Aggressive Treatment Key to Afleet Alex's Recovery

As Afleet Alex walked the shedrow for the second of three times Tuesday morning, his ears were up and he was looking for peppermints from trainer Tim Ritchey. It was obvious the colt was happy being out of his stall and walking again.

It has been only 13 days since Afleet Alex underwent surgery to repair a small hairline fracture, but the talk around Barn 24 at Saratoga has been about getting the son of Northern Afleet   back to the track.

Although owner Cash Is King Stable and Ritchey hope the Preakness (gr. I) and Belmont Stakes (gr. I) winner can make it back for the Breeders' Cup Classic – Powered by Dodge (gr. I), the most important consideration right now is the welfare of the horse.

Dr. Patricia Hogan, who performed the surgery at the New Jersey Equine Clinic, said the best thing for the horse's leg is to keep it active.

"The post-op care I recommended is somewhat aggressive," said Hogan, who consulted with Dr. Larry Bramlage. "But this wasn't a true type of condylar fracture, and he's such an exceptional athlete. Bone is a really dynamic structure and it needs to be stressed. You can't just throw a horse in a stall for two months and expect it to heal well. He's used to being out several times a day and the screw is doing the job right now, and I really think exercise is important to that horse.

"It's not like they're gunning to make the Breeders' Cup, but I still think it's a possibility," Hogan continued. "They're going to do everything possible to make sure the horse is healthy. But he's an athlete and we're going to treat him like one. Tim Ritchey and his group care deeply about this horse and will do everything they can to make sure he is happy and healthy. This horse will have the most intense monitoring post-operatively, and if something is not 100%, the program will be adjusted to accommodate this horse and his needs. If we are not happy with his X-rays and clinical picture, then the horse will not go forward. Period. The Breeders Cup is not the goal, Alex's health is."

Afleet Alex has been walking for almost a week now, and will continue to walk twice a day before increasing it to three or four times a day. "Three weeks from the surgery date, he'll have another set of X-rays," Ritchey said. "If it looks OK, we'll put the tack on him and he can walk and be ridden around the barn for four or five days. Then, he can go back to the track and begin jogging. The fact that we can walk him is really going to help, because it will maintain some of his fitness."

It was on July 27 that Alex's latest adventure began. "He had trained well that day," Ritchey said. "He went out early and jogged perfectly, then went back to the track about three hours later and jogged with the pony before galloping two miles. He jogged back and never took a bad step. When I came back from the next set, I watched him walk and noticed something wasn't quite right. He has that distinctive walk, like he knows he's somebody.

"When he sees me he always puts his ears up as he walks toward me, probably because I feed him so many peppermints. When he was walking toward me on this day he just didn't have that same swagger to his walk. His ears weren't up and he just didn't look 100%. So, we grazed him for 10 to 15 minutes just to let him down a little bit and relax him. Then, when we jogged him, he wasn't lame or nodding his head, but he wasn't jogging like he normally does. I went over him and he had a little filling in his left ankle, which he's never had before. That sent up a flare, and I decided to have X-rays taken. After the digitals showed there was something there, we jumped on it and got an appointment as quickly as we could."

Afleet Alex's stay at the New Jersey Equine Clinic was brief, but long enough for the colt to make an impression on all those who came in contact with him. Wherever Alex goes, he leaves a part of himself behind, and this was no exception.

He arrived at the Clarksburg, N.J. clinic at 1:30 the following afternoon, with Ritchey following the van. The trip, which normally would take 1 1/2 to two hours, took three hours due to heavy traffic. There were a number of thoughts running through Ritchey's mind as he made the long drive from Belmont Park. It was certain Alex had a fracture, and surgery had already been scheduled. But the extent of the injury would not be determined until the horse arrived at the clinic. The Aug. 7 Haskell Invitational (gr. I) was no longer in the picture, and Alex's future was in question. But Ritchey's main concern at this time was diagnosing the problem and treating it.

Because of the oppressive heat and the long van ride, Hogan had reservations about performing the surgery that day. But one look at a sprightly Alex coming off the van and she felt reassured that the surgery could go off as scheduled.

"It was really hot, and with the traffic delay, I told everyone that if he didn't ship well I was not going to do the surgery that day," Hogan said. "He walked off the van and he looked great. He wasn't sweating at all. We put him in his stall and he drank some water and began eating some hay. We did the blood work on him and it was perfectly normal. I told Tim we had been thinking of doing the surgery the next day, but the horse seemed fine."

Because of the star status of their new patient, and the secrecy that surrounded his arrival at the clinic, Hogan and several of the employees tried to think of a name they could call the horse and put on the name card on his stall. They came up with "Big Al."

"It was amazing how well everything went," Hogan said. "It was almost surreal. Nobody was around; we had done all our other surgeries for the day. It was just us, Tim, and the horse. We got Tim something to eat and took X-rays of the horse, with Tim right there. Then we called the insurance company together and planned out what we were going to do."

It is not normal practice for a trainer to observe the surgery, but Ritchey wanted to be as close to Alex as possible. "Any time you put a horse under anesthesia, there is some reason for concern, so I wanted to stay and watch everything and see how it went," Ritchey said. "And I wanted to be there when he recovered and came out of anesthesia."

The entire procedure, including the anesthesia, would take only 35 minutes. "Our anesthesiologist, Rebecca Bennett, did a great job," Hogan said. "After inducing (anesthetizing) Alex, we scoped his joint and discussed what we were seeing on the screen with Tim. He was wondering if there was any bruising along the front. I looked inside his fetlock joint and his cartilage was in excellent shape, especially for a 3-year-old that had just been on the Triple Crown trail and had gone through a hard 2-year-old campaign as well. It's remarkable how well he's made.

"What really impressed me about Tim was how early the fracture was detected. I usually don't see these fractures this early. I usually see them after the next gallop when it becomes a true condylar fracture. The horse was not even lame, but Tim knows him so well he could tell he was walking a little bit differently; that his stride was not quite the same as usual. I really commend him for that, because the fracture was such a hairline, it was a unique opportunity to repair it and give him a chance to finish the year."

Ritchey watched the surgery through a large window. The entire procedure took less than 20 minutes. Afleet Alex, with his toughness and grit, and twice-a-day training regimen has been called a throwback to the rugged horses of the past. What Hogan observed during the surgery backed that up.

"When I drilled into his bone, it was unusually hard," she said. "I asked Beryl Scaggs, our head surgery technician, 'Is this a new drill bit or a dull one?' "When I'm drilling the bone, I usually have to take the bit out twice to let it cool off. But in Alex's case I had to take it out five times. That's how hard his bone is. It makes you wonder about his training regimen and how much it's helped him.

"The screw was put in for two reasons -- one, to provide compression and accelerate healing of the fracture," Hogan continued. "And, two, to prevent any further propagation of the fracture line so that it could not progress on to a more significant injury."

Following the surgery, Alex was taken to a recovery stall. "Initially, he was lying down, and we had two gentlemen in there to help him get up," Hogan said. "When he heard Tim's voice, he lifted his head off the mat and looked up toward him even though he still wasn't totally with it. I can tell you, the horse definitely knows Tim's voice. Through everything, Tim was so cool and calm, and professional. That was a big help to me. He just wanted to make sure the horse knew he was there and that nothing would happen to him."

Ritchey said when they walked Alex to his barn stall he was a little wobbly, but that was to be expected. "Once he got in his stall, he whinnied a few times and started checking out the surroundings," Ritchey said. "I always carry a bunch of peppermints, and I took one out of my pocket and started opening it. He heard the paper crinkle and turned around and just ran to the front of the stall and gobbled up around five peppermints. I knew then everything was fine."

Hogan and the clinic's founder, Scott Palmer, have been around a number of top-class horses since the original clinic opened on a small tract of land a couple of miles up the road. Palmer had gained national exposure saving the life of Lost Code, who had suffered a severe fracture, and treating Kentucky Derby (gr. I) favorite Mister Frisky, who had a grapefruit-sized lump in his throat that was cutting off his air supply.

"We've been around enough good horses that you can tell a good one when you see one," Hogan said. "They have a real presence about them. You can look at Alex and you know he is a very intelligent horse, and extremely athletic. He has that eye you like to see. Smarty Jones was the same way when he was here. They take in everything around them, they're calm, and they trust people."

When Hogan left that night, all was well. But that didn't stop her from worrying about her patient, especially one worth anywhere from $25-35 million. At 2:30 a.m., she was still wide awake. "I was worried; I just wanted everything to work out well," she said.

Unable to sleep, she dashed out of the house, still in her pajamas, got in her car and drove the seven miles to the clinic to check on Alex. "I just wanted to make sure he was standing and eating and happy," she said. "It had rained hard that night. There was a light from outside shining into the barn and I could see Alex silhouetted as I entered the barn. I went over to him and he was standing there looking at me, as if to say, 'What the heck are you doing here?' I gave him some hay and made sure his water bucket was OK. Then I drove back home and went to bed. Alex is a special horse, and it was a privilege to have him here."

The following morning Alex departed for Belmont Park, then on to Saratoga, with more heroic exploits still very much in his future.