LOUISVILLE, Ky. – You can find three “Ls” in this river city’s name, two more in the name of the city’s storied racetrack, but the world’s most famous horse race at Churchill Downs here in Louisville, will not include a single “L” next to the names of horses racing in the 2021 Kentucky Derby. “L” in past performance notation stands for “Lasix,” and the masters of the Derby, like much of North American racing, have taken a stand against a race-day medication that, until 2020, had become ubiquitous in the American Thoroughbred. Ten of the 20 likely Derby starters as of Sunday have raced at least once on Lasix, a medication regularly given to horses all over the world to prevent bleeding in the lungs resulting from strenuous exercise. But none of the Derby horses ran on Lasix in their most recent start, half the field never has raced on it, and that marks a sea change: Since 2006, every Derby starter save two overseas shippers, Mubtaahij in 2015 and Master Fencer in 2019, ran on Lasix. Whoever crosses the wire first on Saturday will become the first Lasix-free Derby winner since Grindstone in 1996, and this marks the first Lasix-free Kentucky Derby since . . . who knows when. Kentucky didn’t require the reporting of pre-race Lasix administration, widely legalized for race-day use in the mid-1970s, until 1986. The second letter in Alysheba’s name is “L” and in 1987 he became the first known Lasix-using Derby winner, one of just two Derby horses on Lasix that year after five raced on the medication in 1986. Seven out of the next nine Derby winners ran Lasix-free, but even as Grindstone was becoming the last in that string, the landscape had radically changed. Fourteen of Grindstone’s 19 rivals raced on Lasix, and 1998’s Derby, 15 strong, was the first in which every starter was a Lasix user. You might think, given the pervasiveness of a drug intended to suppress bleeding, that disaster looms Saturday. Most available evidence suggests otherwise. Churchill’s “Road to the Kentucky Derby” is a set of races that awards qualifying points to the top four finishers, the 20 horses with the most points filling the Derby starting gate. This year’s crop could earn no points in eligible races if they raced on Lasix. Yet it appears that no horse bled enough during a Road to the Derby race to compromise performance. Caddo River in the Rebel Stakes and Mandaloun in the Louisiana Derby ran well below form, but trainer Brad Cox said neither horse bled. Risk Taking in the Wood Memorial turned in a surprisingly dull race, but trainer Chad Brown said the poor showing had nothing to do with bleeding. Candy Man Rocket won the Sam Davis in February at Tampa Bay Downs and a month later finished 11th as the 8-5 favorite in the Tampa Bay Derby. Bleeding, though, had nothing to do with it. :: Get Kentucky Derby Betting Strategies for exclusive wager recommendations, contender profiles, pedigree analysis, and more “Didn’t bleed,” Hall of Fame trainer Bill Mott said. “In fact, I haven’t had any more horses bleed without Lasix than I have with it. I see some people getting pretty worked up about no-Lasix, and I want to tell them to just relax. If you gave me a choice, ‘Run on Lasix or don’t run on it,’ I guess I’d use it, because maybe it would help a little. But we can adapt.” Todd Pletcher, who himself will become a Hall of Fame trainer later this year, has used Lasix on his four Derby runners when he could. All of them came off Lasix for their final Derby prep, as Known Agenda won the Florida Derby, Sainthood was second in the Jeff Ruby, and Bourbonic and Dynamic One ran one-two in the Wood Memorial. “I’m not worried about going back and forth. If it’s available, then we’re going to use it,” Pletcher said. “First, we want to be on a level playing field, and second, if it possibly helps from bleeding on that day, why not use it? If they don’t bleed on the day, they are less likely to bleed again later.” Pletcher knows the science: One episode of meaningful bleeding tends to make a horse more susceptible to others. Trainers like Pletcher, Brown, and Mark Casse – all with Derby runners – perform regular endoscopic examinations on all their horses following exercise, and because they train such large stables, they’re on the forefront of collecting data regarding the effect of racing’s burgeoning no-Lasix movement. :: DRF's Kentucky Derby Headquarters: Contenders, latest news, past performances, analysis, and more “I scope all my horses, win or lose,” said Brown, whose Derby runner, Highly Motivated, never has raced on Lasix. “It’s a policy we’ve learned a lot with. What are the effects? It’s still a small sample size, and we need more information. What I’ve seen is not rampant bleeding, but some.” Lasix, known also as salix and furosemide, is a strong diuretic developed in Europe during the early 1960s. The Food and Drug administration didn’t approve it for human use until 1982, but Lasix became a permissible race-day medication across much of North America in the mid-1970s. The growth of its widespread application coincided with advances in endoscopic technology; when an equine vet could insert an endoscope down a horse’s nostril and have a post-exercise look at the animal’s airway, it revealed the degree of exercise-induced pulmonary hemorrhage, EIPH. Think of the cartoon image of a man locked in a fit of rage, clenching fists, squeezing his face so hard blood rushes into reddening cheeks. That approximates what happens in a horse’s lungs working at peak performance; a dose of Lasix apparently lowers pulmonary blood pressure and makes it less likely capillaries pop. Before scopes, bleeding showed itself in the most serious cases, when enough blood accumulated that it ran out of the nostrils. This is called epistaxis, and it can be serious business. Why does this happen to horses? Good question. Nature isn’t perfect. The horse’s digestive tract – subject to fickle colic, which can be fatal – also could use a redesign. Lasix floated around the track as a diuretic used in the test barn to help expedite collection of post-race urine samples before some adroit vets discovered it could aid the prevention of bleeding. The onset of its widespread administration to North American Thoroughbreds created controversy from the start. Lasix’s effect on Thoroughbreds went beyond mere bleeding, the drug’s critics said: It enhanced performance and could be used as a masking agent for other drugs. Lasix, later studies showed, did not mask the presence of other drugs – at least not with improved testing technology. And since the majority of Thoroughbreds do experience at least a nominal level of bleeding during a race, Lasix might well increase performance, just likely not to the extent propounded in early days, when it commonly was said many horses could improve five, 10 lengths on the drug. The reliance on race-day medication made American racing a global outlier since no other major racing jurisdiction permitted such drug use. The famed turf writer Bill Nack, penning an opinion piece for Sports Illustrated regarding his 1987 Horse of the Year vote, wrote: “The reason for my reluctant Alysheba vote is simple: He’s a druggie.” Allowing bleeders to win important races and pass along their genes would beget future generations of bleeders. Maybe it has; we are about to find out. In 2012, a group of prominent owners pledged to race their 2-year-olds Lasix-free, and juvenile Breeders’ Cup races that year forbade Lasix use. That movement died on the vine; a year later, the status quo returned. But anti-Lasix forces burbled along, and 2020 was a watershed. Again, there was no Lasix in Breeders’ Cup 2-year-old races, but some tracks also disallowed Lasix in all 2-year-old races. Churchill put forth its no-Lasix Derby rules, while many graded stakes races for 2021 went Lasix-free. This year, all races in the Breeders’ Cup Challenge series, as well as the Breeders’ Cup itself, will be filled with horses racing without Lasix. :: Get DRF Clocker Reports for the Kentucky Derby and Oaks cards to access exclusive insights from morning training Handicappers in early Lasix-reporting days looked for performance jumps in new Lasix users. Now, the concern is bettors can’t trust the form of horses racing without Lasix. But, using Beyer Speed Figures as a guide, data from 2-year-old and 3-year-old races suggests a decline in performance hasn’t accompanied this nascent era of Lasix-free racing. The average winning Beyer for a 2-year-old during 2020 was 56.74. That was down from 2019, when Lasix use remained in full force and the average winning 2-year-old Beyer was 57.04, but up compared to 2018’s average, 56.04. The average winning 2-year-old stakes Beyer all three years was 68, while the average winning maiden special weight Beyer was 58 in 2019 and 2020 and 57 in 2018. Looking at 3-year-olds racing between January and April 15 – like the Derby horses this week – the average winning Beyer for this sophomore crop is 61.22, the highest in the last four years. The 2020 average (again, January through mid-April) was 61.01, the 2019 average 60.63, the 2018 average 60.46. It’s hard to compare Lasix-using 3-year-olds so far in 2021 with horses racing without Lasix since the non-Lasix users skew so heavily toward high-end performers. This year’s average winning stakes Beyer, 84, easily is the highest in the last four years. There have been 89 stakes-winning 3-year-olds racing without Lasix compared to six the previous three years combined. Maybe this is working better than many expected, and among six big-stable Derby trainers interviewed for this article, all but one said bleeding hadn’t created any actual attrition in young horses with Classic aspirations. Several pointed out, though, that 2-year-olds and young 3-year-olds, contrary to some belief, do bleed, and the greater concern is with older horses already accustomed to using Lasix who suddenly are asked to race without it. Brown recently had Analyze It bleed badly in the Danger’s Hour Stakes at Aqueduct; the same thing happened to Brad Cox-trained Hidden Scroll in the Commonwealth at Keeneland. Many horsemen with lesser horses and smaller stables wonder what will become of them if, as planned, a total Lasix phase-out is completed in 2022. “I’m not really in favor of that,” said Casse, who publicly has taken anti-medication stands in other areas. “I’ve always said with Lasix they’re barking up the wrong tree. We have much bigger issues. I still and always will believe it’s the most humane source of treatment we have at the current time.” The absence of race-day Lasix does not mean horses, like those in the Derby, aren’t getting the diuretic while preparing to race Lasix-free. Casse said he still works some horses on Lasix who won’t be allowed to race on the drug. So do Brown and Pletcher. Pletcher points out that while the rest of the racing world might not race on Lasix, it’s commonly given between races. “It’s a misconception we’re the only ones that use Lasix; it’s used in training all over the world,” Pletcher said. Cox, who has his first Derby runners this year, including undefeated favorite Essential Quality, takes a different approach. “I’m trying not to work them on it at all,” he said. “I think it’s a crutch. If you can’t run a mile on it on race day, why would I need it to work a half-mile seven days before? I’m not using it in the morning if I’m not using it [in races]. It hasn’t slowed anything down that I’ve done – if anything it’s made me better.” Some trainers are limiting feed and water before a horse runs without Lasix, trying to mimic the effect Lasix has on a performance horse. Doug O’Neill, who runs Hot Rod Charlie in the Derby, said on a recent media conference call that his stable employs these tactics. “It’s just being more thoughtful of what they have in their stomach before exercise,” he said. In the end, none of the Derby trainers with major contenders said they worried about their horse bleeding in the race. “Any time you run a horse with Lasix or without Lasix, you always have that chance a horse will bleed and hurt performance, but I feel – knock on wood – pretty confident with our two,” Casse said of Helium and Soup and Sandwich. “I’m not going to lose any sleep about that. I’m more worried about post position and breaking from the gate.” Bettors might as well take the same approach. Scour the form, the workouts, the regular markers. Forget about the “L” and just try to determine who’s getting the “W.”