Thyroxine In SoCal: Nearly 300 Scrips This Year, Over Half for Two Trainers

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Despite an advisory designed to eliminate stable-wide usage of thyroxine that has been in effect since the California Horse Racing Board (CHRB) investigated seven sudden deaths of horses trained by Bob Baffert in 2013 and found that all of them had been administered that drug “more as a supplement than a medication,” the use of thyroxine in Southern California remains astoundingly high.

In introducing a new rule proposal on Thursday to curb thyroxine use “to the point that it really will not be used any longer within CHRB facilities,” CHRB equine medical director Rick Arthur, DVM, revealed that between January and the first week of October this year, “veterinarians reporting to the official veterinarians on just the Southern California Thoroughbred circuit and their auxiliary training centers have reported 256 prescriptions for thyroxine between January 2020 and the first week of October.”

Arthur added that there have been 31 additional thyroxine prescriptions logged since that report was compiled a month ago, then tacked on this stunner: “Over half of the prescriptions are for just two trainers, and 80% of the thyroxine has been prescribed by just three veterinarians.”

Arthur did not name the trainers or veterinarians involved, nor did CHRB board members inquire as to who they were during the public portion of the Nov. 19 meeting.

“Hypothyroidism is rare in horses and especially so in young racehorses, to the extent that it's virtually non-existent,” Arthur said.

“Nevertheless, thyroid hormones, primarily levo-thyroxine, are commonly prescribed,” Arthur continued. “Thyroxine has been associated with cardiac arrhythmias and atrial fibrillation in humans, and anecdotally similar cardiac arrhythmias and atrial fibrillation have been reported in horses. While we cannot assert a cause-and-effect relationship, one sudden death already in 2020 occurred five days after the horse was prescribed thyroxine.”

Arthur said that “the American Association of Equine Practitioners (AAEP) and Racing Medication and Testing Consortium (RMTC) issued a thyroxine advisory [in August], noting the practice of prescribing levothyroxine to racehorses has drawn scrutiny and raised questions about the legitimacy of its use in horses engaged in training and racing.”

Arthur also explained how “the New York Gaming Commission has already required a similar restriction at New York tracks [and] The Stronach Group has imposed similar restrictions at their Maryland and Florida tracks as a matter of policy.”

The CHRB proposal, which advanced to the 45-day public commentary period after a 7-0 vote, largely mirrors policies the above-mentioned jurisdictions have crafted.

According to the CHRB's information packet for the thyroxine agenda item, “the adoption of Rule 1866.4 would require a TRH-response test to be performed be a Board-licensed veterinarian, a positive hypothyroidism test be obtained, and the positive result indicating hypothyroidism be submitted to the official veterinarian or equine medical director for review and approval of a thyroxine prescription.

“Following approval of the prescription, the thyroxine prescription cannot exceed 90 calendar days without further re-authorization from the official veterinarian or equine medical director, and a horse administered thyroxine is ineligible to start in a race for 30 calendar days of last administration.”

Back in 2013, the CHRB's compilation of Sudden Death Reports stated that although “the blanket prescribing of thyroxine to all horses in Baffert's barn does appear unusual” the cluster of seven sudden deaths of horses “remains unexplained [and] there is no evidence whatsoever CHRB rules or regulations have been violated or any illicit activity played a part.”

The investigation of those deaths did, however, led to the CHRB's 2014 advisory that is still in effect requiring a specific diagnosis and other prescribing, reporting and labeling restrictions for thyroxine and any other thyroid hormones or analogs.

“This proposed regulation addresses an issue that's frustrated me for almost the whole time I've been equine medical director,” Arthur said.

MMV Coming to CA

In other medication-related news, the CHRB Thursday voted 7-0 to adopt the Multiple Medication Violations (MMV) program used in other jurisdictions. It will establish a points system by which enhanced penalties are imposed, whereby the number of points assigned to a trainer depends on the class and number of violations committed.

The number of points accumulated determines the length of the suspension, and the class of violation determines the length of time before the points expire. The new MMV rule will go into effect once it is certified by the state's Office of Administrative Law.

2021 NorCal Dates

Few people are looking to relive the pandemic-skewed racing season known as 2020. But to come up with a workable version of a 2021 Northern California calendar that satisfies most stakeholders, the CHRB voted 7-0 Thursday to try again with a template for next year that nearly matches the dates that were allotted–but not entirely run–this year.

Health-related cancellations during 2020 caused the Santa Rosa, Ferndale and Fresno meets to get transferred to Golden Gate Fields, while Pleasanton ran an extended meet that included Sacramento's dates.

Back at the October meeting, the CHRB had assigned a Dec. 23, 2020-June 16, 2021 block to Golden Gate Fields, leaving the second half of 2021 dates in the region to be determined later.

Commissioners on Thursday recognized there is not much clarity involving how COVID-19 might impact the racing schedule seven months from now. After brief debate about tabling the region's dates allotment because of all the unknowns, the board opted to move forward as if there will be no interruptions, with the backup plan of reconsidering each meet's allotment at a later date if needed.

“We'll put it in place so people can make plans as if it is going to be normal, and then adjust accordingly. That's kind of how we all have to live our lives right now,” said commissioner Wendy Mitchell.

Prior to the vote, CHRB executive director Scott Chaney said that after conferring with stakeholders to try and craft a schedule, “The two real sort of bones of contention seem to be Santa Rosa preferring to [add in] a week earlier, which obviously would cut a week into Sacramento. And [also] if part of Ferndale should run overlapped with Golden Gate Fields.”

CHRB vice chair Oscar Gonzales said that to the first point, Santa Rosa officials have indicated that they are willing to compromise and race just two weeks as proposed, so long as for 2022, the CHRB will give Santa Rosa special consideration to host the three-week meet it prefers.

As for Ferndale, its desire not to have any overlapping dates with Golden Gate Fields wasn't able to be completely worked out. The fair meet and the commercial track will go head-to-head during the second of Ferndale's two-weeks, a setup that was last in effect in 2018. In 2019, the two venues had conflicting meets for the entire two-week period.

Based on those considerations, the CHRB ended up approving the following 2021 NorCal schedule (per custom, the calendar is allocated in blocks of dates, not actual race days):

Golden Gate Fields (GGF): Dec. 23, 2020-June 16, 2021

Pleasanton: June 16-July 13

Sacramento: July 14-Aug. 3

Santa Rosa: Aug. 4-17

Ferndale: Aug. 18-31

GGF: Aug. 25-Oct. 5

Fresno: Oct. 6-19

GGF: Oct. 20-Dec. 21

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