Should the use of omeprazole be allowed during equestrian competition?

BACKGROUND: Prioritising equine welfare, making evidenced-based policy, and consistent decision-making across sports are crucial to maintaining the social licence for equestrian sport. Regulations on the use of omeprazole during competition differ; all regulators argue that their rules prioritise welfare. This discrepancy is a matter of concern to the public and equestrian stakeholders. OBJECTIVES: To apply Campbell's Ethical Framework for the use of Horses in Sport to the question: 'Should the use of omeprazole be allowed during equestrian competition?' STUDY DESIGN: A desk-based ethico-legal study. METHODS: Campbell's Ethical Framework for the Use of Horses in Sport was applied in a stepwise fashion: definition of the ethical question; analysis of the evidence base; consideration of stakeholders' interests; harm:benefit analysis; application of the three central tenets of the framework, and formulation of conclusions and recommendations. RESULTS: Stakeholders in equine sports have a variety of (frequently conflicting) interests; all of them share an interest in optimising equine welfare. The incidence of EGUS in competition horses is high. Omeprazole is a cornerstone treatment. There are currently discrepancies in regulation about the use of omeprazole during competitions. Recent evidence suggests that withholding omeprazole treatment for two clear days before competition allows the recurrence of squamous EGUS, whereas withholding treatment on the day of competition only does not have that effect. MAIN LIMITATIONS: The current state of scientific knowledge about the use of omeprazole in horses. The analysis did not consider possible health and thus welfare effects of the out-of-competition treatment with omeprazole. CONCLUSIONS: Based on recent scientific evidence, if horses are being treated with omeprazole outside of competition then treatment on the day of competition should be permitted on welfare grounds. Revision of regulations around the use of omeprazole during competition by governing bodies is necessary to safeguard the ethical use of horses in sport.

CONTEXTO: Priorizar o bem­estar equino, elaborar políticas baseadas em evidências e tomar decisões consistentes em todos os esportes são cruciais para manter a licença social para o esporte equestre. As regulamentações sobre o uso de omeprazol durante a competição diferem; todos os reguladores argumentam que suas regras priorizam o bem­estar. Essa discrepância é motivo de preocupação para o público. OBJETIVOS: Aplicar o Modelo Ético de Campbell para o Uso de Cavalos em Esportes1 à pergunta: 'Deve o uso de omeprazol ser permitido durante a competição equestre?' DESENHO DO ESTUDO: Um estudo ético­legal baseado em pesquisa documental. METODOLOGIA: O Modelo Ético de Campbell para o Uso de Cavalos em Esportes1 foi aplicado de forma gradual: definição da questão ética; análise da base de evidências; consideração dos interesses do público alvo; uma análise de dano:benefício; aplicação dos três princípios centrais do modelo; e formulação de conclusões e recomendações. RESULTADOS: O público de esporte equino têm uma variedade de interesses (frequentemente conflitantes), enquanto todos compartilham o interesse em otimizar o bem­estar equino. A incidência de EGUS (Síndrome da Úlcera Gástrica Equina) em cavalos de competição é alta, a qual o omeprazol é um tratamento fundamental. Atualmente, há discrepâncias na regulamentação sobre o uso de omeprazol durante competições. Evidências recentes sugerem que a suspensão do tratamento com omeprazol por 2 dias antes da competição permite a recorrência da EGUS da porção escamosa, enquanto a suspensão do tratamento apenas no dia da competição não tem esse efeito. PRINCIPAIS LIMITAÇÕES: O estado atual do conhecimento científico sobre o uso de omeprazol em cavalos. A análise não considerou possíveis efeitos sobre a saúde e, portanto, sobre o bem­estar do tratamento com omeprazol fora da competição. CONCLUSÕES: Com base em evidências científicas recentes, se os cavalos estão sendo tratados com omeprazol fora da competição, o tratamento no dia da competição deve ser permitido por razões de bem­estar. A revisão das regulamentações sobre o uso de omeprazol durante a competição pelos órgãos reguladores é necessária para salvaguardar o uso ético dos cavalos no esporte.

Testing and Refining the Ethical Framework for the Use of Horses in Sport.

In 2021, in response to an acknowledged need for universal, consistent ethics to guide decision making in the horse sport sector, Campbell published a theoretical ethical framework for the use of horses in competitive sport. The research reported here tested the applied usefulness of that theoretical ethical framework through stakeholder engagement in a three-round modified Delphi study and refined it to develop a practical decision-making tool which can be applied consistently across multiple equestrian disciplines. Stakeholders from a broad range of equestrian competitive disciplines participated in the research. Participants were required to apply the ethical framework to a pre-determined ethical dilemma, individually (Rounds 1 and 2) and within a group (Round 3), and at the end of each round to complete a questionnaire designed to gauge opinion and user experience. At the completion of each round of testing, the theoretical framework was refined based on stakeholder feedback. Results showed that participants perceived useability and application of the framework to generally increase with each round. Qualitative content analysis identified key concepts, including cognition (e.g., broadens/deepens thinking) and application (e.g., considers multiple angles from a variety of information sources, needs to be a short/simple process). Results suggested that the refined framework is beneficial for group decision making across a wide variety of ethical issues and equestrian competitive disciplines. The framework thus has the potential to improve equine welfare through facilitating consistent ethical decision making in which the interests of the horse are prioritized.

Social Licence to Operate: What Can Equestrian Sports Learn from Other Industries?

The concept of 'social licence to operate' (SLO) is relevant to all animal-use activities. An SLO is an intangible, implicit agreement between the public and an industry/group. Its existence allows that industry/group to pursue its activities with minimal formalised restrictions because such activities have widespread societal approval. In contrast, the imposition of legal restrictions-or even an outright ban-reflect qualified or lack of public support for an activity. This review discusses current threats to equestrianism's SLO and suggests actions that those across the equine sector need to take to justify the continuation of the SLO. The most important of these is earning the trust of all stakeholders, including the public. Trust requires transparency of operations, establishment and communication of shared values, and demonstration of competence. These attributes can only be gained by taking an ethics-based, proactive, progressive, and holistic approach to the protection of equine welfare. Animal-use activities that have faced challenges to their SLO have achieved variable success in re-establishing the approval of society, and equestrianism can learn from the experience of these groups as it maps its future. The associated effort and cost should be regarded as an investment in the future of the sport.

An Ethical Framework for the Use of Horses in Competitive Sport: Theory and Function.

Growing ethical concern about equestrian sport is reflected in publications by regulatory authorities, animal charities, and the lay press; and in government debate and social media. However, attempts by regulators and stakeholders to address ethical issues in equine sport have been discipline specific and ad hoc. Ethical frameworks can help stakeholders to make contextual decisions about what should or should not be done in a particular situation. However, when existing animal welfare frameworks and existing sports ethics frameworks are reviewed in this paper, it becomes clear that none provide us with a suitable or sufficient tool for considering ethical issues which can arise in situations where the athlete is a non-human, non-consenting participant. This paper presents the theoretical development of a novel ethical framework, with the aim of providing stakeholders with a tool which they might apply to the consideration of the ethical questions which inevitably arise in relation to (equestrian) sport. The derivation and limitations of the ethical framework are explained. The use of the framework will serve both to underwrite the continuation of the social license to use horses in sport and also to enable those within equestrian sport to critically assess existing and proposed practices and to make welfare-improving adjustments to practice if/where necessary. The theoretical framework as presented here is currently being practically tested and refined in consultation with industry stakeholders, and that research will be submitted for publication in due course.

Ethics: use and misuse of assisted reproductive techniques across species.

The boundaries of what we are able to do using ARTs are fast-moving. In both human and veterinary medicine, this presents a fundamental question: 'Just because we can, should we?' or, to rephrase the same question: 'How can we distinguish between what is a use and a misuse of an ART, across species?' This paper assesses the scientific evidence base for and against the use of ARTs and offers a personal opinion on how we can use such evidence to inform an ethical distinction between justifiable and unjustifiable uses of the techniques. It is argued that the law provides a necessary but insufficient basis for such distinctions. Based on the evidence about harms and benefits, ARTs may be classified into three groups: those which should be rarely used; those for which current evidence supports arguments both for and against their use and those which there is an ethical imperative to use. To which category a particular ART falls into varies depending upon the species to which it is being applied and the reason we are using it. In order to ensure that our ethical oversight keeps up with our technical prowess, the medical and veterinary professions should keep discussing and debating the moral basis of the use of ARTs, not only with each other but also with the lay public. LAY SUMMARY: The use of assisted reproductive techniques (ARTs) has become commonplace in both human and veterinary medicine. Technical limitations are rapidly advancing. This raises a fundamental issue: 'How can we distinguish between what is a use and a misuse of an ART, across species?'. 'Misuse' may be defined both in terms of physical and psychological harms and of moral disquiet about 'interfering with nature'. This paper assesses the scientific evidence base for and against the use of ARTs and provides a personal opinion on how we can use such evidence to inform an ethical distinction between justifiable and unjustifiable uses of the techniques. We need to consider not only legal but also non-legal ethical justifications for their use. Based on the evidence about harms and benefits, ARTs may be classified into three groups: those which should be rarely used; those for which current evidence supports arguments both for and against their use and those for which there is an ethical imperative to use. To which category a particular ART falls into varies depending upon the species to which it is being applied and the reason we are using it. Open discussion between the medical and veterinary professions and the public is necessary to ensure that ethical oversight of the use of ARTs across species keeps up with technical developments.

The effects of intrauterine infusion of peanut oil on endometrial health, salivary cortisol and interovulatory period in mares.

Intrauterine infusion of peanut oil at Day 10 post-ovulation has been reported to prolong dioestrus in mares. However, the effects of peanut oil treatment on the endometrium and whether the technique is painful have not been assessed. The objectives of this study were, (i) to determine the effect of intrauterine infusion of peanut oil on endometrial health, (ii) to determine whether use of intrauterine peanut oil is painful and (iii) to confirm that peanut oil causes prolonged dioestrus. Six mares aged 3-12 years old were used in a cross-over design with each mare administered both 1 ml of intrauterine peanut oil and a sham treatment on different oestrous cycles. The effect of intrauterine infusion of 1 ml peanut oil or sham treatment were measured using interovulatory period, uterine fluid accumulation as determined by transrectal ultrasonography, serum progesterone levels, endometrial Kenney biopsy scores and histological features, endometrial eosinophil numbers and salivary cortisol measurements. The individual mare response to intrauterine infusion of peanut oil was variable. Peanut oil infusion did not statistically prolong the luteal phase, nor elevate salivary cortisol levels but did cause superficial erosion of the endometrial surface epithelium in all mares and significantly increased eosinophil numbers in the endometrium (P = 0.0068). The Kenney grade for biopsies from 2/6 mares worsened transiently following infusion. In conclusion, intra-uterine peanut oil does not statistically increase the duration of the luteal phase but results in an inflammatory response and increase in endometrial eosinophil numbers suggesting treatment may be associated with a hypersensitivity-type reaction. Those contemplating using peanut oil to suppress oestrus should also be aware of the legislative and regulatory implications.

Does the current regulation of assisted reproductive techniques in the UK safeguard animal welfare?

Reproductive medicine is one of the fastest-developing fields of veterinary medicine, Regulation of veterinary assisted reproductive technologies (ARTs) is currently divided between the Animals (Scientific Procedures) Act (1986); the Veterinary Surgeons Act 1966, and the Animal Welfare Act (2006). None of those pieces of legislation was purpose designed to protect the welfare of animals undergoing ARTs, either directly or by determining which veterinary ART procedures may or may not be performed. Consequently, due to the lack of reference to such procedures, the welfare protection aims of the legislation are sometimes ambiguous. It is therefore difficult to ascertain whether the aims of the legislation are being fulfilled, but, in the opinion of this author, the legislation is anyway inadequate in scope, most particularly because it fails to provide a reporting function. It is unclear whether all or any veterinary ART procedures being undertaken on post-natal animals are associated with suffering. Some ARTs may cause discomfort, stress or pain: study or review of the welfare effects of these would be valuable. Any future review of the legislation regulating veterinary ARTs, be that an overall review or a review of one of the relevant statutes (for example the VSA), should take into account the interface between research and clinical medicine; the potentially welfare-compromising gaps between the Acts; the need to introduce reporting functions in order to build an evidence base, and the issue of veterinary specialisation and whether specialised techniques should be carried out only by those with specialist post-graduate qualifications.

HOW SHOULD THE WELFARE OF FETAL AND NEUROLOGICALLY IMMATURE POSTNATAL ANIMALS BE PROTECTED?

Legal protection of the welfare of prenatal animals has not previously been addressed as a discrete subject within the academic literature on animal welfare, ethics and law. This paper aims to rectify this by reviewing the protections (or absence of protections) provided for fetuses by existing legislation in various jurisdictions, and considering the extent to which legal protection of animal fetuses can be justified on animal welfare grounds. Questions related to the need to protect the welfare of neurologically immature postnatal animals are also considered. We argue that there are reasons to protect animal fetuses, both in order to protect fetuses themselves against possible suffering, and in order to protect the animals which fetuses will become against negative welfare impacts that originate prenatally. We review the science on whether fetuses can suffer, and argue that extant regulations do not fully reflect current scientific understanding. Following the precautionary principle, we further argue that regulators should consider the possibility that foetuses and neurologically immature postnatal animals may suffer due to subcortically based 'raw basic affects' (i.e. relatively undifferentiated experiences of discomfort suggested to be generated by neural processing at levels below the cerebral cortex). Furthermore we show that there are reasons for affording fetuses protection in order to safeguard the long-term welfare of future animals. However, it may be possible to provide such protection via rules or laws relating to the use of certain techniques and the management of pregnant animals, rather than via direct legal protection of fetuses themselves. In order to provide such protection effectively we need to know more about the relationship between maternal nutrition, stress, exercise, management and fetal health, and about the impact of the timing of a fetal insult on long-term postnatal welfare.

The role of veterinarians in equestrian sport: a comparative review of ethical issues surrounding human and equine sports medicine.

Veterinarians have a key role in providing medical care for sports horses during and between competitions, but the standard client:veterinarian relationship that exists in companion and production animal medicine is distorted by the involvement of third parties in sports medicine, resulting in distinct ethical dilemmas which warrant focused academic attention. By comparing the existing literature on human sports medicine, this article reviews the ethical dilemmas which face veterinarians treating equine athletes, and the role of regulators in contributing to or resolving those dilemmas. Major ethical dilemmas occur both between and during competitions. These include conflicts of responsibility, conflicts between the need for client confidentiality and the need to share information in order to maximise animal welfare, and the need for an evidence base for treatment. Although many of the ethical problems faced in human and equine sports medicine are similar, the duty conferred upon a veterinarian by the licensing authority to ensure the welfare of animals committed to his or her care requires different obligations to those of a human sports medicine doctor. Suggested improvements to current practice which would help to address ethical dilemmas in equine sports medicine include an enhanced system for recording equine injuries, the use of professional Codes of Conduct and Codes of Ethics to establish acceptable responses to common ethical problems, and insistence that treatment of equine athletes is evidence-based (so far as possible) rather than economics-driven.

Livestock Production in the UK in the 21(st) Century: A Perfect Storm Averted?

There is a school of thought that future demand for meat and other farm animal products is unsustainable for several reasons, including greenhouse gas emissions, especially from ruminants; standards of farm animal health and welfare, especially when farm animals are kept intensively; efficiency of conversion by livestock of solar energy into (human) food, particularly by pigs and poultry; water availability and usage for all types of agricultural production, including livestock; and human health and consumption of meat, eggs and milk. Demand for meat is forecast to rise as a result of global population growth and increasing affluence. These issues buttress an impending perfect storm of food shortages, scarce water and insufficient energy, which is likely to coincide with global population reaching about 9 billion people in 2030 (pace Beddington). This paper examines global demand for animal products, the narrative of 'sustainable intensification' and the implications of each for the future of farm animal welfare. In the UK, we suggest that, though non-ruminant farming may become unsustainable, ruminant agriculture will continue to prosper because cows, sheep and goats utilize grass and other herbage that cannot be consumed directly by humans, especially on land that is unsuitable for other purposes. However, the demand for meat and other livestock-based food is often for pork, eggs and chicken from grain-fed pigs and poultry. The consequences of such a perfect storm are beginning to be incorporated in long-term business planning by retailers and others. Nevertheless, marketing sustainable animal produce will require considerable innovation and flair in public and private policies if marketing messages are to be optimized and consumer behaviour modified.