Race-day corticosteroids mask injuries that pre-race vets cannot detect visually

U.S. racing historically permitted race-day administration of corticosteroids (anti-inflammatory drugs) that reduce swelling and pain, allowing horses with sub-clinical injuries to pass pre-race veterinary inspections and run on compromised limbs. Pre-race vet checks consist primarily of watching horses jog 50-100 feet — a visual-only assessment that cannot detect internal bone remodeling, micro-fractures, or soft tissue damage masked by medication. A task force investigation found that corticosteroid use specifically limited veterinarians' ability to identify pre-existing conditions that predisposed horses to catastrophic injuries. A former racetrack veterinarian told NBC News she left the profession because she 'did not want to see young horses euthanized due to being overtrained, overmedicated, and pushed too far.' While HISA has tightened medication rules at regulated tracks, non-HISA states still permit practices that HISA bans, and enforcement depends on post-race testing that catches violations after the damage is done — not before. The structural root cause is that trainers face economic pressure to start horses as frequently as possible (owners pay $50-100/day in training costs whether the horse races or not), and medication enables running horses through minor injuries rather than absorbing lost revenue during recovery.