Does HISA Remedy CHRB, VMB Turf War?

The ongoing stand-off between California's Veterinary Medical Board (VMB) and the California Horse Racing Board (CHRB) has amounted to a regulatory turf war over California's backstretch veterinarians.

So far, the state's VMB has flexed its primacy, issuing dozens of records requests and, in a number of instances, complaints against vets within this colony. The highest profile such case concerned a settlement last year with CHRB equine medical director, Jeff Blea.

In that settlement, the VMB issued Blea a fine of more than $130,000, required him to undergo continuing education classes and placed him on probation–this, for issues that a consensus of prominent equine veterinarians said amounted largely to relatively minor record keeping violations, those typically resulting in just fines.

At the crux of the interagency dispute is this question: To whose set of rules should California's racetrack vets adhere? The VMB's rules built around the California Veterinary Medicine Practice Act, or the CHRB's own set of regulations?

This is a crucial question for the vets with complaints issued against them as the VMB is often seeking punitive actions for veterinary practices that are permitted under the CHRB's rule book.

This means that if a veterinarian settles their case with the VMB and returns to work under a probation order, they face potentially serious consequences–the loss of a license even–for breaching the VMB's standards of equine care, all the while abiding by the CHRB's rule of law.

But given federal preemption of state law, does the advent of the Horseracing Integrity and Safety Act's (HISA) anti-doping and medication control program (ADMC)–now set for launch later this month–change the dynamic of this regulatory impasse by becoming the ultimate arbiter of backstretch veterinary practice?

The answer is not altogether clear.

According to wording of the act, “HISA rules preempt State laws or regulations with respect to matters within the jurisdiction of HISA,” wrote Monica Vargas, a spokesperson for the Department of Consumer Affairs, which oversees the VMB.

In other words, HISA preempts state law only to the rules written into its books. The HISA Authority–the broad non-profit umbrella established by the act–takes a similar stance.

“The Act states that HISA rules preempt state law and regulations on the particular matters that the HISA rules address. In other words, if no HISA rule has been promulgated on a particular matter, a State is free to continue regulating it,” wrote a HISA spokesperson.

Scott Chaney | CHRB Photo

According to CHRB executive director, Scott Chaney, the broader matter of racetrack veterinary oversight is therefore far from resolved, with the advent of HISA meaning that California's backstretch vets are now essentially subject to three main regulatory bodies–the CHRB's rules still applying when neither HISA nor the VMB's rules are applicable.

“To me, this is the worst of all worlds–some areas preempted by HISA and other areas not,” said Chaney.

Craig Robertson, outside counsel for the American Association of Equine Practitioners (AAEP), also views the issue through muddy legal waters.

“If HISA speaks on a subject, it's intended to be pre-emptive. But you're likely to get into arguments about whether a specific subject is one that HISA speaks on and then preempts or not,” Robertson said. “I just don't think it is going to be black and white.”

As such, Robertson said that he is gearing up for a slew of lawsuits around the country, seeking to define who has ultimate jurisdiction over what when it comes to backstretch veterinary practice.

“There's enough grey area and nuance that I think it's going to make for creative lawyering for people like me to be able to argue various sides of these particular issues,” Robertson added.

Among some of the areas of conflict between the VMB and the CHRB that HISA appears to have resolved concerns drug administration.

This includes the use of what the VMB terms “dangerous drugs”–like the ubiquitously administered sedative acepromazine–and the use of non-FDA approved compounded medications like dantrolene, used on horses that tie-up.

Though the use of compounded medications are a standard practice in veterinary medicine, the CHRB's own Rule 1867 (b) has long stated that “the possession and/or use on the premises of a facility under the jurisdiction of the Board of any drug, substance or medication that has not been approved by the United States Food and Drug Administration (FDA) for use in the United States.”

The medical board has interpreted that rule categorically, detailing in complaints how no compounded drugs are FDA approved for use on CHRB licensed grounds, even if compounded from FDA approved parent drugs.

This prompted a recent CHRB emergency rule modification changing the language of the rule to permit awfully prescribed, compounded medications manufactured to federal and state guidelines.

Furthermore, the Horseracing Integrity and Welfare Unit–the arm of HISA charged with rolling out its ADMC program–has issued its lists of controlled and banned substances, making clear which drugs are permitted for use in covered horses and when. HIWU's controlled substances list includes medications like dantrolene and acepromazine.

“HISA obviously talks about medications and the treatment of horses,” confirmed Robertson.

HISA also has a provision that says, “the administration of medications and treatment methods to covered horses should be based upon an examination and diagnosis,” Robertson added.

This leads onto another backbone of the VMB's complaints against California's backstretch veterinary community: Alleged problems with their record keeping and with their veterinarian-client-patient relationships (VCPR), which covers a vet's familiarity with an animal before diagnosing and treating a medical condition.

According to the VMB, multiple California veterinarians have allegedly failed to establish an appropriate VCPR before administering, prescribing, dispensing, or furnishing medications and other medical treatments to the horses in their care.

In this regard, several equine veterinary experts have argued that the VMB has misconstrued the basic nature of backstretch veterinary practice, mistakenly substituting common standards of care around small animal practice for that in large animal practice, including herd animals.

Once again, HISA law appears to preempt the state in these matters, with statutory language covering both veterinary record keeping and the VCPR.

Indeed, “Any HISA regulation that requires veterinary records to be provided to the Authority preempts any state law that would require client consent for the veterinary records to be provided,” confirmed a HISA spokesperson.

But grey areas remain. For one, HISA fails to establish a clear set of protocols around some of the more nuanced aspects of general equine veterinary care, such as the prophylactic administration of medications, along with the use of certain medical procedures like endoscopies (otherwise known as “scoping”), said Chaney.

“The harder cases are when it comes to standard of care and quote, un-quote negligence,” said Chaney. “I can imagine the vet' med' board still wanting or believing that they regulate in that space, and with good reason. But given how HISA is dancing around those issues, has that space been preempted? I think that's murky.”

Equally murky, it seems, is whether the California VMB will unilaterally pursue disciplinary actions against licensees who are sanctioned by HISA for HISA rule violations.

According to HISA, the VMB is prohibited from taking that course of action under specific circumstances.

“The Horseracing Integrity and Safety Act dictates that, now that HISA's Anti-Doping and Medication Control regulations have been approved by the FTC, HISA preempts any state agency from taking enforcement, investigation or disciplinary actions with respect to medication administration by a veterinarian regulated by the Authority in connection with a Covered Horse,” wrote a HISA spokesperson.

The VMB on the other hand appears to view that door as being much wider ajar.

Vargas wrote how under California's Business and Professions Code, the VMB may “discipline a Board licensee on the grounds of conviction of a charge of violating any federal statutes or rule regulating dangerous drugs or controlled substances or a violation of any federal statute, rule, or regulation regulating dangerous drugs or controlled substances.”

In addition, the same code authorizes the VMB “to take disciplinary action against a Board-licensee on the grounds of disciplinary action taken by any agency of the federal government for any act substantially related to the practice regulated by the Board. Each disciplinary matter involving a Board licensee would be reviewed on a case-by-case basis to determine whether formal disciplinary action should be taken,” Vargas added.

To help realign the regulatory disconnect between agencies overseeing backstretch vets, the VMB established last year an equine practice subcommittee.

Respected equine veterinarian, Barrie Grant, was also recently appointed to the VMB, remedying what had hitherto been a noticeable void of equine expertise on the board.

Still, the ongoing legal uncertainty surrounding backstretch veterinary practice in California is making it a shaky enterprise, said Chaney.

“How can one not be concerned given what's happened over the last year and a half and given overlapping jurisdiction,” said Chaney. “At the end of the day, your regulations and rules have to be clear.”

All this prognosticating on jurisdictional authority, however, might prove premature if HISA is quashed in the courts, warned Robertson.

“Obviously, there's a big question as to whether or not HISA will survive legal challenge,” Robertson said.

“And if you get past that, the next question would be: What form does HISA look like if it survives legal challenge?” Robertson added. “Is it in its current form, or will the courts say that certain parts of it are non-enforceable or somehow limited in some way?”

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CHRB Emergency Rule on Compounded Drugs Geared to Shield Veterinarians

In an attempt to help shield California's backstretch veterinary community from possible further punitive actions by the Veterinary Medical Board (VMB), the California Horse Racing Board (CHRB) has issued proposed emergency regulations designed to clear up discord between these two agencies about the correct use of compounded medications across California's backstretches.

The Food and Drug Administration (FDA) defines the compounding of drugs as “the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of an individual patient. Compounding includes the combining of two or more FDA-approved drugs.”

The tranquilizer acepromazine is a prime example of this process, routinely compounded into liquid form to be prescribed and used on fractious dogs and horses. Other commonly used compounded medications across America's backstretches include dantrolene, used on horses that tie-up, and naquasone, for swelling.

Compounded drugs are not FDA-approved, but they are widely used in veterinary medicine provided the compounding process is done according to federal and state guidelines–a dynamic the CHRB has mirrored as a practical regulatory approach for many years, despite the existence of a state statute that essentially forbids drug compounding on CHRB licensed premises.

CHRB's Rule 1867 (b) states that “the possession and/or use on the premises of a facility under the jurisdiction of the Board of any drug, substance or medication that has not been approved by the United States Food and Drug Administration (FDA) for use in the United States.”

The California VMB interprets that rule categorically. Of the roughly 25 backstretch veterinarians currently working in Southern California, nearly all have accusations, are on probation or have record requests pending from the VMB in relation to potential Rule 1867 violations, according to the CHRB.

Last September, the CHRB issued an advisory to its relevant stakeholders stating that the agency's “longstanding interpretation” of rule 1867 “is that lawfully prescribed, compounded medications which are manufactured according to Federal and State guidelines do not violate this regulation.”

But CHRB equine medical director Jeff Blea said that the current Rule 1867 language “falls short of the intention of the rule.” It has been modified “to allow for quality standard care of racehorses by the use of compounded medications provided they are legally manufactured and prescribed in conjunction with a [veterinary client patient relationship].”

The proposed emergency rule making–one along a truncated timeline–appears geared to help shield veterinarians with pending cases by the VMB against them from a potential regulatory trap if they settle with the VMB and return to work under probation: should they then prescribe and administer compounded medications under the current Rule 1867 language, they could face stark professional consequences.

CHRB executive director Scott Chaney explained that the “sole purpose” of the proposed emergency rule making “is to clarify the language both for the vet' med' board but also for the practitioners.”

When asked if Rule 1867 (b)–adopted more than 20 years ago–should have been modified before to avoid the present professional threat that backstretch veterinarians currently face, Chaney pointed to how the CHRB has never cited a veterinarian for a Rule 1867 (b) violation, and that the board wasn't aware of the VMB filing accusations related to the same rule prior to 2020.

“Looking at it today, the easy answer is yes,” said Chaney. “But I think given it's our regulation and we were always purposeful and public about how we interpreted it, there was no reason.”

The proposed new rules modify Rule 1867 with provisions meaning that “possession or use of any compounded drug, substance, or medication, manufactured according to Federal and State laws and regulations, shall not be considered a prohibited veterinary practice” as long as no other human or animal drugs approved by the FDA to do the same job exist and are available, and that the drug is compounded by a California licensed veterinarian or California licensed pharmacy.

The proposed regulations do not differ substantially from any existing comparable federal regulations or statutes, according to the CHRB.

The CHRB has already noticed the proposed emergency regulations, giving interested parties a five-day public comment period. On Feb. 2, the board will submit them to the Office of Administrative Law (OAL). That office then has 10 days to accept or deny the proposed rules.

If the OAL indeed adopts the proposed emergency regulations in this truncated manner, the CHRB has 180 days to formally adopt the rules though its typical rule-making process. If the OAL denies the proposed rules, the CHRB can still adopt them through that normal rule-making process, but they won't go into effect until formally finalized.

The VMB, said Chaney, was involved in the drafting of the proposed regulations.

“We sent them the language we were thinking about, they made some suggestions. We incorporated a few of them but not all,” explained Chaney. “I know they discussed at their last meeting actually commenting, when they had the opportunity, on our regulation.”

The TDN emailed the VMB a series of questions, including whether the agency endorsed the proposed rules, and whether it would urge the OAL to accept or deny it. The VMB has not responded as of publication.

This action is the latest in a regulatory standoff between the CHRB and the VMB, ongoing since the VMB took the unprecedented step of suspending the license of equine medical director Blea at the end of 2021, only to reinstate his license the following September after finding him guilty of only fairly minor record-keeping offenses.

The VMB has complaints currently open against a number of Southern California veterinarians citing them for various alleged offenses beyond Rule 1867 violations, including the alleged misuse of misbranded drugs and of record-keeping offenses.

“This is the only CHRB regulation that the vet' med' board was using in its accusations,” said Chaney, when asked if the CHRB was planning on issuing other similar proposed emergency regulations.

“There are other causes of action, this just eliminated one of them,” he added. “The others the CHRB can't address, like problems with the Veterinary Medicine Practice Act and prosecutorial philosophy.”

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“Horrifically Wrong”: California VMB and Equine Practitioners at Odds

Last month marked the resumption of business as usual for Jeff Blea, back as California Horse Racing Board (CHRB) equine medical director after an eight-month plus enforced hiatus due to the California Veterinary Medical Board's (VMB) controversial step of suspending his license.

In a settlement with the medical board, Blea agreed to continuing education classes in record keeping, a remittance to the VMB of $131,464 for the investigation costs, and a three-year probationary period.

Those believing the return of Blea to his prior role would bring an end to the veterinary medical board's regulatory inroads into the state's racing industry would be sorely mistaken.

The medical board has ongoing cases against at least nine other backstretch veterinarians in California, and the nature of some of the accusations–often identical in nature to those leveled against Blea–reveal a yawning schism between the veterinary board and the CHRB concerning approaches to standard equine veterinary care.

Until these differences are rectified, the legal ramifications hang like a Sword of Damocles over not just the state's racetrack practitioners but the performance horse veterinary community in general.

“It's been very unusual,” says David Foley, executive director of the American Association of Equine Practitioners (AAEP), about the nature of the complaints against Blea and some of the other backstretch veterinarians.

“If the veterinary medical board is going to interpret the rules in a companion animal manner towards equine practitioners, nobody's going to want to practice in California,” Foley says.

Areas of Conflict

The main areas of disconnect with the medical board–at least where the CHRB is concerned–surrounds the use of what the VMB terms misbranded drugs like Thyro-L, non-FDA approved compounded drugs and the correct nature of the veterinarian-patient-client relationship. More broadly, the disconnect also ensnares the prophylactic use of medications and record keeping differences between small and large animal veterinarians.

In the process, these areas highlight often conflicting sets of rules between these separate state agencies throwing the work of backstretch practitioners into confusion and possible professional jeopardy.

In short, some of the veterinarians with pending cases face a conundrum should they settle with the VMB and return to work under probation: If they then continue to practice under the CHRB's standard of equine veterinary care-but against the VMB's interpretation of the rules-they could face stark professional consequences.

The VMB deems Thyro-L, or thyroxine, misbranded under the Federal Food, Drug, and Cosmetic Act. And in laying out its accusations against some of the veterinarians, the medical board argues that the use of such misbranded drugs is prohibited through statutes written into the California Health and Safety Code.

Specifically, the code states that it is “unlawful for any person to receive in commerce any drug or device that is misbranded or to deliver or proffer for delivery any drug or device.”

Sarah Andrew

Essentially, a drug is misbranded if its labeling proves false or misleading in any particular situation, says attorney Mike Casey, who represented Blea in his case against the veterinary board. This could mean that the drug has been proven effective in the treatment of ailments for which it hasn't been labeled, says Casey, or vice versa.

But confusingly, Thyro-L is labeled for use in horses to treat hypothyroidism–a relatively rare equine condition–if dispensed by a licensed veterinarian.

Furthermore, many equine veterinarians routinely use it to treat a variety of conditions, including insulin resistance, for which there's a body of research.

“Veterinarians have a wide authority to prescribe medications,” says David Ramey, president of the Los Angeles Equine Advisory Committee, who says the VMB's stance on Thyro-L runs “absolutely contrary to regular medical practice.”

Most pertinent for backstretch veterinarians operating in California within the last decade is how the CHRB has issued advisories outlining thyroxine use in racehorses.

The first such advisory came in 2014 following an agency investigation into a series of sudden deaths among Bob Baffert-trainees, which found that the uniform use of thyroxine among the horses in question is “concerning in horses with suspected cardiac failure.”

The CHRB's much tightened rules surrounding thyroxine use went into effect earlier this year.

“If the VMB truly believed that Thyro-L was prohibited in use by the FDA as misbranded, why didn't they simply pick up the phone and call the CHRB,” says Casey. “They've been aware of the concerns surrounding Thyro-L since 2013.”

As a non-FDA approved drug, thyroxine overlaps another key area of conflict between the two agencies-the use of non-FDA approved compounded medications, which is permitted in veterinary practice in California.

So, where does the conflict arise?

Look no further than the CHRB's own Rule 1867 (b) which states that “the possession and/or use on the premises of a facility under the jurisdiction of the Board of any drug, substance or medication that has not been approved by the United States Food and Drug Administration (FDA) for use in the United States.”

The veterinary medical board appears to interpret that rule categorically, stating in complaints against several backstretch veterinarians how no compounded drugs are FDA approved, even if compounded from FDA approved parent drugs.

The list of drugs the CHRB prohibits–at least according to the veterinary board–includes commonly used compounded medications like dantrolene, used on horses that tie-up, and naquasone, which ameliorates swelling.

Crucially, the CHRB's own interpretation of its rules follows existing state law, leaving the door open to backstretch practitioners using compounded medications so long as they contain FDA-approved parent drugs.

Indeed, just last month–seemingly with this interpretive discord in mind–the agency issued an advisory to its relevant stakeholders stating that while compounded medications are not FDA approved, the CHRB's “longstanding interpretation” of rule 1867 “is that lawfully prescribed, compounded medications which are manufactured according to Federal and State guidelines do not violate this regulation.”

The advisory continues: “The CHRB recognizes that compounded medications are necessary for the safe and effective treatment of horses. These medications contain approved Federal Food and Drug Administration (F.D.A.) substances, which have been compounded to achieve proper dosages for safe and effective equine treatment and are necessary for equine veterinarians to effectively treat various medical conditions.”

Furthermore, the CHRB has never filed a complaint for violation of 1867 (b), according to CHRB spokesperson, Mike Marten.

Which leads to the final area of tension-how to define the proper veterinarian-client-patient relationship on a racetrack backstretch.

As the veterinary medical board sees it, no veterinarian can prescribe, dispense or administer a medication without first performing three main tasks: examining the patient and documenting the findings, establishing and documenting a diagnosis, then communicating the best course of treatment with the client.

Among the list of common medications that backstretch practitioners allegedly issued without first performing these tasks includes acepromazine, a tranquilizer used routinely to keep horses calm, and GarstroGard, used to treat stomach ulcers.

But backstretch practitioners and performance horse veterinarians voice frustration with what they see as the VMB's narrow interpretation of this relationship.

The problem arises, says Ramey, because the Veterinary Medicine Practice Act-the overarching rules by which all licensed veterinarians must comport their business-is almost entirely geared around small animal practice.

“The practice act doesn't really address herd health,” says Ramey, who added the American Veterinary Medicine Association (AVMA) is currently reviewing its model practice act to possibly address this. “In herd health, animals aren't always treated individually every time.”

Indeed, California's current laws are “far easier to understand and follow for small animal practitioners (who typically see individual animal patients in a brick-and-mortar context) than they are for veterinarians who treat herds, such as equine or livestock veterinarians,” wrote Dan Baxter, executive director of the California Veterinary Medical Association (CVMA), in an emailed response to questions.

Another wrinkle in the picture, say experts, concerns the currently routine prophylactic use of certain medications in performance horses to avoid injury and the onset of common training-driven ailments.

A prime example in racehorses would be the use of acepromazine-or ace, for short-used ubiquitously during morning training to keep fractious horses calm and to minimize the risk of harm to themselves and others.

“They're saying you can't give GastroGard without listening to their gut sounds and without taking their temp' and what-not on every horse every time. But not every medication requires that degree of [daily diagnosis],” says John Madigan, professor emeritus at the UC Davis school of Veterinary Medicine, calling the VMB's recent actions “horrifically wrong,” due to what he sees as those unfamiliar with equine practice leading complaint investigations.

Who Wields the Stick?

One of the main questions that arise is this: To whose rules should backstretch practitioners adhere?

The CHRB strikes the note that neither agency appears to have “primacy” of authority when it comes to regulating backstretch veterinarians. “And that's the problem because in certain areas there seems to be a disagreement about interpretation,” says CHRB executive director, Scott Chaney.

Veterinary medical board spokesperson, Monica Vargas, equivocated, writing that while the VMB “cannot advise on CHRB enforcement of laws applicable to their licensees,” the VMB has jurisdiction over the practice of veterinary medicine in California “unless otherwise pre-empted.”

Legal pre-emption, in this case, appears to come in the form of the federal Horseracing Integrity and Safety Act's (HISA) racetrack safety rules, which went into effect July 1 and provides guidelines for record keeping and appropriate veterinary-patient-client relationships.

Scott Chaney | CHRB

Indeed, “federal authority does pre-empt state law and state reg's,” says Chaney.

A HISA spokesperson told the TDN that the agency has not yet involved itself with the differences that have arisen between the VMB and CHRB.

For backstretch practitioners with cases from prior years open against them, however-along with the state's broad contingent of performance horse practitioners-HISA pre-emption is a moot point.

That's why California's equine veterinarians and leading equine veterinary bodies have been publicly sounding the alarm about the potential pitfalls of this schism since at least the January veterinary board meeting.

After that January meeting, the CVMA and other stakeholder groups asked the VMB if they could submit a presentation at the following April board meeting about their concerns. The board pulled that presentation prior to the meeting, however.

Asked why, Vargas responded that the presentation went beyond the scope of the request and included, among other things, discussion regarding pending disciplinary matters. “The Administrative Procedure Act prohibits the Board from receiving communications regarding the merits of any issue in a pending disciplinary proceeding,” wrote Vargas.

Interestingly, in a subsequent statement to its constituents, the CVMA took issue with that interpretation, writing that the VMB routinely holds policy discussions concerning the Veterinary Medical Practice Act, including while enforcement cases are simultaneously being conducted.

“If it were the case that the VMB could never talk about problematic regulations or statutes due to a risk of infringing on current disciplinary cases, then the VMB would not be able to function as a rulemaking body at all,” wrote the CVMA.

After that aborted presentation, the VMB assembled a two-person Equine Practice Subcommittee tasked with researching the equine practice regulations and statutes, taking “input” from relevant stakeholders, then “returning to the Board with particular recommendations,” wrote Vargas.

The VMB failed to answer other questions about specific goals of the subcommittee, including those about timelines and about whether the subcommittee's work could lead to amendments to the California Veterinary Medicine Practice Act.

Vargas did write, however, that at the upcoming Multidisciplinary Advisory Committee meeting this Tuesday, the Equine Practice Subcommittee will provide an “update on the issues the Board has directed the Subcommittee to research.”

One of these key stakeholders is the CVMA, which has already approached the VMB several times requesting an “in-depth look be taken at the aforementioned laws,” wrote Baxter.

“The CVMA will continue to engage the VMB in dialogue about the regulations and will strongly advocate for the veterinary profession,” Baxter added.

According to Chaney, the CHRB met with the subcommittee some two weeks ago.

The CHRB's goal for these ongoing negotiations, Chaney says, is “clarity” for licenced backstretch practitioner. “All racing veterinarians that I've spoken with want to comply with CHRB rules and vet' med' board rules, they just don't know what they are right now,” he says.

This “clarity” could come the way of changes to the California Veterinary Medicine Practice Act or to the CHRB's own regulations, says Chaney. But changes to these state rule books can be a glacially slow process.

In the meantime, backstretch practitioners with open cases against them face a Catch-22.

On the one hand, they're incentivized to settle their cases swiftly or even to defend themselves due to the VMB's right, if it prevails on any finding, to seek cost recovery, says Casey.

For Blea, that was a six-figure sum.

However, if the veterinarians settle with the VMB before these practical differences have been smoothed over, they face potentially serious consequences if they then return to active practice under a probationary period.

The VMB is “aware of that potential,” responded Chaney, when asked about this conundrum. But he was unable to elaborate on whether the VMB has proposed any timeline for resolving the agencies' differences.

Investigatory integrity

Which leads to concerns among certain stakeholders about the manner in which the VMB is conducting its investigations into California's backstretch practitioners.

According to both Casey and Blea, neither Blea nor the clients relevant to his case were interviewed as part of the investigatory process.

“At no point did anyone ever ask Jeff [Blea] what was the purpose of administering acepromazine. What was the purpose of administering aspirin powder. He was never asked at any point during the quote, investigation, end quote about anything in his medical record. Not once,” says Casey.

A busy backstretch | Sarah Andrew

“Neither were the trainers, the owners, the grooms,” Casey added. “No one.”

The TDN asked the veterinary medical board about these claims-including about standard investigatory procedures when a practitioner's veterinarian-patient-client relationship is in question-but the agency offered no response.

Other prominent figures in equine practice question the VMB's impartiality in these matters.

As someone frequently called upon to provide expert testimony in cases involving equine practice, Ramey responded to the veterinary medical board's open call for experts in Blea's case, he says.

Ramey told the TDN that when he saw the accusations against Blea, however, he spent an hour and a half explaining to two VMB attorneys that the accusations against Blea amounted to typical standards of care in horses facing rigorous training programs.

“These horses are at risk of developing certain problems, and you're trying to help mitigate that risk,” says Ramey, describing his version of the conversation with the VMB's attorneys.

“The next day they let me know that they did not need my services as an expert witness,” says Ramey, who added that he is “firmly convinced” that the VMB had a “pre-determined outcome that they were looking for.”

It should be noted that Ramey considers himself Blea's professional and personal acquaintance.

“I think it's important that the public is protected against poor veterinary practice,” he responded, when asked about how this relationship might color his opinions. “But [Blea's case] wasn't that.”

When asked about Ramey's claims, Vargas wrote that “As the adjudicator in administrative disciplinary actions, the Board does not participate in prosecutorial activity leading up to an administrative hearing. As such, the Board has no knowledge of expert witness preparation discussions for administrative hearings.”

In speaking with nearly a dozen equine practitioners or leading figures within prominent veterinary organizations, it's clear the ongoing philosophical and practical discord in equine practice has rattled the veterinary community in California.

Some veterinarians have already begun to question their professional futures in the state, says Madigan. “Unfortunately,” he adds, “a lot of veterinarians are thinking 'I just hope it doesn't happen to me.'”

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