Barbaro's survival called a long shot

On Thursday, Barbaro's surgeon, Dean Richardson, announced at a crowded news conference that the medical prognosis for the horse could not be much worse.

For the first time since the injury, Richardson was forced to use that same word, "catastrophic," to describe the horse's problems.

The chief surgeon at the University of Pennsylvania's New Bolton Center said the Kentucky Derby winner has developed laminitis in his left hind foot.

The potentially deadly ailment, caused by putting too much weight on the uninjured "other" foot, now makes Barbaro's odds for survival "a long shot," Richardson said in his typically frank manner.

"As long as the horse is not suffering, we're going to continue to try" to save him, Richardson said.

But he added that the inflammation of the tissue in the left foot, which caused Richardson to remove 80 percent of Barbaro's left rear hoof on Wednesday, is "basically as bad as laminitis gets."

Both rear legs now are in casts, since Barbaro's right hind leg was surgically repaired the day after the horse suffered multiple fractures during the Preakness Stakes.

Any decision regarding euthanasia, Richardson said, is not "minute-to-minute," but, he said, "it could happen, I think, within 24 hours. It wouldn't happen minute-to-minute, because it's a judgment that you look at the horse over a period of time."

The surgeon said he is in constant consultation with Barbaro's owners, Roy and Gretchen Jackson of West Grove, Pa., who visit the nearby Kennett Square facility daily, and have said since the accident that their only goal was for the horse to live without pain.

"If you asked me two weeks ago, I really thought we were going to make it," Richardson said at the news conference before 13 television cameras and correspondents from ESPN and ABC's "Nightline." "Today, I am not as confident — which is, for me, unusual."

Richardson said the worst-case scenario is not the only possibility, although he sounded as if the medical team is down to its last card.

"I mean, today the horse looks very good," Richardson said. "You know, like I said, he's bright and eating very well. The horse has a very strong constitution. He's got a great appetite. This is one of the reasons that the Jacksons and Mr. Matz" — Barbaro's trainer, Michael Matz, who also has been at New Bolton daily — "and I all decided to go a little farther, even though we know this is serious. It's because, if you look at this horse, it'd be hard to put him down."

And this is no ordinary horse he has been treating. Even among top thoroughbreds, Barbaro stood out for his feats this year. He and Smarty Jones were the only undefeated Kentucky Derby winners since Seattle Slew in 1977. And Barbaro's 6 1/2-length winning margin in the Derby was the greatest in six decades.

After Thursday's news conference, huge baskets of apples and carrots began arriving at New Bolton, as they had after his initial surgery. One came from Baton Rouge, La.

From the time of Barbaro's breakdown at the Preakness, laminitis was mentioned as a possible complication. It has been fatal to many horses, including Secretariat.

"It's a devastating problem in horses that nobody has a solution to," Richardson said, speaking between surgeries to two other horses.

Barbaro is receiving strong pain medicine, and now spends several hours each day in a sling, which he was trained for over the weekend.

"He's not sagging in a sling, like a limp noodle," Richardson said. "It's a way of giving him support and relief. If he starts acting as if he doesn't like that, we call it quits.

"What we're doing on this horse is absolutely unusual, but it's not unheard of. ... We're not doing anything outrageously experimental on this horse. At the same time, we will try many different things. Anything that I think is scientifically reasonable, we will certainly try."

Right now, Richardson said, "this horse, you look at him in the stall — his ears are up; he's bright. He's looking around. He's spending some time in the sling. Other times, he's out of the sling. ... We're trying to save his life."

Asked to explain laminitis for the layman, Richardson said: "A horse walks on the tip of his middle digit. Evolutionary speaking, they adapted to walk ... they're essentially walking on the nail of their middle finger. Really what you're talking about, the bone inside of that hoof essentially has to be attached to that nail. The hard tissue of the hoof — the bone is attached to that by a tissue called laminae.

"That tissue, if it becomes damaged, separates. Then you lose the connection between the bone and the hoof. If the horse loses the connection between the bone and the hoof, it's exquisitely painful to the horse, because the horse needs that connection to walk around."

Barbaro's fractures suffered in the Preakness have been healing well, and the doctor said the medical team continues to monitor his right hind pastern joint, where an infection was found and treated surgically on Saturday night.

"My impression is that it's doing well," said Richardson, who has put six casts on the leg. "We are continuing to treat it very aggressively."

Along with the recent infection in the pastern joint, Richardson had removed an abscess in the left hind foot. Asked whether it was a forerunner to the laminitis, Richardson said that it likely was.

"The first abscess that he had was not in any way in a typical location to be associated with the laminitis," Richardson said. "But when you have a problem in the foot — it certainly didn't help things in the left hind foot."

As for what's involved in monitoring the laminitis, Richardson said, "It's comfort. It's strictly comfort. ... What we want to see is if the foot starts to essentially dry out and start to form this hard tissue on its surface. That's what we're waiting to happen, because as that happens, we hope that he gets progressively more comfortable in the left hind.

"This is ... a very slow progress. I mean, if we were to get through the other end of this, it'd be crazy to think it would be anything less than five or six months. That would be a rapid recovery for this problem."

But his real focus, he kept repeating, is short term.

"We will try all reasonable avenues, and if they don't work, we will quit," Richardson said.

"As long as the horse is not suffering, we're going to continue to try" to save him.

Dean Richardson

Chief surgeon at Penn's New Bolton Center