Part 3: Lasix Use
and the Incidence
of Bleeders
in Racing
Is Lasix permitted in horses in training in Ireland?
Yes. Most countries including Ireland and UK, but with the exception of Hong Kong, Germany, allow Lasix to be used in horses in training, provided it is not given within a defined period before a race. On race day in Europe horses race free of any drugs including medicines. Why would Lasix be used in training?
Some horses burst or bleed in training on the gallops at home, which makes training very difficult where lung bleeds occur on a regular basis. The use of Lasix in these horses, can help a trainer to get them qualified for a race, even at a racetrack staged under rules not permitting medication. Also many justify its use in training on the basis that if a horse has a bleed in work at home a few days previously, it is more likely to bleed on the track on race day.For horses on Lasix in training, what is the regulatory ‘cut off’ period required before race day?
This varies in different countries and ranges from 48 hours (Australia, France, UAE), to 3.5 days (Singapore), to 10 days (Japan) etc. In Ireland it is approximately 48 hours but it is very important to confirm this with the treating veterinary surgeon whose advice is likely to extend this period as an extra precautionary measure against a positive post race test. What is the procedure for determining the problem of a lung bleed in horses?
Visible bleeding from the nostrils (epistaxis) soon after exercise or in racing, is the official method of identifying a bleeder in most racing jurisdictions including Ireland.For general purposes, internal lung bleeds are identified by post-race endoscopic examination of horses, usually at the trainer’s request. This is the commonest method used to detect and quantify the problem of an internal lung bleed. On endoscopic examination, the blood is visible in the trachea, up to 1-2 hours after exercise, or post racing. Also, a lung wash can be used to check for evidence that a horse has bled during the previous three month period previously.How soon after a lung bleed is a horse allowed to race under Rules?
There is quite a variation worldwide in these restrictions and in their official reporting systems in the different racing jurisdictions.In Ireland there are no mandatory restrictions on racing a horse in the period immediate following on a bleed episode. Generally the trainer rests the horse to allow for adequate healing and recuperation of the affected lung tissue. However if a horse bursts a second time in a short period, it is liable to be suspended for up to 60 days by the stewards.In other racing jurisdictions, the Rules on these horses returning to racing impose temporary racing bans on a horse after one bleed, ranging in time from six months, three months, one month to 21 days in countries such as South Africa, Hong Kong, Malaya, UAE, Japan Macau, etc. In addition, in many of these countries, compulsory retirement is imposed if a horse has a second or third bleed incident. Is there a high incidence of ‘bleeders’ in racehorses internationally?
Yes it is a commonly occurring condition in racehorses globally. EIPH is said to occur in more than 75% of thoroughbreds, with a lower occurrence in racing standardbreds. It is also seen in other horses at high performance in eventing, polo etc. The actual prevalence varies in each country depending on the Lasix rules. Where Lasix is allowed in training, most of these racing jurisdictions have a low incidence of bleeders, ranging from one per 1000 up to the Singapore and Hong Kong incidences of 4.6–5 per 1000, where Lasix is not used. The high humidity and pollution levels are also acknowledged as relevant factors in the latter.In Ireland, the horses that show visible bleeding at the nostrils are categorised as bleeders. Under this definition, a total of 75 horses were reported as having ‘burst’ (bleeders) in 2013 ; the 2014 figure reported as bleeders to date, is 51 horses. U.S. records over a given period show that the incidence of actual bleeding during or immediately after a race is only 0.27 – 0.94 per 1000 starts. This is in contrast to the approximate 2.95 per 1000 before the widespread use of Lasix. In Hong Kong there are two bleeder categories; approximately 0.5% of all horses are said to be “official bleeders” and another 0.6% are reported as having “substantial blood in the trachea” (where horses are scoped at stewards’ request). If the horse scores a three or four on scope, (on a worsening scale of one to five), it cannot race for two weeks and this is subject to veterinary examination. ?Singapore: No lasix is permitted on race day though it can be used in training up to 3.5 days prior to a race. Bleeding is defined as in Hong Kong and is reported to occur in less than 0.5% of starts.Dubai: Lasix is allowed in training with a three-day withdrawal period. As in most of the other jurisdictions, bleeding is defined as bleeding visibly at the nostrils; these horses are barred from racing for gradually longer periods after each bleeding episode.Australia: No race-day lasix is permitted, with a pre-race withdrawal time of 48 hours. Lasix is allowed in training. Horses are reported as “bleeders” if they show bleeding from both nostrils, either after a race or in training. Bleeding that is evident only on scoping, even at the performance-affecting 3/4 levels, does not count. A first-time bleeder is banned from racing for three months. If it bleeds a second time, the horse is banned for life. Germany: Lasix is said to be banned both in training and on race day. Horses are banned for breeding purposes if they have ever bled or if they have ever raced on drugs.United Kingdom: No Lasix on race day, though it can be used in training. UK figures show an overall prevalence of epistaxis of 0.11%, in racing with a specific prevalence of 0.13% in flat horses.Japan: Lasix is allowed in training but is banned for 10 days prior to race day. Bleeding is defined as visible bleeding from the nostrils, with no specific rules about blood visible on a scope. Bleeders are barred from racing for one month in the first instance, two months in the second, and three months in the third. Visible bleeding was reported in between 0.1% and 0.2% in most recent racing years in Japan.The way forward - Is there light at the end of the Lasix tunnel?
There is no easy solution to this very complex problem that clearly requires huge collaborative input from all involved.
For example the European Scientific Liason Committee (EHSLC), which is an independent organisation, are working towards harmonised conditions for doping control for horse racing within those jurisdictions represented on their committee. Its membership is expanding and now has representatives of the racing authorities of Ireland, Great Britain, France, Germany, Italy, and the Nordic countries plus associate countries Hong Kong, South Africa, USA, Australia and Japan.
Currently chaired by Denis Egan, CEO Turf Club, their main work is the determination and publication of drug detection times, to allow treating veterinary surgeons to recommend withdrawal times. Ultimately this helps to combine reasonable assurance of drug-free racing and the application of good veterinary practice in the use of the therapeutic substances to treat thoroughbred horses.