Boehringer Ingelheim Announces 2022 Advancement In Equine Research Award Recipients

Boehringer Ingelheim Animal Health announced the recipients of the 2022 Advancement in Equine Research Awards during the 68th annual American Association of Equine Practitioners (AAEP) Convention in San Antonio, TX, November 18-22. The recipients were chosen based on their research proposals centered on equine infectious respiratory disease and equine asthma syndrome.

Recipients include the following:

  • Renaud Leguillette, DVM, MSc., PhD, DACVIM, ACVSMR and Macarena Sanz, DVM, PhD, DACVIM — University of Calgary College of Veterinary Medicine, Calgary, AB, Canada
  • Shadira Gordon, DVM, MPVM and Nicola Pusterla, DVM, PhD, DACVIM, DAVDC —University of California, Davis, Davis, CA
  • Noah D. Cohan, VMD, MPH, PhD — Texas AgriLife Research College of Veterinary Medicine, College Station, Texas
  • Shannon Massie, MS and Renaud Leguillette, DVM, MSc., PhD, DACVIM, ACVSMR — University of Calgary College of Veterinary Medicine, Calgary, AB, Canada
  • Shadira Gordon, DVM, MPVM, Nicola Pusterla, DVM, PhD, DACVIM, DAVDC and Beatriz Martinez Lopez, DVM, MPVM, PhD — University of California, Davis, Davis, CA

In support of their research, each recipient will receive $15,000. With the inclusion of this year's recipients, Boehringer Ingelheim has given more than $700,000 towards the advancement of equine research since 2011.

“At Boehringer Ingelheim, we acknowledge that the health and well-being of animals is pivotal to the success and development of human life. Our dedication and passion for the advancement of equine research makes Boehringer Ingelheim a global leader in its field,” said Steve Grubbs, DVM, PhD, DACVIM, equine technical manager for Boehringer Ingelheim. “Previous award recipients have made novel research advancements in equine infectious and non-infectious respiratory diseases, and we anticipate that this year's grantees will follow suit.”

Those eligible to submit proposals were veterinarians, diagnosticians, and public and private researchers in the United States, Canada and Mexico.

For more information about the Advancement in Equine Research Awards here.

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In The New Era Of Medication Rules, There Will Be No Withdrawal Guidance

As Jan. 1, 2023, ticks closer, lots of uncertainty remains about the future of the national regulations put in place by the Horseracing Integrity and Safety Act (HISA). The centralized Authority created by the Act was dealt a blow last week when a federal appeals court ruled the group's governance was unconstitutional.

For now though, there is no order in place shutting down the activities of the Authority and therefore nothing that will halt the upcoming implementation of the anti-doping and medication control rules that will go into effect on New Year's Day. At that time, all equine samples will be tested by accredited labs and all will be subject to the same battery of tests, unlike the current system, where drug rules vary from state to state and drug testing contracts do, too. Penalties will also be uniform and officials have promised the arbitration and appeals process will be swifter than it currently is through the state system.

The Authority has contracted with the Horseracing Integrity and Welfare Unit (HIWU), which is a division of Drug-Free Sport International to handle all drug testing and results reporting.

At the recent annual convention of the Association of Equine Practitioners (AAEP) in San Antonio, representatives of the Authority and HIWU gathered to field questions from veterinarians about those upcoming national rules and drug testing changes.

Whether you're a horseman or a veterinarian, there are educational resources available to help you better understand regulations here on the HIWU site and here on the Authority's website.

Here are a few things we learned from that discussion, which included Drs. Sue Stover, chair of Racetrack Safety standing committee, Mary Scollay, chief of science for HIWU, Lisa Fortier, racetrack safety committee member, and Scott Stanley, anti-doping and medication control subcommittee member.

Withdrawal times are a thing of the past. For many years now, trainers and veterinarians have relied on suggested withdrawal times to decide how far ahead of a race they should stop giving a particular drug. The new rules do not include any withdrawal times.

Why not?

The text of the federal law, to which the Authority and HIWU are bound, requires the groups to base their medication rules on international standards for racehorses. Other countries, which base their medication rules on the International Federation of Horseracing Authority's guidance, do not provide withdrawal times. They instead provide “detection times.”

Detection times are based on the available peer-reviewed study of a substance. If a group of horses in a study are all given a drug and sampled at set time points after that administration, “detection time” is the first time point at which all the horses in that study were negative for the substance.

Why does it matter? Scollay noted that many existing administration studies of drugs in horses may be based on small numbers of horses. Everyone recognizes that there is individual variability in drug metabolism, and a lot comes down to the dose given and route of administration.

Detection time should be a starting point for veterinarians and trainers to decide when to withdraw a drug, but they aren't replacements for withdrawal times. If you use detection times interchangeably with withdrawal, you're running a higher risk of a drug positive than you were under the old system, because you could be working with a different dose, administration route, or a horse with a different metabolism.

“It's a big change, but I'm here to tell you, you can do it,” Scollay said.

Previously, withdrawal guidance offered by the Association of Racing Commissioners International or Racing Medication and Testing Consortium looked at these detection time and essentially built in a statistically-calculated cushion to account for these differences.

In many cases, cautious trainers are already building themselves a cushion over the existing withdrawal guidance. One practitioner in the audience stated that although non-steroidal anti-inflammatories may be given up to 48 hours prior to post time, they were on a practical level more often given 52 to 60 hours pre-race since that's when a practicing vet would be at the barn.

–The change is just as much philosophy as practice.

The detection time system is supposed to make trainers and veterinarians think a little harder.

“You shouldn't be frightened on these detection times,” said Scollay. “What they're intended to do is make you say, does this horse really need this medication? If we're just medicating to keep the trainer happy, maybe we shouldn't be doing it.

“I think this is going to get us all to revisit our pre-race protocols as far as blanket administrations, every horse in the barn, all 40, 60 of them getting the same pre-race protocol. Maybe they don't need it. Maybe some of them do but maybe some of them don't. The changes you're dealing with are not going to be cataclysmic, but they are going to require you to think.”

–FDA status is going to be key. If a drug isn't approved by the FDA for use in horses, it's likely considered to be banned by the Authority. That includes substances like isoxsuprine, whose use in horses was common for a while but which the FDA has recently clarified may not be legally compounded for horses.

–With all medication violations, there is mandatory disqualification. New rules do not allow for any wiggle room on this. Officials do have discretion about how large a fine or suspension may be given to a licensee as a result of a positive test, but there is no mechanism for connections to get out of a disqualification.

–Most substances, but not all, should be stopped by 48 hours pre-race. There are a few exceptions to this, and those drugs are okay up to 24 hours pre-race. They include: altrenogist for fillies, certain ulcer medications, isotonic fluids, vitamins by injection, vaccines, anti-microbials, dewormers, and electrolytes by injection. Electrolytes may be given free choice up until the race, whether as topdressing on feed or in a water bucket (if there is also one bucket of clear water provided to the horse).

–All states have requested an exemption to new furosemide restrictions. That means that all 2-year-olds and all stakes runners (including runners in overnight stakes) may only have furosemide 24 hours pre-race. Three-year-olds and up and non-stakes horses will have their existing state rules in place for the foreseeable future.

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–Post-workout sampling will be happening, but it won't be quite the same as post-race testing. Horses may be drug tested after a timed work but the rules aren't exactly the same as a post-race test. Those tests are designed to look for banned substances, local anesthetics, and analgesics (including non-steroidal anti-inflammatories within 48 hours pre-work and corticosteroids within seven days pre-work). Other substances, like dantrolene, furosemide, methocarbamol, etc. are not of concern in post-workout tests.

“This is a safety and welfare initiative so we know we're not sending horses out who are compromised and can hurt themselves while breezing,” said Scollay.

–Intra-articular corticosteroids will be a 14-day stand-down for racing and for works off the vet's list. The reason the rules are different with these drugs for races versus works is that committee members feared a 14-day pre-workout prohibition would encourage trainers to walk or jog a horse into a race, and wouldn't give veterinarians a chance to evaluate a horse's response to the treatment.

–Will the Authority be sending veterinarians to help with shortages? In the early days of the Authority, there was some discussion suggesting the group would send its own veterinarians to fill shortages in racing states that were strapped. Ann McGovern, director of racetrack safety for the Authority, said that besides the nationwide equine veterinary shortage, they're running into another logistical problem – licensing.

There are some veterinarians who want to help short-handed tracks, but many are experiencing difficulty getting licensed outside of the states they normally practice in. The Authority is working on a provision for regulatory veterinarians, since they're not diagnosing, treating, or prescribing and therefore have different roles than most licensed veterinarians.

–There's still hope a national system for testing will be more efficient. Scollay said trainer Steve Asmussen once told her Gun Runner had been out-of-competition tested 15 times in his career because he participated in so many different stakes with OOCT programs in so many different jurisdictions, and sampling authorities had no way to communicate with each other. There's hope that while the testing bill will rise for some states, it will be a more efficient process overall.

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Secretariat’s Legacy 2023 Calendar Sales To Benefit Trio Of Equine Charities

Fans of Terlingua will enjoy the Secretariat's Legacy 2023 calendar, which honors the great Secretariat mare who set six stakes records on the racetrack and then produced Storm Cat, one of the greatest stallions of all time.

It is the sixth annual fundraising calendar honoring Secretariat and his descendants. The first five calendars in the series, which started with the Living Legends theme honoring the remaining Secretariats, have raised $28,000 for equine charities over the years.

“I am very grateful to all the racing fans – especially Secretariat fans – who have supported both the Living Legends calendar series and the newer Secretariat's Legacy series, which began last year when honoring Weekend Surprise,” said writer/photographer Patricia McQueen, whose creative project is part of her research work on Secretariat as a sire. Her book Secretariat's Legacy will be published in early 2023.

The 2023 calendar is all about Terlingua, and her important descendants included in the calendar are:
 Storm Cat, her G1-winning son who became a legendary sire
 Chapel Of Dreams, her graded stakes-winning daughter
 Giant's Causeway, Storm Cat's champion son who also became a superior sire
• Freud, Giant's Causeway's full brother who has been a perennial New York leading sire
• Bricks And Mortar, the 2019 Horse of the Year son of Giant's Causeway
• Gun Runner, the 2017 Horse of the Year out of a Giant's Causeway mare
• Wise Dan, the two-time Horse of the Year who is a great-grandson of Storm Cat and also a grandson of the Secretariat mare Askmysecretary
 American Pharoah, the 2015 Triple Crown winner who is a great-grandson of Storm Cat
• Pink Lloyd, another great-grandson of Storm Cat, who earned eight Sovereign Awards in Canada
• Into Mischief, the latest super-sire from Storm Cat's sire line

As with previous calendars, the Tony Leonard Collection continues to generously support the series with a beautiful photo of Secretariat and Ron Turcotte before the Belmont Stakes. Mr. Turcotte has generously agreed to autograph a limited number of calendars to help raise even more funds.

All profits from the sale of the calendar are allocated to three worthy organizations: Bright Futures Farm and Canada's LongRun Thoroughbred Retirement Society, both accredited by the Thoroughbred Aftercare Alliance; and Victory Alliance Ranch, an equine rescue and sanctuary supporting veterans and special needs children.

Calendars are available for $25 each at www.SecretariatCalendar.com. Free shipping within the US is included.

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Ask Your Veterinarian Presented By Kentucky Performance Products: Dr. Larry Bramlage On Bisphosphonates In Young Horses – Where Are We Now?

Veterinarians at Rood and Riddle Equine Hospital answer your questions about sales and healthcare of Thoroughbred auction yearlings, weanlings, 2-year-olds and breeding stock.

Question: You first raised the alarm about the potential drawbacks of bisphosphonate use in young racehorses several years ago now. Where are we with these drugs now?

Dr. Larry Bramlage, Rood and Riddle Equine Hospital: In 2016, we began talking to our clients about a phenomenon that we were seeing more and more frequently in young racehorses. The problem was being seen in all common bone injuries that we encounter in the racehorse from dorsal cortical stress fractures to condylar fractures to the very common subchondral bone inflammation/bruising of the distal cannon bones. In some horses, orthopedic injuries were not healing or healing very slowly compared to what we expected. Clinical experience, retrospective studies of success rates, and published papers has given us pretty solid evidence of what to expect as the healing time with the treatment of the commonly encountered racehorse conditions. But suddenly some horses were taking three or four times the time expected to heal and a few never fully healed. The number of these slow healing injuries continued to grow during 2015.

As we began assessing the histories of horses where the aberrant healing was occurring, many had a history of bisphosphonate use as yearlings to improve the radiographs for sale or as a racehorse during a bout of lameness. So, we began discussing the findings and informing veterinarians, trainers, and owners of the possible detrimental side effect of bisphosphonate use. Veterinarians in many locations were making the same observations of disturbed healing and possible increased injury rates in young training horses of several breeds.

Bisphosphonates were approved in 2014. In 2015 we began to see storms of slow healing fractures and slow healing distal cannon bone subchondral bone inflammation/bruising. That led to the suspicion that bisphosphonates may be the reason.

Bone healing is a two-phase process. The bone bridges the fracture gap with new, poorly-organized bone that can be formed very quickly. Then it remodels the stabilized fracture back to the bone's pre-fracture architecture. Once the fracture gap is filled, the bone damaged by the fracture and the newly-deposited bone are removed and replaced with the appropriate trabecular or cortical bone, depending on the structure involved. This process involves two cell types — osteoclasts which remove bone and osteoblasts which make bone. As the osteoclasts remove the weak bone, the osteoblasts follow immediately behind to reconstruct the normal bone. The anatomy varies depending on which bone is injured and where it is injured, but bone is one of the few tissues capable of perfectly replacing itself when injured.

Bisphosphonates kill osteoclasts. It bonds to the surface of bone and when the osteoclasts try to remove the bone that needs to be replaced, they die after ingesting the bisphosphonate. This arrests the remodeling process and stalls bone healing by stopping the remodeling phase of healing. This is true for macro injuries such as fractures and for micro injuries which result from routine training. The injured bone can make new bone but it can't be remodeled without osteoclasts to clear the way for the osteoblasts.

Osphos, one of two bisphosphonates FDA-approved for use in horses four years old and up

So what good are bisphosphonates and why were they developed? Bisphosphonates were developed to arrest the hormone-driven bone remodeling which is common in post-menopausal women who get too little exercise. The hormonal driven remodeling removes an inappropriately large amount of bone and weakens the skeleton, especially the vertebrae, which when weakened can result in the “dowager's hump” spinal deformity. The bisphosphonates were given to prevent the removal of the bone by killing the osteoclasts.

But bisphosphonates also have another effect. They cause non-specific pain relief, analgesia, in bone. This led to their use to manage pain in bone tumors in people, especially in cancer of the spine. The mechanism is still unclear, but the analgesia is significant and non-specific so if you give it systemically it will help manage the pain no matter where the tumor is located. This analgesia led to the use of bisphosphonates to manage lameness in horses. The proposed mechanism is that it stops excessive bone remodeling in sites of lameness by arresting bone removal. Whether blocking bone re-absorption or a primary analgesia is the mechanism of action is still debated. The blocking of bone re-absorption led to use to try and increase the density in the skeleton by stopping bone loss to the remodeling process. So, bisphosphonates gained popularity to try to increase the density of bone in bone remodeling sites such as sesamoids and navicular bones. And, they became popular as the perfect lameness treatment; it is effective if the lameness originates in the bone, and you don't even have to know the site of origin.

But there is a price to be paid. Killing the osteoclasts prevented the normal bone remodeling necessary to maintain a developing skeleton (e.g., the young training racehorse). This retards adaptation to training, potentially increasing the susceptibility to injury, and it nearly arrests the remodeling process that is the second phase of bone healing in a fracture or in trauma to the bone.

The difficulty is if a horse is given bisphosphonates it binds to the interior surfaces of bone and can persist two years or more. So many horsemen weren't even aware, when a horse arrived for training, that there was a history of bisphosphonate use.

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To their credit, most horsemen and veterinarians quickly understood the risks of bisphosphonate use and the use rapidly declined over the next two years in young training horses. The drug still has a place in certain conditions in older horses, but it does not in the young training athlete. It can be dangerous to the horse's career and their resistance to injury. It is approved by the FDA for horses with navicular disease who are four years old or older.

So, where are we now? Sales companies and racing jurisdictions have stepped in and outlawed the use of bisphosphonates in most venues. Currently we still see an occasional horse with a fracture that shows disturbed healing but there is nowhere near the incidence of the problem that was occurring in 2015 and 2016. Veterinarians, owners, farm managers and trainers appear to have mitigated the use of bisphosphonates and should be credited with their response to protect the health and welfare of the horses. Sales companies and regulatory agencies have done their part and the current situation appears to be generally free from bisphosphonate use in the young growing and training horses. A horse that we suspect is showing signs of bisphosphonate treatment in the past still presents occasionally, but not regularly any longer. I suspect bisphosphonates are still intermittently used when a horse does not respond to common treatments.

To all of our credit, this has been a positive response to an initially unknown complication of treatment that was detrimental to the racehorse. For all of the things we wring our hands about that we have trouble changing, this is one we could, and did, circumvent for our good and for the good of our athletes.

Dr. Larry Bramlage of Rood & Riddle

Larry Bramlage is a 1975 graduate of the Kansas State University College of Veterinary Medicine (DVM) and received a Master of Science degree from Ohio State (MS) in 1978. He holds a Diploma of the American College of Veterinary Surgery (Diplomate ACVS). 

Bramlage is an internationally recognized equine orthopedic surgeon, and is a senior surgeon at Rood and Riddle Equine Hospital in Lexington, Kentucky. He is a past President of the American Association of Equine Practitioners, and of the American College of Veterinary Surgeons.

In recognition of his dedication and contribution to Thoroughbred racing, Bramlage was awarded the 1994 Jockey Club Gold Medal for contributions to Thoroughbred Racing in the United States. He is also a past chairman of the Research Advisory Committee of the Grayson-Jockey Club Research Foundation and serves on the Board of Directors for that organization. His additional honors include the 1997 Tierlink Hochmoor Prize for his work regarding the internal fixation of fractures, the 1998 distinguished alumnus award from The Ohio State University, Alumni Fellow Award from Kansas State University, a British Equine Veterinary Association's Special Award of Merit, and the American College of Veterinary Surgeons Legends award for the development of the fetlock arthrodesis procedure for horses in 2009, and the Thoroughbred Club Testimonial Award in 2014. He has received the American Association of Equine Practitioners Distinguished Service Award twice. He was elected to membership in the Jockey Club in 2002 and to Distinguished Lifetime Membership in the American Association of Equine Practitioners in 2010.

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