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FEI position on anti-doping in equestrian sport Professor Leo Jeffcott University of Sydney.

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1 FEI position on anti-doping in equestrian sport Professor Leo Jeffcott University of Sydney

2 FEI philosophy on medication in sport FEI philosophy on medication in sport Scheme & results of FEI medication control Scheme & results of FEI medication control Authorised medication at FEI Events Authorised medication at FEI Events 2004 was a watershed for FEI!! 2004 was a watershed for FEI!! new FEI approach to anti-doping new FEI approach to anti-doping Medication Code Medication Code Conclusions Conclusions Plan for this talk Needles are for “Losers” “Losers” Be a “real” Winner!! Winner!! WEG ’98 Rome – Stable compound

3  Aim:- ‘ clean’ competition without influence of any drugs affecting performance  Specific objectives: -  horses must compete on their inherent merits  competition must be safe & fair to all  Prohibited Substances are banned, but ‘Threshold’ levels for some substances  strict medication control programme in place  emergency treatment permitted provided 1-3 are not compromised FEI Philosophy on medication in competition

4 Code of Conduct FEI Philosophy on medication the horse must always be considered paramount the horse must always be considered paramount all handling & vet treatment of horses must protect their health & welfare all handling & vet treatment of horses must protect their health & welfare equine health must be promoted through education & scientific endeavour equine health must be promoted through education & scientific endeavour the Rules & Regs are formulated to protect the horse from all forms of abuse the Rules & Regs are formulated to protect the horse from all forms of abuse

5 in the interest of the sport and the welfare of the horse there are some indications for a scheme of authorised medication in the interest of the sport and the welfare of the horse there are some indications for a scheme of authorised medication such medication must not affect performance such medication must not affect performance experienced vet supervision is essential experienced vet supervision is essential constant review of the ever changing issues in medication of competition horses is required (e.g. gastric ulceration) constant review of the ever changing issues in medication of competition horses is required (e.g. gastric ulceration) Authorised medication - FEI Philosophy

6 onset of FEI Rules onset of FEI Rules anti-doping sampling at FEI events anti-doping sampling at FEI events Medication Control Programme Medication Control Programme in Europe (Gps 1 & 2) in Europe (Gps 1 & 2) rest of the world (Gps 3-9) rest of the world (Gps 3-9) FEI accredited analytical labs FEI accredited analytical labs prohibited substances & threshold levels prohibited substances & threshold levels clearance times for drugs clearance times for drugs procedure for positives procedure for positives Scheme for FEI medication control

7 Onset of FEI Rules unless otherwise stated (e.g. under special conditions of Olympics or WEG) horses are under FEI Rules once they are on the site of the event & have undergone the First Exam unless otherwise stated (e.g. under special conditions of Olympics or WEG) horses are under FEI Rules once they are on the site of the event & have undergone the First Exam for medication control this is one hour before the start of the First Inspection for medication control this is one hour before the start of the First Inspection

8  Random - agreed by President GJ/ Vet Del /MCP Testing Vet(TV)  Mandatory - specific placings for Championships, WEG, Olympics  Spot - requested by GJ/Vet Del/Vet Commission Testing involved at FEI events:- FEI anti-doping sampling

9 Group 2 Group 4 Group 6 Group 5 Group 8 Group 9 Group 3 Group 1 Group 7 FEI Regional Groups

10 Group 1 (n = 21) AUT,BEL, CRO, CYP, CZE, FRA, GRE, HUN, ISR, ITA, LCH, LUX, MON, POR, RUM, SAM, SLO, POR, RUM, SAM, SLO, ESP, SUI,TUR ESP, SUI,TUR Group 2 (n = 12) DEN, EST, FIN, GER, GBR, IRE, LAT, LIT, NED, NOR, POL, SWE Group 3 (n = 10) BEL, BUL, KAZ, KYR, MOL, PAK, RUS, UKR, UZB FEI Groups in Europe

11 initiated by FEI in 1990 & covers events in Europe (Groups I & II) initiated by FEI in 1990 & covers events in Europe (Groups I & II) approved analytical laboratory is currently LAB in Paris (i.e. FEI Central Lab) approved analytical laboratory is currently LAB in Paris (i.e. FEI Central Lab) programme run by FEI Vet Dept in Lausanne programme run by FEI Vet Dept in Lausanne 23 MCP vets appointed from 15 countries 23 MCP vets appointed from 15 countries standard procedure for sampling, despatch and analysis standard procedure for sampling, despatch and analysis annual report/debriefing session in February annual report/debriefing session in February FEI medication control programme (MCP)

12 FEI Medication Control Programme Organising Committee EVENT GroundJury VeterinaryDelegate Select Horse Sample Collected Laboratory under contract to FEI Samples analysed Report sent Report sent SecretaryGeneral JudicialCommittee FEI Testing Vet under FEI contract MCP in Vet Dept at FEI HQ

13 FEI Analytical Labs FEI approved analytical laboratories:- 1 Central Lab (contract every 4 years); tests all samples in MCP in Europe 1 Central Lab (contract every 4 years); tests all samples in MCP in Europe 3 Reference Labs - USA, Hong Kong & Sydney; tests samples in their countries & regional championships and Olympics; labs accredited by Quality control scheme run by Central lab 3 Reference Labs - USA, Hong Kong & Sydney; tests samples in their countries & regional championships and Olympics; labs accredited by Quality control scheme run by Central lab ~14 Associate Labs around the world; test FEI events in their own countries; accredited by by Quality control scheme run by Central lab ~14 Associate Labs around the world; test FEI events in their own countries; accredited by by Quality control scheme run by Central lab

14 NF/OC responsible for approved laboratory and sampling kits NF/OC responsible for approved laboratory and sampling kits Choice of Reference or Associate labs Choice of Reference or Associate labs Vet Official responsible for testing and sending the samples to the lab Vet Official responsible for testing and sending the samples to the lab FEI needs names of horses, riders and signatures (send these with vet report) FEI needs names of horses, riders and signatures (send these with vet report) Lab only knows test result, Vet Official only knows horse & rider Lab only knows test result, Vet Official only knows horse & rider Lab only reports to the FEI Lab only reports to the FEI FEI Testing outside MCP area

15 Some recommendations: local kits can be used if approved by FEI local kits can be used if approved by FEI if not available, LAB kits can be ordered if not available, LAB kits can be ordered LAB kit are designed for urine & blood LAB kit are designed for urine & blood always follow instructions as provided in kit always follow instructions as provided in kit use disposable gloves until sample is closed and secure use disposable gloves until sample is closed and secure make sure the lab can see that these are FEI samples before samples are opened make sure the lab can see that these are FEI samples before samples are opened samples stored must be cool and locked away samples stored must be cool and locked away FEI Testing outside MCP area

16 FEI position on anti-doping Prohibited Substances, Threshold Levels and substances NOT usually on the Prohibited Substance List

17 Prohibited Substances nervous system cardiovascular system nervous system cardiovascular system respiratory system digestive system respiratory system digestive system urinary system reproductive system urinary system reproductive system musculoskeletal system blood system musculoskeletal system blood system skin (e.g. hypersensitising agents) skin (e.g. hypersensitising agents) immune system (other than those in licensed vaccines) immune system (other than those in licensed vaccines) endocrine system, endocrine secretions & their synthetic counterparts endocrine system, endocrine secretions & their synthetic counterparts antipyretics, analgesics & anti-inflammatory agents antipyretics, analgesics & anti-inflammatory agents cytotoxic substances cytotoxic substances Substances originating externally whether they are endogenous to the horse or not and acting on :-

18 Why do we not allow Prohibited Substances? to prevent unfair advantage to prevent unfair advantage to prevent horses further damaging themselves by masking pain to prevent horses further damaging themselves by masking pain having a system that can be properly and fairly policed (i.e. by MCP programme) having a system that can be properly and fairly policed (i.e. by MCP programme)

19 Clearance times for drugs DXMS36h DXMS36h Butorphanol3days Butorphanol3days Xylazine3days Xylazine3days Frusemide60h Frusemide60h Pethidene3days Pethidene3days Romifidine3days Romifidine3days Mepivicaine108h Mepivicaine108h ACP4days Ketoprofen5days Dipyrone5days Bute6days Depomedrone44days European Horserace Scientific Liaison Committee data Feb ‘97

20 Clearance times for drugs ACP6days ACP6days Flunixin15days Flunixin15days DXMS6days DXMS6days DMSO4days DMSO4days Detomidine3days Detomidine3days Procaine7-15days Procaine7-15days Isoxsuprine3-5days Ketoprofen3days Mepivacaine2days Methyl pred10days PBZ2days AAEP Resource Library, R.Sams November 1999

21 Threshold and Permitted Substances Under FEI Rules, horses may compete with the presence of certain substances in their tissues, body fluids or excreta, including anti-infectious agents (except procaine penicillin); cimetidine, ranitidine, omeprazole; and altrenogest (in mares). Currently looking at scopolamine n-butyl bromide (Buscopan). Under FEI Rules, horses may compete with the presence of certain substances in their tissues, body fluids or excreta, including anti-infectious agents (except procaine penicillin); cimetidine, ranitidine, omeprazole; and altrenogest (in mares). Currently looking at scopolamine n-butyl bromide (Buscopan). Thresholds only apply to: Thresholds only apply to: substances endogenous to the horse; substances endogenous to the horse; substances arising from plants traditionally grazed or harvested as equine feed or are demonstrated to be bona fide feed contaminants. substances arising from plants traditionally grazed or harvested as equine feed or are demonstrated to be bona fide feed contaminants.

22 Threshold Substances Available carbon dioxide (CO 2 ) - 36 mmoles/L plasma Available carbon dioxide (CO 2 ) - 36 mmoles/L plasma Boldenone - free and conjugated boldenone μg/mL urine from entire male horses Boldenone - free and conjugated boldenone μg/mL urine from entire male horses Dimethyl sulfoxide - 15 μg/mL urine or 1 μg/mL plasma Dimethyl sulfoxide - 15 μg/mL urine or 1 μg/mL plasma Estranediol - 5α-estrane-3β,17α-diol μg/mL urine Estranediol - 5α-estrane-3β,17α-diol μg/mL urine Hydrocortisone - 1 μg/mL in urine Hydrocortisone - 1 μg/mL in urine Salicylic acid μg/mL urine or 5.4 μg/mL plasma Salicylic acid μg/mL urine or 5.4 μg/mL plasma Testosterone μg/mL free and conjugated testosterone in urine from geldings, or μg/mL free and conjugated testosterone in urine from fillies and mares Testosterone μg/mL free and conjugated testosterone in urine from geldings, or μg/mL free and conjugated testosterone in urine from fillies and mares Theobromine - 2 μg/mL urine. Theobromine - 2 μg/mL urine.

23 1.sample collected at an event; 2.sent to FEI lab for analysis; 3.positive result on Sample A recorded; 4.PR can have Sample B analysed; 5.Result reported to FEI (Vet Dept)  passed to Legal Dept anonymously; 6.Legal & Vet Dept liaise  advice from MAG  +ve confirmed; 7.Legal Dept notifies NF & reports to Judicial Committee; 8.PR can be invited to hearing or submit in writing 9.Judicial Committee makes final decision & impose penalty FEI Procedure for positives

24 FEI position on anti-doping Results of Medication Control Programme

25 Medication Control Programme } Worldwide } Gps I & II No of samples per year

26 Medication Control Programme

27 Highlights 2005: 84% NSAIDs, sedatives & corticosteroids 84% NSAIDs, sedatives & corticosteroids ● In 54 of 60 cases substances acting on locomotor system were detected ‘new’ antipsychotic drug – gabapentin ‘new’ antipsychotic drug – gabapentin higher than expected +ve rate in Endurance, & 1 NF had higher +ve rate than any other higher than expected +ve rate in Endurance, & 1 NF had higher +ve rate than any other “fast tracking” of cases by Judicial Committee proving to be very successful “fast tracking” of cases by Judicial Committee proving to be very successful

28 MCP Programme 79 substances detected in 68 positive samples in 2004 Positives in % NSAIDs, sedatives & corticosteroids

29 MCP Programme Breakdown of 260 substances detected in positive samples from % NSAIDs, sedatives & corticosteroids

30 FEI position on anti-doping Authorised medication at FEI events [see Chapter VII and Annex VI of Vet Regs]

31 Medication at FEI Events- Policy  horses must compete on their inherent merits & medication that might affect performance must be avoided  medication is permitted in emergency situations only  medication must not provide an unfair advantage  if clinical signs are serious then the horse must be withdrawn from competition

32 Authorised Medication at FEI Events - Implementation  Medication control programme & scheme for Authorised Medication are in conflict, prior to and during competition  so guidelines for both must be very clear & effectively communicated to all concerned  Authorised Emergency Medication can only function if based on good communication and common sense  the welfare of the horse is paramount

33 will the horse recover in time? will the horse recover in time? what is the treatment of preference? what is the treatment of preference? period of pharmacological activity & withdrawal times? period of pharmacological activity & withdrawal times? is there a need for a “cocktail” treatment? is there a need for a “cocktail” treatment? is the horse “fit to compete”? is the horse “fit to compete”? Considerations :- Medication at FEI Events - Prior to Competition

34 minor ‘cuts’ & ‘bruises’ minor ‘cuts’ & ‘bruises’ mild transport stress mild transport stress colic colic tranquillisation of nervous horses tranquillisation of nervous horses For conditions such as:- Medication at FEI Events - during transportation

35 minor cuts & bruises minor cuts & bruises muscle problems (stiffness, tying up) muscle problems (stiffness, tying up) colic (spasmodic) colic (spasmodic) conjunctivitis conjunctivitis fly bites fly bites NB. The judgement of minor vs. major disease may differ in the opinion of PR, treating vet and Vet. Del/FVD. Minor conditions :- Medication at FEI Events - During Competition

36 Medication at FEI Events During Competition  Authorisation for ‘Emergency Treatment’  Declaration for admin of altrenogest (Regumate) to mares  Authorisation for medication not on the EPL  Application for Elective Testing Official forms:- Form 1 Form 2 Form 3 Form 4

37 Authorisation for Emergency Treatment during an Event for minor conditions only (Gen Regs 146.3/ Vet Regs , ) for minor conditions only (Gen Regs 146.3/ Vet Regs , ) examples:- examples:- allergic reactionsnon-depot glucocorticoids allergic reactionsnon-depot glucocorticoids minor lacerationslocal anaesthetic minor lacerationslocal anaesthetic spasmodic colicspasmolytic agents spasmodic colicspasmolytic agents dehydrationelectrolytes p.o./i.v. dehydrationelectrolytes p.o./i.v. eye disordersocular preparations eye disordersocular preparations antibiotics, vitamins & fluids not on prohibited list antibiotics, vitamins & fluids not on prohibited list Form 1

38 For Completion by Treating Veterinarian Route of administration:topical  oral  subcutaneous intramuscular  intravenous  rectalother  Event (incl. Event Code No): Date: Name of horse:Passport No. Person Responsible:NF: Competition NoStable No: Symptoms or condition requiring medication: Medication (including dosage): Active ingredient: (see label): Date and time of administration: Name and signature of Treating Veterinarian: Name:Signature: Authorisation Form for Emergency Treatment Form 1

39 For Completion by the Vet. Commission/Delegate After examination of the above horse, I hereby authorise the treatment and consider that, to the best of my knowledge, the horse is: FIT  UNFIT  for participation/continued participation at this event. Date and time of authorisation: Name and signature of authorising Member of Vet Commission/Delegate: Name:Signature: Authorisation Form for Emergency Treatment Form 1

40 For Completion by the President of the Ground Jury In accordance with GRs Art and on the recommendation of the Veterinary Commission/Delegate, the above horse having received veterinary treatment as indicated above:-  MAY participate/continue to participate Date and time of signature: Name of President of the Ground Jury: Signature: Authorisation Form for Emergency Treatment Form 1

41 Declaration for admin of altrenogest (Regumate) Regumate treatment is now permitted for mares with an oestrus-related problem Regumate treatment is now permitted for mares with an oestrus-related problem dose and duration of treatment must be must be in accordance with manufacturer’s recommendations dose and duration of treatment must be must be in accordance with manufacturer’s recommendations Medication Form 2 must be completed by a vet and submitted to the Vet Del before the start of the event Medication Form 2 must be completed by a vet and submitted to the Vet Del before the start of the event Form 2

42 Medication not on the Prohibited list it is necessary to get permission to administer rehydration fluids, antibiotics, ulcer medication etc at an event it is necessary to get permission to administer rehydration fluids, antibiotics, ulcer medication etc at an event route of administration route of administration intravenous; subcutaneous; intramuscular; intra- ocular; per os; nasogastric tube; nebulisation intravenous; subcutaneous; intramuscular; intra- ocular; per os; nasogastric tube; nebulisation details of medication details of medication fluid; electrolyte; antimicrobial fluid; electrolyte; antimicrobial dose & frequency of administration dose & frequency of administration permission for fluids will be on a case by case basis; small volumes (<5 litres) will not be approved permission for fluids will be on a case by case basis; small volumes (<5 litres) will not be approved signed by treating Veterinarian signed by treating Veterinarian authorised by (Foreign) Vet Del authorised by (Foreign) Vet Del Form 3

43 Elective Testing For the substances listed under Vet Regs Annex V, Appendix 1, it is possible to have a horse tested after treatment, prior to a competition in which the horse is scheduled to participate For the substances listed under Vet Regs Annex V, Appendix 1, it is possible to have a horse tested after treatment, prior to a competition in which the horse is scheduled to participate Medication Form 4 (available on the FEI web site)is to be used and the laboratory must be informed, through Form 4, of the exact substances that were administered Medication Form 4 (available on the FEI web site)is to be used and the laboratory must be informed, through Form 4, of the exact substances that were administered Form 4

44 ** 2004 was a watershed for the FEI ** 4.8% horses tested positive over the year 4.8% horses tested positive over the year 4 positive tests in the 2004 Olympic Games of which two were Gold Medal winners (WATERFORD CRYSTAL and GOLDFEVER 3) 4 positive tests in the 2004 Olympic Games of which two were Gold Medal winners (WATERFORD CRYSTAL and GOLDFEVER 3) human anti-psychotic drugs were found in competition horses (zuclopenthixol, fluphenazine, flupenthixol etc) human anti-psychotic drugs were found in competition horses (zuclopenthixol, fluphenazine, flupenthixol etc) riders asked FEI to take action on hypersensitization of limbs riders asked FEI to take action on hypersensitization of limbs

45 The New FEI Approach in ’05-06 Task Force set up and Report adopted April 2005; Task Force set up and Report adopted April 2005; new approach to medication control with distinction between medication and doping and creation of the ‘Medicine Box’ concept with publication of Detection Times; new approach to medication control with distinction between medication and doping and creation of the ‘Medicine Box’ concept with publication of Detection Times; Legal Department totally revamped – now 3 attorneys; introduction of Fast Track system along US lines; Legal Department totally revamped – now 3 attorneys; introduction of Fast Track system along US lines; Additional veterinarian proposed; Additional veterinarian proposed; Stewarding tightened with bandage checks, thermography and swabbing being introduced for hypersensitisation tests Stewarding tightened with bandage checks, thermography and swabbing being introduced for hypersensitisation tests

46 The New FEI Approach General Assembly 2006 Kuala Lumpur General Assembly 2006 Kuala Lumpur Equine Anti-Doping and Medication Control (EADMC) Rules created, based on WADA with an FEI Medication Code; Legal processes; Definitions etc.; Equine Anti-Doping and Medication Control (EADMC) Rules created, based on WADA with an FEI Medication Code; Legal processes; Definitions etc.; EADMC Rules ‘seek to prevent medication violations that may affect the performance of a horse or mask an underlying health problem…against the spirit of the sport’; EADMC Rules ‘seek to prevent medication violations that may affect the performance of a horse or mask an underlying health problem…against the spirit of the sport’; The Rules include an Equine Prohibited List which classifies Prohibited Substances into Doping Agents; Medication Class A, Medication Class B; The Rules include an Equine Prohibited List which classifies Prohibited Substances into Doping Agents; Medication Class A, Medication Class B; Essential concept that a competition horse that requires medication on veterinary grounds must receive it. Essential concept that a competition horse that requires medication on veterinary grounds must receive it. Kent Allen – MAG member

47 The New FEI Approach Medication Advisory Group set up with riders’ representatives, treating vets, regulators and analysts; Medication Advisory Group set up with riders’ representatives, treating vets, regulators and analysts; Detection times being established and agreed for substances in the Medicine Box; Detection times being established and agreed for substances in the Medicine Box; Introduction of formal Elective Testing; Introduction of formal Elective Testing; Laboratory standardisation and harmonisation; Laboratory standardisation and harmonisation; As WADA, Medication Forms are crucial as Equine Therapeutic Use Exemptions (ETUEs). As WADA, Medication Forms are crucial as Equine Therapeutic Use Exemptions (ETUEs).

48 Equine Prohibited List Prohibited Substances (Doping) Agents, cocktails or mixtures of substances that may affect the performance of a horse; masking agents; substances with no generally accepted medical use in competition horses; substances which are usually products prescribed for use in humans or other species; agents used to hypersensitise or desensitise the limbs or body parts, including but not limited to: Agents, cocktails or mixtures of substances that may affect the performance of a horse; masking agents; substances with no generally accepted medical use in competition horses; substances which are usually products prescribed for use in humans or other species; agents used to hypersensitise or desensitise the limbs or body parts, including but not limited to: two or more anti-inflammatory drugs (steroidal and/or non-steroidal) or other combinations of anti- inflammatory substances with similar or distinct pharmacological actions; two or more anti-inflammatory drugs (steroidal and/or non-steroidal) or other combinations of anti- inflammatory substances with similar or distinct pharmacological actions; antipsychotic, anti-epileptic and antihypertensive substances including reserpine, gabapentin, fluphenazine, and guanabenz; antipsychotic, anti-epileptic and antihypertensive substances including reserpine, gabapentin, fluphenazine, and guanabenz; antidepressants such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs); antidepressants such as selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs); tranquilizers, sedatives (including sedating antihistaminics) commonly used in humans and/or non- equine species, including benzodiazepines, barbiturates and azaperone ; tranquilizers, sedatives (including sedating antihistaminics) commonly used in humans and/or non- equine species, including benzodiazepines, barbiturates and azaperone ; narcotics and opioid analgesics; endorphins; narcotics and opioid analgesics; endorphins; amphetamines and other central nervous system (CNS) stimulants including cocaine and related psychotic drugs; amphetamines and other central nervous system (CNS) stimulants including cocaine and related psychotic drugs; beta-blockers including propranolol, atenolol, and timolol; beta-blockers including propranolol, atenolol, and timolol; diuretics and other masking agents; diuretics and other masking agents; anabolic steroids (including testosterone in mares and geldings) and growth promoters; anabolic steroids (including testosterone in mares and geldings) and growth promoters; peptides and genetically recombinant substances such as erythropoietin, insulin growth factor and growth hormone; peptides and genetically recombinant substances such as erythropoietin, insulin growth factor and growth hormone; hormonal products (natural or synthesized) including adrenocorticotropic hormone (ACTH) and cortisol (above the threshold); hormonal products (natural or synthesized) including adrenocorticotropic hormone (ACTH) and cortisol (above the threshold); substances designed and marketed primarily for human use or use in other species and for which alternative and generally accepted products are available for use in horses; substances designed and marketed primarily for human use or use in other species and for which alternative and generally accepted products are available for use in horses; hypersensitizing or sensitizing agents (organic or inorganic or other substances likely to have been applied to body parts or to tack to influence performance); hypersensitizing or sensitizing agents (organic or inorganic or other substances likely to have been applied to body parts or to tack to influence performance); oxygen carriers; oxygen carriers; and other substances with a similar chemical structure or similar biological effect(s). and other substances with a similar chemical structure or similar biological effect(s).

49 Equine Prohibited List Prohibited Substances (Medication Class A) Agents which could influence performance by relieving pain, sedating, stimulating or producing/modifying other physiological or behavioural effects, including: Agents which could influence performance by relieving pain, sedating, stimulating or producing/modifying other physiological or behavioural effects, including: local anaesthetics; local anaesthetics; sympathomimetic cardiac stimulants; sympathomimetic cardiac stimulants; central and respiratory stimulants; central and respiratory stimulants; clenbuterol and other bronchodilators and products used for the treatment of recurrent airway disease (RAD); clenbuterol and other bronchodilators and products used for the treatment of recurrent airway disease (RAD); a single non-steroidal anti-inflammatory drug ± metabolite(s); a single non-steroidal anti-inflammatory drug ± metabolite(s); a single corticosteroid; a single corticosteroid; sedatives or tranquillisers indicated for equine use including antihistamines; thiamine; valerian and other herbal products other than those listed as Prohibited Substances (Doping); sedatives or tranquillisers indicated for equine use including antihistamines; thiamine; valerian and other herbal products other than those listed as Prohibited Substances (Doping); muscle relaxants including methocarbamol and propantheline; muscle relaxants including methocarbamol and propantheline; anti-coagulants including heparin or warfarin; anti-coagulants including heparin or warfarin; and other substances with a similar chemical structure or similar biological effect(s). and other substances with a similar chemical structure or similar biological effect(s).

50 Equine Prohibited List Prohibited Substances (Medication Class B) Substances that either have limited performance enhancing potential or to which horses may have been accidentally exposed, including certain dietary contaminants. These are listed below: Substances that either have limited performance enhancing potential or to which horses may have been accidentally exposed, including certain dietary contaminants. These are listed below: isoxsuprine; isoxsuprine; dimethylsulphoxide (DMSO) when above the threshold; dimethylsulphoxide (DMSO) when above the threshold; mucolytics and cough suppressants: bromhexine and other substances with a similar chemical structure or similar biological effect(s); mucolytics and cough suppressants: bromhexine and other substances with a similar chemical structure or similar biological effect(s); hyoscine (n-butyl-scopolamine); Atropine and other anticholinergic substances with a similar chemical structure or similar biological effect(s); hyoscine (n-butyl-scopolamine); Atropine and other anticholinergic substances with a similar chemical structure or similar biological effect(s); methylxanthines: caffeine and theophylline; theobromine when above the threshold; methylxanthines: caffeine and theophylline; theobromine when above the threshold; plant or animal derivatives: bufotenine, hordenine, tyrosine, gamma- oryzanol and other substances with a similar chemical structure or similar biological effect(s); plant or animal derivatives: bufotenine, hordenine, tyrosine, gamma- oryzanol and other substances with a similar chemical structure or similar biological effect(s); terpines and inorganic contaminants (other than those detected on skin or tack swabs); terpines and inorganic contaminants (other than those detected on skin or tack swabs); evacuants: magnesium sulphate and other substances with a similar chemical structure or similar biological effect(s). evacuants: magnesium sulphate and other substances with a similar chemical structure or similar biological effect(s).

51 “The Medicine Box” original concept came from the ITVA original concept came from the ITVA it is a list of first choice medication for competition horses on which detection times will be provided it is a list of first choice medication for competition horses on which detection times will be provided ‘Detection Time’ (DT) is the period during which a drug remains in the horse’s system such that it is detectable by the laboratory ‘Detection Time’ (DT) is the period during which a drug remains in the horse’s system such that it is detectable by the laboratory “Withdrawal Time” (WT) is the safety margin provided by the Treating Vet to ensure that no infringement of the rules occurs “Withdrawal Time” (WT) is the safety margin provided by the Treating Vet to ensure that no infringement of the rules occurs “Screening Limits of Detection” (SLODs) control the limit of detection to ensure the integrity of the sport. These will be agreed by the FEI for each drug for which DTs have been established “Screening Limits of Detection” (SLODs) control the limit of detection to ensure the integrity of the sport. These will be agreed by the FEI for each drug for which DTs have been established

52 The Medicine Box (as at 1st April 2006) NSAIDs NSAIDs phenylbutazone, flunixin, ketoprofen phenylbutazone, flunixin, ketoprofen Corticosteroids Corticosteroids dexamethasone sodium phosphate (iv), triamcinalone acetonide (ia), methylprednisolone (ia) dexamethasone sodium phosphate (iv), triamcinalone acetonide (ia), methylprednisolone (ia) Local anaesthetics Local anaesthetics lidocaine, mepivacaine lidocaine, mepivacaine Sedatives Sedatives detomidine, romifidine, xylazine detomidine, romifidine, xylazine Respiratory Respiratory dembrexine, clenbuterol, salbutamol dembrexine, clenbuterol, salbutamol Colic Colic scopolamine n-butyl bromide, butorphanol dipyrone (metamizole) scopolamine n-butyl bromide, butorphanol dipyrone (metamizole)

53 The Medicine Box (as at 1st April 2006) “ The Medicine Box ” (as at 1st April 2006) Detection Times are being established for all Medicine Box substances in collaboration with the European Horseracing Scientific Liaison Committee (EHSLC) and funded by the FEI and certain Federations (GBR, USA, GER); It is intended that these Detection Times will be published during 2006; Remember Detection Times are not Withdrawal Times, which depend entirely on the clinical and professional judgment of the attending veterinarian.

54 Screening Limits of Detection (SLODs) SLODs are being established to control the sensitivity of the screening methods used and to be applied universally by the FEI’s four (quality controlled) reference laboratories (Paris, Hong Kong, Sydney and New York) SLODs are being established to control the sensitivity of the screening methods used and to be applied universally by the FEI’s four (quality controlled) reference laboratories (Paris, Hong Kong, Sydney and New York) Substances for which SLODs and/or detection times have been or are being established can be found on the FEI website. Substances for which SLODs and/or detection times have been or are being established can be found on the FEI website.

55 Medication Code All treatments must be given in the best health and welfare interests of the horse. Therefore: All treatments must be given in the best health and welfare interests of the horse. Therefore: Every treatment must be fully justifiable by the medical condition of the horse receiving the treatment. Every treatment must be fully justifiable by the medical condition of the horse receiving the treatment. Horses that cannot compete as a result of injury or disease must be given appropriate Veterinary treatment. The Person Responsible must obtain advice from their treating Veterinarian or team Veterinarian prescribing a treatment and the necessary duration of treatment. Horses that cannot compete as a result of injury or disease must be given appropriate Veterinary treatment. The Person Responsible must obtain advice from their treating Veterinarian or team Veterinarian prescribing a treatment and the necessary duration of treatment. No substance shall be given to any horse during or close to an event unless the appropriate FEI guidelines for medication authorization have been followed. No substance shall be given to any horse during or close to an event unless the appropriate FEI guidelines for medication authorization have been followed.

56 Medication Code A complete and accurate record of all treatments must be maintained. proper use of Medication Forms (including formalising use of MF1 by electronic submission or fax to the FEI Veterinary Department in advance of the event); proper use of Medication Forms (including formalising use of MF1 by electronic submission or fax to the FEI Veterinary Department in advance of the event); look actively towards developing an electronic system for the future look actively towards developing an electronic system for the future

57 Conclusions MCP is efficient and cost effective, but needs to expanded & more samples taken MCP is efficient and cost effective, but needs to expanded & more samples taken the level of positives is still too high (i.e. 10x that of racing) the level of positives is still too high (i.e. 10x that of racing) positives highest in Jumping discipline & problems with “permitted”medication positives highest in Jumping discipline & problems with “permitted”medication Improved dialogue, liason & education of all vets involved Improved dialogue, liason & education of all vets involved More research is needed to keep ahead of “potential dopers” More research is needed to keep ahead of “potential dopers”

58 Goals for 2006 include implementation of the new Equine Anti-Doping and Medication (EADMC) Rules; implementation of the new Equine Anti-Doping and Medication (EADMC) Rules; increase testing by 30%; increase testing by 30%; Elective Testing to start as from 1 st June 2006; Elective Testing to start as from 1 st June 2006; introduce Laboratory Standards; introduce Laboratory Standards; publish Detection Times for 17 Medicine Box substances; publish Detection Times for 17 Medicine Box substances; educate stakeholders (internal and external); educate stakeholders (internal and external); promote the FEI Medication Code. promote the FEI Medication Code.

59 Thanks for listening !!


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