In the 10 years since Dr. Andrew van Eps saw legendary Barbaro come in to the New Bolton Center with a shattered right hind leg, he has continued to research laminitis with fervor.

Having graduated veterinary school in 1999, Van Eps came to the New Bolton Center at the University of Pennsylvania in Kennett Square, Pa., as a resident. Since then, he has spent much of his career at his alma mater, the University of Queensland in Australia, and been inducted into the International Equine Veterinarian Hall Of Fame.

He was already researching laminitis during the Barbaro case — now it has been his focus for almost 20 years. With this wealth of experience, he returned to the New Bolton Center.

Van Eps told how researchers’ understanding of the disease has changed.

“At that point, in the late ’90s, early 2000s, we still felt like all laminitis was the same,” he says. “Most people felt it was a problem with blood flow no matter if it was a sick horse, a fat pony out on pasture, or whether it was a horse like Barbaro with an injury in one leg. We all thought it was all the same mechanism and it was a low-blood-flow problem.”

Dr. Chris Pollitt, a veterinarian van Eps learned from at Queensland, challenged this notion. It was there that researchers realized that high insulin levels could cause laminitis and that most laminitis cases are insulin related.

For insulin-related cases, the underlying condition often can be treated; for sick horses, “foot cooling” has been used in treatment and prevention, but “simple solutions are not quite there yet.”

Still, Barbaro’s case was an issue of shifting too much weight on one leg, inhibiting healthy blood flow.

“The tissue is such an intricate tissue.” Regarding a cure, van Eps is grim. “Besides transplanting a normal leg, it’s probably never going to happen.”

Van Eps is collaborating with fellow Hall Of Fame veterinarian Dr. James Belknap of Ohio State, “looking at a drug to specifically inhibit that process.”

“Prevention is always going to be key for them,” van Eps says.