Benson Helps Implement Santa Anita's New Protocols

It takes courage to ride an eventer, accompanying your horse over a cross-country course while tackling a barrage of obstacles. Dr. Dionne Benson does that in her spare time, riding one of several off-the-track Thoroughbreds she has repurposed.

Not that Benson has much free time these days. She recently jumped from executive director and chief operating officer of the Racing Medication and Testing Consortium to the newly created position of chief veterinary officer for The Stronach Group.

Benson now oversees the veterinary regulatory needs of the racetracks owned by TSG, which includes Santa Anita Park. As anyone in the racing industry knows, a rash of equine fatalities spurred by a very wet winter beset Santa Anita throughout the first half of 2019. Once animal rights' activists began piling on, abetted by mainstream media that seemed to relish reporting the bad news, the track's very existence was at stake.

"Right now, it's kind of been crisis mode," acknowledged Benson.

Santa Anita ended its 2018-19 meeting June 23 with 30 fatalities (a combination of deaths from both racing and training) since the track opened last Dec. 26. Santa Anita had closed through much of March and rehired Dennis Moore, its former track superintendent, as a consultant. The track brought in Dr. Mick Peterson to conduct scientific testing of the track surface.

In addition to its work on both the dirt and turf courses, Santa Anita instituted a series of safety protocols that range from restrictions on medications to additional checks of horses being entered in races and those working in the mornings. The goal, according to TSG officials, was "to establish a culture of health and safety throughout all of the racetracks, creating checks and balances, intervention strategies, and working together to identify factors to help mitigate risk to horses and riders."

As part of these changes, TSG hired Benson.

"We have to put horses first," said Benson. "We've already gotten calls from other jurisdictions to say, 'Can you send us your protocols—we're really interested in them.' I hope that no one else has to deal with the crisis that we've had. But I believe that the minute they do or that something happens on their track, everybody's going to be saying, 'Why didn't you do x, y, or z that's already been done at Santa Anita or in California?'"

Benson didn't take the job only to help Santa Anita solve its current problems. She took it to improve the health and welfare of racehorses and turn a reactive situation into a proactive one.

"If I didn't think there were opportunities to improve racing, there is no way I would have done it," Benson said. "We have the opportunity to lead the rest of the country—and the rest of the world really. Some of the things we're doing are not happening anywhere else."

To give Benson a free hand, TSG structured the position so she reports only to Belinda Stronach, chairman and president of TSG. Benson does not have to worry about whether policies she advocates might be detrimental to the racing office or the business side of racing.

"There are a bunch of people here who are very smart about running a racetrack and making it successful," Benson said. "That is not my scope. My scope is whatever I feel is best for the horses. That's my job—to advocate for that."

As such, Benson supervises the many new safety and medication protocols that TSG has put into place at Santa Anita. She also is beginning similar conversations in Florida and Maryland, where TSG has other tracks, as well as brainstorming more innovations.

When Santa Anita began implementing its new protocols, questions arose as to whether TSG would incorporate them elsewhere. The answer was a qualified 'yes,' with the understanding that each state jurisdiction has its own regulatory agency and methods for implementing changes.

"Florida has opened its rule-making process, and we've submitted a letter requesting basically the adoption of everything we've done here (at Santa Anita)," said Benson. "We are starting to talk to stakeholders in Maryland. Each jurisdiction has different processes."

The crisis in California brought the stakeholders to the table quickly. In mid-March, TSG, the Thoroughbred Owners of California, and California Thoroughbred Trainers came to an agreement regarding new medication rules and safety protocols that allowed racing to resume. That has included a combination of Santa Anita house rules and California Horse Racing Board regulations, in part because the CHRB could not implement new rules immediately, having to conform to California's state laws, such as requiring a public-comment period.

"We continue to support reforms that will make the racetrack safer and will have more vets looking at the horses with the new provisions," said Greg Avioli, president and CEO of TOC. 

Avioli pointed out that TOC helped devise and approve the protocols. He cited as an example of an improvement the prohibition of non-steroidal anti-inflammatories (NSAIDS) within 48 hours of racing.

"I think that everyone believes that has had a real impact in allowing vets to examine horses in their natural state," he said.

CTT management also expressed support of protocols that will enhance horse and rider safety, even while individual trainers might have chafed at some of the changes.

"Generally speaking, the horsemen, while they see many of these things as inconvenient and unnecessary, don't object and are cooperating because they realize that the welfare of their horses is paramount," said Alan Balch, executive director of CTT. "While change comes difficult to all of us—not just trainers—they recognize the importance of change, not just on the perception that we have to do a better job on horse welfare, but if any of these things save a horse or prevent an accident, then great."

One issue for some horsemen was TSG's desire to phase out the use of furosemide as part of its goal to eliminate all race-day medication. Some people feel furosemide is an appropriate race-day medication to reduce or prevent bleeding and that its use does not correlate with musculoskeletal breakdowns.

"We think that we will eventually have a much more sturdy (equine) population," said Benson about the furosemide restrictions. "Part of this, obviously, is that we have to deal with the public and our customer. The public perception isn't if a horse bleeds, you should medicate it. It's if a horse bleeds, you shouldn't race it."

The maximum furosemide dose on race day was cut from 500 mg to 250 mg. According to Santa Anita's official racing and safety procedures in place at the end of the race meeting in June, "Lasix will be prohibited in all horses born in or after 2018."

Horses will still be allowed to train on furosemide, similar to the European model, said Benson.

During the transition, separate races might be written for horses with and without furosemide, especially as the 2-year-olds of 2020 become old enough to compete against older runners. Benson explained that in 2021 separate races might be written for 3-year-olds and 4-year-olds and up. In 2022, races might be written for 3- and 4-year-olds and other races for 5-year-olds and up.

"We're expecting and prepared to deal with the small field size for a few years as we get through that transition," said Benson. "It's not something we haven't thought about. We think it's so important for us to make this transition that we're willing to deal with the growing pains."

Ironically, California once had a lower allowable dose of furosemide than 500 mg.

"We had a 150mg-250 mg limitation on Lasix for almost 15 years in the '90s," said Dr. Rick Arthur, the CHRB equine medical director. "We actually increased ours in an effort to be consistent with the national uniform medication program."

While the safety protocols and medication rules are likely to continue to develop, by the end of Santa Anita's meeting in late June, Benson had a four-page document in place outlining all of the safety procedures, both during racing and training (click here to view the document).

Toward the end of Santa Anita's meeting, at the direction of California Gov. Gavin Newsom, the CHRB added a five-person panel of regulatory veterinarians and stewards who reviewed horses being entered. That panel, headed by Arthur and CHRB chief steward Darrel McHargue, continued when the Southern California racing circuit moved to Los Alamitos Race Course and then on to Del Mar.

"That panel gets together and looks at the past performances of the horse and compares it to certain risk factors in the National Equine Injury Database," said Benson. "Things like a 4-year-old first-time starter, which is a pretty significant risk factor; a horse that's been off for a long period of time; breaks in training."

Arthur explained that the panel's duties are similar to what the official veterinarian has done at major California tracks to identify horses at risk.

"Those horses get added scrutiny when they are examined by the veterinarian," Arthur said. "At Santa Anita, we were looking at horses primarily pre-entry. We still had the official veterinarian analyzing all the factors for the horses entered in that race. We (the panel) had very specific instructions to be overly cautious and eliminate any horse that could be a potential problem."

As the circuit moved on to Del Mar, the panel's duties were being adjusted.

"It is a work in progress," said Arthur. "We are trying to figure out the best way to do it. The whole goal is to make racing safer. Eventually, what we really want is for people to self-regulate because they will do a better job than we'll ever do. We want to set a standard that they understand and that they can meet."

At Santa Anita, those horses approved by the panel were allowed to enter and then underwent very thorough pre-race examinations. Those exams worked hand-in-glove with the new medication requirements: inter-articular treatments prohibited within 14 days of a race, NSAIDs prohibited within 48 hours of a race, and no more than one corticosteroid or NSAID in any concentration.

"There won't be any masking effects of any painkillers, so we really have the ability to better diagnose the horse," said Benson.

These additional examinations are going to require more personnel at Santa Anita, something Benson said will likely happen before the fall meet begins Sept. 26. That meet will culminate in the Breeders' Cup Nov. 1-2. In late June the Breeders' Cup board affirmed its support of Santa Anita by voting to keep the event at the track.

In June, without the additional personnel, Benson said that "we've been extending our existing resources."

Some of those resources included veterinarians who had originally been hired by the track to administer third-party furosemide shots as per CHRB rules.

"They've helped out in the mornings," said Benson. "Our main vet, Dr. Dana Stead, has taken the role of training these people. We're looking at hiring at least one more vet to add to our team full time."

Arthur noted that the CHRB has been adding personnel all along.

"We increased our safety steward presence, just like we did at Del Mar several years ago," he said. "At Del Mar, we are going to have an official veterinarian every day, even dark days, and we are going to have two official veterinarians on race days. We did that last year as well. Previously, and still at some tracks, there is no safety steward or official veterinarian on dark days. That's pretty much typical across the country."

Santa Anita's safety protocols also extend to training hours. New procedures include trainers being required to register horses with the racing secretary 48 hours prior to working, and expanded out-of-competition testing.

"This is an area that we've never had the opportunity to help or intervene," said Benson. "It is an area in which we've been able to make huge strides."

Once a horse is listed to work, Santa Anita personnel examine the past performances looking for risk factors, similar to what the CHRB review panel does prior to racing. A veterinarian will then examine those with higher risk factors approve the horse to work.

"Afterward, a selection of them are required to be blood-tested," said Benson. "They have to meet the same post-race regulations for (such things as) non-steroidals, opioid analgesics, local anesthetics."

An expansion of out-of-competition testing is expected later this year, said Benson, contingent upon a regulation recently adopted by the CHRB.

"We have been doing out-of-competition testing on quite a few workers," said Arthur. "What we do is check for compliance. Even though it (has not been) a regulation violation, we have notified people when they are not in compliance. Frankly, we haven't had to notify anybody in the last month."

The CHRB regulation on out-of-competition testing was filed with California's office of the Secretary of State June 24 and went into effect immediately. Any horseman out of compliance will be subject to sanctions as per the regulation.

TOC's Avioli, who also chairs the Southern California stabling and vanning committee, noted that many of these protocols are being adopted at other California tracks and training facilities.

"Those (facilities) having more standardized protocols for works is a good thing," Avioli said. "Having more structure around the morning training program is a good thing. Do we have the answer of how to do it perfectly? We do not. It is absolutely a work in progress."

Benson hasn't focused completely on Santa Anita's current medication and safety protocols. She is looking forward to implementing innovations that not only reduce injuries but also improve horses' overall health and fitness.

"Nothing is off the table at this point," said Benson. "We're thinking about things like turnout areas for horses, walking paths for horses. We are trying to make it a completely different type of training and racing facility, where the horses have room to be out of their stalls, room to be hacked. We've got enough hills on the property that you could potentially make the space. We're really trying to take a more holistic look at racing."

TSG fast-tracked obtaining a standing positron emission tomography (PET) unit, which would be the first of its kind. TSG and the Dolly Green Research Foundation donated funds for the unit, which is expected to be in place this fall. 

Earlier versions of PET scans have required horses to be anesthetized, limiting its use. Dr. Mathieu Spriet at the University of California, Davis, received a grant from the Grayson-Jockey Club Research Foundation in November 2018 to study the use of a standing PET scan unit on the racehorse fetlock. The first part of his study is being conducted at UC Davis, with Santa Anita to be the site of a clinical trial.

"The PET scan I'm very excited about," said Benson. "Hopefully, it will be a great opportunity for us to see some early diagnosis."

Santa Anita already has nuclear scintigraphy as part of the Southern California Equine Foundation's equine hospital services. The PET unit will be housed in the same building and has the potential to show even more detail of the sesamoid and fetlock area, the site where many of the catastrophic breakdowns occurred.

Because TSG and the Dolly Green Foundation are buying the equipment, Benson said costs of PET scans would be reduced.

"The key is going to be once we get the equipment and it's up and running, how do you select which horses go in it," said Benson. "And once you see stuff, what does it mean clinically? Does that mean the horse has a problem and needs to stop now? Does this mean that this is just normal bone turnover from racing?"

The more data collected, the better trainers and veterinarians can determine what training patterns potentially help cause or conversely avoid this type of injury.

"Right now we're not sure what patterns go along with it because we see it only when the worst thing has happened," Benson said.

Other proactive methods Benson mentioned include expanding educational opportunities for trainers and their employees. She cited the example of a webcast available on the CHRB website about humeral fractures.

"The CHRB has done a wonderful webcast that is online and available that has not been viewed very many times," she said. "It basically says these are the horses that are most likely to fracture their humerus, these are the symptoms you are going to see, these are the training patterns you are going to see."

Arthur, who served on the search committee that hired Benson at the RMTC, said he feels that the addition of Benson to TSG is a positive step.

"Dr. Benson is very professional, very thorough," he said. "She certainly stepped up at RMTC," he added. "She did a better job than any of us could have hoped, and I am sorry to see her go. But I think it's certainly going to be beneficial to California."

Benson wants to position Santa Anita as a world leader in equine safety.

"I think everyone's goal here isn't for people to say, 'You're as good as international.' They want international people to say, 'Well, at Santa Anita and the other Stronach tracks they do this.' I think that the good tracks are going to see what a difference this makes. We want people to want to bring their horses here because it's a great environment for them."

It is too early to tell what effect these safety protocols will have on the state of the racing industry in California.

"Racing is so complex that these measures have other ramifications," cautioned CTT's Balch. "If the same measures are not in the same place everywhere, there will be a lack of uniformity. That may be an increasing problem for California racing. This is supposed to be a pleasurable experience for owners. When owners feel like it is not a pleasurable experience, either they are going to not be as supportive of racing or they will look for another jurisdiction to race in. And that's a risk."

TOC's Avioli acknowledged that these measures might shrink the industry in California short-term.

"I think California racing is already safer," Avioli said, "and I think it will continue to improve to where it is the safest racing in the world. I believe California racing, to continue to exist well into the future, is going to need to be fully transparent and be able to show anybody who wants to look exactly how the horses are trained because California demands that."

Avioli pointed out that some horsemen, after examining Santa Anita's protocols and comparing them to other jurisdictions around the country, are likely to decide to leave California. Anecdotally, the Southern California in-training horse population has already shrunk. But Avioli said he also believes that many owners and trainers will remain or move to California because it will have the safest racing.

"And, by the way, it's still California," he said. "We still have an extraordinary number of graded stakes. There's no better place in the country to run your horse in the summer than Del Mar. Santa Anita is called the Great Race Place for a reason. It's probably the most beautiful racetrack in the world."