Barbaro Develops Laminitis Despite Efforts to Prevent it
July 14, 2006While much of the world closely followed the progress of Barbaro’s right hind leg through the summer of 2006, those in the medical community, including Barbaro’s own veterinarians, were watching the left hind leg.
Barbaro, who won an inspired Kentucky Derby race May 6, shattered three bones in his right hind shortly after the start of the Preakness on May 20.
Surgery the next day at New Bolton Center in Kennett Square, Pa., reconstructed the broken bones with pins and plates.
No matter how well the right leg healed, the bigger concern was the possibility that laminitis would develop on the left side.
On July 13, New Bolton Center held a news conference to announce that veterinarians’ worst fears had come true: Barbara had developed severe laminitis in his left hind foot, and 80 percent of the hoof wall had been removed. The colt’s chances for recovery were reduced to “poor.”
Other equine superstars, including the Triple Crown winner Affirmed, had lost their life due to laminitis developing in a good foot after surgery on the opposite foot forced the good one to bear more weight during the healing process.
Dr. Dean Richardson, Barbaro’s chief veterinarian, used many preventive measures in the weeks that followed surgery. On May 27, Richardson put Barbaro’s left hind foot in a special three-part shoe that was designed to:
• Support the sole;
• Minimize weakening and infection of the sole with a material inserted inside;
• And build up the length of the left hind to compensate for the cast being on the right hind.
Other measures included taking a venogram, or injecting a contrast agent into the left hind foot and taking x-rays to show where the blood flowed; the venogram indicated everything was fine, Richardson said.
For six weeks, all reports were upbeat. Then, the first week of July, complications set in the right hind leg, and surgery was performed several times to replace screws and plates and try to get rid of a newly developed infection.
At the press conference, Richardson said, “The horse had no real problems with the left hind leg until he started to have some problems in terms of comfort in his right hind at about seven weeks.”
When asked how severe the case was, Richardson said, “It is as bad as it gets.”
Richardson admitted there always would be second guessing on how the horse was monitored, but added that, “as far as the catastrophic type of laminitis that developed, it was very rapid.”
In response to a reporter’s question of what caused the laminitis, Richardson said: “It’s a problem in horses due to excessive weight bearing and inflammation.”
He added: “If I knew the answer of how to prevent this, I guarantee I would be giving this press conference from my mansion somewhere. It’s a devastating problem in horses that nobody has a solution to.”
Richardson performed a hoof wall resection on the left foot, removing all the hoof wall that had lost its connection to the coffin bone, or about 80 percent, in order to make room for a new hoof wall to grow again.
To minimize Barbaro’s pain in having to bear weight on a foot without a hoof wall, Barbaro was put in a foot cast with foam padding and antiseptic dressings. He also was trained to stand in a sling so he could take the weight off his feet for several hours a day, a procedure the horse apparently was enjoying. In the days that followed, he was said to be using the sling similar to a Jolly Jumper, bouncing off the ground.
Barbaro’s medical reports following the surgery were upbeat. Richardson said repeatedly that Barbaro had good vital signs, a good attitude, a great appetite, took small walks around his stall and found comfort in his sling.
But when asked what the horse’s chances are, the answer always was the same: Not good.
“I’d be laughed out of the profession if I said this horse’s prognosis is anything but poor,” Richardson told a reporter July 20.
Richardson said recovery would take months, not weeks, and the horse’s veterinarians were in a marathon.
He also said Barbaro’s three other feet showed no signs of laminitis, but should that change, the horse likely would lose the battle.
Barbaro’s trainer, former Olympian Michael Matz, who visited the horse daily, remains realistic about the future. On July 29, he told a reporter: “I’m not getting my hopes up. I’m just taking it one day at a time.”
Barbaro’s Timeline:
May 6: Wins Kentucky Derby by 6 1⁄2 lengths.
May 20: Breaks down right after the start of the Preakness; shatters three bones in his right hind leg.
May 21: Undergoes surgery at New Bolton Center; a plate and 27 screws are inserted in shattered leg. Barbaro’s chances of survival are called a “coin toss.”
May 22: Right hind leg is fitted with fiberglass cast from hock to hoof.
May 27: Left hind leg is fitted with special shoe to help reduce the risk of laminitis.
June 13: Cast on right hind leg is replaced. Report is excellent.
July 3: Cast on right hind leg is replaced again. Two bent screws are replaced and three new ones are added around the pastern joint.
July 5: Cast is replaced again due to discomfort. A small abscess on the left hind foot is treated, as well; Richardson later explained that the abscess was not in a typical location to be associated with laminitis.
July 8: More surgery is performed on the right hind leg to treat a new infection. A plate and many of the screws are replaced, and a longer cast is put on to offer more support.
July 10: Cast on right hind leg is replaced again with a shorter one.
July 13: News conference is held to announce severe laminitis has developed in left hind foot, and 80 percent of hoof wall has been removed. Horse’s chances for recovery are reduced to “poor.”