Bill Brashears and Banamine

“Faced with the choice between changing one’s mind and proving there is no need to do so, almost everyone gets busy on the proof.

– John Kenneth Galbraith

The majority of race tracks are not populated by horses with the qualifications of Dortmund or California Chrome, or by trainers with the name recognition of Todd Pletcher, Bob Baffert or Steve Asmussen. The base of the racing pyramid is built with horses named Grant or Get a Notion, animals that are kept in racing condition by trainers who toil in relative anonymity at tracks often ignored by the people who often forget racing occurs at places other than the cathedrals of the sport like Saratoga or Churchill Downs or Santa Anita. The base of the pyramid is built on the blue collar efforts of guys like Bill Brashears, conditioners keeping $3,500 claimers healthy enough to run and plying their trade in the minor leagues of racing at tracks like Turf Paradise, Arapahoe Park, Farmington, Rilito, and Albuquerque.

Brashears comes across exactly like what he is. A  guy who shoots straight and understands that you treat people with unambiguous honesty and fairness, expecting the same in return. He is guileless and smart and hard-working, a trainer’s trainer. Success in his business is based on relationships, knowing who the good guys and not so good guys are. Who can be trusted and who needs to be taken with a few grains of salt. In Bill’s world you give the good guys the benefit of the doubt until they give you a reason not to. The bad guys – better to just not deal with them.

He treats his horses with the kind of care you only see from someone with a love for the thoroughbred and a passion for watching them run. He is not the guy described by a cynical racing executive as being willing to do anything that will allow him to win. It is simply not in his nature to do anything less than treat his horses as if they were family, the core of Brashears Racing. You can see him metamorphose around his horses, the hardscrabble exterior melting away into a doting grandfather, feeding them peppermints and affectionately scratching at their muzzle. He admits that when he climbed over a fence at 13 so he could see horses run, he was hooked. He trains not simply because it is a job, but because it is so much a part of who he is. He’ll never amass a fortune running at the smaller tracks, but that was never his goal. If Bill Brashears is remembered as a trainer who worked his butt off and played by the rules and was an example to any trainer hoping to make a mark in racing  the right way, he will be satisfied.

What a lot of trainers, including Bill Brashears, are having trouble with is believing they could do everything what they thought was the right way, but have still been hit with medication positives. In Brashears case the offending drug was Banamine, a medication that has been used for years to help control inflammation.

Horses are athletes and they suffer from the same affflictions common to all athletes. It is nothing less than humane to treat horses with therapeutic medications, drugs that will provide comfort to the animals while they recuperate. What a therapeutic like Banamine doesn’t do is mask pain in a way that will allow a horse to run as if nothing is wrong. Ask any veterinarian – if you are trying to mask an injury, you would have to use a fairly strong narcotic not the equine equivalent of ibuprofen.

Again ask any veterinarian – inflammation is a natural process and it is critical for survival. It is defined as “a protective immunovascular response that involves immune cells, blood vessels, and molecular mediators. The purpose of inflammation is to eliminate the initial cause of cell injury, clear out necrotic cells and tissues damaged from the original insult and the inflammatory process, and to initiate tissue repair.”

The problem is that often this process becomes excessive, creating a vicious cycle and causing more tissue damage and pain than the injury itself might. Inflammation can produce different products, including prostaglandins and other inflammatory “mediators” that help bring about these effects.

According to Thal Equine Hospital in Santa Fe, NM, “This is where anti-inflammatory drugs are helpful. Their role is to dampen inflammation by reducing the formation of these mediators, and thus reducing the signs of disease (swelling, pain and fever, for example) while still allowing healing to take place.”

In other words, anti-inflammatory drugs are precisely what are indicated for certain conditions. One might even argue it is cruel not to give a horse with inflammation a medication.

Banamine belongs to a class of drugs known as non-steroidal anti-inflammatory drugs (“NSAIDS”), which includes familiar human drugs like aspirin and ibuprofen. They are drugs that have been used safely and effectively for decades. It is generally the veterinarian’s drug of choice for soft tissue inflammatory conditions (sore muscles) and is considered kinder to a horse’s stomach than phenylbutazone (bute) for treating joint swelling. Banamine is also a good choice for horses that have a tendency to tie-up. The Horsemen’s Benevolent and Protective Association has stated, “Class 4 or 5 therapeutic medications (mostly NSAID-type medications such as Phyenylbutazone) are used to ease the aches and pains of training – akin to a person taking an Advil before or after a competition. It will not make that individual run any faster or jump any higher than his or her natural ability to do so.

For those concerned about the welfare of the horse, NSAIDs, when used as prescribed, do not put a horse at substantially elevated risk of catastrophic injury.

So if you are a racing commissioner and you believe it is necessary to set a standard for Banamine, the question you should ask is straightforward: at what level is the analgesic benefit of Banamine essentially negligible? Whether or not Banamine might have some residual benefit to inflammation should be irrelevant, since good veterinary practice has already established that reductions in inflammation often speed healing. If a horse is not receiving an analgesic effect, it would be hard to argue the drug is performance enhancing. THAT is the level at which we should set the standard. Most vets and pharmacologists agree that any post-race level below 50ng/ml and a withdrawal time of 24-hours from administration will completely ensure elimination of the analgesic effect

Racing is governed for the most part by politically appointed boards and commissions. The commissions are not normally filled with experts on pharmacology, and they are often at the mercy of long-time administrators, people like Rick Arthur in California, Joe Gorajec in Indiana, and Dan Hartman in Colorado. These are the people who populate the Association of Racing Commissioners International (ARCI), a group on the record as calling for “the racing industry and member regulators to embrace a strategy to phase out drugs and medication in horse racing.” (ARCI Press Release March 28, 2011)

The chairman of the ARCI at the time of that press release? Dan Hartman, Executive Director of the Colorado Racing Commission. He becomes an integral part of Bill Brashears story.

In that press release Hartman is quoted as saying that “a five-year phase out [of Lasix] is reasonable to bring North American racing policies in line with what is going on in other parts of the world like Europe and Hong Kong.”

Hartman’s successor, William Koester, Chairman of the Ohio State Racing Commission, added, “Today over 99% of Thoroughbred racehorses and 70% of Standardbred racehorses have a needle stuck in them four hours before a race. That just does not pass the smell test with the public or anyone else except horse trainers who think it necessary to win a race. I’m sure the decision makers at the time meant well when these drugs were permitted, however this decision has forced our jurisdictions to juggle threshold levels as horseman become more desperate to win races and has given horse racing a black eye.

Koester’s statement is meant to inflame (no pun intended) by referencing needles stuck in horses, as if it was some willy-nilly attempt to torture helpless animals. When I was shadowing Doug O’Neill I watched his vet, Dr Ryan Patterson, administer a Lasix shot and if you had blinked you would have missed it. The horse had no negative reaction at all. Koester further pounds home the point that trainers are medicating their horses only to gain an advantage and win races, seemingly arguing they are not doing it to ensure the horse’s health is being managed so that it can race without distress. Not passing the smell test and black eye for racing are the justifications for trying to make all racing drug free. It reminds me of a quote from Arnold Glasow. “The fewer the facts, the stronger the opinion.” As long as administrators with the power to make the rules for racing insist the seamy underbelly of racing is legal therapeutic medication, it can become the facts.

The press release states that ARCI intends to move toward “enacting a policy of zero-tolerance.” (Note: Once Koester took over as chair, he quickly backed off that statement, stating the ARCI does not subscribe to a policy of zero-tolerance, but bear in mind it was Hartman who approved the press release.)

Hartman concludes, “We regulators are the only voice in racing for the animals and betting public. It’s time we raise the bar in service to both.

To reference the famous Pogo line, “We have met the enemy, and he is us.

I have already written about why we cannot be Hong Kong ( Basically, North America  runs more races in a week in August than Hong Kong’s entire racing year. To populate those races we need ten times the number of horses in training than Hong Kong does. How does North America compare with Dubai and its 23 racing days a year? I’ll go out on a limb and say if we were racing at a couple of tracks the equivalent of three weeks a year we could have Dubai’s drug policies too. Look at the standards for Europe or Australia. Other than Lasix, there is often not a significant difference between those jurisdictions and North America for therapeutics, and some threshold levels for therapeutic medications are even higher than the ARCI standards.

The upshot of the zero-tolerance Dan Hartman favors is almost certainly the demise of small tracks and reduced field size at the tracks that survive, incredibly ironic when one considers one of the small tracks that would suffer is Colorado’s own Arapahoe Park.

ARCI has relied on studies commissioned by the Racing Medication and Testing Consortium (RMTC) to establish post-race residual levels and recommended withdrawal times. In the case of Banamine (flunixin), a study done by Heather Kynch, Rick Sams, Rick Arthur, and Scott Stanley on how quickly flunixin was cleared in exercised horses provided the initial recommendation on which the flunixin standard was based.  They tested one model (called the sedentary model) in which four non-exercised horses were tested and it was determined a probable threshold level of 20 ng/mL with a withdrawal time of 24 hours. For those not familiar with the nanogram (ng) it is a billionth of a gram. However, subsequent testing using a racehorse model took 20 horses in training and determined exact plasma concentrations of Banamine, concluding that 99% of horses would have less than 50 ng/mL, and thus recommended a threshold value of 50 ng/mL 24 hours after administration of the recommended dose.

If 20 sounds like a small number for testing animals to set a standard, according to the European Agency for the Evaluation of Medicinal Products study on the Evaluation of Medicines for Veterinary Use (2000), 19 is the minimum number of animals that need to be tested to conclude a 95% confdence level that 95% of the population will be below a respective standard.

Think about this for a minute. Like a lot of ARCI standards, the testing is not to determine at what level a medication stops being performance enhancing (or retarding) but at a level at which almost all horses would have cleared all but a residual amount of the medication by some time in the future. Remember, the ARCI objective as plainly stated by Dan Hartman in 2011 was to eventually rid thoroughbred racing of the scourge of “drugs and medication.”

It also points out something else that is critical when looking at new standards – the availability of new mass spectrometers that can measure ridiculously small amounts, even less than nanograms down to picograms – trillionths of a gram. As Dr. Steven Barker said to me once, “show me a lab measuring amounts in picograms and I’ll show you a lab with an expensive new machine they need to justify.”

Despite the RMTC study recommendation, the ARCI in April 2013 adopted the 20 ng/mL (with a recommended 24-hour withdrawal time) standard. It is critical to note that even at the time ARCI adopted the standard it was cast as a  “95/95 standard.” As noted above, this means there is a 95% level of confidence that 95% of the horses tested would fall below the standard. In plain terms, one in 20 horses would still be expected to fail a post-race test. By that measure, if a track tested the first and second place finishers of a ten race program, and they all had been given 10 cc’s of Banamine, at least one of them had a probability to come back over the standard.

Think about this. ARCI had a chance to adopt a standard (50 ng/mL) that would have all but guaranteed no undeserved positives and no performance enhancement, and instead picked a standard where non-pharmacologically merited violations would abound.

Dr. Steven Barker at LSU didn’t equivocate on the adoption of the original ARCI standard. “The Banamine standard is too high, and it is because ARCI didn’t pay any attention to pharmacologists. With the recommended dose, there is no analgesic effect 24 hours after administering Banamine.

So with Dan Hartman at the helm, Colorado adopted the ARCI therapeutic medication schedule of 20 ng/mL for Banamine and in March 2014 the Colorado Racing Commission staff and the track stewards had a meeting with the veterinarians who worked on track at Arapahoe Park. Dr. James Dysart, Bill Brashears’ veterinarian in Colorado, and a vet who has been practicing about as long as Bill Brashears has been training horses, was in attendance at that meeting and asked specifically about what treatment changes would be indicated in 2014. According to Dr. Dysart, he was clearly told, if you practice as you did last year there should be no problems. With regard to Banamine, in March Dr. Dysart was told 10 cc’s with a 24 hour withdrawal time would prevent positives.

So when it came to Banamine Dr. Dysart did exactly as he did the year before and by July Bill Brashears had three Banamine positives. There were six positives in all in Colorado and half belonged to Brashears.

I asked Dr. Dysart why there were not more positives, and based on his practice, he indicated many trainers had thrown in the towel and switched to bute. Whether the reason was the change in flunixin standard, cost or efficacy, trainers made the switch.

After Brashears was hit with the first Banamine positive, he and Dr. Dysart huddled and decided to drop the dosage by 20% to 8 cc’s and increase the withdrawal time closer to 25 hours. Amounts and times for all horses are documented on the medication sheets maintained by Dr. Dysart, and there is no disagreement that the  dose that was administered had sufficient withdrawal time based on the information Dr. Dysart was given in March. After Brashears had five horses test clean after the first positive, he figured they had found the right formula.

Unfortunately, this turned out not to be the case. Brashears was informed that two horses that raced about 10 days apart in July came back positive (both under 30 ng/mL), even after receiving the 8 cc dosage. Brashears had no way of adjusting dosage or withdrawal time for the third horse since the results of the testing for the second horse had not yet been given to him. In fact, Brashears was informed of the last two violations at the same time, well after he could have made a further adjustment. Based on that Brashears expected the second and third violations to be combined into one.

Until he was given notice of the last two positives, Brashears sensibly was given a warning after the first violation, made a documented adjustment in an effort to comply, and as far as he could see had success with the new protocol, so he stuck with it, not realizing at 20 ng/mL he was still in danger of a violation.

Meanwhile something interesting happened at the RMTC. The high number of Banamine positives in different jurisdictions in 2013 caused them to reexamine the 20 ng/mL standard ARCI had adopted. Remember, the initial RMTC testing suggested 50 ng/ml would ensure 99% of the horses treated appropriately would test negative, and at best with the 20 ng/mL standard ARCI adopted we would still expect 5% positives. It turned out the reality was alarmingly beyond 5% positives.

RMTC then did another study that included 16 horses (less than the 19 required for statistical validity) that were exercised under laboratory conditions, and four (25%) of the 16 showed residual levels over 20 ng/mL after 24 hours. But, given the umbilical tie between ARCI and the RMTC, rather than suggest the standard was wrong, it was determined the withdrawal time was too short. In fact, the subsequent RMTC study concluded at least 32 hours was required to maintain 95/95 compliance with a 20 ng/mL.

In April 2014 ARCI revised the recommended withdrawal time for flunixin a mere year after originally adopting it, but left the 20 ng/mL in place.

This was a critical conclusion because changing the withdrawal time instead of the residual standard ultimately would have the effect of eliminating the therapeutic value of Banamine. At 24 hours the analgesic effect is essentially gone, and approaching 32 hours really limits the anti-inflammatory effect. In other words, this could be seen as an indirect way to ban Banamine consistent with the ARCI stated goal. This was also critical because the ARCI standard was not actually either 20 ng/mL or 32 hours, it was simply 20 ng/mL. Regardless of when Banamine is administered, 24 hours or 32 hours, if the level is over 20 ng/mL the horse is in violation.

According to Dr. Dysart, veterinarians in Colorado were not told the recommended withdrawal time had changed to 32 hours until July. Since the 32 hours was nothing more than a recommendation, there was no need to provide notification of rulemaking. That would only be necessary if the standard was proposed for revision.

The new recommendation came too late for Brashears though. He had to hope the Colorado Racing Commission saw that he and his vet had done everything the Commission assured them would maintain compliance and be lenient with their punishment.

Brashears asked for split samples to be tested for the second and third violations, and both confirmed he was over the 20 ng/mL standard (but well below 50 ng/mL). Brashears appealed, resting his case on the fact that his veterinarian did exactly what he had done hundreds of times and was assured he could continue doing it before the season without risking a violation. In front of a hearing officer he lost and on he went to his final appeal to the Colorado Racing Commission.

Brashears’ attorney made the relevant arguments, and once the testimony and final arguments were completed the Commission voted on a motion to saddle Brashears with both the second and third violations as separate events. One of the five commissioners was absent from the hearing, and the vote on the motion was 2-2, which normally would have been a win for Brashears. In a rare occurrence, the Commission moved to go into executive session where they got the missing commissioner on the phone, and re-voted on the motion. When they came back Brashears had lost his appeal 5-0.

I asked Dan Hartman if this was a regular practice. He said no, but the Assistant Attorney General was consulted and opined it was a perfectly legal procedure. It was never clear exactly what happened to go from 2-2 to 5-0, but Brashears was ultimately assessed a $1,500 fine and 15 days.

One of the people privy to the discussions in the executive session suggested that the Commissioners were advised that letting Brashears off the hook could leave them vulnerable to a subsequent action by Brashears. The concern was that it would essentially be an admission that Colorado had committed an error by leading the veterinarians to believe either historical protocols were sufficient for compliance or that a 24-hour withdrawal time indicated compliance.

Brashears is not new to the game, and he understood a violation, even if it is for a bad standard, is a violation. Despite believing he had done nothing wrong, he was willing to bargain with the Commission, offering to pay a fine (less than the $1,500) if the days were waived. It appeared the Commission wanted nothing less than what Brashears was ultimately given.

Bill Brashears has paid an even higher price than the fine, the loss of purse money and the cost of an attorney. He’s lost clients. After all, owners don’t want to be associated with someone with a medication positive, regardless of the circumstances. He’s lost the ability to even make a living during his suspension. Most of all he’s lost some of his belief that if you do right by racing, racing will do right by you.

For Brashears part, he has sworn off racing again in Colorado. He is firm in his belief he didn’t cheat, and that he was the pawn in a bigger battle over medication in racing. In the end, Colorado not only will lose a long term trainer, but a guy who cares about his horses and about training them the right way. It’s hard to imagine this was a success for anyone.

I asked Bill Brashears what bothered him the most. He said, “What makes me the most upset is [Arapahoe Park General Manager] Bruce Seymore telling me at the first Commission meeting that he knew I was innocent but that they were going to hang me anyway. I believe Hartman knows I’m innocent but their grand plan of Colorado being medication free would go down the tank if their first experiment went so wrong. Spending thousands of dollars in attorney fees for their screw-up and I’m still doing 15 days and being fined $1,500 and the division [the Colorado Division of Racing] calling it trainer responsibility. Where’s their responsibility?”