Equine ER author Leslie Guttman will be signing books at Keeneland Racecourse this Sunday 10/25 at the gift shop from 11 a.m.-1 p.m.  Also: big story in this week's Ace Weekly.

On Monday in Part 2 of the excerpt from the chapter entitled "Marching Orders" from the new book Equine ER we met the inmate whose life was transformed by the stoic Thoroughbred with the big heart. Today, we head back into the operating room where Marching Orders is on the table for surgery. 

With Marching Orders now on the operating table, Dr. Scott Hopper stood over the horse’s open abdomen. A horse’s intestinal tract is seventy to ninety feet from end to end, but packed tight inside its abdomen, it winds back and forth, with changes in diameter. Colic is a broad term to describe pain caused by the intestinal tract being irritated, blocked or bloated for any number of reasons, and it is believed to be responsible for more deaths in horses than any other condition. That said, 80 to 85 percent of colics are considered “simple,” and can be treated without surgery or resolve on their own. Many mild cases are what’s called gas/spasmodic colic, believed to be caused by gas build-up in the colon, resulting in distension and pain. Food can also back up (from dehydration, for example) causing an impaction, which may or may not lead to surgery.

Dr. Scott Hopper operates on Marching Orders. 

More serious cases occur when part of the large colon becomes displaced (moving out of its regular position). By doing so, a portion is subsequently shut off, like a kink in a hose, which doesn't allow the passage of food or the gas created as a normal byproduct of digestion. The large colon can also twist, cutting off blood flow. Hopper found no obvious reasons for the horse's condition in the large colon and moved on to the small colon, looking for blockage or other problems.

At Blackburn, farm program workers had found Marching Orders a few hours earlier out in the paddock trying to lie down and attempting to bite his left side, classic signs of colic. They called Linda Dyer, the farm manager, who was out of town. She was baffled when they told her the horse was colicking. Marching Orders had already been out on new spring grass for a while, and usually horses don’t colic when they’re used to it.

Dyer called Dr. Nick Smith, the Rood & Riddle ambulatory vet who treats the Blackburn horses. When the vet got there, the horse was down and still biting at his side, and he was in a cold sweat. His temperature was low. Smith gave him anti-inflammatories, painkillers, and other drugs hoping that would help him ride it out. But after about forty-five minutes, the horse was still in pain. Smith was worried about a rupture. He called Dyer back. “I tried to smooth him out, but he didn’t smooth out,” he said, recommending the hospital. I visited Marching Orders in his stall shortly after he had arrived at Rood & Riddle. He was covered with sweat, with pieces of hay stuck to his coat. He was heavy on his feet and lethargic. But even though he was doped up, he gave me a deep look.

Back on the operating table, Hopper plunged his arm back in the horse’s abdomen and started feeling around. After a while he said, “Oh crap,” And then, “… that ultrasound doesn’t tell me shit, ever.”

Hopper felt around some more and then stopped. He said a phrase he often did when something wasn’t right. It was from Sesame Street: “One of these things is not like the other.”

Monday: What did the surgeon find?

Equine ER was recently made a "Staff Pick" by Bill Gordon, a longtime bookseller at Joseph-Beth Books in Lexington, Kentucky, one of the largest bookstores in the South. Gordon calls Equine ER "fascinating." To order the book, click here.