Vets Object to New FEI Drug Guidelines, FEI Responds

On Nov. 19 the General Assembly of the Fédération Equestre Internationale (FEI) approved new Equine Anti-Doping and Controlled Medication Regulations as well as a new list of prohibited substances. The passed regulations included a "progressive list" of substances that will now be allowed in competition in limited amounts.

Some national federations called for a second vote on the progressive-list measure, claiming that some voters were confused as to what they were voting for. This request was denied. (Read more: "FEI Takes Steps on Equine Welfare, Doping Issues.")

On Nov. 24, a group of veterinarians submitted the following letter to the FEI:

FEI Clean Sport
The 'Progressive List'
24 November 2009
To: FEI President

Your Royal Highness,

As a group of senior veterinarians with experience of equestrian competition at international level, we write to express our grave concern at the recent decision of the FEI General Assembly to adopt the so-called 'Progressive List' that allows the use of non-steroidal anti-inflammatory drugs (NSAIDs) in competition horses. This resolution has seriously over-shadowed the commendable clean sport campaign recommended by the Stevens/Ljungqvist reports, which offered a major step forward in equestrian sport.

We would like to emphasise that we are fully behind the concept of 'clean sport'.

The 'Progressive List', which we understand was seen for the first time by the delegates when they arrived for the assembly, has not been debated sufficiently and we believe a decision has been made that was premature, illconsidered and seriously retrograde.

Permitting the use of NSAIDs will lead to abuse and the participation of horses in competition that are unfit to compete.

It also removes the 'level playing field' that has been a crucial and fundamental ethos of the FEI since its foundation. We believe the decision must be reconsidered and would draw your attention to the following historical facts.

Firstly, following extensive consultation, the General Assembly meeting in Rio de Janeiro in 1993, finally removed the 'maximum permitted level' for phenylbutazone (PBZ). Over a number of years this had been reduced from 5 μg per millilitre of blood to 2 μg/ml. Under the 'Progressive List', PBZ will be permitted up to a level of 8 μg/ml, a four-fold increase on the level rejected by the Rio meeting. This decision will have a serious and negative effect on welfare and profound repercussions for equestrian sport.

The 'Progressive List' also permits flunixin, another NSAID, to be used up to a level of 0.5 μg/ml in serum or plasma.

Secondly, the 'Progressive List' raises the salicylate threshold. We would point out that this threshold was lowered in 1999 on the advice of the Veterinary Committee and again following extensive consultation. Salicylic acid had been found in CORAL COVE at the 1998 World Equestrian Games (see and it was apparent at the time that intravenous 'topping up' to the threshold was not a rare occurrence. After analysis of 650 equine urine samples collected worldwide and considerable discussion it was decided to reduce the FEI threshold to below that used by racing (where there was no evidence of similar abuse). The work was reported to the International Conference of Racing Analysts and Veterinarians in 2004 and was subsequently published. There was therefore a clear rationale for the threshold of 625 μg/ml in urine or 5.4 μg/ml in plasma.

Thirdly, national legislation in many European countries prohibits any medication in competition animals. This does not apply in parts of the US where 'permitted levels' are more common. A 'controlled restricted' list will surely be unenforceable where it is in conflict with the national laws of a country.

In conclusion, we would urge you to reopen this debate, encourage extensive international consultation and invite National Federations to reconsider their decision in Copenhagen in the interests of the health and welfare of the competition horse.

Sincerely yours,
Leo B. Jeffcott (former Chair, FEI Veterinary Committee)


Andrew Higgins (FEI Honorary Scientific Adviser and former Chair Medication Advisory Group)
Roberto Busetto (FEI MCP Veterinarian)
Jean-François Bruyas (FEI MCP Veterinarian)
Michael Due (former member FEI Veterinary Committee)
Paul Farrington (former Vice Chair, FEI Veterinary Committee)
Wilfried Hanbuecken (Chief Veterinary Officer CHIO Aachen)
Liisa Harmo (FEI MCP Veterinarian)
Miklos Jarmy (FEI MCP Veterinarian)
Peter Kallings (former President, IGSRV and MCP Veterinarian)
Gerit Mattheson (member FEI Veterinary Committee)
Nigel Nichols (former member FEI Veterinary Committee)
Jack Snyder (member FEI Veterinary Committee)
Warwick Vale (FEI Veterinary Delegate and Olympic Games, Sydney 2000
FEI Medication Control Program Supervisor)
Alex Atock (former Head, FEI Veterinary Department)

cc: Sven Holmberg (FEI 1st Vice-President)
Chris Hodson (FEI 2nd Vice-President)
Alex McLin (FEI Secretary General)
John McEwen (Chair, FEI Veterinary Committee)
Graeme Cooke (Director, FEI Veterinary Department)

The FEI responded to this letter Nov. 25. Their response follows:

Lausanne, 25th November 2009
Re. FEI Equine Prohibited Substances List (“Progressive List”)

Dear Professor Jeffcott,

Thank you for your letter regarding the recent decision at the FEI General Assembly to accept a new approach to the FEI Equine Prohibited Substances List.

As you point out the most important part of the decision taken by the General assembly when it voted to accept the new FEI approach was the use of non-steroidal anti-inflammatory drugs (NSAIDs) at allowed levels.

During early consultation, debate revolved around a few key substances, that the removal of these substances from the Prohibited List below certain levels represented a policy change, and that there were welfare arguments in support of both approaches (inclusion or exclusion from the list). As a result, the matter of the policy change was put to our membership to vote upon, resulting in the presentation of the two alternative lists, with a rationale for each. The electorate chose a list which allows the use of these substances below certain levels.

One of the reasons why the World Anti-Doping Agency approach is so successful, also based on an ongoing review of a Prohibited List, is that there is naturally a debate as to whether substances are "performance enhancing" or "performance-restoring". It is however noteworthy that, while certain substances are the subject of debate, on the WADA list nonsteroidal anti-inflammatories are not considered to be problematic in human athletes.

In equestrian sport, the predominant argument in recent years justifying a complete ban on the use of these substances close to competition has been that the horse cannot choose for itself, and that therefore only such an approach can guarantee horse welfare. There are, however, arguments that, just as in human athletes, the use of NSAIDs is acceptable to the extent it does not exceed certain levels (in humans, there is no limit), and is in fact more humane as it allows for very basic treatment close to competition that could be required to treat, for example, simple travel related stiffness. There is also the argument that the banning of such substances is unrealistic as, since these are arguably a necessity, a ban creates a situation that does not allow for legitimate treatment by penalizing it.

I am inclined to support the latter arguments and brought them forward to the 2009 General Assembly in order to offer delegates a real choice.

The voice of our member National Federations on this issue clearly demonstrates that there is not a universal belief that the use of such substances below defined limits is performance-enhancing, and that there is a significant body of opinion that permitting the use of certain substances, in certain cases with prescribed limits, is compatible with protecting horse welfare.

The sport has clamoured for clarity on the issue of the difference between medication and doping, and a debate as to where exactly the line should be drawn can therefore be always expected. What is paramount is that policies and any changes thereto should be based on maintaining the health and well-being of horses through humane and strictly controlled veterinary practices. Imposing sanctions for the abuse of substances also provides a high deterrence value for the abuse of these controls. These were very much the considerations behind proposing two alternative lists which were put forward for a vote, aware of the compelling arguments for both. Horse welfare is and will continue to be my primary concern.

By this vote the level playing field you refer to is maintained because the same regulations apply to all. Specifically you mention the levels that are initially allowed for Phenybutazone, Flunixin (Banamine) and Salicylic Acid.

The annual review of the Prohibited List will include a continual examination of the allowed limits, in light of new evidence.

The levels were advised by experienced national team veterinarians, including those of the US and German Teams. The intention is to allow a single subclinical treatment up to 12 hours before competition that would achieve a mild anti-inflammatory effect. The initial 8 μg/ml allowed is a safety margin, however the intent under new regulations is to ensure that the treatment only takes place in supervised areas and with the oversight of the Veterinary delegate. The salicylic acid levels have been elevated to be more in line with other equestrian regulators.

Regarding national legislation, the FEI Legal Department has consulted with the National Federations of Groups 1 and 2 which cover Europe in order to seek clarity on which countries, if any, have national laws which may conflict with the new Prohibited Substances List. Once that review and consultation is complete the Legal Department will, if necessary, issue a clear statement on how such conflicts will be managed come January 1, 2010 in the context of international competition.

I hope that has gone some way to explain your concerns. An opportunity to look at this matter was granted to stakeholders and debated extensively at the Clean Sport workshop prior to being put to the vote at the General Assembly. The decision was voted upon democratically and the membership has decided in favour of the Progressive List.

HRH Princess Haya

cc. Sven Holmberg
Christopher Hodson
John McEwen

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