The Problem With Drugs

Even though the weather in California is beautiful, you’ve got a horse that’s not acting quite himself. This 2-year-old colt has a fever, has been depressed, has gone off feed, and isn’t tearing the barn down as usual. You know he’s got a respiratory bug, and it’s not getting any better. The veterinarian says the lungs are a bit congested; probably a bacterial infection. While it is worrisome to have a sick horse, you are relieved—modern antibiotics to the rescue

"So," you say, "just give him penicillin for a week or so and he’ll be right as rain."

Feeling smug with your knowledge that Streptococcus strains are the No. 1 pathogen in equine respiratory disease, and that the No. 1 antibiotic for treating strep is penicillin, you start to walk away.

The veterinarian makes you pause with his next question. "When are you planning on running him again?"

Of course, you have no intention of running the good colt until he is well, you think a big indignantly. But then, you know your vet well, and you trust him implicitly. There has to be something behind his question.

"What gives?" you ask innocently.

What gives is not the penicillin. Procaine penicillin, to be exact. Procaine is a seldom-used, short-acting (about an hour) local anesthetic, but when it is combined with penicillin G, it gives a long-sustained action to the antibiotic.However, procaine is one of the drugs selected for testing in racehorses. A procaine positive in California means redistribution of purse monies and possible heavy fines because it also can be a local anesthetic. The tests cannot determine if procaine was given as part of the antibiotic treatment. So, you say to the vet, "Give the horse what he needs. We can give him some extra time off before he goes back to racing."

"Okay," says the vet as he draws up the syringe. "But he could be away from competition for a month or more after the last dose."

What?!? The "snots" can be cured in a week or so. With another week for training him back up to speed, he’ll be rarin’ to go. (Not to mention that he’s the one who has been paying the feed man.)

"The complex of procaine and penicillin has a long half-life," the vet explains. "It could show up as a positive drug in tests for 21-30 days—or longer—after the last treatment. Even with the ‘decision level’ testing used in California (positives are 10 ng/ml or higher), I often advise trainers to have the urine tested after a workout just to make sure the horse has cleared all the metabolites from his body before racing."

The California Horse Racing Board (CHRB) allows a trainer to submit urine samples to be tested by the official state lab to asure that procaine has cleared the horse’s system. If the horse doesn’t clear the medication as quickly as other horses do, it could cause tremendous headaches and financial burdens for an owner (a $15 shot of procaine pencillin versus $2,100 for 30 days of training at $70 per day).

Public Concern Vs. Equine Welfare

When does the good of the horse outweigh the good of the betting public? When does the good of the horse outweigh the concerns of regulating bodies? When is it time to call a halt to unnecessary deaths in horses from diseases that can be treated successfully?

Deaths? Yes. Research done by Cynthia Kollias-Baker, DVM, PhD, of the University of California, Davis, suggests that "current medication regulations make veterinarians reluctant to use procaine penicillin, and this reluctance may be contributing to the mortality of respiratory disease in racehorses."

In a paper presented by Kollias-Baker at the Piedra Foundation seminar in California, the poignant example given was the comparison of fatalities due to respiratory disease in human runners to those of their equine counterparts. The majority of fatal respiratory cases in the California study occurred in horses which died of pneumonia caused by bacteria susceptible to penicillin.

"The tragic finding was that many of these horses had not been treated with penicillin," said Kollias-Baker, "but with agents such as chloramphenicol, which is less effective against Streptococcus species."

Kollias-Baker suspects that this readily available, inexpensive, and highly effective drug might not have been chosen because of the regulations governing its use.

The Foundation’s Board noted the following after Baker’s presentation:"The Board is aware of the need to protect the betting public by regulating the use of medications given racehorses; however, it is the Board's very strong opinion that this need does not outweigh the responsibility to protect the animals on which this industry is based."

Jay Rose, DVM, president of the Piedra Foundation, said that no one is lobbying for the horse in this situation. "We need to address the humane aspects of medication regulations," he said.

The regulating body in California (CHRB), is not burying its head in the sand. It has provided funding for the study of drugs, including penicillin.

Doug Byars, DVM, DACVIM, in an open letter to the Piedra Foundation, said the following while emphasizing the need for a group such as the National Thoroughbred Racing Association to promote uniform medication guidelines and testing: "Normalcy in the horse should be equated with the well being or welfare of the horse. Restoring ‘normalcy’ by therapeutic medications is fair to the horse, the bettor, and the economics of racehorse ownership. This, of course, would require disclosure and not include medications that are known to enhance or depress the genetic performance capabilities of horses. For example, gastric ulcers have a statistical incidence of 70-90% in racehorses. We now have a medication, omeprazole, that has a 90% or better therapeutic cure rate. The medication is neither enhancing nor depressing, doesn’t mask other medications, and is undetectable in excretions and secretions in 24 hours—yet some states will require a five-day withdrawal; plenty of time to increase caustic gastric acid.

"I truly believe our avenue to do what is right for the horses is through education and communication. Racing officials also wish to do the right thing, but have as their primary responsibility to represent the public. We, as either veterinarians, trainers, or owners, must respond to horses as a daily responsibility."

All breeds and disciplines are revisiting the issue of medication. Let’s put horses first in these discussions. They need a lobbyist. Many equine health problems are caused by our management. Let’s not make many deaths due to the same cause.

About the Author

Kimberly S. Brown

Kimberly S. Brown was the Publisher/Editor of The Horse: Your Guide To Equine Health Care from June 2008 to March 2010, and she served in various positions at Blood-Horse Publications since 1980.

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