Medina Spirit To Be Buried At Old Friends

Old Friends, the Thoroughbred Retirement facility in Georgetown, KY., will inter the ashes of multiple graded stakes winner Medina Spirit on Tuesday, April 5. Medina Spirit will be laid to rest in Old Friends's Nikki Bacharach Memorial Garden alongside such champions as Kentucky Derby Winners Charismatic (1999) and War Emblem (2002), as well as Eclipse Winner Hidden Lake and Breeders' Cup Classic Winner Alphabet Soup. Old Friends will host an open house Tuesday, April 5, 2022 from 12:30pm to 2:30pm to offer fans an opportunity to visit the grave site and pay their respects to this great athlete. In addition, the farm will also pay tribute to friend and supporter Bob Neumeier, the acclaimed sports reporter and NBC racing analyst who passed away October 23, 2021.

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Letter to the Editor: Joseph S. Bertino, Jr., PharmD, FCP, FCCP

I am writing to try to clear up some of the confusion concerning the science around betamethasone as it pertains to its use in racehorses. I am a (human) clinical pharmacologist and the Editor-in-Chief of the Journal of Clinical Pharmacology.

Why are there different forms (salts) of betamethasone (in this case acetate and valerate)?

Many drugs do not dissolve well in water, so other molecules are added to them so that they can dissolve in water in order to make useful dosage forms. Sometimes these other molecules are added to the drug to make them last longer in the animal when injected into something like a joint, that is, dissolve very slowly (think of a slow-release drug). Often, the betamethasone used to inject into a joint has two forms, one that is already dissolved to act sooner and one that remains in the joint and delivers [the] drug more slowly. For use on the skin, betamethasone valerate is used and can be absorbed into the animal. Betamethasone from any of these salts is the same in the animal's body; it's a potent drug used to reduce inflammation and pain and its effect is long lasting in any form.

What happens to these other molecules added to betamethasone?

The body removes these extra molecules added leaving the main drug (in this case betamethasone) to do its work. For betamethasone valerate in an ointment, some of it will be absorbed and the amount depends on the integrity of the area it is being applied to. The valerate added to betamethasone would be found in the urine along with some betamethasone valerate. For betamethasone acetate, the acetate is removed and used in the body to make other things so finding it in the urine would be quite unusual.

How does a drug like betamethasone work to reduce inflammation and pain?

Inflammation occurs due to the animal's immune system working and its reaction to an injury. The drug acts to calm down the immune system to produce its effect. Betamethasone in any salt form does not work immediately when injected in a vein, a joint, or applied as an ointment. This effect takes time to occur (at least a few hours after the animal gets the drug). Even when the drug is completely gone from the body, the effect remains for some time (hours or days) because it takes the immune system time to gear back up (and hopefully the injury is healed). So that means even if small amounts or no drug is found in the blood, the effect on inflammation and pain lingers after a dose.

Do we know the relationship of the amount found in the blood and the drugs' effect on reducing inflammation and pain?

Absolutely not, we do not know how much drug in the blood is needed to get the effect to reduce inflammation and pain. Measurement of the drug in blood is not a good indicator of the dose of the drug used or when the drug was given; it simply tells us that the animal has received the drug. This is the reason that there is such a long time between injection of the drug into a joint and when a horse can race “clean” as set up in the rules of a racing commission.

What can measurement of drug in the blood tell us?

Measurement of drug in blood can tell us how much total drug can be found in the blood of the horse but not how much total drug is in the body of the horse. For Medina Spirit, a measurement of 21 pg/mL in the blood was found the day he won the 2021 Kentucky Derby. The average blood volume of a horse is 54.5 liters (54,500 mL or 12.3 gallons). So, if you multiply 21 pg/mL x 54,500mL of blood, you get 1.14 micrograms total in the blood. The usual dose injected into a joint in a horse is 9 mg (9,000 micrograms), and since the betamethasone acetate used is designed to dissolve slowly, we would suspect that there could be more drug remaining in the joint than what is reflected in the blood.

So, what does this all mean? 

Well first, betamethasone is betamethasone, it doesn't matter how it got into an animal (injection, ointment, etc.), it is active in reducing inflammation and pain. Next, finding low amounts of the drug in the blood does not tell us when the drug was last given. It does tell us that an exposure has occurred and may be ongoing. Since the drug effect is long lasting (and lasts even after the drug concentration is low or no longer measurable in the blood), a significant effect on inflammation and pain may still be occurring. Finding betamethasone valerate in the urine is not unexpected when betamethasone valerate is used as an ointment [as] some is absorbed. When using betamethasone acetate injection, finding no acetate in the urine is expected because the body uses the acetate that is shaved off the betamethasone to make other things.

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CDI: Baffert’s Derby Lawsuit a ‘Manufactured Emergency’

The gaming corporation that owns Churchill Downs told a federal judge in a late-night Tuesday court filing that Bob Baffert's lawsuit to try and get his private-property banishment and exclusion from the GI Kentucky Derby lifted would not only harm the corporation's portfolio of tracks, but would hurt the owners and trainers of other horses who have rightfully earned Derby berths but would be precluded from entering if the court rules they had to be pushed off the qualifying list to make room for the barred trainer.

“This lawsuit is Bob Baffert's latest attempt to evade responsibility for his wrongdoing,” stated the Mar. 29 filing by Churchill Downs Incorporated (CDI), in United States District Court (Western District of Kentucky).

“Baffert could have filed this lawsuit ten months ago,” the filing continued. “Instead, his lawyers spent the time working the press and trying without success to persuade other courts and tribunals of Baffert's innocence. They only came to this Court after all their other gambits and legal maneuvers failed.

“They are now rushing into this Court with the 2022 Derby just over a month away, demanding an expedited preliminary injunction on the basis of a manufactured emergency in hopes of litigating Baffert's way into the race.”

Baffert had sued CDI Feb. 28 in an attempt to get an injunction enjoining CDI from suspending him from its tracks and races, and prohibiting Baffert and/or any horse trained directly or indirectly by him from earning points, qualifying and entering the Derby in 2022 and 2023.

Baffert has since transferred four Derby aspirants to other trainers, and he is simultaneously fighting an under-appeal Kentucky Horse Racing Commission suspension of 90 days that is set to start Apr. 4 because of a betamethasone positive in Medina Spirit, his now-deceased 2021 Derby winner.

“There is no legal precedent, in more than a century of Kentucky and federal law, for what would amount to a judicial takeover of the Derby—an eleventh-hour edict forcing CDI to accept a trainer whose conduct threatens the safety and integrity of the race,” CDI's filing stated, explaining how Baffert has failed to meet any of the three requirements for relief.

“First, Baffert has not shown he will suffer irreparable harm absent an injunction,” the filing stated. “His tactical, ten-month delay negates any claim of irreparable harm. His primary alleged harm—the loss of purse money—is speculative and would be fully compensable by money damages in any event.

“Nor will he lose his client base or suffer a loss of goodwill absent relief. Since his CDI suspension began, he has run horses in hundreds of races around the world at virtually the same frequency he did prior to the suspension. Although he claims some horses have been transferred from his care, he provides no evidence that these transfers resulted from CDI's suspension, rather than from the suspension imposed by the KHRC or another state racing authority…

“Second, Baffert has failed to establish a likelihood of success on the merits. His due process claim fails because CDI is a private corporation, the individual defendants are not government officials, and no one violated Baffert's rights in any event,” the filing continued.

“Baffert's claim for “wrongful exclusion” fails because CDI has a well-settled common law and contractual right to exclude from its property and its races repeat offenders like Baffert who endanger the safety of horses and jockeys, and threaten the integrity of the sport and CDI's signature events. And his antitrust claim fails because he does not allege, let alone establish, basic elements of Sherman Act liability.

“Third, the equities cut strongly in CDI's favor. An injunction would cause substantial harm to CDI, including to its business interests, brand, and customer goodwill, and would injure the owners and trainers who would lose their fairly-earned berths in the Derby to make room for Baffert,” the filing stated.

“An injunction would also undermine the strong public interest in ensuring that all who attend, watch, or bet on horse races have confidence in the safety and integrity of the sport. For all these reasons, this Court should deny Baffert's motion for a preliminary injunction. Defendants will soon file a motion to dismiss this lawsuit in its entirety.”

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More Confusion Added to Baffert Appeal Process

With the clock ticking toward the Apr. 4 deadline for trainer Bob Baffert's looming 90-day suspension, a Kentucky Court of Appeals judge now wants to figure out whether the original venue chosen for legal action last month by the owner and trainer of disqualified 2021 GI Kentucky Derby winner Medina Spirit constitutes the correct county-level court. Dick Downey of the Blood-Horse first reported on the judge's order requesting briefs from the movants (Baffert and Zedan) and the respondent (the KHRC) covering just that single issue to be filed with the court by Tuesday.

Because of overlapping uses of the term “appeal,” it has grown difficult to keep track of the status of what has now escalated to Baffert and owner Amr Zedan's intertwined administrative and legal cases against the Kentucky Horse Racing Commission (KHRC).

At the commission level, Baffert and Zedan have already appealed the KHRC's penalties (the suspension and a $7,500 fine for Baffert, plus the forfeiture of Zedan's purse winnings from the Derby) that were handed down Feb. 21 in the wake of now-deceased Medina Spirit's betamethasone positive in last year's Derby.

But when a routine request to stay those penalties (pending the outcome of the commission-level appeal) was denied by the KHRC Feb. 25, Baffert and Zedan took the matter to Franklin Circuit Court Feb. 28.

A Franklin Circuit Court judge Mar. 21 rejected Baffert and Zedan's plea for a stay or temporary injunction to keep the penalties from going into effect, so the trainer and owner bumped up their request to the next legal level, the Court of Appeals, Mar. 24.

On Mar. 25, the Court of Appeals judge raised the out-of-the-blue issue of whether the underlying Franklin Court appeal originated in the correct venue in the first place.

As Downey reported, the question drills down to: Should the case have originally been heard in Jefferson County (specifically Louisville, where the Derby itself is run), Fayette County (Lexington, where the KHRC's offices are headquartered), or Franklin County (Frankfort, where the Kentucky Public Protection Cabinet, the KHRC's parent organization, is housed)?

Even if Baffert prevails in this Court of Appeals attempt, he is still barred from having horses qualify for and run in the Derby based on a separate, private-party prohibition issued by the gaming corporation that owns Churchill Downs.

But Baffert is also fighting that banishment in federal court even while contingently transferring his Derby contenders to other trainers so they can try and earn qualifying points and enter the Derby.

 

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