Derby Winner Barbaro Injured

Barbaro's breakdown after the start of the May 20 Preakness Stakes captured the concern of horse owners and enthusiasts watching on network television and at the Baltimore, Md., track. Equine veterinary medicine was catapulted into the spotlight, and the welfare of one animal became front-page fodder in newspapers across the country.

Barbaro's jockey, Edgar Prado, heard a "click" soon after the race started, and fans saw Barbaro's right hind pastern swing out awkwardly from his fetlock joint. Prado eased the horse to a stop and the screens went up, leaving viewers either in hopeful anticipation of good news, or in tears fearing the worst. Track staff and veterinarians carefully splinted the injury and loaded Barbaro into an ambulance to be taken to his stall. 

After veterinarians radiographed Barbaro's injured right hind leg, Larry Bramlage, DVM, Dipl. ACVS, the American Association of Equine Practitioners' On-Call veterinarian, relayed information about the diagnosis--a condylar fracture of the cannon bone (metatarsus), a comminuted (in pieces) fracture of the long pastern bone (first phalanx) in 20 pieces, and a fractured sesamoid. Barbaro's fetlock was also dislocated.

He was shipped nearly two hours to the University of Pennsylvania's New Bolton Center later that evening. Dean Richardson, DVM, Dipl. ACVS, chief of surgery at New Bolton, performed surgery on Sunday afternoon, May 21. He used a locking compression plate to hold Barbaro's bones together, and he applied a plaster cast. The surgery and recovery took six hours. Barbaro recovered from anesthesia in a special recovery pool (see page 18).

By May 23, Richardson was encouraged by Barbaro's visible signs of recovery. "He's pretty agile," said Richardson "He's done a couple of things that manifest his level of comfort. He actually was scratching his left ear with his left hind leg," which shows he is comfortable putting weight on the injured right hind leg.

"When I was in there working with him this morning (May 23), he kind of waved at me with his left hind leg…he's feeling very good; he's walking very well on the limb," added Richardson.

Hospital staff are watching Barbaro around the clock for any subtle signs of pain or discomfort. They are monitoring signs such as food intake, heart rate, temperature, voluntary movement around the stall, and manure and urine production.

The difficult aspect of Barbaro's care is making sure that he is comfortable on his recovering limb in its plaster cast, and that he's bearing weight evenly on his limbs. Richardson explained that he has taken steps to prevent laminitis in the uninjured hind limb, which is at risk if it bears more weight than the other leg for an extended period of time. "When he came in, his racing shoes were removed altogether, and his left hind foot was shod with a special glue-on shoe that has special padding, which also raises his foot up a little bit so his limb length is equivalent to the cast limb on the right hind," he said.

Generally, hind limb injuries are no more problematic than forelimb injuries, unless the horse will enter the breeding shed. "If we get to a point when he has to mount a mare, that could be a problem," said Richardson. "We're not worried about that now."

The fractures could take many months to heal, and Richardson emphasized that bad things could happen at any time. "The single most important thing is that we are able to maintain his level of comfort on the fractured limb. We obviously look at indications of infection, in terms of blood work, any kind of local heat, pain, or swelling...we'll be changing his cast on a regular basis. We're basically doing just good, solid nursing care."

Barbaro will wear a cast for several months to assist the internal fixation plates in keeping the leg stable. There are 27 screws holding the bones together and to the plate. "The internal fixation--the plates and screws--for this fracture are not adequate to allow him to bear weight without the cast," explained Richardson. "There are many types of surgical repairs that we do that the plates and screws are enough to hold it together. In this case, this is far too complicated a fracture for that."

The team planned to change Barbaro's cast the week of May 29 and to take more X rays to monitor healing. As of May 30, Richardson was holding off on the cast change since Barbaro wasn't showing signs of discomfort or swelling. Changing the cast can present its own challenges. "We will try to change his cast with Barbaro partially in a sling and heavily sedated, so that way he can't kind of slip, stumble, or fall while changing the cast, but at the same time he won't be placed completely under general anesthesia," he explained. "If for some reason Barbaro takes exception to that, he would be placed under general anesthesia, just the way he was before, and woken up in the swimming pool again."

Following the surgery, Richardson and his team gave Barbaro epidurals for pain, but by Day 2 post-surgery, Barbaro remained on a "fairly low" level of systemic analgesics.

With each day that passes, the risks Barbaro faces lessen, and everyone associated with Barbaro and his surgery hope his condition remains stable. "Alex Matz (trainer Michael Matz's son) said the best thing about this horse is that it wins all its races," said Richardson. "That encourages me, because the race of healing his fracture is going to be one that we really would like him to win."

About the Author

Stephanie L. Church, Editor-in-Chief

Stephanie L. Church, Editor-in-Chief, received a B.A. in Journalism and Equestrian Studies from Averett College in Danville, Virginia. A Pony Club and 4-H graduate, her background is in eventing, and she is schooling her recently retired Thoroughbred racehorse, Happy, toward a career in that discipline. She also enjoys traveling, photography, cycling, and cooking in her free time.

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