How veterinarians can maintain peak performance in racehorses

How veterinarians can maintain peak performance in racehorses

AAEP guidelines offer clinical direction for veterinarians when treating these premier equine athletes.
Jun 30, 2014

When caring for performance horses, their well-being should always be the No. 1 priority. In 2009, the AAEP released specific guidelines regarding healthcare for sport horses, including use of therapeutic medications, to ensure proper medical attention as well as the integrity of horse racing. (GETTY IMAGES/GINA GUARNIERI)
Racehorses are bred, raised and trained to perform as athletes. As a result, their performance health needs are critically important to keeping them physically sound, happy and healthy. "The difference between the human athlete and the racehorse is that the person can say, 'Hey, today my knee is really bugging me,' but the horse can't," says Jeff Blea, DVM, president of the American Association of Equine Practitioners (AAEP). "So that's where the groom, the trainer and the veterinarian need to be able to pick up on those subtleties to help keep performance horses healthy and strong."

When maintaining and improving performance horse health, the horse's overall well-being must always come first, says Blea, a partner in VonBluecher, Blea, Hunkin Equine Medicine and Surgery in Sierra Madre, Calif. "Everyone who works on the backside of a racetrack has a lot of respect for these horses," he says. "The care they receive from the hot walker, the groom, the exercise rider, the blacksmith, the trainer and the veterinarian is first and foremost."

Whether it's proper nutrition, dental care, shoeing and foot care, or other aspects of veterinary care, everybody works toward optimizing horse health and performance.

AAEP medication guidelines

"If a horse is healthy, it should perform well. If it's not healthy, it should not be performing," says Blea. "If necessary, therapeutic medications are used to treat ailments and injuries and to improve the horse's health and performance. Any prescribed and administered medication should be based on clinical signs or diagnostic tests and be part of a proper treatment plan."

Suggested withdrawal times and threshold concentrations of therapeutic medications
There are currently 26 approved therapeutic medications with specific thresholds, as established by the Racing Commissioners International (RCI) (see "Suggested withdrawal times and threshold concentrations of therapeutic medications"). The RCI Controlled Therapeutic Medication Schedule lists these medications as well as corresponding detection levels at which a testing laboratory is required to report a positive test result. In 2009, the AAEP established a policy regarding therapeutic medications in racehorses. It states:

"The AAEP policy on medication in pari-mutuel racing is driven by our mission to improve the health and welfare of the horse. The AAEP policy is aimed at providing the best health care possible for the racehorses competing while ensuring the integrity of the sport. The AAEP expects its members to abide by the rules of all jurisdictions where they practice. The AAEP condemns the administration of non-therapeutic or unprescribed medications to racehorses by anyone. The AAEP believes that all therapeutic medication should be administered to racehorses by or under the direction of a licensed veterinarian. Health care decisions on individual horses should involve the veterinarian, the trainer and owner with the best interests of the horse as the primary objective.

"In order to provide the best health care possible for the racehorse, veterinarians should utilize the most modern diagnostic and therapeutic modalities available in accordance with medication guidelines designed to ensure the integrity of the sport."

Here are the essential elements of the AAEP policy concerning veterinary care of racehorses:

> All racing jurisdictions should adopt the uniform medication guidelines set forth by the Racing Medication and Testing Consortium (RMTC; see These guidelines and procedures strive to protect the integrity of racing as well as the health and well-being of the horse.

> Race day medication must be given in accordance with current RMTC guidelines.

> In the absence of a more effective treatment or preventive for exercise-induced pulmonary hemorrhage (EIPH), the AAEP supports the use of furosemide on race day to control EIPH. The AAEP advocates the research and development of new treatments to help prevent or control EIPH.

> The AAEP encourages proactive and constructive communication between regulatory bodies and practicing veterinarians and other industry stakeholders.

> The AAEP believes that all veterinarians should use judicious, prudent and ethical decisions in all treatments to ensure the health and welfare of the horse.

> The AAEP strongly endorses increased surveillance and enforcement of the above-mentioned regulations.

"We tell our young veterinarians, 'Everything you do, you have to be able to justify,'" Blea says. "If you hold to that code of practice, you will be able to show the owner, the trainer, the press or the public that everything you do to a racehorse medically will put the horse first." And that particularly includes administration of medications.

The use of furosemide has divided the industry worldwide. "Whether it's performance-enhancing or not, I don't know, but it is performance-optimizing," suggests Blea. "Furosemide is good for the racehorse, but it's not good for racing. As a veterinarian, my concern is what's good for the racehorse. The AAEP has taken the position, with which I agree, that furosemide is scientifically proven to be efficacious in treating disease in the horseā€”to reduce or prevent EIPH while racing. It is a necessary, therapeutic medication." (see "Furosemide facts and fiction" in the March 2013 issue of dvm360)

Other therapeutic medications are properly administered to racehorses (that is, given within AAEP and RMTC guidelines) for ailments, strains or joint inflammation similar to the way therapeutic drugs are given to human athletes. Both racehorses and human athletes require medical intervention at some point in their training regimen because of either minor or major injuries.

"For the racehorse with athletic issues, some will require rest and others will require medical intervention," Blea says. "Before administration of any treatment or medication, veterinarians need to make a diagnosis and treatment plan. All therapeutic treatments should be prescribed based on a medical diagnosis after a thorough examination to properly evaluate the condition, to properly treat the condition and, more important, to subsequently evaluate the response to treatment. That's critical."