first published in the October 2022 Equiery

Earlier this year, the board of the National Reining Horse Association added the use of compounded romifidine as an approved medication that can be administered up to 30 minutes before a horse enters the competition pen. As stated on the medication’s label, romifidine is “a sedative and analgesic to facilitate handling, clinical examinations, clinical procedures, and minor surgical procedures in adult horses.” The label also states it is “a preanesthetic prior to the induction of general anesthesia in adult horses.”

Many competitors and industry professionals from across the U.S. and around the world have questioned the addition of romifidine as an approved medication and have been urging NRHA to reconsider its addition and use.

One such industry professional speaking up is Dr. Megan Snyder of Woodbine, who has been a practicing equine veterinarian since 2010 and is also a USEF Testing Veterinarian and an official reining FEI veterinarian (when reining was still an FEI sport). Dr. Snyder has also been an active reining competitor since 1995 and currently breeds reining horses. She also will begin a term on the American Association of Equine Practitioners (AAEP) Performance Horse committee this November.

Dr. Snyder stated, “I agree with the statements made by AAEP concerning the use of romifidine in competition horses. As a veterinarian and reining enthusiast, I have worked hard to protect the animals that we use in our daily lives to perform and work on our behalf. I hope that those within NHRA that have the power to make a difference in our industry do the same and support the animals we take pleasure in and base our livelihood on.” Dr. Snyder went on to state she had previously sent a personal statement against the use of romifidine to the NRHA board early this September.

Below is the letter, written by current AAEP president Emma Read, DVM, MVSc, DACVS, that was sent to the NRHA on September 7.

“The American Association of Equine Practitioners (AAEP) is a U.S.-based professional association of more than 9,000 equine veterinarians that is committed to ensuring the health and welfare of horses. We would like to share our concerns regarding recent changes to NRHA’s medications policy, specifically with regards to the addition of romifidine as an approved medication.
We applaud you for many of your policy changes; however, we wish to share our grave concerns regarding your allowance of compounded romifidine for sedative effects and its impact on the health and welfare of both horse and rider.

Romifidine is a sedative of the most common class used in horses, the a2-adrenergic receptor agonists. Unlike phenothiazine tranquilizers such as acepromazine, the a2-agonists produce significant analgesia (decreased pain perception) in addition to sedative effects, including ataxia (loss of coordination and balance). Much research has been conducted on horses receiving romifidine. These studies have demonstrated that at 30 minutes post-administration, 80% of horses still show signs of mild to moderate sedation, and signs of lameness are significantly decreased from a pre-administration baseline evaluation. Ataxia may still be present up to an hour after administration, and diminished response to painful stimuli and other signs of sedation may persist up to 2 hours in some horses.

Taken together, allowing a horse to enter a show ring at 30 minutes post-administration of romifidine presents a safety and welfare risk to both the horse and rider, including masking a lameness that could become worse with riding, or results in the horse tripping and injuring him/herself and the rider. The analgesic effects of this drug furthermore can be considered performance enhancing and an affront to the spirit of fair competition.

Also, as you are aware, there is no FDA-approved form of romifidine manufactured in the United States. Sedivet, previously manufactured in the U.S., is no longer available in the U.S. but is in Canada and Europe. Therefore, romifidine in any form in the U.S. can only be obtained from a compounding company.

As licensed veterinarians, our profession has strict guidelines that we must adhere to for the use of compounded medications, and administration for competitive purposes goes against these guidelines (see below). Secondly, compounding pharmacies are unregulated; as such, there can be variations in concentrations and quality of compounded preparations which has led to disastrous consequences even when there has been the best of intentions (e.g., polo pony deaths).

Legal drug compounding requires a valid Veterinary Client/Patient Relationship (VCPR). A compounded medication can only be used when there is not an equivalent FDA-approved medication available. Off label (extra label) medication is the use of an FDA-approved product for a non-equine species that is used (off label) in the horse. It should be noted that the use of compounded drugs in a highly regulated competitive environment should be discouraged due to the variability of therapeutic levels and detection times. The AAEP Guidelines for Drug Compounding are an excellent reference for the legal and ethical use of medications in horses. The AAEP also offers additional resources on compounding online here.

We note that the NRHA’s Animal Welfare Position Statement embraces the values of ensuring the highest standards of safety for both horse and rider and condemns the use of performance-altering substances in competition. For the safety of the discipline’s equine and human athletes, we urge NRHA members and leadership to reconsider this recent change allowing for the use of compounded romifidine. We do not believe it is in the best interest of the horse.

Thank you for your consideration of our concerns.”