Infection Leaves Barbaro In Jeopardy

Barbaro is held by jockey Edgar Prado after injuring his leg at the start of the 131st running of the Preakness Stakes at Pimlico Race Course in Baltimore in this May 20, 2006, file photo. Barbaro developed "potentially serious" complications to his injured right hind leg, and underwent surgery to replace hardware and treat a new infection, doctors said Sunday, July 9. (Al Behrman - AP)

KENNETT SQUARE, Pa., July 11 -- An infection in Barbaro's right rear pastern joint has reduced the chance the Kentucky Derby winner will survive, Dean Richardson, the chief of surgery at the University of Pennsylvania's New Bolton Center, said Tuesday.

While the majority of bones fractured have healed in the seven weeks since Barbaro's catastrophic breakdown at the start of the Preakness Stakes on May 20 at Pimlico Race Course, problems in the joint that connects the long and short pastern bones in the ankle region are putting the horse's life in jeopardy.

"There's so much concern. It's significant," Richardson said from the George D. Widener Hospital for Large Animals on the New Bolton campus. "It worries me. I have a hard time sleeping at night. So many people want to see this horse survive. He is stable today, and he's got a great appetite, but he's not as good as he was two weeks ago.

"Two weeks ago we were at 50-50 [for survival]. With this new problem, we're less than that."

On Saturday, Richardson performed extensive surgery on Barbaro, changing six screws and applying two new titanium plates in the pastern joint area. Richardson also attempted to clean out and treat an infection that had developed in the joint. Under anesthesia, and with a long cast placed on his leg, Barbaro did not recover enough to stand on his own until 15 hours after the operation began. On Monday, Richardson replaced the long cast with a shorter one to give the colt more mobility.

Barbaro maintains a hearty appetite and his vital signs were stable Tuesday. Richardson continued to treat an abscess on the left hoof, changing the bandage. Richardson stressed that the pastern infection, which is being treated with antibiotics, needs to be controlled before healing in the joint will resume.

The infection in the pastern joint developed despite extensive precautions. For example, the orthopedic surgery suite at the hospital is a completely sterile room with special filters to keep sterilized air flowing in. On the floor at the entrance of each room in the hospital, including the intensive care unit where Barbaro resides, are mats soaked in a powerful disinfectant to cleanse the soles of shoes.

"Parts of the recovery have gone better than average, but the infection now is a complication we'd rather not have," Richardson said. "Do we always succeed in dealing with infection? No, we do not."

There are no medical benchmarks or thresholds to consider when deciding whether to continue trying to save Barbaro, Richardson said.

"When it gets to the point where he's inhumanely uncomfortable, there's no strict, objective measure you have to quote," he said. "It requires experience with consultation among many people. We're not at the point where we're going to pull the plug."