Drugs and Medications Rules Revised at USA Equestrian Meeting

A rule change designed to reduce incidence of corticosteroid abuse in equine athletes was among several topics discussed in the Veterinary and Equine Drugs and Medications (D&M) committee meetings and D&M Open Forum Jan. 16-17 at the 2003 USA Equestrian (USAE) Convention in Lexington, Ky. Veterinarians, competitors, and industry officials on these committees convened to vote on rules which affect 27 breeds and disciplines competing under the jurisdiction of the USAE, which is the current equestrian national governing body in the United States.

The Veterinary Committee had met by conference call Dec. 11, 2002, and formulated the proposal, which was presented to the Equine Drugs & Medications Committee at its January 16 meeting. A. Kent Allen, DVM, Chairman of the USAE Veterinary and D&M Committees, presented the committees’ joint recommendations during an open forum on Jan. 17.
The centerpiece of the rule change proposal would establish a quantitative limit in horses’ plasma for the amount of the corticosteroid dexamethasone, to try and prevent overuse of the medication. Additionally, it would classify other corticosteroids as forbidden, in order to prevent their non-therapeutic use. These other corticosteroids would fall within the requirements of other forbidden medications and could be administered only for a therapeutic purpose, not closer than 24 hours prior to competing, and with submission of a medication report form to the competition steward or technical delegate.

Catherine W. Kohn, VMD, Dipl. ACVIM of The Ohio State University and her colleagues have a study in progress examining USAE medication report forms to survey use of dexamethasone. Preliminary results from this study presented by John Lengel, DVM, administrator of the Equine D&M Program for USA Equestrian, covered 1989 forms pertaining to 947 horses that competed in USAE-sanctioned competitions between May-Sept. 2002. According to the data, 33% of the horses were administered three or more doses of corticosteroids during an event. Up to 10 doses were given in some instances, represented by 0.5% of the horses. According to Allen, Lengel, and members of the veterinary committee, this represents abnormal patterns of use that could potentially harm the horses—overuse of dexamethasone and other corticosteroids can promote immunosuppression (reducing horses’ ability to fight diseases like West Nile virus, shipping fever, and other diseases) and can sometimes cause laminitis.

The proposed rule change would establish the maximum permitted plasma concentration of 0.003 micrograms per millilite for dexamethasone. According to Allen and Lengel, a maximum daily dose of 20mg. intravenous dexamethasone per 1,000 pounds of body weight, or 2.0 mg. per 100 pounds body weight, administered to the horse not closer than 12 hours prior to competing, will help achieve compliance with the rule. USAE members in the forum expressed concern about horses with dermatitis (as a reaction to stall bedding or another stimulus) that flares up closer to the time of competition. Allen assured it is possible to calculate a dose to be used in such a situation, and emphasized that the rule would take effect in Dec. 2003, allowing for plenty of time to establish additional dose and time recommendations and to educate the industry thoroughly on the ramifications of the rule change. The USAE is funding two administration studies this year to help establish guidelines that will provide for administration of intramuscular dexamethasone (since it might metabolize differently than IV dexamethasone and thus necessitate a different recommended dose to keep within the boundaries of the rules), and to determine the pharmacokinetic curve to provide for the administration of small doses of dexamethasone to horses with dermatitis 4-6 hours before the competition.

Among other topics discussed was changing the wording in a rule discussing the therapeutic use of gastric ulcer medication (Art. 409) and its prohibition in the endurance riding division. The words “gastric ulcer substances,” were replaced with the term “anti-ulcer medications,” to more accurately reflect that which is used. The endurance discipline wishes to remain a drug-free sport, so they are the exception to this rule of allowance. Some committee members suggested that disallowing anti-ulcer medications might not be of benefit to the horse, and the endurance groups agreed to keep abreast of current research which might indicate the incidence of gastric ulcers in endurance horses is higher than previously thought and prompt them to revisit the decision to ban anti-ulcer medication. “If a horse is not right (in the first place), they should not be asked to run 100 miles,” explained Jim Baldwin (a representative from the American Endurance Ride Conference). “Medication should be stopped in a time to clear their system to compete naturally.”

Extracorporeal shock wave therapy (ESWT) and its temporary analgesic properties were discussed among veterinary and Equine D&M committee members, since ESWT treatment has become indispensable in many practices across the country. Allen said that rule enforcement regarding ESWT in USA Equestrian events would be virtually impossible. “We do not have monitored facilities at these shows,” he said, since horses are only temporarily stabled at the competition site. Additionally, there is no medication residue in treated horses. He explained that Scott McClure, DVM, PhD, Dipl. ACVS, Assistant Professor of Equine Surgery at Iowa State University recently tried to test the analgesic properties of ESWT. “He could not find (the analgesic effect) lasting more than 2-4 days. I think that situation will become clearer. Perhaps we should follow FEI’s lead (limiting ESWT to five-days prior to competition). I will track this,” he promised.

The USAE Board of Directors approved the corticosteroid rule change proposal at its meeting held on January 19. The existing rule regarding corticosteroids remains in effect until the effective date of the new rule, December 1, 2003.

Visit www.equestrian.org/rulechange/prc.aspx for the Summary of Proposed Rule Changes with individual reports accessible and downloadable, and includes all comments, amendments and final Board actions.

About the Author

Stephanie L. Church, Editor-in-Chief

Stephanie L. Church, Editor-in-Chief, received a B.A. in Journalism and Equestrian Studies from Averett College in Danville, Virginia. A Pony Club and 4-H graduate, her background is in eventing, and she is schooling her recently retired Thoroughbred racehorse, Happy, toward a career in that discipline. She also enjoys traveling, photography, cycling, and cooking in her free time.

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