Barbaro Updates: 191 – 209

Update 209: No update, but someone in the comments asked about the naming of Barbaro. Anita’s response made me smile:

Linda Lee – I read a cute story about the name Barbaro. BEFORE the Kentucky Derby, Michael Matz was being interviewed and was asked by the interviewer what the name Barbaro meant. Michael Matz turned to Peter Brette, the assistant trainer, and repeated the question. Peter Brette immediately replied “KENTUCKY DERBY WINNER!”.

Lynette then provided the more official version of the name, from the link: Batting 1.000:

Paraphrasing:

Mrs. Jackson had foxhunted and competed at hunter trials for much of her life.

Barbaro got his name from a foxhound in a five-panel 1880’s painting the Jackson’s discovered in Mr. Jackson’s mother’s attic after her death. Each dog had their name written at the bottom of their picture. They chose the hound on the right-hand side, Barbaro. The painting is now in the family room.

It has been speculated that the Jackson’s will name Bobby’s full brother (the cute foal we have pictures of) after another hound in the painting.

The following article from yesterday: Trainer reports that Barbaro is resting quietly notes Michael’s win yesterday and discusses Barbaro’s condition yesterday (I think the articles we cited in update 207 and 205 are more recent), including the following about his weight:

According to Gretchen Jackson, Barbaro, whose right hind leg was shattered in the May 20 Preakness, had lost a lot of weight while recovering from the initial surgery on May 21. He had gained that back before getting a fever and showing discomfort in his hind legs about 10 days ago. Now, after four cast changes and a very long, involved surgery Saturday night into Sunday, Barbaro is trying to recover from all that.

Update 208: New Bolton Center press release this morning echoes other recent news: Barbaro’s condition guarded (thanks Sarah):

Kentucky Derby winner Barbaro is continuing to rest comfortably today according to Dr. Dean Richardson, Chief of Surgery. “As we said yesterday, Barbaro’s condition is potentially serious, and we are aggressively seeking all treatment options,” he said. “Today we will focus on further diagnostics and keeping our patient comfortable.” Barbaro is being treated for fractures received at the Preakness on May 20 as well as discomfort in his left hind foot.

“He’s facing tough odds and his condition is guarded,” said Dr. Richardson. “Our entire staff is determined to do all they can for this magnificent horse.” All decisions are being made in constant consultation with the owners, who continue to be only interested in his comfort.

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

Watch for a media advisory for a press conference later this week.

On a lighter note (needed) Tim told me a funny story this morning. His friend Mike, who visits Tim’s barn each saturday morning and now has a horse that may come to training in time, was at Delaware Park. He was talking with someone in the office there, and asked her if she new Tim Woolley. She said no, but I am on his site right now, and showed him the computer screen! Not sure many trainers can say their web-site is more famous than they are!

Update 207: The Baltimore Sun covers the same problem in the “good” leg that was covered by the New York Times (update 205): Barbaro suffers another setback (thanks Sarah). Please read in full. Someone in the comments noted that it was a positive signal that I even saw Michael this morning. Oddly I had the same thought, and had mentioned it to Michael earlier (that I was relieved to see him at Fair Hill). I am not sure if he heard me to be honest.

Update 206: Saw Michael Matz this morning as I was going to the track. He told me Dr. Richardson had called and said Barbaro appeared a little brighter this morning (wednesday). I suspect we should take this news within the context of the two articles reproduced in Update 205. I’ll post more later as I learn more.
updated wednesday 7:20am

Update 205: Articles from the New York Times and Washington Post highlight the current problems Bobby is facing. New York Times Another Serious Turn in Barbaro’s Recovery (thanks Gloria) copied in full:

The recovery prospects of Barbaro, the Kentucky Derby winner, took another serious turn Tuesday when veterinarians discovered that the infection in his left hind leg may be more serious than first thought.

Dr. Dean Richardson, chief of surgery at the George D. Widener Hospital for Large Animals, will detail the setback to Barbaro’s owners, Roy and Gretchen Jackson, on Wednesday, Gretchen Jackson said Tuesday night.

In a telephone interview late Tuesday, Jackson said that tests had identified a bacterial infection on Barbaro’s left hind — or healthy — foot that Richardson hoped he had cleaned out during a three-hour operation late Saturday.

During the operation, Richardson also changed the titanium plate and many of the 27 screws that had been inserted into Barbaro’s injured right hind leg on May 21, a day after the colt shattered it during the opening yards of the Preakness.

Jackson said she did not know the details of the infection or possible treatment, but said that she, her husband and Richardson remained optimistic that Barbaro could overcome the setback.

“Barbaro is alive and he is going to be alive and is acting like he wants to live,” Jackson said. “He is having trouble with his good leg. He can put weight on the leg and is a pain-free horse right now. We, and he, are not quitting. We’re a long way from that.”

Gail Luciani, a spokeswoman for the University of Pennsylvania Veterinarian School, said there might be a news conference about Barbaro’s condition later this week.

Late Tuesday afternoon, the school released a statement saying that Barbaro was eating well, resting comfortably and without fever after undergoing surgery and four cast changes in the last eight days.

Richardson, who on Monday warned that the colt faced tough days after those medical setbacks, said his team had also changed the bandage on the colt’s left hind foot, where they drained an abscess during surgery.

“Barbaro is eating well and resting in his stall,” Richardson said in the statement. “He’s tolerating the new cast well. We have changed his left hind foot bandage and that looks improved. His vital signs remain stable and his attitude and appetite remain excellent.”

On Monday, Richardson had changed Barbaro’s cast from a full-length one intended to protect the colt as he came out of anesthesia to a shorter one that allows Barbaro more mobility. The cast changes and surgery were prompted by fever and infections that made it difficult for Barbaro to support himself on his hind legs and raised the concern he might develop laminitis, a painful condition for horses that is caused by excessive weight bearing on one limb.

While horses with laminitis can be saved, and there was no evidence that Barbaro had developed the condition, the prospect of him having to battle the condition could be devastating, Richardson said Monday. The potentially excruciating pain could put stress on Barbaro and impede his healing process, leaving little choice but for his owners to ask the veterinarians to euthanize Barbaro.

Richardson said that option had not been discussed, and on Tuesday Gretchen Jackson reiterated that she and her husband had yet to consider that option.

Before Barbaro’s bad turn over the weekend, he seemed to be recovering well. X-rays last week showed that his main fracture was healing well. It was the pastern joint, which is above the hoof, that had veterinarians worried.

On Friday and Saturday, however, it was clear that Barbaro was uncomfortable and surgery was needed. The colt had been treated topically for an abscess found on his left foot, had a fever and struggled to put weight on his right foot.

Before Richardson performed the original five-hour operation, he calculated the chances of Barbaro’s survival at 50-50; and he increased them only slightly to 51-49 in the days after the procedure, when the colt’s convalescence was proceeding smoothly.

But Gretchen Jackson said that she and her husband were aware of the long odds they were facing, and they have steeled themselves for the sudden shifts in Barbaro’s status.

“We’ve know all along that what can be going wonderfully can turn disastrous in a moment,” she said. “We also believe that what can be going badly can be turned around, too.”

Washington Post: Infection Leaves Barbaro In Jeopardy (thanks Debbie):

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.”

It appears each article covers a different problem.

Update 204: Just spoke to Peter Brette. He reported that Barbaro remains the same. He is doing OK. That being said, I could just hear in his voice that he knew these were extremely tough days. Barbaro has just been through a lot in the last few days. Time to focus on how successful Nurevey came through: A Look Back: Saving Nureyev. Nureyev is an amazingly uplifting story. Keep all energy for Barbaro please, lets hope he writes a similar story!

Update 203: As update 202 was being composed New Bolton came through with an update: Barbaro stable after sixth cast applied (thanks Faye):

Dr. Dean Richardson, Chief of Surgery, reports today that Kentucky Derby winner Barbaro is resting comfortably after receiving his sixth cast since his accident at the Preakness on May 20. “Barbaro is eating well and resting in his stall,” said Dr. Richardson, who also treated the colt for an abscess in his left hind foot.

“He’s tolerating the shorter cast well,” said Dr. Richardson. “His vital signs remain stable and his attitude and appetite remain good.”

Update 202: No new update until after 6 pm unless New Bolton provides something. Just wanted to let everyone know. I called Peter Brette at 3, he was still at the barn (Fair Hill). Michael is running a horse today, once that has run he will get to NBC and let Peter know. Peter plans to call me later.

As I continue to read through all the recent Barbaro articles this one seemed pretty comprehensive re: the recent events: Barbaro has ‘very significant setback,’ surgeon says (thanks CJ): the following is an excerpt:

After Barbaro’s temperature spiked to 102 degrees Saturday and the Kentucky Derby winner showed signs of discomfort, Richardson performed surgery that evening. Monday was a better day for the horse, the surgeon said.

and

Monday, the horse had a sixth cast put on, his fourth cast replacement in the last week. Richardson put a shorter cast on, like the previous ones Barbaro had been wearing. The doctor had put on a longer cast, covering Barbaro’s entire leg, Saturday night. That cast was designed to protect him better as he woke up.

“He’s a tough horse . . . a big, strong horse that’s kind of aggressive, so we put him in a full-length cast,” Richardson said. “It’s a more protective cast, but it’s also much more cumbersome for a horse to wear. They panic a lot of times because they feel they can’t move their legs. He really didn’t like it very much.

“As a consequence, we spent most of the night trying to get him back standing comfortably. We literally worked on him for close to 15 hours (including the surgery) before he was back in his stall.”

Good luck Bobby, these are the toughest of days I am certain.

Update 201: The Baltimore Sun (which continues to do great Barbaro coverage) has an interesting article: Barbaro faces ‘tough times’ (thanks Anne) that includes quotes from Peter Brette and a vet which I include below:

At the equine center in Leesburg, White said the main concern in such cases is whether the bone is actually healing.

“Any evidence of healing is a good sign,” he said. “It’s a race between that bone healing, having the plate and screws hold up and keeping infection at bay.”

Richardson said Sunday that Barbaro’s main fracture was healing well, but the pastern joint above the hoof – which was shattered into more than 20 pieces – continues to be a concern. The joint, which doctors are attempting to fuse, was stabilized with “new implants and a fresh bone graft.”

Often, such a traumatic break leaves portions of the bone and tissue without sufficient blood supply to grow back together, White said. Inadequate blood supply also hampers the immune system’s ability to find and destroy any bacteria that entered the wound during surgery.

“Then you’ve gone ahead and taken a piece of metal and screws and put them into that environment,” he said. Bacteria will attach to the metal parts, grow and destroy surrounding tissue and bone. That can loosen screws and diminish the support needed by the bone as it heals.

Veterinarians watch animals for signs of postoperative infection. They check for fever and look for evidence of pain, such as limping or favoring the injured leg. They may even be able to feel unusual heat through the cast or spot drainage that signals infection in the wound, White said.

Such contamination is quite common, he added. “You use antibiotics locally during the process to kill as many [bacteria] as you can so there is no infection, but it’s not a perfect science.” If the tissue is healthy and the number of invading bacteria is low, the animal will fight off the infection and recover.

White, who has not participated in Barbaro’s care, declined to speculate on the colt’s chances for survival. “I’ve managed horses with this kind of [injury] that have survived, and I’ve had others that did not,” he said.

One of the big questions Barbaro’s doctors must be addressing now, he said, is whether, after weeks of antibiotic treatment, the bacteria in the animal’s wound have grown resistant.

A less tangible question is whether Barbaro has the heart to keep fighting.

“They have personalities,” White said of thoroughbreds. “Perhaps we’re not perfect at reading their minds, but we get a feel for when they are hurting and not willing to give what they need to survive.”

“There is something there that tells you when they want to quit,” he said. “And you have to make that tough decision.”

I have added a couple of sites to the fan media page.

Update 200: Spoke to Michael Matz this morning (Tuesday) as I was going onto the track, he was ponying Peter off the track. I asked Michael “how’s your horse doing?”… he said Dr. Richardson had just called and reports Barbaro is holding his own.

Also spoke to Kathy Anderson who visited Bobby last night at 6pm (Monday). She was relieved to see him in the condition he was in. He had just had a bath, mane combed, and was eating.
Updated Tuesday 7:10am

Update 199: Trying to identify news stories that have information we have not already seen, so I apologise if I miss a good story! The Daily Racing Form: Barbaro ‘comfortable’ after more surgery (thanks Maria) includes some insights from Dr. C. Wayne McIlwraith, a of Colorado State University’s Equine Orthopedic Research Center, excerpt:

“It’s definitely a setback,” said Dr. C. Wayne McIlwraith, a of Colorado State University’s Equine Orthopedic Research Center. “When you get an infection, it’s always a challenge. But the other thing to state is that, if you have stability, you can heal bone in the presence of infection. So there is still some reason for optimism.”

McIlwraith pointed out that Barbaro’s radiographs have reportedly shown knitting in the fractured areas.

“That means he already has some stability from bony union,” he said. “That’s one of the things that’s positive.”

The new locking compression plate that Richardson implanted Saturday may also aid with stability and allow bone healing, McIlwraith said.

“Ultimately, when you get healing, you can take out the implants and clean out the infection,” he said. “If the infection persists and causes instability in the plate or the screws, that’s difficult.”

I added some new videos to the fan media page, thanks Jessica Franks. You might also want to light a candle for Barbaro at gratefulness.org (thanks Melissa).

Update 198: Jeannine Edwards has posted a comment after her afternoon at New Bolton Center covering Barbaro for ESPN. I copy it here in full (thanks Jeannine):

We spent the afternoon trying to get the latest info on Barbaro. I spoke with Michael Matz on the phone…. he was just leaving New Bolton around 1:45pm. He said it was a long night Sat. night… Dr. Richardson later told me from start to finish the entire ordeal was about 15 hours. They both described Barbaro’s recovery this time around as “long and grueling”. Michael said they had put the longer, full cast on and that Barbaro wasn’t handling it too well. (Thus the decision to remove it earlier today.) For the first time in all of this, Barbaro had been in a sling… they were taking no chances. Michael said it’s been a long, trying week and that it was especially difficult for him to see Barbaro in pain, but that he was encouraged to see him feeling better and looking brighter today. After my conversation with Michael, Dr. Richardson came out for an inpromtu press “conference”, I say it that way because there only 3 or 4 of us there. He said Barbaro had exhibited changes in his condition, that he had a persistent fever, and that his comfort had diminished in both hind legs. His pastern joint is infected (not good) but the primary fractures (in the cannon bone and sesamoids) are healing well. They decided to remove the 16″ plate and some of the screws because all of this hardware was infected. They put in 2 smaller plates and new screws, and did a new bone graft to aid in bone healing in the pastern… which didn’t have much bone left after the injury (many smaller fragments had been removed.) They finally were able to drain the abcess from his left hind foot, so that should make him more comfortable. Richardson called these “serious complications” and that it’s “definitely a setback”. As I said earlier, Michael confirmed to me that the Jacksons have postponed a trip to Africa. When asked if the subject of euthanasia had come up at all over the weekend, Richardson said “We’re nowhere close to that… we haven’t even contemplated that… not even close to calling it a day with Barbaro.” So that’s a good sign. He did tell me the timing of the complications was unusual, as they would have expected infection soon after the original surgery, not 6 weeks later. His condition is “guarded”, and he’s still at 50/50 for survival, although 2 weeks ago his chances were at least 60/40. It’s a day to day situation and he’s being monitored around the clock. We then did a live report for ESPN News at 4pm, then taped reports for tonight’s SportsCenters and tomorrow’s Wire To Wire. This coming Sunday we have a live show (the Delaware Handicap) so we will be including a Barbaro update then as well. Ok, it’s 8pm, time to grab a bite for dinner. Let’s all say a prayer and hope for the best.
Jeannine

Update 197: Just saw Jeannine Edward’s coverage on ESPN. She used some of the same footage we can see from the press conference noted in the CBS3 video below (Richardson press conference). She also spoke of Michael Matz and how hard is was for Michael to see Bobby in some pain again (I guess over the weekend) and that he was a little brighter today (Bobby, and I guess Michael!). My somewhat educated guess, Michael is there now, as he seems to be camping out there lately other than training hours in the morning. Jeannine also noted the Jackson’s decision to cancel their trip to Africa. I am hoping Jeannine will post a comment here later tonight noting her experience at New Bolton today.

Update 196: CBS3 has video footage of Dr. Richardson’s press conference today: Dr. Dean Richardson Updates Barbaro’s Condition (thanks Skyler)

Update 195: NBC10s coverage today: Barbaro Chances 50 – 50 (thanks Cheryl) If anyone wondered whether we cared for Barbaro, check the stats on this site today 5,190 visits by 6:06 pm

Update 194: Saw the NBC10 coverage, if you get a chance to see it at 6pm, it’s well worth it. It includes footage of Bobby, and commentary from Dean Richardson. He is quoted “He is feeling reasonably good right now”. Dr. Richardson noted they had 6 weeks with no problems, then multiple problems in one week. He noted Bobby remains 50 – 50, and clearly it’s a day to day situation. The piece was about two – three minutes and ran early in the newscast.

No recent update from Mike Rea, I assume that is not a bad sign, lets hope for an update soon!

Update 193: NBC10, for those in the local area are covering Barbaro today (thanks Danielle) along with Jeannine Edwards and ESPN:

For those in the NJ, MD, DE area, the local nbc10 news station will be airing the same footage as espn did at 5pm ( it was on at 4 as well) along with some other interviews of horse lovers.

ESPN article: Doctor: ‘Tough days ahead’ for Barbaro (thanks Lynda) copied in full:

Kentucky Derby winner Barbaro was facing major problems for the first time since surgery to repair the right hind leg he shattered in the Preakness seven weeks ago, with Dr. Dean Richardson saying “we’re in tough times right now.”

Barbaro had the cast on the leg replaced for a sixth time Monday — the fourth time in a week. The latest development followed many hours of surgery Saturday night when doctors replaced the metal plate and many screws and also treated an infection.

“I think we’re in for tough times right now. I think we’re going to have some tough days ahead,” Richardson said at the University of Pennsylvania’s New Bolton Center. “I’m being realistic about it. When a horse has a setback like this, it’s a problem.”

Richardson, the chief surgeon at the New Bolton Center, looked haggard during the briefing, and said it took more than 15 hours from the start of Saturday’s surgery before Barbaro had fully recovered from anesthesia.

He said Barbaro was back in his stall in the intensive care unit, where he’s been since the catastrophic injury occurred just a few hundred yards after the start of the Preakness.

“Right now, he’s happier,” Richardson said. “He’s got a normal heart rate, normal temperature, he’s eating like crazy. He’s very hungry. He’s making lots of manure. He looks actually pretty happy today. Now we have to see how he responds to what’s going on.”

The long cast applied Saturday night was replaced by a shorter cast Monday, and was done with Barbaro in a sling and under mild sedation, Richardson said.

“The long cast was used as extra support during the anesthetic recovery phase,” Richardson said. “It is much easier for him to move around his stall and get up and down with a short cast. We also found and treated an abscess in his left hind foot that was bothering him.”

Barbaro is receiving pain medication, antibiotics and other supportive care, Richardson added.

Update 192: New Bolton Press Release: Barbaro receives sixth cast (thanks Faye):

After evaluating Kentucky Derby winner Barbaro this morning, Dr. Dean Richardson, Chief of Surgery, replaced the cast on the colt’s injured hind leg for a sixth time. “The long leg cast was replaced with a short leg cast this morning. This was done with Barbaro in a sling and only under mild sedation,” said Dr. Richardson. “The long cast was used as extra support during the anesthetic recovery phase. It is much easier for him to move around his stall and get up and down with a short cast. We also found and treated an abscess in his left hind foot that was bothering him.”

Barbaro spent a comfortable night and is eating well after surgery to stabilize the pastern joint this weekend. “We’re continuing his pain medication, antibiotics and other supportive care,” said Dr. Richardson. “He appears more comfortable today and has had a normal temperature, heart rate and overall attitude.”

I spoke to Peter Brette a little earlier. He mentioned the new cast. He also noted the second abscess in the good hind leg (left hind) which they can now deal with (I assume they already have). This was good news as it revealed a source of discomfort. Peter (who did visit) said Bobby was standing well and munching on hay when he was leaving. I also spoke with Jeannine Edwards who attended a press conference at New Bolton. I assume content from that will be used for her ESPN bulletins we noted in update 191.