HANDLING WITH CARE

KENTUCKY DERBY winner Barbaro's life was in danger from the moment his right rear leg blew apart a few hundred yards into the May 20 Preakness. Even as the months passed after the May 21 surgery to repair the fractures, more surgery to cut away 80 percent of the colt's left rear hoof in July, good days and bad days, the basic prognosis has never changed. Barbaro's life is in danger.

Long term, there are no guarantees because animals react differently than humans and every little thing is complicated. And the complications have complications.

After another surgery on Saturday, Barbaro's right rear foot, which developed a "deep subsolar abscess," is no longer weight bearing and there is a chance that a bone now bearing the weight could fracture.

Roy Jackson, who, along with his wife Gretchen owns Barbaro, said last night that, "I think we're all on the same page. If his quality of life doesn't look good and he's in pain, then we have to make a decision."

That has been the Jacksons' stance from the start. They want to give Barbaro every chance, but will, as Dr. Dean Richardson, the chief of surgery at New Bolton Center, has said on many occasions, "quit" if it is obvious there is no long-term hope or the horse is in pain.

Richardson put out a statement yesterday that explained the surgery was necessary "because we could not keep him comfortable on his right hind foot."

Since July, Richardson has been much more concerned with the left foot that developed laminitis. Now, it's the right foot again.

"They are four-legged weight-bearing animals," said Mark Reid, a longtime trainer who now owns Walnut Green, a few miles from New Bolton in Chester County. "The bottom line is they are very fragile animals. They need all four of their support [apparatus] to exist. As one improves, that shifts weight back to the other."

According to Richardson's statement, "That foot developed a deep subsolar abscess secondary to bruising when he went through a period of discomfort on the left hind foot. It is not laminitis but the undermining of the sole and part of the lateral heel region are potentially just as serious.

"We attempted to manage the right hind foot in a cast and then in a custom fabricated brace but it was impossible to have access to the foot for treatment as well as acceptable stability and comfort. We elected to place his right hind in an external skeletal fixation device in order to provide the foot a chance to heal. This means that two steel pins have been placed transversely through his right hind cannon bone. These pins are connected to external sidebars that in turn are connected to a lightweight alloy foot plate.

"This results in the horse eliminating all weight bearing from the foot; the horse's weight is borne through the pins across his cannon bone. There is significant risk in this approach but we believed it was our only option given the worsening of the right hind foot problem. The major risk of the external skeletal fixation device is that the bone bearing the weight can fracture. Unfortunately, we felt we needed to take this risk because this approach offered our only hope of keeping Barbaro acceptably comfortable."

According to Jackson, Barbaro's foot can "now be soaked," to promote healing.

"He had a perfect recovery from anesthesia and has been in and out of the sling since then," Richardson said. "His left hind foot appears to be stable at this time. We remain concerned about both front feet. Remarkably, his attitude and appetite were excellent overnight.

"We will continue to treat Barbaro aggressively as long as he remains bright, alert and eating. This is another significant setback that exemplifies how complex his medical situation remains because both hind limbs have major problems."

On Dec. 13 at New Bolton, Richardson said: "It's certainly within my mind's eye that he could leave the hospital within the not-too-distant future."

Richardson wasn't saying the colt was cured, far from it. He was just saying there was nothing more they could do for Barbaro in the hospital, if the only issue was waiting to see if the left rear hoof, the one stricken by laminitis in July, would grow back so it could have a proper structure.

On Jan. 3, Dr. Scott Morrison put a cast on that hoof to "help realign the coffin bone properly in the foot," according to Richardson. The foot was not growing back evenly and that was a significant long-term issue if the colt was ever going to be able to lead a normal existence.

A week after the cast was applied, Barbaro showed significant discomfort in the foot. The cast was removed. At the time, Richardson called it "a significant setback."

On Jan. 12, Richardson said: "We've got to worry more about his right hind because he's bearing so much more weight on his right hind, getting off his left."

Now, of course, they are dealing with the right hind, just as Richardson feared.

"It's hour by hour, 1 day at a time," Jackson said. "You have bright periods. Then, something comes up."

That is simply the nature of this. There is no straight line to a cure.

"The big thing that people don't understand about these animals although they are noble and great creatures, you can't explain to them that, 'It's OK, we can deal with it and you'll be fine,' " Reid said. "They're much more primitive than us. They only react to pain, swelling . . . Particularly in a horse like this, people try to put human terms on them and there's no human terms . . . We can put our feet up. We can lie in a hospital bed. Horses don't react like people react, they only react to direct stimuli."

The issue for Barbaro once again is pain.

"He's nowhere near on as much medication as after he got the laminitis," Jackson said. "Life goes on. You have to not look back and keep a positive attitude."

There are, as Richardson said, unknowns with this latest surgery.

"I don't think Dean knows at all," Jackson said. "We've just got to wait." *