More Anesthesia, Second Tenotomy for Barbaro

From the University of Pennsylvania, via news release:

As previously planned, Kentucky Derby winner Barbaro was placed under general anesthesia this morning to fully examine his left hind foot. “While his condition was unchanged over the last two days, we were unable to fully assess his left hind foot with him in his stall,” said Dr. Dean W. Richardson, Chief of Surgery. “In today’s procedure, another area of undermined hoof wall was removed. The left hind deep digital flexor tendon was cut to help decrease the pull on the coffin bone by that tendon. This was previously done in July, but the tendon had healed and was pulling on the coffin bone, contributing to the malalignment of the coffin bone. Because he has been more uncomfortable on his left hind, we put a cast back on the right hind lower limb for additional support. ”

Dr. Richardson reports that “Barbaro was awoken from anesthesia once more in the recovery-pool and had an uneventful recovery. He continues to receive intensive management for his discomfort on the left hind foot.”

Barbaro remains in the Intensive Care Unit of Penn’s George D. Widener Hospital at New Bolton Center.

Barbaro Clarification: Richardson Explains Cast Did Not Cause Relapse

The American public received a good lesson in the frustration of dealing with laminitis this week, as injured racehorse Barbaro experienced a flare-up of discomfort in his foundered foot. The episode began less than a week after a foot cast was applied by Rood and Riddle veterinarian Scott Morrison to stabilize the foot.

Surgeon Dean Richardson clarified today that the horse's problem is the sub-quality hoof growth, not the cast itself, in an interview with Dan Gelston.

"The medial aspect of the hoof was always going to be a problem because of the way it was healing," Richardson told Gelston, whose stories are distributed worldwide by the Associated Press (AP). "The cast did not cause this problem. This issue with the foot was probably inevitable."

Photo caption: Dr. Scott Morrison tends to a low-rise hoof cast on Thoroughbred mare Banjolene at the Rood and Riddle Equine Hospital. Photo courtesy of Dr. Morrison; © Hoofcare & Lameness Journal

Barbaro: Cast Removed at New Bolton Center

This just in from the University of Pennsylvania:

"Barbaro has had a significant setback over the last 24 hours. He became acutely more uncomfortable on his left hind foot. The foot cast was removed and some new separation of the medial (inside) portion of his hoof was found. This required some additional debridement (removal of the damaged tissue) last night.

"He is being treated much more aggressively at this time for his discomfort. He is continuing to eat well and is otherwise stable."

Third Sport Horse Veterinary Congress in The Netherlands This Month

Jumping Amsterdam & Veterinary Sport Horse Congress
January 26-27, 2007 - Amsterdam, The Netherlands

The Third Veterinary Sport Horse Congress will once again be held in combination with the "Jumping Amsterdam" showjumping event on January 26-27 in Amsterdam, The Netherlands at the RAI Congress Center.

The two-day program brings a unique atmosphere featuring international speakers from the USA, United Kingdom and Spain.

On Friday January 26 different orthopaedic problems of the back, stifle, shoulder and foot will be addressed.

One of the topics is the diagnosis and prognosis of collateral ligament injuries, presented by Jorge de la Calle DVM of Spain. Another highlight is a presentation about the risk of laminitis in sport horses and Andy Bathe's case-based presentation of lameness and poor performance evaluation. The second part of the afternoon contains topics about shoulder and back problems.

On Saturday January 27, the main topics will be tendon and the Metacam Pain Management Panel, with an international panel discussing the (ab)use of medication in sport horses. One of the speakers in this pain management panel will be Dr. Frits Sluyter, a member of the veterinary committee of the FEI.

International speakers at the Veterinary Sport Horse Congress are veterinarians Andy Bathe (UK), Jorge de la Calle (ESP), Rick Mitchell (USA), Jim Orsini (USA) and Frits Sluyter (SUI).

The chair of the congress is Gertjan ter Heijden, equine veterinarian at the veterinary clinic in Zeddam (NED).

In the evening, Jumping Amsterdam will present international show jumping. At Jumping Amsterdam 2007, sport and education will meet at the highest level!

For more information, or to register, please visit http://www.proveto.org

Note: On January 25th, a practical workshop on advanced ultrasound of tendons in sport horses will be held with teaching clinicians Hans van Schie and Andy Bathe (UK). This "Meet the Specialist" session will be held at the Veterinary Clinic in Emmeloord and is intended for veterinarians with advanced ultrasound experience.

Bryan Fraley Will Speak on Laminitis Therapy at North American Veterinary Conference on January 17

Bryan T. Fraley DVM will present a full day's program on laminitis and foot therapy at the North American Veterinary Conference in Orlando, Florida on Wednesday, January 17. Dr. Fraley is a foot-specialist veterinarian at Rood and Riddle Equine Hospital in Lexington, Kentucky, where he is works with Scott Morrison DVM on laminitis and other hoof problems. Morrison recently made headlines for his consulting role in treating racehorse Barbaro's laminitic left hind foot at the University of Pennsylvania's New Bolton Center.

Fraley's topics will be: Acute Sinker Syndrome Diagnosis and Therapeutic Options, Management of Severe Foot Infections, Treatment Options for Acute and Chronic Laminitis, Brief Review of Some Interesting Podiatry Cases, and How to Apply Foot Casts with Axial Support for Sinker Syndrome and Cast Shoes for a Multitude of Foot Conditions.

The conference, which continues through the weekend, will be held at the Gaylord Palms resort and conference center in Orlando. It is one of the largest meetings of veterinarians in the world.

Barbaro Update: Morrison Casts Foundered Foot for Stability

Left: Rood and Riddle Equine Hospital's Scott Morrison DVM finishing tendon surgery on a laminitic horse.(Hoofcare & Lameness Journal photo)

On Wednesday, January 3, Scott Morrison DVM of Rood and Riddle Equine Hospital in Lexington, Kentucky traveled to Kennett Square, Pennsylvania. Rattling around in his briefcase were strips of 3M Fiberglas casting tape, Goretex fabric, thick felt, Betadine and a large aluminum bar shoe. One can only imagine what that jumble looked like on the security screen. For once, TSA inspectors waved the veterinarian through.

Morrison used those materials to create a temporary supportive foot cast for Barbaro, the champion 2006 three-year-old colt whose right hind leg shattered soon after the start of the Preakness Stakes last May. Since then, Barbaro has been a patient at the University of Pennsylvania's Widener Hospital for Large Animals at the university's rural vet school campus called New Bolton Center. In July and August, the colt fought the painful disease of laminitis in his "good" hind leg. He was left with one broken leg and one hoofless one, but he struggled to survive. The damage to his laminitic foot continues to be the greatest concern.

Laminitis is the devastating disease that ended the lives of great racehorses like Secretariat and Sunday Silence, the Standardbred champion Nihilator, and more recently, the two great European champion dressage mares, Annastasia and Poetin.

Morrison, who heads Rood and Riddle's innovative podiatry clinic, was sought as a consultant to assist with the foundered (a common term for a foot that has been ravaged by the disease of laminitis) foot. He first saw the horse on December 20 for an evaluation, then returned on Wednesday to try to help stabilize the foot.

On Friday, January 5, Dr. Morrison told me that the cast was applied, "because the foot is so unstable. He's just not growing enough wall on the medial (inner) side, and he's bearing most of his weight on the arthrodesis (surgically-fused) leg."

Morrison padded the bottom of the foot with thick felt soaked in Betadine (iodine solution); the hoof wall was padded with Goretex fabric padding which was then covered with 3M casting tape. The cast extends up over the pastern area to just below the fetlock, according to Dr. Morrison.

"He lands on his toe when he walks," Morrison commented, "and that needed to be addressed. I had asked them to take radiographs before I got there, and they showed demineralization (thinning or actual deterioration) of the coffin bone (pyramid-shaped bone in the base of the foot, encased by hoof capsule) at the toe and on the medial (inside) wing.

"I attached a big aluminum bar shoe to the bottom of the cast to help with derotation, to try to get that coffin bone more parallel to the ground."

Morrison observed that the horse was uncomfortable at first with the change in footwear, but that surgeon Dean Richardson reported the horse was more comfortable with it the next morning.

An ancillary purpose of the cast is to stabilize the foot in the event that the horse needs to be moved out of his intensive care unit home at New Bolton Center. Speculation is that the horse will be moved to an as-yet unnamed farm, possibly in central Kentucky, to continue treatment in a more active setting. No date has been announced for his discharge from New Bolton.

Dr. Morrison is the founder and head of the podiatry clinic at Rood and Riddle; his unit is the largest such clinic in the world. The clinic currently employs four foot-specialist veterinarians and five lameness-specialist farriers, as well as a staff of technicians and administrative support staff. Morrison is a specialist in laminitis and consults on cases all over the world. He is also a consulting editor to Hoofcare and Lameness Journal.

His most recent article chronicled the transplant of frog tissue on the bottom of an injured foot via the punch biopsy tool method; he was able to create a germinating bed of new frog tissue in a damaged area. Ironically, he is probably most renowned for an article detailing his use of sterile maggots to debride many cases of infected hoof tissue. That article can be downloaded at http://www.hoofcare.com.

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