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Performance Enhancing or Performance Restoring

I read the line “performance enhancing or performance restoring” as part of a quote from a regulatory veterinarian in a discussion regarding drug use in the equine industry.  I like the line, because it helps to create potential criteria that determines a drug or herb’s potential use and implications. We all want to achieve the best, win that competition, but we have to ask what are we doing with these medications?  Are we trying to enhance performance in an animal that may not be able to perform at the desired level, inherantly, or are we trying to restore performance to an animal that has become compromised to some degree?

In the not so distant past, a well known and respected TB trainer was in the spotlight due to having a high incidence of acute deaths in horses under his care.  The exact cause is unknown, however, early reports from veterinary autopsies have indicated possible cardiac failure as well as diffuse hemorrhage internally.  I am hopeful that further conclusions can be made regarding the final diagnosis in order to help curb the issue in the future, but my concern is that the deaths are closely linked to medication abuse.

When reading many of the articles regarding these events, one becomes engulfed by the large number of corresponding comments being made, usually from other trainers in the industry.  Overall, the biggest concern and implications being made are regarding abuse of various ‘performance enhancing’ medications.  It would be one thing if it was the public (non-horse owners) making these statements, but in this case, the majority of them are coming from trainers themselves, calling for action and calling for change in the industry.  Despite most trainers and riders wanting change, they are afraid to change and let down their guard.  It is almost as if two people hold a gun at each other, but want peace, waiting for each other to put down their weapon. As trainers and riders, we are afraid to let down our guard, change our protocol, unless we are guaranteed that others are doing the same, fearing that they will continue to have the advantage. Do medications really create an advantage?

I brought up a discussion regarding banned substances several weeks back, but it continues to weigh on my mind as a veterinarian and horse lover.  This issue crosses disciplines, from the TB industry to barrel racing.  Drugs are being abused and used for the wrong purposes, often with no knowledge of what those medications are and possible side effects outside of original intended use.  Using the title of this article as a guide, let’s look at a short list of commonly used medications, their original intended uses as well as what they are being used for,  by their generic names.  The term ‘off label’ is inserted often in the below descriptions, referring to how medications are used outside of their intended use, in situations they were not originally intended.

  • Furosemide:  a commonly used diuretic intended to reduce fluid accumulation in the body associated with heart and kidney failure.  Currently being used ‘off label’ to aid in the management of EIPH by inducing a low level of dehydration, leading to a reduced pulmonary (lung) blood pressure and hopefully reduced bleeding.  Side effects include dehydration and electrolyte abnormalities.
  • Clenbuterol:  a bronchodilator (opens the airways) used to help alleviate the clinical signs associated with COPD (asthma) and certain airway conditions.  Currently being used ‘off label’ to open the airways to enhance air movement as well as for its purported stimulatory effects.  Side effects include cardiac stimulation, possible arrythmias, death and excitement.
  • Dexamethasone:  a corticosteroid used most commonly to reduce the clinical signs of allergic type reactions in the horse.  Currently being used to reduce inflammation and pain associated with a variety of conditions.  Side effects include possible induction of hyperadrenocorticism, increased water consumption/urination, water retention and gastric ulcers.
  • Methylprednisone:  see above description for dexamethasone. Commonly injected into joints to reduce inflammation and pain.
  • Phenylbutazone/Flunixin Meglumine:  both are non-steroidal anti-inflammatory medications designed to reduce pain by blocking COX enzymes and prostaglandin formation.  Side effects include gastric ulceration as well as potential kidney/liver complications.

There are many other medications, but overall we need to ask ourselves if they are performance enhancing or performance restoring and whether if we are inflicting more harm upon these animals than good? In the view of the equine industry, most medications are viewed as performance enhancing, but one really has to look at how they accomplish this feat.  In most instances, the medications are covering up a medical condition that is holding the athlete back in terms of performance.  Maybe the condition is an arthritic joint, or a tight back or a respiratory condition such as EIPH.  Performance is enhanced indirectly by reducing the inhibiting condition.  The problem that comes with this approach is that in many instances there are secondary complications produced such as bone fractures due to blocking pain response, abnormal heart rhythms or overall worsening of the condition due to masking of clinical signs.  This can lead to a need to increase the medication dose in future doses, use of multiple medications to achieve more pronounced results or euthanasia of the animal due to catastrophic injury. Essaentially, in most cases of medication use, we are not really addressing the performance limiting problem, but more so chasing clinical effects.  When we do this, the original problem stil exists, which can then come out to bite us more severly as degeneration continues.

I think the biggest question we need to ask ourselves is whether if we are trying to improve the performance in an animal already competing soundly, or are we trying to mask problems that exist in that animal which are then limiting performance?

Examples of this include a horse that is already running at a 2D level in barrel racing, soundly, with no evident lameness or other health concerns.  In this situation, we may be seeking to enhance performance, at an energy and stamina level, determining if maybe we can bring that animal to a 1D level.  In a different example, maybe we have a jumper that has hock problems, which are creating pain for that animal and reduced range of motion, inhibiting collection ability to clear a jump successfully, which we are trying to mask with joint injections.  In the first example, we have a sound competitor looking for a boost, while in the second, we have a comprised athlete which needs to be re-evaluated in many aspects. We have to remember part of the medical oath, and that is “first, we want to do no harm.”  The first example really has no performance problems, while the second’s performance ability is inhibited by a health condition.  

Are Drugs the Only Answer?

Medications or pharmaceuticals were created originally to impact disease and improve quality of life, with most of those medications targeting some pretty serious health ailments.  When we look at how they are used in today’s equestrian world, this is not their purpose.  They are being used ‘off label’ to impact certain aspects of performance inhibiting conditions such as joint degeneration, tendon conditions or respiratory ailments.  Many of those patients likely shouldn’t be competing anyway, until properly evaluated. Given this, is it right to attempt performance enhancement in a compromised animal via pharmaceuticals, without that patient’s personal consent, considering possible negative consquences? A study that I came across recently actually looked at performance enhancement through the use of various medications and determined that despite their use, the impact on actual performance was limited, and that really, that performance ability was inherant in that animal, more so than produced by a drug.  Essentially, either that animal has the ability or they do not. 

Now, many can agree with that statement as it is obvious and why we look at specific bloodlines and other physical factors in that animal for ideas of potential in a discipline.  But, even then, many of these horses start off with great potential but for a variety of reasons lose that potential, lose that drive, which we then chase down with medications, hoping to produce a positive. In many, their loss of potential has come due to injury, health conditions, mental factors or even dietary influences.  I think we fail to see the big picture, but instead implement a medication regimen in hopes that things will get better.  We might produce a positive in the short term, but in the long term, often the animal suffers as the original problem was not addressed properly.

As a veterinarian, I was trained in college to promote animal health and reduce suffering.  I am all for competition and enjoy seeing these equine athletes perform at their peak, but what is the end cost to this animal for our entertainment? I was not trained to use medications ‘off label’ to push a patient to compete, but more so was trained to see that poorly performing athlete and dig deep, finding answers and solutions to achieve health.  There is always a reason, we just have to look for it.

In many cases, herbs can be used to achieve “performance restoring” effects which are different than the effects of many medications.  Most medications are simply covering up clinical signs without addressing the underlying problems.  Herbs can have similar effects, but tend to also address the bottom line problem whether if it is a nutrient deficiency, poor circulation or impaired cellular health.  Herbs can reduce inflammation naturally as well as pain, similar to various medications, but they do it differently and more completely by returning inflammatory protein levels to normal levels and without side effects.  Performance is restored in many cases through the use of herbs not only due to the reduction of inflammation and pain, but cellular health is restored which means improved energy production and tissues are stronger. Sadly, most dismiss herbs and their potential, not because it does not exist, but because we fail to understand and use them properly. 

Users of our Cur-OST products not only report improvement in pain and inflammation levels, but healing of wounds is enhanced, energy levels are increased and likewise performance is restored.  In many cases, the damage to the body is done whether if it is in the joint or the lungs and is unlikely to be reversed.  That being said, it is possible to slow progression of the condition and minimize clinical signs through the restoration of health.  We can restore performance in many cases, on multiple levels, through restored health, but only in a patient that is willing and capable to continue. In many instances, this is accomplished through restoring healthy cellular function, which impacts every tissue in the body.

We often forget about the underlying causes of certain conditions, whether if it is a joint problem, tendon injury, lung bleed or sore back.  We forget about how stress, mental or physical, can actually drain the body of vital energy, which then impacts performance.  All of these factors can be addressed with the proper herb regimen, restoring and bringing that patient back to optimal levels of health.  If we just resort to medication use, we often miss the point and force an animal to compete, when really, they are not ready.  This is when we continue to have problems, have worsening of existing problems, become more dependent on medications by increasing doses and potentially ending up with a catastrophic situation.

The bottom line is that we can “cover up” clinical problems through the use of various medications or we can take a deeper look at what is causing those problems to manifest.  When we look deeper, we find opportunities to improve cellular function and restore health.  This then reduces the need for those medications but more importantly creates a healthier and stronger athlete…naturally!  Considering that herbs are plant material and essentially food, it then drives the point home that nutrition is the key to overall health.

Just my thoughts.

Tom Schell, D.V.M.

Nouvelle Research, Inc.

www.nouvelleresearch.com

 

 

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