ELMONT, N.Y. – As top racing officials met behind closed doors on Tuesday at Belmont Park in an attempt to find common ground over the industry’s raceday use of furosemide to treat bleeding in the lungs, the question that remains is whether the therapeutic benefit of the drug outweighs its perception as a performance-enhancer. Even international horsemen, who routinely criticize the liberal use of the diuretic in the U.S. and Canada, acknowledge that furosemide, commonly known as Lasix, is an effective treatment. On Monday, in a series of public panel discussions on the first day of a two-day drug summit, horsemen, veterinarians, and regulators from the United Kingdom, Australia, Ireland, and South Africa all said they supported the use of the drug during training because of its ability to mitigate the impact of bleeding, a condition that affects all breeds of horses who exercise intensely. Several scientific papers have concluded that the drug is effective, including a 2009 study on horses racing in South Africa that is commonly cited by U.S. horsemen as a justification for the North American racing industry’s current policy. But the perception that the drug enhances performance is also backed up by studies showing that horses who compete on furosemide typically run faster and finish in the money more often than horses who are not administered the drug. The exact means by which the drug treats bleeding or enhances performance are unclear. Many U.S. horsemen contend that any effect is due only to the reduction in the amount of blood that leaks into a horse’s lungs from burst capillaries. In the opinion of most horsemen from international jurisdictions, however, the perception of performance-enhancement trumps any therapeutic benefit. “Once you introduce performance-enhancing drugs into a trainer’s arsenal, you really are asking from trouble, certainly from the betting public’s point of view,” said Dr. Treve Williams, a veterinarian in Australia. That perception is so strong in Hong Kong that trainers in the province’s highly regulated racing industry are prohibited from administering the drug during training, said Dr. Brian Stewart, the head of veterinary regulation for the Hong Kong Jockey Club. To allow Lasix during training would provide misleading information to handicappers who closely monitor morning workouts, Stewart contended. U.S. horsemen contend that even if the drug enhances performance, the policy that allows for its liberal use regardless of the severity of an individual horse’s bleeding provides for a level playing field by allowing all horses to benefit. The current policy was developed decades ago. John Kimmel, a New York-based trainer who is a former veterinarian, said on a Monday panel that resistance to a rollback in the use of furosemide stems in large part from a sense of helplessness. “There’s a lot of fear in the people in the trenches, among the trainers, about how to manage these horses if Lasix is taken away,” Kimmel said. “One of the real issues is that we have a generation of veterinarians, including myself, and [a generation] of our trainers, who’ve never really trained without furosemide,” said Dr. Rick Arthur, the equine medical director of the California Horse Racing Board. “We don’t know how to do it, and the unknown is difficult to undertake.” There is also fear that a ban on Lasix would lead to experimentation with other treatments that have dubious value but high costs, according to Dr. Scott Hay, a partner in an equine veterinary practice. “Lasix, to its benefit, has simplified a lot of these treatments,” Hay said. For all the talk about the pros and cons of furosemide use on raceday, one opinion seems to be missing: that of U.S. racing fans and handicappers. Polls conducted by the National Thoroughbred Racing Association indicate that racing fans enthusiastically backed the industry’s ban three years ago of the non-therapeutic use of anabolic steroids. Alex Waldrop, chief executive of the National Thoroughbred Racing Association, one of three groups that organized the summit, said Monday that the association has never conducted such a poll about raceday use of Lasix. Dr. Robert Northrup, a racetrack veterinarian in Kentucky who is a member of that state’s racing commission, said that concerns over Lasix paled in comparison with other problems, including dramatic declines in the foal crop, national wagering handle, and bloodstock prices. To Northrup, the current effort to place a raceday ban on furosemide would be better focused on solving other problems. “This industry has a bull’s-eye on its back that is totally unfair,” Northrup said. “There are a lot bigger problems in this game than medication. There are a lot bigger problems in this game than veterinarians.”