When popular Grand National runner Balthazar King crashed out of the race this year, his fans feared the worst.

Screens were drawn around the stricken gelding as racetrack vets worked to assess his injuries and stabilise his condition. Thanks to their swift action, followed by expert aftercare at a leading equine hospital, the popular bay is well on the road to recovery — and may return to racing. Andrea Oakes sheds light on the recovery of this horse.

Balthazar King’s story starts at the Canal Turn hedge…

11 April 2015

After taking a nasty tumble, Balthazar King tries but fails to get to his feet. He is finally persuaded to stand after receiving emergency treatment and painkillers, and transported by ambulance to the University of Liverpool’s Philip Leverhulme Equine Hospital.

“It was evident he had fractured some ribs,” says Fernando Malalana MRCVS, who treated the 11-year-old gelding during his stay at the hospital.

“He was struggling to breathe and was given supplementary oxygen through a nasal tube. It looked as if the fractured bones had lacerated the lungs. Gas from the lungs was escaping into the thoracic cavity, which then squashes the lungs and makes breathing difficult. Worse still, the rupturing of blood vessels caused blood to accumulate in the chest, further compressing the lungs.

“His chest was full of gas and blood, so we had to drain this to give his lungs the chance to expand,” adds Fernando. “He was sedated for this procedure, as it’s risky to anaesthetise a horse when his breathing is compromised. We also considered a blood transfusion, but decided it was not necessary.”

Chest X-rays and ultrasound scans confirm that Balthazar King — or BK as he is known — has fractured four ribs on the right side. His lungs are presumed punctured.

Red arrows show BK's broken ribs, blue arrows show the line of gas in the thoracic cavity

Red arrows show BK’s broken ribs, blue arrows show the line of gas in the thoracic cavity

“It can be difficult to see the extent of the damage through the chest,” says Fernando. “Broken ribs can be corrected through surgery, but these were fractured very close to the spine so surgical fixation was not possible. This injury can be very painful, so we put a pressure dressing around the ribs to make him more comfortable.”

12 April 2015

BK has a good 24 hours. While he may be out of the immediate danger zone, infection remains a very real threat.

“Blood in the chest is a fantastic culture to support infection, so it’s important to keep the injured horse under close supervision,” says Fernando.

BK remains on fluids, painkillers and antibiotics, but seems comfortable and is eating well. Although he is subdued, he is making steady progress.

15 April 2015

Vets continue to monitor BK’s breathing for evidence of fluid or air around his lungs, which could indicate problems. He still has an IV (intravenous) line and a supportive bandage, but seems brighter and is able to walk out in-hand for a nibble of grass.

8 May 2015

BK remains under observation for signs of infection or further complications. His demeanour is good and the aim is to keep him quiet to allow his ribs to heal.

“Transport can increase the risk of infection, plus the movement of the lorry is not good for healing ribs,” says Fernando, adding that BK is not yet ready to leave hospital.

As for the long-term prognosis, Fernando says: “Because we couldn’t repair the ribs surgically, he will have a slightly deformed chest for the rest of his life and his breathing capacity could be slightly reduced. He should be able to return to athletic activities, but perhaps not to racing.”

His trainer, Philip Hobbs, adds: “It was very worrying to start with as his life was in danger. The worst situation now would be that he’ll have a good retirement.”

22 May 2015

Six weeks after his accident and BK is deemed fit to travel. His groom and work rider, Hannah Ball, accompanies him on the long journey back to his owners’ Hampshire farm.

The gelding celebrates being at home by getting down to roll in his stable.

“It’s clear that things are settling down and his ribs are not hurting him,” says Philip. “He now needs three to four months off. We won’t really know about his racing future until he is ridden again and back in training.”

get well cards

David Rees, one of his owners, reports that BK is on good form after his ordeal.

“He’s very lean and not a pretty sight, but he’s perky,” he says.

27 May 2015

BK is now turned out each morning in a small paddock and is enjoying physiotherapy sessions.

“His hindquarters are quite sore and he has been moving a bit crab-like,” says Penny Lownds, who trains point-to-pointers for David and is looking after BK.

“The physiotherapy is ironing out a muscle spasm in his pelvis, probably sustained in the fall. He looks a bit poor and has lost a lot of muscle after being in his box for seven weeks, but he’s amazingly sound.”

1 June 2015

Now able to spend all day in the field, BK is slowly regaining condition. He’ll spend the summer at grass.

“He’s a sensible horse and a good patient, but he does get bored very quickly,” reports Penny. “By September, he’ll be getting quite boisterous — he’ll be wanting to jump the gate and get on with it.”

“We’re very happy with this progress,” adds David. “Our objective is to get him back to Cheltenham if and when it suits him.”

Ref: Horse & Hound; 11 June 2015