Part II of Mark Berner's report on how betting and cheating issues threaten the future of Thoroughbred racing

JAN. 16, 2019--According to research found at the website procon.org, here are some of the known methods that cheaters use, and the ways they can game the system:

BIOSIMILARS: A growing problem is the rise of copycat versions of Erythropoietin (EPO). Because it has been so successful financially, companies in India, China and Cuba have developed drugs that do a similar job in the body, but have a slightly different molecular fingerprint.

These cheap versions of EPO, Biosimilars, are easily bought on the Internet. Some scientists who track and monitor the development of copycat EPO drugs say there could be hundreds of different versions from different parts of the world.

Blood transfusions have long been used to enhance athletic performance. Transfusions are an extremely straightforward, simple, and effective method of increasing the blood's oxygen carrying capacity. Recombinant equine erythropoietin, EPO, has been the drug of choice.

With the advent of more effective and inclusive testing, the use of EPO has become more difficult and complex. Because of the increased risk of detection, horse dopers may turn to an older form of blood doping that, until recently, has been virtually undetectable.

BLOOD DOPING: There are two methods of doping through blood transfusions: autologous and homologous. With an autologous transfusion, a horse receives its own blood. The donated blood is stored and then the horse receives that blood at a later point in time. In a homologous transfusion, the blood comes from another horse.

The benefit of homologous transfusion is there is no decrease in performance during the donation period.

DIURETICS and PERMA CLEANSE: Horses are often administered diuretics in an effort to cleanse its system before having to provide a sample. These work tremendously well. One mail-order system, supposedly undetectable as a diuretic or in any lab test, uses the same means to evade a positive test - detoxification - is Perma Cleanse.

A classic method of evading positive drug tests is to couple the use of natural herb diuretics such as dandelion root, uva ursi, and caffeine with fasting. Both EPO and diuretics thicken the blood.

Human athletes on an EPO/Lasix program do not sleep normally because if they do not continually awaken to exercise, the blood can thicken so much that it ceases to flow. This may be the link to what has been termed sudden equine-death syndrome.

THE CREAM, a testosterone-based ointment distributed by BALCO, was designed to mask the use of other steroids [recall baseball scandals]. It was a mixture of synthetic testosterone and epitestosterone. EPI, as it is known in the drug-testing culture, is present in the body but has no known function.

The Cream helps the horse maintain a normal ratio and conceals what otherwise would be a telltale sign of the use of an undetectable steroid: an abnormally low testosterone level.

When a horse is given steroids, the body stops producing testosterone to the point that it can bottom out at zero. A zero level would set off red flags for drug testers, the Cream elevates testosterone enough to avoid suspicion.

EPITESTOSTERONE: Testosterone, once tested at a ratio of 6:1, has been reduced to 4:1 by the International Olympic Committee. The ratio compares levels of testosterone to epistosterone, or the T/E ratio.

The normal testosterone-epitestosterone ratio is 1:1 but because top horses are often genetically advanced, their ratios may differ compared to those of the average horse. The 4:1 ratio is, for most, a large variance in their natural levels.

This leaves open the possibility for a certain amount of exogenous testosterone if one is careful enough to make sure the hormone stays within accepted limits. For those animals already producing more hormone [testosterone] than their competition, or for those who want to use more than they can sneak in under the radar, epitestosterone is employed.

When used, it increases the variable testosterone is compared to, thus allowing for increased amounts. Scientists made the discovery after a former Tour de France cyclist said he was given an unidentified powder to sabotage surprise tests.

Anti-doping authorities need to start checking for protease, a class of enzymes that destroys EPO can be found in soap powder, dishwashing solution and contact-lens cleaner.

There is no reference to protease on the World Anti-Doping Agency's list of banned substances. Using soap powder would destroy all EPO in urine, both synthetic and what is produced naturally by kidney cells.

GENE DOPING: A sophisticated method of cheating, many experts believe this is already happening and warn that tinkering with equine DNA to boost performance could seriously injure or even kill. A test to detect it is years away - perhaps as much as a decade.

The gene that governs a certain desirable function is isolated - the source is usually another horse. Then a laboratory amplifies it, making more powerful. That gene is inserted into a viral vector, a virus that has had the harmful part of its structure deactivated, but which retains the ability to penetrate and colonize human cells.

The gene is a sort of biological Trojan horse. Adenovirus - a common cause of respiratory problems - is most often used, but other viruses such as herpes simplex or even HIV are now in use. The vector is injected into the horse and begins to take over the cells.

Once inside, an altered gene becomes part of the cell's DNA and recodes it to behave differently - producing, for example, more and stronger muscle or creating EPO, which in turn creates more red blood cells. The virus colonizes cells at the same rate as if carrying disease. Once the gene is embedded there is no turning back; it will be expressed.

MICRODOSING of drugs and hormones, chemically altered molecules of steroids, testosterone patches and the old doping chestnut, equine growth hormone, are the recent trends with drug cheaters.

EGH, despite being used for decades, is still being abused, especially in combination with steroids. Despite recent research, showing that EGH is ineffective on its own, it is used in horses to boost the effect of other performance-enhancing drugs.

Horses can be given regular low doses of the blood-boosting hormone erythropoietin (EPO) in combination with insulin growth factor or EGH. The combination accelerates the impact of EPO but enables the user to escape detection for the smaller dose of EPO.

TATTOOS: Olympic cheats are taking performance-enhancing drugs via tattoos. Inserting drugs through tattoo needles increases the effect of drugs, meaning athletes can take smaller doses and 'fly under the radar' in dope tests.

Research in Germany has shown that delivering DNA vaccines via tattoo is 16 times more effective than injecting through the muscles or veins as the vibrating tattoo needle prepares the body's immune system and increases the body's response to the drug.

Some of the technologies are so new, the concept so bizarre, that there would only be a handful of well-tapped-in veterinarians using it. The problem is that some of the drugs now fly under the radar with the tattoo technique because horses would receive a much smaller dose.

Barr-Tonko was dead on arrival, but the death certificate is unsigned as of yet. Does this complex drug issue along with the challenges faced by bettors indicate that our sport in jeopardy? You bet it is. And then there would be no image left for McKinsey to polish.