cuts, saw no head abrasions, no blood in his nose then. They put him back in the gate and let him run. If they had seen anything, I'm sure they would have scratched him.

The first thing I do after a race is look at their legs, and make sure everything is OK. When I subsequently saw his nose and blood just pouring off his left nostril, you have to assume the horse bled.

When the press asked me about the race, the first thing I said was, “Well, I think my horse ran a great race, got beat by a very good horse.” I said, “He beat me, I beat him (in 2019 Shakertown), only noses separated them.”

Then I started on the bleeding, because I thought my horse bled horribly. That's when I made my statement that someone has to explain to me why we're making horses bleed, older horses that have run on Lasix their whole life, and now all of a sudden you're going to penalize the best horses in the country. It's not good for the game, when we can stop it with an easy fix.

My veterinarian's endoscopic exam of Imprimis showed that most of the blood was from banging his head. He did have traces, a trickle down his throat, showing that he did bleed a little in the trachea. We were very lucky. Now he might still be on track for his next race. I was very pleased for the owners that I didn't have to put him away for four or five months. He's bright-eyed today and looks great. He just has a bump on his nose.

There are many horses that bleed significantly but not always externally. It is wrong and naive to think no damage is being done to horses just because they didn't bleed through the nostrils. It is also deceptive for those who are trying to label an EIPH episode only by visible blood from the nostrils. How are you going to tell an owner this horse is going to only run four times this year instead of eight or nine because I need more time in between to heal them up because he bleeds and we can't use Lasix? They are going to start to get disgusted, and horses will be hurt if they return at all. Owners are not going to be as excited about buying horses and racing if they can't run them more than four times a year.

I am on the board of the Florida HBPA. We are scoping stakes horses – which must run without Lasix at Gulfstream Park – and we're paying for it so we hopefully can all learn something and together make informed and intelligent policy decisions from transparent data going forward. I'd say overall that the overwhelming majority of these horses are bleeding to some degree. The numbers aren't good. Do we really want to do this to our horses? I sure don't.

The post Orseno: ‘Wrong And Naïve To Think No Damage Is Being Done To Horses Just Because They Didn’t Bleed Through The Nostrils’ appeared first on Horse Racing News | Paulick Report.

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“Published reports and social media have had some incorrect information about what did and didn't happen to my horse Imprimis…Saturday while racing without the anti-bleeder medication Lasix. I want to set the record straight.

“Thank God the considerable blood coming from Imprimis' left nostril after the race was not pulmonary hemorrhaging. It also was not from what has been erroneously reported as being a cut on his nose sustained when he broke through the gate prior to the start. Imprimis does have a sizable bump on his nose–about six inches from his nostril–from where his head apparently hit the gate, but he did not sustain any cuts. The endoscopic examination that I had my private veterinarian conduct did reveal trace levels of Exercise Induced Pulmonary Hemorrhaging [EIPH]. I'm just so thankful that it wasn't more severe.”

Orseno reported Imprimis is doing well this week, but does have a large bump still visible on his nose. He stands by what he said about the new Lasix rules.

“I also don't retract what I told journalists after the race. I'll say it again right now: It's not good for the industry what they're doing forcing horses, particularly older horses, to run without Lasix in stakes races. And apparently that's not just one trainer's opinion. I didn't know so many people had my phone number, all the horsemen who called or emailed me and said, 'Thank you for speaking up'–trainers I don't even know. Someone in California called me out of the clear blue and said, 'Thank you, someone had the guts to say something.' I don't look at it that way. At the time, it wasn't about guts, it was about being very upset over my horse. I've been doing this 44 years and it's not just my livelihood, it's my life.

“I made my statement that someone has to explain to me why we're making horses bleed, older horses that have run on Lasix their whole life, and now all of a sudden you're going to penalize the best horses in the country. It's not good for the game, when we can stop it with an easy fix.

“My veterinarian's endoscopic exam of Imprimis showed that most of the blood was from banging his head. He did have traces, a trickle down his throat, showing that he did bleed a little in the trachea. We were very lucky.

“There are many horses that bleed significantly but not always externally. It is wrong and naive to think no damage is being done to horses just because they didn't bleed through the nostrils. It is also deceptive for those who are trying to label an EIPH episode only by visible blood from the nostrils. How are you going to tell an owner this horse is going to only run four times this year instead of eight or nine because I need more time in between to heal them up because he bleeds and we can't use Lasix? They are going to start to get disgusted, and horses will be hurt if they return at all. Owners are not going to be as excited about buying horses and racing if they can't run them more than four times a year.

“I am on the board of the Florida HBPA. We are scoping stakes horses–which must run without Lasix at Gulfstream Park–and we're paying for it so we hopefully can all learn something and together make informed and intelligent policy decisions from transparent data going forward. I'd say overall that the overwhelming majority of these horses are bleeding to some degree. The numbers aren't good. Do we really want to do this to our horses? I sure don't.”

The post Trainer Orseno Responds to Bleeding Incident appeared first on TDN | Thoroughbred Daily News | Horse Racing News, Results and Video | Thoroughbred Breeding and Auctions.

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Miller said asking the six and 7-year-olds (respectively) to do so is “inhumane,” because Lasix helps to prevent exercise-induced pulmonary hemorrhage (EIPH).

Miller believes the Lasix ban in California stakes races was enacted as a response to anti-horse racing activists in the state, and argued that images of horses visibly bleeding from the nostrils will be now be publicized by those same groups.

“Talk about just shooting yourself in the foot. These idiots think that is going to move the needle. It's going to move it the wrong way,” Miller said. “The people that like horse racing like it. People that don't—Lasix doesn't matter.”

Read more at bloodhorse.com.

The post ‘These Idiots Think That Is Going To Move The Needle’: Peter Miller Against California Stakes Lasix Ban appeared first on Horse Racing News | Paulick Report.

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They've gone silent.

Officials with the Breeders' Cup, Keeneland and the Kentucky Horse Racing Commission managed to stage five world championship races for 2-year-olds on Nov. 6 (seven races for juveniles if you include a pair of undercard stakes) where the letter “L” for Lasix was missing next to each horse's name in the program, past performances and official chart.

Eighty-five 2-year-olds competed without race-day administration of Lasix. I'm sure some of the horses showed signs of exercise-induced pulmonary hemorrhage when they were examined by endoscope following their races, but the bottom line is this: The sky did not fall because of a ban on Lasix.

On Nov. 7, the second day of the Breeders' Cup, things were back to “normal.” All 88 North American-based horses contesting nine championship races (plus all 28 runners in undercard stakes) were given an injection of Lasix approximately four hours before competition – whether or not they really needed it to treat internal bleeding. Trainers of 13 of 18 runners from overseas opted to have the drug given to their horses, too, even though they don't need it or use it in their home countries. All of the European winners – Glass Slippers in the Turf Sprint, Audarya in the Filly & Mare Turf, Order of Australia in the Mile (plus the second- and third-place runners from Aidan O'Brien's Irish stable) and Tanawa in the Turf – raced on Lasix.

I think it's fair to assume the use of this drug is a “when in Rome” decision by those overseas  trainers who don't want to compete on a playing field that isn't level. And if they didn't believe Lasix enhances performance of the competition they were facing, why would they use it on their horses?

It's not just the Breeders' Cup Future Stars Friday program that has gone Lasix-free. In several major racing jurisdictions across the U.S., 2-year-old Thoroughbreds are competing without the use of the race-day drug. And the sky is still not falling.

I've talked to several trainers who were not eager for the change and they've said a small percentage of their 2-year-olds have bled this year – one of them adding that it's possible a horse that did bleed might have done so even if it had been administered Lasix. One of the trainers said horses seem to be coming out of their no-Lasix races with more energy than their 2-year-olds had in previous years when competing with the drug in their system..

Things get more complicated in 2021 when the ban on Lasix is extended to all stakes races in states where a coalition of tracks are partially eliminating the drug. That means horses likely will be racing on Lasix in non-2-year-old maiden and allowance races, then going without it in stakes races. Will “Lasix off” become the same kind of handicapping angle many horseplayers now use with “Lasix on”?  It's not a good look for a sport when drugs are considered a factor in whether or not a horse will win.

The stakes race Lasix ban also means trainers with horses that have a history of bleeding will be trying other remedies. There will be lots of junk science and snake oil being sold.

The pearl clutchers who claim American racehorses cannot survive without Lasix are the same people who maintained that anabolic steroids were therapeutic and that horses (especially geldings) needed them to get through demanding training regimens. They're the same people who say horses need regular doses of clenbuterol because they're in dusty barn environments that create breathing problems.

Lasix is not the biggest problem facing this sport. It's nowhere near the focus of the FBI's investigation into illegal doping of racehorses that will be playing out for months, possibly years, to come. But the use of Lasix in nearly 100% of horses to address a problem that exists in a much smaller percentage of runners is an indication of how pervasive horse racing's drug culture has become.

That's my view from the eighth pole.

The post View From The Eighth Pole: The Sky Is Not Falling Because Of Lasix Ban appeared first on Horse Racing News | Paulick Report.

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Size doesn't matter much when it comes to wounds, said Dr. Suzanne Mund, a veterinarian in the Western College of Veterinary Medicine's Department of Large Animal Clinical Sciences. A small wound on a joint can be much more serious than a large wound over a lot of muscle.

More-severe wounds often occur on areas of the horse's body that has a lot of blood vessels, which increases the risk of bleeding and infection. Areas of concern include along the jugular vein, between the hind legs, around the elbow and underneath the skin. Injuries to the backs of legs are of great concern as many tendons and ligaments are located here. Wounds in any of these areas should be seen by a veterinarian as soon as possible.

Wounds that occur on high-motion areas like joints are fraught with complications, including the trapping of gas beneath the horse's skin. Wounds in these locations open and close as the horse moves, forcing air up and potentially elsewhere into the horse's body, like between the lungs and heart. This can become an emergency situation if the air collapses a horse's lung.

Tears or cuts to the skin are generally treated by flushing, draining and stitching them. Puncture wounds are more dangerous and can carry bacteria and debris deep into tissues, potentially encouraging an abscess or tetanus.

If there is an object embedded in a horse, it's important that it not be removed until an X-ray of the area can be taken. This will help guide the veterinarian on the correct course of treatment. Any wound that exposes internal structures is an emergency situation and a vet should be called.

Mund encourages owners and caretakers to call a vet if there is any question on how serious the wound is.

Read more at Horse Journals.

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