Clenbuterol Q&A With Dr. Rick Arthur

The tide is turning on clenbuterol. Within the past month, regulators and racetracks nationwide have announced new initiatives to quell its abuse. New prohibitions are in the pipeline for the New York State Gaming Commission, the Maryland Racing Commission, Gulfstream Park, Oaklawn Park and an alliance of Mid-Atlantic racetracks.

On May 1, the Canadian Pari-Mutuel Agency started banning clenbuterol 28 days out from race day at tracks country-wide. The California Horse Racing Board (CHRB) took action four months before that, enacting a years-in-the making, zero-tolerance clenbuterol clampdown that began New Year’s Day 2020.

Drawing upon 10 1/2 months of perspective so far, TDN wanted to hear from Rick Arthur, DVM, the CHRB’s equine medical director, to find out what California regulators and racetrackers have learned since the ban went into effect. Arthur fielded questions during a Nov. 17 phone interview, and an edited transcript of the conversations follows.

TDN: Please open with a condensed history of clenbuterol’s rise in California from a bronchodilator to treat equine airway disease to a widely abused drug known to mimic the muscle-building properties of anabolic steroids.

RA: It is a very effective drug for lower airway disease. It is, I think, one of the better drugs I saw introduced during my years of practice. It just wasn’t being used for small airway disease in some of the stables that we saw.

Shortly after the ban on anabolic steroids [by the CHRB in 2008] we started seeing an increase in the use of clenbuterol, primarily in Quarter Horses, but also in Thoroughbreds. In fact, in out-of-competition testing [OOC] we found 58% of Thoroughbreds and 100% of Quarter Horses had clenbuterol in blood tests. It became clear that it was an issue, and there were trainers who were very adept at using a lot of clenbuterol and still being able to get below the threshold level, which at the time was 5ng/ml in urine, which is fairly high.

Finally, the Quarter Horse industry came to us and said we need to do something about this. And what we did was eliminated the authorization for clenbuterol. And then some Thoroughbred trainers shortly thereafter asked us to do the same thing, which we did [in 2012]. So what happens is, if one guy is using clenbuterol, everybody has to use it, right? It does have a partitioning effect [that promotes lean muscle mass].

So what we did is we eliminated the authorization for clenbuterol. At the time our detection time was roughly between 14 and 21 days. And for the most part that worked fairly well. But what we saw in Quarter Horse racing is there were still certain trainers that were still able to find ways to use clenbuterol to their advantage.

The CHRB adopted the Racing Medication and Testing Consortium [RMTC]’s 140pg/ml threshold in blood in October 2014. In 2015, Quarter Horses reverted back to no authorized level-no threshold. And then that Quarter Horse regulation for clenbuterol became effective for Thoroughbreds on Jan. 1, 2020.

   TDN: And what is the plain-language explanation of CHRB Rule 1866.1? (Read the full version here).

   RA: Any horse who is treated with clenbuterol goes on the vet’s list. That horse stays on the vet’s list until it tests negative for clenbuterol in both blood and urine after working out. Even though it doesn’t have a specific stand-down [time frame], it is very hard to get a horse of the vet’s list that’s been treated with clenbuterol within 30 days. Most of them [stay on the list] quite a bit longer, just as a practical matter. But that’s how the rule reads: To prescribe clenbuterol, you have to have [an appropriate respiratory] diagnosis. You have to report the dosage. You can’t have a prescription that goes for over 30 days.

   TDN: What has the CHRB learned about clenbuterol since the new rule went into effect?

   RA: Most practicing veterinarians say that even though they miss the drug, they have not seen very many negative effects. And we [as regulators] certainly have not seen any negative effects so far this year from not having clenbuterol. They can still use it if really needed, but the restrictions make it difficult to use with an actively racing horse.

I’m sure there would be some trainers who would like to use clenbuterol, in terms of horses, particularly, that aren’t receiving Lasix. Those horses would be treated after their races. But we haven’t seen that. We monitor this with [OOC] hair testing, and when we see clenbuterol in hair, we require the trainer to show us a prescription for that drug in our OOC regulations. In fact, all of the horses [this year] that have tested for clenbuterol in hair have been treated outside of California. That number would probably be a dozen, roughly.

We still see clenbuterol prescribed occasionally. It’s still being used, but we don’t see it in blanket use that we saw previously. Those horses are on the vet’s list, and I don’t think any of them started within 30 days of being treated with clenbuterol.

TDN: As you watch other jurisdictions crafting clenbuterol rules, what advice would you have for those regulators or for racetrack officials considering in-house policies?

RA: I think testing the horse to be clear of clenbuterol is key. From our experience with the drug, which is pretty extensive, trying to set a withdrawal time-like 30 days, which some jurisdictions are talking about-is not adequate. There’s enormous individual variation with this drug, and I think that before a horse is allowed to enter, they should prove that they have no clenbuterol in their system with a urine test.

TDN: Regulators are always involved in a cat-and-mouse chase with dopers who are one step ahead of the rules. Now that the window of abuse on clenbuterol is closing, what under-the-radar performance-enhancing substance or practice is likely to surface next?

RA: It’s not really under the radar. We are concerned with SARMs [selective androgen receptor modulators]. Those are a class of drugs that have anabolic-like activity, but they are not really anabolic steroids. We’ve seen some of them in testing already. The RMTC has recommended that a number of those be classified as serious violations. So that is a group of drugs that I think that we have to pay attention to.

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Casse: Kentucky, Louisiana Need To ‘Get On Board’ With Clenbuterol Restrictions

Hall of Fame trainer Mark Casse shared his thoughts on this year's new clenbuterol restrictions with the Thoroughbred Daily News on Tuesday. First, he said he was pleased with the new policies implemented at Woodbine this year, and lauded the Mid-Atlantic region, Oaklawn, and Gulfstream Park for adding restrictions for 2021.

“As a result, we have seen almost none of the nonsensical form reversals that had haunted us in the past at Woodbine in 2020,” Casse told the TDN.

Still, there are several major racing jurisdictions that have yet to change their policies, Casse lamented.

“My question is, what is taking Kentucky and Louisiana so long to get on board?” he said. “I am very disappointed that we ran the recent Breeders' Cup series at Keeneland with the same Clenbuterol rules that have failed us in the past. In life and horse racing, there are not many things I am certain of, but one thing I am positive about is the need for the Horseracing Integrity and Safety Act to be passed by the Senate. Because only when we have national uniformity of medication rules will inequities of this patchwork quilt that has plagued the sport be solved.”

Read more at the Thoroughbred Daily News.

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Mark Casse On Clenbuterol Changes

Editor’s Note: In Monday’s TDN, Bill Finley made reference to Mark Casse’s comments on Clenbuterol in a Mar. 2 Op/Ed in the TDN. Casse sent us this note in response.

Much has changed since my Mar. 2 Op/Ed with regards to Clenbuterol. Canada made big changes to their Clenbuterol policy and, as a result, we have seen almost none of the nonsensical form reversals that had haunted us in the past at Woodbine in 2020. I was elated to see the Clenbuterol changes for 2021 in the Mid-Atlantic region. Also, I commend Louis Cella and Oaklawn for their revised Clenbuterol policies. And just today, I read where The Stronach Group has implemented new Clenbuterol rules for the upcoming Gulfstream Park Championship Meet. Cheers!

My question is, what is taking Kentucky and Louisiana so long to get on board? I am very disappointed that we ran the recent Breeders’ Cup series at Keeneland with the same Clenbuterol rules that have failed us in the past. In life and horse racing, there are not many things I am certain of, but one thing I am positive about is the need for the Horse Integrity and Safety Act to be passed by the Senate. Because only when we have national uniformity of medication rules will inequities of this patchwork quilt that has plagued the sport be solved.

The post Mark Casse On Clenbuterol Changes appeared first on TDN | Thoroughbred Daily News | Horse Racing News, Results and Video | Thoroughbred Breeding and Auctions.

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View From The Eighth Pole: The Sky Is Not Falling Because Of Lasix Ban

Where are the pearl clutchers? You know, those people who promised that we'd be seeing jockeys with red-splattered pants getting off horses who gushed blood during a Thoroughbred race because trainers couldn't give the animals a diuretic four hours before competition.

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.

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