A Whirlwind of Concern and Care for Barbaro New York Times

By JOE DRAPE
Published: July 13, 2006
KENNETT SQUARE, Pa, July 12 — For seven weeks, the George D. Widener Hospital for Large Animals has been the home of Barbaro, the Kentucky Derby winner who had lifesaving surgery here on May 21 to repair the right hind leg he shattered in the opening yards of the Preakness Stakes.

There are 70 buildings in the facility and a pastoral backdrop of green, rolling farmland. But Wednesday, there was a sense of foreboding after officials at the facility described Barbaro’s condition as “guarded” and tried to figure out how to reverse medical setbacks that the hospital’s chief of surgery, Dean Richardson, said were “potentially serious.”

Richardson, who performed the initial surgery on Barbaro, issued his daily update early Wednesday, rather than in the afternoon, reflecting an increased sense of urgency.

In the statement, Richardson said that Barbaro was resting comfortably, but he stressed that he and his team were “aggressively seeking all treatment options” for the infection and discomfort that is now present in both of Barbaro’s hind legs.

“He’s facing tough odds and his condition is guarded,” said Richardson, adding that more diagnostics would be performed on the colt. “Our entire staff is determined to do all they can for this magnificent horse,” the statement added.

Later Wednesday, there was one more piece of news: an announcement that Richardson would hold a news conference Thursday morning to provide more details about Barbaro, a horse who once seemed to have the Triple Crown in his sights, and is now simply trying to survive.

It has been a tough eight days for Barbaro, a period in which the colt has endured four leg-cast changes and a three-hour surgical procedure late Saturday in which a plate and screws from the initial surgery were replaced. The colt did not come out of that surgery as well as he did after the initial lifesaving operation in May, needing 12 hours to shake off the effects of anesthesia and return to his stall in the facility’s intensive-care unit.

Since then, concerns about infections in Barbaro’s repaired right hind leg and the previously healthy left one have added to feelings of unease.

Ever since Barbaro’s horrific breakdown in the Preakness transfixed the nation, and then his startlingly smooth recovery in the ensuing days lifted the spirits of everyone involved with the horse, his owners, Roy and Gretchen Jackson, have remained committed to the expensive goal of returning the colt to a normal, pain-free life, albeit one away from the racetrack.

They also have said they were prepared for the ups and downs that would accompany a convalescence that could take months. Now the downs have clearly replaced the ups.

“Everything is about the same,” Roy Jackson said Wednesday. “There’s nothing new to report. I’m not going to get into the medical stuff. I’m going to leave that to Dr. Richardson.”

On Tuesday, Gretchen Jackson said Barbaro was bothered by the infection in his left hind leg, but that over all the colt was comfortable. Richardson, meanwhile, has maintained that Barbaro’s full recovery was an uphill proposition from the start and that the recent complications could not be easily dismissed.

Among his concerns is the infection in the right rear pastern joint, which is above the hoof and was shattered into more than 20 pieces when the initial injury occurred. While most of the fractured bones in the right leg have healed, the joint that connects the long and short pastern bones remains unstable.

“When you have that type of infection the bone becomes porous, like a sponge, and it’s difficult to get the hardware stable enough for the bone to fuse and heal,” said Dr. George Mundy, a veterinarian and general manager of Adena Springs Farm in Kentucky. “You need to get rid of the infection and stabilize the bone. Then you need time. You can almost say they’re back to ground zero.”

Richardson has also been concerned about the possibility of Barbaro developing laminitis, a painful condition for horses that is caused by excessive weight-bearing on one limb.

It is not unusual for the condition to emerge six to eight weeks after surgery, which is a critical period in all recoveries and the period that Barbaro is now in, said Dr. Larry Bramlage, an equine surgeon in Kentucky.

“It goes hand in hand,” Bramlage said. “With the problems with the right pastern, it increases the load on the opposite leg,” the left one, where Barbaro now has an infection.

“Laminitis is usually the terminal event for any horse that has had a severe orthopedic surgery,’’ Bramlage added.

While horses with laminitis can be saved, the prospect of Barbaro having to battle that condition, as well as other infections stemming from the original surgery, could mean extreme discomfort for the colt that would undermine the healing process.

Ultimately, the Jacksons have sought, and veterinarians here have worked to achieve, a balance in which Barbaro remains comfortable and his healing progresses. If that balance is threatened, the Jacksons would have a difficult decision to make.

The Jacksons have visited Barbaro daily and have been in close consultation with Richardson, who in turn has stressed his team’s efforts to keep the horse as calm and pain-free as possible.

“They have been very, very aggressive, and Dr. Richardson has done this long enough, and well enough, to recognize when something is going the wrong way and to go right after it,” Mundy said. “It is very challenging to put Humpty Dumpty back together.”