Causes: as in solipeds, youth, overfeeding, plethora, dietetic blunders, temperament, over-exertion, chill when heated, gestation, foul water, irritants, drastics, infections. Symptoms: as in enteritis with false membranes, complications. Duration. Lesions: false membranes, extent, color, structure, composition, congested mucosa. Treatment: Glauber and other salts, pilocarpin, potassium iodide, antiseptics, sulphites, sulphides, borax, bismuth, naphthol, creolin, muriatic acid, bitters.
Causes. The same causes are quoted as in solipeds, youth, extra high condition, rich feeding, sudden change to the green food of spring, climatic vicissitudes of the same season, a sanguineous (Reynal) or lymphatic (Friedberger and Fröhner) temperament, overwork, exhausting travel, suppressed perspiration, gestation, plethora, foul drinking water, special irritant plants (chicory, Huzard), and drastic purgatives. Cadeac suggests bacteria, quoting instances of a fifth or a fourth of a herd suffering at once. The same would come from any other cause acting on the whole herd and it seems probable that a microbian factor is present but can find occasion for its pathogenesis only in given morbid conditions of the mucous membrane. This would explain the failure of the affection to propagate itself like a plague, and at the same time its tendency to manifest itself extensively in given herds with a common predisposing condition.
Symptoms. There are indications of enteric inflammation and fever, rigors, slight hyperthermia, drying up of the milk secretion, impaired or suspended appetite and rumination, constipation, colicy pains, increasing dullness and prostration. As the disease advances the excrements become soft, pultaceous or watery, with floating hard baked pieces, dark and even glistening on the surface and more or less false membranes. These are sometimes stained with blood, which may also be mingled with the liquid debris. As in solipeds these membranes constitute the only true diagnostic symptom. They may appear as shreds, bands or complete cylindroid casts of the intestine.
Other complications, like pseudomembranous exudate on wounds, abortions and profound weakness are sometimes noted. The disease may last eight days before ending in recovery. When death takes place it is about the fourth or sixth day.
Lesions. The false membranes are found on the ilium and colon, in thin films or in thick masses, or tubular casts. In extreme cases the membrane has covered an extent of 24 feet in length, and if recent it is soft and friable. If older it may be firm, consistent and yellow or stained by the blood or ingesta. As in solipeds it shows a reticulated network and a fine granular structure, and is composed mainly of inspissated mucus with albuminoids and fibrine. The exudate covers a surface of extreme redness, with points of darker blood-staining and even abrasion or ulceration. The surrounding mucosa is also congested, the villi hypertrophied, the mucous follicles swollen.
Treatment. In the early stages a laxative of soda sulphate is of especial value in depleting from the inflamed mucosa, liquefying the secretions and dissolving and loosening the false membranes. Epsom salts, cream of tartar, Rochelle salts, calomel, and pilocarpin are more or less valuable substitutes. Iodide of potassium is most valuable in dissolving the exudate and acting as a microbicide (dose 3–4 drs.).
Other alkaline salts may be substituted or as antiseptics the sulphites, hyposulphites, or sulphides of potash or soda. Borax, bismuth, naphthol and creolin have also been recommended. Enemata of warm water are desirable.
In very adynamic conditions, muriatic acid (½ dr. doses) may be given with vegetable bitters and the same may be allowed during convalescence.
Causes: As in cattle, draughts in folds, overfeeding. Symptoms: fever, inappetence, weakness of hind parts, diarrhœa, tenesmus, false membranes, blood in stools, tympany. Treatment: change diet of dam, exercise, Glauber salts, potassium iodide, bismuth, flaxseed, elm bark, mallow, gum, carminatives, bitters, antiseptics.
Causes. The same causes are claimed as for cattle. Clavel attributed it to too rich milk, and exposure to cold draughts, in folded lambs.
Symptoms. To the general symptoms of fever are added refusal of the teat, weakness or paresis of the hind limbs, looseness of the bowels and the ejection of false membranes with an unusual amount of straining. The dejections may be watery and mixed with blood. In some cases defecation is suppressed, the intestines being blocked by the membranes, and then acute indigestion and fatal tympany may follow.
The pathological anatomy and lesions resemble those seen in the ox.
Treatment. Change the diet of the ewe, and allow more outdoor exercise. Give the lamb Glauber salts (½ to 1 oz.) with potassium iodide (10 grs.), and bismuth (1 dr.). Decoctions of flaxseed, or solutions of elm bark, mallow or gum arabic are desirable, and infusions of aromatic plants or oils of peppermint, anise, or fennel may be added with quinia. As in the other animals such antiseptics as salol, naphthol, naphthalin, boric acid, or salicylate of soda may be administered.
Complication of other diseases like distemper. Symptoms: fever, retching, vomiting, tense, tender, tympanitic abdomen, irregular bowels, false membranes. Lesions: stomach empty, congested, croupous exudate, extravasations. Treatment: sodium sulphate, boric acid, sodium salicylate, salol, bismuth, by mouth or enema, strychnia, vermifuges.
In dogs the formation of false membranes on the intestinal mucosa seems to have less of an individual character, and is found associated with other affections, like canine distemper and parasitism. In the absence, however, of accurate knowledge of the specific cause of croupous enteritis in other animals it seems permissible for the present, to arrange the whole in one class characterized by the presence of false membranes.
Symptoms. Along with the general symptoms of fever and the special ones of the existing specific disease there is more or less disturbance of the digestive organs, anorexia, vomiting, tense, tender, perhaps tympanitic abdomen, irregularity of the bowels and the passage of the false membranes. A morose disposition and tendency to snap has been noticed by Röll.
Lesions. The stomach is empty with red or dark mottled mucosa, the intestinal mucosa is congested covered with a layer of mucopurulent exudate, and at intervals patches of false membranes which are also found in shreds floating in the glairy contents. The exudates are of a yellowish gray color, more or less streaked with blood, and the mucosa infiltrated, swollen, highly congested and with spots of extravasation of blood.
Treatment. Small doses (1 to 2 drachms) of sulphate of soda may be given by the mouth, or boric acid (1 scruple), salicylate of soda (10 grains), salol (5 grains), or bismuth nitrate (½ drachm). Injections of boric acid, borax, sodium hyposulphite, or even Glauber salts prove useful, and powdered nux vomica (1 grain twice daily) may be added.
In case of intestinal parasites vermifuges must be resorted to.
In pigeons: Ærobic, non-motile bacillus, in lesions, membrane and internal organs, pathogenesis, in chickens pathogenesis differs, also in man, parts attacked, exudate, other symptoms, mortality early and late in outbreak, American form, pathogenesis to rabbits and Guinea-pigs. Prevention: Avoidance of infection, quarantine of birds, separation of sick, disinfection, accidental bearers of infection, pigeons, buzzards, carrion crows, dogs, men, cleanliness. Treatment: Locally antiseptics, phenol, boric acid, generally, phenol.
This has been especially seen in pigeons in which it has been studied by Löffler, Cornil and Megnin, and Babes and Puscarin. Löffler found an ærobic, non-motile, non-liquefying bacillus in the false membranes, inflamed tissues, liver, lungs and blood, even in the leucocytes. It formed irregular masses, and grew in nutrient gelatine, blood serum and potato. It proved pathogenic to pigeons, linnets, rabbits and mice, but not to hens, Guinea-pigs, rats or dogs. Chickens, however, suffer from an acute diphtheritic affection caused by a nearly allied bacillus, and it remains to be seen whether the varying pathogenesis may not be due to the habit of long continued growth in a particular genus and an acquired unfitness for growing in the other. The pathogenesis is also different from the bacillus of diphtheria of man, and the two diseases are not usually inter-communicable, in spite of the fact that in rare instances infection has appeared to have taken place from man to birds.
In pigeons and fowls the upper parts of the air passages and digestive tract are mainly involved, the tongue, fauces, corners of the mouth, nares, larynx, and conjunctiva. The bowels suffer less frequently and mostly concurrently with the mouth, nose and throat. The mucosa is deeply congested and in part covered by a yellowish exudate which may accumulate in masses, and dry into a firm substance. The disease affects particularly high bred birds, kept in close warm houses, and is often imported by prize animals returned from a show. There may be dullness, listlessness, sunken head, trailing wings and tail, erect plumage, diarrhœa, and, if the nose and throat are affected, a modification of the voice as in roup. Death may occur from asphyxia from the second to the fourth day near the beginning of an outbreak or the illness may last twenty days, after the more susceptible birds have been killed off.
In investigating a series of outbreaks of roup in chickens in America, Dr. V. A. Moore found a non-motile bacillus allied to the colon bacillus which proved much more deadly to rabbits and guinea pigs than to chickens, and which was not found in the blood nor internal organs but only in the local lesions where inoculated. The disease tended to assume a chronic type in place of the acute form as seen in Europe. Three inoculated chickens escaped the disease altogether. It would appear therefore that we have here a disease distinct from that described by Lœffler, or that there was an absence of some unknown predisposing or contributing conditions that were present in the European outbreaks. In both diseases however infection is an undoubted factor and similar measures of prevention and even of treatment may be followed.
Prevention. The first consideration is the seclusion of flocks from outside animals in affected localities. Newly purchased birds or those returning from a poultry show should be placed in strict quarantine for a few weeks until the absence of infection shall have been demonstrated. Different flocks should not be allowed to mingle, nor the members of a healthy flock to wander where the manure of another flock has been laid. Birds having diarrhœa, or any discharge from eyes, nose or beak, or any false membrane on such parts should be excluded from the flock, and the house and yard disinfected. It should not be forgotten that rabbits, guinea pigs and mice may be bearers of the infection, and that it may be introduced on the feet of dogs or their masters. Pigeons, buzzards, and carrion crows are especially dangerous as possible bearers of the infection. Cleanliness as regards food and water, buildings and yards is of vital importance.
Treatment. The sick birds should be strictly secluded and handled by a special attendant. When the lesions appear on visible mucosæ they should be painted several times a day with a 5 per cent. solution of phenol, or a saturated solution of boric acid, or salicylic acid, potassium permanganate, iodine, or some other germicide may be used. For the bowel affection one or two drops phenol in water may be given daily, and the drinking water should be slightly charged with the same. Cleanliness, pure air, warmth, dryness and sloppy food are all important.
Definition. Causes: Irritants swallowed, debility, improper, insufficient food, congestions, parasitisms, impaired innervation or circulation, iced water, chills, perspirations, fatigue, hot, damp weather, overfeeding, cryptogams, bacteria, newly harvested fodder, septic, or fermented food, leafy fodder, toxins, stagnant, septic water, lack of pepsin, muriatic acid and bile, diseased teeth or jaws or salivary glands. Lesions: Gastritis, congestion of small intestine and colon, in striæ, thickening, ecchymosis, ulceration, necrosis, excess of mucus with pus, villi, follicles and glands swollen. Symptoms: Fever, high colored urine, costiveness, coated tongue, red eyes, inappetence, sluggishness, emaciation, weakness, unthriftiness, colics, rumbling, diarrhœa; or more fever, suffering, anorexia, icterus, hurried breathing, pleuritic ridge, arched back, tender abdomen, rumbling, flatus, diarrhœa, critical or bloody, anxiety, debility, prostration, collapse. Prognosis. Treatment: In mild cases, careful diet, and laxatives with antiferments, in severe cases, laxatives, anodynes, antiseptics, demulcents, stimulants of peristalsis, enemata, counter-irritants, fomentations, compresses, mustard, in profuse diarrhœa antiseptics, anodynes, demulcents, calomel and chalk, bismuth, astringents, boiled flour or starch, gums. Dieting during convalescence.
Definition. Inflammation of the intestinal mucosa.
Causes. Irritants of all kinds taken in with food, or as medicine or otherwise and acting on the mucosa. Debilitating conditions (chronic disease, starvation, overwork, close indoor life) which lower the tone of the system at large, and local debilitating conditions like coarse, dry, fibrous, innutritious food, congestions, parasitisms, impaired innervation and troubles of the circulation are strongly predisposing. Drinking iced water may operate by lowering the tone of the intestines but seems to habitually act rather by inducing reaction and congestion. Chills of the surface, especially when perspiring and fatigued, act in the same way. The relaxation and atony attending on long continued hot weather, predisposes to enteritis, but is doubtless even more injurious by the abundance of ferments which it propagates in food and water.
Overfeeding and stimulating aliments thrown on an alimentary canal in such an atonic condition become especially hurtful. The injury, however, comes most commonly from food that contains an excess of cryptogams or bacterial ferments or from water similarly charged. Newly harvested fodders in which the microbes are still in a state of vigorous life, when added to the poisonous principles in certain immature seeds (leguminosæ, gramineæ, etc.); fodders that have undergone fermentative changes (rotten potatoes, turnips, musty hay or oats); fodders that are leafy and harbor an excess of microbes (alfalfa, sainfoin, cowpea, clover) are especially dangerous at times. If musty or otherwise altered they often contain besides, dangerous toxins.
In taking into account the fungi and microbes in spoiled foods, we need not give exclusive attention to the particular species of microbe present. An extended observation shows that the same ferments may be present in the dry, well cured, wholesome fodder, and in the musty or spoiled specimen, the main difference being in the excess found in the latter case as compared with the former. With the excess too, there is always present a large amount of toxins, ptomaines and other more or less poisonous products, which, acting on the intestinal mucosa or even on the system at large, tend to reduce its vitality and to lay it open to the attacks of bacteria which had otherwise remained perfectly harmless. Porcher and Desoubry, Achard and Phulpin and Wurz have shown experimentally that intestinal microbes can enter the chyle and blood from even a healthy bowel. The streptococcus of pneumoenteritis equi of Galtier and Violet appears to be a common fodder and intestinal microbe, which has become pathogenic, because of its excess or on account of a lack of resistance on the part of the animal. In the same way the various intestinal cocci and the common colon bacillus may become pathogenic when the normal antagonism of the bowels and their contents is lessened.
In the same way stagnant and septic water may be harmless to one animal of great vigor and good tone and pathogenic to another which lacks these qualities; or the excess of the ferment and its toxins may overcome the natural resistance of the animal. The lack of the natural antiferments of the intestine, pepsin and hydrochloric acid, on the one hand and bile on the other, will also conduce to multiplication of the microbes and their products, so that they can successfully attack the mucous membrane.
Other accessory causes operate more or less, thus any impairment of the process of mastication, through diseased teeth or jaws tends to the escape of undigested food through the stomach, as a specially favorable culture media for the microbes, and irritants of the mucosa.
Lesions. As the disease very often implicates the stomach (gastro-enteritis), the usual lesions of gastritis will be seen. Most commonly the lesions are best marked in the small intestine, and again in other cases in the colon, but usually there is more or less change in all parts of the intestinal canal. The small intestine is almost devoid of aliments and the mucosa deeply congested in patches or striæ, with at points thickening, softening so that it crushes under the finger, hemorrhagic discoloration, and even ulceration, and necrotic changes. It is covered with a layer of mucus, thin and mucilaginous or thick and glutinous, containing many granular and pus cells. The villi are swollen, the follicles of Lieberkuhn puffed up, and the agminated and solitary glands widely dilated, filled with exudate, and surrounded by an area of congestion. Proliferation of small, round cells has produced embryonic tissue in the mucosa and especially between the glands.
Symptoms. In the mildest form there is hyperthermia, thirst, insensible loins, scanty, high colored urine, costive bowels, a few small pellets only being passed at a time, hard, dry and covered with a mucous film, hot, clammy mouth, coated tongue, with redness along the edges and tip, yellowish red eyes, impaired appetite, dull, sluggish habit, a tendency to hang back on the halter, and a steady loss of flesh and increased dryness and unthriftiness of the coat. Slight, intermittent colics occurring especially after meals and attended by loud rumbling of the bowels are marked features. This may be followed by slight relaxation of the bowels and recovery in about a week, unless it should become complicated by intestinal indigestion or impaction, or should merge into the acute form.
In the more intense forms all symptoms are aggravated. There is anorexia and even refusal of water, dullness and prostration are well marked, the head carried low, and the gait is unsteady. The mouth is hot with tenacious mucus, and a fœtid odor; the tongue is furred and red at the tip and margins, the eye is sunken, the conjunctiva icteric, the face pinched, and the pulse accelerated. Hyperthermia may reach 104° F. Breathing may be almost normal, or with fever, may become rapid and accompanied by a pleuritic ridge on the flank. The back is slightly arched and rigid, the belly drawn up and tender, after meals it may be tympanitic, and colics set in or are aggravated, pawing, uneasy movements of the hind limbs, and lying down to rise again shortly, with frequent looking at the flanks being noticeable.
Defecations are at first abundant and coated with mucus, later the balls are small and scanty and expelled with much effort. From the first the everted rectum is of a very deep red. Toward the end of the first day or later the intestinal rumbling increases, flatus passes freely, and diarrhœa may set in and prove critical. This usually indicates disease in the colon and tends to recovery; it may be entirely absent if the inflammation is confined to the duodenum, the effused liquid being re-absorbed from the cæcum and colon. If the diarrhœa should prove critical there is a return of appetite and spirit, the fæcal discharges become firmer and recovery takes place in a week. If, however, the diarrhœa becomes more profuse and bloody, the colics more intense, the eyes more sunken and hopeless, the face more pinched and anxious, and the temperature reduced to or below the normal, with great weakness and debility, the near approach of death may be feared. This state of collapse may be further marked by extreme coldness, or dropsy of the limbs, increased icterus, hurried breathing and rapid loss of flesh.
A prominent icterus indicates implication of the liver from the ascent of the infecting germs through the bile ducts, or the passage of microbes or their products or both through the portal vein. In either case it is a serious complication.
Prognosis. In its uncomplicated form the disease is not very fatal to vigorous, mature horses, though more trying to the young. If infective germs or their products implicate the liver producing marked jaundice, or if the general system is poisoned by the microbes or their toxins, producing marked depression and prostration the danger is enormously enhanced.
Treatment. In the mildest cases a limitation of the food to moderate bran mashes, and a dose of ½ lb. of sodic sulphate, with salicylate of soda (3–4 drs.) or bismuth will usually suffice.
In severe cases, at the outset, while constipation exists give 3 or 4 drs. of cape aloes, or ½ lb. Glauber salts or ½ pint olive oil, combined with 2 drs. of extract of hyoscyamus or belladonna and 3 drs. salicylate of soda. This serves to deplete from the inflamed vessels and the whole portal system, to soothe suffering, to expel much of the offensive and infective matters from the bowels, and to check fermentation in that which remains. They should be given with, or followed by mucilaginous liquids like solutions of slippery elm or gum arabic, flaxseed tea, or well boiled farinaceous gruels.
Pilocarpin, 3 grs., or eserine, 2 grs., or both have been recommended and may be resorted to when action of the bowels is urgently demanded. They need not supersede the other laxatives. In manifest impaction of the large intestines, salts, aloes, pilocarpin and eserine may form an effective combination.
Copious enemata with mucilaginous liquids or warm soap suds should be given at frequent intervals.
Counter-irritants and derivatives to the abdomen are most important. Hot fomentations may be persisted in for an hour at a time, or a damp compress around the abdomen covered closely by dry blankets and held in place by elastic circingles. Mustard pulp made with cold water rubbed in against the hair and at once covered by paper and a thick blanket is often of great value as drawing blood and nervous action to the skin and relieving the suffering intestine.
In all cases the diet and drink must be carefully supervised. A little thoroughly scalded wheat bran, or farina, and decoctions of flaxseed, farinas, slippery elm or mallow, or a solution of gum arabic will refresh the animal without overloading the digestive organs or favoring further fermentation.
In case of the onset of diarrhœa which threatens to prove excessive and persistent, the giving by mouth and anus of antiseptics and anodynes with mucilaginous agents may be resorted to. Calomel may be given in 10 grain doses twice daily mixed with five times the amount of chalk. Or 2 drs. each of nitrate of bismuth and salicylate of soda and ½ oz. of laudanum may be given three times a day. Or quinine, 2 drs. and nux vomica 10 grs. may be added to the above. A choice may be made of other anodynes, (hyoscyamus, belladonna), antiseptics, (salol, chloral, naphthol, naphthalin, creolin), and bitters, (gentian, calumba, cascarilla).
Antiseptic and even astringent injections must be given, and well boiled farinas and mucilaginous agents may be given by the mouth. Wheat flour boiled for several hours; starch prepared with boiling water as for the laundry, (1 pint); gum arabic, or slippery elm may suffice as examples.
The patient should have a dry comfortable box and warm clothing according to the season of the year. He must be kept for a week on linseed gruel or other equally simple demulcent agent and brought back to his customary food by slow degrees.