BloodHorse is sharing this story from the March 2022 magazine looking at the initial impact of Lasix restrictions. The story earned first place from American Horse Publications in the breaking news/investigative reporting single article category. For more in-depth features and news stories, subscribe to BloodHorse Magazine.
The two United States racing divisions that have largely moved away from race-day Lasix have seen little change in the actual running of races, a welcome norm considering the dire predictions a couple of years ago that horses would be frequently pulled up because of exercise-induced pulmonary hemorhage. Thankfully those predictions have not become reality, but a comprehensive statistical study by BloodHorse suggests racing could face some business concerns after a decline in starts in both divisions.
With U.S. racing gradually moving away from permitting race-day Lasix (furosemide)—a change that ends a three-to-five decade run in which the diuretic was widely used to prevent or reduce the severity of EIPH—BloodHorse examined some of the initial numbers from the two divisions where Lasix has been largely phased out the past two years (2020 and 2021): 2-year-old racing and graded stakes. While interpreting data during a time when COVID-19 has played havoc with racing schedules has its limitations, there are some numbers on starts and completed races that—at the least—deserve further scrutiny.
To compile these numbers, a computer-generated search counted all DNF incidents. Then BloodHorse editors individually examined each incident, using race charts or occasionally video replay, to eliminate DNFs related to equipment failure, gate incidents, jockey falls, clipped heels, etc. BloodHorse examined all starts in juvenile races and graded stakes in the U.S. for the past five seasons.
In looking at the data, there has been no significant change in the percentage of horses not finishing races. In fact, a slightly higher percentage of horses finished their races in these divisions in 2021 than in any of the past five years.
While horses in these divisions continue to finish races, the number of starts by 2-year-olds and the number of starts in graded stakes both declined in 2021. While 2-year-old starts in general have been going down, there was a 7.4% decline in 2021. BloodHorse opted to compare 2021 with 2019 as so many 2-year-olds in 2020 saw their schedules change significantly because of COVID-19 protocols. In comparing the 2021 decline with other single-season drops in 2-year-old racing, it’s the largest since the 11% decline in 2013. That 2013 decline is linked to the Great Recession, when there was a 12% decline in the 2011 foal crop from 2010.
The use of Lasix was gradually adopted, with the first jurisdictions permitting its use in 1974 and the New York Racing Association becoming the final jurisdiction to get on board when it began allowing it in 1995. In recent years the worm has turned as the sport attempts to align its rules with other major international racing jurisdictions that do not allow Lasix. Opponents of race-day medication also believe these moves will help the sport more readily live up to public expectations of a clean sport.
Under the banner of the Thoroughbred Safety Coalition, leading track owners Churchill Downs Inc., The Stronach Group, NYRA, Keeneland, Del Mar, and others, took the lead in phasing out Lasix. Coalition members, sometimes working with their state regulators, banned Lasix from 2-year-old races in 2020 and from stakes races in 2021. The coalition lists this effort as one of its safety initiatives.
In July (2022), the Horseracing Integrity and Safety Authority is scheduled to launch its safety responsibilities with eventual plans to oversee the sport’s drug testing and equine medication issues at a later date. The federal legislation that created HISA calls for a ban of Lasix and a three-year study of that ban. States can apply for a three-year buffer on the Lasix prohibition while the study is conducted. HISA officials acknowledge that any state that requests a three-year stay before Lasix is banned will be granted that request.
THE NUMBERS
In 2017, 2-year-olds in the U.S. raced on Lasix 90% of the time. With the policy changes in place at major tracks, that percentage fell to 37% in 2020 and to 32% in 2021. In graded stakes, 89% of starts in 2021 were without Lasix, compared with just 2% in 2017.
While the vast majority of starts in these two divisions are now made without race-day medication, the percentage of horses not finishing races—which has always been low—is about the same, statistically speaking. In fact, in the two divisions combined, the 2021 rate, at 0.36%, is the lowest in the five years examined—not that it’s down much from the three years examined when the vast majority of horses in these divisions received Lasix; as those rates ranged from 0.41%-0.47%. (Keep in mind that all of these figures are less than 1%.)
The Jockey Club, which supports the elimination of race-day medication, is encouraged by the initial numbers.
“We were confident that racing without Lasix in the United States would produce an outcome similar to that of Lasix-free racing in other countries, and we are very pleased with what the data shows,” said The Jockey Club president and COO Jim Gagliano.
While noting that incidents of EIPH are not going to go away magically, Racing Hall of Fame trainer Mark Casse said racing in the 2-year-old division hasn’t looked much different the past two seasons.
“It was pretty much the same,” Casse said. “There’s still horses that are bleeding—anybody that thinks they’re not is living in Fantasyland. But I don’t know that it’s been as big a deal as everybody thought it was going to be. … The good news is we’re not seeing horses being pulled up with blood running out of their nostrils.”
Horsemen had raised concerns that moving toward Lasix bans would increase the number of horses not finishing races. In a 2019 open letter, the National Horsemen’s Benevolent and Protective Association predicted, “Research also proves an increased number of horses will bleed significantly out of their nostrils, or into in their lungs, and an increased number will die.”
National HBPA CEO Eric Hamelback acknowledges that worst-case scenario hasn’t taken place, but he believes one reason it hasn’t occurred is horsemen have adjusted by not running at-risk horses in races that don’t allow Lasix. He believes that approach is showing up in the decreased starts for 2-year-olds and graded stakes horses.
“Horsemen are picking their spots,” Hamelback said. “If a horsemen is working a 2-year-old and it’s at risk for bleeding, rather than risk racing without Lasix, they’re opting to just wait until the horse turns 3 and can get Lasix.”
Ron Moquett, conditioner of retired champion sprinter Whitmore, said trainers are not risking starting bleeders in non-Lasix races. He pointed to one of his current horses—7-year-old gelding Seven Nation Army —as an example. Seven Nation Army earned a graded stakes try after a stretch of three wins and two runner-up finishes racing on Lasix in 2020-21. But in his graded stakes debut in May 2021, he raced without Lasix, bled, and was eased in the Maryland Sprint Match Series Stakes (G3). Moquett rested the son of First Samurai and then returned him to racing Jan. 14, 2022, where, racing on Lasix, he finished second in a lucrative allowance-level race at Oaklawn Park.
“We wake up and we’re going to do right by these horses,” Moquett said of protecting potential bleeders. “They painted this one therapeutic drug as a bad thing to achieve an agenda; It’s sad. It’s a sad deal.
“We have a lot of real problems in our sport. I promise you if you asked the average gambler, the average breeder, average owner, average trainer, or the average jockey, the five things they would like to fix in Thoroughbred racing that Lasix would not be in the top five.”
Moquett wants cheaters thrown out of the sport through tougher sanctions but he he doesn’t want a ban on Lasix as part of those reforms. Should a full ban become reality, he believes some useful horses will no longer have a place to compete safely.
“I think a lot of good people are going to say, ‘I’m not going to take a shot of my horse bleeding.’ I really believe that,” Moquett said. “I think you’re going to see a lot of smaller tracks that are shunned by the graded stakes committee put more of their money into bigger purses for non-graded stakes races (that allow Lasix).”
Casse said EIPH affects each horse differently, noting that he’s had horses have fairly significant levels of bleeding that still win. He tries to make some training adjustments to horses that might have a problem with EIPH—perhaps a lighter work schedule ahead of a race.
While Casse understands many of the concerns about phasing out Lasix, he hopes this one issue doesn’t slow the overall medication reform that he believes has been a big positive for U.S. racing.
“We have so many other bigger issues,” Casse said. “Lasix, to me, is just a way to get off the topic.”
While the decline in starts should be monitored for its impact, industry leaders have seen some encouraging trends as Lasix is phased out. With the U.S. moving its Lasix rules toward the international standard, the 2021 Breeders’ Cup saw record international entries—56. For the first time the event conducted all 14 of its races Lasix-free.
“Tightening the restrictions on Lasix in recent years has been positively recognized by many Japanese racing connections since it contributes largely in upholding the integrity of horse racing and ensures a level playing field to all stakeholders,” said Japan Racing Association president and CEO Masayuki Goto before Japan-trained horses, for the first time, earned a pair of Breeders’ Cup victories. “I have no doubt that it is one of the factors in the added participation of Japan-based horses this year.”
With the JRA offering betting on three 2021 Breeders’ Cup races, Japan bettors wagered $11.7 million.
UPCOMING STUDY
Going forward, HISA has been tasked with convening a panel of experts to conduct their three-year study on the race-day use of Lasix on horses, including its effect on equine health and the integrity of competition. Prior to the expiration of the three-year period, the panel is required to submit to the authority a written report on the study’s results. The board will then have the opportunity to modify the rules on Lasix, provided that it makes the decision unanimously.
The study cannot begin until sometime after HISA actually launches, which is planned for July 1. HISA has accepted industry comments on the study. In those submissions, Reps. Kurt Schrader and Dusty Johnson, co-chairs of the Congressional Veterinary Medicine Caucus, requested the study be science-based.
“As you undertake the important role tasked to you by Congress in the Horseracing Integrity and Safety Act, we want to make sure you are aware of areas of particular importance,” their statement reads. “As you know, HISA requires the Authority to conduct a study on the effects of furosemide (Lasix) on horses. Additional science-based research on the use of Lasix in a horse prior to a race, and on equine health in general, will provide the scientific foundation that is needed to make informed decisions about regulatory measures. To address this concern, we believe the study should be peer-reviewed, employ a large sample size, and include racehorses from all three major racing breeds at the outset.”
A review of the submitted comments makes it clear that one point of contention will be how “EIPH” is defined. That is to say will the study only look at cases of epistaxis or will it look at lower grades of EIPH that only can be observed through an endoscopic examination.
“The NHBPA believes the current definition of ‘bled’ is inconsistent with scientific literature regarding EIPH, or in lay terms ‘bleeding in the lungs.’ As submitted, ‘bled’ is defined as when ‘blood from one or both nostrils of a horse has been observed after exercise.’ That sort of visible bleeding is called epistaxis. But bleeding does not have to be observed from the nostrils before injury occurs,” the National HBPA said. “About 70% of horses that experience EIPH bleed internally. Scientific evidence shows that internal bleeding, visible only with endoscopic analysis, causes irreversible damage to the equine athlete’s lungs. This irreversible damage escalates with each episode and adversely affects the horse’s ability to compete. Therefore, the definition will prove extremely harmful to the health of horses. The definition is overly simplistic, vague, and lacking a basis in modern veterinary science. The FTC should refrain from approving the regulation until the definition is changed to comport with veterinary science.”
At the other end of the spectrum are supporters of reform who have tired of the endless twists and turns. California Horse Racing Board executive director Scott Chaney questions the need for a phase-out approach. He believes there’s enough information already available to ban the diuretic.
“The Authority (to the extent that the Act will allow) should just ban Lasix,” Chaney said. “We just ran two days of Breeders’ Cup races and undercard races Lasix-free and we ban it in 2-year-olds and most stake races, but this incremental approach is painful and stupid. Just be done with it and move on. This carve out in the law is absurd.”
In racing the Lasix debate has raged for decades. It will continue at least another three years.
