Research: Anti-inflammatory treatment did not decrease movement asymmetry identified in riding horses in training

Sometimes, it seems like research raises more questions than it answers, and a new study from Sweden this summer asked some very interesting questions. Research into asymmetry in horses, as identified by sensor-based gait analysis, brings into the discussion the rider's perception that a horse is sound...even if its movement suggests otherwise. 

Bisphosphonates Ban: Keeneland, Fasig-Tipton and Ocala Breeders’ Sales Ban Off-Label Use of Popular Navicular Disease Medication in Young Thoroughbreds

Bisphosphonates are a type of medication used to treat osteoporosis in humans. They have been approved by the US Food and Drug Administration since 2014 for treatment of navicular disease in horses older than four. Research in Europe, conducted by Professor Jean-Marie Denoix and others, has also investigated the possible expanded use of one bisphosphonate, tiludronate (Tildren) for other lameness problems, such as bone spavin and osteoarthritic lesions of the thoracolumbar vertebral column. Professor Denoix also led the initial research on Tildren for navicular disease in older horses.

Laminitis Treatment: UC Davis Experimental Anti-Inflammatory Shows Promise in Test Case

Can an anti-inflammatory medication have curative power over a disease like laminitis? Researchers at the University of California at Davis are beginning clinical testing of a new medication that might be an outside-the-box hope for relieving horses suffering with the disease. Here's a report from UC Davis School of Veterinary Medicine:

Four horses suffering from laminitis have been treated with the investigational anti-inflammatory drug so far. One experienced a complete remission that has lasted for more than a year, and three others have shown some improvement.

A paper on the first laminitis case has been accepted for publication by the peer-reviewed Journal of Veterinary Anaesthesia and Analgesia. The paper is expected to be published in the journal’s February issue, but journal editors authorized the authors to disclose their findings ahead of publication.

Alonso Guedes, an assistant professor of veterinary medicine, treated this four-year-old Thoroughbred mare by administering an experimental anti-inflammatory drug to treat laminitis. (Don Preisler/UC Davis photo)

“This is an unusual step for us to announce this so far in advance, but because euthanasia is often the only way to alleviate pain in severe laminitis, we felt that it was important to let the veterinarians and horse owners know that this compound has shown potential as a treatment,” said Alonso Guedes, an assistant professor in the School of Veterinary Medicine.

The horses were treated under a “compassionate use” protocol approved by the UC Davis Institutional Animal Care and Use Committee. That protocol allows animals to be treated with an experimental drug if no approved alternative treatment exists.

A clinical trial to assess the drug’s safety and establish a tolerable dose for the compound is expected to begin in the spring. Further clinical trials would be needed to establish the drug’s effectiveness as a laminitis treatment.

The experimental compound, known as t-TUCB, belongs to a group of anti-inflammatory compounds called sEH (soluble epoxide hydrolases) inhibitors. It stems from a discovery made more than 40 years ago by UC Davis entomology professor Bruce Hammock while doing basic insect biology research.

The "cure" for laminitis is
the rehabilitation of the
horse's foot and the
elimination of the triggering
cause. (Plastination model
of advanced laminitis by
Christoph von Horst DVM PhD)

 

 

Originally interested in finding biological insect control methods, Hammock has since broadened his research to also search for biomedical applications. He and colleagues have identified a group of anti-inflammatory compounds, including the sEH inhibitors, that have proven to be effective in relieving inflammatory discomfort and pain related to nervous system disorders in mice and rats. Their work has been published in scientific journals including the Proceedings of the National Academy of Sciences and the Journal of Medicinal Chemistry.

Guedes noted that the safe management of laminitis-related pain is one of the biggest challenges for equine veterinarians. Often, euthanasia is the only humane alternative for alleviating pain and suffering in horses afflicted with the condition.

Consequently, according to UC Davis, the survival rate for laminitis is estimated to be only 25 percent. Very few surviving horses return to their previous levels of activity, and laminitis often reappears.

In his upcoming paper, Guedes reports the case of a four-year old Thoroughbred mare named Hulahalla. The horse had been retired from racing following a tendon injury and donated to the UC Davis School of Veterinary Medicine, where it was participating in a study focused on healing tendon injuries using stem cell treatments. She developed laminitis.

Veterinarians from UC Davis’ William R. Pritchard Veterinary Medical Teaching Hospital treated the laminitis with conventional therapies including cold immersion, antibiotics, leg wraps, and two commonly-used nonsteroidal drugs intended to reduce inflammation and relieve pain — but the horse only got worse. At the point that the mare was spending most of the day lying down, Guedes got involved.

Before resorting to euthanasia, Guedes and the veterinary team decided to try one last treatment, t-TUCB.

The veterinarians administered the experimental compound intravenously early on the eighth day of Hulahalla’s illness. After receiving the first dose, the horse remained standing in the stall most of the day, became interested in her surroundings and walked voluntarily.

The mare’s demeanor, posture and mobility continued to improve over four days of treatment, and her high blood pressure gradually returned to normal. No adverse affects from t-TUCB were observed, and Hulahalla has remained laminitis-free for a full year.

The sEH inhibitors, including t-TUCB, are currently available from the Hammock lab, which has provided the experimental compounds to more than 100 academic scientists around the world for basic investigation into their role in treating disease.

Hammock said that work aimed at moving t-TUCB and related compounds toward clinical use is advancing in several areas. He and Guedes are working on compounds with potential for targeting pain and arthritis in companion animals. And they are working with UC Davis to move the intellectual property from this research into a company to develop medications for difficult-to-manage neuropathic pain associated with diabetes and nerve injury.

Funding was provided by the National Institute of Environmental Health Sciences and the UC Davis Center for Equine Health.

The University of California at Davis provided this article.

Click to order this award-winning anatomy reference graphic for the wall of your clinic, forge or office.

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines on the Hoofcare + Lameness Facebook Page

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Acute Laminitis Medication Available to Field Case(s) for Testing

SPONSORED HOOF BLOG POST

WANTED: YOUR NEXT ACUTE LAMINITIS CASE

MAY 18, 2012--Hoofcare Publishing is asking the blog readership for assistance. The developer of a promising medication to improve the prognosis of acute laminitis cases is seeking a collaborator in the field who has a case that has just been diagnosed.

The medication is a mast cell inhibitor (stabilizer) that has been FDA-approved for use in humans. It is designed to inhibit the release of inflammatory mediators from the cells involved in laminitic reactions and has been successfully tested as a medication for induced laminitis in cattle, sheep and horses in university and private test studies.

A mast cell contains a bundle of granules. When it is activated, the pink granules, in this case of histamine, are released.  Mast cells are important in the immune response system but have many functions that are being studied in medicine. Color-enhanced transmission electron microscope image credit: University of Edinburgh. Wellcome Images

The developer now needs some clinical tests of the drug, which ships in solution in a vial. It is injected into the foot via retrograde venous therapy, similar to the way that antibiotics are injected into feet with infections. A tourniquet is used at the fetlock and the medication, in solution, is injected into the digital vein.

Only acute laminitis cases are being sought at this time. Horses that have progressed to chronic laminitis are not suitable for this test.

A stimulated mast cell that has just exploded, releasing histamine granules. The remains of the cell are seen towards the lower left, still containing a number of granules that are yet to escape. Image credit: K. Whitley, D. Becker, Wellcome Images

The medication is a mast-cell stabilizer, meaning that it inhibits the release of excess inflammatory mediators contained within mast cells. This is a much-studied area of immune-response medicine and other areas of disease pathways. The laminitis formulation also offers anti-inflammatory properties but must be administered only to horses that are not receiving Bute for therapy.

 A $75 formulation fee will be waived to a Hoofcare + Lameness blog reader who comes forward with a case to participate.

A clinic or private practitioner who would like to participate agrees to:

a. Administer the drug via the retrograde administration instructions provided.

b. Complete a Post-Treatment – Results Form – “5-Days” Post-Treatment.

c. To allow study sponsor to contact horse owner to complete Post-Treatment survey.

d. An owner-consent form must be completed.

If you are interested in participating, please send an email to Hoofcare Publishing and the developer will contact you.

Caution: Federal (United States) Law restricts this drug to use by or on the order of a licensed veterinarian.   Storage requirements: Room Temperature 

Followup: this product is also known as Laminil 

 

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read more hoofcare headlines on the Hoofcare + Lameness Facebook Page

 

Prascend® PPID (Equine Cushings Disease) Treatment Approved by FDA for US Horses

Maybe I'm biased, but I thought that the CSI (Cushings Scene Investigation) ad run by Boehringer-Ingelheim Vetmedica in British horse magazines was the most clever horse ad so far this year. It heralded the introduction of Prascend to treat Cushings-suffering horses; Prascend will soon be available in the USA.

The following press release is not an ad, it is published here as a "heads up". Anyone involved in the world of Hoofcare + Lameness is going to hear about this. Farriers and veterinarians will be asked questions by horseowners about this medication, and you need to know about how pergolide has evolved into Prascend®.

Prascend has been available in the United Kingdom for a few months, and Boehringer-Ingelheim Vetmedica has launched an awareness campaign there to urge horse owners to have their horses tested for PPID. I don't know yet what B-I has planned in the USA, but I feel confident in saying that "this is news".

In 2007, this blog reported that a potential crisis loomed for horseowners who were treating the symptoms of their horses' PPID condition with Permax (pergolide). (See links at end of this blog post.) The medication was taken from the market temporarily because of problems with human prescriptions. Before long, it became available again in the compounded form, which many horse owners ordered directly and in different forms.

Compounding pharmacies have been at the center of a controversy in the veterinary industry. At this time, it is too early to give a reliable answer whether compounded (and less expensive) pergolide will remain an option for horseowners as pill-only Prascend enters the marketplace. Ideally, horseowners will have safe and multiple alternatives to keep their horses comfortable.

Much more information will be available at or following the AAEP Convention in San Antonio later this month. 

Everyone can recognize the advanced PPID (Cushing disease) horse. But laminitis and stretched white lines in younger horses may not seem to be related to PPID until much later, when a definitive diagnosis is made. Only careful testing will discern if horses without obvious signs suffer from PPID. (photo provided by Dr. Christian A. Bingold)

Boehringer Ingelheim’s Prascend^® Approved for PPID in Horses

Product is the first and only FDA-approved treatment for the management of PPID.

ST. JOSEPH, Mo. (November 2, 2011) – Boehringer Ingelheim Vetmedica, Inc. (BIVI), has received approval from the Food and Drug Administration (FDA) to market Prascend® (pergolide mesylate), for treatment of clinical signs associated with pituitary pars intermedia dysfunction (PPID), also known as equine Cushing’s disease.

PRASCEND is the first and only FDA-approved product for the management of PPID in horses. (1) Administered in tablet form, treatment with PRASCEND can improve the quality of life for PPID-affected horses by managing clinical signs and decreasing the risk of complications of the disease, including those that have the potential to be life-threatening.

It is estimated that one in seven horses over the age of 15 has PPID (2) and horses as young as seven years of age have been diagnosed with the disease (3). In addition, up to 70 percent of clinical laminitis cases also may be affected with underlying PPID4. The most common clinical signs of advanced-stage PPID that occur in horses are hirsutism (hypertrichosis) or an abnormal amount of hair growth, abnormal sweating, weight loss, muscle wasting, abnormal fat distribution, lethargy, laminitis, polyuria/polydipsia and chronic/recurrent infections.

“Unfortunately, PPID is not a curable disease,” says Dr. John Tuttle, BIVI equine technical services veterinarian. “However, PRASCEND does offer a safe and efficacious treatment option to veterinarians and horse owners that can help reduce the clinical signs of the disease and effectively improve the quality of life of infected horses.”

While PPID is typically considered a late-stage-of-life disease in the horse, Tuttle adds that with horse owner vigilance and regular veterinary care, the disease may be detected earlier.

“Because the early symptoms of PPID may be difficult to recognize, some horses with PPID may go undiagnosed until the disease becomes more advanced,” says Tuttle. “Through regular veterinary wellness exams, oftentimes the disease can be caught earlier. By beginning treatment in the earlier stages of the disease, we are able to reduce the risk of some of the potential complications associated with PPID, such as laminitis, recurring infections, dental disease and other potential issues of uncontrolled PPID.”

Farriers often notice the early signs of PPID in horses' feet while trimming. As Cushings diseases advances, farriers are challenged to keep PPID sufferers comfortable and manage any flare-ups of chronic lamiitis. (Massachusetts farrier Allie Hayes trimming a Cushings-affected pony, photo © Hoofcare Publishing)

Not only can PRASCEND aid in the management of clinical signs of disease, the FDA approval also assures the product has been thoroughly evaluated for safety and efficacy. In addition, PRASCEND has met the standards set forth by the FDA in regard to production to preserve its identity, strength, quality, purity and consistency from batch to batch, and the product has demonstrated stability and effectiveness over time through a variety of environmental conditions.

“We are excited to offer a treatment option for horses suffering from PPID,” says Tuttle. “We encourage horse owners to continue to work with their veterinarians to find the best treatment for their horse and are confident that PRASCEND can help make a difference in the lives of horses suffering from this disease.”

PPID horses may be quite thin under all that hair. Cushings sufferers are also believed to be more highly perceptible to worms than non-sufferers. Many people clip their long-haired horses to be more aware of body condition. (photo © Hoofcare Publishing)

PRASCEND is for use in horses only. PRASCEND has not been evaluated in breeding, pregnant or lactating horses. Refer to the package insert for complete product information or contact Boehringer Ingelheim Vetmedica at 800-325-9167.

(Hoof Blog note: A web address should be available soon.)

Reference:

1.  PRASCEND^® (pergolide mesylate) [Freedom of Information Summary]. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.; 2011.
2. McGowan TW, Hodgson DR, McGowan CM. The prevalence of equine Cushing’s syndrome in aged horses. In: Proceedings from the 25th American College of Veterinary Internal Medicine Forum; June 6–9, 2007; Seattle, WA. Abstract 603.
3. Schott HC. Pars pituitary intermedia dysfunction: challenges of diagnosis and treatment. In: Proceedings from the 52nd American Association of Equine Practitioners Annual Convention; December 2–6, 2006; San Antonio, TX.
4. Donaldson MT. Evaluation of suspected pituitary pars intermedia dysfunction in horses with laminitis. J Am Vet Med Assoc. 2004;224(7):1123–1127.

Send your message to thousands of blog readers with a post footer ad like this that links to your site! Call 978 281 3222 to buy inexpensive footer ads, sponsor a blog post, or reserve a sidebar block ad.

 TO LEARN MORE

AAEP Statement on FDA Withdrawal of Pergolide for Human Use: Will It Still Be Available for Horses?

Pergolide Cleared for Equine Veterinary Use by FDA

Laminitis Research: Australian Breakthrough on Insulin Function in Equine Foot

Too Fat? Too Thin? British Court Faces Conflict Over "Abused" Horse with Cushings Disease

Cornell Laminitis Research Beneficiary of Arabian Horse Foundation Grant to Study Genetic Markers in Equine Metabolic Syndrome and Cushings Disease

Equine Pituitary Dysfunction Test Choices Analyzed by New Bolton Center's Jill Beech VMD

Three Chimneys Farm Works to Help Slew 'o Gold Keep His Cool

© Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines on Facebook

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

Totilas and Matthias Rath Cancel Competition Debut; Hoof Abscess Resolved

Team Totilas: Owner Paul Schockemohle, Totilas, and rider Matthias Rath as they appeared on German television in early February when Rath rode Totilas in a demonstration at a stallion exhibition

Almost two weeks ago, the Hoof Blog reported that world champion dressage gold medalist Totilas is now wearing heart-bar shoes. At that time, he was unable to perform for a press conference because of a hoof abscess.

Today, rider Matthias Rath announced that the horse's planned return to competition next weekend at the "Dressage and Dreams" show in Hagen, Germany has been cancelled.

Here is Matthias Rath's statement today:

"We very much regret not being able to compete in Hagen, but the health and welfare of our horses is always the top priority. We had a great feeling before the injury and the preparations and joint development were going much better than expected, which is why we had made firm plans for our early competition debut in May and we were really looking forward to it."

(English version supplied by Matthias Rath)

According to the team, the abscess has healed completely. Rath and Totilas trained over Easter but the veterinary treatment required brings into question the withdrawal/detection times that need to be observed before a competition when a horse has been treated for a medical condition.

 © Fran Jurga and Hoofcare Publishing; Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.  

Follow Hoofcare + Lameness on Twitter: @HoofcareJournal

Read this blog's headlines and read special Facebook-only news and links when you "like" the Hoofcare + Lameness Facebook Page

Tweet

 

Disclosure of Material Connection: I have not received any direct compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned, other than Hoofcare Publishing. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: Guides Concerning the Use of Endorsements and Testimonials in Advertising.

FEI NSAID Background: Alex Atock Explains When and Why Bute Was Banned

Many people I meet in the horse world are shocked and even a bit put off sometimes when they first learn that the FEI does not allow horses to compete on even the smallest amount of non-steroidal anti-inflammatory drugs (NSAIDs, pronounced "en-saids"). If it's ok for horses in the United States to race and show on Bute and other NSAIDS, why are the other countries so backward?

Or is it the other way around?

Whether it is horse racing or horse sports like eventing, driving, showjumping and dressage, the world's perception of horses competing on even the lowest dose of therapeutic medication are polarized.

Last week's congress on NSAIDs, organized by the Federation Equestre Internationale (FEI) in Lausanne, Switzerland, was designed to fully educate all interested parties before the FEI's General Assembly vote in November which will ask the world's equestrian bodies if it would like to liberalize the FEI's NSAID policy by going with a "progressive list" of allowed medications for competition horses.

Much of the NSAID Congress was scientific presentations by leading experts like the USA's Dr. Wayne McIlwraith but there were some ethical considerations as well. So far, the FEI has posted 12 videos of lectures from the Congress on YouTube for us to watch. That's a lot of pharmacology research.

But perhaps most important of all the lectures was a bit of a history lesson from horse welfare specialist veterinarian Alex Atock of Ireland, who was in the middle of the FEI's upheaval over NSAID reform in the late 1980s and early 1990s, when he served as head of the FEI's veterinary department. Bute was banned under Alex Atock's watch; who better to take us back in time to find out when and why the ban was initiated?

Listening to this video, I felt like I was thumbing through old issues of Hoofcare & Lameness. As the FEI strugged with the issue of banning Bute, I was writing about it, and about all the horror stories that were happening in the horse industry at the same time. Were they related to Bute? No, but they were related to horse welfare and the perception that people in horse sports had little regard for the well-being and even the lives of their horses. Somehow, this all spilled over to the drug debate, though.

As Atock says, we had German pole rapping scandals, American insurance-collecting horse killers, and the 1990 Breeders Cup had been called the blackest day in horse racing history, as three horses were euthanized as a result of breakdowns in one day's races, including the magnificent three-year-old filly Go For Wand. It's amazing horse sports of any kind survived that era.

The FEI's decision to completely ban Bute from competition horses was painful. It has been painful all along the way since then, but never more painful than the past year, when the old dichotomy opened up again.

Which way will the FEI vote in November--with the liberalized science-is-God view or with the welfare-ethics old guard of Europe who staunchly maintain that Bute and NSAIDs were banned for a reason and horse sport needs to distance itself from the perception that equine athletes are drugged in order to perform?

Does a horse on Bute deserve a Gold Medal if the Silver goes to a horse that is "clean"? On the other hand, should a horse be forced to withdraw from a world-championship competition because of a minor episode of colic a week beforehand that has nothing to do with a performance-enhancing effect of a drug that could be given to treat the colic? Should a vet have to hesitate to medicate a horse because of the performance-drug testing repercussions of a therapeutic substance?

These questions go around and around and around.

By way of education, here's a clip from a lecture by USEF veterinarian Kent Allen, explaining to event riders how to fill out forms to report the NSAID(s) their horses are on, since the USEF rules were changed this year. This clip is one of a 24-part YouTube series with Dr. Allen presented by US Eventing and sponsored by SmartPak to help riders through the process of understanding what is permissable for their horses and how to manage their horses within USEF rules while competing at USEF (as opposed to FEI) events. That's right: 24 videos to explain how to manage your horse's medications within the rules, and to help riders understand the issues and regulations surrounding the approved and unapproved medications themselves.

Dr. Allen is chairman of the USEF Drug and Medication Committee and vice-chair of the FEI Medication Advisory Group.  He is also official Veterinary Coordinator of the 2010 Alltech FEI World Equestrian Games. It is of critical importance to him that riders and trainers understand the medication process and that the American horse public understands the reasoning behind the USEF policies, which are different from the major European nations, but in line with some other countries around the world.

The one-med-or-two forms explanation is vaguely reminiscent of some of my phone calls with Blue Cross Blue Shield about my HMO care.

I highly recommend that ANYONE who even thinks of commenting one way or the other on the medication debate in the FEI watch all the FEI NSAID Congress videos AND Dr. Allen's USEF rules videos.

Educate yourself before you speak. The FEI and US Eventing have laid out a great menu of education for you, for free. You don't have to buy airplane tickets, stay in hotels, or sit all day in uncomfortable chairs. Just watch and listen and learn about medication rules, here, there and everywhere.

What do you want the future of the horse world to be like? How do you think international horse sports will be perceived if medications are allowed?

Most importantly, now that Alex Atock has reminded us where we have been, and opened up the closet where the skeletons have been hiding, where on earth is all this going?

© Fran Jurga and Hoofcare Publishing Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.

Follow the Hoof Blog on Twitter: @HoofcareJournal

Join the Hoofcare & Lameness Facebook Page

Tweet

FEI NSAID Congress Presents Medication Facts and Philosophies for Equestrian Sport Decision Makers

Background: In November, the Federation Equestre Internationale, the world governing body of horse sports, will convene its General Assemby in Taipei. On the agenda is the groundbreaking and emotional vote whether or not international horse sports should allow horses to compete on low levels of mild anti-inflammatory medication, similar to what is now allowed in the United States. Currently the FEI operates under a zero tolerance policy, which is in keeping with many nations' national policies and even legal statutes. 

An attempt to pass this important rule change at last year's General Assembly was clouded in confusion and resulted in international furor that led to a decision to reconsider and re-vote in 2010. To make sure that the latest information was available to all voting nations, a congress convened in Switzerland last week with leading veterinary experts.

For this reason, the Alltech FEI World Equestrian Games in Kentucky next month will be competed under current FEI rules. Had last year's attempt passed permanently, horses from all over the world would have come to the USA and perhaps competed on medication for the first time in their careers, much like the international racehorses who come for our Breeders Cup. Some countries had grumbled about boycotting the 2010 WEG if the drugs were allowed. 

An emotional issue? It's hard to think of a more hot-button issue in international sport or racing. It is what sets the USA apart from the rest of the world. We think they should be like us. They think we should be like them. And so the world goes round.

Last week's FEI Congress on Non-Steroidal Anti-Inflammatory Drugs (NSAID) Usage and Medication in the Equine Athlete has been called an invaluable contribution to the debate on the in-competition use of NSAIDs. In a ground-breaking approach by the FEI, the Congress brought together both the most up-to-date scientific data and non-scientific aspects of NSAID usage for over 200 delegates from 29 countries at the two-day Congress, which was held at the Olympic Museum in Lausanne, Switzerland.

The second day of the Congress clearly demonstrated that this is a debate that cannot be viewed purely from a scientific perspective and that ethical values and legal issues also have to be taken into account.

Following Monday’s mainly science-based presentations, FEI General Counsel Lisa Lazarus opened Tuesday’s session by outlining details from nine European countries that prohibit or may prohibit the use of NSAIDs under national law.

In light of these legal issues, Ms Lazarus stated that the FEI has two options: either abandon any proposed change in the treatment of NSAIDs, maintaining the status quo that NSAIDs cannot be administered to sport horses during FEI competition anywhere in the world; or permit the use of NSAIDs at appropriate levels as far as the FEI and its members are concerned, but make it clear to all athletes and participants that the FEI’s rules do not supersede national law, and that anyone participating in the sport in any of the nine countries must note that national laws prohibit, or may prohibit, the use of NSAIDs.

Lynn Hillyer (GBR) of the British Horse Racing Authority, explained that the Racing Authorities of Europe, Hong Kong, North and South Africa, Australasia, Asia and the Middle East (except Saudi Arabia) rule that horses must not race under the effects of any drugs, but acknowledge that medication is necessary – off the racetrack – to ensure a horse’s physical well-being. “In other words, medication should be an aid to recovery, not a tool to enable a horse that should be resting and recuperating to race or train.”

Stephen Schumacher, Chief Administrator of the Equine Drugs and Medications Program of the United States Equestrian Federation (USEF), stated that the USEF Equine Drugs and Medications Rules allow NSAIDs usage with quantitative restrictions. “We believe that the welfare of our horses is not put into jeopardy with the judicious use of NSAIDs and their use may in fact be beneficial,” he said.

Dominik Burger, President of the Veterinary Commissions of the Breeding Associations for Swiss sport horses, spoke on the breeding perspective. He concluded that the issue would benefit from a pluralistic ethical analysis based not just on the welfare of horse and rider but also on regional and global public values like integrity, equity, justice, duties and responsibility.

Steve Maynard, Laboratory Director at Horseracing Forensic Laboratory Sport Science, outlined that quantitative analysis, applied to determine the exact level of a substance being present in the body, is significantly more costly than qualitative analysis carried out to detect the presence of a substance.

The public perception of equestrian sports, sponsors and the media perspective were all aired in Tuesday’s panel discussion, when British journalist Brough Scott asked some hard-hitting questions about the possible repercussions of reintroducing NSAIDs in competition.

Sven Holmberg, FEI First Vice President chaired the final debate on the pros and cons of the in-competition use of NSAIDs. Tim Ober (USA) and Mike Gallagher (CAN) spoke for the use of NSAIDs and Peter Kallings (SWE) and Christian Paillot (FRA) spoke against their use.

FEI Veterinary Director Graeme Cooke, who had earlier updated participants on the work of the FEI List Group, summarized both sides of the debate, drawing on key points from all the speakers over the two days. The FEI has achieved a number of key objectives through the Congress, he said, gathering up the science that had become available since 1993, bringing together the scientific and non-scientific, providing an opportunity to hear related views, and ensuring there will be a record of this unique event in order to inform not just National Federations, but everyone with an interest in the debate and allowing for further review before the FEI General Assembly in November.

In his final summing-up, Holmberg stressed the importance of keeping the debate alive between now and the vote on in-competition use of NSAIDs in November, so that the decision taken at the FEI General Assembly is one that is founded on sound knowledge and in the best interest of the sport and the horses.

“There is no doubt that both sides of the Atlantic and the rest of the world have the same clear goal in mind: that the welfare of the horse is really paramount to whatever we do,” he said.

A report on the Congress will be sent out to all National Federations, and the FEI website will continue to offer a feedback area for comments. To maintain the flow of information for National Federations that were unable to attend the Congress, videos of all speeches and power point presentations, as well as the panel sessions and full debate, will be made available on the FEI YouTube Channel later this week. 

A mini site for the Congress with documents and abstracts has been set up on the FEI web site. Comments on the medication issue are invited; please email your opinions to nsaidcongress2010@fei.org

© Fran Jurga and Hoofcare Publishing Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. Please, no use without permission. You only need to ask. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.

Follow the Hoof Blog on Twitter: @HoofcareJournal

Join the Hoofcare & Lameness Facebook Page

Tweet

USEF Reduces Medications Levels: Only One NSAID Allowed in Competition Horses After This Year

16 January 2010 | Fran Jurga's Hoof Blog at Hoofcare.com

Horses showing in USEF-sanctioned horse shows will be subject to new drugs and medications policies beginning at the end of 2010 as more than 30 years of permissive use of pain medication is being restricted under a more conservative rule. Even with half the medication formerly allowed, US horse shows still have a very liberal policy compared to most countries.

Big news from Louisville, Kentucky tonight: At the annual convention of the United States Equestrian Federation (USEF), the governing body of most equestrian sports in the United States, a significant rule change is being agreed upon which will reduce the number of medications that a horse can have in its system when competing.

Various committees within USEF have been working toward a compromise on this issue throughout the convention, which began on Wednesday. Current USEF rules allow two non-steroidal anti-inflammatory medications to be used simultaneously; that policy has been in place for more than 30 years.

The change was not without its opponents; the US Hunter Jumper Association's Open Hunter Task Force had filed for a rule change (GR410.1) that would have allowed two medications if written notification was given, but then withdrew its proposal on December 9.

Some breed and sport representatives felt that limiting medication is a penalty to older horses or to lower-level shows that do not have the best footing. Perhaps some horses will now show in fewer shows, or be entered in fewer classes. Some arguments were made that the current low value of horses makes it a hardship to sideline horses that could be competing if medicated. It remains to be seen if the new rule will affect horse show revenue; it is not expected to take effect until December 2010.

In most European countries, no medications are allowed; no medications are allowed in competitions sanctioned by the Federation Equestre International (FEI), the world governing body of horse sports. A recent vote to change the FEI medication policy caused an international uproar.

There is a lot to this story, and more will emerge in the days and weeks to come as the official final wording of the rule and dates are made public. One thing is known, and that is that the push to make the change came from veterinarians, who are often accused of promoting drug use in show horses.

Dr. Kent Allen, longtime chair of the Drugs and Medications Committee for USEF, commented on the obvious rise in joint injection that may be the result of a limit on medication. In a document available on the USEF website he offered this insight: "First, it is important to understand that a joint injection properly performed in experienced veterinary hands is the single most effective anti-inflammatory treatment we have for (an) equine joint.

"Secondly, there are numerous medications to inject into joints. Often it is hyaluronic acid in combination with a variety of cortisones, or bioregenerative therapies such as IRAP. Some of these medications are extremely safe and all of them will significantly reduce joint inflammation.

"On the question of 'are joint injections going to be overused', the answer is that is already happening today! In some cases joint injections are being used as treatments in 4, 6 or 8 joints without a diagnosis of joint inflammation ever being established. This is dangerous not only from the standpoint of increasing the number of joint injections in the horse and potential side effects but you may or may not be treating the real problem. Accurate diagnosis, including lameness examination, nerve blocks, joint blocks and diagnostic imaging is the most effective method of determining what the problem is and if the horse needs joint injections. This also has the benefit of reducing the cost to owners as well as the risk to the horse."

USEF approved the use of Surpass, a topical anti-inflammatory recently; there's no prediction so far if there will be a trend to more specific treatments rather than generalized medication for pain, stiffness or soreness.

While rumors of a compromise were circulating today, equestrian journalist Nancy Jaffer broke the news tonight in her column for the Star-Ledger in New Jersey that the new medication policy would be adopted. More insight into the process of the rule change can be found in Nancy's article.

The new rule will affect most breed shows, including Arabians, Saddlebreds and Morgans, plus USEF-sanctioned hunter-jumper, dressage, driving, endurance and eventing competitions and individual breeds and sports who are under USEF's umbrella. It will not affect Quarter horse, Paint, Tennessee Walking horse or Appaloosa shows, as well as many other breeds, or the sports of reining, cutting and barrel racing, unless they are held at a USEF event or as part of a USEF-member breed show.

The medication policy change is endorsed by the American Association of Equine Practitioners, the American Veterinary Medical Association and by the Humane Society of the United States.

USEF assembled an impressive bank of articles and information on medications in sport and performance horses for the delegates to the convention. Since medication policy is sure to be a topic of conversation throughout the coming months, you might want to save some of those documents for reference.

© Fran Jurga and Hoofcare Publishing. Please, no use without permission. You only need to ask.

Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page).

To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found.

Questions or problems with this blog? Send email to blog@hoofcare.com.

AQHA: Uniform Medication, Welfare Rules for Western Performance Across Breed and Sport Lines May Be Possible

9 November 2009 | Fran Jurga's Hoof Blog at Hoofcare.com

The American Quarter Horse Association reported today that western breed and sport industry alliance partners reached a general consensus involving humane treatment and equine welfare during a meeting October 20 and 21 at the American Quarter Horse Hall of Fame & Museum in Amarillo, Texas.

Attendees included representatives from the American Quarter Horse Association, United States Equestrian Federation, American Association of Equine Practitioners, National Cutting Horse Association, National Snaffle Bit Association, National Reining Horse Association, National Reined Cow Horse Association, United States Team Penning Association, American Paint Horse Association and Equine Canada.

“Never before have so many leaders in the performance-horse disciplines gotten together to seriously discuss medication and animal welfare in relation to our events,” said Gary Carpenter, AQHA's executive director of breed integrity and animal welfare. “In-depth discussions led to a good, overall agreement on these vital subjects and the direction we need to go in the future.”

Meeting participants discussed the merits of developing a uniform therapeutic medications program and humane treatment policies that could be adopted by all of the groups involved. Executive directors from these associations scheduled a follow-up meeting for January 2010.

© Fran Jurga and Hoofcare Publishing. No use without permission. You only need to ask. Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.

"Relax Dressage Medication Rules!" Anky Speaks Out in Support of Isabell, Defends Meds for Therapeutic Use

by Fran Jurga | 6 July 2009 | Fran Jurga's Hoof Blog

They are the Affirmed and Alydar of the sport horse world. Venus and Serena on horseback. One wins one day for technical perfection. The other wins the next day for taking risks on a horse that seems barely under control...and yet delivers in artistic superlatives. A single hoofprint out of line often is all that separates the two.

When Germany's top dressage star Isabell Werth was suspended last week for a positive medication test on her lower level horse, her arch-rival Anky Van Grunsven of Holland did not shout with glee that her rival would not be at the World Equestrian Festival in Aachen this weekend to oppose her.

In a poignant moment of sport solidarity, Anky stepped up to microphone and voiced her criticism for the zero tolerance medication rules that make it impossible to sedate a nervous horse for a routine stable procedure like shoeing or clipping. In Isabell's case, it was a medication for the condition known as "shivers". (Click here to read post about Isabell and shivers medication.)

Here's Anky's statement, taken from a video published in Dutch last week:

"I am not a supporter of doping at all but I want to do what is best for the horse.

"An example: when I want to clip my horse before a show, I would like to give him a light sedation to relax because my horse is a bit afraid of the clipping machine. The stuff we use to relax the horse is doping positive. Imagine, I asked the vet how many days before the show I can clip my horse and he says three days. But what if it is found in my horse’s blood at the show five days after I used it? That means my horse is doping positive! But I think it’s for the horse benefit to clip him.

"I think the rules have to be changed. The research regarding doping is very expensive but it will be a good idea to work with a logbook and write down what had been given and why.

"If the medication is not to improve the performance, I think there is no reason to maintain the zero tolerance for these cases."

Click here to watch the video. It's in Dutch but has some nice footage.

Note: in another poignant twist of fate, Anky did not win at Aachen this weekend. That honor went to the American, Steffen Peters, on Ravel. One can only wonder what might have happened if Isabell had been allowed to compete.

Click here to follow Fran Jurga and The Hoof Blog on Twitter!

© Fran Jurga and Hoofcare Publishing. No use without permission. You only need to ask.

Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page).

To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found.

Questions or problems with this blog? Send email to blog@hoofcare.com.

AAEP: New Racehorse Safety and Welfare Veterinary Recommendations

by Fran Jurga | 16 February 2009 | Fran Jurga's Hoof Blog
(received via press release)

The American Association of Equine Practitioners today issued guidelines for protecting the health of the Thoroughbred racehorse. The white paper, Putting the Horse First: Veterinary Recommendations for the Safety and Welfare of the Thoroughbred Racehorse, provides veterinary guidance on many issues challenging the racing industry and the care of the racehorse.

Recommendations within the white paper are focused in four key areas: the racing business model, the veterinarian-owner-trainer relationship, medication, and the public perception of racing. Additionally, changes to the structure of claiming races and medication usage in horses intended for sale at public auction are addressed.

“As an organization with the primary mission of protecting the health and welfare of the horse, the safety of the racehorse is one of our highest priorities,” said AAEP President Dr. Harry Werner. “This is a critical time for the racing industry, and we join the efforts of other groups who are determined to make improvements for the health of our equine athletes.”

Key points in the white paper include:
· Continued identification and implementation of procedures and strategies that will significantly reduce the injury rate of horses.
· Standardization and enhancement of pre-race and post-race veterinary examinations with mandatory cross-jurisdictional sharing of information.
· Universal adoption in all racing jurisdictions of the Association of Racing Commissioners International model medication rules which state that no medication should be administered on race day except for furosemide (Salix®).
· Increased racetrack security to ensure compliance by all racing participants with medication rules.
· Provide complete transparency for the veterinarian-trainer-owner relationship in all aspects of health care decisions.
· Development in all racing jurisdictions of a program for the rehabilitation, retraining and adoption of horses whose racing careers have ended.

The white paper was developed by the AAEP’s Racing Task Force, a group comprised of private racetrack practitioners, regulatory veterinarians and veterinary specialists. Dr. Scott Palmer of Clarksburg, New Jersey, and Dr. Foster Northrop of Louisville, Kentucky, served as chair and vice chair, respectively. This group is now a standing committee of the AAEP.

“Our premise is very simple: What is good for the horse is good for racing,” explained Dr. Palmer. “In a unique climate of widespread industry commitment to fix what is wrong with racing, veterinarians have made every effort to put the horse first in that process. It is fair to say that particular recommendations will resonate with some individuals and alienate others within the industry. Nonetheless, we’d like to think that if our horses could read this document, they would be pleased.”

The AAEP intends its white paper to provide guidance and support to those who are working to bring meaningful change.

The white paper is available at http://www.aaep.org/images/files/Racing%20Industry%20White%20Paper%20Final.pdf. For more information, contact Sally Baker, AAEP director of marketing and public relations, at (859) 233-0147 or sbaker@aaep.org.


© Fran Jurga and Hoofcare Publishing. No use without permission. You only need to ask. Fran Jurga's Hoof Blog is a between-issues news service for subscribers to Hoofcare and Lameness Journal. This blog may be read online at the blog page, checked via RSS feed, or received via a digest-type email (requires signup in box at top right of blog page). To subscribe to Hoofcare and Lameness (the journal), please visit the main site, www.hoofcare.com, where many educational products and media related to equine lameness and hoof science can be found. Questions or problems with this blog? Send email to blog@hoofcare.com.

Big Brown's Part Owners Pledge Drug-Free Stable After October 1st

Here's a statement issued today by International Equine Acquisitions Holdings (IEAH), the partnership that is part owner of Kentucky Derby and Preakness winner Big Brown. The statement comes on the heels of a Congressional hearing held Thursday in Washington DC in which House committee members were highly critical of lax drug policies (among other things) in US horse racing.

This is the first announcement of this sort that has been issued, although there are probably racing stables and/or trainers who have similar policies without stating them. Remember that medication rules vary by state. For many years, New York had a much tougher medication policy than other states. Today, it is legal to race horses on steroids and other medications in most states.

The Jockey Club has been promoting a nation-wide ban on steroids by the end of this year, by the issuance of a model rule that would be adopted by individual states. They also have issues a model rule change outlawing any traction devices or toe grabs on front shoes. However, no one has the power to force a state to change its drug or horseshoe regulations.

From IEAH's statement:

"In an effort to re-build confidence and the integrity to the great sport of Thoroughbred horse racing in North America, IEAH Stables is proud to announce effective October 1 all horses in training and racing in IEAH silks will run only with Lasix. No other medication, drugs, or steroids will be administered.

"While regulatory standards and indeed legislation may be required to resolve most of the controversial issues surrounding our sport, we believe our announcement today is a step in the right direction. To the best of our knowledge, we are the first racing stable in North America to make this commitment. We encourage others to follow our lead.

"We have selected an effective date of October 1 as the official "free-of-medication" withdrawal date because our horses should be clear of all substances by that time. As of October 1, we will request all tracks at which our horses run to perform pre-race and post-race testing at our expense. These procedures have proven effective under racing conditions outside North America.

"Moreover, in the interest of fairness to the wagering public, we will request and strongly urge that race programs include data indicating which horses will run with medication, which will run free of medication. The programs should also indicate which owners/trainers decline to divulge this information.

"As a further test of our commitment, beginning October 1, if any of our runners test positive for medication other than Lasix, we pledge to donate our share or purse money to charities related to thoroughbred horse racing. We will specify those charitable organizations at a later date.

"We believe this change is for the betterment of our sport. In the long run, it will benefit all involved in the game -- the tracks, horsemen and most of all the fans."

(end quote)

(Note: Lasix, the one drug that IEAH says it will allow, is a diuretic anti-bleeding medication.)

An interesting footnote to this story is that Benny the Bull, owned by IEAH, won the Golden Shaheen, a tough international race in Dubai this fall. Dubai racing has a zero tolerance for medication and the Dutrow-trained horse managed to win impressively in spite of the drug ban, international travel, and searing desert heat, as did 2007 Horse of the Year Curlin.

IEAH's October 1 deadline means that their horses, if entered, would not run on medication for the 2008 Breeders Cup to be held in California later that month.

AAEP Statement on FDA Withdrawal of Pergolide for Human Use: Will It Still Be Available for Horses?

The American Association of Equine Practitioners (AAEP) has issued this statement to its members about the potential crisis of pergolide's removal from the drug market.

"As you may be aware, the FDA has withdrawn the drug pergolide from the market for use in humans. In order for the drug to continue to be available for use in veterinary medicine, the FDA must approve an exception for pergolide to be used by veterinarians and to be compounded in bulk quantities.

"The AAEP, through its Drug Compounding Task Force, has been in contact with the FDA, and they are aware of the significant impact of pergolide’s withdrawal from the market on equine medicine. The FDA Center for Veterinary Medicine is working with its counterpart for human medicine, the Center for Drug Evaluation and Research, to allow importation of pergolide for use by compounding pharmacies. The FDA expects to have an official announcement by the end of this week.

"The AAEP will continue to communicate with the FDA on this issue."

Note to blog readers: Pergolide is a drug that has been found to have some problems in human use; it is often prescribed for Parkinson's disease. Pergolide has been very helpful to some older horses suffering from problems like Cushings disease or insulin resistance that may have laminitis as a side effect. Many horse owners are concerned about a shortage of the medication for their horses.

Please read my original post from March 30 for more information.