Medication | AAEP

Position on Therapeutic Medications for the Racehorse (2020)

The AAEP policy on medication in pari-mutuel racing is driven by our mission to improve the health and welfare of the horse. The AAEP policy is aimed at providing the best healthcare possible for the racehorses competing while ensuring the integrity of the sport.

The racetrack veterinarian should be directly involved in the diagnosis and treatment of soundness and health disorders; and, must advocate with all stakeholders for professional and ethical practice at all times.

There is much consistency across racing jurisdictions with respect to therapeutic medication control and anti-doping regulations; however, some differences do exist. It is therefore essential that veterinarians providing care to the racehorse know and carefully follow the rules, especially as they concern the health and welfare of the horse. The AAEP expects its members to abide by the rules of all jurisdictions where they practice.

Medication usage for non-therapeutic purposes can put horse health at risk and deprives ethical stakeholders of fair competition. The AAEP condemns the administration of non-therapeutic or unprescribed medications to racehorses based on our belief that it is not in the interest of horse welfare and racing integrity. The AAEP believes that all therapeutic medication (prescription or otherwise) should be administered by or under the direction of a licensed veterinarian and based on a diagnosis. (Click here to view the ARCI Controlled Therapeutic Medication Schedule). Healthcare decisions for individual horses should involve the veterinarian, the trainer and owner with the best interests of the horse as the primary objective.

In order to provide the best healthcare possible for the racehorse, veterinarians should utilize the most current diagnostic and therapeutic modalities available in accordance with medication guidelines designed to ensure the integrity of the sport. To this end, the following are the essential elements of AAEP policy concerning veterinary care for all horses in competition:

The AAEP believes the welfare of the horse must be placed above the demands of competition and monetary or social gain.
The AAEP strongly supports veterinary practitioner adherence to the ethical guidelines of the American Veterinary Medical Association and the American Association of Equine Practitioners.
The AAEP recommends wherever possible to follow the principles of evidence-based medicine before proceeding with a treatment recommendation. The AAEP believes that treatment recommendations be based on a thorough knowledge of the horse’s condition based on previous and current examinations as well as appropriate diagnostic testing.
The AAEP recommends all medical procedures and treatments be performed in the context of a valid veterinarian-client-patient relationship.
The AAEP recommends a detailed medical record be completed for each examination, and all records should comply with the veterinary medical board requirements in the state where one practices.
The AAEP recommends a horse’s history and medical records be shared between the horse’s primary veterinarian, consulting veterinarian, trainer and owners, as well as any veterinarian the owner chooses in order to provide a continuity of care.

Additionally, the following are AAEP guidelines specific to the sport of horse racing:

The AAEP strongly recommends and advocates that all racing jurisdictions should adopt the national uniform medication program (NUMP) and penalty schedules as set forth by the Association of Racing Commissioners International (ARCI), including the Racing Medication and Testing Consortium’s oversight on laboratory performance and proficiency. These regulations and procedures strive to protect the integrity of racing as well as the health and welfare of the horse.
The AAEP recommends abiding by the rules and regulations of the jurisdiction in which one practices, recognizing that some state regulations do not conform to the NUMP.
The AAEP encourages proactive and constructive communication between regulatory bodies and practicing veterinarians, as well as other industry stakeholders based on the premise that attending veterinarians should be unconditional advocates for the welfare and safety of horses and work closely with regulatory veterinarians to identify and protect horses that are at increased risk for injury.
The AAEP endorses “rest” as an important component of a comprehensive healthcare program for racehorses and recommends the integration of rest into therapeutic medication programs.
The AAEP supports the judicious use of compounded medications in strict compliance with FDA regulations and in accordance with the AAEP’s compounding guidelines.
The AAEP supports the communication of all medical and treatment history to the new trainer and owner of a horse claimed or purchased to ensure continuity of care.
The AAEP supports a minimum interval of 14 days following an intra-articular injection to a horse’s next race, recognizing that differences in risk among varied racing disciplines may warrant consideration.
The AAEP supports a 48-hour restricted administration time for non-steroidal anti-inflammatory drugs (NSAIDs) for racing and breezing as well as the elimination of stacking (i.e. administration of two or more drugs of the same classification).
The AAEP strongly endorses increased surveillance and out of competition testing to facilitate enforcement of the above-mentioned regulations.
The AAEP currently supports the use of furosemide as a race-day medication to control exercise-induced pulmonary hemorrhage (EIPH) in the absence of a more effective treatment and/or management strategy for EIPH.
The AAEP recognizes the ongoing industry initiatives to phase out race-day administration of furosemide. Therefore, it is incumbent upon all racetrack veterinarians to develop an evidence-based comprehensive medical and stable management plan to minimize the incidence and degree of EIPH commonly associated with high-speed exercise, consistent with the medication rules of the jurisdictions in which they practice. The AAEP strongly advocates for research and the development of new strategies including, but not limited to, training methods, nutritional management, genetics, and environmental modifications, to assist in improving respiratory health and mitigating the effects of EIPH in training and racing horses.
The AAEP strongly recommends continued research in determining guidelines for withdrawal intervals that allow for the responsible and ethical use of medication in training and racing horses. The AAEP is aware of the dynamics of the development of new products, as well as the continuing evaluation of current medications, and will continue to evaluate its policy based upon available scientific research and the best interests of the horse.

Approved by AAEP board of directors in 2020.

AAEP Statement on the Use of Medroxyprogesterone Acetate in Competition Horses (2019)

Medroxyprogesterone acetate (MPA) is a synthetic progestin hormone administered to mares off-label in an attempt to suppress behavioral estrus. However, a controlled research study found that MPA was not effective at suppression of behavioral estrus. (1) Many veterinarians believe MPA modifies behavior by producing a calming effect in the horse and does not have a therapeutic benefit that goes beyond this behavior modification. Therefore, the AAEP recommends that MPA should not be administered to horses in competition.

1. Gee EK, C DeLuca, JL Stylski, PM McCue. Efficacy of medroxyprogesterone acetate in suppression of estrus in cycling mares. J Equine Vet Sci 2009;29:140-145.

Position on Endurance Horse Medications (1975)

Endurance rides and competitive trail rides differ from racing in that horses competing in these events are judged primarily on their endurance, physical fitness and ability to withstand the stress of sustained hard work on long trails. Speed and time are considerations, but not the determining factors.

AAEP policy recommends that the use of any medication in horses participating in competitive trail or endurance rides is prohibited. Medications for this purpose are defined as injectable, oral or topical administered substances other than oral electrolytes and vitamins.

Reviewed by AAEP board of directors in 2010.

AAEP Position on Therapeutic Medication for the Competition Horse (2020)

The AAEP policy on medication in the competition horse is driven by our mission to improve the health and welfare of the horse. To this end, this policy is aimed at providing the best healthcare possible while ensuring the integrity of each discipline.

The majority of AAEP members work on horses competing in one of the many disciplines encompassing the activities of the sport horse. The veterinarian is typically directly involved in diagnosing and treating soundness and health issues. However, veterinarians may play a limited role in the area of medicating the horse at competitions because riders and trainers employ procedures and administer medications acquired from non-veterinary sources or from veterinarians at the horse show.

These disciplines are quite varied and are governed by sanctioning bodies with widely disparate rules and guidelines. It is, therefore, incumbent on the veterinarian providing care to the competition horse that they understand these rules and follow them carefully, especially as it concerns the health and wellbeing of the horse. Ultimately, in the interest of horse welfare, horses should compete on their own merits. Therefore, medications used for non-therapeutic purposes is a distortion of the spirit of competition.

The essential elements of AAEP policy concerning the veterinarians’ role regarding the horse in competition are as follows:

The AAEP believes the welfare of the horse must be placed above the demands of competition and monetary or social gain.
The AAEP strongly supports veterinary practitioner adherence to the ethical guidelines of the American Veterinary Medical Association and the American Association of Equine Practitioners.
The AAEP recommends wherever possible to follow the principles of evidence-based medicine before proceeding with a treatment recommendation. The AAEP believes that treatment recommendations be based on a thorough knowledge of the horse's condition based on previous and current examinations as well as appropriate diagnostic testing.
The AAEP recommends all medical procedures and treatments be performed in the context of a valid veterinarian-client-patient relationship.
The AAEP recommends a detailed medical record be completed for each examination, and all records should comply with the veterinary medical board requirements in the state where one practices.
The AAEP recommends a horse's history and medical records be shared between the horse's primary veterinarian, consulting veterinarian, trainer and owners, as well as any veterinarian the owner chooses in order to provide a continuity of care.

The essential elements of AAEP policy concerning the veterinarians’ role in medication administration for the horse in competition are as follows:

Veterinarians should refer clients’ questions regarding medication advice to the appropriate source such as the AQHA, FEI and USEF. It is recommended that these resources be made readily available to veterinarians, owners, riders and trainers from each of the sanctioning bodies.
Organizations that have published drug regulations (AQHA, FEI, USEF) should be consulted by the sanctioning body of the equestrian competition which have no regulation on the use of medication for competition.
US Equestrian (USEF) has a 12-hour rule that prohibits injections prior to competition with certain, well-defined exceptions. This rule should be adopted by other sanctioning bodies and promoted by the practitioner.
Oral administration of various supplements containing a combination of electrolytes, amino acids and herbs are marketed and sold in large quantities to the performance horse owner/trainer with the advertised purpose to “quiet” the competition horse. The use of these supplements violates the spirit of the rules concerning the quieting of competition horses and the AAEP recommends that their use be discouraged by veterinarians.
The use of medroxyprogesterone (MPA) should be discouraged for horses in competition. The AAEP has issued a statement opposing the use of MPA in competition horses and the USEF prohibits its use in their sanctioned events.
Bisphosphonates in the competing horse should be used with discretion. Its use should be restricted to those forms of bisphosphonate that are labeled for use in horses, be administered as labeled by the manufacturer, and in accordance with the rules and regulations governing the event.
In some disciplines, acepromazine is sometimes permitted to be used as a quieting agent. The AAEP discourages its use in competition.

Approved by AAEP board of directors in 2020.

Position on the Use of Anabolic Steroids (2007)

Definition and Mode of Action
Anabolic steroids are a group of naturally occurring and/or synthetic hormones including androgens (testosterone and its derivatives), estrogen and progestins. The action of these substances is to increase protein synthesis, particularly in skeletal muscle. Anabolic steroids have specific indications in the therapeutic treatment of medical conditions of horses.

Indications for Use
Indications for use: Anabolic steroids are primarily effective when the objective is to improve appetite, repair tissue, promote weight gain and accelerate recovery from disease. In horses, anabolic steroids may stimulate appetite and increase muscle mass, particularly when there has been marked tissue breakdown associated with disease, prolonged anorexia, stress, or surgery.

Potential side effects of anabolic therapy: Anabolic steroids may cause aggressive or male-like behavior in mares or geldings. Of greater concern are the potentially adverse effects of anabolic steroids on the reproductive function of both mares and stallions. Although these effects are not thought to be permanent, consideration must be given to this possibility.

Additionally, anabolic steroids, like other drugs, should only be prescribed where a doctor/client/patient relationship exists and only for the therapeutic treatment of specific medical conditions. In adherence with its medication policies related to competition horses, the AAEP recommends that practitioners abide by the rules governing the jurisdiction or competition in which they practice. Veterinarians must exercise extreme caution in prescribing anabolic steroids to prevent their acquisition for human use.

Reviewed by AAEP board of directors in 2010.

Position on the Use of Corticosteroids (2007)

Definition and Mode of Action
Corticosteroids occur naturally or may be synthesized. The most useful and desired effect of these compounds is to control inflammation. Corticosteroids have specific indications in the therapeutic treatment of medical conditions of horses.

Indications for Use
Corticosteroids act and are indicated in a wide variety of conditions that require anti-inflammatory therapy, such as joint inflammation, allergic conditions and skin disease.

Potential side effects of corticosteroid therapy: Some corticosteroids, when used excessively or too frequently, may have a negative effect on the body’s natural immune response. Locally injected, corticosteroids may weaken support tissues such as the cartilage and ligaments of a damaged joint if used excessively or indiscriminately. The frequent systemic use of corticosteroids may suppress the ability of the adrenal gland to produce naturally occurring corticosteroids and other hormones, thus creating a hormonal imbalance. Some corticosteroids have been implicated anecdotally as a cause of laminitis.

Additionally, corticosteroids, like other drugs, should only be prescribed where a doctor/client/patient relationship exists and only for the therapeutic treatment of specific medical conditions. In adherence with its medication policies related to competition horses, the AAEP recommends that practitioners abide by the rules governing the jurisdiction or competition in which they practice.

Reviewed by AAEP board of directors in 2010.