This brief article and illustration, titled “One Horse, One Week of Injections” was in the New York Times recently.  The original article and the illustration may be found by clicking here.  I have attempted to copy/paste below:

One Horse, One Week of Injections

Coronado Heights, a 4-year-old thoroughbred who received a diagnosis of early degenerative joint disease, broke down and was euthanized on the track at Aqueduct on Feb. 25. Below, an illustration of the drugs and dosages given to Coronado Heights the week before he broke down. Related stories »

Phenylbutazone

(painkiller)

Bute is an anti- inflammatory used to control pain. It is injected intravenously and can contribute to gastric ulcers.

Estrone

(hemorrage prevention)

A longtime racetrack remedy; an estrogen-based hormone used to prevent pulmonary hemorrhaging while running.

Flunixin

(painkiller)

A very potent anti-inflammatory that acts quicker than phenylbutazone.

Hyaluronic acid

(loosens joints)

A synthetic joint fluid that replaces degraded joint fluid. It improves a horse’s range of motion and reduces swelling.

Lasix

(prevents bleeding)

A diuretic given four hours before races; flushes the system of water and reduces blood pressure to prevent pulmonary hemorrhaging.

Adequan

(promotes healthy cartilage)

A synthetic replacement for cartilage to combat the wear and tear of running.

Xylazine, Detomidine

(sedative)

A sedative injected in a horse’s neck to calm it before injecting the stifle joints in the hind legs.

Vitamin B1

(calms horse)

Commonly administered four or six hours before a race to calm a horse.

Methylprednisolone

(anti-inflammatory)

A powerful cortisone usually shot in the joints to battle arthritis and degenerative joint disease.

Calcuim

(calms horse)

Another intravenous injection usually administered to keep a horse calm and composed.

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I guess in a completely selfish way I should be happy to see this.  After all with that type of management program we should not be hurting for future retirees.  Like most of you (I hope) my actual reaction was ‘holy crap, poor horse, no wonder he broke down and was euthanized.”  
Some of the injections themselves I don’t have any issue with. I do not fall into the camp that joint injections are evil, and a lot of people who take this stance do not seem to fully understand what the injections do and how they actually work.  That being said joint injections need to be used appropriately.  It amazes me how many people have a horse that is stiff behind and just have the hocks injected before actually doing an x-ray.  No way is anyone sticking a needle in my horse’s joint without an xray first.  I also think if the same area is needing to be injected 3 to 4 times per year then all involved need to take a step back and reevaluate the horse’s entire program and make some significant changes.  According to the illustration above this horse had his stifle injected a few days before racing.  I would never inject a horse’s joints a few days before he raced.  If you look at the boxes under the pictures there are 7 of them with the last one being race day, and the lighter shade box indicates the day that particular injection was given.  
As I review the above I think the only injection I don’t have a problem with when I look at the whole picture is the adequan injection.  Given separately over the course of time many of these injections are valid.  Give some bute after a particularly hard workout?  I have no problem with that.  But this horse was being propped up on pain meds before race day. The joint injection would involve the sedative, the hyaluronic acid and also an anti-inflammatory.  I’m assuming the xylazene was the sedative and the methylprednisolone the anti-inflammatory for the joint injections. Used judiciously I have no problem with joint injections. A few days before a race does not fall into the category of judicious use in my opinion.
The one thing that threw me was the Hyaluronic acid being given 5 days before race day and then again two days before race day. My best guess is that the first injection was the stifle joint injection and then maybe the horse had a Legend injection two days before race day on top of his joint injection.  This might be the one other injection this horse had the week before his race that would not bother me.  If I am going to go away to say two horse shows back to back where my horse would be working hard and stuck in a temporary stall at a show for two weeks I would consider giving a Legend shot before we loaded up on the trailer and left.  
According to this the estrone was given to prevent pulmonary hemorrhaging.  In the sport horse world it is often used to help stifles so I am wondering if that was the actual use for it or if maybe at the track estrone serves two purposes?  
As far as the Lasix for racing I am not a fan.  However you can find people to rabidly argue for and against the use of Lasix for racing.  Some states have banned it, others have not.
Flunixin is more commonly known as banamine, and this horse was doubled up on bute (phenylbutazone above) and banamine the day before the race.  In my little world you don’t double stack NSAIDs unless you are in a truly exceptional medical situation with the horse, the potential repercussions are too high, especially doing this repeatedly.
As for the B-1 and the Calcium I know they are used in the sport horse world to attain a calming effect and it states above this was the same aim for poor Coronado Heights.  I consider the Calcium downright dangerous, right along with the current trend of giving IV Magnesium to the show hunters.
In total this horse had 17 injections in the week before the race where he broke down and was euthanized.  SEVENTEEN.  He was four years old.  Out of those 17 injections the only ones I could be comfortable with in the week leading up to a race or a show would be the adequan injection and the second HA injection if it was legend.  
It is easy to pick on the sport of racing but it is amazing to me how the sport horse world is gravitating more and more towards this type of management.  And I mean all sport horses from western pleasure to reining to dressage to jumpers. Multiple joints injected multiple times per year.  Everyone trying to find the calming injection that won’t test.  Routinely buting horses to keep them in work.  The trainers continually fighting to have the medications rules made more lax.
I first saw this article a few days ago and have been thinking about it ever since.  Did the same vet sell and/or give all these medications to this horse or did the trainer have to use multiple vets so one would not be aware of that the other one had done?  What do the jockeys think about riding a horse propped up by 17 injections in one week?  Do the owners know, care or even understand any of this?  Clearly the trainer knew what was going on and had no issues with it which is unfathomable to me. 
Would you be comfortable with any of these injections being given to your horse in the days before an event, show or race?   
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Cinnamon, MyLight and Silky

Leo and Chance
Lucky, O’Reilly and Snappy

Noble, Lightening and Fabrizzio

Tiny and Johnny

Lily (and Maisie in the background)

Cuffie

Sam doing his post meal licking routine; he licks the air for about 10 minutes after a meal or treat like he is saying “that was SO GOOD!”

Faune, Winston and Lotus

New face around the farm:  Titan
Titan having a fun run through the field with Romeo, Silver and Lotus