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New York, for example, is reviewing its race-day medication policy.
"It's not proven either way, but it is an issue that has caused concern to a number of people who have seriously examined horse racing and the medication policy".
"What we really had was a situation where our doping medication policy was not wholly clear," Cooke said, "and it was relatively simple for those who invested time to understand it, but not entirely easy to understand coming for competitors and their advisers".
That is, unless the feds step in with a medication policy, mandate regulation and oversee its implementation.
The denominator consists of all patients for whom the medication policy should be followed; the numerator consists of the subgroup of patients in the denominator for whom the medication policy has not been followed.
The framework covers five areas in the development of palliative care: access to medication, policy, education, quality, and research [ 19].
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The Association of Racing Commissioners International, the sport's regulators, asked for a major overhaul of medication policies, including ending raceday medications like the diuretic furosemide, known as Lasix.
"The time has come to modify our medication policies to be consistent with international practices," said Tom Ludt, the Breeders' Cup chairman.
Dr. Anthony Stirk, the senior veterinary adviser to the British Horse Racing Authority, said that it would benefit American horsemen to get in step with the rest of the world, not only in medication policies but also in racing less frequently.
Horses are notoriously vulnerable to pharmaceutical manipulation, and these days with all the permissive medication policies, trainers and their veterinarians remain notoriously tempted to pursue every pharmaceutical ploy they can devise to move a horse up.
Even with the prohibition of steroids in the past year, the United States continues to have the world's loosest medication policies for thoroughbreds, and there is a growing concern within the veterinary community that overmedication — with drugs like corticosteroids, anti-inflammatories that can have dangerous consequences — and lax oversight have imperiled the safety and welfare of racehorses.
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