Nearly 32 years ago, a champion filly named Ruffian snapped her right front leg on the backstretch at Belmont Park on Long Island, New York, during a heralded one-on-one match race with Derby winner Foolish Pleasure. In the genteel euphemism of racing, Ruffian "broke down." Surgeons labored, but euthanized her within hours.
Today, swift death after such a severe injury is still the fate of many, many racehorses. By virtue of size and anatomy, they make challenging patients, and healing them often costs more than they are worth or their owners can afford. But surgery, anesthesia, infection control and recovery have raced far forward since Ruffian's death in 1975. The public may see Barbaro merely as a compelling narrative. A model athlete, he was nearing his sport's pinnacle when, in a finger snap, the quest became not more trophies but survival. Yet Barbaro also represents bigger things. He is the greatest illustration of the advancements of equine medicine. He also highlights how far it needs to go.
There remains an insidious threat to the health of all horses, not just Thoroughbreds. It is a hoof disease called laminitis. Science has not fully parsed its workings, much less found a pill to ward it off. Research money is scant, even though a federal study suggests tens of thousands of horses have laminitis each year and several thousand die from it. A horse with a broken limb is especially susceptible to it. "It is the Achilles' heel of all these repairs we do," said Wayne McIlwraith, a professor of equine surgery at Colorado State University.
After the accident, New Bolton's medical skill gave Barbaro a chance to live, and by January his broken leg was healed, though not perfectly. But by then, laminitis was trumping medicine.
With the 2006 Preakness having just concluded, a veterinarian named Dan Dreyfuss stood inside Stall 40 at Pimlico Race Course in Baltimore. He was waiting for images to materialize on a computer he had set atop a straw bale. Or maybe it wasn't a straw bale. He cannot recall all the details of those intense moments. Stripped of saddle and silks, Barbaro stood diagonally in Stall 40, which on Preakness Day is offered to the reigning Kentucky Derby winner.
The colt was the least anxious mammal present. "He stood there like a statue," Dreyfuss said. Barbaro seemed calmly aware that he was grievously wounded, because he was keeping weight off the injured leg, now braced with an aluminum splint called a Kimzey. Any horse person would know the leg was broken near the fetlock, a joint just above the hoof, but only X-rays would tell how severely.
Dreyfuss, a private practitioner in Maryland, had never seen Barbaro up close until earlier that day. Trainers often hire a local veterinarian when they bring a horse to a track, and Barbaro's trainer, Michael Matz, had used Dreyfuss before. Having seen the leg break on a television in a hospitality tent, the doctor had started sprinting even as jockey Edgar Prado slowed Barbaro to a sickening walk as the field thundered ahead.
In the stall, in the straw, a technician was bent beneath the horse, moving a radiographic plate around the damaged leg, as Dreyfuss' partner, Nick Meittinis, snapped images with a hand-held X-ray machine. At the computer screen, black-and-white photos took shape, one after the other.
The pastern bone, below the fetlock joint, had dissolved into some two dozen pieces. The cannon bone, above the fetlock, had splintered. A sesamoid bone in back of the fetlock had cracked. Even a single break is bad. Barbaro was at the extreme end of the injury scale. "One look at that and you know you're in for an absolutely huge fight," Dreyfuss said.
A Thoroughbred weighs more than half a ton, and as he gallops, no more than two legs at a time absorb the shock of earthly contact at more than 35 miles per hour. Sue Stover, a professor at the University of California at Davis veterinary research laboratory, says that many runners, animal or human, wind up with microscopic bone damage because of the repetitive pounding of training and competition. Regularly, the body swaps such damaged tissue for new, but weak spots can develop if damage occurs faster than replacement.