Several changes happened to national and international medication rules last fall. You probably heard the controversy and discussion surrounding one or both, which isn’t surprising if you read this magazine or actively compete.

One of the issues is the U.S. Equestrian Federation single non-steroidal anti-inflammatory rule. This is a discussion about reducing two allowed NSAIDs (such as bute, Banamine, etc.) given to our horses down to one.

It was discussed in and out of committees and within disciplines and affiliates for as long as two years prior to the vote. This discussion, in the end, focused on the fact that this is a horse welfare issue and that having more than one NSAID in the horse may be additive and can cover up significant lameness and may have detrimental side effects in intestines and joints.

The direction then changed to the timeline of enacting the new rule. Some leaders in some disciplines became concerned that the proposed implementation date of Dec. 1, 2010, was too soon, and their members couldn’t comply. So, a compromise was reached.

Beginning April 1, 2010, USEF members need to file a form prior to competing declaring the use of two NSAIDs. The implementation date for reducing NSAID usage to one at a time was pushed back until Dec. 1, 2011.

So what does this all mean to you?

If you choose to use two NSAIDs between April 1, 2010 and Dec. 1, 2011, you must go to the show office and pick up, fill out and turn in an NSAID Disclosure Form.

This form will list the two NSAIDs you’re using, the dose, the time and the diagnosis of the problem as well as the veterinarian prescribing them. Normal prohibitions such as the use of bute and Banamine together will still apply.

The form is similar to the USEF Medication Report Form, but it’s not the same. Be sure to double check and use the appropriate form. That’s all you have to do!

Now, what happens if you don’t fill out the form? The first time you don’t file an NSAID Disclosure Form and your horse is tested and found to have two NSAIDs, you’ll receive a warning letter. The second time you do it you might get a penalty.

A more important question is whether you should give your horse two NSAIDs while you can during this transition time between April 2010 to Dec. 2011. To quote Dr. Shauna Spurlock in the U.S. Hunter Jumper Association Resource Guide, “The potential for the NSAIDs to affect normal physiology in the joints, intestinal and bone healing, in addition to the increased risk of gastrointestinal ulceration and kidney damage, has led to the rules that limit this practice and limit the risk for the horse. Even when using two NSAIDs in accordance with the existing rules, it should be done understanding the real risk as well as the potential benefits.”

So, just because you can give two NSAIDs for an additional short period of time, it doesn’t mean you should! You may be masking soft tissue injuries or joint problems that would be better discovered and treated than ignored. I think a larger number of the trainers, owners and amateurs understand this fact.

Since we started discussing this problem in 2007, the use of double NSAIDs has dropped from 4.8 percent in 2008 to 3.1 percent in 2009. This change means that thousands of people get it and aren’t allowing their horses to be administered more than one NSAID at a time. I hope as well that they’ve determined that if a single NSAID doesn’t help my horse, then it needs a diagnosis and more appropriate treatment, not just another drug.

On The FEI Side

The other area of discussion in changing medication rules is the Fédération Equestre Internationale and the changes they’ve made to their medication rules.

There’s a lot of discussion out in the horse world about this topic, but what are the facts?

The FEI started the year with a revamp of their approach to medication rules to bring them more into line with the World Anti-Doping Agency. This is the agency that sets the rules and ensures human athletes comply with drug rules at the upper levels of their sports.

This is a good concept because when a challenge occurs with an FEI medication ruling it goes to the Court of Arbitration for Sport in Switzerland, which also uses WADA-like principles.

One part of the revamp consisted of listing drugs and medications and then deciding what was and what wasn’t allowed during FEI competitions. The result was a final list called the Equine Prohibited Substance List and is split into two parts: banned substances that have no regular place in equine medicine and controlled medications that are regularly and legitimately used but are not allowed during FEI competitions.

You can see this list and much more at www.FEICleanSport.org. “The List” is very long because many human/veterinary medications are listed there because of their high potential for abuse, i.e. fluphenazine.

Some of the drugs listed will look more familiar, as they’re commonly used in veterinary medicine—drugs such as acepromazine, detomidine, lidocaine, Banamine, etc. All of these drugs being found in the horse at detectable levels under FEI rules carry the possibility of a suspension of six months to two years or less depending on mitigating circumstances.

There’s a sub-list of this group that’s worth noting. It’s called the FEI list of detection times, or as it used to be known “the medicine box.” This is a listing of commonly used prohibited medications that have detailed accurate detection times and are harmonized to the five FEI reference laboratories worldwide (the USEF testing laboratory is one of the five). If a veterinarian is going to administer a medication close to an FEI event, he or she should be selecting off of this list if at all possible.

The last group is not a list as such but is a concept of what you can use. Antibiotics, anti-ulcer medications, anti-EPM medications, vitamins, fluids, Regumate for mares, have been allowed under FEI rules for some time and continue to be allowed. There are obvious restrictions as to how and when and under what super-vision they can be administered to the horse in an FEI compound.

New this year will be the universal understanding that Legend, Adequan and pentosan products will be allowed to be administered to the horses in the FEI compounds legally, but only under the FEI Veterinary Delegate’s or steward’s super-vision. Forms will have to be filled out as they always have for permission to medicate. Check with your veterinarian or the FEI Veterinary Delegate for the forms or details.

Also in the new FEI Veterinary Rules will be a requirement to keep a medication log book on each horse. There will be some guidelines available to download and keep in the log, or you can start a log yourself. Each FEI horse should have its own log that lists the date, the medication and dose, how and where it was administered and who administered it.

The listing of prohibited medications and associated drug and veterinary rules will all go into effect on April 5, 2010.

The possibility of allowing low levels of NSAIDs will be discussed at the FEI General Assembly in November after the presentation of available research and discussion. There’s no possibility of using NSAIDs in FEI competition during the 2010 competition year.

The Controversy

So what caused all of the controversy, and why were the European federations so upset? It was because FEI officials did all of this medication work throughout the year, but it was right before the annual General Assembly that the concept was raised concerning the use of NSAIDs and a few other medications on a permitted basis. It’s a novel but controversial concept that bears some consideration.

We certainly cause travel fatigue and muscle soreness from the way we trailer, fly and train and compete these horses. None of these are major injuries in the horses so one side of the argument says why not use a low sub-clinical dose of an NSAID in the horse? The dose used would have to be one that would not mask pain or lameness but provide for low-level anti-inflammatory activity such as in simple muscle fatigue. Is it possible to do? What do human athletes do?

In human athletes governed by WADA, the NSAIDs are not currently considered performance enhancing and can be used as wanted by the athlete. A double standard, yes. But then again human athletes can say no. The horse can’t.

The FEI equine athlete is the most closely scrutinized athlete in the world, however. Did you see any of the Alpine skiers at the Olympic Games in Vancouver jogging up before the judges prior to being allowed to compete? That’s because the human athletes don’t have their health scrutinized. They can just withdraw. But, on the other hand, the horse cannot ask to withdraw.

So is it possible to find a middle ground and a dose and a level of bute or Banamine that won’t mask lameness but would help our equine athletes deal with muscle soreness? Research and further discussion are needed.

So, what will happen this year to deal with this controversial subject?

FEI officials need to collect the research and make sure all parties involved have the time to study it, including the leaders of the European federations where NSAIDs haven’t been allowed in more than 15 years. The FEI needs to do this in a quiet, well-planned and organized manner.

A Medication Summit will allow scientists, veterinarians and stakeholders to debate this subject in a calm, respectful manner that allows all sides to keep the welfare of the horse paramount. A decision with that objective in mind should be made, agreed upon, and then everyone can move on.

A. Kent Allen received his veterinary degree from the University of Missouri in 1979. His practice currently focuses on top-level sports medicine, lameness and diagnostic imaging at Virginia Equine Imaging in Middleburg, Va., and he’s certified in equine locomotor pathology. He is chairman of the U.S. Equestrian Federation Veteri-nary and Drug and Medications Committees and serves on the Board of Directors. He is the contact veterinarian for the Fédération Equestre Internationale and the USEF in the United States and answers medication questions for veterinarians and competitors around the nation and the world. He is also the vice chairman of the FEI Veterinary Committee. He began contributing to Between Rounds in 2009.