Lasix works: No cheerleading necessary

A groundbreaking study proves that furosemide (often known by the brand name Lasix) does just what its proponents always touted: It enhances the racing performance of thoroughbreds by reducing the incidence of exercise-induced pulmonary hemorrhage.

That's more like what the lead paragraph should be of a story reporting that study's findings at The Blood-Horse online. Instead, the magazine/Web site adds a phrase to its lead for which there is no claim made by the study and little or no actual evidence from the study to support: "furosemide does more than enhance performance in thoroughbred racehorses; it also has beneficial effects on the health and welfare of those horses."

I will go on record as being a fence-rider at this stage on the subject of Lasix. I'm not against it outright and I'm certainly not among those who fear that Lasix is the hidden factor that is leading to fragile bones in thoroughbreds. But I do believe it would be best for horses and for the sport if there were some way to race without any race-day meds. (And they do race without meds in virtually every jurisdiction other than the U.S. and Canada.)

But The Blood-Horse's lead paragraph reads to me -- and I do this for a living -- like someone plugging for the drug's use and not the work of a publication that is simply trying to factually report the study's findings. And maybe that isn't surprising, considering The Blood-Horse is operated by the Thoroughbred Owners and Breeders Association, whose board of directors has considerable membership and influence from the The Jockey Club. And, the Grayson-Jockey Club Research Foundation was among the contributors that financed the study; small degrees of separation that should be noted for readers when The Blood-Horse reports on the study's results.

The Daily Racing Form's reporting of the study -- which is more thorough and objective (The Blood-Horse calls its unbylined piece an "edited press release") -- goes into the study's specifics in greater detail. The headlines on the two are also an interesting contrast. The Form is direct and factual: "Study finds that Lasix reduces bleeding." The Blood-Horse's headline is considerably less specific, open-ended and reads more like a drug company wrote it: "Study shows furosemide has beneficial effects."

This is not to say that the research is flawed or offers fraudulent information. That appears not to be the case.

I've read the study as it will be printed in the Journal of American Veterinary Medicine myself, as you can online.

For the first time, researchers set out to specifically study whether furosemide had the intended beneficial effects of controlling pulmonary bleeding (which some horses suffer under extreme exertion) on a controlled population of racehorses, when administered on race day.

And it did.

Researchers included: Kenneth Hinchcliff, professor and dean of the faculty of veterinary science at The University of Melbourne; Paul Morley of Colorado State University (who undertook earlier research of furosemide's effects by simply reviewing past-performances of horses on- and off-Lasix); and Alan Guthrie of the University of Pretoria in South Africa.

The study used 167 thoroughbreds racing in South Africa. Each horse was raced twice, in fields ranging in size from nine to 16 competitors, once using furosemide and once without. And researchers determined that "horses were substantially more likely to develop EIPH" when racing without the furosemide than they were when administered the drug.

Case closed, at least in the debate of whether administering Lasix helps EIPH-prone horses -- known as "bleeders" -- perform better when racing.

But where is the evidence -- as The Blood-Horse's story reads -- of having "beneficial effects on the health and welfare of the horse?" ... It isn't there, certainly not in so many words. And such claim was in no substantial way inferred by the authors of the study. (How their press release, received by The Blood-Horse and not by me, happened to be phrased, I don't know.)

If The Blood-Horse reports that "furosemide does more than enhance performance in Thoroughbred racehorses; it also has beneficial effects on the health and welfare of those horses," I need to see evidence in the study of precisely that.

To me, that passage reads as though there was some additional, surprising finding in the study, perhaps that furosemide unexpectedly protected horses from some airborne contagion or healed them of a seemingly unrelated malady. That isn't the case.

In fact, the term "welfare" appears nowhere in the entire study, and the word "health" only appears once, when researchers state that "EIPH is believed to adversely affect the overall health of racehorses." I suppose it is not, then, a quantum leap to say that treating a racehorse with furosemide for his propensity to suffer EIPH is better for the health of that racehorse. And from there, the next hop, skip and jump apparently lands the writers on the words "and welfare" as tagalongs for "health."

Treating a racehorse for his EIPH is good for the health and welfare of that horse.

But you know what foreign jurisdictions have found is also beneficial to the health and welfare of the racehorse who happens to be a bleeder?

They don't race bleeders.

Not racing horses who are prone to EIPH (and whose performance suffers greatly as a result) likely has the additional effect of not chemically-inflating the performance of horses who have a significant physical flaw -- the predisposition to bleed in the lungs under exertion. Thus, top runners in Europe, Japan and elsewhere are more likely to be those whose track performance wasn't restricted by their suffering from EIPH. And it isn't much of a stretch, then, to wonder whether that means the horses who are champions and destined for stallion careers overseas are thus not bleeders, and not as prone to passing along to their foals a predisposition to suffer from EIPH.

That should be the next study.

But back to the subject of neutrality in reporting this study.

While The Blood-Horse leads with a phrase implying that furosemide is good for the overall welfare of the horses who take it, the study's "Conclusions and Clinical Relevance" -- in effect, the what you should know about this study part of the document -- does not attempt to make that case.

It reads: "Results indicated that prerace administration of furosemide decreased the incidence and severity of EIPH in Thoroughbreds racing under typical conditions in South Africa."

So furosemide works as-advertised when used as a race-day medication. End of story. Anything else is educated conjecture and the study's authors state it as such, writing that EIPH "is believed" (i.e., not proven by the study) to affect the "overall health of racehorses."

This might seem like picking nits. But to me as both an experienced journalist and a fledgling horseman, it's serious business.

The results of this furosemide study -- performed by a global cast of scientists on a well-documented population of racing thoroughbreds in South Africa -- are important and valuable enough without The Blood-Horse cheerleading those results by phrasing their coverage of the study in terms that go beyond the findings of the study itself.