WHOA, Nelly! Horse Racing’s Perceived Need for Speed at All Costs to Horse = Absolutely, Positively Unacceptable.

 The following is Part 1 of a three-part article, about WHOA, horses, humans and racing medications.

WHOA (Water Hay Oats Alliance) is a brilliant organization of kind-hearted people who are focused on one thing:  the health and well-being of horses.   Period.   They love horses, and they know that healthy horses who aren’t doped are the only hope if horse racing is to flourish, and to grow.   Indeed, the health of the equine economy depends on WHOA’s campaign to wake up the industry, and get unnecessary medications off the table in the life of race horses.

No horse ever should be given medications for reasons other than healing a situation, or stabilizing the horse during convalescence.  One of the meds that’s part of the dialogue is Lasix.

So this article is Part 1 of a multi-article piece, because it’s important for you–for horse racing, if it’s to have a future in the United States–to understand the importance of regulating medications given to race horses.  Humans can’t be trusted to always do The Right Thing, so WHOA is working with US Rep. Andy Barr and US Rep Paul Tonko–and many genuine horse lovers–toward the day when horses’ bodies and needs will be the first, foremost and only criteria when deciding what to give a horse other than…hay, oats and water.

I’m going to share something with you–apparently, with the entire Universe–that really is none of your business.  Yikes.  But precisely because this article is about horse health–and I care more about horse welfare than about my own modesty–I’m forced to tell you something about my intimate health story.   And my personal experience is why I know that WHOA (Water Hay Oats Alliance) is on the right path in their support of clean racing.

On my business card next to my name, this is printed:  (L).  I put it on there last year as a joke, because at that time in my Life–things had gone from OK to REALLY Rotten.  I was in desperate need of the ability to look at my circumstances, and laugh.  From my perspective today, the entire last 16 months still looks like a movie based on Dali’s Surrealist painting,  “Persistence of Memory.”  (A film in which I star–but which I’ve watched unfold without benefit of myself as the witty writer of the screenplay.)  Hence the (L) on my business card:  I was so depressed that day in my ICU bed…I used my smartphone to reach out to the world, including the creation of new biz cards.   (Anyone who knows me, knows that, the more depressed I am–the funnier I become.)

My harsh reality is that, as of March 29th, 2016–I take diuretics, every day–and will continue for the rest of my Life.   But it was my choice– that of accepting my cardiologist’s advice.  I need the diuretics, and I choose to take them, and thereby–to live.

Horses, on the other hoof–don’t have a choice, about what’s put into their bodies.  Yes, they can refuse to eat or drink.  But they can’t control a human who has a syringe in his/her hand, aiming for their hind-end.  Horses are sentient and wildly intelligent–but when a human sneaks up on them and sticks them with a needle full of ANYthing–the horse is helpless to prevent it.

Allow me to elucidate, to explain why I am an expert–or at least, I can write on this topic with empathy:

Last March, I fainted thrice.   All three times, I chalked it up to stress and exhaustion–but never figured out the real reason that I awoke on my face three times within seven days.  The third time, I checked into an ER, and a few days later–had completely-unexpected open-heart surgery.   (ER tests showed that, when I was eight, I had Rheumatic Fever and my aortic valve stopped growing.  By March, 2016 [52 years later]–no  one had figured this out.  So, from an ER to a battery of tests, thence to an operating table–I did a whirlwind tour of two regional hospitals.  This tour ended 32 days later.  To quote my cardiologist, I was “…a very sick girl.”)

Before my surprise hospital stay, I took two pills a day.  One of them, aspirin.  Now I take 12 a day, some of them more than once.

One of those meds is Bumetanide, a diuretic.  Similar to Furosemide (Lasix) in that both are diuretics, and both are designed to rid the body of excess fluid.   I must take Bumex every day for the rest of my life, or fluids build up in my heart and lungs.  (In the heart, this is called, “congestive heart failure.”  A Very Bad Thing.)

So, unlike horses–I HAVE to take this diuretic.  Every day.  Forever.  My journey following this traumatic event last year has been rough, so like many people–I use humor to try to work through it.  

And of course, taking one medication often leads to the necessity of another.  I was born with Hypokalemia, which means that my body tries to toss Potassium out of me, and has since the day I was born.  Since 1999, I’ve taken Potassium Chloride, (Henceforth, KCI.) –to try to replace that electrolyte that my body is spewing.  Any living organism that is given a diuretic has the potential to develop Hypokalemia, eventually.

So.  Bumex is a constant in my Life–so KCI has become my BFF.   Bumex drives fluids out of my body with a ferocious vengeance.   So, now my daily regimen includes a whopping 20 mEq a day of KCI.   (Hmmm… KCI…Potassium Chloride…sound familiar?  KCI is the third part of a lethal injection.  The first two parts anesthetize, then paralyze.   Then, 100 mEq of KCI  is administered,  to induce a heart attack.   Ergo,  if someone doesn’t need KCI, and they take it with an otherwise-healthy heart–it’ll kill ’em.  (Hence, all the episodes of “Law & Order” and other crime procedurals in which the sneaky perp got KXI into his victim via a syringe, and thereby committed murder.)

So, what does my health history have to do with horse racing?  And, why the long telling of the tale?

Because:  1) Everything.  And 2) It’s germane.   I have a unique perspective:  I can see the topic of Lasix from the position of The Horse.

As a living, sentient being who must take a diuretic in order to stay alive–I am qualified to discuss the use of diuretics as a training tool.   (Why?  Because I could say Yay or Neigh to my doctor, when we went over my regimen at the beginning–and we work closely together to monitor and tweak my meds as needed.)

Horses can’t do that:  horses stand or lie there, literally–and take their medicine.

Furosemide (Lasix)  is not used by horse racing professionals as a cure, but rather as a preventative. There’s a wide difference between those two nouns.

We’ve all heard arguments many times, that some horses need Lasix because it keeps a horse from bleeding.

Some horses are bleeders.  It’s true.  So maybe those horses shouldn’t be racing:  instead,  transferred to sports in which their breathing won’t be consistently challenged every, single time they train or participate in the sport.   Both training and racing put tremendous stress on a horse’s lungs and breathing tissues–and so, some horses bleed.  So trainers and owners who actually care about their horses not only should consider carefully whether a horse’s health indicates that they’re not cut out to race.  A horse who bleeds when racing full-out will not bleed doing Dressage, precisely because her/his heart isn’t being pushed from its standing, 44 beats per minute to an average of 117bpm.

The (very logical-sounding) arguments in favor of giving Lasix to race horses all come across as loving, as in, “We give horses Lasix because s/he a bleeder, and it would be cruel to race her/him and let her/his lungs bleed.”  Yes, it would.

But the problem here is multi-fold:  bear with me, bulletpoints to drive home the points:

*  Too many bettors think of Lasix as being a Performance Enhancing Drug.  That concept may have elements of truth, but only the smallest of percentages.  Losing eight pounds of fluids will not cause a horse to run 75 miles an hour (intentional exaggeration there)–but it’s a myth that’s held by so many bettors and fans that it DOES affect wagering, handicapping, etc.  That’s WHY (L) is put next to a horse’s name–because it’s a handicapping tool.   When a horse is given Lasix, s/he has to urinate–and this takes excess weight out of the horse.  A lighter horse = a winner…?  Thus goes the long-held belief,  in many bettors’ minds.     So, even though Lasix isn’t a Performance Enhancing Drug, per se–it’s perceived thus.  And perception, you know, is Truth, to many people.

Result:   bettors use it as a handicapping tool–handle is affected–the odds change–etc.

*   From my perspective as a patient--I know that the use of a diuretic indeed depletes the body of electrolytes.  ANY cardiologist or patient can confirm this.  (Hence, my need for Potassium Chloride (KCI.)  Many people who take diuretics are given scripts, as OTC Potassium just doesn’t cut it to replace that volume of Potassium.)

Result:  so, my thinking colleagues, the question arises:  how many horses who are on Lasix, also get blood tested once a week to test for Potassium and other electrolyte levels?   Not very many, I’d wager.  I may be WAY off-base:  it may be that EVERY horse who’s on Lasix gets blood-tested, and given the correct level of Potassium and other electrolytes to supplement the losses.  If I’m wrong–I want to know.

As my cardiologist explained:  the heart is a muscle, and muscles need…POTASSIUM to function properly.  The example she gave was that, nighttime cramps in leg muscles indicate a need for Potassium.   [BTW: 20 mEq a day of KCI = the Potassium in 40 bananas.]  Imagine how much Potassium a horse requires for a healthily-functioning, non-“cramping” heart.

My question is born of my own experience, but it has obvious, scientific merit.  Here’s a bit from “Furosemide in the Horse,” a workshop paper:

“As with many diuretics, it can cause dehydration and electrolyte imbalance, including loss of potassium… Excessive use of furosemide will most likely lead to…hypokalemia. The drug should, therefore, not be used in horses that are dehydrated or experiencing kidney failure. It should be used with caution in horses with liver problems or electrolyte abnormalities. Overdose may lead to dehydration, change in drinking patterns and urination, seizures, gastrointestinal problems, kidney damage, lethargy, collapse, and coma…”[1]

*   I’d like to see a statistic, indicating how many equine heart attacks happen during workouts and races–and how many of those heart attacks occur in horses who are on Lasix?   If it’s not happening already, every horse who’s on Lasix should be blood-tested for their Potassium levels, because it’s impossible to give any diuretic on a regular basis–to any living organism–without depleting Potassium and other vital electrolytes.

I’m taking a very-wild guess here, that historically, a large percentage of seemingly-healthy horses who drop dead during a workout or a race–and then are diagnosed as having suffered cardiac arrest–are/were on Lasix on a regular basis.    It is absolutely inevitable that Lasix takes Potassium and other electrolytes out of the horse’s body–but his/her heart needs Potassium just to function.  If the heart isn’t receiving Potassium in proportionately-high, medically-monitored doses–the heart and all the other muscles will suffer.  This is not a matter for dispute.

Lasix is just one medication that’s out of control on race tracks across America–and yet, elsewhere on this planet–it’s outright banned.  There are many meds–and lots of voodoo “medicine” (frog venom, etc.) that still are given to horses by win-obsessed trainers and owners.

This is why WHOA is working with Reps. Barr and Tonko to pass the Horse Racing Integrity Act of 2017, [2] and finally establish “…a uniform anti-doping and medication control program to be developed and enforced by an independent Horseracing Anti-Doping and Medication Control Authority…”

This Authority would/will have the same clout as WADA.   (World Anti-Doping Agency)  WADA has a laundry list of banned medications, and the list in S5, Diuretics and other Masking Agents includes yes, both my Bumetanide (Bumex) and Furosemide (Lasix).

IF WADA knows that use of diuretics on the hearts of human athletes is detrimental–how much more do we, in the horse racing industry, owe it to our horses who cannot speak for themselves–to sit down seriously, once and for all, and work with WHOA and Congress to outlaw the unregulated use of this medication?  (Unless actually, medically necessary?  And IF it’s medically necessary for a horse–then the regulations must stipulate that weekly blood tests for Potassium and other electrolytes absolutely must be conducted, by an independent agent.)

It’s the least–and I mean, the very least–we can do for the horses who give us love, peace and the most-thrilling rides of our lives. 

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Next…
Part 2:  WHOA, the nobility of racing.  Also, WHOA membership:  disappointing, that so many racing pros from a particular state are conspicuous by their absence.  N.B.:  It AIN’T Kentucky.
Part 3:  Arabian Horse Racing:  Thoroughbred people, take note and…Riders Up! (This piece will lead us directly to an article dedicated to Arabian Racing’s strong stand on Lasix and other medications.)

ADDENDA:

1)   I’m a human.  I take 1 mg of Bumex, once a day.  The recommended dosage of Lasix, for a horse:  0.5 mg, per pound = 500 mg per dose, for a 1,000 pound horse. [4]

2)  I saw Barbara Banke yesterday at WHOA’s Meet & Greet in Saratoga.  Ms. Banke is a member of WHOA, and it happens that she’ll be a Featured Speaker on Sunday, the 13th at the Jockey Club Round Table in Saratoga.  The Round Table always is thought-provoking and offers insights; I’ll be interested to hear Ms. Banke’s thoughts as she speaks about the challenges that face horse racing in America.

REFERENCES:

[1]  “Furosemide in the Horse,” conference paper.  Editors:  J.D. Harking, Wyndee Carter, C.G. Hughes, Thomas Tobin.  1998, Wind Publications

[2]  Horse Racing Integrity Act of 2017:  

http://waterhayoatsalliance.com/pdfs/HIA2017.pdf

[3]  WADA:

The World Anti-Doping Code
THE 2014
PROHIBITED LIST INTERNATIONAL STANDARD

https://www.wada-ama.org/sites/default/files/resources/files/WADA-prohibited-list-2014-EN.pdf

[4]   Stablemade.com product instructions and precautions:

http://www.stablemade.com/hproducts/drugs/lasix.htm