The cast on Barbaro's right hind leg had a small crack in it so it was changed on Sunday, August 27. Dr. Dean W. Richardson, Chief of Surgery said, "Based on new radiographs that were taken, the leg looked excellent under the cast. The pastern joint looks completely fused, and there is only a small area in the long pastern bone that has a little farther to go before we take him out of the cast completely. Barbaro is bright and happy this morning with an excellent appetite."
In addition, the radiographs showed that there were no signs of infection. The cast change took place under general anesthesia, and Barbaro had another successful pool recovery before returning to his stall. Although his left hind foot still has laminitis, Barbaro seems comfortable with that foot as well and the bandage on it continues to be changed daily.
Barbaro remains in the Intensive Care Unit of the University of Pennsylvania's George D. Widener Hospital. The next update will be posted on Tuesday, September 5 unless there is a significant change in Barbaro's condition.
Update 08/23: Barbaro remains comfortable this week according to veterinarians at Penn's George D. Widener Hospital. "Barbaro is doing well on both hind limbs," said Dr. Dean Richardson, Chief of Surgery. "Because of this, we do not plan to change his right hind cast in the next two weeks."
The colt's left hind foot has laminitis, but Barbaro seems comfortable with that foot as well. "He needs to continue to improve over the next few months before we will have a better idea about his long term comfort." said Dr. Richardson. "Barbaro's appetite and his attitude right now are phenomenal; he attacks his feed and when he goes out to graze, he acts like he thinks he could train."
Doctors remain cautious about Barbaro's prognosis because, according to Dr. Richardson, there is no assurance that he will surmount all of his medical problems. "Right now, he is a surprisingly happy horse," he said. "He is gaining weight and has had his pain medications reduced without any effect on his well being. His strength and overall appearance have been improving since he became well enough to be walked outside each day."
Update 08/17: After almost three months in the Intensive Care Unit of Penn's George D. Widener Hospital, Kentucky Derby winner Barbaro has begun brief outings to some grassy areas adjacent to the ICU to hand graze. "We felt he was ready for a change of scenery, so last week we took him outside to pick his own grass," said Dr. Dean Richardson, Chief of Surgery. "He's not outside for a long time, but it's enough to let him enjoy the fresh air and sunshine. If he remains this comfortable, he will be hand-grazed daily."
Photos are available on the Penn Vet Web site that show Barbaro being walked to the ICU's grazing area. "I'm very pleased with his progress," said Dr. Richardson. "His appetite remains strong, he sleeps well, and we continue to monitor him closely. He is measurably gaining weight and his overall attitude is great."
Barbaro continues to do well, and is being hand-grazed for 20 – 30 minutes a day. "His blood work is completely normal and his vital signs are good," said Dr. Dean Richardson, Chief of Surgery. "I can't complain. Barbaro has had a very good week." Dr. Richardson also reports that Barbaro is no longer using the sling. "His comfort level has improved to the point that when he was in the sling, he wasn't "using" it at all. The sling is only bearing the horse's weight when he wants it to, and Barbaro's comfort level has improved to the point that he was not using the sling to support his weight."
It is definitely nice to hear such encouraging news about his condition. He looks quite skinny in the photos, so it is good he is eating well and starting to gain weight back. I hope we continue to hear more good news about his progress.
Update 08/09: Barbaro is doing well this morning after the cast on his right hind limb was changed late yesterday afternoon under general anesthesia. "The leg looked good under the cast, especially considering the length of time that he has been in a cast," said Dr. Dean Richardson, Chief of Surgery. "The radiographs also were encouraging. There is no sign of active infection. This is further supported by his markedly improving blood values over the last two weeks. He had an excellent pool recovery; he is a very intelligent horse and has definitely figured out the whole process."
The cast on the right hind leg encloses the foot and extends up to just below the hock. It will continue to be changed regularly until the fractures and joint fusions have healed completely enough to sustain full weight bearing.
The bandage and protective boot on Barbaro's laminitic left hind foot continues to be changed daily. "The appearance of the foot is very good. It is dry and healthy looking with excellent early regrowth at the coronary band," said Dr. Richardson.
Barbaro remains in the Intensive Care Unit of the University of Pennsylvania's George D. Widener Hospital. Remember in this case "no news is good news" as progress is very, very slow but bad things can happen in a heartbeat.
Update 08/03: Barbaro's left hind hoof is slowly showing evidence of regrowth after surgery last month to treat laminitis. Laminitis occurs when laminae, the strong connecting tissues that attach the pedal bone and the inner hoof wall, are inflamed. "The coronary band (the portion of the hoof that is responsible for continued downward growth of the hoof) is beginning to re-establish itself," said Dean Richardson, Chief of Surgery at the George D. Widener Hospital.
Barbaro's right hind leg continues to be protected in a cast. "The original fractures have apparently healed well, but the cast is necessary to protect the pastern fusion," Dr. Richardson said. "This protection is required because he must bear most of his weight on the right hind limb due to the laminitis in the left hind leg."
Barbaro remains in the Intensive Care Unit of the University of Pennsylvania's George D. Widener Hospital.
Update 08/01: Chief of Surgery Dean Richardson reports that Kentucky Derby winner Barbaro's condition continues to be stable. The colt's left hind foot, which has laminitis, is monitored closely for signs of infection. "We change his left hind foot bandage daily, and it looks good," said Dr. Richardson. "His right hind leg also looks good, and his appetite remains strong."
Barbaro remains in the Intensive Care Unit of the University of Pennsylvania's George D. Widener Hospital.
Update 7/28: Barbaro continues to be stable after another comfortable night according to Chief of Surgery Dean Richardson. His right hind leg cast was changed late Wednesday. "We took new radiographs, and they look good," said Dr. Richardson. "No problems were evident." In addition, the modified foot cast on Barbaro's left hind foot, which has laminitis, is changed daily so the foot can be treated and watched for signs of infection.
"Barbaro has a strong appetite, and he has been enjoying hand-picked grass and 'healthy snacks' daily," said Dr. Richardson.
Barbaro remains in the Intensive Care Unit of Penn's George D. Widener Hospital and will stay there for quite some time if all continues to go well.
Update 7/26: According to Chief of Surgery Dean Richardson, Kentucky Derby winner Barbaro slept well after his left hind foot bandage was changed Tuesday. "I'm happy with the appearance of this foot, which is doing as well as can be expected," said Dr. Richardson. "Over the last several days, his temperature has been normal and his blood work has significantly improved suggesting that the infection in his right hind is under control." His heart rate is also consistently normal now, a good indication that he is stable and comfortable.
Barbaro remains in the Intensive Care Unit of Penn's George D. Widener Hospital and will stay there for quite some time if all continues to go well.
Update 7/19: After all the doom and gloom of a week ago, Barbaro continues to remain in stable condition with good vital signs and is eating and resting well. Chief of Surgery Dean Richardson said, "Yesterday afternoon we changed his right hind leg cast to take new radiographs and to examine the incision. The radiographs looked good; the plates we placed on July 8 to fuse the pastern are intact and the fetlock fusion is unchanged. The leg and the incision looked as good as we could have hoped."
The modified foot cast, which acts like a bandage on Barbaro's left hind foot, was also changed yesterday. The foot cast is rigid and provides stability and support, but will be changed often so that the hoof can be treated. Both cast changes were performed with Barbaro lightly sedated in a sling. He has adapted very well to being managed as needed in the sling. "He is a very intelligent horse," said Dr. Richardson.
Progress will be slow on the left hind foot with laminitis and Barbaro will remain in intensive care and closely monitored for quite some time.
Update 7/13: There was a teleconference with Dr. Dean Richardson at the University of Pennsylvania New Bolton Center this morning, July 13, to give out the latest on Barbaro's condition. You can view a full transcript of the press conference here.
He has had more serious complications in the last two days, including a catastrophic case of laminitis in his left hind uninjured foot. They had to do a partial hoof wall resection on that foot Wednesday morning which means a large part of the hoof wall was removed and only about 20% of the hoof wall is now connected to the coffin bone. It is in a foot cast with foam padding and only time will tell now if he can recover from this. Basically, his hoof was to regrow which takes months. This is not a typical treatment, but they do have options there in terms of pain management that aren't available everywhere. He is spending a few hours a day in a sling to take weight off it and his front feet are fine for now.
At the moment there are no plans to put him down, this procedure was done for his comfort. He got uncomfortable on his right injured leg and that brought on the problems in the left. He is still eating well and has excellent GI function and can walk around his stall. His heart rate is low and temp is back to normal now and he does walk around his stall and get up and down on his own. Things seem to be under reasonable control in the right leg now but they have to deal with the catastrophic problem of laminitis in the left foot. He is on a pain control regimen to keep him comfortable which includes opiates and epidurals, same as a person in hospital might get. They are only going to go on with this horse as long as everyone is convinced that he is acceptably comfortable. That doesn't mean he won't have some discomfort, but that he will be eating, drinking, getting up and down, moving around the stall, and acting normal.
Chances of a full recovery at this point are poor and his condition is guarded. As long as he is not suffering they will continue to try and they have had horses recover from a case of laminitis this severe, but it is a longshot. If they can't keep him comfortable they won't continue. It is possible he could develope laminitis in another foot, and if so they will not continue with him. He is still in intensive care and constantly monitored, but he is still bright and happy at this point.
Two weeks ago he thought Barbaro would make it, but now he is not as confident. What he wants to see is the left hind foot to dry out and start to form hard tissue on the surface. Then he would get progressively more comfortable in the left hind, but 5-6 months would be a rapid recovery time for this problem. They are not doing anything outrageously experimental on him, but they will try anything reasonable
2006-09-04 04:03:33
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answer #6
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answered by illinoissux 2
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