Barbaro (April 29, 2003 – January 29, 2007) was an American thoroughbred racehorse who decisively won the 2006 Kentucky Derby, but shattered his leg two weeks later in the 2006 Preakness Stakes, ending his racing career and eventually leading to his death.

On May 20, 2006, Barbaro ran in the Preakness Stakes as a heavy favorite, but, after he false-started, he fractured three bones in and around the fetlock of his right hind leg. The injury ruined any chance of a Triple Crown in 2006 and ended his racing career. The next day, he underwent surgery at the New Bolton Center at the University of Pennsylvania for his injuries. In July he developed laminitis in his left rear leg. He underwent five further operations, and his prognosis varied during an exceptionally long stay in the Equine Intensive Care Unit at the New Bolton Center. While his right hind leg eventually healed, a final risky procedure on it proved futile because the colt soon developed further laminitis in both front legs. His veterinarians and owners concluded that he could not be saved, and Barbaro was euthanized on January 29, 2007.  He was a third-generation descendant of Mr. Prospector, and as such Barbaro was related to many Triple Crown hopefuls of his time including Afleet Alex, Smarty Jones, Funny Cide and Fusaichi Pegasus.

Going into the Kentucky Derby, Barbaro was undefeated. He was sent off as the second choice of the betting public, at odds of 6:1, in a full field of twenty horses. Barbaro charged ahead during the last turn and straightaway of the race to win by six and a half lengths. Barbaro’s lead in the final furlong expanded, although jockey Edgar Prado did not use the whip and ask for his top speed. This margin of victory at the Kentucky Derby was the largest since 1946, when Triple Crown winner Assault took the “Run for the Roses” by eight lengths. Barbaro’s win made him only the sixth undefeated horse to win the Kentucky Derby. Barbaro had not competed for five weeks prior to the race, which was the longest layoff in 50 years for a Derby winner.

Barbaro’s Preakness Stakes began with a false start when he broke from the starting gate prematurely. Barbaro was deemed fit upon being reloaded into the gate. As the restarted race began, Barbaro broke cleanly, but suffered a catastrophic injury as the horses passed the grandstand shortly after the start.  Many theories arose as to the cause of the accident, though none have been confirmed. Barbaro broke his right hind leg in more than 20 places: a broken cannon bone above the pastern, a broken sesamoid bone behind the fetlock and a broken long pastern bone below the fetlock. The fetlock joint was dislocated, and his foot was left dangling loosely. Veteran jockey Edgar Prado immediately pulled Barbaro up, and brought him to a gentle stop. He dismounted and leaned his shoulder into the horse’s shoulder to support Barbaro until track attendants could arrive. Bernardini went on to win the race.

Barbaro’s injuries were life-threatening. Unlike other mammals, such as dogs, a horse cannot survive in humane circumstances on three legs. A broken leg in a horse can lead to complications as the other legs attempt to bear the weight of the horse’s body.

In 1971 Hoist The Flag underwent successful pioneering surgery for a similar injury to that suffered by Barbaro. Having been taken to the University of Pennsylvania’s New Bolton Center in Kennett Square, Pennsylvania for treatment, Barbaro was assigned to the care of equine surgeon Dr. Dean Richardson. The New Bolton Center is renowned for its specialized care, especially for animals needing complicated bone surgery. The day after the race, Richardson performed a fusion of the fetlock and pastern joints to stabilize the leg and make it strong enough for Barbaro to walk on. It was a five hour procedure and was one of the most difficult surgeries Richardson had performed. The surgical team successfully implanted a Synthes stainless steel Locking Compression Plate (LCP) and 27 screws into the colt’s injured leg to span the comminuted fracture and joints. They used the LCP because its screws thread into the plate to provide maximum strength. Richardson was one of the first equine surgeons to implement this new technology, originally designed for humans. A fiberglass cast was placed over the LCP to further protect the construct. Barbaro was put into the recovery pool at 7:40 pm.

After about an hour in the pool, at around 9:00 p.m. EDT, Barbaro began to calmly awaken from the anesthesia. He stood and then practically jogged to his stall. He ate and was able to comfortably put weight on the injured leg. The blood supply to the injury site was very good, but Richardson still gave Barbaro a 50-50 chance of survival. By the following morning Barbaro was already showing interest in some of the mares at the facility. He was walking well on his limb around the stall and was quite active for his condition; in short, his first week of recovery went well. The cast was replaced on June 13, and again on July 3.

In the first week of July, complications arose, and Barbaro had problems with both hind legs. He developed an abscess on his uninjured left foot, which was treated topically, but he carried a fever through the weekend and failed to put weight on his injured right foot for any significant time.

By July 13, Barbaro had developed a severe case of laminitis in the left hind hoof—a potentially life-threatening affliction that is common in horses who shift weight to one foot for extended periods to keep pressure off an injured foot (in Barbaro’s case, the right ankle he broke in the Preakness). A procedure called a hoof wall resection removed 80% of Barbaro’s left rear hoof. The remaining 20% of his hoof wall was still attached to the coffin bone and was still living tissue, but it was unclear how much of it would grow back. Both rear legs were in casts. Richardson stated that his plans were to restrict himself to aggressive but standard treatments; he would use no experimental procedures. Barbaro was given a special support boot for his laminitic hoof and placed on painkillers; a support sling was brought into his stall to allow him to take the weight off his hooves for hours at a time.

On August 8 Barbaro’s broken right leg had fused to the point where the veterinarians would have replaced the cast with a brace if his left leg had been sound. The coronary band (the area from which the hoof grows) on his left leg appeared healthy and all signs were encouraging. On August 15 it was reported that Barbaro had been allowed to graze outside for the first time since his accident. Two days later, Barbaro was no longer using the sling to support his weight, and its use was discontinued. The next day, August 18, radiographs showed that his fractured right leg was almost completely fused.  By September 26, it was decided that Barbaro’s cast would not be replaced as long as he was comfortable in it. His left hind hoof had regrown about 18 millimeters and the support shoe had been replaced with a bandage. The hoof would have to grow to at least three times that length, a process that could take more than six months.

On October 10, Barbaro’s cast and protective shoe were changed. His left rear hoof was gradually improving from laminitis. There was good growth along the quarters (closer to the heel) but there were still months of healing required for the front of the hoof.  Barbaro reached another milestone on November 6, 2006 when his cast was removed permanently and replaced with a splinted bandage. Barbaro’s laminitic hoof showed no new problems, but several months of growth would have been necessary before it could be further diagnosed. Around December 12, Barbaro’s bandage on his right hind leg was removed completely. This was announced during a press conference on Wednesday, December 13.

Early in January 2007, the laminitic left hoof became the source of further complications. On January 10, another section of the hoof was surgically removed. Updates over the next few days revealed that the cast had been reapplied to Barbaro’s right hind leg for support, and that aggressive pain management and the use of the support sling had been resumed. Nevertheless, Barbaro’s condition was better than it had been the previous July.

In another setback, Barbaro developed a deep abscess in his right hind foot, a problem generally caused by lack of grip exercise. Additional surgery was performed on January 27 to insert two steel pins into the healed bones of Barbaro’s right foot as part of an external skeletal fixation device. This would allow the right foot to bear more weight, but the procedure was risky, with the major danger being that the bones might break again. Later that same weekend, Barbaro’s front legs, which had remained healthy throughout the ordeal, displayed clear signs of laminitis due to him not being able to bear weight on his hind legs. Thus, Barbaro could not then comfortably put his weight on any of his legs.

Barbaro was euthanized on January 29, 2007 at around 10:30 A.M. EST by decision of his owners Roy and Gretchen Jackson, who indicated that they felt that his pain was no longer manageable.  For his efforts to save Barbaro, the Turf Publicists of America voted to award Richardson their 2006 Big Sport of Turfdom Award.