It is a tall order when nearly 10 horses a week, on average, died at American racetracks in 2018, according to the Jockey Club’s Equine Injury Database. That’s a fatality rate that is anywhere from two and a half to five times greater than in the rest of the racing world. A repeat of 2008, when the filly Eight Belles suffered a compound fracture in front of millions of fans after finishing second in the Derby and was euthanized, could be catastrophic for the sport.

Fravel knows that better than most. Each year, his organization hosts the best horses in the world, employs an equine medical staff and adopts surveillance and medication rules on par with Europe, and still it has suffered a handful of fatalities.

“They get hurt, and because of the nature of the animal, you can’t put them back together like you do in human medicine,” he said. “There’s no way to spin that — our job is to give maximum effort to minimize that. You have to get up in the morning and look at the mirror and ask yourself, ‘Are you doing everything you can to keep that from happening?’”

Not enough racetrack owners, trainers and veterinarians are looking in the mirror and answering honestly in the affirmative. A vital move, experts and animal-rights activist say, is to dial back significantly on the use of performance-enhancing drugs and painkillers, which allow horses to perform better than they naturally would, increasing the danger of catastrophic breakdowns.

The Stronach Group, the owner of Santa Anita Park, is in the process of adopting international standards that are expected to transform the racetrack into one of the safest and most progressive ones in the country. It also backs a federal bill introduced in March with bipartisan support to create a uniform national standard for drug testing and medication rules in racehorses that would be overseen by the United States Anti-Doping Agency.

Notably, Churchill Downs Inc. and Mitch McConnell, the Senate majority leader, who counts the company among his top patrons, do not support the bill.