FEI president HRH Princess Haya welcomed the Fédération Equestre Internationale initiative to hold a congress on Non-Steroidal Anti-Inflammatory Drugs, declaring it long overdue. She hailed it as the first real opportunity to bring together new science on NSAIDs since the FEI’s 1993 ban on their use.

Opening the event at the Olympic museum in Lausanne, Switzerland, Aug. 16-17, she referred to the tensions the debate had created since being raised at the General Assembly last year. She hoped that the distillation of information would continue in the run-up to the vote at the 2010 GA in Taipei, Taiwan, in November, as well as informing the wider horse community.

The horse is “our partner, not a tennis racquet,” said Haya, adding, “Knowledge is indeed very important, but it is nothing if we do not understand what we do not know, and knowledge itself is worthless without having the wisdom to apply it properly.”

Sven Holmberg, FEI first vice president and congress chairman, strongly criticized the vote in favor of the “progressive list” last year and accurately predicted the resulting media storm.

“The way our sport is perceived is fundamental to our ability to attract interest from the general spectator, from the media and from future sponsors. The outcome of this congress should not only guide us in future discussions but also give the outside world the right message,” he said.

Do The Drugs Help Too Much?

Dr. Wayne McIlwraith of Colorado State University discussed studies on pain control. A dose of 4.4 mg/kg phenylbutazone significantly reduced clinical lameness scores at six and 12 hours, and at 24 hours with the higher 8.8 mg/kg dose. Flunixin can allow onset of analgesia within two hours and can persist for 30 hours. Results depend on the timing and duration of dosage, and they are even more effective combined—but with side effects. After one five-day “stacking” experiment using both drugs, one horse died of necrotizing colitis. More specific types of NSAIDs had less risk of slowing healing processes in the joint.

However, Professor Ken Hinchcliff of the University of Melbourne said that most studies had insufficient sample numbers to inspire confidence in the findings. Few studies used healthy horses, or studies used horses that do “not closely mimic those of the target population.”

Peter Kallings of the Swedish-Norwegian Foundation for Equine Research said that other studies showed NSAIDs allow a horse with a musculoskeletal condition to compete better despite injury.

“This type of therapeutic use could threaten the welfare of the equine athlete,” he stated.

Jon Foreman from the University of Illinois said the analgesic benefits of half-doses wane rapidly. “If half-doses do not cause a masking effect at the time of competition (12 or more hours after administration), and if they allow horses to receive appropriate medical therapy for mild soreness, then it seems logical to allow these doses within the proscriptions of the proposed rule change,” he said. “The FEI code of conduct requires that at all times the health of the horse is paramount. But is it healthy to allow horses to remain in competition with mild sorenesses that are not performance limiting, and not necessarily visible to the observer, when those sorenesses could have been alleviated earlier with half-doses of NSAIDs, which do not mask lameness when observed in the 12-hour window proposed in the new FEI rule?”

An Aid To Recovery

Veterinarian Lynn Hillyer of the British Horseracing Authority said the racing authorities of Europe, Hong Kong, North and South Africa, Australia, Asia and the Middle East (except Saudi Arabia) prohibit racing under the effects of any drugs but acknowledge that medication is necessary—off track—to ensure a horse’s physical well-being.

“In other words, medication should be an aid to recovery, not a tool to enable a horse that should be resting and recuperating to race or train,” Hillyer said.

A significantly more permissive stance taken by two North American racing authorities in 2008 resulted in a greater rate of catastrophic injuries (increases of 49 percent and 228 percent over previous incidences) when the screening levels for phenylbutazone were raised from 2 mg/ml to 5 mg/ml. One of the jurisdictions has since changed back.

Stephen Schumacher, chief administer of the U.S. Equestrian Federation Equine Drugs and Medications Program, said that the USEF allows NSAIDs with quantitative restrictions and takes into account the clear differences between the age range, career span and performance demands of racehorses and competition horses, the average age of the latter being 10 across 29 member groups.

“We believe that the welfare of our horses is not put into jeopardy with the judicious use of NSAIDs, and their use may in fact be beneficial,” he said.

Preliminary data showed that only 3 percent of horses competing under USEF national rules have more than one NSAID simultaneously (as permitted) when tested in medication control.

Side effects of prolonged NSAID use were outlined in a paper by the absent Johanna Fink-Gremmels, from the Veterinary School in Hanover, Germany. These include liver damage, as NSAIDs suppress the formation of prostoglandins, which are essential for renal blood flow under stress conditions. There is also evidence of inhibited blood flood in the gastric-intestinal area and of continuous irritation, which might impair food intake and gastric emptying.

Roly Owers from World Horse Welfare referred to the FEI Code of Conduct, which states: “Participation in competition must be restricted to fit horses” and that “no horse showing lameness should compete.” Owers said that the stakes are high, both for the FEI and horse sport globally, asking if the general public was ready to accept the use in competition and if it was the right message to give ordinary riders.

FEI general counsel Lisa Lazarus outlined details from nine European countries that prohibit or may prohibit NSAID use under national law and said the FEI has two options: to abandon any proposed change or to permit their use as far as the FEI and its members are concerned. In this case, they would have to make it clear that FEI rules do not supersede national law, and this must be acknowledged by anyone competing in any of the nine countries.

Panel discussions about the in-competition approach involved Yves Rossier, Phillipe Benoit, Yogi Breisner, Rodrigo Pessoa and Richard Davison. Later Tim Ober (USA) and Mike Gallagher (Canada) spoke in favor, and Peter Kallings (Sweden) and Christian Paillot (France) against.

Public perception was aired in another debate. The British racing community has been particularly critical of the FEI’s “progressive list.”

Holmberg, in his final summing-up, stressed the importance of keeping the topic alive. “There is no doubt that both sides of the Atlantic and the rest of the world have the same clear goal: that the welfare of the horse is really paramount to whatever we do,” he said.

A congress report will be sent to national federations. Videos of all speeches, panel sessions and full debate are due to posted on the FEI YouTube channel by the week ending Aug. 27.