A man of Hispanic descent approached the truck, and Cole got out to meet him. As the man came closer, Cole could make out his saddened expression, and he was reminded of a bloodhound: long face, sad droopy eyes. He extended his hand. “I’m Dr. Walker.”
The man offered a limp handshake with a well-calloused hand but didn’t state his name. “Patron,” he said, waving his other hand toward the racetrack.
Cole didn’t understand much Spanish, but he knew the man was telling him that the boss was out there on the horse. “Okay,” he said, making his way toward the track. He could see now that the rider was a woman, presumably Carmen Santiago.
The rider pulled up and slipped from the saddle, landing lightly on her feet. The man hurried to take the horse’s reins.
“I’m Carmen,” she said, extending her hand.
“Dr. Walker.” Her handshake was so firm that for a moment he thought he’d entered an arm-wrestling contest.
Carmen, also of Hispanic descent, was gorgeous. She wore her long, shiny hair pulled back and secured at the base of her neck in a black braid. Her flawless skin was a deep tan, the same color as Mattie’s. She looked at him with earnest brown eyes so dark they were almost black. “Thank you for coming so quickly. I’ll take you to see Diablo.”
He followed her toward the barn. Near the entryway, a huge Doberman went ballistic at the end of his chain. Seeing the great jaws and flashing white teeth as the dog snarled and thrashed to get loose, Cole hoped mightily that the chain would hold.
“I see you have a guard dog,” he said.
Carmen shouted at the dog in Spanish, but he ignored her and continued to struggle to get free. “Yes, we imported him from Germany. He’s supposed to be a fully trained protection dog, but he’s not as obedient as he should be. We allow him to patrol the grounds at night. These horses are very valuable.”
Nothing like having a poorly trained dog roaming the property at night. He hoped the dog didn’t bite an innocent person by accident. They’d continued to walk as they spoke and soon moved from the sunlight outside into the subdued light of the barn. The central alleyway had stalls and rooms branching off on either side and smelled of hay and horse manure. Wheelbarrows, pitchforks, rakes, and small stacks of hay sat at intervals down the alley. It was neat and well organized, a place for everything and everything in its place.
“He’s in this first stall,” Carmen said. “We gave him the medicine you suggested, but he doesn’t seem to be feeling any better.”
Cole peered over the stall door. The black stallion moved stiffly around the stall, clearly in pain but too agitated to stand still. Sweat ran in rivulets down his neck and torso, dripping from his chest and belly. Muscle fasciculation, fine muscle tremors, ran through his entire body. The sight shocked even Cole, who was somewhat used to seeing animals in pain.
He followed Carmen into the stall. She murmured sounds of comfort, and the stallion let her clip a lead rope onto his halter. “I didn’t know if I should tie him or let him move around. I called to ask, but your secretary said you were on your way. He seemed too nervous to tie, so I left him alone.”
“That’s fine. That’s what I typically recommend. He’s sweating more than I would expect. How long has he been like this?”
“Since a little before eight o’clock this morning.”
Cole still suspected this was an acute episode of exertional rhabdomyolysis, commonly known as “tying up,” but it was worse than any case he’d seen before. He ran a hand down the horse’s back, over his rump, and down the hind leg near the stifle—hard as stone beneath the skin, no body fat. This thoroughbred was in peak racing condition, so a lack of body fat didn’t come as a big surprise. Unfortunately the hardness in the large muscles of the back, rump, and hind leg didn’t either. It indicated spasm and confirmed his suspicions.
Cole used his stethoscope to listen to the stallion’s heartbeat—eighty-eight per minute, indicating severe pain.
“Will he let me get a temp while you hold him?” he asked.
“Yes. He’s usually hard to work with, but today he seems too sick to care.”
Diablo—not the type of name you give a gentle horse. Nevertheless, the stallion stood in place, muscles quivering, while Cole temped him. Not elevated. Usually there was a slightly elevated temp with rhabdomyolysis.
A loud crash from down the alleyway echoed through the building. From the same direction, a horse snorted and kicked the wall in his stall. Diablo jumped and pulled back on the rope, dragging Carmen with him. Cole sidestepped to move out of the way and then reached to help Carmen, but she was already bringing the huge stallion under control.
Carmen frowned, obviously displeased. “One minute. I’ll be right back,” she said, handing Cole the lead rope.
Although Cole stayed with Diablo, he could hear Carmen’s voice from farther down the alley, reaming someone out in Spanish. He didn’t understand what she was saying, but her tone made it clear that someone was getting a reprimand, and he was glad he wasn’t on the receiving end of that tongue-lashing.
While she was gone, Cole pulled open Diablo’s lips and pressed the gum above his teeth to check capillary refill time—several seconds, prolonged. Again, not quite what he’d expected. Typically the gums were reddened and capillary refill was quick. But with this much sweating, Diablo was probably becoming dehydrated or toxic.
Carmen quietly slipped back inside the box stall.
“I’m going to need to set up an IV and give him some fluids,” Cole told her. He looked around the stall, choosing the best place to set things up. “We’ll tie him here by his hay after I get it established, and I can hang the bag up above. I’ll go get my supplies out of the truck and be right back.”
Cole found the supplies he needed, carried them back to the stall in a stainless steel bucket, and let himself back in. “There’ll be a needle stick to put in the IV,” he told Carmen. “Just let him circle around us if he won’t stand still. I’ll stay with him.”
Carmen murmured to the horse in Spanish while Cole approached. He blocked the jugular vein in Diablo’s neck with one hand while he inserted the needle. Leaving the flexible catheter in place, he withdrew the sharp needle and secured the external part with tape. The stallion tolerated the procedure well, not moving after the first flinch. “I need to draw some blood before I set up the fluids.”
“What are you testing for?”
“I want to measure some enzymes and minerals in his blood. This amount of sweating might throw something off.”
Cole drew the blood sample from the IV and then administered sedation. He squeezed a dose of anti-inflammatory medication through a tube placed into Diablo’s mouth. The stallion thrust his tongue against it and bobbed his head but swallowed the paste anyway. Cole hooked up a bag of fluid and held it high. “This will take a few minutes,” he said. “Go ahead and tie him now, and I’ll hang this up above.”
After hooking the bag on top of the feed bunk, Cole stepped back to observe the horse. “Let’s give him a few minutes.”
Still uncomfortable, Diablo shifted his weight as he stood with his back slightly hunched, the typical stance expected from rhabdomyolysis.