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The Kentucky Derby Winner failed his drug test. Now what?

Medina Spirit's trainer Bob Baffert maintains they never used betamethasone on the horse.

SHAKOPEE, Minn. — Hailed as one of the most prestigious horse races in the world, the Kentucky Derby — for those who don't follow closely — is the first leg of a total of three races to be named the Triple Crown winner.

The race is a big deal according to Minnesota Racing Commission's executive director Steve May.

"It is the biggest race of the year for most fans," May said. "It doesn't have the highest purse, but it is the one that every owner, every trainer wants to win."

Last week, Medina Spirit became the winner of the 147th Run for the Roses.

Behind him is seven-time Derby winning trainer Bob Baffert.

However, the win was soon overshadowed by Baffert's announcement that Medina Spirit had tested positive for betamethasone, an anti-inflammatory drug. Something Baffert denies he's used on the horse.

"That's the part that's really disturbing to us," Baffert said. "We don't use betamethasone. My vets don't even carry it anymore."

RELATED: Medina Spirit could lose Kentucky Derby win; track bans Baffert after failed postrace drug test

May said betamethasone is commonly used in both horses and humans.

"If you have a friend or a colleague who might have a sore knee, they might go into their physician and get some kind of a joint injection," May explained. "Maybe similar — betamethasone or some other anti-inflammatory — it's very common in humans and in equine athletes as well."

However, the problem is that Medina Spirit tested positive for 21 picograms of the anti-inflammatory drug, which is double the legal racing limit. While betamethasone itself isn't a blood doping agent, it could still cause problems.

"The concern with betamethasone — with all anti-inflammatories — is that if you give high doses of it, you can actually mask pain," May said. "So you may have a horse that — well horses can't speak to us of course — but you have to be able to witness any kind of indications of soreness in the knee or ankle, because it could potentially lead to a catastrophic injury on the race track. That's what we're trying to do, to make sure it's not masking any kind of natural pain in the horse."

Baffert so far has asked for a split-sample re-evaluation in a different lab for Medina Spirit.

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He's been suspended by Churchill Downs in Louisville, Kentucky.

It's unclear at this point if Medina Spirit will run in the Preakness in Baltimore.

If the second sample tests positive though, May said it's the industry of horse racing that will most likely take a hit.

"The vast majority of any medication positives that we have are really the result of a misadministration of a legal medication too close to race time, or maybe given the wrong dosage," May said. "Most of them probably don't affect the performance of the horse but we have to test them the same way to make sure they don't have anything in the system that shouldn't be there. But this obviously — it's hard for the industry when something like this does happen."

If the split-sample does confirm betamethasone in Medina Spirit, Churchill Downs said they will strip his Derby winner title and it will go to the runner-up, Mandaloun.

The folks who made their bets on Mandaloun, though, will not get their money.

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