PennVet | A Legacy of Barbaro
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A Legacy of Barbaro

By: Katherine Unger Baillie Published: Mar 26, 2018

Barbaro and Dr. Dean RichardsonDr. Dean Richardson and Barbaro pictured above; below, Dr. Andrew van Eps

In 2006, Dr. Andrew van Eps was a resident at Penn Vet’s New Bolton Center when Kentucky Derby winner Barbaro arrived with a broken leg sustained in the Preakness. Though Dr. Dean Richardson, the Charles W. Raker Professor of Equine Surgery, was able to repair the jigsaw-puzzle-like fracture, the New Bolton Center team was not able to spare the horse from the laminitis that followed.

In late 2016, van Eps returned to Penn Vet after working at the University of Queensland in Australia, where he made significant progress in identifying strategies to prevent and treat acute laminitis.

Now Associate Professor of Equine Musculoskeletal Research at New Bolton Center, he is determined to continue advancing understanding of the condition’s underlying causes, and to capitalize on that knowledge to develop improved, practical treatments.

“Although I always had a strong interest in research, it took a back seat to clinics, teaching, and administrative work in recent years,” he said. “The position at New Bolton Center allows me to prioritize research, which for me is very exciting.”

Dr. Andrew van EpsMore than a decade ago, New Bolton Center was also his choice destination for his residency, as he considered it “the best place in the world to train in large animal internal medicine.”

Learning from highly regarded clinicians such as Richardson, van Eps saw that impressive surgical skills could bring horses back from seemingly devastating injuries. But he also observed that, for some horses, surgery wasn’t enough. “You’d always have this specter of laminitis looming,” he said.

In the intervening decade, van Eps and others in the field have explored the nuances of laminitis.

“We’ve done a lot of good work over the last 10 years, since Barbaro,” van Eps noted. “We know now that there are different mechanisms that can lead to the disease, and we’re working out ways to prevent or ameliorate the different forms.”

Laminitis can manifest as any of three different types, van Eps explained. Barbaro suffered from what is known as supportinglimb laminitis, where an injury to one leg causes the opposite leg to support more weight than usual, leading to the disease.

Far more common, however, is a form of laminitis triggered by overproduction of insulin.

“It’s a little similar to type 2 diabetes in people,” van Eps said. “The difference is, people will stop producing insulin, while horses and ponies just keep making it, and that insulin triggers changes in the feet of these animals.”

Laminitis can also arise in horses with systemic disease, such as colitis or sepsis. For this third form, van Eps has made major progress in treatment, using foot cooling, or cryotherapy, to effectively stop and even partially reverse damage in affected animals.

With the supporting-limb form of laminitis, van Eps is partnering with colleagues to develop mechanical interventions that address what they believe to be the root cause of disease—namely disturbances to blood flow that occur when the horse’s ability to cycle weight bearing among its limbs is impaired.

“We’re very excited to use the robotic CT here at New Bolton to do some studies that look at blood flow and weight bearing in standing horses,” he said.

Additionally, van Eps is continuing to probe the underlying molecular events that contribute to the metabolic form of disease, including finding potential drugs to block the insulin-triggered pathways that can lead to problems in the foot. He also hopes to test whether the foot cooling method could help in this form of laminitis, as it does in horses with systemic illness.

With this many-pronged attack, van Eps is working to make a difference to horses of all stripes, from Triple Crown contenders to pastured ponies. And he says a lot of the advancements owe a debt to Barbaro.

“After his case, there was an exponential increase in interest and funding in laminitis, and we owe a lot to Roy and Gretchen Jackson, his owners,” van Eps noted. “Our progress is part of the Barbaro legacy.”