Therapeutic Medication Addendum

(Does not apply if prohibited by governmental regulations)

Exhibitors, owners, trainers and veterinarians are cautioned against the use of medicinal preparations, tonics, pastes and products of any kind, the ingredients and quantitative analysis of which are not specifically known, as many of them may contain a forbidden substance.

A. Forbidden drugs or substances:

1. i. Any drug or substance considered a Class I or Class II substance as defined in the most recent edition of ARCI's Uniform Classification Guidelines for Foreign Substances.
2. ii. Any stimulant, depressant, tranquilizer or sedative which could affect the performance of a horse (stimulants and depressants are defined as substances that stimulate or depress the cardiovascular, respiratory or central nervous system).
3. iii. Any substance, regardless of how harmless or innocuous it might be, that might interfere with the detection or quantitation of any substance defined in (i)(ii) or (iii).
4. iv. Any anabolic steroid in halter classes, section (b) below does not apply.
5. v. Any nonsteroidal anti-inflammatory drug (NSAID) other than those listed in section (c)(iii)(1-8) below.
6. vi. Any metabolite and/or analog of any of the above described forbidden drugs or substances.

B. Conditionally permitted therapeutic medication: Any drug, medication or substance that could affect the performance of a horse that is used for the legitimate treatment of illness or injury and is not specified as a forbidden substance as defined in sections (a)(i) or (a)(v) above. However, these drugs or substances are forbidden and use thereof subjects the person to disciplinary action, unless all conditions of their administration are met. Each of the following requirements is a condition to authorize administration of conditionally permitted therapeutic medications, which shall be verified in a written medication report to be attached to the health paper of the horse, and filed with show

1. i. Administration by a veterinarian who is licensed to practice veterinary medicine in the state, province or country where the event is being held ("Licensed Veterinarian") or from a written prescription (written instructions) by a Licensed Veterinarian which documents administration of medication is necessary for the legitimate treatment of illness or injury. The administration of a conditionally permitted therapeutic medication for the purpose of transport, grooming, training, etc. is not therapeutic under this authorization rule.
2. ii. The horse must be withdrawn and kept out of competition for not less than 24 hours after the medication is administered.
3. iii. Written Medication Report should include the following:
   1. 1. Identification of the medication: the name, amount, strength/concentration and mode of administration.
   2. 2. Date and time of administration or prescription.
   3. 3. Identification of the horse: name, age, and sex. 
   4. 4. Diagnosis of illness/injury, reason for administration, and name of administering and/or prescribing veterinarian. 
   5. 5. Signature of veterinarian or person administering the medication. If by prescription (written instructions), a copy must be attached to the medication report. 
   6. 6. The medication report must be filed with show management within one hour after administration of the medication or one hour after show management is available, if administration occurs at a time other than during competition hours. 
   7. 7. While the medication report must be filed only if the administered medication will be present in amounts detectable in blood and/or urine samples at the time of competition/sampling, exhibitors are hereby cautioned it is their responsibility to determine whether or not such medication has had time to clear the horse's system. IF THERE IS ANY DOUBT, A MEDICATION REPORT SHOULD BE FILED. 
   8. 8. Regardless of whether the medication report requirements­ described above are met, laboratory detection of concentration levels of an otherwise conditionally permitted therapeutic drug that are inconsistent with the administration of a therapeutic dosage of such drug (including, but not limited to, inconsistencies regarding reported dosage and time constraints) shall constitute presumption of a violation of this rule, and the responsible party has the burden of persuasion to establish that the drug was administered in a therapeutic dosage and not less than 24 hours prior to competition.
4. iv. Regardless of whether all of the conditionally permitted therapeutic medication requirements listed in section 13.b. are met, it shall be considered a rule violation if the same plasma or urine sample contains more than one (1) of the permitted NSAIDs listed in section (c)(iii)(1-8) below.

C. Restrictions concerning the use of conditionally permitted therapeutic medications that may be administered within 24 hours of showing:

1. a. Subject to the specified restrictions, only those thirteen (13) drugs or medications listed in section (c)(iii)(1-13) below may be administered within 24 hours of showing. The provisions in (c)(iii)(1-13) below contain rules concerning maximum allowable plasma concentration levels followed by "Guidelines". The Guidelines are applicable to most horses. Nevertheless, reliance upon the Guidelines does not guarantee compliance with the rules, since the response of individual horses may vary. Exhibitors, owners, and trainers should consult the drug manufacturer and knowledgeable veterinarians for up-to-date information and more specific advice concerning the therapeutic use of a drug or medication for a particular horse. The guidelines, if needed, will minimize the chances of positive drug tests. However, all responsible parties are cautioned that the guidelines are only general guidelines, and it is their responsibility to see to it that conditions prevail for full compliance with all nebraska 4-H horse rules. Reliance upon the guidelines will not serve as a defense to a charge of violation of the rule in the event of a positive drug test.   Should the testing laboratory report the presence of one of the drugs or medications listed in section (c)(iii)(1-13) below in an amount greater than what would be consistent with the Guidelines or at a level higher than a specified maximum permitted plasma concentration, the matter will be reviewed and disciplinary action may be taken.
2. b. Regardless of whether all of the conditionally permitted therapeutic medication requirements for a specific NSAID listed in section (c)(iii)(1-8) below are met, it shall be considered a rule violation if the same plasma or urine sample contains more than one (1) of the NSAIDs listed in section (c)(iii)(1-8) below.
3. c. Only those thirteen (13) drugs or medications listed in section (c)(iii)(1-13) below may be administered within 24 hours of showing:
   1. 1. Phenylbutazone (an NSAID) — The maximum permitted plasma concentration of phenylbutazone is 15.0 micrograms per milliliter. Guidelines: When phenylbutazone is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 2.0 milligrams per pound of body weight should be administered, preferably less. For a 1,000 pound animal, the maximum daily dose is 2.0 grams, which equals two 1.0 gram tablets, or two 1.0 gram units of paste, or 10.0 cc of the injectable (200 milligrams per milliliter). Neither a total daily dose nor part of an injectable dose should be administered during the 12 hours prior to competing. In the event the phenylbutazone is administered orally, half of the maximum daily dose (1.0 gram per 1,000 lbs) can be administered each 12 hours (i.e., 12 hours apart) during a five day treatment program even if such oral administration occurs within 12 hours of competition. Phenylbutazone should not be used for more than five successive days. 
   2. 2. Diclofenac (Surpass) (an NSAID) — The maximum permitted plasma concentration of Diclofenac (Surpass) is 0.005 micrograms per milliliter. Guidelines: Every 12 hours, not more than 73 mg of diclofenac liposomal cream should be administered (not more than 146 mg per 24 hour period) to one affected site. This 73 mg dose equals a 5-inch ribbon of cream not greater than 1/2 inch in width, which should be rubbed thoroughly into the hair over the joint or affected site using gloved hands. Administration of diclofenac cream should be discontinued 12 hours prior to competing. Do not apply diclofenac cream in combination with any other topical preparations including DMSO, nitrofurazone or liniments, and do not use on an open wound. Diclofenac cream should not be administered for more than 10 successive days. 
   3. 3. Flunixin (an NSAID) — The maximum permitted plasma concentration of Flunixin is 1.0 microgram per milliliter. Guidelines: When Flunixin Meglumine (Banamine®) is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 0.5 milligrams per pound of body weight should be administered. For a 1,000 pound animal, the maximum daily dose is 500 milligrams, which equals two 250 milligram packets of granules, or one 500 milligram packet of granules, or 500 milligrams of the oral paste (available in 1,500 milligram dose syringes), or 10.0 cc of the injectable (50 milligrams per milliliter). No part of a dose should be administered during the twelve (12) hours prior to competing. Any medicated feed must be consumed and/or removed at least twelve (12) hours prior to competing. The medication should not be used for more than five successive days. 
   4. 4. Ketoprofen (an NSAID) — The maximum permitted plasma concentration of Ketoprofen is 40.0 nanograms per milliliter. Guidelines: When Ketoprofen (Ketofen®) is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 1.0 milligram per pound of body weight should be administered. For a 1,000 pound animal, the maximum daily dose is 1.0 gram, which equals 10.0 cc of the injectable (100 milligrams per milliliter). No part of a dose should be administered during the twelve (12) hours prior to competing. The medication should not be used for more than five successive days.
   5. 5. Meclofenamic Acid (an NSAID) — The maximum permitted plasma concentration of Meclofenamic Acid (Arquel®) is 2.5 micrograms per milliliter. Guidelines: When Meclofenamic Acid is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 12 hours, not more than 0.5 milligram per pound of body weight should be administered, preferably less. For a 1,000 pound animal, the maximum 12 hour dose is 0.5 gram, which equals one 500 milligram packet of granules. The medication should not be used for more than five successive days. 
   6. 6. Naproxen (an NSAID) — The maximum permitted plasma concentration of Naproxen is 40.0 micrograms per milliliter. Guidelines: When Naproxen is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 4.0 milligrams per pound of body weight should be administered. For a 1,000 pound animal, the maximum daily dose is 4.0 grams, which equals eight 500 milligram tablets. No part of a dose should be administered during the twelve (12) hours prior to competing. Any medicated feed should be consumed and/or removed at least twelve (12) hours prior to competing. The medication should not be used for more than five successive days. 
   7. 7. Firocoxib (Equioxx) (an NSAID) — The maximum permitted plasma concentration of Firocoxib (Equioxx) is 0.240 micrograms per milliliter. Guidelines: When Firocoxib (Equioxx) is administered, the dose should be accurately calculated according to the actual weight of the animal. For a 1,000 pound animal, the maximum daily does is 45.5 milligrams, which equals 0.1 milligram per kilogram of body weight once daily. No part of a dose should be administered during the 12 hours prior to competition. Firocoxib (Equioxx) should not be administered for more than 14 successive days. 
   8. 8. Acetazolamide — may only be administered to horses documented through DNA testing to be positive (N/H or H/H) for HYPP (Hyperkalemic Periodic Paralysis). While these rules do not contain a maximum allowable plasma concentration level for Acetazolamide, laboratory detection of levels of Acetazolamide that are not consistent with administration in accordance with the following Guidelines may result in prosecution of a rule violation. Guidelines: When acetazolamide is administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 3 milligrams per pound of body weight should be administered. For a 1000 pound animal, the maximum daily dose is 3 grams. 
   9. 9. Furosemide or Lasix® — When used must be administered intravenously at least four hours prior to competition. 
   10. 10. Isoxsuprine — Guidelines: When administered, the dose should be accurately calculated according to the actual weight of the animal. Each 24 hours, not more than 1.6 milligrams per pound of body weight should be administered (usually divided in two equal doses given 12 hours apart). For a 1,000 pound animal, the maximum daily dose is 1,600 milligrams, which equals 80 20-milligram tablets. No part of a dose should be administered during the four hours prior to competing. Any medicated feed should be consumed and/or removed at least four hours prior to competing. 
   11. 11. Lidocaine/Mepivicaine — may only be used under actual observation of event management (or designated representative) and/or the official show veterinarian, either of which must sign the medication report form, to aid in the surgical repair of minor skin lacerations which, by their very nature, would not prevent the horse from competing following surgery. Medication report form must be filed with show management as required in section 2 above. 
   12. 12. Dexamethasone — The maximum permitted plasma concentration is 3.0 nanograms per milliliter at the time of competition. Guidelines: In order to help trainers, owners and their veterinarians achieve compliance with this rule in connection with the therapeutic use of dexamethasone, it should be administered in accordance­ with the guidelines below. These guidelines include several alternative scenarios for dose time and route of administration. Whenever dexamethasone is administered, the dose should be accurately calculated according to the actual weight of the animal. Alternative Number 1. (2.0 mg or less per 100 pounds IV or IM at 12 or more hours before competition). Each 24 hours, not more than 2.0 milligrams of dexamethasone injectable solution per 100 pounds of body weight should be administered intravenously or intramuscularly, preferably less. For a 1,000 pound animal, the maximum daily intravenous or intramuscular dose of dexamethasone injectable solution is 20.0 milligrams, which equals 5.0 milliliters of the injectable solution (4.0 milligrams per milliliter). No part of this dose should be administered during the 12 hours prior to competing. Dexamethasone should not be administered for more than five successive days. Alternative Number 2. (0.5 mg or less per 100 pounds IV at 6 or more hours before competition). Each 24 hours, not more than 0.5 milligram of dexamethasone injectable solution per 100 pounds of body weight should be administered intravenously, preferably less. For a 1,000 pound animal, the maximum daily intravenous dose of dexamethasone injectable solution is 5.0 milligrams, which equals 1.25 milliliters of the injectable solution (4.0 milligrams per milliliter). No part of this dose should be administered during the six hours prior to competing. Dexamethasone should not be administered for more than five successive days. Alternative Number 3. (1.0 mg or less per 100 pounds orally at 6 or more hours before competition). Each 24 hours, not more than 1.0 milligram of dexamethasone powder per 100 pounds of body weight should be administered orally, preferably less. For a 1,000 pound animal, the maximum daily oral dose of dexamethasone powder is 10.0 milligrams, which equals one packet of dexamethasone powder (10.0 milligrams per packet). No part of this dose should be administered during the 6 hours prior to competing. Any medicated feed should be either consumed or removed at least six (6) hours prior to competing. Dexamethasone should not be administered for more than five successive days. 
       1. a. Administration of these drugs does not require that the horse be withdrawn and kept out of competition for a period not less than 24 hours after the medication is administered, nor is there a requirement that a medication report be filed with show management, except when Lidocaine/Mepivicaine is used (see (12) on previous page).