In The New Era Of Medication Rules, There Will Be No Withdrawal Guidance

As Jan. 1, 2023, ticks closer, lots of uncertainty remains about the future of the national regulations put in place by the Horseracing Integrity and Safety Act (HISA). The centralized Authority created by the Act was dealt a blow last week when a federal appeals court ruled the group’s governance was unconstitutional.

For now though, there is no order in place shutting down the activities of the Authority and therefore nothing that will halt the upcoming implementation of the anti-doping and medication control rules that will go into effect on New Year’s Day. At that time, all equine samples will be tested by accredited labs and all will be subject to the same battery of tests, unlike the current system, where drug rules vary from state to state and drug testing contracts do, too. Penalties will also be uniform and officials have promised the arbitration and appeals process will be swifter than it currently is through the state system.

The Authority has contracted with the Horseracing Integrity and Welfare Unit (HIWU), which is a division of Drug-Free Sport International to handle all drug testing and results reporting.

At the recent annual convention of the Association of Equine Practitioners (AAEP) in San Antonio, representatives of the Authority and HIWU gathered to field questions from veterinarians about those upcoming national rules and drug testing changes.

Whether you’re a horseman or a veterinarian, there are educational resources available to help you better understand regulations here on the HIWU site and here on the Authority’s website.

Here are a few things we learned from that discussion, which included Drs. Sue Stover, chair of Racetrack Safety standing committee, Mary Scollay, chief of science for HIWU, Lisa Fortier, racetrack safety committee member, and Scott Stanley, anti-doping and medication control subcommittee member.

Withdrawal times are a thing of the past. For many years now, trainers and veterinarians have relied on suggested withdrawal times to decide how far ahead of a race they should stop giving a particular drug. The new rules do not include any withdrawal times.

Why not?

The text of the federal law, to which the Authority and HIWU are bound, requires the groups to base their medication rules on international standards for racehorses. Other countries, which base their medication rules on the International Federation of Horseracing Authority’s guidance, do not provide withdrawal times. They instead provide “detection times.”

Detection times are based on the available peer-reviewed study of a substance. If a group of horses in a study are all given a drug and sampled at set time points after that administration, “detection time” is the first time point at which all the horses in that study were negative for the substance.

Why does it matter? Scollay noted that many existing administration studies of drugs in horses may be based on small numbers of horses. Everyone recognizes that there is individual variability in drug metabolism, and a lot comes down to the dose given and route of administration.

Detection time should be a starting point for veterinarians and trainers to decide when to withdraw a drug, but they aren’t replacements for withdrawal times. If you use detection times interchangeably with withdrawal, you’re running a higher risk of a drug positive than you were under the old system, because you could be working with a different dose, administration route, or a horse with a different metabolism.

“It’s a big change, but I’m here to tell you, you can do it,” Scollay said.

Previously, withdrawal guidance offered by the Association of Racing Commissioners International or Racing Medication and Testing Consortium looked at these detection time and essentially built in a statistically-calculated cushion to account for these differences.

In many cases, cautious trainers are already building themselves a cushion over the existing withdrawal guidance. One practitioner in the audience stated that although non-steroidal anti-inflammatories may be given up to 48 hours prior to post time, they were on a practical level more often given 52 to 60 hours pre-race since that’s when a practicing vet would be at the barn.

–The change is just as much philosophy as practice.

The detection time system is supposed to make trainers and veterinarians think a little harder.

“You shouldn’t be frightened on these detection times,” said Scollay. “What they’re intended to do is make you say, does this horse really need this medication? If we’re just medicating to keep the trainer happy, maybe we shouldn’t be doing it.

“I think this is going to get us all to revisit our pre-race protocols as far as blanket administrations, every horse in the barn, all 40, 60 of them getting the same pre-race protocol. Maybe they don’t need it. Maybe some of them do but maybe some of them don’t. The changes you’re dealing with are not going to be cataclysmic, but they are going to require you to think.”

–FDA status is going to be key. If a drug isn’t approved by the FDA for use in horses, it’s likely considered to be banned by the Authority. That includes substances like isoxsuprine, whose use in horses was common for a while but which the FDA has recently clarified may not be legally compounded for horses.

–With all medication violations, there is mandatory disqualification. New rules do not allow for any wiggle room on this. Officials do have discretion about how large a fine or suspension may be given to a licensee as a result of a positive test, but there is no mechanism for connections to get out of a disqualification.

–Most substances, but not all, should be stopped by 48 hours pre-race. There are a few exceptions to this, and those drugs are okay up to 24 hours pre-race. They include: altrenogist for fillies, certain ulcer medications, isotonic fluids, vitamins by injection, vaccines, anti-microbials, dewormers, and electrolytes by injection. Electrolytes may be given free choice up until the race, whether as topdressing on feed or in a water bucket (if there is also one bucket of clear water provided to the horse).

–All states have requested an exemption to new furosemide restrictions. That means that all 2-year-olds and all stakes runners (including runners in overnight stakes) may only have furosemide 24 hours pre-race. Three-year-olds and up and non-stakes horses will have their existing state rules in place for the foreseeable future.

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–Post-workout sampling will be happening, but it won’t be quite the same as post-race testing. Horses may be drug tested after a timed work but the rules aren’t exactly the same as a post-race test. Those tests are designed to look for banned substances, local anesthetics, and analgesics (including non-steroidal anti-inflammatories within 48 hours pre-work and corticosteroids within seven days pre-work). Other substances, like dantrolene, furosemide, methocarbamol, etc. are not of concern in post-workout tests.

“This is a safety and welfare initiative so we know we’re not sending horses out who are compromised and can hurt themselves while breezing,” said Scollay.

–Intra-articular corticosteroids will be a 14-day stand-down for racing and for works off the vet’s list. The reason the rules are different with these drugs for races versus works is that committee members feared a 14-day pre-workout prohibition would encourage trainers to walk or jog a horse into a race, and wouldn’t give veterinarians a chance to evaluate a horse’s response to the treatment.

–Will the Authority be sending veterinarians to help with shortages? In the early days of the Authority, there was some discussion suggesting the group would send its own veterinarians to fill shortages in racing states that were strapped. Ann McGovern, director of racetrack safety for the Authority, said that besides the nationwide equine veterinary shortage, they’re running into another logistical problem – licensing.

There are some veterinarians who want to help short-handed tracks, but many are experiencing difficulty getting licensed outside of the states they normally practice in. The Authority is working on a provision for regulatory veterinarians, since they’re not diagnosing, treating, or prescribing and therefore have different roles than most licensed veterinarians.

–There’s still hope a national system for testing will be more efficient. Scollay said trainer Steve Asmussen once told her Gun Runner had been out-of-competition tested 15 times in his career because he participated in so many different stakes with OOCT programs in so many different jurisdictions, and sampling authorities had no way to communicate with each other. There’s hope that while the testing bill will rise for some states, it will be a more efficient process overall.

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