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Title: Special Report on Diseases of the Horse
Author: Agriculture, United States Department of, Pearson, Leonard, Huidekoper, Rush Shippen, Michener, Ch. B., Harbaugh, W. H.
Language: English
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U. S. DEPARTMENT OF AGRICULTURE, BUREAU OF ANIMAL INDUSTRY.
A. D. MELVIN, CHIEF OF BUREAU.
* * * * *
SPECIAL REPORT
ON
DISEASES OF THE HORSE.
BY
Drs. PEARSON, MICHENER, LAW, HARBAUGH, TRUMBOWER, LIAUTARD, HOLCOMBE,
HUIDEKOPER, MOHLER, EICHHORN, HALL, AND ADAMS.
* * * * *
REVISED EDITION, 1916.
[Illustration]
WASHINGTON:
GOVERNMENT PRINTING OFFICE.
1916.
DEPARTMENT OF AGRICULTURE,
_Washington, March 30, 1916._
* * * * *
Transcriber's note: The italic markup for single italized letters are
deleted for easier reading. Minor typos have been corrected and footnotes
moved to the end of the sections.
* * * * *
This edition of the Special Report on Diseases of the Horse has been
prepared in compliance with House Concurrent Resolution No. 13, passed
February 3, 1916, as follows:
_Resolved by the House of Representatives (the Senate
concurring)_, That there be printed and bound in cloth one
hundred thousand copies of the Special Report on the Diseases
of the Horse, the same to be first revised and brought to date,
under the supervision of the Secretary of Agriculture; seventy
thousand copies for the use of the House of Representatives and
thirty thousand for use of the Senate.
Since the original edition issued by the Department in 1890 several
editions have been printed by order of Congress. The work was reprinted
in 1896, and revised and reprinted in 1903, 1908, and 1911. In
accordance with the foregoing resolution it again has been revised so as
to embody the latest practical development of knowledge of the subject.
D. F. HOUSTON,
_Secretary._
CONTENTS.
Page.
The examination of a sick horse. By Leonard Pearson 7
Fundamental principles of disease. By Rush Shippen Huidekoper 27
Methods of administering medicines. By Ch. B. Michener 44
Diseases of the digestive organs. By Ch. B. Michener 49
Diseases of the respiratory organs. By W. H. Harbaugh 95
Diseases of the urinary organs. By James Law 134
Diseases of the generative organs. By James Law 164
Diseases of the nervous system. By M. R. Trumbower 210
Diseases of the heart, blood vessels, and lymphatics.
By M. R. Trumbower 247
Diseases of the eye. By James Law 274
Lameness. By A. Liautard 298
Diseases of the fetlock, ankle, and foot. By A. A. Holcombe 395
Diseases of the skin. By James Law 458
Wounds and their treatment. By Ch. B. Michener 484
Infectious diseases. By Rush Shippen Huidekoper 507
Shoeing. By John W. Adams 583
Index 607
ILLUSTRATIONS.
PLATES.
Page.
PLATE
I. Inflammation 32
II. Inflammation 32
III. Digestive apparatus 48
IV. Age of horses as indicated by teeth 58
V. Intestinal worms 92
VI. Bots 92
VII. Position of the left lung 112
VIII. Longitudinal section through kidney 136
IX. Microscopic anatomy of kidney 136
X. Microscopic anatomy of kidney 136
XI. Calculi and instrument for removal 152
XII. Normal presentation 192
XIII. Some factors in difficult labor 192
XIV. Instruments used in difficult labor 192
XV. Abnormal presentations 200
XVI. Abnormal presentations 200
XVII. Abnormal presentations 200
XVIII. Abnormal presentations 200
XIX. The nervous system 216
XX. Interior of chest, showing position of heart and diaphragm 248
XXI. Circulatory apparatus 248
XXII. Diagrammatic vertical section through horse's eye 277
XXIII. Skeleton of horse 304
XXIV. Superficial layer of muscles 304
XXV. Splint 312
XXVI. Ringbone 312
XXVII. Various types of spavin 312
XXVIII. Bone spavin 312
XXIX. Bone spavin 312
XXX. Dislocation of shoulder and elbow, Bourgelat's apparatus 360
XXXI. The sling in use 360
XXXII. Anatomy of foot 400
XXXIII. Anatomy of foot 400
XXXIV. Anatomy and diseases of foot 400
XXXV. Sound and contracted feet 400
XXXVI. Quarter crack and remedies 432
XXXVII. Foundered feet 432
XXXVIII. The skin and its diseases 458
XXXIX. Mites that infest the horse 480
XL. Glanders 544
XLI. Glanders 544
XLII. Glanders 544
TEXT FIGURES.
Page.
FIG.
1. Ground surface of a right fore hoof of the
"regular" form 590
2. Pair of fore feet of regular form in regular standing position 591
3. Pair of fore feet of base-wide form in toe-wide standing
position 591
4. Pair of fore feet of base-narrow form in toe-narrow standing
position 592
5. Side view of an acute-angled fore foot, of a regular fore
foot, and of a stumpy fore foot 592
6. Side view of foot with the foot-axis broken backward as a
result of too long a toe 595
7. Left fore hoof of a regular form, shod with a plain fullered
shoe 599
8. Side view of hoof and fullered shoe 599
9. An acute-angled left fore hoof shod with a bar shoe 601
10. A fairly formed right fore ice shoe for a roadster 601
11. Left fore hoof of regular form shod with a rubber pad and
"three-quarter" shoe 602
12. A narrow right fore hoof of the base-wide standing position
shod with a plain "dropped crease" shoe 602
13. Hoof surface of a right hind shoe to prevent interfering 603
14. Ground surface of shoe shown in fig. 13 603
15. Side view of a fore hoof shod so as to quicken the "breaking
over" in a "forger" 604
16. Side view of a short-toed hind hoof of a forger 604
17. A toe-weight shoe to increase the length of stride of fore
feet 605
18. Most common form of punched heel-weight shoe to induce high
action in fore feet 605
SPECIAL REPORT ON DISEASES OF THE HORSE.
THE EXAMINATION OF A SICK HORSE.
By Leonard Pearson, B. S., V. M. D.
In the examination of a sick horse it is important to have a method or
system. If a definite plan of examination is followed one may feel
reasonably sure, when the examination is finished, that no important
point has been overlooked and that the examiner is in a position to
arrive at an opinion that is as accurate as is possible for him. Of
course, an experienced eye can see, and a trained hand can feel, slight
alterations or variations from the normal that are not perceptible to
the unskilled observer. A thorough knowledge of the conditions that
exist in health is of the highest importance, because it is only by a
knowledge of what is right that one can surely detect a wrong condition.
A knowledge of anatomy, or of the structure of the body, and of
physiology, or the functions and activities of the body, lie at the
bottom of accuracy of diagnosis. It is important to remember that
animals of different races or families deport themselves differently
under the influence of the same disease or pathological process. The
sensitive and highly organized thoroughbred resists cerebral depression
more than does the lymphatic draft horse. Hence a degree of fever that
does not produce marked dullness in a thoroughbred may cause the most
abject dejection in a coarsely bred, heavy draft horse. This and similar
facts are of vast importance in the diagnosis of disease and in the
recognition of its significance.
The order of examination, as given hereafter, is one that has proved to
be comparatively easy of application and sufficiently thorough for the
purpose of the readers of this work, and is recommended by several
writers.
HISTORY.
It is important to know, first of all, something of the origin and
development of the disease; therefore the cause should be looked for.
The cause of a disease is important, not only in connection with
diagnosis, but also in connection with treatment. The character of feed
that the horse has had, the use to which he has been put, and the kind
of care he has received should all be closely inquired into. It may be
found by this investigation that the horse has been fed on damaged feed,
such as brewers' grains or moldy silage, and this may be sufficient to
explain the profound depression and weakness that are characteristic of
forage poisoning. If it is learned that the horse has been kept in the
stable without exercise for several days and upon full rations, and that
he became suddenly lame in his back and hind legs, and finally fell to
the ground from what appeared to be partial paralysis, this knowledge,
taken in connection with a few evident symptoms, will be enough to
establish a diagnosis of azoturia (excess of nitrogen in the urine). If
it is learned that the horse has been recently shipped in the cars or
has been through a dealer's stable, we have knowledge of significance in
connection with the causation of a possible febrile disease, which is,
under these conditions, likely to prove to be influenza, or edematous
pneumonia.
It is also important to know whether the particular horse under
examination is the only one in the stable, or on the premises, that is
similarly afflicted. If it is found that several horses are afflicted
much in the same way, we have evidence of a common cause of disease
which may prove to be of an infectious nature.
Another item of importance in connection with the history of the case
relates to the treatment that the horse may have had before he is
examined. It sometimes happens that medicine given in excessive
quantities produces symptoms resembling those of disease, so it is
important that the examiner be fully informed as to the medication that
has been employed.
ATTITUDE AND GENERAL CONDITION.
Before beginning the special examination, attention should be paid to
the attitude and general condition of the animal. Sometimes horses
assume positions that are characteristic of a certain disease. For
example, in tetanus (lockjaw) the muscles of the face, neck, and
shoulders are stiff and rigid, as well as the muscles of the jaw. This
condition produces a peculiar attitude, that once seen is subsequently
recognized as rather characteristic of the disease. A horse with tetanus
stands with his muscles tense and his legs in a somewhat bracing
position, as though he were gathered to repel a shock. The neck is stiff
and hard, the head is slightly extended upon it, and the face is drawn,
and the nostrils are dilated. The tail is usually held up a little, and
when pressed down against the thighs it springs back to its previous
position. In inflammation of the throat, as in pharyngolaryngitis, the
head is extended upon the neck and the angle between the jaw and the
lower border of the neck is opened as far as possible to relieve the
pressure that otherwise would fall upon the throat. In dumminess, or
immobility, the hanging position of the head and the stupid expression
are rather characteristic. In pleurisy, peritonitis, and some other
painful diseases of the internal organs, the rigid position of the body
denotes an effort of the animal to avoid pressure upon and to protect
the inflamed sensitive region.
The horse may be down in the stall and unable to rise. This condition
may result from paraplegia (paralysis), from azoturia, from forage
poisoning, from tetanus, or from painful conditions of the bones or
feet, such as osteoporosis or founder. Lying down at unusual times or in
unusual positions may indicate disease. The first symptom of colic may
be a desire on the part of the horse to lie down at an unusual or
inappropriate time or place. Sometimes disinclination to lie down is an
indication of disease. When there is difficulty in breathing, the horse
knows that he can manage himself better upon his feet than upon his
breast or his side. It happens, therefore, that in nearly all serious
diseases of the respiratory tract he stands persistently, day and night,
until recovery has commenced and breathing is easier, or until the
animal falls from sheer exhaustion. If there is stiffness and soreness
of the muscles, as in rheumatism, inflammation of the muscles from
overwork, or of the bones in osteoporosis, or of the feet in founder, or
if the muscles are stiff and beyond control of the animal, as in
tetanus, a standing position is maintained, because the horse seems to
realize that when he lies down he will be unable to rise.
Abnormal attitudes are assumed in painful diseases of the digestive
organs (colic). A horse with colic may sit upon his haunches, like a
dog, or may stand upon his hind feet and rest upon his knees in front,
or he may endeavor to balance himself upon his back, with all four feet
in the air. These positions are assumed because they give relief from
pain by lessening pressure or tension upon the sensitive structures.
Under the general condition of the animal it is necessary to observe the
condition or state of nutrition, the conformation, so far as it may
indicate the constitution, and the temperament. By observing the
condition of nutrition one may be able to determine to a certain extent
the effect that the disease has already had upon the animal and to
estimate the amount of strength that remains and that will be available
for the repair of the diseased tissues. A good condition of nutrition is
shown by the rotundity of the body, the pliability and softness of the
skin, and the tone of the hair. If the subcutaneous fat has disappeared
and the muscles are wasted, allowing the bony prominences to stand out;
if the skin is tight and inelastic and the coat dry and harsh, we have
evidence of a low state of nutrition. This may have resulted from a
severe and long-continued disease or from lack of proper feed and care.
When an animal is emaciated--that is, becomes thin--there is first a
loss of fat and later the muscles shrink. By observing the amount of
shrinkage in the muscles one has some indication as to the duration of
the unfavorable conditions under which the animal has lived.
By constitution we understand the innate ability of the animal to
withstand disease or unfavorable conditions of life. The constitution
depends largely upon the conformation. The type of construction that
usually accompanies the best constitution is deep, broad chest, allowing
plenty of room for the lungs and heart, indicating that these vital
organs are well developed; capacious abdomen, allowing sufficient space
for well-developed organs of digestion; the loins should be short--that
is, the space should be short between the last rib and the point of the
hip; the head and neck should be well molded, without superfluous or
useless tissue; this gives a clear-cut throat. The ears, eyes, and face
should have an expression of alertness and good breeding. The muscular
development should be good; the shoulders, forearms, croup, and thighs
must have the appearance of strength. The withers are sharp, which means
that they are not loaded with useless, superfluous tissue; the legs are
straight and their axes are parallel; the knees and hocks are low, which
means that the forearms and thighs are long and the cannons relatively
short. The cannons are broad from in front to behind and relatively thin
from side to side. This means that the bony and tendinous structures of
the legs are well developed and well placed. The hoofs are compact,
tense, firm structures, and their soles are concave and frogs large.
Such a horse is likely to have a good constitution and to be able to
resist hard work, fatigue, and disease to a maximum degree. On the other
hand, a poor constitution is indicated by a shallow, narrow chest, small
bones, long loins, coarse neck and head, with thick throat, small, bony,
and muscular development, short thighs and forearms, small joints, long,
round cannons, and hoofs of open texture with flat soles.
The temperament is indicated by the manner in which the horse responds
to external stimuli. When the horse is spoken to, or when he sees or
feels anything that stimulates or gives alarm, if he responds actively,
quickly, and intelligently, he is said to be of lively, or nervous,
temperament. On the other hand, if he responds in a slow, sluggish
manner, he is said to have a sluggish, or lymphatic, temperament. The
temperament is indicated by the gait, by the expression of the face, and
by the carriage of the head and ears. The nature of the temperament
should be taken into consideration in an endeavor to ascertain the
severity of a given case of illness, because the general expression of
an animal in disease as well as in health depends to a large extent on
the temperament.
THE SKIN AND THE VISIBLE MUCOUS MEMBRANES.
The condition of the skin is a fair index to the condition of the
animal. The effect of disease and emaciation upon the pliability of the
skin have been referred to above. There is no part of the body that
loses its elasticity and tone as a result of disease sooner than the
skin. The practical herdsman or flockmaster can gain a great deal of
information as to the condition, of an animal merely by grasping the
coat and looking at and feeling the skin. Similarly, the condition of
the animal is shown to a certain extent by the appearance of the mucous
membranes. For example, when the horse is anemic as a result of disease
or of inappropriate feed the mucous membranes become pale. This change
in the mucous membranes can be seen most readily in the lining of the
eyelids and in the lining of the nostril. For convenience of examination
the eyelids can readily be everted. Paleness means weak circulation or
poor blood. Increased redness occurs physiologically in painful
conditions, excitement, and following severe exertion. Under such
conditions the increase of circulation is transitory. In fevers there is
an increased redness in the mucous membrane, and this continues so long
as the fever lasts. In some diseases red spots or streaks form in the
mucous membrane. This usually indicates an infectious disease of
considerable severity, and occurs in blood poisoning, purpura
hemorrhagica, hemorrhagic septicemia, and in urticaria. When the liver
is deranged and does not operate, or when the red-blood corpuscles are
broken down, as in serious cases of influenza, there is a yellowish
discoloration of the mucous membrane. The mucous membranes become bluish
or blue when the blood is imperfectly oxidized and contains an excess of
carbon dioxid. This condition exists in any serious disease of the
respiratory tract, as pneumonia, and in heart failure.
The temperature of the skin varies with the temperature of the body. If
there is fever the temperature of the skin is likely to be increased.
Sometimes, however, as a result of poor circulation and irregular
distribution of the blood, the body may be warmer than normal, while the
extremities (the legs and ears) may be cold. Where the general surface
of the body becomes cold it is evident that the small blood vessels in
the skin have contracted and are keeping the blood away, as during a
chill, or that the heart is weak and is unable to pump the blood to the
surface, and that the animal is on the verge of collapse.
The skin is moist, to a certain degree, at all times in a healthy horse.
This moisture is not in the form of a perceptible sweat, but it is
enough to keep the skin pliable and to cause the hair to have a soft,
healthy feel. In some chronic diseased conditions and in fever, the skin
becomes dry. In this case the hair has a harsh feel that is quite
different from the condition observed in health, and from the fact of
its being so dry the individual hairs do not adhere to one another, they
stand apart, and the animal has what is known as "a staring coat." When,
during a fever, sweating occurs, it is usually an indication that the
crisis is passed. Sometimes sweating is an indication of pain. A horse
with tetanus or azoturia sweats profusely. Horses sweat freely when
there is a serious impediment to respiration; they sweat under
excitement, and, of course, from the well-known physiological causes of
heat and work. Local sweating, or sweating of a restricted area of the
body, denotes some kind of nerve interference.
Swellings of the skin usually come from wounds or other external causes
and have no special connection with the diagnosis of internal diseases.
There are, however, a number of conditions in which the swelling of the
skin is a symptom of a derangement of some other part of the body. For
example, there is the well-known "stocking," or swelling of the legs
about the fetlock joints, in influenza. There is the soft swelling of
the hind legs that occurs so often in draft horses when standing still
and that comes from previous inflammation (lymphangitis) or from
insufficient heart power. Dropsy, or edema of the skin, may occur
beneath the chest or abdomen from heart insufficiency or from chronic
collection of fluid in the chest or abdomen (hydrothorax, ascites, or
anemia). In anasarca or purpura hemorrhagica large soft swellings appear
on any part of the skin, but usually on the legs, side of the body, and
about the head.
Gas collects under the skin in some instances. This comes from a local
inoculation with an organism which produces a fermentation beneath the
skin and causes the liberation of gas which inflates the skin, or the
gas may be air that enters through a wound penetrating some
air-containing organ, as the lungs. The condition here described is
known as emphysema. Emphysema may follow the fracture of a rib when the
end of a bone is forced inward and caused to penetrate the lung, or it
may occur when, as a result of an ulcerating process, an organ
containing air is perforated. This accident is more common in cattle
than it is in horses. Emphysema is recognized by the fact that the
swelling that it causes is not hot or sensitive on pressure. It emits a
peculiar crackling sound when it is stroked or pressed upon.
Wounds of the skin may be of importance in the diagnosis of internal
disease. Wounds over the bony prominence, as the point of the hip, the
point of the shoulder, and the greatest convexity of the ribs, occur
when a horse is unable to stand for a long time and, through continually
lying upon his side, has shut off the circulation to the portion of the
skin that covers parts of the body that carry the greatest weight, and
in this way has caused them to mortify. Little, round, soft, doughlike
swellings occur on the skin and may be scattered freely over the surface
of the body when the horse is afflicted with urticaria. Similar
eruptions, but distributed less generally, about the size of a silver
dollar, may occur as a symptom of dourine, or colt distemper. Hard
lumps, from which radiate welt-like swellings of the lymphatics, occur
in glanders, and blisterlike eruptions occur around the mouth and
pasterns in horsepox.
THE ORGANS OF CIRCULATION.
The first item in this portion of the examination consists in taking the
pulse. The pulse may be counted and its character may be determined at
any point where a large artery occupies a situation close to the skin
and above a hard tissue, such as a bone, cartilage, or tendon. The most
convenient place for taking the pulse of the horse is at the jaw. The
external maxillary artery runs from between the jaws, around the lower
border of the jawbone, and up on the outside of the jawbone to the face.
It is located immediately in front of the heavy muscles of the cheek.
Its throb can be felt most distinctly just before it turns around the
lower border of the jawbone. The balls of the first and second or of the
second and third fingers should be pressed lightly on the skin over this
artery when its pulsations are to be studied.
The normal pulse of the healthy horse varies in frequency as follows:
Stallion 28 to 32 beats per minute.
Gelding 33 to 38 beats per minute.
Mare 34 to 40 beats per minute.
Foal 2 to 3 years old 40 to 50 beats per minute.
Foal 6 to 12 months old 45 to 60 beats per minute.
Foal 2 to 4 weeks old 70 to 90 beats per minute.
The pulse is accelerated by the digestion of rich food, by hot weather,
exercise, excitement, and alarm. It is slightly more rapid in the
evening than it is in the morning. Well-bred horses have a slightly more
rapid pulse than sluggish, cold-blooded horses. The pulse should be
regular; that is, the separate beats should follow each other after
intervals of equal length, and the beats should be of equal fullness, or
volume.
In disease, the pulse may become slower or more rapid than in health.
Slowing of the pulse may be caused by old age, great exhaustion, or
excessive cold. It may be due to depression of the central nervous
system, as in dumminess, or be the result of the administration of
drugs, such as digitalis or strophantus. A rapid pulse is almost always
found in fever, and the more severe the infection and the weaker the
heart the more rapid is the pulse. Under these conditions, the beats may
rise to 80, 90, or even 120 per minute. When the pulse is above 100 per
minute the outlook for recovery is not promising, and especially if this
symptom accompanies high temperature or occurs late in an infectious
disease. In nearly all of the diseases of the heart and in anemia the
pulse becomes rapid.
The pulse is irregular in diseases of the heart, and especially where
the valves are affected. The irregularity may consist in varying
intervals between the beats or the dropping of one or more beats at
regular or irregular intervals. The latter condition sometimes occurs in
chronic diseases of the brain. The pulse is said to be weak, or soft,
when the beats are indistinct, because little blood is forced through
the artery by each contraction of the heart. This condition occurs when
there is a constriction of the vessels leading from the heart and it
occurs in certain infectious and febrile diseases, and is an indication
of heart weakness.
In examining the heart itself it is necessary to recall that it lies in
the anterior portion of the chest slightly to the left of the median
line and that it extends from the third to the sixth rib. It extends
almost to the breastbone, and a little more than half of the distance
between the breastbone and the backbone. In contracting, it rotates
slightly on its axis, so that the point of the heart, which lies below,
is pressed against the left chest wall at a place immediately above the
point of the elbow. The heart has in it four chambers--two in the left
and two in the right side. The upper chamber of the left side (left
auricle) receives the blood as it comes from the lungs, passes it to the
lower chamber of the left side (left ventricle), and from here it is
sent with great force (for this chamber has very strong, thick walls)
through the aorta and its branches (the arteries) to all parts of the
body. The blood returns through the veins to the upper chamber of the
right side (right auricle), passes then to the lower chamber of the
right side (right ventricle), and from this chamber is forced into the
lungs to be oxidized. The openings between the chambers of each side and
into the aorta are guarded by valves.
If the horse is not too fat, one may feel the impact of the apex of the
heart against the chest wall with each contraction of the heart by
placing the hand on the left side back of the fifth rib and above the
point of the elbow. The thinner and the better bred the horse is the
more distinctly this impact is felt. If the animal is excited, or if he
has just been exercised, the impact is stronger than when the horse is
at rest. If the horse is weak, the impact is reduced in force.
The examination of the heart with the ear is an important matter in this
connection. Certain sounds are produced by each contraction of the
normal heart. It is customary to divide these into two, and to call them
the first and second sounds. These two sounds are heard during each
pulsation, and any deviation of the normal indicates some alteration in
the structure or the functions of the heart. In making this examination,
one may apply the left ear over the heavy muscles of the shoulder back
of the shoulder joint, and just above the point of the elbow, or, if the
sounds are not heard distinctly, the left fore leg may be drawn forward
by an assistant and the right ear placed against the lower portion of
the chest wall that is exposed in this manner.
The first sound of the heart occurs while the heart muscle is
contracting and while the blood is being forced from the heart and the
valves are rendered taut to prevent the return of the blood from the
lower to the upper chambers. The second sound follows quickly after the
first and occurs during rebound of blood in the arteries, causing
pressure in the aorta and tensions of the valves guarding its opening
into the left ventricle. The first sound is of a high pitch and is
longer and more distinct than the second. Under the influence of disease
these sounds may be altered in various ways. It is not profitable, in a
work such as this, to describe the details of these alterations. Those
who are interested will find this subject fully discussed in the
veterinary textbooks.
TEMPERATURE.
The temperature of the horse is determined roughly by placing the
fingers in the mouth or between the thighs or by allowing the horse to
exhale against the cheek or back of the hand. In accurate examination,
however, these means of determining temperature are not relied upon, but
recourse is had to the use of the thermometer. The thermometer used for
taking the temperature of a horse is a self-registering clinical
thermometer, similar to that used by physicians, but larger, being from
5 to 6 inches long. The temperature of the animal is measured in the
rectum.
The normal temperature of the horse varies somewhat under different
conditions. It is higher in the young animal than in the old, and is
higher in hot weather than in cold. The weather and exercise decidedly
influence the temperature physiologically. The normal temperature varies
from 99.5° to 101° F. If the temperature rises to 102.5° the horse is
said to have a low fever; if the temperature reaches 104° the fever is
moderate; if it reaches 106° it is high, and above this point it is
regarded as very high. In some diseases, such as tetanus or sunstroke,
the temperature goes as high as 108° or 110°. In the ordinary infectious
diseases it does not often exceed 106°. A temperature of 107.5° and
above is very dangerous and must be reduced promptly if the horse is to
be saved.
THE ORGANS OF RESPIRATION.
In examining this system of organs and their functions it is customary
to begin by noting the frequency of the respiratory movements. This
point can be determined by observing the motions of the nostrils or of
the flanks; on a cold day one can see the condensation of the moisture
of the warm air as it comes from the lungs. The normal rate of
respiration for a healthy horse at rest is from 8 to 16 per minute. The
rate is faster in young animals than in old, and is increased by work,
hot weather, overfilling of the stomach, pregnancy, lying upon the side,
etc. Acceleration of the respiratory rate where no physiological cause
operates is due to a variety of conditions. Among these is fever;
restricted area of active lung tissue, from filling of portions of the
lungs with inflammatory exudate, as in pneumonia; compression of the
lungs or loss of elasticity; pain in the muscles controlling the
respiratory movements; excess of carbon dioxid in the blood; and
constriction of the air passages leading to the lungs.
Difficult or labored respiration is known as dyspnea. It occurs when it
is difficult, for any reason, for the animal to obtain the amount of
oxygen that it requires. This may be due to filling of the lungs, as in
pneumonia; to painful movements of the chest, as in rheumatism or
pleurisy; to tumors of the nose and paralysis of the throat, swellings
of the throat, foreign bodies, or weakness of the respiratory passages,
fluid in the chest cavity, adhesions between the lungs and chest walls,
loss of elasticity of the lungs, etc. Where the difficulty is great the
accessory muscles of respiration are brought into play. In great dyspnea
the horse stands with his front feet apart, with his neck straight out,
and his head extended upon his neck. The nostrils are widely dilated,
the face has an anxious expression, the eyeballs protrude, the
up-and-down motion of the larynx is aggravated, the amplitude of the
movement of the chest walls increased, and the flanks heave.
The expired air is of about the temperature of the body. It contains
considerable moisture, and it should come with equal force from each
nostril and should not have an unpleasant odor. If the stream of air
from one nostril is stronger than from the other, there is an indication
of an obstruction in a nasal chamber. If the air possesses a bad odor,
it is usually an indication of putrefaction of a tissue or secretion in
some part of the respiratory tract. A bad odor is found where there is
necrosis of the bone in the nasal passages or in chronic catarrh. An
ulcerating tumor of the nose or throat may cause the breath to have an
offensive odor. The most offensive breath occurs where there is
necrosis, or gangrene, of the lungs.
In some diseases there is a discharge from the nose. In order to
determine the significance of the discharge it should be examined
closely. One should ascertain whether it comes from one or both
nostrils. If but from one nostril, it probably originates in the head.
The color should be noted. A thin, watery discharge may be composed of
serum, and it occurs in the earlier stages of coryza, or nasal catarrh.
An opalescent, slightly tinted discharge is composed of mucus and
indicates a little more severe irritation. If the discharge is sticky
and puslike, a deeper difficulty or more advanced irritation is
indicated. If the discharge contains flakes and clumps of more or less
dried, agglutinated particles, it is probable that it originates within
a cavity of the head, as the sinuses or guttural pouches. The discharge
of glanders is of a peculiar sticky nature and adheres tenaciously to
the wings of the nostrils. The discharge of pneumonia is of a somewhat
red or reddish brown color and, on this account has been described as a
prune-juice discharge. The discharge may contain blood. If the blood
appears as clots or as streaks in the discharge, it probably originates
at some point in the upper part of the respiratory tract. If the blood
is in the form of a fine froth, it comes from the lungs.
In examining the interior of the nasal passage one should remember that
the normal color of the mucous membrane is a rosy pink and that its
surface is smooth. If ulcers, nodules, swellings, or tumors are found,
these indicate disease. The ulcer that is characteristic of glanders is
described fully in connection with the discussion of that disease.
Between the lower jaws there are several clusters of lymphatic glands.
These glands are so small and so soft that it is difficult to find them
by feeling through the skin, but when a suppurative disease exists in
the upper part of the respiratory tract these glands become swollen and
easy to feel. They may become soft and break down and discharge as
abscesses; this is seen constantly in strangles. On the other hand, they
may become indurated and hard from the proliferation of connective
tissue and attach themselves to the jawbone, to the tongue, or to the
skin. This is seen in chronic glanders. If the glands are swollen and
tender to pressure, it indicates that the disease causing the
enlargement is acute; if they are hard and insensitive, the disease
causing the enlargement is chronic.
The manner in which the horse coughs is of importance in diagnosis. The
cough is a forced expiration, following immediately upon a forcible
separation of the vocal cords. The purpose of the cough is to remove
some irritant substance from the respiratory passages, and it occurs
when irritant gases, such as smoke, ammonia, sulphur vapor, or dust,
have been inhaled. It occurs from inhalation of cold air if the
respiratory passages are sensitive from disease. In laryngitis,
bronchitis, and pneumonia, cough is very easily excited and occurs
merely from accumulation of mucus and inflammatory product upon the
irritated respiratory mucous membrane. If one wishes to determine the
character of the cough, it can easily be excited by pressing upon the
larynx with the thumb and finger. The larynx should be pressed from side
to side and the pressure removed the moment the horse commences to
cough. A painful cough occurs in pleurisy, also in laryngitis,
bronchitis, and bronchial pneumonia. Pain is shown by the effort the
animal exerts to repress the cough. The cough is not painful, as a rule,
in the chronic diseases of the respiratory tract. The force of the cough
is considerable when it is not especially painful and when the lungs are
not seriously involved. When the lungs are so diseased that they can not
be filled with a large volume of air, and in heaves, the cough is weak,
as it is also in weak, debilitated animals. If mucus or pus is coughed
out, or if the cough is accompanied by a gurgling sound, it is said to
be moist; it is dry when these characteristics are not present--that is,
when the air in passing out passes over surface not loaded with
secretion.
In the examination of the chest we resort to percussion and
auscultation. When a cask or other structure containing air is tapped
upon, or percussed, a hollow sound is given forth. If the cask contains
fluid, the sound is of a dull and of quite a different character.
Similarly, the amount of air contained in the lungs can be estimated by
tapping upon, or percussing, the walls of the chest. Percussion is
practiced with the fingers alone or with the aid of a special percussion
hammer and an object to strike upon known as a pleximeter. If the
fingers are used, the middle finger of the left hand should be pressed
firmly against the side of the horse and should be struck with the ends
of the fingers of the right hand bent at a right angle so as to form a
hammer. The percussion hammer sold by instrument makers is made of
rubber or has a rubber tip, so that when the pleximeter, which is placed
against the side, is struck the impact will not be accompanied by a
noise. After experience in this method of examination one can determine
with a considerable degree of accuracy whether the lung contains a
normal amount of air or not. If, as in pneumonia, air has been displaced
by inflammatory product occupying the air space, or if fluid collects in
the lower part of the chest, the percussion sound becomes dull. If, as
in emphysema, or in pneumothorax, there is an excess of air in the
chest cavity, the percussion sound becomes abnormally loud and clear.
Auscultation consists in the examination of the lungs with the ear
applied closely to the chest wall. As the air goes in and out of the
lungs a certain soft sound is made which can be heard distinctly,
especially upon inspiration. This sound is intensified by anything that
accelerates the rate of respiration, such as exercise. This soft,
rustling sound is known as vesicular murmur, and wherever it is heard it
signifies that the lung contains air and is functionally active. The
vesicular murmur is weakened when there is an inflammatory infiltration
of the lung tissue or when the lungs are compressed by fluid in the
chest cavity. The vesicular murmur disappears when air is excluded by
the accumulation, of inflammatory product, as in pneumonia, and when the
lungs are compressed by fluid in the chest cavity. The vesicular murmur
becomes rough and harsh in the early stages of inflammation of the
lungs, and this is often the first sign of the beginning of pneumonia.
By applying the ear over the lower part of the windpipe in front of the
breastbone a somewhat harsh, blowing sound may be heard. This is known
as the bronchial murmur and is heard in normal conditions near the lower
part of the trachea and to a limited extent in the anterior portions of
the lungs after sharp exercise. When the bronchial murmur is heard over
other portions of the lungs, it may signify that the lungs are more or
less solidified by disease and the blowing bronchial murmur is
transmitted through this solid lung to the ear from a distant part of
the chest. The bronchial murmur in an abnormal place signifies that
there exists pneumonia or that the lungs are compressed by fluid in the
chest cavity.
Additional sounds are heard in the lungs in some diseased conditions.
For example, when fluid collects in the air passages and the air is
forced through it or is caused to pass through tubes containing
secretions or pus. Such sounds are of a gurgling or bubbling nature and
are known as mucous râles. Mucous râles are spoken of as being large or
small as they are distinct or indistinct, depending upon the quantity of
fluid that is present and the size of the tube in which this sound is
produced. Mucous râles occur in pneumonia after the solidified parts
begin to break down at the end of the disease. They occur in bronchitis
and in tuberculosis, where there is an excess of secretion.
Sometimes a shrill sound is heard, like the note of a whistle, fife, or
flute. This is due to a dry constriction of the bronchial tubes and it
is heard in chronic bronchitis and in tuberculosis.
A friction sound is heard in pleurisy. This is due to the rubbing
together of roughened surfaces, and the sound produced is similar to a
dry rubbing sound that is caused by rubbing the hands together or by
rubbing upon each other two dry, rough pieces of leather.
THE EXAMINATION OF THE DIGESTIVE TRACT.
The first point in connection with the examination of the organs of
digestion is the appetite and the manner of taking food and drink. A
healthy animal has a good appetite. Loss of appetite does not point to a
special diseased condition, but comes from a variety of causes. Some of
these causes, indeed, may be looked upon as being physiological.
Excitement, strange surroundings, fatigue, and hot weather may all cause
loss of appetite. Where there is cerebral depression, fever, profound
weakness, disorder of the stomach, or mechanical difficulty in chewing
or swallowing, the appetite is diminished or destroyed. Sometimes there
is an appetite or desire to eat abnormal things, such as dirty bedding,
roots of grass, soil, etc. This desire usually comes from a chronic
disturbance of nutrition.
Thirst is diminished in a good many mild diseases unaccompanied by
distinct fever. It is seen where there is great exhaustion or depression
or profound brain disturbance. Thirst is increased after profuse
sweating, in diabetes, diarrhea, in fever, at the crises of infectious
diseases, and when the mouth is dry and hot.
Some diseases of the mouth or throat make it difficult for the horse to
chew or swallow his feed. Where difficulty in this respect is
experienced, the following named conditions should be borne in mind and
carefully looked for: Diseases of the teeth, consisting in decay,
fracture, abscess formation, or overgrowth; inflammatory conditions, or
wounds or tumors of the tongue, cheeks, or lips; paralysis of the
muscles of chewing or swallowing; foreign bodies in upper part of the
mouth between the molar teeth; inflammation of throat. Difficulty in
swallowing is sometimes shown by the symptom known as "quidding."
Quidding consists in dropping from the mouth well-chewed and insalivated
boluses of feed. A mouthful of hay, for example, after being ground and
masticated, is carried to the back part of the mouth. The horse then
finds that from tenderness of the throat, or from some other cause,
swallowing is difficult or painful, and the bolus is then dropped from
the mouth. Another quantity of hay is similarly prepared, only to be
dropped in turn. Sometimes quidding is due to a painful tooth, the bolus
being dropped from the mouth when the tooth is struck and during the
pang that follows. Quidding may be practiced so persistently that a
considerable pile of boluses of feed accumulate in the manger or on the
floor of the stall. In pharyngitis one of the symptoms is a return
through the nose of fluid that the horse attempts to swallow.
In some brain diseases, and particularly in chronic internal
hydrocephalus, the horse has a most peculiar manner of swallowing and of
taking feed. A similar condition is seen in hyperemia of the brain. In
eating the horse will sink his muzzle into the grain in the feed box
and eat for a while without raising the head. Long pauses are made while
the feed is in the mouth. Sometimes the horse will eat very rapidly for
a little while and then slowly; the jaws may be brought together so
forcibly that the teeth gnash. In eating hay the horse will stop at
times with hay protruding from the mouth and stand stupidly, as though
he has forgotten what he was about.
In examining the mouth one should first look for swellings or for
evidence of abnormal conditions upon the exterior; that is, the front
and sides of the face, the jaws, and about the muzzle. By this means
wounds, fractures, tumors, abscesses, and disease accompanied by
eruptions about the muzzle may be detected. The interior of the mouth is
examined by holding the head up and inserting the fingers through the
interdental space in such a way as to cause the mouth to open. The
mucous membrane should be clean and of a light-pink color, excepting on
the back of the tongue, where the color is a yellowish gray. As
abnormalities of this region, the chief are diffuse inflammation,
characterized by redness and catarrhal discharge; local inflammation, as
from eruptions, ulcers, or wounds; necrosis of the lower jawbone in
front of the first back tooth; and swellings. Foreign bodies are
sometimes found embedded in the mucous membrane lining of the mouth or
lodged between the teeth.
The examination of the pharynx and of the esophagus is made chiefly by
pressing upon the skin covering these organs in the region of the throat
and along the left side of the neck in the jugular gutter. Sometimes,
when a more careful examination is necessary, an esophageal tube or
probang is passed through the nose or mouth down the esophagus to the
stomach.
Vomiting is an act consisting in the expulsion of all or part of the
contents of the stomach through the mouth or nose. This act is more
difficult for the horse than for most of the other domestic animals,
because the stomach of the horse is small and does not lie on the floor
of the abdominal cavity, so that the abdominal walls in contracting do
not bring pressure to bear upon it so directly and forcibly, as is the
case in many other animals. Beside this, there is a loose fold of mucous
membrane at the point where the esophagus enters the stomach, and this
forms a sort of valve which does not interfere with the passage of food
into the stomach, but does interfere with the exit of food through the
esophageal opening. Still, vomiting is a symptom that is occasionally
seen in the horse. It occurs when the stomach is very much distended
with food or with gas. Distention stretches the mucous membrane and
eradicates the valvular fold referred to, and also makes it possible for
more pressure to be exerted upon the stomach through the contraction of
the abdominal muscles. Since the distention to permit vomiting must be
extreme, it not infrequently happens that it leads to rupture of the
stomach walls. This has caused the impression in the minds of some that
vomiting can not occur in the horse without rupture of the stomach, but
this is incorrect, since many horses vomit and afterwards become
entirely sound. After rupture of the stomach has occurred vomiting is
impossible.
In examination of the abdomen one should remember that its size depends
largely upon the breed, sex, and conformation of the animal, and also
upon the manner in which the animal has been fed and the use to which it
has been put. A pendulous abdomen may be the result of an abdominal
tumor or of an accumulation of fluid in the abdominal cavity; or, on the
other hand, it may merely be an indication of pregnancy, or of the fact
that the horse has been fed for a long time on bulky and innutritious
food. Pendulous abdomen occurring in a work horse kept on a concentrated
diet is an abnormal condition. The abdomen may increase suddenly in
volume from accumulation of gas in tympanic colic. The abdomen becomes
small and the horse is said to be "tucked up" from long-continued poor
appetite, as in diseases of the digestive tract and in fever. This
condition also occurs in tetanus from the contraction of the abdominal
walls and in diarrhea from emptiness.
In applying the ear to the flank, on either the right or left side,
certain bubbling sounds may be heard that are known as peristaltic
sounds, because they are produced by peristalsis, or wormlike
contraction of the intestines. These sounds are a little louder on the
right side than on the left on account of the fact that the large
intestines lie in the right flank. Absence of peristaltic sounds is
always an indication of disease, and suggests exhaustion or paralysis of
the intestines. This may occur in certain kinds of colic and is an
unfavorable symptom. Increased sounds are heard where the intestines are
contracted more violently than in health, as in spasmodic colic, and
also where there is an excess of fluid or gas in the intestinal canal.
The feces show, to a certain extent, the thoroughness of digestion. They
should show that the feed has been well ground, and should, in the
horse, be free from offensive odor or coatings of mucus. A coating of
mucus shows intestinal catarrh. Blood on the feces indicates severe
inflammation. Very light color and bad odor may come from inactive
liver. Parasites are sometimes in the dung.
Rectal examination consists in examination of the organs of the pelvic
cavity and posterior portion of the abdominal cavity by the hand
inserted into the rectum. This examination should be attempted by a
veterinarian only, and is useless except to one who has a good knowledge
of the anatomy of the parts concerned.
THE EXAMINATION OF THE NERVOUS SYSTEM.
The great brain, or cerebrum, is the seat of intelligence, and it
contains the centers that control motion in many parts of the body. The
front portion of the brain is believed to be the region that is most
important in governing the intelligence. The central and posterior
portions of the cerebrum contain the centers for the voluntary motions
of the face and of the front and hind legs. The growth of a tumor or an
inflammatory change in the region of a center governing the motion of a
certain part of the body has the effect of disturbing motion in that
part by causing excessive contraction known as cramps, or inability of
the muscles to contract, constituting the condition known as paralysis.
The nerve paths from the cerebrum, and hence from these centers to the
spinal cord and thence to the muscles, pass beneath the small brain, or
the cerebellum, and through the medulla oblongata to the spinal cord.
Interference with these paths has the effect of disturbing motion of the
parts reached by them. If all of the paths on one side are interfered
with, the result is paralysis of one side of the body.
The small brain, or cerebellum, governs the regularity, or coordination,
of movements. Disturbances of the cerebellum cause a tottering,
uncertain gait. In the medulla oblongata, which lies between the spinal
cord and the cerebellum, are the centers governing the circulation and
breathing.
The spinal cord carries sensory messages to the brain and motor
impressions from the brain. The anterior portions of the cord contain
the motor paths, and the posterior portions of the cord contain the
sensory paths.
Paralysis of a single member or a single group of muscles is known as
monoplegia and results from injury to the motor center or to a nerve
trunk leading to the part that is involved. Paralysis of one-half of the
body is known as hemiplegia and results from destruction or severe
disturbances of the cerebral hemisphere of the opposite side of the body
or from interference with nerve paths between the cerebellum, or small
brain, and the spinal cord. Paralysis of the posterior half of the body
is known as paraplegia and results from derangement of the spinal cord.
If the cord is pressed upon, cut, or injured, messages can not be
transmitted beyond that point, and so the posterior part becomes
paralyzed. This is seen when the back is fractured.
Abnormal mental excitement may be due to congestion of the brain or to
inflammation. The animal so afflicted becomes vicious, pays no attention
to commands, cries, runs about in a circle, stamps with the feet,
strikes, kicks, etc. This condition is usually followed by a dull,
stupid state, in which the animal stands with his head down, dull and
irresponsive to external stimuli. Cerebral depression also occurs in the
severe febrile infectious diseases, in chronic hydrocephalus, in chronic
diseases of the liver, in poisoning with a narcotic substance, and with
chronic catarrh of the stomach and intestines.
Fainting is a symptom that is not often seen in horses. When it occurs
it is shown by unsteadiness of gait, tottering, and, finally, inability
to stand. The cause usually lies in a defect of the small brain, or
cerebellum. This defect may be merely in respect of the blood supply, to
congestion, or to anemia, and in this case it is likely to pass away and
may never return, or it may be due to some permanent cause, as a tumor
or an abscess, or it may result from a hemorrhage, from a defect of the
valves of the heart, or from poisoning.
Loss of consciousness is known as coma. It is caused by hemorrhage in
the brain, by profound exhaustion, or may result from a saturation of
the system with the poison of some disease. Coma may follow upon
cerebral depression, which occurs as a secondary state of inflammation
of the brain.
Where the sensibility of a part is increased the condition is known as
hyperesthesia, and where it is lost--that is, where there is no feeling
or knowledge of pain--the condition is known as anesthesia. The former
usually accompanies some chronic disease of the spinal cord or the
earlier stages of irritation of a nerve trunk. Hyperesthesia is
difficult to detect in a nervous, irritable animal, and sometimes even
in a horse of less sensitive temperament. An irritable, sensitive spot
may be found surrounded by skin that is not sensitive to pressure. This
is sometimes a symptom of beginning of inflammation of the brain.
Anesthesia occurs in connection with cerebral and spinal paralysis,
section of a nerve trunk leading to a part, in severe mental depression,
and in narcotic poisoning.
URINARY AND SEXUAL ORGANS.
In considering the examination of the urinary and sexual organs we may
consider, at the beginning, a false impression that prevails to an
astonishing extent. Many horsemen are in the habit of pressings upon the
back of a horse over the loins or of sliding the ends of the fingers
along on either side of the median line of this region. If the horse
depresses his back it is at once said "his kidneys are weak." Nothing
could be more absurd or further from the truth. Any healthy horse--any
horse with normal sensation and with a normally flexible back--will
cause it to sink when manipulated in this way. If the kidneys are
inflamed and sensitive, the back is held more rigidly and is not
depressed under this pressure.
To examine the kidneys by pressure the pressure should be brought to
bear over these organs. The kidneys lie beneath the ends of the
transverse processes of the vertebræ of the loins and beneath the
hind-most ribs. If the kidneys are actually inflamed and especially
sensitive, pressure or light blows applied here may cause the horse to
shrink.
The physical examination of the sexual and generative organs is made in
large part through the rectum, and this portion of the examination
should be carried out by a veterinarian only. By this means it is
possible to discover or locate cysts of the kidneys, urinary calculi in
the ureters, bladder, or upper urethra, malformations, and acute
inflammations accompanied by pain. The external genital organs are
swollen, discolored, or show a discharge as a result of local disease or
from disease higher in the tract.
The manner of urinating is sometimes of considerable diagnostic
importance. Painful urination is shown by frequent attempts, during
which but a small quantity of urine is passed; by groaning, by
constrained attitude, etc. This condition comes from inflammation of the
bladder or urethra, urinary calculi (stones of the bladder or urethra),
hemorrhage, tumors, bruises, etc. The urine is retained from spasms of
the muscle at the neck of the bladder, from calculi, inflammatory
growths, tumors, and paralysis of the bladder.
The urine dribbles without control when the neck of the bladder is
weakened or paralyzed. This condition is seen after the bladder is
weakened from long-continued retention and where there is a partial
paralysis of the hind quarters.
Horses usually void urine five to seven times a day, and pass from 4 to
7 quarts. Disease may be shown by increase in the number of voidings or
of the quantity. Frequent urination indicates an irritable or painful
condition of the bladder or urethra or that the quantity is excessive.
In one form of chronic inflammation of the kidneys (interstitial
nephritis) and in polyuria the quantity may be increased to 20 or 30
quarts daily. Diminution in the quantity of urine comes from profuse
sweating, diarrhea, high fever, weak heart, diseased and nonsecreting
kidneys, or an obstruction to the flow.
The urine of the healthy horse is a pale or at times a slightly reddish
yellow. The color is less intense when the quantity is large, and is
more intense when the quantity is diminished. Dark-brown urine is seen
in azoturia and in severe acute muscular rheumatism. A brownish-green
color is seen in jaundice. Red color indicates admixture of blood from a
bleeding point at some part of the urinary tract, usually in the
kidneys.
The urine of the healthy horse is not clear and transparent. It contains
mucus, which causes it to be slightly thick and stringy, and a certain
amount of undissolved carbonates, causing it to be cloudy. A sediment
collects when the urine is allowed to stand. The urine of the horse is
normally alkaline. If it becomes acid the bodies in suspension are
dissolved and the urine is made clear. The urine may be unusually cloudy
from the addition of abnormal constituents, but to determine their
character a chemical or microscopic examination is necessary. Red or
reddish flakes or clumps in the urine are always abnormal, and denote a
hemorrhage or suppuration in the urinary tract.
The normal specific gravity of the urine of the horse is about 1.040. It
is increased when the urine is scanty and decreased when the quantity is
excessive.
Acid reaction of the urine occurs in chronic intestinal catarrh, in high
fever, and during starvation. Chemical and microscopic tests and
examinations are often of great importance in diagnosis, but require
special apparatus and skill.
Other points in the examination of a sick horse require more discussion
than can be afforded in this connection, and require special training on
the part of the examiner. Among such points may be mentioned the
examination of the organs of special sense, the examination of the
blood, the microscopic examination of the secretions and excretions,
bacteriological examinations of the secretions, excretions, and tissues,
specific reaction tests, and diagnostic inoculation.
FUNDAMENTAL PRINCIPLES OF DISEASE.
By RUSH SHIPPEN HUIDEKOPER, M. D., VET.
[Revised by Leonard Pearson, B. S., V. M. D.]
ANIMAL TISSUES.
The nonprofessional reader may regard the animal tissues, which are
subject to inflammation, as excessively simple structures, as similar,
simple, and fixed in their organization as the joists and boards which
frame a house, the bricks and iron coils of pipe which build a furnace,
or the stones and mortar which make the support of a great railroad
bridge. Yet while the principles of structure are thus simple, for the
general understanding by the student who begins their study the complete
appreciation of the shades of variation, which differentiate one tissue
from another, which define a sound tendon or a ligament from a fibrous
band--the result of disease filling in an old lesion and tying one organ
with another--is as complicated as the nicest jointing of Chinese
woodwork, the building of a furnace for the most difficult chemical
analysis, or the construction of a bridge which will stand for ages and
resist any force or weight.
All tissues are composed of certain fundamental and similar elements
which are governed by the same rules of life, though at first glance
they may appear to be widely different. These are (a) amorphous
substances, (b) fibers, and (c) cells.
(a) Amorphous substances may be in liquid form, as in the fluid of the
blood, which holds a vast amount of salts and nutritive matter in
solution; or they may be in a semiliquid condition, as the plasma which
infiltrates the loose meshes of connective tissue and lubricates the
surface of some membranes; or they may be in the form of a glue or
cement, fastening one structure to another, as a tendon or muscle end to
a bone; or, again, they hold similar elements firmly together, as in
bone, where they form a stiff matrix which becomes impregnated with lime
salts. Amorphous substances, again, form the protoplasm or nutritive
element of cells or the elements of life.
(b) Fibers are formed of elements of organic matter which have only a
passive function. They can be assimilated to little strings, or cords,
tangled one with another like a mass of waste yarn, woven regularly like
a cloth, or bound together like a rope. They are of two kinds--white
connective tissue fibers, only slightly extensible, pliable, and very
strong, and yellow elastic fibers, elastic, curly, ramified, and very
dense. These fibers once created require the constant presence of fluids
around them in order to retain their functional condition, as a piece of
harness leather demands continual oiling to keep its strength, but they
undergo no change or alteration in their form until destroyed by death.
(c) Cells, which may even be regarded as low forms of life, are masses
of protoplasm or amorphous living matter, with a nucleus and frequently
a nucleolus, which are capable of assimilating nutriment or food,
propagating themselves either into others of the same form or into fixed
cells of another outward appearance and different function but of the
same constitution. It is simply in the mode of the grouping of these
elements that we have the variation in tissues, as (1) loose connective
tissue, (2) aponeurosis and tendons, (3) muscles, (4) cartilage, (5)
bones, (6) epithelia and endothelia, (7) nerves.
(1) Loose connective tissue forms the great framework, or scaffolding,
of the body, and is found under the skin, between the muscles
surrounding the bones and blood vessels, and entering into the
structures of almost all the organs. In this the fibers are loosely
meshed together like a sponge, leaving spaces in which the nutrient
fluid and cells are irregularly distributed. This tissue we find in the
skin, in the spaces between the organs of the body where fat
accumulates, and as the framework of all glands.
(2) Aponeurosis and tendons are structures which serve for the
termination of muscles and for their contention, and for the attachment
of bones together. In these the fibers are more frequent and dense, and
are arranged with regularity, either crossing each other or lying
parallel, and here the cells are found in minimum quantity.
(3) In the muscles the cells lie end to end, forming long fibers which
have the power of contraction, and the connective tissue is in small
quantity, serving the passive purpose of a band around the contractile
elements.
(4) In cartilage a mass of firm amorphous substance, with no vascularity
and little vitality, forms the bed for the chondroplasts, or cells of
this tissue.
(5) Bone differs from the above in having the amorphous matter
impregnated with lime salts, which gives it its rigidity and firmness.
(6) Epithelia and endothelia, or the membranes which cover the body and
line all its cavities and glands, are made up of single or stratified
and multiple layers of cells bound together by a glue of amorphous
substance and resting on a layer composed of fibers. When the membrane
serves for secreting or excreting purposes, as in the salivary glands or
the kidneys, it is usually simple; when it serves the mechanical purpose
of protecting a part, as over the tongue or skin, it is invariably
multiple and stratified, the surface wearing away while new cells
replace it from beneath.
(7) In nerves, stellate cells are connected by their rays to each other,
or to fibers which conduct the nerve impressions, or they act as
receptacles, storehouses, and transmitters for them, as the switch-board
of a telephone system serves to connect the various wires.
All these tissues are supplied with blood in greater or less quantity.
The vascularity depends upon the function which the tissue is called
upon to perform. If this is great, as in the tongue, the lungs, or the
sensitive part of the hoof, a large quantity of blood is required; if
the labor is a passive one, as in cartilage, the membrane over the
withers, or the tendons of the legs, the vessels only reach the
periphery, and nutrition is furnished by imbibition of the fluids
brought to their surface by the blood vessels.
Blood is brought to the tissues by arterioles, or the small terminations
of the arteries, and is carried off from them by the veinlets, or the
commencement of the veins. Between these two systems are small, delicate
networks of vessels called capillaries, which subdivide into a veritable
lacework so as to reach the neighborhood of every element.
In health the blood passes through these capillaries with a regular
current, the red cells or corpuscles floating rapidly in the fluid in
the center of the channel, while the white or ameboid cells are
attracted to the walls of the vessels and move very slowly. The supply
of blood is regulated by the condition of repose or activity of the
tissue, and under normal conditions the outflow exactly compensates the
supply. The caliber of the blood vessels, and consequently the quantity
of blood which they carry, is governed by nerves of the sympathetic
system in a healthy body with unerring regularity, but in a diseased
organ the flow may cease or be greatly augmented. In health a tissue or
organ receives its proper quantity of blood; the nutritive elements are
extracted for the support of the tissue and for the product, which the
function of the organ forms. The force required in the achievement of
this is furnished by combustion of the hydrocarbons and oxygen brought
by the arterial blood, then by the veins this same fluid passes off,
less its oxygen, loaded with the waste products, which are the result of
the worn-out and disintegrated tissues, and of those which have
undergone combustion. The foregoing brief outline indicates the process
of nutrition of the tissues.
Hypernutrition, or excessive nutrition of a tissue, may be normal or
morbid. If the latter, the tissue becomes congested or inflamed.
CONGESTION.
Congestion is an unnatural accumulation of blood in a part. Excessive
accumulation of blood may be normal, as in blushing or in the red face
which temporarily follows a violent muscular effort, or, as in the
stomach or liver during digestion, or in the lungs after severe work,
from which, in the latter case, it is shortly relieved by a little rapid
breathing. The term congestion, however, usually indicates a morbid
condition, with more or less lasting effects. Congestion is active or
passive. The former is produced by an increased supply of blood to the
part, the latter by an obstacle preventing the escape of blood from the
tissue. In either case there is an increased supply of blood, and as a
result increased combustion and augmented nutrition.
ACTIVE CONGESTION.
Active congestion is caused by--
(1) _Functional activity._--Any organ which is constantly or excessively
used is habituated to hold an unusual quantity of blood; the vessels
become dilated; if overstrained the walls become weakened, lose their
elasticity, and any sudden additional quantity of blood engorges the
tissues so that they can not contract, and congestion results. Example:
The lungs of a race horse, after an unusual burst of speed or severe
work, in damp weather.
(2) _Irritants._--Heat and cold, chemical or mechanical. Any of these,
by threatening the vitality of a tissue, induce immediately an augmented
flow of blood to the part to furnish the means of repair--a hot iron,
frostbites, acids, or a blow.
(3) _Nerve influence._--This may produce congestion either by acting on
the part reflexly or as the result of some central nerve disturbance
affecting the branch which supplies a given organ.
(4) _Plethora and sanguinary temperament._--Full-blooded animals are
much more predisposed to congestive diseases than those of a lymphatic
character or those in an anemic condition. The circulation in them is
forced to all parts with much greater force and in large quantities. A
well-bred, full-blooded horse is much more subject to congestive
diseases than a common, coarse, or old, worn-out animal.
(5) _Fevers._--In fever the heart works more actively and forces the
current of blood more rapidly; the tissues are weakened, and it requires
but a slight local cause at any part to congest the structures already
overloaded with blood. Again, in certain fevers, we find alteration of
the blood itself, rendering it less or more fluid, which interferes with
its free passage through the vessels and induces a local predisposition
to congestion.
(6) _Warm climate and summer heat._--Warmth of the atmosphere relaxes
the tissues; it demands of the animals less blood to keep up their own
body temperature, and the extra quantity accumulates in the blood-vessel
system. It causes sluggishness in the performance of the organic
functions, and in this way it induces congestion, especially of the
internal organs. So we find founders, congestive colics, and staggers
more frequent in summer than in winter.
(7) _Previous congestion._--Whether the previous congestion of any organ
has been a continuous normal one--that is, a repeated functional
activity--or has been a morbid temporary overloading, it always leaves
the walls of the vessels weakened and more predisposed to recurrent
attacks from accidental causes than are perfectly healthy tissues. Thus
a horse which has had a congestion of the lungs from a severe drive is
liable to have another attack from even a lesser cause.
The alterations of congestion are distention of the blood vessels,
accumulation of the cellular elements of the blood in them, and effusion
of a portion of the liquid of the blood into the fibrous tissues which
surround the vessels. When the changes produced by congestion are
visible, as in the eye, the nostril, the mouth, the genital organs, and
on the surface of the body in white or unpigmented animals, the part
appears red from the increase of blood; it becomes swollen from the
effusion of liquid into the spongelike connective tissues; it is at
times more or less hot from the increased combustion; the part is
frequently painful to the animal from pressure of the effusion on the
nerves, and the function of the tissue is interfered with. The secretion
or excretion of glands may be augmented or diminished. Muscles may be
affected with spasms or may be unable to contract. The eyes and ears may
be affected with imaginary sights and sounds.
PASSIVE CONGESTION.
Passive congestion is caused by interference with the return of the
current of blood from a part.
Old age and debility weaken the tissues and the force of the
circulation, especially in the veins, and retard the movement of the
blood. We then see horses of this class with stocked legs, swelling of
the sheath of the penis or of the milk glands, and of the under surface
of the belly. We find them also with effusions of the liquid parts of
the blood into the lymph spaces of the posterior extremities and organs
of the pelvic cavity.
Tumors or other mechanical obstructions, by pressing on the veins,
retard the flow of blood and cause it to back up in distal parts of the
body causing passive congestion.
The alterations of passive congestion, as in active congestion, consist
of an increased quantity of blood in the vessels and an exudation of
its fluid into the tissues surrounding them, but in passive congestion
we have a dark, thick blood which has lost its oxygen, instead of the
rich, combustible blood rich in oxygen which is found in active
congestion.
The termination of congestion is by resolution or inflammation. In the
first case, the choked-up blood vessels find an outlet for the excessive
quantity of blood and are relieved; the transuded serum or fluid of the
blood is reabsorbed, and the part returns almost to its normal
condition, with, however, a tendency to weakness predisposing to future
trouble of the same kind. In the other case further alterations take
place, and we have inflammation.
INFLAMMATION.
(Plates I and II.)
Inflammation is a hypernutrition of a tissue. It is described by Dr.
Agnew, the surgeon, as "a double-edged sword, cutting either way for
good or for evil." The increased nutrition may be moderate and cause a
growth of new tissue, a simple increase of quantity at first; or it may
produce a new growth differing in quality; or it may be so great that,
like luxuriant, overgrown weeds, the elements die from their very haste
of growth, and we have immediate destruction of the part. According to
the rapidity and intensity of the process of structural changes which
takes place in an inflamed tissue, inflammation is described as acute or
chronic, with a vast number of intermediate forms. When the phenomena
are marked it is termed sthenic; when less distinct, as the result of a
broken-down and feeble constitution in the animal, it is called
asthenic. Certain inflammations are specific, as in strangles, the
horsepox, glanders, etc., where a characteristic or specific cause or
condition is added to the origin, character of phenomena, or alterations
which result from an ordinary inflammation. An inflammation may be
circumscribed or limited, as in the abscess on the neck caused by the
pressure of a collar, in pneumonia, in glanders, in the small tumors of
a splint or a jack; or it may be diffuse, as in severe fistulas of the
withers, in an extensive lung fever, in the legs in a case of grease, or
in the spavins which affect horses with poorly nourished bones. The
causes of inflammation are practically the same as those of congestion,
which is the initial step of all inflammation.
The temperament of a horse predisposes the animal to inflammation of
certain organs. A full-blooded animal, whose veins show on the surface
of the body, and which has a strong, bounding heart pumping large
quantities of blood into the vascular organs like the lungs, the
intestines, and the laminæ of the feet, is more liable to have
pneumonia, congestive colics, and founder, than lymphatic, cold-blooded
animals which have pleurisies, inflammation of the bones, spavins,
ringbones, inflammation of the glands of the less vascular skin of the
extremities, greasy heels, thrush, etc.
[Illustration: PLATE I.
INFLAMMATION.
1--_Uninflamed wing of the bat._
2--_Inflamed wing of the bat._]
[Illustration: PLATE II.
INFLAMMATION.
1--_Non-inflamed mesentery of the frog, 400 diameters, reduced 1/2: a,
a, Venule with red and white corpuscles; b, b, Gelatinous nerve fibre;
c, Capillary; d, d, Dark-bordered nerve fibre; e, e, Connective tissue
with connective tissue corpuscles and leucocytes scattered sparsely
through it._
2--_Inflamed mesentery of the frog, 400 diameters, reduced 1/2: a, a,
Venule filled with red and white corpuscles, the red in the centre and
the white crowding along the walls; c, c, Capillary, distended with red
and white corpuscles, number of the white much decreased; d, d,
Connective tissue between venule and capillary filled with migrated
leucocytes; e, e, Connective tissue with less infiltration; f,
Dark-bordered nerve fibre; g, Number of nuclei, in sheaths increased._]
Young horses have inflammation of the membranes lining the air passages
and digestive tract, while older animals are more subject to troubles in
the closed serous sacs and in the bones.
The work to which a horse is put (saddle or harness, speed or draft)
will influence the predisposition of an animal to inflammatory diseases.
As in congestion, the functional activity of a part is an important
factor in localizing this form of disease. Given a group of horses
exposed to the same draft of cold air or other exciting cause of
inflammation, the one which has just been eating will be attacked with
an inflammation of the bowels; the one that has just been working so as
to increase its respiration will have an inflammation of the throat,
bronchi, or lungs; the one that has just been using its feet excessively
will have a founder or inflammation of the laminæ of the feet.
The direct cause of inflammation is usually an irritant of some form.
This may be a pathogenic organism--a disease germ--or it may be
mechanical or chemical, external or internal. Cuts, bruises, injuries of
any kind, parasites, acids, blisters, heat, cold, secretions, such as an
excess of tears over the cheek or urine on the legs, all cause
inflammation by direct injury to the part. Strains or wrenches of
joints, ligaments, and tendons cause trouble by laceration of the
tissue.
Inflammations of the internal organs are caused by irritants as above,
and by sudden cooling of the surface of the animal, which drives the
blood to that organ which at the moment is most actively supplied with
blood. This is called repercussion. A horse which has been worked at
speed and is breathing rapidly is liable to have pneumonia if suddenly
chilled, while an animal which has just been fed is more liable to have
a congestive colic if exposed to the same influence, the blood in this
case being driven from the exterior to the intestines, while in the
former it was driven to the lungs.
_Symptoms._--The symptoms of inflammation are, as in congestion, change
of color, due to an increased supply of blood; swelling, from the same
cause, with the addition of an effusion into the surrounding tissues;
heat, owing to the increased combustion in the part; pain, due to
pressure on the nerves, and altered function. This latter may be
augmented or diminished, or first one and then the other. In addition to
the local symptoms, inflammation always produces more or less
constitutional disturbance or fever. A splint or small spavin will cause
so little fever that it is not appreciable, while a severe spavin, an
inflamed joint, or a pneumonia may give rise to a marked fever.
The alterations in an inflamed tissue are first those of congestion,
distention of the blood vessels, and exudation of the fluid of the blood
into the surrounding fibers, with, however, a more nearly complete
stagnation of the blood; fibrin, or lymph, a plastic substance, is
thrown out as well, and the cells, which we have seen to be living
organisms in themselves, no longer carried in the current of the blood,
migrate from the vessels and, finding proper nutriment, proliferate or
multiply with greater or lesser rapidity. The cells which lie dormant in
the meshes of the surrounding fibers are awakened into activity by the
nutritious lymph which surrounds them, and they also multiply.
Whether the cell in an inflamed part is the white ameboid cell of the
blood or the fixed connective tissue embedded in the fibers, it
multiplies in the same way. The nucleus in the center is divided into
two, and then each again into two, ad infinitum. If the process is slow,
each new cell may assimilate nourishment and become, like its ancestor,
an aid in the formation of new tissues; if, however, the changing takes
place rapidly, the brood of young cells have not time to grow or use up
the surrounding nourishment, and, but half developed, they die, and we
then have destruction of tissue, and pus or matter is formed, a material
made up of the imperfect dead elements and the broken-down tissue.
Between the two there is an intermediate form, where we have imperfectly
formed tissues, as in "proud flesh," large, soft splints; fungous
growths, greasy heels, and thrush.
Whether the inflamed tissue is one like the skin, lungs, or intestines,
very loose in their texture, or a tendon or bone, dense in structure,
and comparatively poor in blood vessels, the principle of the process is
the same. The effects, however, and the appearance may be widely
different. After a cut on the face or an exudation into the lungs, the
loose tissues and multiple vessels allow the proliferating cells to
obtain rich nourishment; absorption can take place readily, and the part
regains its normal condition entirely, while a bruise at the heel or at
the withers finds a dense, inextensible tissue where the multiplying
elements and exuded fluids choke up all communication, and the parts die
(necrose) from want of blood and cause a serious quittor, or fistula.
This effect of structure of a part on the same process shows the
importance of a perfect knowledge in the study of a local trouble, and
the indispensable part which such knowledge plays in judging of the
gravity of an inflammatory disease, and in formulating a prognosis or
opinion of the final termination of it. It is this which allows the
veterinarian, through his knowledge of the intimate structure of a part
and the relations of its elements, to judge of the severity of a
disease, and to prescribe different modes of treatment in two animals
for troubles which, to the less experienced observer, appear to be
absolutely identical.
_Termination of inflammation._--Like congestion, inflammation may
terminate by resolution. In this case the exuded lymph undergoes
chemical change, and the products are absorbed and carried off by the
blood vessels and lymphatics, to be thrown out of the body by the
kidneys, liver, the glands of the skin, and the other excretory organs.
The cells, which have wandered into the neighboring tissues from the
blood vessels, gradually disappear or become transformed into fixed
cells. Those which are the result of the tissue cells, wakened into
active life, follow the same course. The vessels themselves contract,
and, having resumed their normal caliber, the part apparently reassumes
its normal condition; but it is always weakened, and a new inflammation
is more liable to reappear in a previously inflamed part than in a sound
one. The alternate termination is necrosis, or mortification. If the
necrosis, or death of a part, is gradual, by small stages, each cell
losing its vitality after the other in more or less rapid succession, it
takes the name of ulceration. If it occurs in a considerable part at
once, it is called gangrene. If this death of the tissues occurs deep in
the organism, and the destroyed elements and proliferated and dead cells
are inclosed in a cavity, the result of the process is called an
abscess. When it occurs on a surface, it is an ulcer, and an abscess by
breaking on the exterior becomes then also an ulcer. Proliferating and
dying cells, and the fluid which exudes from an ulcerating surface and
the débris of broken-down tissue is known as pus, and the process by
which this is formed is known as suppuration. A mass of dead tissue in a
soft part is termed a slough, while the same in bone is called a
sequestrum. Such changes are especially liable to occur when the part
becomes infected with microorganisms that have the property of
destroying tissue and thus causing the production of pus. These are
known as pyogenic microorganisms. There are also bacilli that are
capable of multiplying in tissues and so irritating them as to cause
them to die (necrose) without forming pus.
_Treatment of inflammation._--The study of the causes and pathological
alterations of inflammation has shown the process to be one of
hypernutrition, attended by excessive blood supply, so this study will
indicate the primary factor to be employed in the treatment of it. Any
agent which will reduce the blood supply and prevent the excessive
nutrition of the elements of the part will serve as a remedy. The means
employed may be used locally to the part, or they may be constitutional
remedies, which act indirectly.
_Local treatment._--Removal of the cause will frequently allow the part
to heal at once. Among causes of inflammation may be mentioned a stone
in the frog, causing a traumatic thrush; a badly fitting harness or
saddle, causing ulcers of the skin; decomposing manure and urine in a
stable, which, by their vapors, irritate the air tubes and lungs and
cause a cough.
Motion stimulates the action of the blood, and thus feeds an inflamed
tissue. This is alike applicable to a diseased point irritated by
movement to an inflamed pair of lungs surcharged with blood by the use
demanded of them in a working animal, or to an inflamed eye exposed to
light, or an inflamed stomach and intestines still further fatigued by
feed. Rest, absolute quiet, a dark stable, and small quantities of
easily digested feed will often cure serious inflammatory troubles
without further treatment.
The application of ice bags or cold water by bandages, douching with a
hose, or irrigation with dripping water, contracts the blood vessels,
acts as a sedative to the nerves, and lessens the vitality of a part; it
consequently prevents the tissue change which inflammation produces.
Either dry or moist heat acts as a derivative. It quickens the
circulation and renders the chemical changes more active in the
surrounding parts; it softens the tissues and attracts the current of
blood from the inflamed organ; it also promotes the absorption of the
effusion and hastens the elimination of the waste products in the part.
Heat may be applied by hand rubbing or active friction and the
application of warm coverings (bandages) or by cloths wrung out of warm
water; or steaming with warm, moist vapor, medicated or not, will answer
the same purpose. The latter is especially applicable to inflammatory
troubles in the air passages.
Local bleeding frequently affords immediate relief by carrying off the
excessive blood and draining the effusion which has already occurred. It
affords direct mechanical relief, and, by a stimulation of the part,
promotes the chemical changes necessary for bringing the diseased
tissues to a healthy condition. Local blood-letting can be done by
scarifying, or making small punctures into the inflamed part, as in the
eyelid of an inflamed eye, or into the sheath of the penis, or into the
skin of the latter organ when congested, or the leg when acutely
swelled.
Counterirritants are used for deep inflammations. They act by bringing
the blood to the surface and consequently lessening the blood pressure
within. The derivation of the blood to the exterior diminishes the
amount in the internal organs and is often very rapid in its action in
relieving a congested lung or liver. The most common counterirritant is
mustard flour. It is applied as a soft paste mixed with warm water to
the under surface of the belly and to the sides, where the skin is
comparatively soft and vascular. Colds in the throat or inflammations at
any point demand the treatment applied in the same manner to the belly
and sides and not to the throat or on the legs, as so often used.
Blisters, iodin, and many other irritants are used in a similar way.
_Constitutional treatment_ in inflammation is designed to reduce the
current of blood, which is the fuel for the inflammation in the diseased
part, to quiet the patient, and to combat the fever or general effects
of the trouble in the system, and to favor the neutralization or
elimination of the products of the inflammation.
Reduction of blood is obtained in various ways. The diminution of the
quantity of the blood lessens the amount of pressure on the vessels,
and, as a sequel, the volume of it which is carried to the point of
inflammation; it diminishes the body temperature or fever; it numbs the
nervous system, which plays an important part as a conductor of
irritation in diseases.
Blood-letting is the most rapid means, and frequently acts like a charm
in relieving a commencing inflammatory trouble. One must remember,
however, that the strength of the body and repair depend on the blood;
hence blood-letting should be practiced only in full-blooded,
well-nourished animals and in the early stages of the disease.
Cathartics act by drawing off a large quantity of fluid from the blood
through the intestines, and have the advantage over the last remedy of
removing only the watery and not the formed elements from the
circulation. The blood cells remain, leaving the blood as rich as it was
before. Again, the glands of the intestines are stimulated to excrete
much waste matter and other deleterious material which may be acting as
a poison in the blood.
Diuretics operate through the kidneys in the same way.
Diaphoretics aid depletion of the blood by pouring water in the form of
sweat from the surface of the skin and stimulating the discharge of
waste material out of its glands, which has the same effect on the blood
pressure.
Antipyretics are remedies to reduce the temperature. This may be
accomplished by depressing the center in the brain that controls heat
production. Some coal-tar products are very effective in this way, but
they have the disadvantage of depressing the heart, which should always
be kept as strong as possible. If they are used it must be with
knowledge of this fact, and it is well to give heart tonics or
stimulants with them. The temperature of the body may be lowered by cold
packs or by showering with cold water. This is a most useful procedure
in many diseases.
Depressants are drugs which act on the heart. They slow or weaken the
action of this organ and reduce the quantity and force of the current of
the blood which is carried to the point of local disease; they lessen
the vitality of the animal, and for this reason are now used much less
than formerly.
Anodynes quiet the nervous system. Pain in the horse, as in the man, is
one of the important factors in the production of fever, and the dulling
of the former often prevents, or at least reduces, the latter. Anodynes
produce sleep, so as to rest the patient and allow recuperation for the
succeeding struggle of the vitality of the animal against the exhausting
drain of the disease.
The diet of an animal suffering from acute inflammation is a factor of
the greatest importance. An overloaded circulation can be starved to a
reduced quantity and to a less rich quality of blood by reducing the
quantity of feed given to the patient. Feeds of easy digestion do not
tire the already fatigued organs of an animal with a torpid digestive
system. Nourishment will be taken by a suffering brute in the form of
slops and cooling drinks when it would be totally refused if offered in
its ordinary form, as hard oats or dry hay, requiring the labor of
grinding between the teeth and swallowing by the weakened muscles of the
jaws and throat.
Tonics and stimulants are remedies which are used to meet special
indications, as in the case of a feeble heart, and which enter into the
after treatment of inflammatory troubles as well as into the acute
stages of them. They brace up weakened and torpid glands; they stimulate
the secretion of the necessary fluids of the body, and hasten the
excretion of the waste material produced by the inflammatory process;
they regulate the action of a weakened heart; they promote healthy
vitality of diseased parts, and aid the chemical changes needed for
returning the altered tissues to their normal condition.
FEVERS.
Fever is a general condition of the animal body in which there is an
elevation of the animal body temperature, which may be only a degree or
two or may be 10° F. The elevation of the body temperature, which
represents tissue change or combustion, is accompanied with an
acceleration of the heart's action, a quickening of the respiration, and
an aberration in the functional activity of the various organs of the
body. These organs may be stimulated to the performance of excessive
work, or they may be incapacitated from carrying out their allotted
tasks, or, in the course of a fever, the two conditions may both exist,
the one succeeding the other. Fever as a disease is usually preceded by
chills as an essential symptom.
Fevers are divided into essential fevers and symptomatic fevers. In
symptomatic fever some local disease, usually of an inflammatory
character, develops first, and the constitutional febrile phenomena are
the result of the primary point of combustion irritating the whole body,
either through the nervous system or directly by means of the waste
material which is carried into the circulation and through the blood
vessels, and is distributed to distal parts. Essential fevers are those
in which there is from the outset a general disturbance of the whole
economy. This may consist of an elementary alteration in the blood or a
general change in the constitution of the tissues. Fevers of the latter
class are usually due to some infecting agent and belong, therefore, to
the class of infectious diseases.
Essential fevers are subdivided into ephemeral fevers, which last but a
short time and terminate by critical phenomena; intermittent fevers, in
which there are alterations of exacerbations of the febrile symptoms and
remissions, in which the body returns to its normal condition or
sometimes to a depressed condition, in which the functions of life are
but badly performed; and continued fevers, which include contagious
diseases, such as glanders, influenza, etc., the septic diseases, such
as pyemia, septicemia, etc., and the eruptive fevers, such as variola,
etc.
Whether the cause of the fever has been an injury to the tissues, such
as a severe bruise, a broken bone, an inflamed lung, or excessive work,
which has surcharged the blood with the waste products of the combustion
of the tissues, which were destroyed to produce force, or the toxins of
influenza in the blood, or the presence of irritating material, either
in the form of living organisms or of their products, as in glanders or
tuberculosis--the general train of symptoms are much the same, varying
as the amount of the irritant differs in quantity, or when some special
quality in them has a specific action on one or another tissue.
There is in fever at first a relaxation of the small blood vessels,
which may have been preceded by a contraction of the same if there was a
chill, and as a consequence there is an acceleration of the current of
the blood. There is, then, an elevation of the peripheral temperature,
followed by a lowering of tension in the arteries and an acceleration in
the movement of the heart. These conditions may be produced by a primary
irritation of the nerve centers of the brain from the effects of heat,
as is seen in thermic fever, or sunstroke, or by the entrance into the
blood stream of disease-producing organisms or their chemical products,
as in anthrax, rinderpest, influenza, etc.
There are times when it is difficult to distinguish between the
existence of fever as a disease and a temporary feverish condition which
is the result of excessive work. Like the condition of congestion of the
lungs, which is normal up to a certain degree in the lungs of a race
horse after a severe race, and morbid when it produces more than
temporary phenomena or when it causes distinct lesions, the temperature
may rise from physiological causes as much as four degrees, so fever,
or, as it is better termed, a feverish condition, may follow any work or
other employment of energy in which excessive tissue change has taken
place; but if the consequences are ephemeral, and no recognizable lesion
is apparent, it is not considered morbid. This condition, however, may
predispose to severe organic disturbance and local inflammations which
will cause disease, as an animal in this condition is liable to take
cold and develop lung fever or a severe enteritis, if chilled or
otherwise exposed.
Fever in all animals is characterized by the same general phenomena, but
we find the intensity of the symptoms modified by the species of animals
affected, by the races which subdivide the species, by the families
which form groups of the races, and by certain conditions in individuals
themselves. For example, a pricked foot in a Thoroughbred may cause
intense fever, while the same injury in the foot of a Clydesdale may
scarcely cause a visible general symptom. In the horse, fever produces
the following symptoms:
The normal body temperature, which varies from 99° to 100° F., is
elevated from 1° to 9°. A temperature of 102° or 103° F. is moderate
fever, 104° to 105° F. is high, and 106° F. and over is excessive. The
temperature is accurately measured by means of a clinical thermometer
inserted in the rectum.
This elevation of temperature can readily be felt by the hand placed in
the mouth of the animal, or in the rectum, and in the cleft between the
hind legs. It is usually appreciable at any point over the surface of
the body and in the expired air emitted from the nostrils. The ears and
cannons are often as hot as the rest of the body, but are sometimes
cold, which denotes a debility in the circulation and irregular
distribution of the blood. The pulse, which in a healthy horse is felt
beating about 42 to 48 times in the minute, is increased to 60, 70, 90,
or even 100. The respirations are increased from 14 or 16 to 24, 30, 36,
or even more. With the commencement of a fever the horse usually has
diminished appetite, or it may have total loss of appetite if the fever
is excessive. There is, however, a vast difference among horses in this
regard. With the same degree of elevation of temperature one horse may
lose its appetite entirely, while another, usually of the more common
sort, will eat at hay throughout the course of the fever, and will even
continue to eat oats or other grains. Thirst is usually increased, but
the animal desires only a small quantity of water at a time, and in most
cases of fever a bucket of water should be kept standing before the
patient, which may be allowed to drink ad libitum. The skin becomes dry
and the hairs stand on end. Sweating is almost unknown in the early
stage of fevers, but frequently occurs later in their course, when an
outbreak of warm sweat is often a most favorable symptom. The mucous
membranes, which are most easily examined in the conjunctivæ of the eyes
and inside of the mouth, change color if the fever is an acute one;
without alteration of blood the mucous membranes become of a rosy or
deep-red color at the outset; if the fever is attended with distinct
alteration of the blood, as in influenza, and at the end of two or three
days in severe cases of pneumonia or other extensive inflammatory
troubles the mucous membranes are tinged with yellow, which may even
become a deep ocher in color, the result of the decomposition of the
blood corpuscles and the freeing of their coloring matter, which acts as
a stain. At the outset of a fever the various glands are checked in
their secretions, the salivary glands fail to secrete the saliva, and we
find the surface of the tongue and inside of the cheeks dry and covered
with a brownish, bad-smelling deposit. The excretion from the liver and
intestinal glands is diminished and produces an inactivity of the
digestive organs which causes a constipation. If this is not remedied at
an early period, the undigested material acts as an irritant, and later
we may have it followed by an inflammatory process, producing a severe
diarrhea.
The excretion from the kidneys is sometimes at first entirely
suppressed. It is always considerably diminished, and what urine is
passed is dark in color, undergoes ammoniacal change rapidly, and
deposits quantities of salts. At a later period the diminished excretion
may be replaced by an excessive excretion, which aids in carrying off
waste products and usually indicates an amelioration of the fever.
While the ears, cannons, and hoofs of a horse suffering from fever are
usually found hot, they may frequently alternate from hot to cold, or be
much cooler than they normally are. This latter condition usually
indicates great weakness on the part of the circulatory system.
It is of the greatest importance, as an aid in diagnosing the gravity of
an attack of fever and as an indication in the selection of its mode of
treatment, to recognize the exact cause of a febrile condition in the
horse. In certain cases, in very nervous animals, in which fever is the
result of nerve influence, a simple anodyne, or even only quiet with
continued care and nursing, will sometimes be sufficient to diminish it.
When fever is the result of local injury, the cure of the cause produces
a cessation in the constitutional symptoms. When it is the result of a
pneumonia or other severe parenchymatous inflammation, it usually lasts
for a definite time, and subsides with the first improvement of the
local trouble, but in these cases we constantly have exacerbations of
fever due to secondary inflammatory processes, such as the formation of
small abscesses, the development of secondary bronchitis, or the death
of a limited quantity of tissue (gangrene).
In specific cases, such as influenza, strangles, and septicemia, there
is a definite poison in the blood-vessel system and carried to the heart
and to the nervous system, which produces a peculiar irritation, usually
lasting for a specific period, during which the temperature can be but
slightly diminished by any remedy.
In cases attended with complications, the diagnosis at times becomes
still more difficult, as at the end of a case of influenza which becomes
complicated with pneumonia. The high temperature of the simple
inflammatory disease may be grafted on that of the specific trouble, and
the determination of the cause of the fever, as between the two, is
therefore frequently a difficult matter but an important one, as upon it
depends the mode of treatment.
Any animal suffering from fever, whatever the cause, is much more
susceptible to attacks of local inflammation, which become complications
of the original disease, than are animals in sound health. In fever we
have the tissues and the walls of the blood vessels weakened, we have an
increased current of more or less altered blood flowing through the
vessels and stagnating in the capillaries, which need but an exciting
cause to transform the passive congestion of fever into an active
congestion and acute inflammation. These conditions become still more
distinct when the fever is accompanied with a decided deterioration in
the blood itself, as is seen in influenza, septicemia, and at the
termination of severe pneumonias.
Fever, with its symptoms of increased temperature, acceleration of the
pulse, acceleration of respiration, dry skin, diminished secretions,
etc., must be considered as an indication of organic disturbance. This
organic disturbance may be the result of local inflammation or other
irritants acting through the nerves on nerve centers, alterations of the
blood, in which a poison is carried to the nerve centers, or direct
irritants to the nerve centers themselves, as in cases of heat stroke,
injury to the brain, etc.
The treatment of fever depends upon its cause. One of the important
factors in treatment is absolute quiet. This may be obtained by placing
a sick horse in a box stall, away from other animals and extraneous
noises and sheltered from excessive light and drafts of air. Anodynes,
belladonna, hyoscyamus, and opium act as antipyretics simply by quieting
the nervous system. As an irritant exists in the blood in most cases of
fever, any remedy which will favor the excretion of foreign elements
from it will diminish this cause. We therefore use diaphoretics to
stimulate the sweat and excretions from the skin; diuretics to favor the
elimination of matter by the kidneys; cholagogues and laxatives to
increase the action of the liver and intestines, and to drain from these
important organs all the waste material which is aiding to choke up and
congest their rich plexuses of blood vessels. The heart becomes
stimulated to increased action at the outset of a fever, but this does
not indicate increased strength; on the contrary, it indicates the
action of an irritant to the heart that will soon weaken it. It is,
therefore, irrational further to depress the heart by the use of such
drugs as aconite. It is better to strengthen it and to favor the
elimination of the substance that is irritating it. The increased blood
pressure throughout the body may be diminished by lessening the quantity
of blood. This is obtained in some cases with advantage when the disease
is but starting and the animal is plethoric by direct abstraction of
blood, as in bleeding from the jugular or other veins; or by
derivatives, such as mustard, turpentine, or blisters applied to the
skin; or by setons, which draw to the surface the fluid of the blood,
thereby lessening its volume without having the disadvantage of
impoverishing the elements of the blood found in bleeding. In many cases
antipyretics given by the mouth and cold applied to the skin are most
useful.
When the irritation which is the cause of fever is a specific one,
either in the form of bacteria (living organisms), as in glanders,
tuberculosis, influenza, septicemia, etc., or in the form of a foreign
element, as in rheumatism, gout, hemaglobinuria, and other so-called
diseases of nutrition, we employ remedies which have been found to have
a direct specific action on them. Among the specific remedies for
various diseases are counted quinin, carbolic acid, salicylic acid,
antipyrene, mercury, iodin, the empyreumatic oils, tars, resins,
aromatics, sulphur, and a host of other drugs, some of which are of
known effect and others of which are theoretical in action. Certain
remedies, like simple aromatic teas, vegetable acids, such as vinegar,
lemon juice, etc., alkalines in the form of salts, sweet spirits of
niter, etc., which are household remedies, are always useful, because
they act on the excreting organs and ameliorate the effects of fever.
Other remedies, which are to be used to influence the cause of fever,
must be selected with judgment and from a thorough knowledge of the
nature of the disease.
METHODS OF ADMINISTERING MEDICINES.
By CH. B. MICHENER, V. S.
[Revised by Leonard Pearson, B. S., V. M. D.]
Medicine may enter the body through any of the following designated
channels: First, by the mouth; second, by the air passages; third, by
the skin; fourth, by the tissue beneath the skin (hypodermic methods);
fifth, by the rectum; sixth, by the genito-urinary passages; and,
seventh, by the blood (intravenous injections).
BY THE MOUTH.--Medicines can be given by the mouth in the form of
solids, as powders or pills; liquids, and pastes, or electuaries.
_Powders._--Solids administered as powders should be as finely
pulverized as possible, in order to obtain rapid solution and
absorption. Their action is in this way facilitated and intensified.
Powders must be free from any irritant or caustic action upon the mouth.
Those that are without any disagreeable taste or smell are readily eaten
with the feed or taken in the drinking water. When placed with the feed
they should first be dissolved or suspended in water and thus sprinkled
on the feed. If mixed dry the horse will often leave the medicine in the
bottom of his manger. Nonirritant powders may be given in capsules, as
balls are given.
_Pills, or "balls"_ when properly made, are cylindrical in shape, 2
inches in length and about three-fourths of an inch in diameter. They
should be fresh, but if necessary to keep them some time they should be
made up with glycerin, or some such agent, to prevent their becoming too
hard. Very old, hard balls are sometimes passed whole with the manure
without being acted upon at all. Paper is sometimes wrapped around balls
when given, if they are so sticky as to adhere to the fingers or the
balling gun. Paper used for this purpose should be thin but firm, as the
tougher tissue papers. Balls are preferred to drenches when the medicine
is extremely disagreeable or nauseating; when the dose is not too large;
when the horse is difficult to drench; or when the medicine is intended
to act slowly. Certain medicines can not or should not be made into
balls, as medicines requiring to be given in large doses, oils, caustic
substances, unless in small dose and diluted and thoroughly mixed with
the vehicle, deliquescent, or efflorescent salts. Substances suitable
for balls can be made up by the addition of honey, sirup, soap, etc.,
when required for immediate use. Gelatin capsules of different sizes are
now obtainable and are a convenient means of giving medicines in ball
form.
When balls are to be given we should observe the following directions:
In shape they should be cylindrical, of the size above mentioned, and
soft enough to be easily compressed by the fingers. If made round or
egg-shaped, if too long or too hard, they are liable to become fixed in
the gullet and cause choking. Balls may be given with the "balling gun"
(obtainable at any veterinary instrument maker's) or by the hand. If
given by the hand a mouth speculum or gag may be used to prevent the
animal from biting the hand or crushing the ball. Always loosen the
horse before attempting to give a ball; if tied he may break his halter
and injure himself or the one giving the ball. With a little practice it
is much easier to give a ball without the mouth gag, as the horse always
fights more or less against having his mouth forced open. The tongue
must be firmly grasped with the left hand and gently pulled forward; the
ball, slightly moistened, is then to be placed with the tips of the
fingers of the right hand as far back into the mouth as possible; as the
tongue is loosened it is drawn back into the mouth and carries the ball
backward with it. The mouth should be kept closed for a minute or two.
We should always have a pail of water at hand to offer the horse after
balling. This precaution will often prevent him from coughing out the
ball or its becoming lodged in the gullet.
_Pastes or electuaries_ are medicines mixed with licorice-root powder,
ground flaxseed, molasses, or sirup to the consistency of honey, or a
"soft solid." They are intended, chiefly, to act locally upon the mouth
and throat. They are given by being spread upon the tongue, gums, or
teeth with a wooden paddle or strong, long-handled spoon.
_Liquids._--It is, very often, impossible to get balls properly made, or
to induce owners or attendants to attempt to give them, and for these
reasons medicines by the mouth are mostly given in the form of liquids.
Liquids may be given as drenches when the dose is large, or they may,
when but a small quantity is administered, be injected into the mouth
with a hard-rubber syringe or be poured upon the tongue from a small
vial.
When medicine is to be given as a drench we must be careful to use water
or oil enough to dissolve or dilute it thoroughly; more than this Wakes
the drench bulky and is unnecessary. Insoluble medicines, if not
irritant or corrosive, may be given simply suspended in water, the
bottle to be well shaken immediately before giving the drench. The
bottle used for drenching purposes should be clean, strong, and smooth
about its neck; it should be without shoulders, tapering, and of a size
to suit the amount to be given. A horn or tin bottle may be better,
because it is not so easily broken by the teeth. If the dose is a small
one the horse's head may be held up by the left hand, while the medicine
is poured into the mouth by the right. The left thumb is to be placed in
the angle of the lower jaw, and the fingers spread out in such manner
as to support the lower lip. Should the dose be large, the horse ugly,
or the attendant unable to support the head as directed above, the head
is then to be held up by running the tines of a long-handled wooden fork
under the noseband of the halter or the halter strap or a rope may be
fastened to the noseband and thrown over a limb, beam, or through a
pulley suspended from the ceiling. Another way of supporting the head is
to place a loop in the end of a rope, and introduce this loop into the
mouth just behind the upper front teeth or tusks of the upper jaw, the
free end to be run through a pulley, as before described, and held by an
assistant. It is never to be fastened, as the horse might in that case
do himself serious injury. The head is to be elevated just enough to
prevent the horse from throwing the liquid out of his mouth. The line of
the face should be horizontal, or only the least bit higher. If the head
is drawn too high the animal can not swallow with ease or even with
safety. (If this is doubted, just fill your mouth with water, throw-back
the head as far as possible, and then try to swallow.) The person giving
the drench should stand on some object in order to reach the horse's
mouth--on a level, or a little above it. The bottle or horn is then to
be introduced at the side of the mouth, in front of the molar teeth, in
an upward direction. This will cause the horse to open his mouth, when
the base of the bottle is to be elevated, and about 4 ounces of the
liquid allowed to escape on the tongue as far back as possible, care
being taken not to get the neck of the bottle between the back teeth.
The bottle is to be immediately removed, and if the horse does not
swallow this can be encouraged by rubbing the fingers or neck of the
bottle against the roof of the mouth, occasionally removing them. As
soon as this is swallowed repeat the operation until he has taken all
the drench. If coughing occurs, or if, by any mishap, the bottle should
be crushed in the mouth, lower the head immediately.
Do not rub, pinch, or pound the throat nor draw out the tongue when
giving a drench. These processes in no way aid the horse to swallow and
oftener do harm than good. In drenching, swallowing may be hastened by
pouring into the nose of the horse, while the head is high, a few
teaspoonfuls of clean water, but _drenches must never be given through
the nose_. Large quantities of medicine given by pouring into the nose
are liable to strangle the animal, or, if the medicine is irritating, it
sets up an inflammation of the nose, fauces, windpipe, and sometimes the
lungs.
BY THE AIR PASSAGES.--Medicines are administered to the lungs and upper
air passages by insufflation, inhalation, injection, and nasal douche.
_Insufflation_ consists in blowing an impalpable powder directly into
the nose. It is but rarely resorted to.
_Inhalation._--Gaseous and volatile medicines are given by inhalation,
as is also medicated steam or vapor. Of the gases used there may be
mentioned, as the chief ones, sulphurous acid gas and, occasionally,
chlorin. The animal or animals are to be placed in a tight room, where
these gases are generated until the atmosphere is sufficiently
impregnated with them. Volatile medicines--as the anesthetics (ether,
chloroform, etc.)--are to be given by the attending surgeon only.
Medicated vapors are to be inhaled by placing a bucket containing hot
water, vinegar and water, scalded hay or bran, to which carbolic acid,
iodin, compound tincture of benzoin, or other medicines have been added,
in the bottom of a long grain bag. The horse's nose is to be inserted
into the top of the bag, and he thus inhales the "medicated steam." Care
must be taken not to have it hot enough to scald the animal. The vapor
from scalding bran or hay is often thus inhaled to favor discharges in
sore throat or "distemper."
_Injections_ are made into the trachea by means of a hypodermic syringe.
This method of medication is used for the purpose of treating local
diseases of the trachea and upper bronchial tubes. It has also been used
as a mode of administering remedies for their constitutional effect, but
is now rarely used for this purpose.
_The nasal douche_ is employed by the veterinarian in treating some
local diseases of the nasal chambers. Special appliances and
professional knowledge are necessary when using liquid medicines by this
method. It is not often resorted to, even by veterinary surgeons, since,
as a rule, the horse objects very strongly to this mode of medication.
BY THE SKIN.--Medicines are often administered to our hair-covered
animals by the skin, yet care must be taken in applying some
medicines--as tobacco water, carbolic-acid solutions, strong creolin
solutions, mercurial ointment, etc.--over the entire body, as poisoning
and death follow in some instances from absorption through the skin. For
the same reasons care must also be exercised and poisonous medicines not
applied over very large raw or abraded surfaces. With domestic animals
medicines are only to be applied by the skin to allay local pain or cure
local disease.
BY THE TISSUE BENEATH THE SKIN (HYPODERMATIC METHOD).--Medicines are
frequently given by the hypodermic syringe under the skin. It is not
safe for any but medical or veterinary practitioners to use this form of
medication, since the medicines thus given are powerful poisons. There
are many precautions to be observed, and a knowledge of anatomy is
indispensable. One of the chief precautions has to do with the
sterilization of the syringe. If it is not sterile an abscess may be
produced.
BY THE RECTUM.--Medicines may be given by the rectum when they can not
be given by the mouth, or when they are not retained in the stomach;
when we want a local action on the last gut; when it is desired to
destroy the small worms infesting the large bowels or to stimulate the
peristaltic motion of the intestines and cause evacuation. Medicines are
in such cases given in the form of suppositories or as liquid injections
(enemas.) Foods may also be given in this way.
_Suppositories_ are conical bodies made up of oil of theobroma and opium
(or whatever medicine is indicated in special cases), and are introduced
into the rectum or vagina to allay irritation and pain of these parts.
They are not much used in treating horses.
_Enemas_, when given for absorption, should be small in quantity,
neutral or slightly acid in reaction, and of a temperature of from 90°
to 100° F. These, like feeds given by the rectum, should be introduced
only after the last bowel has been emptied by the hand or by copious
injections of tepid water. Enemas, or clysters, if to aid the action of
physics, should be in quantities sufficient to distend the bowel and
cause the animal to eject them. Simple water, salt and water, or soap
and water, in quantities of a gallon or more, may be given every half
hour. It is best that the horse retain them for some little time, as the
liquid serves to moisten the dung and favors a passage. Stimulating
enemas, as glycerin, should be administered after those already
mentioned have emptied the last bowel, with the purpose of still further
increasing the natural motion of the intestines and aiding the purging
medicine.
Liquids may be thrown into the rectum by the means of a large syringe or
a pump. A very good "irrigator" can be bought of any tinsmith at a
trifling cost, and should be constantly at hand on every stock farm. It
consists of a funnel about 6 inches deep and 7 inches in diameter, which
is to be furnished with a prolongation to which a piece of rubber hose,
such as small garden hose, 4 feet long may be attached. The hose, well
oiled, is to be inserted gently into the rectum about 2 feet. The liquid
to be injected may then be poured in the funnel and the pressure of the
atmosphere will force it into the bowels. This appliance is better than
the more complicated and expensive ones.
Ordinary cold water or even ice-cold water is highly recommended by many
as a rectal injection for horses overcome by the excessive heat of
summer, and may be given by this simple pipe.
BY THE GENITO-URINARY PASSAGES.--This method of medication is especially
useful in treating local diseases of the genito-urinary organs. It finds
its chief application in the injection and cleansing of the uterus and
vagina. For this purpose a large syringe or the irrigator described
above may be used.
BY THE BLOOD.--Injections directly into veins are to be practiced by
medical or veterinary practitioners only, as are probably some other
means of giving medicines--intratracheal injections, etc.
[Illustration: PLATE III.
DIGESTIVE APPARATUS.
1. Mouth. 2. Pharynx. 3. Esophagus. 4. Diaphragm. 5. Spleen. 6. Stomach.
7. Duodenum. 8. Liver, upper extremity. 9. Large colon. 10. Cecum. 11.
Small intestine. 12. Floating colon. 13. Rectum. 14. Anus. 15. Left
kidney and its ureter. 16. Bladder. 17. Urethra.]
DISEASES OF THE DIGESTIVE ORGANS.
By CH. B. MICHENER, V. S.
[Revised by John R. Mohler, V. M. D.]
It is not an easy task to write "a plain account of the common diseases,
with directions for preventive measures, hygienic care, and the simpler
forms of medical treatment," of the digestive organs of the horse. Being
limited as to space, the endeavor has been made to give simply an
outline--to state the most important facts--leaving many gaps, and
continually checking the disposition to write anything like a full
description as to cause, prevention, and modes of treatment of diseases.
WATER.
It is generally held, at least in practice, that any water that stock
can be induced to drink is sufficiently pure for their use. This
practice occasions losses that would startle us if statistics were at
hand. Water that is impure from the presence of decomposing organic
matter, such as is found in wells and ponds in close proximity to manure
heaps and cesspools, is frequently the cause of diarrhea, dysentery, and
many other diseases of stock, while water that is impregnated with
different poisons and contaminated in very many instances with specific
media of contagion produces death.
Considering first the quantity of water required by the horse, it may be
stated that when our animals have access to water continually they never
drink to excess. Were the horse subjected to ship voyages or any other
circumstances where he must depend upon his attendant for the supply of
water, it may be roughly stated that he requires a daily average of
about 8 gallons of water. This varies somewhat upon the character of his
feed; if upon green feed, less water will be needed than when fed upon
dry hay and grain.
The time of giving water should be carefully studied. At rest, the horse
should receive it at least three times a day; when at work, more
frequently. The rule should be to give it in small quantities and often.
There is a popular fallacy that if a horse is warm he should not be
allowed to drink, many asserting that the first swallow of water
"founders" the animal or produces colic. This is erroneous. No matter
how warm a horse may be, it is always entirely safe to allow him from
six to ten swallows of water. If this is given on going into the
stable, he should have at once a pound or two of hay and allowed to rest
about an hour before feeding. If water is now offered him it will in
many cases be refused, or at least he will drink but sparingly. The
danger, then, is not in the "first swallow" of water, but is due to the
excessive quantity that the animal will take when warm if he is not
restrained.
Ice-cold water should never be given to horses. It may not be necessary
to add hot water, but we should be careful in placing water troughs
about our barns to have them in such position that the sun may shine
upon the water during the winter mornings. Water, even though it is thus
cold, seldom produces serious trouble if the horse has not been deprived
for a too great length of time.
In reference to the purity of water, Smith, in his "Veterinary Hygiene,"
classes spring water, deep-well water, and upland surface water as
wholesome; stored rain water and surface water from cultivated land as
suspicious; river water to which sewage gains access and shallow-well
water as dangerous. The water that is used so largely for drinking
purposes for stock throughout some States can not but be impure. I refer
to those sections where there is an impervious clay subsoil. It is the
custom to scoop, or hollow out, a large basin in the pastures. During
rains these basins become filled with water. The clay subsoil, being
almost impervious, acts as a jug, and there is no escape for the water
except by evaporation. Such water is stagnant, but would be kept
comparatively fresh by subsequent rains were it not for the fact that
much organic matter is carried into it by surface drainage during each
succeeding storm. This organic matter soon undergoes decomposition, and,
as the result, we find diseases of different kinds much more prevalent
where this water is drunk than where the water supply is wholesome.
Again, it must not be lost sight of that stagnant surface water is much
more certainly contaminated than is running water by one diseased animal
of the herd, thus endangering the remainder.
The chief impurities of water may be classified as organic and
inorganic. The organic impurities are either animal or vegetable
substances. The salts of the metals are the inorganic impurities. Lime
causes hardness of water, and occasion will be taken to speak of this
when describing intestinal concretions. Salts of lead, iron, and copper
are also frequently found in water; they also will be referred to.
About the only examination of water that can be made by the average
stock raiser is to observe its taste, color, smell, and clearness. Pure
water is clear and is without taste or smell.
Chemical and microscopic examination will frequently be necessary in
order to detect the presence of certain poisons, bacteria, etc., and
can, of course, be conducted by experts only.
FEEDS AND FEEDING.
In this place one can not attempt anything like a comprehensive
discussion of the subject of feeds and feeding, and I must content
myself with merely giving a few facts as to the different kinds of feed,
preparation, digestibility, proper time of feeding, quality, and
quantity. Improper feeding and watering will doubtless account for more
than one-half the digestive disorders met with in the horse, and hence
the reader can not fail to see how very important it is to have some
proper ideas concerning these subjects.
KINDS OF FEED.
In this country horses are fed chiefly upon hay, grass, corn fodder,
roots, oats, corn, wheat, and rye. Many think that they could be fed on
nothing else. Stewart, in "The Stable Book," gives the following extract
from Loudon's Encyclopedia of Agriculture, which is of interest at this
point:
In some sterile countries they [horses] are forced to subsist
on dried fish, and even on vegetable mold; in Arabia, on milk,
flesh balls, eggs, broth. In India horses are variously fed.
The native grasses are judged very nutritious. Few, perhaps no,
oats are grown; barley is rare, and not commonly given to
horses. In Bengal a vetch, something like the tare, is used. On
the western side of India a sort of pigeon pea, called gram
(_Cicer arietinum_), forms the ordinary food, with grass while
in season, and hay all the year round. Indian corn or rice is
seldom given. In the West Indies maize, guinea corn, sugar-corn
tops, and sometimes molasses are given. In the Mahratta country
salt, pepper, and other spices are made into balls, with flour
and butter, and these are supposed to produce animation and to
fine the coat. Broth made from sheep's head is sometimes given.
In France, Spain, and Italy, besides the grasses, the leaves of
limes, vines, the tops of acacia, and the seeds of the carob
tree are given to horses.
We can not, however, leave aside entirely here a consideration of the
digestibility of feeds; and by this we mean the readiness with which
they undergo those changes in the digestive canal that fit them for
absorption and deposition as integral parts of the animal economy.
The age and health of the animal will, of course, modify the
digestibility of feeds, as will also the manner and time of harvesting,
preserving, and preparing.
In the horse digestion takes place principally in the intestines, and
here, as in all other animals and with all feeds, it is found that a
certain part only of the provender is digested; another portion is
undigested. This proportion of digested and undigested feed must claim
passing notice at least, for if the horse receives too much feed, or
bulky feed containing much indigestible waste, a large portion of it
must pass out unused, entailing not only the loss of this unused feed,
but also calling for an unnecessary expenditure of vital force on the
part of the digestive organs of the horse. It is thus that, in fact, too
much feed may make an animal poor.
In selecting feed for the horse we should remember the anatomical
arrangement of the digestive organs, as well as the physiological
functions performed by each one of them. Feeds must be wholesome, clean,
and sweet, the hours of feeding regular, the mode of preparation found
by practical experience to be the best must be adhered to, and
cleanliness in preparation and administration must be observed.
The length of time occupied by stomach digestion in the horse varies
with the different feeds. Hay and straw pass out of the stomach more
rapidly than oats. It would seem to follow, then, that oats should be
given after hay, for if reversed the hay would cause the oats to be sent
onward into the intestines before being fully acted upon by the stomach,
and as a result produce indigestion. Experience confirms this. There is
another good reason why hay should be given first, particularly if the
horse is very hungry or if exhausted from overwork, namely, it requires
more time in mastication (insuring proper admixture of saliva) and can
not be bolted, as are the grains. In either instance water must not be
given soon after feeding, as it washes or sluices the feed from the
stomach before it is fitted for intestinal digestion.
The stomach begins to empty itself very soon after the commencement of
feeding, and continues rapidly while eating. Afterwards the passage is
slower, and several hours are required before the stomach is entirely
empty. The nature of the work required of the horse must guide us in the
selection of his feed. Rapid or severe labor can not be performed on a
full stomach. For such labor feed must be given in small quantity and
about two hours before going to work. Even horses intended for slow work
must never be engorged with bulky, innutritious feed immediately before
going to labor. The small stomach of the horse would seem to lead us to
the conclusion that he should be fed in small quantities and often,
which, in reality, should be done. The disproportion between the size of
the stomach and the quantity of water drunk tells us plainly that the
horse should always be watered before feeding. One of the common errors
of feeding, and the one that produces more digestive disorders than any
other, is _to feed too soon after a hard day's work_. This must never be
done. If a horse is completely jaded, it will be found beneficial to
give him an alcoholic stimulant on going into the stable. A small
quantity of hay may then be given, but his grain should be withheld for
one or two hours. These same remarks will apply with equal force to the
horse that for any reason has been fasting for a long time. After a
fast, feed less than the horse would eat, for if allowed too much the
stomach becomes engorged, its walls paralyzed, and "colic" is almost
sure to follow. The horse should be fed three or four times a day. It
will not do to feed him entirely upon concentrated feed. Bulky feed must
be given to detain the grains in their passage through the intestinal
tract; bulk also favors distention, and thus mechanically aids
absorption. For horses that do slow work the greater part of the time,
chopped or cut hay fed with crushed oats, ground corn, etc., is the best
manner of feeding, as it gives the required bulk, saves time, and half
the labor of feeding.
Sudden changes of diet are always dangerous. When desirous of changing,
do so very gradually. If a horse is accustomed to oats, a sudden change
to a full meal of corn will almost always sicken him. If we merely
intend to increase the quantity of the _usual_ feed, this also must be
done gradually. The quantity of feed given must always be in proportion
to the amount of labor to be performed. If a horse is to do a small
amount of work, or rest entirely from work for a few days, he should
receive a proportionate quantity of feed. If this should be observed
even on Saturday night and Sunday, there would be fewer cases of "Monday
morning sickness," such as colics and lymphangitis.
Feeds should also be of a more laxative nature when the horse is to
stand for several days.
MUSTY OR MOLDY FEEDS.--Above all things, avoid feeding musty or moldy
feeds. They are very frequent causes of disease of different kinds. Lung
trouble, such as bronchitis and "heaves," often follows their use. The
digestive organs always suffer from moldy or musty feeds. Musty hay is
generally considered to produce disorder of the kidneys, and all know of
the danger from feeding pregnant animals upon ergotized grasses or
grains. It has often been said to produce that peculiar disease known
variously as cerebrospinal meningitis, putrid sore throat, or choking
distemper.
HAY.--The best hay for horses is timothy. It should be about one year
old, of a greenish color, crisp, clean, fresh, and possessing a sweet,
pleasant aroma. Even this good hay, if kept too long, loses part of its
nourishment, and, while it may not be positively injurious, it is hard,
dry, and indigestible. New hay is difficult to digest, produces much
salivation (slobbering), and occasional purging and irritation of the
skin. If fed at all it should be mixed with old hay.
_Second crop, or aftermath._--This is not considered good hay for
horses, but it is prized by some farmers as good for milch cows, the
claim being made that it increases the flow of milk. The value of hay
depends upon the time of cutting, as well as care in the curing. Hay
should be cut when in full flower, but before the seeds fall; if left
longer it becomes dry, woody, and lacks in nutrition. An essential
point in making hay is that when the crop is cut it should remain in the
field as short a time as possible. If left too long in the sun it loses
color, flavor, and dries or wastes. Smith asserts that one hour more
than is necessary in the sun causes a loss of 15 to 20 per cent in the
feeding value of hay. It is impossible to state any fixed time that hay
must have to cure, this depending, of course, upon the weather,
thickness of the crop, and many other circumstances; but it is well
known that in order to preserve the color and aroma of hay it should be
turned or tedded frequently and cured as quickly as possible. On the
other hand, hay spoils in the mow if harvested too green or when not
sufficiently dried. Mow-burnt hay produces disorder of the kidneys and
bowels and causes the horse to fall off in condition.
The average horse on grain should be allowed from 10 to 12 pounds of
good hay a day. It is a mistake of many to think that horses at light
work can be kept entirely on hay. Such horses soon become potbellied,
fall off in flesh, and do not thrive. The same is true of colts; unless
the latter are fed with some grain they grow up to be long, lean, gawky
creatures, and never make so good horses as those accustomed to grain
with, or in addition to, their hay.
STRAW.--The straws are not extensively fed in this country, and when
used at all they should be cut and mixed with hay and ground or crushed
grain. Wheat, rye, and oat straw are the ones most used; of these, oat
straw is most easily digested and contains the most nourishment. Pea and
bean straw are occasionally fed to horses, the pea being preferable,
according to most writers.
CHAFF.--Wheat and rye chaff should never be used as a feed for horses.
The beards frequently become lodged in the mouth or throat and are
productive of more or less serious trouble. In the stomach and
intestines they often serve as the nucleus of the "soft concretions,"
which are to be described when treating of obstructions of the digestive
tract.
Oat chaff, if fed in small quantities and mixed with cut hay or corn
fodder, is very much relished by horses. It is not to be given in large
quantities, as I have repeatedly witnessed a troublesome and sometimes
fatal diarrhea following the practice of allowing horses or cattle free
access to a pile of oat chaff.
GRAINS.--Oats take precedence of all grains as a feed for horses, as the
ingredients necessary for the complete nutrition of the body exist in
them in the best proportions. Oats are, besides, more easily digested
and a larger proportion absorbed and converted into the various tissues
of the body. Care must be taken in selecting oats. According to Stewart,
the best oats are one year old, plump, short, hard, clean, bright, and
sweet. New oats are indigestible. Kiln-dried oats are to be refused, as
a rule, for even though originally good this drying process injures
them. Oats that have sprouted or fermented are injurious and should
never be fed. Oats are to be given either whole or crushed--whole in the
majority of instances; crushed to old horses and those having defective
teeth. Horses that bolt their feed are also best fed upon crushed oats
and out of a manger large enough to permit of spreading the grain in a
thin layer.
In addition to the allowance of hay above mentioned, the average horse
requires about 12 quarts of good oats daily. The best oats are those cut
about one week before they are fully ripe. Not only is the grain richer
in nutritive materials at this time, but there is also less waste from
"scattering" than if left to become dead ripe. Moldy oats, like hay and
straw, not only produce serious digestive disorders but have been the
undoubted cause of outbreaks of that dread disease in horses, already
referred to, characterized by inability to eat or drink, sudden
paralysis, and death.
WHEAT AND RYE.--These grains are not to be used for horses except in
small quantities, bruised or crushed, and fed mixed with other grains or
hay. If fed alone, in any considerable quantities, they are almost
certain to produce digestive disorders, laminitis (founder), and similar
troubles. They should never constitute more than one-fourth the grain
allowance, and should always be ground or crushed.
BRAN.--The bran of wheat is the one most used, and its value as a
feeding stuff is variously estimated. It is not to be depended upon if
given alone, but may be fed with other grains. It serves to keep the
bowels open. Sour bran is not to be given, for it disorders the stomach
and intestines and may even produce serious results.
MAIZE (CORN).--This grain is not suitable as an exclusive feed for young
horses, as it is deficient in salts. It is fed whole or ground. Corn on
the cob is commonly used for horses affected with "lampas." If the corn
is old and is to be fed in this manner it should be soaked in pure,
clean water for 10 or 12 hours. Corn is better given ground, and fed in
quantities of from 1 to 2 quarts at a meal, mixed with crushed oats or
wheat bran. Great care should be taken in giving corn to a horse that is
not accustomed to its use. It must be commenced in small quantities and
very gradually increased. I know of no grain more liable to produce what
is called acute indigestion than corn if these directions are not
observed.
LINSEED.--Ground linseed is occasionally fed with other feeds to keep
the bowels open and to improve the condition of the skin. It is of
particular service during convalescence, when the bowels are sluggish in
their action. Linseed tea is very often given in irritable or inflamed
conditions of the digestive organs.
POTATOES.--These are used as an article of feed for the horse in many
sections. If fed raw and in large quantities they often produce
indigestion. Their digestibility is increased by steaming or boiling.
They possess, in common with other roots, slight laxative properties.
BEETS.--These are not much used as feed for horses.
CARROTS.--These make a most excellent feed, particularly during
sickness. They improve the appetite and slightly increase the action of
the bowels and kidneys. They possess also certain alterative properties,
making the coat smooth and glossy. Some veterinary writers assert that
chronic cough is cured by giving carrots for some time. The roots may be
considered, then, as an adjunct to the regular regimen, and if fed in
small quantities are highly beneficial.
GRASSES.--Grass is the natural food of horses. It is composed of a great
variety of plants, differing widely as to the amount of nourishment
contained, some being almost entirely without value and only eaten when
nothing else is obtainable, while others are positively injurious, or
even poisonous. None of the grasses are sufficient to keep the horse in
condition for work. Horses thus fed are "soft," sweat easily, purge, and
soon tire on the road or when at hard work. Grass is indispensable to
growing stock, and there is little or no doubt that it acts as an
alterative when given to horses accustomed to grain and hay. It must be
given to such horses in small quantities at first. The stomach and
intestines undergo rest, and recuperate if the horse is turned to grass
for a time each year. It is also certain that during febrile diseases
grass acts almost as a medicine, lessening the fever and favoring
recovery. Wounds heal more rapidly than when the horse is on grain, and
some chronic disorders (chronic cough, for instance) disappear entirely
when at grass. In my experience, grass does more good when the horse
crops it himself. This may be due to the sense of freedom he enjoys at
pasture, to the rest to his feet and limbs, and for many other similar
reasons. When cut for him it should be fed fresh or when but slightly
wilted.
SILAGE.--Regarding silage as a feed for horses, Rommel in Farmers'
Bulletin 578 writes as follows:
Silage has not been generally fed to horses, partly on account
of a certain amount of danger which attends its use for this
purpose, but still more, perhaps, on account of prejudice. In
many cases horses have been killed by eating moldy silage, and
the careless person who fed it at once blamed the silage
itself, rather than his own carelessness and the mold which
really was the cause of the trouble. Horses are peculiarly
susceptible to the effects of molds, and under certain
conditions certain molds grow on silage which are deadly
poisons to both horses and mules. Molds must have air to grow,
and therefore silage which is packed air-tight and fed out
rapidly will not become moldy. If the feeder watches the silage
carefully as the weather warms up he can soon detect the
presence of mold. When mold appears, feeding to horses or mules
should stop immediately.
It is also unsafe to feed horses frozen silage on account of
the danger of colic. * * *
To summarize, silage is safe to feed to horses and mules only
when it is made from fairly mature corn, properly stored in the
silo. When it is properly stored and is not allowed to mold, no
feed exceeds it as a cheap winter ration. It is most valuable
for horses and mules which are not at heavy work, such as brood
mares and work horses during the slack season. With plenty of
grain on the cornstalks, horses will keep in good condition on
a ration of 20 pounds of silage and 10 pounds of hay for each
1,000 pounds of live weight.
PREPARATION OF FEEDS.
Feed is prepared for any of the following reasons: To render it more
easily eaten; to make it more digestible; to economize in amount; to
give it some new property; and to preserve it. We have already spoken of
the preparation of drying, and need not revert to this again, as it only
serves to preserve the different feeds. Drying does, however, change
some of the properties of feed, _i. e._, removes the laxative tendency
of most of them.
The different grains are more easily eaten when ground, crushed, or even
boiled. Rye or wheat should never be given whole, and even of corn it is
found that there is less waste when ground, and, in common with all
other grains, it is more easily digested than when fed whole.
Hay and fodder are economized when cut in short pieces. Not only will
the horse eat the necessary quantity in a shorter time, but it will be
found that there is less waste, and the mastication of the grains (whole
or crushed) fed with them is insured.
Reference has already been made to those horses that bolt their feed,
and we need only remark here that the consequences of such ravenous
eating may be prevented if the grains are fed with cut hay, straw, or
fodder. Long or uncut hay should also be fed, even though a certain
quantity of hay or straw is cut and fed mixed with grain.
One objection to feeding cut hay mixed with ground or crushed grains,
and wetted, must not be overlooked during the hot months. Such feed is
liable to undergo fermentation if not fed directly after it is mixed;
even the mixing trough, unless frequently scalded and cleaned, becomes
sour and enough of its scrapings are given with the feed to produce
flatulent (wind) colic. A small quantity of salt should always be mixed
with such feed. Bad hay should never be cut simply because it insures a
greater consumption of it; bad feeds are dear at any price, and should
never be fed.
The advantage of boiling roots has been mentioned. Not only does this
render them less liable to produce digestive disorders, but it also
makes them clean. Boiling or steaming grains is to be recommended when
the teeth are poor, or when the digestive organs are weak.
DISEASES OF THE TEETH.
_Dentition._--This covers the period during which the young horse is
cutting his teeth--from birth to the age of 5 years. With the horse more
difficulty is experienced in cutting the second or permanent teeth than
with the first or milk teeth. There is a tendency among farmers and many
veterinarians to pay too little attention to the teeth of young horses.
Percivall relates an instance illustrative of this that is best told in
his own words:
I was requested to give my opinion concerning a horse, then in
his fifth year, who had fed so sparingly for the last
fortnight, and so rapidly declined in condition in consequence,
that his owner, a veterinary surgeon, was under no light
apprehensions about his life. He had himself examined his mouth
without having discovered any defect or disease, though another
veterinary surgeon was of opinion that the difficulty or
inability manifested in mastication, and the consequent
cudding, arose from preternatural bluntness of the surfaces of
the molar teeth, which were, in consequence, filed, but without
beneficial result. It was after this that I saw the horse, and
I confess I was, at my first examination, quite as much at a
loss to offer any satisfactory interpretation as others had
been. While meditating, however, after my inspection, on the
apparently extraordinary nature of the case, it struck me that
I had not seen the tusks. I went back into the stable and
discovered two little tumors, red and hard, in the situation of
the inferior tusks, which, when pressed, gave the animal
insufferable pain. I instantly took out my pocketknife and made
crucial incisions through them both, down to the coming teeth,
from which moment the horse recovered his appetite and, by
degrees, his wonted condition.
The mouths of young horses should be examined from time to time to see
whether one or more of the milk teeth are not remaining too long,
causing the second teeth to grow in crooked, in which case the first
teeth should be removed with the forceps.
_Irregularities of teeth._--There is a fashion of late years, especially
in large cities, to have horses' teeth regularly "floated," or "rasped,"
by "veterinary dentists." In some instances this is very beneficial,
while in most cases it is entirely unnecessary. From the character of
the feed, the rubbing, or grinding, surface of the horse's teeth should
be rough. Still, we must remember that the upper jaw is somewhat wider
than the lower, and that, from the fact of the teeth not being perfectly
apposed, a sharp ridge is left unworn on the inside of the lower molars
and on the outside of the upper, which may excoriate the tongue or
cheeks to a considerable extent. This condition may readily be felt by
the hand, and these sharp ridges when found should be rasped down by a
guarded rasp. In some instances the first or last molar tooth is
unnaturally long, owing to the fact that its fellow in the opposite jaw
has been lost or does not close perfectly against it. Should it be the
last molar that is thus elongated, it will require the aid of the
veterinary surgeon, who has the necessary forceps or chisel for cutting
it. The front molar may be rasped down, if much patience is taken. In
decay of the teeth it is quite common to find the tooth corresponding to
the decayed one on the opposite jaw very much elongated, sometimes to
such an extent that the mouth can not be perfectly closed. Such teeth
must also be shortened by the tooth forceps, chisel, tooth saw, or rasp.
In all instances in which horses "quid" their feed, if they are
slobbering, or evince pain in mastication, shown by holding the head to
one side while chewing, the teeth should be carefully examined. Horses
whose teeth have unduly sharp edges are liable to drive badly; they pull
to one side, do not bear on the bit, or bear on too hard and "big," toss
the head, and start suddenly when a tender spot is touched. If, as is
mostly the case, all the symptoms are referable to sharp corners or
projections, these must be removed by the rasp. If decayed teeth ere
found, or other serious difficulty detected, or if the cause of the
annoying symptoms is not discovered, an expert should be called.
[Illustration: PLATE IV.
AGE OF HORSES AS INDICATED BY TEETH.
Longitudinal section of left central lower incisor and cross sections of
same tooth showing table surfaces as they appear at the ages of 3, 5, 7,
9, 15, 20 and 25 years. _C_, Cement; _D_, Dentine; _E_, Enamel; _I_,
Infundibulum; _K_, Cup; _P_, Pulp Cavity; _S_, Star.]
_Toothache._--This is rare in the horse and is mostly witnessed when
there is decay of a tooth or inflammation about its root. Toothache is
to be discovered in the horse by the pain expressed by him while feeding
or drinking cold water. I have seen horses, affected with toothache,
that would suddenly stop chewing, throw the head to one side, and
slightly open the mouth. They behave as though some sharp body had
punctured the mouth. If upon examination, no foreign body is found, we
must then carefully examine each tooth. If this can not be done with the
hand in the mouth, we can, in most instances, discover the aching tooth
by pressing each tooth from without. By tapping the teeth in succession
with a hard object, such as a small hammer, the one that is tender may
be identified. The horse will flinch when the sore tooth is pressed or
tapped upon. In most cases there is nothing to be done but extract the
decayed tooth, and this, of course, is to be attempted by the
veterinarian only.
_Deformity._--There is a deformity, known as parrot-mouth, that
interferes with prehension, mastication, and, indirectly, with
digestion. The upper incisors project in front of and beyond the lower
ones. The teeth of both jaws become unusually long, as they are not worn
down by friction. Such horses experience much difficulty in grazing.
Little can be done except to examine the teeth occasionally, and if
those of the lower jaw become so long that they bruise the "bars" of the
upper jaw, they must be shortened by the rasp or saw. Horses with this
deformity should never be left entirely at pasture.
The method of determining the age of a horse by the teeth is illustrated
in Plate IV.
DISEASES OF THE MOUTH.
LAMPAS.
Lampas is the name given to a swelling of the mucous membrane covering
the hard palate and projecting in a more or less prominent ridge
immediately behind the upper incisors. The hard palate is composed of
spongy tissue that fills with blood when the horse is feeding, which
causes the ridges to become prominent, and they then help to keep feed
from dropping from the mouth. This swelling is entirely natural and
occurs in every healthy horse. Where there is some irritation in the
mouth, as in stomatitis or during teething, the prominence of the hard
palate may persist, owing to the increased blood supply. In such cases
the cause of the irritation should be nought for and removed. By way of
direct treatment, slight scarification is the most that will be
required. Burning the lampas is barbarous and injurious, and it should
never be tolerated.
It is a quite common opinion among owners of horses and stablemen that
lampas is a disease that very frequently exists. In fact whenever a
horse fails to eat, and if he does not exhibit very marked symptoms of a
severe illness, they say at once "he has the lampas." It is almost
impossible to convince them to the contrary; yet it is not the case. It
may be put down, then, as an affliction of the stable-man's imagination
rather than of the horse's mouth.
STOMATITIS.
Stomatitis is an inflammation of the mucous membrane lining the mouth
and is produced by irritating medicines, feeds, or other substances. The
symptoms are swelling of the mouth, which is also hot and painful to the
touch; there is a copious discharge of saliva; the mucous membrane is
reddened, and in some cases vesicles or ulcers in the mouth are
observed. The treatment is simple, soft feed alone often being all that
is necessary. A bucket of fresh, cold water should be kept constantly in
the manger so that the horse may drink or rinse his mouth at will. In
some instances, it may be advisable to use a wash of chlorate of potash,
borax, or alum, about one-half ounce to a pint of water. Hay, straw, or
oats should not be fed unless steamed or boiled. A form of contagious
stomatitis, characterized by the formation within the mouth of small
vesicles, or blisters, sometimes occurs. In this disease the horse
should be isolated from other horses, and his stall, especially the feed
box, and his bit should be disinfected.
GLOSSITIS (INFLAMMATION OF THE TONGUE).
Glossitis, or inflammation of the tongue, is very similar to stomatitis,
and mostly exists with it and is due to the same causes. Injuries to the
tongue may produce this simple inflammation of its covering membrane,
or, if severe, may produce lesions much more extensive, such as
lacerations, abscesses, etc. These latter would require surgical
treatment, but for the simpler forms of inflammation of the tongue the
treatment recommended for stomatitis should be followed.
SALIVATION (PTYALISM).
Ptyalism, or salivation, consists in an abnormal and excessive secretion
of saliva. This is often seen as a symptom of irregular teeth;
inflammation of the mouth or tongue, or of the use of such medicines as
lobelia, mercury, and many others. Some feeds, such as clover, and
particularly second crop, produce it; foreign bodies, such as nails,
wheat chaff, and corncobs becoming lodged in the mouth, also are causes.
If the cause is removed no further attention is necessary, as a rule.
Astringent washes may be applied to the mouth as a gargle or by means of
a sponge.
PHARYNGITIS.
Pharyngitis is an inflammation of the mucous membrane lining of the
pharynx or throat. It rarely exists unless accompanied with stomatitis
or laryngitis, especially the latter. In those rare instances in which
the inflammation is mostly confined to the pharynx are noticed febrile
symptoms--difficulty of swallowing either liquids or solids; there is
but little cough except when trying to swallow; there is no soreness on
pressure over larynx (head of the windpipe). Increased flow of saliva,
difficulty of swallowing liquids in particular, and cough only when
attempting to swallow, are the symptoms best marked in pharyngitis. In
some cases the throat becomes gangrenous and the disease ends in death.
For treatment a wet sheet should be wrapped around the throat and
covered with rubber sheeting and a warm blanket. This should be changed
three times daily; or the region of the throat may be rubbed with
mercurial ointment twice daily until the skin becomes irritated, but no
longer; chlorate of potash may be given in 2-dram doses four times
daily, mixed with flaxseed meal or licorice-root powder and honey, as an
electuary. Soft feeds should be given, and fresh water should be
constantly before the horse.
PARALYSIS OF THE PHARYNX.
Paralysis of the pharynx, or, as it is commonly called, "paralysis of
the throat," is a rare but very serious disease. The symptoms are as
follows: The horse will constantly try to eat or drink, but will be
unable to do so; if water is offered him from a pail he will apparently
drink with avidity, but the quantity of water in the pail will remain
about the same; he will continue by the hour to try to drink; if he can
get any fluid into the back part of the mouth it will come out at once
through the nose. Feeds also return through the nose, or are dropped
from the mouth, quidded. An examination of the mouth by inserting the
hand fails to find any obstruction or any abnormal condition. These
cases go on from bad to worse; the horse constantly and rapidly loses in
condition, becomes very much emaciated, the eyes are hollow and
lusterless, and death occurs from inanition.
Treatment is very unsatisfactory. A severe blister should be applied
behind and under the jaw; the mouth is to be frequently swabbed out with
alum or chlorate of potash, 1 ounce to a pint of water, by means of a
sponge fastened to the end of a stick. Strychnia may be given in 1-grain
doses two or three times a day.
This disease may be mistaken at times for foreign bodies in the mouth or
for the so-called cerebrospinal meningitis. It is to be distinguished
from the former, upon a careful examination of the mouth, by the absence
of any offending body and by the flabby feel of the mouth, and from the
latter by the animal appearing in perfect health in every particular
except this inability to eat or drink.
ABSCESSES.
Abscesses sometimes form back of the pharynx and give rise to symptoms
resembling those of laryngitis or distemper. Interference with breathing
that is of recent origin and progression, without any observable
swelling or soreness about the throat, will make one suspect the
formation of an abscess in this location. But little can be done in the
way of treatment, save to hurry the ripening of the abscess and its
discharge by steaming with hops, hay, or similar substances and by
poulticing the throat. The operation for opening an abscess in this
region necessitates an intimate knowledge of the complex anatomy of the
throat region.
DISEASES OF THE ESOPHAGUS OR GULLET.
It is rare to find diseases of this organ, except as a result of the
introduction of foreign bodies too large to pass or to the administering
of irritating medicines. In the administration of irritant or caustic
medicines great care should be taken that they be thoroughly diluted. If
this is not done, erosions and ulcerations of the throat ensue, and this
again is prone to be followed by constriction (narrowing) of the gullet.
CHOKING.
The mechanical trouble of choking is quite common. It may occur when the
animal is suddenly startled while eating apples or roots, and we should
be careful never to approach suddenly or put a dog after horses or cows
that are feeding upon such substances. If left alone these animals very
rarely attempt to swallow the object until it is sufficiently
masticated.
Choking also arises from feeding oats in a deep, narrow manger to such
horses as eat very greedily or bolt their feed. Wheat chaff is also a
frequent cause of choke. This accident may result from the attempts to
force eggs down without breaking or from giving balls that are too large
or not of the proper shape.
Whatever object causes the choking, it may lodge in the upper part of
the esophagus, at its middle portion, or close to the stomach, giving
rise to the designations of pharyngeal, cervical, and thoracic choke. In
some cases where the original obstruction is low we find all that part
of the gullet above it to be distended with feed.
_Symptoms._--The symptoms vary somewhat according to the position of the
body causing choke. In pharyngeal choke the object is lodged in the
upper portion of the esophagus. The horse will present symptoms of great
distress, hurried breathing, frequent cough, excessive flow of saliva,
sweating, trembling, or stamping with the fore feet. The abdomen rapidly
distends with gas. The diagnosis is completed by manipulating the upper
part of the throat from without and by the introduction of the hand into
the back part of the mouth, finding the body lodged here. In cervical
choke (where the obstruction is situated at any point between the
throatlatch and the shoulder) the protrusion caused by the object can be
seen and the object can be felt. The symptoms here are not so severe;
the horse will be seen occasionally to draw himself up, arch his neck,
and make retching movements as though he wished to vomit. The abdomen
may be tympanitic. Should there be any question as to the trouble, a
conclusion may be reached by pouring water into the throat from a
bottle. If the obstruction is complete, by standing on the left side of
the horse and watching the course of the esophagus, you can see the
gullet, just above the windpipe, become distended with each bottle of
water. This is not always a sure test, as the obstruction may be an
angular body, in which case liquids would pass it. Solids taken would
show in these cases; solids should not, however, be given, as they serve
to increase the trouble by rendering the removal of the body more
difficult.
In thoracic choke the symptoms are less severe. Feed or water may be
ejected through the nose or mouth after the animal has taken a few
swallows. There will be some symptoms of distress, fullness of the
abdomen, cough, and occasionally retching movements. Sometimes a choking
horse is heard to emit groans. The facial expression always denotes
great anxiety and the eyes are bloodshot. The diagnosis is complete if,
upon passing the probang (a flexible tube made for this purpose), an
obstruction is encountered.
_Treatment._--If the choke is at the beginning of the gullet
(pharyngeal) an effort must be made to remove the obstacle through the
mouth. A mouthgag, or speculum, is to be introduced into the mouth to
protect the hand and arm of the operator. Then, while an assistant, with
his hands grasped tightly _behind_ the object, presses it upward and
forward with all his force, the operator must pass his hand into the
mouth until he can seize the obstruction and draw it outward. This mode
of procedure must not be abandoned with the first failure, as by
continued efforts we may get the obstacle farther toward the mouth. If
we fail with the hand, forceps may be introduced through the mouth and
the object seized when it is just beyond the reach of the fingers.
Should our efforts entirely fail, we must then endeavor to force the
obstruction downward by means of the probang. This instrument, which is
of such signal service in removing choke in cattle, is decidedly more
dangerous to use for the horse, and I can not pass this point without a
word of caution to those who have been known to introduce into the
horse's throat such objects as whipstalks, shovel handles, etc. These
are always dangerous, and more than one horse has been killed by such
barbarous treatment.
In cervical as well as in thoracic choke we must first of all endeavor
to soften or lubricate the obstruction by pouring oil or mucilaginous
drinks down the gullet. After this has been done endeavor to move the
object by gentle manipulations with the hands. If choked with oats or
chaff (and these are the objects that most frequently produce choke in
the horse), begin by gently squeezing the lower portion of the impacted
mass and endeavor to work it loose a little at a time. This is greatly
favored at times if we apply hot fomentations immediately about the
obstruction. Persist in these efforts for at least an hour before
deciding to resort to other and more dangerous modes of treatment. If
unsuccessful, however, the probang may be used. In the absence of the
regular instrument, a piece of inch hose 6 feet long or a piece of new
three-quarter-inch manila rope well wrapped at the end with cotton twine
and thoroughly greased with tallow should be used. The mouth is to be
kept open by a gag of wood or iron and the head slightly raised and
extended. The probang is then to be carefully guided by the hand into
the upper part of the gullet and gently forced downward until the
obstruction is reached. Pressure must then be gradual and firm. At first
too much force should not be used, or the esophagus will be ruptured.
Firm, gentle pressure should be kept up until the object is felt to
move, after which it should be followed rapidly to the stomach. If this
mode of treatment is unsuccessful, a veterinarian or a physician should
be called, who can remove the object by cutting down upon it. This
should scarcely be attempted by a novice, as a knowledge of the anatomy
of the parts is essential to avoid cutting the large artery, vein, and
nerve that are closely related to the esophagus in its cervical
portion.
Thoracic choke can be treated only by means of the introduction of oils
and mucilaginous drinks and the careful use of the probang.
STRICTURE OF THE ESOPHAGUS.
This is due to corrosive medicines, previous choking (accompanied with
lacerations, which, in healing, narrow the passage), or pressure on the
gullet by tumors. In the majority of cases of stricture, dilatation of
the gullet in front of the constricted portion soon occurs. This
dilatation is the result of the frequent accumulation of solid feed
above the constriction. Little can be done in either of these instances
except to give sloppy or liquid feed.
SACULAR DILATATION OF THE ESOPHAGUS.
This follows choking, and is due to stretching or rupture of the
muscular coat of the gullet, allowing the internal, or mucous, coat to
protrude through the lacerated muscular walls. Such a dilatation, or
pouch, may gradually enlarge from the frequent imprisonment of feed.
When liquids are taken, the solid materials are partially washed out of
the pouch.
The symptoms are as follows: The horse is able to swallow a few
mouthfuls without apparent difficulty; then he will stop feeding, paw,
contract the muscles of his neck, and eject a portion of the feed
through his nose or mouth, or it will gradually work down to the
stomach. As the dilatation thus empties itself the symptoms gradually
subside, only to reappear when he has again taken solid feed. Liquids
pass without any, or but little, inconvenience. Should this dilatation
exist in the cervical region, surgical interference may sometimes prove
effectual; if in the thoracic portion, nothing can be done, and the
patient rapidly passes from hand to hand by "swapping," until, at no
distant date, the contents of the sac become too firm to be dislodged as
heretofore, and the animal succumbs.
DISEASES OF THE STOMACH AND INTESTINES.
As a rule it is most difficult to distinguish between diseases of the
stomach and of the intestines of the horse. The reason for this is that
the stomach is relatively small. It lies away from the abdominal wall,
and so pressure from without can not be brought to bear upon it to
reveal sensitiveness or pain. Nor does enlargement, or distention, of
the stomach produce visible alteration in the form of the abdomen of the
horse. Moreover, it is a rule to which there are few exceptions, that an
irritant or cause of disease of the stomach acts likewise upon the
intestines, so that it is customary to find them similarly deranged. For
these reasons it is logical to discuss together the diseases of the
stomach and intestines and to point out such localizations in one organ
or another as are of importance in recognizing and treating the diseases
of the digestive organs of the horse.
It should be understood that gastritis signifies an inflammation of the
stomach and enteritis an inflammation of the intestines. The two terms
may be used together to signify a disease of the stomach and intestines,
as gastro-enteritis.
COLIC.
The disease of the horse that is most frequently met with is what is
termed "colic," and many are the remedies that are reputed to be "sure
cures" for this disease. Let us discover, then, what the word "colic"
means. This term is applied loosely to almost all diseases of the organs
of the abdomen that are accompanied with pain. If the horse evinces
abdominal pain, he probably will be considered as suffering with colic,
no matter whether the difficulty is a cramp of the bowel, an internal
hernia, overloading of the stomach, or a painful disease of the bladder
or liver. Since these conditions differ so much in their causation and
their nature, it is manifestly absurd to treat them alike and to expect
the same drugs or procedures to relieve them all. Therefore, it is
important that, so far as possible, the various diseased states that are
so roughly classed together as colic shall be separated and
individualized in order that appropriate treatments may be prescribed.
With this object in view, colics will be considered under the following
headings: (1) Engorgement colic, (2) obstruction colic, (3) flatulent or
tympanitic colic, (4) spasmodic colic. Worm colic is discussed under the
heading "Gastrointestinal parasites," page 90.
The general symptoms of abdominal pain, and therefore of colic, are
restlessness, cessation of whatever the horse is about, lying down,
looking around toward the flank, kicking with the hind feet upward and
forward toward the belly, jerky switching of the tail, stretching as
though to urinate, frequent change of position, and groaning. In the
more intense forms the horse plunges about, throws himself, rolls,
assumes unnatural positions, as sitting on the haunches, and grunts
loudly. Usually the pain is not constant, and during the intermissions
the horse may eat and appear normal. During the period of pain sweat is
poured out freely. Sometimes the horse moves constantly in a circle. The
respirations are accelerated, and usually there is no fever.
ENGORGEMENT COLIC.--This form of colic consists in an overloading of the
stomach with feed. The horse may have been overfed or the feed may have
collected in the stomach through failure of this organ to digest it and
pass it backward into the intestines. Even a normal quantity of feed
that the horse is unaccustomed to may cause disease. Hence a sudden
change of feed may produce engorgement colic. Continued full rations
while the horse is resting for a day or two or working too soon after
feeding may serve as a cause. New oats, corn, or hay, damaged feed, or
that which is difficult of digestion, such as barley or beans, may
incite engorgement colic. This disease may result from having fed the
horse twice by error or from its having escaped and taken an
unrestricted meal from the grain bin. Ground feeds that pack together,
making a sort of dough, may cause engorgement colic if they are not
mixed with cut hay. Greedy eaters are predisposed to this disease.
_Symptoms._--The horse shows the general signs of abdominal pain, which
may be long continued or of short duration. Retching or vomiting
movements are made; these are shown by labored breathing, upturned upper
lip, contraction of the flank, active motion at the throat, and drawing
in of the nose toward the breast, causing high arching of the neck. The
horse may assume a sitting position like a dog. At times the pain is
very great and the horse makes the most violent movements, as though
mad. At other times there is profound mental depression, the horse
standing in a sleepy, or dazed, way, with the head down, the eyes
closed, and leaning his head against the manger or wall. There is,
during the struggles, profuse perspiration. Following retching, gas may
escape from the mouth, and this may be followed by a sour froth and some
stomach contents. The horse can not vomit except when the stomach is
violently stretched, and, if the accumulation of feed or gas is great
enough to stretch the stomach so that vomiting is possible, it may be
great enough to rupture that organ. So it happens not infrequently that
a horse dies from ruptured stomach after vomiting. After the stomach
ruptures, however, vomiting is impossible. The death rate in this form
of colic is high.
_Treatment._--The bowels should be stimulated to contraction by the use
of clysters of large quantities of water and of glycerin. Veterinarians
use hypodermic injections of eserin or arecolin or intravenous
injections of barium chlorid, but they must be employed with great
caution. It is not profitable to give remedies by the stomach, for they
can not be absorbed. But small doses of morphin (5 grains) or of the
fluid extract of Indian hemp (2 drams) may be placed in the mouth and
are absorbed in part, at least, without passing to the stomach. These
drugs lessen pain and thus help to overcome the violent movements that
are dangerous, because they may be the means of causing rupture of the
diaphragm or stomach. If facilities are available, relief may be
afforded by passing an esophageal tube through which some of the gaseous
and liquid contents of the stomach may escape.
_Rupture of the stomach._--This mostly occurs as a result of engorged or
tympanitic stomach (engorgement colic) and from the horse violently
throwing himself when so affected. It may result from disease of the
coats of the stomach, gastritis, stones (calculi), tumors, or anything
that closes the opening of the stomach into the intestines, and very
violent pulling or jumping immediately after the animal has eaten
heartily of bulky feed. These or similar causes may lead this accident.
The symptoms of rupture of the stomach are not constant or always
reliable. Always make inquiry as to what and how much the horse has been
fed at the last meal. Vomiting may precede rupture of this organ, as
stated above. This accident appears to be most liable to occur in heavy
draft horses. A prominent symptom observed (though it may also occur in
diaphragmatic hernia) is when the horse, if possible, gets the front
feet on higher ground than the hind ones or sits on his haunches, like a
dog. This position affords relief to some extent, and it will be
maintained for several minutes; it is also quickly regained when the
horse has changed it for some other. Colicky symptoms, of course, are
present, which vary much and present no diagnostic value. As the case
progresses the horse will often stretch forward the fore legs, lean
backward and downward until the belly nearly touches the ground, and
then rise up again with a groan, after which the fluid from his nostrils
is issued in increased quantity. The pulse is fast and weak, breathing
hurried, body bathed in a clammy sweat, limbs tremble violently, the
horse reels or staggers from side to side, and death quickly ends the
scene.
In the absence of any pathognomonic symptom we must consider the history
of the case; the symptoms of colic that cease suddenly and are succeeded
by cold sweats and tremors; the pulse quick and small and thready,
growing weak and more frequent, and at length running down and becoming
altogether imperceptible; looking back at the flank and groaning;
sometimes crouching with the hind quarters; with or without eructation
and vomiting.
There is no treatment that can be of any use whatever. Could we be sure
of our diagnosis it would be better to destroy the animal at once.
Since, however, there is always the possibility of a mistake in
diagnosis, we may give powdered opium in 1-dram doses every two or three
hours, with the object of keeping the stomach as quiet as possible.
OBSTRUCTION COLIC.--The stomach or bowels may be obstructed by
accumulations of partly digested feed (fecal matter), by foreign bodies,
by displacements, by paralysis, or by abnormal growths.
_Impaction of the large intestines._--This is a very common bowel
trouble and one which, if not promptly recognized and properly treated,
results in death. It is caused by overfeeding, especially of bulky feed
containing an excess of indigestible residue; old, dry, hard hay, or
stalks when largely fed; deficiency of secretions of the intestinal
tracts; lack of water; want of exercise, medicines, etc.
Impaction of the large bowels is to be diagnosed by a slight abdominal
pain, which may disappear for a day or two to reappear with more
violence. The feces are passed somewhat more frequently, but in smaller
quantities and drier; the abdomen is full, but not distended with gas;
the horse at first is noticed to paw and soon begins to look back at his
sides. Probably one of the most characteristic symptoms is the position
assumed when down. He lies flat on his side, head and legs extended,
occasionally raising his head to look toward his flank; he remains on
his side for from five to fifteen minutes at a time. Evidently this
position is the one giving the most freedom from pain. He rises at
times, walks about the stall, paws, looks at his sides, backs up against
the stall, which he presses with his tail, and soon lies down again,
assuming his favored position. The intestinal sounds, as heard by
applying the ear to the flank, are diminished, or there is no sound,
indicating absence of motion of the bowels. The bowels may cease
entirely to move. The pressure of the distended intestine upon the
bladder may cause the horse to make frequent attempts to urinate. The
pulse is but little changed at first, being full and sluggish; later, if
this condition is not overcome, it becomes rapid and feeble. Horses may
suffer from impaction of the bowels for a week, yet eventually recover,
and cases extending two or even three weeks have ended favorably. As a
rule, however, they seldom last more than four or five days, many, in
fact, dying sooner than this.
The treatment consists of efforts to produce movement of the bowels and
to prevent inflammation of the same from arising. A large cathartic is
to be given as early as possible. Either of the following is
recommended: Powdered Barbados aloes 1 ounce, calomel 2 drams, and
powdered nux vomica 1 dram; or linseed oil 1 pint and croton oil 15
drops; or from 1 pint to 1 quart of castor oil may be given. Some favor
the administration of Epsom or Glauber's salt, 1 pound, with one-quarter
pound of common salt, claiming that this causes the horse to drink
largely of water, thus mechanically softening the impacted mass and
favoring its expulsion. Whichever physic is selected, it is essential
that a full dose be given. This is much better than small and repeated
doses. It must be borne in mind that horses require about twenty-four
hours in which to respond to a physic, and under no circumstances is it
to be repeated sooner. If aloes has been given and has failed to operate
at the proper time, oil or some different cathartic should then be
administered. Allow the horse all the water he will drink. Calomel may
be administered in half-dram doses, the powder being placed on the
tongue, one dose every two hours until four doses are given.
Enemas of glycerin, 2 to 4 ounces, are often beneficial. Rubbing or
kneading of the abdominal walls and the application of stimulating
liniments or strong mustard water also, at times, favor the expulsion of
this mass. Walking exercise must occasionally be given. If this
treatment is faithfully carried out from the start the majority of cases
will terminate favorably. When relief is not obtained inflammation of
the bowels may ensue and cause death.
_Constipation, or costiveness._--This is often witnessed in the horse,
and particularly in the foal. Many colts die every year from failure on
the part of the attendant to note the condition of the bowels soon after
birth. Whenever the foal fails to pass any feces, and in particular if
it presents any signs of colicky pains--straining, etc.--immediate
attention must be given it. As a rule, it will be necessary only to give
a few injections of soapy water in the rectum and to introduce the
finger through the anus to break down any hardened mass of dung found
there. If this is not effective a purgative must be given. Oils are the
best for these young animals, and preferably castor oil, giving from 2
to 4 ounces. The foal should always get the first of the mother's milk,
which, for a few days, possesses decidedly laxative properties. If a
mare, while suckling, is taking laudanum, morphin, atropia, or similar
medicines, the foal during this time should be fed by hand and the mare
milked upon the ground. Constipation in adult horses is often the result
of long feeding on dry, innutritious feed, deficiency of intestinal
secretions, scanty water supply, or lack of exercise. If the case is not
complicated with colicky symptoms a change to light, sloppy diet,
linseed gruel or tea, with plenty of exercise, is all that is required.
If colic exists a cathartic is needed. In very many instances the
constipated condition of the bowels is due to lack of intestinal
secretions, and when so caused may be treated by giving fluid extract of
belladonna in 2-dram doses three times a day and handful doses of Epsom
salt daily in the feed. It is always best, when possible, to overcome
this trouble by a change of diet rather than by the use of medicines.
For the relief of constipation such succulent feeds as roots, grass, or
green forage are recommended. Silage, however, should be fed sparingly,
and not at all unless it is in the very best condition. Moldy silage may
cause fatal disease.
_Foreign bodies (calculi, stones) in the stomach._--There are probably
but few symptoms exhibited by the horse that will lead one to suspect
the presence of gastric calculi, and possibly none by which we can
unmistakably assert their presence. They have been found most frequently
in millers' horses fed sweepings from the mills. A depraved and
capricious appetite is common in horses that have a stone forming in the
stomachs. There is a disposition to eat the woodwork of the stable,
earth, and, in fact, almost any substance within their reach. This
symptom must not, however, be considered as pathognomonic, since it is
observed when calculi are not present. Occasional colics may result from
these "stomach stones," and when the latter lodge at the outlet of the
stomach they may give rise to symptoms of engorged stomach, already
described. There is, of course, no treatment that will prove effective.
Remedies to move the bowels, to relieve pain, and to combat inflammation
should be given.
_Intestinal concretions (calculi or stones in the intestines)._--These
concretions are usually found in the large bowels, though they are
occasionally seen in the small intestines. They are of various sizes,
weighing from 1 ounce to 25 pounds; they may be single or multiple, and
differ in composition and appearance, some being soft (composed mostly
of animal or vegetable matter), while others are porous, or honeycombed
(consisting of animal and mineral matter), and others are entirely hard
and stonelike. The hair balls, so common to the stomach and intestines
of cattle, are very rare in horses. Intestinal calculi form around some
foreign body, as a rule--a nail or piece of wood--whose shape they may
assume to a certain extent. Layers are arranged concentrically around
such nucleus until the sizes above spoken of are attained. These stones
are also often found in millers' horses, as well also as in horses in
limestone districts, where the water is hard. When the calculi attain a
sufficient size and become lodged or blocked in some part of the
intestines, they cause obstruction, inflammation of the bowels, colicky
symptoms, and death. There are no certain signs or symptoms that reveal
them. Recurring colics of the type of impaction colic, but more severe,
may lead one to suspect the existence of this condition. Examination
through the rectum may reveal the calculus.
The symptoms will be those of obstruction of the bowels. Upon
post-mortem examinations these stones will be discovered mostly in the
large bowels; the intestines will be inflamed or gangrenous about the
point of obstruction. Sometimes calculi have been expelled by the action
of a physic, or they may be removed by the hand when found to occupy the
rectum.
As in concretions of the stomach, but little can be done in the way of
treatment more than to overcome spasm (if any exists), and to give
physics with the hope of dislodging the stone or stones and carrying
them on and outward.
_Intussusception, or invagination._--This is the slipping of a portion
of the intestine into another portion immediately adjoining, like a
partially turned glove finger. This may occur at any part of the bowels,
but is most frequent in the small guts. The invaginated portion may be
slight--2 or 3 inches only--or extensive, measuring as many feet. In
intussusception, the inturned bowel is in the direction of the anus.
There are adhesions of the intestines at this point, congestion,
inflammation, or even gangrene. This accident is most liable to occur in
horses that are suffering from spasm of the bowel, or in those in which
a small portion of the gut is paralyzed. The natural wormlike or
ringlike contraction of the gut favors the passage of the contracted or
paralyzed portion into that immediately behind it. It may occur during
the existence of almost any abdominal trouble, as diarrhea, inflammation
of the bowels, or from injuries, exposure to cold, etc. A fall or
leaping may give the initial maldirection. Foals are most likely to be
thus afflicted.
Unless the invaginated portion of the gut becomes strangulated, probably
no symptoms except constipation will be appreciable. Strangulation of
the bowel may take place suddenly, and the horse die within 24 hours, or
it may occur after several days--a week even--and death then follow.
There are no symptoms positively diagnostic. Colicky pains, more or less
severe and continuous, are observed, and at first there may be diarrhea,
followed by constipation. Severe straining occurs in some instances of
intussusception, and when this occurs it should receive due credit. As
death approaches, the horse sweats profusely, sighs, presents an anxious
countenance, the legs and ears become cold, and there is often freedom
from pain immediately before death. In some rare instances he recovers,
even though the invaginated portion of the gut has become strangulated.
In this case the imprisoned portion sloughs away so gradually that a
union has taken place between the intestines at the point where one
portion has slipped into that behind it. The piece sloughing off is
found passed with the manure. Such cases are exceedingly rare.
Nonirritating laxatives, such as castor oil, sweet oil, or calomel in
small doses, should be given. Soft feed and mucilaginous and nourishing
drinks should be given during these attacks. E. Mayhew Michener has
operated successfully on a foal with intussusception by opening the
abdomen and releasing the imprisoned gut.
_Volvulus, gut tie, or twisting of the bowels._--These are the terms
applied to the bowels when twisted or knotted. This accident is rather a
common one, and frequently results from the violent manner in which a
horse throws himself about when attacked by spasmodic colic. The
symptoms are the same as those of intussusception and obstructions of
the bowels; the same directions as to treatment are therefore to be
observed.
_Paralysis of the intestine._--This occurs in old, debilitated animals
that have been fed on coarse, innutritious fodder. This produces a
condition of dilatation so pronounced as to make it impossible for the
intestine to advance its contents, and so obstruction results. The
symptoms are as in other forms of obstruction colic. The history of the
case is of much service in diagnosing the trouble. The treatment
consists in the administration of laxatives. One may give 1 quart of raw
linseed oil and follow it the next day with 1 pound of Glauber's salt
dissolved in a quart of warm water. Strychnia may be given in doses of 1
grain two or three times daily. If the stagnant mass of feces is in the
rectum, it must be removed with the hand.
_Abnormal growths_, such as tumors or fibrous tissue, producing
contraction or stricture, may be causes of obstruction. The colic caused
by these conditions is chronic. The attacks occur at gradually
shortening intervals and become progressively more severe. Relief is
afforded by the use of purgatives that render the feces soft and thin
and thus enable them to pass the obstruction, but in time the contracted
place is liable to close so far that passage is impossible and the horse
will die.
FLATULENT COLIC (TYMPANITIC COLIC, WIND COLIC, OR BLOAT).--Among the
most frequent causes of this form of colic are to be mentioned sudden
changes of feed, too long fasting and feed then given while the animal
is exhausted, new hay or grain, large quantities of feed that is green
or that has lain in the manger for some time and become sour,
indigestible feed, irregular teeth, crib biting, and, in fact, anything
that produces indigestion may produce flatulent colic.
_Symptoms._--The symptoms of wind colic are not so suddenly developed
nor so severe as those of cramp colic. At first the horse is noticed to
be dull, paws slightly, and may or may not lie down. The pains from the
start are continuous. The belly enlarges, and by striking it in front of
the haunches a drumlike sound results. If not soon relieved the above
symptoms are aggravated, and in addition difficult breathing, bloodshot
eyes, and red mucous membranes, loud tumultuous heart beat, profuse
perspiration, trembling of front legs, sighing respiration, staggering
from side to side are noticed, and, finally, plunging forward dead. The
diagnostic symptom of flatulent colic is the distention of the bowels
with gas, detected by the bloated appearance and resonance on
percussion.
_Treatment._--The treatment for wind colic differs very greatly from
that of cramp colic. Absorbents are of some service, and charcoal may be
given in any quantity. Relaxants and antispasmodics are also beneficial
in this form of colic. Chloral hydrate not only possesses these
qualities, but it also is an antiferment and a pain reliever. It is,
then, particularly well adapted to the treatment of wind colic, and
should be given in the same-sized doses and in the manner directed for
spasmodic colic. Diluted alcohol or whisky may be given, or aromatic
spirits of ammonia in 1-ounce doses at short intervals.
A physic should always be given as early as possible in flatulent colic,
the best being Barbados aloes in the dose already mentioned. Injections,
per rectum, of turpentine 1 to 2 ounces, linseed oil 8 ounces, may be
given frequently to stimulate the peristaltic motion of the bowels and
to favor the escape of wind. Blankets wrung out of hot water do much to
afford relief; they should be renewed every 5 or 10 minutes and covered
with a dry woolen blanket. This form of colic is much more fatal than
cramp colic, and requires prompt and persistent treatment. It is
entirely unsafe to predict the result, some apparently mild attacks
going on to speedy death, while others that at the onset appear to be
very severe yielding rapidly to treatment. No efforts should be spared
until the animal is known to be dead. In these severe cases puncturing
of the bowels in the most prominent (distended) part by means of a small
trocar and cannula or with a needle of a hypodermic syringe, thus
allowing the escape of gas, has often saved life, and such punctures, if
made with a clean, sharp instrument that is not allowed to remain in the
horse too long, are accompanied with little danger and do more to
relieve the patient quickly than any other treatment.
SPASMODIC OR CRAMP COLIC.--This is the name given to that form of colic
produced by contraction, or spasm, of a portion of the small intestines.
It is produced by indigestible feed; large drinks of cold water when the
animal is warm; driving a heated horse through deep streams; cold rains;
drafts of cold air, etc. Unequal distribution of or interference with
the nervous supply here produces cramp of the bowels, the same as
external cramps are produced. Spasmodic colic is much more frequently
met with in high-bred, nervous horses than in coarse, lymphatic ones.
_Symptoms._--These should be carefully studied in order to diagnose this
from other forms of colic requiring quite different treatment. Spasmodic
colic always begins suddenly. If feeding, the horse is seen to stop
abruptly, stamp impatiently, and probably look back. He soon evinces
more acute pain, shown by pawing, suddenly lying down, rolling, and
getting up. During the period of pain the intestinal sounds, as heard by
applying the ear over the flank, are louder than in health. There is
then an interval of ease; he will resume feeding and appear to be
entirely well. In a little while, however, the pains return and are
increased in severity, only to pass off again for a time. As the attack
progresses these intervals of ease become shorter and shorter, and pain
may be continuous, though even then there are exacerbations of pain.
Animals suffering from this form of colic evince the most intense pain;
they throw themselves, roll over and over, jump up, whirl about, drop
down again, paw, or strike rather, with the front feet, steam and sweat,
and make frequent attempts to pass their urine. Only a small quantity of
water is passed at a time; this is due to the bladder being so
frequently emptied. These attempts to urinate are often regarded by
horsemen as symptoms of trouble of the kidneys or bladder. In reality
they are only one of the many ways in which the horse expresses the
presence of pain. As a matter of fact, diseases of the bladder or
kidneys of the horse are exceedingly rare.
To recapitulate the symptoms of spasmodic colic: The history of the
case, the type of horse, the suddenness of the attack, the increased
intestinal sounds, the intervals of ease (which become of shorter
duration as the case progresses), the violent pain, the normal
temperature and pulse during the intervals of ease, the frequent
attempts to urinate, etc., should be kept in mind, and there is then but
little danger of confounding this with other forms of colic.
_Treatment._--Since the pain is due to spasm or cramp of the bowels,
medicines that overcome spasms--antispasmodics--are the ones indicated.
Chloral hydrate may be used. This is to be given in a dose of 1 ounce in
a pint of water as a drench. As this drug is irritant to the throat and
stomach, it has to be well diluted. A common and good remedy is
sulphuric ether and laudanum, of each 2 ounces, in a half pint of
linseed oil. Another drench may be composed of 2 ounces each of
sulphuric ether and alcohol in 8 ounces of water. If nothing else is at
hand give whisky, one-half pint in hot water. Jamaica ginger is useful.
If relief is not obtained in one hour from any of the above doses, they
may then be repeated. The body should be warmly clothed and perspiration
induced. Blankets dipped in very hot water to which a small quantity of
turpentine has been added should be placed around the belly and covered
with dry blankets or the abdomen may be rubbed with stimulating
liniments or mustard water. The difficulty, however, of applying hot
blankets and keeping them in place forces us in most instances to
dispense with them. If the cramp is due to irritants in the bowels, a
cure is not complete until a cathartic of 1 ounce of aloes or 1 pint of
linseed oil is given. Injections of warm, soapy water or salt and water
into the rectum aid the cure.
Rectal injections, clysters, or enemas as a rule should be lukewarm, and
from 3 to 6 quarts are to be given at a time. They may be repeated every
half hour if necessary. Great care is to be taken not to injure the
rectum in giving such injections. A large syringe or a piece of rubber
hose 4 or 5 feet long, with a funnel attached at one end, affords the
best means by which to give them. The pipe of the syringe or the hose
introduced into the rectum must be blunt, rounded, and smooth; it is to
be thoroughly oiled and then carefully pushed through the anus in a
slightly upward direction. Much force must be avoided, for the rectum
may be lacerated and serious complications or even death result.
Exercise will aid the action of the bowels in this and similar colicky
troubles, but severe galloping or trotting is to be avoided. If the
horse can have a loose box or paddock, it is the best, as he will then
take what exercise he wants. If the patient is extremely violent, it is
often wise to restrain him by leading him with a halter, since rupture
of the stomach or displacement of the bowels may result and complicate
the trouble.
INDIGESTION OR GASTROINTESTINAL CATARRH.
From the facts that they merge insensibly into each other and usually
occur simultaneously, there is ample reason for considering these
conditions together. This condition may be acute--that is, of sudden
onset--or it may be chronic. The changes of structure produced by this
disease occur in the mucous membrane lining of the stomach and
intestines. This membrane becomes red from increased blood supply or
from hemorrhage into it, is swollen, and is covered by a coating of
slimy mucus. In some especially severe cases the membrane is destroyed
in spots, causing the appearance of ulcers or of erosions.
The causes of indigestion are numerous, but nearly all are the result of
errors in feeding.
Some horses are naturally endowed with weak digestive organs, and such
are predisposed to this condition. Anything that irritates the stomach
or intestines may cause this disease. Feeds that the animal is
unaccustomed to, sudden changes of diet, imperfectly cured, unripe, or
damaged feeds are all fruitful causes, and so are worms. In suckling
foals this condition may come from some disease of the dam that renders
her milk indigestible, or from overexertion or overheating of the mare.
Another prolific cause is bad teeth, making mastication imperfect, and
thus causing the horse to swallow his feed in a condition unfit for the
action of the digestive juices. Working a horse too soon or too hard
after feeding may cause either colic or indigestion. Any condition that
reduces the vitality, such as disease, overwork, poor feed, or lack of
care, may directly bring on indigestion by weakening the digestive
organs.
_Symptoms._--Indigestion is characterized by irregular appetite;
refusing all feed at times, and at others eating ravenously; the
appetite is not only irregular, but is often depraved; there is a
disposition on the part of the horse to eat unusual substances, such as
wood, soiled bedding, or even his own feces; the bowels are irregular
to-day, loose and bad smelling, to-morrow bound; whole grain is often
passed in the feces, and the hay passed in balls or impacted masses,
undergoing but little change; the horse frequently passes considerable
quantities of sour-smelling wind. The animal loses flesh, the skin
presents a hard, dry appearance and seems very tight (hidebound). If the
stomach is very seriously involved, the horse may yawn by stretching
the head forward and upward and by turning the upper lip outward. There
may be more or less colicky pain. In the chronic cases there is mental
depression; the horse is sluggish and dull. The abdomen gradually
becomes small, giving a "tucked up" appearance, or, on the other hand,
it becomes flaccid and pendulous.
_Treatment._--One should commence with the feed--its quality, quantity,
and time of feeding; examine the water supply, and see, besides, that it
is given before feeding; then carefully observe the condition of the
mouth and teeth; and, continuing the observations as best we may,
endeavor to find the seat of the trouble. If the teeth are sharp or
irregular they must be rasped down; if any are decayed they must be
extracted; if indigestion is due to ravenous eating or bolting, the feed
must then be given from a large manger where the grain can be spread and
the horse thus compelled to eat slowly.
Any irritation, such as worms, undigested feed, etc., that is operating
as a cause is to be removed by appropriate treatment, as advised
elsewhere. If there is a tendency to distention of the stomach and
bowels, with gas, during indigestion, the following may be used: Baking
soda, powdered ginger, and powdered gentian, equal parts. These are to
be thoroughly mixed and given in heaping tablespoonful doses, twice a
day, before feeding. This powder is best given by dissolving the
above-named quantity in a half pint of water and given as a drench.
As a digestive tonic the following is good: Glauber's salt, 2 pounds;
common salt, 1 pound; baking soda, one-half pound. Of this a heaping
tablespoonful may be given in each feed. If diarrhea exists, the
treatment advised below may be used.
DIARRHEA.
Diarrhea is due to indigestion or intestinal catarrh or to irritation of
the bowels from eating moldy or musty feed, drinking stagnant water,
diseased condition of the teeth, eating irritating substances, to being
kept on low, marshy pastures, and to exposure during cold nights, or in
low, damp stables. Some horses are predisposed to scour and are called
"washy" by horsemen; they are those with long bodies, long legs, and
narrow, flat sides. Horses of this build are almost sure to scour if fed
or watered immediately before being put to work. Fast or road work, of
course, aggravates this trouble. Diarrhea may exist as a complication of
other diseases, as pneumonia and influenza, for instance, and again
during the diseases of the liver.
The symptoms are the frequent evacuations of liquid stools, with or
without pronounced abdominal pain, loss of appetite, emaciation, etc.
_Treatment_ is at times very simple, but requires the utmost care and
judgment. If due to faulty feed or water it is sufficient to change
these. If it results from some irritant in the intestines this is best
gotten rid of by the administration of an oleaginous purge, for which
nothing is better than castor oil, although raw linseed oil may be used
if the case is not severe. The diarrhea often disappears with the
cessation of the operation of the medicine. If, however, purging
continues it may be checked by giving wheat flour in water, starch
water, white-oak bark tea, chalk, opium, or half-dram doses of sulphuric
acid in one-half pint of water twice or thrice daily. Good results
follow the use of powdered opium 2 drams and subnitrate of bismuth 1
ounce, repeated three times a day. In all cases it should be remembered
to look to the water and feed the horse is receiving. If either of these
is at fault it is at once to be discontinued. We should feed sparingly
of good, easily digested feeds. With that peculiar build of nervous
horses that scour on the road but little can be done as a rule. They
should be watered and fed as long as possible before going on a drive.
If there is much flatulency accompanying diarrhea baking soda or other
alkaline medicines may effect a cure, while if the discharges have a
very disagreeable odor it may be corrected by 1 ounce of sulphite of
soda or dram doses of creolin in water, repeated twice a day. Be slow to
resort to either the vegetable or mineral astringents, since the
majority of cases will yield to change of feed and water or the
administration of oils. Afterwards feed upon wheat-flour gruel or other
light feeds. The body should be warmly clothed.
SUPERPURGATION.--This is the designation of that diarrhea, or flux from
the bowels, that, at times, is induced by and follows the action of a
physic. It is accompanied with much irritation or even inflammation of
the bowels and is always of a serious character. Although in rare
instances it follows from a usual dose of physic and where every
precaution has been taken, it is most likely to result under the
following circumstances: Too large a dose of physic; giving physics to
horses suffering from pneumonia, influenza, or other debilitating
diseases; riding or driving a horse when purging; exposure or drafts of
cold air; or giving large quantities of cold water while the physic is
operating. There is always danger of superpurgation if a physic is given
to a horse suffering from diseases of the respiratory organs. Small and
often-repeated physics are also to be avoided, as they produce debility
and great depression of the system and predispose to this disorder. When
a physic is to be given one should rest the horse and give him sloppy
feed until the medicine begins to operate; clothe the body with a warm
blanket; keep out of drafts; give only warm water in small quantities.
After a horse has purged from twelve to twenty-four hours it can mostly
be stopped, or "set," as horsemen say, by feeding on dry oats and hay.
Should the purging continue, however, it is best treated by giving
demulcent drinks--linseed tea and oatmeal or wheat-flour gruel. After
this the astringents spoken of for diarrhea may be given. Besides this
the horse is to receive brandy in doses of from 2 to 4 ounces, with milk
and eggs, four or five times a day.
Laminitis ("founder") is a frequent sequel of superpurgation and is to
be guarded against by removing the shoes and standing the horse on moist
sawdust or some similar bedding.
DYSENTERY.
This disease, sometimes called "bloody flux," is an intestinal disease
attended with fever, occasional abdominal pains, and fluid discharges
mingled with blood. Discharges in dysentery are coffee colored or
bloody, liquid, and very offensive in odor, and passed with much
straining. It is rare in the horse, but is sometimes quite prevalent
among foals.
_Causes._--Probably the most common cause is keeping young horses in
particular for a long time on low, wet, marshy pastures, without other
feed (a diarrhea of long standing sometimes terminates in dysentery);
exposure during cold, wet weather; decomposed feeds; stagnant water that
contains large quantities of decomposing vegetable matter; low, damp,
and dark stables, particularly if crowded; the existence of some
disease, as tuberculosis of the abdominal form. In suckling foals it may
come from feeding the dam on irritant feeds or from disease of the
udder. In other foals it may be produced by exposure to cold and damp,
to irritant feed, or to worms.
_Symptoms._--The initial symptom is a chill, which probably escapes
notice in the majority of instances. The discharges are offensive and
for the most part liquid, although it is common to find lumps of solid
fecal matter floating in this liquid portion; shreds of mucous membrane
and blood may be passed or the evacuations may be mucopurulent; there is
much straining, and, rarely, symptoms of abdominal pain; the subject
lies down a great deal; the pulse is quickened and the temperature
elevated. Thirst is a prominent symptom. In the adult, death rarely
follows under two to three weeks, but in foals the disease may end in
death after a few days.
_Treatment._--This is most unsatisfactory, and I am inclined to place
more dependence upon the care and feed than any medication that may be
adopted. First of all the horse must be placed in a dry, warm, yet
well-ventilated stable; the skin is to receive attention by frequent
rubbings of the surface of the body, with blankets, and bandages to the
legs. The water must be pure and given in small quantities; the feed,
that which is light and easily digested. Medicinally, give at first a
light dose of castor oil, about one-half pint, to which has been added 2
ounces of laudanum. The vegetable or mineral astringents are also to be
given. Starch injections containing laudanum often afford great relief.
The strength must be kept up by milk punches, eggs, beef tea, oatmeal
gruel, etc. In spite of the best care and treatment, however, dysentery
is likely to prove fatal. In the case of nurslings, the dam should be
placed in a healthy condition or, failing in this, milk should be had
from another mare or from a cow.
GASTROENTERITIS.
This condition consists in an inflammation of the stomach and
intestines. Instead of being confined to the mucous, or lining,
membrane, as in gastrointestinal catarrh, the inflammatory process
extends deeper and may even involve the entire thickness of the wall of
the organ.
This disease may be caused by irritant feed, hot drinks, sudden
chilling, moldy or decayed feeds, foul water, parasites, or by chemical
poisons. It may also complicate some general diseases, especially
infectious diseases, as anthrax, influenza, rabies, or petechial fever.
Long-continued obstruction of the bowels or displacement resulting in
death are preceded by enteritis.
_Symptoms._--The symptoms differ somewhat with the cause and depend
also, to some extent, upon the chief location of the inflammation. In
general the animal stops eating or eats but little; it shows colicky
pain; fever develops; the pulse and respiration become rapid; the mucous
membrane becomes red; the mouth is hot and dry. Pressure upon the
abdomen may cause pain. Intestinal sounds can not be heard at the flank.
There is constipation in the earlier stages that is, followed later by
diarrhea. The extremities become cold. Sometimes the feces are coated
with or contain shreds of fibrin, looking like scraps of dead membrane,
and they have an evil, putrid odor. If the disease is caused by moldy or
damaged feed there may be great muscular weakness, with partial
paralysis of the throat, as shown by inability to swallow. If chemical
poisons are the cause, this fact may be shown by the sudden onset of the
disease, the history of the administration of a poison or the entire
absence of known cause, the rapid development of threatening symptoms,
the involvement of a series of animals in the absence of a contagious
disease, and the special symptoms and alterations known to be produced
by certain poisons. To make this chain of evidence complete, the poison
may be discovered in the organs of the horse by chemical analysis. In
nearly all cases of gastro-enteritis there is nervous depression.
The poisons that are most irritant to the digestive tract are arsenic,
corrosive sublimate, sugar of lead, sulphate of copper, sulphate or
chlorid of zinc, lye, or other strong alkalies, mineral acids, and,
among the vegetable poisons, tobacco, lobelia, and water hemlock.
_Treatment._--The treatment will depend upon the cause, but if this can
not be detected, certain general indications may be observed. In all
cases feed should be given in small amounts and should be of the most
soothing description, as oatmeal gruel, flaxseed tea, hay tea, fresh
grass, or rice water. The skin should be well rubbed with alcohol and
wisps of straw, to equalize the distribution of the blood; the legs,
after being rubbed until warm, should be bandaged in raw cotton or with
woolen bandages. The horse should be warmly blanketed. It is well to
apply to the abdomen blankets wrung out of hot water and frequently
changed; or mustard paste may be rubbed on the skin of the belly.
Internally, opium is of service to allay pain, check secretion, and
soothe the inflamed membrane. The dose is from 1 to 2 drams, given every
three of four hours. If there is constipation, the opium should be mixed
with 30 grains of calomel. Subnitrate of bismuth may be given with the
opium or separately in 2-dram doses. Stimulants, such as alcohol,
aromatic spirits of ammonia, or camphor may be given in 2-ounce doses,
mixed with warm water to make a drench.
If putrid feed has been consumed, creolin may be administered in doses
of 2 drams, mixed with 1 pint of warm water or milk. If there is
obstinate constipation and if a laxative must be employed, it should be
sweet or castor oil, from 1 pint to 1 quart.
_Antidotes for poisons._--For the various poisons the remedies are as
follows:
Arsenic: Oxyhydrate of iron solution, 1 pint to 1 quart; or calcined
magnesia, one-half ounce in 1 pint of water.
Corrosive sublimate (bichlorid of mercury): The whites of a dozen eggs,
or 2 ounces of flowers of sulphur.
Sugar of lead: Glauber's salt, 1 pound in 1 quart of warm water; to be
followed with iodid of potash, 3 drams at a dose, in water, three times
daily for five days.
Sulphate of copper: Milk, the whites of eggs, or reduced iron.
Sulphate or chlorid of zinc: Milk, the whites of eggs, or calcined
magnesia.
Lye or alkalies, as caustic potash or soda: Vinegar, dilute sulphuric
acid, and linseed tea, with opium, 3 drams.
Mineral acids: Chalk, or calcined magnesia, or baking soda; later give
linseed tea and opium.
HEMORRHOIDS, OR PILES.
These are rare, comparatively, in horses. They are diagnosed by the
appearance of bright-red irregular tumors after defecation, which may
remain visible at all times or be seen only when the horse is down or
after passing his manure. They are mostly due to constipation,
irritation, or injuries, or follow from the severe straining during
dysentery. I have observed them to follow from severe labor pains in the
mare.
_Treatment._--Attention must be paid to the condition of the bowels;
they should be soft, but purging is to be avoided. The tumors should be
washed in warm water and thoroughly cleansed, after which scarify them
and gently but firmly squeeze out the liquid that will be seen to follow
the shallow incisions. After thus squeezing these tumors and before
replacing through the anus, bathe the parts with some anodyn wash. For
this purpose the glycerite of tannin and laudanum in equal parts is
good. Mucilaginous injections into the rectum may be of service for a
few days.
HERNIA, OR RUPTURE.
There are several kinds or hernias that require notice, not all of
which, however, produce serious symptoms or results. Abdominal hernias,
or ruptures, are divided into reducible, irreducible, and strangulated,
according to condition; and into inguinal, scrotal, ventral, umbilical,
and diaphragmatic, according to their situation. A hernia is reducible
when the displaced organ can be returned to its natural location. It
consists of a soft swelling, without heat, pain, or any uneasiness,
generally larger on full feed, and decreases in size as the bowels
become empty. An irreducible hernia is one that can not be returned into
the abdomen, and yet does not cause any pain or uneasiness. Strangulated
hernia is one in which the contents of the sac are greatly distended, or
when from pressure upon the blood vessels of the imprisoned portion the
venous circulation is checked or stopped, thereby causing congestion,
swelling, inflammation, and, if not relieved, gangrene of the part and
death of the animal. According to the time or mode of origin, hernias
may be congenital or acquired.
CONGENITAL SCROTAL HERNIA.--Not a few foals are noticed from birth to
have an enlarged scrotum, which gradually increases in size until about
the sixth month, sometimes longer. Sometimes the scrotum of a
six-months-old colt is as large as that of an adult stallion, and
operative treatment is considered. This is unnecessary in the great
majority of cases, as the enlargement often disappears by the time the
colt has reached his second year. Any interference, medicinal or
surgical, is worse than useless. If the intestine contained within the
scrotum should at any time become strangulated, it must then be treated
the same as in an adult horse.
SCROTAL HERNIA is caused by dilatation of the sheath of the testicle,
combined with relaxation of the fibrous tissues surrounding the inguinal
ring, thus allowing the intestine to descend to the scrotum. At first
this is intermittent, appearing during work and returning when the horse
is at rest. For a long time this form of hernia may not cause the least
uneasiness or distress. In course of time, however, the imprisoned gut
becomes filled with feces, its return into the abdominal cavity is
prevented, and it becomes strangulated. While the gut is thus filling
the horse often appears dull, is disinclined to move, appetite is
impaired, and there is rumbling and obstruction of the bowels. Colicky
symptoms now supervene. Strangulation and its consequent train of
symptoms do not always follow in scrotal hernia, for often horses have
this condition for years without suffering inconvenience.
INGUINAL HERNIA is but an incomplete scrotal hernia, and, like the
latter, may exist and cause no signs of distress, or, again, it may
become strangulated and cause death. Inguinal hernia is seen mostly in
stallions, next in geldings, and very rarely in the mare. Bearing in
mind that scrotal hernia is seen only in entire horses, we may proceed
to detail the symptoms of strangulated, inguinal, and scrotal hernia at
the same time. When, during the existence of colicky symptoms, we find a
horse kicking with his hind feet while standing or lying upon his back,
we should look to the inguinal region and scrotum. If scrotal hernia
exists, the scrotum will be enlarged and lobulated; by pressure we may
force a portion of the contents of the gut back into the abdomen,
eliciting a gurgling sound. If we take a gentle but firm hold upon the
enlarged scrotum and then have an assistant cause the horse to cough,
the swelling will be felt to expand and as quickly contract again.
The history of these cases will materially aid us, as the owner can
often assure us of preceding attacks of "colic," more or less severe,
that have been instantaneously relieved in some (to him) unaccountable
manner. The colicky symptoms of these hernias are not diagnostic, but,
probably, more closely resemble those of enteritis than any other bowel
diseases. In many cases the diagnosis can be made only by a
veterinarian, when he has recourse to a rectal examination; the bowels
can here be felt entering the internal abdominal ring.
_Treatment of inguinal hernia._--If the reader is sure of the existence
of hernia, he should secure the horse upon its back, and, with a hand in
the rectum, endeavor to catch hold of the wandering bowel and pull it
gently back into the cavity of the abdomen. Pressure should be made upon
the scrotum during this time. If this fails, a veterinarian must be
called to reduce the hernia by means of incising the inguinal ring,
replacing the intestines, and to castrate, using clamps and performing
the "covered operation."
VENTRAL HERNIA.--In this form of hernia the protrusion is through some
accidental opening or rupture of the abdominal wall. It may occur at any
part of the belly except at the umbilicus, and is caused by kicks,
blows, hooks, severe jumping or pulling, etc. Ventral hernia is most
common in pregnant mares, and is here due to the weight of the fetus or
to some degenerative changes taking place in the abdominal coats. It is
recognized by the appearance of a swelling, at the base of which can be
felt the opening or rent in the abdominal tunics, and from the fact that
the swelling containing the intestines can be made to disappear when the
animal is placed in a favorable position.
_Treatment of ventral hernia._--In many instances there is no occasion
for treatment, and again, where the hernial sac is extensive, treatment
is of no avail. If the hernia is small, a cure may be attempted by the
methods to be described in treating of umbilical hernia. If one is
fortunate enough to be present when the hernia occurs, and particularly
if it is not too large, he may, by the proper application of a pad and
broad bandage, effect a perfect cure.
UMBILICAL HERNIA is the passing of any portion of the bowel or omentum
("caul") through the navel, forming a "tumor" at this point. This is
often congenital in our animals, and is due to the imperfect closure of
the umbilicus and to the position of the body. Many cases of umbilical
hernia, like inguinal and scrotal of the congenital kind, disappear
entirely by the time the animal reaches its second or third year.
Advancing age favors cure in these cases from the fact that the omentum
(swinging support of the bowels) is proportionally shorter in adults
than in foals, thus lifting the intestines out of the hernial sac and
allowing the opening in the walls to close. Probably one of the most
frequent causes of umbilical hernia in foals is the practice of keeping
them too long from their dams, causing them to fret and worry, and to
neigh, or cry, by the hour. The contraction of the abdominal muscles and
pressure of the intestines during neighing seem to open the umbilicus
and induce hernia. Accidents may cause umbilical hernia in adults in the
same manner as ventral hernia is produced, though this is very rare.
_Treatment of umbilical hernia._--In the treatment of umbilical hernia
it should be remembered that congenital hernias are often removed with
age, but probably congenital _umbilical hernias_ less frequently than
others. Among the many plans of treatment are to be mentioned the
application of a pad over the tumor, the pad being held in place by a
broad, tight bandage placed around the animal's body. The chief
objection to this is the difficulty in keeping the pad in its place.
Blisters are often applied over the swelling, and, as the skin hardens
and contracts by the formation of scabs, an artificial bandage or
pressure is produced that at times is successful. Another treatment that
has gained considerable repute of late years consists in first clipping
off the hair over the swelling. Nitric acid is then applied with a small
brush, using only enough to moisten the skin. This sets up a
deep-seated, adhesive inflammation, which, in very many cases, closes
the opening in the navel. Still another plan is to inject a solution of
common salt by means of the hypodermic syringe at three or four points
about the base of the swelling. This acts in the same manner as the
preceding, but may cause serious injury if the syringe or solution is
not sterile.
Others, again, after keeping the animal fasting for a few hours, cast
and secure it upon its back; the bowel is then carefully returned into
the abdomen. The skin over the opening is pinched up and one or two
skewers are run through the skin from side to side as close as possible
to the umbilical opening. These skewers are kept in place by passing a
cord around the skin between them and the abdomen and securely tying it.
Great care must be taken not to draw these cords too tight, as this
would cause a speedy slough of the skin, the intestines would extrude,
and death result. If properly applied, an adhesion is established
between the skin and the umbilicus, which effectually closes the
orifice. Special clamps are provided for taking up the fold of the skin
covering the hernial sac and holding it until the adhesion is formed.
DIAPHRAGMATIC HERNIA.--This consists of the passage of any of the
abdominal viscera through a rent in the diaphragm (midriff) into the
cavity of the thorax. It is a rather rare accident, and one often
impossible to diagnose during life. Colicky symptoms, accompanied with
great difficulty in breathing, and the peculiar position so often
assumed (that of sitting upon the haunches), are somewhat characteristic
of this trouble, though these symptoms, as we have already seen, may be
present during diseases of the stomach or anterior portion of the
bowels. Even could we diagnose with certainty this form of hernia, there
is little or nothing that can be done. Leading the horse up a very steep
gangway or causing him to rear up may possibly cause the hernial portion
to return to its natural position. This is not enough, however; it must
be kept there.
PERITONITIS.
Peritonitis is an inflammation of the serous membrane lining the cavity
of and covering the viscera contained within the abdomen. It is very
rare to see a case of primary peritonitis. It is, however, somewhat
common as a secondary disease from extension of the inflammatory action
involving organs covered by the peritoneum. Peritonitis is often caused
by injuries, as punctured wounds of the abdomen, severe blows or kicks,
or, as is still more common, following the operation of castration. It
follows strangulated hernia, invagination, or rupture of the stomach,
intestines, liver, or womb.
_Symptoms._--Peritonitis is mostly preceded by a chill; the horse is not
disposed to move, and, if compelled to do so, moves with a stiff or sore
gait; he paws with the front feet and may strike at his belly with the
hind ones; lies down very carefully; as the pain is increased while
down, he maintains the standing position during most of the time; he
walks uneasily about the stall. Constipation is usually present.
Pressure on the belly causes acute pain, and the horse will bite,
strike, or kick if so disturbed; the abdomen is tucked up; the
extremities are fine and cold. The temperature is higher than normal,
reaching from 102° to 104° F. The pulse in peritonitis is rather
characteristic; it is quickened, beating from 70 to 90 beats a minute,
and is hard and wiry. This peculiarity of the pulse occurs in
inflammation of the serous membrane, and if accompanied with colicky
symptoms, and, in particular, if following any injuries, accidental or
surgical, of the peritoneum, there is reason to think that peritonitis
is present. Peritonitis in the horse is mostly fatal when it is at all
extensive. If death does not occur in a short time, the inflammation
assumes a chronic form, in which there is an extensive effusion of water
in the cavity of the belly, constituting what is known as ascites, and
which, as a rule, results in death.
_Treatment._--The treatment of peritonitis is somewhat like that of
enteritis. Opium in powder, 1 to 2 drams, with calomel, one-half dram,
is to be given every two, three, or four hours, and constitutes the main
dependence in this disease. Extensive counterirritants over the belly,
consisting of mustard plasters, applications of mercurial ointment,
turpentine stupes, or even mild blisters, are recommended. Purgatives
must never be given during this complaint. Should we desire to move the
bowels, it can be done by gentle enemas, though it is seldom necessary
to resort even to this.
ASCITES, OR DROPSY OF THE ABDOMEN.
This is seen as a result of subacute or chronic peritonitis, but may be
due to diseases of the liver, kidneys, heart, or lungs. There will be
found, on opening the cavity of the belly, a large collection of
yellowish or reddish liquid; from a few quarts to several gallons may be
present. It may be clear in color, though generally it is yellowish or
of a red tint, and contains numerous loose flakes of coagulable lymph.
_Symptoms._--There is slight tenderness on pressure; awkward gait of the
hind legs; the horse is dull, and may have occasional very slight
colicky pains, shown by looking back and striking at the belly with the
hind feet. Oftener, however, these colicky symptoms are absent. Diarrhea
often precedes death, but during the progress of the disease the bowels
are alternately constipated and loose. On percussing the abdominal walls
we find that dullness exists to the same height on both sides of the
belly; by suddenly pushing or striking the abdomen we can hear the
rushing or flooding of water. If the case is an advanced one, the horse
is potbellied in the extreme, and dropsical swellings are seen under the
belly and upon the legs.
Treatment is, as a rule, unsatisfactory. Saline cathartics, as Epsom or
Glauber's salt, and diuretics, ounce doses of saltpeter, may be given.
If a veterinarian is at hand he will withdraw the accumulation of water
by tapping and then endeavor to prevent its recurrence (though this is
almost sure to follow) by giving three times a day saltpeter 1 ounce and
iodid of potash 1 dram, and by the application of mustard or blisters
over the abdominal walls. Tonics, mineral and vegetable, are also
indicated. Probably the best tonic is one consisting of powdered
sulphate of iron, gentian, and ginger in equal parts; a heaping
tablespoonful of the mixture is given as a drench or mixed with the
feed, twice a day. Good nutritious feeds and gentle exercise complete
the treatment.
DISEASES OF THE LIVER.
In the United States the liver of the horse is but rarely the seat of
disease, and when we consider how frequently the liver of man is
affected this can not but appear strange. The absence of the gall
bladder may account to a certain extent for his freedom from liver
diseases, as overdistention of this and the presence in it of calculi
(stones) in man is a frequent source of trouble. In domestic animals, as
in man, hot climates tend to produce diseases of the liver, just as in
cold climates lung diseases prevail. Not only are diseases of the liver
rare in horses in temperate climates, but they are also very obscure,
and in many cases pass totally unobserved until after death. There are
some symptoms, however, which, when present, should make us examine the
liver as carefully as possible. These are jaundice (yellowness of the
mucous membranes of the mouth, nose, and eyes) and the condition of the
dung, it being light in color and pasty in appearance.
HEPATITIS, OR INFLAMMATION OF THE LIVER.
This disease may be general or local, and may assume an acute or chronic
form.
_Symptoms._--The symptoms of acute hepatitis are: Dullness; the horse is
suffering from some internal pain, but not of a severe type; constipated
and clay-colored dung balls; scanty and high-colored urine; and general
febrile symptoms. If lying down, he is mostly found on the left side;
looks occasionally toward the right side, which, upon close inspection,
may be found to be slightly enlarged over the posterior ribs, where pain
upon pressure is also evinced. Obscure lameness in front, of the right
leg mostly, may be a symptom of hepatitis. The horse, toward the last,
reels or staggers in his gait and falls backward in a fainting fit,
during one of which he finally succumbs. Death is sometimes due to
rupture of the enveloping coat of the liver or of some of its blood
vessels.
_Causes._--Among the causes that lead to this disease we must mention
first the stimulating effect of overfeeding, particularly during hot
weather. Horses that are well fed and receive but little exercise are
the best subjects for diseases of this organ. We must add to these
causes the more mechanical ones, as injuries on the right side over the
liver, worms in the liver, gallstones in the biliary ducts, foreign
bodies--as needles or nails that have been swallowed and in their
wanderings have entered the liver--and, lastly, in some instances, the
extension of inflammation from neighboring parts, thus involving this
organ. Acute hepatitis may terminate in chronic inflammation, abscesses,
rupture of the liver, or may disappear, leaving behind no trace of
disease whatever.
_Treatment._--This should consist, at first, of the administration of 1
ounce of Barbados aloes or other physic. General blood-letting, if had
recourse to early, must prove of much benefit in acute inflammation of
the liver. The vein in the neck (jugular) must be opened, and from 4 to
6 quarts of blood may be drawn. Saline medicines, as Glauber's salt or
the artificial Carlsbad salt, are indicated. These may be given with the
feed in tablespoonful doses. The horse is to be fed sparingly on soft
feed, bran mashes chiefly. If treatment proves successful and recovery
takes place, see to it that the horse afterwards gets regular exercise
and that his feed is not of a too highly nutritious character and not
excessive.
JAUNDICE, ICTERUS, OR THE YELLOWS.
This is a condition caused by the retention and absorption of bile into
the blood. It was formerly considered to be a disease of itself, but is
now regarded as a symptom of disorder of the liver. "The yellows" is
observed by looking at the eyes, nose, and mouth, when it will be seen
that these parts are yellowish instead of the pale-pink color of health.
In white or light-colored horses the skin even may show this yellow
tint. The urine is saffron colored, the dung is of a dirty-gray color,
and constipation is usually present. Jaundice may be present as a
symptom of almost any inflammatory disease. We know that when an animal
has fever the secretions are checked, the bile may be retained and
absorbed throughout the system, and yellowness of the mucous membranes
follows. Jaundice may also exist during the presence of simple
constipation, hepatitis, biliary calculi, abscesses, hardening of the
liver, etc.
_Treatment._--When jaundice exists we must endeavor to rid the system of
the excess of bile, and this is best accomplished by giving purgatives
that act upon the liver. Calomel, 2 drams, with aloes, 7 drams, should
be given. Glauber's salt in handful doses once or twice a day for a week
is also effective. May apple, rhubarb, castor oil, and other cathartics
that act upon the first or small bowels may be selected. We must be
careful to see that the bowels are kept open by avoiding hard, dry,
bulky feeds.
RUPTURE OF THE LIVER.
This is known to occur at times in the horse, most frequently in old,
fat horses and those that get but little exercise. Horses that have
suffered from chronic liver disease for years eventually present
symptoms of colic and die quite suddenly. Upon post-mortem examination
we discover that the liver has ruptured. The cicatrices, or scars, that
are often found upon the liver indicate that this organ may suffer
_small_ rupture and yet the horse may recover from it. This can not be
the result, however, if the rent or tear is extensive, since in such
cases death must quickly follow from hemorrhage, or, later, from
peritonitis. Enlarged liver is particularly liable to rupture.
The immediate causes of rupture appear to be excessive muscular
exertion, as leaping a fence, a fall, a blow from a collision, a kick
from a horse, or sudden distention of the abdomen with gas.
The symptoms of rupture of the liver will depend upon the extent of the
laceration. If slight, there will be simply the symptoms of abdominal
pain, looking back to the sides, lying down, etc.; if extensive, the
horse is dull and dejected, has no appetite, breathing becomes short and
catching, he sighs or sobs, visible mucous membranes are pale,
extremities cold, pulse fast, small, and weak or running down.
Countenance now shows much distress, he sweats profusely, totters in his
gait, props his legs wide apart, reels, staggers, and falls. He may get
up again, but soon falls dead. The rapid running-down pulse, paleness of
the eyes, nose, and mouth, sighing, stertorous breathing, tottering
gait, etc., are symptoms by which we know that the animal is dying from
internal hemorrhage.
_Treatment._--But little can be done in the way of treatment. Opium in
powder, in doses of 2 drams every two or three hours, may be given, with
the idea of preventing as much as possible all movements of internal
organs. If there is reason to suspect internal bleeding, we should give
large and frequent doses of white-oak bark tea, dram doses of tannic or
gallic acid, or the same quantity of sugar of lead, every half hour or
hour. Fluid extract of ergot or tincture of the chlorid of iron, in
ounce doses, may be selected. Cold water dashed upon the right side or
injected into the rectum is highly spoken of as a means of checking the
hemorrhage.
BILIARY CALCULI, OR GALLSTONES.
These are rarely found in the horse, but may occupy the hepatic ducts,
giving rise to jaundice and to colicky pains. There are no absolutely
diagnostic symptoms, but should one find a horse that suffers from
repeated attacks of colic, accompanied with symptoms of violent pain,
and that during or following these attacks the animal is jaundiced, it
is possible that gallstones are present. There is little or nothing to
be done except to give medicines to overcome pain, trusting that these
concretions may pass on to the bowels, where, from their small size,
they will not occasion any inconvenience.
DISEASES OF THE PANCREAS AND SPLEEN.
Diseases of the pancreas and spleen are so rare, or their symptoms so
little understood, that it is impossible to write anything concerning
either of these organs and their simple diseases that will convey to the
reader information of practical value.
GASTROINTESTINAL PARASITES.
[By Maurice C. Hall, Ph. D., D. V. M.]
Horses are subject to infestation by a number of species of worms, these
worms being especially numerous at certain points in the alimentary
canal.
The tapeworms of the horse are relatively unimportant and not very
common. There are three species, the smallest about two inches long and
the largest about eight inches long. These two occur in the small
intestine; a form intermediate in size may also be found in the cecum
and colon. These are flat, segmented worms with the head at the smaller
end.
Flukes occur in horses elsewhere, but have apparently never been
reported in the United States.
Roundworms, or nematodes, constitute the most important group of
parasitic worms in the horse. The more important of these are as
follows:
ROUNDWORM (_Ascaris equorum_).--This is the common large, yellowish
roundworm (Pl. V, fig. 5), about the size of a lead pencil or larger,
which may be found in horses almost anywhere in the United States. It
occurs in the intestine and probably occasions little damage as a rule,
except when present in large numbers, in which case it will probably be
found in the droppings. The symptoms occasioned by it are rather obscure
and are such as might arise from a number of other causes, namely,
colicky pains, depraved appetite, diarrhea or constipation, and general
unthriftiness. In a general way, the presence of parasites may be
suspected when an animal shows no fever but is unthrifty, debilitated,
and shows disordered bowel movements in cases where there is no evident
explanation in the way of feed, care, and surroundings.
_Treatment_ for the removal of this worm consists in the use of
anthelmintics such as tartar emetic, turpentine, and carbon bisulphid,
but as these remedies are essentially poisons intended to kill the worm,
and as their use by persons unused to determining conditions unfavorable
for their use is dangerous and likely to result in the death of the
animal or in permanent injury to the kidneys or other organs, it is
advisable to call in a veterinarian in such cases.
PINWORM (_Oxyuris equi_).--This is a rather large worm (Pl. V, fig. 1),
somewhat smaller than the foregoing and readily distinguishable from it
by the presence of a long, slender tail. It also occurs generally
throughout the United States, and except when present in large numbers
probably does very little damage. It inhabits the large intestine and
hence is difficult to reach with medicines administered by the mouth.
The use of a half ounce of gentian on the feed night and morning for a
week has been recommended, but the use of rectal enemas will give more
prompt and perhaps more certain results. These enemas may be made up
with one or two tablespoonfuls of salt to the pint, or infusions of
quassia chips, a half pound to the gallon of water, and injected into
the rectum once or twice a day.
STOMACH WORMS OF THE HORSE (_Habronema_ spp.).--These worms (Pl. V, fig.
4) occur in nodules in the mucous lining of the horse's stomach and are
credited with doing more or less damage. Their presence is not likely to
be diagnosed in the present state of our knowledge, but in case their
presence is determined or suspected in connection with the summer sores
noted later, tartar emetic is recommended. At least one of these worms
has an intermediate stage in the ordinary housefly, the fly becoming
infested while it is a larva developing in horse manure. Obviously,
therefore, any measures looking toward the eradication of the fly or the
proper disposal of manure will aid in the control and eradication of
this worm. The United States Bureau of Entomology has shown that fly
maggots travel downward through a manure pile as it comes time for the
maggot to enter the ground and pupate, and an excellent maggot trap,
consisting of an exposed manure platform raised on posts which are set
in a concrete basin extending under the platform and filled with three
or four inches of water, has been devised. As maggots work down they
come to the platform and escape through the spaces between the boards,
left open for the purpose, to the water in the concrete basin, where
they are drowned. In this way the exposed manure pile serves to attract
flies with a deceptive proffer of a breeding place.
Apparently it is the young forms of these stomach worms which develop at
times on the skin, causing a cutaneous habronemiasis known as summer
sores. This is discussed under diseases of the skin.
STRONGYLES (_Strongylus_ spp. and _Cylicostomum_ spp.).--These worms
(Pl. V, figs. 2 and 3) live in the large intestines of the horse as
adult worms and are often present in enormous numbers. Many of them are
very small, and the largest are less than two inches long. The adult
worms do considerable damage, but the immature or larval worms do even
more.
The larva of _Strongylus vulgaris_ enters the blood vessels of the
intestinal wall and finally attaches in the great mesenteric artery,
where it causes aneurisms; here it transforms to an adult without sexual
organs, which passes to the walls of the cecum and encysts, giving rise
to small cysts or abscesses; these cysts finally discharge to the
interior of the cecum, setting the worms, now mature, at liberty in the
lumen of the intestines.
The larvæ of _Strongylus equinus_ are found principally in the liver,
lungs, and pancreas.
The larvæ of _Strongylus edentatus_ may be met with almost anywhere,
especially under the serous membranes, the pleura and peritoneum.
The embryos and larvæ of species of _Cylicostomum_ are found in the
mucosa of the large intestine.
Aneurisms impede the circulation of the blood, and may give rise to
intermittent lameness. The aneurism may rupture, since it constitutes a
weak place in the wall of the blood vessel, and the horse die of the
resulting hemorrhage. Particles of blood clots in the aneurisms may
break off and plug a blood vessel at the point where they lodge, thereby
causing the death of the part from which the blood is shut off and
occasioning a type of colic which often terminates fatally. The larvæ of
_Cylicostomum_ form cysts in the walls of the large intestine, and when
these open they give rise to small sores; when they are numerous they
cause a thickening and hardening which impair the proper functioning of
the intestine. Abscesses sometimes perforate, causing death. The adult
worm attacks the intestinal wall, causing bleeding which results in
anemia. The numerous small sores thus caused allow bacteria to get into
the circulation, sometimes resulting in localized abscesses or in septic
arthritis or joint disease.
[Illustration: PLATE V.
INTESTINAL WORMS.
Oxyuris equi
Strongylus equinus.
Habronema microstoma
Cylichnostomum Sp.
Ascaris equorum]
[Illustration: PLATE VI.
BOTS
1. Bots in the stomach.
2. Bots in the duodenum.]
The disease due to these worms is quite common. The worms enter the body
as immature forms in the spring, when the animal is turned out on
pasture. The first symptoms show in November or December, the disease
being in a latent stage during the development of the worms. The first
symptoms are diarrhea, loss of appetite, and emaciation. The animal
becomes anemic. Secondary symptoms are edema and such complications as
joint infection, colic due to embolism, and accidents from falls,
hemorrhage from ruptured aneurisms, or perforation at the site of
abscess. The animal may die, recover, or become a chronic sufferer, the
internal injuries failing to make a satisfactory recovery even with the
removal of the worms in chronic cases.
_Treatment_ calls for the expulsion of the adult worms from the
intestine, the development of the body resistance to repair the damage
wrought by the developing worms, and the combating of complications. For
the expulsion of the worms the use of carbon bisulphid in gelatin
capsules, 2 to 5 grams, according to the size of the patient, for five
days, followed by magnesium sulphate the sixth day, has been
recommended. Owing to the difficulty and danger in the administration of
carbon bisulphid in capsule, it is advisable to call in a veterinarian.
Tonic treatment consists in the subcutaneous administration of
artificial serum and caffein. The various complications of bacterial
infection, colic, heart depression, etc., call for the attention of a
veterinarian. Preventive measures consist in avoiding reinfection with
worms so far as possible by using dry upland pasture in preference to
low, wet land, and by rotating pastures or rotation of the stock on a
given pasture. Horses may be alternated with cattle, sheep, or hogs to
advantage, so far as parasites are concerned. Another feature, always of
importance, is the provision of a pure, potable drinking water.
BOTS (_Gastrophilus_ spp.).--Bots (Pl. VI) are quite common in the
stomach and upper part of the small intestine of the horse anywhere in
the United States, one kind being occasionally found in the rectum. They
attach to that portion of the mucous lining of the stomach nearest the
esophagus or sometimes around the pyloric opening to the intestine or
even in the upper intestine, and undoubtedly interfere with the proper
functioning of the stomach and the health of the animal to a certain
extent. The symptoms are rather vague as a rule, but the general result
is a condition of unthriftiness.
A treatment which has been found effective consists in feeding lightly
on the day preceding treatment, withholding food in the evening and
giving an ounce of Barbados aloes or a pint of linseed oil. The next
day give 3 drams of carbon bisulphid in a gelatin capsule at 6 o'clock,
repeat the dose at 7 o'clock, and again at 8 o'clock, making a total of
9 drams altogether for an adult horse; half that amount will be
sufficient for a yearling colt. As previously noted, there is some
little difficulty and danger of accident in the administration of
treatments of this character and it is advisable to call in a
veterinarian.
Unless destroyed by treatment, the bots in the stomach of the horse pass
out in the manure in the spring and burrow down into the soil an inch or
two. Here they undergo a certain amount of development and finally
emerge as adult flies. These bot flies mate and during the summer the
eggs are deposited by the female on the forelegs and shoulders or around
the chin, mouth and nostrils of the horse, the location and appearance
of the eggs varying somewhat with different species of bot flies. These
eggs or the young maggots escaping from them are ingested by the horse
in licking the portions irritated by the movement of the escaping
maggots, and when swallowed develop to form bots in the stomach. Careful
currying, especially around the forequarters, is an aid in keeping down
bot infestation, but this is not commonly feasible with horses on
pasture, the ones most liable to become infested.
DISEASES OF THE RESPIRATORY ORGANS.
By W. S. HARBAUGH, V. S.
[Revised by Leonard Pearson, B. S., V. M. D.]
The organs pertaining to the respiratory function may be enumerated in
natural order as follows: The nasal openings, or nostrils; the nasal
chambers, through which the air passes in the head; the sinuses in the
head, communicating with the nasal chambers; the pharynx, common to the
functions of breathing and swallowing; the larynx, at the top of the
windpipe; the trachea, or windpipe; the bronchi (into which the windpipe
divides), two tubes leading from the windpipe to the right and left
lungs, respectively; the bronchial tubes, which penetrate and convey air
to all parts of the lungs; the lungs.
The pleura is a thin membrane that envelops the lung and lines the walls
of the thoracic cavity. The diaphragm is a muscular structure,
completely separating the contents of the thoracic cavity from those of
the abdominal cavity. It is essentially a muscle of inspiration, and the
principal one. Other muscles aid in the mechanism of respiration, but
the diseases or injuries of them have nothing to do with the diseases
under consideration.
Just within the nasal openings the skin becomes gradually but
perceptibly finer, until it is succeeded by the mucous membrane. Near
the junction of the skin and membrane is a small hole, presenting the
appearance of having been made with a punch; this is the opening of the
lachrymal duct, a canal that conveys the tears from the eyes. Within and
above the nasal openings are the cavities, or fissures, called the false
nostrils. The nasal chambers are completely separated, the right from
the left, by a cartilaginous partition, the nasal septum. Each nasal
chamber is divided into three continuous compartments by two thin,
scroll-like turbinated bones.
The mucous membrane lining the nasal chambers, and, in fact, the entire
respiratory tract, is much more delicate and more frequently diseased
that the mucous membrane of any other part of the body. The sinuses of
the head are compartments which communicate with the nasal chambers and
are lined with a continuation of the same membrane that lines the nasal
chambers; their presence increases the volume and modifies the form of
the head without increasing its weight.
The horse, in a normal condition, breathes exclusively through the
nostrils. The organs of respiration are quite liable to become
diseased, and, as many of the causes which lead to these attacks can be
avoided, it is both important and profitable to know and study the
causes.
CAUSES OF DISEASES OF RESPIRATORY ORGANS.
The causes of many of the diseases of these organs may be given under a
common head, because even a simple cold, if neglected or badly treated,
may run into the most complicated lung disease and terminate fatally. In
the spring and fall, when the animals are changing their coats, there is
a marked predisposition to contract disease, and consequently at those
periods care should be taken to prevent other exciting causes.
Badly ventilated stables are a frequent source of disease. It is a
mistake to think that country stables necessarily have purer air than
city stables. Stables on some farms are so faultily constructed that it
is almost impossible for the foul air to gain an exit. All stables
should have a sufficient supply of pure air, and be so arranged that
strong drafts can not blow directly on the animals. In ventilating a
stable, it is best to arrange to remove air from near the floor and
admit it through numerous small openings near the ceiling. The reason
for this is that the coldest and most impure air in the stable is near
the floor, while that which is warmest and purest, and therefore can
least be spared, is near the top of the room. In summer, top exits and
cross currents should be provided to remove excessive heat. Hot stables
are almost always poorly ventilated, and the hot stable is a cause of
disease on account of the extreme change of temperature that a horse is
liable to when taken out, and extreme changes of temperature are to be
avoided as certain causes of disease.
A cold, close stable is invariably damp, and is to be avoided as much as
the hot, close, and foul one. Horses changed from a cold to a warm
stable are more liable to contract cold than when changed from a warm to
a cold one. Pure air is more essential than warmth, and this fact should
be especially remembered when the stable is made close and foul to gain
the warmth. It is more economical to keep the horse warm with blankets
than to prevent the ingress of pure air in order to make the stable
warm.
Stables should be well drained and kept clean. Some farmers allow large
quantities of manure to accumulate in the stable. This is a pernicious
practice, as the decomposing organic matter evolves gases that are
predisposing or exciting causes of disease. When a horse is overheated,
it is not safe to allow him to dry by evaporation; rubbing him dry and
gradually cooling him out is the wisest treatment. When a horse is
hot--covered with sweat--it is dangerous to allow him to stand in a
draft; it is the best plan to walk him until his temperature moderates.
In such cases a light blanket thrown over the animal may prevent a cold.
Overwork or overexertion often causes the greater number of fatal cases
of congestion of the lungs. Avoid prolonged or fast work when the horse
is out of condition or unaccustomed to it. Animals that have been
working in cold rains should be dried and cooled out and not left to dry
by evaporation. When the temperature of the weather is at the extreme,
either of heat or cold, diseases of the organs of respiration are most
frequent.
It is not to be supposed that farmers can give their horses the
particular attention given to valuable racing and pleasure horses, but
they can most assuredly give them common-sense care, and this may often
save the life of a valuable animal. If the owner properly considers his
interests, he will study the welfare of his horses so that he may be
able to instruct the servant in details of stable management.
WOUNDS ABOUT THE NOSTRILS.
Wounds in this neighborhood are common, and are generally caused by
snagging on a nail or splinter or by the bite of another horse; or by
getting "run into," or by running against something. Occasionally the
nostril is so badly torn and lacerated that it is impossible to effect a
cure without leaving the animal blemished for life, but in the majority
of instances the blemish, or scar, is the result of want of conservative
treatment. As soon as possible after the accident the parts should be
brought together and held there by stitches. If too much time is allowed
to elapse, the swelling of the parts will considerably interfere. Never
cut away any skin that may be loose and hanging, or else a scar will
certainly remain. Bring the parts in direct apposition and place the
stitches from a quarter to a half-inch apart, as circumstances may
demand. It is not necessary to have special surgeons' silk and needles
for this operation; good linen thread or ordinary silk thread will
answer. The wound afterwards only requires to be kept clean. For this
purpose it should be cleansed and discharges washed away daily with a
solution made of carbolic acid 1 part in 40 parts of water. If on
account of the irritability the horse is inclined to rub the wound
against some object, his head should be tied by means of two halter
ropes attached to the opposite sides of the stall to prevent him from
opening the wound. Except when at work or eating, the head should be so
tied about 10 days.
TUMORS WITHIN THE NOSTRILS.
A small, globular tumor is sometimes found within the false nostril,
under that part of the skin that is seen to puff or rise and fall when a
horse is exerted and breathing hard. These tumors contain matter of a
cheesy consistency.
_Treatment._--If the tumor is well opened and the matter squeezed out,
nature will perform a cure. If the opening is made from the outside
through the skin, it should be at the most dependent part, but much the
best way to open the tumor is from the inside. Quiet the animal, gently
insert your finger up in the direction of the tumor, and you will soon
discover that it is much larger inside than it appears to be on the
outside. If necessary put a twitch on the ear of the horse to quiet him;
run the index finger of your left hand against the tumor; now, with the
right hand, carefully insert the knife by running the back of the blade
along the index finger of the left hand until the tumor is reached; with
the left index finger guide the point of the blade quickly and surely
into the tumor; make the opening large. A little blood may flow for a
while, but it is of no consequence. Squeeze out the matter and keep the
part clean.
COLD IN THE HEAD, OR NASAL CATARRH.
Catarrh is an inflammation of a mucous membrane. It is accompanied with
excessive secretion. In nasal catarrh the inflammation may extend from
the membrane lining the nose to the throat, the inside of the sinuses,
and to the eyes. The causes are the general causes of respiratory
disease enumerated above. It is especially common in young horses and in
horses not acclimated.
_Symptoms._--The membrane at the beginning of the attack is dry,
congested, and irritable; it is of a deeper hue than natural, pinkish
red or red. Soon a watery discharge from the nostrils makes its
appearance; the eyes may also be more or less affected and tears flow
over the cheeks. The animal has some fever, which may be easily detected
by means of a clinical thermometer inserted in the rectum or, roughly,
by placing the finger in the mouth, as the feeling of heat conveyed to
the finger will be greater than natural.
To become somewhat expert in ascertaining the changes of temperature in
the horse it is only necessary to place the finger often in the mouths
of horses known to be healthy. After you have become accustomed to the
warmth of the mouth of the healthy animal you will have no difficulty in
detecting a marked increase of the temperature. The animal may be dull;
he sneezes or snorts, but does not cough unless the throat is affected;
he expels the air forcibly through his nostrils, very often in a manner
that may be aptly called "blowing his nose." A few days after the attack
begins the discharge from the nostrils changes from a watery to that of
a thick, mucilaginous state, of a yellowish-white color, and may be more
or less profuse. Often the appetite is lost and the animal becomes
debilitated.
_Treatment._--This disease is not serious, but inasmuch as neglect or
bad treatment may cause it to lead to something worse or become chronic
it should receive proper attention. The animal should not be worked for
a time. A few days of rest, with pure air and good feed, will be of
greater benefit than most medication. The value of pure air can not be
overestimated, but drafts must be avoided. The benefit derived from the
inhalation of steam is considerable. This is effected by holding the
horse's head over a bucketful of boiling water, so that the animal will
be compelled to inhale steam with every inhalation of air. Stirring the
hot water with a wisp of hay causes the steam to arise in greater
abundance. One may cause the horse to put his nose in a bag containing
cut hay upon which hot water has been poured, the bottom of the bag
being stood in a bucket, but the bag must be of loose texture, as gunny
sack, or, if of canvas, holes must be cut in the side to admit fresh
air.
The horse may be made to inhale steam four or five times a day, about 15
or 20 minutes each time.
Particular attention should be paid to the diet. Give bran mashes,
scalded oats, linseed gruel, and grass, if in season. If the horse
evinces no desire for this soft diet, it is better to allow any kind of
feed he will eat, such as hay, oats, corn, etc., than to keep him on
short rations.
If the animal is constipated, relieve this symptom by injections
(enemas) of warm water into the rectum three or four times a day, but do
not administer purgative medicines, except of a mild character.
For simple cases the foregoing is all that is required, but if the
appetite is lost and the animal appears debilitated and dull, give 3
ounces of the solution of acetate of ammonia and 2 drams of powdered
chlorate of potassium diluted with a pint of water three times a day as
a drench. Be careful when giving the drench; do not pound the horse on
the gullet to make him swallow; be patient, and take time, and do it
right.
If the weather is cold, blanket the animal and keep him in a comfortable
stall. If the throat is sore, treat as advised for that ailment, to be
described hereafter.
If, after 10 days or 2 weeks, the discharge from the nostrils continues,
give one-half dram of reduced iron three times a day. This may be mixed
with damp feed. Common cold should be thoroughly understood and
intelligently treated in order to prevent more dangerous diseases.
CHRONIC CATARRH (OR NASAL GLEET, OR COLLECTION IN THE SINUSES).
This is a subacute or chronic inflammation of some part of the membrane
affected in common cold, the disease just described. It is manifested by
a persistent discharge of a thick white or yellowish-white matter from
one or both nostrils. The commonest cause is a neglected or badly
treated cold, and it usually follows those cases where the horse has
suffered exposure, been overworked, or has not received proper feed,
and, as a consequence, has become debilitated. It may occur as a sequel
to influenza.
Other but less frequent causes for this affection are: Fractures of the
bones that involve the membrane of the sinuses, and even blows on the
head over the sinuses. Diseased teeth often involve a sinus and cause a
fetid discharge from the nostril. Violent coughing is said to have
forced particles of feed into the sinus, which acted as a cause of the
disease. Tumors growing in the sinuses are known to have caused it. It
is also attributed to disease of the turbinated bones. Absorption of the
bones forming the walls of the sinuses has been caused by the pressure
of pus collecting in them and by tumors filling up the cavity.
_Symptoms._--Great caution must be exercised when examining these cases,
for the horse may have glanders, while, on the other hand, horses have
been condemned as glandered when really there was nothing ailing them
but nasal gleet. This is not contagious, but may stubbornly resist
treatment and last for a long time. In most cases the discharge is from
one nostril only, which may signify that the sinuses on that side of the
head are affected. The discharge may be intermittent; that is,
quantities may be discharged at times and again little or none for a day
or so. Such an intermittent discharge usually signifies disease of the
sinuses. The glands under and between the bones of the lower jaw may be
enlarged. The peculiar ragged-edged ulcer of glanders is not to be found
on the membrane within the nostrils, but occasionally sores are to be
seen there. If there is any doubt about it, the symptoms of glanders
should be well studied in order that one may be competent to form a safe
opinion.
The eye on the side of the discharging nostril may have a peculiar
appearance and look smaller than its fellow. There may be an
enlargement, having the appearance of a bulging out of the bone over the
part affected, between or below the eyes. The breath may be offensive,
which indicates decomposition of the matter or bones or disease of the
teeth. A diseased tooth is further indicated by the horse holding his
head to one side when eating, or by dropping the feed from the mouth
after partly chewing it. When the bones between the eyes, below the
eyes, and above the back teeth of the upper jaw are tapped on, a hollow,
drumlike sound is emitted, but if the sinus is filled with pus or
contains a large tumor the sound emitted will be the same as if a solid
substance were struck; by this means the sinus affected may be located
in some instances. The hair may be rough over the affected part, or even
the bone may be soft to the touch and the part give somewhat to pressure
or leave an impression where it is pressed upon with the finger.
_Treatment._--The cause of the trouble must be ascertained before
treatment is commenced. In the many cases in which the animal is in poor
condition (in fact, in all cases) he should have the most nutritive feed
and regular exercise. The feed, or box containing it, should be placed
on the ground, as the dependent position of the head favors the
discharge.
The cases that do not require a surgical operation must, as a rule, have
persistent medical treatment. Mineral tonics and local medication are of
the most value. For eight days give the following mixture: Reduced iron,
3 ounces; powdered nux vomica, 1 ounce. Mix and make into 16 powders;
one powder should be mixed with the feed twice a day. Arsenious acid
(white arsenic) in doses of from 3 to 6 grains three times daily is a
good tonic for such cases. Sulphur burnt in the stable while the animal
is there to inhale its fumes is also a valuable adjunct. Care should be
taken that the fumes of the burning sulphur are sufficiently diluted
with air so as not to suffocate the horse. Chlorid of lime sprinkled
around the stall is good. Also keep a quantity of it under the hay in
the manger so that the gases will be inhaled as the horse holds his head
over the hay while eating. Keep the nostrils washed and the discharge
cleaned away from the manger and stall. The horse may be caused to
inhale the vapor of compound tincture of benzoin by pouring 2 ounces of
this drug into hot water and fumigating in the usual way.
If the nasal gleet is the result of a diseased tooth, the latter must be
removed. Trephining is the best possible way to remove it in such cases,
as the operation immediately opens the cavity, which can be attended to
direct. In all those cases of nasal gleet in which sinuses contain
either tumors or collections of pus the only relief is by the trephine;
and, no matter how thoroughly described, this is an operation that will
be seldom attempted by the nonprofessional. It would therefore be a
waste of time to give the modus operandi.
An abscess involving the turbinated bones is similar to the collection
of pus in the sinuses and must be relieved by trephining.
THICKENING OF THE NASAL MEMBRANE.
This is sometimes denoted by a chronic discharge, a snuffling in the
breathing, and a contraction of the nostril. It is a result of common
cold and requires the same treatment as prescribed for nasal gleet,
namely, the sulphate of iron, sulphate of copper, iodid of potassium,
etc. The membranes of both sides may be affected, but one side only is
the rule; the affected side may be easily detected by holding the hand
tightly over one nostril at a time. When the healthy side is closed in
this manner the breathing through the affected side will demonstrate a
decreased caliber or an obstruction.
NASAL POLYPUS.
Tumors with narrow bases (somewhat pear-shaped) are occasionally found
attached to the membrane of the nasal chambers, and are obstructions to
breathing through the side in which they are located. They vary much in
size; some are so small that their presence is not manifested, while
others almost completely fill the chamber, thereby causing a serious
obstruction to the passage of air. The stem, or base, of the tumor is
generally attached high in the chamber, and usually the tumor can not be
seen, but occasionally it increases in size until it can be observed
within the nostril. Sometimes, instead of hanging down toward the nasal
opening, it falls back into the pharynx. It causes a discharge from the
nostril, a more or less noisy snuffling sound in breathing, according to
its size, a discharge of blood (if it is injured), and sneezing. The
side that it occupies can be detected in the same way as described for
the detection of the affected side when the breathing is obstructed by a
thickened membrane.
The only relief is removal of the polypus, which, like all other
operations, should be done by an expert when it is possible to obtain
one. The operation is performed by grasping the base of the tumor with
suitable forceps and twisting it round and round until it is torn from
its attachment, or by cutting it off with a noose of wire. The resulting
hemorrhage is checked by the use of an astringent lotion, such as a
solution of the tincture of iron, or by packing the nostrils with
surgeon's gauze.
PHARYNGEAL POLYPUS.
This is exactly the same kind of tumor described as nasal polypus, the
only difference being in the situation. Indeed, the stem of the tumor
may be attached to the membrane of the nasal chamber, as before
explained, or it may be attached in the fauces (opening of the back part
of the mouth), and the body of the tumor then falls into the pharynx. In
this situation it may seriously interfere with breathing. Sometimes it
drops into the larynx, causing the most alarming symptoms. The animal
coughs, or tries to cough, saliva flows from the mouth, the breathing is
performed with the greatest difficulty and accompanied with a loud
noise; the animal appears as if strangled and often falls exhausted.
When the tumor is coughed out of the larynx the animal regains quickly
and soon appears as if nothing were ailing. These sudden attacks and
quick recoveries point to the nature of the trouble. The examination
must be made by holding the animal's mouth open with a balling iron or
speculum and running the hand back into the mouth. If the tumor is
within reach, it must be removed in the same manner as though it were in
the nose.
BLEEDING FROM THE NOSE.
This often occurs during the course of certain diseases, namely,
influenza, bronchitis, purpura hemorrhagica, glanders, etc. But it also
occurs independently of other affections and, as before mentioned, is a
symptom of polypus, or tumor, in the nose.
Injuries to the head, exertion, violent sneezing--causing a rupture of a
small blood vessel--also induce it. The bleeding is almost invariably
from one nostril only, and is never very serious. The blood escapes in
drops (seldom in a stream) and is not frothy, as when the hemorrhage is
from the lungs. (See Bleeding from the lungs, p. 127.) In most cases
bathing the head and washing out the nostril with cold water are all
that is necessary. If the cause is known, you will be guided according
to circumstances. If the bleeding continues, pour ice-cold water over
the face, between the eyes and down over the nasal chambers. A bag
containing ice in small pieces applied to the head is often efficient.
If in spite of these measures the hemorrhage continues, plugging the
nostrils with cotton, tow, or oakum, should be tried. A string should be
tied around the plug before it is pushed up into the nostril, so that it
can be safely withdrawn after 4 or 5 hours. If both nostrils are
bleeding, only one nostril at a time should be plugged. If the
hemorrhage is profuse and persistent, a drench composed of 1 dram of
acetate of lead dissolved in 1 pint of water, or ergot, 1 ounce, should
be given.
INFLAMMATION OF THE PHARYNX.
As already stated, the pharynx is common to the functions of both
respiration and alimentation. From this organ the air passes into the
larynx and thence onward to the lungs. In the posterior part of the
pharynx is the superior extremity of the gullet, the canal through which
the feed and water pass to the stomach. Inflammation of the pharynx is a
complication of other diseases--namely, influenza, strangles, etc.--and
is probably always more or less complicated with inflammation of the
larynx. That it may exist as an independent affection there is no reason
to doubt, and it is discussed as such with the diseases of the digestive
tract.
SORE THROAT, OR LARYNGITIS.
The larynx is situated in the space between the lower jawbones just back
of the root of the tongue. It may be considered as a box (somewhat
depressed on each side), composed principally of cartilages and small
muscles, and lined on the inside with a continuation of the respiratory
mucous membrane. Posteriorly it opens into and is continuous with the
windpipe. It is the organ of the voice, the vocal cords being situated
within it; but in the horse this function is of little consequence. It
dilates and contracts to a certain extent, thus regulating the volume of
air passing through it. The mucous membrane lining it internally is so
highly sensitive that if the smallest particle of feed happens to drop
into it from the pharynx violent coughing ensues instantly and is
continued until the source of irritation is ejected. This is a provision
of nature to prevent foreign substances gaining access to the lungs.
That projection called Adam's apple in the neck of man is the prominent
part of one of the cartilages forming the larynx.
Inflammation of the larynx is a serious and sometimes fatal disease,
and, as before stated, is usually complicated with inflammation of the
pharynx, constituting what is popularly known as "sore throat." The
chief causes are chilling and exposure.
_Symptoms._--About the first symptom noticed is cough, followed by
difficulty in swallowing, which may be due to soreness of the membrane
of the pharynx, over which the feed or water must pass, or from the pain
caused by the contraction of the muscles necessary to impel the feed or
water onward to the gullet; or this same contraction of the muscles may
cause a pressure on the larynx and produce pain. In many instances the
difficulty in swallowing is so great that water, and in some cases feed,
is returned through the nose. This, however, does not occur in
laryngitis alone, but only when the pharynx is involved in the
inflammation. The glands between the lower jawbones and below the ears
may be swollen. Pressure on the larynx induces coughing. The head is
more or less "poked out," and has the appearance of being stiffly
carried. The membrane in the nose becomes red. A discharge from the
nostrils soon appears. As the disease advances, the breathing may assume
a more or less noisy character; sometimes a harsh, rasping snore is
emitted with every respiration, the breathing becomes hurried, and
occasionally the animal seems threatened with suffocation.
_Treatment._--In all cases steam the nostrils, as has been advised for
cold in the head. In bad cases cause the steam to be inhaled
continuously for hours--until relief is afforded. Have a bucketful of
fresh boiling water every fifteen or twenty minutes. In each bucketful
of water put a tablespoonful of oil of turpentine, or compound tincture
of benzoin, the vapor of which will be carried along with the steam to
the affected parts and have a beneficial effect. In mild cases steaming
the nostrils five, six, or seven times a day will suffice.
The animal should be placed in a comfortable, dry stall (a box stall
preferred), and should have pure air to breathe. The body should be
blanketed, and bandages applied to the legs. The diet should consist of
soft feed--bran mashes, scalded oats, linseed gruel, and, best of all,
fresh grass, if in season. The manger, or trough, should neither be too
high nor too low, but a temporary one should be constructed at about
the height he carries his head. Having to reach too high or too low may
cause so much pain that the animal would rather forego satisfying what
little appetite he may have than inflict pain by craning his head for
feed or water. A supply of fresh water should be before him all the
time; he will not drink too much, nor will the cold water hurt him.
Constipation (if present) must be relieved by enemas of warm water,
administered three or four times during the twenty-four hours.
A liniment composed of 2 ounces of olive oil and 1 each of solution of
ammonia and tincture of cantharides, well shaken together, may be
thoroughly rubbed in about the throat from ear to ear, and about 6
inches down over the windpipe, and in the space between the lower jaws.
This liniment should be applied once a day for two or three days.
If the animal is breathing with great difficulty, persevere in steaming
the nostrils, and dissolve 2 drams of chlorate of potassium in every
gallon of water he will drink; even if he can not swallow much of it,
and even if it is returned through the nostrils, it will be of some
benefit to the pharynx as a gargle.
An electuary of acetate of potash, 2 drams, honey, and licorice powder
may be spread on the teeth with a paddle every few hours. If the pain of
coughing is great, 2 or 3 grains of morphin may be added to the
electuary.
When the breathing begins to be loud, relief is afforded in some cases
by giving a drench composed of 2 drams of fluid extract of jaborandi in
half a pint of water. If benefit is derived, this drench may be repeated
four or five hours after the first dose is given. It will cause a free
flow of saliva from the mouth.
In urgent cases, when suffocation seems inevitable, the operation of
tracheotomy must be performed. To describe this operation in words that
would make it comprehensible to the general reader is a more difficult
task than performing the operation, which, in the hands of the expert,
is simple and attended with little danger.
The operator should be provided with a tracheotomy tube (to be purchased
from any veterinary instrument maker) and a sharp knife, a sponge, and a
bucket of clean cold water. The place to be selected for opening the
windpipe is that part which is found, upon examination, to be least
covered with muscles, about 5 or 6 inches below the throat. Right here,
then, is the place to cut through. Have an assistant hold the animal's
head still. Grasp your knife firmly in the right hand, select the spot
and make the cut from above to below directly on the median line on the
anterior surface of the windpipe. Make the cut about 2 inches long in
the windpipe; this necessitates cutting three or four rings. One bold
stroke is usually sufficient, but if it is necessary to make several
other cuts to finish the operation, do not hesitate. Your purpose is to
make a hole in the windpipe sufficiently large to admit the tracheotomy
tube. It is quickly manifested when the windpipe is severed; the hot air
rushes out, and when air is taken in it is sucked in with a noise. A
slight hemorrhage may result (it never amounts to much), which is easily
controlled by washing the wound with a sponge and cold water, but use
care not to get any water in the windpipe. Do not neglect to instruct
your assistant to hold the head down immediately after the operation, so
that the neck will be in a horizontal line. This will prevent the blood
from getting into the windpipe and will allow it to drop directly on the
ground. If you have the self-adjustable tube, it retains its place in
the wound without further trouble after it is inserted. The other kind
requires to be secured in position by means of two tapes or strings tied
around the neck. After the hemorrhage is somewhat abated, sponge the
blood away and see that the tube is thoroughly clean, then insert it,
directing the tube downward toward the lungs.
The immediate relief this operation affords is gratifying to behold. The
animal, a few minutes before on the verge of death from suffocation,
emitting a loud wheezing sound with every breath, with haggard
countenance, body swaying, pawing, gasping, fighting for breath, now
breathes tranquilly, and may be in search of something to eat.
The tube should be removed once a day and cleaned with carbolic-acid
solution (1 to 20), and the discharge washed away from the wound with a
solution of carbolic acid, 1 part to 40 parts water. Several times a day
the hand should be held over the opening in the tube to test the
animal's ability to breathe through the nostrils, and as soon as it is
demonstrated that breathing can be performed in the natural way the tube
should be removed, the wound thoroughly cleansed with carbolic-acid
solution (1 to 40), and closed by inserting four or five stitches
through the skin and muscle. Do not include the cartilages of the
windpipe in the stitches. Apply the solution to the wound three or four
times a day until healed. When the tube is removed to clean it the lips
of the wound may be pressed together to ascertain whether or not the
horse can breathe through the larynx. The use of the tube should be
discontinued as soon as possible.
It is true that tracheotomy tubes are seldom to be found on farms, and
especially when most urgently required. In such instances there is
nothing left to be done but, with a strong needle, pass a waxed end or
other strong string through each side of the wound, including the
cartilage of the windpipe, and keep the wound open by tying the strings
over the neck.
During the time the tube is used the other treatment advised must not be
neglected. After a few days the discharge from the nostrils becomes
thicker and more profuse. This is a good symptom and signifies that the
acute stage has passed. At any time during the attack, if the horse
becomes weak, give whisky or aromatic spirits of ammonia, 2 ounces in
water. Do not be in a hurry to put the animal back to work, but give
plenty of time for a complete recovery. Gentle and gradually increasing
exercise may be given as soon as the horse is able to stand it. The feed
should be carefully selected and of good quality. Tonics, as iron or
arsenic, may be employed.
If abscesses form in connection with the disease they must be opened to
allow the escape of pus, but do not rashly plunge a knife into swollen
glands; wait until you are certain the swelling contains pus. The
formation of pus may be encouraged by the constant application of
poultices for hours at a time. The best poultice for the purpose is made
of linseed meal, with sufficient hot water to make a thick paste. If the
glands remain swollen for some time after the attack, rub well over them
an application of the following: Biniodid of mercury, 1 dram; lard, 1
ounce; mix well. This may be applied once every day until the part is
blistered.
Sore throat is also a symptom of other diseases, such as influenza,
strangles, purpura hemorrhagica, etc., which diseases may be consulted
under their proper headings.
After a severe attack of inflammation of the larynx the mucous membrane
may be left in a thickened condition, or an ulceration of the part may
ensue, either of which is liable to produce a chronic cough. For the
ulceration it is useless to prescribe, because it can neither be
diagnosed nor topically treated by the nonprofessional.
If a chronic cough remains after all the other symptoms have
disappeared, it is advisable to give 1 dram of iodid of potassium
dissolved in a bucketful of drinking water, one hour before feeding,
three times a day for a month if necessary. Also rub in well the
preparation of iodid of mercury (as advised for the swollen glands)
about the throat, from ear to ear, and in the space between the lower
jawbones. The application may be repeated every third day until the part
is blistered.
SPASM OF THE LARYNX.
The symptoms are as follows: Sudden seizure by a violent fit of
coughing; the horse may reel and fall, and after a few minutes recover
and be as well as ever. The treatment recommended is this: Three drams
of bromid of potassium three times a day, dissolved in the drinking
water, or give as a drench in about a half pint of water for a week.
Then give 1 dram of powdered nux vomica (either on the food or shaken
with water as a drench) once a day for a few weeks.
CROUP AND DIPHTHERIA.
Neither of these diseases affects the horse, but these names are
sometimes wrongly applied to severe laryngitis or pharyngitis, or to
forage poisoning, in which the throat is paralyzed and becomes
excessively inflamed and gangrenous.
THICK WIND AND ROARING.
Horses that are affected with chronic disease that causes a loud,
unnatural noise in breathing are said to have thick wind, or to be
roarers. This class does not include those affected with severe sore
throat, as in these cases the breathing is noisy only during the attack
of the acute disease.
Thick wind is caused by an obstruction to the free passage of the air in
some part of the respiratory tract. Nasal polypi, thickening of the
membrane, pharyngeal polypi, deformed bones, paralysis of the wing of
the nostril, etc., are occasional causes. The noisy breathing of horses
after having been idle and put to sudden exertion is not due to any
disease and is only temporary. Very often a nervous, excitable horse
will make a noise for a short time when started off, generally caused by
the cramped position in which the head and neck are forced in order to
hold him back.
Many other causes may occasion temporary, intermittent, or permanent
noisy respiration, but chronic roaring is caused by paralysis of the
muscles of the larynx; and almost invariably it is the muscles of the
left side of the larynx that are affected.
In chronic roaring the noise is made when the air is drawn into the
lungs; only when the disease is far advanced is a sound produced when
the air is expelled, and even then it is not nearly so loud as during
inspiration.
In a normal condition the muscles dilate the aperture of the larynx by
moving the cartilage and vocal cord outward, allowing a sufficient
volume of air to rush through. But when the muscles are paralyzed the
cartilage and vocal cord that are normally controlled by the affected
muscles lean into the tube of the larynx, so that when the air rushes in
it meets this obstruction and the noise is produced. When the air is
expelled from the lungs its very force pushes the cartilage and vocal
cords out, and consequently noise is not produced in the expiratory act.
The paralysis of the muscles is due to derangement of the nerve that
supplies them with energy. The muscles of both sides are not supplied by
the same nerve; there is a right and a left nerve, each supplying its
respective side. The reason why the muscles on the left side are the
ones usually paralyzed is owing to the difference in the anatomical
arrangement of the nerves. The left nerve is much longer and more
exposed to interference than the right nerve.
In chronic roaring there is no evidence of any disease of the larynx
other than the wasted condition of the muscles in question. The disease
of the nerve is generally far from the larynx. Disease of parts
contiguous to the nerve along any part of its course may interfere with
its proper function. Enlargement of lymphatic glands within the chest
through which the nerve passes on its way back to the larynx is the most
frequent interruption of nervous supply, and consequently roaring. When
roaring becomes confirmed, medical treatment is entirely useless, as it
is impossible to restore the wasted muscle and at the same time remove
the cause of the interruption of the nervous supply. Before roaring
becomes permanent the condition may be benefited by a course of iodid of
potassium, if caused by disease of the lymphatic glands. Electricity has
been used with indifferent success. Blistering or firing over the larynx
is, of course, not worthy of trial if the disease is due to interference
of the nerve supply. The administration of strychnia (nux vomica) on the
ground that it is a nerve tonic with the view of stimulating the
affected muscles is treating only the result of the disease without
considering the cause, and is therefore useless. The operation of
extirpating the collapsed cartilage and vocal cord is believed to be the
only relief, and, as this operation is critical and can be performed
only by the skillful veterinarian, it will not be described here.
From the foregoing description of the disease it will be seen that the
name "roaring," by which the disease is generally known, is only a
symptom and not the disease. Chronic roaring is also in many cases
accompanied with a cough. The best way to test whether a horse is a
"roarer" is either to make him pull a load rapidly up a hill or over a
sandy road or soft ground; or, if he is a saddle horse, gallop him up a
hill or over soft ground. The object is to make him exert himself. Some
horses require a great deal more exertion than others before the
characteristic sound is emitted. The greater the distance he is forced,
the more he will appear exhausted if he is a roarer; in bad cases the
animal becomes utterly exhausted, the breathing is rapid and difficult,
the nostrils dilate to the fullest extent, and the animal appears as if
suffocation was imminent.
An animal that is a roarer should not be used for breeding purposes. The
taint is transmissible in many instances.
_Grunting._--A common test used by veterinarians when examining "the
wind" of a horse is to see if he is a "grunter." This is a sound emitted
during expiration when the animal is suddenly moved, or startled, or
struck at. If he grunts he is further tested for roaring. Grunters are
not always roarers, but, as it is a common thing for a roarer to grunt,
such an animal must be looked upon with suspicion until he is thoroughly
tried by pulling a load or galloped up a hill. The test should be a
severe one. Horses suffering with pleurisy, pleurodynia, or rheumatism,
and other affections accompanied with much pain, will grunt when moved,
or when the pain is aggravated, but grunting under these circumstances
does not justify the term of "grunter" being applied to the horse, as
the grunting ceases when the animal recovers from the disease that
causes the pain.
_High blowing._--This term is applied to a noisy breathing made by some
horses. It is distinctly a nasal sound, and must not be confounded with
"roaring." The sound is produced by the action of the nostrils. It is a
habit and not an unsoundness. Contrary to roaring, when the animal is
put to severe exertion the sound ceases. An animal that emits this sound
is called a "high blower." Some horses have naturally very narrow nasal
openings, and they may emit sounds louder than usual in their breathing
when exercised.
_Whistling_ is only one of the variations of the sound emitted by a
horse called a "roarer," and therefore needs no further notice, except
to remind the reader that a whistling sound may be produced during an
attack of severe sore throat or inflammation of the larynx, which passes
away with the disease that causes it.
CHRONIC BRONCHITIS.
This may be due to the same causes as acute bronchitis or it may follow
the latter disease. An attack of the chronic form is liable to be
converted into acute bronchitis by a very slight cause. This chronic
affection in most instances is associated with thickening of the walls
of the tubes. Its course is slower, it is less severe, and is not
accompanied with so much fever as the acute form. If the animal is
exerted, the breathing becomes quickened and he soon shows signs of
exhaustion. In many instances the animal keeps up strength and
appearances moderately well, but in other cases the appetite is lost,
flesh gradually disappears, and he becomes emaciated and debilitated. It
is accompanied with a persistent cough, which in some cases is husky,
smothered, or muffled, while in others it is hard and clear. A whitish
matter, which may be curdled, is discharged from the nose. If the ear is
placed against the chest behind the shoulder blade, the rattle of the
air passing through the mucus can be heard within.
_Treatment._--Rest is necessary, as even under the most favorable
circumstances a cure is difficult to effect. The animal can not stand
exertion and should not be compelled to undergo it. It should have much
the same general care and medical treatment prescribed for the acute
form. Arsenious acid in tonic doses (3 to 7 grains) three times daily
may be given. As arsenic is irritant, it must be mixed with a
considerable bulk of moist feed and never given alone. Arsenic may be
given in the form of Fowler's solution, 1 ounce three times daily in the
drinking water. An application of mustard applied to the breast is a
beneficial adjunct. The diet should be the most nourishing. Bulky feed
should not be given. Linseed mashes, scalded oats, and, if in season,
grass and green-blade fodder are the best diet.
THE LUNGS.
The lungs (see Pl. VII) are the essential organs of respiration. They
consist of two (right and left) spongy masses, commonly called the
"lights," situated entirely within the thoracic cavity. On account of
the space taken up by the heart, the left lung is the smaller.
Externally, they are completely covered by the pleura. The structure of
the lung consists of a light, soft, but very strong and remarkably
elastic tissue, which can be torn only with difficulty. Each lung is
divided into a certain number of lobes, which are subdivided into
numberless lobules (little lobes). A little bronchial tube terminates in
every one of these lobules. The little tube then divides into minute
branches which open into the air cells (pulmonary vesicles) of the
lungs. The air cells are little sacs having a diameter varying from
one-seventieth to one two-hundredth of an inch; they have but one
opening, the communication with the branches of the little bronchial
tubes. Small blood vessels ramify in the walls of the air cells. The air
cells are the consummation of the intricate structures forming the
respiratory apparatus. They are of prime importance, all the rest being
complementary. It is here that the exchange of gases takes place. As
before stated, the walls of the cells are very thin; so, also, are the
walls of the blood vessels. Through these walls escapes from the blood
the carbonic acid gas that has been absorbed by the blood in its
circulation through the different parts of the body; through these walls
also the oxygen gas, which is the life-giving element of the atmosphere,
is absorbed by the blood from the air in the air cells.
CONGESTION OF THE LUNGS.
Congestion is essentially an excess of blood in the vessels of the parts
affected. Congestion of the lungs in the horse, when it exists as an
independent affection, is generally caused by overexertion when the
animal is not in a fit condition to undergo more than moderate exercise.
Very often what is recognized as congestion of the lungs is but a
symptom of exhaustion or dilatation of the heart.
The methods practiced by the trainers of running and trotting horses
will give an idea of what is termed "putting a horse in condition" to
stand severe exertion. The animal at first gets walking exercises, then
after some time he is made to go faster and farther each day; the amount
of work is daily increased until he is said to be "in condition." An
animal so prepared runs no risk of being affected with congestion of
the lungs, if he is otherwise healthy. On the other hand, if the horse
is kept in the stable for the purpose of laying on fat or for want of
something to do, the muscular system becomes soft, and the horse is not
in condition to stand the severe exertion of going fast or far, no
matter how healthy he may be in other respects. If such a horse be given
a hard ride or drive, he may start off in high spirits, but soon becomes
exhausted, and if he is pushed he will slacken his pace, show a desire
to stop, and may stagger or even fall. Examination will show the
nostrils dilated, the flanks heaving, the countenance haggard, and the
appearance of suffocation. The heart and muscles were not accustomed to
the sudden and severe strain put upon them; the heart became unable to
perform its work; the blood accumulated in the vessels of the lungs,
which eventually became engorged with the stagnated blood, constituting
congestion of the lungs.
The animal, after having undergone severe exertion, may not exhibit
alarming symptoms until returned to the stable; then he will be noticed
standing with his head down, legs spread out, the eyes wildly staring or
dull and sunken. The breathing is very rapid and almost gasping; in most
cases the body is covered with perspiration, which, however, may soon
evaporate, leaving the surface of the body and the legs and ears cold;
the breathing is both abdominal and thoracic; the chest rises and falls
and the flanks are powerfully brought into action. If the pulse can be
felt at all it will be found beating very frequently, one hundred or so
to a minute. The heart may be felt tumultuously thumping if the hand is
placed against the chest behind the left elbow, or it may be scarcely
perceptible. The animal may tremble all over. If the ear is placed
against the side of the chest a loud murmur will be heard and perhaps a
fine, crackling sound.
One can scarcely fail to recognize a case of congestion of the lungs
when brought on by overexertion, as the history of the case indicates
the nature of the ailment. In all cases of suffocation the lungs are
congested. It is also seen in connection with other diseases.
_Treatment._--If the animal is attacked by the disease while on the
road, stop him immediately. Do not attempt to return to the stables. If
he is in the stable, make arrangements at once to insure an unlimited
supply of pure air. If the weather is warm, out in the open air is the
best place, but if too cold let him stand with head to the door. Let him
stand still; he has all he can do, if he obtains sufficient pure air to
sustain life. If he is encumbered with harness or saddle, remove it at
once and rub the body with cloths or wisps of hay or straw. This
stimulates the circulation in the skin, and thus aids in relieving the
lungs of the extra quantity of blood that is stagnated there. If you
have three or four assistants, let them rub the body and legs well until
the skin feels natural; rub the legs until they are warm, if possible.
When the circulation is reestablished, put bandages on the legs from the
hoofs up as far as possible. Throw a blanket over the body and let the
rubbing be done under the blanket. Diffusible stimulants are the
medicines indicated--brandy, whisky (or even ale or beer if nothing else
is at hand), ether, and aromatic spirits of ammonia. A drench of 2
ounces each of spirits of nitrous ether and alcohol, diluted with a pint
of water, every hour until relief is afforded, is among the best
remedies. Or, give a quarter of a pint of whisky in a pint of water
every hour, or the same quantity of brandy as often, or a quart of ale
every hour, or 1 ounce of tincture of arnica in a pint of water every
hour until five or six doses have been given. If none of these remedies
are at hand, 2 ounces of oil of turpentine, shaken with a half pint of
milk, may be given once, but not repeated. The animal may be bled from
the jugular vein. Do not take more than 5 or 6 quarts from the vein, and
do not repeat the bleeding. The blood thus drawn will have a tarry
appearance.
[Illustration: PLATE VII.
POSITION OF THE LEFT LUNG.]
When the alarming symptoms have subsided active measures may be stopped,
but care must be used in the general treatment of the animal for several
days, for it must be remembered that congestion may be followed by
pneumonia. The animal should have a comfortable stall, where he will not
be subjected to drafts or sudden changes of temperature; he should be
blanketed and the legs kept bandaged. The air should be pure, a
plentiful supply of fresh, cold water always in the stall; and a diet
composed principally of bran mashes, scalded oats, and, if in season,
grass. When ready for use again the horse should at first receive only
moderate exercise, which may be daily increased until he may safely be
put to regular work.
PNEUMONIA, OR LUNG FEVER.
Pneumonia is inflammation of the lungs. The chief varieties of pneumonia
are catarrhal--later discussed in connection with bronchitis, under the
name of broncho-pneumonia--and the fibrinous or croupous variety. The
latter form receives its names from the fact that the air spaces are
choked with coagulated fibrin thrown out from the blood. This causes the
diseased portions of the lungs to become as firm as liver, in which
condition they are said to be hepatized. As air is excluded by the
inflammatory product, the diseased lung will not float in water.
The inflammation usually begins in the lower part of the lung and
extends upward. The first stage of the disease consists of congestion,
or engorgement, of the blood vessels, followed by leakage of serum
containing fibrin from the blood vessels into the air passages. The
fluids thus escaping into the air cells and in the minute branches of
the little bronchial tubes become coagulated.
The pleura covering the affected parts may be more or less inflamed. A
continuance of the foregoing phenomena is marked by a further escape of
the constituents of the blood, and a change in the membrane of the
cells, which becomes swollen. The exudate that fills the air cells and
minute bronchial branches undergoes disintegration and softening when
healing commences.
The favorable termination of pneumonia is in resolution that is, a
restoration to health. This is gradually brought about by the exuded
material contained in the air cells and lung tissues being broken down
and softened and absorbed or expectorated through the nostrils. The
blood vessels return to their natural state, and the blood circulates in
them as before. In the cases that do not terminate so happily the lung
may become gangrenous (or mortified), an abscess may form, or the
disease may be merged into the chronic variety.
Pneumonia may be directly induced by any of the influences named as
general causes for diseases of the organs of respiration, but in many
instances it is from neglect. A common cold or sore throat may be
followed by pneumonia if neglected or improperly treated. An animal may
be debilitated by a cold, and when in this weakened state may be
compelled to undergo exertion beyond his strength; or he may be kept in
a badly ventilated stable, where the foul gases are shut in and the pure
air is shut out; or the stable may be so open that parts of the body are
exposed to drafts of cold air. An animal is predisposed to pneumonia
when debilitated by any constitutional disease, and especially during
convalescence if exposed to any of the exciting causes. Foreign bodies,
such as feed accidentally getting into the lungs by way of the windpipe,
as well as the inhalation of irritating gases and smoke, ofttimes
produce fatal attacks of inflammation of the lung and bronchial tubes.
Pneumonia is frequently seen in connection with other diseases, such as
influenza, purpura hemorrhagica, strangles, glanders, etc. Pneumonia and
pleurisy are most common during cold, damp weather, and especially
during the prevalence of the cold north or northeasterly winds. Wounds
puncturing the thoracic cavity may cause pneumonia.
_Symptoms._--Pneumonia, when a primary disease, is ushered in by a
chill, more or less prolonged, which in many cases is seen neither by
the owner nor the attendant, but is overlooked. The breathing becomes
accelerated, and the animal hangs its head and has a very dull
appearance. The mouth is hot and has a sticky feeling to the touch; the
heat conveyed to the finger in the mouth demonstrates a fever; if the
thermometer is placed in the rectum the temperature will be found to
have risen to 103° F. or higher. The pulse is frequent, beating from
fifty or sixty to eighty or more a minute. There is usually a dry cough
from the beginning, which, however, changes in character as the disease
advances; for instance, it may become moist, or if pleurisy sets in, the
cough will be peculiar to the latter affection; that is, cut short in
the endeavor to suppress it. In some cases the discharge from the
nostrils is tinged with blood, while in other cases it has the
appearance of muco-pus. The appetite is lost to a greater or less
extent, but the desire for water is increased, particularly during the
onset of the fever. The membrane within the nostrils is red and at first
dry, but sooner or later becomes moist. The legs are cold. The bowels
are more or less constipated, and what dung is passed is usually covered
with a slimy mucus. The urine is passed in smaller quantities than usual
and is of a darker color.
The animal prefers to have the head where the freshest air can be
obtained. When affected with pneumonia a horse does not lie down, but
persists in standing from the beginning of the attack. If pneumonia is
complicated with pleurisy, however, the horse may appear restless and
lie down for a few moments to gain relief from the pleuritic pains, but
he soon rises. In pneumonia the breathing is rapid and difficult, but
when the pneumonia is complicated with pleurisy the ribs are kept as
still as possible and the breathing is abdominal; that is, the abdominal
muscles are now made to do as much of the work as they can perform. If
pleurisy is not present there is little pain. To the ordinary observer
the animal may not appear dangerously ill, as he does not show the
seriousness of the ailment by violence, as in colic, but a careful
observer will discover at a glance that the trouble is something more
serious than a cold. By percussion it will be shown that some portions
of the chest are less resonant than in health, indicating exclusion of
air. If the air is wholly excluded the percussion is quite dull, like
that elicited by percussion over the thigh.
By auscultation important information may be gained. When the ear is
placed against the chest of a healthy horse, the respiratory murmur is
heard more or less distinctly, according to the part of the chest that
is beneath the ear. In the very first stage of pneumonia this murmur is
louder and hoarser; also, there is a fine, crackling sound something
similar to that produced when salt is thrown in a fire. After the
affected part becomes solid there is an absence of sound over that
particular part. After absorption begins one may again hear sounds that
are of a more or less moist character and resemble bubbling or gurgling,
which gradually change until the natural sound is heard announcing
return to health.
When a fatal termination is approaching all the symptoms become
intensified. The breathing becomes still more rapid and difficult; the
flanks heave; the animal stares wildly about as if seeking aid to drive
off the feeling of suffocation; the body is bathed with sweat; the horse
staggers, but quickly recovers his balance; he may now, for the first
time during the attack, lie down; he does so, however, in the hope of
relief, which he fails to find, and with difficulty struggles to his
feet; he pants; the nostrils flap; he staggers and sways from side to
side and backward and forward, but still tries to retain the standing
position, even by propping himself against the stall. It is no use, as
after an exhausting fight for breath he goes down; the limbs stretch out
and become rigid. In fatal cases death usually occurs in from 10 to 20
days after the beginning of the attack. On the other hand, when the
disease is terminating favorably the signs are obvious. The fever abates
and the animal gradually improves in appetite; he takes more notice of
things around him; his spirits improve; he has a general appearance of
returning health, and he lies down and rests. In the majority of cases
pneumonia, if properly treated, terminates in recovery.
_Treatment._--The comfort and surroundings of the patient must be
attended to first. The quarters should be the best that can be provided.
Pure air is essential. Avoid placing the animal in a stall where he may
be exposed to drafts of cold air and sudden changes of temperature. It
is much better for the animal if the air is cold and pure than if it is
warm and foul. It is better to make the animal comfortable with warm
clothing than to make the stable warm by shutting off the ventilation.
From the start the animal should have an unlimited supply of fresh, cold
drinking water. Blanket the body. Rub the legs until they are warm and
then put bandages on them from the hoofs up to the knees and hocks. If
warmth can not be reestablished in the legs by hand rubbing alone, apply
dry, ground mustard and rub well in. The bandages should be removed once
or twice every day, the legs well rubbed, and the bandages replaced.
Much harm is often done by clipping off hair and rubbing in powerful
blistering compounds. They do positive injury and retard recovery, and
should not be allowed. Much benefit may be derived from hot application
to the sides of the chest if the facilities are at hand to apply them.
If the weather is not too cold, and if the animal is in a comfortable
stable, the following method may be tried: Have a tub of hot water handy
to the stable door; soak a woolen blanket in the water, then quickly
wring as much water as possible out of it and wrap it around the chest.
See that it fits closely to the skin; do not allow it to sag so that air
may get between it and the skin. Now wrap a dry blanket over the wet hot
one and hold in place with three girths. The hot blanket should be
renewed every half hour, and while it is off being wetted and wrung the
dry one should remain over the wet part of the chest to prevent
reaction. The hot applications should be kept up for three or four
hours, and when stopped the skin should be quickly rubbed as dry as
possible, an application of alcohol rubbed over the wet part, and a dry
blanket snugly fitted over the animal. If the hot applications appear to
benefit, they may be tried on three or four consecutive days. Unless
every facility and circumstance favors the application of heat in the
foregoing manner, it should not be attempted. If the weather is very
cold or any of the details are omitted, more harm than good may result.
Mustard may be applied by making a paste with a pound of freshly ground
mustard mixed with warm water. This is to be spread evenly over the
sides back of the shoulder blades and down to the median line below the
chest. Care should be taken to avoid rubbing the mustard upon the thin
skin immediately back of the elbow. The mustard-covered area should be
covered with a paper and this with a blanket passed up from below and
fastened over the back. The blanket and paper should be removed in from
one to two hours. When pneumonia follows another disease, the system is
always more of less debilitated and requires the careful use of
stimulants from the beginning. To weaken the animal still further by
bleeding him is one of the most effectual methods of retarding recovery,
even if it does not hasten a fatal termination.
Another and oftentimes fatal mistake made by the nonprofessional is the
indiscriminate and reckless use of aconite. This drug is one of the most
active poisons, and should not be handled by anyone who does not
thoroughly understand its action and uses. It is only less active than
prussic acid in its poisonous effects. It is a common opinion, often
expressed by nonprofessionals, that aconite is a stimulant. Nothing
could be more erroneous; in fact, it is just the reverse. It is one of
the most powerful sedatives used in the practice of medicine. In fatal
doses it kills by paralyzing the very muscles used in breathing; it
weakens the action of the heart, and should not be used. Do not give
purgative medicines. If constipation exists, overcome it by an allowance
of laxative diet, such as scalded oats, bran, and linseed mashes; also,
grass, if in season. If the costiveness is not relieved by the laxative
diet, give an enema of about a quart of warm water three or four times a
day.
A diet consisting principally of bran mashes, scalded oats, and, when in
season, grass or corn fodder is preferable if the animal retains an
appetite; but if no desire is evinced for feed of this particular
description, then the animal must be allowed to eat anything that will
be taken spontaneously. Hay tea, made by pouring boiling water over good
hay in a large bucket and allowing it to stand until cool, then
straining off the liquid, will sometimes create a desire for feed. The
animal may be allowed to drink as much of it as he desires. Corn on the
cob is often eaten when everything else is refused. Bread may be tried;
also apples or carrots. If the animal can be persuaded to drink milk,
it may be supported by it for days. Three or four gallons of sweet milk
may be given during the day, in which may be stirred three or four fresh
eggs to each gallon. Some horses will drink milk, while others will
refuse to touch it. It should be borne in mind that all feed must be
taken by the horse as he desires it; none should be forced down him. If
he will not eat, you will only have to wait until a desire is shown for
feed. All kinds may be offered, first one thing and then another, but
feed should not be allowed to remain long in trough or manger; the very
fact of its constantly being before him will cause him to loathe it.
When the animal has no appetite for anything the stomach is not in a
proper state to digest food, and if it is poured or drenched into him it
will only cause indigestion and aggravate the case. It is a good
practice to do nothing when there is nothing to be done that will
benefit. This refers to medicine as well as feed. Nothing is well done
that is overdone.
There are many valuable medicines used for the different stages and
different types of pneumonia, but in the opinion of the writer it is
useless to refer to them here, as this work is intended for the use of
those who are not sufficiently acquainted with the disease to recognize
its various types and stages; therefore they would only confuse. If you
can administer a ball or capsule, or have anyone at hand who is capable
of doing it, a dram of sulphate of quinin in a capsule, or made into a
ball, with sufficient linseed meal and molasses, given every three hours
during the height of the fever, will do good in many cases. The ball of
carbonate of ammonia, as advised in the treatment of bronchitis, may be
tried if the animal is hard to drench. The heart should be kept strong
by administering digitalis in doses of 2 drams of the tincture every
three hours, or strychnia 1 grain, made into a pill with licorice
powder, three times daily.
If the horse becomes very much debilitated, stimulants of a more
pronounced character are required. The following drench is useful:
Rectified spirits, 3 ounces; spirits of nitrous ether, 2 ounces; water,
1 pint. This may be repeated every four or five hours if it seems to
benefit; or 6 ounces of good whisky diluted with a pint of water may be
given as often, instead of the foregoing.
During the period of convalescence good nutritive feed should be allowed
in a moderate quantity. Tonic medicines should be substituted for those
used during the fever. The same medicines advised for the convalescing
period of bronchitis are equally efficient in this case, especially the
iodid of potash; likewise, the same general instructions apply here.
The chief causes of death in pneumonia are heart failure from
exhaustion, suffocation, or blood poisoning from death (gangrene) of
lung tissue. The greater the area of lung tissue diseased the greater
the danger; hence double pneumonia is more fatal than pneumonia of one
lung.
THE WINDPIPE.
The windpipe, or trachea as it is technically called, is the flexible
tube that extends from, the larynx, which it succeeds at the throat, to
above the base of the heart in the chest, where it terminates by
dividing into the right and left bronchi--the tubes going to the right
and left lung, respectively. The windpipe is composed of about fifty
incomplete rings of cartilage united by ligaments. A muscular layer is
situated on the superior surface of the rings. Internally the tube is
lined with a continuation of the mucous membrane that lines the entire
respiratory tract, which here has very little sensibility in contrast to
that lining the larynx, which is endowed with exquisite sensitiveness.
The windpipe is not subject to any special disease, but is more or less
affected during laryngitis (sore throat), influenza, bronchitis, etc.,
and requires no special treatment. The membrane may be left in a
thickened condition after these attacks. One or more of the rings may be
accidentally fractured, or the tube may be distorted or malformed as the
result of violent injury. After the operation of tracheotomy it is not
uncommon to find a tumor or malformation as a result, or sequel, of the
operation. In passing over this section attention is merely called to
these defects, as they require no particular attention in the way of
treatment. It may be stated, however, that any one of the
before-mentioned conditions may constitute one of the causes of noisy
respiration described as "thick wind."
GUTTURAL POUCHES.
These two sacs are situated above the throat, and communicate with the
pharynx, as well as with the cavity of the tympanum of the ear. They are
peculiar to solipeds. Normally, they contain air. Their function is
unknown.
One or both guttural pouches may contain pus. The symptoms are as
follows: Swelling on the side below the ear and an intermittent
discharge of matter from one or both nostrils, especially when the head
is depressed.
The swelling is soft, and, if pressed upon, matter will escape from the
nose if the head is depressed. As before mentioned, these pouches
communicate with the pharynx, and through this small opening matter may
escape. A recovery is probable if the animal is turned out to graze, or
if he is fed from the ground, as the dependent position of the head
favors the escape of matter from the pouches. In addition to this, give
the tonics recommended for nasal gleet. If this treatment fails, an
operation must be performed, which should not be attempted by any one
unacquainted with the anatomy of the part.
BRONCHITIS AND BRONCHO-PNEUMONIA.
Bronchitis is an inflammation of the bronchial tubes. When this
inflammation extends to the air sacs at the termini of the smallest
branches of the bronchial tubes, the disease is broncho-pneumonia.
Bronchitis affecting the larger tubes is less serious than when the
smaller are involved. The disease may be either acute or chronic. The
causes are generally much the same as for other diseases of the
respiratory organs, noticed in the beginning of this article. The
special causes are these: The inhalation of irritating gases and smoke
and fluids or solids gaining access to the parts. Bronchitis is
occasionally associated with influenza and other specific fevers. It
also supervenes on common cold or sore throat.
_Symptoms._--The animal appears dull; the appetite is partially or
wholly lost; the head hangs; the breathing is quickened; the cough, at
first dry, and having somewhat the character of a "barking cough," is
succeeded in a few days by a moist, rattling cough; the mouth is hot;
the visible membranes in the nose are red; the pulse is frequent, and
during the first stage is hard and quick, but as the disease advances
becomes smaller and more frequent. There is a discharge from the
nostrils that is at first whitish, but later becomes creamy or frothy,
still later it is sometimes tinged with blood, and occasionally it may
be of a brownish or rusty color. By auscultation, or placing the ear to
the sides of the chest, unnatural sounds can now be heard. The air
passing through the diseased tubes causes a wheezing sound when the
small tubes are affected, and a hoarse, cooing, or snoring sound when
the larger tubes are involved. After one or two days the dry stage of
the disease is succeeded by a moist state of the membrane. The ear now
detects a different sounds caused by the bursting of the bubbles as the
air passes through the fluid, which is the exudate of inflammation and
the augmented mucous secretions of the membrane. The mucus may be
secreted in great abundance, which, by blocking up the tubes, may cause
a collapse of a large extent of breathing surface. Usually the mucus is
expectorated; that is, discharged through the nose. The matter is
coughed up, and when it reaches the larynx much of it may be swallowed,
and some is discharged from the nostrils. The horse can not spit, like
the human being, nor does the matter coughed up gain access to the
mouth. If in serious cases all the symptoms become aggravated, the
breathing is labored, short, and quick, it usually indicates that the
inflammation has reached the breathing cells and that catarrhal
pneumonia is established. In this case the ribs rise and fall much more
than natural. This fact alone is enough to exclude the idea that the
animal may be affected with pleurisy, because in that disease the ribs
are as nearly fixed as it is in the power of the animal to do so, and
the breathing is accomplished to a great extent by aid of the abdominal
muscles. The horse persists in standing throughout the attack. He
prefers to stand with head to a door or window to gain all the fresh air
possible, but if not tied may occasionally wander listlessly about the
stall. The bowels most likely are constipated; the dung is covered with
slimy mucus. The urine is decreased in quantity and darker in color than
usual. The animal shows more or less thirst; in some cases the mouth is
full of saliva. The discharge from the nose increases in quantity as the
disease advances and inflammation subsides. This is rather a good
symptom, as it shows that one stage has passed. The discharge then
gradually decreases, the cough becomes less rasping, but of more
frequent occurrence, until it gradually disappears with the return of
health.
Bronchitis, affecting the smaller tubes, is one of the most fatal
diseases, while that of the larger tubes is never very serious. It must
be stated, however, that it is an exceedingly difficult matter for a
nonexpert to discriminate between the two forms, and, further, it may as
well be said here that he will have difficulty in discriminating between
bronchitis and pneumonia.
_Treatment._--The matter of first importance is to insure pure air to
breathe, and next to make the patient's quarters as comfortable as
possible. A well-ventilated box stall serves best for all purposes.
Cover the body with a blanket, light or heavy, as the season of the year
demands. Hand-rub the legs until they are warm, then wrap them in cotton
and apply flannel or Derby bandages from the hoofs to the knees and
hocks. If the legs can not be made warm with hand rubbing alone, apply
dry mustard. Rub in thoroughly and then put the bandages on; also rub
mustard paste well over the side of the chest, covering the space
beginning immediately behind the shoulder blade and running back about
eighteen inches, and from the median line beneath the breast to within
ten inches of the ridge of the backbone. Repeat the application to the
side of the chest about three days after the first one is applied.
Compel the animal to inhale steam from a bucketful of boiling water
containing a tablespoonful of oil of turpentine and spirits of camphor,
as advised for cold in the head. In serious cases the steam should be
inhaled every hour, and in any case the oftener it is done the greater
will be the beneficial results. Three times a day administer an
electuary containing acetate of potash (2 drams), with licorice and
molasses or honey. It is well to keep a bucketful of cold water before
the animal all the time. If the horse is prostrated and has no appetite,
give the following drench: Spirits of nitrous ether, 2 ounces;
rectified spirits, 3 ounces; water, 1 pint. Repeat the dose every four
or five hours if it appears to benefit. When the horse is hard to
drench, give the following: Pulverized carbonate of ammonia, 3 drams;
linseed meal and molasses sufficient to make the whole into a stiff
mass; wrap it with a small piece of tissue paper and give as a ball.
This ball may be repeated every four or five hours. When giving the ball
care should be taken to prevent its breaking in the mouth, as in case of
such accident it will make the mouth sore and prevent the animal from
eating. If the bowels are constipated, give enemas of warm water. Do not
give purgative medicines. Do not bleed the animal.
If the animal retains an appetite, a soft diet is preferable, such as
scalded oats, bran mashes, and grass, if in season. If he refuses cooked
feed, allow in small quantities anything he will eat. Hay, cob corn,
oats, bread, apples, and carrots may be tried in turn. Some horses will
drink sweet milk when they refuse all other kinds of feed, and
especially is this the case if the drinking water is withheld for a
while. One or 2 gallons at a time, four or five times a day, will
support life. Bear in mind that when the disease is established recovery
can not occur in less than two or three weeks, and more time may be
necessary. Good nursing and patience are required.
When the symptoms have abated and nothing remains of the disease except
the cough and a white discharge from the nostrils, all other medicines
should be discontinued and a course of tonic treatment pursued. Give the
following mixture: Reduced iron, 3 ounces; powdered gentian, 8 ounces;
mix well together and divide into sixteen powders. Give a powder every
night and morning mixed with bran and oats, if the animal will eat it,
or shaken with about a pint of flaxseed tea and administered as a
drench.
If the cough remains after the horse is apparently well, give 1 dram of
iodid of potassium dissolved in a bucketful of drinking water one hour
before each meal for two or three weeks if necessary. Do not put the
animal to work too soon after recovery. Allow ample time to regain
strength. This disease is prone to become chronic and may run into an
incurable case of thick wind.
PLEURISY.
The thoracic cavity is divided into two lateral compartments, each
containing one lung and a part of the heart. Each lung has its separate
pleural membrane, or covering. The pleura is the thin, glistening
membrane that covers the lung and also completely covers the internal
walls of the chest. It is very thin, and to the ordinary observer
appears to be part of the lung, which, in fact, it is for all practical
purposes. The smooth, shiny surface of the lung, as well as the smooth,
shiny surface so familiar on the rib, is the pleura. In health this
surface is always moist. A fluid is thrown off by the pleura, which
causes the surface to be constantly moist. This is to prevent the
effects of friction between the lungs and the walls of the chest and
other contiguous parts which come in contact. It must be remembered that
the lungs are dilating each time a breath is taken in, and contracting
each time a breath of air is expelled. It may be readily seen that if it
were not for the moistened state of the surface of the pleura the
continual dilatation and contraction and the consequent rubbing of the
parts against each other would cause serious friction.
Inflammation of this membrane is called pleurisy. Being so closely
united with the lung, it can not always escape participation in the
disease when the latter is inflamed. Pleurisy may be due to the same
predisposing and exciting causes as mentioned in the beginning of this
work as general causes for diseases of the organs of respiration, such
as exposure to sudden changes of temperature, confinement in damp
stables, etc. It may be caused also by wounds that penetrate the chest,
for it must be remembered that such wounds must necessarily pierce the
pleura. A fractured rib may involve the pleura. The inflammation
following such wounds may be circumscribed; that is, confined to a small
area surrounding the wound, or it may spread from the wound and involve
a large portion of the pleura. The pleura may be involved secondarily
when the heart or its membrane is the primary seat of the disease. It
may occur in conjunction with bronchitis, influenza, and other diseases.
Diseased growths that interfere with the pleura may induce pleurisy. The
most frequent cause of pleurisy is an extension of inflammation from
adjacent diseased lung. It is a common complication of pneumonia.
Pleurisy will be described here as an independent affection, although it
should be remembered that it is very often associated with the foregoing
diseases.
The first lesion of pleurisy is overfilling of the blood vessels that
ramify in this membrane and dryness of the surface. This is followed by
the formation of a coating of coagulated fibrin on the diseased pleura
and the transudation of serum which collects in the chest. This serum
may contain flakes of fibrin and it may be straw colored or red from an
admixture of blood. The quantity of this accumulation may amount to
several gallons.
_Symptoms._--When the disease exists as an independent affection it is
ushered in by a chill, but this is usually overlooked. About the first
thing noticed is the disinclination of the animal to move or turn
around. When made to do so he grunts or groans with pain. He stands
stiff; the ribs are fixed--that is, they move very little in the act of
breathing--but the abdomen works more than natural; both the fore feet
and elbows may be turned out; during the onset of the attack the animal
may be restless and act as if he had a slight colic; he may even lie
down, but does not remain long down, for when he finds no relief he soon
gets up. After effusion begins these signs of restlessness disappear.
Every movement of the chest causes pain; therefore the cough is
peculiar; it is short and suppressed and comes as near being no cough as
the animal can make it in his desire to suppress it. The breathing is
hurried, the mouth is hot, the temperature being elevated from 102° or
103° to 105° F. Symptoms that usually accompany fever are present, such
as costiveness, scanty, dark-colored urine, etc. The pulse is frequent,
perhaps 70 or more a minute, and is hard and wiry. The legs and ears are
cold.
Percussion is of valuable service in this affection. After effusion
occurs the sound produced by percussing over the lower part of the chest
is dull. By striking different parts one may come to a spot of greater
or less extent where the blows cause much pain to be evinced. The animal
may grunt or groan every time it is struck. Another method of detecting
the affected part is to press the fingers between the ribs, each space
in succession, beginning behind the elbow, until a place where the
pressure causes more flinching than at any other part is reached.
Auscultation is also useful. In the first stage, when the surfaces are
dry and rough, one may hear, immediately under the ear, a distinct sound
very much like that produced by rubbing two pieces of coarse paper
together. No such friction sound occurs when the membrane is healthy, as
the natural moisture, heretofore mentioned, prevents the friction. In
many cases this friction is so pronounced that it may be felt by placing
the hand over the affected part. When the dry stage is succeeded by the
exudation of fluid this friction sound disappears. After the effusion
into the cavity takes place sometimes there is heard a tinkling or
metallic sound, due to dropping of the exudate from above into the
collected fluid in the bottom of the cavity, as the collected fluid more
of less separates the lung from the chest walls.
Within two or three days the urgent symptoms may abate owing to the
exudation of the fluid, and the subsidence of the pain. The fluid may
now undergo absorption, and the case may terminate favorably within a
week or 10 days.
If the quantity of the effusion is large its own volume retards the
process of absorption to a great extent, and consequently convalescence
is delayed. In severe cases the pulse becomes more frequent, the
breathing more hurried and labored, the flanks work like bellows, the
nostrils flap, the eyes stare wildly, the countenance expresses much
anxiety, and general signs of dissolution are plain. After a time
swellings appear under the chest and abdomen and down the legs. The
accumulation in the chest is called hydrothorax, or dropsy of the chest.
When this fluid contains pus the case usually proves fatal. The
condition of pus within the cavity is called empyema.
Pleurisy may affect only a small area of one side or it may affect both
sides. It is oftener confined to the right side.
_Treatment._--The instructions in regard to the general management of
bronchitis and pneumonia must be adhered to in the treatment of
pleurisy. Comfortable quarters, pure air, warm clothing to the body and
bandages to the legs, a plentiful supply of pure cold water, the
laxative feed, etc., in this case are equally necessary and efficacious.
The hot applications applied to the chest, as directed in the treatment
of pneumonia, are very beneficial in pleurisy, and should be kept up
while the symptoms show the animal to be in pain.
During the first few days, when pain is manifested by restlessness,
apply hot packs to the sides diligently. After four or five days, when
the symptoms show that the acute stage has somewhat subsided, mustard
may be applied as recommended for pneumonia. From the beginning the
following drench may be given every six hours, if the horse takes it
kindly: Solution of the acetate of ammonia, 3 ounces; spirits of nitrous
ether, 1 ounce; bicarbonate of potassium, 3 drams; water, 1 pint.
If the patient becomes debilitated, the stimulants as prescribed for
pneumonia should be used according to the same directions. The same
attention should be given to the diet. If the animal will partake of the
bran mashes, scalded oats, and grass, it is the best; but if he refuses
the laxative diet, then he should be tried with different kinds of feed
and allowed whichever kind he desires.
In the beginning of the attack, if the pain is severe, causing the
animal to lie down or paw, morphin may be given by the mouth in 5-grain
doses, or the fluid extract of _Cannabis indica_ may be used in doses of
2 to 4 drams.
If the case is not progressing favorable in ten or twelve days after the
beginning of the attack, convalescence is delayed by the fluid in the
chest failing to be absorbed. The animal becomes dull and weak and
evinces little or no desire for feed. The breathing becomes still more
rapid and difficult. An effort must now be made to excite the absorption
of the effusion. An application of liniment or mild blister should be
rubbed over the lower part of both sides and the bottom of the chest.
The following drench may be given three times a day, for seven or eight
days, if it is necessary and appears to benefit: Tincture of the
perchlorid of iron, 1 ounce; tincture of gentian, 2 ounces; water, 1
pint. Also give 1 dram of iodid of potassium, dissolved in the drinking
water, an hour before feeding every night and morning for a week or
two.
_Hydrothorax_ is sometimes difficult to overcome by means of the use of
medicines alone, when the operation of tapping the chest is performed to
allow an escape for the accumulated fluid. The operation is performed
with a combined instrument called the trocar and cannula. The puncture
is made in the lower part of the chest, in the space between the eighth
and ninth ribs. Wounding of the intercostal artery is avoided by
inserting the instrument as near as possible to the anterior edge of the
rib. If the operation is of benefit, it is only so when performed before
the strength is lowered beyond recovery. The operation merely receives a
passing notice here, as it is not presumed that the nonprofessional will
attempt it, although in the hands of the expert it is attended with
little danger or difficulty.
We have described here bronchitis, pneumonia, and pleurisy mainly as
they occur as independent diseases, but it should be remembered that
they merge into each other and may occur together at one time. While it
is true that much more might have been said in regard to the different
stages and types of the affections, and also in regard to the treatment
of each stage and each particular type, the plan adopted of advising
plain, conservative treatment is considered the wisest on account of
simplifying as much as possible a subject of which the reader is
supposed to know very little.
PLEUROPNEUMONIA.
This is the state in which an animal is affected with pleurisy and
pneumonia combined, which is not infrequently the case. At the beginning
of the attack only one of the affections may be present, but the other
soon follows. It has already been stated that the pleura is closely
adherent to the lung. The pleura on this account is frequently more or
less affected by the spreading of the inflammation from the lung tissue.
There is a combination of the symptoms of both diseases, but to the
ordinary observer the symptoms of pleurisy are the most obvious. The
course of treatment to be pursued differs in no manner from that given
for the affections when they occur independently. The symptoms will be
the guide as to the advisability of giving oil and laudanum for the pain
if the pleurisy is very severe. It should not be resorted to unless it
is necessary to allay the pain.
BRONCHO-PLEUROPNEUMONIA.
This is the term or terms applied when bronchitis, pleurisy, and
pneumonia all exist at once. It is impossible for one who is not an
expert to diagnose the state with certainty. The apparent symptoms are
the same as when the animal is affected with pleuropneumonia.
SUPPURATION AND ABSCESS IN THE LUNG.
There are instances, and especially when the surroundings of the patient
have been bad or the disease is of an especially severe type, when
pneumonia terminates in an abscess in the lung. Sometimes, when the
inflammation has been extreme, suppuration in a large portion of the
lung takes place. Impure air, the result of improper ventilation, is
among the most frequent causes of this termination. The symptoms of
suppuration in the lung are chronic pneumonia, a solidified area of lung
tissue, continued low fever, and, in some cases, offensive smell of the
breath, and the discharge of the matter from the nostrils.
MORTIFICATION.
Gangrene, or mortification, means the death of the part affected.
Occasionally, owing to the intensity of the inflammation or bad
treatment, pneumonia and pleuropneumonia terminate in mortification,
which is soon followed by the death of the animal. Perhaps the most
common cause of this complication is the presence of a foreign body in
the lung, as food particles or medicine. Rough drenching or drenching
through the nostrils may cause this serious condition.
HEMOPTYSIS, OR BLEEDING FROM THE LUNGS.
Bleeding from the lungs may occur during the course of congestion of the
lungs, bronchitis, pneumonia, influenza, purpura hemorrhagica, or
glanders. An accident or exertion may cause a rupture of a vessel.
Plethora and hypertrophy of the heart predispose to it. Following the
rupture of a vessel the blood may escape into the lung tissue and cause
a serious attack of pneumonia, or it may fill up the bronchial tubes and
prove fatal by suffocating the animal. When the hemorrhage is from the
lung it is accompanied with coughing; the blood is frothy, of a bright
red color, and comes from both nostrils; whereas when the bleeding is
merely from a rupture of a vessel in some part of the head (heretofore
described as bleeding from the nose) the blood is most likely to issue
from one nostril only, and the discharge is not accompanied with
coughing. The ear may be placed against the windpipe along its course,
and if the blood is from the lungs a gurgling or rattling sound will be
heard. When it occurs in connection with another disease it seldom
requires special treatment. When caused by accident or overexertion the
animal should be kept quiet. If the hemorrhage is profuse and continues
for several hours, 1 dram of the acetate of lead dissolved in a pint of
water may be given as a drench, or 1 ounce of the tincture of the
perchlorid of iron, diluted with a pint of water, may be given instead
of the lead. It is rare that the hemorrhage is so profuse as to require
internal remedies. But hemorrhage into the lung may occur and cause
death by suffocation without the least manifestation of it by the
discharge of blood from the nose.
TUBERCULOSIS OF THE LUNGS.
Pulmonary consumption or tuberculosis has been recognized in the horse
in a number of instances. The symptoms are as of chronic pneumonia or
pleurisy. There is no treatment for the disease.
HEAVES, BROKEN WIND, OR ASTHMA.
Much confusion exists in the popular mind in regard to the nature of
heaves. Many horsemen loosely apply the term to all ailments where the
breathing is difficult or noisy. Scientific veterinarians are well
acquainted with the phenomena and locality of the affection, but there
is a great diversity of opinion as regards the exact cause. Asthma is
generally thought to be caused by spasm of the small circular muscles
that surround the bronchial tubes. The continued existence of this
affection of the muscles leads to a paralysis of them, and the forced
breathing to emphysema, which always accompanies heaves.
Heaves is usually associated with disorder of the function of digestion
or to an error in the choice of feed. Feeding on clover hay or damaged
hay or straw, too bulky and innutritious feed, and keeping the horse in
a dusty atmosphere or a badly ventilated stable produce or predispose to
heaves. Horses brought from a high to a low level are predisposed.
In itself broken wind is not a fatal disease, but death is generally
caused by an affection closely connected with it. After death, if the
organs are examined, the lesions found depend much upon the length of
time broken wind has affected the animal. In recent cases very few
changes are noticeable, but in animals that have been broken-winded for
a long time the changes are well-marked. The lungs are paler than
natural, and of much less weight in proportion to the volume, as
evidenced by floating them in water. The walls of the small bronchial
tubes and the membrane of the larger tubes are thickened. The right side
of the heart is enlarged and its cavities dilated. The stomach is
enlarged and its walls stretched. The important change found in the
lungs is a condition technically called pulmonary emphysema. This is of
two varieties: First, what is termed "vesicular emphysema," which
consists of an enlargement of the capacity of the air cells (air
vesicles) by dilation of their walls. The second form is called
interlobular, or interstitial, emphysema, and follows the first. In
this variety the air finds its way into the lung tissue between the air
cells or the tissue between the small lobules.
_Symptoms._--Almost every experienced horseman is able to detect heaves.
The peculiar movement of the flanks and abdomen point out the ailment at
once. In recent cases, however, the affected animal does not always
exhibit the characteristic breathing unless exerted to a certain extent.
The cough which accompanies this disease is peculiar to it. It is
difficult to describe, but the sound is short and something like a
grunt. When air is inspired--that is, taken in--it appears to be done in
the same manner as in health; it may possibly be done a little quicker
than natural, but not enough to attract any notice. It is when the act
of expiration (or expelling the air from the lungs) is performed that
the great change in the breathing is perceptible. It must be remembered
that the lungs have lost much of their elasticity, and in consequence of
their power of contracting on account of the degeneration of the walls
of the air cells, and also on account of the paralysis of muscular
tissue before mentioned. The air passes into them freely, but the power
to expel it is lost to a great extent by the lungs; therefore the
abdominal muscles are brought into play. These muscles, especially in
the region of the flank, are seen to contract, then pause for a moment,
then complete the act of contracting, thus making a double bellowslike
movement at each expiration, a sort of jerky motion with every breath.
The double expiratory movement may also be detected by allowing the that
the expiratory current is not continuous, but is broken into two jets.
When the animal is exerted a wheezing noise accompanies the breathing.
This noise may be heard to a less extent when the animal is at rest if
the ear is applied to the chest.
As before remarked, indigestion is often present in these cases. The
animal may have a depraved appetite, as shown by a desire to eat dirt
and soiled bedding, which he often devours in preference to the clean
feed in the trough or manger. The stomach is liable to be overloaded
with indigestible feed. The abdomen may assume that form called
"potbellied." The animal frequently passes wind of a very offensive
odor. When first put to work dung is passed frequently; the bowels are
often loose. The animal can not stand much work, as the muscular system
is soft. Round-chested horses are said to be predisposed to the disease,
and it is certain that in cases of long standing the chest usually
becomes rounder than natural.
Certain individuals become very expert in managing a horse affected with
heaves in suppressing the symptoms for a short time. They take advantage
of the fact that the breathing is much easier when the stomach and
intestines are empty. They also resort to the use of medicines that
have a depressing effect. When the veterinarian is examining a horse for
soundness, and he suspects that the animal has been "fixed," he usually
gives the horse as much water as he will drink and then has him ridden
or driven rapidly up a hill or on a heavy road. This will bring out the
characteristic breathing of heaves if the horse is so afflicted, but
will not cause the symptoms of heaves in a healthy horse. All
broken-winded horses have the cough peculiar to the affection, but it is
not regular. A considerable time may elapse before it is heard and then
it may come on in paroxysms, especially when first brought out of the
stable into the cold air, or when excited by work, or after a drink of
cold water. The cough is usually the first symptom of the disease.
_Treatment._--When the disease is established there is no cure for it.
Proper attention paid to the diet will relieve the distressing symptoms
to a certain extent, but they will undoubtedly reappear in their
intensity the first time the animal overloads the stomach or is allowed
food of bad quality. Clover hay or bulky feed which contains but little
nutriment have much to do with the cause of the disease, and therefore
should be entirely omitted when the animal is affected, as well as
before. It has been asserted that the disease is unknown where clover
hay is never used. The diet should be confined to feed of the best
quality and in the smallest quantity. The bad effect of moldy or dusty
hay, fodder, or feed of any kind can not be overestimated. A small
quantity of the best hay once a day is sufficient. This should be cut
and dampened. The animal should invariably be watered before feeding;
never directly after a meal. The animal should not be worked immediately
after a meal. Exertion, when the stomach is full, invariably aggravates
the symptoms. Turning on pasture gives relief. Carrots, potatoes, or
turnips chopped and mixed with oats or corn are a good diet. Half a pint
to a pint of thick, dark molasses with each feed is useful.
Arsenic is efficacious in palliating the symptoms. It is best
administered in the form of a solution of arsenic, as Fowler's solution
or as the white powdered arsenious acid. Of the former the dose is 1
ounce to the drinking water three times daily; of the latter one may
give 3 grains in each feed. These quantities may be cautiously increased
as the animal becomes accustomed to the drug. If the bowels do not act
regularly, a pint of raw linseed oil may be given once or twice a month,
or a handful of Glauber's salt may be given in the feed twice daily, so
long as necessary. It must, however, be borne in mind that all medicinal
treatment is of secondary consideration; careful attention paid to the
diet is of greatest importance. Broken-winded animals should not be used
for breeding purposes. A predisposition to the disease may be
inherited.
CHRONIC COUGH.
A chronic cough may succeed the acute disease of the respiratory organs,
such as pneumonia, bronchitis, laryngitis, etc. It accompanies chronic
roaring, chronic bronchitis, broken wind; it may succeed influenza. As
previously stated, cough is but a symptom and not a disease in itself.
Chronic cough is occasionally associated with diseases other than those
of the organs of respiration. It may be a symptom of chronic indigestion
or of worms. In such cases it is caused by a reflex nervous irritation.
The proper treatment in all cases of chronic cough is to ascertain the
nature of the disease of which it is a symptom, and then cure the
disease if possible and the cough will cease.
The treatment of the affections will be found under their appropriate
heads, to which the reader is referred.
PLEURODYNIA.
This is a form of rheumatism that affects the intercostal muscles; that
is, the muscles between the ribs. The apparent symptoms are very similar
to those of pleurisy. The animal is stiff and not inclined to turn
round; the ribs are kept in a fixed state as much as possible. If the
head is pulled round suddenly, or the affected side struck with the
hand, or if the spaces between the ribs are pressed with the fingers,
the animal will flinch and perhaps emit a grunt or groan expressive of
much pain. It is distinguished from pleurisy by the absence of fever,
cough, the friction sound, the effusion into the chest, and by the
existence of rheumatism in other parts. The treatment for this affection
is the same as for rheumatism affecting other parts.
WOUNDS PENETRATING THE WALLS OF THE CHEST.
A wound penetrating the wall of the chest admits air into the thoracic
cavity outside the lung. This condition is known as pneumothorax and may
result in collapse of the lung. The wound may be so made that when the
walls of the chest are dilating a little air is sucked in, but during
the contraction of the wall the contained air presses against the torn
part in such manner as entirely to close the wound; thus a small
quantity of air gains access with each inspiration, while none is
allowed to escape until the lung is pressed into a very small compass
and forced into the anterior part of the chest. The same thing may occur
from a broken rib inflicting a wound in the lung. In this form the air
gains access from the lung, and there may not be even an opening in the
walls of the chest. In such cases the air may be absorbed, when a
spontaneous cure is the result, but when the symptoms are urgent it is
recommended that the air be removed by a trocar and cannula or by an
aspirator.
It is evident that the treatment of wounds that penetrate the thoracic
cavity should be prompt. It should be quickly ascertained whether or not
a foreign body remains in the wound; then it should be thoroughly
cleaned with a solution of carbolic acid, 1 part in 40 parts of water.
The wound should then be closed immediately. If it is an incised wound,
it should be closed with sutures or with adhesive plasters; if torn or
lacerated, adhesive plaster may be used or a bandage around the chest
over the dressing. At all events, air must be prevented from getting
into the chest as soon and as effectually as possible. The after
treatment of the wound should consist principally in keeping the parts
clean with a solution of carbolic acid, and applying fresh dressing as
often as required to keep the wound in a healthy condition. Care should
be taken that the discharges from the wound have an outlet in the most
dependent part. (See Wounds and their treatment, p. 484.) If pleurisy
supervenes, it should be treated as advised under that head.
THUMPS, OR SPASM OF THE DIAPHRAGM.
"Thumps" is generally thought by the inexperienced to be a palpitation
of the heart. While it is true that palpitation of the heart is
sometimes called "thumps," it must not be confounded with the affection
under consideration.
In the beginning of this article on the diseases of the organs of
respiration, the diaphragm was briefly referred to as the principal and
essential muscle of respiration. Spasmodic or irregular contractions of
it in man are manifested by what is familiarly known as hiccoughs.
Thumps in the horse is similar to hiccoughs in man although in all cases
the peculiar noise is not made in the throat of the horse.
There should be no difficulty in distinguishing this affection from
palpitation of the heart. The jerky motion affects the whole body, and
is not confined to the region of the heart. If one hand is placed on the
body at about the middle of the last rib, while the other hand is placed
over the heart behind the left elbow, it will be easily demonstrated
that there is no connection between the thumping or jerking of the
diaphragm and the beating of the heart. In fact, when the animal is
affected with spasms of the diaphragm the beating of the heart is
usually much weaker and less perceptible than natural. Thumps is
produced by causes similar to those that produce congestion of the lungs
and dilatation or palpitation of the heart, and may occur in connection
with these conditions. If not relieved, death usually results from
congestion or edema of the lungs, as the breathing is interfered with
by the inordinate action of this important muscle of inspiration so much
that proper aeration of the blood can not take place. The treatment
should be as prescribed for congestion of the lungs, and, in addition,
antispasmodics, such as 1 ounce of sulphuric ether in warm water or 3
drams of asafetida.
RUPTURE OF THE DIAPHRAGM.
Post-mortem examinations after colic or severe accident sometimes reveal
rupture of the diaphragm. This may take place after death, from the
generation of gases in the decomposing carcass, which distend the
intestines so that the diaphragm is ruptured by the great pressure
against it. The symptoms are intensely difficult respiration and great
depression. There is no treatment.
DISEASES OF THE URINARY ORGANS.
BY JAMES LAW, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., in Cornell University._
USES OF THE URINARY ORGANS.
The urinary organs constitute the main channel through which are
excreted the nitrogenous or albuminoid principles, whether derived
directly from the feed or from the muscular and other nitrogenized
tissues of the body. They constitute, besides, the channel through which
are thrown out most of the poisons, whether taken in by the mouth or
skin or developed in connection with faulty or natural digestion,
blood-forming, nutrition, or tissue destruction; or, finally, poisons
that are developed within the body, as the result of normal cell life or
of the life of bacterial or other germs that have entered the body from
without. Bacteria themselves largely escape from the body through the
kidneys. To a large extent, therefore, these organs are the sanitary
scavengers and purifiers of the system, and when their functions are
impaired or arrested the retained poisons quickly show their presence in
resulting disorders of the skin and connective tissue beneath it, of the
nervous system, or other organs. Nor is this influence one-sided.
Scarcely an important organ of the body can suffer derangement without
entailing a corresponding disorder of the urinary system. Nothing can be
more striking than the mutual balance maintained between the liquid
secretions of the skin and kidneys during hot and cold weather. In
summer, when so much liquid exhales through the skin as sweat,
comparatively little urine is passed, whereas in winter, when the skin
is inactive, the urine is correspondingly increased. This vicarious
action of skin and kidneys is usually kept within the limits of health,
but at times the draining off of the water by the skin leaves too little
to keep the solids of the urine safely in solution, and these are liable
to crystallize out and form stone and gravel. Similarly the passage, in
the sweat, of some of the solids that normally leave the body, dissolved
in the urine, serves to irritate the skin and produce troublesome
eruptions.
PROMINENT CAUSES OF URINARY DISORDERS.
A disordered liver contributes to the production under different
circumstances of an excess of biliary coloring matter which stains the
urine; of an excess of hippuric acid and allied products which, being
less soluble than urea (the normal product of tissue change), favor the
formation of stone, of taurocholic acid, and other bodies that tend when
in excess to destroy the blood globules and to cause irritation of the
kidneys by the resulting hemoglobin excreted in the urine, and of
glycogen too abundant to be burned up in the system, which induces
saccharine urine (diabetes). Any disorder leading to impaired functional
activity of the lungs is causative of an excess of hippuric acid and
allied bodies, of oxalic acid, of sugar, etc., in the urine, which
irritate the kidneys, even if they do not produce solid deposits in the
urinary passages. Diseases of the nervous system, and notably of the
base of the brain and of the spinal cord, induce various urinary
disorders, prominent among which are diabetes, chylous urine, and
albuminuria. Certain affections, with imperfect nutrition or destructive
waste of the bony tissues, tend to charge the urine with phosphates of
lime and magnesia and endanger the formation of stone and gravel. In all
extensive inflammations and acute fevers the liquids of the urine are
diminished, while the solids (waste products), which should form the
urinary secretion, are increased, and the surcharged urine proves
irritant to the urinary organs or the retained waste products poison the
system at large.
Diseases of the heart and lungs, by interfering with the free, onward
flow of the blood from the right side of the heart, tend to throw that
liquid back on the veins, and this backward pressure of venous blood
strongly tends to disorders of the kidneys. Certain poisons taken with
the feed and water, notably that found in magnesian limestone and those
found in irritant, diuretic plants, are especially injurious to the
kidneys, as are also various cryptogams, whether in musty hay or oats.
The kidneys may be irritated by feeding green vegetables covered with
hoar frost or by furnishing an excess of feed rich in phosphates (wheat
bran, beans, peas, vetches, lentils, rape cake, cottonseed cake) or by a
privation of water, which entails a concentrated condition and high
density of the urine. Exposure in cold rain or snow storms, cold drafts
of air, and damp beds are liable to further disorder an already
overworked or irritable kidney. Finally, sprains of the back and loins
may cause bleeding from the kidneys or inflammation.
The right kidney, weighing 23-1/2 ounces, is shaped like a French bean,
and extends from the loins forward to beneath the heads of the last two
ribs. The left kidney (Pl. VIII) resembles a heart of cards, and extends
from the loins forward beneath the head of the last rib only. Each
consists of three distinct parts--(a) the external (cortical), or
vascular part, in which the blood vessels form elaborate capillary
networks within the dilated globular sacs which form the beginnings of
the secreting (uriniferous) tubes and on the surface of the sinuous,
secreting tubes leading from the sacs inward toward the second, or
medullary, part of the organ; (b) the internal (medullary) part, made
up in the main of blood vessels, lymphatics, and nerves extending
between the notch on the inner border of the kidney to and from the
outer vascular portion, in which the secretion of urine is almost
exclusively carried on; and (d) a large, saccular reservoir in the
center of the kidney, into which all uriniferous tubes pour their
secretions and from which the urine is carried away through a tube g
(ureter), which passes out of the notch at the inner border of the
kidney and which opens by a valve-closed orifice into the roof of the
bladder just in front of its neck. The bladder is a dilatable reservoir
for the retention of the urine until the discomfort of its presence
causes its voluntary discharge. It is kept closed by circular, muscular
fibers surrounding its neck or orifice, and is emptied by looped,
muscular fibers extending in all directions forward from the neck around
the blind anterior end of the sac. From the bladder the urine escapes
through a dilatable tube (urethra) which extends from the neck of the
bladder backward on the floor of the pelvis, and in the male through the
penis to its free end, where it opens through a pink, conical papilla.
In the mare the urethra is not more than an inch in length, and is
surrounded by the circular, muscular fibers closing the neck of the
bladder. Its opening may be found directly in the median line of the
floor of the vulva, about 4-1/2 inches from its external opening.
GENERAL SYMPTOMS OF DISEASE.
These apply especially to acute inflammations and the irritation caused
by stone. The animal moves stiffly on the hind limbs, straddles, and
makes frequent attempts to pass urine, which may be in excess, deficient
in amount, liable to sudden arrest in spite of the straining, passed in
driblets, or entirely suppressed. Again, it may be modified in density
or constituents. Difficulty in making a sharp turn, or in lying down and
rising with or without groaning, dropping the back when mounted or when
pinched on the loins is suggestive of kidney disease, and so to a less
extent are swelled legs, dropsy, and diseases of the skin and nervous
system. The oiled hand introduced through the rectum may feel the
bladder beneath and detect any overdistention, swelling, tenderness, or
stone. In ponies the kidneys even may be reached.
EXAMINATION OF THE URINE.
In some cases the changes in the urine are the sole sign of disease. In
health the horse's urine is of a deep amber color and has a strong odor.
On a feed of grain and hay it may show a uniform transparency, while on
a green ration there in an abundant white deposit of carbonate of lime.
Of its morbid changes the following are to be looked for: (1) _Color_:
White from deposited salts of lime; brown or red from blood clots or
coloring matter; yellow or orange from bile or blood pigment; pale from
excess of water; or variously colored from vegetable ingredients
(santonin makes it red; rhubarb or senna, brown; tar or carbolic acid,
green). (2) _Density_: The horse's urine may be 1.030 or 1.050, but it
may greatly exceed this in diabetes and may sink to 1.007 in diuresis.
(3) _Chemical reaction_, as ascertained by blue litmus or red test
papers. The horse on vegetable diet has alkaline urine turning red test
papers blue, while in the sucking colt and the horse fed on flesh or on
his own tissue (in starvation or abstinence during disease) it is acid,
turning blue litmus red. (4) _Organic constituents_, as when glairy from
albumen coagulable by strong nitric acid and boiling, when charged with
microscopic casts of the uriniferous tubes, with the eggs or bodies of
worms, with sugar, blood, or bile. (5) _In its salts_, which may
crystallize out spontaneously, or on boiling, or on the addition of
chemical reagents.
[Illustration: PLATE VIII.
LONGITUDINAL SECTION THROUGH KIDNEY.]
[Illustration: PLATE IX.
MICROSCOPIC ANATOMY OF KIDNEY.]
[Illustration: PLATE X.
MICROSCOPIC ANATOMY OF KIDNEY.]
Albuminous urine in the horse is usually glairy, so that it may be drawn
out in threads, but its presence can always be tested as follows: If the
liquid is opaque, it may be first passed through filter paper; if very
dense and already precipitating its salts, it may be diluted with
distilled water; add to the suspected liquid acetic acid drop by drop
until it reddens the blue litmus paper; then boil gently in a test tube;
if a precipitate is thrown down, set the tube aside to cool and then add
strong nitric acid. If the precipitate is not dissolved, it is albumen;
if dissolved it is probably urate or hippurate of ammonia. Albumen is
normally present in advanced gestation; abnormally it is seen in
diseases in which there occurs destruction of blood globules (anthrax,
low fevers, watery states of the blood, dropsies), in diseases of the
heart and liver which prevent the free escape of blood from the veins
and throw back venous pressure on the kidneys, in inflammation of the
lungs and pleuræ, and even tympany (bloating), doubtless from the same
cause, and in all congestive or inflammatory diseases of the kidneys,
acute or chronic.
Casts of the uriniferous tubes can be seen only by placing the suspected
urine under the microscope. They are usually very elastic and mobile,
waving about in the liquid when the cover glass is touched, and showing
a uniform, clear transparency (waxy) or entangled circular epithelial
cells or opaque granules or flattened, red-blood globules or clear,
refrangent oil globules. They may be even densely opaque from crystals
of earthy salts.
Pus cells may be found in the urine associated with albumen, and are
recognized by clearing up, when treated with acetic acid, so that each
cell shows two or three nuclei.
DIURESIS (POLYURIA, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF
URINE).
This consists in an excessive secretion of a clear, watery urine of a
low specific gravity (1.007) with a correspondingly ardent thirst, a
rapidly advancing emaciation, and great loss of strength and spirit.
_Causes._--Its causes may be any agent--medicinal, alimentary, or
poisonous--which unduly stimulates the kidneys; the reckless
administration of diuretics, which form such a common constituent of
quack horse powders; acrid diuretic plants in grass or hay; new oats
still imperfectly cured; an excess of roots or other very watery feed; a
full allowance of salt to animals that have become inordinately fond of
it; but, above all, feeding on hay, grain, or bran which has not been
properly dried and has become musty and permeated by fungi. Thus hay,
straw, or oats obtained in wet seasons and heating in the rick or stack
is especially injurious. Hence this malady, like coma somnolentum
(sleepy staggers), is widespread in wet seasons, and especially in rainy
districts.
_Symptoms._--The horse drinks deep at every opportunity and passes urine
on every occasion when stopped, the discharge being pale, watery, of a
low density, and inodorous; in short, it contains a great excess of
water and a deficiency of the solid excretions. So great is the quantity
passed, however, that the small amount of solids in any given specimen
amounts in 24 hours to far more than the normal--a fact in keeping with
the rapid wasting of the tissues and extreme emaciation. The flanks
become tucked up, the fat disappears, the bones and muscles stand out
prominently, the skin becomes tense and hidebound, and the hair erect,
scurfy, and deficient in luster. The eye becomes dull and sunken, the
spirits are depressed, the animal is weak and sluggish, sweats on the
slightest exertion, and can endure little. The subject may survive for
months, or may die early of exhaustion. In the slighter cases, or when
the cause ceases to operate, a somewhat tardy recovery may be made.
_Treatment_ consists in stopping the ingestion of the faulty drugs,
poisons, or feed, and supplying sound hay and grain free from all taint
of heating or mustiness. A liberal supply of boiled flaxseed in the
drinking water at once serves to eliminate the poison and to sheathe and
protect the irritated kidneys. Tonics like sulphate or phosphate of iron
(2 drams morning and evening) and powdered gentian or Peruvian bark (4
drams) help greatly by bracing the system and hastening repair. To these
may be added agents calculated to destroy the fungus and eliminate its
poisonous products. In that form which depends on musty food nothing
acts better than large doses of iodid of potassium (2 drams), while in
other cases creosote, carbolic acid (1 dram), or oil of turpentine (4
drams), properly diluted, may be resorted to.
SACCHARINE DIABETES (DIABETES MELLITUS, GLYCOSURIA, OR INOSURIA).
This is primarily a disease of the nervous system or liver rather than
of the kidneys, yet, as the most prominent symptom is the sweet urine,
it may be treated here.
_Causes._--Its causes are varied, but resolve themselves largely into
disorder of the liver or disorder of the brain. One of the most
prominent functions of the liver is the formation of glycogen, a
principle allied to grape sugar, and passing into it by further
oxidation in the blood. This is a constant function of the liver, but in
health the resulting sugar is burned up in the circulation and does not
appear in the urine. On the contrary, when the supply of oxygen is
defective, as in certain diseases of the lungs, the whole of the sugar
does not undergo combustion and the excess is excreted by the kidneys.
Also in certain forms of enlarged liver the quantity of sugar produced
is more than can be disposed of in the natural way, and it appears in
the urine. A temporary sweetness of the urine often occurs after a
hearty meal on starchy feed, but this is due altogether to the
super-abundant supply of the sugar-forming feed, lasts for a few hours
only, and has no pathological significance. In many cases of fatal
glycosuria the liver is found to be enlarged, or at least congested, and
it is found that the disorder can be produced experimentally by agencies
which produce an increased circulation through the liver. Thus Bernard
produced glycosuria by pricking the oblong medulla at the base of the
brain close to the roots of the pneumogastric nerve, which happens to be
also the nerve center (vasomotor) which presides over the contractions
of the minute blood vessels. The pricking and irritation of this center
leads to congestion of the liver and the excessive production of sugar.
Irritation carried to this point through the pneumogastric nerve causes
saccharine urine, and, in keeping with this, disease of the pancreas has
been found in this malady. The complete removal of the pancreas,
however, determines glycosuria, the organ having in health an inhibitive
action on sugar production by the liver. The same result follows the
reflection of irritation from other sources, as from different ganglia
(corpora striata, optic thalami, pons, cerebellum, cerebrum) of the
brain. Similarly it is induced by interruption of the nervous control
along the vasomotor tracts, as in destruction of the upper or lower
cervical sympathetic ganglion, by cutting the nervous branch connecting
these two, in injury to the spinal marrow in the interval between the
brain and the second or fourth dorsal vertebra, or in disease of the
celiac plexus, which directly presides over the liver. Certain chemical
poisons also cause saccharine urine, notably woorara, strychnia,
morphia, phosphoric acid, alcohol, ether, quinia, chloroform, ammonia,
arsenic, and phlorizin.
_Symptoms._--The symptoms are ardent thirst and profuse secretion of a
pale urine of a high density (1.060 and upward), rapid loss of
condition, scurfy, unthrifty skin, costiveness or irregularity of the
bowels, indigestion, and the presence, in the urine, of a sweet
principle--grape sugar or inosite, or both. This may be most promptly
detected by touching the tip of the tongue with a drop. Sugar may be
detected simply by adding a teaspoonful of liquid yeast to 4 ounces of
the urine and keeping it lightly stopped at a temperature of 70° to 80°
F. for 12 hours, when the sugar will be found to have been changed into
alcohol and carbon dioxid. The loss of density will give indication of
the quantity of sugar transformed; thus a density of 1.035 in a urine
which was formerly 1.060 would indicate about 15 grains of sugar to the
fluid ounce.
Inosite, or muscle sugar, frequently present in the horse's urine, and
even replacing the glucose, is not fermentable. Its presence may be
indicated by its sweetness and the absence of fermentation or by
Gallois's test. Evaporate the suspected urine at a gentle heat almost to
dryness, then add a drop of a solution of mercuric nitrate and evaporate
carefully to dryness, when a yellowish residue is left that is changed
on further cautious heating to a deep rose color, which disappears on
cooling and reappears on heating.
In advanced diabetes, dropsies in the limbs and under the chest and
belly, puffy, swollen eyelids, cataracts, catarrhal inflammation of the
lungs, weak, uncertain gait, and drowsiness may be noted.
_Treatment_ is most satisfactory in cases dependent on some curable
disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a
run at pasture in warm weather, or in winter a warm, sunny, well-aired
stable, with sufficient clothing and laxatives (sulphate of soda, 1
ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may
benefit. To this may be added mild blistering, cupping, or even leeching
over the last ribs. Diseases of the brain or pancreas may be treated
according to their indications. The diet should be mainly albuminous,
such as wheat bran or middlings, peas, beans, vetches, and milk. Indeed,
an exclusive milk diet is one of the very best remedial agencies. It may
be given as skimmed milk or butter-milk, and in the last case combines
an antidiabetic remedy in the lactic acid. Under such an exclusive diet
recent and mild cases are often entirely restored, though at the expense
of an attack of rheumatism. Codeia, one of the alkaloids of opium, is
strongly recommended by Tyson. The dose for the horse would be 10 to 15
grains thrice daily. In cases in which there is manifest irritation of
the brain, bromid of potassium, 4 drams, or ergot one-half ounce, may be
resorted to. Salicylic acid and salicylate of sodium have proved useful
in certain cases; also phosphate of sodium. Bitter tonics (especially
nux vomica one-half dram) are useful in improving the digestion and
general health.
HEMATURIA (BLOODY URINE).
_Cause._--As seen in the horse, bloody urine is usually the direct
result of mechanical injuries, as sprains and fractures of the loins,
lacerations of the sublumbar muscles (psoas), irritation caused by stone
in the kidney, ureter, bladder, or urethra. It may, however, occur with
acute congestion of the kidney, with tumors in its substance, or with
papilloma or other diseased growth in the bladder. Acrid diuretic plants
present in the feed may also lead to the escape of blood from the
kidney. The predisposition to this affection is, however, incomparably
less than in the case of the ox or the sheep, the difference being
attributed to the greater plasticity of the horse's blood in connection
with the larger quantity of fibrin.
The blood may be present in small clots or in more or less intimate
admixture with the urine. Its condition may furnish some indication as
to its source; thus, if from the kidneys it is more liable to be
uniformly diffused through the urine, while as furnished by the bladder
or passages clots are more liable to be present. Again, in bleeding from
the kidney, minute, cylindrical clots inclosing blood globules and
formed in the uriniferous tubes can be detected under the microscope.
Precision also may be approximated by observing whether there is
coexisting fracture, sprain of the loins, or stone or tumor in the
bladder or urethra.
_Treatment._--The disease being mainly due to direct injury, treatment
will consist, first, in removing such cause whenever possible, and then
in applying general and local styptics. Irritants in feed must be
avoided, sprains appropriately treated, and stone in bladder or urethra
removed. Then give mucilaginous drinks (slippery elm, linseed tea)
freely, and styptics (tincture of chlorid of iron 3 drams, acetate of
lead one-half dram, tannic acid one-half dram, or oil of turpentine 1
ounce). If the discharge is abundant, apply cold water to the loins and
keep the animal perfectly still.
HEMOGLOBINURIA (AZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS).
Like diabetes, this is rather a disease of the liver and blood-forming
functions than of the kidney, but as prominent symptoms are loss of
control over the hind limbs and the passage of ropy and dark-colored
urine, the vulgar idea is that it is a disorder of the urinary organs.
It is a complex affection directly connected with a plethora in the
blood of nitrogenized constituents, with extreme nervous and muscular
disorder and the excretion of a dense reddish or brownish urine. It is
directly connected with high feeding, especially on highly nitrogenized
feed (oats, beans, peas, vetches, cottonseed meal), and with a period of
idleness in the stall under full rations. The disease is never seen at
pasture, rarely under constant daily work, even though the feeding is
high, and the attack is usually precipitated by taking the horse from
the stable and subjecting it to exercise or work. The poisoning is not
present when taken from the stable, as the horse is likely to be
noticeably lively and spirited, but he will usually succumb under the
first hundred yards or half mile of exercise. It seems as if the
aspiratory power of the chest under the sudden exertion and accelerated
breathing speedily drew from the gorged liver and abdominal veins
(portal) the accumulated store of nitrogenous matter in an imperfectly
oxidized or elaborated condition, and as if the blood, surcharged with
these materials, were unable to maintain the healthy functions of the
nerve centers and muscles. It has been noticed rather more frequently in
mares than horses, attributable, perhaps, to the nervous excitement
attendant on heat, and to the fact that the unmutilated mare is
naturally more excitable than the docile gelding.
Lignières has found in hemoglobinuria a streptococcus which produced
nephritis, bloody urine, and paraplegia in experimental animals,
including horses.
_Symptoms._--In the milder forms this affection may appear as a lameness
in one limb, from indefinite cause, succeeding to some sudden exertion
and attended by a dusky-brown color of the membranes of the eye and nose
and some wincing when the last ribs are struck. The severe forms come on
after one or two days of rest on a full ration, when the animal has been
taken out and driven one hundred paces or more: The fire and life with
which he had left the stable suddenly give place to dullness and
oppression, as shown in heaving flanks, dilated nostrils, pinched face,
perspiring skin, and trembling body. The muscles of the loins or haunch
become swelled and rigid, the subject moves stiffly or unsteadily,
crouches behind, the limbs being carried semiflexed, and he soon drops,
unable to support himself. When down, the body and limbs are moved
convulsively, but there is no power of coordination of movement in the
muscles. The pulse and breathing are accelerated, the eyes red with a
tinge of brown, and the urine, if passed, is seen to be highly colored,
dark brown, red, or black, but it contains neither blood clots nor
globules. The color is mainly due to hemoglobin and other imperfectly
elaborated constituents of the blood.
It may end fatally in a few hours or days, or a recovery may ensue,
which is usually more speedy and perfect if it has set in at an early
stage. In the late and tardy recoveries a partial paralysis of the hind
limbs may last for months. A frequent sequel of these tardy cases is an
extensive wasting of the muscles leading up from the front of the stifle
(those supplied by the crural nerve) and a complete inability to stand.
_Prevention._--The prevention of this serious affection lies in
restricting the diet and giving daily exercise when the animal is not at
work. A horse that has had one attack should never be left idle for a
single day in the stall or barnyard. When a horse has been condemned to
absolute repose on good feeding he may have a laxative (one-half to 1
pound Glauber's salt), and have graduated exercise, beginning with a
short walk and increasing day by day.
_Treatment._--The treatment of the mild cases may consist in a laxative,
graduated daily exercise, and a daily dose of saltpeter (1 ounce).
Sudden attacks will sometimes promptly subside if taken on the instant
and the subject kept still and calmed by a dose of bromid of potassium
(4 drams) and sweet spirits of niter (1 ounce). The latter has the
advantage of increasing the secretion of the kidneys. Iodid of potassium
in one-half ounce doses every four hours has succeeded well in some
hands. In severe cases, as a rule, it is desirable to begin treatment by
a dose of aloes (4 to 6 drams) with the above-named dose of bromid of
potassium, and this latter may be continued at intervals of four or six
hours, as may be requisite to calm the nervous excitement. Fomentations
with warm water over the loins are always useful in calming the
excitable conditions of the spinal cord, muscles, liver, and kidneys,
and also in favoring secretion from the two latter. On the second day
diuretics may be resorted to, such as saltpeter one-half ounce, and
powdered colchicum, one-half dram, to be repeated twice daily. A
laxative may be repeated in three or four days should the bowels seem to
demand it, and as the nervous excitement disappears any remaining
muscular weakness or paralysis may be treated by one-half dram doses of
nux vomica twice a day and a stimulating liniment (aqua ammonia and
sweet oil in equal proportions) rubbed on the torpid muscles.
During the course of the disease friction to the limbs is useful, and in
the advanced paralytic stage the application of electricity along the
line of the affected muscles. When the patient can not stand he must
have a thick, soft bed, and should be turned from side to side at least
every twelve hours. As soon as he can be made to stand he may be helped
up and even supported in a sling.
ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS.
Inflammations of the kidneys have been differentiated widely, according
as they were acute or chronic, parenchymatous or tubal, suppurative or
not, with increased or shrunken kidney, etc. In a work like the present,
however, utility will be consulted by classing all under acute or
chronic inflammation.
_Causes._--The causes of inflammation of the kidneys are extremely
varied. Congestion occurs from the altered and irritant products passed
through these organs during recovery from inflammations of other organs
and during fevers. This may last only during the existence of its cause,
or may persist and become aggravated. Heart disease, throwing the blood
pressure back on the veins and kidneys, is another cause. Disease of the
ureter or bladder, preventing the escape of urine from the kidney and
causing increased fullness and tension in its pelvis and tubes, will
determine inflammation. Decomposition of the detained urine in such
cases and the production of ammonia and other irritants must also be
named. In elimination of bacteria through the kidney, the latter is
liable to infection with consequent inflammation. The advance of
bacteria upward from the bladder to the kidneys is another cause. The
consumption in hay or other fodder of acrid or irritant plants,
including fungi, the absorption of cantharidine from a surface blistered
by Spanish flies, the reckless administration of diuretics, the presence
of stones in the kidney, exposure of the surface to cold and wet, and
the infliction of blows or sprains on the loins, may contribute to its
production. Liver disorders which throw on the kidneys the work of
excreting irritant products, diseases of the lungs and heart from which
clots are carried, to be arrested in the small blood vessels of the
kidney, and injuries and paralysis of the spinal cord, are additional
causes.
_Symptoms._--The symptoms are more or less fever, manifest stiffness of
the back and straddling gait with the hind limbs, difficulty in lying
down and rising, or in walking in a circle, the animal sometimes
groaning under the effort, arching of the loins and tucking up of the
flank, looking back at the abdomen as if from colicky pain, and
tenderness of the loins to pinching, especially just beneath the bony
processes 6 inches to one side of the median line. Urine is passed
frequently, a small quantity at a time, of a high color, and sometimes
mixed with blood or even pus. Under the microscope it shows the
microscopic casts referred to under general symptoms. If treated by
acetic acid, boiling and subsequent addition of strong nitric acid, the
resulting and persistent precipitate indicates the amount of albumen.
The legs tend to swell from the foot up, also the dependent parts
beneath the belly and chest, and effusions of liquid may occur within
the chest or abdomen. In the male the alternate drawing up and
relaxation of the testicles in the scrotum are suggestive, and in small
horses the oiled hand introduced into the rectum may reach the kidney
and ascertain its sensitiveness.
_Treatment_ demands, first, the removal of any recognized cause. Then,
if the suffering and fever are high, 2 to 4 quarts of blood may be
abstracted from the jugular vein; in weak subjects or unless in high
fever this should be omitted. Next relieve the kidneys so far as
possible by throwing their work on the bowels and skin. A pint of castor
oil is less likely than either aloes or salts to act on the kidneys. To
affect the skin a warm stall and heavy clothing may be supplemented by
dram doses of Dover's powder. Pain may be soothed by dram doses of
bromid of potassium. Boiled flaxseed may be added to the drinking water,
also thrown into the rectum as an injection, and blankets saturated with
hot water should be persistently applied to the loins. This may be
followed by a very thin pulp of the best ground mustard made with tepid
water, rubbed in against the direction of the hair and covered with
paper and a blanket. This may be kept on for an hour, or until the skin
thickens and the hair stands erect. It may then be rubbed or sponged off
and the blanket reapplied. When the action of the bowels has been
started it may be kept up by a daily dose of 2 or 3 ounces of Glauber's
salt.
During recovery a course of bitter tonics (nux vomica 1 scruple, ground
gentian root 4 drams) should be given. The patient should also be
guarded against cold, wet, and any active exertion for some time after
all active symptoms have subsided.
CHRONIC INFLAMMATION OF THE KIDNEYS.
_Causes._--Chronic inflammation of the kidneys is more commonly
associated with albumen and casts in the urine than the acute form, find
in some instances these conditions of the urine may be the only
prominent symptoms of the disease. Though it may supervene on blow,
injuries, and exposures, it is much more commonly connected with faulty
conditions of the system--as indigestion, heart disease, lung or liver
disease, imperfect blood formation, or assimilation; in short, it is
rather the attendant on a constitutional infirmity than on a simple
local injury.
It may be associated with various forms of diseased kidneys, as
shrinkage (atrophy), increase (hypertrophy), softening, red congestion,
white enlargement, etc., so that it forms a group of diseases rather
than a disease by itself.
_Symptoms._--The symptoms may include stiffness, weakness, and increased
sensibility of the loins, and modified secretion of urine (increase or
suppression), or the flow may be natural. Usually it contains albumen,
the quantity furnishing a fair criterion of the gravity of the
affection, and microscopic casts, also most abundant in bad cases.
Dropsy, manifested in swelled legs, is a significant symptom, and if the
effusion takes place along the lower line of the body or in chest or
abdomen, the significance is increased. A scurfy, unthrifty skin,
lack-luster hair, inability to sustain severe or continued exertion,
poor or irregular appetite, loss of fat and flesh, softness of the
muscles, and pallor of the eyes and nose are equally suggestive. So are
skin eruptions of various kinds. Any one or more of these symptoms would
warrant an examination of the urine for albumen and casts, the finding
of which signifies renal inflammation.
_Treatment_ of these cases is not always satisfactory, as the cause is
liable to be maintained in the disorders of important organs elsewhere.
If any such coincident disease of another organ or function can be
detected, that should be treated first or simultaneously with this
affection of the kidneys. In all cases the building up of the general
health is important. Hence a course of tonics may be given (phosphate of
iron 2 drams, nux vomica 20 grains, powdered gentian root 4 drams,
daily) or 60 drops of sulphuric acid or nitrohydrochloric acid may be
given daily in the drinking water. If there is any elevated temperature
of the body and tenderness of the loins, fomentations may be applied,
followed by a mustard pulp, as for acute inflammation, and even in the
absence of these indications the mustard may be resorted to with
advantage at intervals of a few days. In suppression of urine,
fomentations with warm water or with infusion of digitalis leaves is a
safer resort than diuretics, and cupping over the loins may also
benefit. To apply a cup, shave the skin and oil it; then take a
narrow-mouthed glass, rarify the air within it by introducing a taper in
full flame for a second, withdraw the taper and instantly apply the
mouth of the glass to the skin and hold it closely applied till the
cooling tends to form a vacuum in the glass and to draw up the skin,
like a sucker.
As in the acute inflammation, every attention must be given to secure
warm clothing, a warm stall, and pure air.
TUMORS OF THE KIDNEYS.
Tumors, whether malignant or simple, would give rise to symptoms
resembling some form of inflammation, and are not liable to be
recognized during life.
PARASITES.
To parasites of the kidney belong the echinococcus, the larval, or
bladder worm, stage of the small echinococcus tapeworm of the dog.
_Dioctophyme renale_, the largest of roundworms, has been found in the
kidney of the horse. Its presence can be certified only by the passage
of its microscopic eggs or of the entire worm. Immature stages of
roundworms, either _Strongylus equinus_ or a related species, may be
found in the renal artery or in the kidney itself.
SPASM OF THE NECK OF THE BLADDER.
This affection consists in spasmodic closure of the outlet from the
bladder by tonic contraction of the circular muscular fibers. It may be
accompanied with a painful contraction of the muscles on the body of the
bladder; or, if the organ is already unduly distended, these will be
affected with temporary paralysis. It is most frequent in the horse, but
by no means unknown in the mare.
_Causes._--The causes are usually hard and continuous driving without
opportunity for passing urine, cold rainstorms, drafts of cold air when
perspiring and fatigued, the administration of Spanish fly or the
application of extensive blisters of the same, abuse of diuretics, the
presence of acrid, diuretic plants in the fodder, and the presence of
stone in the bladder. As most mares refuse to urinate while in harness,
they should be unhitched at suitable times for urination. Spasms of the
bowels are always attended by spasm of the bladder, hence the free
passage of water is usually a symptom of relief.
_Symptoms._--The symptoms are frequent stretching and straining to
urinate, with no result or a slight dribbling only. These vain efforts
are attended by pain and groaning. On resuming his natural position the
animal is not freed from the pain, but moves uneasily, paws, shakes the
tail, kicks at the abdomen with his hind feet, looks back to the flank,
lies down and rises, arches the back, and attempts to urinate as before.
If the oiled hand is introduced into the rectum the greatly distended
bladder may be felt beneath, and the patient will often shrink when it
is handled.
It is important to notice that irritation of the urinary organs is often
present in impaction of the colon with solid matters, because the
impacted intestine under the straining of the patient is forced backward
into the pelvis and presses upon and irritates the bladder. In such
cases the horse stands with his fore limbs advanced and the hind ones
stretched back beyond the natural posture and makes frequent efforts to
urinate, with varying success. Unpracticed observers naturally conclude
that the secondary urinary trouble is the main and only one, and the
intestinal impaction and obstruction is too often neglected until it is
irremediable. In cases in which the irritation has caused spasm of the
neck of the bladder and overdistention of that organ, the mistake is
still more easily made; hence it is important in all cases to examine
for the impacted bowel, forming a bend or loop at the entrance of the
pelvis and usually toward the left side. The impacted intestine feels
soft and doughy and is easily indented with the knuckles, forming a
marked contrast with the tense, elastic, resilient, overdistended
bladder.
It remains to be noted that similar symptoms may be determined by a
stone or sebaceous mass, or stricture obstructing the urethra, or in the
newborn by thickened mucus in that duct and by the pressure of hardened,
impacted feces in the rectum. In obstruction, the hard, impacted body
can usually be felt by tracing the urethra along the lower and posterior
surface of the penis and forward to the median line of the floor of the
pelvis to the neck of the bladder. That part of the urethra between the
seat of obstruction and the bladder is usually distended with urine and
feels enlarged, elastic, and fluctuating.
_Treatment._--Treatment may be begun by taking the animal out of
harness. This failing, spread clean litter beneath the belly or turn the
patient out on the dung heap. Some seek to establish sympathetic action
by pouring water from one vessel into another with dribbling noise.
Others soothe and distract the attention by slow whistling. Friction of
the abdomen with wisps of straw may succeed, or it may be rubbed with
ammonia and oil. These failing, an injection of 2 ounces of laudanum or
of an infusion of 1 ounce of tobacco in water may be tried. In the mare
the neck of the bladder is easily dilated by inserting two oiled fingers
and slightly parting them. In the horse the oiled hand introduced into
the rectum may press from before backward on the anterior or blind end
of the bladder. Finally, a well-oiled gum-elastic catheter may be
entered into the urethra through the papilla at the end of the penis and
pushed on carefully until it has entered the bladder. To effect this the
penis must first be withdrawn from its sheath, and when the advancing
end of the catheter has reached the bend of the urethra beneath the anus
it must be guided forward by pressure with the hand, which guidance must
be continued onward into the bladder, the oiled hand being introduced
into the rectum for this purpose. The horse catheter, 3-1/2 feet long
and one-third inch in diameter, may be bought of a surgical-instrument
maker.
PARALYSIS OF THE BLADDER.
Paralysis of the body of the bladder with spasm of the neck has been
described under the last heading, and may occur in the same way from
overdistention in tetanus, acute rheumatism, paraplegia, and hemiplegia,
in which the animal can not stretch himself to urinate, and in cystitis,
affecting the body of the bladder but not the neck. In all these cases
the urine is suppressed. It also occurs as a result of disease of the
posterior end of the spinal marrow and with broken back, and is then
associated with palsy of the tail, and, it may be, of the hind limbs.
_Symptoms._--The symptoms are a constant dribbling of urine when the
neck is involved, the liquid running down the inside of the thighs and
irritating the skin. When the neck is unaffected the urine is retained
until the bladder is greatly overdistended, when it may be expelled in a
gush by the active contraction of the muscular walls of the abdomen;
this never empties the bladder, however, and the oiled hand introduced
through the rectum may feel the soft, flabby organ still half full of
urine. This retained urine is liable to decompose and give off ammonia,
which dissolves the epithelial cells, exposing the raw, mucous membrane
and causing the worst type of cystitis. Suppression and incontinence of
urine are common also to obstruction of the urethra by stone or
otherwise; hence this source of fallacy should be excluded by manual
examination along the whole course of that duct.
_Treatment._--Treatment is only applicable in cases in which the
determining cause can be abated. In remedial sprains of the back or
disease of the spinal cord these must have appropriate treatment, and
the urine must be drawn off frequently with a catheter to prevent
overdistention and injury to the bladder. If the paralysis persists
after recovery of the spinal cord, or if it continues after relief of
spasm of the neck of the bladder, apply a pulp of mustard and water over
the back part of the belly in front of the udder, and cover with a rug
until the hair stands erect. In the male the mustard may be applied
between the thighs from near the anus downward. Daily doses of 2 drams
extract of belladonna or of 2 grains powdered Spanish fly may serve to
rouse the lost tone. These failing, a mild current of electricity daily
may succeed.
INFLAMMATION OF THE BLADDER (CYSTITIS, OR UROCYSTITIS).
Cystitis may be slight or severe, acute or chronic, partial or general.
It may be caused by abuse of diuretics, especially such as are
irritating (cantharides, turpentine, copaiba, resin, etc.), by the
presence of a stone or gravel in the bladder, the irritation of a
catheter or other foreign body introduced from without, the septic
ferment (bacterium) introduced on a filthy catheter, the overdistention
of the bladder by retained urine, the extrication of ammonia from
retained decomposing urine, resulting in destruction of the epithelial
cells and irritation of the raw surface, and a too concentrated and
irritating urine. The application of Spanish flies or turpentine over a
too extensive surface, sudden exposure of a perspiring and tired horse
to cold or wet, and the presence of acrid plants in the fodder may cause
cystitis, as they may nephritis. Finally, inflammation may extend from a
diseased vagina or urethra to the bladder.
_Symptoms._--The symptoms are slight or severe colicky pains; the animal
moves his hind feet uneasily or even kicks at the abdomen, looks around
at his flank, and may even lie down and rise frequently. More
characteristic are frequently repeated efforts to urinate, resulting in
the discharge of a little clear, or red, or more commonly flocculent
urine, always in jets, and accompanied with signs of pain, which persist
after the discharge, as shown in continued straining, groaning, and
perhaps in movements of the feet and tail. The penis hangs from the
sheath, or in the mare the vulva is frequently opened and closed, as
after urination. The animal winces when the abdomen is pressed in the
region of the sheath or udder, and the bladder is found to be sensitive
and tender when pressed with the oiled hand introduced through the
rectum or vagina. In the mare the thickening of the walls of the bladder
may be felt by introducing one finger through the urethra. The
discharged urine, which may be turbid or even oily, contains an excess
of mucus, with flat shreds of membrane, with scaly epithelial cells, and
pus corpuscles, each showing two or more nuclei when treated with acetic
acid, but there are no microscopic tubular casts, as in nephritis. If
due to stone in the bladder, that will be found on examination through
rectum or vagina.
_Treatment_ implies, first, the removal of the cause, whether poisons in
feed or as medicine, the removal of Spanish flies or other blistering
agents from the skin, or the extraction of stone or gravel. If the urine
has been retained and decomposed it must be completely evacuated through
a clean catheter, and the bladder thoroughly washed out with a solution
of 1 dram of borax in a quart of water. This must be repeated twice
daily until the urine no longer decomposes, because so long as ammonia
is developed in the bladder the protecting layer of epithelial cells
will be dissolved and the surface kept raw and irritable. The diet must
be light (bran mashes, roots, fresh grass), and the drink impregnated
with linseed tea, or solution of slippery elm or marsh mallow. The same
agents may be used to inject into the rectum, or they may even be used
along with borax and opium to inject into bladder (gum arabic 1 dram,
opium 1 dram, tepid water 1 pint). Fomentations over the loins are often
of great advantage, and these may be followed or alternated with the
application of mustard, as in paralysis; or the mustard may be applied
on the back part of the abdomen below or between the thighs from the
anus downward. Finally, when the acute symptoms have subsided, a daily
dose of buchu 1 dram and nux vomica one-half dram will serve to restore
lost tone.
IRRITABLE BLADDER.
Some horses, and especially mares, show an irritability of the bladder
and nerve centers presiding over it by frequent urination in small
quantities, though the urine is not manifestly changed in character and
no more than the natural quantity is passed in the twenty-four hours.
The disorder appears to have its source quite as frequently in the
generative or nervous system as in the urinary. A troublesome and
dangerous form is seen in mares, which dash off and refuse all control
by the rein if driven with a full bladder, but usually prove docile if
the bladder has been emptied before hitching. In other cases the
excitement connected with getting the tail over the reins is a powerful
determining cause. The condition is marked in many mares during the
period of heat.
An oleaginous laxative (castor oil 1 pint) will serve to remove any
cause of irritation in the digestive organs, and a careful dieting will
avoid continued irritation by acrid vegetable agents. The bladder should
be examined to see that there is no stone or other cause of irritation,
and the sheath and penis should be washed with soapsuds, any sebaceous
matter removed from the bilocular cavity at the end of the penis, and
the whole lubricated with sweet oil. Irritable mares should be induced
to urinate before they are harnessed, and those that clutch the lines
under the tail may have the tail set high by cutting the cords on its
lower surface, or it may be prevented from getting over the reins by
having a strap carried from its free end to the breeching. Those proving
troublesome when "in heat" may have 4-dram doses of bromid of potassium,
or they may be served by the male or castrated. Sometimes irritability
may be lessened by daily doses of belladonna extract (1 dram), or a
better tone may be given to the parts by balsam copaiba (1 dram).
DISEASED GROWTHS IN THE BLADDER.
These may be of various kinds, malignant or simple. In the horse I have
found villous growths from the mucous membrane especially troublesome.
They may be attached to the mucous membrane by a narrow neck or by a
broad base covering a great part of the organ.
_Symptoms._--The symptoms are frequent straining, passing of urine and
blood with occasionally gravel. An examination of the bladder with the
hand in the rectum will detect the new growth, which may be
distinguished from a hard, resistant stone. In mares, in which the
finger can be inserted into the bladder, the recognition is still more
satisfactory. The polypi attached by narrow necks may be removed by
surgical operation, but for those with broad attachments treatment is
eminently unsatisfactory.
DISCHARGE OF URINE BY THE NAVEL, OR PERSISTENT URACHUS.
This occurs only in the newborn, and consists in the nonclosure of the
natural channel (urachus), through which the urine is discharged into
the outer water bag (allantois) in fetal life. At that early stage of
the animal existence the bladder resembles a long tube, which is
prolonged through the navel string and opens into the outermost of the
two water bags in which the fetus floats. In this way the urine is
prevented from entering the inner water bag (amnion), where it would
mingle with the liquids, bathing the skin of the fetus and cause
irritation. At birth this channel closes up, and the urine takes the
course normal to extra-uterine life. Imperfect closure is more frequent
in males than in females, because of the great length and small caliber
of the male urethra and its consequent tendency to obstruction. In the
female there may be a discharge of a few drops only at a time, while in
the male the urine will be expelled in strong jets coincidently with the
contractions of the bladder and walls of the abdomen.
The first care is to ascertain whether the urethra is pervious by
passing a human catheter. This determined, the open urachus may be
firmly closed by a stout, waxed thread, carried with a needle through
the tissues back of the opening and tied in front of it so as to inclose
as little skin as possible. If a portion of the naval string remains,
the tying of that may be all sufficient. It is important to tie as early
as possible so as to avoid inflammation of the navel from contact with
the urine. In summer a little carbolic-acid water or tar water may be
applied to keep the flies off.
EVERSION OF THE BLADDER.
This can occur only in the female. It consists in the turning of the
organ outside in through the channel of the urethra, so that it appears
as a red, pear-shaped mass hanging from the floor of the vulva and
protruding externally between its lips. It may be a mass like the fist,
or it may swell up to the size of an infant's head. On examining its
upper surface the orifices of the urethra maybe seen, one on each side,
a short distance behind the neck, with the urine oozing from them drop
by drop.
This displacement usually supervenes on a flaccid condition of the
bladder, the result of paralysis, overdistention, or severe compression
during a difficult parturition.
The protruding organ may be washed with a solution of 1 ounce of
laudanum and a teaspoonful of carbolic acid in a quart of water, and
returned by pressing a smooth, rounded object into the fundus and
directing it into the urethra, while careful pressure is made on the
surrounding parts with the other hand. If too large and resistant it may
be wound tightly in a strip of bandage about 2 inches broad to express
the great mass of blood and exudate and diminish the bulk of the
protruded organ so that it can be easily pushed back. This method has
the additional advantage of protecting the organ against bruises and
lacerations in the effort made to return it. After the return, straining
may be kept in check by giving laudanum (1 to 2 ounces) and by applying
a truss to press upon the lips of the vulva. (See Eversion of the womb.)
The patient should be kept in a stall a few inches lower in front than
behind, so that the action of gravity will favor retention.
[Illustration: PLATE XI.
CALCULI AND INSTRUMENT FOR REMOVAL.]
INFLAMMATION OF THE URETHRA (URETHRITIS, OR GLEET).
This affection belongs quite as much to the generative organs, yet it
can not be entirely overlooked in a treatise on urinary disorders. It
may be induced by the same causes as cystitis (which see); by the
passage and temporary arrest of small stones, or gravel; by the
irritation caused by foreign bodies introduced from without; by blows on
the penis by sticks, stones, or by the feet of a mare that kicks while
being served; by an infecting inflammation contracted from a mare served
in the first few days after parturition or one suffering from
leucorrhea; by infecting matter introduced on a dirty catheter, or by
the extension of inflammation from an irritated, bilocular cavity filled
with hardened sebaceous matter, or from an uncleansed sheath.
_Symptoms._--The symptoms are swelling, heat, and tenderness of the
sheath and penis; difficulty, pain, and groaning in passing urine, which
is liable to sudden temporary arrests in the course of micturition, and
later a whitish, mucopurulent oozing from the papilla on the end of the
penis. There is a tendency to erection of the penis, and in cases
contracted from a mare the outer surface of that organ will show more or
less extensive sores and ulcers. Stallions suffering in this way will
refuse to mount or, having mounted, will fail to complete the act of
coition. If an entrance is effected, infection of the mare is liable to
follow.
_Treatment_ in the early stages consists in a dose of physic (aloes 6
drams) and fomentations of warm water to the sheath and penis. If there
is reason to suspect the presence of infection, inject the urethra twice
daily with borax 1 dram, tepid water 1 quart. When the mucopurulent
discharge indicates the supervention of the second stage a more
astringent injection may be used (nitrate of silver 20 grains, water 1
quart), and the same may be applied to the surface of the penis and
inside the sheath. Balsam of copaiba (1 dram daily) may also be given
with advantage after the purulent discharge has appeared.
Every stallion suffering from urethritis should be withheld from
service, as should mares with leucorrhea.
STRICTURE OF THE URETHRA.
This is a permanent narrowing of the urethra at a given point, the
result of previous inflammation, caused by the passage or arrest of a
stone, or gravel, by strong astringent injections in the early
nonsecreting stage of urethritis, or by contraction of the lining
membrane occurring during the healing of ulcers in neglected
inflammations of that canal. The trouble is shown by the passage of
urine in a fine stream, with straining, pain, and groaning, and by
frequent painful erections. It must be remedied by mechanical
dilatation, with catheters just large enough to pass with gentle force,
to be inserted once a day, and to be used of larger size as the passage
will admit them. The catheter should be kept perfectly clean and washed
in a borax solution and well oiled before it is introduced.
URINARY CALCULI (STONE, OR GRAVEL).
These consist in some of the solids of the urine that have been
precipitated from the urine in the form of crystals, which remain apart
as a fine, powdery mass, or magma, or aggregate into calculi, or stones,
of varying size. (See Pl. XI.) Their composition is therefore determined
in different animals by the salts or other constituents found dissolved
in the healthy urine, and by the additional constituents which may be
thrown off in solution in the urine in disease. In this connection it is
important to observe the following analysis of the horse's urine in
health:
Water 918.5
Urea 13.4
Uric acid and urates .1
Hippuric acid 26.4
Lactic acid and lactates 1.2
Mucus and organic matter 22.0
Sulphates (alkaline) 1.2
Phosphates (lime and soda) .2
Chlorids (sodium) 1.0
Carbonates (potash, magnesia, lime) 16.0
-----
1000.0
The carbonate of lime, which is present in large quantity in the urine
of horses fed on green fodder, is practically insoluble, and therefore
forms in the passages after secretion, and its microscopic rounded
crystals give the urine of such horses a milky whiteness. It is this
material which constitutes the soft, white, pultaceous mass that
sometimes fills the bladder to repletion and requires to be washed out.
In hay-fed horses carbonates are still abundant, while in those mainly
grain-fed they are replaced by hippurates and phosphates--the products
of the wear of tissues--the carbonates being the result of oxidation of
the vegetable acids in the feed. Carbonate of lime, therefore, is a very
common constituent of urinary calculi in herbivora, and in many cases is
the most abundant constituent.
Oxalate of lime, like carbonate of lime, is derived from the burning up
of the carbonaceous matter of the feed in the system, one important
factor being the less perfect oxidation of the carbon. Indeed,
Füstenberg and Schmidt have demonstrated on man, horse, ox, and rabbit
that under the full play of the breathing (oxidizing) forces oxalic
acid, like other organic acids, is resolved into carbonic acid. In
keeping with this is the observation of Lehmann, that in all cases in
which man suffered from interference with the breathing oxalate of lime
appeared in the urine. An excess of oxalate of lime in the urine may,
however, claim a different origin. Uric and hippuric acids are found in
the urine of carnivora and herbivora, respectively, as the result of the
healthy wear (disassimilation) of nitrogenous tissues. If these products
are fully oxidized, however, they are thrown out in the form of the more
soluble urea rather than as these acids. When uric acid out of the body
is treated with peroxid of lead it is resolved into urea, allantoin, and
oxalic acid, and Woehler and Frerrichs found that the administration
of uric acid not only increased the excretion of urea but also of oxalic
acid. It may therefore be inferred that oxalic acid is not produced from
the carbonaceous feed alone but also from the disintegration of the
nitrogenous tissues of the body. An important element of its production
is, however, the imperfect performance of the breathing functions, and
hence it is liable to result from diseases of the chest (heaves, chronic
bronchitis, etc.). This is, above all, liable to prove the case if the
subject is fed to excess on highly carbonaceous feeds (grass and green
feed generally, potatoes, etc.).
Carbonate of magnesia, another almost constant ingredient of the urinary
calculi of the horse, is formed the same way as the carbonate of
lime--from the excess of carbonaceous feed (organic acids) becoming
oxidized into carbon dioxid, which unites with the magnesia derived from
the feed.
The phosphates of lime and magnesia are not abundant in urinary calculi
of the horse, the phosphates being present to excess in the urine in
only two conditions--(a) when the ration is excessive and especially
rich in phosphorus (wheat, bran, beans, peas, vetches, rape cake, oil
cake, cottonseed cake); and (b) when, through the morbid, destructive
changes in the living tissues, and especially of the bones, a great
quantity of phosphorus is given off as a waste product. Under these
conditions, however, the phosphates may contribute to the formation of
calculi, and this, above all, is liable if the urine is retained in the
bladder until it has undergone decomposition and given off ammonia. The
ammonia at once unites with the phosphate of magnesia to form a double
salt--phosphate of ammonia and magnesia--which, being insoluble, is at
once precipitated. The precipitation of this salt is, however, rare in
the urine of the horse, though much more frequent in that of man and
sheep.
These are the chief mineral constituents of the urine which form
ingredients in the horse's calculi, for though iron and manganese are
usually present it is only in minute quantities.
The excess of mineral matter in a specimen of urine unquestionably
contributes to the formation of calculi, just as a solution of such
matters out of the body is increasingly disposed to throw them down in
the form of crystals as it becomes more concentrated and approaches
nearer to the condition of saturation. Hence, in considering the causes
of calculi we can not ignore the factor of an excessive ration, rich in
mineral matters and in carbonaceous matters (the source of carbonates
and much of the oxalates), nor can we overlook the concentration of the
urine that comes from dry feed and privation of water, or from the
existence of fever which causes suspension of the secretion of water. In
these cases, at least the usual quantity of solids is thrown off by the
kidneys, and as the water is diminished there is danger of its
approaching the point of supersaturation, when the dissolved solids must
necessarily be thrown down. Hence, calculi are more common in stable
horses fed on dry grain and hay, in those denied a sufficiency of water
or that have water supplied irregularly, in those subjected to profuse
perspiration (as in summer), and in those suffering from a watery
diarrhea. On the whole, calculi are most commonly found in winter,
because the horses are then on dry feeding, but such dry feeding is even
more conducive to them in summer when the condition is aggravated by the
abundant loss of water by the skin.
In the same way the extreme hardness of the water in certain districts
must be looked upon as contributing to the concentration of the urine
and correspondingly to the production of stone. The carbonates,
sulphates, etc., of lime and magnesia taken in the water must be again
thrown out, and just in proportion as these add to the solids of the
urine they dispose it to precipitate its least soluble constituents.
Thus the horse is very subject to calculi on certain limestone soils, as
over the calcareous formations of central and western New York,
Pennsylvania, and Ohio, in America; of Norfolk, Suffolk, Derbyshire,
Shropshire, and Gloucestershire, in England; of Poitou and Landes, in
France; and Munich, in Bavaria.
The saturation of the urine from any or all of these conditions can only
be looked on as an auxiliary cause, however, and not as in itself an
efficient one, except on the rarest occasions. For a more direct and
immediate cause we must look to the organic matter which forms a large
proportion of all urinary calculi. This consists of mucus, albumen, pus,
hyaline casts of the uriniferous tubes, epithelial cells, blood, etc.,
mainly agents that belong to the class of colloid or noncrystalline
bodies. A horse may live for months and years with the urine habitually
of a high density and having the mineral constituents in excess without
the formation of stone or gravel; again, one with dilute urine of low
specific gravity will have a calculus.
Rainey, Ord, and others furnish the explanation. They not only show that
a colloid body, like mucus, albumen, pus, or blood, determined the
precipitation or the crystalline salts in the solution, but they
determined the precipitation in the form of globules, or spheres,
capable of developing by further deposits into calculi. Heat intensifies
this action of the colloids, and a colloid in a state of decomposition
is specially active. The presence, therefore, of developing fungi and
bacteria must be looked upon as active factors in causing calculi.
In looking, therefore, for the immediate causes of calculi we must
consider especially all those conditions which determine the presence of
albumen, blood, and excess of mucus, pus, etc., in the urine. Thus
diseases of distant organs leading to albuminuria, diseases of the
kidneys and urinary passages causing the escape of blood or the
formation of mucus or pus, become direct causes of calculi. Foreign
bodies of all kinds in the bladder or kidney have long been known as
determining causes of calculi and as forming the central nucleus. This
is now explained by the fact that these bodies are liable to carry
bacteria into the passages and thus determine decomposition, and they
are further liable to irritate the mucous membrane and become enveloped
in a coating of mucus, pus, and perhaps blood.
The fact that horses, especially on the magnesian limestones, the same
districts in which they suffer from goiter, appear to suffer from
calculi may be similarly explained. The unknown poison which produces
goiter presumably leads to such changes in the blood and urine as will
furnish the colloid necessary for precipitation of the urinary salts in
the form of calculi.
CLASSIFICATION OF URINARY CALCULI.
These have been named according to the place where they are found, renal
(kidney), ureteric (ureter), vesical (bladder), urethral (urethra), and
preputial (sheath, or prepuce). They have been otherwise named according
to their most abundant chemical constituent, carbonate of lime, oxalate
of lime, and phosphate of lime calculi. The stones formed of carbonates
or phosphates are usually smooth on the surface, though they may be
molded into the shape of the cavity in which they have been formed; thus
those in the pelvis of the kidney may have two or three short branchlike
prolongations, while those in the bladder are round, oval, or slightly
flattened upon each other. Calculi containing oxalate of lime, on the
other hand, have a rough, open, crystalline surface, which has gained
for them the name of mulberry calculi, from a supposed resemblance to
that fruit. These are usually covered with more or less mucus or blood,
produced by the irritation of the mucous membrane by their rough
surfaces. The color of calculi varies from white to yellow and deep
brown, the shades depending mainly on the amount of the coloring matter
of blood, bile, or urine which they may contain.
_Renal calculi._--These may consist of minute, almost microscopic,
deposits in the uriniferous tubes in the substance of the kidney, but
more commonly they are large masses and lodged in the pelvis. The larger
calculi, sometimes weighing 12 to 24 ounces, are molded in the pelvis of
the kidney into a cylindroid mass, with irregular rounded swellings at
intervals. Some have a deep brown, rough, crystalline surface of oxalate
of lime, while others have a smooth, pearly white aspect from carbonate
of lime. A smaller calculus, which has been called coralline, is also
cylindroid, with a number of brown, rough, crystalline oxalate of lime
branches and whitish depressions of carbonate. These vary in size from
15 grains to nearly 2 ounces. Less frequently are found masses of very
hard, brownish white, rounded, pealike calculi. These are smoother, but
on the surface crystals of oxalate of lime may be detected with a lens.
Some renal calculi are formed of more distinct layers, more loosely
adherent to one another, and contain an excess of mucus, but no oxalate
of lime. Finally, a loose aggregation of small masses, forming a very
friable calculus, is found of all sizes within the limits of the pelvis
of the kidney. These, too, are in the main carbonate of lime (84 to 88
per cent) and without oxalate.
Symptoms of renal calculi are violent, colicky, pains, appearing
suddenly, very often in connection with exhausting work or the drawing
of specially heavy loads, and in certain cases disappearing with equal
suddenness. The nature of the colic becomes more manifest if it is
associated with stiffness of the back and hind limbs, frequent passage
of urine, and, above all, the passage of gravel with the urine,
especially at the time of the access of relief. The passage of blood and
pus in the urine is equally significant. If the irritation of the kidney
goes on to active inflammation, then the symptoms of nephritis are
added.
_Ureteric calculi._--These are so called because they are found in the
passage leading from the kidney to the bladder. They are simply small,
renal calculi which have escaped from the pelvis of the kidney and have
become arrested in the ureter. They give rise to symptoms almost
identical with those of renal calculi, with this difference, that the
colicky pains, caused by the obstruction of the ureter by the impacted
calculus, are more violent, and if the calculus passes on into the
bladder the relief is instantaneous and complete. If the ureter is
completely blocked for a length of time, the retained urine may give
rise to destructive inflammation in the kidney, which may end in the
entire absorption of that organ, leaving only a fibrous capsule
containing an urinous fluid. If both the ureters are similarly blocked,
the animal will die of uremic poisoning.
_Treatment of renal and ureteric calculi._--Treatment is unsatisfactory,
as it is only the small calculi that can pass through the ureters and
escape into the bladder. This may be favored by agents which will relax
the walls of the ureters by counteracting their spasm and even lessening
their tone, and by a liberal use of water and watery fluids to increase
the urine and the pressure upon the calculus from behind. One or two
ounces of laudanum, or 2 drams of extract of belladonna, may be given
and repeated as it may be necessary, the relief of the pain being a fair
criterion of the abating of the spasm. To the same end use warm
fomentations across the loins, and these should be kept up persistently
until relief is obtained. These act not only by soothing and relieving
the spasm and inflammation, but they also favor the freer secretion of a
more watery urine, and thus tend to carry off the smaller calculi. To
accomplish this object further give cool water freely, and let the feed
be only such as contains a large proportion of liquid, gruels, mashes,
turnips, beets, apples, pumpkins, ensilage, succulent grasses, etc. If
the acute stage has passed and the presence of the calculus is
manifested only by the frequent passage of urine with gritty particles,
by stiffness of the loins and hind limbs, and by tenderness to pressure,
the most promising resort is a long run at pasture where the grasses are
fresh and succulent. The long-continued secretion of a watery urine will
sometimes cause the breaking down of a calculus, as the imbibition of
the less dense fluid by the organic, spongelike framework of the
calculus causes it to swell and thus lessens its cohesion. The same end
is sought by the long-continued use of alkalies (carbonate of
potassium), and of acids (muriatic), each acting in a different way to
alter the density and cohesion of the stone. It is only exceptionally,
however, that any one of these methods is entirely satisfactory. If
inflammation of the kidneys develops, treat as advised under that head.
_Stone in the bladder (vesical calculus, or cystic calculus)._--These
may be of any size up to over a pound in weight. One variety is rough
and crystalline and has a yellowish-white or deep-brown color. These
contain about 87 per cent carbonate of lime, the remainder being
carbonate of magnesia, oxalate of lime, and organic matter. The
phosphatic calculi are smooth, white and formed of thin, concentric
layers of great hardness extending from the nucleus outward. Besides the
phosphate of lime they contain the carbonates of lime and magnesia and
organic matter. In some cases the bladder contains and may be even
distended by a soft, pultaceous mass made up of minute, round granules
of carbonates of lime and magnesia. This, when removed and dried, makes
a firm, white, and stony mass. Sometimes this magma is condensed into a
solid mass in the bladder by reason of the binding action of the mucus
and other organic matter, and then forms a conglomerate stone of nearly
uniform consistency and without stratification.
_Symptoms of stone in the bladder._--The symptoms of stone in the
bladder are more obvious than those of renal calculus. The rough,
mulberry calculi especially lead to irritation of the mucous membrane
and frequent passing of urine in small quantities and often mingled with
mucus or blood or containing minute, gritty particles. At times the flow
is suddenly arrested, though the animal continues to strain and the
bladder is not quite emptied. In the smooth, phosphatic variety the
irritation is much less marked and may even be altogether absent. With
the pultaceous deposit in the bladder there is incontinence of urine,
which dribbles away continually and keeps the hair on the inner side of
the thighs matted with soft magma. In all cases alike the calculus may
be felt by the examination of the bladder with the oiled hand in the
rectum. The pear-shaped outline of the bladder can be felt beneath, and
within it the solid, oval body. It is most easily recognized if the
organ is half full of liquid, as then it is not grasped by the
contracting walls of the bladder, but may be made to move from place to
place in the liquid. If a pultaceous mass is present it has a soft,
doughy feeling, and when pressed an indentation is left.
In the mare the hard stone may be touched by the finger introduced
through the short urethra.
_Treatment of stone in the bladder._--The treatment of stone in the
bladder consists in the removal of the offending body; in the mare this
is easily effected with the lithotomy forceps. These are slightly warmed
and oiled, and carried forward along the floor of the passage of the
vulva for 4 inches, when the orifice of the urethra will be felt exactly
in the median line. Through this the forceps are gradually pushed with
gentle, oscillating movement until they enter the bladder and strike
against the hard surface of the stone. The stone is now grasped between
the blades, care being taken to include no loose fold of the mucous
membrane, and it is gradually withdrawn with the same careful,
oscillating motions as before. Facility and safety in seizing the stone
will be greatly favored by having the bladder half full of liquid, and
if necessary one oiled hand may be introduced into the rectum or vagina
to assist. The resulting irritation may be treated by an injection of
laudanum, 1 ounce in a pint of tepid water.
The removal of the stone in the horse is a much more difficult
proceeding. It consists in cutting into the urethra just beneath the
anus and introducing the lithotomy forceps from this forward into the
bladder, as in the mare. It is needful to distend the urethra with
tepid water or to insert a sound or catheter to furnish a guide upon
which the incision may be made, and in case of a large stone it may be
needful to enlarge the passage by cutting in a direction upward and
outward with a probe-pointed knife, the back of which is slid along in
the groove of a director until it enters the bladder.
The horse may be operated upon in the standing position, being simply
pressed against the wall by a pole passed from before backward along the
other side of the body. The tepid water is injected into the end of the
penis until it is felt to fluctuate under the pressure of the finger, in
the median line over the bone just beneath the anus. The incision is
then made into the center of the fluctuating canal, and from above
downward. When a sound or catheter is used as a guide it is inserted
through the penis until it can be felt through the skin at the point
where the incision is to be made beneath the anus. The skin is then
rendered tense by the thumb and fingers of the left hand pressing on the
two sides of the sound, while the right hand, armed with a scalpel, cuts
downward onto the catheter. This vertical incision into the canal should
escape wounding any important blood vessel. It is in making the
obliquely lateral incision in the subsequent dilatation of the urethra
and neck of the bladder that such danger is to be apprehended.
If the stone is too large to be extracted through the urethra, it may be
broken down with the lithotrite and extracted piecemeal with the
forceps. The lithotrite is an instrument composed of a straight stem
bent for an inch or more to one side at its free end so as to form an
obtuse angle, and having on the same side a sliding bar moving in a
groove in the stem and operated by a screw so that the stone may be
seized between the two blades at its free extremity and crushed again
and again into pieces small enough to extract. Extra care is required to
avoid injury to the urethra in the extraction of the angular fragments,
and the gravel or powder that can not be removed in this way must be
washed out, as advised below.
When a pultaceous magma of carbonate of lime accumulates in the bladder
it must be washed out by injecting water through a catheter by means of
a force pump or a funnel, shaking it up with the hand introduced through
the rectum and allowing the muddy liquid to flow out through the tube.
This is to be repeated until the bladder is empty and the water come
away, clear. A catheter with a double tube is sometimes used, the
injection passing in through the one tube and escaping through the
other. The advantage is more apparent than real, however, as the
retention of the water until the magma has been shaken up and mixed with
it hastens greatly its complete evacuation.
To prevent the formation of a new deposit any fault in feeding (dry
grain and hay with privation of water, excess of beans, peas, wheat
bran, etc.) and disorders of stomach, liver, and lungs must be
corrected. Give abundance of soft drinking water, encouraging the animal
to drink by a handful of salt daily. Let the feed be laxative,
consisting largely of roots, apples, pumpkins, ensilage, and give daily
in the drinking water a dram of either carbonate of potash or soda.
Powdered gentian root (3 drams daily) will also serve to restore the
tone of the stomach and system at large.
_Urethral calculus (stone in the urethra)._--This is less frequent in
horses than in cattle and sheep, owing to the larger size of the urethra
in the horse and the absence of the S-shaped curve and vermiform
appendix. The calculi arrested in the urethra are never formed there,
but consist of cystic calculi which have been small enough to pass
through the neck of the bladder, but are too large to pass through the
whole length of the urethra and escape. Such calculi therefore are
primarily formed either in the bladder or kidney, and have the chemical
composition of the other calculi found in those organs. They may be
arrested at any point of the urethra, from the neck of the bladder back
to the bend of the tube beneath the anus, and from that point down to
the extremity of the penis. I have found them most frequently in the
papilla on the extreme end of the penis, and immediately behind this.
_Symptoms of urethral calculus._--The symptoms are violent straining to
urinate, but without any discharge, or with the escape of water in drops
only. Examination of the end of the penis will detect the swelling of
the papilla or the urethra behind it, and the presence of a hard mass in
the center. A probe inserted into the urethra will strike against the
gritty calculus. If the stone has been arrested higher up, its position
may be detected as a small, hard, sensitive knot on the line of the
urethra, in the median line of the lower surface of the penis, or on the
floor of pelvis in the median line from the neck of the bladder back to
the bend of the urethra beneath the anus. In any case the urethra
between the neck of the bladder and the point of obstruction is liable
to be filled with fluid, and to feel like a distended tube, fluctuating
on pressure.
_Treatment of urethral calculus_ may be begun by an attempt to extract
the calculi by manipulation of the papilla on the end of the penis. This
failing, the calculus may be seized with a pair of fine-pointed forceps
and withdrawn from the urethra; or, if necessary, a probe-pointed knife
may be inserted and the urethra slightly dilated, or even laid open, and
the stone removed. If the stone has been arrested higher up it must be
extracted by a direct incision through the walls of the urethra and down
upon the nodule. If in the free (protractile) portion of the penis,
that organ is to be withdrawn from its sheath until the nodule is
exposed and can be incised. If behind the scrotum, the incision must be
made in the median line between the thighs and directly over the nodule,
the skin having been rendered tense by the fingers and thumb of the left
hand. If the stone has been arrested in the intrapelvic portion of the
urethra, the incision must be made beneath the anus and the calculus
extracted with forceps, as in stone in the bladder. The wound in the
urethra may be stitched up, and usually heals slowly but satisfactorily.
Healing will be favored by washing two or three times daily with a
solution of a teaspoonful of carbolic acid in a pint of water.
_Preputial calculus (calculus in the sheath, or bilocular
cavity)._--These are concretions in the sheath, though the term has been
also applied to the nodule of sebaceous matter which accumulates in the
blind pouches (bilocular cavity) by the sides of the papilla on the end
of the penis. Within the sheath the concretion may be a soft,
cheesy-like sebaceous matter, or a genuine calculus of carbonate,
oxalate, phosphate and sulphate of lime, carbonate of magnesia, and
organic matter. These are easily removed with the fingers, after which
the sheath should be washed out with castile soap and warm water and
smeared with sweet oil.
DISEASES OF THE GENERATIVE ORGANS.
By JAMES LAW, F. R. C. V. S.,
Formerly Professor of Veterinary Science, etc., in Cornell University.
CONGESTION AND INFLAMMATION OF THE TESTICLES, OR ORCHITIS.
In the prime of life, in vigorous health, and on stimulating feed,
stallions are subject to congestion of the testicles, which become
swollen, hot, and tender, but without any active inflammation. A
reduction of the grain in the feed, the administration of 1 or 2 ounces
of Glauber's salt daily in the feed, and the bathing of the affected
organs daily with tepid water or alum water will usually restore them to
a healthy condition.
When the factors producing congestion are extraordinarily potent, when
there has been frequent copulation and heavy grain feeding, when the
weather is warm and the animal has had little exercise, and when the
proximity of other horses or mares excites the generative instinct
without gratification, this congestion may grow to actual inflammation.
Among the other causes of orchitis are blows and penetrating wounds
implicating the testicles, abrasions of the scrotum by a chain or rope
passing inside the thigh, contusions and frictions on the gland under
rapid paces or heavy draft, compression of the blood vessels of the
spermatic cord by the inguinal ring under the same circumstances, and,
finally, sympathetic disturbance in cases of disease of the kidneys,
bladder, or urethra. Stimulants of the generative functions, like rue,
savin, tansy, cantharides, and damiana, may also be accessory causes of
congestion and inflammation. Finally, certain specific diseases, like
dourine, glanders, and tuberculosis, localized in the testicles, will
cause inflammation.
_Symptoms._--Apart from actual wounds of the parts, the symptoms of
orchitis are swelling, heat, and tenderness of the testicles, straddling
with the hind legs alike in standing and walking, stiffness and dragging
of the hind limbs or of the limb on the affected side, arching of the
loins, abdominal pain, manifested by glancing back at the flank, more or
less fever, elevated body temperature, accelerated pulse and breathing,
lack of appetite, and dullness. In bad cases the scanty urine may be
reddish and the swelling may extend to the skin and envelopes of the
testicle, which may become thickened and doughy, pitting on pressure.
The swelling may be so much greater in the convoluted excretory duct
along the upper border of the testicle as to suggest the presence of a
second stone. Even in the more violent attacks the intense suffering
abates somewhat on the second or third day. If it lasts longer, it is
liable to give rise to the formation of matter (abscess). In exceptional
cases the testicle is struck with gangrene, or death. Improvement may go
on slowly to complete recovery, or the malady may subside into a
subacute and chronic form with induration. Matter (abscess) may be
recognized by the presence of a soft spot, where pressure with two
fingers will detect fluctuation from one to the other. When there is
liquid exudation into the scrotum, or sac, fluctuation may also be felt,
but the liquid can be made out to be around the testicle and can be
pressed up into the abdomen through the inguinal canal. When abscess
occurs in the cord the matter may escape into the scrotal sac and cavity
of the abdomen and pyemia may follow.
_Treatment_ consists in perfect rest and quietude, the administration of
a purgative (1 to 1-1/2 pounds Glauber's salt), and the local
application of an astringent lotion (acetate of lead 2 drams, extract of
belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool,
kept in contact with the part by a suspensory bandage. This bandage, of
great value for support, may be made nearly triangular and tied to a
girth around the loins and to the upper part of the same surcingle by
two bands carried backward and upward between the thighs. In severe
cases scarifications one-fourth inch deep serve to relieve vascular
tension. When abscess is threatened its formation may be favored by warm
fomentations or poultices, and on the occurrence of fluctuation the
knife may be used to give free escape to the pus. The resulting cavity
may be injected daily with a weak carbolic-acid lotion, or salol may be
introduced. The same agents may be used on a gland threatened with
gangrene, but its prompt removal by castration is to be preferred,
antiseptics being applied freely to the resulting cavity.
SARCOCELE.
This is an enlarged and indurated condition of the gland, resulting from
chronic inflammation, though it is often associated with a specific
deposit, like glanders. In this condition the natural structure of the
gland has given place to embryonal tissue (small, round cells, with a
few fibrous bundles), and its restoration to health is very improbable.
Apart from active inflammation, it may increase very slowly. The
diseased testicle is enlarged, firm, nonelastic, and comparatively
insensible. The skin of the scrotum is tense, and it may be edematous
(pitting on pressure), as are the deeper envelopes and spermatic cord.
If liquid is present in the sac, the symptoms are masked somewhat. As it
increases it causes awkward, straddling, dragging movement of the hind
limbs, or lameness on the affected side. The spermatic cord often
increases at the same time with the testicle, and the inguinal ring
being thereby stretched and enlarged, a portion of intestine may escape
into the sac, complicating the disease with hernia.
The only rational and effective treatment is castration, and when the
disease is specific (glanders, tuberculosis), even this may not succeed.
HYDROCELE, OR DROPSY OF THE SCROTUM.
This may be merely an accompaniment of dropsy of the abdomen, the cavity
of which is continuous with that of the scrotum in horses. It may be the
result, however, of local disease in the testicle, spermatic cord, or
walls of the sac.
_Symptoms._--The symptoms are enlargement of the scrotum, and
fluctuation under the fingers, the testicle being recognized as floating
in water. By pressure the liquid is forced, in a slow stream and with a
perceptible thrill, into the abdomen. Sometimes the cord or the scrotum
is thickened and pits on pressure.
_Treatment_ may be the same as for ascites, yet when the effusion has
resulted from inflammation of the testicle or cord, astringent
applications (chalk and vinegar) may be applied to these. Then, if the
liquid is not reabsorbed under diuretics and tonics, it may be drawn off
through the nozzle of a hypodermic syringe which has been first passed
through carbolic acid. In geldings it is best to dissect out the sacs.
VARICOCELE.
This is an enlargement of the venous network of the spermatic cord, and
gives rise to general thickening of the cord from the testicle up to the
ring. The same astringent dressings may be tried as in hydrocele, and,
this failing, castration may be resorted to.
ABNORMAL NUMBER OF TESTICLES.
Sometimes one or both testicles are wanting; in most such cases,
however, they are merely partially developed, and retained in the
inguinal canal or abdomen (cryptorchid). In rare cases there may be a
third testicle, the animal becoming to this extent a double monster.
Teeth, hair, and other indications of a second fetus have likewise been
found in the testicle or scrotum.
DEGENERATION OF THE TESTICLES.
The testicles may become the seat of fibrous, calcareous, fatty,
cartilaginous, or cystic degeneration, for all which the appropriate
treatment is castration. They also become the seat of cancer, glanders,
or tuberculosis, and castration is requisite, though with less hope of
arresting the disease. Finally, they may become infested with cystic
tapeworms or the agamic stage of a strongyle (_Strongylus edentatus_).
WARTS ON THE PENIS.
These are best removed by twisting them off, using the thumb and
forefinger. They may also be cut off with scissors and the roots
cauterized with nitrate of silver.
DEGENERATION OF PENIS (PAPILLOMA, OR EPITHELIOMA).
The penis of the horse is subject to great cauliflower-like growths on
its free end, which extend back into the substance of the organ,
obstruct the passage of urine, and cause very fetid discharges. The only
resort is to cut them off, together with whatever portion of the penis
has become diseased and indurated. The operation, which should be
performed by a veterinary surgeon, consists in cutting through the organ
from its upper to its lower aspect, twisting or tying the two dorsal
arteries, and leaving the urethra longer by half an inch to 1 inch than
the adjacent structures.
EXTRAVASATION OF BLOOD IN THE PENIS.
As the result of kicks, blows, or of forcible striking of the penis on
the thighs of the mare which it has failed to enter, the penis may
become the seat of effusion of blood from one or more ruptured blood
vessels. This gives rise to a more or less extensive swelling on one or
more sides, followed by some heat and inflammation, and on recovery a
serious curving of the organ. The treatment in the early stages may be
the application of lotions, of alum, or other astringents, to limit the
effusion and favor absorption. The penis should be suspended in a sling.
PARALYSIS OF THE PENIS.
This results from blows and other injuries, and also in some cases from
too frequent and exhausting service. The penis hangs from the sheath,
flaccid, pendulous, and often cold. The passage of urine occurs with
lessened force, and especially without the final jets. In cases of local
injury the inflammation should first be subdued by astringent and
emollient lotions, and in all cases the system should be invigorated by
nourishing diet, while 30-grain doses of nux vomica are given twice a
day. Finally, a weak current of electricity sent through the penis from
just beneath the anus to the free portion of the penis, continued for 10
or 15 minutes and repeated daily, may prove successful.
SELF-ABUSE, OR MASTURBATION.
Some stallions acquire this vicious habit, stimulating the sexual
instinct to the discharge of semen by rubbing the penis against the
belly or between the fore limbs. The only remedy is a mechanical one,
the fixing of a net under the penis in such fashion as to prevent the
extension of the penis or so prick the organ as to compel the animal to
desist through pain.
DOURINE.
This disease is discussed in the chapter on "Infectious Diseases."
CASTRATION.
CASTRATION OF STALLIONS.
This is usually done at 1 year old, but may be accomplished at a few
weeks old at the expense of an imperfect development of the fore parts.
The simplicity and safety of the operation are greatest in the young.
The delay till 2, 3, or 4 years old will secure a better development and
carriage of the fore parts. The essential part of castration is the safe
removal or destruction of the testicle and the arrest or prevention of
bleeding from the spermatic artery round in the anterior part of the
cord. Into the many methods of accomplishing this limited space forbids
us to enter here, so that only the method most commonly adopted,
castration by clamps, will be noticed. The animal having been thrown on
his left side, and the right hind foot drawn up on the shoulder, the
exposed scrotum, penis, and sheath are washed with soap and water, any
concretion of sebum being carefully removed from the bilocular cavity in
the end of the penis. The left spermatic cord, just above the testicle,
is now seized in the left hand, so as to render the skin tense over the
stone, and the right hand, armed with the knife, makes an incision from
before backward, about three-fourths of an inch from and parallel to the
median line between the thighs, deep enough to expose the testicle and
long enough to allow that organ to start out through the skin. At the
moment of making this incision the left hand must grasp the cord very
firmly, otherwise the sudden retraction of the testicle by the cremaster
muscle may draw it out of the hand and upward through the canal and even
into the abdomen. In a few seconds, when the struggle and retraction
have ceased, the knife is inserted through the cord, between its
anterior and posterior portions, and the latter, the one which the
muscle retracts, is cut completely through. The testicle will now hang
limp, and there is no longer any tendency to retraction. It should be
pulled down until it will no longer hang loose below the wound and the
clamps applied around the still attached portion of the cord, close up
to the skin. The clamps, which may be made of any tough wood, are
grooved along the center of the surfaces opposed to each other, thereby
fulfilling two important indications--(a) enabling the clamps to hold
more securely and (b) providing for the application of an antiseptic
to the cord. For this purpose a dram of sulphate of copper may be mixed
with an ounce of vaseline and pressed into the groove in the face of
each clamp. In applying the clamp over the cord it should be drawn so
close with pincers as to press out all blood from the compressed cord
and destroy its vitality, and the cord applied upon the compressing
clamps should be so hard-twined that it will not stretch later and
slacken the hold. When the clamp has been fixed the testicle is cut off
one-half to 1 inch below it, and the clamp may be left thus for 24
hours; then, by cutting the cord around one end of the clamp, the latter
may be opened and the stump liberated without any danger of bleeding.
Should the stump hang out of the wound it should be pushed inside with
the finger and left there. The wound should begin to discharge white
matter on the second day in hot weather or the third in cold, and from
that time a good recovery may be expected.
The young horse suffers less from castration than the old, and very
rarely perishes. Good health in the subject is all important. Castration
should never be attempted during the prevalence of strangles, influenza,
catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura
hemorrhagica, or other specific disease, nor on subjects that have been
kept in close, ill-ventilated, filthy buildings, where the system is
liable to have been charged with putrid bacteria or other products. Warm
weather is to be preferred to cold, but the fly time should be avoided
or the flies kept at a distance by the application of a watery solution
of tar, carbolic acid, or camphor to the wound.
CASTRATION OF CRYPTORCHIDS (RIDGLINGS).
This is the removal of a testicle or testicles that have failed to
descend into the scrotum, but have been detained in the inguinal canal
or inside the abdomen. The manipulation requires an accurate anatomical
knowledge of the parts, and special skill, experience, and manual
dexterity, and can not be made clear to the unprofessional mind in a
short description. It consists, however, in the discovery and removal of
the missing gland by exploring through the natural channel (the inguinal
canal), or, in case it is absent, through the inguinal ring or through
an artificial opening made in front and above that channel between the
abdominal muscles and the strong fascia on the inner side of the thigh
(Poupart's ligament). Whatever method is used, the skin, hands, and
instruments should be rendered aseptic with a solution of mercuric
chlorid 1 part, water 2,000 parts (a carbolic-acid lotion for the
instruments), and the spermatic cord is best torn through by the
écraseur. In many such cases, too, it is desirable to sew up the
external wound and keep the animal still, to favor healing of the wound
by adhesion.
CONDITIONS FOLLOWING CASTRATION.
_Pain after castration._--Some horses are pained and very restless for
several hours after castration, and this may extend to cramps of the
bowels and violent colic. This is best kept in check by carefully
rubbing the patient dry when he rises from the operation, and then
leading him in hand for some time. If the pain still persists a dose of
laudanum (1 ounce for an adult) may be given.
_Bleeding after castration._--Bleeding from the wound in the scrotum and
from the little artery in the posterior portion of the spermatic cord
always occurs, and in warm weather may appear to be quite free. It
scarcely ever lasts, however, more than 15 minutes, and is easily
checked by dashing cold water against the part.
Bleeding from the spermatic artery in the anterior part of the cord may
be dangerous when due precaution has not been taken to prevent it. In
such case the stump of the cord should be sought for and the artery
twisted with artery forceps or tied with a silk thread. If the stump can
not be found, pledgets of tow wet with tincture of muriate of iron may
be stuffed into the canal to favor the formation of clot and the closure
of the artery.
_Strangulated spermatic cord._--If in castration the cord is left too
long, so as to hang out of the wound, the skin wound in contracting
grasps and strangles it, preventing the free return of blood and causing
a steadily advancing swelling. In addition the cord becomes adherent to
the lips of the wound in the skin, whence it derives an increased supply
of blood, and is thereby stimulated to more rapid swelling. The subject
walks stiffly, with a straddling gait, loses appetite, and has a rapid
pulse and high fever. Examination of the wound discloses the partial
closure of the skin wound and the protrusion, from its lips, of the end
of the cord, red, tense, and varying in size from a hazelnut upward. If
there is no material swell and little protrusion, the wound may be
enlarged with the knife and the end of the cord broken loose from any
connection with the skin and pushed up inside. If the swelling is
larger, the mass constitutes a tumor and must be removed. (See below.)
_Swelling of the sheath, penis, and abdomen._--This occurs in certain
unhealthy states of the system, in unhealthful seasons, as the result of
operating without cleansing the sheath and penis, or of keeping the
subject in a filthy, impure building, as the result of infecting the
wound by hands or instruments bearing septic bacteria, or as the result
of premature closure of the wound, and imprisonment of matter.
Pure air and cleanliness of groin and wound are to be obtained.
Antiseptics, like the mercuric-chlorid lotion (1 part to 2,000) are to
be applied to the parts; the wound, if closed, is to be opened anew, any
accumulated matter or blood washed out, and the antiseptic liquid freely
applied. The most tense or dependent parts of the swelling in sheath or
penis, or beneath the belly, should be pricked at intervals of 3 or 4
inches to a depth of half an inch, and antiseptics freely applied to the
surface. Fomentations with warm water may also be used to favor oozing
from the incisions and to encourage the formation of white matter in the
original wounds, which must not be allowed to close again at once. A
free, creamlike discharge implies a healthy action in the sore, and is
the precursor of recovery.
_Phymosis and paraphymosis._--In cases of swelling, as above, the penis
may be imprisoned within the sheath (phymosis) or protruded and swollen
so that it can not be retracted into it (paraphymosis). In these cases
the treatment indicated above, and especially the scarifications, will
prove a useful preliminary resort. The use of astringent lotions is
always desirable, and in case of the protruded penis the application of
an elastic or simple linen bandage, so as to press the blood and
accumulated fluid out, will enable the operator to return it.
_Tumors on the spermatic cord._--These are due to rough handling or
dragging upon the cord in castration, to strangulation of unduly long
cords in the external wound, to adhesion of the end of the cord to the
skin, to inflammation of the cord succeeding exposure to cold or wet, or
to the presence of infection (_Staphylococcus botriomyces_). These
tumors give rise to a stiff, straddling gait, and may be felt as hard
masses in the groin connected above with the cord. They may continue to
grow slowly for many years until they reach a weight of 15 or 20 pounds,
and contract adhesions to all surrounding parts. If disconnected from
the skin and inguinal canal they may be removed in the same manner as
the testicle, while if larger and firmly adherent to the skin and
surrounding parts generally, they must be carefully dissected from the
parts, the arteries being tied as they are reached and the cord finally
torn through with an écraseur. When the cord has become swollen and
indurated up into the abdomen such removal is impossible, though a
partial destruction of the mass may still be attempted by passing
white-hot, pointed irons upward toward the inguinal ring in the center
of the thickened and indurated cord.
CASTRATION BY THE COVERED OPERATION.
This is only required in case of hernia or protrusion of bowels or
omentum into the sac of the scrotum, and consists in the return of the
hernia and the application of the caustic clamps over the cord and inner
walls of the inguinal canal, so that the walls of the latter become
adherent above the clamps, the canal is obliterated, and further
protrusion is hindered. For the full description of this and of the
operation for hernia for geldings, see remarks on hernia.
CASTRATION OF THE MARE.
Castration is a much more dangerous operation in the mare than in the
females of other domesticated quadrupeds and should never be resorted to
except in animals that become unmanageable on the recurrence of heat and
that will not breed or that are utterly unsuited to breeding. Formerly
the operation was extensively practiced in Europe, the incision being
made through the flank, and a large proportion of the subjects perished.
By operating through the vagina the risk can be largely obviated, as the
danger of unhealthy inflammation in the wound is greatly lessened. The
animal should be fixed in a trevis, with each foot fixed to a post and a
sling placed under the body, or it may be thrown and put under
chloroform. The manual operation demands special professional knowledge
and skill, but it consists essentially in making an opening through the
roof of the vagina just above the neck of the womb, then following with
the hand each horn of the womb until the ovary on that side is reached
and grasped between the lips of forceps and twisted off. It might be
torn off by an écraseur especially constructed for the purpose. The
straining that follows the operation may be checked by ounce doses of
laudanum, and any risk of protrusion of the bowels may be obviated by
applying the truss advised to prevent eversion of the womb. To further
prevent the pressure of the abdominal contents against the vaginal wound
the mare should be tied short and high for twenty-four or forty-eight
hours, after which I have found it best to remove the truss and allow
the privilege of lying down. Another important point is to give bran
mashes and other laxative diet only, and in moderate quantity, for a
fortnight, and to unload the rectum by copious injections of warm water
in case impaction is imminent.
STERILITY.
Sterility may be in the male or in the female. If due to the stallion,
then all the mares put to him remain barren; if the fault is in the
mare, she alone fails to conceive, while other mares served by the same
stallion get in foal.
In the stallion sterility may be due to the following causes: (a)
Imperfect development of the testicles, as in cases in which they are
retained within the abdomen; (b) inflammation of the testicles,
resulting in induration; (c) fatty degeneration of the testicles, in
stallions liberally fed on starchy feed and not sufficiently exercised;
(d) fatty degeneration of the excretory ducts of the testicles (_vasa
deferentia_); (e) inflammation or ulceration of these ducts; (f)
inflammation or ulceration of the mucous membrane covering the penis;
(g) injuries to the penis from blows (often causing paralysis); (h)
warty growths on the end of the penis; (i) tumors of other kinds
(largely pigmentary), affecting the testicles or penis; (j) nervous
diseases which abolish the sexual appetite or that control the muscles
which are essential to the act of coition; (k) azoturia with resulting
weakness or paralysis of the muscles of the loins or the front of the
thigh (above the stifle); (l) ossification (_anchylosis_) of the
joints of the back or loins, which render the animal unable to rear or
mount; (m) spavins, ringbones, or other painful affections of the hind
limbs, the pain of which in mounting causes the animal to suddenly stop
short in the act. In the first three of these only (a, b, and c)
is there real sterility in the sense of the nondevelopment or imperfect
development of the male vivifying element (spermatozoa). In the other
examples the secretion may be imperfect in kind and amount, but as
copulation is prevented it can not reach and impregnate the ovum.
In the mare barrenness is equally due to a variety of causes. In a
number of breeding studs the proportion of sterile mares has varied from
20 to 40 per cent. It may be due to: (a) Imperfect development of the
ovary and nonmaturation of ova; (b) cystic or other tumors of the
ovary; (c) fatty degeneration of the ovary in very obese, pampered
mares; (d) fatty degeneration of the excretory tubes of the ovaries
(Fallopian tubes); (e) catarrh of the womb, with mucopurulent
discharge; (f) irritable condition of the womb, with profuse
secretion, straining, and ejection of the semen; (g) nervous
irritability, leading to the same expulsion of the male element; (h)
high condition (plethora), with profuse secretion and excitement; (i)
low condition, with imperfect maturation of the ova and lack of sexual
desire; (j) poor feeding, overwork, and chronic debilitating diseases,
as leading to the condition just named; (k) closure of the neck of the
womb, temporarily by spasm or permanently by inflammation and
induration; (l) closure of the entrance to the vagina through
imperforate hymen, a rare, though not unknown, condition in the mare;
(m) acquired indisposition to breed, seen in old, hard-worked mares
which are first put to the stallion when aged; (n) change of climate
has repeatedly been followed by barrenness; (o) hybridity, which in
male and female alike usually entails sterility.
_Treatment._--The treatment of the majority of these conditions will be
found dealt with in other parts of this work, so that it is only
necessary here to name them as causes. Some, however, must be specially
referred to in this place. Stallions with undescended testicles are
beyond the reach of medicine, and should be castrated and devoted to
other uses. Indurated testicles may sometimes be remedied in the early
stages by smearing with a weak iodin ointment daily for a length of
time, and at the same time invigorating the system by liberal feeding
and judicious work. Fatty degeneration is best met by an albuminoid diet
(wheat bran, cottonseed meal, rape cake) and constant, well-regulated
work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.)
are to be specially avoided. In the mare one diseased and irritable
ovary should be removed, to do away with the resulting excitability of
the remainder of the generative organs. An irritable womb, with frequent
straining and the ejection of a profuse secretion, may sometimes be
corrected by a restricted diet and full but well-regulated work. Even
fatigue will act beneficially in some such cases, hence the practice of
the Arab riding his mare to exhaustion just before service. The
perspiration in such case, like the action of a purgative or the
abstraction of blood just before service, benefits, by rendering the
blood vessels less full, by lessening secretion in the womb and
elsewhere, and thus counteracting the tendency to the ejection and loss
of semen. If these means are ineffectual, a full dose of camphor (2
drams) or of salicin may at times assist. Low condition and anemia
demand just the opposite kind of treatment--rich, nourishing, albuminoid
feed, bitter tonics (gentian), sunshine, gentle exercise, liberal
grooming, and supporting treatment generally are here in order.
Spasmodic closure of the neck of the womb is common and is easily
remedied in the mare by dilatation with the fingers. The hand, smeared
with belladonna ointment and with the fingers drawn into the form of a
cone, is introduced through the vagina until the projecting, rounded
neck of the womb is felt at its anterior end. This is opened by the
careful insertion of one finger at a time, until the fingers have been
passed through the constricted neck into the open cavity of the womb.
The introduction is made with a gentle, rotary motion, and all
precipitate violence is avoided, as abrasion, laceration, or other cause
of irritation is likely to interfere with the retention of the semen and
consequently with impregnation. If the neck of the womb is rigid and
unyielding from the induration which follows inflammation--a rare
condition in the mare, though common in the cow--more force will be
requisite, and it may even be needful to incise the neck to the depth of
one-sixth of an inch in four or more opposite directions prior to
forcible dilatation. The incision may be made with a probe-pointed
knife, and should be done by a professional man if possible. The
subsequent dilatation may be best effected by the slow expansion of
sponge or seaweed tents inserted into the narrow canal. In such cases it
is best to let the wounds of the neck heal before putting to horse. An
imperforate hymen may be freely incised in a crucial manner until the
passage will admit the human hand. An ordinary knife may be used for
this purpose, and after the operation the stallion may be admitted at
once or only after the wounds have healed.
PREGNANCY.
INDICATIONS OF PREGNANCY.
As the mere fact of service by the stallion does not insure pregnancy,
it is important that the result should be determined to save the mare
from unnecessary and dangerous work or medication when actually in foal
and to obviate wasteful and needless precautions when she is not.
The cessation and nonrecurrence of the symptoms of heat (horsing) are
most significant, though not an infallible, sign of conception. If the
sexual excitement speedily subsides and the mare persistently refuses
the stallion for a month, she is probably pregnant. In very exceptional
cases a mare, though pregnant, will accept a second or third service
after weeks or months, and some mares will refuse the horse
persistently, though conception has not taken place, and this in spite
of warm weather, good condition of the mare, and liberal feeding. The
recurrence of heat in the pregnant mare is most liable to take place in
hot weather. If heat merely persists an undue length of time after
service, or if it reappears shortly after, in warm weather and in a
comparatively idle mare, on good feeding, it is less significant, while
the persistent absence of heat under such conditions may be usually
accepted as proof of conception.
An unwonted gentleness and docility on the part of a previously
irritable or vicious mare, and supervening on service, is an excellent
indication of pregnancy, the generative instinct which caused the
excitement having been satisfied.
An increase of fat, with softness and flabbiness of muscle, a loss of
energy, indisposition for active work, a manifestation of laziness,
indeed, and of fatigue early and easily induced, when preceded by
service, will usually imply conception.
Enlargement of the abdomen, especially in its lower third, with slight
falling in beneath the loins and hollowness of the back are significant
symptoms, though they may be entirely absent. Swelling and firmness of
the udder, with the smoothing out of its wrinkles, is a suggestive sign,
even though it appears only at intervals during gestation.
A steady increase in weight (1-1/2 pounds daily) about the fourth or
fifth month is a useful indication of pregnancy. So is a swollen and red
or bluish-red appearance of the vaginal mucous membrane.
From the seventh or eighth month onward the foal may be felt by the hand
(palm or knuckles) pressed into the abdomen in front of the left stifle.
The sudden push displaces the foal toward the opposite side of the womb,
and as it floats back its hard body is felt to strike against the hand.
If the pressure is maintained the movements of the live foal are felt,
and especially in the morning and after a drink of cold water or during
feeding. A drink of cold water will often stimulate the fetus to
movements that may be seen by the eye, but an excess of iced water may
prove injurious, even to the causing of abortion. Cold water dashed on
the belly has a similar effect on the fetus and is equally provocative
of abortion.
Examination of the uterus with the oiled hand introduced into the rectum
is still more satisfactory, and, if cautiously conducted, no more
dangerous. The rectum must be first emptied and then the hand carried
forward until it reaches the front edge of the pelvic bones below, and
pressed downward to ascertain the size and outline of the womb. In the
unimpregnated state the vagina and womb can be felt as a single rounded
tube, dividing in front to two smaller tubes (the horns of the womb). In
the pregnant mare not only the body of the womb is enlarged, but still
more so one of the horns (right or left), and on compression the latter
is found to contain a hard, nodular body, floating in a liquid, which in
the latter half of gestation may be stimulated by gentle pressure to
manifest spontaneous movements. By this method the presence of the fetus
may be determined as early as the third month. If the complete, natural
outline of the virgin womb can not be made out, careful examination
should always be made on the right and left side for the enlarged horn
and its living contents. Should there still be difficulty the mare
should be placed on an inclined plane, with her hind parts lowest, and
two assistants, standing on opposite sides of the body, should raise the
lower part of the abdomen by a sheet passed beneath it. Finally the ear
or stethoscope applied on the wall of the abdomen in front of the stifle
may detect the beating of the fetal heart (one hundred and twenty-five a
minute) and a blowing sound (the uterine sough), much less rapid and
corresponding to the number of the pulse of the dam. It is heard most
satisfactorily after the sixth or eighth month and in the absence of
active rumbling of the bowels of the dam.
DURATION OF PREGNANCY.
Mares usually go about eleven months with young, though first
pregnancies often last a year. Foals have lived when born at the three
hundredth day, so with others carried till the four hundredth day. With
the longer pregnancies there is a greater probability of male offspring.
HYGIENE OF THE PREGNANT MARE.
The pregnant mare should not be exposed to teasing by a young and ardent
stallion, nor should she be overworked or fatigued, particularly under
the saddle or on uneven ground. Yet exercise is beneficial to both
mother and offspring, and in the absence of moderate work the breeding
mare should be kept in a lot where she can take exercise at will.
The feed should be liberal, but not fattening--oats, bran, sound hay,
and other feeds rich in the principles which form flesh and bone being
especially indicated. All aliments that tend to indigestion are to be
especially avoided. Thus rank, aqueous, rapidly growing grasses and
other green feed, partially ripe rye grass, millet, Hungarian grass,
vetches, peas, beans, or maize are objectionable, as is overripe,
fibrous, innutritious hay, or that which has been injured and rendered
musty by wet, or that which is infested with smut or ergot. Feed that
tends to costiveness should be avoided. Water given often, and at a
temperature considerable above freezing, will avoid the dangers of
indigestion and abortion which result from taking too much ice-cold
water at one time. Very cold or frozen feed is objectionable in the same
sense. Severe surgical operations and medicines that act violently on
the womb, bowels, or kidneys are to be avoided as being liable to cause
abortion. Constipation should be corrected, if possible, by bran mashes,
carrots, or beets, seconded by exercise, and if a medicinal laxative is
required it should be olive oil or other equally bland agent.
The stall of the pregnant mare should not be too narrow, so as to cramp
her when lying down or to entail violent effort in getting up, and it
should not slope too much from the front backward, as this throws the
weight of the uterus back on the pelvis and endangers protrusions and
even abortion. Violent mental impressions are to be avoided, for though
most mares are not affected thereby, yet a certain number are so
profoundly impressed that peculiarities and distortions are entailed on
the offspring; hence, there is wisdom shown in banishing particolored or
objectionably tinted animals, and those that show deformities or faulty
conformation. Hence, too, the importance of preventing prolonged, acute
suffering by the pregnant mare, as certain troubles of the eyes, feet,
and joints in the foals have been clearly traced to the concentration
of the mother's mind on corresponding injured organs in herself. Sire
and dam alike tend to reproduce their individual defects which
predispose to disease, but the dam is far more liable to perpetuate the
evil in her progeny which was carried while she was individually
enduring severe suffering caused by such defects. Hence, an active bone
spavin or ringbone, causing lameness, is more objectionable than that in
which the inflammation and lameness have both passed, and an active
ophthalmia is more to be feared than even an old cataract. For this
reason all active diseases in the breeding mare should be soothed and
abated as early as possible.
EXTRA-UTERINE GESTATION.
It is rare in the domestic animals to find the fetus developed elsewhere
than in the womb. The exceptional forms are those in which the sperm of
the male, making its way through the womb and Fallopian tubes,
impregnates the ovum prior to its escape, and in which the now vitalized
and growing ovum, by reason of its gradually increasing size, becomes
imprisoned and fails to escape into the womb. The arrest of the ovum may
be in the substance of the ovary itself (ovarian pregnancy), in the
Fallopian tube (tubal pregnancy), or when by its continuous enlargement
it has ruptured its envelopes so that it escapes into the cavity of the
abdomen, it may become attached to any part of the serous membrane and
draw its nourishment directly from that (abdominal pregnancy). In all
such cases there is an increase and enlargement of the capillary blood
vessels at the point to which the embryo has attached itself so as to
furnish the needful nutriment for the growing offspring.
All appreciable symptoms are absent, unless from the death of the fetus,
or its interference with normal functions, general disorder and
indications of parturition supervene. If these occur later than the
natural time for parturition, they are the more significant. There may
be general malaise, loss of appetite, elevated temperature, accelerated
pulse, with or without distinct labor pains. Examination with the oiled
hand in the rectum will reveal the womb of the natural, unimpregnated
size and shape and with both horns of one size. Further exploration may
detect an elastic mass apart from the womb, in the interior of which may
be felt the characteristic solid body of the fetus. If the latter is
still alive and can be stimulated to move, the evidence is even more
perfect. The fetus may die and be carried for years, its soft structures
becoming absorbed so as to leave only the bones, or by pressure it may
form a fistulous opening through the abdominal walls, or less frequently
through the vagina or rectum. In the latter cases the best course is to
favor the expulsion of the foal and to wash out the resulting cavity
with a solution of carbolic acid 1 part to water 50 parts. This may be
repeated daily. When there is no spontaneous opening it is injudicious
to interfere, as the danger from the retention of the fetus is less than
that from septic fermentation in the enormous fetal sac when that has
been opened to the air.
MOLES, OR ANIDIAN MONSTERS.
These are evidently products of conception, in which the impregnated
ovum has failed to develop naturally, and presents only a chaotic mass
of skin, hair, bones, muscles, etc., attached to the inner surface of
the womb by an umbilical cord, which is itself often shriveled and
wasted. They are usually accompanied with a well-developed fetus, so
that the mole may be looked upon as a twin which has undergone arrest
and vitiation of development. They are expelled by the ordinary process
of parturition, and usually at the same time with the normally developed
offspring.
CYSTIC DISEASE OF THE WALLS OF THE WOMB, OR VESICULAR MOLE.
This condition appears to be attributable to hypertrophy (enlargement)
of the villi on the inner surface of the womb, which become greatly
increased in number and hollowed out internally into a series of cysts,
or pouches, containing liquid. Unlike the true mole, therefore, they
appear to be disease of the maternal structure of the womb rather than
of the product of conception. Rodet, in a case of this kind, which had
produced active labor pains, quieted the disorder with anodynes and
effected a recovery. When this can not be done, attempts may be made to
remove the mass with the écraseur or otherwise, following it up with
antiseptic injections, as advised under the last heading.
DROPSY OF THE WOMB.
This appears as a result of some disease of the walls of the womb, but
has been frequently observed as the result of infection after sexual
congress, and has, therefore, been confounded with pregnancy. The
symptoms are those of pregnancy, but without any movements of the fetus
and without the detection of any solid body in the womb when examined
with the oiled hand in the rectum. At the end of four or eight months
there are signs of parturition or of frequent straining to pass urine,
and after a time the liquid is discharged clear and watery, or muddy,
thick, and fetid. The hand introduced into the womb can detect neither
fetus nor fetal membrane. If the neck of the womb closes, the liquid may
accumulate a second time, or even a third, if no means are taken to
disinfect it or to correct the tendency. The best resort is to remove
any diseased product that may be found attached to the walls of the womb
and to inject it daily with a warm solution of carbolic acid 2 drams,
chlorid of zinc one-half dram, water 1 quart. A course of bitter tonics
(gentian 2 drams, sulphate of iron 2 drams, daily) should be given, and
a nutritious, easily digested, and slightly laxative diet allowed.
DROPSY OF THE AMNION.
This differs from simple dropsy of the womb in that the fluid collects
in the inner of the two water bags (that in which the foal floats) and
not in the otherwise void cavity of the womb. This affection can occur
only in the pregnant animal, while dropsy of the womb occurs in the
unimpregnated. The blood of the pregnant mare contains an excess of
water and a smaller proportion of albumen and red globules, and when
this condition is still further aggravated by poor feeding and other
unhygienic conditions there is developed the tendency to liquid
transudation from the vessels and dropsy. As the watery condition of the
blood increases with advancing pregnancy, so dropsy of the amnion is a
disease of the last four or five months of gestation. The abdomen is
large and pendulous, and the swelling fluctuates under pressure, though
the solid body of the fetus can still be felt to strike against the hand
pressed into the swelling. If the hand is introduced into the vagina,
the womb is found to be tense and round, with the projecting rounded
neck effaced, while the hand in the rectum will detect the rounded,
swollen mass of the womb so firm and tense that the body of the fetus
can not be felt within it. The mare moves weakly and unsteadily on her
limbs, having difficulty in supporting the great weight, and in bad
cases there may be loss of appetite, stocking (dropsy) of the hind
limbs, difficult breathing, and colicky pains. The tension may lead to
abortion, or a slow, laborious parturition may occur at the usual time.
_Treatment_ consists in relieving the tension and accumulation by
puncturing the fetal membrane with a cannula and trocar introduced
through the neck of the womb and the withdrawal of the trocar so as to
leave the cannula in situ, or the membranes may be punctured with the
finger and the excess of liquid allowed to escape. This may bring on
abortion, or the womb may close and gestation continue to the full term.
A course of tonics (gentian root 2 drams, sulphate of iron 2 drams,
daily) will do much to fortify the system and counteract further
excessive effusion.
DROPSY OF THE LIMBS, PERINEUM, AND ABDOMEN.
The disposition to dropsy often shows itself in the hind and even in the
fore limbs, around and beneath the vulva (perineum), and beneath the
abdomen and chest. The affected parts are swollen and pit on pressure,
but are not especially tender, and subside more or less perfectly under
exercise, hand rubbing, and bandages. In obstinate cases rubbing with
the following liniment may be resorted to: Compound tincture of iodin,
2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last
more than a day or two after parturition.
CRAMPS OF THE HIND LIMBS.
The pressure of the distended womb on the nerves and blood vessels of
the pelvis, besides conducing to dropsy, occasionally causes cramps of
the hind limbs. The limb is raised without flexing the joints, the front
of the hoof being directed toward the ground, or, the spasms occurring
intermittently, the foot is kicked violently against the ground several
times in rapid succession. The muscles are felt to be firm and rigid.
The cramp may be promptly relieved by active rubbing or by walking the
animal about, and it does not reappear after parturition.
CONSTIPATION.
This may result from compression by gravid womb, and is best corrected
by a graduated allowance of boiled flaxseed.
PARALYSIS.
The pressure on the nerves of the pelvis is liable to cause paralysis of
the hind limbs or of the nerve of sight. These are obstinate until after
parturition, when they recover spontaneously, or under a course of nux
vomica and (local) stimulating liniments.
PROLONGED RETENTION OF THE FETUS (FOAL).
Though far less frequently than in the case of the cow, parturition may
not be completed at term, and the mare, to her serious and even fatal
injury, may carry the foal in the womb for a number of months. Hamon
records one case in which the mare died after carrying the fetus for 17
months, and Caillier a similar result after it had been carried 22
months. In these cases the fetus retained its natural form, but in one
reported by Gohier the bones only were left in the womb amid a mass of
apparently purulent matter.
_Cause._--The cause may be any effective obstruction to the act of
parturition, such as lack of contractile power in the womb, unduly
strong (inflammatory) adhesions between the womb and the fetal
membranes, wrong presentation of the fetus, contracted pelvis (from
fracture or disease of the bones), or disease and induration of the neck
of the womb.
The mere prolongation of gestation does not necessarily entail the death
of the foal; hence the latter has been born alive at the four hundredth
day. Even when the foal has perished putrefaction does not set in unless
the membranes (water bags) have been ruptured and septic bacteria have
been admitted to the interior of the womb. In the latter case a fetid
decomposition advances rapidly, and the mare usually perishes from
poisoning with the putrid matters absorbed.
At the natural period of parturition preparations are apparently made
for that act. The vulva swells and discharges much mucus, the udder
enlarges, the belly becomes more pendent, and the animal strains more or
less. No progress is made, however; there is not even opening of the
neck of the womb, and after a time the symptoms subside. The mare
usually refuses the male, yet there are exceptions to this rule. If the
neck of the womb has been opened and putrefying changes in its contents
have set in, the mare loses appetite and condition, pines, discharges an
offensive matter from the generative passages, and dies of inflammation
of the womb and putrid infection. In other cases there is a slow wearing
out of the strength, and she finally dies of exhaustion.
The treatment is such as will facilitate the expulsion of the fetus and
its membranes and the subsequent washing out of the womb with
disinfectants. So long as the mouth of the womb is closed time should be
allowed for its natural dilatation, but if this does not come about
after a day or two of straining, the opening may be smeared with extract
of belladonna, and the oiled hand, with the fingers and thumb drawn into
the form of a cone, may be inserted by slow oscillating movements into
the interior of the womb. The water bags may now be ruptured, any
malpresentation rectified (see "Difficult parturition"), and delivery
effected. After removal of the membranes wash out the womb first with
tepid water and then with a solution of 2 ounces of borax in half a
gallon of water.
This injection may have to be repeated if a discharge sets in. The same
course may be pursued even after prolonged retention. If the soft parts
of the fetus have been absorbed and the bones only left, these must be
carefully sought for and removed, and subsequent daily injections will
be required for some time. In such cases, too, a course of iron tonics
(sulphate of iron, 2 drams daily) will be highly beneficial in restoring
health and vigor.
ABORTION.
Abortion is, strictly speaking, the expulsion of the impregnated ovum at
any period from the date of impregnation until the foal can survive out
of the womb. If the foal is advanced enough to live, it is premature
parturition, and in the mare this may occur as early as the tenth month
(three hundredth day).
The mare may abort by reason of almost any cause that very profoundly
disturbs the system; hence, very violent inflammations of important
internal organs (bowels, kidneys, bladder, lungs) may induce abortion.
Profuse diarrhea, whether occurring from the reckless use of purgatives,
the consumption of irritants in the feed, or a simple indigestion, is an
effective cause. No less so is acute indigestion with evolution of gas
in the intestines (bloating). The presence of stone in the kidneys,
uterus, bladder, or urethra may induce so much sympathetic disorder in
the womb as to induce abortion. In exceptional cases wherein mares come
in heat during gestation, service by the stallion may cause abortion.
Blows or pressure on the abdomen, rapid driving or riding of the
pregnant mare, especially if she is soft and out of condition from
idleness, the brutal use of the spur or whip, and the jolting and
straining of travel by rail or boat are prolific causes. Bleeding the
pregnant mare, a painful surgical operation, and the throwing and
constraint resorted to for an operation are other causes. Traveling on
heavy, muddy roads, slips and falls on ice, and jumping must be added.
The stimulation of the abdominal organs by a full drink of iced water
may precipitate a miscarriage, as may exposure to a cold rainstorm or a
very cold night after a warm day. Irritant poisons that act on the
urinary or generative organs, such as Spanish flies, rue, savin, tansy,
cotton-root bark, ergot of rye or other grasses, the smut of maize and
other grain, and various fungi in musty fodder are additional causes.
Frosted or indigestible feed, and, above all, green succulent vegetables
in a frozen state, have proved effective factors, and filthy, stagnant
water is dangerous. Low condition in the dam and plethora have in
opposite ways caused abortion, and hot, relaxing stables and lack of
exercise strongly conduce to it. The exhaustion of the sire by too
frequent service, entailing debility of the offspring and disease of the
fetus or of its envelopes, must be recognized as a further cause.
The symptoms vary mainly according as the abortion is early or late in
pregnancy. In the first month or two of pregnancy the mare may miscarry
without observable symptoms, and the fact appears only by her coming in
heat. If more closely observed a small clot of blood may be found behind
her, in which a careful search reveals the rudiments of the foal. If the
occurrence is somewhat later in gestation, there will be some general
disturbance, loss of appetite, neighing, and straining, and the small
body of the fetus is expelled, enveloped in its membranes. Abortions
during the later stages of pregnancy are attended with greater
constitutional disturbance, and the process resembles normal
parturition, with the aggravation that more effort and straining is
requisite to force the fetus through the comparatively undilatable mouth
of the womb. There is the swelling of the vulva, with mucus or even
bloody discharge; the abdomen droops, the flanks fall in, the udder
fills, the mare looks at her flanks, paws with the fore feet and kicks
with the hind, switches the tail, moves around uneasily, lies down and
rises, strains, and, as in natural foaling, expels first mucus and
blood, then the waters, and finally the fetus. This may occupy an hour
or two, or it may be prolonged for a day or more, the symptoms subsiding
for a time, only to reappear with renewed energy. If there is
malpresentation of the fetus it will hinder progress until rectified,
as in difficult parturition. Abortion may also be followed by the same
accidents, as flooding, retention of the placenta, and leucorrhea.
The most important object in an impending abortion is to recognize it at
as early a stage as possible, so that it may, if possible, be cut short
and prevented. Any general, indefinable illness in a pregnant mare
should lead to a close examination of the vulva as regards swelling,
vascularity of its mucous membrane, and profuse mucus secretion, and,
above all, any streak or staining of blood; also the condition of the
udder, if that is congested and swollen. Any such indication, with
colicky pains, straining, however little, and active movement of the
fetus or entire absence of movement, are suggestive symptoms and should
be duly counteracted.
The changes in the vulva and udder, with a soiled and bloody condition
of the tail, may suggest an abortion already accomplished, and the
examination with the hand in the vagina may detect the mouth of the womb
soft and dilatable and the interior of the organ slightly filled with a
bloody liquid.
_Treatment_ should be preventive if possible, and would embrace the
avoidance of all causes mentioned, and particularly of such as may seem
to be particularly operative in the particular case. If abortions have
already occurred in a stud, the especial cause in the matter of feed,
water, exposure to injuries, overwork, lack of exercise, etc., may often
be identified and removed. A most important point is to avoid all causes
of constipation, diarrhea, indigestion, bloating, violent purgatives,
diuretics or other potent medicines, painful operations, and slippery
roads, unless well frosted.
When abortion is imminent, the mare should be placed alone in a roomy,
dark, quiet stall, and have the straining checked by some sedative.
Laudanum is usually at hand and may be given in doses of 1 or 2 ounces,
according to size, and repeated after two or three hours, and even daily
if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted
if more convenient. These should be given in a pint or quart of water,
to avoid burning the mouth and throat. Or _Viburnum prunifolium_ (black
haw), 1 ounce, may be given and repeated if necessary to prevent
straining.
When all measures fail and miscarriage proceeds, all that can be done is
to assist in the removal of the fetus and its membranes, as in ordinary
parturition. As in the case of retention of the fetus, it may be
necessary after delivery to employ antiseptic injections into the womb
to counteract putrid fermentation. This, however, is less necessary in
the mare than in the cow, in which the prevalent contagious abortion
must be counteracted by the persistent local use of antiseptics. After
abortion a careful hygiene is demanded, especially in the matter of pure
air and easily digestible feed. The mare should not be served again for
a month or longer, and in no case until after all discharge from the
vulva has ceased.
INFECTIOUS ABORTION IN MARES.
This disease is discussed in the chapter on "Infectious Diseases."
PARTURITION.
SYMPTOMS OF PARTURITION.
As the period of parturition approaches, the swelling of the udder
bespeaks the coming event, the engorgement in exceptional cases
extending forward on the lower surface of the abdomen and even into the
hind limbs. For about a week a serous fluid oozes from the teat and
concretes as a yellow, waxlike mass around its orifice. About 24 hours
before the birth this gives place to a whitish, milky liquid, which
falls upon and mats the hairs on the inner sides of the legs. Another
symptom is enlargement of the vulva, with redness of its lining
membrane, and the escape of glairy mucus. The belly droops, the flanks
fall in, and the loins may even become depressed. Finally the mare
becomes uneasy, stops feeding, looks anxious, whisks her tail, and may
lie down and rise again. In many mares this is not repeated, but they
remain down; violent contractions of the abdominal muscles ensue; after
two or three pains the water bags appear and burst, followed by the fore
feet of the foal, with the nose between the knees, and by a few more
throes the fetus is expelled. In other cases the act is accomplished
standing. The whole act may not occupy more than 5 or 10 minutes. This,
together with the disposition of the mare to avoid observation, renders
the act one that is rarely seen by the attendants.
The navel string, which connects the foal to the membranes, is ruptured
when the fetus falls to the ground, or when the mare rises, if she has
been down, and the membranes are expelled a few minutes later.
NATURAL PRESENTATION.
When there is a single foal, the common and desirable presentation is
with the fore feet first, the nose between the knees, and with the front
of the hoofs and knees and the forehead directed upward toward the anus,
tail, and croup. (Plate XII, fig. 1.) In this way the natural curvature
of the body of the fetus corresponds to the curve of the womb and
genital passages, and particularly of the bony pelvis, and the foal
passes with much greater ease than if placed with its back downward
toward the udder. When there is a twin birth the second foal usually
comes with its hind feet first, and the backs of the legs, the points of
the hocks, and the tail and croup are turned upward toward the anus and
tail of the mare. (Plate XII, fig. 2.) In this way, even with a
posterior presentation, the curvature of the body of the foal still
corresponds to that of the passages, and its expulsion may be quite as
easy as in anterior presentation. Any presentation aside from these two
may be said to be abnormal and will be considered under "Difficult
parturition."
PREMATURE LABOR PAINS.
These may be brought on by, any violent exertion, use under the saddle,
or in heavy draft, or in rapid paces, or in travel by rail or sea,
blows, kicks, crushing by other animals in a doorway or gate. Excessive
action of purgative or diuretic agents, or of agents that irritate the
bowels or kidneys, like arsenic, paris green, all caustic salts and
acids, and acrid and narcotico-acrid vegetables, is equally injurious.
Finally, the ingestion of agents that stimulate the action of the gravid
womb (ergot of rye or of other grasses, smut, various fungi of fodders,
rue, savin, cotton root, etc.) may bring on labor pains prematurely.
Besides the knowledge that parturition is not yet due, there will be
less enlargement, redness, and swelling of the vulva, less mucous
discharge, less filling of the udder, and fewer appearances of wax and
probably none of milk from the ends of the teats. The oiled hand
introduced into the vulva will not enter with the ease usual at full
term, and the neck of the womb will be felt not only closed, but with
its projecting papillæ, through which it is perforated, not yet
flattened down and effaced, as at full term. The symptoms are, indeed,
those of threatened abortion, but at such an advanced stage of gestation
as is compatible with the survival of the offspring.
_Treatment._--The treatment consists in the separation of the mare, in a
quiet, dark, secluded place, from all other animals, and the free use of
antispasmodics and anodynes. Opium in dram doses every two hours, or
laudanum in ounce doses at similar intervals, will often suffice. When
the more urgent symptoms have subsided these doses may be repeated
thrice a day till all excitement passes off or until the passages have
become relaxed and prepared for parturition. _Viburnum prunifolium_
(black haw), in ounce doses, may be added if necessary. Should
parturition become inevitable, it may be favored and any necessary
assistance furnished.
DIFFICULT PARTURITION.
With natural presentation this is a rare occurrence. The great length of
the fore limbs and face entail, in the anterior presentation, the
formation of a long cone, which dilates and glides through the passages
with comparative ease. Even with the hind feet first a similar conical
form is presented, and the process is rendered easy and quick.
Difficulty and danger arise mainly from the act being brought on
prematurely before the passages are sufficiently dilated, from narrowing
of the pelvic bones or other mechanical obstruction in the passages,
from monstrous distortions or duplications in the fetus, or from the
turning back of one of the members so that the elongated conical or
wedge-shaped outline is done away with. Prompt as is the normal
parturition in the mare, however, difficult and delayed parturitions are
surrounded by special dangers and require unusual precautions and skill.
From the proclivity of the mare to unhealthy inflammations of the
peritoneum and other abdominal organs, penetrating wounds of the womb or
vagina are liable to prove fatal. The contractions of the womb and
abdominal walls are so powerful as to exhaust and benumb the arm of the
assistant and to endanger penetrating wounds of the genital organs. By
reason of the looser connection of the fetal membranes with the womb, as
compared with those of ruminants, the violent throes early detach these
membranes throughout their whole extent, and the foal, being thus
separated from the mother and thrown on its own resources, dies at an
early stage of any protracted parturition. The foal rarely survives four
hours after the onset of parturient throes. From the great length of the
limbs and neck of the foal it is extremely difficult to secure and bring
up limb or head which has been turned back when it should have been
presented. When assistance must be rendered, the operator should don a
thick woolen undershirt with the sleeves cut out at the shoulders. This
protects the body and leaves the whole arm free for manipulation. Before
inserting the arm it should be smeared with lard. This protects the skin
against septic infection and favors the introduction of the hand and
arm. The hand should be inserted with the thumb and fingers drawn
together like a cone. Whether standing or lying, the mare should be
turned with head downhill and hind parts raised as much as possible. The
contents of the abdomen gravitating forward leave much more room for
manipulation. Whatever part of the foal is presented (head, foot) should
be secured with a cord and running noose before it is pushed back to
search for the other missing parts. Even if a missing part is reached,
no attempt should be made to bring it up during a labor pain. Pinching
the back will sometimes check the pains and allow the operator to secure
and bring up the missing member. In intractable cases a large dose of
chloral hydrate (1 ounce in a quart of water) or the inhalation of
chloroform and air (equal proportions) to insensibility may secure a
respite, during which the missing members may be replaced. If the waters
have been discharged and the mucus dried up, the genital passages and
body of the fetus should be lubricated with lard or oil before any
attempt at extraction is made. When the missing member has been brought
up into position and presentation has been rendered natural, traction
on the fetus must be made only during a labor pain. If a mare is
inclined to kick, it may be necessary to apply hobbles to protect the
operator.
DIFFICULT PARTURITION FROM NARROW PELVIS.--A disproportion between the
fetus got by a large stallion and the pelvis of a small dam is a serious
obstacle to parturition, sometimes seen in the mare. This is not the
rule, however, as the foal up to birth usually accommodates itself to
the size of the dam, as illustrated in the successful crossing of
Percheron stallions on mustang mares. If the disproportion is too great
the only resort is embryotomy.
FRACTURED HIP BONES.--More commonly the obstruction comes from
distortion and narrowing of the pelvis as the result of fractures.
(Plate XIII, fig. 2.) Fractures at any point of the lateral wall or
floor of the pelvis are repaired with the formation of an extensive bony
deposit bulging into the passage of the pelvis. The displacement of the
ends of the broken bone is another cause of constriction, and between
the two conditions the passage of the fetus may be rendered impossible
without embryotomy. Fracture of the sacrum (the continuation of the
backbone forming the croup) leads to the depression of the posterior
part of that bone in the roof of the pelvis and the narrowing of the
passage from above downward by a bony ridge presenting its sharp edge
forward.
In all cases in which there has been injury to the bones of the pelvis
the obvious precaution is to withhold the mare from breeding and to use
her for work only.
If a mare with a pelvis thus narrowed has got in foal inadvertently,
abortion may be induced in the early months of gestation by slowly
introducing the oiled finger through the neck of the womb and following
this by the other fingers until the whole hand has been introduced. Then
the water bags may be broken, and with the escape of the liquid the womb
will contract on the solid fetus and labor pains will ensue. The fetus
being small will pass easily.
TUMORS IN THE VAGINA AND PELVIS.--Tumors of various kinds may form in
the vagina or elsewhere within the pelvis, and when large enough will
obstruct or prevent the passage of the fetus. Gray mares, which are so
subject to black pigment tumors (melanosis) on the tail, anus, and
vulva, are the most liable to suffer from this. Still more rarely the
wall of the vagina becomes relaxed, and being pressed by a mass of
intestines will protrude through the lips of the vulva as a hernial sac,
containing a part of the bowels. If a tumor is small it may only retard
and not absolutely prevent parturition. A hernial protrusion of the wall
of the vagina may be pressed back and emptied, so that the body of the
fetus engaging in the passage may find no further obstacle. When a
tumor is too large to allow delivery the only resort is to remove it,
but before proceeding it must be clearly made out that the obstruction
is a mass of diseased tissue, and not a sac containing intestines. If
the tumor hangs by a neck it can usually be most safely removed by the
écraseur, the chain being passed around the pedicel and gradually
tightened until that is torn through.
HERNIA OF THE WOMB.--The rupture of the musculo-fibrous floor of the
belly and the escape of the gravid womb into a sac formed by the
peritoneum and skin hanging toward the ground is described by all
veterinary obstetricians, yet it is very rarely seen in the mare. The
form of the fetus can be felt through the walls of the sac, so that it
is easy to recognize the condition. Its cause is usually external
violence, though it may start from an umbilical hernia. When the period
of parturition arrives, the first effort should be to return the fetus
within the proper abdominal cavity, and this can sometimes be
accomplished with the aid of a stout blanket gradually tightened around
the belly. This failing, the mare may be placed on her side or back and
gravitation brought to the aid of manipulation in effecting the return.
Even after the hernia has been reduced the relaxed state of the womb and
abdominal walls may serve to hinder parturition, in which case the oiled
hand must be introduced through the vagina, the fetus brought into
position, and traction coincident with the labor pains employed to
produce delivery.
TWISTING OF THE NECK OF THE WOMB.--This condition is very uncommon in
the mare, though occasionally seen in the cow, owing to the greater
laxity of the broad ligaments of the womb in that animal. It consists in
a revolution of the womb on its own axis, so that its right or left side
will be turned upward (quarter revolution), or the lower surface may be
turned upward and the upper surface downward (half revolution). The
effect is to throw the narrow neck of the womb into a series of spiral
folds, turning in the direction in which the womb has revolved, closing
the neck and rendering distention and dilatation impossible.
The period and pains of parturition arrive, but in spite of continued
efforts no progress is made, neither water bags nor liquids appearing.
The oiled hand introduced into the closed neck of the womb will readily
detect the spiral direction of the folds on its inner surface.
The method of relief which I have successfully adopted in the cow may be
equally effective in the mare. The dam is placed (with her head uphill)
on her right side if the upper folds of the spiral turn toward the
right, and on her left side if they turn toward the left, and the oiled
hand is introduced through the neck of the womb and a limb or other part
of the body of the fetus is seized and pressed against the wall of the
womb, while two or three assistants turn the animal over on her back
toward the other side. The object is to keep the womb stationary while
the animal is rolling. If success attends the effort, the constriction
around the arm is suddenly relaxed, the spiral folds are effaced, and
the water bags and fetus press forward into the passage. If the first
attempt does not succeed, it may be repeated again and again until
success crowns the effort. Among my occasional causes of failure have
been the prior death and decomposition of the fetus, with the
extrication of gas and overdistention of the womb, and the supervention
of inflammation and inflammatory exudation around the neck of the womb,
which hinders untwisting. The first of these conditions occurs early in
the horse from the detachment of the fetal membranes from the wall of
the womb; and as the mare is more subject to fatal peritonitis than the
cow, it may be concluded that both these sources of failure are more
probable in the former subject.
When the case is intractable, though the hand may be easily introduced,
the instrument shown in Plate XIV, figure 7, may be used. Each hole at
the small end of the instrument has passed through it a stout cord with
a running noose, to be passed around two feet or other portion of the
fetus which it may be possible to reach. The cords are then drawn tight
and fixed around the handle of the instrument; then, by using the cross
handle as a lever, the fetus and womb may be rotated in a direction
opposite to that causing the obstruction. During this process the hand
must be introduced to feel when the twist has been undone. This method
may be supplemented, if necessary, by rolling the mare as described
above.
EFFUSION OF BLOOD IN THE VAGINAL WALLS.--This is common as a result of
difficult parturition, but it may occur from local injury before that
act, and may seriously interfere with it. This condition is easily
recognized by the soft, doughy swelling so characteristic of blood
clots, and by the dark-red color of the mucous membrane. I have laid
open such swellings with the knife as late as 10 days before
parturition, evacuated the clots, and dressed the wound daily with an
astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water
1 quart). A similar resort might be had, if necessary, during
parturition.
CALCULUS (STONE) AND TUMOR IN THE BLADDER.--The pressure upon the
bladder containing a stone or a tumor may prove so painful that the mare
will voluntarily suppress the labor pains. Examination of the bladder
with the finger introduced through the urethra will detect the offending
agent. A stone should be extracted with forceps. (See "Lithotomy.") The
large papillary tumors which I have met with in the mare's bladder have
been invariably delicate in texture and could be removed piecemeal by
forceps. Fortunately, mares affected in this way rarely breed.
FECAL IMPACTION OF THE RECTUM.--In some animals, with more or less
paralysis or weakness of the tail and rectum, the rectum may become so
impacted with solid feces that the mare is unable to discharge them, and
the accumulation both by reason of the mechanical obstruction and the
pain caused by pressure upon it will impel the animal to cut short all
labor pains. The rounded swelling surrounding the anus will at once
suggest the condition, when the obstruction may be removed by the
well-oiled or well-soaped hand.
SPASM OF THE NECK OF THE WOMB.--This occurs in the mare of specially
excitable temperament, or under particular causes of irritation, local
or general. Labor pains, though continuing for some time, produce no
dilatation of the neck of the womb, which will be found firmly closed so
as to admit but one or two fingers; this, although the projection at the
mouth of the womb may have been entirely effaced, so that a simple round
opening is left, with rigid margins.
The simplest treatment consists in smearing this part with solid extract
of belladonna, and after an interval inserting the hand with fingers and
thumb drawn into the form of a cone, rupturing the membranes and
bringing the fetus into position for extraction, as advised under
"Prolonged retention of the fetus." Another mode is to insert through
the neck of the womb an ovoid rubber bag, empty, and furnished with an
elastic tube 12 feet long. Carry the free end of this tube upward to a
height of 8, 10, or 12 feet, insert a filler into it, and proceed to
distend the bag with tepid or warm water.
FIBROUS BANDS CONSTRICTING OR CROSSING THE NECK OF THE WOMB.--These,
occurring as the result of disease, have been several times observed in
the mare. They may exist in the cavity of the abdomen and compress and
obstruct the neck of the womb, or they may extend from side to side of
the vagina across and just behind the neck of the womb. In the latter
position they may be felt and quickly remedied by cutting them across.
In the abdomen they can be reached only by incision, and two
alternatives are presented: (1) To perform embryotomy and extract the
fetus piecemeal, and (2) to make an incision into the abdomen and
extract by the Cæsarean operation, or simply to cut the constricting
band and attempt delivery by the usual channel.
FIBROUS CONSTRICTION OF VAGINA OR VULVA.--This is probably always the
result of direct mechanical injury and the formation of rigid cicatrices
which fail to dilate with the remainder of the passages at the approach
of parturition. The presentation of the fetus in the natural way and the
occurrence of successive and active labor pains without any favorable
result will direct attention to the rigid and unyielding cicatrices
which may be incised at one, two, or more points to a depth of half an
inch or more, after which the natural expulsive efforts will usually
prove effective. The resulting wounds may be washed frequently with a
solution of 1 part of carbolic acid to 50 parts of water, or of 1 part
of mercuric chlorid to 1,000 parts of water.
FETUS ADHERENT TO THE WALLS OF THE WOMB.--In inflammation of the mucous
membrane lining the cavity of the womb and implicating the fetal
membranes the resulting embryonic tissue sometimes establishes a medium
of direct continuity between the womb and fetal membranes; the blood
vessels of the one communicate freely with those of the other and the
fibers of the one are prolonged into the other. This causes retention of
the membranes after birth, and a special risk of bleeding from the womb,
and of septic poisoning. In exceptional cases the adhesion is more
extensive and binds a portion of the body of the foal firmly to the
womb. In such cases it has repeatedly been found impossible to extract
the foal until such adhesions were broken down. If they can be reached
with the hand and recognized, they may be torn through with the fingers
or with a blunt hook, after which delivery may be attempted with hope of
success.
EXCESSIVE SIZE OF FETUS.--It would seem that a small mare may usually be
safely bred to a large stallion, yet this is not always the case; and
when the small size is an individual rather than a racial characteristic
or the result of being very young, the rule can not be expected to hold.
There is always great danger in breeding the young, small, and
undeveloped female, and the dwarfed representative of a larger breed, as
the offspring tend to partake of the large race characteristics and to
show them even prior to birth. When impregnation has occurred in the
very young or in the dwarfed female there are two alternatives--to
induce abortion or to wait until there are attempts at parturition and
to extract by embryotomy if impracticable otherwise.
CONSTRICTION OF A MEMBER BY THE NAVEL STRING.--In man and animals alike
the winding of the umbilical cord around a member of the fetus sometimes
leads to the amputation of the latter. It is also known to get wound
around the neck or a limb at birth, but in the mare this does not
seriously impede parturition, as the loosely attached membranes are
easily separated from the womb and no strangulation or retarding occurs.
The foal may, however, die from the cessation of the placental
circulation unless it is speedily delivered.
WATER IN THE HEAD (HYDROCEPHALUS) OF THE FOAL.--This consists in the
excessive accumulation of liquid in the ventricles of the brain so that
the cranial cavity is enlarged and constitutes a great, projecting,
rounded mass occupying the space from the eyes upward. (See Plate XIII,
fig. 3.) With an anterior presentation (fore feet and nose) this
presents an insuperable obstacle to progress, as the diseased cranium is
too large to enter the pelvis at the same time with the fore arms. With
a posterior presentation (hind feet) all goes well until the body and
shoulders have passed out, when progress is suddenly arrested by the
great bulk of the head. In the first case, the oiled hand introduced
along the face detects the enormous size of the head, which may be
diminished by puncturing it with a knife or trocar and cannula in the
median line, evacuating the water and pressing in the thin, bony walls.
With a posterior presentation, the same course must be followed; the
hand passed along the neck will detect the cranial swelling, which may
be punctured with a knife or trocar. Oftentimes with an anterior
presentation the great size of the head leads to its displacement
backward, and thus the fore limbs alone engage in the passages. Here the
first object is to seek and bring up the missing head, and then puncture
it as above suggested.
[Illustration: PLATE XII.
NORMAL PRESENTATIONS.]
[Illustration: PLATE XIII.
SOME FACTORS IN DIFFICULT LABOR.]
[Illustration: PLATE XIV.
INSTRUMENTS USED IN DIFFICULT LABOR.]
ASCITES, OR DROPSY OF THE ABDOMEN IN THE FOAL.--The accumulation of
liquid in the abdominal cavity of the fetus is less frequent, but when
present it may arrest parturition as completely as will hydrocephalus.
With an anterior presentation the foal may pass as far as the shoulders,
but behind this all efforts fail to effect a further advance. With a
posterior presentation the hind legs as far as the thighs may be
expelled, but at this point all progress ceases. In either case the
oiled hand, passed inward by the side of the foal, will detect the
enormous distension of the abdomen and its soft, fluctuating contents.
The only course is to puncture the cavity and evacuate the liquid. With
the anterior presentation this may be done with a long trocar and
cannula, introduced through the chest and diaphragm, or with a knife an
incision may be made between the first two ribs and the lungs and heart
cut or torn out, when the diaphragm will be felt projecting strongly
forward, and may be easily punctured. Should there not be room to
introduce the hand through the chest, the oiled hand may be passed along
beneath the breast bone and the abdomen punctured. With a posterior
presentation the abdomen must be punctured in the same way, the hand,
armed with a knife protected in its palm, being passed along the side of
the flank or between the hind limbs. It should be added that moderate
dropsy of the abdomen is not incompatible with natural delivery, the
liquid being at first crowded back into the portion of the belly still
engaged in the womb, and passing slowly from that into the advanced
portion as soon as that has cleared the narrow passage of the pelvis and
passed out where it can expand.
GENERAL DROPSY OF THE FETUS.--In this case the tissues generally are
distended with liquid, and the skin is found at all points tense and
rounded, and pitting on pressure with the fingers. In some such cases
delivery may be effected after the skin has been punctured at narrow
intervals to allow the escape of the fluid and then liberally smeared
with fresh lard. More commonly, however, it can not be reached at all
points to be so punctured nor sufficiently reduced to be extracted
whole, and resort must be had to embryotomy.
EMPHYSEMA, OR SWELLING OF THE FETUS WITH GAS.--This has been described
as occurring in a living fetus, but I have met with it only in the dead
and decomposing foal after futile efforts had been made for several days
to effect delivery. These cases are very difficult, as the foal is
inflated to such extent that it is impossible to advance it into the
passages, and the skin of the fetus and the walls of the womb and vagina
have become so dry that it is impracticable to cause the one to glide on
the other. The hair comes off any part that may be seized, and the case
is rendered the more offensive and dangerous by the very fetid liquids
and gases. The only resort is embryotomy, by which I have succeeded in
saving a valuable mare that had carried a colt in this condition for
four days.
CONTRACTIONS OF MUSCLES.--The foal is not always developed
symmetrically, but certain groups of muscles are liable to remain short,
or to shorten because of persistent spasmodic contraction, so that even
the bones become distorted and twisted. This is most common in the neck.
The bones of this part and even of the face are drawn to one side and
shortened, the head being held firmly to the flank and the jaws being
twisted to the right or left. In other cases the flexor muscles of the
fore limbs are contracted so that the latter are strongly bent at the
knee. In neither of these cases can the distorted part be extended and
straightened, so that body or limbs must necessarily present double, and
natural delivery is rendered impossible. The bent neck may sometimes be
straightened after the muscles have been cut on the side to which it is
turned, and the bent limbs after the tendons on the back of the shank
bone have been cut across. Failing to accomplish this, the next resort
is embryotomy.
INCLOSED OVUM, OR TUMORS OF THE FETUS.--Tumors or diseased growths may
form on any part of the foal, internal or external, and by their size
impede or hinder parturition. In some cases what appears as a tumor is
an imprisoned and undeveloped ovum which has grafted itself on the
fetus. These are usually sacculated, and may contain skin, hair, muscle,
bone, and other natural tissues. The only course to be pursued in such
cases is to excise the tumor, or, if this is not feasible, to perform
embryotomy.
MONSTROSITIES.--Monstrosity in the foal is an occasional cause of
difficult parturition, especially such monsters as show excessive
development of some part of the body, a displacement or distortion of
parts, or a redundancy of parts, as in double monsters. Monsters may be
divided into--
(1) Monsters with absence of parts--absence of head, limb, or other
organ.
(2) Monsters with some part abnormally small--dwarfed head, limb, trunk,
etc.
(3) Monsters through unnatural division of parts--cleft head, trunk,
limbs, etc.
(4) Monsters through absence of natural divisions--absence of mouth,
nose, eyes, anus, confluent digits, etc.
(5) Monsters through fusion of parts--one central eye, one nasal
opening, etc.
(6) Monsters through abnormal position or form of parts--curved spine,
face, limb, etc.
(7) Monsters through excess of formation--enormous head, supernumerary
digits, etc.
(8) Monsters through imperfect differentiation of sexual
organs--hermaphrodites.
(9) Double monsters--double-headed, double-bodied, extra limbs, etc.
_Causes._--The causes of monstrosities appear to be very varied. Some
monstrosities, like extra digits, absence of horns or tail, etc., run in
families and are produced almost as certainly as color or form. Others
are associated with too close breeding, the powers of symmetrical
development being interfered with, just as in other cases a sexual
incompatibility is developed, near relatives failing to breed with each
other. Mere arrest of development of a part may arise from accidental
disease of the embryo; hence vital organs are left out, or portions of
organs, like the dividing walls of the heart, are omitted. Sometimes an
older fetus is inclosed in the body of another, each having started
independently from a separate ovum, but the one having become embedded
in the semifluid mass of the other and having developed there
simultaneously with it, but not so largely nor perfectly. In many cases
of redundance of parts the extra part or member has manifestly developed
from the same ovum and nutrient center with the normal member to which
it remains adherent, just as a new tail will grow out in a newt when the
former has been cut off. In the early embryo, with its great powers of
development, this factor can operate to far greater purpose than in the
adult animal. Its influence is seen in the fact pointed out by St.
Hilaire that such redundant parts are nearly always connected with the
corresponding portions in the normal fetus. Thus superfluous legs or
digits are attached to the normal ones, double heads or tails are
connected to a common neck or rump, and double bodies are attached to
each other by corresponding points, navel to navel, breast to breast,
back to back. All this suggests the development of extra parts from the
same primary layer of the impregnated and developing ovum. The effect of
disturbing conditions in giving such wrong directions to the
developmental forces is well shown in the experiments of St. Hilaire and
Valentine in varnishing, shaking, and otherwise breaking up the natural
connections in eggs, and thereby determining the formation of
monstrosities at will. So, in the mammal, blows and other injuries that
detach the fetal membranes from the walls of the womb or that modify
their circulation by inducing inflammation are at times followed by the
development of a monster. The excitement, mental and physical, attendant
on fright occasionally acts in a similar way, acting probably through
the same channels.
The monstrous forms liable to interfere with parturition are such as,
from contracted or twisted limbs or spine, must be presented double;
where supernumerary limbs, head, or body must approach the passages with
the natural ones; where a head or other member has attained to an
unnatural size; where the body of one fetus has become inclosed in or
attached to another, etc.
Extraction is sometimes possible by straightening the members and
obtaining such a presentation as will reduce the presenting mass to its
smallest and most wedgelike dimensions. To effect this it may be needful
to cut the flexor tendons of bent limbs or the muscles on the side of a
twisted neck or body; one or more of the manipulations necessary to
secure and bring up a missing member may be required. In most cases of
monstrosity by excess, however, it is needful to remove the superfluous
parts, in which case the general principles employed for embryotomy must
be followed. The Cæsarean section, by which the fetus is extracted
through an incision in the walls of the abdomen and womb, is
inadmissible, as it practically entails the sacrifice of the mare, which
should never be done for the sake of a monster. (See "Embryotomy," p.
202.)
ENTRANCE OF TWINS INTO THE PASSAGE AT ONCE.--Twins are rare in the mare,
and still more rare is the impaction of both at once into the pelvis.
The condition would be easily recognized by the fact that two fore limbs
and two hind would occupy the passage at once, the front of the hoofs of
the fore feet being turned upward and those of the hind feet downward.
If both belonged to one foal, they would be turned in the same
direction. Once recognized, the condition is easily remedied by passing
a rope with a running noose round each foot of the foal that is furthest
advanced or that promises to be most easily extracted, and to push the
members of the other fetus back into the depth of the womb. As soon as
the one fetus is fully engaged into the passage it will hold its place
and its delivery will proceed in the natural way.
ABNORMAL PRESENTATIONS.
(Pls. XV-XVIII.)
Abnormal presentations may be tabulated as follows:
{ {Incompletely extended.
{ { Flexor tendons shortened.
{Fore limbs {Crossed over the neck.
{ {Bent back at the knee.
{ {Bent back from the shoulder.
Anterior presentations: {
{ {Bent downward on the neck.
{ {Head and neck turned back
{ { beneath the breast.
{Head {Turned to one side.
{ {Turned upward and backward
{ { on the back.
{
{Hind limbs Hind feet engaged in the pelvis.
{
{Transverse Back of foal to side of pelvis.
{
{Inverted Back of foal to floor of pelvis.
{Hind limbs {Bent on itself at the hock.
Posterior presentations { {Bent at the hip.
{
{Transverse Back of foal to side of pelvis.
{
{Inverted Back of foal to floor of pelvis.
{With back and loins presented.
Transverse presentation of body {With breast and belly presented.
FORE LIMBS INCOMPLETELY EXTENDED.--In cases of this kind, not only are
the back tendons behind the knee and shank bone unduly short, but the
sinew extending from the front of the shoulder blade over the front of
the elbow and down to the head of the shank bone is also shortened. The
result is that the fore limb is bent at the knee and the elbow is also
rigidly bent. The condition obstructs parturition by the feet becoming
pressed against the floor of the pelvis or by the elbow pressing on its
anterior brim. Relief is to be obtained by forcible extension. A rope
with a running noose is passed around each fetlock and a repeller (see
Plate XIV) planted in the breast is pressed in a direction upward and
backward while active traction is made on the ropes. If the feet are not
thereby raised from the floor of the pelvis the palm of the hand may be
placed beneath them to protect the mucous membrane until they have
advanced sufficiently to obviate this danger. In the absence of a
repeller, a smooth rounded fork handle may be employed. If the
shortening is too great to allow of the extension of the limbs in this
way, the tense tendons may be cut across behind the shank bone and in
front of the elbow, and the limb will be easily straightened out. This
is most easily done with an embryotomy knife furnished with a ring for
the middle finger, so that the blade may be protected in the palm of the
hand. (See Plate XIII, fig. 4.)
FORE LIMB CROSSED OVER BACK OF NECK.--With the long fore limbs of the
foal this readily occurs, and the resulting increase in thickness, both
at the head and shoulder, offers a serious obstacle to progress. (See
Plate XV, fig. 2.) The hand introduced into the passage detects the head
and one fore foot, and farther back on the same side of the head the
second foot, from which the limb may be traced obliquely across the back
of the neck.
If parturition continues to make progress the displaced foot may bruise
and lacerate the vagina. By seizing the limb above the fetlock it may be
easily pushed over the head to the proper side, when parturition will
proceed normally.
FORE LIMB BENT AT KNEE.--The nose and one fore foot present, and on
examination the knee of the missing fore limb is found farther back.
(Plate XV, fig. 1.) First place a noose each on the presenting pastern
and lower jaw, and push back the body of the fetus with a repeller,
while the operator seizing the shank of the bent limb extends it so as
to press back the knee and bring forward the fetlock and foot. As
progress is made little by little the hand is slid down from the region
of the knee to the fetlock, and finally that is secured and brought up
into the passage, when parturition will proceed without hindrance. If
both fore limbs are bent back the head must be noosed and the limbs
brought up as above, one after the other. It is usually best to employ
the left hand for the right fore limb, and the right hand for the left
fore limb.
FORE LIMB TURNED BACK FROM SHOULDERS.--In this case, on exploration by
the side of the head and presenting limb, the shoulder only can be
reached at first. (Plate XV, fig 4.) By noosing the head and presenting
fore limb, they may be drawn forward into the pelvis, and the oiled hand
being carried along the shoulder in the direction of the missing limb is
enabled to reach and seize the forearm just below the elbow. The body is
now pushed back by the assistants pressing on the head and presenting
limb or on a repeller planted in the breast until the knee can be
brought up into the pelvis, after which the procedure is the same as
described in the last paragraph.
HEAD BENT DOWN BETWEEN FORE LIMBS.--This may be so that the poll or nape
of the neck, with the ears, can be felt far back between the fore limbs,
or so that only the upper border of the neck can be reached, head and
neck being bent back beneath the body. With the head only bent on the
neck, noose the two presenting limbs, then introduce the hand between
them until the nose can be seized in the palm of the hand. Next have the
assistants push back the presenting limbs, while the nose is strongly
lifted upward over the brim of the pelvis. This accomplished, it assumes
the natural position and parturition is easy.
When both head and neck are bent downward it may be impossible to reach
the nose. If, however, the labor has only commenced, the limbs may be
drawn upon until the operator can reach the ear, by dragging on which
the head may be so far advanced that the fingers may reach the orbit;
traction upon this while the limbs are being pushed back may bring the
head up so that it bends on the neck only, and the further procedure
will be as described in the last paragraph.
If the labor has been long in progress and the fetus is jammed into the
pelvis, the womb emptied of the waters, and firmly contracted on its
solid contents, the case is incomparably more difficult. The mare may be
chloroformed and turned on her back with hind parts elevated, and the
womb may be injected with sweet oil. Then, if the ear can be reached,
the correction of the malpresentation may be attempted as above
described. Should this fail, one or more sharp hooks may be inserted in
the neck as near the head as can be reached, and ropes attached to these
may be dragged on, while the body of the foal is pushed back by the fore
limbs or by a repeller. Such repulsion should be made in a direction
obliquely upward toward the loins of the mother, so as to rotate the
fetus in such a way as to bring the head up. As this is accomplished a
hold should be secured nearer and nearer to the nose, with hand or hook,
until the head can be straightened out on the neck.
All means failing; it becomes necessary to remove the fore limbs
(embryotomy) so as to make more space for bringing up the head. If, even
then, this can not be accomplished, it may be possible to push the body
backward and upward with the repeller until the hind limbs are brought
to the passage, when they may be noosed and delivery effected with the
posterior presentation.
HEAD TURNED ON SHOULDERS.--In this case the fore feet present, and the
oiled hand passed along the fore arms in search of the missing head
finds the side of the neck turned to one side, the head being perhaps
entirely out of reach. (Plate XVIII, fig. 1.) To bring the head forward
it may be desirable to lay the mare on the side opposite to that to
which the head is turned, and even to give chloroform or ether. Then the
feet being noosed, the body of the fetus is pushed by the hand or
repeller forward and to the side opposite to that occupied by the head
until the head comes within reach, near the entrance of the pelvis. If
such displacement of the fetus is difficult, it may be facilitated by a
free use of oil or lard. When the nose can be seized it can be brought
into the passage, as when the head is turned down. If it can not be
reached, the orbit may be availed of to draw the head forward until the
nose can be seized or the lower jaw noosed. In very difficult cases a
rope may be passed around the neck by the hand or with the aid of a
curved carrier (Plate XIV), and traction may be made upon this while the
body is being rotated to the other side. In the same way in bad cases a
hook may be fixed in the orbit or even between the bones of the lower
jaw to assist in bringing the head up into position. Should all fail,
the amputation of the fore limbs may be resorted to, as advised under
the last heading.
HEAD TURNED UPWARD ON BACK.--This differs from the last malpresentation
only in the direction of the head, which has to be sought above rather
than at one side, and is to be secured and brought forward in a similar
manner. (Plate XVIII, fig. 2.) If a rope can be passed around the neck
it will prove most effectual, as it naturally slides nearer to the head
as the neck is straightened and ends by bringing the head within easy
reach.
HIND FEET ENGAGED IN PELVIS.--In this case fore limbs and head present
naturally, but the hind limbs bent forward from the hip and the loins
arched allow the hind feet also to enter the passages, and the further
labor advances the more firmly does the body of the foal become wedged
into the pelvis (Plate XVII, fig. 2.) The condition is to be recognized
by introducing the oiled hand along the belly of the fetus, when the
hind feet will be felt advancing. An attempt should at once be made to
push them back, one after the other, over the brim of the pelvis.
Failing in this, the mare may be turned on her back, head downhill, and
the attempt renewed. If it is possible to introduce a straight rope
carrier, a noose passed through this may be put on the fetlock and the
repulsion thereby made more effective. In case of continued failure the
anterior presenting part of the body may be skinned and cut off as far
back toward the pelvis as possible (see "Embryotomy"); then nooses are
placed on the hind fetlocks and traction is made upon these while the
quarters are pushed back into the womb. Then the remaining portion is
brought away by the posterior presentation.
ANTERIOR PRESENTATION WITH BACK TURNED TO ONE SIDE.--The diameter of the
axis of the foal, like that of the pelvic passages, is from above
downward, and when the fetus enters the pelvis with this greatest
diameter engaged transversely or in the narrow diameter of the pelvis,
parturition is rendered difficult or impossible. In such a case the
pasterns and head may be noosed, and the passages and engaged portion of
the foal freely lubricated with lard, the limbs may be crossed over each
other and the head, and a movement of rotation effected in the fetus
until its face and back are turned up toward the croup of the mother;
then parturition becomes natural.
BACK OF FOAL TURNED TO FLOOR OF PELVIS.--In a roomy mare this is not an
insuperable obstacle to parturition, yet it may seriously impede it, by
reason of the curvature of the body of the foal being opposite to that
of the passages, and the head and withers being liable to arrest against
the border of the pelvis. Lubrication of the passage with lard and
traction of the limbs and head will usually suffice with or without the
turning of the mare on her back.
In obstinate cases two other resorts are open: First, to turn the foal,
pushing back the fore parts and bringing up the hind so as to make a
posterior presentation, and, second, the amputation of the fore limbs,
after which extraction will usually be easy.
[Illustration: PLATE XV.
ABNORMAL PRESENTATIONS.]
[Illustration: PLATE XVI.
ABNORMAL PRESENTATIONS.]
[Illustration: PLATE XVII.
ABNORMAL PRESENTATIONS.]
[Illustration: PLATE XVIII.
ABNORMAL PRESENTATIONS.]
HIND PRESENTATION WITH LEG BENT AT HOCK.--In this form the quarters of
the foal with the hind legs bent up beneath them present, but can not
advance through the pelvis by reason of their bulk. (Plate XV, fig. 3.)
The oiled hand introduced can recognize the outline of the buttocks,
with the tail and anus in the center and the sharp points of the hocks
beneath. First pass a rope around each limb at the hock, then with hand
or repeller push the buttocks backward and upward, until the feet can be
brought up into the passages. To this the great length of the shank and
pastern in the foal is a serious obstacle, and in all cases the foot
should be protected in the palm of the hand while being brought up over
the brim of the pelvis; otherwise the womb may be torn. When the pains
are too violent and constant to allow effective manipulation, some
respite may be obtained by the use of chloroform or morphin and by
turning the mare on her back, but too often the operator fails and the
foal must be sacrificed. Two courses are still open: First, to cut
through the cords behind and above the hock and extend the upper part of
the limb, leaving the hock bent, and extract in this way, and, second,
to amputate the hind limbs at the hip joint and remove them separately,
after which the body may be extracted.
HIND PRESENTATION WITH LEGS BENT FORWARD FROM HIP.--This is merely an
aggravated form of the presentation last described. (Plate XVII, fig.
1.) If the mare is roomy, a rope may be passed around each thigh and the
body pushed upward and forward, so as to bring the hocks and heels
upward. If this can be accomplished, nooses are placed on the limb
further and further down until the fetlock is reached and brought into
position. If failure is met with, then amputation at the hips is the
last resort.
HIND PRESENTATIONS WITH BACK TURNED SIDEWAYS OR DOWNWARD.--These are the
counterparts of similar anterior presentations and are to be managed in
the same way.
PRESENTATION OF THE BACK.--This is rare, yet not unknown, the foal being
bent upon itself with the back, recognizable by its sharp row of spines,
presented at the entrance of the pelvis and the head and all four feet
turned back into the womb. (Plate XVI, fig. 1.) The body of the fetus
may be extended across the opening transversely, so that the head
corresponds to one side (right or left), or it may be vertical, with the
head above or below.
In any such position the object should be to push the body of the fetus
forward and upward or to one side, as may best promise to bring up the
fore or hind extremities, and bring the latter into the passage so as to
constitute a normal anterior or posterior presentation. This turning of
the fetus may be favored by a given position of the mother, by the free
use of oil or lard on the surface of the fetus, and by the use of a
propeller.
PRESENTATION OF BREAST AND ABDOMEN.--This is the reverse of the back
presentation, the foal being extended across in front of the pelvic
opening, but with the belly turned toward the passages and with all four
feet engaged in the passage. (Plate XVI, fig. 2.) The most promising
course is to secure the hind feet with nooses and then push the fore
feet forward into the womb. As soon as the fore feet are pushed forward
clear of the brim of the pelvis, traction is made on the hind feet so as
to bring the thighs into the passage and prevent the reentrance of the
fore limbs. If it proves difficult to push the fore limbs back, a noose
may be passed around the fetlock of each and the cord drawn through the
eye of a rope carrier, by means of which the members may be easily
pushed back.
EMBRYOTOMY.
Embryotomy consists in the dissection of the fetus, so as to reduce its
bulk and allow of its exit through the pelvis. The indications for its
adoption have been furnished in the foregoing pages. The operation will
vary in different cases according to the necessity for the removal of
one or more parts in order to secure the requisite reduction in size.
Thus it may be needful to remove head and neck, one fore limb or both,
one hind limb or both, to remove different parts of the trunk, or to
remove superfluous (monstrous) parts. Some of the simplest operations in
embryotomy (incision of the head in hydrocephalus, incision of the belly
in dropsy) have already been described. It remains to notice the more
difficult procedures which can be best undertaken by the skilled
anatomist.
AMPUTATION OF THE HEAD.--This is easy when both fore limbs are turned
back and the head alone has made its exit in part. It is more difficult
when the head is still retained in the passages or womb, as in
double-headed monsters. The head is secured by a hook in the lower jaw,
or in the orbit, or by a halter, and the skin is divided circularly
around the lower part of the face or at the front of the ears, according
to the amount of head protruding. Then an incision is made backward
along the line of the throat, and the skin dissected from the neck as
far back as possible. Then the muscles and other soft parts of the neck
are cut across, and the bodies of two vertebra (neck bones) are severed
by cutting completely across the cartilage of the joint. The bulging of
the ends of the bones will serve to indicate the seat of the joint. The
head and detached portion of the neck may now be removed by steady
pulling. If there is still an obstacle, the knife may be again used to
sever any obstinate connections. In the case of a double-headed monster,
the whole of the second neck must be removed with the head. When the
head has been detached, a rope should be passed through the eyeholes,
or through an artificial opening in the skin, and tied firmly around
the skin, to be employed as a means of traction when the missing limbs
or the second head have been brought up into position.
AMPUTATION OF THE HIND LIMB.--This may be required when there are extra
hind limbs or when the hind limbs are bent forward at hock or hip joint.
In the former condition the procedure resembles that for removal of a
fore limb, but requires more anatomical knowledge. Having noosed the
pastern, a circular incision is made through the skin around the
fetlock, and a longitudinal one from that up to the groin, and the skin
is dissected from the limb as high up as can be reached, over the croup,
if possible. Then cut through the muscles around the hip joint, and, if
possible, the two interarticular ligaments of the joint (pubofemoral and
round), and extract the limb by strong dragging.
AMPUTATION OF THE FORE LIMBS.--This may usually be begun on the fetlock
of the limb projecting from the vulva. An embryotomy knife is desirable.
This knife consists of a blade with a sharp, slightly hooked point, and
one or two rings in the back of the blade large enough to fit on the
middle finger, while the blade is protected in the palm of the hand.
(See Plate XIII, fig. 4.) Another form has the blade inserted in a
mortise in the handle, from which it is pushed out by a movable button
when wanted. First place a noose around the fetlock of the limb to be
amputated, cut the skin circularly entirely around the fetlock, then
make an incision on the inner side of the limb from the fetlock up to
the breastbone. Next dissect the skin from the limb, from the fetlock up
to the breastbone on the inner side, and as far up on the shoulder blade
as possible on the outer side. Finally, cut through the muscles
attaching the limb to the breastbone, and employ strong traction on the
limb, so as to drag out the whole limb, shoulder blade included. The
muscles around the upper part of the shoulder blade are easily torn
through and need not be cut, even if that were possible. In no case
should the fore limb be removed unless the shoulder blade is taken with
it, as that furnishes the greatest obstruction to delivery, above all
when it is no longer advanced by the extension of the fore limb, but is
pressed back so as to increase the already thickest posterior portion of
the chest. The preservation of the skin from the whole limb is
advantageous in various ways; it is easier to cut it circularly at the
fetlock than at the shoulder; it covers the hand and knife in making the
needful incisions, thus acting as a protection to the womb; and it
affords a means of traction on the body after the limb has been removed.
In dissecting the skin from the limb the knife is not needful at all
points; much of it may be stripped off with the fingers or knuckles, or
by a blunt, iron spud, pushed up inside the hide, which is meanwhile
held tense to render the spud effective.
In case the limb is bent forward at the hock, a rope is passed round
that and pulled so as to bring the point of the hock between the lips of
the vulva. The hamstring and the lateral ligaments of the hock are now
cut through, and the limbs extended by a rope tied round the lower end
of the long bone above (tibia). In case it is still needful to remove
the upper part of the limb, the further procedure is the same as
described in the last paragraph.
In case the limb is turned forward from the hip, and the fetus so wedged
into the passage that turning is impossible, the case is very difficult.
I have repeatedly succeeded by cutting in on the hip joint and
disarticulating it, then dissecting the muscles back from the upper end
of the thigh bone. A noose was placed around the neck of the bone and
pulled on forcibly, while any unduly resisting structures were cut with
the knife.
Cartwright recommends to make free incisions round the hip joints and
tear through the muscles when they can not be cut; then with cords round
the pelvic bones, and hooks inserted in the openings in the floor of the
pelvis to drag out the pelvic bones; then put cords around the heads of
the thigh bones and extract them; then remove the intestines; finally,
by means of the loose, detached skin, draw out the body with the
remainder of the hind limbs bent forward beneath it.
Reuff cuts his way into the pelvis of the foal, and with a knife
separates the pelvic bones from the loins, then skinning the quarter
draws out these pelvic bones by means of ropes and hooks, and along with
them the hind limbs.
The hind limbs having been removed by one or the other of these
procedures, the loose skin detached from the pelvis is used as a means
of traction and delivery is effected. In case of a monstrosity with
extra hind limbs, it may be possible to bring these up into the passage
and utilize them for traction.
_Removal of the abdominal viscera._--In case the belly is unduly large,
from decomposition, tumors, or otherwise, it may be needful to lay it
open with the knife and cut or tear out the contents.
_Removal of the thoracic viscera._--To diminish the bulk of the chest it
has been found advisable to cut out the breastbone, remove the heart and
lungs, and allow the ribs to collapse with the lower free ends
overlapping each other.
_Dissection of the trunk._--In case it becomes necessary to remove other
portions of the trunk, we should follow the general rule of preserving
the skin so that all manipulations can be made inside this as a
protector, that it may remain available as a means of exercising
traction on the remaining part of the body, and as a covering to protect
the vaginal walls against injuries from bones while such part is
passing.
FLOODING, OR BLEEDING FROM THE WOMB.
This is rare in the mare, but not unknown, in connection with a failure
of the womb to contract on itself after parturition, or with eversion of
the womb (casting the withers), and congestion or laceration. If the
blood accumulates in the flaccid womb, the condition may be suspected
only by reason of the rapidly advancing weakness, swaying, unsteady
gait, hanging head, paleness of the eyes and other mucous membranes, and
weak, small, failing pulse. The hand introduced into the womb detects
the presence of the blood partly clotted. If the blood escapes by the
vulva, the condition is evident.
_Treatment_ consists in evacuating the womb of its blood clots, giving a
large dose of powdered ergot of rye, and in the application of cold
water or ice to the loins and external generative organs. Besides this,
a sponge impregnated with a strong solution of alum, or, still better,
with tincture of muriate of iron, may be introduced into the womb and
squeezed so as to bring the liquid in contact with the walls generally.
EVERSION OF THE WOMB.
If the womb fails to contract after difficult parturition, the
after-pains will sometimes lead to the fundus passing into the body of
the organ and passing through that and the vagina until the whole
inverted organ appears externally and hangs down on the thighs. The
result is rapid engorgement and swelling of the organ, impaction of the
rectum with feces, and distention of the bladder with urine, all of
which conditions seriously interfere with the return of the mass. In
returning the womb the standing is preferable to the recumbent position,
as the abdomen is more pendent and there is less obstruction to the
return. It may, however, be necessary to put hobbles on the hind limbs
to prevent the mare from kicking. A clean sheet should be held beneath
the womb, and all filth, straw, and foreign bodies washed from its
surface. Then with a broad, elastic (india-rubber) band, or in default
of that a long strip of calico 4 or 5 inches wide, wind the womb as
tightly as possible, beginning at its most dependent part (the extremity
of the horn). This serves two good ends. It squeezes out into the
general circulation the enormous mass of blood which engorged and
enlarged the organ, and it furnishes a strong protective covering for
the now delicate, friable organ, through which it may be safely
manipulated without danger of laceration. The next step may be the
pressure on the general mass while those portions next the vulva are
gradually pushed in with the hands; or the extreme lowest point (the end
of the horn) may be turned within itself and pushed forward into the
vagina by the closed fist, the return being assisted by manipulations by
the other hand, and even by those of assistants. By either mode the
manipulations may be made with almost perfect safety so long as the
organ is closely wrapped in the bandage. Once a portion has been
introduced into the vagina the rest will usually follow with increasing
ease, and the operation should be completed with the hand and arm
extended the full length within the womb and moved from point to point
so as to straighten out all parts of the organ and insure that no
portion still remain inverted within another portion. Should any such
partial inversion be left it will give rise to straining, under the
force of which it will gradually increase until the whole mass will be
protruded as before. The next step is to apply a truss as an effectual
mechanical barrier to further escape of the womb through the vulva. The
simplest is made with two 1-inch ropes, each about 18 feet long, each
doubled and interwoven at the bend, as seen in Plate XIV, figure 4. The
ring formed by the interlacing of the two ropes is adjusted around the
vulva, the two ends of the one rope are carried up on the right and left
of the tail and along the spine, being wound around each other in their
course, and are finally tied to the upper part of the collar encircling
the neck. The remaining two ends, belonging to the other rope, are
carried downward and forward between the thighs and thence forward and
upward on the sides of the belly and chest to be attached to the right
and left sides of the collar. These ropes are drawn tightly enough to
keep closely applied to the opening without chafing, and will fit still
more securely when the mare raises her back to strain. It is desirable
to tie the mare short so that she may be unable to lie down for a day or
two, and she should be kept in a stall with the hind parts higher than
the fore. Violent straining may be checked by full doses of opium
(one-half dram), and any costiveness or diarrhea should be obviated by a
suitable laxative or binding diet.
In some mares the contractions are too violent to allow of the return of
the womb, and full doses of opium one-half dram, laudanum 2 ounces, or
chloral hydrate 1 ounce, may be demanded, or the mare must be rendered
insensible by ether or chloroform.
RUPTURE, OR LACERATION, OF THE WOMB.
This may occur from the feet of the foal during parturition, or from
ill-directed efforts to assist, but it is especially liable to take
place in the everted, congested, and friable organ. The resultant
dangers are bleeding from the wound, escape of the bowels through the
opening and their fatal injury by the mare's feet or otherwise, and
peritonitis from the extension of inflammation from the wound and from
the poisonous action of the septic liquids of the womb escaping into the
abdominal cavity. The first object is to close the wound, but unless in
eversion of the womb this is practically impossible. In the last-named
condition the wound must be carefully and accurately sewed up before
the womb is returned. After its return, the womb must be injected daily
with an antiseptic solution (borax, one-half ounce, or carbolic acid, 3
drams to a quart of tepid water). If inflammation threatens, the abdomen
may be bathed continuously with hot water by means of a heavy woolen
rag, and large doses of opium (one-half dram) may be given twice or
thrice daily.
RUPTURES OF THE VAGINA.
These are attended with dangers similar to those belonging to rupture of
the womb, and in addition by the risk of protrusion of the bladder,
which appears through the lips of the vulva as a red, pyriform mass.
Sometimes such lacerations extend downward into the bladder, and in
others upward into the terminal gut (rectum). In still other cases the
anus is torn so that it forms one common orifice with the vulva.
Too often such cases prove fatal, or at least a recovery is not
attained, and urine or feces or both escape freely into the vagina. The
simple laceration of the anus is easily sewed up, but the ends of the
muscular fibers do not reunite and the control over the lower bowel is
never fully reacquired. The successful stitching up of the wound
communicating with the bladder or the rectum requires unusual skill and
care, and though I have succeeded in a case of the latter kind, I can
not advise the attempt by unprofessional persons.
BLOOD CLOTS IN THE WALLS OF THE VAGINA.
(See "Effusion of blood in the vaginal walls," p. 190.)
LAMINITIS, OR FOUNDER, FOLLOWING PARTURITION.
This sometimes follows on inflammation of the womb, as it frequently
does on disorder of the stomach. Its symptoms agree with those of the
common form of founder, and treatment need not differ.
INFLAMMATION OF THE WOMB AND PERITONEUM.
These may result from injuries sustained by the womb during or after
parturition, from exposure to cold or wet, or from the irritant
infective action of putrid products within the womb. Under the
inflammation the womb remains dilated and flaccid, and decomposition of
its secretions almost always occurs, so that the inflammation tends to
assume a putrid character and general septic infection is likely to
occur.
_Symptoms._--The symptoms are ushered in by shivering, staring coat,
small, rapid pulse, elevated temperature, accelerated breathing, loss of
appetite, with arched back, stiff movement of the body, looking back at
the flanks, and uneasy motions of the hind limbs, discharge from the
vulva of a liquid at first watery, reddish, or yellowish, and later it
may be whitish or glairy, and fetid or not in different cases.
Tenderness of the abdomen shown on pressure is especially
characteristic of cases affecting the peritoneum or lining of the belly,
and is more marked lower down. If the animal survives, the inflammation
tends to become chronic and attended by a whitish mucopurulent
discharge. If, on the contrary, it proves fatal, death is preceded by
extreme prostration and weakness from the general septic poisoning.
_Treatment._--In treatment the first thing to be sought is the removal
of all offensive and irritant matters from the womb through a caoutchouc
tube introduced into the womb, and into which a funnel is fitted. Warm
water should be passed until it comes away clear. To insure that all the
womb has been washed out, the oiled hand may be introduced to carry the
end of the tube into the two horns successively. When the offensive
contents have been thus removed, the womb should be injected with a
quart of water holding in solution 1 dram permanganate of potash, or, in
the absence of the latter, 2 teaspoonfuls of carbolic acid, twice daily.
Fomentation of the abdomen, or the application of a warm flaxseed
poultice, may greatly relieve. Acetanilid, in doses of half an ounce,
twice or thrice a day, or sulphate of quinia in doses of one-third
ounce, may be employed to reduce the fever. If the great prostration
indicates septic poisoning, large doses (one-half ounce) bisulphite of
soda, or salicylate of soda, or sulphate of quinin may be resorted to.
LEUCORRHEA.
This is a white, glutinous, chronic discharge, the result of a
continued, subacute inflammation of the mucous membrane of the womb.
Like the discharge of acute inflammation, it contains many forms of
bacteria, by some of which it is manifestly inoculable on the penis of
the stallion, producing ulcers and a specific, gonorrheal discharge.
_Treatment_ may consist in the internal use of tonics (sulphate of iron,
3 drams, daily) and the washing out of the womb, as described under the
last heading, followed by an astringent antiseptic injection (carbolic
acid, 2 teaspoonfuls; tannic acid, 1/2 dram; water, 1 quart). This may
be given two or three times a day.
DISEASES OF THE UDDER AND TEATS.
CONGESTION AND INFLAMMATION OF THE UDDER.
This is comparatively rare in the mare, though in some cases the udder
becomes painfully engorged before parturition, and a doughy swelling,
pitting on pressure, extends forward on the lower surface of the
abdomen. When this goes on to active inflammation, one or both of the
glands becomes enlarged, hot, tense, and painful; the milk is dried up
or replaced by a watery or reddish, serous fluid, which at times becomes
fetid; the animal walks lame, loses appetite, and shows general disorder
and fever. The condition may end in recovery, in abscess, induration,
or gangrene, and, in some cases, may lay the foundation for a tumor of
the gland.
_Treatment._--The treatment is simple so long as there is only
congestion. Active rubbing with lard or oil, or, better, camphorated
oil, and the frequent drawing off of the milk, by the foal or with the
hand, will usually bring about a rapid improvement. When active
inflammation is present, fomentation with warm water may be kept up for
an hour and followed by the application of the camphorated oil, to which
has been added some carbonate of soda and extract of belladonna. A dose
of laxative medicine (4 drams Barbados aloes) will be of service in
reducing fever, and one-half ounce saltpeter daily will serve a similar
end. In case the milk coagulates in the udder and can not be withdrawn,
or when the liquid becomes fetid, a solution of 20 grains carbonate of
soda and 10 drops carbolic acid dissolved in an ounce of water should be
injected into the teat. In doing this it must be noted that the mare has
three separate ducts opening on the summit of each teat and each must be
carefully injected. To draw off the fetid product it may be needful to
use a small milking tube, or spring teat dilator designed by the writer.
(Plate XIV, figs. 2 and 3.) When pus forms and points externally and can
not find a free escape by the teat, the spot where it fluctuates must be
opened freely with the knife and the cavity injected daily with the
carbolic-acid lotion. When the gland becomes hard and indolent, it may
be rubbed daily with iodin ointment 1 part, vaseline 6 parts.
TUMORS OF THE UDDER.
As the result of inflammation of the udder it may become the seat of an
indurated diseased growth, which may go on growing and seriously
interfere with the movement of the hind limbs. If such swellings do not
give way in their early stages to treatment by iodin, the only resort is
to cut them out with a knife. As the gland is often implicated and has
to be removed, such mares can not in the future suckle their colts and
therefore should not be bred.
SORE TEATS, SCABS, CRACKS, WARTS.
By the act of sucking, especially in cold weather, the teats are subject
to abrasions, cracks, and scabs, and as the result of such irritation,
or independently, warts sometimes grow and prove troublesome. The warts
should be clipped off with sharp scissors and their roots burned with a
solid pencil of lunar caustic. This is best done before parturition to
secure healing before suckling begins. For sore teats use an ointment of
vaseline 1 ounce, balsam of tolu 5 grains, and sulphate of zinc 5
grains.
DISEASES OF THE NERVOUS SYSTEM.
By M. R. TRUMBOWER, V. S.
[Revised by John R. Mohler, A. M., V. M. D.]
ANATOMY AND PHYSIOLOGY OF THE BRAIN AND NERVOUS SYSTEM.
(Pl. XIX.)
The nervous system may be regarded as consisting of two sets of organs,
peripheral and central, the function of one being to establish a
communication between the centers and the different parts of the body,
and that of the other to generate nervous force. The whole may be
arranged under two divisions: First, the cerebrospinal system; second,
the sympathetic or ganglionic system. Each is possessed of its own
central and peripheral organs.
In the first, the center is made up of two portions--one large and
expanded (the brain) placed in the cranial cavity; the other elongated
(spinal cord), continuous with the brain, and lodged in the canal of the
vertebral column. The peripheral portion of this system consists of the
cerebrospinal nerves, which leave the axis in symmetrical pairs and are
distributed to the skin, the voluntary muscles, and the organs.
In the second, the central organ consists of a chain of ganglia,
connected by nerve cords, which extends on each side of the spine from
the head to the rump. The nerves of this system are distributed to the
involuntary muscles, mucous membrane, viscera, and blood vessels.
The two systems have free intercommunication, ganglia being at the
junctions.
Two substances, distinguishable by their color, namely, the white or
medullary and the gray or cortical substance, enter into the formation
of nervous matter. Both are soft, fragile, and easily injured, in
consequence of which the principal nervous centers are well protected by
bony coverings. The nervous substances present two distinct forms--nerve
fibers and nerve cells. An aggregation of nerve cells constitutes a
nerve ganglion.
The nerve fibers represent a conducting apparatus and serve to place the
central nervous organs in connection with peripheral end organs. The
nerve cells, however, besides transmitting impulses, act as
physiological centers for automatic, or reflex, movements, and also for
the sensory, perceptive, trophic, and secretory functions. A nerve
consists of a bundle of tubular fibers, held together by a dense
areolar tissue, and inclosed in a membranous sheath--the neurilemma.
Nerve fibers possess no elasticity, but are very strong. Divided nerves
do not retract.
Nerves are thrown into a state of excitement when stimulated, and are,
therefore, said to possess excitable or irritable properties. The
stimuli may be applied to, or may act upon, any part of the nerve.
Nerves may be paralyzed by continuous pressure being applied. When the
nerves divide into branches, there is never any splitting up of their
ultimate fibers, nor yet is there ever any coalescing of them; they
retain their individuality from their source to their termination.
Nerves which convey impressions to the centers are termed sensory, or
centripetal, and those which transmit stimulus from the centers to
organs of motion are termed motor, or centrifugal. The function of the
nervous system may, therefore, be defined in the simplest terms, as
follows: It is intended to associate the different parts of the body in
such a manner that stimulus applied to one organ may excite or depress
the activity of another.
The brain is that portion of the cerebrospinal axis within the cranium,
which may be divided into four parts--the medulla oblongata, the
cerebellum, the pons Varolii, and the cerebrum--and it is covered by
three membranes, called the meninges. The outer of these membranes, the
dura mater, is a thick, white, fibrous membrane which lines the cavity
of the cranium, forming the internal periosteum of the bones; it is
continuous with the spinal cord to the extremity of the canal. The
second, the arachnoid, is a delicate serous membrane, and loosely
envelops the brain and spinal cord; it forms two layers, having between
them the arachnoid space which contains the cerebrospinal fluid, the use
of which is to protect the spinal cord and brain from pressure. The
third, or inner, the pia mater, is closely adherent to the entire
surface of the brain, but is much thinner and more vascular than when it
reaches the spinal cord, which it also envelops, and is continued to
form the sheaths of the spinal nerves.
The medulla oblongata is the prolongation of the spinal cord, extending
to the pons Varolii. This portion of the brain is very large in the
horse: it is pyramidal in shape, the narrowest part joining the cord.
The pons Varolii is the transverse projection on the base of the brain,
between the medulla oblongata and the peduncles of the cerebrum.
The cerebellum is lodged in the posterior part of the cranial cavity,
immediately above the medulla oblongata; it is globular or elliptical in
shape, the transverse diameter being greatest. The body of the
cerebellum is composed of gray matter externally and of white matter in
the center. The cerebellum has the function of co-ordinating movements;
that is, of so associating them as to cause them to accomplish a
definite purpose. Injuries to the cerebellum cause disturbances of the
equilibrium but do not interfere with the will power or intelligence.
The cerebrum, or brain proper, occupies the anterior portion of the
cranial cavity. It is ovoid in shape, with an irregular, flattened base,
and consists of lateral halves or hemispheres. The greater part of the
cerebrum is composed of white matter. The hemispheres of the cerebrum
are usually said to be the seat of all psychical activities. Only when
they are intact are the process of feeling, thinking, and willing
possible. After they are destroyed the organism comes to be like a
complicated machine, and its activity is only the expression of the
internal and external stimuli which act upon it.
The spinal cord, or spinal marrow, is that part of the cerebrospinal
system which is contained in the spinal canal of the backbone, and
extends from the medulla oblongata to a short distance behind the loins.
It is an irregularly cylindrical structure, divided into two lateral,
symmetrical halves by fissures. The spinal cord terminates posteriorly
in a pointed extremity, which is continued by a mass of nerve
trunks--cauda equinæ. A transverse section of the cord reveals that it
is composed of white matter externally and of gray matter internally.
The spinal cord does not fill the whole spinal canal. The latter
contains, besides, a large venous sinus, fatty matter, the membranes of
the cord, and the cerebrospinal fluid.
The spinal nerves, forty-two or forty-three in number, arise each by two
roots, a superior or sensory, and an inferior or motor. The nerves
originating from the brain are twenty-four in number, and arranged in
pairs, which are named first, second, third, etc., counting from before
backward. They also receive special names, according to their functions
or the parts to which they are distributed, viz:
1. Olfactory.
2. Optic.
3. Oculo-motor.
4. Pathetic.
5. Trifacial.
6. Abducens.
7. Facial.
8. Auditory.
9. Glossopharyngeal.
10. Pneumogastric.
11. Spinal accessory.
12. Hypoglossal.
Inflammation of the Brain and its Membranes (Encephalitis, Meningitis,
Cerebritis).
Inflammation may attack these membranes singly, or any one of the
anatomical divisions of the nerve matter, or it may invade the whole at
once. Practical experience, however, teaches us that primary
inflammation of the dura mater is of rare occurrence, except in direct
mechanical injuries to the head or diseases of the bones of the cranium.
Neither is the arachnoid often affected with acute inflammation, except
as a secondary result. The pia mater is most commonly the seat of
inflammation, acute and subacute, but from its intimate relation with
the surface of the brain the latter very soon becomes involved in the
morbid changes. Practically, we can not separate inflammation of the pia
mater from that of the brain proper. Inflammation may, however, exist in
the center of the great nerve masses--the cerebrum, cerebellum, pons
Varolii, or medulla at the base of the brain--without involving the
surface. When, therefore, inflammation invades the brain and its
enveloping membranes it is properly called encephalitis; when the
membranes alone are affected it is called meningitis, or the brain
substance alone cerebritis. Since all the conditions merge into one
another and can scarcely be recognized separately during the life of the
animal, they may here be considered together.
_Causes._--Exposure to extreme heat or cold, sudden and extreme changes
of temperature, excessive continued cerebral excitement, too much
nitrogenous feed, direct injuries to the brain, such as concussion, or
from fracture of the cranium, overexertion, sometimes as sequelæ to
influenza, pyemia, poisons having a direct influence upon the encephalic
mass, extension of inflammation from neighboring structures, food
poisoning, tumors, parasites, metastatic abscesses, etc.
_Symptoms._--The diseases here grouped together are accompanied with a
variety of symptoms, almost none of which, however, are associated so
definitely with a special pathological process as to point unmistakably
to a given lesion. Usually the first symptoms indicate mental
excitement, and are followed by symptoms indicating depression. Acute
encephalitis may be ushered in by an increased sensibility to noises,
with more or less nervous excitability, contraction of the pupils of the
eyes, and a quick, hard pulse. In very acute attacks these symptoms,
however, are not always noted. This condition will soon be followed by
muscular twitchings, convulsive or spasmodic movements, eyes wide open
with shortness of sight. The animal becomes afraid to have his head
handled. Convulsions and delirium will develop, with inability of
muscular control, or stupor and coma may supervene. When the membranes
are greatly implicated, convulsions and delirium with violence may be
expected, but if the brain substances are principally affected stupor
and coma will be the prominent symptoms. In the former condition the
pulse will be quick and hard; in the latter, soft and depressed, with
often a dilatation of the pupils, and deep, slow, stertorous breathing.
The symptoms may follow one another in rapid succession, and the disease
approach a fatal termination within 12 hours. In subacute attacks the
symptoms are better defined, and the animal seldom dies before the third
day. Within three or four days gradual improvement may become manifest,
or cerebral softening with partial paralysis may occur. In all cases of
encephalitis there is a marked rise in temperature from the very onset
of the disease, with a tendency to increase until the most alarming
symptoms develop, succeeded by a decrease when coma becomes manifest.
The violence and character of the symptoms greatly depend upon the
extent and location of the structures involved. Thus, in some cases
there may be marked paralysis of certain muscles, while in others there
may be spasmodic rigidity of muscles in a certain region. Very rarely
the animal becomes extremely violent early in the attack, and by rearing
up, striking with the fore feet, or falling over, may do himself great
injury. Usually, however, the animal maintains the standing position,
propping himself against the manger or wall, until he falls from
inability of muscular control, or from unconsciousness. Occasionally, in
his delirium, he may go through a series of automatic movements, such as
trotting or walking, and, if loose in a stall, will move around
persistently in a circle. Early and persistent constipation of the
bowels is a marked symptom in nearly all acute affections of the brain;
retention of the urine, also, is frequently observed.
Following these symptoms there are depression, loss of power and
consciousness, lack of ability or desire to move, and usually fall of
temperature. At this stage the horse stands with legs propped, the head
hanging or resting on the manger, the eyes partly closed, and does not
respond when spoken to or when struck with a whip.
Chronic encephalitis or meningitis may succeed the acute stage, or may
be due to stable miasma, blood poison, narcotism, lead poisoning, etc.
This form may not be characterized in its initial stages by
excitability, quick and hard pulse, and high fever. The animal usually
appears at first stupid; eats slowly; the pupil of the eye does not
respond to light quickly; the animal often throws his head up or shakes
it as if suffering sudden twinges of pain. He is slow and sluggish in
his movements, or there may be partial paralysis of one limb, one side
of the face, neck, or body. These symptoms, with some variations, may be
present for several days and then subside, or the disease may pass into
the acute stage and terminate fatally. Chronic encephalitis may effect
an animal for ten days or two weeks without much variation in the
symptoms before the crisis is reached. If improvement commences, the
symptoms usually disappear in the reverse order to that in which they
developed, with the exception of the paralytic effects, which remain
intractable or permanent. Paralysis of certain sets of muscles is a very
common result of chronic, subacute, and acute encephalitis, and is due
to softening of the brain or to exudation into the cavities of the brain
or arachnoid space.
Softening and abscess of the brain are terminations of cerebritis. It
may also be due to an insufficient supply of blood as a result of
diseased cerebral arteries and of apoplexy. The symptoms are drowsiness,
vertigo, or attacks of giddiness, increased timidity, or fear of
familiar objects, paralysis of one limb, hemiplegia, imperfect control
of the limbs, and usually a weak, intermittent pulse. In some cases the
symptoms are analogous to those of apoplexy. The character of the
symptoms depends upon the seat of the softening or abscess within the
brain.
Cerebral sclerosis sometimes follows inflammation in the structure of
the brain affecting the connective tissues, which eventually become
hypertrophied and press upon nerve cells and fibers, causing their
ultimate disappearance, leaving the parts hard and indurated. This
condition gives rise to a progressive paralysis and may extend along a
certain bundle of fibers into the spinal cord. Complete paralysis almost
invariably supervenes and causes death.
_Lesions._--On making post-mortem examinations of horses which have died
in the first stages of either of these diseases we find an excessive
engorgement of the capillaries and small blood vessels, with
correspondingly increased redness and changes in both the contents and
the walls of the vessels. If death has occurred at a later period of the
disease, it will be found that, in addition to the redness and
engorgement, an exudation of the contents of the blood vessels into the
tissues and upon the surfaces of the inflamed parts has supervened. If
the case has been one of encephalitis, there will usually be found more
or less watery fluid in the ventricles (natural cavities in the brain),
in the subarachnoid space, and a serous exudation between the
convolutions and interstitial spaces of the gray matter under the
membranes of the brain. The quantity of fluid varies in different cases.
Exudations of a membranous character may be present, and are found
attached to the surfaces of the pia mater.
In meningitis, especially in chronic cases, in addition to the serous
effusion, there are changes which may be regarded as characteristic in
the formation of a delicate and highly vascular layer or layers of
membrane or organized structure on the surface of the dura mater, and
also indications of hemorrhages in connection with the membranous
formations. Hematoma, or blood tumors, may be found embedded in this
membrane. In some cases the hemorrhages are copious, causing paralysis
or apoplexy, followed by speedy death. The meningitis may be
suppurative. In this case a puslike exudate is found between the
membranes covering the brain.
In cerebritis, or inflammation of the interior of the brain, there is a
tendency to softening and suppuration and the formation of abscesses. In
some cases the abscesses are small and numerous, surrounded with a
softened condition of the brain matter, and sometimes we may find one
large abscess. In cases of recent development the walls of the
abscesses are fringed and ragged and have no lining membrane. In older
or chronic cases the walls of the abscesses are generally lined with a
strong membrane, often having the appearance of a sac or cyst, and the
contents have a very offensive odor.
_Treatment._--In all acute attacks of inflammation involving the
membranes or cerebral masses, it is the pressure from the distended and
engorged blood vessels and the rapid accumulation of inflammatory
products that endangers the life of the animal in even the very early
stage of the disease. The earlier the treatment is commenced to lessen
the danger of fatal pressure from the engorged blood vessels, the less
effusion and smaller number of inflammatory products we have to contend
with later. The leading object, then, to be accomplished in the
treatment of the first stage of encephalitis, meningitis, or cerebritis,
and before a dangerous degree of effusion or exudation has taken place,
is to relieve the engorgement of the blood vessels and thereby lessen
the irritation or excitability of the affected structures. If the
attempt to relieve the engorgement in the first stage has been only
partially successful, and the second stage, with its inflammatory
products and exudations, whether serous or plastic, has set in, then the
main objects in further treatment are to keep up the strength of the
animal and hasten the absorption of the exudative products as much as
possible. To obtain these results, when the animal is found in the
initial stage of the disease, if there is unnatural excitability or
stupor with increase of temperature and quickened pulse, we should apply
cold to the head in the form of cold water or ice. For this purpose
cloths or bags may be used, and they should be renewed as often as
necessary. If the disease is still in its early stages and the animal is
strong, bleeding from the jugular vein may be beneficial. Good results
are to be expected only during the stage of excitement, while there is a
strong, full pulse and the mucous membranes of the head are red from a
plentiful supply of blood. The finger should be kept on the pulse and
the blood allowed to flow until there is distinct softening of the
pulse. As soon as the animal recovers somewhat from the shock of the
bleeding the following medicine should be made into a ball or dissolved
in a pint of warm water and be given at one dose: Barbados aloes, 7
drams; calomel, 2 drams; powdered ginger, 1 dram; tincture of aconite,
20 drops.
The animal should be placed in a cool, dark place, as free from noise as
possible. When the animal becomes thirsty half an ounce of bromid of
potash may be dissolved in the drinking water every six hours.
Injections of warm water into the rectum may facilitate the action of
the purgative. Norwood's tincture of veratrum viride, in 20-drop doses,
should be given every hour and 1 dram of solid extract of belladonna
every four hours until the symptoms become modified and the pulse
regular and full.
[Illustration: PLATE XIX.
THE NERVOUS SYSTEM.]
If this treatment fails to give relief, the disease will pass into the
advanced stages, or, if the animal has been neglected in the early
stages, the treatment must be supplanted with the hypodermic injection
of ergotin, in 5-grain doses, dissolved in 1 dram of water, every six
hours. The limbs may be poulticed above the fetlocks with mustard. Warm
blanketing, to promote perspiration, is to be observed always when there
is no excessive perspiration.
If the disease becomes chronic (encephalitis or meningitis), we must
place our reliance upon alteratives and tonics, with such incidental
treatment as special symptoms may demand. Iodid of potassium in 2-dram
doses should be given three times a day and 1 dram of calomel once a day
to induce absorption of effusions or thickened membranes. Tonics, in the
form of iodid of iron in 1-dram doses, to which is added 2 drams of
powdered hydrastis, may also be given every six or eight hours, as soon
as the active fever has abated. After the disappearance of the acute
symptoms, blisters (cantharides ointment) may be applied behind the
poll. When paralytic effects remain after the disappearance of all other
symptoms, sulphate of strychnia in 2-grain doses, in combination with
the other tonics, may be given twice a day and be continued until it
produces muscular twitching. In some cases of paralysis, as of the lips
or throat, benefit may be derived from the moderate use of the electric
battery. Many of the recoveries will, however, under the most active and
early treatment, be but partial, and in all cases the animals become
predisposed to subsequent attacks. A long time should be allowed to pass
before the animal is exposed to severe work or great heat. When the
disease depends upon mechanical injuries, they have to be treated and
all causes of irritation to the brain removed. If it is due to stable
miasma, uremic poisoning, pyemia, influenza, rheumatism, toxic agents,
etc., they should receive prompt attention for their removal or
mitigation.
Cerebral softening, abscess, and sclerosis are practically inaccessible
to treatment, otherwise than such relief as may be afforded by the
administration of opiates and general tonics, and, in fact, the
diagnosis is largely presumptive.
CONGESTION OF THE BRAIN, OR MEGRIMS.
Congestion of the brain consists in an accumulation of blood in the
vessels, also called hyperemia, or engorgement. It may be active or
passive--active when there is an undue accumulation of blood or
diminished arterial resistance, and passive when it accumulates in the
vessels of the brain, owing to some obstacle to its return by the veins.
_Causes._--Active cerebral congestion may be from hypertrophy of the
left ventricle of the heart, excessive exertion, the influence of
extreme heat, sudden and great excitement, artificial stimulants, etc.
Passive congestion may be produced by any mechanical obstruction which
prevents the proper return of blood through the veins to the heart, such
as a small or ill-fitting collar, which often impedes the blood current,
tumors or abscesses pressing on the vein in its course, and organic
lesions of the heart with regurgitation.
Extremely fat animals with short, thick necks are peculiarly subject to
attacks of cerebral congestion. Simple congestion, however, is merely a
functional affection, and in a slight or moderate degree involves no
immediate danger. Extreme engorgement, on the contrary, may be followed
by rupture of previously weakened arteries and capillaries and cause
immediate death, designated then as a stroke of apoplexy.
_Symptoms._--Congestion of the brain is usually sudden in its
manifestation and of short duration. The animal may stop very suddenly
and shake its head or stand quietly braced, then stagger, make a plunge,
and fall. The eyes are staring, breathing hurried and stertorous, and
the nostrils widely dilated. This may be followed by coma, violent
convulsive movements, and death. Generally, however, the animal gains
relief in a short time, but may remain weak and giddy for several days.
If it is due to organic change of the heart or the disease of the blood
vessels in the brain, then the symptoms may be of slow development,
manifested by drowsiness, dimness or imperfect vision, difficulty in
voluntary movements, diminished sensibility of the skin, loss of
consciousness, delirium, and death. In milder cases effusion may take
place in the arachnoid spaces and ventricles of the brain, followed by
paralysis and other complications.
_Pathology._--In congestion of the brain the cerebral vessels are loaded
with blood, the venous sinuses distended to an extreme degree, and the
pressure exerted upon the brain constitutes actual compression, giving
rise to the symptoms just mentioned. On post-mortem examinations this
engorgement is found universal throughout the brain and its membranes,
which serves to distinguish it from inflammations of these structures,
in which the engorgements are confined more or less to circumscribed
portions. A prolonged congestion may, however, lead to active
inflammation, and in that case we find serous and plastic exudations in
the cavities of the brain. In addition to the intensely engorged
condition of the vessels we find the gray matter of the brain redder
than natural. In cases in which several attacks have occurred the blood
vessels are often found permanently dilated.
_Treatment._--The animal should be taken out of harness at once, with
prompt removal of all mechanical obstructions to the circulation. If it
is caused by venous obstruction by too tight a collar, the loosening of
the collar will give immediate relief. The horse should be bled freely
from the jugular vein. If due to tumors or abscesses, a surgical
operation becomes necessary to afford relief. To revive the animal if it
becomes partially or totally unconscious, cold water should be dashed on
the head. Give a purge of Glauber's salt. If the limbs are cold,
tincture of capsicum or strong mustard water should be applied to them.
If symptoms of paralysis remain after two or three days, an active
cathartic and iodid of potassium will be indicated, to be given as
prescribed for inflammation of the brain. In confirmed cases, treatment
is not advisable, as there is considerable danger to the owner should an
attack occur in a crowded street.
_Prevention._--Well-adjusted collar, with strap running from the collar
to the girth, to hold down the collar when pulling upgrade; regular feed
and exercise, without allowing the animal to become excessively
plethoric; moderate checking, allowing a free-and-easy movement of the
head; well-ventilated stabling, proper cleanliness, pure water, etc.
SUNSTROKE, HEAT STROKE, OR HEAT EXHAUSTION.
The term sunstroke is applied to affections occasioned not exclusively
by exposure to the sun's rays, as the word signifies, but by the action
of great heat combined generally with humid atmosphere. Exhaustion
produced by long-continued heat is often the essential factor, and is
called heat exhaustion. Horses on the race track undergoing protracted
and severe work in hot weather often succumb to heat exhaustion. Draft
horses which do not receive proper care in watering, feeding, and rest
in shady places and are exposed for many hours to the direct rays of the
sun suffer very frequently from sunstroke.
_Symptoms._--Sunstroke is manifested suddenly. The animal stops, drops
his head, begins to stagger, and soon falls to the ground unconscious.
The breathing is marked with great stertor, the pulse is very slow and
irregular, cold sweats break out in patches on the surface of the body,
and the animal often dies without having recovered consciousness.
The temperature becomes very high, reaching 105° to 109° F.
In heat exhaustion the animal usually requires urging for some time
prior to the appearance of any other symptoms, generally perspiration is
checked, and then the horse becomes weak in its gait, the breathing
hurried or panting, eyes watery or bloodshot, nostrils dilated and
highly reddened, assuming a dark, purple color; the pulse is rapid and
weak, the heart bounding, followed by unconsciousness and death. If
recovery takes place, convalescence extends over a long period of time,
during which incoordination of movement may persist.
_Pathology._--Sunstroke, virtually active congestion of the brain, often
accompanied with effusion and blood extravasation, characterizes this
condition, with often rapid and fatal lowering of all the vital
functions. In many instances the death may be due to the complete
stagnation in the circulation of the brain, inducing anemia, or want of
nourishment of that organ. In other cases it may be directly due to the
excessive compression of the nerve matter controlling the heart's
action, and cause paralysis of that organ. There are also changes in the
composition of the blood.
_Treatment._--The animal should be placed in shaded surroundings. Under
no circumstances is blood-letting permissible in sunstroke. Ice or very
cold water should be applied to the head and along the spine, and half
an ounce of carbonate of ammonia or 6 ounces of whisky should be given
in 1 pint of water. Cold water may be used as an enema and should also
be showered upon the body of the horse from the hose or otherwise. This
should be continued until the temperature is down to 103° F. Brisk
friction of the limbs and the application of spirits of camphor often
yields good results. The administration of the stimulants should be
repeated in one hour if the pulse has not become stronger and slower. In
either case, when reaction has occurred, preparations of iron and
general tonics may be given during convalescence: Sulphate of iron, 1
dram; gentian, 3 drams; red cinchona bark, 2 drams; mix and give in feed
morning and evening.
_Prevention._--In very hot weather horses should have wet sponges or
light sunshades on the head when at work, or the head may be sponged
with cold water as many times a day as possible. Proper attention should
be given to feeding and watering, never in excess. During the warm
months all stables should be cool and well ventilated, and if an animal
is debilitated from exhaustive work or disease it should receive such
treatment as will tend to build up the system. Horses should be
permitted to drink as much water as they want while they are at work
during hot weather.
An animal which has been affected with sunstroke is very liable to have
subsequent attacks when exposed to the necessary exciting causes.
APOPLEXY OR CEREBRAL HEMORRHAGE.
Apoplexy is often confounded with cerebral congestion, but true apoplexy
always consists in rupture of cerebral blood vessels, with blood
extravasation and formation of blood clot.
_Causes._--Two causes are involved in the production of apoplexy, the
predisposing and the exciting. The predisposing cause is degeneration,
or disease which weakens the blood vessel; the exciting cause is any one
which tends to induce cerebral congestion.
_Symptoms._--Apoplexy is characterized by a sudden loss of sensation and
motion, profound coma, and stertorous, difficult breathing. The action
of the heart is little disturbed at first, but soon becomes slower, then
quicker and feebler, and after a little time ceases. If the rupture is
one of a small artery and the extravasation limited, sudden paralysis of
some part of the body is the result. The extent and location of the
paralysis depend upon the location within the brain which is
functionally deranged by the pressure of the extravasated blood; hence
these conditions are very variable.
In the absence of any premonitory symptoms or an increase of temperature
in the early stage of the attack, we may be reasonably certain in making
the distinction between this disease and congestion of the brain, or
sunstroke.
_Pathology._--In apoplexy there is generally found an atheromatous
condition of the cerebral vessels, with weakening and degeneration of
their walls. When a large artery has been ruptured it is usually
followed by immediate death, and large rents may be found in the
cerebrum, with great destruction of brain tissue, induced by the
forcible pressure of the liberated blood. In small extravasations
producing local paralysis without marked general disturbance the animal
may recover after a time; in such cases gradual absorption of the clot
takes place. In large clots atrophy of the brain substances may follow,
or softening and abscess from want of nutrition may result, and render
the animal worthless, ultimately resulting in death.
_Treatment._--Place the animal in a quiet, cool place and avoid all
stimulating feed. Administer, in the drinking water or feed, 2 drams of
the iodid of potassium twice a day for several weeks if necessary.
Medical interference with sedatives or stimulants is more liable to be
harmful than of benefit, and blood-letting in an apoplectic fit is
extremely hazardous. From the fact that cerebral apoplexy is due to
diseased or weakened blood vessels, the animal remains subject to
subsequent attacks. For this reason treatment is very unsatisfactory.
COMPRESSION OF THE BRAIN.
_Causes._--In injuries from direct violence a piece of broken bone may
press upon the brain, and, according to its size, the brain is robbed of
its normal space within the cranium. It may also be due to an
extravasation of blood or to exudation in the subdural or arachnoid
spaces. Death from active cerebral congestion results through
compression. The occurrence may sometimes be traced to the direct cause,
which will give assurance for the correct diagnosis.
_Symptoms._--Impairment of all the special senses and localized
paralysis. All the symptoms of lessened functional activity of the brain
are manifested to some degree. The paralysis remains to be our guide
for the location of the cause, for it will be found that the paralysis
occurs on the opposite side of the body from the location of the injury,
and the parts suffering paralysis will denote, to an expert veterinarian
or physician, the part of the brain which is suffering compression.
_Treatment._--Trephining, by a skillful operator, for the removal of the
cause when due to depressed bone or the presence of foreign bodies. When
the symptoms of compression follow other acute diseases of the brain,
apoplectic fits, etc., the treatment must be such as the exigencies of
the case demands.
CONCUSSION OF THE BRAIN.
This is generally caused by falling over backward and striking the poll,
or perhaps falling forward on the nose, by a blow on the head, etc.
Train accidents during shipping often cause concussion of the brain.
_Symptoms._--Concussion of the brain is characterized by giddiness,
stupor, insensibility, or loss of muscular power, succeeding immediately
upon a blow or severe injury involving the cranium. The animal may rally
quickly or not for hours; death may occur on the spot or after a few
days. When there is only slight concussion or stunning, the animal soon
recovers from the shock. When more severe, insensibility may be complete
and continue for a considerable time; the animal lies as if in a deep
sleep; the pupils are insensible to light; the pulse fluttering or
feeble; the surface of the body cold, muscles relaxed, and the breathing
scarcely perceptible. After a variable interval partial recovery may
take place, which is marked by paralysis of some parts of the body,
often of a limb, the lips, ear, etc. Convalescence is usually tedious,
and frequently permanent impairment of some organs remains.
_Pathology._--Concussion produces laceration of the brain, or at least a
jarring of the nervous elements, which, if not sufficiently severe to
produce sudden death, may lead to softening or inflammation, with their
respective symptoms of functional derangement.
_Treatment._--The first object in treatment will be to establish
reaction or to arouse the feeble and weakening heart. This can often be
accomplished by dashing cold water on the head and body of the animal;
frequent injections of weak ammonia water, ginger tea, or oil and
turpentine should be given per rectum. In the majority of cases this
will soon bring the horse to a state of consciousness. In more severe
cases mustard poultices should be applied along the spine and above the
fetlocks. As soon as the animal gains partial consciousness stimulants,
in the form of whisky or capsicum tea, should be given. Owing to
severity of the structural injury to the brain or the possible rupture
of blood vessels and blood extravasation, the reaction may often be
followed by encephalitis or cerebritis, and will then have to be treated
accordingly. For this reason the stimulants should not be administered
too freely, and they must be abandoned as soon as reaction is
established. There is no need for further treatment unless complications
develop as a secondary result. Bleeding, which is so often practiced,
proves almost invariably fatal in this form of brain affection. We
should also remember that it is never safe to drench a horse with large
quantities of medicine when he is unconscious, for he is very liable to
draw the medicine into the lungs in inspiration.
_Prevention._--Young horses, when harnessed or bitted for the first few
times, should not have their heads checked high, for it frequently
causes them to rear up, and, being unable to control their balance, they
are liable to fall over sideways or backwards, thus causing brain
concussion when they strike the ground.
ANEMIA OF THE BRAIN.
This is a physiological condition in sleep. It is considered a disease
or may give rise to disease when the circulation and blood supply of the
brain are interfered with. In some diseases of the heart the brain
becomes anemic, and fainting fits occur, with temporary loss of
consciousness. Tumors growing within the cranium may press upon one or
more arteries and stop the supply of blood to certain parts of the
brain, thus inducing anemia, ultimately atrophy, softening, or
suppuration. Probably the most frequent cause is found in plugging, or
occlusion, of the arteries by a blood clot.
_Symptoms._--Imperfect vision, constantly dilated pupils, frequently a
feeble and staggering gait, and occasionally cramps, convulsions, or
epileptic fits occur.
_Pathology._--The exact opposite of cerebral hyperemia. The blood
vessels are found empty, the membranes blanched, and the brain substance
softened.
_Treatment._--Removal of the remote cause when possible. General tonics,
nutritious feed, rest, and removal from all causes of nervous
excitement.
HYDROCEPHALUS, OR DROPSY OF THE BRAIN.
This condition consists in an unnatural collection of fluid about or in
the brain. Depending upon the location of the fluid, we speak of
external and internal hydrocephalus.
External hydrocephalus is seen chiefly in young animals. It consists in
a collection of fluid under the meninges, but outside the brain proper.
This defect is usually congenital. It is accompanied with an
enlargement of the skull, especially in the region of the forehead. The
pressure of the fluid may cause the bones to soften. The disease is
incurable and usually fatal.
Internal hydrocephalus is a disease of mature horses, and consists in
the accumulation of an excessive quantity of fluid in the cavities or
ventricles of the cerebrum. The cause of this accumulation may be a
previous inflammation, a defect in the circulation of blood through the
brain, heat stroke, overwork, excessive nutrition, or long-continued
indigestion. Common, heavy-headed draft horses are predisposed to this
condition.
_Symptoms._--The symptoms are an expression of dullness and stupidity,
and from their nature this disease is sometimes known as "dumminess" or
"immobility." A horse so afflicted is called a "dummy." Among the
symptoms are loss of intelligence, stupid expression, poor memory, etc.
The appetite is irregular; the horse may stop chewing with a wisp of hay
protruding from his lips; he seems to forget that it is there. Unnatural
positions are sometimes assumed, the legs being placed in clumsy and
unusual attitudes. Such horses are difficult to drive, as they do not
respond readily to the word, to pressure of the bit, or to the whip.
Gradually the pulse becomes weaker, respiration becomes faster, and the
subject loses weight. Occasionally there are periods of great excitement
due to temporary congestion of the brain. At such times the horse
becomes quite uncontrollable. A horse so afflicted is said to have
"staggers." The outlook for recovery is not good.
Treatment is merely palliative. Regular work or exercise and nutritious
feed easy of digestion, with plenty of fresh water, are strongly
indicated. Intensive feeding should not be practiced. The bowels should
be kept open by the use of appropriate diet or by the use of small
regular doses of Glauber's salt.
TUMORS WITHIN THE CRANIUM.
Tumors within the cranial cavity and the brain occur not infrequently,
and give rise to a variety of symptoms, imperfect control of voluntary
movement, local paralysis, epilepsy, etc. Among the more common tumors
are the following:
Osseous tumors, growing from the walls of the cranium, are not very
uncommon.
Dentigerous cysts, containing a formation identical to that of a tooth,
growing from the temporal bone, sometimes are found lying loose within
the cranium.
Tumors of the choroid plexus, known as brain sand, are frequently met
with on post-mortem examinations, but seldom give rise to any
appreciable symptoms during life. They are found in horses at all ages,
and are slow of development. They are found in one or both of the
lateral ventricles, enveloped in the folds of the choroid plexus.
Melanotic tumors have been found in the brain and meninges in the form
of small, black nodules in gray horses, and in one instance are believed
to have induced the condition known as stringhalt.
Fibrous tumors may develop within or from the meningeal structures of
the brain.
Gliomatous tumor is a variety of sarcoma very rarely found in the
structure of the cerebellum.
Treatment for tumors of the brain is impossible.
SPASMS, OR CRAMPS.
Spasm is a marked symptom in many diseases of the brain and of the
spinal cord. Spasms may result from irritation of the motor nerves as
conductors, or may result from irritation of any part of the sympathetic
nervous system, and they usually indicate an excessive action of the
reflex motor centers. Spasms may be induced by various medicinal agents
given in poisonous doses, or by effete materials in the circulation,
such as nux vomica or its alkaloid strychnia, lead preparations, or an
excess of the urea products in the circulation, etc. Spasms may be
divided into two classes: Tonic spasm, when the cramp is continuous or
results in persistent rigidity, as in tetanus; clonic spasm, when the
cramping is of short duration, or is alternated with relaxations. Spasms
may affect involuntary as well as the voluntary muscles, the muscles of
the glottis, intestines, and even the heart. They are always sudden in
their development.
_Spasm of the glottis._--This is manifested by a strangling respiration;
a wheezing noise is produced in the act of inspiration; extreme anxiety
and suffering for want of air. The head is extended, the body profusely
perspiring; pulse very rapid; soon great exhaustion becomes manifest;
the mucous membranes become turgid and very dark colored, and the animal
thus may suffocate in a short time.
_Spasm of the intestines._--(See "Cramp colic," p. 74.)
_Spasm of the neck of the bladder._--This may be due to spinal
irritation or a reflex from intestinal irritation, and is manifested by
frequent but ineffectual attempts to urinate.
_Spasm of the diaphragm, or thumps._--Spasmodic contraction of the
diaphragm, the principal muscle used in respiration, is generally
occasioned by extreme and prolonged speeding on the race track or road.
The severe strain thus put upon this muscle finally induces irritation
of the nerves controlling it, and the contractions become very forcible
and violent, giving the jerking character known among horsemen as
"thumps." This condition may be distinguished from violent beating of
the heart by feeling the pulse beat at the angle of the jaw, and at the
same time watching the jerking movement of the body, when it will be
discovered that the two bear no relation to each other. (See
"Palpitation of the heart," p. 259.)
_Spasm of the thigh, or cramp of a hind limb._--This is frequently
witnessed in horses that stand on sloping plank floors--generally in
cold weather--or it may come on soon after severe exercise. It is
probably due to an irritation of the nerves of the thigh. In cramps of
the hind leg the limb becomes perfectly rigid, and attempts to flex are
unsuccessful; the animal stands on the affected limb, but is unable to
move it; it is unnaturally cold; it does not, however, appear to cause
much suffering unless attempts are made to change position. This cramp
may be of short duration--a few minutes--or it may persist for several
days. This condition is often taken for a dislocation of the stifle
joint. In the latter the foot is extended backward, and the horse is
unable to advance it, but drags the limb. An examination of the joint
also reveals a change in form. Spasms may affect the eyelids, by closure
or by retraction. Spasm of the sterno-maxillaris muscle has been
witnessed, and the animal was unable to close the jaws until the muscle
became relaxed.
_Treatment of spasms._--An anodyne liniment, composed of chloroform 1
part and soap liniment 4 parts, applied to cramped muscles will usually
cause relaxation. This may be used when single external muscles are
affected. In spasms of the glottis, inhalation of sulphuric ether will
give quick relief. In spasm of the diaphragm, rest and the
administration of half an ounce of chloroform in 3 ounces of whisky,
with a pint of water added, will generally suffice to bring relief, or
if this fails give 5 grains of sulphate of morphia by hypodermic
injection. If spasms result from organic disease of the nervous system,
the latter should receive such treatment as its character demands. In
cramp of the leg, compulsory movement usually causes relaxation very
quickly; therefore the animal should be led out of the stable and be
forced to run or trot. Sudden, nervous excitement caused by a crack of
the whip or smart blow will often bring about immediate relief. Should
this fail, the anodyne liniment may be used along the inside of the
thigh, and chloroform, ether, or laudanum given internally. An ounce of
the chloral hydrate will certainly relieve the spasm when given
internally, but the cramp may return soon after the effect has passed
off, which in many cases it does very quickly.
_Convulsions._--Although there is no disease of the nervous system which
can be properly termed convulsive, or justify the use of the word
convulsion to indicate any particular disease, yet it is often such a
prominent symptom that a few words may not be out of place. General,
irregular muscular contractions of various parts of the body, with
unconsciousness, characterize what we regard as convulsions, and like
ordinary spasms are dependent upon some disease or irritation of the
nervous structures, chiefly of the brain. No treatment is required; in
fact, a general convulsion must necessarily be self-limited in its
duration. Suspending, as it does, respiratory movements, checking the
oxygenation and decarbonization of the blood, the rapid accumulation of
carbonic-acid gas in the blood and the exclusion of oxygen quickly puts
the blood in a condition to produce the most reliable and speedy
sedative effect upon the nerve excitability that could be found, and
consequently furnishes its own remedy so far as the continuance of the
convulsive paroxysm is concerned. Whatever treatment is instituted must
be directed toward a removal of the cause of the convulsive paroxysm.
CHOREA, OR ST. VITUS'S DANCE.
Chorea is characterized by involuntary contractions of voluntary
muscles. This disease is an obscure disorder, which may be from pressure
upon a nerve, cerebral or spinal sclerosis, small aneurisms in the
brain, etc. Choreic symptoms have been produced by injecting granules of
starch into the arteries entering the brain. Epilepsy and other forms of
convulsions simulate chorea in appearance.
Stringhalt is by some termed "chorea." This is manifested by a sudden
jerking up of one or both hind legs when the animal is walking. This
symptom may be very slight in some horses, but has a tendency to
increase with age. In some the catching up of the affected leg is very
violent, and when it is lowered to the ground the motion is equally
sudden and forcible, striking the foot to the ground like a pile driver.
Very rarely chorea may be found to affect one of the fore legs, or the
muscles of one side of the neck or the upper part of the neck.
Involuntary jerking of the muscles of the hip or thigh is seen
occasionally, and is termed "shivering" by horsemen.
Chorea is often associated with a nervous disposition, and is not so
frequent in animals with a sluggish temperament. The involuntary
muscular contractions cause no pain, and do not appear to produce much
exhaustion of the affected muscles, although the jerking may be regular
and persistent whenever the animal is in motion.
_Treatment._--In a few cases, early in the appearance of this affection,
general nerve tonics may be of benefit, viz, iodid of iron, 1 dram;
pulverized nux vomica, 1 dram; pulverized scutellaria (skull-cap), 1
ounce. Mix and give in the feed once a day for two weeks. Arsenic in the
form of Fowler's solution is often beneficial. If the cause is connected
with organic brain lesions, treatment is usually unsuccessful.
EPILEPSY, OR FALLING FITS.
The cause of epilepsy is seldom traceable to any special brain lesions.
In a few cases it accompanies disease of the pituitary body, which is
located in the under surface of the brain. Softening of the brain may
give rise to this affection. Attacks may occur only once or twice a year
or they may be of frequent recurrence.
_Symptoms._--No premonitory symptoms precede an epileptic fit. The
animal suddenly staggers; the muscles become cramped; the jaws may be
spasmodically opened and closed, and the tongue become lacerated between
the teeth; the animal foams at the mouth and falls in a spasm. The urine
flows involuntarily, and the breathing may be temporarily arrested. The
paroxysm soon passes off, and the animal gets on its feet in a few
minutes after the return of consciousness.
_Treatment._--Dashing cold water on the head during the paroxysm. After
the recovery 1 dram of oxid of zinc may be given in the feed twice a day
for several weeks, or benefit may be derived from the tonic prescribed
for chorea.
PARALYSIS, OR PALSY.
Paralysis is a weakness or cessation of the muscular contraction by
diminution of loss of the conducting power or stimulation of the motor
nerves. Paralytic affections are of two kinds, the complete and the
incomplete. The former includes those in which both motion and
sensibility are affected; the latter those in which only one or the
other is lost or diminished. Paralysis may be general or partial. The
latter is divided into hemiplegia and paraplegia. When only a small
portion of the body is affected, as the face, a limb, the tail, it is
designated by the term local paralysis. When the irritation extends from
the periphery of the center it is termed reflex paralysis.
Causes are much varied. Most of the acute affections of the brain and
spinal cord may lead to paralysis. Injuries, tumors, disease of the
blood vessels of the brain, etc., all have a tendency to produce
suspension of the conducting motive power to the muscular structures.
Pressure upon, or the severing of, a nerve causes a paralysis of the
parts to which such a nerve is distributed. Apoplexy may be termed a
general paralysis, and in nonfatal attacks is a frequent cause of the
various forms of palsy.
GENERAL PARALYSIS.--This can not take place without producing immediate
death. The term is, however, usually applied to paralysis of the four
extremities, whether any other portions of the body are involved or not.
This form of palsy is due to compression of the brain by congestion of
its vessels, large clot formation in apoplexy, concussion, or shock, or
any disease in which the whole brain structure is involved in functional
disturbance.
HEMIPLEGIA (PARALYSIS OF ONE SIDE OR HALF OF THE BODY).--Hemiplegia is
frequently the result of a tumor in the lateral ventricles of the brain,
softening of one hemisphere of the cerebrum, pressure from extravasated
blood, fracture of the cranium, or it may be due to poisons in the blood
or to reflex origin. When hemiplegia is due to or the result of a prior
disease of the brain, especially of an inflammatory character, it is
seldom complete; it may affect only one limb and one side of the head,
neck, or muscles along the back, and may pass off in a few days after
the disappearance of all the other evidences of the primary affection.
In most cases, however, hemiplegia arises from emboli obstructing one or
more blood vessels of the brain, or the rupture of some vessel the wall
of which had become weakened by degeneration and the extravasation of
blood. Sensibility in most cases is not impaired, but in some there is a
loss of sensibility as well as of motion. In some cases the bladder and
rectum are involved in the paralysis.
_Symptoms._--In hemiplegia the attack may be very sudden, and the animal
fall, powerless to move one side of the body; one side of the lips will
be relaxed; the tongue may hang out on one side of the mouth; the tail
curved around sideways; an inability to swallow feed or water may be
present, and often the urine dribbles away as fast as it collects in the
bladder. Sensibility of the affected side may be entirely lost or only
partial; the limbs may be cold and sometimes unnaturally warm. In cases
wherein the attack is not so severe the animal may be able to maintain
the standing position, but will have great difficulty in moving the
affected side. In such cases the animal may recover from the disability.
In the more severe, in which there is complete loss of power of
movement, recoveries are rare.
PARAPLEGIA (TRANSVERSE PARALYSIS OF THE HIND EXTREMITIES).--Paralysis of
the hind extremities is usually due to some injury or inflammation
affecting the spinal cord. (See "Spinal meningitis," p. 232, and
"Myelitis," p. 233.) It may also be due to a reflex irritation from
disease of peripheral nerves, to spinal irritation or congestion caused
by blood poisons, etc.
_Symptoms._--When due to mechanical injury of the spinal cord, from a
broken back or spinal hemorrhage, it is generally progressive in its
character, although it may be sudden. When it is caused by agents in the
blood, it may be intermittent or recurrent.
Paraplegia is not difficult to recognize, for it is characterized by a
weakness and imperfect control of the hind legs and powerless tail. The
urine usually dribbles away as it is formed and the manure is pushed
out, ball by ball, without any voluntary effort, or the passages may
cease entirety. When paraplegia is complete, large and ill-conditioned
sores soon form on the hips and thighs from chafing and bruising, which
have a tendency quickly to weaken the animal and necessitate his
destruction.
LOCOMOTOR ATAXIA, OR INCOORDINATION OF MOVEMENT.--This is characterized
by an inability to control properly the movement of the limbs. The
animal appears usually perfectly healthy, but when he is led out of his
stall his legs have a wobbly movement and he will stumble or stagger,
especially in turning. When this is confined to the hind parts it may be
termed a modified form of paraplegia, but often it may be seen to affect
nearly all the voluntary muscles when they are called into play, and
must be attributed to some pressure exerted on the base of the brain.
LOCAL PARALYSIS.--This is frequently met with in horses. It may affect
many parts of the body, even vital organs, and it is very frequently
overlooked in diagnosis.
FACIAL PARALYSIS.--This is a frequent type of local paralysis, and is
due to impairment of function of the motor nerve of the facial muscles,
the portio dura. The cause may exist at the base of the brain,
compression along its course after it leaves the medulla oblongata, or
to a bruise after it spreads out on the great masseter muscle.
_Symptoms._--A flaccid condition of the cheek muscles, pendulous lips,
inability to grasp the feed, often a slow and weak movement in chewing,
and difficulty and slowness in drinking.
LARYNGISMUS PARALYTICUS, OR ROARING.--This condition is characterized by
roaring, and is usually caused by an inflamed or hypertrophied bronchial
gland pressing against the left recurrent laryngeal nerve, which
interferes with its conducting power. A similar condition is
occasionally induced in acute pleurisy, when the recurrent nerve becomes
involved in the diseased process or compressed by plastic exudation.
PARALYSIS OF THE RECTUM AND TAIL.--This is generally the result of a
blow or fall on the rump, which causes a fracture of the sacrum bone and
injury to the nerves supplying the tail and part of the rectum and
muscles belonging thereto. This fracture would not be suspected were it
not for the loss of motion of the tail.
INTESTINAL PARALYSIS.--Characterized by persistent constipation;
frequently the strongest purgatives have no effect whatever on the
movement of the bowels. In the absence of symptoms of indigestion, or
special diseases implicating the intestinal canal, torpor of the bowels
must be attributed to deficient innervation. This condition may depend
upon brain affections or be due to reflex paralysis. Sudden checks of
perspiration may induce excessive action of the bowels or paralysis.
PARALYSIS OF THE BLADDER.--This usually affects the neck of the bladder,
and is characterized by incontinence of urine; the urine dribbles away
as fast as it is secreted. The cause may be of reflex origin, disease
of the rectum, tumors growing within the pelvic cavity, injury to the
spinal cord, etc.
PARALYSIS OF THE OPTIC NERVE (AMAUROSIS).--A paralysis of eyesight may
occur very suddenly from rupture of a blood vessel in the brain, acute
local congestion of the brain, the administration of excessive doses of
belladonna or its alkaloid atropia, etc. In amaurosis the pupil is
dilated to its full extent; the eye looks clear, but does not respond to
light.
Paralysis of hearing, of the external ear, of the eyelid, partial
paralysis of the heart and organs of respiration, of the blood vessels
from injury to the vasomotor nerves of the esophagus, or loss of
deglutition, palsy of the stomach, all may be manifested when the supply
of nervous influence is impaired or suspended.
TREATMENT FOR PARALYSIS.--In all paralytic affections there may be
anesthesia, or impairment of sensibility, in addition to the loss of
motion, or there may be hyperesthesia, or increased sensibility, in
connection with the loss of motion. These conditions may call for
special treatment in addition to that for loss of motion. If
hyperesthesia is well marked local anodynes may be needed to relieve
suffering. Chloroform liniment or hypodermic injections of from 3 to 5
grains of sulphate of morphia will allay local pain. If there is marked
anesthesia, or loss of sensibility, it may become necessary to secure
the animal in such way that he can not suffer serious injury from
accidents which he can not avoid or feel. In the treatment of any form
of paralysis we must always refer to the cause, and attempt its removal
if it can be discovered. In cases in which the cause can not be
determined we have to rely solely upon a general external and internal
treatment. Externally, fly blisters or strong, irritant liniments may be
applied to the paralyzed parts. In hemiplegia they should be applied
along the bony part of the side of the neck; in paraplegia, across the
loins. In, some cases hot-water cloths will be beneficial. Internally,
it is well to administer 1 dram of powdered nux vomica or 2 grains of
sulphate of strychnia twice a day until twitching of some of the
voluntary muscles occurs; then discontinue it for several days, and then
commence again with a smaller dose, gradually increasing it until
twitching recurs. Iodid of potassium in 1 to 2 dram doses two or three
times daily may be used with the hope that it will favor the absorption
of the clot or obstruction to the nervous current. In some cases
Fowler's solution of arsenic in teaspoonful doses twice a day in the
drinking water proves beneficial. Occasionally benefit may be derived
from the application of the electric current, especially in cases of
roaring, facial paralysis, paralysis of the eyelid, etc. Nutritious but
not too bulky feed, good ventilation, clean stabling, moderate exercise
if the animal is capable of taking it, good grooming, etc., should be
observed in all cases.
SPINAL MENINGITIS, OR INFLAMMATION OF THE MEMBRANES ENVELOPING THE
SPINAL CORD.
This may be induced by the irritant properties of blood poisons,
exhaustion and exposure, spinal concussion, all forms of injury to the
spine, tumors, caries of the vertebræ, rheumatism, etc.
_Symptoms._--A chill may be the precursor, a rise in temperature, or a
general weakness and shifting of the legs. Soon a painful, convulsive
twitching of the muscles sets in, followed by muscular rigidity along
the spine, in which condition the animal will move very stiffly and
evince great pain in turning. Evidences of paralysis or paraplegia
develop, retention or incontinence of urine, and oftentimes sexual
excitement is present. The presence of marked fever at the beginning of
the attack, associated with spinal symptoms, should lead us to suspect
spinal meningitis or myelitis. These two conditions usually appear
together, or myelitis follows inflammation of the meninges so closely
that it is almost impossible to separate the two; practically it does
not matter much, for the treatment will be about the same in both cases.
Spinal meningitis generally becomes chronic, and is then marked
principally by paralysis of that portion, or parts of it, posterior to
the seat of the disease.
_Pathology._--In spinal meningitis we find essentially the same
condition as in cerebral meningitis; there is an effusion of serum
between the membranes, and often a plastic exudation firmly adherent to
the pia mater serves to maintain a state of paralysis for a long time
after the acute symptoms have disappeared by compressing the cord.
Finally, atrophy, softening, and even abscess may develop within the
cord. Unlike in man, it is usually found localized in horses.
_Treatment._--Bags filled with ice should be applied along the spine, to
be followed later by strong blisters. The fever should be controlled as
early as possible by giving 20 drops of Norwood's tincture of veratrum
viride every hour until the desired result is obtained. One dram of the
fluid extract of belladonna, to control pain and vascular excitement of
the spinal cord, may be given every five or six hours until the pupils
of the eyes become pretty well dilated. If the pain is very intense 5
grains of sulphate of morphia should be injected hypodermically. The
animal must be kept as free from excitement as possible. If the urine is
retained in the bladder it must be drawn off every four or six hours. In
very acute attacks the disease generally proves fatal in a few days. If,
however, the animal grows better, some form of paralysis is liable to
remain for a long time, and the treatment will have to be directed then
toward a removal of the exudative products and a strengthening of the
system and stimulation of the nervous functions. To induce absorption,
iodid of potassium in 2-dram doses, dissolved in the drinking water, may
be given twice a day. To strengthen the system, iodid of iron 1 dram
twice a day and 1 dram of nux vomica once a day may be given in the
feed. Electricity to the paralyzed and weakened muscles is advisable;
the current should be weak, but be continued for half an hour two or
three times daily. If the disease is due to a broken back, caries of the
vertebræ, or some other irremediable cause, the animal should be
destroyed at once.
MYELITIS, OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD.
This is a rare disease, except as a secondary result of spinal
meningitis or injuries to the spine. Poisoning by lead, arsenic,
mercury, phosphorus, carbonic-acid gas, etc., has been known to produce
it. Myelitis may be confined to a small spot in the cord or may involve
the whole for a variable distance. It may lead to softening abscess or
degeneration.
_Symptoms._--The attack may begin with a chill or convulsion; the
muscles twitch or become cramped very early in the disease, and the
bladder usually is affected at the outset, in which there may be either
retention or incontinence of urine. These conditions are followed by
complete or partial paralysis of the muscles posterior to the locality
of the inflamed cord, and the muscles begin to waste away rapidly. The
paralyzed limb becomes cold and dry, due to the suspension of proper
circulation; the joints may swell and become edematous; vesicular
eruptions appear on the skin; and frequently gangrenous sloughs form on
the paralyzed parts. It is exceedingly seldom that recovery takes place.
In a few instances it may assume a chronic type, when all the symptoms
become mitigated, and thus continue for some time, until septicemia,
pyemia, or exhaustion causes death.
_Pathology._--The inflammation may involve nearly the whole length of
the cord, but generally it is more intense in some places than others;
when due to mechanical injury, the inflammation may remain confined to a
small section. The cord is swollen and congested, reddened, often
softened and infiltrated with pus cells, and the nerve elements are
degenerated.
_Treatment._--Similar to that of spinal meningitis.
SPINAL CONGESTION.
This condition consists in an excess of blood. As the blood vessels of
the pia mater are the principal source of supply to the spinal cord,
hyperemia of the cord and of the meninges usually go together. The
symptoms are, therefore, closely allied to those of spinal meningitis
and congestion. When the pia mater is diseased, the spinal cord is
almost invariably affected also.
_Cause._--Sudden checking of the perspiration, violent exercise, blows,
and falls.
_Symptoms._--The symptoms may vary somewhat with each case, and closely
resemble the first symptoms of spinal meningitis, spinal tumors, and
myelitis. First, some disturbance in movement, lowering the temperature,
and partial loss of sensibility posterior to the seat of the congestion.
If in the cervical region, it may cause interference in breathing and
the action of the heart. When in the region of the loins, there may be
loss of control of the bladder. When the congestion is sufficient to
produce compression of the cord, paraplegia may be complete. Usually
fever, spasms, muscular twitching, or muscular rigidity are absent,
which will serve to distinguish spinal congestion from spinal
meningitis.
_Treatment._--Hot-water applications to the spine, 1-dram doses fluid
extract of belladonna repeated every four hours, and tincture of aconite
root 20 drops every hour until the symptoms become ameliorated. If no
inflammatory products occur, the animal is likely to recover.
SPINAL ANEMIA.
This may be caused by extreme cold, exhausting diseases, spinal embolism
or plugging of a spinal blood vessel, an interference with the
circulation through the abdominal aorta, from compression, thrombosis,
or aneurism of that vessel; the spinal vessels may be caused to contract
through vasomotor influence, a result of peripheral irritation of some
nerve.
Spinal anemia causes paralysis of the muscles used in extending the
limbs. When the bladder is affected, it precedes the weakness of motion,
while in spinal congestion it follows, and increased sensibility, in
place of diminished sensibility, as in spinal congestion, is observed.
Pressure along the spine causes excessive pain.
If the exciting cause can be removed, the animal recovers; if this
fails, the spinal cord may undergo softening.
SPINAL COMPRESSION.
When caused by tumors or otherwise, when pressure is slight, it produces
a paralysis of the muscles used in extending a limb and contraction of
those which flex it. When compression is great it causes complete loss
of sensibility and motion posterior to the compressed part of the cord.
Compression of a lateral half of the cord produces motor paralysis,
disturbance of the circulation, and difficulty of movement, an increased
sensibility on the side corresponding to the compressed section, and a
diminished sensibility and some paralysis on the opposite side.
_Treatment._--When it occurs as a sequence of a preceding inflammatory
disease, iodid of potassium and general tonics are indicated. When due
to tumors growing within the spinal canal, or to pressure from displaced
bone, no form of treatment will result in any benefit.
SPINAL HEMORRHAGE.
This may occur from changes in the wall of the blood vessels, in
connection with tumors, acute myelitis, traumatic injuries, etc. The
blood may escape through the pia mater into the subarachnoid cavity, and
large clots be formed.
_Symptoms._--The symptoms are largely dependent upon the seat and extent
of the hemorrhage, as they are principally owing to the compression of
the cord. A large clot may produce sudden paraplegia, accompanied with
severe pain along the spine; usually, however, the paralysis of both
motion and sensation is not very marked at first; on the second or third
day fever is liable to appear, and increased or diminished sensibility
along the spine posterior to the seat of the clot. When the bladder and
rectum are involved in the symptoms it indicates that the spinal cord is
compressed.
_Treatment._--In the occurrence of injuries to the back of a horse,
whenever there is any evidence of paralysis, it is always advisable to
apply bags of ice along the spine to check or prevent hemorrhage or
congestion, and 2 drams of the fluid extract of ergot and 20 drops of
tincture of digitalis may be given every hour until three doses have
been taken. Subsequently tincture of belladonna in half-ounce doses may
be given three times a day. If there is much pain, 5 grains of sulphate
of morphia, injected under the skin, will afford relief and lessen the
excitability of the animal. In all cases the animal should be kept
perfectly quiet.
SPINAL CONCUSSION.
This is rarely observed in the horse, and unless it is sufficiently
severe to produce well-marked symptoms it would not be suspected. It may
occur in saddle horses from jumping, or it may be produced by falling
over an embankment, or a violent fall upon the haunches may produce it.
Concussion may be followed by partial paralysis or spinal hemorrhage;
generally, however, it is confined to a jarring and some disturbance of
the nerve elements of the cord, and the paralytic effect which ensues
soon passes off. Treatment consists in rest until the animal has
completely recovered from the shock. If secondary effects follow from
hemorrhage or compression, they have to be treated as heretofore
directed.
SPINAL TUMORS.
Within the substance of the cord glioma or the mixed gliosarcomata are
found to be the most frequent, tumors may form from the meninges and the
vertebræ, being of a fibrous or bony nature, and affect the spinal cord
indirectly by compression. In the meninges we may find glioma, cancers,
and psammoma, fibromata; aneurisms of the spinal arteries have been
discovered in the spinal canal.
_Symptoms._--Tumors of the spinal canal cause symptoms of spinal
irritation or compression of the cord. The gradual and slow development
of symptoms of paralysis of one or both hind limbs or certain muscles
may lead to a suspicion of spinal tumors. The paralysis induced is
progressive, but not usually marked with atrophy of the muscles or
increased sensibility along the spine. When the tumor is within the
spinal cord itself all the symptoms of myelitis may be present.
_Treatment._--General tonics and 1-dram doses of nux vomica may be
given; iodid of iron or iodid of potassium in 1-dram doses, three times
a day in feed, may, in a very few cases, give some temporary benefit.
Usually the disease progresses steadily until it proves fatal.
NEURITIS, OR INFLAMMATION OF A NERVE.
This is caused by a bruise or wound of a nerve or by strangulation in a
ligature when the nerve is included in the ligation of an artery. The
changes in an inflamed nerve are an enlargement, reddening of the nerve
sheath, spots of extravasated blood, and sometimes an infiltration of
serum mixed with pus.
_Symptoms._--Acute pain of the parts supplied by the nerve and absence
of swelling or increased heat of the part.
_Treatment._--Hypodermic injections of from 3 to 5 grains of morphia to
relieve pain, hot fomentations, and rest. If it is due to an inclusion
of a ligature, the nerve should be divided above and below the ligature.
NEUROMA, OR TUMOR OF A NERVE.
Neuroma may be from enlargement of the end of a divided nerve or due to
fibrous degeneration of a nerve which has been bruised or wounded. Its
most frequent occurrence is found after the operation of neurotomy for
foot lameness, and it may appear after the lapse of months or even
years. Neuroma usually develops within the sheath of the nerve with or
without implicating the nerve fibers. It is oval, running lengthwise
with the direction of the nerve.
_Symptoms._--Pain of the affected limb or part is manifested, more
especially after resting a while, and when pressure is made upon the
tumor it causes extreme suffering.
_Treatment._--Excision of the tumor, including part of the nerve above
and below, and then treat it like any other simple wound.
INJURIES TO NERVES.
These may consist in wounding, bruising, laceration, stretching,
compression, etc. The symptoms which are produced will depend upon the
extent, seat, and character of the injury. Recovery may quickly take
place, or it may lead to neuritis, neuroma, or spinal or cerebral
irritation, which may result in tetanus, paralysis, and other serious
derangements. In all diseases, whether produced by some form of external
violence or intrinsic causes, the nerves are necessarily involved, and
sometimes it is to a primary injury of them that the principal fault in
movement or change of nutrition of a part is due. It is often difficult
or impossible to discover that an injury to a nerve has been inflicted,
but whenever this is possible it may enable us to remedy that which
otherwise would result in permanent evil. Treatment should consist in
relieving compression, in hot fomentations, the application of anodyne
liniments, excision of the injured part, and rest.
FORAGE POISONING, OR SO-CALLED CEREBROSPINAL MENINGITIS.
This disease prevails among horses in nearly all parts of the United
States. Its appearance in America is by no means of recent occurrence,
for the malady was reported by Large in 1847, by Michener in 1850, and
by Liautard in 1869 as appearing in both sporadic and enzootic form in
several of the Eastern States. Since then the disease has occurred
periodically in many States in all sections of the country, and has been
the subject of numerous investigations and publications by a number of
the leading men of the veterinary profession. It is prevalent with more
or less severity every year in certain parts of the United States, and
during the year 1912 the Bureau of Animal Industry received urgent
requests for help from Colorado, Georgia, Iowa, Kansas, Kentucky,
Louisiana, Maryland, Missouri, Nebraska, New Jersey, North Carolina,
Oregon, South Carolina, South Dakota, Virginia, and West Virginia. While
in 1912 the brunt of the disease seemed to fall on Kansas and Nebraska,
other States were also seriously afflicted. In previous years, for
instance in 1882, as well as in 1897, the horses of southeastern Texas
were reported to have died by the thousand, and in the following year
the horses of Iowa were said to have "died like rats." However, Kansas
seems to have had more than her share of this trouble, as a severe
outbreak that extended over almost the entire State occurred in 1891,
while in 1902 and again in 1906 the disease recurred with equal severity
in various portions of the State.
This condition consists in a poisoning and depression of the nervous
system from eating or drinking feed or water containing poison generated
by mold or bacteria. It has been shown to be owing to eating damaged
ensilage, corn, brewers' grains, oats, etc., or to drinking stagnant
pond water or water from a well contaminated by surface drainage. Horses
at pasture may contract the disease when the growth of grass is so
profuse that it mats together and the lower part dies and ferments or
becomes moldy.
In England a similar disease has been called "grass staggers," due to
eating rye grass when it is ripening or when it is cut and eaten while
it is heating and undergoing fermentation. In eastern Pennsylvania it
was formerly known by the name of "putrid sore throat" and "choking
distemper." A disease similar in many respects which is very prevalent
in Virgina, especially along the eastern border, is commonly known by
the name of "blind staggers," and in many of the Southern States this
has been attributed to the consumption of worm-eaten, corn. Horses of
all ages and mules are subject to this disease.
_Symptoms and lesions._--The symptoms which typify sporadic or epidemic
cerebrospinal meningitis in man are not witnessed among horses, namely,
excessive pain, high fever, and early muscular rigidity. In the
recognition of the severity of the attack we may divide the symptoms
into three grades. In the most rapidly fatal attacks the animal may
first indicate it by weak, staggering gait, partial or total inability
to swallow solids or liquids, impairment of eyesight; twitching of the
muscles and slight cramps may be observed. As a rule, the temperature is
not elevated--indeed, it is sometimes below normal. This is soon
followed by a paralysis of the whole body, inability to stand, delirium
in which the animal sometimes goes through a series of automatic
movements as if trotting or running; the delirium may become very
violent and the unconscious animal may bruise his head very seriously in
his struggles; but usually a deep coma renders him quiet until he
expires. Death in these cases usually takes place in from 4 to 24 hours
from the time the first symptoms become manifest. The pulse is variable
during the progress of the disease; it may be almost imperceptible at
times, and then again very rapid and irregular; the respirations
generally are quick and catching. In the next form in which this disease
may develop it first becomes manifest by a difficulty in swallowing and
slowness in mastication, and a weakness which may be first noticed in
the strength of the tail; the animal will be unable to switch it or to
offer resistance when we bend it up over the croup. The pulse is often a
little slower than normal. There is no evidence of pain; the
respirations are unchanged, and the temperature little less than normal;
the bowels may be somewhat constipated. These symptoms may remain
unchanged for two or three days and then gradual improvement may take
place, or the power to swallow may become entirely lost and the weakness
and uncertainty in gait more and more perceptible; then sleepiness or
coma may appear; the pulse becomes depressed, slow, and weak, the
breathing stertorous, and paroxysms of delirium develop, with inability
to stand, and some rigidity of the spinal muscles or partial cramp of
the neck and jaws. In such cases death may occur in from 6 to 10 days
from the commencement of the attack. In many cases there is no evidence
of pain, spasm, or fever at any time during the progress of the disease,
and finally profound coma develops and death follows, painless and
without a struggle.
In the last or mildest form the inability of voluntary control of the
limbs becomes but slightly marked, the power of swallowing never
entirely lost, and the animal has no fever, pain, or unconscious
movements. Generally the animal will begin to improve about the fourth
day and recovers.
In a few cases the spinal symptoms, manifested by paraplegia, may be the
most prominent symptoms; in others they may be altogether absent and the
main symptoms may be difficulty in mastication and swallowing; rarely it
may affect one limb only. In all cases in which coma remains absent for
six or seven days the animal is likely to recover. When changes toward
recovery take place, the symptoms usually leave in the reverse order to
that in which they developed, but local paralysis may remain for some
time, rarely persistent.
On post-mortem the number of lesions observable to the naked eye is in
marked contrast to the severity of the symptoms noted. The pharynx and
larynx are inflamed in many cases, and sometimes coated with a
yellowish-white glutinous deposit, extending at times over the tongue
and occasionally a little way down the trachea. The lungs are normal,
except from complications following drenching or recumbence for a long
period. The heart is usually normal in appearance, except an occasional
cluster of hemorrhagic points on the outer surface, while the blood is
dark and firmly coagulated. The lining of the stomach indicates a
subacute gastritis, while occasionally an erosion is noted. An edema is
observed in the submucosa of such cases. The first few inches of the
small intestines likewise may show slight inflammation in certain cases,
while in others it is quite severe; otherwise the digestive tract
appears normal, excluding the presence of varying numbers of bots,
_Strongylus vulgatus_, and a few other nematodes. The liver is congested
and swollen in some cases, while it appears normal in others. The spleen
is, as a rule, normal, and at times the kidneys are slightly congested.
The bladder is often distended with dark-colored urine, and occasionally
a marked cystitis has been observed. The adipose tissue throughout the
carcass may show a pronounced icteric appearance in certain cases. On
removing the bones of the skull the brain appears to be normal
macroscopically in a few instances, but in most cases the veins and
capillaries of the meninges of the cerebrum, cerebellum, and
occasionally the medulla is distinctly dilated and engorged, and in a
few cases there are pronounced lesions of a leptomeningitis. An
excessive quantity of cerebrospinal fluid is present in most of the
cases. On the floor of the lateral ventricles of several brains there
was noted a slight softening caused by hemorrhages into the brain
substance. There is always an abundance of fluid in the subarachnoid
spaces, ventricles, and at the base of the brain, usually of the color
of diabetic urine, and containing a limited number of flocculi, but in a
few cases it was slightly blood tinged. The spinal cord was not found
involved in the few cases examined.
_Treatment._--One attack of the disease does not confer immunity. Horses
have been observed which have recovered from two attacks, and still
others that recovered from the first but died as a result of the second
attack.
Inasmuch as a natural immunity does not appear after an attack of
cerebrospinal meningitis, it might be anticipated that serum of
recovered cases would possess neither curative nor prophylactic
qualities. Nevertheless, experiments have been made along these lines
with serum from recovered cases, but without any positive results.
Similar investigations have been conducted by others in Europe with
precisely the same results. With the tendency of the disease to produce
pathological lesions in the central nervous system, it seems scarcely
imaginable that a medicinal remedy will be found to heal these foci, and
even when recovery takes place considerable disturbance in the
functions, as blindness, partial paralysis, dumbness, etc., is liable to
remain. Indeed, when the disease once becomes established in an animal,
drugs seem to lose their physiological action. Therefore, with all the
previously mentioned facts before us, it is evident that the first
principle in the treatment of this disease is prevention, which consists
in the exercise of proper care in feeding only clean, well-cured forage
and grain and pure water. These measures when faithfully carried out
check the development of additional cases of the disease upon the
affected premises.
While medicinal treatment has proved unsatisfactory in most cases,
nevertheless the first indication is to clean out the digestive tract
thoroughly, and to accomplish this prompt measures must be used early in
the disease. Active and concentrated remedies should be given,
preferably subcutaneously or intravenously, owing to the great
difficulty in swallowing, even in the early stage. Arecolin in one-half
grain doses, subcutaneously, has given as much satisfaction as any other
drug. After purging the animal the treatment is mostly symptomatic.
Intestinal disinfectants, particularly calomel, salol, and salicylic
acid, have been recommended, and mild, antiseptic mouth washes are
advisable. Antipyretics are of doubtful value, as better results are
obtained, if the temperature is high, by copious cold-water injections.
An ice pack applied to the head is beneficial in case of marked psychic
disturbance. One-ounce doses of chloral hydrate per rectum should be
given if the patient is violent or if muscular spasms are severe. If the
temperature becomes subnormal, the animal should be warmly blanketed,
and if much weakness is shown this should be combated with stimulants,
such as strychnin, camphor, alcohol, atropin, or aromatic spirits of
ammonia. Early in the disease urotropin (hexamethylenamin) in doses of
25 grains, dissolved in water and given by the mouth every two hours,
appeared to have been responsible for the recovery of some cases of the
malady. During convalescence tonic treatment is indicated.
_Hygienic measures needful._--Whenever this disease appears in a stable
all the animals should be removed as soon as possible. They should be
provided with clean, well-ventilated, and well-drained stables, and each
animal should receive a laxative and be fed feed and given water from a
new, clean source. The abandoned stable should be thoroughly cleansed
from all waste matters, receive a coat of whitewash containing 4 ounces
of carbolic acid to the gallon of water and should have time to dry
thoroughly before the horses are replaced. A complete change of feed is
of the very greatest importance on account of the belief that the cause
resides in diseased grain, hay, and grass.
TETANUS, OR LOCKJAW.
This disease is characterized by spasms affecting the muscles of the
face, neck, body, and limbs and of all muscles supplied by the
cerebrospinal nerves. The spasms or muscular contractions are rigid and
persistent, yet mixed with occasional more intense contractions of
convulsive violence.
_Causes._--This disease is caused by a bacillus that is often found in
the soil, in manure, and in dust. This germ forms spores at the end of
the organism and grows only in the absence of oxygen. It produces a
powerful nerve poison, which causes the symptoms of tetanus. The germ
itself multiplies at the point where it is introduced, but its poison is
absorbed and is carried by the blood to all parts of the body, and thus
the nervous system is poisoned. Deep wounds infected by this germ are
more dangerous than superficial wounds, because in them the germ is more
remote from the oxygen of the air. Hence, nail pricks, etc., are
especially dangerous. In the majority of instances the cause of tetanus
can be traced to wounds, especially pricks and wounds of the feet or of
tendinous structures. It sometimes follows castration, docking, the
introduction of setons, inclusion of a nerve in a ligature, etc. It may
come on a long time after the wound is healed--three or four months.
Horses with a nervous, excitable disposition are more predisposed than
those of a more sluggish nature. Stallions are more subject to develop
tetanus as the result of wounds than geldings, and geldings more than
mares.
_Symptoms._--The attacks may be acute or subacute. In an acute attack
the animal usually dies within four days. The first symptoms which
attract the attention of the owner is difficulty in chewing and
swallowing, an extension of the head and protrusion over the inner part
of the eye of the membrana nictitans, or haw. An examination of the
mouth will reveal an inability to open the jaws to their full extent,
and the endeavor to do so will produce great nervous excitability and
increased spasm of the muscles of the jaw and neck. The muscles of the
neck and along the spine become rigid and the legs are moved in a stiff
manner. The slightest noise or disturbance throws the animal into
increased spasm of all the affected muscles. The tail is usually
elevated and held immovable; the bowels become constipated early in the
attack. The temperature and pulse are not much changed. These symptoms
in the acute type become rapidly aggravated until all the muscles are
rigid--in a state of tonic spasm--with a continuous tremor running
through them; a cold perspiration breaks out on the body; the breathing
becomes painful from the spasm of the muscles used in respiration; the
jaws are completely set, eyeballs retracted, lips drawn tightly over the
teeth, nostrils dilated, and the animal presents a picture of the most
extreme agony until death relieves him. The pulse, which at first was
not much affected, will become quick and hard, or small and thready when
the spasm affects the muscles of the heart. In the subacute cases the
jaws may never become entirely locked; the nervous excitability and
rigidity of the muscles are not so great. There is, however, always some
stiffness of the neck or spine manifest in turning; the haw is turned
over the eyeball when the nose is elevated. It is not uncommon for
owners to continue such animals at their work for several days after the
first symptoms have been observed. All the symptoms may gradually
increase in severity for a period of ten days, and then gradually
diminish under judicious treatment, or they may reach the stage wherein
all the characteristics of acute tetanus become developed. In some
cases, however, we find the muscular cramps almost solely confined to
the head or face, perhaps involving those of the neck. In such cases we
have complete trismus (lockjaw), and all the head symptoms are acutely
developed. On the contrary, we may find the head almost exempt in some
cases, and have the body and limbs perfectly rigid and incapable of
movement without falling.
Tetanus may possibly be confounded with spinal meningitis, but the
character of the spasm-locked jaw, retraction of the eyeballs, the
difficulty in swallowing due to spasms of the muscles of the pharynx,
and above all, the absence of paralysis, should serve to make the
distinction.
_Prevention._--When a valuable horse has sustained a wound that it is
feared may be followed by tetanus, it is well to administer a dose of
tetanus antitoxin. This is injected beneath the skin with a hypodermic
syringe. A very high degree of protection may in this way be afforded.
This antitoxin should be administered only by a competent veterinarian.
_Treatment._--The animal should be placed in a box stall without
bedding, as far as possible from other horses. If in a country district,
the animal should be put into an outbuilding or shed, where the noise of
other animals will not reach it; if the place is moderately dark, it is
all the better; in fly time it should be covered with a light sheet. The
attendant must be very careful and quiet to prevent all unnecessary
excitement and increase of spasm. Tetanus antitoxin appears to be useful
as a remedy in some cases, if given in very large quantities early in
the disease; otherwise it is useless. Subcutaneous injections of
carbolic acid in glycerin and water (carbolic acid 30 grains, glycerin
and water each 1 ounce) appear to be useful in some cases. Injections
should be given twice daily.
A cathartic, composed of Barbados aloes 6 to 8 drams, with which may be
mixed 2 drams of the solid extract of belladonna, should be given at
once. This is best given in a ball form; if, however, the animal is
greatly excited by the attempt or can not swallow, the ball may be
dissolved in 2 ounces of olive oil and thrown on the back of the tongue
with a syringe. If the jaws are set, or nearly so, an attempt to
administer medicine by the mouth should not be made. In such cases
one-quarter of a grain of atropia, with 5 grains of sulphate of morphia,
should be dissolved in 1 dram of pure water and injected under the skin.
This should be repeated sufficiently often to keep the animal
continually under its effect. This will usually mitigate the severity of
the spasmodic contraction of the affected muscles and lessen sensibility
to pain. Good results may be obtained sometimes by the rectal injection
of the fluid extract of belladonna and of cannabis indica, of each 1
dram, every four or six hours. This may be diluted with a quart of milk.
When the animal is unable to swallow liquids, oatmeal gruel and milk
should be given by injection per rectum to sustain the strength of the
animal. A pailful of cool water should be constantly before him, placed
high enough for him to reach it without special effort; even if drinking
is impossible, the laving of the mouth is refreshing. Excellent success
frequently may be obtained by clothing the upper part of the head, the
neck, and greater part of the body in woolen blankets kept saturated
with very warm water. This treatment should be continued for six or
eight hours at a time. It often relaxes the cramped muscles and gives
them rest and the animal almost entire freedom from pain; but it should
be used every day until the acute spasms have permanently subsided in
order to be of any lasting benefit.
Recently subcutaneous injections of brain emulsion have been
recommended. It is thought that the tetanus toxin will attach itself to
the brain cells so injected and thus free the system of this poison.
When it is due to a wound, the wound should be thoroughly cleaned and
disinfected with carbolic acid. If from a wound which has healed, an
excision of the cicatrix may be beneficial. In all cases it is not
uncommon to have a partial recovery followed by relapse when the animal
becomes excited from any cause.
RABIES, HYDROPHOBIA, OR MADNESS.
This disease does not arise spontaneously among horses, but is the
result of a bite from a rabid animal--generally a dog or cat. The
development of the disease follows the bite in from three weeks to three
months--very rarely in two weeks. (See also p. 559.)
_Symptoms._--The first manifestation of the development of this disease
may be an increased excitability and viciousness; very slight noises or
the approach of a person incites the animal to kick, strike, or bite at
any near object. Very often the horse will bite his own limbs or sides,
lacerating the flesh and tearing the skin. The eyes appear staring,
bloodshot; the ears are on the alert to catch all sounds; the head is
held erect. In some cases the animal will continually rub and bite the
locality of the wound inflicted by the rabid animal. This symptom may
precede all others. Generally the bowels become constipated and the
animal makes frequent attempts at urination, which is painful, and the
urine very dark colored. The furious symptoms appear in paroxysms; at
other times the animal may eat and drink, although swallowing appears to
become painful toward the latter stage of the disease, and may cause
renewed paroxysms. The muscles of the limbs or back may be subject to
intermittent spasms, or spasmodic tremors; finally, the hind limbs
become paralyzed, breathing very difficult, and convulsions supervene,
followed by death. The pulse and respirations are increased in frequency
from the outset of the attack. Rabies may possibly be mistaken for
tetanus. In the latter disease we find tonic spasms of the muscles of
the jaws, or stiffness of the neck or back very early in the attack, and
evidence of viciousness is absent.
_Treatment._--As soon as the true nature of the disease is ascertained
the animal should be killed.
_Prevention._--When a horse is known to have been bitten by a rabid
animal, immediate cauterization of the wound with a red-hot iron may
possibly destroy the virus before absorption of it takes place.
PLUMBISM, OR LEAD POISONING.
This disease is not of frequent occurrence. It may be due to the
habitual drinking of water which has been standing in leaden conductors
or in old paint barrels, etc. It has been met with in enzootic form near
smelting works, where, by the fumes arising from the works, lead in the
form of oxid, carbonate, or sulphate was deposited on the grass and
herbage which the horses ate.
_Symptoms._--Lead poisoning produces derangement of the functions of
digestion and locomotion, or it may affect the lungs principally. In
whatever system of organs the lead is mostly deposited there we have the
symptoms of nervous debility most manifest. If in the lungs, the
breathing becomes difficult and the animal gets out of breath very
quickly when compelled to run. Roaring, also, is very frequently a
symptom of lead poisoning. When it affects the stomach, the animal
gradually falls away in flesh, the hair becomes rough, the skin tight,
and colicky symptoms develop. When the deposit is principally in the
muscles, partial or complete paralysis gradually develops. When large
quantities of lead have been taken in and absorbed, symptoms resembling
epilepsy may result, or coma and delirium develop and prove fatal. In
lead poisoning there is seldom any increase in temperature. A blue line
forms along the gums of the front teeth, and the breath assumes a
peculiarly offensive odor. Lead can always be detected in the urine by
chemical tests.
_Treatment._--The administration of 2-dram doses of iodid of potassium
three times a day is indicated. This will form iodid of lead in the
system, which is rapidly excreted by the kidneys. If much muscular
weakness or paralysis is present, sulphate of iron in 1-dram doses and
strychnia in 2-grain doses may be given twice a day. In all cases of
suspected lead poisoning all utensils which have entered into the supply
of feed or water should be examined for the presence of soluble lead. If
it occurs near lead works, great care must be given to the supply of
uncontaminated fodder, etc.
UREMIA.
Uremic poisoning may affect the brain in nephritis, acute albuminuria,
or when, from any cause, the functions of the kidneys become impaired or
suppressed and urea (a natural product) is no longer eliminated from
these organs, causing it to accumulate in the system and give rise to
uremic poisoning.
Uremic poisoning is usually preceded by dropsy of the limbs or abdomen;
a peculiar, fetid breath is often noticed; then drowsiness, attacks of
diarrhea, and general debility ensue. Suddenly extreme stupor or coma
develops; the surface of the body becomes cold; the pupils are
insensible to light; the pulse slow and intermitting; the breathing
labored, and death supervenes. The temperature throughout the disease is
seldom increased, unless the disease becomes complicated with acute,
inflammatory disease of the brain or respiratory organs, which often
occur as a result of the urea in the circulation. Albumen and tube casts
may frequently be found in the urine. The disease almost invariably
proves fatal.
Treatment must be directed to a removal of the cause.
ELECTRIC SHOCK.
Electric shock, from coming in contact with electric wires, is becoming
a matter of rather frequent occurrence, and has a similar effect upon
the animal system as a shock from lightning. Two degrees of electric or
lightning shock may be observed, one producing temporary contraction of
muscles and insensibility, from which recovery is possible, the other
killing directly, by producing a condition of nervous and general
insensibility. In shocks which are not immediately fatal the animal is
usually insensible, the respiration slow, labored, or gasping, the pulse
slow, feeble, and irregular, and the pupils dilated and not sensitive,
or they may be contracted and sensitive. The temperature is lowered.
There may be a tendency to convulsions or spasms. The predominating
symptoms are extreme cardiac and respiratory depression.
_Treatment._--Sulphate of atropia should be given hypodermically in
one-quarter grain doses every hour or two hours until the heart beats
are invigorated, the number and fullness of the respirations increased,
and consciousness returns. Stimulating injections per rectum may also be
useful in arousing the circulation; for this purpose whisky or ammonia
water may be used.
DISEASES OF THE HEART, BLOOD VESSELS, AND LYMPHATICS.
By M. R. TRUMBOWER, V. S.
[Revised by Leonard Pearson, B. S., V. M. D.]
ANATOMY AND PHYSIOLOGY OF THE HEART AND BLOOD VESSELS.
(Pls. XX and XXI.)
The heart is a hollow, muscular organ, situated a little to the left of
the center of the chest. Its impulse is felt on the left side on account
of its location and from the rotary movement of the organ in action. It
is cone-shaped, with the base upward; the apex points downward,
backward, and to the left side. It extends from about the third to the
sixth ribs, inclusive. The average weight is about 7 to 8 pounds. In
horses used for speed the heart is relatively larger, according to the
weight of the animal, than in horses used for slow work. It is suspended
from the spine by the large blood vessels and held in position below by
the attachment of the pericardium to the sternum. It is inclosed in a
sac, the pericardium, which is composed of a dense fibrous membrane
lined by a delicate serous membrane, which is reflected over the heart;
the inner layer is firmly adherent to the heart, the outer to the
fibrous sac, and there is an intervening space, known as the pericardial
space, in which a small amount of serum--a thin translucent liquid--is
present constantly.
The heart is divided by a shallow fissure into a right and left side;
each of these is again subdivided by a transverse partition into two
compartments which communicate. Thus there are four cardiac
cavities--the superior, or upper, ones called the auricles; the
inferior, or lower, ones the ventricles. These divisions are marked on
the outside by grooves, which contain the cardiac blood vessels, and are
generally filled with fat.
The right side of the heart may be called the venous side, the left the
arterial side, named from the kind of blood which passes through them.
The auricles are thin-walled cavities placed at the base, and are
connected with the great veins--the venæ cavæ and pulmonary
veins--through which they receive blood from all parts of the body. The
auricles communicate with the ventricles each by a large aperture, the
auriculo-ventricular orifice, which is furnished with a remarkable
mechanism of valves, allowing the transmission of blood from the
auricles into the ventricles, but preventing a reverse course. The
ventricles are thick-walled cavities, forming the more massive portion
of the heart toward the apex. They are separated by a partition, and are
connected with the great arteries--the pulmonary artery and the
aorta--by which they send blood to all parts of the body. At the mouth
of the aorta and at the mouth of the pulmonary artery is an arrangement
of valves in each case which prevents the reflux of blood into the
ventricles. The auriculo-ventricular valve in the left side is composed
of two flaps, hence it is called the bicuspid valve; in the right side
this valve has three flaps and is called the tricuspid valve. The flaps
which form these valves are connected with a tendinous ring between the
auricles and ventricles; and each flap of the auriculo-ventricular
valves is supplied with tendinous cords, which are attached to the free
margin and under-surface, so as to keep the valves tense when closed--a
condition which is produced by the shortening of muscular pillars with
which the cords are connected. The arterial openings, both on the right
and on the left side, are provided with three-flapped semilunar-shaped
valves, to prevent the regurgitation of blood when the ventricles
contract. The veins emptying into the auricles are not capable of
closure, but the posterior vena cava has an imperfect valve at its
aperture.
The inner surface of the heart is lined by a serous membrane, the
endocardium, which is smooth and firmly adherent to the muscular
structure of the heart. This membrane is continuous with the lining
membrane of the blood vessels, and it enters into the formation of the
valves.
The circulation through the heart is as follows: The venous blood is
carried into the right auricle by the anterior and posterior venæ cavæ.
It then passes through the right auriculo-ventricular opening into the
right ventricle, thence through the pulmonary artery to the lungs. It
returns by the pulmonary veins to the left auricle, then is forced
through the auriculo-ventricular opening into the left ventricle, which
propels it through the aorta and its branches into the system, the veins
returning it again to the heart. The circulation, therefore, is double,
the pulmonary, or lesser, being performed by the right side, and the
systemic, or greater, by the left side.
As the blood is forced through the heart by forcible contractions of its
muscular walls, it has the action of a force pump, and gives the impulse
at each beat, which we call the pulse--the dilatation of the arteries
throughout the system. The contraction of the auricles is quickly
followed by that of the ventricles, and then a slight pause occurs; this
takes place in regular rhythmical order during health.
[Illustration: PLATE XX.
INTERIOR OF CHEST SHOWING POSITION OF HEART AND DIAPHRAGM.]
[Illustration: PLATE XXI.
Heart.
Right half, red.
Left half, blue.
Auricles, at upper end.
Ventricles, at lower end.
Arteries, red.
Veins, blue.
1. Left carotid artery.
2. Left jugular vein.
3. Portal system.
4. Vessels of the liver.
5. Arteries of the stomach. (Cæliac axis).
6. Vessels of the large intestine.
7. Vessels of the small intestine.
8. Artery of left kidney.
CIRCULATORY APPARATUS.]
The action of the heart is governed and maintained by the pneumogastric
nerve (tenth pair of cranial nerves); it is the inhibitory nerve of the
heart, and regulates, slows, and governs its action. When the nerve is
cut, the heartbeats increase rapidly, and, in fact, the organ works
without control. When the nerve is unduly irritated the holdback, or
inhibitory force, is increased, and the heart slows up in the same
measure. The left cavities of the heart, the pulmonary veins, and the
aorta, or systemic artery, contain red or florid blood, fit to circulate
through the body. The right cavities of the heart, with the venæ cavæ,
or systemic veins, the pulmonary artery, contain dark blood, which must
be transmitted through the lungs for renovation.
The arteries, commencing in two great trunks, the aorta and the
pulmonary artery, undergo division, as in the branching of a tree. Their
branches mostly come off at acute angles, and are commonly of uniform
diameter in each case, but successively diminish after and in
consequence of division, and in this manner gradually merge into the
capillary system of blood vessels. As a general rule, the combined area
of the branches is greater than that of the vessels from which they
emanate, and hence the collective capacity of the arterial system is
greatest at the capillary vessels. The same rule applies to the veins.
The effect of the division of the arteries is to make the blood move
more slowly along their branches to the capillary vessels, and the
effect of the union of the branches of the veins is to accelerate the
speed of the blood as it returns from the capillary vessels to the
venous trunks.
In the smaller vessels a frequent running together, or anastomosis,
occurs. This admits of a free communication between the currents of
blood, and must tend to promote equability of distribution and of
pressure, and to obviate the effects of local interruption. The arteries
are highly elastic, being extensile and retractile both in length and
breadth. During life they are also contractile, being provided with
muscular tissue. When cut across they present, although empty, an open
orifice; the veins, on the other hand, collapse.
In most parts of the body the arteries are inclosed in a sheath formed
of connective tissue, but are connected so loosely that, when the vessel
is cut across, its ends readily retract some distance within the sheath.
Independently of this sheath, arteries are usually described as being
formed of three coats, named, from the relative positions, external,
middle, and internal. This applies to their structure so far as it is
discernible by the naked eye. The internal, serous, or tunica intima, is
the thinnest, and is continuous with the lining membrane of the heart.
It is made up of two layers--an inner, consisting of a layer of
epithelial scales, and an outer, transparent, whitish, highly elastic,
and perforated. The middle coat, tunica media, is elastic, dense, and
of a yellow color, consisting of nonstriated muscular and elastic
fibers, thickest in the largest arteries and becoming thinner in the
smaller. In the smallest vessels it is almost entirely muscular. The
external coat, tunica adventitia, is composed mainly of fine and closely
woven bundles of white connective tissue, which chiefly run diagonally
or obliquely around the vessel. In this coat the nutrient vessels, the
vasa vasorum, form a capillary network, from which a few penetrate as
far as the muscular coat.
The veins differ from arteries in possessing thinner walls, less elastic
and muscular tissue, and for the most part a stronger tunica adventitia.
They collapse when cut across or when they are empty. The majority of
veins are provided with valves; these are folds of the lining membrane,
strengthened by fibrous tissue. They favor the course of the blood and
prevent its reflux. The nerves which supply both the arteries and the
veins come from the sympathetic system. The smaller arteries terminate
in the system of minute vessels known as the capillaries, which are
interposed between the termination of the arteries and the commencement
of the veins. Their average diameter is about one three-thousandth of an
inch.
DISEASES OF THE HEART AND BLOOD VESSELS.
In considering diseases of the heart we meet with many difficulties,
depending much upon the position which this organ occupies in the
animal. The shoulders cover so much of the anterior portion of the
chest, and often in very heavy-muscled horses the chest walls are so
thick that a satisfactory examination of the heart is attended with
difficulty. Diseases of the heart are not uncommon among horses; the
heart and its membranes are frequently involved in diseases of the
respiratory organs, diseases of the kidneys, rheumatism, influenza, etc.
Some of the diseases of this organ are never suspected by the ordinary
observer during life, and are so difficult to diagnose with any degree
of certainty that we will have to confine ourselves to a general
outline, giving attention to such symptoms as may serve to lead to a
knowledge of their existence, with directions for treatment, care, etc.
Nervous affections often produce prominent heart symptoms by causing
functional disturbance of that organ, which, if removed, will leave the
heart restored to perfect vigor and normal action. Organic changes
involving the heart or valves, however, usually grow worse and
eventually prove fatal. Therefore it is necessary that we arrive at an
appreciation of the true nature and causes so that we may be able to
form a true estimate of the possibilities for recovery or encouragement
for medical treatment.
Disease of the heart may occur at any age, but it is witnessed most
frequently in young horses, which, when being trained for fast work, are
often subjected to excessive hardship and fatigue. Nervous or timid
animals also suffer from such diseases more frequently than those of a
sluggish disposition. Any cause which induces a violent or sudden change
in the circulation may result in injury to the heart. Symptoms which may
frequently denote disease of the heart are difficult breathing or
short-windedness, dropsies of the limbs, habitual coldness of the
extremities, giddiness or fainting attacks, inability to stand work,
although the general appearance would indicate strength and ability,
etc.
MYOCARDITIS, OR INFLAMMATION OF THE MUSCULAR STRUCTURE OF THE HEART.
The heart muscle sometimes becomes inflamed as a complication or result
of the existence of general or febrile and of infectious diseases.
Severe influenza or infectious pneumonia is not infrequently followed by
myocarditis. By extension of inflammation of the endocardium or
pericardium the muscle of the heart may become involved. Overexertion or
especially hard work continued for a long time may cause this muscle to
become inflamed.
_Symptoms._--Inflammation of the heart muscle is shown by inability to
contract forcibly. This results in a rapid but weak, soft pulse and
irregular heart sounds. The pulse may be quite irregular as a result of
the irregular, tumultuous action of the heart. There is great general
weakness, shortness of breath, and rapid respiratory movements. In some
cases, where the muscle is very much softened and weakened, or, perhaps
when an abscess forms in the wall of the heart, the course of the
disease is very rapid and terminates suddenly from paralysis or rupture
of the heart.
_Alterations._--The heart muscle has a brownish or yellowish, boiled
appearance, and is so brittle that it tears easily. There may be a
spotted appearance of the muscle from the intense changes in structure
in small areas. These small areas may be due to suppuration, in which
case they have the characteristics of small abscesses. This last
condition is seen in pyemia (blood poisoning). If the disease is of long
duration, the fibrous tissue in the wall of the heart may increase to
such an extent as to produce an unnatural hardness of the wall.
_Treatment._--In this disease the nutrition and strength of the heart
should be kept up as much as possible with good food, good care, and
heart tonics and stimulants. The horse should be tempted to eat such
foods as he will take; he should be kept in an airy box stall; his legs
should be well rubbed as often as necessary to keep them warm and
bandaged loosely with flannel bandages. Internally the horse may have
strychnia, in 2-grain doses twice daily, whisky in 4-ounce doses every
two to four hours, digitalis in the form of the tincture in doses of 1
dram every three to six hours. Artificial Carlsbad salts in heaping
tablespoonful doses in the feed may be given three times daily for a
couple of weeks. Rest is of the greatest importance and should be
allowed for a few weeks after recovery seems to be complete.
ENDOCARDITIS, OR INFLAMMATION OF THE LINING MEMBRANE OF THE HEART.
Endocarditis frequently occurs as a complication of rheumatism, some of
the specific or zymotic fevers, specific poisoning, etc. This is a more
frequent disease among horses than is generally known, and often gives
rise to symptoms which at first are obscure and unnoticed.
In influenza we may find the heart becoming involved in the disease, in
consequence of the morbid material conveyed through the heart in the
blood stream. In view of the fact that many affections in even remote
portions of the body may be traced directly to a primary endocardial
disease, we shall feel justified in inviting special attention to this
disease.
Endocarditis may be acute, subacute, or chronic. In acute inflammation
we find a thickening and a roughened appearance of the endocardium
throughout the cavities of the heart. This condition may be followed by
a coagulation of fibrin upon the inflamed surface, which adheres to it,
and by attrition soon becomes worked up into shreddy-like granular
elevations. This may lead to a formation of fibrinous clots in the heart
and sudden death early in the disease the second or third day.
Subacute endocarditis, which is the most common form, may not become
appreciable for several days after its commencement. It is characterized
by being confined to one or more anatomical divisions of the heart, and
all the successive morbid changes follow each other in a comparatively
slow process. Often we would not be led to suspect heart affection were
it not for the distress in breathing, which it generally occasions when
the animal is exercised, especially if the valves are much involved.
When coagula or vegetations form upon the inflamed membrane, either in
minute shreds or patches, or when formation of fibrinous clots occurs in
the cavity affected, some of these materials may be carried from the
cavity of the heart by the blood current into remote organs,
constituting emboli that are liable to suddenly plug vessels and thereby
interrupt important functions. In the great majority of either acute or
subacute grades of endocarditis, whatever the exciting cause, the most
alarming symptoms disappear in a week or 10 days, often leaving,
however, such changes in the interior lining or valvular structures as
to cause impairment in the circulation for a much longer period of time.
These changes usually consist of thickening or induration of the
inflamed structures. But while the effects of the inflammation in the
membrane lining the walls of the ventricles may subside to such a degree
as to cause little or no inconvenience, or even wholly disappear, yet
after the valvular structures have been involved, causing them to be
thicker, less flexible than normal, they usually remain, obstructing the
free passage of the blood through the openings of the heart, thereby
inducing secondary changes, which take place slowly at first, but
ultimately seriously impair the animal's usefulness. What was but a
slight obstruction to the circulation during the first few weeks after
the subsidence of the cardiac inflammatory attack becomes in process of
time so much increased as to induce increased growth in the muscular
structure of the heart, constituting hypertrophy of the walls of the
ventricles, more particularly of the left, with corresponding fullness
of the left auricle and pulmonary veins, thereby producing fullness of
the capillaries in the lungs, pressure upon the air cells, difficult or
asthmatic breathing--greatly increased in attempts to work--until in a
few months many of these cases become entirely disabled for work.
Sometimes, too, dropsical effusions in the limbs or into the cavities of
the body result from the irregular and deficient circulation.
Derangement of the urinary secretion, with passive congestion of the
kidneys, may also appear.
Endocardial inflammation is seldom fatal in its early stages, but in
many cases the recovery is incomplete, for a large proportion is left
with some permanent thickening of the valves, which constitutes the
beginning of valvular disease.
_Symptoms._--Endocarditis may be ushered in by a chill, with sudden and
marked rise in temperature. The pulse rapidly decreases in strength or
may become irregular, while the heart beats more or less tumultuously.
In the early stages soft-blowing sounds may be heard by placing the ear
over the heart on the left side, which correspond in number and rhythm
to the heart's action. Excessive pain, though not so great as in acute
pleuritis, is manifested when the animal is compelled to trot; very
often difficulty in breathing, or shortness of breath, on the slightest
exertion develops early in the attack. When the valves are involved in
the inflammatory process the visible mucous membranes become either very
pale or very dark colored, and fainting may occur when the head is
suddenly elevated. When the valves of the right side are affected we may
find a regurgitant pulsation in the jugular vein. Occasionally it
happens that the heart contracts more frequently than the pulse
beats--that is, there may be twice as many contractions of the heart in
a minute as there are pulse waves in the arteries. The pulse is always
very fast. In some cases we find marked lameness of the left shoulder,
and when the animal is turned short to the left side he may groan with
pain, and the heart's action become violently excited, although
pressure against the chest wall will not produce pain unless roughly
applied. The animal is not disposed to eat or drink much; the surface of
the body and legs are cold--rarely excessively hot--and frequently the
body of the animal is in a subdued tremor. In nearly all cases there is
partial suppression of the urinary secretion. The symptoms may continue
with very little modification for three or four days, sometimes seven
days, without any marked changes. If large fibrinous clots form in the
heart the change will be sudden and quickly prove fatal unless they
become loosened and are carried away in the circulation; then apoplexy
may result from the plugging of arteries too small to give further
transmission. If the animal manifests symptoms of improvement, the
changes usually are slow and steady until he feels apparently as well as
ever, eats well, and moves freely in his stall or yard. When he is taken
out, however, the seeming strength often proves deceptive, as he may
quickly weaken if urged into a fast gait, the breathing becomes
quickened with a double flank movement as in heaves, and all the former
symptoms reappear in a modified degree. An examination at this stage may
reveal valvular insufficiency, cardiac hypertrophy, or pulmonary
engorgement.
In fatal cases of endocarditis death often occurs about the fourth day,
from the formation of heart clot or too great embarrassment of the
circulation. Endocarditis may be suspected in all cases where plain
symptoms of cardiac affection are manifested in animals affected with
influenza, rheumatism, or any disease in which the blood may convey
septic matter.
Acute endocardial inflammation may be distinguished from pleuritis by
the absence of any friction murmur, absence of pain when the chest wall
is percussed, and the absence of effusion in the cavity of the chest. It
may be distinguished from pericarditis by the absence of the friction
sounds and want of an enlarged area of dullness on percussion.
_Treatment._--The objects to be attained by treatment will be to remove
or mitigate as much as possible the cause inducing the disease; to find
a medicine which will lessen the irritability of the heart without
weakening it; and, last, to maintain a free urinary secretion and
prevent exudation and hypertrophy. So long as there is an increase of
temperature, with some degree of scantiness of the urine, it may be safe
to believe that there is some degree of inflammatory action existing in
the cardiac structures, and as long as any evidence of inflammatory
action remains, however moderate in degree, there is a tendency to
increase or hypertrophy of the connective tissue of the heart or valves,
thereby rendering it almost certain that the structural changes will
become permanent unless counteracted by persistent treatment and
complete rest.
The tincture of digitalis, in 20-drop doses, repeated every hour, is
perhaps the most reliable agent we know to control the irritability of
the heart, and this also has a decided influence upon the urinary
secretion. After the desired impression upon the heart is obtained the
dose may be repeated every two or three hours, or as the case may
demand. Tincture of strophanthus, in 2-dram doses, will quiet the
tumultuous action of the heart in some cases where the digitalis fails.
Bleeding, blistering, and stimulating applications to the chest should
be avoided. They serve to irritate the animal and can do no possible
good. Chlorate of potassium in 2-dram doses may be given in the drinking
water every four hours for the first five or six days, and then be
superseded by the nitrate of potassium in half-ounce doses for the
following week or until the urinary secretion becomes abnormally
profuse. Where the disease is associated with rheumatism, 2-dram doses
of salicylate of soda may be substituted for the chlorate of potassium.
To guard against chronic induration of the valves, the iodid of
potassium, in 1 to 2 dram doses, should be given early in the disease
and may be repeated two or three times a day for several weeks. When
chronic effects remain after the acute stage has passed this drug
becomes indispensable.
When dropsy of the limbs develops, it is due to weakened circulation or
functional impairment of the kidneys. When there is much weakness in the
action of the heart, or general debility is marked, the iodid of iron,
in 1-dram doses, combined with hydrastis, 3 drams, may be given three
times a day. Arsenic, in 5-grain doses twice a day, will give excellent
results in some cases of weak heart associated with difficult breathing.
In all cases absolute rest and warm stabling, with comfortable clothing,
become necessary, and freedom from work should be allowed for a long
time after all symptoms have disappeared.
PERICARDITIS, OR INFLAMMATION OF THE SAC INCLOSING THE HEART.
_Causes._--Pericarditis may be induced by cold and damp stabling,
exposure and fatigue, from wounds caused by broken ribs, etc. Generally,
however, it is associated with an attack of influenza, rheumatism,
pleuritis, etc.
_Symptoms._--Usually the disease manifests itself abruptly by a brief
stage of chills coincident with pain in moving, a short painful cough,
rapid and short breathing, and high temperature, with a rapid and hard
pulse. In the early stages of the disease the pulse is regular in beat;
later, when there is much exudation present in the pericardial sac, the
heartbeat becomes muffled, and may be of a double or rebounding
character. By placing the ear against the left side of the chest behind
the elbow a rasping sound may be heard, corresponding to the frequency
of the heartbeat. This is known as a friction sound. Between the second
and fourth days this sound may disappear, due to a distension of the
pericardium by an exudate or serous effusion. As soon as this effusion
partly fills the pericardium, percussion will reveal an abnormally
increased area of dullness over the region of the heart, the heartbeats
become less perceptible than in health, and in some cases a splashing or
flapping sound may become audible.
If the effusion becomes absorbed, the friction sound usually recurs for
a short time; this friction may often be felt by applying the hand to
the side of the chest. In a few cases clonic spasms of the muscles of
the neck may be present. In acute pericarditis, when the effusion is
rapid and excessive, the animal may die in a few days or recovery may
begin equally as early. In subacute or in chronic cases the effusion may
slowly become augmented until the pressure upon the lungs and
interference with the circulation become so great that death will
result. Whether the attack is acute, subacute, or chronic, the
characteristic symptoms which will guide us to a correct diagnosis are
the friction sound, which is always synchronous with the heart's action,
the high temperature with hard, irritable pulse, and, in cases of
pericardial effusion, the increased area of dullness over the cardiac
region. When the disease is associated with influenza or rheumatism,
some of the symptoms may be obscure, but a careful examination will
reveal sufficient evidence upon which to base a diagnosis. When
pericarditis develops as a result of or in connection with pleuritis,
the distinction may not be very clearly definable, neither will many
recover. When it results from a wound or broken rib, it almost
invariably proves fatal.
_Pathology._--Pericarditis may at all times be regarded as a very
serious affection. At first we will find an intense injection or
accumulation of blood in the vessels of the pericardium, giving it a red
and swollen appearance, during which we have the friction sound. In 24
to 48 hours this engorgement is followed by an exudation of
sero-fibrinous fluid, the fibrinous portion of which may soon form a
coating over the internal surface of the pericardial sac, and may
ultimately form a union of the opposing surfaces. Generally this
adhesion will only be found to occupy a portion of the surfaces. As the
serous or watery portion of this effusion is absorbed, the distinctness
of the friction sound recurs, and may remain perceptible in a varied
degree for a long time. When the serous effusion is very great, the
pressure exerted upon the heart weakens its action, and may produce
death soon; when it is not so great, it may cause dropsies of other
portions of the body. When the adhesions of the pericardial sac to the
body of the heart are extensive, they generally lead to increased
growth, or hypertrophy, of the heart, with or without dilatation of its
cavities; when they are but slight, they may not cause any
inconvenience.
_Treatment._--In acute or subacute pericarditis the tincture of
digitalis may be given in 20 to 30 drop doses every hour until the pulse
and temperature become reduced. Whisky or carbonate of ammonia may be
given regularly as stimulants. Bandages should be applied to the legs;
if the legs are very cold, tincture of capsicum should be first applied;
the body should be warmly clothed in blankets, to promote perspiration.
When the suffering from pain is very severe, 10 grains of morphin may be
given by the mouth once or twice a day; nitrate of potassium, half an
ounce, in drinking water, every six hours; after the third day, iodid of
potassium, in 2-dram doses, may be substituted. Cold packs to the chest
in the early stages of the disease may give marked relief, or, late in
the disease, smart blisters may be applied to the sides of the chest
with benefit. If the disease becomes chronic, iodid of iron and gentian
to support the strength will be indicated, but the iodid of potassium,
in 1 or 2 dram doses, two or three times a day, must not be abandoned so
long as there is an evidence of effusion or plastic exudate accumulating
in the pericardial sac. Where the effusion is great and threatens the
life of the patient, tapping by an expert veterinarian may save the
animal.
VALVULAR DISEASE OF THE HEART.
Acute valvular disease can not be distinguished from endocarditis, and
chronic valvular affections are generally the result of endocardial
inflammation. The valves of the left side are the most subject--the
bicuspid or mitral and the aortic or semilunar. The derangement may
consist of mere inflammation and swelling, or the edges of the valves
may become covered by the organization of the exudation, thus narrowing
the passage. Valvular obstruction and adhesions may occur or the
tendinous cords may be lengthened or shortened, thus obstructing the
orifices and permitting the regurgitation of blood. In protected cases
the fibrous tissue of the valves may be transformed into fibro-cartilage
or bone, or there may be deposits of salts of lime beneath the serous
membrance, which may terminate in ulceration, rupture, or fissures.
Sometimes the valves become covered by fibrinous, fleshy, or hard
vegetations, or excrescences. In cases of considerable dilatation of the
heart there may be atrophy and shrinking of the valves.
_Symptoms._--Valvular disease may be indicated by a venous pulse,
jerking pulse, intermittent pulse, irregular pulse; palpitation;
constant abnormal fullness of the jugular veins; difficulty of breathing
when the animal becomes excited or is urged out of a walk or into a
fast trot; attacks of vertigo; congestion of the brain; dropsical
swelling of the limbs. A blowing, cooing, or bubbling murmur may
sometimes be heard by placing the ear over the heart on the left side of
the chest.
Hypertrophy, or dilatation, or both, usually follow valvular disease.
_Treatment._--When the pulse is irregular or irritable, tonics, such as
preparations of iron, gentian, and ginger, may be given. When the action
of the heart is jerking or violent, 20 to 30 drop doses of tincture of
digitalis or of veratrum viride may be given until these symptoms abate.
As the disease nearly always is the result of endocarditis, the iodid of
potassium and general tonics, sometimes stimulants, when general
debility supervenes, may be of temporary benefit. Very few animals
recover or remain useful for any length of time after once marked
organic changes have taken place in the valvular structure of the heart.
ADVENTITIOUS GROWTHS IN THE HEART.
Fibrous, cartilaginous, and bony formations have been observed in some
rare instances in the muscular tissue. Isolated calcareous masses have
sometimes been embedded in the cardiac walls. Fibrinous coagula and
polypous concretions may be found in the cavities of the heart. The
former consist of coagulated fibrin, separated from the mass of blood,
of a whitish or yellowish white color, translucent, of a jellylike
consistence, and having a nucleus in the center. They may slightly
adhere to the surface of the cavity, from which they can easily be
separated without altering the structure of the endocardium. They
probably result from an excess of coagulability of fibrin, which is
produced by an organization of the lymph during exudation. They are
usually found in the right auricle and ventricle.
Polypous concretions are firmer than in the preceding, more opaque, of a
fibrous texture, and may be composed of successive layers. In some
instances they are exceedingly minute, while in others they almost fill
one or more of the cavities. Their color is usually white, but
occasionally red from the presence of blood. They firmly adhere to the
endocardium, and when detached from it give it a torn appearance.
Occasionally, a vascular communication seems to exist between them and
the substance of the heart. They may be the result of fibrinous
exudation from inflammation of the inner surface of the heart or the
coagulation of a portion of the blood which afterwards contracts
adhesion with the heart. These concretions prove a source of great
inconvenience and often danger, no matter how formed. They cause a
diminution in the cavity in which they are found, thus narrowing the
orifice through which the blood passes, or preventing a proper
coaptation of the valves, which may produce most serious valvular
disease.
_Symptoms._--These are frequently uncertain; they may, however, be
suspected when the action of the heart suddenly becomes embarrassed with
irregular and confused pulsations, great difficulty of breathing, and
the usual signs dependent upon the imperfect arterialization of the
blood.
_Treatment._--Stimulants, whisky, or carbonate of ammonia may be of
service.
PALPITATION OF THE HEART.
This is a tumultuous and usually irregular beating of the heart. It may
be due to a variety of causes, both functional and organic. It may occur
as a result of indigestion, fright, increased nervousness, sudden
excitement, excessive speeding, etc. (See "Thumps," p. 225.)
_Symptoms._--The heart may act with such violence that each beat may jar
the whole body of the animal; very commonly it may be heard at a short
distance away from the animal. It can usually be traced very readily to
the exciting cause, which we may be able to avoid or overcome in the
future and thereby obviate subsequent attacks. Rest, a mild stimulant,
or a dose or two of tincture of digitalis or opium will generally give
prompt relief. When it is due to organic impairment of the heart it must
be regarded as a symptom, not as a matter of primary specific treatment.
SYNCOPE, OR FAINTING.
Actual fainting rarely occurs among horses. It may, however, be induced
by a rapid and great loss of blood, pain of great intensity, a
mechanical interference with the circulation of the brain, etc.
_Symptoms._--Syncope is characterized by a decrease or temporary
suspension of the action of the heart and respiration, with partial or
total loss of consciousness. It generally occurs suddenly, though there
may be premonitory symptoms, as giddiness, or vertigo, dilated pupil,
staggering, blanching of the visible mucous membranes, a rapidly sinking
pulse, and dropping to the ground. The pulse is feeble or ceases to
beat; the surface of the body turns cold; breathing is scarcely to be
perceived, and the animal may be entirely unconscious. This state is
uncertain in duration--generally it lasts only a few minutes; the
circulation becomes restored, breathing becomes more distinct, and
consciousness and muscular strength return. In cases attended with much
hemorrhage or organic disease of the heart, the fainting fit may be
fatal; otherwise it will prove but a transient occurrence. In paralysis
of the heart the symptoms may be exactly similar to syncope. Syncope may
be distinguished from apoplexy by the absence of stertorous breathing
and lividity of the visible mucous membranes.
_Treatment._--Dash cold water on the head; administer a stimulant--4
ounces of whisky or half an ounce of carbonate of ammonia. Prevent the
animal from getting up too soon, or the attack may immediately recur.
Afterwards, if the attack was due to weakness from loss of blood,
impoverished blood, or associated with debility, general tonics, rest,
and nourishing food are indicated.
HYPERTROPHY OF THE HEART, OR CARDIAC ENLARGEMENT.
Hypertrophy of the heart implies augmentation of bulk in its muscular
substance, with or without dilatation or contraction of its cavities. It
may exist with or without other cardiac affections. In valvular disease
or valvular insufficiency hypertrophy frequently results as a
consequence of increased demand for propelling power. The difficulties
with which it is most frequently connected are dilatation and
ossification of the valves. It may also occur in connection with
atrophied kidneys, weak heart, etc. It may be caused by an increased
determination of blood to the organ or from a latent form of
myocarditis, and it may arise from a long-continued increase of action
dependent upon nervous disease. All the cavities of the heart may have
their walls hypertrophied or the thickening may involve one or more.
While the wall of a ventricle is thickened, its cavity may retain its
normal size (simple hypertrophy) or be dilated (eccentric hypertrophy),
or it may be contracted (concentric hypertrophy). Hypertrophy of both
ventricles increases the length and breadth of the heart. Hypertrophy of
the left ventricle alone increases its length; of the right ventricle
alone increases its breadth toward the right side. Hypertrophy with
dilatation may affect the chambers of the heart conjointly or
separately. This form is by far the most frequent variety of cardiac
enlargement. When the entire heart is affected, it assumes a globular
appearance, the apex being almost obliterated and situated transversely
in the chest. The bulk may become three or four times greater than the
average heart.
_Symptoms._--In hypertrophy of the heart, in addition to the usual
symptoms manifested in organic diseases of the heart, there is a
powerful and heaving impulse at each beat, which may be felt on the left
side, often also on the right. These pulsations are regular, and when
full and strong at the jaw there is a tendency to active congestion of
the capillary vessels, which frequently give rise to local inflammation,
active hemorrhage, etc. If the pulse is small and feeble at the jaw, we
may conclude that there is some obstacle to the escape of the blood from
the left ventricle into the aorta, which has given rise to the
hypertrophy. In case of hypertrophy with dilatation, the impulse is not
only powerful and heaving, but it is diffused over the whole region of
the heart, and the normal sounds of the heart are greatly increased in
intensity. Percussion reveals an enlarged area of dullness, while the
impulse is usually much stronger than normal.
Dropsy of the pericardium will give the same wide space of dullness, but
the impulse and sound are lessened. An animal with a moderate degree of
enlargement may possibly live a number of years and be capable of
ordinary work; it depends largely upon concomitant disease. As a rule,
an animal affected with hypertrophy of the heart will soon be
incapacitated for work, and becomes useless and incurable.
_Treatment._--If the cause can be discovered and is removable, it should
be done. The iodid of potassium, in cases of valvular thickening, may be
of some benefit if continued for a sufficient length of time; it may be
given in 2-dram doses, twice a day, for a month or more. The tincture of
digitalis may be given, in cases where the pulse is weak, in doses of 2
teaspoonfuls three times daily. This remedy should not be continued if
the pulse becomes irregular. General tonics, freedom from excitement or
fatigue, avoidance of bulky food, good ventilation, etc., are indicated.
DILATATION OF THE HEART.
This is an enlargement, or stretching, of the cavities of the heart, and
may be confined to one or extend to all. Two forms of dilatation may be
mentioned--simple dilatation, where there is normal thickness of the
walls, and passive, or attenuated, dilatation, where the walls are
simply distended or stretched out without any addition of substance.
_Causes._--Any cause producing constant and excessive exertion of the
heart may lead to dilatation. Valvular disease is the most frequent
cause. General anemia predisposes to it by producing relaxation of
muscular fiber. Changes in the muscular tissue of the heart walls,
serous infiltration from pericarditis, myocarditis, fatty degeneration
and infiltration, and atrophy of the muscular fibers may all lead to
dilatation.
_Symptoms._--The movements of the heart are feeble and prolonged, a
disposition to staggering or vertigo, dropsy of the limbs, very pale or
very dark-colored membranes, and difficult breathing on the slightest
excitement.
_Treatment._--General tonics, rich feed, and rest.
FATTY DEGENERATION OF THE HEART.
Fatty degeneration may involve the whole organ, or may be limited to its
walls, or even to circumscribed patches. The latter is situated at the
exterior, and gives it a mottled appearance. When generally involved it
is flabby or flaccid, and in extreme cases collapses when emptied or
cut. Upon dissection the interior of the ventricles is observed to be
covered with buff-colored spots of a singular zigzag form. This
appearance may be noticed beneath the pericardium, and pervading the
whole thickness of the ventricular walls, and in extreme cases those of
the fleshy columns in the interior of the heart. These spots are found
to be degenerated muscular fibers and colonies of oil globules. Fatty
degeneration is often associated with other morbid conditions of the
heart, such as obesity, dilatation, rupture, aneurism, etc. It may be
connected with fatty diseases of other organs, such as the liver,
kidneys, etc. When it exists alone its presence is seldom suspected
previous to death. It may be secondary to hypertrophy of the heart, to
myocarditis, or to pericarditis. It may be due to deteriorated
conditions of the blood in wasting diseases, excessive hemorrhages,
etc., or to poisoning with arsenic and phosphorus.
_Symptoms._--The most prominent symptoms of fatty degeneration are a
feeble action of the heart, a remarkably slow pulse, general debility,
and attacks of vertigo. It may exist for a long time, but is apt to
terminate suddenly in death upon the occurrence of other diseases,
surgical operations, etc. It may involve a liability to sudden death
from rupture of the ventricular walls.
_Treatment._--Confinement in feed to oats, wheat or rye bran, and
timothy hay. Twenty drops of sulphuric acid may be given in drinking
water three times a day, and hypophosphite of iron in 2-dram doses,
mixed with the feed, twice a day. Other tonics and stimulants as they
may be indicated.
RUPTURE OF THE HEART.
This may occur as the result of some previous disease, such as fatty
degeneration, dilatation with weakness of the muscular walls, etc. It
may be caused by external violence, a crushing fall, pressure of some
great weight, etc. Usually death follows a rupture very quickly, though
an animal may live for some time when the rent is not very large.
WEAKNESS OF THE HEART.
This may arise from general debility, the result of exhausting disease,
overwork, or heart strain, or loss of blood. It is indicated by a small,
feeble, but generally regular pulse, coldness of the body, etc.
Treatment should be directed to support and increase the strength of the
animal by tonics, rest, and nutritious feed. Carbonate of ammonia may be
given to stimulate the heart's action and to prevent the formation of
heart clot.
CONGESTION OF THE HEART
Congestion, or an accumulation of the blood in the cavities of the
heart, may occur in consequence of fibrinous deposits interfering with
the free movements of the valves, usually the product of endocarditis or
as a result of excessive muscular exertion.
Symptoms are great difficulty of breathing, paleness of the visible
mucous membranes, great anxiety, frequently accompanied by a general
tremor and cold perspiration, followed by death. It usually results in
death very quickly.
CYANOSIS OF NEWBORN FOALS.
This is a condition sometimes found in foals immediately after birth,
and is due to nonclosure of the foramen ovale, which allows a mixture of
the venous with the arterial blood in the left cavities of the heart. It
is characterized by a dark purple or bluish color of the visible mucous
membranes, shortness of breath, and a general feebleness. Foals thus
affected generally live only a few hours after birth.
DISEASES OF ARTERIES, OR ARTERITIS AND ENDARTERITIS.
Inflammation of arteries is rarely observed in the horse as a primary
affection. Direct injuries, such as blows, may produce a contusion and
subsequent inflammation of the wall of an artery; severe muscular strain
may involve an arterial trunk; hypertrophy of the heart, by increasing
arterial tension, may result in the production of a general
endarteritis. Septic infection may affect the inner coat and ultimately
involve all three, or it may be the result of an inflammation in the
vicinity of the vessels, etc. Inflammation of arteries, whatever the
cause may be, often leads to very serious results in the development of
secondary changes in their walls. Arteritis may be acute, subacute, or
chronic; when the inner coat alone is affected it is known as
endarteritis.
_Symptoms._--Arteritis is characterized by a painful swelling along the
inflamed vessel, throbbing pulse, coldness of the parts supplied by the
inflamed vessel, sometimes the formation of gangrenous sloughs,
suppuration, abscess, etc. In an inflammation of the iliac arteries we
find coldness and excessive lameness or paralysis of one or both hind
limbs.
_Pathology._--In acute arteritis we find swelling along the vessel, loss
of elasticity, friability, and thickening of the walls; a roughness and
loss of gloss of the inner coat, with the formation of coagula or pus in
the vessel. Subacute or chronic arteritis may affect only the outer coat
(periarteritis), both the outer and middle coat, or the inner coat alone
(endarteritis); and by weakening the respective coats leads to rupture,
aneurism, or to degenerations, such as bony, calcareous, fatty,
atheromatous, etc. It may also lead to sclerosis or increase of fibrous
tissue, especially in the kidneys, when it may result in the condition
known as arterio-capillary fibrosis. Chronic endarteritis is fruitful in
the production of thrombus and atheroma. Arteritis may be limited to
single trunks or it may affect, more or less, all the arteries of the
body. Arteries which are at the seat of chronic endarteritis are liable
to suffer degenerative changes, consisting chiefly of fatty
degeneration, calcification, or the breaking down of the degenerated
tissue, and the formation of erosions or ulcerlike openings in the inner
coat. These erosions are frequently called atheromatous ulcers, and
fragments of tissue from these ulcers may be carried into the
circulation, forming emboli. Fibrinous thrombi are apt to form upon the
roughened surface of the inner coat or upon the surface of the erosions.
Fatty degeneration and calcification of the middle and outer coats may
occur, and large, hard, calcareous plates project inward, upon which
thrombi may form or may exist in connection with atheroma of the inner
coat. When there is much thickening and increase of new tissue in the
wall of the affected artery it may encroach upon the capacity of the
vessel, and even lead to obliteration. This is often associated with
interstitial inflammation of glandular organs.
_Treatment._--Carbonate of potassium in 1-dram doses, to be given in 4
ounces liquor acetate of ammonia every six hours; scalded bran
sufficient to produce loosening of the bowels, and complete rest;
externally, applications of hot water or hot hop infusion.
ATHEROMA.
Atheroma is a direct result of an existing chronic endarteritis, the
lining membrane of the vessels being invariably involved to a greater or
less degree. It is most frequently found in the arteries, although the
veins may develop an atheromatous condition when exposed to any source
of prolonged irritation. Atheroma may affect arteries in any part of the
body; in some instances almost every vessel is diseased, in others only
a few, or even parts of one vessel. It is a very common result of
endocarditis extending into the aorta, which we find perhaps the most
frequent seat of atheroma. As a result of this condition the affected
vessel becomes impaired in its contractile power, loses its natural
strength, and, in consequence of its inability to sustain its accustomed
internal pressure, undergoes in many cases dilatation at the seat of
disease, constituting aneurism. In an atheromatous vessel, calcareous
deposits soon occur, which render it rigid, brittle, and subject to
ulceration or rupture. In such vessels the contractility is destroyed,
the middle coat atrophied and beyond repair. Atheroma in the vessels of
the brain is a frequent cause of cerebral apoplexy. No symptoms are
manifested by which we can recognize this condition during life.
CONSTRICTION OF AN ARTERY.
This is usually the result of arteritis, and may partly or wholly be
impervious to the flow of blood. When this occurs in a large vessel it
may be followed by gangrene of the parts; usually, however, collateral
circulation will be established to nourish the parts previously supplied
by the obliterated vessel. In a few instances constriction of the aorta
has produced death.
ANEURISM.
Aneurism is usually described as true or false. True aneurism is a
dilatation of the coats of an artery over a larger or smaller part of
its course. Such dilatations are usually due to chronic endarteritis and
atheroma. False aneurism is formed after a puncture of an artery by a
dilatation of the adhesive lymph by which the puncture was united.
_Symptoms._--If the aneurism is seated along the neck or a limb it
appears as a tumor in the course of an artery and pulsating with it. The
tumor is round, soft, and compressible, and yields a peculiar
fluctuation upon pressure. By applying the ear over it a peculiar
purring or hissing sound may sometimes be heard. Pulsation, synchronous
with the action of the heart, is the diagnostic symptom. It is of a
slow, expansive, and heavy character, as if the whole tumor were
enlarging under the hand. Aneurisms seated internally may occupy the
cavity of the cranium, chest, or abdomen. As regards the first, little
is known during life, for all the symptoms which they produce may arise
from other causes. Aneurism of the anterior aorta may be situated very
closely to the heart or in the arch, and it is very seldom that we can
distinguish it from disease of the heart. The tumor may encroach upon
the windpipe and produce difficulty in breathing, or it may produce
pressure upon the vena cava or the thoracic duct, obstructing the flow
of blood and lymph. In fact, whatever parts the aneurism may reach or
subject to its pressure, may have their functions suspended or
disturbed. When the tumor in the chest is large, we generally find much
irregularity in the action of the heart; the superficial veins of the
neck are distended, and there is usually dropsical swelling under the
breast and of the limbs. There may be a very troublesome cough without
any evidence of lung affection. Sometimes pulsation of the tumor may be
felt at the lower part of the neck where it joins the chest. When the
aneurism occurs in the posterior aorta no diagnostic symptoms are
appreciable; when it occurs in the internal iliac arteries an
examination per rectum will reveal it.
There is one form of aneurism which is not infrequently overlooked,
affecting the anterior mesenteric artery, primarily induced by a
worm--_Strongylus vulgaris_. This worm produces an arteritis, with
atheroma, degeneration, and dilatation of the mesenteric arteries,
associated with thrombus and aneurism. The aneurism gives rise to colic,
which appears periodically in a very violent and often persistent type.
Ordinary colic remedies have no effect, and after a time the animal
succumbs to the disease. In all cases of animals which are habitually
subject to colicky attacks, parasitic aneurism of the anterior
mesenteric artery may be suspected. (See p. 92.)
_Pathology._--Aneurisms may be diffuse or sacculated. The diffuse
consists in a uniform dilatation of all the coats of an artery, so that
it assumes the shape of a cylindrical swelling. The wall of the aneurism
is atheromatous, or calcified; the middle coat may be atrophied. The
sacculated, or circumscribed, aneurism consists either in a dilatation
of the entire circumference of an artery over a short portion of its
length, or in a dilatation of only a small portion of one side of the
wall. Aneurism may become very large; as it increases in size it presses
upon and causes the destruction of neighboring tissues. The cavity of
the aneurismal sac is filled with fluid or clotted blood or with layers
of fibrin which adhere closely to its wall. Death is produced usually by
the pressure and interference of the aneurism with adjoining organs or
by rupture. In worm aneurism we usually find large thrombi within the
aneurismal dilatation of the artery, which sometimes plug the whole
vessel or extend into the aorta. Portions of this thrombus, or clot, may
be washed away and produce embolism of a smaller artery. The effect in
either case is to produce anemia of the intestinal canal, serous or
bloody exudation in its walls, which leads to paralysis of the intestine
and resultant colicky symptoms.
_Treatment._--The only treatment advisable is to extirpate or ligate the
tumor above and below.
RUPTURE OF AN ARTERY.
Endarteritis, with its subsequent changes in the walls of arteries, is
the primary cause of rupture in the majority of instances. The rupture
may be partial, involving only one or two coats, and will then form an
aneurism. If complete, it may produce death when it involves a large
vessel, especially if it is situated in one of the large cavities
permitting an excessive escape of blood. Rupture may be produced by
mechanical violence or accident.
_Symptoms._--In fatal rupture, associated with profuse bleeding, the
animal becomes weak, the visible mucous membranes become blanched, the
breathing hurried or gasping, pupils dilated, staggering in gait,
syncope, death. When the hemorrhage is limited the symptoms may not
become noticeable; if it is near the surface of the body a round or
diffuse swelling or tumor may form, constituting a hygroma. If the
rupture is associated with an external wound, the bleeding artery should
be ligated, or where a bandage is applicable, pressure may be applied
by tight bandaging. As a secondary result of rupture of an artery we may
have formation of abscess, gangrene of a part, etc.
_Treatment._--When rupture of a deep-seated artery is suspected, large
doses of fluid extract of ergot may be given to produce contraction of
the blood vessels. Tannin and iron are also useful. The animal should be
allowed to have as much water as he desires. Afterwards stimulants and
nourishing feed are indicated.
THROMBUS AND EMBOLISM.
By thrombosis is generally understood the partial or complete closure of
a vessel by a morbid product developed at the site of the obstruction.
The coagulum, which is usually fibrinous, is known as a thrombus. The
term "embolism" designates an obstruction caused by any body detached
and transported from the interior of the heart or of some vessel.
Thrombi occur as the result of an injury to the wall of the vessel or
may follow its compression or dilatation; they may result from some
alteration of the wall of the vessel by disease or by the retardation of
the circulation. These formations may occur during life, in the heart,
arteries, veins, or in the portal system. When a portion of fibrin
coagulates in one of the arteries and is carried along by the
circulation, it will be arrested, of course, in the capillaries, if not
before; when in the veins, it may not be stopped until it reaches the
lungs; and when in the portal system the capillaries of the liver will
prevent its further progress. The formation of thrombi may act primarily
by causing partial or complete obstruction, and, secondarily, either by
larger or smaller fragments becoming detached from their end and by
being carried along by the circulation of the blood to remote vessels,
embolism; or by the coagulum becoming softened and converted into pus,
constituting suppurative phlebitis. These substances occur most
frequently in those affections characterized by great exhaustion or
debility, such as pneumonia, purpura hemorrhagica, endocarditis,
phlebitis, puerperal fever, hemorrhages, etc. These concretions may form
suddenly and produce instantaneous death by retarding the blood current,
or they may arise gradually, in which case the thrombi may be organized
and attached to the walls of the heart, or they may soften, and
fragments of them (emboli) may be carried away. The small, wartlike
excrescences occurring sometimes in endocarditis may occasionally form a
foundation on which a thrombi may develop.
_Symptoms._--When heart clot, or thrombus, exists in the right side, the
return of blood from the body and the aeration in the lungs is impeded,
and if death occurs, it is owing to syncope rather than to strangulation
in pulmonary respiration. There will be hurried and gasping breathing,
paleness and coldness of the surface of the body, a feeble and
intermittent or fluttering pulse, and fainting. When a fibrinous
coagulum is carried into the pulmonary artery from the right side of the
heart, the indications are a swelling and infiltration of the lungs and
pulmonary apoplexy. When the clot is situated in the left cavities of
the heart or in the aorta, death, if it occurs, takes place either
suddenly or at the end of a few hours from coma.
_Pathology._--When a coagulum is observed in the heart it may become a
question whether it was formed during life or after death. The loose,
dark coagula so often found after death are polypi. If the deposition
has taken place during the last moments of life, the fibrin will be
isolated and soft, but not adherent to the walls; if it be isolated,
dense, and adherent or closely intertwined with the muscles of the
papillæ and tendinous cords, the deposition has occurred more or less
remote from the act of dying. Occasionally the fibrin may be seen lining
one of the cavities of the heart, like a false endocardium, or else
forming an additional coat to the aorta or other large vessels without
producing much obstruction. Thrombi, in some instances, soften in their
centers, and are then observed to contain a puslike substance. If this
softening has extended considerably, an outer shell, or cyst, only may
remain. The sources of danger exist not only in the interruption of the
circulation of the blood, but also in a morbid state of the system,
produced by the disturbed nutrition of a limb or organ, as well as the
mingling of purulent and gangrenous elements with the blood.
_Treatment._--The urgent symptoms should be relieved by rest,
stimulants, and the use of agents which will act as solvents to the
fibrinous clots. Alkalis are specially useful for this purpose.
Carbonate of ammonia may be administered in all cases of thrombus, and
should be continued for a long time in small doses several times a day.
In cases of great debility associated with a low grade of fever,
stimulants and tonics, and nitro-muriatic acid as an antiseptic, may be
beneficial.
DISEASES OF VEINS, OR PHLEBITIS.
Inflammation of veins may be simple or diffuse. In simple phlebitis the
disease of the vein is confined to a circumscribed or limited portion of
a vein; in diffuse it involves the vein for a long distance; it may even
extend from a limb or foot to the heart.
_Causes._--Phlebitis may be induced by contusions or direct injuries, an
extension of inflammation from surrounding tissue, such as in abscess,
formation of tumor, or malignant growth. It is often due to embolism of
infective material, gangrenous matter, etc. Blood-letting from the
jugular vein is occasionally followed by dangerous phlebitis.
_Symptoms._--The symptoms vary according to the extent and severity of
the inflammation. In most cases the vein is swollen, thickened, and
indurated to such a degree as to resemble an artery. A diffused
swelling, with great tenderness, may extend along the affected vessel
and the animal manifest all the symptoms connected with acute fever and
general functional disturbance.
_Pathology._--The disease is only serious when large veins are affected.
The coats undergo the same changes as in arteritis; clots of blood and
lymph plug the inflamed vessel, and, if the inflammatory process
continues, these are converted into pus, which ruptures the vessel and
produces a deep abscess; or it may be carried away in the circulation
and produce metastatic abscess in the lungs or other remote organs. In
mild cases the clots may become absorbed and the vessel restored to
health. Phlebitis in the course of the veins of the limbs frequently
leads to numerous abscesses, which may be mistaken for farcy
ulcerations. A very common result of phlebitis is an obliteration of the
affected portion of the vein, but as collateral circulation is readily
established this is seldom of any material inconvenience.
_Treatment._--Phlebitis should be treated by the application of a smart
blister along the course of the inflamed vessel; early opening of any
abscesses which may form; the animal should have complete rest, and the
bowels be kept loose with bran mashes. When the fever runs high,
half-ounce doses of nitrate of potassium may be given in the drinking
water, which may be changed in two or three days for 1-dram doses of the
iodid of potassium. If the animal becomes debilitated, carbonate of
ammonia, 1 dram, and powdered gentian, 3 drams, may be given every six
hours.
VARICOSE VEINS, VARIX, OR DILATATION OF VEINS.
This may be a result of weakening of the coats from inflammatory disease
and degeneration. It may also be due to mechanical obstruction from
internal or external sources. It is sometimes found in the vein which
lies superficial over the inside of the hock joint, and may be due to
the pressure of a spavin. Occasionally it may be observed in stallions,
which are more or less subject to varicocele, or dilatation of the veins
of the testicular cord. Hemorrhoidal veins, or piles, are occasionally
met with, generally in horses which run at pasture. Varicose veins may
ulcerate and form an abscess in the surrounding tissues, or they may
rupture from internal blood pressure and the blood form large tumors
where the tissues are soft.
_Treatment._--Stallions which manifest a tendency to varicocele should
wear suspensory bags when they are exercised. Piles may often be reduced
by astringent washes--tea made from white-oak bark or a saturated
solution of alum. The bowels should be kept loose with bran mashes and
the animal kept quiet in the stable. When varicose veins exist
superficially and threaten to produce inconvenience, they may be ligated
above and below and thus obliterated. Sometimes absorption may be
induced by constant bandages.
AIR IN VEINS, OR AIR EMBOLISM.
It was formerly supposed that the entrance of air into a vein at the
time of the infliction of a wound or in blood-letting was extremely
dangerous and very often produced sudden death by interfering with the
circulation of the blood through the heart and lungs. Danger from air
embolism is exceedingly doubtful, unless great quantities were forced
into a large vein by artificial means.
PURPURA HEMORRHAGICA.
Purpura hemorrhagica usually occurs as a sequel to debilitating
diseases, such as strangles, influenza, etc. It may, however, arise in
the absence of any previous disease in badly ventilated stables, among
poorly fed horses, and in animals subject to exhausting work and extreme
temperatures. The disease is probably due to some as yet undiscovered
infectious principle. Its gravity does not depend so much upon the
amount of blood extravasated as it does upon the disturbance or
diminished action of the vasomotor centers.
_Symptoms._--This disease becomes manifested by the occurrence of sudden
swellings on various parts of the body, on the head or lips, limbs,
abdomen, etc. These swellings may be diffused or very markedly
circumscribed, though in the advanced stages they cover large areas.
They pit on pressure and are but slightly painful to the touch. The
limbs may swell to a very large size, the nostrils may become almost
closed, and the head and throat may swell to the point of suffocation.
The swellings not infrequently disappear from one portion of the body
and develop on another, or may recede from the surface and invade the
intestinal mucous membrane. The mucous lining of the nostrils and mouth
show more or less dark-red or purple spots. There may be a discharge of
blood-colored serum from the nostrils; the tongue may be swollen so as
to prevent eating or closing of the jaws. In the most intense cases,
within from twenty-four to forty-eight hours bloody serum may exude
through the skin over the swollen parts, and finally large gangrenous
sloughs may form. The temperature is never very high, the pulse is
frequent and compressible, and becomes feebler as the animal loses
strength. A cough is usually present. The urine is scanty and high
colored, and when the intestines are much affected a bloody diarrhea may
set in, with colicky pains. Some of the internal organs become
implicated in the disease, the lungs may become edematous, extravasation
may occur in the intestinal canal, or effusion of serum into the cavity
of the chest or abdomen; occasionally the brain becomes affected. A few
cases run a mild course and recovery may commence in three or four days;
generally, however, the outlook is unfavorable. In severe cases septic
poisoning is liable to occur, which soon brings the case to a fatal
issue.
_Pathology._--On section we find the capillaries dilated, the connective
tissue filled with a coagulable or coagulated lymph, and frequently we
may discover gangrenous spots beneath the skin or involving the skin.
The lymphatic glands are swollen and inflamed. Extensive extravasations
of blood may be found embedded between the coats of the intestines, or
excessive effusion into the substance of the lungs.
_Treatment._--Diffusible stimulants and tonics should be given from the
start. Carbonate of ammonia, 1 dram, fluid extract of red cinchona bark,
2 drams, and tincture of ginger half an ounce, with half a pint of
water; thin gruel or milk should be given every four or six hours. But
especial care should be exercised to avoid injury by drenching. If the
horse has difficulty in getting the head up and swallowing, smaller
doses must be given with a small hard-rubber syringe. Sulphate of iron
in 1-dram doses may be dissolved in water and given every six hours.
Chlorate of potassium, in 2-ounce doses, may be given every eight or
twelve hours. Colloidal silver may be administered intravenously in
doses of from 5 to 12 grains. Washings with lead and alum water are
useful and may be repeated several times each day. If the swellings are
very great, they may be incised freely and the resulting wounds should
be washed at least twice daily with a warm 3 per cent solution of
carbolic acid or other good antiseptic. Tracheotomy may be necessary.
Complications, when they arise, must be treated with proper
circumspection.
DISEASES OF THE LYMPHATIC SYSTEM.
The lymphatic, or absorbent, system is connected with the blood-vascular
system, and consists of a series of tubes which absorb and convey to the
blood certain fluids. These tubes lead to lymphatic glands, through
which the fluids pass to reach the right lymphatic vein and thoracic
duct, both of which enter the venous system near the heart. Through the
excessively thin walls of the capillaries the fluid part of the blood
transudes to nourish the tissues outside the capillaries; at the same
time fluid passes from the tissues into the blood. The fluid, after it
passes into the tissues, constitutes the lymph, and acts like a stream
irrigating the tissue elements. Much of the surplus of this lymph passes
into the lymph vessels, which in their commencement can hardly be
treated as independent structures, since their walls are so closely
joined with the tissues through which they pass, being nothing more
than spaces in the connective tissue until they reach the larger lymph
vessels, which finally empty into lymph glands. These lymph glands are
structures so placed that the lymph flowing toward the larger trunks
passes through them, undergoing a sort of filtration. From the fact of
this arrangement lymph glands are subject to inflammatory diseases in
the vicinity of diseased structures, because infective material being
conveyed in the lymph stream lodges in the glands and produces
irritation.
LOCAL INFLAMMATION AND ABSCESS OF LYMPHATIC GLANDS.
Acute inflammation of the lymph glands usually occurs in connection with
some inflammatory process in the region from which its lymph is
gathered. Several or all of the glands in a cluster may become affected,
as in strangles, nasal catarrh, or nasal gleet, diseased or ulcerated
teeth, the lymph glands between the branches of the lower jaw almost
invariably become affected, which may lead to suppuration or induration.
Similar results obtain in other portions of the body; in pneumonia the
bronchial glands become affected; in pharyngitis the postpharyngeal
glands lying above the trachea become affected, etc.
_Symptoms._--The glands swell and become painful to the touch, the
connective tissue surrounding them becomes involved, suppuration usually
takes place, and one or more abscesses form. If the inflammation is of a
milder type, resolution may take place and the swelling recede, the
exudative material being absorbed, and the gland restored without the
occurrence of suppuration. In the limbs a whole chain of the glands
along the lymphatic vessels may become affected, as in farcy, phlebitis,
or septic poisoning.
_Treatment._--Fomentation with hot water and the application of
camphorated soap liniment or camphorated oil may produce a revulsive
action and prevent suppuration. If there is any indication of abscess
forming, poultices of linseed meal and bran made into a paste with hot
water should be applied, or a mild blistering ointment rubbed in over
the swollen gland. As soon as fluctuation can be felt a free opening
must be made for the escape of the contained pus. The wound may
subsequently be washed out with a solution of chlorid of zinc, 5 grains
to the ounce of water, three times a day.
LYMPHANGITIS.
Specific inflammation of the lymphatic structures usually affects the
hind legs; very seldom a fore leg. This disease is very sudden in its
attack, exceedingly painful, accompanied by a high temperature and great
general disturbance.
_Causes._--Horses of lymphatic or sluggish temperament are predisposed
to this affection. It usually attacks well-fed animals, and in such
cases may be due to an excess of nutritive elements in the blood. Sudden
changes in work or in the habits of the animal may induce an attack.
_Symptoms._--It is usually ushered in by a chill, rise in temperature,
and some uneasiness; in a very short time this is followed by lameness
in one leg and swelling on the inside of the thigh. The swelling
gradually surrounds the whole limb and continues on downward until it
reaches the foot. The limb is excessively tender to the touch, the
animal perspires, the breathing is accelerated, pulse hard and quick,
and the temperature may reach 106° F. The bowels early become very
constipated and urine scanty. The symptoms usually are on the increase
for about two days, then they remain stationary for the same length of
time; the fever then abates; the swelling recedes and becomes less
painful. It is very seldom, though, that all the swelling leaves the
leg; generally it leaves some permanent enlargement, and the animal
becomes subject to recurrent attacks. Occasionally the inguinal
lymphatic glands (in the groin) undergo suppuration, and pyemia may
supervene and prove fatal. In severe cases the limb becomes denuded of
hair in patches, and the skin remains indurated with a fibrous growth,
which is known by the name of elephantiasis.
_Treatment._--The parts should be bathed freely and frequently with
water as hot as the hand can bear and then fomented with vinegar and
water, equal parts, to which add 2 ounces of nitrate of potassium for
each gallon. This should be applied frequently, after the hot water, for
the first day. Afterwards the leg may be dried with a woolen cloth and
bathed with camphorated soap liniment. Internally administer artificial
Carlsbad salts in 2 to 4 ounce doses three times daily. Feed lightly and
give complete rest. This treatment, if instituted early in the attack,
very frequently brings about a remarkable change within 24 hours.
DISEASES OF THE EYE.
BY JAMES LAW, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., Cornell University_.
We can scarcely overestimate the value of sound eyes in the horse, and
hence all diseases and injuries which seriously interfere with vision
are matters of extreme gravity and apprehension, for should they prove
permanent they invariably depreciate the selling price to a considerable
extent. A blind horse is always dangerous in the saddle or in single
harness, and he is scarcely less so when, with partially impaired
vision, he sees things imperfectly, in a distorted form or in a wrong
place, and when he shies or avoids objects which are commonplace or
familiar. When we add to this that certain diseases of the eyes, like
recurring inflammation (moon blindness), are habitually transmitted from
parent to offspring, we can realize still more fully the importance of
these maladies. Again, as a mere matter of beauty, a sound, full, clear,
intelligent eye is something which must always add a high value to our
equine friends and servants.
STRUCTURE OF THE EYE.
(Pl. XXII.)
THE EYEBALL.
A full description of the structure of the eye is incompatible with our
prescribed limits, and yet a short description is absolutely essential
to the clear understanding of what is to follow.
The horse's eye is a spheroidal body, flattened behind, and with its
posterior four-fifths inclosed by an opaque, white, strong fibrous
membrane (the sclerotic), on the inner side of which is laid a more
delicate, friable membrane, consisting mainly of blood vessels and
pigment cells (the choroid), which in its turn is lined by the extremely
delicate and sensitive expansion of the nerve of sight (the retina). The
anterior fifth of the globe of the eye bulges forward from what would
have been the direct line of the sclerotic, and thus forms a segment of
a much smaller sphere than is inclosed by the sclerotic. Its walls, too,
have in health a perfect translucency, from which it has derived the
name of transparent cornea. This transparent coat is composed, in the
main, of fibers with lymph interspaces, and it is to the condition of
these and their condensation and compression that the translucency is
largely due. This may be shown by compressing with the fingers the eye
of an ox which has just been killed, when the clear transparent cornea
will suddenly become clouded over with a whitish-blue opacity, and this
will remain until the compression is interrupted. The interior of the
eye contains three transparent media for the refraction of the rays of
light on their way from the cornea to the visual nerve. Of these media
the anterior one (aqueous humor) is liquid, the posterior (vitreous
humor) is semisolid, and the intermediate one (crystalline lens) is
solid. The space occupied by the aqueous humor corresponds nearly to the
portion of the eye covered by the transparent cornea. It is, however,
divided into two chambers, anterior and posterior, by the iris, a
contractile curtain with a hole in the center (the pupil), and which may
be looked on as in some sense a projection inward of the vascular and
pigmentary coat from its anterior margin at the point where the
sclerotic or opaque outer coat becomes continuous with the cornea or
transparent one. This iris, or curtain, besides its abundance of blood
vessels and pigment, possesses two sets of muscular fibers, one set
radiating from the margin of the pupil to the outer border of the
curtain at its attachment to the sclerotic and choroid, and the other
encircling the pupil in the manner of a ring. The action of the two sets
is necessarily antagonistic, the radiating fibers dilating the pupil and
exposing the interior of the eye to view, while the circular fibers
contract this opening and shut out the rays of light. The form of the
pupil in the horse is ovoid, with its longest diameter from side to
side, and its upper border is fringed by several minute, black bodies
(corpora nigra) projecting forward and serving to some extent the
purpose of eyebrows in arresting and absorbing the excess of rays of
light which fall upon the eye from above. These pigmentary projections
in front of the upper border of the pupil are often mistaken for the
products of disease or injury in place of the normal and beneficent
protectors of the nerve of sight which they are. Like all other parts,
they may become the seat of disease, but so long as they and the iris
retain their clear, dark, aspect, without any tints of brown or yellow,
they may be held to be healthy.
The vitreous or semisolid refracting medium occupies the posterior part
of the eye--the part corresponding to the sclerotic, choroid, and
retina--and has a consistency corresponding to that of the white of an
egg, and a power of refraction of the light rays correspondingly greater
than the aqueous humor.
The third or solid refracting medium is a biconvex lens, with its
convexity greatest on its posterior surface, which is lodged in a
depression in the vitreous humor, while its anterior surface corresponds
to the opening of the pupil. It is inclosed in a membranous covering
(capsule) and is maintained in position by a membrane (suspensory
ligament) which extends from the margin of the lens outward to the
sclerotic at the point of junction of the choroid and iris. This
ligament is, in its turn, furnished with radiating, muscular fibers,
which change the form or position of the lens so as to adapt it to see
with equal clearness objects at a distance or close by.
Another point which strikes the observer of the horse's eye is that in
the darkness a bright, bluish tinge is reflected from the widely dilated
pupil. This is owing to a comparative absence of pigment in the choroid
coat inside the upper part of the eyeball, and enables the animal to see
and advance with security in darkness where the human eye would be of
little use. The lower part of the cavity of the horse's eye, into which
the dazzling rays fall from the sky, is furnished with an intensely
black lining, by which the rays penetrating the inner nervous layer are
instantly absorbed.
MUSCLES OF THE EYE.
These consist of four straight muscles, two oblique, and one retractor.
The straight muscles pass from the depth of the orbit forward on the
inner, outer, upper, and lower sides of the eyeball, and are fixed to
the anterior portion of the fibrous (sclerotic) coat, so that in
contracting singly they respectively turn the eye inward, outward,
upward, and downward. When all act together they draw the eyeball deeply
into its socket. The retractor muscle also consists of four muscular
slips, repeating the straight muscles on a smaller scale, but as they
are only attached on the back part of the eyeball they are less adapted
to roll the eye than to draw it down into its socket. The two oblique
muscles rotate the eye on its own axis, the upper one turning its outer
surface upward and inward, and the lower one turning it downward and
inward.
THE HAW (THE WINKING CARTILAGE, OR CARTILAGO NICTITANS).
This is a structure which, like the retractor muscle, is not found in
the eye of man, but it serves in the lower animals to assist in removing
foreign bodies from the front of the eyeball. It consists, in the horse,
of a cartilage of irregular form, thickened inferiorly and posteriorly
where it is intimately connected with the muscles of the eyeball and the
fatty material around them, and expanded and flattened anteriorly where
its upper surface is concave, and, as it were, molded on the lower and
inner surface of the eyeball. Externally it is covered by the mucous
membrane which lines the eyelids and extends over the front of the eye.
In the ordinary restful state of the eye the edge of this cartilage
should just appear as a thin fold of membrane at the inner angle of the
eye, but when the eyeball is drawn deeply into the orbit the cartilage
is pushed forward, outward, and upward over it until the entire globe
may be hidden from sight. This protrusion of the cartilage so as to
cover the eye may be induced in the healthy eye by pressing the finger
and thumb on the upper and lower lids, so as to cause retraction of the
eyeball into the socket. When foreign bodies, such as sand, dust, and
chaff, or other irritants, have fallen on the eyeball or eyelids it is
similarly projected to push them off, their expulsion being further
favored by a profuse flow of tears.
[Illustration: PLATE XXII.
DIAGRAMMATIC VERTICAL SECTION THROUGH HORSE'S EYE.]
This is seen, to a lesser extent, in all painful inflammations of the
eye, and to a very marked degree in lockjaw, when the spasm of the
muscles of the eyeball draws the latter deeply into the orbit and
projects forward the masses of fat and the cartilage. The brutal
practice of cutting off this apparatus whenever it is projected
necessitates this explanation, which it is hoped may save to many a
faithful servant a most valuable appendage. That the cartilage and
membrane may become the seat of disease is undeniable, but so long as
its edge is thin and even and its surface smooth and regular the mere
fact of its projection over a portion or the whole of the eyeball is no
evidence of disease in its substance, nor any warrant for its removal.
It is usually but the evidence of the presence of some pain in another
part of the eye, which the suffering animal endeavors to assuage by the
use of this beneficent provision. For the diseases of the cartilage
itself, see "Encephaloid cancer."
LACRIMAL APPARATUS.
This consists, first, of a gland for the secretion of the tears, and,
second, of a series of canals for the conveyance of the superfluous
tears into the cavity of the nose.
The gland is situated above the outer part of the eyeball, and the tears
which have flowed over the eye and reached the inner angle are there
directed by a small, conical papilla (lacrimal caruncle) into two minute
orifices, and thence by two ducts (lacrimal) to a small pouch (lacrimal
sac) from which a canal leads through the bones of the face into the
nose. This opens in the lower part of the nose on the floor of the
passage and a little outside the line of union of the skin which lines
the false nostril with the mucous membrane of the nose. In the ass and
mule this opening is situated on the roof instead of the floor of the
nose, but still close to the external opening.
EXAMINATION OF THE EYE.
To avoid unnecessary repetition the following general directions are
given for the examination of the eye: The eye, and to a certain extent
the mucous membrane lining the eyelids, may be exposed to view by gently
parting the eyelids with the thumb and forefinger pressed on the middle
of the respective lids. The pressure, it is true, causes the protrusion
of the haw over a portion of the lower and inner part of the eye, but by
gentleness and careful graduation of the pressure this may be kept
within bounds, and oftentimes even the interior of the eye can be seen.
As a rule it is best to use the right hand for the left eye, and the
left hand for the right, the finger in each case being pressed on the
upper lid while the thumb depresses the lower one. In cases in which it
is desirable to examine the inner side of the eyelid further than is
possible by the above means, the upper lid may be drawn down by the
eyelashes with the one hand and then everted over the tip of the
forefinger of the other hand, or over a probe laid flat against the
middle of the lid. When the interior of the eye must be examined it is
useless to make the attempt in the open sunshine or under a clear sky.
The worst cases, it is true, can be seen under such circumstances, but
for the slighter forms the horse should be taken indoors, where all
light from above will be shut off, and should be placed so that the
light may fall on the eye from the front and side. Then the observer,
placing himself in front of the animal, will receive the reflected rays
from the cornea, the front of the lens and the back, and can much more
easily detect any cloudiness, opacity, or lack of transparency. The
examination can be made much more satisfactory by placing the horse in a
dark chamber and illuminating the eye by a lamp placed forward and
outward from the eye which is to be examined. Any cloudiness is thus
easily detected, and any doubt may be resolved by moving the lamp so
that the image of the flame may be passed in succession over the whole
surface of the transparent cornea and of the crystalline lens. Three
images of the flame will be seen, the larger one upright, reflected from
the anterior surface of the eye; a smaller one upright, reflected from
the anterior surface of the lens; and a second small one inverted from
the back surface of the lens.
So long as these images are reflected from healthy surfaces they will be
clear and perfect in outline, but as soon as one strikes on an area of
opacity it will become diffused, cloudy, and indefinite. Thus, if the
large, upright image becomes hazy and imperfect over a particular spot
of the cornea, that will be found to be the seat of disease and opacity.
Should the large image remain clear, but the small upright one become
diffuse and indefinite over a given point, it indicates opacity on the
front of the capsule of the lens. If both upright images remain clear
while the inverted one becomes indistinct at a given point, then the
opacity is in the substance of the lens itself or in the posterior part
of its capsule.
If in a given case the pupil remains so closely contracted that the
deeper parts of the eye can not be seen, the eyelids may be rubbed with
extract of belladonna, and in a short time the pupil will be found
widely dilated.
DISEASES OF THE EYELIDS.
CONGENITAL DISORDERS.
Some faulty conditions of the eyelids are congenital, as division of an
eyelid in two, after the manner of harelip, abnormally small opening
between the lids, often connected with imperfect development of the eye,
and closure of the lids by adhesion. The first is to be remedied by
paring the edges of the division and then bringing them together, as in
torn lids. The last two, if remediable at all, require separation by the
knife, and subsequent treatment with a cooling astringent eyewash.
NERVOUS DISORDERS.
SPASM OF EYELIDS may be owing to constitutional susceptibility, or to
the presence of local irritants (insects, chemical irritants, sand,
etc.) in the eye, to wounds or inflammation of the mucous membrane, or
to disease of the brain. When due to local irritation it may be
temporarily overcome by instilling a few drops of a 4 per cent solution
of cocaine into the eye, when the true cause may be ascertained and
removed. The nervous or constitutional disease must be treated according
to its nature.
DROOPING EYELIDS, OR PTOSIS.--This is usually present in the upper lid,
or is at least little noticed in the lower. It is sometimes but a
symptom of paralysis of one-half of the face, in which case the ear,
lips, and nostrils on the same side will be found soft, drooping, and
inactive, and even the half of the tongue may partake of the palsy. If
the same condition exists on both sides, there is difficult, snuffling
breathing, from the air drawing in the flaps of the nostrils in
inspiration, and all feed is taken in by the teeth, as the lips are
useless. In both there is a free discharge of saliva from the mouth
during mastication. This paralysis is a frequent result of injury, by a
poke, to the seventh nerve, as it passes over the back of the lower jaw.
In some cases the paralysis is confined to the lid, the injury having
been sustained by the muscles which raise it, or by the supraorbital
nerve, which emerges from the bone just above the eye. Such injury to
the nerve may have resulted from fracture of the orbital process of the
frontal bone above the eyeball.
The condition may, however, be due to spasm of the sphincter muscle,
which closes the lids, or to inflammation of the upper lid, usually a
result of blows on the orbit. In the latter case it may run a slow
course with chronic thickening of the lid.
The paralysis due to the poke may be often remedied, first, by the
removal of any remaining inflammation by a wet sponge worn beneath the
ear and kept in place by a bandage; secondly, when all inflammation has
passed, by a blister on the same region, or by rubbing it daily with a
mixture of olive oil and strong aqua ammonia in equal proportions.
Improvement is usually slow, and it may be months before complete
recovery ensues.
In paralysis from blows above the eyes the same treatment may be applied
to that part.
Thickening of the lid may be treated by painting with tincture of iodin,
and that failing, by cutting out an elliptical strip of the skin from
the middle of the upper lid and stitching the edges together.
INFLAMMATION OF THE EYELIDS.
The eyelids suffer more or less in all severe inflammations of the eye,
whether external or internal, but inasmuch as the disease sometimes
starts in the lids and at other times is exclusively confined to them,
it deserves independent mention.
Among the causes may be named: Exposure to drafts of cold air, or to
cold rain or snow storms; the bites or stings of mosquitoes, flies, or
other insects; snake bites, pricks with thorns, blows of whip or club;
accidental bruises against the stall or ground, especially during the
violent struggles of colic, enteritis, phrenitis (staggers), and when
thrown for operations. It is also a result of infecting inoculations, as
of erysipelas, anthrax, boil, etc., and is noted by Leblanc as
especially prevalent among horses kept on low, marshy pastures. Finally,
the introduction of sand, dust, chaff, beards of barley and seeds of the
finest grasses, and the contact with irritant, chemical powders,
liquids, and gases (ammonia from manure or factory, chlorin, strong
sulphur fumes, smoke, and other products of combustion, etc.) may start
the inflammation. The eyelids often undergo extreme inflammatory and
dropsical swelling in urticaria (nettlerash, surfeit) and in the general
inflammatory dropsy known as purpura hemorrhagica.
The affection will, therefore, readily divide itself into (1)
inflammations due to constitutional causes; (2) those due to direct
injury, mechanical or chemical; and (3) such as are due to inoculation
with infecting material.
(1) Inflammations due to constitutional causes are distinguished by the
absence of any local wound, and the history of a low, damp pasture,
exposure, indigestion from unwholesome feed, or the presence elsewhere
on the limbs or body of the general, doughy swellings of purpura
hemorrhagica. The lids are swollen and thickened; it may be slightly or
it may be so extremely that the eyeball can not be seen. If the lid can
be everted to show its mucous membrane, that is seen to be of a deep-red
color, especially along the branching lines of the blood vessels. The
part is hot and painful, and a profuse flow of tears and mucus escapes
on the side of the face, causing irritation and loss of the hair. If
improvement follows, this discharge becomes more tenacious, and tends to
cause adhesion to the edges of the upper and lower lids and to mat
together the eyelashes in bundles. This gradually decreases to the
natural amount, and the redness and congested appearance of the eye
disappears, but swelling, thickening, and stiffness of the lids may
continue for a time. There may be more or less fever according to the
violence of the inflammation, but so long as there is no serious disease
of the interior of the eye or of other vital organ, it is usually
moderate.
The local treatment consists in astringent, soothing lotions (sugar of
lead 30 grains, laudanum 2 teaspoonfuls, rain water--boiled and
cooled--1 pint), applied with a soft cloth kept wet with the lotion, and
hung over the eye by tying it to the headstall of the bridle on the two
sides. If the mucous membrane lining of the lids is the seat of little
red granular elevations, a drop of solution of 2 grains of nitrate of
silver in an ounce of distilled water should be applied with the soft
end of a clean feather to the inside of the lid twice a day. The patient
should be removed from all such conditions (pasture, faulty feed,
exposure, etc.) as may have caused or aggravated the disease, and from
dust and irritant fumes and gases. He should be fed from a manger high
enough to favor the return of blood from the head, and should be kept
from work, especially in a tight collar which would prevent the descent
of blood by the jugular veins. The diet should be laxative and
nonstimulating (grass, bran mashes, carrots, turnips, beets, potatoes,
or steamed hay), and any costiveness should be corrected by a mild dose
of raw linseed oil (1 to 1-1/2 pints). In cold weather warm blanketing
may be needful, and even loose flannel bandages to the limbs, but heat
should never be sought at the expense of pure air.
(2) In inflammations due to local irritants of a noninfective kind a
careful examination will usually reveal their presence, and the first
step must be their removal with a pair of blunt forceps or the point of
a lead pencil. Subsequent treatment will be in the main the local
treatment advised above.
(3) In case of infective inflammation there will often be found a prick
or tear by which the septic matter has entered, and in such case the
inflammation will for a time be concentrated at that point. A round or
conical swelling around an insect bite is especially characteristic. A
snake bite is marked by the double prick made by the two teeth and by
the violent and rapidly spreading inflammation. Erysipelas is attended
with much swelling, extending beyond the lids and causing the mucous
membrane to protrude beyond the edge of the eyelid (chemosis). This is
characterized by a bright, uniform, rosy red, disappearing on pressure,
or later by a dark, livid hue, but with less branching redness than in
noninfecting inflammation and less of the dark, dusky, brownish or
yellowish tint of anthrax. Little vesicles may appear on the skin, and
pus may be found without any distinct limiting membrane, as in abscess.
It is early attended with high fever and marked general weakness and
inappetence. Anthrax of the lids is marked by a firm swelling,
surmounted by a blister, with bloody serous contents, which tends to
burst and dry up into a slough, while the surrounding parts become
involved in the same way. Or it may show as a diffuse, dropsical
swelling, with less of the hard, central sloughing nodule, but, like
that, tending to spread quickly. In both cases alike the mucous membrane
and the skin, if white, assumes a dusky-brown or yellowish-brown hue,
which is largely characteristic. This may pass into a black color by
reason of extravasation of blood. Great constitutional disturbance
appears early, with much prostration and weakness and generalized
anthrax symptoms.
_Treatment._--The treatment will vary according to the severity. Insect
bites may be touched with a solution of equal parts of glycerin and aqua
ammonia, or a 10 per cent solution of carbolic acid in water. Snake
bites may be bathed with aqua ammonia, and the same agent given in doses
of 2 teaspoonfuls in a quart of water, or alcohol may be given in pint
or quart doses, according to the size of the animal. In erysipelas the
skin may be painted with tincture of chlorid of iron, or with a solution
of 20 grains of iodin in an ounce of carbolic acid, and one-half an
ounce of tincture of chlorid of iron may be given thrice daily in a
bottle of water. In anthrax the swelling should be painted with tincture
of iodin, or of the mixture of iodin and carbolic acid, and if very
threatening it may have the tincture of iodin injected into the swelling
with a hypodermic syringe, or the hard mass may be freely incised to its
depth with a sharp lancet and the lotion applied to the exposed tissues.
Internally, iodid of potassium may be given in doses of 2 drams thrice a
day, or tincture of the chlorid of iron every four hours.
STY, OR FURUNCLE (BOIL) OF THE EYELID.
This is an inflammation of limited extent, advancing to the formation of
matter and the sloughing out of a small mass of the natural tissue of
the eyelid. It forms a firm, rounded swelling, usually near the margin
of the lid, which suppurates and bursts in four or five days. Its course
may be hastened by a poultice of camomile flowers, to which have been
added a few drops of carbolic acid, the whole applied in a very thin
muslin bag. If the swelling is slow to open after having become
yellowish white, it may be opened by a lancet, the incision being made
at right angles to the margin of the lid.
ENTROPION AND ECTROPION, OR INVERSION AND EVERSION OF THE EYELID.
These are respectively caused by wounds, sloughs, ulcers, or other
causes of loss of substance of the mucous membrane on the inside of the
lid and of the skin on the outside; also of tumors, skin diseases, or
paralysis which leads to displacement of the margin of the eyelid. As a
rule, they require a surgical operation, with removal of an elliptical
portion of the mucous membrane or skin, as the case may be, but which
requires the skilled and delicate hand of the surgeon.
TRICHIASIS.
This consists in the turning in of the eyelashes so as to irritate the
front of the eye. If a single eyelash, it may be snipped off with
scissors close to the margin of the eyelid or pulled out by the root
with a pair of flat-bladed forceps. If the divergent lashes are more
numerous, the treatment may be as for entropion, by excising an
elliptical portion of skin opposite the offending lashes and stitching
the edges together, so as to draw outward the margin of the lid at that
point.
WARTS AND OTHER TUMORS OF THE EYELIDS.
The eyelids form a favorite site for tumors, and above all, warts, which
consist in a simple diseased overgrowth (hypertrophy) of the surface
layers of the skin. If small, they may be snipped off with scissors or
tied around the neck with a stout, waxed thread and left to drop off,
the destruction being completed, if necessary, by the daily application
of a piece of sulphate of copper (blue vitriol), until any unhealthy
material has been removed. If more widely spread, the wart may still be
clipped off with curved scissors or knife, and the caustic thoroughly
applied day by day.
A bleeding wart, or erectile tumor, is more liable to bleed, and is best
removed by constricting its neck with the waxed cord or rubber band, or
if too broad it may be transfixed through its base by a needle armed
with a double thread, which is then to be cut in two and tied around the
two portions of the neck of the tumor. If still broader, the armed
needle may be carried through the base of the tumor at regular
intervals, so that the whole may be tied in moderately sized sections.
In gray and in white horses black, pigmentary tumors (melanotic) are
common on the black portions of skin, such as the eyelids, and are to be
removed by scissors or knife, according to their size. In the horse they
do not usually tend to recur when thoroughly removed, but at times they
prove cancerous (as is the rule in man), and then they tend to reappear
in the same site or in internal organs with, it may be, fatal effect.
Encysted, honeylike (melicerous), sebaceous, and fibrous tumors of the
lids all require removal with the knife.
TORN EYELIDS OR WOUNDS OF EYELIDS.
The eyelids are torn by attacks with horns of cattle, or with the teeth,
or by getting caught on nails in stall, rack, or manger, on the point of
stumps, fences, or fence rails, on the barbs of wire fences, and on
other pointed bodies. The edges should be brought together as promptly
as possible, so as to effect union without the formation of matter,
puckering of the skin, and unsightly distortions. Great care is
necessary to bring the two edges together evenly without twisting or
puckering. The simplest mode of holding them together is by a series of
sharp pins passed through the lips of the wound at intervals of not more
than a third of an inch, and held together by a thread twisted around
each pin in the form of the figure 8, and carried obliquely from pin to
pin in two directions, so as to prevent gaping of the wound in the
intervals. The points of the pins may then be cut off with scissors, and
the wound may be wet twice a day with a weak solution of carbolic acid.
TUMOR OF THE HAW, OR CARIES OF THE CARTILAGE.
Though cruelly excised for alleged "hooks," when itself perfectly
healthy, in the various diseases which lead to retraction of the eye
into its socket, the haw may, like other bodily structures, be itself
the seat of actual disease. The pigmentary, black tumors of white horses
and soft (encephaloid) cancer may attack this part primarily or extend
to it from the eyeball or eyelids; hairs have been found growing from
its surface, and the mucous membrane covering it becomes inflamed in
common with that covering the front of the eye. These inflammations are
but a phase of the inflammation of the external structures of the eye,
and demand no particular notice nor special treatment. The tumors lead
to such irregular enlargement and distortion of the haw that the
condition is not to be confounded with the simple projection of the
healthy structure over the eye when the lids are pushed apart with the
finger and thumb, and the same remark applies to the ulceration, or
caries, of the cartilage. In the latter case, besides the swelling and
distortion of the haw, there is this peculiarity, that in the midst of
the red inflamed mass there appears a white line or mass formed by the
exposed edge of the ulcerating cartilage. The animal having been thrown
and properly fixed, an assistant holds the eyelids apart while the
operator seizes the haw with forceps or hook and carefully dissects it
out with blunt-pointed scissors. The eye is then covered with a cloth,
kept wet with an eyewash, as for external ophthalmia.
OBSTRUCTION OF THE LACRIMAL APPARATUS, OR WATERING EYE.
The escape of tears on the side of the cheek is a symptom of external
inflammation of the eye, but it may also occur from any disease of the
lacrimal apparatus which interferes with the normal progress of the
tears to the nose; hence, in all cases when this symptom is not attended
with special redness or swelling of the eyelids, it is well to examine
the lacrimal apparatus. In some instances the orifice of the lacrimal
duct on the floor of the nasal chamber and close to its anterior outlet
will be found blocked by a portion of dry mucopurulent matter, on the
removal of which tears may begin to escape. This implies an inflammation
of the canal, which may be helped by occasional sponging out of the nose
with warm water, and the application of the same on the face. Another
remedy is to feed warm mashes of wheat bran from a nosebag, so that the
relaxing effects of the water vapor may be secured.
The two lacrimal openings, situated at the inner angle of the eye, may
fail to admit the tears by reason of their deviation outward in
connection with the eversion of the lower lid or by reason of their
constriction in inflammation of the mucous membrane. The lacrimal sac,
into which the lacrimal ducts open, may fail to discharge its contents
by reason of constriction or closure of the duct leading to the nose,
and it then forms a rounded swelling beneath the inner angle of the eye.
The duct leading from the sac to the nose may be compressed or
obliterated by fractures of the bones of the face, and in disease of
these bones (osteosarcoma, so-called osteoporosis, diseased teeth,
glanders of the nasal sinuses, abscess of the same cavities).
The narrowed or obstructed ducts may be made pervious by a fine, silver
probe passed down to the lacrimal sac, and any existing inflammation of
the passages may be counteracted by the use of steaming mashes of wheat
bran, by fomentations or wet cloths over the face, and even by the use
of astringent eyewashes and the injection of similar liquids into the
lacrimal canal from its nasal opening. The ordinary eyewash may be used
for this purpose, or it may be injected after dilution to half its
strength. The fractures and diseases of the bones and teeth must be
treated according to their special demands when, if the canal is still
left pervious, it may be again rendered useful.
EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS.
In inflammation of the outer parts of the eyeball the exposed vascular
and sensitive mucous membrane (conjunctiva) which covers the ball, the
eyelids, the haw, and the lacrimal apparatus, is usually the most deeply
involved, yet adjacent parts are more or less implicated, and when
disease is concentrated on these contiguous parts it constitutes a
phase of external opththalmia which demands a special notice. These have
accordingly been already treated of.
_Causes._--The causes of external opththalmia are mainly those that act
locally--blows with whips, clubs, and twigs, the presence of foreign
bodies, like hayseed, chaff, dust, lime, sand, snuff, pollen of plants,
flies attracted by the brilliancy of the eye, wounds of the bridle, the
migration of the scabies (mange) insect into the eye, smoke, ammonia
arising from the excretions, irritant emanations from drying marshes,
etc. Road dust containing infecting microbes is a common factor. A very
dry air is alleged to act injuriously by drying the eye as well as by
favoring the production of irritant dust; the undue exposure to bright
sunshine through a window in front of the stall, or to the reflection
from snow or water, also is undoubtedly injurious. The unprotected
exposure of the eyes to sunshine through the use of a very short
overdraw check is to be condemned, and the keeping of the horse in a
very dark stall, from which it is habitually led into the glare of full
sunlight, intensified by reflection from snow or white limestone, must
be set down among the locally acting causes. Exposure to cold and wet,
to wet and snow storms, to cold drafts and wet lairs must also be
accepted as causes of conjunctivitis, the general disorder which they
produce affecting the eye, if that happens to be the weakest and most
susceptible organ of the body, or if it has been subjected to any
special local injury, like dust, irritant gases, or excess of light.
Again, external opththalmia is a constant concomitant of inflammation of
the contiguous and continuous mucous membranes, as those of the nose and
throat--hence the red, watery eyes that attend on nasal catarrh, sore
throat, influenza, strangles, nasal glanders, and the like. In such
cases, however, the affection of the eye is subsidiary and is manifestly
overshadowed by the primary and predominating disease.
_Symptoms._--The symptoms are watering of the eye, swollen lids, redness
of the mucous membrane exposed by the separation of the lids--it may be
a mere pink blush with more or less branching redness, or it may be a
deep, dark red, as from effusion of blood--and a bluish opacity of the
cornea, which is normally clear and translucent. Except when resulting
from wounds and actual extravasation of blood, however, the redness is
seen to be superficial, and if the opacity is confined to the edges, and
does not involve the entire cornea, the aqueous humor behind is seen to
be still clear and limpid. The fever is always less severe than in
internal ophthalmia, and runs high only in the worst cases. The eyelids
may be kept closed, the eyeball retracted, and the haw protruded over
one-third or one-half of the ball, but this is due to the pain only and
not to any excessive sensibility to light, as shown by the comparatively
widely dilated pupil. In internal ophthalmia, on the contrary, the
narrow, contracted pupil is the measure of the pain caused by the
falling of light on the inflamed and sensitive optic nerve (retina) and
choroid.
If the affection has resulted from a wound of the cornea, not only is
that the point of greatest opacity, forming a white speck or fleecy
cloud, but too often blood vessels begin to extend from the adjacent
vascular covering of the eye (sclerotic) to the white spot, and that
portion of the cornea is rendered permanently opaque. Again, if the
wound has been severe, though still short of cutting into the anterior
layers of the cornea, the injury may lead to ulceration that may
penetrate more or less deeply and leave a breach in the tissue which, if
filled up at all, is repaired by opaque fibrous tissue in place of the
transparent cellular structure. Pus may form, and the cornea assumes a
yellowish tinge and bursts, giving rise to a deep sore which is liable
to extend as an ulcer, and may be in its turn followed by bulging of the
cornea at that point (staphyloma). This inflammation of the conjunctiva
may be simply catarrhal, with profuse mucopurulent discharge; it may be
granular, the surface being covered with minute reddish elevations, or
it may become the seat of a false membrane (diphtheria).
_Treatment._--In treating external ophthalmia the first object is the
removal of the cause. Remove any dust, chaff, thorn, or other foreign
body from the conjunctiva, purify the stable from all sources of
ammoniacal or other irritant gas; keep the horse from dusty roads, and,
above all, from the proximity of a leading wagon and its attendant cloud
of dust; remove from pasture and feed from a rack which is neither so
high as to drop seeds, etc., into the eyes nor so low as to favor the
accumulation of blood in the head; avoid equally excess of light from a
sunny window in front of the stall and excess of darkness from the
absence of windows; preserve from cold drafts and rains and wet bedding,
and apply curative measures for inflammation of the adjacent mucous
membranes or skin. If the irritant has been of a caustic nature, remove
any remnant of it by persistent bathing with tepid water and a soft
sponge, or with water mixed with white of egg, or a glass filled with
the liquid may be inverted over the eye so that its contents may dilute
and remove the irritant. If the suffering is very severe, a lotion with
a few grains of extract of belladonna or of morphia in an ounce of water
may be applied, or, if it is available, a few drops of 4 per cent
solution of cocaine may be instilled into the eye.
In strong, vigorous patients benefit will usually be obtained from a
laxative, such as 2 tablespoonfuls of Glauber's salt daily, and if the
fever runs high from a daily dose of half an ounce of saltpeter. As
local applications, astringent solutions are usually the best, as 30
grains of borax or of sulphate of zinc in a quart of water, to be
applied constantly on a cloth, as advised under "Inflammation of the
eyelids." In the absence of anything better, cold water may serve every
purpose. Above all, adhesive and oily agents (molasses, sugar, fats) are
to be avoided, as only adding to the irritation. By way of suggesting
agents that may be used with good effect, salt and sulphate of soda may
be named, in solutions double the strength of sulphate of zinc, or 7
grains of nitrate of silver may be added to a quart of distilled water,
and will be found especially applicable in granular conjunctivitis,
diphtheria, or commencing ulceration. A cantharides blister (1 part of
Spanish fly to 4 parts lard) may be rubbed on the side of the face 3
inches below the eye, and washed off next morning with soapsuds and
oiled daily till the scabs are dropped.
WHITE SPECKS AND CLOUDINESS OF THE CORNEA.
As a result of external ophthalmia, opaque specks, clouds, or haziness
are too often left on the cornea and require for their removal that they
be daily touched with a soft feather dipped in a solution of 3 grains
nitrate of silver in 1 ounce distilled water. This should be applied
until all inflammation has subsided, and until its contact is
comparatively painless. It is rarely successful with an old, thick scar
following an ulcer, nor with an opacity having red blood vessels running
across it.
ULCERS OF THE CORNEA.
These may be treated with nitrate of silver lotion of twice the strength
used for opacities. Powdered gentian, one-half ounce, and sulphate of
iron, one-fourth ounce, daily, may improve the general health and
increase the reparatory power.
INTERNAL OPHTHALMIA (IRITIS, CHOROIDITIS, AND RETINITIS).
Although inflammations of the iris, choroid, and retina--the inner,
vascular, and nervous coats of the eye--occur to a certain extent
independently of each other, yet one usually supervenes upon the other,
and, as the symptoms are thus made to coincide, it will be best for our
present purposes to treat the three as one disease.
_Causes._--The causes of internal ophthalmia are largely those of the
external form only, acting with greater intensity or on a more
susceptible eye. Severe blows, bruises, punctures, etc., of the eye, the
penetration of foreign bodies into the eye (thorns, splinters of iron,
etc.), sudden transition from a dark stall to bright sunshine, to the
glare of snow or water, constant glare from a sunny window, abuse of the
overdraw checkrein, vivid lightning flashes, drafts of cold, damp air;
above all, when the animal is perspiring, exposure in cold rain or
snowstorms, swimming cold rivers; also certain general diseases like
rheumatism, arthritis, influenza, and disorders of the digestive
organs, may become complicated by this affection. From the close
relation between the brain and eye--alike in the blood vessels and
nerves--disorders of the first lead to affection of the second, and the
same remark applies to the persistent irritation to which the jaws are
subjected in the course of dentition. So potent is the last agency that
we dread a recurrence of ophthalmia so long as dentition is incomplete,
and hope for immunity if the animal completes its dentition without any
permanent structural change in the eye.
_Symptoms._--The symptoms will vary according to the cause. If the
attack is due to direct physical injury, the inflammation of the eyelids
and superficial structures may be quite as marked as that of the
interior of the eye. If, on the other hand, from general causes, or as a
complication of some distant disease, the affection may be largely
confined to the deeper structures, and the swelling, redness, and
tenderness of the superficial structures will be less marked. When the
external coats thus comparatively escape, the extreme anterior edge of
the white or sclerotic coat, where it overlaps the border of the
transparent cornea, is in a measure free from congestion, and, in the
absence of the obscuring dark pigment, forms a whitish ring around the
cornea. This is partly due to the fact that a series of arteries
(ciliary) passing to the inflamed iris penetrate the sclerotic coat a
short distance behind its anterior border, and there is therefore a
marked difference in color between the general sclerotic occupied
between these congested vessels and the anterior rim from which they are
absent. Unfortunately, the pigment is often so abundant in the anterior
part of the sclerotic as to hide this symptom. In internal ophthalmia
the opacity of the cornea may be confined to a zone around the outer
margin of the cornea, and even this may be a bluish haze rather than a
deep, fleecy white. In consequence it becomes impossible to see the
interior of the chamber for the aqueous humor and the condition of the
iris and pupil. The aqueous humor is usually turbid, and has numerous
yellowish-white flakes floating on its substance or deposited in the
lower part of the chamber, so as to cut off the view of the lower
portion of the iris. The still visible portion of the iris has lost its
natural, clear, dark luster, which is replaced by a brownish or
yellowish sere-leaf color. This is more marked in proportion as the iris
is inflamed, and less so as the inflammation is confined to the choroid.
The quantity of flocculent deposit in the chamber of the aqueous humor
is also in direct ratio to the inflammation of the iris. Perhaps the
most marked feature of internal ophthalmia is the extreme and painful
sensitiveness to light. On this account the lids are usually closed, but
when opened the pupil is seen to be narrowly closed, even if the animal
has been kept in a darkened stall. Exceptions to this are seen when
inflammatory effusion has overfilled the globe of the eye, and by
pressure on the retina has paralyzed it, or when the exudation into the
substance of the retina itself has similarly led to its paralysis. Then
the pupil may be dilated, and frequently its margin loses its regular,
ovoid outline and becomes uneven by reason of the adhesions which it has
contracted with the capsule of the lens, through its inflammatory
exudations. In the case of excessive effusion into the globe of the eye
that is found to have become tense and hard so that it can not be
indented with the tip of the finger, paralysis of the retina is liable
to result. With such paralysis of the retina, vision is heavily clouded
or entirely lost; hence, in spite of the open pupil, the finger may be
approached to the eye without the animal's becoming conscious of it
until it touches the surface, and if the nose on the affected side is
gently struck and a feint made to repeat the blow the patient makes no
effort to evade it. Sometimes the edges of the contracted pupil become
adherent to each other by an intervening plastic exudation, and the
opening becomes virtually abolished. In severe inflammations pus may
form in the choroid or iris, and escaping into the cavity of the aqueous
humor show as a yellowish-white stratum below. In nearly all cases there
is resulting exudation into the lens or its capsule, constituting a
cloudiness or opacity (cataract), which in severe and old-standing cases
appears as a white, fleecy mass behind a widely dilated pupil. In the
slighter cases cataract is to be recognized by examination of the eye in
a dark chamber, with an oblique side light, as described in the
introduction to this article. Cataracts that appear as a simple haze or
indefinite, fleecy cloud are usually on the capsule (capsular), while
those that show a radiating arrangement are in the lens (lenticular),
the radiating fibers of which the exudate follows. Black cataracts are
formed by the adhesion of the pigment on the back of the iris to the
front of the lens, and by the subsequent tearing loose of the iris,
leaving a portion of its pigment adherent to the capsule of the lens. If
the pupil is so contracted that it is impossible to see the lens, it may
be dilated by applying to the front of the eye with a feather some drops
of a solution of 4 grains of atropia in an ounce of water.
_Treatment._--The treatment of internal ophthalmia should embrace,
first, the removal of all existing causes or sources of aggravation of
the disease, which need not be repeated here. Special care to protect
the patient against strong light, cold, wet weather, and active exertion
must, however, be insisted on. A dark stall and a cloth hung over the
eye are important, while cleanliness, warmth, dryness, and rest are
equally demanded. If the patient is strong and vigorous, a dose of 4
drams of Barbados aloes may be given, and if there is any reason to
suspect a rheumatic origin one-half a dram powdered colchicum and
one-half ounce salicylate of soda may be given daily. Locally the
astringent lotions advised for external ophthalmia may be resorted to,
especially when the superficial inflammation is well marked. More
important, however, is to instill into the eye, a few drops at a time, a
solution of 4 grains of atropia in 1 ounce of distilled water. This may
be effected with the aid of a soft feather, and may be repeated at
intervals of 10 minutes until the pupil is widely dilated. As the horse
is to be kept in a dark stall, the consequent admission of light will be
harmless, and the dilation of the pupil prevents adhesion between the
iris and lens, relieves the constant tension of the eye in the effort to
adapt the pupil to the light, and solicits the contraction of the blood
vessels of the eye and the lessening of congestion, exudation, and
intraocular pressure. Should atropia not agree with the case, it may be
replaced by morphia (same strength) or cocaine in 4 per cent solution.
Another local measure is a blister, which can usually be applied to
advantage on the side of the nose or beneath the ear. Spanish flies may
be used as for external ophthalmia. In very severe cases the parts
beneath the eye may be shaved and three or four leeches applied. Setons
are sometimes beneficial, and even puncture of the eyeball, but these
should be reserved for professional hands.
The diet throughout should be easily digestible and moderate in
quantity--bran mash, middlings, grass, steamed hay, etc.
Even after the active inflammation has subsided the atropia lotion
should be continued for several weeks to keep the eye in a state of rest
in its still weak and irritable condition, and during this period the
patient should be kept in semidarkness, or taken out only with a dark
shade over the eye. For the same reason heavy drafts and, rapid paces,
which would cause congestion of the head, should be carefully avoided.
RECURRENT OPHTHALMIA (PERIODIC OPHTHALMIA, OR MOON-BLINDNESS).
This is an inflammatory affection of the interior of the eye, intimately
related to certain soils, climates, and systems, showing a strong
tendency to recur again and again, and usually ending in blindness from
cataract or other serious injury.
_Causes._--Its causes may be fundamentally attributed to soil. On damp
clays and marshy grounds, on the frequently overflowed river bottoms and
deltas, on the coasts of seas and lakes alternately submerged and
exposed, this disease prevails extensively, and in many instances in
France (Reynal), Belgium, Alsace (Zundel, Miltenberger), Germany, and
England it has very largely decreased under land drainage and improved
methods of culture. Other influences, more or less associated with such
soil, are potent causative factors. Thus damp air and a cloudy, wet
climate, so constantly associated with wet lands, are universally
charged with causing the disease. These act on the animal body to
produce a lymphatic constitution with an excess of connective tissue,
bones, and muscles of coarse, open texture, thick skins, and gummy legs
covered with a profusion of long hair. Hence the heavy horses of Belgium
and southwestern France have suffered severely from the affection, while
high, dry lands adjacent, like Catalonia, in Spain, and Dauphiny,
Provence, and Languedoc; in France, have in the main escaped.
The rank, aqueous fodders grown on such soils are other causes, but
these again are calculated to undermine the character of the nervous and
sanguineous temperament and to superinduce the lymphatic. Other feeds
act by leading to constipation and other disorders of the digestive
organs, thus impairing the general health. Hence in any animal
predisposed to this disease, heating, starchy feeds, such as maize,
wheat, and buckwheat, are to be carefully avoided. It has been widely
charged that beans, peas, vetches, and other Leguminosæ are dangerous,
but a fuller inquiry contradicts the statement. If these feeds are well
grown, they invigorate and fortify the system, while, like any other
fodder, if grown rank; aqueous, and deficient in assimilable principles,
they tend to lower the health and open the way for the disease.
The period of dentition and training is a fertile exciting cause, for
though the malady may appear at any time from birth to old age, yet the
great majority of victims are from 2 to 6 years old, and if a horse
escapes the affection till after 6 there is a reasonable hope that he
will continue to resist it. The irritation about the head during the
eruption of the teeth, and while fretting in the unwonted bridle and
collar, the stimulating grain diet and the close air of the stable all
combine to rouse the latent tendency to disease in the eye, while direct
injuries by bridle, whip, or hay seeds are not without their influence.
In the same way local irritants, like dust, severe rain and snow storms,
smoke, and acrid vapors are contributing causes.
It is evident, however, that no one of these is sufficient of itself to
produce the disease, and it has been alleged that the true cause is a
microbe, or the irritant products of a microbe, which is harbored in the
marshy soil. The prevalence of the disease on the same damp soils which
produce ague in man and anthrax in cattle has been quoted in support of
this doctrine, as also the fact that, other things being equal, the
malady is always more prevalent in basins surrounded by hills where the
air is still and such products are concentrated, and that a forest or
simple belt of trees will, as in ague, at times limit the area of its
prevalence. Another argument for the same view is found in the fact that
on certain farms irrigated by town sewage this malady has become
extremely prevalent, the sewage being assumed to form a suitable nidus
for the growth of the germ. But on these sewage farms a fresh crop may
be cut every fortnight, and the product is precisely that aqueous
material which contributes to a lymphatic structure and a low tone of
health. The presence of a definite germ in the system has not yet been
proved, and in the present state of our knowledge we are only warranted
in charging the disease to the deleterious emanations from the marshy
soil in which bacterial ferments are constantly producing them.
Heredity is one of the most potent causes. The lymphatic constitution is
of course transmitted and with it the proclivity to recurring
ophthalmia. This is notorious in the case of both parents, male and
female. The tendency appears to be stronger, however, if either parent
has already suffered. Thus a mare may have borne a number of sound
foals, and then fallen a victim to the malady, and all foals
subsequently borne have likewise suffered. So it is in the case of the
stallion. Reynal even quotes the appearance of the disease in alternate
generations, the stallion offspring of blind parents remaining sound
through life and yet producing foals which furnish numerous victims of
recurrent ophthalmia. On the contrary, the offspring of diseased parents
removed to high, dry regions and furnished with wholesome, nourishing
rations will nearly all escape. Hence the dealers take colts that are
still sound or have had but one attack from the affected low Pyrenees
(France) to the unaffected Catalonia (Spain), with confidence that they
will escape, and from the Jura Valley to Dauphiny with the same result.
Yet the hereditary taint is so strong and pernicious that intelligent
horsemen everywhere refuse to breed from either horse or mare that has
once suffered from recurrent ophthalmia, and the French Government studs
not only reject all unsound stallions, but refuse service to any mare
which has suffered with her eyes. It is this avoidance of the hereditary
predisposition more than anything else that has reduced the formerly
wide prevalence of this disease in the European countries generally. A
consideration for the future of our horses would demand the disuse of
all sires that are unlicensed, and the refusal of a license to any sire
which has suffered from this or any other communicable constitutional
disease.
Other contributing causes deserve passing mention. Unwholesome feed and
a faulty method of feeding undoubtedly predisposes to the disease, and
in the same district the carefully fed will escape in far larger
proportion than the badly fed; it is so also with every other condition
which undermines the general health. The presence of worms in the
intestines, overwork, and debilitating diseases and causes of every kind
weaken the vitality and lay the system more open to attack. Thierry long
ago showed that the improvement of close, low, dark, damp stables, where
the disease had previously prevailed, practically banished the
affection. Whatever contributes to strength and vigor is protective;
whatever contributes to weakness and poor health is provocative of the
disease in the predisposed subject.
_Symptoms._--The symptoms vary according to the severity of the attack.
In some cases there is marked fever, and in some slighter cases it may
be almost altogether wanting, but there is always a lack of vigor and
energy, bespeaking general disorder. The local symptoms are in the main
those of internal ophthalmia, in many cases with an increased hardness
of the eyeball from effusion into its cavity. The contracted pupil does
not expand much in darkness, nor even under the action of belladonna.
Opacity advances from the margin, over a part or whole of the cornea,
but so long as it is transparent there may be seen the turbid, aqueous
humor with or without flocculi, the dingy iris robbed of its clear,
black aspect, the slightly clouded lens, and a greenish-yellow
reflection from the depth of the eye. From the fifth to the seventh day
the flocculi precipitate in the lower part of the chamber, exposing more
clearly the iris and lens, and absorption commences, so that the eye may
be cleared up in ten or fifteen days.
The characteristic of the disease is, however, its recurrence again and
again in the same eye until blindness results. The attacks may follow
one another after intervals of a month, more or less, but they show no
relation to any particular phase of the moon, as might be inferred from
the familiar name, but are determined rather by the weather, the health,
the feed, or by some periodicity of the system. From five to seven
attacks usually result in blindness, and then the second eye is liable
to be attacked until it also is ruined.
In the intervals between the attacks some remaining symptoms betray the
condition, and they become more marked after each successive access of
disease. Even after the first attack there is a bluish ring around the
margin of the transparent cornea. The eye seems smaller than the other,
at first because it is retracted in its socket, and often after several
attacks because of actual shrinkage (atrophy). The upper eyelid, in
place of presenting a uniform, continuous arch, has, about one-third
from its inner angle, an abrupt bend, caused by the contraction of the
levator muscle. The front of the iris has exchanged some of its dark,
clear brilliancy for a lusterless yellow, and the depth of the eye
presents more or less of the greenish-yellow shade. The pupil remains a
little contracted, except in advanced and aggravated cases, when, with
opaque lens, it is widely dilated. If, as is common, one eye only has
suffered, the contrast in these respects with the sound eye is all the
more characteristic. Another feature is the erect, attentive carriage of
the ear, to compensate to some extent for the waning vision.
The attacks vary greatly in severity in different cases, but the
recurrence is characteristic, and all alike lead to cataract and
intraocular effusion, with pressure on the retina and abolition of
sight.
_Prevention._--The prevention of this disease is the great object to be
aimed at, and this demands the most careful breeding, feeding, housing,
and general management, as indicated under "Causes." Much can also be
done by migration to a high, dry location, but for this and malarious
affections the improvement of the land by drainage and good cultivation
should be the final aim.
_Treatment_ is not satisfactory, but is largely the same as for common
internal ophthalmia. Some cases, like rheumatism, are benefited by
1-scruple doses of powdered colchicum and 2-dram doses of salicylate of
soda twice a day. In other cases, with marked hardness of the globe of
the eye from intraocular effusion, aseptic puncture of the eye, or even
the excision of a portion of the iris, has helped. During recovery a
course of tonics (2 drams oxid of iron, 10 grains nux vomica, and 1
ounce sulphate of soda daily) is desirable to invigorate the system and
help to ward off another attack. The vulgar resort to knocking out the
wolf teeth and cutting out the haw can only be condemned. The temporary
recovery would take place in one or two weeks, though no such thing had
been done, and the breaking of a small tooth, leaving its fang in the
jaw, only increases the irritation.
CATARACT.
The common result of internal ophthalmia, as of the recurrent type, may
be recognized as described under the first of these diseases. Its
offensive appearance may be obviated by extraction or depression of the
lens, but as the rays of light would no longer be properly refracted,
perfect vision would not be restored, and the animal would be liable to
prove an inveterate shyer. If perfect blindness continued by reason of
pressure on the nerve of sight, no shying would result.
PALSY OF THE NERVE OF SIGHT, OR AMAUROSIS.
_Causes._--The causes of this affection are tumors or other disease of
the brain implicating the roots of the optic nerve, injury to the nerve
between the brain and eye, and inflammation of the optic nerve within
the eye (retina), or undue pressure on the same from dropsical or
inflammatory effusion. It may also occur from overloaded stomach, from a
profuse bleeding, and even from the pressure of the gravid womb in
gestation.
_Symptoms._--The symptoms are wide dilatation of the pupils, so as to
expose fully the interior of the globe, the expansion remaining the
same in light and darkness. Ordinary eyes when brought to the light have
the pupils suddenly contract and then dilate and contract alternately
until they adapt themselves to the light. The horse does not swerve when
a feint to strike is made unless the hand causes a current of air. The
ears are held erect, turn quickly toward any noise, and the horse steps
high to avoid stumbling over objects which it can not see.
_Treatment_ is only useful when the disease is symptomatic of some
removable cause, like congested brain, overloaded stomach, or gravid
womb. When recovery does not follow the termination of these conditions,
apply a blister behind the ear and give one-half dram doses of nux
vomica daily.
TUMORS OF THE EYEBALL.
A variety of tumors attack the eyeball--dermoid, papillary, fatty,
cystic, and melanotic--but perhaps the most frequent in the horse is
encephaloid cancer. This may grow in or on the globe, the haw, the
eyelid, or the bones of the orbit, and can be remedied, if at all, only
by early and thorough excision. It may be distinguished from the less
dangerous tumors by its softness, friability, and great vascularity,
bleeding on the slightest touch, as well as by its anatomical structure.
STAPHYLOMA.
This consists in a bulging forward of the cornea at a given point by the
sacculate yielding and distention of its coats, and it may be either
transparent or opaque and vascular. In the last form the iris has become
adherent to the back of the cornea, and the whole structure is filled
with blood vessels. In the first form the bulging cornea is attenuated;
in the last it may be thickened. The best treatment is by excision of a
portion of the rise so as to relieve the intraocular pressure.
PARASITES IN THE EYE.
Acari in the eye have been incidentally alluded to under inflammation of
the lids.
_Filaria palpebralis_ is a white worm, one-half to 1 inch long, which
inhabits the lacrimal duct and the underside of the eyelids and haw in
the horse, producing a verminous conjunctivitis. The first step in
treatment in such cases is to remove the worm with forceps, then treat
as for external inflammation.
_Setaria equina_ is a delicate, white, silvery-looking worm, which I
have repeatedly found 2 inches in length (a length as great as 5 inches
has been reported). It invades the aqueous humor, where its constant
active movements make it an object of great interest, and it is
frequently exhibited as a "snake in the eye."[1] When present in the
eye it causes inflammation and has to be removed through an incision
made with the lancet in the upper border of the cornea close to the
sclerotic, the point of the instrument being directed slightly forward
to avoid injury to the iris. Then cold water or astringent antiseptic
lotions should be applied.
_Filaria conjunctivæ_, resembling _Setaria equina_ very much in size and
general appearance, is another roundworm which has been found in the eye
of the horse.
The echinococcus, the cystic or larval stage of the echinococcus
tapeworm of the dog, has been found in the eye of the horse, and a
cysticercus is also reported.
FOOTNOTES:
[1] This worm is normally a parasite of the peritoneal cavity, and is
probably transmitted from one horse to another by some biting insect
which becomes infected by embryos in the blood.--M. C. HALL.
LAMENESS: ITS CAUSES AND TREATMENT.
BY A. LIAUTARD, M. D., V. M.,
_Formerly principal of the American Veterinary College, New York._
[Revised by John R. Mohler, A. M., V. M. D.]
It is as living, organized, locomotive machines that the horse, camel,
ox, and their burden-bearing companions are of practical value to man.
Hence the consideration of their usefulness and consequent value to
their human masters ultimately and naturally resolves itself into an
inquiry concerning the condition of that special portion of their
organism which controls their function of locomotion. This is especially
true in regard to the members of the equine family, the most numerous
and valuable of all the beasts of burden, and it naturally follows that
with the horse for a subject of discussion the special topic and leading
theme of inquiry, by an easy lapse, will become an inquest into the
condition and efficiency of his power for usefulness as a carrier or
traveler. There is a great deal of abstract interest in the study of
that endowment of the animal economy which enables its possessor to
change his place at will and convey himself whithersoever his needs or
his moods may incline him; how much greater, however, the interest that
attaches to the subject when it becomes a practical and economic
question and includes within its purview the various related topics
which belong to the domains of physiology, pathology, therapeutics, and
the entire round of scientific investigation into which it is finally
merged as a subject for medical and surgical consideration--in a word,
of actual disease and its treatment. It is not surprising that the
intricate and complicated apparatus of locomotion, with its symmetry and
harmony of movement and the perfection and beauty of its details and
adjuncts, by students of creative design and attentive observers or
nature and her marvelous contrivances and adaptations, should be
admiringly denominated a living machine.
Of all the animal tribe the horse, in a state of domesticity, is the
largest sharer with his master in his liability to the accidents and
dangers which are among the incidents of civilized life. From his
exposure to the missiles of war on the battlefield to his chance of
picking up a nail from the city pavement there is no hour when he is
not in danger of incurring injuries which for their repair may demand
the best skill of the veterinary practitioner. This is true not alone of
casualties which belong to the class of external and traumatic cases,
but includes as well those of a kind perhaps more numerous, which may
result in lesions of internal parts, frequently the most serious and
obscure of all in their nature and effects.
The horse is too important a factor in the practical details of human
life and fills too large a place in the business and pleasure of the
world to justify any indifference to his needs and physical comfort or
neglect in respect to the preservation of his peculiar powers for
usefulness. In entering somewhat largely, therefore, upon a review of
the subject, and treating in detail of the causes, the symptoms, the
progress, the treatment, the results, and the consequences of lameness
in the horse, we are performing a duty which needs no word of apology or
justification. The subject explains and justifies itself, and is its own
vindication and illustration, if any are needed.
The function of locomotion is performed by the action of two principal
systems of organs, known in anatomical and physiological terminology as
passive and active, the muscles performing the active and the bones the
passive portion of the movement. The necessary connection between the
cooperating parts of the organism is effected by means of a vital
contact by which the muscle is attached to the bone at certain
determinate points on the surface of the latter. These points of
attachment appear sometimes as an eminence, sometimes as a depression,
sometimes a border or an angle, or again as a mere roughness, but each
perfectly fulfilling its purpose, while the necessary motion is provided
for by the formation of the ends of the long bones into the requisite
articulations, joints, or hinges. Every motion is the product of the
contraction of one or more of the muscles, which, as it acts upon the
bony levers, gives rise to a movement of extension or flexion, abduction
or adduction, rotation or circumduction. The movement of abduction is
that which passes from and that of adduction that which passes toward
the median line, or the center of the body. The movements of flexion and
extension are too well understood to need defining. It is the
combination and rapid alterations of these movements which produce the
different postures and various gaits of the animal, and it is their
interruption and derangement, from whatever causes, which constitute the
pathological condition known as lameness.
A concise examination of the general anatomy of these organs, however,
must precede the consideration of the pathological questions pertaining
to the subject. A statement, such as we have just given, containing only
the briefest hint of matters which, though not necessarily in their
ultimate scientific minutiæ, must be clearly comprehended in order to
acquire a symmetrical and satisfactory view of the theme as a practical
collation of facts to be remembered, analyzed, applied, and utilized.
It was the great Bacon who wrote: "The human body may be compared, from
its complex and delicate organization, to a musical instrument of the
most perfect construction, but exceedingly liable to derangement." In
its degree the remark is equally applicable to the equine body, and if
we would keep it in tune and profit by its harmonious action we must at
least acquaint ourselves with the relations of its parts and the mode of
their cooperation.
ANATOMY.
The bones, then, are the hard organs which in their connection and
totality constitute the skeleton of an animal (see Plate XXIII). They
are of various forms, three of which--the long, the flat, and the
small--are recognized in the extremities. These are more or less regular
in their form, but present upon their surfaces a variety of aspects,
exhibiting in turn, according to the requirement of each case, a
roughened or smooth surface, variously marked with grooves, crests,
eminences, and depressions, for the necessary muscular attachments, and,
as before mentioned, are connected by articulations and joints, of which
some are immovable and others movable.
The substance of the bone is composed of a mass of combined earthy and
animal matter surrounded by a fine, fibrous enveloping membrane (the
periosteum) which is intimately adherent to the external surface of the
bone, and is, in fact, the secreting membrane of the bony structure. The
bony tissue proper is of two consistencies, the external portion being
hard and "compact," and called by the latter term, while the internal,
known as the "spongy" or "areolar tissue," corresponds to the
descriptive terms. Those of the bones that possess this latter
consistency contain also, in their spongy portion, the medullary
substance known as marrow, which is deposited in large quantities in the
interior of the long bones, and especially where a central cavity
exists, called, for that reason, the medullary cavity. The nourishment
of the bones is effected by means of what is known as the nutrient
foramen, an opening established for the passage of the blood vessels
which convey the nourishment necessary to the interior of the organ.
Concerning the nourishment of the skeleton, there are other minutiæ,
such as the venous arrangement and the classification of their arterial
vessels into several orders, which, though of interest as an abstract
study, are not of sufficient practical value to refer to here.
The active organs of locomotion, the muscles (see Plate XXIII), speaking
generally, form the fleshy covering of the external part of the skeleton
and surround the bones of the extremities. They vary greatly in shape
and size, being flat, triangular, long, short, or broad, and are
variously and capriciously named, some from their shape, some from their
situation, others from their use; and thus we have abductors and
adductors--the pyramidal, orbicular, the digastricus, the vastus, and so
on. Those which are under the control of the will, known as the
voluntary muscles, appear in the form of fleshy structures, red in
color, and with fibers of various degrees of fineness, and are composed
of fasciculi, or bundles of fibers, united by connective or cellular
tissue, each fasciculus being composed of smaller ones but united in a
similar manner to compose the larger formations, each of which is
enveloped by a structure of similar nature known as the sarcolemma. Many
of the muscles are united to the bones by the direct contact of their
fleshy fibers, but in other instances the body of the muscle is more or
less gradually transformed into a cordy or membranous structure known as
the tendon or sinew, and the attachment is made by the very short
fibrous threads through the medium of a long tendinous band, which,
passing from a single one to several others of the bones, effects its
object at a point far distant from its original attachment. In thus
carrying its action from one bone to another, or from one region of a
limb to another, these tendons must necessarily have smooth surfaces
over which to glide, either upon the bones themselves or formed at their
articulations, and this need is supplied by the secretion of the
synovial fluid, a yellowish, unctuous substance, furnished by a peculiar
tendinous synovial sac designed for the purpose.
Illustrations in point of the agency of the synovial fluid in assisting
the sliding movements of the tendons may be found under their various
forms at the shoulder joint, at the upper part of the bone of the arm,
at the posterior part of the knee joint, and also at the fetlocks, on
their posterior part.
As the tendons, whether singly or in company with others, pass over
these natural pulleys they are retained in place by strong, fibrous
bands or sheaths, which are by no means exempt from danger of injury, as
will be readily inferred from a consideration of their important special
use as supports and reenforcements of the tendons themselves, with which
they must necessarily share the stress of whatever force or strain is
brought to bear upon both or either.
We have referred to that special formation of the external surface of a
bone by which it is adapted to form a joint or articulation, either
movable or fixed, and a concise examination of the formation and
structure of the movable articulations will here be in place. These are
formed generally by the extremities of the long bones, or may exist on
the surfaces of the short ones. The points or regions where the contact
occurs are denominated the articular surface, which assumes from this
circumstance a considerable variety of aspect and form, being in one
case comparatively flat and another elevated; or as forming a protruding
head or knob, with a distinct convexity; and again presenting a
corresponding depression or cavity, accurately adapted to complete, by
their coaptation, the ball-and-socket joint. The articulation of the arm
and shoulder is an example of the first kind, while that of the hip with
the thigh bone is a perfect exhibition of the latter.
The structure whose office it is to retain the articulating surfaces in
place is the ligament. This is usually a white, fibrous, inelastic
tissue; sometimes, however, it is elastic in character and yellowish. In
some instances it is funicular shaped or corded, serving to bind more
firmly together the bones to which its extremities are attached; in
others it consists of a broad membrane, wholly or partially surrounding
the broad articulations, and calculated rather for the protection of the
cavity from intrusion by the air than for other security. This latter
form, known as capsular, is usually found in connection with joints
which possess a free and extended movement. The capsular and funicular
ligaments are sometimes associated, the capsular appearing as a
membranous sac wholly or partially inclosing the joint, the funicular,
here known as an interarticular ligament, occupying the interior, and
thus securing the union of the several bones more firmly and effectively
than would be possible for the capsular ligament unassisted.
The universal need which pertains to all mechanical contrivances of
motion has not been forgotten while providing for the perfect working of
the interesting piece of living machinery which performs the function of
locomotion, as we are contemplating it, and nature has consequently
provided for obviating the evils of attrition and friction and insuring
the easy play and smooth movement of its parts by the establishment of
the secretion of the synovia, the vital lubricant of which we have
before spoken, as a yellow, oily, or rather glairy secretion, which
performs the indispensable office of facilitating the play of the
tendons over the joints and certain given points of the bones. This
fluid is deposited in a containing sac, the lining (serous) membrane of
which forms the secreting organ. This membrane is of an excessively
sensitive nature, and while it lines the inner face of the ligaments,
both capsular and fascicular, it is attached only upon the edges of the
bones, without extending upon their length, or between the layers of
cartilage which lie between the bones and their articular surfaces.
Our object in thus partially and concisely reviewing the structure and
condition of the essential organs of locomotion has been rather to
outline a sketch which may serve as a reference chart of the general
features of the subject than to offer a minute description of the parts
referred to. Other points of interest will receive proper attention as
we proceed with the illustration of our subject and examine the matters
which it most concerns us to bring under consideration. The foundation
of facts which we have thus far prepared will be found sufficiently
broad, we trust, to include whatever may be necessary to insure a ready
comprehension of the essential matters which are to follow as our review
is carried forward to completion. What we have said touching these
elementary truths will probably be sufficient to facilitate a clear
understanding of the requirements essential to the perfection and
regularity which characterize the normal performance of the various
movements that result in the accomplishment of the action of locomotion.
So long as the bones, the muscles and their tendons, the joints with
their cartilages, their ligaments, and their synovial structure, the
nerves and the controlling influences which they exercise over all, with
the blood vessels which distribute to every part, however minute, the
vitalizing fluid which sustains the whole fabric in being and
activity--so long as these various constituents and adjuncts of animal
life preserve their normal exemption from disease, traumatism, and
pathological change, the function of locomotion will continue to be
performed with perfection and efficiency.
On the other hand, let any element of disease become implanted in one or
several of the parts destined for combined action, any change or
irregularity of form, dimensions, location, or action occur in any
portion of the apparatus--any obstruction or misdirection of vital power
take place, any interference with the order of the phenomena of normal
nature, any loss of harmony and lack of balance be betrayed--and we have
in the result the condition of lameness.
DEFINITION OF LAMENESS.
_Physiology._--Comprehensively and universally considered, then, the
term lameness signifies any irregularity or derangement of the function
of locomotion, irrespective of the cause which produced it or the degree
of its manifestation. However slightly or severely it may be exhibited,
it is all the same. The nicest observation may be demanded for its
detection, and it may need the most thoroughly trained powers of
discernment to identify and locate it, as in cases in which the animal
is said to be fainting, tender, or to go sore. On the contrary, the
patient may be so far affected as to refuse utterly to use an injured
leg, and under compulsory motion keep it raised from the ground, and
prefer to travel on three legs rather than to bear any portion of his
weight upon the afflicted member. In these two extremes, and in all the
intermediate degrees, the patient is simply lame--pathognomonic minutiæ
being considered and settled in a place of their own.
This last condition of disabled function--lameness on three legs--and
many of the lower degrees of simple lameness are very easy of detection,
but the first, or mere tenderness or soreness, may be very difficult to
identify, and at times very serious results have followed from the
obscurity which has enveloped the early stages of the malady. For it may
easily occur that in the absence of the treatment which an early correct
diagnosis would have indicated, an insidious ailment may so take
advantage of the lapse of time as to root itself too deeply into the
economy to be subverted, and become transformed into a disabling chronic
case, or possibly one that is incurable and fatal. Hence the impolicy of
depreciating early symptoms because they are not accompanied with
distinct and pronounced characteristics, and from a lack of threatening
appearances inferring the absence of danger. The possibilities of an
ambush can never be safely ignored. An extra caution costs nothing, even
if wasted. The fulfillment of the first duty of a practitioner, when
introduced to a case, is not always an easy task, though it is too
frequently expected that the diagnosis, or "what is the matter" verdict,
will be reached by the quickest and surest kind of an "instantaneous
process" and a sure prognosis, or "how will it end," guessed at
instanter.
Usually the discovery that the animal is becoming lame is comparatively
an easy matter to a careful observer. Such a person will readily note
the changes of movements which will have taken place in the animal he
has been accustomed to drive or ride, unless they are indeed slight and
limited to the last degree. But what is not always easy is the
detection, after discovering the fact of an existing irregularity, of
the locality of its point of origin, and whether its seat be in the near
or off leg, or in the fore or the hind part of the body. These are
questions too often wrongly answered, notwithstanding the fact that with
a little careful scrutiny the point may be easily settled. The error,
which is too often committed, of pronouncing the leg upon which the
animal travels soundly as the seat of the lameness, is the result of a
misinterpretation of the physiology of locomotion in the crippled
animal. Much depends upon the gait with which the animal moves while
under examination. The act of walking is unfavorable for accurate
observation, though, if the animal walks on three legs, the decision is
easy to reach. The action of galloping will often, by the rapidity of
the muscular movements and their quick succession, interfere with a nice
study of their rhythm, and it is only under some peculiar circumstances
that the examination can be safely conducted while the animal is moving
with that gait. It is while the animal is trotting that the
investigation is made with the best chances of an intelligent decision,
and it is while moving with that gait, therefore, that the points should
be looked for which must form the elements of the diagnosis.
[Illustration: PLATE XXIII.
SKELETON OF HORSE.]
[Illustration: PLATE XXIV.
SUPERFICIAL LAYER OF MUSCLES.]
Our first consideration should be the physiology of normal or healthy
locomotion, that thence we may the more easily reach our conclusions
touching lameness, or that which is abnormal, and by this process we
ought to succeed in obtaining a clew to the solution of the first
problem, to wit, in which leg is the seat of the lameness?
A word of definition is here necessary, in order to render that which
follows more easily intelligible. In veterinary nomenclature each two of
the legs, as referred to in pairs, is denominated a biped. Of the four
points occupied by the feet of the animal while standing at rest,
forming a square, the two fore legs are known as the anterior biped; the
two hinder, the posterior; the two on one side, the lateral: and one of
either the front or hind biped with the opposite leg of the hind or
front biped will form the diagonal biped.
Considering, as it is proper to do, that in a condition of health each
separate biped and each individual leg is required to perform an equal
and uniform function and to carry an even or equal portion of the weight
of the body, it will be readily appreciated that the result of this
distribution will be a regular, evenly balanced, and smooth displacement
of the body thus supported by the four legs, and that therefore,
according to the rapidity of the motion in different gaits, each single
leg will be required at certain successive moments to bear the weight
which had rested upon its congener while it was itself in the air, in
the act of moving; or, again, two different legs of a biped may be
called upon to bear the weight of the two legs of the opposite biped
while also in the air in the act of moving.
To simplify the matter by an illustration, the weight of an animal may
be placed at 1,000 pounds, of which each leg, in a normal and healthy
condition, supports while at rest 250 pounds. When one of the fore legs
is in action, or in the air, and carrying no weight, its 250 pounds
share of the weight will be thrown upon its congener, or partner, to
sustain. If the two legs of a biped are both in action and raised from
the ground, their congeners, still resting in inaction, will carry the
total weight of the other two, or 500 pounds. And as the succession of
movements continues, and the change from one leg to another or from one
biped to another, as may be required by the gait, proceeds, there will
result a smooth, even, and equal balancing of active movements, shifting
the weight from one leg or one biped to another, with symmetrical
precision, and we shall be presented with an interesting example of the
play of vital machanics in a healthy organization.
Much may be learned from the accurate study of the action of a single
leg. Normally, its movements will be without variation or failure. When
at rest it will easily sustain the weight assigned to it without
showing hesitancy or betraying pain, and when it is raised from the
ground in order to transfer the weight to its mate it will perform the
act in such manner that when it is again placed upon the ground to rest
it will be with a firm tread, indicative of its ability to receive again
the burden to be thrown back upon it. In planting it upon the ground or
raising it again for the forward movement while in action, and again
replanting it upon the earth, each movement will be the same for each
leg and for each biped, whether the act is that of walking or trotting,
or even of galloping. In short, the regular play of every part of the
apparatus will testify to the existence of that condition of orderly
soundness and efficient activity eloquently suggestive of the condition
of vital integrity which is simply but comprehensively expressed by the
terms health and soundness.
But let some change, though slight and obscure, occur among the elements
of the case; some invisible agency of evil intrude among the harmonizing
processes going forward; any disorder occur in the relations of
cooperating parts; anything appear to neutralize the efficiency of
vitalizing forces; any disability of a limb to accept and to throw back
upon its mate the portion of the weight which belongs to it to
sustain--present itself, whether as the effect of accident or otherwise;
in short, let anything develop which tends to defeat the purpose of
nature in organizing the locomotive apparatus and we are confronted at
once by that which may be looked upon as a cause of lameness.
Not the least of the facts which it is important to remember is that it
is not sufficient to look for the manifestation of an existing
discordance in the action of the affected limb alone, but that it is
shared by the sound one and must be searched for in that as well as the
halting member, if the hazard of an error is to be avoided. The mode of
action of the leg which is the seat of the lameness will vary greatly
from that which it exhibited when in a healthy condition, and the sound
leg will also offer important modifications in the same three
particulars before alluded to, to wit, that of resting on the ground,
that of its elevation and forward motion, and that of striking the
ground again when the full action of stepping is accomplished. Inability
in the lame leg to sustain weight will imply excessive exertion by the
sound one, and lack of facility or disposition to rest the lame member
on the ground will necessitate a longer continuance of that action on
the sound side. Changes in the act of elevating the leg, or of carrying
it forward, or in both, will present entirely opposite conditions
between the two. The lame member will be elevated rapidly, moved
carefully forward, and returned to the ground with caution and
hesitancy, and the contact with the earth will be effected as lightly as
possible, while the sound limb will rest longer on the ground, move
boldly and rapidly forward, and strike the ground promptly and forcibly.
All this is due to the fact that the sound member carries more than its
normal, healthy share of the weight of the body, a share which may be in
excess from 1 to 250 pounds, and thus bring its burden to a figure
varying from 251 to 500 pounds, all depending upon the degree of the
existing lameness, whether it is simply a slight tenderness or soreness,
or whether the trouble has reached a stage which compels the patient to
the awkwardness of traveling on three legs.
That all this is not mere theory, but rests on a foundation of fact may
be established by observing the manifestations attending a single
alteration in the balancing of the body. In health the support and
equilibrium of that mass of the body which is borne by the fore legs is
equalized and passes by regular alternations from the right to the left
side and vice versa. But if the left leg, becoming disabled, relieves
itself by leaning, as it were, on the right, the latter becomes,
consequently, practically heavier and the mass of the body will incline
or settle upon that side. Lameness of the left side, therefore, means
dropping or settling on the right and vice versa. We emphasize this
statement and insist upon it, the more from the frequency of the
instances of error which have come under our notice, in which persons
have insisted upon their view that the leg which is the seat of the
lameness is that upon which he drops and which the animal is usually
supposed to favor.
HOW TO DETECT THE SEAT OF LAMENESS.
Properly appreciating the remarks which have preceded, and fully
comprehending the modus operandi and the true pathology of lameness, but
little remains to be done in order to reach an answer to the question as
to which side of the animal is the seat of the lameness, except to
examine the patient while in action. We have already stated our reasons
for preferring the movement of trotting for this purpose. In conducting
such an examination the animal should be unblanketed, and held by a
plain halter in the hands of a man who knows how to manage his paces,
and the trial should always be made over a firm, hard road whenever it
is available. He is to be examined from various positions--from before,
from behind, and from each side. Watching him as he approaches, as he
passes by, and as he recedes, the observer should carefully study that
important action which we have spoken of as the dropping of the body
upon one extremity or the other, and this can readily be detected by
attending closely to the motions of the head and of the hip. The head
drops on the same side on which the mass of the body will fall, dropping
toward the right when the lameness is in the left fore leg, and the hip
dropping in posterior lameness, also on the sound leg, the reversal of
the conditions, of course, producing reversed effects. In other words,
when the animal in trotting exhibits signs of irregularity of action, or
lameness, and this irregularity is accompanied with dropping or nodding
the head, or depressing the hip on the right side of the body, at the
time the feet of the right side strike the ground, the horse is lame on
the left side. If the dropping and nodding are on the near side the
lameness is on the off side.
In a majority of cases, however, the answer to the first question
relating to the lameness of a horse is, after all, not a very difficult
task. There are two other problems in the case more difficult of
solution and which often require the exercise of a closer scrutiny, and
draw upon all the resources of the experienced practitioner to settle
satisfactorily. That a horse is lame in a given leg may be easily
determined, but when it becomes necessary to pronounce upon the query as
to what part, what region, what structure is affected, the easy part of
the task is over, and the more difficult and important, because more
obscure, portion of the investigation has commenced--except, of course,
in cases of which the features are too distinctly evident to the senses
to admit of error. It is true that by carefully noting the manner in
which a lame leg is performing its functions, and closely scrutinizing
the motions of the whole extremity, and especially of the various joints
which enter into its structure; by minutely examining every part of the
limb; by observing the outlines; by testing the change, if any, in
temperature and the state of the sensibility--all these investigations
may guide the surgeon to a correct localization of the seat of trouble,
but he must carefully refrain from the adoption of a hasty conclusion,
and, above all, assure himself that he has not failed to make the foot,
of all the organs of the horse the most liable to injury and lesion, the
subject of the most thorough and minute examination of all the parts
which compose the suffering extremity.
The greater liability of the foot than of any other part of the
extremities to injury from casualties, natural to its situation and use,
should always suggest the beginning of an inquiry, especially in an
obscure case of lameness at that point. Indeed the lameness may have an
apparent location elsewhere when that is the true seat of the trouble,
and the surgeon who, while examining his lame patient, discovers a
ringbone, and convincing himself that he has encountered the cause of
the disordered action suspends his investigation without subjecting the
foot to a close scrutiny, at a later day when regrets will avail
nothing, may deeply regret his neglect and inadvertence. As in human
pathological experience, however, there are instances when inscrutable
diseases will deliver their fatal messages, while leaving no mark and
making no sign by which they might be identified and classified, so it
will happen that in the humbler animals the onset and progress of
mysterious and unrecognizable ailments will at times baffle the most
skilled veterinarian, and leave our burden-bearing servants to succumb
to the inevitable, and suffer and perish in unrelieved distress.
DISEASES OF BONES.
PERIOSTITIS, OSTITIS, AND EXOSTOSIS.
From the closeness and intimacy of the connection existing between the
two principal elements of the bony structure while in health, it
frequently becomes exceedingly difficult, when a state of disease has
supervened, to discriminate accurately as to the part primarily affected
and to determine positively whether the periosteum or the body of the
bone is originally implicated. Yet a knowledge of the fact is often of
the first importance, in order to obtain a favorable result from the
treatment to be instituted. It is, however, quite evident that in a
majority of instances the bony growths which so frequently appear on the
surface of their structure, to which the general term of exostosis is
applied, have had their origin in an inflammation of the periosteum, or
enveloping membrane, and known as periostitis. However this may be, we
have as a frequent result, sometimes on the body of the bone, sometimes
at the extremities, and sometimes involving the articulation itself,
certain bony growths, or exostoses, known otherwise by the term of
splint, ringbone, and spavin, all of which, in an important sense, may
be finally referred to the periosteum as their nutrient source and
support, at least after their formation, if not for their incipient
existence.
_Cause._--It is certain that inflammation of the periosteum is
frequently referable to wounds and bruises caused by external agencies,
and it is also true that it may possibly result from the spreading
inflammation of surrounding diseased tissues, but in any case the result
is uniformly seen in the deposit of a bony growth, more or less diffuse,
sometimes of irregular outline, and at others projecting distinctly from
the surface from which it springs, as so commonly presented in the
ringbone and the spavin.
_Symptoms._--This condition of periostitis is often difficult to
determine. The signs of inflammation are so obscure, the swelling of the
parts so insignificant, any increase of heat so imperceptible, and the
soreness so slight, that even the most acute observer may fail to find
the point of its existence, and it is often long after the discovery of
the disease itself that its location is positively revealed by the
visible presence of the exostosis. Yet the first question had been
resolved, in discovering the fact of the lameness, while the second and
third remained unanswered, and the identification of the affected limb
and the point of origin of the trouble remained unknown until their
palpable revelation to the senses.
_Treatment._--When, by careful scrutiny, the ailment has been located, a
resort to treatment must be had at once, in order to prevent, if
possible, any further deposit of the calcareous structure and increase
of the exostotic growth. With this view the application of water, either
warm or cold, rendered astringent by the addition of alum or sugar of
lead, will be beneficial. The tendency to the formation of the bony
growth, and the increase of its development after its actual formation,
may often be checked by the application of a severe blister of Spanish
fly. The failure of these means and the establishment of the diseased
process in the form of chronic periostitis cause various changes in the
bone covered by the disordered membrane, and the result may be
softening, degeneration, or necrosis, but more usually it is followed by
the formation of the bony growths referred to, on the cannon bone, the
coronet, the hock, etc.
SPLINTS.
We first turn our attention to the splint, as certain bony enlargements
that are developed on the cannon bone, between the knee or the hock and
the fetlock joint, are called. (See Plate XXV.) They are found on the
inside of the leg, from the knee, near which they are frequently found,
downward to about the lower third of the principal cannon bone. They are
of various dimensions, and are readily perceptible both to the eye and
to the touch. They vary considerably in size, ranging from that of a
large nut downward to very small proportions. In searching for them they
may be readily detected by the hand if they have attained sufficient
development in their usual situation, but must be distinguished from a
small, bony enlargement that may be felt at the lower third of the
cannon bone, which is neither a splint nor a pathological formation of
any kind, but merely the buttonlike enlargement at the lower extremity
of the small metacarpal or splint bone.
We have said that splints are to be found on the inside of the leg. This
is true as a general statement, but it is not invariably so, for they
occasionally appear on the outside. It is also true that they appear
most commonly on the fore legs, but this is not exclusively the case,
because they may at times be found on both the inside and outside of the
hind leg. Usually a splint forms only a true exostosis, or a single bony
growth, with a somewhat diffuse base, but neither is this invariably the
case. In some instances they assume more important dimensions, and pass
from the inside to the outside of the bone, on its posterior face,
between that and the suspensory ligament. This form is termed the pegged
splint, and constitutes a serious and permanent deformity, in
consequence of its interference with the play of the fibrous cord which
passes behind it, becoming thus a source of continual irritation and
consequently of permanent lameness.
_Symptoms._--A splint may thus frequently become a cause of lameness
though not necessarily in every instance, but it is a lameness
possessing features peculiar to itself. It is not always continuous, but
at times assumes an intermittent character, and is more marked when the
animal is warm than when cool. If the lameness is near the knee joint,
it is very liable to become aggravated when the animal is put to work,
and the gait acquires then a peculiar character, arising from the manner
in which the limb is carried outward from the knees downward, which is
done by a kind of abduction of the lower part of the leg. Other
symptoms, however, than the lameness and the presence of the splint,
which is its cause, may be looked for in the same connection as those
which have been mentioned as pertaining to certain evidences of
periostitis, in the increase of the temperature of the part, with
swelling and probably pain on pressure. This last symptom is of no
little importance, since its presence or absence has in many cases
formed the determining point in deciding a question of difficult
diagnosis.
_Cause._--A splint being one of the results of periostitis, and the
latter one of the effects of external hurts, it naturally follows that
the parts which are most exposed to blows and collisions will be those
on which the splint will most commonly be found, and it may not be
improper, therefore, to refer to hurts from without as among the common
causes of the lesion. But other causes may also be productive of the
evil, and among these may be mentioned the over-straining of an immature
organism by the imposition of excessive labor upon a young animal at a
too early period of his life. The bones which enter into the formation
of the cannon are three in number, one large and two smaller, which,
during the youth of the animal, are more or less articulated, with a
limited amount of mobility, but which become in maturity firmly joined
by a rigid union and ossification of their interarticular surface. If
the immature animal is compelled, then, to perform exacting tasks beyond
his strength, the inevitable result will follow in the muscular
straining, and perhaps tearing asunder of the fibers which unite the
bones at their points of juncture, and it is difficult to understand how
inflammation or periostitis can fail to develop as the natural
consequence of such local irritation. If the result were deliberately
and intelligently designed, it could hardly be more effectually
accomplished.
The splint is an object of the commonest occurrence--so common, indeed,
that in large cities a horse which can not exhibit one or more specimens
upon some portion of his extremities is one of the rarest of spectacles.
Though it is in some instances a cause of lameness, and its discovery
and cure are sometimes beyond the ability of the shrewdest and most
experienced veterinarians, yet as a source of vital danger to the
general equine organization, or even of functional disturbance, or of
practical inconvenience, aside from the rare exceptional cases which
exist as mere samples of possibility, it can not be considered to belong
to the category of serious lesions. The worst stigma that attaches to it
is that in general estimation it is ranked among eyesores and continues
indefinitely to be that and nothing different. The inflammation in which
they originated, acute at first, either subsides or assumes the chronic
form, and the bony growth becomes a permanence--more or less
established, it is true, but doing no positive harm and not hindering
the animal from continuing his daily routine of labor. All this,
however, requires a proviso against the occurrence of a subsequent acute
attack, when, as with other exostoses, a fresh access of acute symptoms
may be followed by a new pathological activity, which shall again
develop, as a natural result, a reappearance of the lameness.
_Treatment._--It is, of course, the consideration of the comparative
harmlessness of splints that suggests and justifies the policy of
noninterference, except as they become a positive cause of lameness. And
a more positive argument for such noninterference consists in the fact
that any active and irritating treatment may so excite the parts as to
bring about a renewed pathological activity, which may result in a
reduplication of the phenomena, with a second edition, if not a second
and enlarged volume, of the whole story. For our part, our faith is firm
in the impolicy of interference, and this faith is founded on an
experience of many years, during which our practice has been that of
abstention.
Of course, there will be exceptional conditions which will at times
indicate a different course. These will become evident when the
occasions present themselves, and extraordinary forms and effects of
inflammation and growth in the tumors offer special indications. But our
conviction remains unshaken that surgical treatment of the operative
kind is usually useless, if not dangerous. We have little faith in the
method of extirpation except under very special conditions, among which
that of diminutive size has been named; this seems in itself to
constitute a sufficient negative argument. Even in such a case a resort
to the knife or the gouge could scarcely find a justification, since no
operative procedure is ever without a degree of hazard, to say nothing
of the considerations which are always forcibly negative in any question
of the infliction of pain and the unnecessary use of the knife.
[Illustration: PLATE XXV.
SPLINT.]
[Illustration: PLATE XXVI.
SOUND FOOT.
RINGBONE.]
[Illustration: PLATE XXVII.
VARIOUS TYPES OF SPAVIN.]
[Illustration: PLATE XXVIII.
BONE SPAVIN. HOCKS, WITH SKIN REMOVED.]
[Illustration: PLATE XXIX.
BONE SPAVIN.]
If an acute periostitis of the cannon bone has been readily discovered,
the treatment we have already suggested for that ailment is at once
indicated, and the astringent lotions may be relied upon to bring about
beneficial results. Sometimes, however, preference may be given to a
lotion possessing a somewhat different quality, the alterative
consisting of tincture of iodin applied to the inflamed spot several
times daily. If the lameness persists under this mild course of
treatment, it must, of course, be attacked by other methods, and we must
resort to the cantharides ointment or Spanish-fly blister, as we have
before recommended. Besides this, and producing an analogous effect, the
compounds of biniodid of mercury are favored by some. It is prepared in
the form of an ointment, consisting of 1 dram of the biniodid to 1 ounce
of either lard or vaseline. It forms an excellent blistering and
alterative application, and is of special advantage in newly formed or
recently discovered exostosis.
It remains a pertinent query, however, and one which seems to be easily
answered, whether a tumor so diminutive in size that it can be detected
only by diligent search, and which is neither a disfigurement nor an
obstruction to the motion of the limb, need receive any recognition
whatever. Other modes of treatment for splints are recommended and
practiced which belong strictly to the domain of operative veterinary
surgery; among these are to be reckoned actual cauterization, or the
application of the fire iron and the operation of periosteotomy. These
are frequently indicated in the treatment of splints which have resisted
milder means.
The mode of the development of their growth; their intimacy, greater or
less, with both the large and the small cannon bones; the possibility of
their extending to the back of these bones under the suspensory
ligament; the dangerous complications which may follow the rough
handling of the parts, with also a possibility, and, indeed, a
probability, of their return after removal--these are the considerations
which have influenced our judgment in discarding from our practice and
our approval the method of removal by the saw or the chisel, as
recommended by certain European veterinarians.
RINGBONES.
Ringbone is the designation of the exostosis which is found on the
coronet and in the digital and phalangeal regions. (See Plate XXVI.) The
name is appropriate, because the growth extends quite around the
coronet, which it encircles in the manner of a ring, or perhaps because
it often forms upon the back of that bone a regular osseous arch,
through which the back tendons obtain a passage. The places where these
growths are usually developed have caused their subdivision and
classification into three varieties, with the designations of high,
middle, and low, though much can be said as to the importance of the
distinction. It is true that the ringbone or phalangeal exostosis may be
found at various points on the foot, in one case forming a large bunch
on the upper part and quite close to the fetlock joint; in another
around the upper border of the hoof, or perhaps on the extreme front or
on the very back of the coronet. The shape in which they commonly appear
is favorable to their easy discovery, their form when near the fetlock
usually varying too much from the natural outlines of the part when
compared with those of the opposite side to admit of error in the
matter. (See also page 439.)
A ringbone, when on the front of the foot, even when not very largely
developed, assumes the form of a diffused convex swelling. If situated
on the lower part, it will form a thick ring, encircling that portion of
the foot immediately above the hoof; when found on the posterior part, a
small, sharp osseous growth somewhat projecting, sometimes on the inside
and sometimes on the outside of the coronet, may comprise the entire
manifestation.
_Cause._--As with splints, ringbones may result from severe labor in
early life, before the process of ossification has been fully perfected;
or they may be referred to bruises, blows, sprains, or other violence;
injuries of tendons, ligaments, or joints also may be among the
accountable causes.
It is certain that they may commonly be traced to diseases and traumatic
lesions of the foot, and their appearance may be reasonably expected
among the sequelæ of an abscess of the coronet; or the cause may be a
severe contusion resulting from calking, or a deep-punctured wound from
picking up a nail or stepping upon any hard object of sufficiently
irregular form to penetrate the sole.
Moreover, a ringbone may originate in heredity. This is a fact of no
little importance in its relation to questions connected with the
extensive interests of the stock breeder and purchaser.
That the hereditary transmission of constitutional idiosyncrasies is an
active cause with regard to diseases in general, it would be absurd to
assert, but we do say that a predisposition to contract ringbone through
faulty conformation, such as long, thin pasterns with narrow joints and
steep fetlocks, may be inherited in many cases, and in a smaller
proportion of cases this predisposition may act as a secondary cause in
the formation of ringbone.
The importance of this point when considered in reference to the policy
which should be observed in the selection of breeding stock is obvious,
and, as the whole matter is within the control of the owners and
breeders, it will be their own fault if the unchecked transmission of
ringbones from one equine generation to another is allowed to continue.
It is our belief that among the diseases which are known for their
tendency to perpetuate and repeat themselves by individual succession,
those of the bony structures stand first, and the inference from such
fact which would exclude every animal of doubtful soundness in its
osseous apparatus from the stud list and the brood farm is too plain for
argument.
_Symptoms._--Periostitis of the phalanges is an ailment requiring
careful exploration and minute inspection for its discovery, and is very
liable to result in a ringbone of which lameness is the result. The
mode of its manifestation varies according to the state of development
of the diseased growth as affected by the circumstances of its location
and dimensions. It is commonly of the kind which, in consequence of its
intermittent character, is termed lameness when cool, having the
peculiarity of exhibiting itself when the animal starts from the stable
and of diminishing, if not entirely disappearing after some distance of
travel, to return to its original degree, if not indeed a severer one,
when he has again cooled off in his stable. The size of the ringbone
does not indicate the degree to which it cripples the patient, but the
position may, especially when it interferes with the free movement of
the tendons which pass behind and in front of the foot. While a large
ringbone will often interfere but little with the motion of the limb, a
smaller growth, if situated under the tendon, may become the cause of
considerable and continued pain.
A ringbone is doubtless a worse evil than a splint. Its growth, its
location, its tendency to increased development, its exposure to the
influence of causes of renewed danger, all tend to impart an unfavorable
cast to the prognosis of a case and to emphasize the importance and the
value of an early discovery of its presence and possible growth. Even
when the discovery has been made, it is often the case that the truth
has come to light too late for effectual treatment. Months may have
elapsed after the first manifestation of the lameness before a discovery
has been made of the lesion from which it has originated, and there is
no recall for the lapsed time. And by the uncompromising seriousness of
the discouraging prognosis must the energy and severity of the treatment
and the promptness of its administration be measured. The periostitis
has been overlooked; any chance that might have existed for preventing
its advance to the chronic stage has been lost; the osseous formation is
established; the ringbone is a fixed fact, and the indications are
urgent and pressing.
_Treatment._--The preventive treatment consists in keeping colts well
nourished and in trimming the hoof and shoeing to balance the foot
properly and thus prevent an abnormal strain on the ligaments. Even
after the ringbone has developed, a cure may sometimes be occasioned by
proper shoeing directed toward straightening the axis of the foot as
viewed from the side by making the wall of the hoof from the coronet to
the toe continuous with the line formed by the front of the pastern. So
long as inflammation of the periosteum and ligaments remains, a sharp
blister of biniodid of mercury and cantharides may do good if the animal
is allowed to rest for four or five weeks. If this fails, some success
may be accomplished by point firing in two or three lines over the
ringbone. It is necessary to touch the hot iron well into the bone, as
superficial firing does little good. When all these measures have failed
to remove the lameness, or when the animal is not worth a long and
uncertain treatment, a competent veterinarian should be engaged to
perform double neurectomy, high or low, of the plantar nerves, or
neurectomy of the median nerve as indicated by the seat of the lesion.
SIDEBONES.
On each side of the bone of the hoof--the coffinbone--there are normally
two supplementary organs which are called the cartilages of the foot.
They are soft, and though in a degree elastic, yet somewhat resisting,
and are implanted on the lateral wings of the coffinbone. Evidently
their office is to assist in the elastic expansion and contraction of
the posterior part of the hoof, and their healthy and normal action
doubtless contributes in an important degree to the perfect performance
of the functions of that part of the leg. These organs are, however,
liable to undergo a process of disease which results in an entire change
in their properties, if not in their shape, by which they acquire a
character of hardness resulting from the deposit of earthy substance in
the intimate structure of the cartilage, and it is this change, when its
consummation has been effected, that brings to our cognizance the
diseased growth which has received the designation of sidebones. They
are situated on one or both sides of the leg, bulging above the superior
border of the hoof in the form of two hard bodies composed of ossified
cartilage, irregularly square in shape and unyielding under the pressure
of the fingers.
_Cause._--Sidebones may be the result of a low inflammatory condition or
of an acute attack as well, or may be caused by sprains, bruises, or
blows; or they may have their rise in certain diseases affecting the
foot proper, such as corns, quarter cracks, or quittor. The deposit of
calcareous matter in the cartilage is not always uniform, the base of
that organ near its line of union with the coffinbone being in some
cases its limit, while at other times it is diffused throughout its
substance, the size and prominence of the growth varying much in
consequence.
_Symptoms._--It would naturally be inferred that the degree of
interference with the proper functions of the hoof which must result
from such a pathological change would be proportioned to the size of the
tumor, and that as the dimensions increase the resulting lameness would
be the greater in degree. This, however, is not the fact. A small tumor
while in a condition of acute inflammation during the formative stage
may cripple a patient more severely than a much larger one in a later
stage of the disease. In any case the lameness is never wanting, and
with its intermittent character may usually be detected when the animal
is cooled off after labor or exercise. The class of animals in which
this feature of the disease is most frequently seen is that of the
heavy draft horse and others similarly employed. There is a wide margin
of difference in respect to the degrees of severity which may
characterize different cases of sidebone. While one may be so slight as
to cause no inconvenience, another may develop elements of danger which
may involve the necessity of severe surgical interference.
_Treatment._--The curative treatment should be similar to the
prophylactic, and such means should be used as would tend to prevent the
deposit of bony matters by checking the acute inflammation which causes
it. The means recommended are the free use of the cold bath; frequent
soaking of the feet, and at a later period treatment with iodin, either
by painting the surface with the tincture several times daily or by
applying an ointment made by mixing 1 dram of the crystals with 2 ounces
of vaseline, rubbed in once a day for several days. If this proves to be
ineffective, a Spanish-fly blister to which a few grains of biniodid of
mercury have been added will effect in a majority of cases the desired
result and remove the lameness. If finally this treatment is ineffectual
the case must be relegated to the surgeon for the operation of
neurectomy, or the free and deep application of the firing iron.
SPAVIN.
(Pls. XXVII-XXIX.)
This affection, popularly termed bone spavin, is an exostosis of the
hock joint. The general impression is that in a spavined hock the bony
growth should be seated on the anterior and internal part of the joint,
and this is partially correct, as such a growth will constitute a spavin
in the most nearly correct sense of the term. But an enlargement may
appear on the upper part of the hock also, or possibly a little below
the inner side of the lower extremity of the shank bone, forming what is
known as a high spavin; or, again, the growth may form just on the
outside of the hock and become an outside or external spavin. And,
finally, the entire under surface may become the seat of the osseous
deposit, and involve the articular face of all the bones of the hock,
which again is a bone spavin. There would seem, then, to be but little
difficulty in comprehending the nature of a bone spavin, and there would
be none but for the fact that there are similar affections which may
confuse one if the diagnosis is not very carefully made.
But the hock may be "spavined," while to all outward observation it
still retains its perfect form. With no enlargement perceptible to sight
or touch the animal may yet be disabled by an occult spavin, an
anchylosis in fact, which has resulted from a union of several of the
bones of the joint, and it is only those who are able to realize the
importance of its action to the perfect fulfillment of the function of
locomotion by the hind leg who can comprehend the gravity of the only
prognosis which can be justified by the facts of the case--a prognosis
which is essentially a sentence of serious import in respect to the
future usefulness and value of the animal. For no disease, if we except
those acute inflammatory attacks upon vital organs to which the patient
succumbs at once, is more destructive to the usefulness and value of a
horse than a confirmed spavin. Serious in its inception, serious in its
progress, it is an ailment which, when once established, becomes a fixed
condition which there is no known means of dislodging.
_Cause._--The periostitis, of which it is nearly always a termination,
is usually the effect of a traumatic cause operating upon the
complicated structure of the hock, such as a sprain which has torn a
ligamentous insertion and lacerated some of its fibers, or a violent
effort in jumping, galloping, or trotting, to which the victim has been
compelled by the torture of whip and spur while in use as a gambling
implement by a sporting owner, under the pretext of "improving his
breed"; the extra exertion of starting an inordinately heavy load, or an
effort to recover his balance from a misstep, slipping upon an icy
surface, or sliding with worn shoes upon a bad pavement, and other
kindred causes. We can repeat here what we have before said concerning
bones, in respect to heredity as a cause. From our own experience we
know of equine families in which this condition has been transmitted
from generation to generation, and animals otherwise of excellent
conformation have been rendered valueless by the misfortune of a
congenital spavin.
_Symptoms._--The evil is one of the most serious character for other
reasons, among which may be specified the slowness of its development
and the insidiousness of its growth. Certain indefinite phenomena and
alarming changes and incidents furnish usually the only portents of
approaching trouble. Among these signs may be mentioned a peculiar
posture assumed by the patient while at rest, and becoming at length so
habitual that it can not fail to suggest the action of some hidden
disorder. The posture is due to the action of the adductor muscles, the
lower part of the leg being carried inward, and the heel of the shoe
resting on the toe of the opposite foot. Then an unwillingness may be
noticed in the animal to move from one side of the stall to the other.
When driven he will travel, but stiffly, with a sort of sidelong gait
between the shafts, and after finishing his task and resting again in
his stall will pose with the toe pointing forward, the heel raised, and
the hock flexed. Considerable heat and inflammation soon appear. The
slight lameness which appears when backing out of the stall ceases to be
noticeable after a short distance of travel.
A minute examination of the hock may then reveal the existence of a bony
enlargement which may be detected just at the junction of the hock and
the cannon bone, on the inside and a little in front, and tangible both
to sight and touch. This enlargement, or bone spavin, grows rapidly and
persistently and soon acquires dimensions which renders it impossible to
doubt any longer its existence or its nature. Once established, its
development continues under conditions of progress similar to those to
which we have before alluded in speaking of other like affections. The
argument advanced by some that because these bony deposits are
frequently found on both hocks they are not spavins is fallacious. If
they are discovered on both hocks, it proves merely that they are not
confined to a single joint.
The characteristic lameness of bone spavin, as it affects the motion of
the hock joint, presents two aspects. In one class of cases it is most
pronounced when the horse is cool, in the other when he is at work. The
first is characterized by the fact that when the animal travels the toe
first touches the ground, and the heel descends more slowly, the motion
of flexion at the hock taking place stiffly, and accompanied with a
dropping of the hip on the opposite side. In the other case the
peculiarity is that the lameness increases as the horse travels; that
when he stops he seeks to favor the lame leg, and when he resumes his
work soon after he steps much on his toe, as in the first variety.
As with sidebones, though for a somewhat different reason, the
dimensions of the spavin and the degree of the lameness do not seem to
bear any determinate relation, the most pronounced symptoms at times
accompanying a very diminutive growth. The distinction between the two
varieties of cool and warm, however, may easily be determined by
remembering the fact that in most cases the first, or cool, is due to a
simple exostosis, while the second is generally connected with disease
of the articulation, such as ulceration of the articular surface--a
condition which, as we proceed further, will receive our attention when
we reach the subject of stringhalt.
An excellent test for spavin lameness, which may be readily applied,
consists in lifting the affected leg from the ground for one or two
minutes and holding the foot high so as to flex all the joints. An
assistant, with the halter strap in his hand, quickly starts the animal
off in a trot, when, if the hock joint is affected, the lameness will be
so greatly intensified as to lead readily to a diagnosis.
_Prognosis._--Having thus fully considered the history of bone spavin,
we are prepared to give due weight to the reasons that exist for the
adverse prognosis which we must usually feel compelled to pronounce when
encountering it in practice, as well as to realize the importance of
early discovery. It is but seldom, however, that the necessary advantage
of this early knowledge can be obtained, and when the true nature of
the trouble has become apparent it is usually too late to resort to the
remedial measures which, if duly forewarned, a skillful practitioner
might have employed. We are fully persuaded that but for the loss of the
time wasted in the treatment of purely imaginary ailments very many
cases of bone spavin might be arrested in their incipiency and their
victims preserved for years of comfort for themselves and valuable labor
to their owners.
_Treatment._--To consider a hypothetical case: An early discovery of
lameness has been made; that is, the existence of an acute
inflammation--of periostitis--has been detected. The increased
temperature of the parts has been observed, with the stiffened gait and
the characteristic pose of the limb, and the question is proposed for
solution, What is to be done? Even with only these comparatively
doubtful symptoms--doubtful with the nonexpert--we should direct our
treatment to the hock in preference to any other joint, since of all the
joints of the hind leg it is this which is most liable to be attacked, a
natural result from its peculiarities of structure and function. And in
answer to the query, What is the first treatment indicated? We should
answer _rest_--emphatically, and as an essential condition, _rest_.
Whether only threatened, suspected, or positively diseased, the animal
must be wholly released from labor, and it must be no partial or
temporary quiet of a few days. In all stages and conditions of the
disease, whether the spavin is nothing more than a simple exostosis, or
whether accompanied with the complication of arthritis, there must be a
total suspension of effort until the danger is over. Less than a month's
quiet ought not to be thought of--the longer the better.
Good results may also be expected from local applications. The various
lotions which cool the parts, the astringents which lower the tension of
the blood vessels, the tepid fomentations which accelerate the
circulation in the engorged capillaries, the liniments of various
composition, the stimulants, the opiate anodynes, the sedative
preparations of aconite, the alterative frictions of iodin--all these
are recommended and prescribed by one or another. We prefer
counterirritants, for the reason, among many others, that by the
promptness of their action they tend to prevent the formation of the
bony deposits. The lameness will often yield to the blistering action of
cantharides, in the form of ointment or liniment, and to the alterative
preparations of iodin or mercury. If the owner of a "spavined" horse
really succeeds in removing the lameness, he has accomplished all that
he is justified in hoping for; beyond this let him be well persuaded
that a "cure" is impossible.
For this reason, moreover, he will do well to be on his guard against
the patented "cures" which the traveling horse doctor may urge upon him,
and withhold his faith from the circular of the agent who will deluge
him with references and certificates. It is possible that nostrums may
in some exceptional instances prove serviceable, but the greater number
of them are capable of producing only injurious effects. The removal of
the bony tumor can not be accomplished by any such means, and if a trial
of these unknown compounds should be followed by complications no worse
than the establishment of one or more ugly, hairless cicatrices, it will
be well for both the horse and his owner.
Rest and counterirritation, with the proper medicaments, constitute,
then, the prominent points in the treatment designed for the relief of
bone spavin. Yet there are cases in which all the agencies and methods
referred to seem to lack effectiveness and fail to produce satisfactory
results. Either the rest has been prematurely interrupted or the
blisters have failed to modify the serous infiltration, or the case in
hand has some undiscernible characteristics which seem to have rendered
the disease neutral to the agencies used against it. An indication of
more energetic means is then presented, and free cauterization with the
firing iron becomes necessary.
At this point a word of explanation in reference to this operation of
firing may be appropriate for the satisfaction of any among our readers
who may entertain an exaggerated idea of its severity and possible
cruelty.
The operation is one of simplicity, but is nevertheless one which, in
order to secure its benefits, must be reserved for times and occasions
of which only the best knowledge and highest discretion should be
allowed to judge. It is not the mere application of a hot iron to a
given part of the body which constitutes the operation of firing. It is
the methodical and scientific introduction of heat into the structure
with a view to a given effect upon a diseased organ or tissue by an
expert surgeon. The first is one of the degrees of mere burning. The
other is scientific cauterization, and is a surgical manipulation which
should be committed exclusively to the practiced hand of the veterinary
surgeon.
Either firing alone or stimulation with blisters is of great efficacy
for the relief of lameness from bone spavin. Failure to produce relief
after a few applications and after allowing a sufficient interval of
rest should be followed by a second or, if needed, a third firing.
In case of further failure there is a reserve of certain special
operations which have been tried and recommended, among which those of
cunean tenotomy, periosteotomy, the division of nervous branches, etc.,
may be mentioned. These, however, belong to the peculiar domain of the
veterinary practitioner, and need not now engage our attention.
FRACTURES.
In technical language a fracture is a "solution of continuity in the
structure or substance of a bone." It ranks among the most serious of
the lesions to which the horse--or any animal--can be subject. It is a
subject of special interest to veterinarians and horse owners in view of
the fact that it occurs in such a variety of forms and subjects the
patient to much loss of time, resulting in the suspension of his earning
capacity. Though of less serious consequence in the horse than in man,
it is always a matter of grave import. It is always slow and tedious in
healing and is frequently of doubtful and unsatisfactory result.
This solution of continuity may take place in two principal ways. In the
most numerous instances it includes the total thickness of the bone and
is a complete fracture. In other cases it involves only a portion of the
thickness of the bone, and for that reason is described as incomplete.
If the bone is divided into two separate portions and the soft parts
have received no injury, the fracture is a simple one, or it becomes
compound if the soft parts have suffered laceration, and comminuted if
the bones have been crushed or ground into fragments, many or few. The
direction of the break also determines its further classification.
Broken at a right angle, it is transverse; at a different angle it
becomes oblique, and it may be longitudinal or lengthwise. In a complete
fracture, especially of the oblique kind, there is a condition of great
importance in respect to its effect upon the ultimate result of the
treatment in the fact that from various causes, such as muscular
contractions or excessive motion, the bony fragments do not maintain
their mutual coaptation, but become separated at the ends, which makes
it necessary to add another descriptive term--with displacement. These
words again suggest the negative and introduce the term without
displacement, when the facts justify that description. Furthermore, a
fracture may be intra-articular or extra-articular, as it extends into a
joint or otherwise, and, once more, intra-periosteal when the periosteum
remains intact. Finally, there is no absolute limit to the use of
descriptive terminology in the case.
The condition of displacement is largely influential in determining the
question of treatment and as affecting the final result of a case of
fracture. This, however, is dependent upon its location or whether its
seat is in one or more of the axes of the bone, in its length, its
breadth, its thickness, or its circumference. An incomplete fracture may
also be either simple or comminuted. In the latter case the fragments
are held together by the periosteum when it is intact; in that case the
fracture belongs to the intra-periosteal class. At times, also, there is
only a simple fissure or split in the bone, making a condition of much
difficulty of diagnosis.
_Causes._--Two varieties of originating cause may be recognized in cases
of fracture. They are the predisposing and the occasional. As to the
first, different species of animals differ in the degree of their
liability. That of the dog is greater than that of the horse, and in
horses the various questions of age, the mode of labor, the season of
the year, the portion of the body most exposed, and the existence of
ailments, local and general, are all to be taken into account.
Among horses, those employed in heavy draft work or that are driven over
bad roads are more exposed than light-draft or saddle horses, and
animals of different ages are not equally liable. Dogs and young horses,
with those which have become sufficiently aged for their bones to have
acquired an enhanced degree of frangibility, are more liable than those
which have not exceeded the time of their prime. The season of the year
is undoubtedly, though in an incidental way, an important factor in the
problem of the etiology of these accidents, for though they may be
observed at all times, it is during the months when the slippery
condition of the icy roads renders it difficult for both men and beasts
to keep their feet that they occur most frequently. The long bones,
those especially which belong to the extremities, are most frequently
the seat of fractures, from the circumstance of their superficial
position, their exposure to contact and collision, and the violent
muscular efforts involved both in their constant, rapid movement and
their labor in the shafts or at the pole of heavy and heavily laden
carriages.
The relation between sundry idiosyncrasies and diathesis and a liability
to fractures is too constant and well-established a pathological fact to
need more than a passing reference. The history of rachitis, of
melanosis, and of osteoporosis, as related to an abnormal frangibility
of the bones, is a part of our common medical knowledge. There are few
persons who have not known of cases among their friends of frequent and
almost spontaneous fractures, or at least of such as seem to be produced
by the slightest and most inadequate violence, and there is no tangible
reason for doubting an analogous condition in dividuals of the equine
race. Among local predisposing causes mention must not be omitted of
such bony diseases as caries, tuberculosis, and others of the same
class.
Exciting, occasional, or "efficient" causes of fracture are in most
instances external traumatisms, as violent contacts, collisions, falls,
etc., or sudden muscular contractions. These external accidents are
various in their character, and are usually associated with quick
muscular exertion. A violent, ineffectual effort to move too heavy a
load; a semispasmodic bracing of the frame to avoid a fall or resist a
pressure; a quick jump to escape a blow; stopping too suddenly after
speeding; struggling to liberate a foot from a rail, perhaps to be
thrown in the effort--all these are familiar and easy examples of
accidents happening hourly by which our equine servants become
sufferers. We may add to these the fracture of the bones of the
vertebræ, occurring when casting a patient for the purpose of undergoing
a surgical operation, quite as much as the result of muscular
contraction as of a preexisting diseased condition of the bones. A
fracture occurring under these circumstances may be called with
propriety indirect, while one which has resulted from a blow or a fall
differently caused is of the direct kind.
_Symptoms._--We now return to the first items in our classification of
the varieties of fractures for the purpose of bringing them in turn
under an orderly review, and our first examination will include those
which belong to the first category, or the complete kind. Irregularity
in the performance of the functions of the apparatus to which the
fractured bone belongs is a necessary consequence of the existing
lesion, and this is lameness. If the broken bone belongs to one of the
extremities, the impossibility of the performance of its natural
function in sustaining the weight of the body and contributing to the
act of locomotion is usually complete, though the degree of disability
will vary according to the kind of fracture and the bone which is
injured. For example, a fracture of the cannon bone without
displacement, or of one of the phalanges, which are surrounded and
sustained by a complex fibrous structure, is, in a certain degree, not
incompatible with some amount of resting on the foot. On the contrary,
if the shank bone, or that of the forearm is the implicated member, it
would be very difficult for the leg to exercise any agency whatever in
the support of the body, and in a fracture of the lower jaw it would be
obviously unreasonable to expect it to contribute materially to the
mastication of feed.
It seldom happens that a fracture is not accompanied with a degree of
deformity, greater or less, of the region or the leg affected. This is
due to the exudation of the blood into the meshes of the surrounding
tissues and to the displacement which occurs between the fragments of
the bones, with subsequently the swelling which follows the inflammation
of the surrounding tissues. The character of the deformity will mainly
depend upon the manner in which the displacement occurs.
In a normal state of things the legs perform their movements with the
joints as their only centers or bases of action, with no participation
of intermediate points, while with a fracture the flexibility and motion
which will be observed at unnatural points are among the most strongly
characteristic signs of the lesion. No one need be told that, when the
shaft of a limb is seen to bend midway between the joints, with the
lower portion swinging freely, the leg is broken. There are still some
conditions, however, in which the excessive mobility is not easy to
detect. Such are the cases in which the fracture exists in a short
bone, near a movable joint, or in a bone of a region where several short
and small bones are united in a group, or even in a long bone the
situation of which is such that the muscular covering prevents the
visible manifestation of the symptom.
If the situation of a fracture precludes its discovery by means of this
abnormal flexibility, other modes of detection remain. There is one
method which is absolute and positive and which can be applied in by far
the most, though not in all cases. This is crepitation, or the peculiar
effect which is produced by the friction of the fractured surfaces one
against another. Though discerned by the organs of hearing it can
scarcely be called a sound, for the grating of the parts as the rubbing
takes place is more felt than heard; however, there is no mistaking its
import in cases favorable for the application of the test. The
conditions in which it is not available are those of incomplete
fracture, in which the mobility of the part is lacking, and those in
which the whole array of phenomena are usually obscure. To obtain the
benefit of this pathognomonic sign requires deliberate, careful, and
gentle manipulation. Sometimes the slightest of movements will be
sufficient for its development, after much rougher handling has failed
to discover it. Perhaps the failure in the latter case is due to a sort
of defensive spasmodic rigidity caused by the pain resulting from the
rude interference.
More or less reactive fever is a usual accompaniment of a fracture.
Ecchymosis in the parts is but a natural occurrence, and is more easily
discovered in animals possessing a light-colored and delicate skin than
in those of any other character.
There are difficulties in the way of the diagnosis of an incomplete
fracture, even sometimes when there is a degree of impairment in the
function of locomotion, with evidences of pain and swelling at the seat
of lesion. There should then be a careful examination for evidences of a
blow or other violence sufficient to account for the fracture, though
very often a suspicion of its existence can be converted into a
certainty only by a minute history of the patient if it can be obtained
up to the moment of the occurrence of the injury. A diagnosis ought not
to be hastily pronounced, and where good ground for suspicion exists it
ought not to be rejected upon any evidence less than the best. We too
often read of serious and fatal complications following careless
conclusions in similar cases, among which we may refer to one instance
of a complete fracture manifesting itself in an animal during the act of
rising in his stall after a decision had been pronounced that he had no
fracture at all.
Fractures are of course liable to complications, especially those which
are of a traumatic character, such as extensive lacerations, tearing of
tissues, punctures, contusions, etc. Unless these are in communication
with the fracture itself the indication is to treat them simply as
independent lesions upon other parts of the body. A traumatic emphysema
at times causes trouble, and abscesses, more or less deep and diffused,
may follow. In some cases small, bony fragments from a comminuted
fracture, becoming loose and acting as foreign bodies, give rise to
troublesome fistulous tracts. A frequent complication is hemorrhage,
which often becomes of serious consequence. A fracture in close
proximity to a joint may be accompanied with dangerous inflammations of
important organs, and induce an attack of pneumonia, pleurisy,
arthritis, etc., especially if near the chest; it may also cause
luxations, or dislocations. Gangrene, as a consequence of contusions or
of hemorrhage or of an impediment to the circulation, caused by
unskillfully applied apparatus, must not be overlooked among the
occasional incidents; nor must lockjaw, which is not an uncommon
occurrence. Even founder, or laminitis, has been met with as the result
of forced and long-continued immobility of the feet in the standing
posture, as one of the involvements of unavoidably protracted treatment.
When a simple fracture has been properly treated and the broken ends of
the bone have been securely held in coaptation, one of two things will
occur. Either--and this is the more common event--there will be a union
of the two ends by a solid cicatrix, the callus, or the ends will
continue separated or become only partially united by an intermediate
fibrous structure. In the first instance the fracture is consolidated or
united; in the second there is a false articulation, or pseudarthrosis.
The time required for a firm union or true consolidation of a fracture
varies with the character of the bone affected, the age and constitution
of the patient, and the general conditions of the case. The union will
be perfected earlier in a young than in an adult animal, and sooner in
the latter than in the aged, and a general healthy condition is, of
course, in every respect, an advantage.
The mode of cicatrization, or method of repair in lesions of the bones,
has been a subject of much study among investigators in pathology, and
has elicited various expressions of opinion from those high in
authority. The weight of evidence and preponderance of opinion are about
settled in favor of the theory that the law of reparation is the same
for both the hard and the soft tissues. In one case a simple exudation
of material, with the proper organization of newly formed tissue, will
bring about a union by the first intention, and in another the work will
be accompanied with suppuration, or union by the second intention, a
process so familiar in the repair of the soft structures by granulation.
Considering the process in its simplest form, in a case in which it
advances without interruption or complication to a favorable result, it
may probably be correctly described in this wise:
On the occurrence of the injury an effusion of blood takes place between
the ends of the bone. The coagulation of the fluid soon follows, and
this, after a few days, undergoes absorption. There is then an excess of
inflammation in the surrounding structure, which soon spreads to the
bony tissue, when a true ostitis is established, and the compact tissue
of the bone becomes the seat of a new vascular organization, and of a
certain exudation of plastic lymph, appearing between the periosteum and
the external surface of the bone, as well as on the inner side of the
medullary cavity. After a few days the ends of the bone thus surrounded
by this exudate become involved in it, and the lymph, becoming vascular,
is soon transformed into cartilaginous, and in due time into bony,
tissue.
Thus the time required for the consolidation of the fractured segments
is divisible into two distinct periods. In the first they are surrounded
by an external bony ring, and the medullary cavity is closed by a bony
plug or stopper, constituting the period of the provisional callus. This
is followed by the period of permanent callus, during which the process
of converting the cartilaginous into the osseous form is going forward.
The restorative process is sooner completed in the carnivorous than in
the herbivorous tribes. In the former the temporary callus may attain
sufficient fineness of consistency for the careful use of the limb
within four weeks, but with the latter a period of from six weeks to two
months is not too long to allow before removing the supporting apparatus
from the limb.
This, in general terms, represents the fact when the resources of nature
have not been thwarted by untoward accidents, such as a want of vigor in
the constitution of the patient or a lack of skill on the part of the
practitioner, and especially when, from any cause, the bony fragments
have not been kept in a state of perfect immobility and the constant
friction has prevented the osseous union of the two portions. Failures
and misfortunes are always more than possible, and instead of a solid
and practicable bony union the sequel of the accident is sometimes a
false joint, composed of mere flexible cartilage, a poor pseudarthrosis.
The explanation of this appears to be that, first, the sharp edges of
the ends of the bone disappear by becoming rounded at their extremities
by friction and polishing against each other. Then follows an exudation
of a plastic nature which becomes transformed into a cartilaginous layer
of a rough, articular aspect. In this bony nuclei soon appear, and the
lymph secreted between the segments thus transformed, instead of
becoming truly ossified, is changed into a sort of fibrocartilaginous
pouch, or capsular sac, in which a somewhat albuminous secretion, or
pseudo-synovia, permits the movement to take place. Most commonly,
however, in our animals, the union of the bony fragments is obtained
wholly through the medium of a layer of fibrous tissue, and it is
because the union has been accomplished by a ligamentous formation only
that motion becomes practicable.
_Prognosis._--The prognosis in a case of fracture in an animal is one of
the gravest vital import to the patient, and therefore of serious
pecuniary concern to his owner. The period has not long elapsed when to
have received such a hurt was quite equivalent to undergoing a sentence
of death for the suffering animal, and perhaps to-day a similar verdict
is pronounced in many cases in which the exercise of a little mechanical
ingenuity, with a due amount of careful nursing, might secure a contrary
result and insure the return of the patient to his former condition of
soundness and usefulness.
_Treatment._--Considered per se, a fracture in an animal is in fact no
less amenable to treatment than the same description of injury in any
other living being. But the question of the propriety and expediency of
treatment is dependent upon certain specific points of collateral
consideration.
(1) The nature of the lesion is a point of paramount importance. A
simple fracture occurring in a bone where the ends can be firmly secured
in coaptation presents the most favorable condition for successful
treatment. If it is that of a long bone, it will be the less serious if
situated at or near the middle of its length than if it were in close
proximity to a joint, from the fact that perfect immobility can rarely,
in the latter case, be secured without incurring the risk of subsequent
rigidity of the joint.
A simple is always less serious than a compound fracture. A comminuted
is always more dangerous than a simple, and a transverse break is easier
to treat than one which is oblique. The most serious are those which are
situated on parts of the body in which it is difficult to obtain perfect
immobility, and especially those which are accompanied with severe
contusions and lacerations in the soft parts; the protrusion of
fragments through the skin; the division of blood vessels by the broken
ends of the bone; the existence of an articulation near the point to
which inflammation is liable to extend; the luxation of a fragment of
the bone; laceration of the periosteum; the presence of a large number
of bony particles, the result of the crushing of the bone--all these are
circumstances which discourage a favorable prognosis, and weigh against
the hope of saving the patient for future usefulness.
Fractures which may be accounted curable are those which are not
conspicuously visible, as those of the ribs, where displacements are
either very limited or do not occur, the parts being kept in situ by the
nature of their position, the shape of the bones, the articulations they
form with the vertebra, the sternum, or their cartilages of
prolongation; those of transverse processes of the lumbar vertebra;
those of the bones of the face; those of the ilium; and that of the
coffinbones. To continue the category, the following are evidently
curable when their position and the character of the patient contribute
to aid the treatment: Those of the cranium, in the absence of cerebral
lesions; those of the jaws; of the ribs, with displacement; of the hip;
and those of the bones of the leg in movable regions, but where their
vertical position admits of perfect coaptation.
On the contrary, a compound, complicated, or comminuted, fracture, in
whatever region it may be situated, may be counted incurable.
In treating fractures time is an important element and "delays are
dangerous." Those of recent occurrence unite more easily and more
regularly than older ones.
(2) As a general rule, fractures are less serious in animals of the
smaller species than in those of more bulky dimensions. This influence
of species will be readily appreciated when we realize that the
difficulties involved in the treatment of the latter class have hardly
any existence in connection with the former. The difference in weight
and size, and consequent facility in handling and making the necessary
applications of dressings and other appliances for the purpose of
securing the indispensable immobility of the parts, and usually a less
degree of uneasiness in the deportment of the patients are
considerations in this connection of great weight.
(3) In respect to the utilization of the animal, the most obvious point
in estimating the gravity of the case in a fracture accident is the
certainty of the total loss of the services of the patient during
treatment--certainly for a considerable period of time; perhaps
permanently. For example, the fracture of the jaw of a steer just
fattening for the shambles will involve a heavier loss than a similar
accident to a horse. Usually the fracture of the bones of the
extremities in a horse is a very serious casualty, the more so
proportionately as the higher region of the limb is affected. In working
animals it is exceedingly difficult to treat a fracture in such manner
as to restore a limb to its original perfection of movement. A fracture
of a single bone of an extremity in a breeding stallion or mare will not
necessarily impair the value of the animal as a breeder. Other
specifications under this head, though pertinent and more or less
interesting, may be omitted.
(4) Age and temper are important factors of cure. A young, growing,
robust patient whose vis vitæ is active is amenable to treatment which
one with a waning constitution and past mature energies would be unable
to endure, and a docile, quiet disposition will act cooperatively with
remedial measures which would be neutralized by the fractious opposition
of a peevish and intractable sufferer.
The fulfillment of three indications is indispensable in all fractures.
The first is the reduction, or the replacement, of the parts as nearly
as possible in their normal position. The second is their retention in
that position for a period sufficient for the formation of the
provisional callus, and the third, which, in fact, is but an incident of
the second, the careful avoidance of any accidents or causes of
miscarriage which might disturb the curative process.
In reference to the first consideration, it must be remembered that the
accident may befall the patient at a distance from his home, and his
removal becomes the first duty to be attended to. Of course, this must
be done as carefully as possible. If he can be treated on the spot, so
much the better, though this is seldom practicable, and the method of
removal becomes the question calling for settlement. But two ways
present themselves--he must either walk or be carried. If the first, it
is needless to say that every caution must be observed in order to
obviate additional pain and to avoid any aggravation of the injury. Led
slowly, and with partial support, if practicable, the journey will not
always involve untoward results. If he is carried, it must be by means
of a wagon, a truck, or an ambulance; the last being designed and
adapted to the purpose, would, of course, be the most suitable vehicle.
As a precaution which should never be overlooked, a temporary dressing
should first be applied. This may be so done as for the time to answer
all the purposes of the permanent adjustment and bandaging. Without thus
securing the patient, a fracture of an inferior degree may be
transformed to one of the severest kind, and, indeed, a curable changed
to an incurable injury. We recall a case in which a fast-trotting horse,
after running away in a fright caused by the whistle of a locomotive,
was found on the road limping with excessive lameness in the off fore
leg, and walked with comparative ease some 2 miles to a stable before
being seen by a surgeon. His immediate removal in an ambulance was
advised, but before that vehicle could be procured the horse lay down,
and upon being made to get upon his feet was found with a well-marked
comminuted fracture of the os suffraginis, with considerable
displacement. The patient, however, after long treatment, made a
comparatively good recovery and though with a large, bony deposit, a
ringbone, was able to trot in the forties.
The two obvious indications in cases of fracture are reduction, or
replacement, and retention.
In an incomplete fracture, where there is no displacement, the necessity
of reduction does not exist. With the bone kept in place by an intact
periosteum, and the fragments secured by the uninjured fibrous and
ligamentous structure which surrounds them, there is no dislocation to
correct. Reduction is also at times rendered impossible by the seat of
the fracture itself, by its dimensions, alone, or by the resistance
arising from muscular contraction. That is illustrated even in small
animals, as in dogs, by the exceeding difficulty encountered in
bringing together the ends of a broken femur or humerus, the muscular
contractions being even in these animals sufficiently forcible to renew
the displacement.
It is generally, therefore, only fractures of the long bones, and then
at points not in close proximity to the trunk, that may be considered to
be amenable to reduction. It is true that some of the more superficial
bones, as those of the head, of the pelvis, and of the thoracic walls,
may in some cases require special manipulations and appliances for their
retention in their normal positions; hence the treatment of these and of
a fractured leg can not be the same.
The methods of accomplishing reduction vary with the features of each
case, the manipulations being necessarily modified to meet different
circumstances. If the displacement is in the thickness of the bone, as
in transverse fracture, the manipulation of reduction consists in
applying constant pressure upon one of the fragments, while the other is
kept steady in its place, the object of the pressure being the
reestablishment of the exact coincidence of the two bony surfaces. If
the displacement has taken place at an angle it will be sufficient in
order to effect the reduction to press upon the summit, or apex, of the
angle until its disappearance indicates that the parts have been brought
into coaptation. This method is often practiced in the treatment of a
fractured rib. In a longitudinal fracture, or when the fragments are
pressed together by the contraction of the muscles to which they give
insertion until they so overlap as to correspond by certain points of
their circumference, the reduction is to be accomplished by effecting
the movements of extension, counter extension, and coaptation. Extension
is accomplished by making traction upon the lower portion of the limb.
Counter extension consists in firmly holding or confining the upper or
body portion in such manner, that it shall not be affected by the
traction applied to the lower part. In other words, the operator,
grasping the limb below the fracture, draws it down or away from the
trunk, while he seeks not to draw away, but simply to hold the upper
portion still until the broken ends of bone are brought to their natural
relative positions, when the coaptation, which is thus effected, has
only to be made permanent by the proper dressings to perfect the
reduction.
In treating fractures in small animals the strength of the hand is
usually sufficient for the required manipulations. In the fracture of
the forearm of a dog, for example, while the upper segment is firmly
held by one hand the lower may be grasped by the other and the bone
itself made to serve the purpose of a lever to bring about the desired
coaptation. In such case that is sufficient to overcome the muscular
contraction and correct the overlapping or other malposition of the
bones. If, however, the resistance can not be overcome in this way, the
upper segment may be committed to an assistant for the management of
the counter extension, leaving to the operator the free use of both
hands for the further manipulation of the case.
If the reduction of fractures in small animals is an easy task, however,
it is far from being so when the patient is a large animal whose
muscular force is largely greater than that of several men combined. In
such case resort must be had not only to superior numbers for the
necessary force, but in many cases to mechanical aids. A reference to
the manner of proceeding in a case of fracture with displacement of the
forearm of a horse will illustrate the matter. The patient is first to
be carefully cast, on the uninjured side, with ropes or a broad, leather
strap about 18 feet long passed under and around his body and under the
axilla of the fractured limb and secured at a point opposite to the
animal and toward his back. This will form the mechanical means of
counter extension. Another rope will then be placed around the inferior
part of the leg below the point of fracture, with which to produce
extension, and this will sometimes be furnished with a block and
pulleys, in order to augment the power when necessary; there is, in
fact, always an advantage in their use, on the side of steadiness and
uniformity, as well as of increased power. It is secured around the
fetlock or the coronet or, what is better, above the knee and nearer the
point of fracture, and is committed to assistants. The traction on this
should be firm, uniform, and slow, without relaxing or jerking, while
the operator carefully watches the process. If the bone is superficially
situated he is able, by the eye, to judge of any changes that may occur
in the form or length of the parts under traction, and discovering, at
the moment of its happening, the restoration of symmetry in the
disturbed region he gently but firmly manipulates the place until all
appearance of severed continuity has vanished. Sometimes the fact and
the instant of restoration are indicated by a peculiar sound or "click"
as the ends of the bones slip into contact, to await the next step of
the restorative procedure.
The process is the same when the bones are covered with thick muscular
masses except that it is attended with greater difficulties from the
fact that the finger must be substituted for the eye and taxis must take
the place of sight.
It frequently happens that perfect coaptation is prevented by the
interposition, between the bony surfaces, of such substances as a small
fragment of detached bone or a clot of blood; sometimes the extreme
obliquity of the fracture, by permitting the bones to slip out of place,
is the opposing cause. These are difficulties which can not always be
overcome, even in small-sized animals, and still it is only when they
are mastered that a correct consolidation can be looked for. Without it
the continuity between the fragments will be by a deformed callus, the
union will leave a shortened, crooked, or angular limb, and the animal
will be disabled.
If timely assistance can be obtained, and the reduction accomplished
immediately after the occurrence of the accident, that is the best time
for it, but if it can not be attended to until inflammation has become
established and the parts have become swollen and painful, time must be
allowed for the subsidence of these symptoms before attempting the
operation. A spasmodic, muscular contraction which sometimes interposes
a difficulty may be easily overcome by subjecting the patient to general
anesthesia, and need not, therefore, cause any loss of time. A tendency
to this may also be overcome by the use of sedatives and antiphlogistic
remedies.
The reduction of the fracture having been accomplished, the problem
which follows is that of retention. The parts which have been restored
to their natural position must be kept there, without disturbance or
agitation, until the perfect formation of a callus, and it is here that
ample latitude exists for the exercise of ingenuity and skill by the
surgeon in the contrivance of the necessary apparatus. One of the most
important of the conditions which are available by the surgeon in
treating human patients is denied to the veterinarian in the management
of those which belong to the animal tribes. This is position. The
intelligence of the human patient cooperates with the instructions of
the surgeon, in the case of the animal sufferer there is a continual
antagonism between the parties, and the forced extension and fatiguing
position which must for a considerable period be maintained as a
condition of restoration require special and effective appliances to
insure successful results. To obtain complete immobility is scarcely
possible, and the surgeon must be content to reach a point as near as
possible to that which is unattainable. For this reason, as will
subsequently be seen, the use of slings and the restraint of patients in
very narrow stalls is much to be preferred to the practice sometimes
recommended of allowing entire freedom of motion by turning them loose
in box stalls. Temporary and movable apparatus are not usually of
difficult use in veterinary practice, but the restlessness of the
patients and their unwillingness to submit quietly to the changing of
the dressings render it obligatory to have recourse to permanent and
immovable bandages, which should be retained without disturbance until
the process of consolidation is complete.
The materials composing the retaining apparatus consist of oakum,
bandages, and splints, with an agglutinating compound which forms a
species of cement by which the different constituents are blended into a
consistent mass to be spread upon the surface covering the locality of
the fracture. Its components are black pitch, rosin, and Venice
turpentine, blended by heat. The dressing may be applied directly to
the skin, or a covering of thin linen may be interposed. A putty made
with powdered chalk and the white of egg is recommended for small
animals, though a mixture of sugar of lead and burnt alum with the
albumen is preferred by others. Another formula is spirits of camphor,
Goulard's extract, and albumen. Another recommendation is to saturate
the oakum and bandages with an adhesive solution formed with gum arabic,
dextrin, flour paste, or starch. This is advised particularly for small
animals, as is also the silicate of soda. Dextrin mixed while warm with
burnt alum and alcohol cools and solidifies into a stony consistency,
and is preferable to plaster of Paris, which is less friable and has
less solidity, besides being heavier and requiring constant additions as
it becomes older. Starch and plaster of Paris form another good
compound.
In applying the dressing the leg is usually padded with a cushion of
oakum thick and soft enough to equalize the irregularities of the
surface and to form a bedding for the protection of the skin from
chafing. Over this the splints are placed. The material for these is,
variously, pasteboard, thin wood, bark, laths, gutta-percha, strips of
thin metal, as tin or perhaps sheet iron. They should be of sufficient
length not only to cover the region of the fracture but to extend
sufficiently above and below to render the immobility more nearly
complete than in the surrounding joints. The splints, again, are covered
with cloth bandages--linen preferably--soaked in a glutinous mixture.
These bandages are to be carefully applied, with a perfect condition of
lightness. They are usually made to embrace the entire length of the leg
in order to avoid the possibility of interference with the circulation
of the extremity as well as for the prevention of chafing. They should
be rolled from the lower part of the leg upward and carefully secured
against loosening. In some instances suspensory bandages are
recommended, but except for small animals our experience does not
justify a concurrence in the recommendation.
These permanent dressings always need careful watching with reference to
their immediate effect upon the region they cover, especially during the
first days succeeding that of their application. Any manifestation of
pain, or any appearance of swelling above or below, or any odor
suggestive of suppuration should excite suspicion, and a thorough
investigation should follow without delay. The removal of the dressing
should be performed with great care, and especially so if time enough
has elapsed since its application to allow of a probability of a
commencement of the healing process or the existence of any points of
consolidation. With the original dressing properly applied in its
entirety in the first instance, the entire extremity will have lost all
chance of mobility, and the repairing process may be permitted to
proceed without interference. There will be no necessity and there need
be no haste for removal or change except under such special conditions
as have just been mentioned, or when there is reason to judge that
solidification has become perfect, or for the comfort of the animal, or
for its readaptation in consequence of the atrophy of the limb from want
of use. Owners of animals are often tempted to remove a splint or
bandage prematurely at the risk of producing a second fracture in
consequence of the failure of the callus properly to consolidate.
The method of applying the splints which we have described refers to the
simple variety only. In a compound case the same rules must be observed,
with the modification of leaving openings through the thickness of the
dressing, opposite the wound, in order to permit the escape of pus and
to secure access to the points requiring the application of treatment.
FRACTURE OF CRANIAL BONES.
Fractures of the cranial bones in large animals are comparatively rare,
though the records are not destitute of cases. When they occur, it is as
the result of external violence, the sufferers being usually run-aways
which have come in collision with a wall or a tree or other obstruction,
or it may occur in those which in pulling upon the halter have broken it
with a jerk and been thrown backward, as may occur in rearing too
violently. Under these conditions we have witnessed fractures of the
parietal, of the frontal, and of the sphenoid bones. These fractures may
be of both the complete and the incomplete kinds, which indeed is
usually the case with those of the flat bones, and they are liable to be
complicated with lacerations of the skin, in consequence of which they
are easily brought under observation. When the fact is otherwise and the
skin is intact, however, the diagnosis becomes difficult.
_Symptoms._--The incomplete variety may be unaccompanied with any
special symptoms, but in the complete kind one of the bony plates may be
so far detached as to press upon the cerebral substance with sufficient
force to produce serious nervous complications. When the injury occurs
at the base of the cranium hemorrhage may be looked for, with paralytic
symptoms, and when these are present the usual termination is death. It
may happen, however, that the symptoms of an apparently very severe
concussion may disappear, resulting in an early and complete recovery,
and the surgeon will therefore do well to avoid undue haste in venturing
upon a prognosis. In fractures of the orbital or the zygomatic bones the
danger is less pressing than with injuries otherwise located about the
head.
_Treatment._--The treatment of cranial fractures is simple, though
involving the best skill of an experienced surgeon. When incomplete
hardly any interference is needed; even plain bandaging may usually be
dispensed with. In the complete variety the danger to be combated is
compression of the brain, and attention to this indication must not be
delayed. The means to be employed are the trephining of the skull over
the seat of the fracture and the elevation of the depressed bone or the
removal of the portion which is causing the trouble. Fragments of bone
in comminuted cases, bony exfoliations, collections of fluid, or even
protruding portions of the brain substance must be carefully cleansed
away and a simple bandage so applied as to facilitate the application of
subsequent dressings.
FRACTURES OF THE BONES OF THE FACE.
In respect to their origin--usually traumatic--these injuries rank with
the preceding, and are commonly of the incomplete variety. They may
easily be overlooked, and may even sometimes escape recognition until
the reparative process has been well established and the wound is
discovered owing to the prominence caused by the presence of the
provisional callus which marks its cure. When the fracture is complete
it will be marked by local deformity, mobility of the fragments, and
crepitation. Nasal hemorrhage, roaring, frequent sneezing, loosening or
loss of teeth, difficulty of mastication, and inflammation of the
cavities of the sinuses are varying complications of these accidents.
The object of the treatment should be the restoration of the depressed
bones as nearly as possible to their normal position and their retention
in place by protecting splints, which should cover the entire facial
region. Special precautions should be observed to prevent the patient
from disturbing the dressing by rubbing his head against surrounding
objects, such as the stall, manger, rack, etc. Clots of blood in the
nasal passages must be washed out, collections of pus removed from the
sinuses, and, if the teeth are loosened and liable to fall out, they
should be removed. If roaring is threatened, tracheotomy is indicated.
FRACTURES OF THE PREMAXILLARY BONE.
These are mentioned by continental authors and are usually encountered
in connection with fractures of the nasal bone, and may take place
either in the width or the length of the bone.
The deformity of the upper lip, which is drawn sidewise in this lesion,
renders it easy of diagnosis. The abnormal mobility and the crepitation,
with the pain manifested by the patient when undergoing examination, are
concurrent symptoms. Looseness of the teeth, abundant salivation, and
entire inability to grasp the feed complete the symptomatology of these
accidents. In the treatment splints of gutta-percha or leather are
sometimes used, but they are of difficult application. Our own judgment
and practice are in favor of the union of the bones by means of metallic
sutures.
FRACTURES OF THE LOWER JAW.
A fracture here is not an injury of infrequent occurrence. It involves
the body of the bone, at its symphysis, or back of it, and includes one
or both of its branches, either more or less forward, or at the
posterior part near the temporomaxillary articulation, at the coronoid
process.
Falls, blows, or other external violence, or powerful muscular
contractions during the use of the speculum, may be mentioned among the
causes of this lesion. The fracture of the neck, or that portion formed
by the juncture of the two opposite sides, and of the branches in front
of the cheeks, causes the lower jaw, the true dental arch, to drop,
without the ability to raise it again to the upper, and the result is a
peculiar and characteristic physiognomy. The prehension and mastication
of feed become impossible; there is an abundant escape of fetid and
sometimes bloody saliva, especially if the gums have been wounded; there
is excessive mobility of the lower end of the jawbone; and there is
crepitation, and frequently paralysis of the under lip. Although an
animal suffering with a complete and often compound and comminuted
fracture of the submaxilla presents at times a serious aspect, the
prognosis of the case is comparatively favorable, and recovery is
usually only a question of time. The severity of the lesion corresponds
in degree to that of the violence to which it is due, also to the
resulting complications and the situation of the wound. It is simple
when at the symphysis, but becomes more serious when it affects one of
the branches, and most aggravated when both are involved. Fracture of
the coronoid process becomes important principally as an evidence of the
existence of a morbid diathesis, such as osteoporosis, or the like.
The particular seat of the injury, with its special features, will, of
course, determine the treatment. For a simple fracture, without
displacement, provided there is no laceration of the periosteum, an
ordinary supporting bandage will usually be sufficient, but when there
is displacement the reduction of the fracture must first be
accomplished, and for this special splints are necessary. In a fracture
of the symphysis or of the branches the adjustment of the fragments by
securing them with metallic sutures is the first step necessary, to be
followed by the application of supports, consisting of splints of
leather or sheets of metal, the entire front of the head being then
covered with bandages prepared with adhesive mixtures. During the entire
course of treatment a special method of feeding becomes necessary. The
inability of the patient to appreciate the situation, of course,
necessitates a resort to an artificial mode of introducing the necessary
feed into his stomach; this is accomplished by forcing between the
commissures of the lips, in a liquid form, by means of a syringe, the
milk or nutritive gruels selected for his sustenance until the
consolidation is sufficiently advanced to permit the ingestion of feed
of a more solid consistency. The callus will usually be sufficiently
hardened in two or three weeks to allow of a change of diet to mashes of
cut hay and scalded grain, until the removal of the dressing restores
the animal to its old habit of mastication.
FRACTURES OF VERTEBRÆ.
These are not very common, but when they do occur the bones most
frequently injured are those of the back and loins.
_Causes._--The ordinary causes of fracture are responsible here as
elsewhere, such as heavy blows on the spinal column, severe falls while
conveying heavy loads, and especially violent efforts in resisting the
process of casting. Although occurring more or less frequently under the
latter circumstances, the accident is not always attributable to
carelessness or error in the management. It may, of course, sometimes
result from such a cause as a badly prepared bed, or the accidental
presence of a hard body concealed in the straw, or to a heavy fall when
the movements of the patient have not been sufficiently controlled by an
effective apparatus and its skillful adaptation, but it is quite as
liable to be caused by the violent resistance and the consequent
powerful muscular contraction by the frightened patient. The simple fact
of the overarching of the vertebral column, with excessive pressure
against it from the intestinal mass, owing to the spasmodic action of
the abdominal muscles, may account for it, and so also may the struggles
of the animal to escape from the restraint of the hobbles while frantic
under the pain of an operation without anesthesia. In these cases the
fracture usually occurs in the body or the annular part, or both, of the
posterior dorsal or the anterior lumbar vertebra. When the transverse
processes of the last-named bones are injured, it is probably in
consequence of the heavy concussion incident to striking the ground when
cast. The diagnosis of a fracture of the body of a vertebra is not
always easy, especially when quite recent, and more especially when
there is no accompanying displacement.
_Symptoms._--There are certain peculiar signs accompanying the
occurrence of the accident while an operation is in progress which
should at once excite the suspicion of the surgeon. In the midst of a
violent struggle the patient becomes suddenly quiet; the movement of a
sharp instrument, which at first excited his resistance, fails to give
rise to any further evidence of sensation; perhaps a general trembling,
lasting for a few minutes, will follow, succeeded by a cold, profuse
perspiration, particularly between the hind legs, and frequently there
will be micturition and defecation. Careful examination of the vertebral
column may then detect a slight depression or irregularity in the
direction of the spine, and there may be a diminution or loss of
sensation in the posterior part of the trunk, while the anterior portion
continues to be as sensitive as before. In making an attempt to get upon
his feet, however, upon the removal of the hobbles, only the fore part
of the body will respond to the effort, a degree of paraplegia being
present, and while the head, neck, and fore part of the body will be
raised, the hind quarters and hind legs will remain inert. The animal
may perhaps succeed in rising and probably may be removed to his stall,
but the displacement of the bone will follow, converting the fracture
into one of the complete kind, either through the exertion of walking or
by a renewed attempt to rise after another fall before reaching his
stall. By this time the paralysis is complete, and the extension of the
meningitis, which has become established, is a consummation soon
reached.
To say that the prognosis of fracture of the body of the vertebra is
always serious is to speak very mildly. It would be better, perhaps, to
say that _occasionally_ a case _may_ recover. Fractures of the
transverse processes are less serious.
_Treatment._--Instead of stating the indication in this class of cases
as if assuming them to be amenable to treatment, the question naturally
would be: Can any treatment be recommended in a fracture of the body of
a vertebra? The only indication in such a case, in our opinion, is to
reach the true diagnosis in the shortest possible time and to act
accordingly. If there is displacement, and the existence of serious
lesions may be inferred from the nervous symptoms, the destruction of
the suffering animal appears to suggest itself as the one conclusion in
which considerations of policy, humanity, and science at once unite.
If, however, it is fairly evident that no displacement exists; that
pressure upon the spinal cord is not yet present; that the animal with a
little assistance is able to rise upon his feet and to walk a short
distance--it may be well to experiment upon the case to the extent of
placing the patient in the most favorable circumstances for recovery and
allow nature to operate without further interference. This may be
accomplished by obtaining immobility of the whole body as much as
possible, and especially of the suspected region, by placing the patient
in slings, in a stall sufficiently narrow to preclude lateral motion,
and covering the loins with a thick coat of agglutinative mixture.
Developments should be watched and awaited.
FRACTURE OF THE RIBS.
The different regions of the chest are not equally exposed to the
violence that causes fractures of the ribs, and they are therefore
either more common or more easily discovered during life at some points
than at others. The more exposed regions are the middle and the
posterior, while the front is largely covered and defended by the
shoulder. A single rib may be the seat of fracture, or a number may be
involved, and there may be injuries on both sides of the chest at the
same time. It may take place lengthwise, in any part of the bone, though
the middle, being the most exposed, is the most frequently hurt.
Incomplete fractures are usually lengthwise, involving a portion only of
the thickness of one or other of the surfaces. The complete kind may be
either transverse or oblique, and are most commonly denticulated. The
fracture may be comminuted, and a single bone may show one of the
complete and one of the incomplete kind at different points. The extent
of surface presented by the thoracic region, with its complete exposure
at all points, explains the liability of the ribs to suffer from all the
forms of external violence.
_Symptoms._--In many instances fractures, especially the incomplete
variety, of these bones continue undiscovered, without displacement,
though the evidences of local pain, a certain amount of swelling, and a
degree of disturbance of the respiration, if noticed during the
examination of a patient, may suggest a suspicion of their existence.
Abnormal mobility and crepitation are difficult of detection, even when
present, and they are not always present. When there is displacement the
deformity which it occasions will betray the fact, and when such an
injury exists the surgeon, in view of possible and probable
complications of thoracic trouble, of course will become vigilant and
prepare himself for an encounter with a case of traumatic pleuritis or
pneumonia. Fatal injuries of the heart are recorded. Subcutaneous
emphysema is a common accompaniment of broken ribs, and I recall the
death, from this cause, of a patient of my own which had suffered a
fracture of two ribs in the region of the withers, under the cartilages
of the shoulder, and of which the diagnosis was made only after the
fatal ending of the case.
These hurts are not often of a very serious character, though the union
is never so solid and complete as in other fractures, the callus being
usually imperfect and of a fibrous character, with an amphiarthrosis
formation. Still, complications occur which may impart gravity to the
prognosis.
_Treatment._--Fractures with but a slight or no displacement need no
reduction. All that is necessary is a simple application of a blistering
nature as a preventive of inflammation or for its subjugation when
present, and in order to excite an exudation which will tend to aid in
the support and immobilization of the parts. At times, however, a better
effect is obtained by the application of a bandage placed firmly around
the chest, although, while this limits the motion of the ribs, it is
liable to render the respiration more labored.
If there is displacement, with much accompanying pain and evident
irritation of the lungs, the fracture must be reduced without delay.
The means of effecting this vary according to whether the displacement
is outward or inward. In the first case the bone may be straightened by
pressure from without, while in the second the end of it must be raised
by a lever, for the introduction of which a small incision through the
skin and intercostal spaces will be necessary. When coaptation has been
effected it must be retained by the external application of an adhesive
mixture, with splints and bandages around the chest.
FRACTURES OF THE BONES OF THE PELVIS.
These fractures will be considered under their separate denominations,
as those of the sacrum and the os innominatum, or hip, which includes
the subdivisions of the ilium, the pubes, and the ischium.
_The sacrum._--Fractures of this bone are rarely met with among
solipeds. Among cattle, however, it is of common occurrence, being
attributed not only to the usual varieties of violence, as blows and
other external hurts, but to the act of coition and violent efforts in
parturition. It is generally of the transverse kind and may be
recognized by the deformity which it occasions. This is due to the
dropping of the bone, with a change in its direction and a lower
attachment of the tail, which also becomes more or less paralyzed. The
natural and spontaneous relief which usually interposes in these cases
has doubtless been observed by the extensive cattle breeders of the
West, and their practice and example fully establish the inutility of
interference. Still, cases may occur in which reduction may be
indicated, and it then becomes a matter of no difficulty. It is effected
by the introduction of a round, smooth piece of wood into the rectum as
far as the fragment of bone and using it as a lever, resting upon
another as a fulcrum placed under it outside. The bone, having been thus
returned, may be kept in place by the ordinary external means in use.
_The os innominatum._--Fracture of the ilium may be observed either at
the angle of the hip or at the neck of the bone; those of the pubes may
take place at the symphysis, or in the body of the bone; those of the
ischium on the floor of the bone, or at its posterior external angle.
Or, again, the fracture may involve all three of these constituent parts
of the hip bone by having its situation in the articular cavity--the
acetabulum by which it joins the femur or thigh bone.
_Symptoms._--Some of these fractures are easily recognized, while others
are difficult to identify. The ordinary deformity which characterizes a
fracture of the external angle of the ilium, its dropping and the
diminution of that side of the hip in width, unite in indicating the
existence of the condition expressed by the term "hipped." An incomplete
fracture, however, or one that is complete without displacement, or even
one with displacement, often demands the closest scrutiny for its
discovery. The lameness may be well marked, and an animal may show it
but little while walking, though upon being urged into a trot will
manifest it more and more, until presently it will cease to use the
crippled limb altogether, and travel entirely on three legs. The acute
character of the lameness will vary in degree as the seat of the lesion
approximates the acetabulum. In walking, the motion at the hip is very
limited, and the leg is dragged; while at rest it is relieved from
bearing its share in sustaining the body. An intelligent opinion and
correct conclusion will depend largely upon a knowledge of the history
of the case, and while in some instances that will be but a report of
the common etiology of fractures, such as blows, hurts, and other
external violence, the simple fact of a fall may furnish in a single
word a satisfactory solution of the whole matter.
With the exception of the deformity of the ilium in a fracture of its
external angle, and unless there has been a serious laceration of
tissues and infiltration of blood, or excessive displacement, there are
no very definite external symptoms in a case of a fracture of the hip
bone. There is one, however, which, in a majority of cases, will not
fail--it is crepitation. This evidence is attainable by both external
and internal examination--by manipulation of the gluteal surface and by
rectal taxis. Very often a lateral motion, or balancing of the hinder
parts by pressing the body from one side to the other, will be
sufficient to render the crepitation more distinct--a slight sensation
of grating, which may be perceived even through the thick coating of
muscle which covers the bone--and the sensation may not only be felt,
but to the expert may even become audible. This external manifestation
is, however, not always sufficient in itself, and should invariably be
associated with the rectal taxis for corroboration. It is true that this
may fail to add to the evidence of fracture, but till then the simple
testimony afforded by the detection of crepitation from the surface,
though a strong confirmatory point, is scarcely sufficiently absolute to
establish more than a reasonable probability or strong suspicion in the
case.
In addition to the fact that the rectal examination brings the exploring
hand of the surgeon into near proximity to the desired point of search,
and to an accurate knowledge of the situation of parts, both pro and con
as respects his own views, there is another advantage attendant upon it
which is well entitled to appreciation. This is the facility with which
he can avail himself of the help of an assistant, who can aid him by
manipulating the implicated limb and placing it in various positions, so
far as the patient will permit, while the surgeon himself is making
explorations and studying the effect from within. By this method he can
hardly fail to ascertain the character of the fracture and the condition
of the bony ends. By the rectal taxis, as if with eyes in the finger
ends, he will "see" what is the extent of the fracture of the ilium or
of the neck of that bone; to what part of the central portion of the
bone (the acetabulum) it reaches; whether this is free from disease or
not, and in what location on the floor of the pelvis the lesion is
situated. By this method we have frequently been able to detect a
fracture at the symphysis, which, from its history and symptoms and an
external examination, could only have been guessed at. Yet, with all its
advantages, the rectal examination is not always necessary, as, for
example, when the fracture is at the posterior and external angle of the
ischium, when by friction of the bony ends the surgeon may discern the
crepitation without it.
Every variety of complication, including muscular lacerations with the
formation of deep abscesses and injuries to the organs of the pelvic
cavity, the bladder, the rectum, and the uterus, may be associated with
fractures of the hip bone.
_Prognosis._--The prognosis of these lesions will necessarily vary
considerably. A fracture of the most superficial part of the bone of the
ilium or of the ischium, especially if there is little displacement,
will unite rapidly, leaving a comparatively sound animal often quite
free from subsequent lameness. If there is much displacement, however,
only a ligamentous union will take place, with much deformity and more
or less irregularity in the gait. Other fractures may be followed by
complete disability of the patient, as, for example, when the cotyloid
cavity is involved, or when the reparatory process has left bony
deposits in the pelvic cavity at the seat of the union, which may, in
the case of the female, interfere with the steps of parturition, or
induce some local paralysis by pressure upon the nerves which govern the
muscles of the hind legs. This is a condition not infrequently observed
when the callus has been formed on the floor of the pelvis near the
obturator foramen, pressing upon the course or involving the obturator
nerve.
_Treatment._--In our estimation, the treatment of all fractures of the
hip bone should be of the simplest kind. Rendered comparatively
immovable by the thickness of the muscles by which the region is
enveloped, one essential indication suggests itself, and that is to
place the animal in a position which, so far as possible, will be fixed
and permanent. For the accomplishment of this purpose the best measure,
as we consider it, is to place the horse in a stall of just sufficient
width to admit him, and to apply a set of slings, snugly, but
comfortably. (See Plate XXXI.) This will fulfill the essential
conditions of recovery--rest and immobility. Blistering applications
would be injurious, though the adhesive mixture might prove in some
degree beneficial.
The minimum period allowable for solid union in a fractured hip is, in
our judgment, two months, and we have known cases in which that was too
short a time.
As we have said before, there may be cases in which the treatment for
fracture at the floor of the pelvis has been followed by symptoms of
partial paralysis, the animal, when lying down, being unable to regain
his feet, but moving freely when placed in an upright position. This
condition is owing to the interference of the callus with the functions
of the obturator nerve, which it presses upon or surrounds. By my
experience in similar cases I feel warranted in cautioning owners of
horses in this condition to exercise due patience, and to avoid a
premature sentence of condemnation against their invalid servants; they
are not all irrecoverably paralytic. With alternations of moderate
exercise, rest in the slings, and the effect of time while the natural
process of absorption is taking effect upon the callus, with other
elements of change that may be so operating, the horse in due time may
become able once more to earn his subsistence and serve his master.
FRACTURE OF THE SCAPULA.
This bone is seldom fractured, its comparative exemption being due to
its free mobility and the protection it receives from the superimposed
soft tissues. Only direct and powerful causes are sufficient to effect
the injury, and when it occurs the large rather than the smaller animals
are the subjects.
_Cause._--The causes are heavy blows or kicks and violent collisions
with unyielding objects. Those which are occasioned by falls are
generally at the neck of the bone, and of the transverse and comminuted
varieties.
_Symptoms._--The diagnosis is not always easy. The symptoms are
inability to rest the leg on the ground and to carry weights, and they
are present in various degrees from slight to severe. The leg rests upon
the toe, seems shortened, and locomotion is performed by jumps. Moving
the leg while examining it and raising the foot for inspection seem to
produce much pain and cause the animal to rear. Crepitation is readily
felt with the hand upon the shoulder when the leg is moved. If the
fracture occurs in the upper part of the bone, overlapping of the
fragments and displacement will be considerable.
The fracture of this bone is usually classed among the more serious
accidents, though cases may occur which are followed by recovery without
very serious ultimate results, especially when the seat of the injury is
at some of the upper angles of the bone or about the acromion crest. But
if the neck and the joint are the parts involved, complications which
are likely to disable the animal for life are liable to be present.
_Treatment._--If there is no displacement, a simple adhesive dressing to
strengthen and immobilize the parts will be sufficient. A coat of black
pitch dissolved with wax and Venice turpentine, and kept in place over
the region with oakum or linen bands, will be all the treatment
required, especially if the animal is kept quiet in the slings.
Displacement can not be remedied, and reduction is next to impossible.
Sometimes an iron plate is applied over the parts and retained by
bandages, as in the dressing of Bourgelat (Plate XXX); this may be
advantageously replaced by a pad of thick leather. In smaller animals
the parts are retained by figure-8 bandages, embracing both the normal
and the diseased shoulders, crossing each other in the axilla and
covered with a coating of adhesive mixture.
FRACTURES OF THE HUMERUS.
These are more common in small than in large animals, and are always the
result of external traumatism, such as falls, kicks, and collisions.
They are generally very oblique, are often comminuted, and though more
usually involving the shaft of the bone will in some cases extend to the
upper end and into the articular head.
_Symptoms._--There is ordinarily considerable displacement in
consequence of the overlapping of the broken ends of the bone, and this
of course causes more or less shortening of the limb. There will also be
swelling, with difficulty of locomotion, and crepitation will be easy of
detection. This fracture is always a serious damage to the patient,
leaving him with a permanently shortened limb and an incurable, lifelong
lameness.
_Treatment._--If treatment is determined on, it will consist in the
reduction of the fracture by means of extension and counter extension,
to accomplish which the animal must be thrown. If successful in the
reduction, then follows the application and adjustment of the apparatus
of retention, which must be of the most perfect and efficient kind.
Finally, this, however skillfully contrived and carefully adapted, will
often fail to effect any good purpose whatever.
FRACTURES OF THE FOREARM.
A fracture in this region may also involve the radius or the ulna, the
latter being broken at times in its upper portion above the radio-ulnar
arch at the olecranon. If the fracture occurs at any part of the forearm
from the radio-ulnar arch down to the knee, it may involve either the
radius alone or the radius and the cubitus, which are there intimately
united.
_Cause._--Besides having the same etiology with most of the fractures,
those of the forearm are, nevertheless, more commonly due to kicks from
other animals, especially when crowded together in large numbers in
insufficient space. It is a matter of observation that under these
circumstances fractures of the incomplete kind are those which occur on
the inside of the leg, the bone being in that region almost entirely
subcutaneous, while those of the complete class are either oblique or
transverse. The least common are the longitudinal, in the long axis of
the bone.
_Symptoms._--This variety of fracture is easily recognized by the
appearance of the leg and the different changes it undergoes. There is
inability to use the limb; impossibility of locomotion; mobility below
the injury; the ready detection of crepitation--in a word, the
assemblage of all the signs and symptoms which have been already
considered as associated with the history of broken bones.
The fracture of the ulna alone, principally above the radio-ulnar arch,
may be ascertained by the aggravated lameness, the excessive soreness on
pressure, and perhaps a certain increase of motion, with a very slight
crepitation if tested in the usual way. Displacement is not likely to
take place except when it is well up toward the olecranon or its
tuberosity, the upper segment of the bone being in that case likely to
be drawn upward. For a simple fracture of this region there is a fair
chance of recovery, but in a case of the compound and comminuted class
there is less ground for a favorable prognosis, especially if the elbow
joint has suffered injury. A fracture of the ulna alone is not of
serious importance, except when the same conditions prevail. A fracture
of the olecranon is less amenable to treatment, and promises little
better than a ligamentous union.
_Treatment._--Considering all the various conditions involving the
nature and extent of these lesions, the position and direction of the
bones of the forearm are such as to render the chances for recovery from
fracture as among the best. The reduction, by extension and
counterextension; the maintenance of the coaptation of the segments; the
adaptation of the dressing by splints, oakum, and agglutinative
mixtures; in fact, all the details of treatment may be here fulfilled
with a degree of facility and precision not attainable in any other part
of the organism. An important, if not an essential, point, however, must
be emphasized in regard to the splints. Whether they are of metal, wood,
or other material, they should reach from the elbow joint to the ground,
and should be placed on the posterior face and on both sides of the leg.
This is then to be so confined in a properly constructed box as to
preclude all possibility of motion, while yet it must sustain a certain
portion of the weight of the body. The iron splint (represented in Plate
XXX) recommended by Bourgelat is designed for fractures of the forearm,
of the knee, and of the cannon bone, and will prove to be an appliance
of great value. For small animals the preference is for an external
covering of gutta-percha, embracing the entire leg. A sheet of this
substance of suitable thickness, according to the size of the animal,
softened in lukewarm water, is, when sufficiently pliable, molded on the
outside of the leg, and when suddenly hardened by the application of
cold water forms a complete casing sufficiently rigid to resist all
motion. Patients treated in this manner have been able to use the limb
freely, without pain, immediately after the application of the dressing.
The removal of the splint is easily effected by cutting it away, either
wholly or in sections, after softening it by immersing the leg in a warm
bath.
FRACTURE OF THE KNEE.
This accident, happily, is of rare occurrence, but when it takes place
is of a severe character, and always accompanied with synovitis, with
disease of the joint.
_Cause._--It may be caused by falling upon a hard surface, and is
usually compound and comminuted. Healing seldom occurs, and when it does
there is usually a stiffness of the joint from arthritis.
_Symptoms._--As a result of this fracture there is inability to bear
weight on the foot. The leg is flexed as in complete radial paralysis,
or fracture of the ulna. There is abnormal mobility of the bones of the
knee, but crepitation is usually absent.
_Prognosis._--Healing is hard to effect, as one part of the knee is
drawn upward by the two flexor muscles which separate it from the lower
part. The callus which forms is largely fibrous, and if the animal is
put to work too quickly this callus is liable to rupture. In favorable
cases healing takes place in two or three months. Many horses during the
treatment develop founder, with consequent drop sole in the sound leg,
as a result of pressure due to continuous standing.
_Treatment._--Place the animal in the slings, bring the pieces of bone
together if possible, and try to keep them in place by a tight
plaster-of-Paris dressing about the leg, extending down to the fetlock.
Place the animal in a roomy box stall well provided with bedding so that
he can lie down, to prevent founder.
FRACTURE OF THE FEMUR.
The protection which this bone receives from the large mass of muscles
in which it is enveloped does not suffice to invest it with immunity in
regard to fractures.
_Cause._--It contributes its share to the list of accidents of this
description, sometimes in consequence of external violence and sometimes
as the result of muscular contraction; sometimes it takes place at the
upper extremity of the bone; sometimes at the lower; sometimes at the
head, when the condyles become implicated; but it is principally found
in the body or diaphysis. The fracture may be of any of the ordinary
forms, simple or compound, complete or incomplete, transverse or
oblique, etc. A case of the comminuted variety is recorded in which 85
fragments of bone were counted and removed.
The thickness of the muscular covering sometimes renders the diagnosis
difficult by interfering with the manipulation, but the crepitation test
is readily available, even when the swelling is considerable, and which
is liable to be the case as the result of the interstitial hemorrhage
which naturally follows the laceration of the blood vessels of the
region involved.
_Symptoms._--If the fracture is at the neck of the bone the muscles of
that region (the gluteal) are firmly contracted, and the leg seems to be
shortened in consequence. Locomotion is impossible. There is intense
pain and violent sweating at first. Crepitation may in some cases be
discerned by rectal examination, with one hand resting over the
coxo-femoral (hip) articulation. Fractures of the tuberosities of the
upper end of the bone, the great trochanter, may be identified by the
deformity, the swelling, the impossibility of rotation, and the dragging
of the leg in walking. Fracture of the body is always accompanied with
displacement, and as a consequence a shortening of the leg, which is
carried forward. The lameness is excessive, the foot being moved, both
when raising it from the ground and when setting it down, very timidly
and cautiously. The manipulations for the discovery of crepitation
always cause much pain. Lesions of the lower end of the bone are more
difficult to diagnosticate with certainty, though the manifestation of
pain while making heavy pressure upon the condyles will be so marked
that only crepitation will be needed to turn a suspicion into a
certainty.
_Treatment._--The question as to treatment in fractures of this
description resolves itself into the query whether any treatment can be
suggested that will avail anything practically as a curative measure;
whether, upon the hypothesis of reduction as an accomplished fact, any
permanent or efficient device as a means of retention is within the
scope of human ingenuity. If the reduction were successfully performed,
would it be possible to keep the parts in place by any known means at
our disposal? At the best the most favorable result that could be
anticipated would be a reunion of the fragments with a considerable
shortening of the bone and a helpless, limping, crippled animal to
remind us that for human achievement there is a "thus far and no
farther."
In small animals, such as dogs and cats, however, attempts at treatment
are justifiable, and we are convinced that in many cases of difficulty
in the application of splints and bandages a patient may be placed in a
condition of undisturbed quiet and left to the processes of nature for
"treatment" as safely and with as good an assurance of a favorable
result as if he had been subjected to the most heroic secundum artem
doctoring known to science. As a case in point, mention may be made of
the case of a pregnant bitch which suffered a fracture of the upper end
of the femur by being run over by a light wagon. Her "treatment"
consisted in being tied up in a large box and let alone. In due time she
was delivered of a family of puppies, and in three weeks she was running
in the streets, limping very slightly, and nothing the worse for her
accident.
FRACTURE OF THE PATELLA.
This, fortunately, is a rare accident, and can result only from direct
violence, as a kick or other blow. The lameness which follows it is
accompanied with enormous tumefaction of the joint, pain, inability to
bear weight upon the foot, and finally disease of the articulation.
Crepitation is absent, because the hip muscles draw away the upper part
of the bone. The prognosis is unavoidably adverse, destruction being the
only termination of this incurable and very painful injury. Most of the
reported cases of cures are based upon a wrong diagnosis.
FRACTURES OF THE TIBIA.
Of all fractures these are probably more frequently encountered than any
others among the class of accidents we are considering. As with injuries
of the forearm of a like character, they may be complete or incomplete;
the former when the bone is broken in the middle or at the extremities,
and transverse, oblique, or longitudinal. The incomplete kind are more
common in this bone than in any other.
_Symptoms._--Complete fractures are easy to recognize, either with or
without displacement. The animal is very lame, and the leg is either
dragged or held clear from the ground by flexion at the stifle, while
the lower part hangs down. Carrying weight or moving backward is
impossible. There is excessive mobility below the fracture, and
well-marked crepitation. If there is much displacement, as in an oblique
fracture, there will be considerable shortening of the leg.
While incomplete fractures can not be recognized in the tibia with any
greater degree of certainty than in any other bone, there are some facts
associated with them by which a diagnosis may be justified. The
hypothetical history of a case may serve as an illustration:
An animal has received an injury by a blow or a kick on the inside of
the bone, perhaps without showing any mark. Becoming very lame
immediately afterwards, he is allowed a few days' rest. If taken out
again, he seems to have recovered his soundness, but within a day or
two he betrays a little soreness, and this increasing he becomes very
lame again, to be furloughed once more, with the result of a temporary
improvement, and again a return to labor and again a relapse of the
lameness; and this alternation seems to be the rule. The leg being now
carefully examined, a local periostitis is readily discovered at the
point of the injury, the part being warm, swollen, and painful. What
further proof is necessary? Is it not evident that a fracture has
occurred, first superficial--a mere split in the bony structure, which,
fortunately, has been discovered before some extra exertion or a casual
misstep had developed it into one of the complete kind, possibly with
complications? What other inference can such a series of symptoms thus
repeated establish?
The prognosis of fracture of the tibia, as a rule, must be unfavorable.
_Treatment._--The difficulty of obtaining a union without shortening,
and consequently without lameness, is proof of the futility of ordinary
attempts at treatment, but though this may be true in respect to
fractures of the complete kind, it is not necessarily so with the
incomplete variety, and with this class the simple treatment of the
slings is all that is necessary to obtain consolidation. A few weeks of
this confinement will be sufficient.
With dogs and other small animals there are cases which may be
successfully treated. If the necessary dressings can be successfully
applied and retained, a cure will follow.
FRACTURES OF THE HOCK.
Injuries of the astragalus which had a fatal termination have been
recorded. Fractures of the os calcis have also been observed, but never
with a favorable prognosis, and attempts to induce recovery, as might
have been expected, have proved futile.
FRACTURES OF THE CANNON BONES.
Whether these occur in the fore or hind legs, they appear either in the
body or near their extremities. If in the body as a rule the three
metacarpal or metatarsal bones are affected, and the fracture is
generally transverse and oblique. On account of the absence of soft
tissue and tightness of the skin, the broken bones pierce the skin and
render the fracture a complicated one. The diagnosis is easy when all
the bones are completely broken, but the incomplete fracture can be only
suspected.
_Symptoms._--There is no displacement, but excessive mobility,
crepitation, inability to sustain weight, and the leg is kept off the
ground by the flexion of the upper joint.
No region of the body affords better facilities for the application of
treatment, and the prognosis on this account is usually favorable. We
recall a case, however, which proved fatal, though under exceptional
circumstances. The patient was a valuable stallion of highly nervous
organization, with a compound fracture of one of the cannon bones, and
his unconquerable resistance to treatment, excited by the intense pain
of the wound, precluded all chance of recovery, and ultimately caused
his death.
_Treatment._--The general form of treatment for these lesions will not
differ from that which has been already indicated for other fractures.
Reduction, sometimes necessitating the casting of the patient;
coaptation, comparatively easy by reason of the subcutaneous situation
of the bone; retention, by means of splints and bandages--applied on
both sides of the region, and reaching to the ground as in fractures of
the forearm--these are always indicated. We have obtained excellent
results by the use of a mold of thick gutta-percha, composed of two
sections and made to surround the entire lower part of the leg as in an
inflexible case.
FRACTURE OF THE FIRST PHALANX.
The hind extremity is more liable than the fore to this injury. It is
usually the result of a violent effort, or of a sudden misstep or
twisting of the leg, and may be transverse, or, as has usually been the
case in our experience, longitudinal, extending from the upper articular
surface down to the center of the bone, and generally oblique and often
comminuted. The symptoms are the swelling and tenderness of the region,
possibly crepitation; a certain abnormal mobility; an excessive degree
of lameness, and in some instances a dropping back of the fetlock, with
perhaps a straightened or upright condition of the pastern.
The difficulty of reduction and coaptation in this accident, and the
probability of bony deposits, as of ringbones, resulting in lameness,
are circumstances which tend to discourage a favorable prognosis.
The treatment is that which has been recommended for all fractures, so
far as it can be applied. The iron splint which has been mentioned gives
excellent results in many instances, but if the fracture is incomplete
and without displacement, a form of treatment less energetic and severe
should be attempted. One case is within our knowledge in which the owner
lost his horse by his refusal to subject the animal to treatment, the
post-mortem revealing only a simple fracture with very slight
displacement.
FRACTURES OF THE SECOND PHALANX (CORONET).
Though these are generally of the comminuted kind, there are often
conditions associated with them which justify the surgeon in attempting
their treatment. Though crepitation is not always easy to detect, the
excessive lameness, the soreness on pressure, the inability to carry
weight, the difficulty experienced in raising the foot, all these
suggest, as the solution of the question of diagnosis, the fracture of
the coronet, with the accompanying realization of the fact that there is
yet, by reason of the situation of the member, immobilized as it is by
its structure and its surroundings, room left for a not unfavorable
prognosis. Only a slight manipulation will be needed in the treatment of
this lesion. To render the immobility of the region more fixed, to
support the bones in their position by bandaging, and to establish
forced immobility of the entire body with the slings is usually all that
is required. Ringbone, being a common sequela of the reparative process,
must receive due attention subsequently. One of the severest
complications liable to be encountered is an immobile joint
(anchylosis). Neurectomy of the median nerve may relieve lameness after
a fracture of the phalanges.
FRACTURES OF THE THIRD PHALANX (OS PEDIS).
These lesions may result from a penetrating street nail, or follow
plantar or median neurectomy. In the latter instance it is caused by the
animal setting the foot down carelessly and too violently, and partly
due to degeneration of bone tissue which follows nerving.
Though these fractures are not of very rare occurrence, their
recognition is not easy, and there is more of speculation than of
certainty pertaining to their diagnosis. The animal is very lame and
spares the injured foot as much as possible, sometimes resting it upon
the toe alone and sometimes holding it from the ground. The foot is very
tender, and the exploring pinchers of the examining surgeon cause much
pain. During the first 24 hours there is no increased pulsation in the
digital and plantar arteries, but on the second day it is apparent.
There is nothing to encourage a favorable prognosis, and a not unusual
termination is an anchylosis with either the navicular bone or the
coronet.
No method of treatment needs to be suggested here, the hoof performing
the office of retention unaided. Local treatment by baths and
fomentations will do the rest. It may be months before there is any
mitigation of the lameness.
An ultimate recovery depends to a great extent upon whether the other
foot can support the weight during the healing process without causing a
drop sole in the supporting foot.
FRACTURE OF THE SESAMOID BONES.
This lesion has been considered by veterinarians, erroneously, we think,
as one of rare occurrence. We believe it to be more frequent than has
been supposed. Many observations and careful dissections have convinced
us that fractures of these little bones have been often mistaken for
specific lesions of the numerous ligaments that are implanted upon their
superior and inferior parts, and which have been described as a "giving
way" or "breaking down" of these ligaments. In my post-mortem
examinations I have always noted the fact that when the attachments of
the ligaments were torn from their bony connections minute fragments of
bony structure were also separated, though we have failed to detect any
diseased process of the fibrous tissue composing the ligamentous
substance.
_Cause._--From whatever cause this lesion may arise, it can hardly be
considered as of a traumatic nature, no external violence having any
apparent agency in producing it, and it is our belief that it is due to
a peculiar degeneration or softening of the bones themselves, a theory
which acquires plausibility from the consideration of the spongy
consistency of the sesamoids. The disease is a peculiar one, and the
suddenness with which different feet are successively attacked, at short
intervals and without any obvious cause, seems to prove the existence of
some latent, morbid cause which has been unsuspectedly incubating. It is
not peculiar to any particular class of horses, nor to any special
season of the year, having fallen under our observation in each of the
four seasons.
_Symptoms._--The general fact is reported in the history of most cases
that it makes its appearance without premonition in animals which, after
enjoying a considerable period of rest, are first exercised or put to
work, though in point of fact it may manifest itself while the horse is
still idle in his stable. A hypothetical case, in illustration, will
explain our theory: An animal which has been at rest in his stable is
taken out to work, and it will be presently noticed that there is
something unusual in his movement. His gait is changed, and he travels
with short, mincing steps, without any of his accustomed ease and
freedom. This may continue until his return to the stable, and then,
after being placed in his stall, he will be noticed shifting his weight
from side to side and from one leg to another, continuing the movement
until rupture of the bony structure takes place. But it may happen that
the lameness in one or more of the extremities, anterior or posterior,
suddenly increases, and it becomes evident that the rupture has taken
place in consequence of a misstep or a stumble while the horse is at
work. Then, upon coming to a standstill, he will be found with one or
more of his toes turned up; he is unable to place the affected foot flat
on the ground. The fetlock has dropped and the leg rests upon this part,
the skin of which may have remained intact or may have been more or less
extensively lacerated. It seldom happens that more than one toe at a
time will turn up, yet still the lesion in one will be followed by its
occurrence in another. Commonly two feet, either the anterior or
posterior, are affected, and we recall one case in which the two fore
and one of the hind legs were included at the same time. The accident,
however, is quite as liable to happen while the horse is at rest in his
stall, and he may be found in the morning standing on his fetlocks. One
of the earliest of the cases occurring in my own experience had been
under care for several weeks for suspected disease of the fetlocks, the
nature of which had not been made out, when, apparently improved by the
treatment which he had undergone, the patient was taken out of the
stable to be walked a short distance into the country, but had little
more than started when he was called to a halt by the fracture of the
sesamoids of both fore legs.
While there are no positive premonitory symptoms of these fractures
known, we believe that there are signs and symptoms which come but
little short of being so, and the appearance of which will always
justify a strong suspicion of the truth of the case. These have been
indicated when referring to the soreness in standing, the short, mincing
gait, and the tenderness betrayed when pressure is made over the
sesamoids on the sides of the fetlock, with others less tangible and
definable.
_Prognosis._--These injuries can never be accounted less than serious,
and in our judgment will never be other than fatal. If our theory of
their pathology is the correct one, and the cause of the lesions is
truly the softening of the sesamoidal bony structure and independent of
any changes in the ligamentous fibers, the possibility of a solid
osseous union can hardly be considered admissible.
_Treatment._--In respect to the treatment to be recommended and
instituted it can be employed only with any rational hope of benefit
during the incubation, and with the anticipatory purpose of prevention.
It must be suggested by a suspicion of the verities of the case, and
applied before any rupture has taken place. To prevent this and to
antagonize the causes which might precipitate the final catastrophe--the
elevation of the toes--resort must be had to the slings and to the
application of firm bandages or splints, perhaps of plaster of Paris,
with a high shoe, as about the only indications which science and nature
are able to offer. When the fracture is an occurred event, and the toes,
one or more, are turned up, any further resort to treatment will be
futile.
DISEASES OF JOINTS.
Three classes of injury will be considered under this head. These are,
affections of the synovial sacs, those of the joint structures, or of
the bones and their articular surfaces, and those forms of solution of
continuity known as dislocations or luxations.
DISEASES OF THE SYNOVIAL SACS.
Two forms of affection here present themselves, one being the result of
an abnormal secretion which induces a dropsical condition of the sac
without any acute, inflammatory action, while the other is characterized
by excessive inflammatory symptoms, with their modifications,
constituting synovitis.
SYNOVIAL DROPSIES.
We have already considered in a general way the presence of these
peculiar oil bags in the joints, and in some regions of the legs where
the passage of the tendons takes place, and have noticed the similarity
of structure and function of both the articular and the tendinous bursæ,
as well as the etiology of their injuries and their pathological
history, and we will now treat of the affections of both.
WINDGALLS.
This name is given to the dilated bursæ found at the posterior part of
the fetlock joint. They have their origin in a dropsical condition of
the bursæ of the joint itself, also of the tendon which slides behind
it, and are therefore further known by the designations of articular and
tendinous windgalls, or puffs. (See also p. 401.)
They appear in the form of soft and somewhat symmetrical tumors, of
varying dimensions, and generally well defined in their circumference.
They are more or less tense, according to the quantity of secretion they
contain, apparently becoming softer as the foot is raised and the
fetlock flexed. Usually they are painless and only cause lameness under
certain conditions, as when they begin to develop themselves under the
stimulus of inflammatory action, or when large enough to interfere with
the functions of the tendons, or again when they have undergone certain
pathological changes, such as calcification, which is among their
tendencies.
_Cause._--Windgalls may be attributed to external causes, such as severe
labor or strains resulting from heavy pulling, fast driving, or jumping,
or they may be among the sequelæ of internal disorders, such as
strangles or the resultants of a pleuritic or pneumonic attack.
Unnecessary anxiety is sometimes experienced respecting these growths,
with much questioning touching the expediency of their removal, all of
which might be spared, for, while they constitute a blemish, their
unsightliness will not hinder the usefulness of the animal, and in any
case they rarely fail to show themselves easily amenable to treatment.
_Treatment._--When in their acute stage, and when the dropsical
condition is not excessive, the inflammation may be checked during the
day by continuous, cold-water irrigation by means of a hose or soaking
tub and at night by applying a moderately tight-roller bandage. Later
absorption may be promoted by a Priessnitz bandage,[2] pressure by
roller bandages, sweating, the use of liniments, or if necessary by a
sharp blister of biniodid of mercury. This treatment should subdue the
inflammation, abate the soreness, absorb the excess of secretion,
strengthen the walls of the sac, and finally cause the windgalls to
disappear, provided the animal is not too quickly returned to labor and
exposed to the same factors that occasioned them at first.
If the inflammation has become chronic, however, and the enlargement has
been of considerable duration, the negative course will be the wiser
one. If any benefit results from treatment it will be of only a
transient kind, the dilatation returning when the patient is again
subjected to labor, and it will be a fortunate circumstance if
inflammation has not supervened.
Notwithstanding the generally benignant nature of the swelling there are
exceptional cases, usually when it is probably undergoing certain
pathological changes, which may result in lameness and disable the
animal, in which case surgical treatment will be indicated, especially
if repeated blisters have failed to improve the symptoms. Line firing is
then a preeminent suggestion, and many a useful life has received a new
lease as the result of this operation timely performed. Another method
of firing, which consists in emptying the sac by means of punctures
through and through, made with a red-hot needle or wire, and the
subsequent injection of certain irritating and alterative compounds into
the cavity, designed to effect its closure by exciting adhesive
inflammation, such as tincture of iodin, may be commended. But they are
all too active and energetic in their effects and require too much
special attention and intelligent management to be trusted to any hands
other than those of an expert veterinarian.
BLOOD SPAVIN, BOG SPAVIN, AND THOROUGHPIN.
The blood spavin is situated in front and to the inside of the hock and
is merely a varicose or dilated condition of the saphena vein. It occurs
directly over the point where the bog spavin is found, and has thus been
frequently confused with the latter.
The complicated arrangement of the hock joint, and the powerful tendons
which pass on the posterior part, are lubricated with the product of
secretion from one tendinous synovial and several articular synovial
sacs. A large articular sac contributes to the lubrication of the shank
bone (the tibia) and one of the bones of the hock (the astragalus). The
tendinous sac lies back of the articulation itself and extends upward
and downward in the groove of that joint through which the flexor
tendons slide. The dilatation of this articular synovial sac is what is
denominated bog spavin, the term thoroughpin being applied to the
dilatation of the tendinous capsule.
The bog spavin is a round, smooth, well-defined, fluctuating tumor
situated in front and a little inward of the hock. On pressure it
disappears at this point to reappear on the outside and just behind the
hock. If pressed to the front from the outside it will then appear on
the inside of the hock. On its outer surface it presents a vein which is
quite prominent, running from below upward, and it is to the
preternatural dilatation of this blood vessel that the term blood spavin
is applied.
The thoroughpin is found at the back and on the top of the hock in that
part known as the "hollows," immediately behind the shank bone. It is
round and smooth, but not so regularly formed as the bog spavin, and is
most apparent when viewed from behind. The swelling is usually on both
sides and a little in front of the so-called hamstring, but may be more
noticeable on the inside or on the outside.
In their general characteristics bog spavins and thoroughpins are
similar to windgalls, and one description of the origin, symptoms,
pathological changes, and treatment will serve for all equally, except
that it is possible for a bog spavin to cause lameness, and thus to
involve a verdict of unsoundness in the patient, a circumstance which
will, of course, justify its classification by itself as a severer form
of a single type of disease.
We have already referred to the subject of treatment and the means
employed--rest, of course--with liniments, blisters, etc., and what we
esteem as the most active and beneficial of any, early, deep, and
well-performed cauterization. There are, besides, commendatory reports
of a form of treatment by the application of pressure pads and peculiar
bandages upon the hocks, and it is asserted that the removal of the
tumors has been effected by their use. Our experience with this
apparatus, however, has not been accompanied with such favorable results
as would justify our indorsement of the flattering representations which
have sometimes appeared in its behalf.
OPEN JOINTS, BROKEN KNEES, SYNOVITIS, AND ARTHRITIS.
The close relationship which exists among these several affections,
their apparently possible connection as successive developments of a
similar, if not an essentially identical, origin, together with the
advantage gained by avoiding frequent repetitions in the details of
symptoms, treatment, etc., are our reasons for treating under a single
head the ailments we have grouped together in the present section.
_Cause._--The great, comprehensive, common cause of, sometimes
permanent, sometimes only transient, disability of the horse is external
traumatism.
Blows, bruises, hurts by nearly every known form of violence, falls,
kicks, lacerations, punctures--we may add compulsory speed in racing and
cruel overloading of draft animals--cover the entire ground of causation
of the diseases and injuries of the joints now receiving our
consideration.
In one case, a working horse making a misstep stumbles, and falling on
his knees receives a hurt, variously severe, from a mere abrasion of the
skin to a laceration, a division of the tegument, a slough,
mortification, and the escape of the synovial fluid, with or without
exposure of the bones and their articular cartilages.
In another case, an animal, from one cause or another, perhaps an
impatient temper, has formed the habit of striking or pawing his manger
with his fore feet until inflammation of the knee joint is induced,
first as a little swelling, diffused, painless; then as a periostitis of
the bones of the knee; later as bony deposits, then lameness, and
finally the implication of the joint, with all the various sequelæ of
chronic inflammation of the knee joint.
In another case, a horse has received a blow with a fork from a careless
hostler on or near a joint, or has been kicked by a stable companion,
with the result of a punctured wound, at first mild-looking, painless,
apparently without inflammation, and not yet causing lameness, but
which, in a few hours, or it may be only after a few days, becomes
excessively painful, grows worse, the entire joint swells, presently
discharges, and at last a case of suppurative synovitis is presented,
with perhaps disease of the joint proper, and arthritis as a climax. The
symptoms of articular injuries vary not only in the degrees of the hurt
but in the nature of the lesion.
Or the condition of broken knees, resulting as we have said, may have
for its starting point a mere abrasion of the skin--a scratch,
apparently, which disappears without a scar. The injury may, however,
have been more severe, the blow heavier, the fall aggravated by
occurring upon an irregular surface, or sharp or rough object, with
tearing or cutting of the skin, and this laceration may remain. A more
serious case than the first is now brought to our notice.
Another time, immediately following the accident, or possibly as a
sequel of the traumatism, the tendinous sacs may be opened, with the
escape of the synovia, or, worse, the tendons which pass in front of the
knee are torn, the inflammation spreads, the joint and leg are swollen,
the animal is becoming very lame; synovitis has set in. With this the
danger becomes very great, for soon suppuration will be established,
then the external coat of the articulation proper becomes ulcerated, if
it is not already in that state, and we find ourselves in the presence
of an open joint with suppurative synovitis--that is, with the worst
among the conditions of diseased processes, because of the liability of
the suppuration to become infiltrated into every part of the joint,
macerating the ligaments and irritating the cartilages, soon to be
succeeded by their ulceration, with the destruction of the articular
surface--or the lesion of ulcerative arthritis, one of the gravest among
all the disorders known to the animal economy.
Ulcerative arthritis and suppurative synovitis may be developed
otherwise than in connection with open joints; the simplest and
apparently most harmless punctures may prove to be sufficient cause. For
example, a horse may be kicked, perhaps, on the inside of the hock;
there is a mark and a few drops of blood to indicate the spot; he is put
to work apparently free from pain or lameness and performs his task with
his usual ease and facility. On the following morning, however, the hock
is found to be a little swollen and there is some stiffness. A little
later on he betrays a degree of uneasiness in the leg, and shrinks from
resting his weight upon it, moving it up and down for relief. The
swelling has increased and is increasing; the pain is severe; and
finally, at the spot where the kick inpinged, there is an oozing of an
oily liquid mixed with whitish drops of suppuration. The mischief is
done; a simple, harmless, punctured wound has expanded into a case of
ulcerative arthritis and suppurative synovitis.
_Prognosis._--From ever so brief and succinct description of this
traumatism of the articulations, the serious and important character of
these lesions, irrespective of which particular joint is affected, will
be readily understood. Yet there will be modifications in the prognosis
in different cases, in accordance with the peculiarities of structure in
the joint specially involved, as, for example, it is obvious that a
better result may be expected from treatment when but a single joint,
with only its plain articular surfaces, is the place of injury, than in
one which is composed of several bones, united in a complex formation,
as in the knee or hock. As severe a lesion as suppurative synovitis
always is, and as frequently fatal as it proves to be, still cases arise
in which, the inflammation assuming a modified character and at length
subsiding, the lesion terminates favorably and leaves the animal with a
comparatively sound and useful joint. There are cases, however, which
terminate in no more favorable a result than the union of the bones and
occlusion of the joint, to form an anchylosis, which is scarcely a
condition to justify a high degree of satisfaction, as it insures a
permanent lameness with very little capacity for usefulness.
Appreciating now the dangers associated with all wounds of
articulations, however simple and apparently slight, and how serious and
troublesome are the complications which are liable to arise during their
progress and treatment, we are prepared to understand and realize the
necessity and the value of early and prompt attention upon their
discovery and diagnosis.
_Treatment._--For simple bruises, like those which appear in the form of
broken knees or of carpitis, simple remedies, such as warm fomentations
or cold-water applications and compresses of astringent mixtures,
suggest themselves at once. Injuries of a more complicated character, as
lacerations of the skin or tearing of soft structures, will also be
benefited by simple dressings with antiseptic mixtures, as those of the
carbolic-acid order. The escape of synovia should suggest the prompt use
of collodion dressings to check the flow and prevent the further escape
of the fluid. But if the discharge is abundant and heavily suppurative,
little can be done more than to put in practice the "expectant" method
with warm fomentations, repeatedly applied, and soothing, mucilaginous
poultices. Improvement, if any is possible, will be but slow to manifest
itself. The most difficult of all things to do, in view of varying
interests and opinions--that is, in a practical sense--is to abstain
from "doing" entirely, and yet in the cases we are considering we are
firmly convinced that noninterference is the best and wisest policy.
In cases which are carried to a successful result the discharge will
diminish by degrees, the extreme pain will gradually subside, the
convalescent will begin timidly to rest his foot upon the ground, and
presently to bear weight upon it, and perhaps, after a long and tedious
process of recuperation, he may be returned to his former and normal
condition of usefulness. When the discharge has wholly ceased and the
wounds are entirely healed, a blister covering the whole of the joint
for the purpose of stimulating the absorption of the exudation will be
of great service. If, on the contrary, there is no amelioration of
symptoms and the progress of the disease resists every attempt to check
it; if the discharge continues to flow not only without abatement but in
an increased volume, and not alone by a single opening but by a number
of fistulous tracts which have successively formed; if it seems evident
that this drainage is rapidly and painfully sapping the suffering
animal's vitality, and a deficient _vis vitæ_ fails to cooperate with
the means of cure--all rational hope of recovery may be finally
abandoned. Any further waiting for chances, or time lost in
experimenting, will be mere cruelty and there need be no hesitation
concerning the next step. The poor beast is under sentence of death, and
every consideration of interest and of humanity demands an anticipation
of nature's evident intent in the quick and easy execution of the
sentence.
[Illustration: PLATE XXX.
DISLOCATION OF SHOULDER AND ELBOW
Bourgelat's apparatus]
[Illustration: PLATE XXXI.
THE SLING IN USE]
One of the essentials of treatment, and probably an indispensable
condition when recovery is in any wise attainable, is the suspension of
the patient in slings. He should be continued in them so long as he can
be made to submit quietly to their restraint.
DISLOCATIONS.
Dislocations and luxations are interchangeable terms, meaning the
separation and displacement of the articulating surfaces of the bones
entering into the formation of a joint. This injury is rarely
encountered in our large animals on account of the combination of
strength and solidity in the formation of their joints. It is met with
but seldom in cattle and less so in horses, while dogs and smaller
animals are more often the sufferers.
_Cause._--The accident of a luxation is less often encountered in the
animal races than in man. This is not because the former are less
subject to occasional violence involving powerful muscular contractions,
or are less often exposed to casualties similar to those which result
in luxations in the human skeleton, but because it requires the
cooperation of conditions--anatomical, physiological, and perhaps
mechanical--present in the human race and lacking in the others, which,
however, can not in every case be clearly defined. Perhaps the greater
relative length of the bony levers in the human formation may constitute
a cause of the difference.
Among the predisposing causes in animals may be enumerated caries of
articular surfaces, articular abscesses, excessive dropsical conditions,
degenerative softening of the ligaments, and any excessive laxity of the
soft structures.
_Symptoms and diagnosis._--Three signs of dislocation must usually be
taken into consideration. They are: (1) An alteration in the shape of
the joint and in the normal relationship of the articulating surfaces;
(2) an alteration in the length of the limb, either shortening or
lengthening; (3) an alteration in the movableness of the joint, usually
an unnatural immobility. Only the first, however, can be relied upon as
essential. Luxations are not always complete; they may be partial; that
is, the articulating surfaces may be displaced but not separated. In
such cases several symptoms may not be present. And not only may the
third sign be absent, but the mobility of the first be greatly increased
when the character of the injury has been such as to produce extensive
lacerations of the articular ligaments.
In addition to the above signs, a luxation is usually characterized by
pain, swelling, hemorrhage beneath the skin from damaged or ruptured
blood vessels, and even paralysis, when important nerves are pressed on
by the displaced bones.
Sometimes a bone is fractured in the immediate vicinity of a joint. The
knowledge of this fact requires us to be able to diagnose between a
dislocation and such a fracture. In this we generally have three points
to assist us: (1) The immobility of a dislocated joint as against the
apparently remarkable freedom of movement in fracture; (2) in a
dislocation there is no true crepitus--that peculiar grating sensation
heard as well as felt on rubbing together the rough ends of fractured
bones; however, it must be remembered that in a dislocation two or three
days old the inflammatory changes around the joint may give rise to a
crackling sensation similar to that in fracture; (3) as a rule, in
luxations, if the ligamentous and muscular tissues about the joint are
not badly torn, the displacement, when reduced, does not recur.
_Prognosis._--The prognosis of a luxation is comparatively less serious
than that of a fracture, though at time the indications of treatment may
prove to be so difficult to apply that complications of a very severe
character may arise.
_Treatment._--The treatment of luxations must, of course, be similar to
that of fractures. Reduction, naturally, will be the first indication in
both cases, and the retention of the replaced parts must follow. The
reduction involves the same steps of extension and counter extension,
performed in the same manner, with the patient subdued by anesthetics.
The difference between the reduction of a dislocation and that of a
fracture consists in the fact that in the former the object is simply to
restore the bones to their true, normal position, with each articular
surface in exact contact with its companion surface, the apparatus
necessary afterwards to keep them in situ being similar to that which is
employed in fracture cases, and which will usually require to be
retained for a period of from 40 to 50 days, if not longer, before the
ruptured retaining ligaments are sufficiently firm to be trusted to
perform their office unassisted. A variety of manipulations are to be
used by the surgeon, consisting in pushing, pulling, pressing, rotating,
and, indeed, whatever movement may be necessary, until the bones are
forced into such relative positions that the muscular contraction,
operating in just the right directions, pulls the opposite matched ends
together in true coaptation--a head into a cavity, an articular eminence
into a trochlea, as the case may be. The "setting" is accompanied with a
peculiar, snapping sound, audible and significant, as well as a visible
return of the surface to its normal symmetry.
_Special dislocations._--While all the articulations of the body are
liable to this form of injury, there are three in the large animals
which may claim a special consideration, viz:
THE SHOULDER JOINT.
We mention this displacement without intending to imply the
practicability of any ordinary attempt at treatment, which is usually
unsuccessful, the animal whose mishap it has been to become a victim to
it being disabled for life. The superior head of the arm bone as it is
received into the lower cavity of the shoulder blade is so situated as
to be liable to be forced out of place in four directions. It may escape
from its socket, according to the manner in which the violence affects
it--outward, inward, backward, or forward--and the deformity which
results and the effects which follow will correspondingly differ. We
have said that treatment is generally unsuccessful. It may be added that
the difficulties which interpose in the way of reduction are nearly
insurmountable, and that the application of means for the retention of
the parts after reduction would be next to impossible. The prognosis,
from any point of view, is sufficiently grave for the luckless animal
with a dislocated shoulder.
THE HIP JOINT.
This joint partakes very much of the characteristics of the
humero-scapular articulation, but is more strongly built. The head of
the thigh bone is more separated, or prominent and rounder in form, and
the cup-like cavity, or socket, into which it fits is much deeper,
forming together a deep, true ball-and-socket joint, which is, moreover,
reenforced by two strong cords of funicular ligaments, which unite them.
It will be easily comprehended, from this hint of the anatomy of the
region, that a luxation of the hip joint must be an accident of
comparatively rare occurrence; yet cases are recorded in which the head
of the bone has been affirmed to slip out of its cavity and assume
various positions--inward, outward, forward, or backward.
The indications of treatment are those of all cases of dislocation. When
the reduction is accomplished the surgeon will be apprised of the fact
by the peculiar, snapping sound usually heard on such occasions.
PSEUDO-LUXATIONS OF THE PATELLA.
This is not a true dislocation. The stifle bone is so peculiarly
articulated with the thigh bone that the means of union are of
sufficient strength to resist the causes which usually give rise to
luxations, yet there is sometimes discovered a peculiar, pathological
state in the hind legs of animals, the effect of which is closely to
simulate the manifestation of many of the general symptoms of
dislocations. This condition originates in muscular cramps, the action
of which is seen in a certain change in the coaptation of the articular
surfaces of the stifle and thigh bone, resulting in the exhibition of a
sudden and alarming series of symptoms which have suggested the phrase
of "stifle out" as a descriptive term.
_Symptoms._--The animal so affected stands quietly and firmly in his
stall, or perhaps with one of his hind legs extended backward, and
resists every attempt to move him backward. If urged to move forward he
will either refuse or comply with a jump, with the toe of the disabled
leg dragging on the ground and brought forward by a second effort. There
is no flexion at the hock and no motion at the stifle, while the
circular motion of the hip is quite free. The leg appears to be much
longer than the other, owing to the straightened position of the thigh
bone, which forms almost a straight line with the tibia from the hip
joint down. The stifle joint is motionless, and the motions of all the
joints below it are more or less interfered with. External examination
of the muscles of the hip and thigh reveals a certain degree of
rigidity, with perhaps some soreness, and the stifle bone may be seen
projecting more or less on the outside and upper part of the joint.
This state of things may continue for some time and until treatment is
applied, or it may spontaneously and suddenly terminate, leaving
everything in its normal condition, but perhaps to return again.
_Cause._--Pseudo-dislocation of the patella is liable to occur under
many of the conditions which cause actual dislocation, and yet it may
often occur in animals which have not been exposed to the ordinary
causes, but which have remained at rest in their stables. Sometimes
these cases are assignable to falls in a slippery stall, or perhaps
slipping when endeavoring to rise; sometimes to weakness in convalescing
patients; sometimes to lack of tonicity of structure and general
debility; sometimes to relaxation of tissues from want of exercise or
use. A straight leg, sloping croup, and the young are predisposed to
this dislocation.
_Treatment._--The reduction of these displacements of the patella is not
usually attended with difficulty. A sudden jerk or spasmodic action will
often be all that is required to spring the patella into place, when the
flexion of the leg at the hock ends the trouble for the time. But this
is not always sufficient, and a true reduction may still be indicated.
To effect this the leg must be drawn well forward by a rope attached to
the lower end, and the patella, grasped with the hand, forcibly pushed
forward and inward and made to slip over the outside border of the
trochlea of the femur. The bone suddenly slips into position, the
excessive rigor of the leg ceases with a spasmodic jerk, and the animal
may walk or trot away without suspicion of lameness. Though this may end
the trouble for the time, and the restoration seem to be perfect and
permanent, a repetition of the entire transaction may subsequently take
place, and perhaps from the loss of some proportion of tensile power
which would naturally follow the original attack in the muscles involved
the lesion might become a habitual weakness.
Warm fomentations and douches with cold water will often promote
permanent recovery, and liberty in a box stall or in the field will in
many cases insure constant relief. The use of a high-heeled shoe is
recommended by European veterinarians. The use of stimulating liniments,
with frictions, charges, or even severe blisters, may be resorted to in
order to prevent the repetition of the difficulty by strengthening and
toning up the parts.
DISEASES OF MUSCLES AND TENDONS.
SPRAINS.
This term expresses a more or less complete laceration or yielding of
the fibers of the muscles, tendons, or the sheaths surrounding and
supporting them. The usual cause of a sprain is external violence, such
as a fall or a powerful exertion of strength, with following symptoms of
soreness, heat, swelling, and a suspension of function. Their
termination varies from simple resolution to suppuration, and commonly
fibrinous exudation difficult to remove. None of the muscles or tendons
of the body are exempt from liability to this lesion, though naturally
from their uses and the exposure of their situation the extremities are
more liable than other regions to become their seat. The nature of the
prognosis will be determined by a consideration of the seat of the
injury and the complications likely to arise.
_Treatment._--The treatment will resolve itself into the routine of
local applications, including warm fomentations, stimulating liniments,
counterirritation by blistering, and in some cases even firing. Rest, in
the stable or in a box stall, will be of advantage by promoting the
absorption of whatever fibrinous exudation may have formed, or
absorption may be stimulated by the careful persevering application of
iodin in the form of ointments of various degrees of strength.
There are many conditions in which not only the muscular and tendinous
structures proper are affected by a strain, but, by contiguity of parts,
the periosteum of neighboring bones may become involved, with a
complication of periostitis and its sequelæ.
LAMENESS OF THE SHOULDER.
The frequency of the occurrence of lameness in the shoulder from sprains
entitles it to precedence of mention in the present category, for,
though so well covered with its muscular envelope, it is often the seat
of injuries which, from the complex structure of the region, become
difficult to diagnosticate with satisfactory precision and facility. The
flat bone which forms the skeleton of that region is articulated in a
comparatively loose manner with the bone of the arm, but the joint is,
notwithstanding, rather solid, and is powerfully strengthened by tendons
passing outside, inside, and in front of it. Still, shoulder lameness or
sprain may exist, originating in lacerations of the muscles, the tendons
or the ligaments of the joint, or perhaps in diseases of the bones
themselves. "Slip of the shoulder" is a phrase frequently applied to
such lesions.
The identification of the particular structures involved in these
lesions is of much importance, in view of its bearing upon the question
of prognosis. For example, while a simple superficial injury of the
spinatus muscles, or the muscles by which the leg is attached to the
trunk, may not be of serious import and may readily yield to treatment,
or even recover spontaneously and without interference, the condition is
quite changed in a case of tearing of the flexor brachii, or of its
tendons as they pass in front of the articulation, or, what is still
more serious, if there is inflammation or ulceration in the groove over
which this tendon slides, or upon the articular surfaces or their
surroundings, or periostitis at any point adjacent.
_Causes._--The frequency of attacks of shoulder lameness is not
difficult to account for. The superficial and unprotected position of
the part and the numerous movements of which it is capable, and which,
in fact, it performs, render it both subjectively and objectively
preeminently liable to accident or injury. It would be difficult and
would not materially avail to enumerate all the forms of violence by
which the shoulder may be crippled. A fall, accompanied with powerful
concussion; a violent muscular contraction in starting a heavily loaded
vehicle from a standstill; a misstep following a quick muscular effort;
a jump accompanied with miscalculated results in alighting; a slip on a
smooth, icy road; balling the feet with snow; colliding with another
horse or other object--indeed, the list may be indefinitely extended,
but without profit or utility.
_Symptoms._--Some of the symptoms of shoulder lameness are peculiar to
themselves, and yet the trouble is frequently mistaken for other
affections--navicular disease more often than any other. The fact that
in both affections there are instances when the external symptoms are
but imperfectly defined, and that one of them especially is very similar
in both, is sufficient to mislead careless or inexperienced observers
and to occasion the error which is sometimes committed of applying to
one disease the name of the other, erring both ways in the interchange.
The true designation of pathological lesions is very far at times from
being of certain and easy accomplishment, and, owing to the massive
structure of the parts we are considering, this is especially true in
the present connection. Still there are many cases in which there is
really no reasonable excuse for an error in diagnosis by an average
practitioner.
Shoulder lameness will, of course, manifest itself by signs and
appearances more or less distinct and pronounced, according to the
nature of the degrees and the extent of the originating cause. We
summarize some of these signs and appearances:
The lameness is not intermittent, but continued, the disturbance of
motion gaging the severity of the lesion and its extent. It is more
marked when the bones are diseased than when the muscles alone are
affected. When in motion the two upper bony levers--the shoulder blade
and the bone of the upper arm--are reduced to nearly complete immobility
and the walking is performed by the complete displacement of the entire
mass, which is dragged forward without either flexion of extension. The
action of the joint below, as a natural consequence, is limited in its
flexion. In many instances there is a certain degree of swelling at the
point of injury--at the joint, or, more commonly, in front of it, or on
the surface of the spinatus muscle. Again, instead of swelling there
will be muscular atrophy, though, while this condition of loss of
muscular power may interfere with perfect locomotion, it is not in
itself usually a cause of shoulder lameness. "Sweenied" shoulders are
more often due to disease below the fetlock than to affections above the
elbow.
During rest the animal often carries his leg forward, somewhat analogous
to the "pointing" position of navicular disease, though in some cases
the painful member drops at the elbow in a semiflexed position. The
backing is sometimes typical, the animal when performing it, instead of
flexing his shoulder, dragging the whole leg without motion in the upper
segment of the extremity.
The peculiar manner in which the leg is brought forward in the air for
another step in the act of walking or trotting is in some instances
characteristic of injuries of the shoulder. The lameness also manifests
itself in bringing the leg forward with a circumflex swinging motion and
a shortening in the extension of the step. The foot is carried close to
the ground and stumbling is frequent, especially on an uneven road.
With the utmost scrutiny and care the vagueness and uncertainty of the
symptoms will contribute to perplex and discredit the diagnosis and
embarrass the surgeon, and sometimes the expedient is tried of
aggravating the symptoms by way of intensifying their significance, and
thus rendering them more intelligible. This has been sought by requiring
the patient to travel on hard or very soft ground and compelling him to
turn on the sound leg as a pivot, with other motions calculated to
betray the locality of the pain.
_Treatment._--It is our conviction that lameness of the shoulder will in
many cases disappear with no other prescription than that of rest.
Provided the lesions occasioning it are not too severe, time is all that
is required. But the negation of letting alone is seldom accepted as a
means of doing good, in the place of the active and the positive forms
of treatment. This is in accordance with a trait of human nature which
is universal, and is unlimited in its applications; hence something must
be done. In mild cases of shoulder lameness, then, the indications are
water, either in the cold douche or by showering, or by warm
fomentations. Warm, wet blankets are of great service; in addition, or
as alternative, anodyne liniments, camphor, belladonna, either in the
form of tincture or the oils, are of benefit, and at a later period
stimulating friction with suitable mixtures, sweating liniments,
blistering compounds, subcutaneous injections over the region of the
muscle of 1-1/2 grains of veratrin (the variety insoluble in water)
mixed in 2 drams of water, etc., will find their place, and finally,
when necessity demands it, the firing iron and the seton.
The duration of the treatment must be determined by its effects and the
evidence that may be offered of the results following the action of the
reparative process. But the great essential condition of cure, and the
one without which the possibility of relapse will always remain as a
menace, is, as we have often reiterated in analogous cases, _rest_,
imperatively rest, irrespective of any other prescriptions with which it
may be associated.
SPRAIN OF THE ELBOW MUSCLES.
_Causes._--This injury, which fortunately is not very common, is mostly
encountered in cities among heavy draft horses or rapidly driven animals
which are obliged to travel, often smooth shod, upon slippery, icy, or
greasy pavements, where they are easily liable to lose their foothold.
The region of the strain is the posterior part of the shoulder, and the
affected muscles are those which occupy the space between the posterior
border of the scapula and the posterior face of the arm. It is the
muscles of the olecranon which give way.
_Symptoms._--The symptoms are easily recognized, especially when the
animal is in action. While at rest the attitude may be normal, or by
close scrutiny a peculiarity may perhaps be detected. The leg may seem
to drop; the elbow may appear to be lower than its fellow, with the knee
and lower part of the leg flexed and the foot resting on the toe, with
the heel raised. Such an attitude, however, may be occasionally assumed
by an animal without having any special significance, but when it
becomes more pronounced in motion the fact acquires a symptomatic value,
and this is the case in the present instance. A rapid gait becomes quite
impossible, and the walk, as in some few other diseases, becomes
sufficiently characteristic to warrant a diagnosis even when observed
from a distance. An entire dropping of the anterior part of the trunk
becomes manifest, and no weight is carried on the disabled side in
consequence of the loss of action in the suspensory muscles. There are
often heat, pain, and swelling in the muscular mass at the elbow, though
at times a hollow, or depression, may be observed near the posterior
border of the scapula, which is probably the seat of injury.
These hurts are of various degrees of importance, varying from mere
minor casualties of quick recovery to lesions which are of sufficient
severity to render an animal useless and valueless for life.
_Treatment._--The prime elements of treatment, which should be strictly
observed, are rest and quiet. Prescriptions of all kinds, of course,
have their advocates. Among them are ether, chloroform, camphor,
alcoholic frictions, warm fomentations, blisters, setons, etc. Unless
the conclusions of experience are to be ignored, my own judgment is
decisive in favor of rest, judiciously applied, however, and my view of
what constitutes a judicious application of rest has been more than once
presented in these pages. There are degrees of this rest. One
contemplates simple immobility in a narrow stall. Another means the
enforced mobility of the slings and a narrow stall as well. Another a
box stall, with ample latitude as to posture and space, and option to
stand or lie down. As wide as this range may appear to be, radical
recovery has occurred under all of these modified forms of _letting our
patients alone._
HIP LAMENESS.
The etiology of injuries and diseases of the hip is one and the same
with that of the shoulder. The same causes operate and the same results
follow. The only essential change, with an important exception, which
would be necessary in passing from one region to the other in a
description of its anatomy, its physiology, and its pathology would be a
substitution of anatomical names in reference to certain bones,
articulations, muscles, ligaments, and membranes concerned in the
injuries and diseases described. It would be only a useless repetition
to cover again the ground over which we have so recently passed in
recital of the manner in which certain forms of external violence
(falls, blows, kicks, etc.) result in other certain forms of lesion
(luxation, fracture, periostitis, ostitis, etc.), and to recapitulate
the items of treatment and the names of the medicaments proper to use.
The same rules of diagnosis and the same indications and prognosis are
applicable equally to every portion of the organism, with only such
modifications in applying dressings and apparatus as may be required by
differences of conformation and other minor circumstances, which must
suggest themselves to the judgment of every experienced observer when
the occasion arrives for its exercise.
An exception is to be made, while considering the subject in connection
with the region now under advisement, in respect to the formidable
affection known as morbus coxarius, or hip-joint disease; and leaving
the detail of other lesions to take their place under other heads, that
relating to the shoulder, for instance, we turn to the hip joint and its
ailments as the chief subject of our present consideration.
_Symptoms._--In investigating for morbus coxarius, let the observer
first examine the lame animal by scanning critically the outlines of the
joint and the region adjacent for any difference of size or disturbance
of symmetry in the parts, any prominence or rotundity, and on both
sides. The lame side will probably be warmer, more developed, and
fuller, both to the touch and to the eye. Let him then grasp the lower
part of the leg (as he would in examining a case of shoulder lameness)
and endeavor to produce excessive passive motion. This will probably
cause pain when the leg is made to assume a given position. Let him push
the thigh forcibly against the hip bone, and the contact will again
probably cause a manifestation of pain. If the horse is trotted, the
limited action of the hip joint proper and the excessive dropping and
rising of the hip of the opposite side will be easily recognized.
Usually the animal does not extend the foot so far as customarily and
picks it up much sooner.
The abductive or circumflex motion observed in shoulder lameness is also
present in hip lameness, but under special conditions, and the test of
the difficulty, either by traveling on soft ground or in turning the
horse in a circle, may here also contribute to the diagnosis, as in
testing for lameness in the anterior extremity.
_Prognosis._--The prognosis of hip lameness is at times quite serious,
not only on account of the long duration of treatment required to effect
good results, and because of the character which may be assumed by the
disease, but of the permanence of the disability resulting from it.
Exostosis and ulcerative arthritis are sequelæ which often resist every
form of treatment.
_Treatment._--As before intimated, this is little more than a repetition
of the remarks upon the lameness of the shoulder, with slight
modifications occasioned by the muscular structure of the hip, and we
are limited to the same recommendations of treatment. The advantages of
rest must be reaffirmed, with local applications, of which, however, it
may be said that they are more distinctly indicated and likely to be
more effective in their results than in shoulder lameness, and may be
more freely employed, whether in the form of liniments, blisters (singly
or repeated), firing, or setoning.
SPRAINS OF SUSPENSORY LIGAMENTS AND OF FLEXOR TENDONS OR THEIR SHEATHS.
The fibrous structure situated behind the cannon bones, both in the fore
and hind legs, is often the seat of lacerations or sprains resulting
from violent efforts or sudden jerks.
_Cause._--The injury may be considered serious or trifling, according to
the circumstances of each case as judged by its own history. Among the
predisposing causes are a long, thin fetlock and a narrow knee or hock
as viewed from the side, with the flexor muscles tied in just below the
joint. The longer and more oblique the pastern the greater is the strain
on the flexor tendons and suspensory ligaments; hence a low quarter, a
toe calk, and no heel calks, or a thin calk placed at the tip under the
toe, and leaving the quarters long abnormally stretches the back tendons
and causes a great strain upon them just before the weight is shifted
from the foot in locomotion. In runners and hunters the disease is
liable to be periodic. In driving horses it is most common in well-bred
animals of nervous temperament. Draft horses suffer most frequently in
the hind legs.
_Symptoms._--The injury is readily recognized by the changed aspect of
the region and the accompanying local symptoms. The parts which in
health are well defined, with the outlines of the tendons and ligaments
well marked, become the seat of a swelling, more or less developed, from
a small spot on the middle of the back of the tendon to a tumefaction
reaching from the knee down to and even involving the fetlock itself. It
is always characterized by heat, and it is variously sensitive, ranging
from a mere tenderness to a degree of soreness which shrinks from the
lightest touch. The degree of the lameness varies, and it has a
corresponding range with the soreness, sometimes showing only a slight
halting and at others the extreme of lameness on three legs, with
intermediate degrees.
The lameness is always worse when the weight is thrown on the foot and
is most marked toward the end of the phase of contact with the ground.
Either passive irritation of the leg or turning the animal in a circle
causes pain as in diseases of the joints. Sometimes the horse likes to
get the heels on a stone or some elevation so as to relieve the weight
from the flexor tendons. Finally, in cases of long standing, a
shortening of the tendons occurs, resulting in the abnormal flexion of
the foot known by horsemen as "broken down," or a more upright position
of the foot may follow, producing perhaps knuckling or the so-called
clubfoot.
_Prognosis._--It may be safely assumed on general principles that a leg
which has received such injuries seldom returns to a perfect condition
of efficiency and soundness, and that as a fact a certain absolute
amount of thickening and deformity will remain permanent, even when the
lameness has entirely disappeared.
_Treatment._--The injured member should receive the earliest attention
possible, not only when the inflammatory condition is present, but when
it is subsiding and there is only the thickening of the ligaments, the
tendons, or the sheath.
The most important remedy is rest, and the shoes should always be
removed. During the first three days cold in the form of immersion or
continuous irrigation is indicated. Then warm moisture and continuous
pressure are advised. The latter is best applied by placing two padded
splints about the thickness of the thumb along the two sides of the
tendon and binding them in place with even pressure by bandage. Frequent
bathing with warm soap suds is also beneficial. The absorption of the
exudate may be promoted and the work of restoration effected by
frictions with alcohol, tincture of soap, spirits of camphor, mild
liniments, strong, sweating liniments, and blisters. An excellent
ointment to apply with massage consists of equal parts of blue ointment
and green soap, with double the quantity of vaseline. The action of
blisters in these cases depends chiefly upon the massage used in
applying them and upon the continuous pressure of the swollen skin on
the inflamed tendons. In old cases more beneficial results will follow
line firing. In these cases shoeing is very important. Leave the
quarters long, shorten the toe, give the shoe rolling motion, and either
put short heel calks on the branches or thicken the branches. Although
this line of treatment is efficacious in many cases, there are others in
which the thickening of the tendons refuses to yield and the changed
tissues remain firmly organized, leaving them in the form of a thick
mass resting upon the back part of the cannon bone.
KNUCKLING OF FETLOCK.
As a consequence of the last-mentioned lesion of the tendons, a new
condition presents itself in the articular disposition, constituting the
deformity known as the knuckling fetlock. (See also p. 400.)
By this is meant a deformity of the fetlo