Presentation to the Darley Flying Start Conference at Keadeen Hotel, Newbridge, Ireland
October 25th 2006

Liz Pathak

The “Milkshaking” Issue in North America

Hello Ladies and Gentlemen. Welcome to our conference and thank-you all for attending. My name is Elizabeth Pathak and today I will be discussing milkshaking in North America. To give you an introduction to the topic I’ll look at an incident in California that touches on many of the main issues in my presentation.

In the spring of 2004, the California Horse Racing board responded to widespread accusations among trainers of the occurrence of illegal race-day treatments by instituting random pre-race testing for “milkshakes”. The testing was implemented as a survey with no penalties for high levels. In early testing, ten percent of horses exceeded commonly used threshold limits. In December of 2004 legislation was put in place to ban milkshaking and penalties for positive tests were implemented.

In January of 2005 a horse trained by leading California trainer Jeff Mullins tested positive for sodium bicarbonate. He claimed the finding was a result of the horse’s feed program and claimed to “not be trying to beat the system”. As a penalty, any of his horses entered within 30 days of his positive result were required to stay in a detention barn for 24 hours before racing. His 28% win percentage dropped to 13%, a drop he claimed to be due to disruption in the routine of his horses. To his credit, his percentage returned to 22% by the end of the meet, including a win in the 2005 Santa Anita derby with Buzzard’s Bay without incurring another positive. Nonetheless, the press had a field day. To add to the controversy, Mullins drew fire for placing the blame on “All the addicts and idiots crying because they lost a $2 bet”, in a heated discussion with a reporter for the LA times. He also questioned the test results of top trainer Richard Mandella, citing a conflict of interest in his private vet sitting on the CHRB and overseeing testing. Despite his expressed regret for his comments and his claims that his statements were taken out of context, the damage was done. The NTRA Commissioner D G Van Clief commented that Mullins comments were inexcusable, stating, “Anybody realizes that horse racing depends on the bettor for its livelihood. As an industry, we do not overlook and we won’t forget our number one asset, which is our customer.” I can’t tell you if he was truly guilty, but reading through the sensationalistic media coverage two very different stories were presented both skewing the situation to one side or the other. The well-publicized incident cast a negative image on the sport in general.

Frank Lyons is an American based Irishman who is a commentator for TVG. He is a successful horseplayer and trainer, having won $22,513 in the Breeders’ Cup Ultra Pick Seven in 1995, on the same day he sent Desert Stormer out to win the Breeders’ Cup Sprint. He now owns horses, including, at the time 15% of the Irish bred Castledale, winner of the 2004 Santa Anita derby, trained by Mullins himself. He commented: “This guy is off….way, way off. Sometimes it is better to shut your mouth and let people think you are stupid than to remove your foot and remove all doubt. We should realize that without the fans, the sport wouldn’t exist. I think we are way too lenient against people who get caught. If you are going to blacken a sport, as far as I’m concerned, it’s goodbye. I’m the kind of guy that believes sport is almost ruined by the amount of medication they’re using these days. If you are going to tell me that we have to use this much medication to race, and remember this is the sport of kings, then I’m sorry, we have to race horses less. I firmly believe it should be a “hay, oats and water sport”; that’s what I grew up on, that’s how I remember it back in Ireland. If you keep pumping medications into these horses you’re only going to be breeding inferior racehorses to inferior racehorses and weakening the breed for generations to come.”

From that story, I’d like you note the varied opinion on milkshaking, the recent implementation of testing procedures, the claim that positive tests can occur innocently and the importance of the betting public and their perception of the sport; I will touch on these issues in my presentation.

Milkshaking is the common term for bicarbonate loading. It involves the administration of a buffering agent 3-5 hours pre-race. Sodium bicarbonate, or baking soda, is usually the main constituent, mixed with glucose and occasionally other additives. Mixed together it results in a frothy white concoction that is traditionally administered by tube as a stomach drench. Milkshaking increases the pH or alkalinity of the blood. This may, and note the may, enhance performance by increasing the buffering capacity of the blood, thereby decreasing the negative effects of lactic acid on skeletal muscle. Build up of lactic acid as a by-product of metabolism in muscle results in fatigue, cellular damage and post-exercise soreness. To give you a better understanding of the theory I am going to talk briefly about muscle and acid-base physiology.

Skeletal muscle is made up of bundles of muscle fibres. Muscle fibres are classified into two main types. Type two fibres are the predominant type in the thoroughbred. They are known as fast-contracting or fast-twitch fibres. They burn up fuel quickly and therefore fatigue rapidly. They are used for high speed or high intensity work. Type two muscle fibres produce most of their energy anaerobically, or without oxygen. Lactic acid is a by-product of this process and its build-up in the muscles can contribute to their fatigue. Maintenance of acid base balance within the body is very important. pH is a measure of acidity. The normal pH of blood is 7.4. The pH of blood can drop to as low as 6.8 immediately following exercise due to the production of lactic acid. Compensatory measures within the body act quickly to return the pH to a normal level.

The kidney and lungs play a role in the regulation of body pH but the most important immediate control is achieved using buffer systems. The carbonic acid-sodium bicarbonate buffer pair is the most important buffer pair in the blood. Due to the huge production of lactic acid by muscles in high speed work, there is not enough sodium bicarbonate present naturally in the blood to neutralize it all. Hence anything done to increase the amount of sodium bicarbonate in the blood, such as milkshaking, can act to minimize changes in blood pH and encourage efflux of lactic acid from the muscle into the blood where it can be neutralized, potentially improving performance and decreasing muscle damage.

Although the theory behind milkshaking sounds good and the administration of sodium bicarbonate does induce a metabolic alkalosis, its effects on performance in the thoroughbred racehorse are unclear. Based the physiological principles I just explained to you it makes sense that anything done to decrease the build-up of lactic acid or neutralize its detrimental effects should delay the fatigue process and allow a horse to run longer or at least maintain a maximum speed for a longer period of time. Despite the logic of this theory, there has been difficulty proving its efficacy in the racing thoroughbred. There has been significant research into the matter with conflicting results. Some studies show an increase in time to fatigue and an improvement in racetimes while others show no beneficial effects. The effects are not consistent and all horses may not benefit. It may be that horses that are over trained or under trained gain the most benefit while those that are well trained, with attention paid to scientific methods would benefit little from the procedure. A limitation to the existing studies is a lack of quality controlled research in real performance situations. These studies are difficult to perform due to the expense of getting statistically relevant numbers of racing thoroughbreds to use as candidates. The potential benefits of milkshaking are mainly found with exercise durations of longer than two minutes. A great number of thoroughbred races are completed before the benefits would be seen. For this reason, the procedure is thought to have more benefit in the racing standardbred, where it was initially used. Lactic acid build-up is also more significant to them because of their increased warm-up and same day heats.

Because of its increased benefit and widespread use in the Standardbred industry, testing measures for bicarbonate have been in place for longer than in the thoroughbred industry. There has been a recent push within the thoroughbred industry in North America for increased testing. Without proven ergogenic benefits, one might question the necessity of testing. Is it a waste of resources to test for something that has negligible negative side effects on the horse health and very questionable performance enhancing capabilities? The push for increased testing is more likely rooted in a desire to preserve an air of integrity for the betting public. If public perception is that milkshaking is cheating, then measures have to be in place to discourage it. I think the issue may be more of a showcase to demonstrate the industries desire to ensure a level playing field and protect bettors, an issue grounded in perception rather than scientific fact. Another reason to test is the potential masking effects of bicarbonate loading on the detection of other banned substances. Again, its impact on drug testing is unclear. Current information on the topic is conflicting though theoretically it could have an impact on the detection of certain drugs. Bicarbonate loading is banned in all 43 racing states. From 2004 to present implementation of testing has occurred in Arkansas, Illinois, Arizona, California, Kentucky, Louisiana and New York.

With Ontario’s significant standardbred industry, testing for bicarbonate has been in place for longer than many jurisdictions in the states. Milkshaking in harness racing in Ontario was first detected in 1989. The Ontario Racing Commission regulates both standardbred and thoroughbred racing in Ontario. Rules were implemented in 1992 on a track by track basis and in 1999 province wide testing was brought into place. The ORC requires 24 samples per race day selected randomly and drawn 35 minutes pre-race. The samples are sent to an approved lab for total carbon dioxide analysis. From 1999-2003, there were 44 positives detected from over 100,000 samples. Bicarbonate is classified as a Class three drug on a scale of 1-5, with a first offence penalty of $1500-$2000 and a 45-60 day suspension.

The protection of horsemen within the industry must be considered alongside the protection of the betting public and fans. Current testing procedures vary from jurisdiction to jurisdiction and the majority could be improved to decrease the number of innocent positives. Along with the variation in testing procedures comes a variation in penalties and they can be quite severe in some states. Acid-base physiology is complex and compensatory changes further complicate things. Furthermore, there is a variety of other factors that could potentially innocently raise TCO2 levels over the set threshold level. These include: the cyclical rise and fall of an individual’s TCO2 levels and potential increases associated with changes in ambient temperature, pre-race exercise, the administration of Furosemide, sweating, dehydration, decreased renal or respiratory function, anaemia, diet and other supplements. The current trend of testing a single variable, TCO2, ignores the science behind acid-base regulation.

Testing methods exist which would decrease the number of false positives. With the availability of the technology and expertise to more accurately test for administration of alkalinizing agents there is no excuse for jeopardizing the careers of the horsemen. If these measures were put in place, we could be more confident in penalizing those truly guilty of cheating and protect innocent individuals. I also feel that testing methods and penalties should be standardized across North America. The racing medication and testing consortium is working towards this with a mandate “to develop, promote and coordinate at the national level, policies, research and educational programs which seek to ensure fairness and integrity of racing and the health and welfare of racehorses and participants, and protect the interest of the betting public.” Their ability to accomplish this goal relies on the voluntary acceptance of their suggestions by the various racing jurisdictions.

The answer to the question of whether or not we should be testing is complicated. I think that the previously discussed issues with testing need to be resolved with uniform testing, uniform penalties and research into and implementation of more reliable methods of testing. The question of whether or not bicarbonate loading actually enhances performance also needs to be answered. The racing medication and testing consortium made a call in 2004 for projects investigating the effects of and best methods for forensic control of bicarbonate loading in the thoroughbred. The projects were asked to simulate raceday conditions as much as possible. To date, no acceptable projects have been put forward to receive a grant from the RMTC.

The basic question of whether or not bicarbonate loading should be allowed revolves around the controversial issue of the use of performance enhancing measures in racing. There is a continuum of performance enhancement from improved diet and training methods through supplementation and medication. The diet has progressed since domestication from strictly forage to the feeding of higher energy products and supplements with the hope of improving performance. What of these practices should we consider as ergogenic aids and where should the line be drawn in banning them? Is it right to single out alkalinizing agents as an enforceable prohibited substance while legalizing the use of Furosemide which has proven performance enhancing capabilities likely not associated with its intended use as an anti-bleeding medication. A consensus needs to be reached on which is more important, the improvement of performance through ergogenic aids or through genetics and whether or not the two are mutually exclusive. In as far as I can tell, the main reason behind bicarbonate testing at the moment is the preservation of the idea that the integrity of the sport is being protected so that the betting public and fans have a product they can rely on. This is a very valid reason, but maybe we should be focussing more on debunking myths, anecdote and rumours throughout the industry through the use and dispersal of valid concrete fact.

The take home message I want to leave you all with today after my presentation on the milkshaking issue in North America is not, does it work, should we test for it, should it be allowed because I don’t have the answers to these questions. I want to demonstrate how one seemingly simple topic generates not only these specific questions within it, but an infinite number of other questions leading from it. While I was researching the topic I was constantly being drawn down different related but diverging lines of research from genetic strengthening of the breed to nutritional manipulation of performance to the performance enhancing capabilities of Furosemide to regulatory issue; the list is endless. So the thought I want you to take away with you is how we can work together within the thoroughbred industry as an international community to look for the answers to these questions through quality research and then use that research to come up with further questions. I want you to think of how that information can best be dispersed throughout and accepted within industry and how we can work together to investigate the problems and strengths within our individual communities and develop common goals internationally for the betterment of the breed and the sport. Thank you all for your attention.

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