by Kimberly S. Herbert
from THE BLOOD-HORSE, May 29, 1993
The birth announcement read, "It's a boy!" and journalists around the world took note. He shared national TV air time on the evening news and has appeared, or will appear, in a wide variety of newspapers and magazines. But the month-long watch by media was nothing compared to the 12 years of anxiety and frustration that confronted those closest to the mother, owners Bert and Diana Firestone. Their patience and persistence was rewarded on May 15, at 5:05 p.m., when Kentucky Derby (gr. I) winner Genuine Risk, at age 16, produced her first foal to live.
The flashy chestnut colt by the Blushing Groom sire Rahy is doing well, and "Jenny" is proving to be a doting mother. But the youngster's final day of gestation, and his first week of life, proved a challenge to him and his caretakers.
The personnel at Robert N. Clay's Three Chimneys Farm near Midway, Ky., breathed a collective sigh of relief on Thursday, May 20, when Genuine Risk and her unnamed colt were returned to the farm from Rood and Riddle Equine Hospital near Lexington for the second time. The first visit was when Genuine Risk's labor was induced and the foal was born. The second was for surgery on the colt to remove two colon impactions.
Jim Becht, resident veterinarian at Three Chimneys, had monitored Genuine Risk and the fetus daily with ultrasound through the mare's abdomen beginning at day 300 of gestation. Although it's difficult to save premature foals at that stage, it has been done, and Becht wanted to give the fetus and dam every chance at a normal delivery.
At day 330 of gestation, Becht started monitoring the fetus twice a day-first thing in the morning and last thing in the evening. "We measured the foal's position, noted which way the head was, and measured the fetal heart rate, which was about 130 on day 300," said Becht. "It's supposed to decrease as parturition approaches, and normal mares foal, supposedly, within 48 hours of the fetal heart rate dropping to 60.
"We also measured placenta thickness and assessed the quantity and quality of the fetal fluids inithe amnion and the allantois." The amnion is the small sac around the fetus and the allantois is the larger sac between the amnion and chorion, the outermost membrane in contact with the uterus.
Another thing Becht measured was the diameter of the fetus' aorta. "That supposedly grows about one-tenth of a centimeter every five days after day 300," said Becht, who was using the various measurements to determine not only the quality of the fetus' environment, but the possible size and maturity of the fetus.
"Its hard to ultrasound a fetus and determine it's size."
The heart rate of a fetus is not the same all the time, and that was true for Genuine Risk's colt. If the mare or fetus is active, the fetal heart rate can go up to 80-90 beats per minute. When the fetus is at rest, it can be lower. But a low heart rate also can be a sign of distress or impending parturition, so Becht, a board-certified internist, on three occasions called in Johanna Reimer, a board-certified cardiologist, to consult about the fetus'heart rate.
"On Saturday morning (May 15), the fetal heart rate was 60-72," said Becht. "Then at 3 p.m., the heart rate had dropped to 40, and it only went up to 48 after we trotted the mare around. The heart beat was also very irregular."
Becht looked with ultrasound for placental damage, but there was none. "Some studies have shown that when the fetal heart rate slows and becomes arrhythmic, the mare will abort within hours," said Becht. "I took it as a sign of fetal distress."
The plan all along had been that if the fetus became distressed, the mare would be induced into labor. Genuine Risk's cervix had dilated, there were accurate breeding records to show at what point the fetus was in gestation, and the fetus was in proper position. But she did not have a big udder, and a colostrum check showed that the calcium level was low, a possible sign of fetal immaturity. Also, sodium decreases and calcium increases as the fetus matures toward parturition, and that had not happened to a great extent with Genuine Risk's colostrum.
Genuine Risk was vanned to Rood and Riddle, where the fetus again was examined via ultrasound. The Three Chimneys team of Becht, manager Dan Rosenberg, broodmare manager Gary Bush, and attendants Tom Clark and Joey Mattingly basically took over one of the large stalls at Rood and Riddle. "We thought it in the mare's best interest to be assisted by the people she knew," said Rosenberg.
There was a team ready to assist the foal upon de-, livery. Becht was overseeing the entire procedure,although Bush was in charge of foaling the mare. "I asked Dr. Reimer to worry about the heart and nothing else," said Becht. "Dr. (Bill) Bernard was going to get an oxygen tube into the foal, and I was going to get a catheter in the foal to start it on fluids."
Becht administered a small bolus of oxytocin (15 units intravenously, less than 1 cc), the female hormone that causes the uterus to contract, which is the first stage of labor. Genuine Risk laid down, sweated some, and was in "a little pain" when the uterus was contracting. The first stage of labor forces the fetus toward the cervix.
Twenty minutes later, the mare was checked vaginally. "We found two feet, a nose, and a foal that was very anxious to get out," said Becht. "He was kicking the hell out of her."
The big front feet surprised everyone, especially Becht. "I was scared to death it was going to be a scrawny little thing," he said. Becht gave Genuine Risk a smaller dose of oxytocin (10 units, about a half cc) intravenously. Fifteen minutes later, the foal was presented and ready for birth. Because he was big, veterinary obstetric chains were used to help pull the foal in the final stages of delivery.
"The foal never was in trouble as far as getting out," noted Becht, "but we wanted to get it out rapidly."
Out he came, and within 30 seconds Reimer had an EKG hooked up to him. Reimer characterized the arrhythmia as atrial fibrillation, "like a car being out of timing. It's electrical." Oxygen and fluids also were administered-"Which he probably didn't need," Becht said in retrospect. The heart rate started out at 60 at birth, then went to a normal 100. "Since then, the foal hasn't been arrhythmic at all.
"There has been some question whether this means the foal will have a heart problem," continued Becht. "I think the atrial fibrillation was his way of telling us he needed out. What would have happened if we had left him in there? It's hard to say. We may have lost him, or she may have had him that night. No one knows."
The oxygen and fluids were discontinued after a few minutes, when it was determined the colt was a big, strong, healthy foal. He was put on antibiotics since he was stressed, and his catheter was left in for that purpose. He also was tubed several times with colostrum, since the quality of Genuine Risk's colostrum was in question. A test the next day showed he had adequate transfer of passive immunities.
There was some concern that Genuine Risk would not produce enough milk for the colt since her udder had not seemed large and full at birth. However, she began producing a plentiful supply within a short time, "and when the colt was taken to surgery and gone a couple of hours, when we took him back to her she was running milk," said Becht.
The foal stood at 6:30 p.m., nursed at 8:10, and by 11:30 on May 15, he and Genuine Risk were back in their own stall at Three Chimneys.
Surgery on day three
On Sunday, May 16, about noon, the colt began showing mild signs of colic. He would lie in abnormal positions, occasionally roll, then get up, "shake it off," and go nurse. He even played in the stall some. He had been given an enema at birth like every foal, and was given another enema when he was returned to the farm. "He passed a fair quantity of meconium (the first bowel movement)," said Becht.
About 4 p.m. Sunday afternoon, Becht said he became concerned and did an ultrasound examination of the colt's abdomen. "I saw distended loops of intestine, which could be consistent with a high meconium impaction," said Becht. "But I was also concerned that he could have displacement or a twist. It wasn't strangulated, but I was concerned."
Becht opted to send the colt back to the hospital, where radiographs and ultrasound examinations were conducted. "We could see what we thought was a meconium impaction," said Becht. The colt was treated conservatively with mineral oil orally and intravenous fluids to try to increase fluid secretion in the intestines to try and push the impaction on. The colt continued to nurse and occasionally would play, so the prognosis didn't look bad.
Then at 3 a.m. Monday morning, the colt exhibited signs of extreme pain, and his heart rate went from 80 to 120. Bernard called Becht, who immediately went to the hospital. Radiographs and ultrasounds were repeated, showing that the meconium impaction had not moved, but there was more distention in the intestine in front of the impaction.
"With that and a little deterioration in his systemic status and also worsening of the gas distention, Bernard, Rolf Embertson, and I decided to take him to surgery," said Becht. Embertson performed the surgery, where he found a large ("about the size of a baseball") meconium impaction in the large colon ("which is unusual to have one that high") and a smaller one in the small colon. The impactions, both very firm and tight, were removed.
"The colt had a little diarrhea after surgery, which was encouraging," said Becht, adding that the foal had no complications from the operation.
By noon on Thursday, May 20, the mare and foal were back at Three Chimneys. After a time in the stall, they were allowed in a small paddock for about an hour.
Although a Caesarean section was never out of the question, Becht preferred natural birth because, "1) You have to give general anesthesia to the mare (in a Caesarean), and 2) I wanted the foal to come through the birth canal. During birth, the mare squeezes all the fluid out of the foal's lungs so when they come out, they expand with air. I've cut foals out of dead or dying mares or performed Caesarean sections and you pull the foal out of a fluid-filled environment and expect it to breathe. Those are more prone to pneumonia."
The Risk of years gone by
Genuine Risk was first bred in 1982, and according to The Jockey Club, she produced a dead foal in 1983. Barren for the next two years, she was not bred in 1985, then in 1987 and 1988, she again was barren. She slipped foals in 1989, 1990, 1991, and 1992. She had arrived at Three Chimneys on June 15, 1990.
After she aborted on Feb. 10, 1992, Becht examined the fetus and placenta. He said the umbilical cord was longer than normal, and the fetus smaller, for that stage of gestation based on research data. Those two phenomenon go together, he said, because the blood is not as oxygenated by the time it reaches the fetus through the long umbilical cord and the fetus does not grow as well. He noted that Genuine Risk did not have that problem this year.
Genuine Risk was covered by Blushing Groom's son for the first time last year in April and did not become pregnant. She was bred again on May 20 and that time conceived. She was scanned in foal at 13 days post-breeding, and there were three embryos. At 14 days, she still was carrying three embryos, and each was growing. That day, the smallest of the three was eliminated.
On day 15, there were still two growing embryos, and the smallest of the two was eliminated. She was maintained on Regumate (an oral preparation of a progesterone compound) until about 158 days of gestation. The ovaries are responsible for producing progesterone until about day 130, then the placenta becomes the main source of progesterone.
Genuine Risk was managed during her pregnancy like the other mares at Three Chimneys, although she was perhaps watched a little more closely. She was in a field with a number of other mares, and her buddy was Mime, another Firestone maiden mare (who produced a colt by Capote on April 24). Plans are to bypass breeding Genuine Risk on her foal heat and breed her later this season.
Firestone said when he and his wife come to visit Genuine Risk and the colt for the first time on May 25, they will consider mating plans. They also said they have not decided on a name for the colt. "The first thing we were hoping was to get a foal on the ground," said Firestone. "After everything was okay, then we said we'd decide on a name. We're open to suggestions."
Firestone said he never gave up on the mare producing a foal. "You know racing is a sport you have to keep trying and hoping for the best and living a dream sometimes." Firestone noted that physically, there was never anything wrong with Genuine Risk that prevented her *om having a foal, and he hopes that this will be the first of several she will produce.
Firestone was not surprised at the general public's interest in Genuine Risk and her foal. "One thing about Genuine Risk was that she was a star," he said. "She got the general public enthused about racing. I think we need more of that. I'm glad to see she's gotten so much publicity. At the farm, they've gotten hundreds of letters from well-wishers and people who remembered Genuine Risk when she was running, and even from school kids who didn't remember. I think that's what the sport needs-more stars that people can relate to."
Genuine Risk was a tough racehorse, Firestone recalled. "When Diane and I went down to the Derby, we had a lot of confidence she was going to win that race because she was training so good. She was the only filly in history to run in all three Triple Crown races, and she was first in the Derby and second in the other two races. She had speed. She had the ability. She had everything it takes to make a good race filly. And she had a sensible head."
The hard-trying filly of the racetrack is now, at long last, a mother. It appears she is taking to her new role with equal vigor.
"When we induced the mare, it was pretty hard on her," Becht said. "The colt weighed 134 pounds. That's a big foal for a maiden mare. She was Iying there after she delivered pretty quiet, with Gary Bush with her, and we were all working on the foal. Then the foal kind of nickered. As soon as she heard it, she rolled up and looked over. At first she really didn't act like she knew what this thing was. That's typical of a maiden mare.
"Then the foal got up and the mare got up, and she made a big effort to keep the foal in front of her. After a while, she started nuzzling the foal with her nose on his back. Even now in the paddock, the foal trots someplace and Genuine Risk is right behind him. She's a tremendous mother. You can just look at her and see she is just tickled to death to have him.
"The big hero in all this is Genuine Risk. And she's the one enjoying it more than anyone."
