Bisphosphonates Listed With 'Blood Doping' Agents in NY

The New York Gaming Commission has included bisphosphonates to its list of blood doping agents. Any owners, trainers, or veterinarians found responsible for causing or failing to guard against this class of drug in a racehorse less than 4 years old will now face a $25,000 fine and have their occupational license revoked.

"Any administration of a bisphosphonate to a racehorse less than 4 years old is an unacceptable practice because of an unacceptably high risk of serious injury or death from deleterious effects on bone growth and strength as a consequence of such use," read an advisory issued by the commission March 28.

"Trainers are responsible to guard their horses and to prevent the administration of any substance in violation of Commission rules," the advisory also stated. "Owners and veterinarians are responsible for their acts or omissions that cause such violations."

New York has added bisphosphonates, sold for equine use under the brand names Tildren and Osphos, to its panel of prohibited substances, though existing tests are limited to a window of about 28 days from when the drug is administered.

"Testing is problematic right now, but the message is that if this is discovered either through testing or medical records, you can be prosecuted," said Dr. Scott Palmer, equine medical director for the New York Gaming Commission. "A drug like this would not normally be considered something like EPO (erythropoietin), but we included it with prohibited substances because the risks and complications from this drug are great. This is not a trivial violation."

Concerns about bisphosphonate use in younger Thoroughbreds surfaced a couple years ago when veterinarians were hearing about its use in young sale horses to improve radiographs. The drug is reportedly effective in hiding sesamoiditis, an inflammatory condition affecting the sesamoid bones behind the fetlock joint. Sesamoiditis in moderate to severe cases could mean a horse's athleticism has been compromised but more often means a horse will require significant time to heal before advancing to breaking and training. In yearlings, such a condition can influence their appeal to pinhookers. 

These drugs are a problem in young horses because they disrupt the natural absorption and rebuilding of bone tissue that makes it stronger as horses mature.

"These effects predispose affected bone to delayed union and fractures," stated the New York Gaming Commission advisory.

Bisphosphonates also have an analgesic affect, which is of particular concern with 2-year-old sale horses and young racehorses.

Several other Thoroughbred industry organizations have take action regarding bisphosphonates. Sale companies Keeneland, Fasig-Tipton, and Ocala Breeders' Sales have banned their use. A buyer can rescind a sale if a horse tests positive for the drug. Also, a coalition of 29 Mid-Atlantic Thoroughbred organizations have united behind a region-wide ban of the medication's use in horses under 4. 

The American Association of Equine Practitioners endorsed the sale companies' decision to include post-sale bisphosphonate testing in their Conditions of Sales on horses under 4 years of age and said in a statement it hopes this is one facet of a multi-pronged effort within the Thoroughbred industry to address the misuse of these drugs in young horses.

AAEP also noted that bisphosphonates have been approved by the U.S. Food and Drug Administration for therapeutic use in horses for certain conditions and that it is the misuse of these products that is in question, not the drugs themselves.

"While addressing this issue, it is important to remember that we do not know the extent of the use of these products in young horses and do not wish to impugn the integrity of an entire industry based upon anecdotal information," said Dr. Jeff Berk, AAEP president.

Palmer also acknowledged bisphosphonates have a legitimate therapeutic use in horses 4 and older that are being treated specifically for navicular disease. 

"It is not a violation to administer a bisphosphonate to a racehorse pursuant to a valid therapeutic, evidence-based treatment plan," Palmer wrote in the state's advisory. "A therapeutic, evidence-based treatment plan is a planned course of treatment written and prescribed by an attending veterinarian before the horse is treated that describes the medical need of the horse for the treatment, the evidence-based scientific or clinical justification for using the bisphosphonate, and a determination that recognized therapeutic alternates do not exist. This exception does not permit bisphosphonate possession on the grounds of a licensed racetrack in New York. It is strongly recommended that any such plan be submitted to the equine medical director before any use, including for horses that might ship into New York."