Surgery leaves Barbaro at risk

With doctors at New Bolton also dealing with issues involving the laminitis in Barbaro's left hind foot, Richardson talked of the risks involved in adding the fixation device.

"Unfortunately, we felt we needed to take this risk because this approach offered our only hope of keeping Barbaro acceptably comfortable," the surgeon said.

The major risk of the external device, Richardson said, is that the bone bearing the weight can fracture. "The other thing - we've been really struggling. . . . It's one thing to have [problems with] one foot at a time, but to have two hind legs, it means he's really going to overload his front feet. Clearly, laminitis in his front feet is a strong concern.

"The best way to describe this: It's essentially like a house of cards," Richardson added. "When one starts to go significantly awry, then more can happen."

This latest surgery became necessary, Richardson explained, after Barbaro developed "a deep subsolar abscess" last week on his right hind foot and other techniques failed to relieve his comfort.

"We elected to place his right hind [leg] in an external skeletal fixation device in order to provide the foot a chance to heal," Richardson said in a statement issued by New Bolton yesterday. "This means that two steel pins have been placed transversely through his right hind cannon bone. These pins are connected to external side-bars 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."

In the telephone interview, Richardson said, "The big thing is, we not see anything bad happen at this point for a while."

Richardson and Barbaro's owners, Roy and Gretchen Jackson, talked in advance about the procedure, as they always do, but there wasn't any debate on whether it was worth trying.

"This is a logical thing to try under the circumstances," Richardson said. ". . . This is not something that makes a horse real uncomfortable. Typically, when you put a fixer on, it makes him more comfortable."

For months, the biggest medical issues for Barbaro had involved the laminitis in his left hind foot.

"He's got a lot of issues, and not any of them is bad enough to say goodbye. But put together - it's not a good day for Barbaro," Gretchen Jackson had said Saturday afternoon.

Barbaro had a procedure Wednesday to replace the cast on his left hind foot. At that time, Richardson said, Barbaro also had the cast on his right hind leg "replaced with a custom-fabricated plastic and steel orthotic brace to give his foot additional support." But Gretchen Jackson said, "The brace didn't work on him. They had to take that off. He really didn't like that brace they put on him."

When laminitis was discovered in Barbaro's left hind foot in July, Richardson had to remove 80 percent of his hoof. There have been more issues recently. Earlier this month, Barbaro had experienced "a significant setback," causing Richardson to surgically remove damaged tissue from his left hind foot.

Even before that, when it appeared that Barbaro was going to leave New Bolton for a horse farm in Kentucky, Richardson never changed his overall prognosis, that the potential for problems meant the horse wasn't out of the woods. "The prognosis always has been extremely guarded," Richardson said yesterday.

Richardson's statement issued yesterday included this postsurgical update: "He had a perfect recovery from anesthesia and has been in and out of the sling since then. 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."

Richardson also told the Associated Press: "I'm upset, worried, not sleeping well. A lot of people are very, very committed and spent a huge amount of emotional sources on this horse. So it's very upsetting when things go badly."

After visiting Barbaro yesterday, Roy Jackson said last night: "He appears to be fairly comfortable. He had his three buckets of grass, and is doing as well as could be expected under the circumstances."

At this point, everybody involved is just taking things "day-to-day, hour-to-hour," Jackson said. One positive that he could find about the latest surgery: "If this had happened two months after the [Preakness], the fractures would not have healed enough to do something like that. Thank goodness there's a chance."