Maryland steroid violations raise questions about equine veterinarians' role

Horses trained by thoroughbred trainers A. Ferris Allen III, Jerry Thurston, Scott Lake and Hector Garcia have recently tested positive for stanozolol, an anabolic steroid, within the 30-day pre-race window at Laurel Park racetrack in Maryland. Testing took place in December 2014 and January 2015, according to the Maryland Racing Commission. Anabolic steroids are prohibited in horseracing, and the detection of stanozolol in postrace samples is evidence of administration inside the 30-day pre-race window.

The eight horses that tested positive won their respective races, with total purses of more than $100,000, and the purses were redistributed. Garcia, who had multiple positives among his horses, was suspended for more than a year. Lake was suspended for 120 days; Allen and Thurston were suspended for 30 days.

Use of anabolic steroids in horseracing

Anabolic steroids are highly regulated in horseracing. “There are thresholds for only three anabolic steroids in racing,” says Dionne Benson, DVM, JD, executive director of the Racing Medication and Testing Consortium (RMTC). “This allows their use to be controlled during the 45- to 180-day period before racing.”

Benson says a regulated threshold previously existed for stanozolol, but since the medication is no longer available commercially as an approved U.S. product, the RMTC recommended that it be completely removed from consideration as a threshold substance in racing.

Jeff Blea, DVM, is past president of the American Association of Equine Practitioners (AAEP) and a practitioner who works on Southern California racetracks. “The sentiment within society is that anabolic steroids have no place in racing horses,” he says.

“There is a legitimate use of anabolic steroids in veterinary practice as a therapeutic medication,” Blea continues. “But it should be based on a therapeutic indication, with a diagnosis and specific treatment plan, under the veterinarian-client-patient relationship [VCPR] with the trainer of the horse. There's no legitimate use in horseracing as a performance enhancer.”

Benson echoes these thoughts. “If anabolic steroids need to be used therapeutically to treat specific ailments, that needs to be done well outside of racing, and they can have no presence as medication, per se, at race time,” she says.

Mary Scollay, DVM, is director of the Kentucky Horse Racing Commission and a member of the AAEP Horse Safety Committee. “One of the interesting things about stanozolol,” she says, “is that it's a sustained-release product that releases over a number of weeks. It's composed of a liquid component along with particles of different sizes. Small pellets release the drug more quickly, the larger ones more slowly, resulting in the sustained-release effect. It's possible that you could have the same amount of drug in two vials on a per-weight basis, but each could behave differently because of differences in the relative quantity of the different-sized granules of drug.”

Blea agrees that there is variability in compounded products. “A practitioner should be buying compounded products from a reputable compounder,” he says. “The veterinarian has to factor that variability in with his or her risk assessment when administering a product like stanozolol in a regulatory environment.” Typically the withdrawal time frame for regulated substances is 21 to 30 days, though with stanozolol that can be extended to 53 days depending on compounded-product variability, Blea says.

Scollay acknowledges that there are legitimate uses of anabolic steroids, including compounded stanozolol, in recovery from a specific injury, and it is not in her agency's interest to ban them entirely so they're unavailable therapeutically.

Prohibition on the racetrack

Ed Martin, president of the Racing Commissioners International (RCI), says no horse should be testing positive in a postrace examination, period-whether it's for stanozolol or any other banned drug. “If a particular drug is to be used in a horse prior to racing at some point to treat an injury, that's a matter between the veterinarian and the client. But we are very clear that is not to show up in a postrace sample,” he says.

“If a horse requires medication to treat an ailment, we are concerned that that ailment is something that might preclude that horse from competing,” Martin continues. “We rely extensively on the attending veterinarians who have primary care responsibility for these horses to work with the owner and trainer to make the decision to run a horse or not.”

Martin says that, historically, drug regulation has been focused on anti-doping-on not giving a horse an unfair advantage in a contest. However, “we have taken the position that if a medical professional determines that a horse in training requires a certain medication to treat a condition or alleviate pain, it would be cruel to deny the horse that treatment, as long as that treatment does not impact the performance of the horse in an actual contest or make it impossible for a regulatory veterinarian to do a prerace examination of soundness,” he says.

The Laurel Park situation

Garcia, one of the suspended trainers, has said publicly that he had “no idea” where the stanozolol that turned up in his horses' postrace samples came from. Blea finds that hard to believe. “As a practitioner, I don't go around treating a horse without a specific diagnosis and request,” he says. “The trainer needs to have a discussion with that veterinarian regarding that animal or individual. Something that's as much of a lightning rod as an anabolic steroid, in my opinion, had to involve a discussion regarding the condition of the animal, the expected outcome and the treatment protocol-the specific purpose of why you're using it as a veterinarian.”

If a horse or trainer comes up with several multiple positive results for stanozolol, is the veterinarian culpable? “Yes, the veterinarian is culpable for the purpose of administering it, though that is always pending mitigating circumstances,” Blea responds.

He admits he doesn't know all the specifics of the Laurel Park situation, but “as veterinarians, we have to be responsible for what we administer and prescribe,” he states. “Anything we do should be based on a diagnosis, a treatment plan, a VCPR, and communication with the trainer. If not with the trainer, then with the owner. We should be responsible for our actions.”

Blea says that prior to using any medication, a veterinarian must have important discussions with their clients. “Things will happen day-to-day that will change the course of where you started the treatment plan, and you may end up somewhere you didn't want to be,” he says. “But you still have to have those conversations where everybody stays on the same page.

“When medication positives occur, the best thing we can do is address it quickly, swiftly and move on,” Blea concludes. “In that way you show the general public you're not going to tolerate it.”

Ed Kane, PhD, is a researcher and consultant in animal nutrition. He is an author and editor on nutrition, physiology and veterinary medicine with a background in horses, pets and livestock. Kane is based in Seattle.