Enhancing performance or giving a level playing field — what drug use is acceptable in equestrian sport?

In her new book Animals, Ethics and Us, vet and past president of the British Equine Veterinary Association Madeleine L.H. Campbell discusses the different ways that people use animals and the moral issues surrounding this.

In this second extract, she focuses on the use of drugs in animals used for sport…

The use of drugs is a matter of ethical concern in human as well as in equine sport. In human sport, the ban on performance-enhancing drugs relates primarily to society’s desire to see a “level playing field” of competition — partly out of a moral sense of fairness, but also because undisclosed use of performance-enhancing drugs can skew the betting market. “Ethics” in relation to human sport and the use of performance-enhancing drugs is largely a matter of sporting ethics, and fair play.

In the world of animal sport, ethics relating to the administration of performance-enhancing drugs does also relate to sporting ethics and unfair advantage, but it also has an additional dimension that relates to the possible short- and long-term effects of drug administration on the athlete’s health. Of course, taking performance-enhancing drugs such as anabolic steroids can have a detrimental effect on the health of a human athlete. One can debate how easy it is, for example, for a contracted member of a cycling team in which the use of performance-enhancing drugs is rife to refuse to take the drugs being condoned by his/her teammates and management. However, in general it is fair to say that human athletes have some choice at least about whether they take performance-enhancing drugs, and some understanding of the associated possible negative effects on their health, whereas animal athletes do not. That being so, there is something doubly ethically wrong about the administration of performance-enhancing drugs to animal athletes — first, it is cheating and against the rules, and, second, it may cause an unnecessary harm to health to which the animal has not consented.

There seems, therefore, to be a fairly straightforward argument that the use of performance-enhancing drugs is an abuse that should not be allowed in animal sport. However, the real situation is less clear-cut. One can certainly make an argument that the administration of drugs such as anabolic steroids is intended primarily for performance-enhancement, and has known detrimental effects on long-term health, and is therefore an abuse. However, it is not always so clear whether the administration of drugs to animal athletes is ethical or unethical. Take the example of omeprazole, a drug used to treat and prevent gastric ulceration in horses. The British Horseracing Authority does not allow the use of omeprazole during competition (although it does allow its use during training), whereas the Federation Equestrian Internationale (FEI) (which governs most non-racing equine sports) does allow the use of omeprazole during competition. Gastric ulceration is painful, and therefore constitutes a welfare issue. One would think that the ethical thing to do is to prevent horses that are prone to gastric ulcers from developing this painful condition by using omeprazole. However, gastric ulceration is also recognized as one possible cause of reduced athletic performance. Arguably, administering omeprazole enhances athletic performance in horses that would otherwise perform less well due to the effects of gastric ulceration. The use of painkillers during competition to improve the performance of animals with an underlying, performance-limiting lameness is not allowed. Is masking reduced performance caused by gastric ulceration actually any different from masking reduced performance caused by lameness? In terms of cheating, and sporting ethics, perhaps it is not — in which case the use of omeprazole should no more be allowed during competition than the use of painkillers. On the other hand, one could argue that by negating the performance-reducing effects of gastric ulceration, one is simply creating a fair competition by allowing the horse to compete on equal terms with other horses that are not suffering from gastric ulceration! This is an argument analogous to that which allows the use of certain drugs under “therapeutic use exemptions” in human sport. The use of corticosteroids and the bronchodilator Salbutamol by international cyclists provides recent high-profile examples. The use of the drugs is within the rules of sport, providing that the cyclists involved have a genuine medical need for them — for example, if they are asthmatic — and if a “therapeutic exemption” has consequently been granted by the World Anti-Doping Authority (WADA). In such a situation, it is argued, the drugs merely return the cyclists to the same physiological state as other cyclists who do not suffer from asthma, against whom they are competing. However, it may be that the drugs have positive effects on performance that go beyond a return to normal function, for example by enhancing the breakdown of adipose fat and improving the power:weight ratio. Thus, the potential for the system of therapeutic use exemptions to be exploited for competitive advantage clearly exists.

A not dissimilar situation exists in relation to the use of the synthetic progestagen, Altrenogest, in competition horses. Altrenogest can be used to suppress behavioural signs of oestrus (which are thought to interfere with competitive performance in some individuals) in mares. Its use for this purpose during competition is allowed by the FEI, providing that the use has been declared and a particular veterinary form completed, the rationale being that suppressing the undesirable behavioural signs of oestrus will allow the mares to compete on level terms with mares who are not affected by reproductive hormones, and with horses of all other sexes. However, Altrenogest has potentially anabolic and sedative effects, meaning that its use (in both female and male animals) under a therapeutic exemption system is open to abuse in much the same way as the use of corticosteroids and bronchodilators are in human athletes.

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The persuasiveness of the argument that drug use simply returns the animal athlete to normal function is somewhat dependent upon the disease the drug is masking. Very few of us would argue that the use of painkillers during competition should be allowed in order to enable horses with an underlying lameness to compete on equal terms with those who are not lame, even if we believe that omeprazole should be allowed to enable horses with gastric ulceration to compete on equal terms with those without ulceration. The basis of this ethical distinction lies in concerns about animal welfare, rather than sporting ethics. In welfare terms, there is an ethical difference between treating a competing horse with painkillers and treating it with omeprazole. The painkillers will mask the pain, but they will not treat the underlying injury/disease. Omeprazole, on the other hand, will reduce pain/discomfort, but its mechanism of action is such that it also has a beneficial effect in terms of reducing the occurrence of gastric ulcers. Furthermore, a horse competing on painkillers is quite likely to damage the injured leg more, whereas the use of omeprazole during competition is unlikely to result in an acute exacerbation of the gastric ulceration.

Even this argument, however, is not straightforward, as many of the contributing factors associated with gastric ulceration relate to the management of competition horses — being stabled for prolonged periods of time, eating a low-forage, high-concentrate diet, and travelling. Arguably, the use of omeprazole allows owners and trainers to mask the welfare effects of poor management, and the ethical thing to do would be to address those management issues rather than to administer drugs. However, some of the factors that induce gastric ulceration, particularly the stress associated with long-distance transportation, simply cannot be avoided if horses are to compete internationally. In that case, maybe it is more ethical to use omeprazole in horses prone to develop gastric ulceration as a result of transport stress than it is to leave them to suffer when a drug is available that could alleviate that suffering. On the other hand, maybe the ethical solution is simply not to compete horses internationally at all!

It is obvious from this example that, even in the apparently straight-forward matter of performance-enhancing drugs, it is difficult to draw definitive lines between what constitutes use and what constitutes abuse in animal sport.

Some minor edits have been made to the text where the original includes cross-references to other parts of the book or other sources.

Price: Animals, Ethics and Us can be purchased for £18.95 from 5m Publishing
Published by: 5m Publishing, 2019

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