Liar's Poker

It could be that some readers have a passing interest in horse racing, especially during the Triple Crown season. I fall into that category, though I've never placed a bet. I have, not surprisingly, long ago formed the opinion that Bob Baffert is a fundamental cheat. Just like wannaBePresident Huey Long 2024, though I don't know whether they're Best Buds.

The crux of Baffert's excuse is that some ointment containing some amount of betamethasone made its way into the horse's bloodstream, thus causing the positive test. Now, that whole idea struck me as outlandish, to put it kindly, when I first read it. So, off to the innterTubes. This is a professional vet's assessment.

Q: Would the levels of betamethasone detected in Medina Spirit also have required him to have ingested the topical ointment?

A: No way to know. I don't know that there's any pharmacokinetic data on concentrations of betamethasone following topical treatment. And again–because I never make anything easy, right–that would depend on the condition of the skin, too. Intact skin would likely absorb less into the blood stream than inflamed skin, or an open wound where there's more direct contact between the blood and the blood vessels and the medication.

So, how much betamethasone is there in Otomax?

Each gram of Otomax Otic Ointment contains... USP equivalent to 1 mg betamethasone

That's one milligram. The test said there were 21 picograms (per what?) in the blood sample. A picogram is one trillionth of a gram, vs. one thousandth in the ointment. It doesn't take much to run afoul. On the other hand, given the volume of blood in a horse, and if the measure is per gram, that could be a lot of beta. Some reports said that this was twice the allowed limit, others that Kentucky now has an absolute ban.

For comparison, a 1,100 lb. horse has 40 liters of blood. Humans, 5 liters. For dogs, for which Otomax was created to clear ear infections, a Labrador retriever for example, it's 2.35 liters.

So, where does speculation leave us? Is it likely that an ointment meant to topically treat ear infections in a 2.35 liter animal could generate a measurable quantity in a 40 liter animal, applied not in the ear? Color me No Bloody Way.