Kentucky Legislative Committee Debates New Lasix Rules

The divisive topic of using the diuretic Lasix in racehorses was debated in the Kentucky Legislature's Interim Joint Committee on Licensing, Occupations, and Administrative Regulations Aug. 25. 

Speaking before a group of state legislators assigned with studying and discussing issues affecting the commonwealth, veterinarians Dr. Bruce Howard and Dr. Clara Fenger expressed differing viewpoints regarding the medication. The drug is used to control exercise‐induced pulmonary hemorrhage, or respiratory bleeding, which can impede performance.

Lasix, the brand name for furosemide also known as Salix, is often criticized for alleged performance-enhancing properties and for its pervasive use, even among unestablished bleeders. It is banned in many other parts of the world but is allowed in the United States and Canada.

Beginning this year, some jurisdictions, including Kentucky, have begun prohibiting its use in races for 2-year-old horses—a ban that will extend to graded stakes races next year. That action is currently being contested in the Kentucky court system with the Kentucky Horsemen's Benevolent and Protective Association having filed a suit against the tracks that first implemented the new measures.

Howard, equine medical director for the Kentucky Horse Racing Commission, told legislators the results of 60 races for juveniles this year at Keeneland, Churchill Downs, and Ellis Park showed only one horse had been observed visually bleeding from the nostrils. This was from a sample of 532 starters, as "observed by our regulatory veterinarians or reported to us by private practitioners," he said.

More often, bleeding is discovered during endoscopic examinations, but Howard said returns from a study at Keeneland over its week-long summer meet were promising among those trainers that elected to participate.

"Eighty-nine percent of the 2-year-olds showed no evidence of blood in their airways and only two out of the 47 scoped showed anything more than a trace of blood," he said.

Fenger countered with a different veterinary viewpoint, urging legislators to let "science drive the policy-making."

"Dr. Howard questions the science that demonstrates that Lasix is an effective preventative for EIPH, and yet, as a veterinarian, he pretty much stands alone in that opinion," she said. "As an exercise physiologist and internal medicine specialist I can assure you that the science has proven this unequivocally: Lasix attenuates exercise-induced pulmonary hemorrhage."

She pointed to the results of eight recent KHRC-reported necropsies that showed horses that suffered catastrophic musculoskeletal injuries also were shown to have bled.

"Severe hemorrhage in the lungs interferes with oxygenation of the blood, leading to fatigue, and in exercise science, unequivocally it's been well established that injury is more likely to occur when you have fatigue," she said.

Sen. Damon Thayer (Republican, Georgetown), a member of the Kentucky Equine Drug Research Council and a proponent of medication reform, called the Lasix ban in 2-year-old races and graded stakes races in 2021 worthy of support. 

"Should we ignore the fact that racing has been under increased scrutiny for safety issues over the past year and a half is to keep one's head in the proverbial sand," he said. "We have to move forward and deal with changing public opinion as it deals with equine sports."

Rep. Matthew Koch (Republican, Paris) also backed the rule changes, noting the importance of the Kentucky equine industry, not just in racing, but within breeding and sales.

"That's what so many of us do in this business in Central Kentucky—we sell our product. So it's very, very important to me that we keep up with the rest of the world, and we stay in pace with them so that our product remains the best out there and they come in and may want to purchase it," Koch said. "California, Maryland, New York, they're already moving forward with these changes."

Other legislators expressed at least partial concerns about rule changes that prohibit Lasix, led by Sen. Paul Hornback (Republican, Shelbyville).

"I do think it's very detrimental to those that are the bread and butter of the Thoroughbred industry and—that's the claiming races and some of those folks," he said.

Howard told the committee that the KHRC and Churchill Downs and Keeneland are in discussion to set up a study this fall that would evaluate the airways of 2-year-olds after their races. 

Fenger also wants to see more data and information, not only with regard to Lasix but to other medication changes. Those include a 14-day stand down on intra-articular corticosteroid injections and moving the non-steroidal anti-inflammatory drug administration from 24 hours to 48 hours before a race.

"I do know that there still stands to be a very, very large divide in the industry here in the state amongst horsemen, amongst regulators, amongst veterinarians, about the effects of some of these drugs, and what the potential is if this goes on," added Rep. Michael Meredith, (Republican, Oakland). "I think it's very important that as this moves forward—if it does today—that we track this heavily and make sure that we've made the proper decision. Because when we make decisions based upon public opinion and emotion, many times they are some of the decisions that we make that aren't the best decisions."

Thayer said after the committee meeting that the regulations are now in effect.