Because of space limitations, not all the stories I followed and wrote about in the forthcoming book Equine ER,
made it into the book, such as this one below about an older Quarter
Horse named Trouble. Also, some early buzz: Susan Richards, author of the New York Times best-seller “Chosen by a
Horse,” calls Equine ER as “thrilling and drama-filled as any
of the popular hospital shows on television today. As (author Leslie)
Guttman takes us along on rounds with the vets from the prestigious
Rood & Riddle Equine Hospital, we enter the life-and-death world of
some of the most famous racing barns in America. Over and over, Guttman
shows us that even in the high stakes world of racing, compassion and
an enduring love of equines is the guiding force behind the decisions
of this extraordinary group of veterinarians ...”
The book is coming out very soon. Special deal for early birds who want to pre-order (free shipping, more than 20 percent off, click here. Thank you for visiting this blog.


Top: Trouble, a 22-year-old Quarter Horse; above: Trouble in his younger days (photo by Don Shugart, reprinted with permission).
With a No. 10 blade on his scalpel, Dr. Brett Woodie made a nine-inch incision from Trouble’s mid-section up toward his xyphoid, or breastbone. The horse had first been intubated — sedated, anesthetized, and a tube put down his mouth and into his trachea to deliver anesthetic gas and maintain his airway. His pasterns were shackled; an electric hoist had gotten him on the table. The vet’s first cut went through Trouble’s skin, the subcutaneous tissue, and then the body wall. Then Woodie used his fingers to open the peritoneum, the thin, opaque tissue that lines the abdominal cavity.
Inside, the doctor had to search by feel for the suspected lipoma, an accumulation of noncancerous fatty tissue he believed was wrapped around the small intestine, cutting off blood supply for the 22-year-old Quarter Horse. A rectal exam earlier had pointed to the possibility of a lipoma; during it, the small intestine, which always felt like a bunch of bike tire inner tubes to the doctor, had been distended, and on the grainy screen of the ultrasound the loops of the intestine were blown up twice their size.
On the operating table, Woodie started his search at the cecum, the four-foot-long pouch that lies at the junction of the small and large intestine; inside it microbes break down undigested feed. He worked his way from the terminal, or ending, point, of the small intestine backward to where it originated. The trick was not to mistake any part of the intestine or a blood vessel for the lipoma. Woodie couldn’t explain how he could tell a lipoma from everything else; it was just something that came with time, the way blind people learn to distinguish people’s footsteps. But it was still nerve-wracking, and even the best surgeons make mistakes.
Woodie is in his late 30s, 5 foot 11, with bristly reddish-brown hair and a matching mustache. He is confident, level-headed, pragmatic, an oldest child who turned down a college baseball scholarship to instead focus on getting into vet school. He made that decision like he makes his surgical ones: He weighed the odds and went with the best shot. He didn’t want to gamble and end up with a life spent rattling around in the minor leagues, taking crummy buses to half-filled stands. One of his mottoes is: If you don’t try, you’ll never win. But then he adds: But you have to know when to try and when to stop.
In some ways, though, surgery isn’t that different from baseball. Woodie loves the mystery of it, figuring out how to correct problems on the fly, the responsibility he holds in his hands. Any cases that don’t go smoothly on the table are analyzed and the lessons methodically applied to the next. It is a new play every time.
Nobody who buys their first horse thinks about what it will truly cost them – financially and emotionally, and Trouble’s owners, Tom and Diane Lumadue, were no exception. Trouble was their first, followed by Cupcake, a miniature pinto, and Cocoa, a brown pony Diane admits with embarrassment was an impulse purchase … but she was determined to find a horse for her 8-year-old twins who were outgrowing Cupcake. The horses needed their feet trimmed regularly … worming every six to eight weeks … hay and grain and bedding … and of course, if you wanted to take them places, you needed a way to do it. The Lumadues are like so many regular, middle-class people who come down with horse fever. They wake up with a truck and a Featherlite trailer in the driveway and wonder: How did we get here?
But it wasn’t a complete accident. They wanted the twins to grow up in the country. So they bought 11 acres with a red barn and a pond and oak trees that the twins climb instead of watching tiny TV after school on their iPods. They have chickens that are chased on a regular basis; manure is thrown in combat. It is a “Charlotte’s Web” kind of place. That book’s author, E.B. White, himself left the city with his family to live on a farm for much the same reason the Lumadues did: He wanted his family to have “adventures in contentment."*
It was 1 a.m. on a cold March morning when Diane heard a thumping sound. The noise sounded like it was coming from the barn, even though the barn is at least 500 feet away the house. She prodded her husband. He was zonked. Finally, she got him up. Tom thought the sound was coming from the subdivision up the road, but his wife was sure it was the barn. When they got there, they found Trouble covered with mud and rolling in pain. He had kicked the water bucket off the wall, and was kicking the wooden stall walls. The bedding was torn up. Trouble had colic. It all happened so fast, as emergencies do — the local vet couldn’t take the horse’s pain away and thought he might need surgery; by afternoon they were on the road with him for the three and a half hour drive from West Virginia to Lexington.
Tom Lumadue has thick brown hair, blue eyes, and a boyish face. His great-grandparents came to West Virginia from France and were coal miners. Diane Lumadue is about 5 foot 6, with dark blonde hair she often wears back in a ponytail. She’s lived in the state all her life. Tom’s an engineer with Columbia Gas; she’s a stay-at-home mom and former cosmetics sales rep. Trouble had lived on some property next door to their old place. A Texas businessman owned him and was rarely home. When Diane asked if she could ride him, he said sure. The woman-horse thing took over, something her husband freely admits is beyond his understanding. As she put it, “For a horse and a woman, we can be two together,” but for many men (though certainly not all), the connection just isn’t there. She bought the horse. She loved what she called Trouble’s giantness, the innocence of his nature, the smell of his coat. He was from Texas, stocky, solid, muscular. He had been a show horse, a cutting horse who excelled in the Western event where a horse separates a cow from a herd and keeps it from returning. At 22, he was not a paddock potato; he still won at local shows; his grandfather was the sire of Shining Spark, the famous palomino stallion and leading sire for the National Reining Horse Association, among others. Trouble was taciturn, typical of many Quarter Horses; he let Diane love on him, but only to a point.
When they got Trouble down to the equine hospital, Tom was blown away by the size of it. It reminded him of a regular hospital — his dad had died almost exactly a year ago, and they had spent quite a bit of time in hospital waiting rooms during his illness. The family was still grieving. Diane didn’t think she could handle it if Trouble died on top of losing her father-in-law.
When Woodie first saw Trouble, he was pawing the ground, still trying to go down to relieve the pain and pressure in his gut. Now back on the operating table, the doctor kept feeling his way through the small intestine section by section, and in about the middle of it — jackpot: the lipoma. Then he looked over the large intestine and the rest of the abdomen for any other problems. As long as you’re in there, you better look around. Everything else looked okay.
Colic has been said to kill more horses than any other condition. With colic, the intestinal tract is irritated, blocked, or bloated for any number of reasons. A horse’s stomach is tiny compared to its size, making up about 10 percent of its digestive system. Horses are meant to roam around and eat small amounts of roughage throughout the day. However, domestication has changed that, with most horses eating concentrated food at one or two mealtimes in large amounts. Many are not turned out enough. All this means more digestive problems for today’s horses than there were for their evolutionary parents (or currently are for their wild cousins). It has been estimated that there are 12,000 to 14,000 equine colic surgeries each year — close to three an hour. However, in general, the design of a horse’s intestinal tract is such that it’s easy for intestine to move into places it shouldn’t, get distended, and not return to where it belongs.
The Lumadues had been watching the surgery from an observation window outside the operating room. Woodie left the table and met them at the door. With Trouble, there were only two choices: continue the surgery or euthanize now, he told them. Sewing him back up without doing anything wasn’t a choice. With dead intestine in there (caused by the strangulation of the intestine by the lipoma), bacteria would leak out of the G.I. tract, enter the abdominal cavity and the bloodstream, and cause the horse to die a terrible death. The doctor thought Trouble would likely recover, although he would probably be sick for up to a week, or possibly more, and would have to stay at Rood and Riddle. Of course, there was always the possibility that because of his age or complications, he wouldn’t make it, and then there was the matter of cost.
Woodie has seen people who could afford to keep their horses alive choose to put them down, and people who couldn’t afford to keep them alive try anyway. He doesn’t think either way is wrong. But you shouldn’t keep a suffering animal alive for your sake, or risk your family’s financial future for theirs, he believes. With a sick horse, owners often find themselves reluctantly playing God, or at times, going broke — that goes even for healthy horses. In 2008, a hay shortage had hit Kentucky, and prices had doubled — from $4 a bale the year before to $8 to $10. Authorities were finding horses starving because owners could no longer take care of them. But many were being kept by people who couldn’t afford them any longer, who found themselves behind in rent, canceling cable TV, cell phone plans, whatever. One of the receptionists at Rood and Riddle had rescued a starving pony and a colt from nearby Harrison County. Their personalities weren’t so sanguine, and a part of her regretted it even though she felt compelled to keep them. West Virginia was also feeling the hay shortage, and so were the Lumadues. Still, outside the operating room, they told Woodie to go ahead.
Woodie worked his finger in between the lipoma and the small intestine. It was tight, and he’d have to be careful when he cut it off not to nick the intestine. He cut it with a pair of scissors, like you’d cut a ring off a swollen finger. He removed the dead intestine and joined the healthy ends together, aligning the tissue and suturing first the inner layer, called the mucosa, and then the outer, the seromuscular layer. The plumbing was changed. A horse can lose over half its small intestine and still be able to digest food. It’s not clear what causes lipomas; some are incidental and don’t harm anything, but this one wasn’t.
Trouble, as expected, was ill for much of the nine days he stayed at the hospital. Horses can’t throw up; their stomachs would likely rupture instead, so they have to reflux — a tube is placed down the nasal passage, into the esophagus, and then into the stomach. Water is pumped in to create a siphon. While he was at the hospital, the Quarter Horse gained a small fan club of techs who were taken with his age and dignity. Many horse people respect their equine elders, unlike many humans. In the month Trouble was ill, fans of John Henry, the famous racehorse who had died earlier in the year, threw him a posthumous thirty-third birthday party with chocolate cake and donuts at the Kentucky Horse Park, located near Rood and Riddle. In people years, Trouble would have been in his 80s. He was a $4,500 horse mending in a stall that had held million-dollar broodmares and stallions that had launched front-page bidding wars at Keeneland sales. I visited him late one night a couple of days before he left. He stood motionless in the dim light of the stall. His eyes were tired but determined and patient; his demeanor reminded me of those of the grandparents I see at the grocery stoically pushing around their grandkids. His coat was the color of a robin’s breast.
On the day Trouble left the hospital to go home, the cost of his medical bill meant that the Lumadues’ kitchen would not be remodeled this year. A vacation was questionable. The dog would have to do without his big milk bones. Trouble walked slowly and determinedly toward the trailer and boarded it without hesitation. The Lumadues were exhausted. In a few days, it would be the anniversary of the death of Tom’s dad. They had lived too close this year to the unfortunate truth that most of what we love torpedoes our hearts. The late horse trainer, poet, and writer Vicki Hearne once said: “In over 25 years of training, I have never seen an animal who was replaceable.” But loss wouldn’t come again this year for the family. Trouble would mend. He remains healthy today.

Trouble leaves the hospital.
*When Cornell University professor and writer Morris Bishop discovered E.B. White was moving to the country, he told him “I trust you will spare the reading public your little adventures in contentment.” Thankfully, he did not.