When Cleveland is diagnosed with high cholesterol, Donna puts him on a new high-fiber diet, which causes an intestinal backlash. Cleveland sees his doctor, who he hopes will be able to treat his uncontrollable flatulence. He is disappointed when the doctor tells him his farts are normal and are caused by the amount of fiber in his diet. In order to reduce Cleveland’s embarrassment, the doctor gives him a “fart card” to help him bypass the social stigma. The card makes other characters more accepting of Cleveland’s bad habit, even a police officer who backs off on arresting Cleveland after Cleveland flashes his fart card. Things take a turn for the better when Cleveland realizes his gas might score him a few points in the Broken Stool’s karaoke contest. Everyone but Donna is impressed. Later, Cleveland is informed that his ex-wife Loretta is dead. As explained by Glenn Quagmire, who transported her body to Stoolbend, Brian dug up a dinosaur skeleton, Peter Griffin tried to move it into his house with a crane, but accidentally swung it into Cleveland’s former house, the continued running gag in the other series. But this time, when Loretta falls out of the tub, she snaps her neck on impact. Though Cleveland Jr. is not so broken up by his mother’s death, Cleveland breaks down crying at her funeral. Donna concludes that he still loves her, even though she slept with Quagmire and various other people (Peter told Donna at their wedding), and chooses Coach McFall as her partner for the karaoke competition to spite him. While mourning at Loretta’s grave, Cleveland has an epiphany after a shenanigan with an oreo. He rushes to Donna and explains that he was having survivor’s guilt for not dying in Loretta’s place. He further explains that he had fallen out of the tub multiple times and had been left without a scratch in every incident. Donna was not convinced, until Cleveland pointed out that she may be broken up if her ex-husband Robert died. They reconcile and do the competition. Unfortunately, everyone wants Cleveland to let out some gas, especially the bar’s owner, who says, “Any ass can sing. We want the singing ass!” Cleveland obliges, resulting in his and Donna’s winning of the competition.
At the close of the episode, a brief montage is played in Loretta’s memory, showing clips from the Family Guy episode “The Cleveland-Loretta Quagmire”.