SHINING LIGHT ON THE HORSE INDUSTRY

Many racing fans may have negative associations with the drug stanozolol, or Winstrol as it was known years ago. Stanozolol is an anabolic steroid that largely entered the racing public's consciousness in 2008 when Big Brown trainer Rick Dutrow told a reporter off-handedly that the Kentucky Derby and Preakness winner received the drug monthly, sparking a debate about whether anabolic steroids should be permitted in racehorses.

Medication regulation has changed considerably since 2008, and systemic use of anabolic steroids is significantly reduced as a result of current rules.

But according to a presentation at the recent annual convention of the American Association of Equine Practitioners, it's possible the drug could have a purpose besides improving performance through increased appetite and muscle acquisition.

Dr. Scott McClure, veterinarian at Midwest Equine Surgery and Sports Medicine, presented an overview of the drug's use intra-articularly for certain types of joint conditions.

There have been several academic studies conducted on intra-articular stanozolol use through the years, some of it in vivo and some of it in living horses. It's thought the drug reduces inflammatory processes and stimulates the production of local growth factors that improve joint health.

A 2012 study of 60 horses with lameness that had not responded to other treatments found no adverse reactions and improvement in 39% of cases treated with stanozolol joint injections. Another study examined the use of weekly intra-articular stanozolol use in horses with acute and chronic osteoarthritis. In that one, 15 of 21 horses in the acute arthritis group rated 0/5 on the AAEP lameness scale after 21 days of treatment, while seven of 19 horses with chronic arthritis were at 0/5 after 35 days of treatment.

McClure said in his anecdotal experience, the drug can be useful in dealing with osteochondral defects in young horses, including subchondral cysts of the media femoral condyle, meniscal injuries, and racehorses with palmar or plantar osteochondral disease.

There are a number of cautions that go along with the drug's use in a joint, however.

First of all, McClure said, while he's had success with stanozolol, he doesn't consider it a magic bullet and its main purpose is not to cover up pain.

“You still need to be aware of what you're doing,” McClure said. “Your objective is healing. This is not a quick fix. Our objective with this is more to decrease inflammation and stimulate healing of the joint.”

The treatment should be used in conjunction with rest and rehabilitation.

It has been successfully paired with hyaluronic acid and antibiotics, but should not be paired with a corticosteroid, as that would likely inhibit the anabolic pathways that make the stanozolol work in the joint.

Secondly, there is no Food and Drug Administration-approved version of equine stanozolol being produced in this country. There are approved manufacturers in Europe, and compounding pharmacies do make the drug here. McClure cautioned that veterinarians need to be sure they're using micronized stanozolol. Micronized suspensions have smaller particle sizes that are less likely to negatively impact the joint's interior.

Veterinarians should be aware that the use of a non-FDA-approved drug may negate the coverage of their malpractice insurance in specific cases, as most policies will not protect the vet from negative outcomes if an unapproved drug has been used. McClure said he doesn't worry too much about this in his practice, and has established relationships with pharmacies he considers reputable for purchasing the drug.

Of course, the obvious complication is the drug's use in performance horses. Stanozolol has been the cause of drug positives in racehorses internationally, and it is banned by the Federation Equestre Internationale, and prohibited by the United States Equestrian Federation. Those cases are thought to have happened due to systemic introduction, not use in a joint.

“There is one publication that shows the five milligrams in the tarsocrural joint will be absorbed in the synovial membrane fairly quickly,” said McClure. “What is found in the systemic circulation comes and goes rapidly and was not detectable at 36 hours. So it is very short-lived.”

So far, research would suggest that if it's confined to the joint, the drug is not likely to circulate throughout the body in blood for very long. However, injection technique or the use of other therapies can change this, as can the particle size of the preparation and overall joint health.

“If you put this in the wrong horse and get a positive test, it's on you,” said McClure. “Do not reach for a bottle of stanozolol because you're out of Depo (Medrol) or triamcinolone. That is not the right move.”

EquiSport Photos (Matt and Wendy Wooley)

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