Thursday, January 11, 2007

FEI Challenge: Drugs and Drug Testing in Endurance

by Nicola Freud

Cecille Miletto and Baja Depoul winning Rambouillet's 160k
One of the French endurance community's better known secrets came out of the closet last month with the news that Cecile Miletto's horse, Baja de Piboul, had tested positive for an anti inflammatory drug. Miletto had won the 160k 3* ride at Rambouillet in April 2006 which was the race that the selectors used to choose their short list for the WEG. She was dropped from the team two weeks before Aachen and has now been banned for a year.

Sadly, to an outsider, it must seem that the sport at its top levels is riddled with people happy to risk everything for the sake of winning. The drawn out fiasco over Hachim's drug testing in Dubai, which resulted in France's Barbara Lissarague being awarded the World Championship, is still being talked about.

The most common attempts at performance enhancing doping are direct medication of joints or systemic use of drugs to target multiple joints which then act as anti-inflammatories and/or improve the quality of the joint fluid. Direct medication of joints with corticosteroids is commonplace, but in the competition horse the timing is crucial, it has to be done so that by the time of competition the steroid is undetectable in tests, while still having a positive effect. It must be remembered that corticosteroids, especially administered systemically, have multiple other effects that may affect or temporarily improve a horse’s performance or measured parameters such as heart rate. Methylprednisolone, the drug used on Hachim in Dubai's 2005 World Endurance Championship, falls into this category.

In more recent years drugs such as hyaluronic acid, polysulphated
glycosaminoglycan, and pentosan polysulphate have all been used both systemically and directly into the joints because they are all found naturally in the body and are hence unsusceptible to testing. The morality of their use is debatable; the reality is that they are intended to increase the long-term efficacy of the horse's joints and cannot boost performance levels as such. They are widespread across all the disciplines and their use is certain to continue unless a whole new legislation comes into play. In the UK during the 'seventies a horse called Hill House who'd returned a positive test was, after three appeals, found to create his own adrenalin, resulting in the conviction being overturned.

The anti-inflammatory drugs such as bute/flunixin/meclofenamic acid etc are all theoretically open to abuse but no-one really knows how much effect they will actually have in a horse at the end of a 120/160km ride. They may help a horse trot up sound at the pre- ride vetting but it's unlikely, at the normal dose, that they would actually improve a lame horse's chances at the end of a race. A higher-than-standard dose might well result in an elevated heart rate. However, they may significantly improve the chances of winning a best condition award the following day by limiting swelling and reducing stiffness.

Anti-inflammatory drugs have been picked up in 3 recent cases of endurance horses. One, in a junior ride in Qatar, was bute in a borrowed horse; it was presumed that the horse was given the drug to get it started as it then was spun part-way for metabolic reasons. The other 2 involved multiple drugs and were not explained by the persons responsible so we have to assume (as did the FEI) they were deliberate attempts to enhance performance.

Of increasing use in other disciplines like dressage and show jumping, whose governing bodies are far more tolerant of drug use and abuse, are the mood-enhancing drugs that stop some animals "blowing their brains" in big arenas. These are widely used to calm horses for the dressage section of a 3 day event and to keep the lid on an ultra-fit cross-country horse. Such drugs include gabapentin and reserpine as well as ACP and are seriously frowned on by the authorities. As they should be, because (apart from ACP) these drugs are unlicensed and untested in horses. I am not aware of them being used for endurance horses as they would be totally counterproductive and extremely dangerous due to their side effects, which, in an exhausted/dehydrated horse, could be fatal.

There are currently rumours are about low dose EPO - i.e. less than has been used in racehorses. If the endurance horse has a higher haemoglobin level then this might accelerate the speed at which it would start to produce lactic acid. If EPO increased blood volume then that would be advantageous; however, thicker blood may also have a negative effect! This is a very risky game if you don't know what you are doing ... As an indicator of the potential dangers, consider the story circulating some years back that you could always tell the cyclists in the Tour de France who were taking EPO because they had to get up every couple of hours through the night to run the hotel corridors otherwise they risked dying in their sleep as their blood was too thick for the heart to move it around.

Of more significance is the drug found in "Orkara", trained by Ismail Mohammed and ridden by the young Sh Majid bin Mohammed al Maktoum at Compiegne’s European championships in 2005. The drug used was Guanabenz, normally prescribed to treat high blood pressure in humans. It acts to relax the blood vessel walls and hence reduce blood pressure but will also often profoundly lower the heart rate. One can see how this might be open to abuse especially at the final vet gate where you have long enough to administer it before needing to present..... The trainer was given a 12 month suspension which was reduced to eight months on appeal. As always in cases where there is a minor, it is very difficult to know where to apportion blame.

Hypothetically, if somebody really wants to win at any cost, thought that cheating was the way and had the money, it would theoretically be possible to create a drug cocktail which lowered the heart rate, disguised lameness and would include a masking agent to avoid detection.

In reality a significant number of the positives picked up by FEI testing are due to either competitors' carelessness or assuming they won't be tested or caught. Drugs which are used routinely for medical conditions, when used too close to a competition, will test positive and bring shame on you and your country e.g sedatives for clipping, bute or other anti-inflammatories for wounds, local anaesthetics for stitching minor wounds or procaine when procaine penicillin is used as an antibiotic.

The chances of accidental positive testing are also increasing as drug testing becomes ever more sensitive and accurate. A smoking or coffee drinking or asthmatic groom who has neglected to wash his hands after having indulged in nicotine, caffeine or ventalin, and then proceeds to mix electrolytes and fill a syringe is unwittingly putting his horse at risk of elimination!

In ignorant or accidental incidents when there is no deliberate attempt at "doping" with the intention of performance enhancement, the FEI still has to punish accordingly because the intention cannot be accurately determined; although they are often more lenient if it can be proved the medication was given legitimately.

In France the job of the "wee man" is not an enviable one. He can stand in the door of the stable for up to two hours before the horse obliges with a sample. The day will surely come when testing can be carried out cheaply and easily (maybe just with a hair from the mane) and with equipment in situ on the day, until then we have the FEI to thank for their vigilance.


Anonymous said...

A very interesting and thought-provoking article. Let's hope the increased attention to this growing concern will help to dissuade others from taking the same route. LC, GB.

Anonymous said...

its a most interessant writing thank you. A big shame for France! But very excellent article.

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