For owners, the disease is emotionally and financially draining, and for the horse it is "horrible," said Fran Jurga, editor of Hoofcare and Lameness magazine. Horses are "prey" animals, meaning the hunted, not the hunters. Running is a defense; it's in their genes. If laminitis restricts them, they become depressed. "They know they can't escape," Jurga said. "They're kept in their stalls. They lose their sociability."
Laminitis begins with any of an odd assortment of triggers, many of them involving problems in the gastrointestinal tract, including eating too much green grass or too many carbohydrates. Among other causes are severe colic and pneumonia. But knowing the triggers is not the same as knowing why they cause laminitis. How the feet wind up in trouble is not yet fully understood. All a horse owner can do is try to avoid the triggers and, if laminitis begins, treat the symptoms and reduce the effect of the triggers.
From the first moments after the Preakness, Barbaro faced a serious trigger: uneven weight distribution. A horse with a broken leg will, naturally, shift weight to the other three legs. That burden often leads to laminitis in the hoof opposite the broken leg. But, says Rustin M. Moore, an equine surgeon and researcher at Ohio State University, "we really don't know" the precise sequences and interactions. Sometimes laminitis comes, sometimes it doesn't.
Barbaro's laminitis came soon after major follow-up surgery. Screws in his leg had bent or shifted, and infection had set in. On the leg opposite the broken one, the disease erupted so severely that Richardson had to remove most of the hoof in the hope that Barbaro would grow a better one with working laminae. It was a very long shot.
"We were close to putting him down," Gretchen said. "We just thought we're asking too much of him." She kept turning it over. "You see all this, and it's just like, ‘God, this poor horse.'" But then: "He's back, trying to bite you. Eating. Never stopped eating." Sick horses often retreat to corners, lose their appetites, surrender their spirit. But Barbaro, Roy said, always kept looking at them as if to say "I can get through this." In conversations with Richard-son, they agreed to go forward as long as Barbaro was comfortable.
Slowly, the horse got better. His hoof started to regrow. As the months passed, Richardson took him outside for short walks. Christmas came, and New Bolton released a video of the patient, strolling. Soon, he might be well enough to continue his recovery in more comfortable surroundings, perhaps the fields of Kentucky.
On Monday, January 29, the Jacksons brought grass from the farm to Barbaro, who ate every shoot. Then, as they stood by at his stall, Richardson gave America's most famous horse a tranquilizer and then an overdose of barbiturate, and Barbaro died in a deep sleep. Gretchen hugged the doctor and thanked him. "And he said, ‘I failed you.'"
The turn of the year had brought a swift descent. In the leg with laminitis, the hoof wall was regrowing only in front. The foot was unstable, so Barbaro was shifting more weight to the broken leg, which developed an abscess. Richardson tried to ease the burden on that leg with an exterior scaffold, but then the two front legs developed laminitis. Every leg was impaired. On the last weekend of January, Gretchen and Roy were ready to let go. "I think Roy and I were pushing Dean more than Dean was pushing us," she said.
In the end, was it all for nothing?
"I feel good he had eight months," Richardson said by phone a week later. That was nearly 20 percent of his life, and most of those days were pleasant. "I would love for the public at large to understand that he had lots of time where he was a good, comfortable horse." But the patient died, so "in my mind, I absolutely failed."