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Sunday, January 28, 2007

What's Next for Barbaro: External Fixation for Collapsing Right Hind

Left: Barbaro's right hind leg as it appeared on radiographs in November. This leg is now equipped with an external fixation device for support; pins were surgically implanted through the leg to attach to a brace.

A sobering statement from New Bolton Center this morning:

"On Saturday, January 27, Barbaro was taken back to surgery because we could not keep him comfortable on his right hind foot. 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.

"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."

External fixation for laminitis and other conditions is not an unproven technique for New Bolton. The hospital's Dr. David Nunamaker is probably the world's leading expert on this type of support. Photos of similar fixations from Hoofcare & Lameness files will be added to this story when I am back in the office.

From Gretchen Jackson, owner of Barbaro, on Saturday:

"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," Mrs. Jackson told Mike Jensen of the Philadelphia Inquirer.

Scott Morrison DVM, consultant on Barbaro's foundered left hind foot, was at home in Kentucky yesterday.

Journalist Jensen recently won an Eclipse Award, racing's highest honor, for his reporting on Barbaro. He is basically embedded at New Bolton Center, somewhere near the reception desk.

1 comment:

Eric Cohen said...

My name is Eric Cohen. I am the inventor of the Reebok PUMP and 3 years ago I helped a horse with severe laminitis heal and live comfortably for an addition 2 years. How do I get in touch with the jacksons or Dr. Richardson to see if the technique I used can help Barbaros. You can see who I am by Googling "Eric Cohen" and seeing my Ziggs profile. For the horse I helped, I hand made shoes to delicately support the frog area and the coffin bone so the horse could bear weight more comfortably and not favor on leg over another. The devices that were available on the market did not have the specific requirements that this horse needed.

Perhaps there is somethng that my technique will do that can help Barbaros?