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Stomach Tubing Article By Vet

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    Posted: 10 Nov 2012 at 6:22pm
From The Age:

OVER recent weeks there have been two episodes where trainers involved in the spring carnival have been caught with a horse stomach tube on raceday. Some of the racing public will wonder what all the fuss is about, while others will wonder what, exactly, a stomach tube is.

A horse stomach tube is a time-honoured piece of veterinary equipment - it is very similar in size and diameter to a two-metre length of normal garden hose.

The horse has a peculiar throat anatomy, which allows a veterinarian to pass a stomach tube up the horse's nose and then down into the horse's stomach. There is no gag reflex, horses tolerate this very well and it is normally done in a standing, conscious horse with minimal restraint.

Howmuchdoyouloveme is at the centre of an adjourned inquiry into stomach tubing.

Howmuchdoyouloveme is at the centre of an adjourned inquiry into stomach tubing. Photo: Pat Scala

Once the tube is in the horse's stomach, medications can be administered through the tube directly into the stomach, then into the small intestine from where they are absorbed into the bloodstream. So a horse stomach tube is a delivery system for oral medications.

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Normally, when horses are treated with oral medications such as powders, they are mixed in with feed and the effectiveness of the medication is totally dependent on the horse eating the treated feed. It's a hit-and-miss approach, as many racehorses are fussy and finicky eaters.

In contrast, the stomach tube offers the horse veterinarian a reliable and predictable way to administer oral medications. Oral drugs are absorbed by the intestines and taken to the target organ by the blood in just the same way as drugs given intravenously (IV) or intramuscularly - the only difference is that oral drugs are absorbed slowly and may take one to two hours to reach peak blood levels, as opposed to the almost immediate effect of an IV injection.

How stomach tubing is performed on a horse.

How stomach tubing is performed on a horse. Photo: Supplied

The stomach tube is an integral part of horse veterinarians' equipment and it is vital in treating serious and life-threatening conditions such as colic. But when one understands its specific purpose, it has no place out of the veterinarians' hands and its possession or use on raceday has sinister overtones.

Historically, the use of a stomach tube on raceday can be linked to harness racing, where the term “milkshake” was coined. This describes when a horse is stomach tubed and drenched with a concentrated solution of bicarbonate in the hours preceding a race. The procedure was obviously developed by someone with a good understanding of exercise physiology. We know that when a horse is racing in distance events and using aerobic metabolism, the byproduct of exercise in the muscles is lactic acid.

Furthermore, the build-up of lactic acid causes the onset of muscle fatigue and then there is a loss or decrease in performance. In simple terms bicarbonate is a buffer - it neutralises the lactic acid so that the build-up and accompanying muscle fatigue is delayed or postponed, allowing the horse to keep running faster for longer.

The use of the common kitchen ingredient bicarb of soda in a racehorse also takes on sinister connotations because its use in this manner before a race is purely an attempt to improve performance and influence the race result.

This was recognised by racing authorities around the world in the late '80s and early '90s, which led to the introduction of rules to combat bicarb doping. There was an extra concern for racing authorities as bicarb affects the PH of urine and thereby affects the detection of some drugs in urine - so there was concern that quite apart from its affect on performance, the bicarb might be being used as a masking agent for other drugs.

In the early '90s a measure for bicarb - total carbon dioxide (TC02) - was introduced with a threshold level. Bicarb and other buffers are normally present in the body as part of the body's acid-base regulation. As these buffers occur naturally there was a need for racing authorities to develop threshold levels to differentiate the normal horse from the “doped” or treated horse.

The threshold level is currently 36mmol/litre of blood; when the TC02 levels exceed this, the racing authorities regard it as a positive swab and an inquiry follows. The possibility of a horse naturally achieving a level 36 or higher without administration is one in 2 million. In addition, one needs to understand that the body tightly regulates acid-base balance and will resist wide fluctuations. The TC02 range in a normal horse is 28-32, with an average of 30.

In addition to setting a threshold, racing authorities also introduced a rule which prohibited the use of a stomach tube in the 24-hour period preceding a race.

Again this rule had a scientific premise in its development. We know that when a horse is stomach-tubed with a buffering agent such as bicarb, there is delayed absorption with a peak of blood levels after about six hours, and that the levels return to normal after about 12?hours. Therefore, if the horse was not stomach tubed for the 24?hours preceding a race - bicarb doping would be stamped out. To enforce the TC02 thresholds and deter bicarb doping, racehorses are blood tested when they arrive on course or as close to race time as possible. But there is concern that if a horse is drenched or doped with bicarb just before the blood test, then there is not enough time for the bicarb to be absorbed by the body, the TC02 levels will be under the detection thresholds, and people still can cheat.

Another approach to detect bicarb doping which has proved successful in Western Australia and overseas is the holding of horses and the collection of blood samples two hours after racing. This has been done because where bicarb has been administered there is a rebound effect one to two hours after racing, when TC02 levels climb above the threshold.

This system has provided regulators with the ability to detect clever bicarb doping, which is done very close to the pre-race test to beat detection. When the TC02 of a horse exceeds the threshold levels of 36, there are two possible charges that can be brought against the trainer. First, presenting a horse at the races with an elevated TC02 level or, second, administering an alkalising agent to a horse on raceday. Clearly, the second charge is much more serious. But, to date, most trainers charged in Victoria have been charged with the lesser offence of presenting a horse with elevated levels.

Although trainers in the past have only faced the lesser charge, a strong argument can be made on scientific grounds that an elevated TC02 above the threshold is prima-facie evidence that administration must have occurred.

This is because the threshold has been set so high that a normal horse could not naturally get above 36 and the elevated levels after administration return to normal quickly, within 8-12?hours. This means that defence arguments stating that nothing has been given or that it was given days ago are fanciful when one understands the science of TC02 and acid-base balance in the body.

Such arguments are akin to someone with a blood-alcohol reading of 0.10 claiming they only had one beer and that was two days ago.

Finally, there is a need to differentiate TC02 positive swabs from the positive swabs that arise from the detection of therapeutic medicines.

Most of the positive swabs in racing over the past 10 years have been to traces of commonly used therapeutic medicines. These have been attributed to mistakes in which horses were treated too close to the race, or they have been put down to improved detection and testing by drug laboratories - but in such cases there has been no intentional doping. In contrast, TC02 positives need to be considered, along with the other performance-enhancing drugs such as narcotics, EPO etc, because in the case of TC02 there is a conscious and deliberate attempt to enhance performance of the horse by doping and this cannot be tolerated by the industry.

Dr Glenn Robertson-Smith is the founding partner of the Melbourne Equine Veterinary Group. He is a specialist in equine surgery.


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Grinnersawinner View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grinnersawinner Quote  Post ReplyReply Direct Link To This Post Posted: 10 Nov 2012 at 6:54pm
Good article and backs up many of the things I've been telling people on the forum for the last week.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Run For Fun Quote  Post ReplyReply Direct Link To This Post Posted: 10 Nov 2012 at 6:55pm
Good article from him Gay.
 
Pity it runs to several paras which means quite a few around here won't get past the first two sentences and therefore won't be prepared or able to offer an opinion.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote spinner Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:09pm
Originally posted by Run For Fun Run For Fun wrote:

Good article from him Gay.
 
Pity it runs to several paras which means quite a few around here won't get past the first two sentences and therefore won't be prepared or able to offer an opinion.


what do you call that sort of post Confused when you dont seem to be offering an opinion yourself ?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Run For Fun Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:26pm
Well Spinner I suggested it was a good article, so there's an opinion of sorts.
 
ps you manage to get beyond the second sentence? Wink
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Gay3 Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:27pm
I think the opinion offered was that it's a good article, worth reading in full Smile
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pazman Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:27pm
Though the tube went in the other end, thanks for clearing it up Gay.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Quezacotl Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:35pm
Tubing is not the only way of course..there are injections, but these are hard to hide, there is another way similar to drenching...

Large plastic syringes capable of holding 500ml of liquid can be squirted into the throat of the horse whilst twitched, head held up, neck rubbed, repeat...have seen this used in the flesh..a plastic syringe is a lot easier to hide than funnels, tubes and buckets...
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Post Options Post Options   Thanks (0) Thanks(0)   Quote spinner Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:45pm
Originally posted by Run For Fun Run For Fun wrote:

Well Spinner I suggested it was a good article, so there's an opinion of sorts.
 
ps you manage to get beyond the second sentence? Wink


i got to the third Wink thanks 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Grinnersawinner Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 12:57pm
Originally posted by Quezacotl Quezacotl wrote:

Tubing is not the only way of course..there are injections, but these are hard to hide, there is another way similar to drenching...

Large plastic syringes capable of holding 500ml of liquid can be squirted into the throat of the horse whilst twitched, head held up, neck rubbed, repeat...have seen this used in the flesh..a plastic syringe is a lot easier to hide than funnels, tubes and buckets...

Well yeah, you can put molasses, cough medicines, electrolytes in syringes as well, but the horse just won't eat/drink some gelati hence you need to tube.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Run For Fun Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 1:00pm
Originally posted by spinner spinner wrote:

Originally posted by Run For Fun Run For Fun wrote:

Well Spinner I suggested it was a good article, so there's an opinion of sorts.  ps you manage to get beyond the second sentence? Wink
 
i got to the third Wink thanks 
 
LOLLOL
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HUSSLER Quote  Post ReplyReply Direct Link To This Post Posted: 12 Nov 2012 at 1:47pm
Looks like a beer bong to my eyes
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