Barbaro has 2 fractures, future still uncertain...

[Wabash Wonders]

The following is a strory from espn.com:


BALTIMORE -- His career certainly over and his life in jeopardy, Kentucky Derby winner Barbaro left Pimlico Race Course with a police escort at 7:18 Saturday evening and was taken to the New Bolton Center of the University of Pennsylvania in Kennett Square, Pa. There, surgeons will perform surgery in an attempt to save his life.

New Bolton is about 75 miles from Pimlico.

According to Dr. Larry Bramlage, the media liaison for the American Association of Equine Practitioners, Barbaro broke his right hind leg in two places. One fracture was above the ankle and the other was below it. He called the injury "life-threatening."

Bramlage refused to predict whether Barbaro would survive the ordeal, but he conceded that the colt has a fight on his hands.

"I can't give you a prognosis; it's a little early," Bramlage said, adding that even if the surgery is successful, "it will be two months before he is out of the woods."

He said there are two major obstacles Barbaro will face in his potential recovery. One, he said, is whether Barbaro lost a significant amount of blood in the area of the injury. The other, he said, is how he comes out of the surgery and whether further damage is caused to the injured area while he is recovering. Horses must have some mobility while recovering from surgery to avoid complications.

"You and I would lie in bed," Bramlage said. "He'll have to walk around."

Dr. Dan Dreyfuss, Barbaro's attending veterinarian, also declined to speculate whether the horse will have to be euthanized.

"That's up to the owners," he said.

Bramlage said the surgeons at New Bolton will have to evaluate Barbaro's condition before they decide when to operate.

"It could be tonight," he said. "It might be tomorrow."

Bramlage said the occurrence of the second fracture is what sets this injury apart from more minor ones.

"Normally, the way it happens is the fracture above the ankle occurs first," he said. "Before [jockey] Edgar [Prado] could pull him up, the second fracture occurred. It's like if you were in a football game and twisted your ankle badly. The problem is, people know enough to stop. He ran on and that caused the second component to the injury."

Barbaro broke through the starting gate prior to the start, but Bramlage did not believe that had anything to do with the injury.

It was an emotional scene in the Pimlico barn area after the race as several hundred onlookers and members of the media tried to get a glimpse of what was happening with the horse. Trainer Michael Matz got into a silver Lexus SUV and left just moments before the horse. As he was getting into the car, someone shouted, "Good luck, Michael." Another person yelled out, "We're praying for him."

Matz turned to the crowd and gave a brief wave before getting into the car.

Prado told the media Barbaro felt great before the race.

"When he went to the gate, he felt super and I felt like he was in the best condition for this race," he said. "He actually tried to buck me off a couple of times. He was feeling that good. He just touched the front doors of the gate and went right through it. During the race, he took a bad step and I can't really tell you what happened. I heard a noise about 100 yards into the race and pulled him right up."

[cheezer]

Here are a couple more articles:



Dr. Larry Bramlage, the on call veterinarian representing the American Association of Equine Practitioners (AAEP), discussed the injury to and condition of Barbaro following the Preakness Stakes.

DR. BRAMLAGE: At this point he’s been x-rayed so we know the injury, he has a fracture both above and below the ankle. Dr. Dan Dreyfuss is his attending veterinarian who took the radiographs.

The way that practical happens is they break the one above the ankle first, and they have so much energy and adrenaline that they try to keep running. It would be very much analogous to someone twisting their ankle badly and fracturing their ankle. They can stay in bed. Tried to keep running and he broke the bone just below the ankle because of the instability of the scenario.
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The problems that brings up are two-fold. One, there are significant danger to the blood supply to the lower limb. That’s the one you worry about the most as far as this being a life-threatening injury, but equally as important is that’s an injury that you or I would be put in bed for six weeks before we were allowed to walk on it, and that’s impossible to do with a horse.

So it’s going to take some sort of major stabilizing surgery. The preliminary word was he was going to go to the University of Pennsylvania for treatment, but there’s a couple of steps to take care of before that.

First of all, he didn’t get a chance to run the race, so he is still full of energy. So they’ve tranquilized him and settled him down in the stall, and then you have to stabilize the limb in some fashion for transport so that he doesn’t do additional damage to it while he’s hauled up there.

So there’s some major hurdles here. This is a significant injury, and there are at least a couple of things that it are very life-threatening for him. His career is over. This will be it for him as a racehorse.


Q. Just to confirm, Dr. Bramlage, is it the right hind ankle?

A. The right hind ankle. And the fractures are fracture of the bone just above and a serious fracture of the bone just below the ankle.

Q. Now, you said this was a touchy situation at best and that surgery was in the offing provided he could get that far. Best case scenario, when would he have this surgery in?

A. Well, that’s somewhat depends on him. If you have your choice, you would like to settle the horse down, get him used to the fact that he has a fracture. He becomes a much better patient for anesthesia and recovery from anesthesia, which as everyone knows is a major obstacle for a horse like that for an animal of 1200 pounds.

But in some instances, the fracture is unstable enough that you’ll take some intermediate route. We try not to take them immediately to the operating table because we know with a horse physiology and their psyche, especially, as I said in this scenario, he didn’t get a chance to expend these energies.

He’s still full of energy that they have to somehow deal with that psychological aspects of getting him under control and then taking him and make him a good patient for surgery and the anesthesia because this surgery will take some hours when they reconstruct him.

Q. Dr. Bramlage, Gary Stevens mentioned on the telecast before the race started that he seemed particularly revved up. Later he broke through the gate, and I presume he was vet checked after came back around before he was permitted to reenter the starting gate?

A. Right.

Q. Could that, that pent-up energy in anyway have served as the foundation for this kind of trying to do too much, or is it just a total fluke in the same way that this could happen to any horse at any moment?

A. Any horse, any person. You know, why does a football player turn their ankle, break their tibia? Why does a basketball player blow out their knee. It’s all of this excitement and energy certainly but that energy doesn’t predispose the fact that he’s going to have an injury. It has to be some sort of, you know, bad step, load the thing unevenly.

As everyone knows, they have six times our body weight and have about the same amount of ground surface as you or I do and those really elegantly built lower legs are very vulnerable to twisting it as just exactly the wrong ankle and create the fracture.

Q. Dr. Bramlage, before it was apparent to nay of us laymen that something was amiss, Edgar Prado was already in the process of pulling him up.

To what degree does the quickness of Prado’s actions improve Barbaro’s chances over the next 24, 48 hours?

A. Well, that relates to what I mentioned about the blood supply. The more steps he takes on an unstable limb, the more damage it’s going to do to the blood supply.

Horses only have two relatively small arteries to that part of the leg and so it’s critical that the horse get pulled up before they damage those too badly.

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Edgar Prado probably knew something was wrong when that first fracture happened but the horse doesn’t likely know that. They don’t sense even in the end if Edgar had let him go he probably would have tried to chase him around the field because it doesn’t hurt initially with all that adrenaline rush especially when you tear the covering of the bone where the—where all nerve supply is.

The horse feels relatively nothing until the in inflammation set it. Edgar was probably more aware that he was injured than the horse was.

Q. Could you attempt to clarify Dr. Bramlage when in your estimation the first fracture occurred? Was it after he broke through the starting gate, the actual running of the race? I mean after the real running of the race could it have happened earlier?

A. No, it couldn’t have happened earlier because he broke out of the gate and was going whenever his action began to — when Edgar felt something was wrong so this happened sometime after he was going in the what, the first future long or so.

At around that time and then it took him another hundred yards to get him slowed down. So, in my opinion, this had nothing to do with him breaking through the gate as far as a cause and effect of the fracture in his leg. He wouldn’t have been able to go around the gate, get back in and break like he did.

Normally the way these happen is the one above happened first. Before Edgar could get him pulled up, the second fracture occurred, which makes this doubly difficult for the horse to heal everything up.

This is a very serious injury. The critical scenario is how the horse responds when you splint him, take care of him and get him on his way to be treated.

It will be a while before New Bolton Center will know exactly when the best time to treat him is.


Poise on the track may save horse's life
By Doug Donovan and Bradley Olson
Sun reporters
Originally published May 21, 2006
By all accounts, Barbaro has been as good a patient as he was a racehorse - and his poise is what may ultimately save his life, medical experts said.

"Without having that type of disposition, he wouldn't have made it this far," said Dr. James M. Casey, a Laurel veterinarian.

The 3-year-old colt faces surgery today at the University of Pennsylvania's New Bolton Center in Kennett Square, Pa. From the moment jockey Edgar Prado heard a snap seconds after the Preakness Stakes started to the arrival of Barbaro at the hospital, doctors said the horse's grace helped it from compounding a catastrophic and rare injury.

According to Dr. Nicholas L. Meittinis, a veterinarian who treated Barbaro at Pimlico, the horse broke two bones in his right hind leg - the 4-inch-long pastern bone, below the ankle, and the 12-inch cannon bone above the ankle. The diameters of both bones are no bigger than the size of a tennis ball, he said.

All experts agree that Barbaro's racing days are over. But if he survives the recovery from surgery, he could go on as a stud.

It's the recovery, not the surgery, that they say is most dangerous.

The operation, which could last up to four hours, will proceed much like a human's surgery. Barbaro will be placed on a surgical bed, and general anesthesia will be administered through a tube placed down his throat.

The broken bones will be repaired with pins and plates, Casey said. As Barbaro awakens from his haze of anesthesia, he will likely find himself suspended by a sling in a pool to prevent him from thrashing about, Meittinis said.

To keep Barbaro from injuring himself during recovery, the colt will spend most of his time - for up to six months - tethered to a wall. He will be able to reach his water and food and hay, but Barbaro will have to sleep standing up.

"I haven't seen this exact injury before where they break both" bones, said Meittinis, a veterinarian since 1989. "This is an unusual injury."

So rare that one report by a California doctor stated that the "prevalence of deaths due to catastrophic, fatal injuries in racehorses is less than 2 per 1,000 race starts."

With bodies weighing upward of 1,300 pounds, medical experts said, breeding, training and genetics are what keep those spindly ankles from buckling under more often.

A horse's instinct, even after an injury, is to keep running, causing greater damage.

"Lesser skilled jockeys would have broken Barbaro's leg on the track, and he would have had to have been put down on the spot," Casey said. "You're only one step away from something like this."

Shortly after Barbaro's missteps, medical staff affixed a splint and moved the horse in an ambulance to Barn E, Stall 40, the Kentucky Derby winner's reserved space. There Meittinis and his associate Dr. Dan Dreyfuss sedated Barbaro, took digital X-rays and wrapped the injury in a pressure bandage.

Dr. Larry Bramlage, a veterinarian who attended to Barbaro at Pimlico, said blood circulation is one of the most life-threatening concerns with broken bones in horses.

"There's significant danger to the blood supply to the lower limb," Bramlage said.

As Meittinis described it, "The fracture can act like a knife and sever the blood supply to the limb below."

He said Barbaro's "thready" pulse at Pimlico indicated blood flow blockage and mild shock.

"It's not always apparent right away because there is swelling and you can't assess the [blood] circulation for a day or two," he added. "This horse had a tremendous amount of poise. He never tried to kick anyone. He was all business."

Barbaro was loaded into an ambulance and transported last night to the New Bolton Center, one of the nation's premier surgical centers for horses. Once there he was placed on analgesics and pain medication, and was suspended in a sling to avoid standing.

He was scheduled to be given fluids all evening, and six to 10 nurses and veterinary residents will monitor Barbaro all evening.

"There are some horses that just don't make it for some very strange reasons," said Dr. David Nunamaker, chairman of New Bolton's Department of Clinical Studies. "If the horse is a good patient, that helps. If he fights you and is contrary to what you want to do," it makes it hard for the animal to recover.

"There are lots of hurdles - recovering from anesthesia, and healing his fracture, which may take some period of time, he said. "This horse is a good patient."

[bluesky8921]

that made me sad when I watched all that yesterday

[WildKat]

The Courier Journal(Louisville) reports that he is in his 5th hour of surgery.