For most people, the concept of doping in athletics brings to mind shady dealings, illicit injections of illegal substances, muscle-bound athletes, and Congressional hearings.  We tend to think of doping in terms of giving a forbidden substance to a human or animal athlete with the intent of causing that athlete to perform beyond normal physiologic capabilities.  This may be why equine drug testing rules are so confusing to many owners.  Not only are there multiple regulatory agencies that oversee performance horses, but it can be difficult to verify the legality of medications that are routinely prescribed for normal medical conditions.

This article will examine drug testing regulations in the non-racing performance horse within the United States.  This article is to be used as a guideline only and as a place to find sources for further information on drug regulation.  It is the exhibitor’s responsibility to be aware of any medications or supplements given to the horse and to be fully informed as to the admissibility of those substances under show regulations.

Equine Sport Regulatory Bodies

The two main organizations overseeing drug regulation in performance horses in the United States are the United States Equestrian Federation (USEF) and the Fédération Equestre Internationale (FEI).  The USEF, formerly the American Horse Shows Association (AHSA), is the governing body for equestrian sport in the United States.  The USEF oversees drug regulations for 28 breeds and disciplines and also contracts to implement the drug testing rules for other state and national groups.

The FEI is the international governing body of equestrian sport.  While most equine events in the United States will fall under USEF or specific association rules, some higher-level dressage and jumping events are subject to FEI guidelines. 

Individual breed or discipline associations or state governments may have different, and in some cases conflicting, rules.  In California, for example, public shows and sales are subject to the California Equine Medication Rule, found in Food and Agricultural Code, Sections 24000-24018.  The Equine Medication Rule is enforced through the Equine Medication Monitoring Program.  Other organizations with their own equine medication rules include the American Quarter Horse Association (AQHA), the United States Polo Association (USPA), and the American Endurance Ride Conference (AERC). 

Purpose of Horse Medication Regulations

According to the FEI Clean Sport website, “Equestrian sport derives its credibility and public acceptance from the concept of fair play, the idea that the best athlete or team should win fairly and squarely, having competed under equitable conditions and under rules that are fair and applied evenly with true competence. To be valid and meaningful, competition results must be achieved on a level playing field.”  The USEF 2011 Guidelines for Drugs and Medications states that, “The USEF Equine Drugs and Medications Rules are driven by a mission to protect equine welfare and to maintain a balance of competition among USEF’s 28 unique breeds and disciplines, while simultaneously recognizing and accommodating the varied differentiations required of each."

Although medication rules may seem arbitrary, the guidelines have been developed to ensure that:

1. Horses perform within their physiologic capabilities;
2. No competitor has an unfair advantage;
3. The health and well-being of the horse is not put in jeopardy through competition.

Classes of Substances

While specific categories and definitions of substances contained within these categories may vary, most medications, supplements, and other drugs are listed under one of three headings used by both USEF and FEI.

Prohibited Substances (Forbidden Medications)

In his article, “Drug Testing for the Equine Athlete,” in the Proceedings of the 2010 Kentucky Equine Research Nutrition Conference:  Feeding and Veterinary Management of the Sport Horse, Dr. A. Kent Allen writes, “Forbidden medications and substances include those that may affect the cardiovascular, respiratory, or central nervous systems, or those that have a behavior-altering effect. This includes any stimulant, depressant, tranquilizer, local anesthetic, psychotropic substance, or drug that might affect the performance of a horse and/or pony including corticosteroids and analgesics.” 

Banned/Forbidden Substances

The FEI defines banned substances as “doping substances, which have no place in equine sport.”  These are substances which have no recognized therapeutic benefit to the horse.  Some examples of banned substances include amphetamines, capsaicin, clonazepam, cocaine, dopamine, fentanyl, growth hormones, naloxone, morphine, pentobarbital, and fluphenazine.  These examples represent only a fraction of the comprehensive banned substance list.  A complete list may be found on the FEI website (see Figure 1 for link).  Note the following wording at the bottom of the FEI list:  “And other substances with a similar chemical structure or similar biological effect(s).”

Restricted/Controlled Substances

Restricted medications are substances routinely used for therapeutic purposes in equine medicine but which are forbidden in competition.  Examples of controlled medications include acepromazine, carprofen, clenbuterol (Ventipulmin), diclofenac (Surpass), detomidine, DMSO, firocoxib (Equioxx), flunixin (Banamine), lidocaine, isoxuprine, pergolide, phenylbutazone, and tiludronic acid (Tildren).  As with the examples of banned substances, this list is nowhere near complete.  See figure 1 for link to the complete FEI list.

Permitted Substances

According to the FEI, there is no list of what is permitted, only of substances that are prohibited in competition; however, below is a list of substances that are generally not prohibited in FEI and USEF regulated competition:

1. Antibiotics (all except procaine penicillin G);
2. Antiprotozoals (specific brand names include Marquis and Navigator);
3. Anti-ulcer medications (specific generic names include Omeprazole, Ranitidine, Cimetidine, and Sucralfate);
4. Insect repellents;
5. Antihelmintics (except Levamisole or Tetramisole);
6. Rehydration fluid intravenously, minimum 10 litres (Fluids are not allowed to be administered to horses in the Eventing discipline on the morning or afternoon prior to their start on cross-country.  B-vitamins, amino acids, and electrolytes have always been allowed orally, and in many cases this is still the preferred route of administration, but in some circumstances a veterinarian may prefer to administer them intravenously or intramuscularly. If your veterinarian does want to administer them through an injectable, the rule for administration of fluids above must be followed.);
7. Altrenogest/Regumate (This is permitted in mares only when an ETUE form 2 is properly submitted. Please be aware that it is considered a Banned Substance in geldings and stallions.);
8. All topical wound ointments that do not contain a corticosteroid, local anesthetic, or irritant (such as capsaicin) or other Prohibited Substances;
9. Preventative or restorative joint therapies (Many of these products in the oral form, such as chondroitin or glucosamine, have always been allowed orally, and, in many cases, this is the preferred route of administration; however, in some circumstances a veterinarian may prefer to administer joint restorative therapy intravenously or intramuscularly.  Specific examples of the medications used in this manner are Legend or Hyonate intravenously, Adequan intramuscularly, or Pentosan polysulfate intramuscularly.  No intra-articular administration of any medications is allowed under FEI rules.)

Non-Steroidal Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs are arguably the most frequently used class of drugs administered to performance horses.  Most commonly used NSAIDs are classified under restricted/controlled use in FEI and USEF events.

USEF regulations with regard to allowable NSAID levels will change as of December 1, 2011.  From April 1, 2010 to November 30, 2011, a maximum of two of the following substances have been allowed to be present in the same plasma or urine sample (with the exception of flunixin and phenylbutazone, the two of which are forbidden to be present together in samples from the same horse):  phenylbutazone, flunixin, diclofenac, ketoprofen, meclofenamic acid, naproxen, and firocoxib.

After November 30, 2011, only the permissible levels of ONE of these substances will be allowed in the same plasma or urine sample under both USEF and FEI guidelines.

Note:  Where California Equine Medication Rule is in effect, both diclofenac and firocoxib are listed as prohibited substances.

Steroids

Following wide-spread and highly publicized, non-therapeutic use in human athletics, the term “steroid” has become a controversial one; however, not all chemicals that fall into the steroid class are the same, and they can have both therapeutic and non-therapeutic uses.

Steroids can be divided into two categories.  Corticosteroids have anti-inflammatory, and sometimes anti-immune, properties, and are used medically to treat inflammatory conditions such as allergic reactions, auto-immune diseases, and the inflammation of joint disease.  Examples of corticosteroids are prednisone, dexamethasone, and betamethasone.

Anabolic steroids are most commonly used to build muscle mass and stamina and are the class of drugs often associated with steroid controversies in human athletic performances.  Anabolic steroids have been used routinely in horse racing for years; however, recent attention to the adverse effects of anabolic steroid use has brought to light potential concerns when using this category of drug in equine athletics.

In the past, anabolic steroids were not forbidden for use in horses under USEF’s Drugs and Medication Rules “with the exception of Arabian, Half-Arabian, and Anglo-Arabian horses 3 years old and younger competing in breeding or in-hand classes.”  As the last athletic federation in the United States to allow the use of anabolic steroids in performers, the USEF is moving towards prohibition of anabolic steroids in competition.  As of December 1, 2011, anabolic steroids will be considered forbidden in competing animals.

“Natural” and/or Compounded Substances

It is important to note that most medication rules prohibit not only the presence of specific forbidden substances in the blood or urine of a competing horse, but also the metabolites of those substances or any substance with a similar mechanism of action. 

This allows the regulatory bodies to control the use of “designer drugs” that may not yet be on the commercial market.

“Natural” or plant-based supplements should be used with extreme caution in competition.  Many illegal substances (such as marijuana, opium, cocaine, and heroin) are plant derivatives.  Natural supplements, or so-called nutraceuticals, are not regulated by the FDA as drugs and levels of active ingredients are not consistently monitored.  Several common plant compounds appear on the FEI and USEF forbidden substance lists.

Final Thoughts

Drug regulations in equine competition fall under the auspices of several regulatory agencies and are frequently revised.  It is the duty of the “person responsible,” most commonly the rider or driver of the horse, to understand the regulations for each specific event and to be aware of the current medication status of the horse.

The USEF says it best, “The common thread that binds all of equestrian sport, however, is a dedication and commitment to the health, welfare and safety of the equine athlete, which must take precedence over all other aspects of training, competing and showing.”

Dig deeper^TM

Organizations:

USEF -- http://www.usef.org/contentPage2.aspx?id=ruleshome

FEI -- http://www.feicleansport.org/

American Endurance Ride Conference -- http://www.aerc.org/Drugs_Supplements_info.asp

American Association of Equine Practitioners -- http://www.aaep.org/medication_rules.htm

CA Equine Medication Rule -- http://www.cdfa.ca.gov/ahfss/Animal_Health/EMMP/EMMP_CA_Equine_Med_Rule.html

American Quarter Horse Association -- http://aqha.com/en/Showing/Content-Pages/Resources/Exhibitors/Handbook.aspx

Medication Lists and Other Resources:

USEF

http://usef.org/documents/drugsMeds/ruleBook.pdf

http://www.usef.org/issuu/flipbook.ashx?docname=drugsmedsguidelines&pdfurl=http://www.usef.org/documents/drugsMeds/DrugsMedsGuidelines.pdf

http://usef.org/documents/drugsMeds/VetCommitteePositionAnabolicSteroids.pdf

http://usef.org/_IFrames/newsdisplay/viewPR.aspx?id=5447&star=true

http://www.usef.org/_IFrames/newsdisplay/viewPR.aspx?id=4157

http://usef.org/documents/drugsMeds/DetectionTimesLab010408.pdf

http://usef.org/_IFrames/newsDisplay/viewPR.aspx?id=2228

http://usef.org/documents/drugsMeds/ValerianRoot.pdf

FEI

http://www.horsesport.org/

http://usef.org/documents/drugsMeds/2011FEIEquineProhibitedList.pdf

http://usef.org/documents/drugsMeds/SummaryofchangestoFEIEquineProhibitedListEffective4thApril2011.pdf

http://usef.org/documents/drugsMeds/EADCMRS,1stEd_eff_5Ap2010-updates_eff_1Jan2011.pdf

http://usef.org/documents/drugsMeds/Veterinary_Regulations_12th_Edition_2010_Updates_Effective_1_January_2011._1_.pdf

AQHA

http://usef.org/documents/drugsMeds/showrules_09.pdf