When is It Doping?

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Three words no horse show exhibitor wants to hear are “positive drug test.” When an official testing laboratory reports that result, the verdict is clear and it’s too late for excuses. A positive test can lead to fines and suspensions for everyone involved.

The U.S. Equestrian Federation (USEF) sets the standard for regulations governing show horses and drugs through its drugs and medications (D&M) rules. The overriding goal is to ensure that horses in competition are not being aided by drugs. Kent Allen, DVM, of Virginia Equine Imaging, Middleburg, Va., says, “The goal is that the best horse and rider combination wins the competition, not the person who is cleverest in medicating the horse.” He adds, “Our goal is to have a fair and level playing field in competition, and we would withdraw the horse if the horse has a problem he should not be competing with, and certainly if we are trying to mask a problem.”

What Allen says carries weight. He is vice chair of the Federation Equestre Internationale (FEI) Medication Advisory group, and the chair of two USEF Committees: Equine D&M and Veterinary.

Whatever breed or discipline you show in, chances are good that the USEF rules (General Rules 401-412, cited here as GR) govern the use of substances that can influence a horse’s performance for several breeds. Two major breed associations—AQHA and APHA—model their rules on USEF. Similarly, FEI rules apply to horses competing in international events.

Across associations, understand that rules cover both prescribed and over-the-counter drugs. Even herbal supplements may contain drugs that affect performance.

Limits on Drugs and Medications

The USEF D&M rules allow you to treat show horses with therapeutic medications—commercial products that promote health. But remember, the aim of the rules is to keep these drugs out of horses while they are competing. To that end, the rules group these drugs into two categories, forbidden or restricted, which are described under the Therapeutic Substance Provisions (GR 410.1). The main difference between the two categories is that the use of forbidden medications requires notification of use via a one-page USEF Equine Drugs and Medications Report Form for specific drugs administered prior to a competition (GR 411.2). Restricted drugs require no report. In either case, though, any drug detected beyond accepted trace or naturally-occurring levels is a violation. Depending upon the severity of the violation and whether you filed the proper paperwork, a violation can result in everything from no action to disqualification, fines, and suspension from sanctioned events for a year—or longer.

How does this work in practice? Allen describes treating the horse for gastric ulceration, for example: “We understand it’s a common problem. The good news is the medication rules provide for that, there are no forms, and it’s easy to treat.”

Therapeutic use of any “forbidden” drugs must meet three requirements, as outlined in GR 411.1:

• It must be for legitimate therapeutic use. Allen adds that “legitimate use” requires a veterinary diagnosis, as that implies therapeutic intent, not the intent to cheat.

• The horse must be withdrawn from competition for a specified period of time, determined individually for each drug.

• You must file the Drugs and Medications Report.

Herbal calming supplements are largely forbidden. “Valerian root has been proven to calm the horse,” Allen says. “Does that meet our measure of a level playing field? No, because that means the cleverest person who can adjust their dose of valerian just right wins.”

The USEF pamphlet, “Drugs and Medications Guidelines,” lists several forbidden natural ingredients, including devil’s claw, lavender, and chamomile. “Any herbal supplements that contain those sort of things are illegal,” Allen says. “I can make it simpler for you. People ask me on these herbal calming products, ‘What’s legal and what’s illegal?’ I say, ‘If it works, it’s illegal.’”

GR 410.4 and 410.5 describe 10 restricted therapeutic substances. “There is a very finite number of restricted substances,” says Allen. “This is a list of a commonly used group of drugs. No forms are needed, but they have to be used with dose and time restrictions to stay within the rules.” The list includes several NSAIDs and dexamethasone, a corticosteroid. Each has its own specific dose limits, administration times prior to competition, and administration methods (see GR 410.4.g for details). Be aware, though, that these guidelines do not guarantee that your horse won’t trigger a positive test. If your horse tests positive for excessive amounts of a restricted substance, you are in violation, and may be subject to penalties.

As new equine drugs receive approval by the U.S. FDA, their therapeutic use is incorporated into USEF rules. Two of the NSAIDs on the restricted medications list are relatively new products: the topical medication diclofenac (trade name Surpass) and Firocoxib (trade name Equioxx). The newest restricted NSAID, eltenac (trade name Telzenac), is still awaiting FDA approval. USEF rules already recommend dosage and time restrictions for IV use.

Equioxx differs from other NSAIDs, says Allen. It’s a so-called COX-2 inhibitor, while most NSAIDS are COX-1. “These different types reduce inflammation by inhibiting the action of the enzyme cyclooxygenase-1 (COX-1) or cyclooxygenase-2 (COX-2),” he says. Time limits on use of COX-1 drugs are more stringent than for COX-2, as COX-1 NSAIDs can cause greater stomach upset. “With chronic use they can cause some kidney damage, eventually,” Allen says. “That’s why all these drugs have time and dose [limitations]. We say all those drugs can’t be used past [more than] five days.” He recommends giving the horse two days off before resuming a COX-1 NSAID.

In contrast, he notes, “Equioxx is a COX-2 inhibitor. A COX-2 inhibitor does not have much in the way of stomach or kidney problems. This drug can be used up to 14 days in a row.”

Dosage and Withdrawal Times

How much medication do you give a horse before a show, and when do you stop treatment? Hard to say. Best bet is to consult your vet, who is prescribing the therapeutic medication in the first place. You should consider a medication’s absorption rate for each animal, and how the substance starts to act. You don’t have to master biochemistry, but understand how you affect your horse with drugs and medications.

Allen uses bute as an example. “What I usually recommend is 1 gram orally every 12 hours, for a maximum of two doses a day. I do that with a paste so I know the horse got it. It’s not sitting in the bucket for him to eat whenever he gets around to it.” Then, follow USEF guidelines for how long it takes the drug can clear the system before a possible drug test.

Treating your horse with a forbidden substance also requires that you end treatment for a specified time before showing (GR 411.1). Allen cites the example of treating a horse with a minor laceration at the showgrounds. “Under USEF rules, if the horse is examined by the treating vet, the horse can be sutured. You can use lidocaine or carbocaine with no problem, but the horse must be withdrawn [from competition] for 24 hours after that.”

Another example is cortico-steroids injected into hocks. “If you’re using depomedrol, it’s the longer-acting of all the corticosteroids used commonly,” said Allen. “If you use it within two weeks of competing, file a medication report form. Any other corticosteroid [such as triamcinolone or betamethasone], will be shorter.” He advises to file the drug report form if you use these within a week of the show, because these corticosteroids can be detectable for seven days.

Before your veterinarian administers such corticosteroids, be sure to tell him when you next plan to show the horse. “Find out what drug was used, how much, how it was administered, what was the diagnosis, and fill out the form,” advises Allen.

If you choose to use a forbidden substance at home for a non-therapeutic reason, such as shipping, clipping, or turnout, “do it in a timeframe so the drug is completely out of the horse’s system,” Allen advises. “We would call that the withdrawal time. Your vet should help you with the withdrawal time, so get him involved.”

So, how can you be more certain that your horse will be drug-free during competition? Allen points to a new FEI project, the Medicine Box. It lists many commonly-used drugs—all in the USEF forbidden category—and presents withdrawal times proven through recent research. The information helps riders, trainers, grooms, and veterinarians understand the time it takes to eliminate the systemic amount that could show up in laboratory testing. Examples include: the sedative xylazine, 48 hours; respiratory drug clenbuterol, 120 hours; and colic medication scopolamine n-butyl bromide, 72 hours.

A key concept to keep in mind is the threshold level. The USEF recognizes that a horse absorbs certain substances through the environment or in his feed, along with some common medications. Allen cites substances such as DMSO, salicylic acid, and aspirin. “If you feed your horse alfalfa hay, it's guaranteed he has salicylic acid,” he says. “But the threshold level is built into [the test process]. There are levels that are already set to protect you. You have to exceed those levels by a pretty good margin to trip the test as a positive.”

Allen also warns against the possibility of “re-uptake” in a show stall. “The horses are urinating the drug or the metabolites onto the straw,” he says. “They’re not that discreet in their grazing patterns, and they pick it back up again so it’s recirculating within the horse.”

To prevent this problem, clean show stalls thoroughly on arrival. Also dedicate feed buckets to each horse, so a horse being treated won’t affect his stablemate.

Managing Medications

If your horse is selected for drug testing at the show, you’re responsible for cooperating with the procedure. Testers will collect blood and urine samples (GR 402).

Who’s named in a positive drug test? Association rules identify the person responsible for managing the horse’s care. That makes it imperative to be vigilant about any and all drugs your horse can come in contact with.

“If there is a positive drug test, there is an investigation to determine who has care, custody, control of the horse,” says Allen. “One very basic thing is that if you train the horse and have care, custody, and control of it in your barn, you are the trainer. If your horse goes occasionally to see the trainer, or meets a trainer at shows, that is the coach, and that person fills out a separate line on the entry form.”

What happens if you do hear those three words (positive drug test)? Well, that depends on how serious the D&M committee deems the violation. “If it’s an overage on bute, the average administrative penalty would be about $750. You can pay it and be done with it,” says Allen.

By filing the medication report form for a forbidden drug, though, you make it clear that you are not trying to cheat, and this can often help you avoid penalties. “If you filled out the form appropriately, there is a positive generated from the lab and it is married up to the form—you never hear about that,” Allen says. In most cases, “that won’t be a problem because you have complied. You did your paperwork properly. That positive is filed, and it goes away.” (GR 411.2)

Since any penalties are based on both the size of the effect on performance or health of the horse and your intent, there are no cut-and-dried outcomes of a positive drug test. The chair of the D&M Committee determines whether or not a positive drug test result is a punishable violation (GR 412.2). The chair also decides when to issue an administrative penalty and/or the extent of any fines and suspensions. The committee has a fair amount of leeway in determining the penalty, which can include hefty fines and suspensions from competition for a year or more.

If you are found guilty of violating the rules, there’s little you can do about it. Contesting a positive test is usually futile. Few appeals are successful, and an appeal usually costs much more in attorney’s fees than the amount of any fines. USEF posts its Hearing Committee reports and Suspension List online. That constitutes its own form of punishment, in the form of embarrassment and a damaged reputation.

Even if you don’t know how a drug got into your horse, you are accountable. Allen says, “You are the person responsible for your horse. Ignorance is not a defense.” That’s all the more reason to use drugs and medications sparingly, and to take every precaution to avoid even an accidental positive drug test.