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Carpenter: The Public Wants Change, Not Explanations, When It Comes To Racing Injuries

For racetrackers outside the state of California, the public uproar over the 2018-19 spate of racehorse deaths at Santa Anita probably feels like a memory. After all, in the time since then, many have been riding out constant financial uncertainty thanks to an ongoing global pandemic, and several states have faced threats to supplemental gaming or HHR income.

For racetrack practitioner and surgeon Dr. Ryan Carpenter though, the sea changes that started with mainstream media attention on Santa Anita haven't finished – and they probably won't anytime soon. Carpenter has been outspoken ever since about the ways he has seen the public focus improve racing for the better in California. At a recent virtual edition of the Tex Cauthen Seminar on racing safety, Carpenter continued to provide his thoughts on the interaction between the racing world and the world at large.

Carpenter was the first to admit he was skeptical of the initial changes the state and track ownership rolled out in response to the crisis — chiefly, backing up therapeutic drug administrations – but after seeing them in action, he believes they are making a real difference. The new requirement to have horses examined after workouts and races has been key in letting veterinarians get a look at horses in vulnerable moments when they're most likely to show signs of a brewing discomfort due to bone remodeling.

But although trade media acknowledged when Santa Anita's spike not only passed, but fatality rates decreased significantly, Carpenter pointed out the mainstream media did not view it the same way. He highlighted a recent Los Angeles Times editorial that concluded: “If track owners and trainers want to keep racing horses, then they need to keep them from dying in the process.”

“The reality is that every horse that sustains a fatal injury in Southern California is going to make the news, in one form or another,” he said. “It's talked about commonly on news outlets like NPR and it's going to be in the LA Times or the national news.”

Carpenter presented the results of a study undertaken by the Thoroughbred Safety Coalition to better understand the impact of the Santa Anita breakdowns on public opinion. Survey takers were asked about what they thought the future of racing should be before and after they read about the Santa Anita fatalities. They were asked to choose whether they believed racing should continue, continue with reform, or be banned outright. As other surveys have shown, a small group of survey takers wanted racing banned – 16% of respondents before they'd read about Santa Anita and 19% after reading about it. The most interesting change for Carpenter was that 57% said prior to learning about Santa Anita that racing should continue on with reforms, but the number jumped to 66% after they read about the breakdowns.

Most people (82%) said the industry's biggest priority should be better protection of the safety and well-being of horses. Another 46% wanted to see increased transparency and accountability for rulebreakers.

The survey also asked people to indicate whether they had a favorable or an unfavorable opinion of various sports, including professional football, basketball, soccer, and racing. The Triple Crown was viewed favorably by 46% of respondents, unfavorably by 24%, and 30% had never heard of the series or didn't know enough to form an opinion. The American horse racing industry generally was 37% favorable, 35% unfavorable, 27% undecided – roughly equal to boxing and not too far off from the rankings for the greyhound racing industry. Professional football, by contrast, had left a favorable impression with 60% of followers and an unfavorable one with just 28%.

Carpenter thought the latter statistic was interesting, given the heat professional football took for its treatment of concussions a few years ago. It would seem it has rebounded some of its public trust in the intervening years thanks to reform and good marketing.

One of the most disturbing findings for Carpenter was a question asking people who they trusted to help enforce safety rules in racing. Large animal veterinarians like himself ranked highest, getting trust from 70% of the audience. Animal rights groups including the People for the Ethical Treatment of Animals (PETA) ranked second, with 49% of respondents saying they trusted the group to help enforce safety rules in racing.

“We can't let PETA – who doesn't want to reform the way we do things, they want to eliminate the way we do things – be the trusted voice for people to go to,” he said.

Carpenter cited a bill sponsored by a California assemblyman who took input from the industry and from PETA when drafting the legislation.

“Unfortunately, he followed some of PETA's recommendations. This bill was passed and is currently the law of the land in California. Some of the things we're doing differently is because PETA was able to speak on our behalf. In all honesty, we can't let this happen. We as veterinarians have to be the ones to speak on our behalf, and on the behalf of the horse.”

What about the familiar refrain from many hardboots that we simply have to tell the outside world what a good job racing does at protecting its equine athletes?

“People often say to me, 'You know Ryan, we just have to educate them about what we're doing. Once they understand what we're doing, they'll understand why we're doing it,'” he said. “I think it's important to acknowledge the fact that by and large, that train has left the station. While I don't think education is bad, if you look at this graph and you look at the stat analysis, people aren't asking us to teach them what we're doing. They're asking us to do it differently by putting the horse's safety first. I think you can do that when you cultivate a cultural change in your industry and in your backstretch.”

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Kentucky, New York Move Toward Tougher Restrictions On Clenbuterol

Trainers in several states could soon contend with tougher restrictions on the administration of clenbuterol, a bronchodilator prescribed for respiratory issues which veterinarians say can be misused. At a Dec. 1 meeting of the Kentucky Equine Drug Research Council (EDRC), committee members passed a proposed rule change for the drug which would move administration time from 14 days pre-race to 21 days pre-race, with a requirement the horse be tested for the substance before being cleared to run.

Clenbuterol is a beta-2 agonist which is known as an effective solution for horses battling respiratory ailments — a particularly common problem in racetrack barns which often have poor ventilation. Like other beta-2 agonists, however, it can also decrease body fat and increase muscle mass, particularly by converting slow twitch muscle to fast twitch muscle when used repeatedly.

At a September meeting of the EDRC, Kentucky Horse Racing Commission equine medical director Dr. Bruce Howard revealed that nearly 100 percent of Kentucky-based horses from trainers currently under federal indictment showed signs of clenbuterol administration when they were hair tested. Howard has also seen instances of veterinarians prescribing the drug to every horse in the barn.

The measure to move back the drug's administration time was not without debate. Dr. Andy Roberts, member of the EDRC and longtime Standardbred veterinarian, raised concerns about the harness population's ability to treat horses for illness under a 21-day withdrawal.

“I don't want to diminish the concerns about clenbuterol, because I think it's not illegitimate to want to control its administration to legitimate therapeutic purposes, however I think the Standardbreds are taking it quite strongly in the shorts in this because our horses race every week,” said Roberts. “There's almost no opportunity to put horses on clenbuterol already. Several other states already recognize this and have shorter withdrawals on clenbuterol.”

Roberts asked Howard whether out-of-competition testing at Red Mile had detected any clenbuterol use thus far, and Howard said it had not.

“That's because you've taken the drug out of my hands on a therapeutic basis,” said Roberts, who also maintained that the repartitioning effect of clenbuterol on muscle lasts for 11 days. “Passing rules based on speculation that somebody else is doing something — and I say this specifically from a Standardbred point of view because these horses are in to go often enough that you have already severely limited my ability to use this drug properly. People would rather leave horses sick and end up with pleural pneumonia than treat them with clenbuterol. That means we are over-regulating it.”

The 21-day window is based on the limit of detection by drug testing laboratories tasked with finding clenbuterol in a horse's urine sample. Blood and urine tests would be used to clear a horse to race after clenbuterol administration. Hair samples would show clenbuterol administration for up to six to twelve months after administration, but are highly variable depending on hair growth rates.

All EDRC committee members except Roberts voted for the increased restriction.

The vote comes a day after commissioners in New York expressed an interest in restricting clenbuterol use there, too. The Daily Racing Form reported the New York State Gaming Commission voted to require veterinarians to seek permission from the equine medical director before administering the drug, and that horses receiving clenbuterol must pass drug tests showing it has cleared the system before being permitted to run. That is similar to rule language being considered in other Mid-Atlantic states. In Canada, clenbuterol administration was pushed out to 28 days pre-race earlier this year. The American Quarter Horse Association announced a zero tolerance policy on clenbuterol in 2014, which has subsequently been picked up by several states where Quarter Horse racing is a central part of the calendar.

Experts have raised concerns about the potential for clenbuterol abuse for years, but the drug has made more headlines this year, as influential trainers like Mark Casse have called it one of the “most abused drug in our industry.”

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Hall Of Fame Veterinarian Swanstrom Dies At 80

Veterinarian Dr. Oscar Swanstrom has died at the age of 80 after a lifetime devoted to veterinary medicine. Swanstrom grew up on a family farm in Arrowsith, Ill., and attended veterinary school at the University of Illinois.

Swanstrom enlisted in the U.S. Air Force, where he was commissioned a captain and served as base veterinarian at Moody Air Force Base. He then received a master's degree in veterinary medicine with a focus on radiology and orthopedic surgery before practicing in Illinois, largely at Chicago area Thoroughbred tracks. He eventually moved to Kentucky, where he became a well-known practitioner at Churchill Downs and surrounding facilities.

Swanstrom is the author of several academic studies and is known for his work studying therapeutic swimming, as well as intra-articular therapies.

Swanstrom was inducted into the International Veterinary Hall of Fame in 2005 at Churchill Downs.

He is survived by his wife Theresa, son Justin, daughter Kasi Cox (Jeremy) of Westport; his grandsons, Colton S. Cox and Ryan L. Cox of Westport; his granddaughter, Ruby Elizabeth Swanstrom of Simpsonville and several nieces and nephews.

Read a complete obituary here.

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University Of Florida Vets Use Placenta-Derived Treatment For Animals With Severe Bone Loss

A human placenta-derived compound developed by a University of Florida faculty member in the Herbert Wertheim College of Engineering is being used with promising results by veterinarians at UF's College of Veterinary Medicine to treat animals with severe bone loss.

Without the compound, the animals — which included a giraffe at the Jacksonville Zoo and Gardens and two pet dogs — would have almost certainly faced amputation of the affected areas, the veterinarians said.

The product's developer, Peter McFetridge, Ph.D., the Integra Lifesciences Term Professor in the J. Crayton Pruitt Family Department of Biomedical Engineering, studies the engineering of viable “living” tissues and organs for the repair and regeneration of diseased tissues. Stan Kim, BVSc., an associate professor of small-animal surgery at UF, learned of McFetridge's work and was intrigued about the placental compound he had been testing in rodent models with some success.

McFetridge and Kim began discussing possibilities for the product's additional use in small animals. Kim treated the dogs with the new compound at UF's Small Animal Hospital earlier this year.

“Both dogs had very bad fractures that did not heal and had lost a lot of bone,” Kim said. “Typical treatments usually fail in these types of cases.”

The dogs were completely healed after the placental treatment, he said, and are doing very well.

“The most exciting thing about the placental compound is that it seems to regenerate bone in a remarkable manner,” Kim said. “Although our main excitement is with regenerating bone, we have also had very positive results with wounds.”

Meanwhile, Kim's colleague, Adam Biedrzycki, BVSc., Ph.D., an assistant professor of equine surgery at UF, had been contacted in January by the Jacksonville Zoo and Gardens about the possibility of helping with the treatment of a 2-year-old reticulated giraffe named JoJo, who had become severely lame in October. Despite various treatments provided at the zoo, JoJo's foot problems had worsened.

“They asked if I or a colleague had any interest in consulting or participating in the case,” Biedrzycki said.

JoJo had a severe case of septic arthritis in the medial claw of her right front foot, he said. The zoo had been treating the giraffe with analgesics, antibiotics and stall rest, and had even applied a custom-made boot from a farrier who works with exotic hoof stock. However, radiographs appeared to show bone abnormalities and deterioration, contributing to lesions and fluid drainage.

“I told them that giraffes are certainly not my area of expertise, but in a bovine or horse with this condition we would do massive bone grafts, place antibiotic beads, administer antibiotics directly into the limb and spend lots of time and money trying to save the digit. In a cow, we would drill out and remove the dead or damaged tissue surrounding the foot bone. Then we would cast it followed by regular bandage changes on the limb and leave it to heal.”

That was essentially what was done with the giraffe, he said — but with the addition of the placental compound.

Biedrzycki spoke with Kim, who had used the placental compound successfully in a few cases. Kim put Biedrzycki in touch with McFetridge to further discuss the product and its potential for treating infections and stimulating bone growth.

Biedrzycki then brainstormed with Jacksonville Zoo veterinarian Yousef Jafarey, D.V.M., and his team to develop a plan: They would cut out the diseased bone, clean out the area and put in bone allografts, antibiotic beads and the placental product “to try to speed things up.”

The giraffe wore a cast on her foot, and three cast changes were performed six weeks apart. The second time, the area was cleaned out a bit more and additional placental compound was applied, Biedrzycki said.

“It was a very big deal,” he said. “I was really impressed with the whole team effort.”

That effort involved the zoo's keepers, its animal health team, an anesthesia crew and many more people performing various duties along the way, Biedrzycki said.

“You also had an army of people massaging the giraffe's neck, another team putting antibiotics in the vein, and the surgery team working on the foot, along with a farrier to help trim the foot,” he said. “There were probably about 30 people altogether working on this giraffe. I think they have the whole procedure down to an art now.”

He said the collaborative effort and range of expertise at the zoo was likely why JoJo did so well with the procedure and continues to improve.

“So far, the outcome is excellent,” he said. “The infection is gone and there is new bone growth at the site showing fusion between the bones, which is really unheard of. She still has some limb swelling, which will take a while to go down. But JoJo seems pretty happy at this stage.”

Jafarey said the zoo was astounded at JoJo's progress since working with Biedrzycki and the UF team.

“The introduction of this new compound has been integral in her recovery and we are excited that our organization participated in this groundbreaking research,” he said.

The material the UF veterinarians have been using started out being used to drive the regeneration of large vessels for heart bypass, McFetridge said.

“I never thought it could be used clinically, as it contains a lot of human maternal tissues, from the placenta, as well as the fetal side of the placenta,” he said. “But after several animal studies, we discovered that there was no negative immune response at all, and that it had a potent healing effect across a range of different tissues.”

Unlike typical biologic treatments that have one response, the placenta-derived material seems to promote healing in several vastly different tissues including bone, blood vessels and skin, McFetridge added.

McFetridge and two of his biomedical engineering department colleagues, Jon Dobson, Ph.D., the J. Crayton Pruitt Family Professor, and Blanka Sharma, Ph.D., an associate professor and the J. Crayton Pruitt Family Term Fellow, have co-founded a company in Gainesville, 42Bio, to commercialize the product for veterinary applications. They recently got private funding to move forward with research facilities at The Hub, UF's business incubator.

“So we're hoping to be able to provide this amazing material more widely, especially as we find out, almost daily, how well it helps heal critical injuries. The healing responses we've seen in the giraffe and the dogs are almost jaw-dropping.”