Letter From New Bolton

- When my buddy Bob so graciously granted me a sliver of his stable as a wedding present earlier this year, one of the horses involved was Primal Peak, who he'd claimed for 25K last December. Trainer Keith LeBarron made a shoe change, and the horse responded, winning a claiming event at Philadelphia Park in his second start for the stable with his usual closing rush. Moved back up to allowance company, he finished an agonizingly close second place, as described explicitly to me on the phone by Bob (not) Durkin.

Primal Peak earned a serious Beyer of 95 in that race, and his being a PA-bred made him eligible for lucrative state-bred stakes in which we felt he could compete. Whatsmore, he had shown versatility, having run well on dirt, grass, Keeneland Poly, and the Tapeta Footing at Presque Isle Downs right there in Pennsylvania. LeBarron was particularly psyched to get him on the grass, and a stakes at Atlantic City was under consideration. However, he was pointed to a $75,000 state-bred stakes at Philly Park on May 10. He seemed a definite contender, and I was set to drive down to the race.

The last entry I wrote on this blog about Primal Peak was this: Primal Peak will be scratched from that PA-bred stakes at Philly Park tomorrow due to a foot abscess. Nothing serious, but bad timing. It was a very winnable spot with a $75,000 purse. We were all naturally disappointed, but I remember that Bob was upbeat, reporting that horsemen that he spoke to assured him that once the abscess popped in a few days, the horse would be fine.

However, as the days went on, there was no progress to report. The abscess was not going away, and had blossomed into a full blown infection. The horse's condition had deteriorated to "an almost non-weightbearing lameness." Thus, Primal Peak became Case No. 080631 at New Bolton Center at the University of Pennsylvania School of Veterinary Medicine, and the reports were not good. Bob and his wife Sue, who by the way plays a proactive role in Kasey K and who I've been remiss for not crediting as such previously, received from a letter from that institution in June. They passed a copy on to the partners with the latest statement, and it explains what happened from there.

On presentation, Primal Peak was 4-5/5° lame on his right front limb. The remainder of his physical examination and blood work was within normal limits. He was extremely sensitive to palpation on the medial quarter of his right front hoof. Radiographs were obtained, which did not show any bony abnormalities, nor was there any radiographic evidence of laminitis of the oppostie limb. The conformation of his feet was poor, with under run heels and minimal sole thickness. He had a bulging sole and frog, which resulted in his main weight bearing on these surfaces. Drainage from the medial quarter was present and initially he was treated with foot bandages soaked in magnesium sulfate. Regional limb perfusions with amikacin were performed daily to try to control the infection. Unfortunately, his comfort did not improve and drainage continued. A 3/4 shoe was placed in an attempt to improve his comfort and relieve pressure of the medial quarter. He was started on intravenous antimicrobials, continued on pheunylbutazone and his opposite limb was iced continuously to try to prevent support limb laminitis.

Over the following days this comfort was acceptable and additional drainage was achieved from his coronary band. He was extremely smart and was lying down the majority of the time. Radiographs were repeated, which revealed progression of the infection towards the dorsal aspect of the sole and the shoe was removed. Despite all our efforts, the infection had progressed, undermining the medial and dorsal aspect of his sole and the medial half of his hoof wall. Aggressive debridement of the sole was performed and the majority of his sole was removed. After this procedure it initially seemed that the infection was under control, but unfortunately after several days it appeared that the infection had progressed towards the lateral aspect of his sole and his lateral hoof wall. It was very likely he was going to lose his entire right front foot and at this point he was also showing some evidence of support limb laminitis of the opposite limb. All these findings and his progress were discussed. Due to poor prognosis and prospect of a lengthy and painful recovery period, euthanasia was recommended.

Primal Peak was euthanized on June 3, 2008. Postmortem examination confirmed our clinical findings. There was severe infection and inflammation of his coffin bone and the infection had progressed to the lateral aspect underneath the corium. There was evidence of laminitis on the opposite limb.

I am very sorry for your loss. As you know, Primal Peak became very well loved in our hospital within a short period of time due to his kind and intelligent personality. It is unfortunate we were unable to get the infection under control despite all our efforts. Please call if you have any questions or if I can be of service in any other regard.