Ogden Mills Phipps:
I, too, want to thank Bill Thomason and his colleagues at Keeneland for being such willing and gracious hosts for this Welfare and Safety Summit. They’ve been truly remarkable in how helpful they’ve been.
Dr. Benson has been leading the charge for the RMTC for the last two years, and today she’s going to tell us about some of the recent efforts of the organizations. Dr. Benson brings a unique set of qualifications to the task. In addition to her veterinary degree, she’s practiced law for eight years, including a stint on the National Arbitration Forum, and she was once a detention barn technician at the Minnesota State Veterinarian’s Office. She’s been all over the place and we welcome her today.
Dionne Benson, DVM:
Thank you for inviting me to speak with you this morning. In my two years as executive director of the RMTC I’ve learned how important research and data are to developing a medication policy that safeguards the health and well-being of the horse.
First, a medication policy is an absolute necessity. Racehorses require medical treatment for their comfort, well-being and safety.
Unfortunately, when it comes to Thoroughbreds untreated ailments or injuries, even minor ones can quickly cascade into more grave conditions. So we need medication. At the same time, we need to ensure that medications are not being used to mask injury. Now as much as it sounds attractive to say no medication ever, that is not an appropriate medication policy.
Such a policy is a dereliction of our responsibility to the horse.
So begins the debate. What is good policy? When it comes to medication, not only is there no shortage of opinions, there is no shortage of conflicting facts or at least opinions presented as fact, and that’s where research and data becomes so vital to sound policy.
Thanks to the financial support of a variety of industry groups and especially The Jockey Club the RMTC has funded extensive research in therapeutic drugs to help horses in training, as well as guidelines to prevent their misuse. The resulting data has made an incredible impact in racing policy today.
After half a century of dissonant state policies, RMTC has established thresholds for 26 therapeutic medications, and with few exceptions, these protocols mandate the discontinuation of medications well in advance of a race to insure the horse is not competing under the active effect of these medications, simply put just because of a medication can be detected at a minute level does not mean the drug has any active effect.
In fact, a metabolite for alcohol can be detected for as many as four days after a cocktail. That is not to say everyone is walking around Saratoga under the influence.
Globally, it is well recognized that scientific research must drive decision making. Only by combining clinical information and pharmacokinetic data through these type of research projects are we able to create practical and enforceable regulations to protect our human and equine athletes. Some have criticized the RMTC’s therapeutic threshold list which was used to develop the Controlled Therapeutic List. How is the Controlled Therapeutic List created? We took the most common positives for therapeutic medications and matched them up with a list of necessary medications provided by AAEP veterinarians. Jurisdictions across the United States are currently working to authorize and implement this list. Research into therapeutic medication is comprised of two parts.
First, how long is the medication effective, and what is the trace level of medication when it is no longer effective? One recent example of using research to set a threshold is the medication Ketoprofen. In 2014, the Kentucky Equine Research Council and the RMTC funded research to determine a threshold for this non-steroidal anti-inflammatory medication.
The new goal of the research was to develop a new methodology for detecting Ketoprofen. The previous methodology limited the laboratory's ability to find Ketoprofen to administrations occurring within 12 hours of racing. With this research, the new method allows for a much lower level of detection increasing the threshold fivefold. This in turn allows the commissions to regulate Ketoprofen to levels found when it is administered at 24 and even 48 hours pre-race.
Within the past year there have been a number of similar projects funded with the assistance of other organizations. For example, the New York Thoroughbred Horseman’s Association funded a study of Banamine through the RMTC. This study allowed for revision of the withdrawal recommendations for this non-steroidal anti-inflammatory medication from 24 to 32 hours.
Another area which the RMTC uses research to protect horses is its tactical research program. Tactical research is used to help identify and develop testing for new illicit substances. The RMTC receives Jockey Club funding specifically for this purpose.
Finding new substances starts with intelligence from investigators as well as information from trainers, grooms, and other concerned individuals. Often samples are confiscated from searches of barns, licensees, or veterinary trucks.
I have been involved in many of these searches and removed as many as 200 bottles of inappropriate substances from veterinarians, trainers and grooms in a single day of inspections.
The RMTC will use confiscated and in some instances purchase samples for analysis.
Our RMTC accredited laboratories perform analyses of these samples to determine which substances are present. This can allow the laboratory to develop testing for new or illicit substances. The RMTC has also used this process to assist commissions in the identification of unmarked illegal substances obtained from licensees.
Moreover, the industry in general has used this type of research in creating testing and regulations for substances such as dermorphin and cobalt.
Individual racing jurisdictions are also using these tactics to combat the presence of unapproved compounded medications. For example, in my home state of Minnesota, the racing commission submitted two seized compounded products to an RMTC accredited laboratory. They were able to test the concentration of the medication compared to the claimed concentration on the label.
For one substance, the laboratory reported the concentration was less than 45% of that claimed on the label. For the other, the same laboratory reported the actual concentration was less than .02% of that claimed on the label.
By using this information to educate veterinarians regarding the inconsistency of certain products as well as their potential dangers, we promote human and equine safety by keeping these substances off the racetrack.
A number of other commissions are using data to protect our equine athletes. Kentucky is involved in two such initiatives. The first involves using intelligence-based decision making to select horses for post-race sampling. With the exception of stakes races where a minimum of four horses undergo sampling, Kentucky currently collects blood and urine samples from two horses in each race.
The winner of the race is always sampled. The second horse to be sampled in a race is selected by the stewards. The samples are then designated either red or gold. In terming whether a sample is designated gold, the stewards consider the factors listed on this slide.
All gold samples are to be analyzed in the laboratory. Fifty percent of the red samples are blindly selected by the laboratory for analysis. The other 50% are not analyzed but maintained for six months and can be analyzed at a later time.
Using this model, the Kentucky Horse Racing Commission has reduced its overall testing costs by 16%, and has not significantly changed the number of positive tests reported. This cost savings allows Kentucky to continue to provide a high level of testing for both therapeutic medications and other substances.
Another way that the Kentucky Horseracing Commission is using data to protect horse welfare is by reviewing what they call filters-off data.
Filters-off data allows Dr. Scollay, the equine medical director, to see all the trace levels residue in tested horses. This review allows for identification of the full spectrum of medication administration. This can ultimately drive overall regulatory efforts as well as increase scrutiny of specific medication practices in horses.
Here [slide] we have the filters-off data from a track in Kentucky. Prior to -- this is prior to when the new regulations went into effect. Each horizontal line represents a horse. You’ll see the overall medication burden of these horses is relatively low. Most of these horses have received only one non-steroidal anti-inflammatory medication, and some have been administered one corticosteroid. None of these are in excess of the then in effect regulations.
By comparison, this slide shows the filters-off data on another day at a Kentucky track. If you look at the analytical data from the highlighted horse, this horse has a corticosteroid and three non-steroidal anti-inflammatories at measurable levels on race day. None of these is above the regulatory threshold.
However, to prevent a horse from racing with three anti-inflammatories present, the RMTC has recommended secondary thresholds for adoption. This is a great example of data-driven recommendations geared toward equine safety.
In addition to comparing one track to another and one day to another, the veterinarian can even identify specific horses or trainers for increased scrutiny. For example, if a specific horse has a high medication burden based upon this information, it may allow for closer scrutiny of that horse during its next pre-race examination. By being aware of how much and what types of medication have been in a horse, the regulatory veterinarians are better equipped to judge its soundness for racing.
This information makes the equine medical director and state veterinarians better able to identify at risk horses or concerning trends in trainer medication policies. Both of which will ultimately protect the horse.
Using data, we make better decisions with regard to testing, medication, policy, horse safety, and the wise and sustainable use of finite industry resources, and better decision making will translate into improved safety for our equine and human athletes.