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Barbaro Benefits from Medical Advances

Kentucky Derby winner Barbaro is continuing to improve following marathon surgery over the weekend. The colt shattered his right hind leg in Saturday's Preakness, the second jewel of thoroughbred racing's triple crown.

Barbaro's surgeon, Dean Richardson of the University of Pennsylvania's New Bolton Center, told reporters Tuesday that he's encouraged with the colt's progress.

"He's got absolutely normal vital signs; temperature, pulse, respiration; attitude, appetite,” Richardson says. “He actually was scratching his left ear with his left hind leg, which is his good leg."

That's significant, Richardson says. It means Barbaro was comfortable putting that much more weight on his bad leg.

Not too long ago, vets wouldn't have even tried to save Barbaro. But much has changed in the care of catastrophically injured horses since the champion filly Ruffian had to be put down in 1975 following a somewhat less severe injury sustained in a match race with that year's Kentucky Derby champion Foolish Pleasure.

In fact, veterinary medicine has advanced so much that Richardson joked about it at the news conference to discuss Barbaro's condition Tuesday. He said he was a bit concerned that the university has set up a special e-mail address for the public to send the horse messages.

"I'm a little upset this is the first I've heard about the e-mail, because we actually don't have a keyboard in his stall yet," Richardson says.

But Barbaro's stall is about the only place at the New Bolton Center, about a half-hour drive west of Philadelphia, where you won't find the very latest in high-tech medical equipment.

Other than animal footsteps, and wards with stalls instead of beds, New Bolton looks a lot like many human hospitals. There's a neonatal unit, a sports medicine facility, even a giant treadmill. In radiology, where patients include not just horses but sheep, goats, antelope -- even an occasional elephant, Dr. Lexie McKnight describes the giant MRI machine.

"It's similar to an Oreo cookie without the cream in the middle,”McKnight says. “And in between there's a space for a human or a patient or a horse to position a portion of their body, such as a head or an ankle or a foot into the center of that hole, where we can acquire images about the anatomy."

On the other side of the padded wall, a horse and a goat are undergoing routine surgery in the same room. Vets here have advanced furthest, though, in caring for horses with critical injuries like Barbaro's.

"Everybody's focused on the injury; on that one bone," says Joan Hendricks, dean of the University of Pennsylvania Vet school, "but the entire other 999 pounds of the horse; the level of care that we've learned to do with the intensive care unit; it's 24/7; it has been for 10 or 15 years now."

Hendricks, says that unlike with humans, a broken leg has long been a life-threatening event for a horse, because you can't just put them on bed rest.

"If a horse does not bear weight evenly on all four legs, the legs that are not injured suffer terrible inflammation and changes in blood flow," she says. Eventually, the problem, called laminitis, can become so severe that "you can't sustain the horse," she says.

Vets have made major strides in equine surgery with the use of titanium implants and less invasive techniques, but the most dangerous part remains not the surgery itself, but what happens when you wake the horse up, Hendricks says.

"Anybody waking up from anesthesia is confused, and kind of thrashes around; not just horses. But here we have a large, young animal, and in some cases, particularly anxious," she says.

That thrashing around, in fact, is what led to the death of Ruffian, who survived the surgery following her broken leg, but couldn't be controlled when she woke up. So New Bolton has pioneered the wake-up pool. Anesthetized horses are carried in a sling from the operating room, then lowered into a rubber raft that fits over their legs like a giant horse glove. Then the horse is lowered into a pool, so if it thrashes, it can't re-injure itself.

The process is both time- and labor-consuming.

"At one end of this raft is an inflatable area where, once the animal is in the water, we inflate that and the recovery team sits around the animal's head to make sure that as it awakes it is kept calm," says Jane Simone, New Bolton's development director. "There's a huge crew on hand to recover an animal in a pool. About a dozen were here for Barbaro, and always a technician at the head of the animal and Dr. Richardson coming in frequently to check on him."

And all that specialized care does not come cheap. Barbaro's bills will certainly run into the tens of thousands of dollars, his vets acknowledge. Vet school dean Joan Hendricks says veterinary medicine is facing the same dilemma as human medicine: There's a growing gap between what doctors can do and what people can afford.

"As we become capable of doing extraordinary things that sometimes work; and then everybody really wants -- everybody loves their animal and wants the absolute ultimate to be done -- how does society afford that for any living creature?" Hendricks says.

Money is not an issue for Barbaro's owners, however. They are major donors to New Bolton, and Gretchen Jackson, who owns the horse with her husband, is a member of the vet school's board of overseers. At the news conference, Gretchen Jackson stressed that she would have wanted the same care even if Barbaro didn't have a potentially lucrative future as a breeding stallion.

"I hope there's some knowledge now that owners and trainers and jockeys care. It's not about the money; it's not about the limelight," she said. "What's better than love? I don't know."

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