07/09/2006 11:00PM

Barbaro 'comfortable' after more surgery


Kentucky Derby winner Barbaro appeared "more comfortable" on Monday, his surgeon said, two days after an infection prompted his surgical team to replace the compression plate and many of the screws that have been holding his shattered right hind leg together since May 21. He remains in intensive care at the University of Pennsylvania's New Bolton Center equine hospital, and the surgical team reported Monday afternoon that his vital signs were normal after the Saturday surgery and a sixth cast change on Monday.

The infection was a setback in the 3-year-old colt's recovery, and chief of surgery Dr. Dean Richardson said in a release the hospital issued Sunday that the problem was "potentially serious."

Richardson performed the surgery Saturday in order to clean the site of the infection and also to stabilize the colt's pastern joint, a key requirement if the bone injuries are to heal properly.

"Barbaro had developed some discomfort and a consistently elevated temperature, so we believed it was in his best interest to remove the hardware and thoroughly clean the site of the infection," Richardson said.

Barbaro's main fracture has shown progress in healing, but "the pastern joint that doctors are attempting to fuse continues to be the area of concern," according to a statement the hospital issued Sunday. "This joint was stabilized with new implants and a fresh bone graft."

Richardson also noted that Barbaro's post-surgical recovery from anesthesia took longer after the Saturday surgery.

On Monday, the colt received a new cast - his sixth since the initial May 21 surgery - in order to make it easier for him to move in his stall. This replaced a long cast Richardson had put on his leg immediately after surgery on Saturday.

"The long leg cast was replaced with a short leg cast this morning," Richardson said. "This was done with Barbaro in a sling and only under mild sedation. 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."

The surgical team reported Monday that Barbaro "spent a comfortable night" and is eating well. "We're continuing his pain medication, antibiotics, and other supportive care," Richardson said. "He appears more comfortable today and has had a normal temperature, heart rate, and overall attitude."

Infection is a common post-surgical concern, and while it can lead to more serious problems, it also can be survivable.

"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."

So far, Barbaro appears to have avoided another major and potentially fatal complication that is common in horses with injured legs: painful, stress-related laminitis in the opposite leg.

"He's in a lot better situation than we often have in these cases," McIlwraith said.

Barbaro fractured his right hind leg early in the running of the Preakness Stakes on May 20 and was shipped immediately to the University of Pennsylvania's New Bolton Center in Kennett Square, Pa. He underwent surgery on May 21 to insert the plate and 27 screws to stabilize the fractured areas and has been in the center's George Widener Large Animal Hospital's intensive care unit ever since.

Last week, Richardson replaced Barbaro's cast twice, once on July 3 and again on July 5 in an attempt to alleviate discomfort the colt had shown.

Barbaro continues to receive frequent visits from Roy and Gretchen Jackson, who bred and own the colt; trainer Michael Matz; and other connections such as his regular exercise rider, Peter Brette.

"It's one of those setbacks that we've prepared ourselves for as best we can," Gretchen Jackson told the Baltimore Sun on Monday. "Sure, it's disappointing, but we've been warned.

"But a lot of bone has healed, a lot. There's a lot of good stuff. And the horse is incredibly strong, healthy, and we've got to keep the faith."