NYTHA Lasix Primer & Letter to NYS RWB

[pointman]

Originally Posted by RolloTomasi

Also, let me reiterate that just because a medication is banned on raceday doesn't mean that it shouldn't be utilized for training or recovery. There is nothing hypocritical in that.

Honestly Rollo, how can you take the position that Lasix is a performance enhancer and that it is ok to train on it? If you believe it is a peformance enhancer, then what scientific evidence exists that shots a couple of times a week to train won't enhance peformance in a race?

[RolloTomasi]

Originally Posted by pointman

Honestly Rollo, how can you take the position that Lasix is a performance enhancer and that it is ok to train on it? If you believe it is a peformance enhancer, then what scientific evidence exists that shots a couple of times a week to train won't enhance peformance in a race?

I haven't taken any position. I simply quoted a study. Personally, I think all the debate about lasix being a "performance enhancer" is an exercise in semantics.

Didn't someone try and call it a "performance enabler" as an alternative? Good stuff.

The real issue is whether or not its justifiable to allow racehorses predisposed to severe bleeding to benefit competively by the administration of lasix. Why is simple barring/retirement from racing off the table?

Probably because we have extremists clouding the issue by noting that you can find minute evidence of bleeding in over 90% of racehorses, attempting to equate insignificant (from a performance standpoint) levels of bleeding with the more severe ones. In one dubious swoop, you go from having a problem affecting ~2-5% of the population to one that affects nearly 100%.

[cmorioles]

Originally Posted by RolloTomasi

In one dubious swoop, you go from having a problem affecting ~2-5% of the population to one that affects nearly 100%.

And that sums this whole thing up in a nutshell. People figured out pretty quickly that these horses that had severe bleeding not only recovered to previous levels of performance, they surpassed them, sometimes by a lot. It became a race to see how fast a horse could get "the juice". It got us to where we are today where virtually any horse can get Lasix with a note from the vet. We all know many of these "notes" are handed out like candy on Halloween with no actual testing done. Hell, you can probably get one for a weanling if you ask.

So, instead of getting rid of the small percentage of the horse population that have severe EIPH, it was easier apparently to just give every horse the drug, including those with tiny amounts of bleeding that doesn't change performance. As far as that goes, if there is one thing of which I am certain, it is that none of these studies can actually measure performance. You can only do that in actual races.

[Riot]

Originally Posted by RolloTomasi

From the study you rather know...

Just cutting and pasting words.

You have every right to have a position on drugs in racing. Stand up and say you don't want any drugs whatsoever on race day. Nothing wrong with that.

However, you should probably come up with a reason why you oppose the direct and specific medical advice of the veterinary profession, who says that doing what you want is not best for the health and welfare of the horse.

We say these lay person interpretations (such as published by some of the anti-lasix folks) of the scientific information surrounding lasix use is wrong and off base. We advise the very opposite of what some lay people in racing are proposing.

Why are 60,000 medical professionals wrong, but lay people with no scientific education, correct?

The concepts being parroted about lasix by the anti-lasix crowd is like calling "creation science" science.

It's sad, like watching Jenny McCarthy continue to contend that autuism is caused by vaccination, in the face of overwhelming evidence to the contrary.

Why would every horse have a TCO2 positive? The TCO2 threshold used for detecting "milkshaking" is higher than the level signifying alkalosis.

No, the TCO2 threshold used for detecting milkshaking is "not higher than the level signifying alkalosis". That's false. You've misunderstood and confused two different concepts.

Hey, I'm just asking questions for the most part, trying to obtain some consistency and impartiality to the proceedings.

Have you read the paper Steve posted in the first post of this thread? Have you READ it yet? The first page is 100% accurate. There is absolutely zero scientific dissent with what is stated in that lay person synopsis.

Why has the use of lasix as a treatment for EIPH remained controversial for all these years?

It's not "controversial" What do you think is "controversial"?

Why has there been hundreds of studies trying to validate its efficacy if it's effects were so cut-and-dry from the outset?

First, no, the hundreds of studies done in the horse about lasix (not counting the thousands of human and non-equine species) are not trying to "validate it's efficacy" The validity is why most of the studies are being done in the first place. When science observes something happening, the point is to quantitate the physiology and other specifics behind it.

Grandma takes horse lasix, at the same dose as race horses, for her congestive failure. That's how terrible this very predictable, very low incidence of side effects loop diuretic is

[RolloTomasi]

Originally Posted by Riot

Just cutting and pasting words.

Interesting. You asked me to directly quote the study that states that lasix is associated with superior performance. I did. Now you say I'm "just cutting and pasting".

Cute. But anyone with a pulse sees right through it. Refute Dr. Hinchcliff's (you know, the guy who proved lasix was effective under actual race conditions) conclusions.

You have every right to have a position on drugs in racing. Stand up and say you don't want any drugs whatsoever on race day. Nothing wrong with that.

I don't need you to tell me that I have a right to have an opinion. I'm trying to participate in a discussion like most of the others in this thread. I'm not pushing an agenda or climbing all over someone who posts something I don't agree with or questions my own posts. Try using some tact for once.

However, you should probably come up with a reason why you oppose the direct and specific medical advice of the veterinary profession, who says that doing what you want is not best for the health and welfare of the horse.

I like how questioning something is apparently the same as opposing it.

We say these lay person interpretations (such as published by some of the anti-lasix folks) of the scientific information surrounding lasix use is wrong and off base. We advise the very opposite of what some lay people in racing are proposing.

Why are 60,000 medical professionals wrong, but lay people with no scientific education, correct?

I highly doubt all 60,000 medical professionals are comfortable with you being their self-appointed spokesman.

But enough of that duck-and-dive tactic you're so good at. You're cherry-picking my last post. Why don't you comment on the mechanism of action of furosemide and how, according to your claim, it does not affect acid-base balance in a racing Thoroughbred?

The lay people want to know.

No, the TCO2 threshold used for detecting milkshaking is "not higher than the level signifying alkalosis". That's false. You've misunderstood and confused two different concepts.

Interesting, once again. Dr. Kenneth McKeever noted in a paper in 2005 that several studies have shown that the mean plasma concentration of total CO2 of normal horses is ~30 mmol/L. Yet, in many racing jurisdictions, the total CO2 threshold is 37 mmol/L. Is 37 higher than 30? Anyone? Anyone? Is there a mathematician in the house?

Ironically, some states, such as New York have two thresholds for total CO2. 37 mmol/L and 39 mmol/L. Anyone know which horses are held to the higher (that's the 39 level for the non-mathematicians here) threshold?

Yep, you guessed it. It's for horses that were administered lasix.

Interesting that the rules of racing seem to suggest that lasix alters the acid-base status (specifically, has an alkalinizing effect) of a horse. No?

Have you read the paper Steve posted in the first post of this thread? Have you READ it yet? The first page is 100% accurate. There is absolutely zero scientific dissent with what is stated in that lay person synopsis.

I read it. It has an obvious bias, as someone else mentioned. Once again, I'm trying to eliminate any bias in the discussion. We're being fed half-truths by both sides.

It's not "controversial" What do you think is "controversial"?

Dr. Kenneth Hinchcliff: "Therapy for EIPH is controversial..." (2004) and "Given...the finding that furosemide can improve the performance of Thoroughbred racehorses, the use of furosemide to prevent EIPH remains controversial." (2009)

Dr. Warwick Bayly: "...this review emphasizes issues that relate to the highly controversial subject of furosemide use in racehorses." (2000)

Do we need those pesky lay people to voice their concern, too? Or are we good here?

[cmorioles]

"However, you should probably come up with a reason why you oppose the direct and specific medical advice of the veterinary profession, who says that doing what you want is not best for the health and welfare of the horse. "

This part is easy. Given the current state of the game, why in the world should we trust vets? Many are associated with the "move up" trainers that are ruining the game.

[Riot]

Originally Posted by RolloTomasi

Interesting. You asked me to directly quote the study that states that lasix is associated with superior performance. I did. Now you say I'm "just cutting and pasting".

Yes, indeed. You are just cutting and pasting things with words in it. Because, if you had actually read and understoodthe study you are quoting, you'll see the conclusions are far different than the little part you cut and paste

For example, you say this:

Interesting that the rules of racing seem to suggest that lasix alters the acid-base status (specifically, has an alkalinizing effect) of a horse. No?

No. The reason that laboratory values are set where they are because of simple and usual statistical mathematical distribution. Has nothing at all to do with "lasix altering the acid-base balance". Sorry. BTW - can you name 5 other things that affect TCO2 values? Because you've just put all your eggs in one basket of blame - and you're wrong. Not surprising, considering you don't really know anything about the scope of what you are talking about, and you just jumped to a false conclusion.

I don't need you to tell me that I have a right to have an opinion. I'm trying to participate in a discussion like most of the others in this thread. I'm not pushing an agenda or climbing all over someone who posts something I don't agree with or questions my own posts. Try using some tact for once.

When it comes to the scientific actions of furosemide, you're a bloviating ignoramus.

I highly doubt all 60,000 medical professionals are comfortable with you being their self-appointed spokesman.

I'm not. I'm merely agreeing with my colleagues. As you already know but ignore repeatedly, 60,000 members of AAEP and the AVMA (of which I belong) have come out in full and unwavering support of lasix as a race day therapeutic medication.

But enough of that duck-and-dive tactic you're so good at. You're cherry-picking my last post. Why don't you comment on the mechanism of action of furosemide and how, according to your claim, it does not affect acid-base balance in a racing Thoroughbred?

Your posts deserve cherry-picking, because you post falsehoods about lasix. The details matter.

Why don't you support your own crazy claim that it does? You made a weird claim, completely outside of known medical knowledge and experience, prove it.

Cutting and pasting random quotes, while completely ignoring the basic physiology and misunderstanding what you are reading, is hilarious and sad. Start with chloride and the ascending loop of Henle.

You see, you actually have to understand what you are going on about. Just googling and posting doesn't make you a lasix expert. Believe me - I am a lasix expert, and you've repeatedly demonstrated you are clueless.

Please - stick to gambling. Leave medicine and veterinary advice to the experts. You are free to hold the completely opposite opinion than the entire medical veterinary medical community on this subject, but having you argue basic physiology and pharmacology from a level of zero obvious knowledge - by cutting and pasting - is simply uncomfortable to watch.

But ... you are just repeating what some in this sport are doing, falsifying and ignoring all the relevant information, in an effort to further their own preconceived agenda. But when they step into our realm, the medical realm, and really start with the lies, we're calling bull.sh.i.at. on that stuff.

The funny thing is that on the equine veterinarian private blogs, we are talking about this, too. Very different discussion, as you might guess.

[RolloTomasi]

Originally Posted by Riot

Yes, indeed. You are just cutting and pasting things with words in it. Because, if you had actually read and understoodthe study you are quoting, you'll see the conclusions are far different than the little part you cut and paste

For example, you say this:

Duck.

Again, refute the statement: "...we believe our results present clear and unequivocal evidence of an association between use of furosemide and superior performance in Thoroughbred racehorses."

No. The reason that laboratory values are set where they are because of simple and usual statistical mathematical distribution. Has nothing at all to do with "lasix altering the acid-base balance". Sorry. BTW - can you name 5 other things that affect TCO2 values? Because you've just put all your eggs in one basket of blame - and you're wrong. Not surprising, considering you don't really know anything about the scope of what you are talking about, and you just jumped to a false conclusion.

Dive.

You are completely trying to steer away from what was said. There are two separate threshold levels for total carbon dioxide used in New York to identify "milkshaked" horses, not a range. One for horses not receiving lasix. One for horses receiving lasix. The latter is allowed a higher threshold (ie more total carbon dioxide ergo more bicarbonate). Why is that?

You trying to cover up this fact with a blanket of statistical nonsense is pathetic beyond belief.

As to "other things" that affect total CO2 values, I never said lasix was the only thing that did. Why would I? The point of testing for total CO2 is to discover horses that have been "milkshaked", not administered lasix.

When it comes to the scientific actions of furosemide, you're a bloviating ignoramus.

How do you know? I'll I ever said was that furosemide caused a 3% drop in body weight and that it had an alkalinizing effect. Are these untrue? Simply refute them without evasion and maybe we can get down to business.

Why don't you support your own crazy claim that it does? You made a weird claim, completely outside of known medical knowledge and experience, prove it.

Duck and dive. I made a weird claim? Where? By quoting a recognized (by the magical, all-knowing veterinary community) authority on lasix?

The onus is on you. This is not hot potato.

Cutting and pasting random quotes, while completely ignoring the basic physiology and misunderstanding what you are reading, is hilarious and sad. Start with chloride and the ascending loop of Henle.

Kicking and scratching from a scared creature trapped in a corner.

You see, you actually have to understand what you are going on about. Just googling and posting doesn't make you a lasix expert. Believe me - I am a lasix expert, and you've repeatedly demonstrated you are clueless.

If you're an expert, then why are you having trouble refuting what other experts have observed in published, peer-reviewed, scientific papers?

Please - stick to gambling. Leave medicine and veterinary advice to the experts. You are free to hold the completely opposite opinion than the entire medical veterinary medical community on this subject, but having you argue basic physiology and pharmacology from a level of zero obvious knowledge - by cutting and pasting - is simply uncomfortable to watch.

Do you think anyone reading this thread is actually buying into your condescending, weak-willed bullying?

Obviously your bark is loud. Now put up and fucl<ing bite already.

But ... you are just repeating what some in this sport are doing, falsifying and ignoring all the relevant information, in an effort to further their own preconceived agenda. But when they step into our realm, the medical realm, and really start with the lies, we're calling bull.sh.i.at. on that stuff.

That's funny. Because I've only quoted veterinarians with regards to lasix.

The funny thing is that on the equine veterinarian private blogs, we are talking about this, too. Very different discussion, as you might guess.

To hear you tell it, it must be a very one-sided debate about the Cassandra Complex.

Is Madeleine Stowe leading the discussion?

[Riot]

Originally Posted by RolloTomasi

Probably because we have extremists clouding the issue by noting that you can find minute evidence of bleeding in over 90% of racehorses,

You calling the veterinary medical profession and world-renowned scientific researchers "extremists" is utter bullshiat.

You're the guy at the corner bar, nursing a beer and pontificating on how to do open heart surgery.

... attempting to equate insignificant (from a performance standpoint) levels of bleeding with the more severe ones.

The trouble with lay people with an agenda is that they make ridiculous statements like the above as if they are fact.

Go google and find some words by someone who knows what they are talking about, that says alveolar bleeding, the rupture of the capillary-oxygenation interface - which means it doesn't work, big guy - is "insignificant from a performance standpoint".

How about the words "oxygen dissociation curve" "VO2max" "Arterial O2 saturation". Ring a bell, doc?

[Danzig]

Originally Posted by RolloTomasi

I haven't taken any position. I simply quoted a study. Personally, I think all the debate about lasix being a "performance enhancer" is an exercise in semantics.

Didn't someone try and call it a "performance enabler" as an alternative? Good stuff.

The real issue is whether or not its justifiable to allow racehorses predisposed to severe bleeding to benefit competively by the administration of lasix. Why is simple barring/retirement from racing off the table?

Probably because we have extremists clouding the issue by noting that you can find minute evidence of bleeding in over 90% of racehorses, attempting to equate insignificant (from a performance standpoint) levels of bleeding with the more severe ones. In one dubious swoop, you go from having a problem affecting ~2-5% of the population to one that affects nearly 100%.

or perhaps it's because it could affect others? like i said, as soon as they can identify who will bleed with certainty, by all means, adjust the rules.

[cmorioles]

Originally Posted by Danzig

or perhaps it's because it could affect others? like i said, as soon as they can identify who will bleed with certainty, by all means, adjust the rules.

I ask again, what it the harm in waiting? Nobody seems to want to answer that question. The real reason nobody wants to wait until a horse actually bleeds to get Lasix is everyone knows it puts them at a competitive disadvantage. It really is that simple.

[Riot]

Originally Posted by cmorioles

I ask again, what it the harm in waiting? Nobody seems to want to answer that question.

No. It's been answered multiple times. You've deliberately and repeatedly ignored it.

The answer is: 93% of horses experience EIPH when racing. Furosemide decreases that number. That is why the veterinary and scientific world overwhelmingly and without reservation advises furosemides' continued use as a therapeutic race day drug.

[cmorioles]

Originally Posted by Riot

No. It's been answered multiple times. You've deliberately and repeatedly ignored it.

The answer is: 93% of horses experience EIPH when racing. Furosemide decreases that number. That is why the veterinary and scientific world overwhelmingly and without reservation advises furosemides' continued use as a therapeutic race day drug.

Two questions...what about the other 7%? What is the harm in actually waiting until they bleed? It is obvious to me these bleeding episodes don't do any long term damage to the horse. The facts don't lie.

[Merlinsky]

Bob Baffert on Twitter -‏ @Midnightlute If they take race day lasix away I will recommend to all my clients to sell their broodmares asap. Racing will not survive.

So you'll help it along by telling your clients to sell their broodmares?

[Riot]

Originally Posted by cmorioles

Two questions...what about the other 7%? What is the harm in actually waiting until they bleed?

Who is giving those horses lasix? You're the only one saying they are. Is that based upon your own personal experience with your own horses?

It is obvious to me these bleeding episodes don't do any long term damage to the horse. The facts don't lie.

The facts are that the veterinary scientific community says, repeatedly and with emphasis, that you are wrong. The veterinary community says that yes, Exercise-Induced Pulmonary Hemorrhage scars lungs and causes increasing and permanent damage over time.

No. The facts don't lie.

People who are non-scientifically oriented mistakenly think that simply saying something with conviction, and repeating it ever more loudly, makes something true. They are wrong. And it needs to stop.

[Danzig]

Originally Posted by cmorioles

I ask again, what it the harm in waiting? Nobody seems to want to answer that question. The real reason nobody wants to wait until a horse actually bleeds to get Lasix is everyone knows it puts them at a competitive disadvantage. It really is that simple.

because you said yourself, no one knows til it happens if it'll happen. you also said lasix doesn't harm a horse.

if there is potential harm if you don't use it, and no harm if you use it, why wait?


and 'everybody knows'? makes you wonder why then that some choose not to use it. or maybe that's because everyone doesn't know that. perhaps they paid attention to all the studies linked in the last week or so that said there is no advantage. but then, even tho there is proof there can be permanent lung damage from a severe enough bleeding episode, you're still insisting otherwise.

[cmorioles]

Originally Posted by Danzig

because you said yourself, no one knows til it happens if it'll happen. you also said lasix doesn't harm a horse.

if there is potential harm if you don't use it, and no harm if you use it, why wait?


and 'everybody knows'? makes you wonder why then that some choose not to use it. or maybe that's because everyone doesn't know that. perhaps they paid attention to all the studies linked in the last week or so that said there is no advantage. but then, even tho there is proof there can be permanent lung damage from a severe enough bleeding episode, you're still insisting otherwise.

Your writing skills are horrid. I don't think your reading skills are much better judging by the things you attribute to me. I think it is best if I just ignore your posts from now on, sorry.

[Danzig]

Originally Posted by cmorioles

Your writing skills are horrid. I don't think your reading skills are much better judging by the things you attribute to me. I think it is best if I just ignore your posts from now on, sorry.

05-10-2012, 09:22 PM
cmorioles
Churchill Downs Join Date: Mar 2007
Location: Moore, OK
Posts: 1,959



--------------------------------------------------------------------------------
Quote:
Originally Posted by Riot
Here's your challenge: give any objective evidence at all to prove that lasix is harmful to horses.



you, cm replied:


Where have I ever said it was harmful? I am quite sure I have never said that. Feel free to keep making things up though.


then there's this exchange:

05-10-2012, 09:11 PM
cmorioles
Churchill Downs Join Date: Mar 2007
Location: Moore, OK
Posts: 1,959



--------------------------------------------------------------------------------
Quote:
Originally Posted by Danzig
and i will ask for a third time, how can you know if a horse will bleed? or when?

and thinking isn't a fact, it's an opinion.


this was your reply cm:




'You can't.'


but yeah, you're right on....i don't know what you've written. feel free to attack my writing skills rather than stick to the points. i've never claimed to be an english or writing major, so i'm sorry if i don't put things together too well. however, i do remember what i've read, and who wrote it.