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New Bolton Center Kennett Square, PA
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Ryan Hospital Philadelphia, PA

Success After Surgery: Penn Vet Patient Qualifies for Prestigious Race

By: Lousia Shepard Date: Oct 1, 2014

Watching Thoroughbred Hardest Core power past his champion competitors to win a million-dollar race is thrilling, but even more so considering that he underwent emergency life-saving surgery just eight months earlier.

Hardest Core was rushed to Penn Vet’s New Bolton Center in November, his small intestine hanging from where he had recently been gelded. Trainer Eddie Graham, who found him down in the field, gives credit to the New Bolton Center team and Dr. Louise Southwood, a surgeon in Emergency and Critical Care, for saving the horse’s life.

Hardest Core in his winner's blanket from Arlington Million.“Really the biggest part of his success is that Dr. Southwood is able to do her job,” said Graham on a recent morning, holding Hardest Core while he grazed in the fall sunshine. “Thanks to her, he’s won the Arlington Million.”

And what a win – Hardest Core charging around the final turn on the outside and, with tremendous strides, passing Magician, the favorite, in the home stretch, flying over the finish a length ahead. View the race here.

“It’s hard to express how good it is to win that race,” Graham said. “I’ve always been a two-horse, three-horse trainer. I guess the only people who would understand how I feel are the people who are like me – people who go in at four o’clock in the morning, seven days a week, hoping for that one good horse.”

Graham, 43, is the trainer for Andrew Bentley Stables in Chester County, PA, just a few miles from New Bolton Center. Greg and Caroline Bentley bought Hardest Core for $210,000 at the Keeneland Sale in Kentucky, a 30th birthday gift for their son, Andrew, who was born with Down’s syndrome. This four-year-old son of 2007 Kentucky Derby runner-up, Hard Spun, had great promise.

Clinicians at New Bolton Center work to put Hardest Core's small intestines back inside his body.“That’s pretty much what we work for. To actually be lucky enough, and humbled enough, to have a horse like Hardest Core,” Graham continued. “The big trainers get them once a month. We get them once in a lifetime. The smaller trainers understand how I feel because we all work for everything we earn. So it’s hard to find words to express my feelings because this is beyond words. It’s a dream.”

Hardest Core’s win at the Arlington Million earned him a place in the prestigious Breeders’ Cup Turf Classic, set for November 1 at Santa Anita Park in Los Angeles. The race is 1.5 miles on a grass course, with a purse of $3 million. (Magician won that race in 2013.)

“Everyone at New Bolton Center is so happy for them,” Southwood said in a recent interview. “There is always a lot of emotion with any emergency, particularly when surgery is necessary. But in this case, Hardest Core was their dream horse. They obviously cared so much about him. It was also very traumatic for them, finding their horse in so much pain with his bowel herniating through the gelding site.”

Pre-surgery examination by Dr. Louise SouthwoodThe Breeders’ Cup was far from the mind of trainer Graham last November when primary care veterinarian, Dr. Tom Reid, a Penn Vet graduate, gelded Hardest Core. As is typical, the procedure was done in the field, and the incisions were left open to drain and heal on their own.  

“Everything looked good in the morning. I turned him out and he looked happy while grazing in the field,” Graham recalled. “I went back into the barn, and about 20 minutes later, I saw him lying in the field acting colicky. When I walked out there, his intestines were coming out.”

Graham works by himself, so he struggled to get Hardest Core, who stands more than 17 hands high, into the barn. Clearly in pain, the horse kept trying to throw himself down on the ground. Finally Graham got him into the stall, and ran for help. Half a dozen people came, but even together they couldn’t get him to stand.

“We thought he was going to have to be put down because there was no way to get him up,” Graham said. “By some miracle, he popped up, and we got him on the trailer.”

Dr. Louise Southwood in surgeryGraham rode in the trailer with Hardest Core for the 10-mile ride to New Bolton Center. Dr. Southwood, an Associate Professor of Emergency and Critical Care, was ready for their arrival. 

“Dr. Southwood just took over. We couldn’t have asked for anybody better. She was fantastic,” Graham said. “She was excellent during and after the surgery. She kept us informed about what was going on every step of the way.”

Hardest Core was in extreme pain when he arrived, Southwood said. Intestines were coming out of both incisions, which is unusual, but may have been important in this case because the intestines didn’t drop down far enough to tangle in his legs.

During surgery, the intestine was thoroughly cleaned and examined. Southwood removed nearly 19 feet, or about one-third of Hardest Core’s intestine, and sewed together the healthy ends. She said a horse can lose up to about two-thirds of the small intestine and still survive.

The “vaginal rings” that should keep the intestines intact after gelding were unusually large, which is what allowed them to slip through, Southwood said. Dr. Eric Parente, Professor of Surgery, repaired tears in the rings and sewed them to make them smaller. Dr. Maia Aitken, a surgeon and Lecturer in Emergency and Critical Care, also assisted.

Hardest Core with his trainer, Eddie GrahamThe three-hour surgery went well. “It was a team effort, all of us working together,” Southwood said.

Hardest Core was given medication, including antibiotics and anti-inflammatories, and recovered quickly. “He was banging the tub asking for feed only two days after surgery,” Graham said. The horse stayed at New Bolton Center for five days and then returned home to recover without further complications.

“What a good patient,” said Tim Durborow, his groom, who took care of him after the surgery. “He was pure class. I couldn’t believe how well-behaved he was during the stall rest.”

But why geld him? Graham decided to geld Hardest Core when he saw him at the Keeneland sale. “I thought he was large down there,” Graham said. “I believe horses can be better when cut, and sounder behind, and I was right because he’s doing better behind than he ever has.”

Gelding is a very common procedure, performed on nearly half the world’s horses. But when complications occur, they can be life-threatening, Southwood said. Complications include hemorrhage, serious infections, and, like Hardest Core, evisceration.

Tom Durborow, Hardest Core's groom, feeds him a carrot during convalescence.Getting veterinary care quickly was key to saving Hardest Core, Southwood said. And constant care and attention during recovery helped keep him healthy.

Graham trained Hardest Core slowly during his recovery, jogging him for six weeks before galloping again. Rarely going to a track for exercise, Hardest Core is trained over the hills and fields of Chester County, going from farm to farm, ridden by jockey Jody Petty. Sometimes he is sent to the nearby Fair Hill Training Center for workouts.

Gentle and calm, this four-year-old horse loves to eat and sleep. He stands calmly, lead line loose, while bathed and groomed. But he knows his job when he gets on a racetrack, Petty says.

“He’s quiet most of the time, but when he’s strong, you better hold on,” Petty said. “When I get him to the track, he’s a machine. He is all business.” 

In addition to providing the best in clinical care and education, New Bolton Center is also dedicated to research. Southwood is researching the impact of colic surgery on the performance of racehorses. Results so far show that a racehorse that returns to the track after colic surgery can be expected to perform just as well as his peers. 

Jockey Jody Petty rides Hardest Core to victory at the Arlington Million. Photo courtesy of Four Footed Fotos.Southwood’s study compared the performance records of 59 racehorses that underwent colic surgery to those of 90 untreated control horses of an equivalent athletic class. Of the 76 percent of horses that returned to racing after surgery, the number of starts and earnings did not differ from those who had not had colic surgery.

Currently, Southwood and her team are conducting new research, examining more than 300 cases that have been treated at New Bolton Center over a two-year period, looking at long-term outcome.

“If given the opportunity, horses can return to racing after colic surgery, and perform just as successfully as they did prior to surgery,” Southwood said, just like Hardest Core, who also won two other races in 2014, prior to the Arlington Million.

What’s next for Hardest Core, after the Breeders’ Cup? There has been some discussion of steeplechase racing, because this horse can jump, as well. “I do what’s best for the horse,” Graham said. “I don’t make future plans. I do what the horse and I discuss because he lets me know by the way he is training.”

Group shot of the Bentley family with Hardest Core after the Arlington Million win. Photo courtesy of Four Footed Fotos.