By John Scheinman
Special to The Washington Post
Friday, July 14, 2006; E03

KENNETT SQUARE, Pa., July 13 -- Prospects for the long-term survival of Kentucky Derby winner Barbaro dimmed Thursday after the surgeon in charge of his care announced the colt has acute laminitis that has left only 20 percent of his left hind hoof connected to the cannon bone.

The potentially fatal inflammation, said Dean Richardson, chief surgeon at the University of Pennsylvania's New Bolton Center, usually is caused by excessive weight on the hoof, as when overcompensating for an injured leg. Barbaro's right leg shattered when he misstepped at the start of the Preakness Stakes on May 20 at Pimlico Race Course.

"The left hind foot is basically as bad a laminitis as you can have," Richardson said Thursday morning in a briefing room at the hospital. "His prognosis for long-term life and comfort has been significantly diminished by this particular complication. However, there was a lot of wild speculation that the reason we were [holding the news conference] is because the horse is being put down, humanely destroyed, euthanized, whatever word you choose to use is, and that's simply not the case."

Nevertheless, Richardson said Barbaro's chances of recovery are poor.

On Wednesday, the surgeon performed a hoof wall resection, cutting away 80 percent of Barbaro's left hind hoof and cleaning out the dead laminae, or connective tissue, that was no longer binding hoof and bone.

"That tissue, if it becomes damaged, which is what happens in laminitis, separates and then you lose the connection between the bone and the hoof," Richardson said. "And if the horse loses the connection between the bone and the hoof, it's exquisitely painful to the horse because the horse needs that connection to walk around."

Regrowth of the laminae could take up to six months, Richardson said, as the horse grows a new hoof wall, "just the way you would regrow a nail if you had your nail essentially pulled out, which I think everyone recognizes to be very painful."

Pain will be the determining factor as to whether Richardson continues to try to save Barbaro's life. The colt's owners, Roy and Gretchen Jackson of West Grove, Pa., have said repeatedly they do not want to press on if Barbaro is not comfortable.

"We have to keep our fingers crossed and hope he can pull through," Barbaro's trainer, Michael Matz, told WJZ (Channel 13) in Baltimore. "It's been very stressful the last couple weeks. He's gone through a lot, and it hurts to see him like that. We have to hope the one chance he has will pull him through."

Despite the prognosis, Barbaro continues to eat well, nickers when approached and walks around his stall, Richardson said.

Without getting into specifics, Richardson stressed he was not anesthetizing Barbaro's leg but treating the horse with opiates, epidurals -- which are injected anesthetics -- and other pain management techniques. The horse also spends several hours a day in a sling, which elevates him off the ground.

"We will try all reasonable avenues," Richardson said, "and if they don't work, we will quit."

For the past 10 days, as Barbaro's promise for recovery spiraled after six relatively smooth weeks, Richardson focused on an infection that developed in the pastern joint of the colt's injured right hind leg.

Most of the bones fractured in the Preakness have healed since the surgery the day after the race, but on Saturday, Richardson changed six screws in the region that connects the long and short pastern bones, applied two new titanium plates and attempted to clean out the infection.

At the time, the surgeon mentioned an abscess that had formed in Barbaro's left hind hoof, but by Wednesday that condition had grown far worse.

"There's no book you go to that says, 'This is laminitis 101,' " Richardson said. "We are not doing anything outrageous on this horse."

Yet, Richardson said, the New Bolton Center has been besieged with offers of help and ideas on how to treat Barbaro.

"Nobody who called Doctor Richardson offering any of these things had anywhere near the experience he has," said Larry Bramlage, a surgeon at the Rood and Riddle Equine Hospital, who diagnosed Barbaro's fractures in the aftermath of the Preakness. "The thing is, the number of supplements and special healing aids out there that have no scientific evidence that they help is huge."

While Barbaro is watched around the clock, his future is not being determined on a minute-by-minute basis, Richardson said.

"But it could certainly happen within a day or two," he said of a decision to euthanize the horse. "I mean, today the horse looks very good."