Spoiled foods. Toxic rye. Botulism. Brine poisoning. Flesh of overdriven (leucomaines). Symptoms: from mouldy bread, brain disorder, gastric, urinary, hæmatic: from brine, restlessness, convulsions, eructations, vomiting, weakness, paresis. Lesions: congestion of stomach, bowels and mesenteric glands; with brine, heart and skin charged with black blood, congestion of brain, kidneys and bladder. Petechiæ. Treatment: empty stomach, emetics, purgatives, potassium iodide, antiferments, sedatives, cold to head, enemata, counter-irritants. Prevention.
Causes. Spoiled foods of all kinds such as mouldy bread, musty meal, spoiled grains of all kinds, or rotten potatoes, or apples are common causes of poisoning. In specimens of toxic rye Woronin found four fungi:—fusarium roseum, gilberella Sanbinetti, belminthosporium, and cladosporium herbarium. Prilleux and Delacroix have obtained a fifth, endoconidium temulentum. Rye so affected produced nervous disorder in swine, dogs, birds and even in man. Pigs often die from botulism, being fed flesh in a more or less advanced stage of putrefaction. Old meat brine is also a source of toxin and ptomaine poisoning since its toxic property increases with age which is not the case with a mere solution of common salt. Yet this is very deadly to the pig, a half a pint often proving fatal. Kuhnert records that the flesh of an overdriven horse proved fatal to the pigs that ate it.
Symptoms. From mouldy bread the pig becomes dull, stupid, sluggish, stiff, stilty and staggering in his gait, and usually costive. There are usually signs of colicy pains, inappetence, frothy lips, champing of the jaws, yawning, retching and vomiting. The mucosæ become yellow and the urine red and albuminous.
The symptoms caused by old brine are more violent. There are dullness, prostration, and inclination to lie, but at short intervals the animal gets up and wanders round, moving stiffly, is seized by tremors and finally convulsions, in which he falls to the ground, dashes his head from side to side, champs his teeth, rolls his eyes and froths at the mouth. There are usually eructations and often vomiting which does not, however, give the desired relief. The animal becomes rapidly weaker and though unable to rise has frequent paroxysms of trembling and other nervous symptoms.
Lesions. With mouldy bread the congestion of the gastric and intestinal mucosa, and of the mesenteric glands are marked features. With brine there is in addition the heart gorged with black, tarry blood, the skin and subcutaneous connective tissue shows a similar dark congestion, also the brain and its membranes and the kidneys and bladder. Petechiæ are abundant on the serous membranes and other parts of the body.
Treatment. Evacuate the stomach by tickling the fauces, giving tepid drinks, or ipecacuan. Follow with purgative of sulphate of soda and diuretics especially potassium iodide. Potassium bromide, sodium salicylate or salol may be given to calm nervous excitement and check fermentation. Degoix recommends chloral hydrate, enemata, cold to the head, and counter-irritants and in very prostrate conditions stimulants may be employed.
The most important measure, however, is the cutting off of the supply of the poison and the administration of a wholesome diet. Medicinal treatment is too often unsatisfactory and will seldom pay for the trouble; prevention is the one rational and economical measure.
Botulism. Racial immunity. Acquired immunity. Gastric secretions, protective. Bacteria in septic beef, old brine, stale fish, privy air. Symptoms: sudden onset, colic, nausea, retching, vomiting, septic vomit, fever, tender abdomen, bloody, fœtid, mucous diarrhœa, prostration, death in three to twenty-four hours. Lesions: of gastro-enteritis, ingesta fœtid, congestions and petechiæ of other organs. Treatment: emetic, laxative, diuretics, potassium iodide, antiseptics, demulcents, stimulants.
Causes. What is called botulism in man is not uncommon in carnivora. Eating carcasses of animals that have died of disease, of poisoning, etc., in a raw condition and too often in an advanced state of putrefaction, they are liable not only to infection by the pathogenic or poisonous microbes, but also to direct poisoning by the ptomaines and toxins. There are however certain protective conditions. Accustomed as this class of animals is to the consumption of such food, they have by selective evolution acquired an insusceptibility to many such poisons which would prove deadly to the herbivora. Again the mature dog or cat has already been subjected to many of these poisons and having survived them has acquired an immunity which renders it comparatively safe for the future. The antiseptic power of the gastric secretion of the dog may be easily shown, by letting him bolt a moderate piece of putrid meat, and killing him ten or fifteen minutes later when the mass will be found in the stomach without odor of decomposition. He succumbs to the poison either when the quantity ingested is too large, or when the digestion is from any cause deranged and the gastric secretion impaired. Anthrax flesh may produce pharyngeal or intestinal anthrax in the dog. In the animal with temporarily impaired immunity the more virulent septicæmias may prove infecting. From putrid beef the following pathogenic bacteria have been isolated: 1. Gärtner and Basenau have independently isolated bacillus bovis morbificans which forms clear colonies on the surface of peptonized gelatine, and brownish ones beneath the surface, and coagulates milk in 24 hours. This is short with rounded ends, very motile, non-liquefying, and capable of surviving the freezing temperature. Its toxins are not destroyed by boiling. It causes enteritis, or, subcutem, debility, somnolence, and stupor. This bacillus was pathogenic to mice, rats, guinea-pigs, rabbits, goats and calves but had little effect on dogs or cats. 2. The bacillus of Poels which produces paralysis. 3. The bacillus of Gatky which performs very rapid gyratory movements only, and is not found in the muscles.
Old Brine is as poisonous for the dog as for pigs. Six to nine ounces proved fatal, (Reynal).
Stale Fish has been known to prove poisonous in the same way.
Three dogs that were made to breathe the air over a foul privy were seized with vomiting, fever and diarrhœa.
Symptoms. These usually develop six or more hours after a feed. The earlier symptoms are those of digestive disorder. There is colic, nausea, retching, vomiting of septic or bilious matter, ardent thirst, dry mouth, furred tongue, redness of the buccal mucosa, and tenderness of the abdomen. Diarrhœa sets in early and may become bloody, fœtid and dysenteric. There is usually much prostration and debility so that apart from his compulsory movements under the colics the animal remains most of the time curled up. Fever is usually slight but the temperature may rise to 105° F. Death may take place in 3 hours, or may be deferred 24 hours or longer.
Lesions. There is usually gastro-enteritis, the mucosa being congested, red œdematous, with petechiæ, and congestion and swelling of Peyer’s patches, the solitary glands, the mesenteric glands, the liver and kidneys. The contents of the bowel are brownish red, and an effusion into the peritoneum is common. The spleen is often engorged and enlarged. Congestions of the lungs and brain are common.
Treatment. Evacuate the stomach by ipecacuan, etc., and the bowels by a purgative. Next seek elimination of the toxins by potassium iodide and other diuretics. Antiseptics (calomel, salol, naphthalin) to counteract the further formation of toxins, and demulcents by draught and enema are indicated. In cases of great prostration, heart and nerve stimulants may be useful.
Definition. Concomitant of other affections. Causes: Congestion, effusion from small and large intestine, irritants in bowels, or blood, chill or other shock acting as reflex, cold drink and violent exercise, aqueous food, cooked, pulped; irritants, feculent concretions, parasites, fermentation products, diseased teeth, jaws or salivary glands, drink after grain, gastric hepatic or pancreatic disease, spoiled food, purgative agents in food, fever products, purgative waters, rains, dews, damp stalls, etc., fear, “washy” horses, nervous animals, root diet, œstrum, hepatic torpor, equine susceptibility. Symptoms: with root diet, with much or little bile, slight cases do not affect system, in severe cases, tympany, pawing, straining, fœtor, in infective diseases; complications, laminitis, enteritis, pneumonia. Treatment: remove or expel cause, demulcents, laxatives, anodynes, antiseptics; chronic cases, iron, bitters, antiseptics, astringents, dietetics, rest.
Definition. A frequent discharge of fluid or semi-fluid evacuations from the bowels without excessive griping or painful straining.
This is a common condition attending many diseases, rather than a specific disease of itself yet it is such a prominent feature of these various affections, and one so very characteristic that it seems well to give it a special place, even at the risk of repeating much of what must necessarily appear elsewhere.
The immediate cause of diarrhœa is a congestion of the intestinal mucous membrane and a profuse secretion into the intestinal canal. When such congestion occurs in the small intestine alone, it may be counterbalanced by increased absorption in the large, so that the secretion must be excessive to produce liquid alvine discharges. When on the other hand it occurs in the large intestine or in both large and small, the product is likely to escape in the liquid form.
In its turn the congestion of the intestinal mucosa may result from irritants in the bowels, from the presence in the blood of irritant agents which being secreted stimulate the intestinal glands to excessive secretion, and from reflex nervous action, starting from a distant point as in chilling or irritation of the skin or other organ.
Among direct irritants of the intestinal mucosa may be named a full drink of cold water especially if the horse is trotted or galloped for twenty minutes immediately after;—soft, juicy, rapidly grown green food, to which the animal is unaccustomed, as the first grasses of spring;—cooked or pulped food or ensilage in hard worked animals;—many irritant and acid plants;—accumulations of hard feculent masses in the intestines;—irritation caused by intestinal worms especially the blood-suckers;—the presence in the intestines of undigested matters, and resulting fermentations, the result of diseased teeth and jaws and imperfect mastication, of disease of the salivary glands or ducts and imperfect insalivation, of a drink of water after a grain feed, washing a part out of the stomach in an undigested condition, of disease of the stomach, liver or pancreas interfering with their proper functions; unwholesome and fermenting food like spoiled grain, or fodder, or decomposed potatoes, apples, turnips, pumpkins, carrots, cabbages, etc.;—stagnant and putrid water;—tumors, ulcers, volvulus, invaginations, adhesions and other serious lesions of the bowels may act in the same way.
As examples of the secretion of irritant matters from the blood may be mentioned almost all the different agents used as purgatives, and purgative agents accidentally taken in, these being as a rule absorbed and later secreted again on the intestinal surface, increasing the secretions in their passage:—also the morbid products of fevers which irritate the intestinal mucosa and glands as they are thrown out by them (rinderpest, lung plague, Southern cattle fever):—the purgative waters on certain “scouring lands” act in a similar way. Under the head of reflex action may be named the chills from exposure to cold rains, night dews, damp stalls or beds, and damp, hot buildings, seasons and localities. Under the head of nervous causes must be included strong emotions as excitement, fear, etc., which lead to increase of both secretion and peristalsis. Some horses are very subject to this and are known as “washy”. These have usually a slim abdomen and long loin, and scour whenever they are put to hard work. Other nervous animals with good conformation, but which fret under saddle or in harness will scour under specially severe work or under excitement. This is especially common in young colts while being “broken”, and will occasionally show in mares which are in heat. Cattle that have been on a specially succulent diet (turnips, beets, ensilage, grass) are liable to scour profusely if driven far or fast, and stock men seek to obviate this by feeding some dry bran, meal, and above all fresh dry brewer’s grains just before starting. Cows running at large when in heat are very liable to scour. An exclusive diet of turnips or beets will keep cattle in a chronic condition of mild diarrhœa, though not enough to interfere with rapid improvement in flesh. Chronic diseases of the liver by obstructing the flow of blood through the portal vein, cause intestinal congestion and predispose to diarrhœa.
Of the various domestic animals horses are the most liable to superpurgation, from an undue dose of aloes acting on the very large colon and cæcum. Hence the importance of using such an agent carefully in the young, fat or debilitated especially, of the avoidance of cold drinks or exercise to excess after the aloes has been given, and of keeping from work during its operation or immediately after.
Symptoms. These are of all degrees of severity from the frequent pulpy evacuations of animals fed exclusively on roots, (beets, turnips, potatoes), to the excessive and almost constant discharge of a dark colored liquid mingled with more or less mucus. The discharge may be of a light color and fœtid, indicating deficiency of bile, or of a dark yellowish brown and odorless.
Slight diarrhœa does not affect the appetite nor general health, nor check improvement in condition. In the more severe and continued forms there is loud rumbling in the abdomen, loss of appetite and condition, a rapid small pulse, accelerated breathing, pallid mucous membranes, sunken glassy eye, and increasing debility even to an unsteady gait. Distension of the abdomen with pawing and other indications of abdominal pain may appear in bad cases. In the milder cases due to simple irritation and congestion there is no tenesmus, no excess of mucus, no formation of bubbles or froth in the stools, as occurs in active intestinal fermentation and dysentery. In symptomatic cases on the other hand there are superadded the marked symptoms of intestinal inflammation, or fermentation, and the fæces become putrid and offensive, which they do also in the different infectious diseases (influenza, contagious pneumonia, rinderpest, lung plague, hog cholera, swine plague, canine distemper, fowl cholera), when the toxins and waste matters of the food and decomposing tissues are being thrown off by the bowels.
Diarrhœa may be complicated with other diseases and especially in the horse with laminitis.
In mild cases it tends to a spontaneous recovery, and is followed by some slight costiveness, and if this should prove extreme there may be some danger of complicating sequelæ such as indigestion, enteritis, pneumonia or laminitis.
Treatment. The first consideration for the practitioner is to discover if possible the immediate cause of the diarrhœa. If this is found to reside in some infectious or other disease aside from the bowel, the attention must be directed to that even more than to the diarrhœa. If it depends on an overdose of some purgative agent or of acrid purgative plants taken with the food, any further laxative is to be avoided, and yet astringents and other agents which tend to lock up the offending material in the alimentary canal must be equally guarded against. An abundance of mucilaginous and demulcent liquids (mallow, flaxseed gruel, boiled starch, etc.) may be given both by the mouth and anus, to sheathe and protect the irritable mucous membrane and to dilute and carry off the irritant contents. Moderate doses of opium may be required to allay the violence of the spasms and peristalsis, but this should not be pushed to the extent of locking up the irritants. Sometimes antiseptics (naphthalin, salol) are useful to check fermentation, and pepsin may be given to assist digestion.
In ordinary cases due to the presence of an irritant the first object must be to relieve the bowels of this, and the second to soothe the irritated mucous membrane. A laxative is usually all that is required, but it must be a mild one so as not to add to already existing irritation. Olive or castor oil are to be preferred as a rule (horse and ox 1 pint; sheep and swine 4 ounces; dog ½ ounce), alone or with a moderate dose of laudanum. Or rhubarb or aloes may be substituted if desired. A dose of whisky or brandy, or oil of turpentine will often do much to allay the secretion and peristalsis. These should be followed by moderate doses of flaxseed gruel, or solution of slippery elm or mallow, or simple well boiled gruels.
If the discharge persists after the laxative has had time to operate, these mucilaginous agents may be replaced by solutions of boiled starch, or of gum arabic, and small doses of calmatives such as laudanum (horse or ox 1 ounce, sheep or pig 2 drachms, dog 20 drops), or prussic acid or cyanide of potassium (30 drops of the acid or grains of the salt for horse or cow). Sub-carbonate of bismuth, chalk, and carminatives and antiseptics may also be given. According to the indications the practitioner must combat persistent intestinal fermentation, or a relaxed adynamic condition of the intestinal mucosa, or general weakness and exhaustion, with such agents as seem best adapted to the individual case.
Chronic cases will demand the exercise of much judgment. After a gentle laxative, salts of iron (sulphate, chloride) and pure bitters may be given with antiseptics. Or vegetable astringents (catechu, kino) with freshly burned charcoal and essential oils (peppermint, cloves, cajeput) may be employed. In some instances calomel and chalk (1:12) will serve a good end. In others silver nitrate, or arsenite of copper succeeds. Quinine, nux vomica, pepsin, may be used to improve tone. The diet is usually all important. Well boiled gruels, boiled milk, arrowroot, pulped or scraped raw flesh may be demanded in different cases. The patient should be kept at perfect rest, and all excitement avoided.
Definition. Colicy pains from spasm, enteralgia, tympanitic indigestion, overloading of bowels, impaction, calculi, concretions, sand, foreign bodies, intestinal and arterial parasites, irritants, enteritis, catarrhal, bacteridian, protozoan, chemicals, strangulation, adhesion, volvulus, invagination, hernia, trauma of stomach or intestine, peritonitis, pleuritis, metritis, ovaritis, hepatitis, biliary calculus, nephritis, urinary calculus, neoplasms, lead poisoning. Causes of enteralgia or spasm, idiosyncrasy, nervousness, cold, wet, high condition, debility, cold, rain, dew, perspiration, fatigue, indigestion, rheumatism. Symptoms: horse—sudden attack, paws, kicks, anxious look at flank, crouches, goes down, rolls, sits, rises, shakes himself, feeds, repeats at intervals, rumbling, defecations. Complications. Diagnosis, symptoms violent, transient, completely intermittent, no fever, no tenderness; from acute indigestion by absence of faulty feed, loaded or tympanitic abdomen, crepitation, continuous pain, and of careful decubitus; from constipation by complete intermissions and freer passages; from intestinal worms by absence of fur on anus, of rubbed rump, and of parasites in stools; from verminous thrombosis by complete intermissions and absence of prostration, cold sweats and of bloody stools; from enteritis and other inflammations by absence of fever; from intestinal anthrax by the intermissions, the absence of brownish mucosa, and perhaps of anthrax from the district; from hepatitis by absence of icterus, tender hypochondrium, and fever; from kidney affections by lack of stiff, straddling gait, tender loins, stretching; from pleurisy by absence of catching breathing, tender intercostals, and friction sound; ruminants—similar symptoms except sitting up or rolling; swine—sudden starting with grunt or scream, vomiting, etc.; Carnivora—frequent moving, yelps, snapping, straining, looking at flank. Treatment: solipeds, morphia subcutem, anodynes, laxative, friction, walking, enemata, chloral hydrate: ruminants, walking, enemata, morphia, laxative; swine, morphia, laxative, antispasmodics, injections, derivatives; dog,—purgative, injections, chloral hydrate, ether, olive oil.
The term colic is loosely applied to all abdominal pains from whatever cause they may arise. It is thus allowed to embrace all diseases of the abdomen. In its more restricted sense in which it will here be considered it may be held to indicate abdominal pain without inflammation or any structural lesion.
It may however be well to note the most common causes of abdominal pain so that the distinction may be more definitely reached by a process of exclusion.
1st. Simple spasmodic colic. 2d. Enteralgia or neuralgia of the intestines. 3d. Colics from indigestion, a tympanitic, b from overloading with ingesta, c from impaction or constipation, d from calculi or concretions or from sand, or gravel taken with the food or from foreign bodies swallowed, e from worms in the intestines, f from worms in the mesenteric vessels (thrombo-embolic), g from irritants taken with the food or otherwise. 4th. Colics from structural lesions of the intestines; a from inflammation of intestine, b from bacteridian inflammation of the bowels, c from protozoan inflammation, d from chemical or other irritants, e from intestinal strangulations, f from adhesions, g from volvulus, h from invagination, i from mesenteric omental or phrenic hernia, j from strangulated inguinal, femoral ventral or umbilical hernia, k from wounds, ruptures or perforations of stomach or intestines, l from peritonitis or pleuritis, m from metritis or ovaritis, n from hepatitis or biliary calculus, o from pancreatitis or pancreatic calculus, p from nephritis, nephritic, uretral, cystic or urethral calculus, q from neoplasms affecting any of the abdominal organs. 5th. Colic due to lead poisoning.
Causes of enteralgia and spasmodic colic. Enteralgia may be defined as a neuralgic pain of the bowel which may therefore be free from spasm or any other appreciable structural or functional change. Its existence in the lower animal is necessarily somewhat problematical, as it can only be inferred from the analogy of the animal with man, and of the enteron with the superficial parts that are more frequently attacked with neuralgia, and also from the absence of visible spasmodic contractions in the bowel which has been the seat of intense pain, yet shows no inflammatory lesion. But whether this is accepted or not, the occurrence of spasm is undeniable and as both are functional nervous disorders the same causative factors will apply to both.
In some nervous animals, especially high bred horses and dogs, there is undoubtedly an idiosyncrasy which shows itself in a special susceptibility of the nervous system. In such animals an exposure to cold or wet, or the presence of a local irritant which would have been without effect under other circumstances, lights up the nervous disorder and produces an explosion, it may be as spasm or it may be as nervous pain. Animals that are kept under the best care, that are least accustomed to exposure and neglect, that are highly fed, and maintained in high spirits and are impatient of control are more susceptible than those that become inured to change and exposure, yet are kept in moderately good condition. On the other hand the subject which has become debilitated by overwork, underfeeding, exhausting disease, or the generation in the system of some depressing poison is likely to show a similar nervous susceptibility, so that at the two extremes of plethora and nervous susceptibility, on the one hand, and anæmia and neurasthenia on the other, we find a corresponding tendency to nervous disorder under comparatively slight causes. Thus it happens that a drink of ice cold water, an exposure to a cold blast or a drenching rain or a heavy night dew may seem to be the one appreciable cause of the trouble. If the animal has been perspiring and fatigued the attack is more likely to occur. In other cases a slight indigestion unattended by impaction or tympany, or the ingestion of an irritant which on another occasion, or in another animal would have been perfectly harmless, will induce a violent nervous colic. In some instances the attack is supposed to be of a rheumatic nature the causative action of the cold giving color to the theory.
Symptoms. The attack usually comes on suddenly especially if it has followed on a drink of cold water or a cold exposure.
Solipeds. The horse leaves off feeding or whatever he may have been engaged in, paws with his fore feet, moves uneasily with his hind ones or kicks with them, one at a time against the abdomen or out backward, he looks back at the abdomen with pinched, drawn, anxious countenance, bright anxious eye, and dilated nostrils, he moves uneasily from side to side of the stall or box, crouches for a few seconds with semi-bent knees and hocks and then throws himself down violently with a prolonged groan. When down he may roll from side to side over the back, and struggle in various ways, he may start to rise, sit for a moment on his haunches, then go down and roll as before. Or he may get up, shake himself and resume feeding as if entirely well. Soon the spasms reappear, suddenly as at first, and after a time subside as before. Thus the disease proceeds, each succeeding paroxysm diminishing in violence until they permanently subside, or increasing until the animal dies worn out with shock, suffering and exhaustion. If the paroxysms are severe the skin is usually bathed more or less in perspiration. Usually the peristalsis continues more or less, a rumbling is heard in the bowels and more or less fæces are passed in small solid balls or semi-liquid.
The course of the disease is usually rapid and followed by recovery. When prolonged it may become complicated by volvulus, invagination, indigestion or even enteritis.
Diagnosis. The characteristic symptoms are the suddenness of the onset, the extreme suffering during the paroxysm, the reckless manner in which the animal throws himself down, the intermissions with complete absence of pain, the natural condition of the pulse and temperature in the intermissions, the comfort with which the patient shakes himself, and the absence of all abdominal tenderness, manipulation and friction seeming to give relief rather than discomfort.
In the colic of acute indigestion there is the previous excessive or unwholesome meal, or the full drink after feeding; there is tympany, or a loaded state of the abdomen proving flat on percussion, there may be crepitation on auscultation, there is continuous pain with exacerbations (not complete intermissions), and there is rather a careful mode of lying down.
In intestinal constipation or other obstruction, fæces may be passed at first in small pellets coated with mucus or they may be at first passed freely but in steadily lessening quantities until they stop altogether. The pain is constant but worse at one time than another and in case of external hernia the swelling will be visible.
In helminthiasis there is the general unthriftiness, irregular appetite, frizzled broken hair on the base of the tail, a fur of dried mucus around the anus and the presence of parasites in the droppings.
In verminous thrombosis, to the symptoms just named there are added the reckless method of throwing himself down, hyperthermia, constancy of the pain, rapidly running down pulse, cold sweats, and profound prostration. When blood is passed per anum it is all the more significant.
In enteritis or peritonitis the hyperthermia and the constancy of the pains are sufficiently pathognomonic.
In intestinal anthrax there are the dusky brownish yellow mucosæ, the marked prostration, the hyperthermia and the constancy of the suffering. There is also the fact that the region is subject to anthrax and bacilli may be present in the blood.
In acute hepatic disease there is hyperthermia, dusky or icteric mucous membranes, great tenderness when percussion is made over the short ribs, and sometimes lameness of one shoulder (usually the right).
In disease of the urinary or generative organs the stiff or straddling gait, tender loins, and the frequent stretching as if to urinate, are nearly pathognomonic.
In pleurisy the hyperthermia, the transient duration of the colic, and the tenderness on manipulating the intercostal spaces will usually differentiate.
Ruminants. In cattle, as in the horse, the symptoms of spasmodic colic are restlessness, constant movement, looking round at the flanks, wriggling of the tail, uneasy lifting of the hind feet, kicking at the abdomen, and abruptly lying down and rising again. The animal does not roll on the back nor sit on the haunches. Fæces may be passed in small quantity or entirely suppressed, and there may be a slight tympany of the paunch.
Swine. The animal is attacked abruptly, starts with a grunt or scream, moves around uneasily, lies down, rolls, gets up, and repeats the motions. Vomiting is not uncommon, and the belly may be tense, tympanitic and even tender. The bowels may be confined or relaxed.
Carnivora. The colicy dog is very restless, changing from place to place, sitting on his haunches, lying down curled up, starting up suddenly with a yelp, and repeating the restless movements. He looks anxiously at his flank, sometimes bites at it, and cries plaintively. The bowels are usually torpid, and defecation effected with straining.
There are distinct intermissions but these are cut short by a new accession of pain.
The attack is usually transient and ends in recovery.
Treatment. Solipeds. For nervous colic the hypodermic injection of sulphate of morphia (2 grs.) is very effective. This will commonly bring relief in less than five minutes. Should there be no effect at the end of this time it may be repeated with advantage, but should a second dose fail, it is well to resort to other measures. Eserine and barium chloride are contraindicated as being liable to increase the spasm, and if there is no irritant to expel there is no object in their exhibition. The old prescriptions of laudanum and turpentine; laudanum and ether; sweet spirits of nitre with belladonna, or hyoscyamus, and other stimulants and narcotics are of little avail as they are not absorbed from the horse’s stomach and cannot operate until they have reached the duodenum. If given at all, their action may often be hastened by injecting them into the rectum.
When the morphia fails it is the safest treatment to give a moderate dose of aloes or other laxative, in combination with extract of hyoscyamus or chloral hydrate. This takes time to pass into the duodenum, and be absorbed and secreted anew in order to have its full effect, and therefore it may be necessary to keep up a moderate action of the morphia as a palliative. In four hours, however, at the latest, the aloes can be counted on to bring permanent relief. This appears to come as soon as the active principles have been absorbed, the nauseating effect operating at once on the overexcited nerve centres. The action is more perfect still when a free secretion has been started from the intestinal mucosa, and the circulation and innervation in the intestinal walls are essentially changed. This measure which was long successfully practiced and advocated by the late Joseph Gamgee, is even more perfectly adapted to the colics of indigestion and irritation, of impaction and fermentation. There are of course cases of complete obstruction in which it must fail, but it is probably the most successful method for colicy affections in general.
In addition to the above, other methods of correcting the disordered innervation are available. Active friction of the abdomen with straw wisps is often effective, also fomenting the abdomen with hot water. Simply leading the animal around acts as a nervous derivative, and may be employed to prevent his dashing himself down so suddenly as to injure himself. Then copious injections of warm water soothe the rectum, solicit its peristalsis and by sympathy affect the other intestines in the same way. They may often be made more effective by the addition of antispasmodics (extracts of belladonna or hyoscyamus or chloral hydrate).
In all cases a soft bed should be provided to secure the animal against injury in his sudden reckless movements.
Ruminants. Simple spasmodic colic is usually transient and may be successfully treated by driving around, giving copious warm water injections, and using morphia subcutem. Frictions to the abdomen with straw wisps, or with oil of turpentine should be tried. Should these fail there is a presumption of further trouble and no time should be lost in giving a laxative (Glauber salts) 1 to 2 pounds, or castor oil 1 quart, with antispasmodics and stimulants as for the horse.
Swine. The antispasmodic treatment may be tried on the pig, but usually it is well to give a purgative at once in combination with the narcotic. Castor oil 4 ounces, laudanum ½ drachm, or jalap 2 drachms, and extract of hyoscyamus 20 grains in electuary. Warm injections and embrocations to the abdomen are desirable.
Dog. It is usually well to give a purgative at once (jalap ½ drachm) with 10 to 20 drops laudanum according to size. Copious injections of warm water and a warm bath may follow. Chloral hydrate 20 to 60 grains, may be exhibited by the rectum; also ether 1 drachm, in olive oil.
Definition. Symptomatic. Causes: habit of retention in horse, dog and cat, indigestible matters in colon, calculi, dry food, lack of water, fever, diuresis, diaphoresis, milking, bleeding, hepatic torpor, verminous thrombi, old age, debility, nervous disease, matting of hairs, hæmorrhoids, abdominal suffering. Lesions: dilatation and catarrh of bowel, disease of rectum. Symptoms: solipeds—small, dry, coated, infrequent stools, straining, inappetence, tympany, colic, stretching as if to urinate; dog, fruitless straining, or dry, earthy looking fæces, coated, bloody, fœtid, anus swollen, tender, moist, palpitation, colic, vomiting, diarrhœa may fruitlessly occur, male urinates like bitch, foul, fœtid mouth; may last days or months; complications, sequelæ. Treatment: solipeds—exercise, pasturage, cold water before morning feed, regular regimen, bran, flaxseed, carrots, turnips, ensilage, common salt, Glauber salts, nux, cold injection, glycerine, barium chloride, purgative, enemata; dog:—mechanical unloading of the rectum and colon, injections, exercise, water, regular habits, laxative food, eserine, oil, calomel, jalap, podophyllin, colocynth, belladonna, nux vomica, abdominal massage, electricity.
Definition. Constipation consists in dryness, hardness, and undue retention of the fæces. It has of course many grades and may lay claim to many different causes, so that it might, like its antithesis diarrhœa, be held as merely a symptom of another disease. It has however such a definite character, that it is convenient to retain the name to designate those cases in which the torpor or atony is the most prominent and dominating feature, while other forms of obstruction will be treated under different heads.
Causes. Defecation is immediately due to the active peristaltic movements of the rectum overcoming the resistance of the sphincter. There is also the concurrent closure of the glottis and contraction of the diaphragm and abdominal walls, and it is usually the voluntary operation of these forces that rouses the rectum to effective peristalsis. The excitability of the rectum depends greatly on habit, hence the habitual retention of fæces, gradually dulls that organ and renders it less and less disposed to respond. In horses this is seen largely in connection with abundant dry feeding and lack of exercise. In house dogs and cats on the other hand, inculcated habits of cleanliness, compels the suppression of the natural instinct, and the habitually overloaded bowel becomes less and less responsive. The retained excrements meanwhile give up more and more of their liquids until they become so dry, and incompressible as well as massive that they can be expelled only by violent efforts. Inflammation of the mucosa naturally follows the retention and this in its turn adds to the weakness and torpor.
Acting in a similar way the partial obstruction, by accumulations of bones and other undigested matters in the colon, and by calculi, tends to continued accessions of new material and to gradually increasing intestinal paresis. So with the other forms of obstruction which will not be further referred to here.
In all animals dry feeding and a lack of water are potent causes of inspissation of the ingesta and torpor of the bowels.
All or nearly all febrile affections, leading as they do to suppression of secretions, cause drying and tardy movement of the contents of the bowels.
The excessive loss of liquid through other channels,—by diuresis, by profuse perspirations, by excessive secretion of milk, or by bleeding—has a similar tendency.
The suppression of the biliary secretion through liver disease, or obstruction of the biliary duct, withholds from the intestine, the most important of the stimuli to peristalsis, and tends to constipation, unless the resulting irritation should cause excessive secretion.
The derangement in the circulation in the intestinal walls caused by verminous thrombi in the horse, acts in the same way, the imperfectly nourished walls not only losing the normal power of peristalsis, but sometimes contracting so as to cause a stricture. Parasites encysted in the walls of the bowels, like catarrhal and other inflammations of these parts tend to atony and tardy peristalsis.
A weakness of the nervous system attendant on old age, or debility, or chronic lead poisoning often tells with force on the alimentary canal, and the loss of nervous power through disease of the great nerve centers (ganglionic system, brain, spinal cord) impairs the vermicular motion. This is notoriously the case in paraplegia, chronic hydrocephalus, and vertigo.
Finally among the causes of constipation must be noted the matting of the hairs around the anus (in dogs), and painful affections of the anus, or the abdominal walls, which render efforts at defecation painful and deter the animal from attempting them.
Lesions. These are as varied as the diseases which give rise to constipation, or result from it. Permanent dilatation or sacculation of the intestine, and the structural changes attendant on intestinal catarrh are the most common local lesions. But proctitis, hemorrhoids and ulcers of the anal follicles are met with in canine patients and ulcers of the colon in the seat of impaction are common.
Symptoms. In Solipeds the fæces are passed, at long intervals, in small quantity, usually only a very few balls at a time, firm, dry, moulded smooth and black on the surface, often covered with mucus, or with streaks of blood. They are passed with unusual effort and straining, and even with groaning, and one or more balls that may be exposed in the act are often drawn back and retained by the inversion of the rectum and closure of the sphincter. It is liable to be complicated by impaired appetite, tympanies, slight recurrent colics, and dryness, scurfiness and unthriftiness of the skin. Not unfrequently the pressure of the impacted colon (pelvic flexure) irritates the bladder causing stretching as if to urinate, and the passage of urine often in small quantity. There may be the symptoms of any one of the different nervous affections that lead to impaired peristaltic action, or of the local diseases which tend to obstruction of the bowels.
In dogs there are violent and painful efforts to defecate, which may be fruitless, or may lead to the expulsion of small masses of dry, earthy looking fæces, smoothly moulded on the surface, coated with mucus, streaked it may be with blood and highly offensive in odor. The anus may be puffy and swollen with mucopurulent secretion from the anal glands, which soils the hair of the hips and tail. If the abdomen is flaccid, manipulation with both hands on opposite sides usually detects a solid mass representing the impacted rectum and colon, and extending from the pelvis forward, often to the sternum. The same mass will be reached by the oiled finger introduced into the rectum. Both methods of exploration are painful and may call forth cries from the patient. The abdomen is usually distended, largely from the impacted fæces, in which case it gives a flat sound on percussion, or from gaseous emanation, in which case it is tense, resilient and resonant. Colicy pains are liable to appear, and vomiting at first of food only, then more or less yellow and bilious, and finally of distinctly feculent matters. For a time appetite may be retained, but this is gradually lost. There may supervene diarrhœa, which in favorable cases may lead to expulsion of the impacted mass, but in others it fails to completely dislodge it. The patient is dull and spiritless, inclined to lie curled up in dark corners, and when raised walks slowly and stiffly, with the tail carried straight or slightly to one side. The male urinates like a bitch without lifting the leg. The nose is dry, the tongue furred, the teeth usually covered with tartar, and the breath fœtid. There is at first no hyperthermia, but some rise of temperature attends on the advance of the disease, and the auto-poisoning by absorbed products of the putrefaction of retained fæces.
The disease may last a few days only or it may continue for weeks or months. In the last case intestinal catarrh, ulceration, and circumscribed necrosis are likely to supervene and the animal may die of auto intoxication, acute peritonitis or enteritis. Yet the majority of cases in the dog reach a favorable termination, or recover with remaining cicatrices, strictures or dilatations.
Treatment. In solipeds accustomed to an idle or pampered life, plenty of daily exercise will often correct the torpor. A run at pasture will often effectually counteract the tendency. If the patient must be kept in the stable a full drink of cold water every morning before feeding will often succeed. Regularity in feeding and watering is of the utmost importance, and the addition of a little wheat bran or flaxseed to the grain is often of material advantage. Next may be added a moderate allowance of carrots, turnips, or ensilage to furnish the needed succulence and organic acids. If in addition medicinal measures are wanted, a small handful of common salt, or of Glauber salts, in the morning drink to be taken ten or fifteen minutes before the first feed, will usually operate well. This may be continued for a length of time if necessary, without the ill effects of purgatives given at other times. It may be rendered slightly more effectual by the addition of 10 grains nux vomica on each occasion. A morning injection of a quart or two of cold water with one or two ounces of glycerine may be tried. Another resort is 2 or 3 grains of barium chloride in the morning drink or hypodermically repeated daily for some time.
In the more severe cases with already existing impaction of the colon, purgatives and copious injections will be demanded as advised under that disease.
In dogs the first object is the unloading of the rectum and colon and this usually demands direct mechanical intervention. (See Intestinal Indigestion with Constipation.) In case of hypertrophied prostate this may be rendered somewhat difficult, yet with a free use of oily, soapy or mucilaginous injections it can usually be accomplished.
The further treatment is on the same line as for the soliped. An abundance of exercise in the open air is a prime essential, together with a free access to fresh water. House dogs must be taken out for urination and defecation at regular times that are not too far apart. The food must be of a laxative nature. At first fresh whey or buttermilk only may be allowed, but as some action of the bowels is obtained well salted beef tea, pulped or scraped red muscle seasoned with salt, or milk treated in the same way is permissible. If the bowels fail to respond when the dog is taken out at the regular times an injection of cold water may be given. Sulphate of eserine (⅕ gr.) may be given daily by the mouth or hypodermically, or castor oil (½ to 1 oz.) may be administered at one dose to be followed by careful dietary and hygienic measures. Or sweet oil, calomel and jalap, podophyllin, or colocynth may be substituted. When the bowels have been freely opened a daily morning dose of a drop of the fluid extract of belladonna and ½ gr. of nux vomica will often materially improve the peristalsis. Active manipulation of the abdomen may be employed, or, if available, a current of electricity through the torpid bowels for 10 or 15 minutes daily.
Causes: Matted feathers, impacted cloaca, arrest of eggs, debility, catarrh, parasites, nervous disorder. Symptoms: swelling of anus, pendent abdomen, waddling gait, straining without effect. Treatment: remove obstruction by mechanical means, cut off matted feathers, egg matter may demand laparotomy, castor oil, tincture of rhubarb, enemata, green food, ensilage, roots, onions.
In birds torpid and obstructed bowels may come from the effects of a previous diarrhœa, which has led to the matting together of the feathers over the anus at once obstructing defecation and rendering it painful. It may result in and be aggravated by a slow accumulation of indigestible matters in the intestine or cloaca (pebbles, feathers, etc.), and the arrest of eggs in the oviduct, pressing upon and obstructing the bowel. In a recent case the author removed 18 ozs. of impacted egg matter from the oviduct of a hen, which when divested of this load weighed barely 2 lbs. Debility of the general system and particularly of the walls of the bowels, and its various causes (old age, exhausting disease, intestinal catarrh, parasites, nervous diseases, etc.) retard defecation and favor impaction as in the mammal.
The symptoms may be; hard dry droppings, matting of the feathers over the anus with feculent matters, a firm swelling surrounding the sphincter, a pendent condition of the abdomen which when manipulated is felt to be firm and resistant, ruffling of the feathers, drooping of the head, wings and tail, walking sluggishly with legs half bent and a waddling gait, and ineffectual attempts to defecate.
Treatment. As in dogs remove the obstructing mass by mechanical means. Matted feathers may be clipped off, and feculent accumulations may be dislodged by the aid of the finger, or in small birds of a blunt prob. This may be favored by manipulation through the abdominal walls, and the injection of soapy or oily enemata. Accumulations of impacted egg matter may be similarly removed, or, failing this, by an incision made through the abdominal walls and oviduct. As a purgative give one or two teaspoonfuls castor oil according to the size of the hen, or a few drops to a small cage bird. For the latter Friedberger and Fröhner advise a few drops of tincture of rhubarb in the drinking water. Injections of warm or cold soapsuds or water may be continued as symptoms demand. Green food, ensilage, roots, worms, snails and insects are indicated to correct the tendency to costiveness and may be continued until the bowels have acquired their proper tone. A moderate allowance of onions is often of great value.
Seat, colon, cæcum; hair of oat seed, clover leaf, vine tendrils, hair of horse, nucleus, calcic admixture, straw, in horses on dry food, with depraved appetite, or with skin disease. Symptoms: none, or torpid bowels, colics, recurring, fermentations, tympany, obstruction, rupture, peritonitis, rectal exploration. Lesions: impacted ball, with excess of liquid and gas in front, rupture, ragged bloody edges. Treatment: extraction, enemata, eserine, barium chloride.
Hair balls, received the name of egagropiles because of their discovery in the alimentary canal of the wild goat, but they are found in various forms in all the domestic animals. In horses they occupy the cæcum and colon and are most frequently composed of the fine vegetable hairs that surround the grain of the oat, or the leaf of clover, of the woody tendrils of vines, and of the hairs of themselves and their fellows taken in at the period of moulting. They sometimes contain a nucleus of leather or other foreign body which has been swallowed but in many cases no such object can be found, the hair having become rolled and felted by the vermicular movements of the stomach and intestines. An admixture of mucus assists materially in the felting, and calcareous and magnesian salts may make up the greater part of the mass, rendering it virtually a calculus. They may further have a large admixture of straw and vegetable fibres of larger size than oat or clover hairs. They are most frequent in horses kept on dry food, (sweepings of oatmeal mills) and at hard work, and which show depraved appetite and lick each other. Omnibus horses suffer more than army horses. Skin diseases, by encouraging licking, contribute to their production.
Symptoms. In the great majority of cases hair balls do not seriously incommode the horse. They do not attain a large size, and being light do not drag injuriously on the intestine and mesentery. They do, however, retard the movement of the ingesta, and when grown to a considerable size they may block the intestine, more particularly the pelvic flexure, the floating colon or rectum. Under such conditions they produce colics which may be slight, transient, and recurrent, or severe and even fatal, having all the characteristics of complete obstruction from other causes. Fermentations, tympanies, and straining without defecation are common features. When the obstruction takes place in the pelvic flexure, the floating colon or rectum, it may often be detected by rectal exploration. When complete obstruction occurs all the violent symptoms of that condition are present, and these may pass into those of rupture (Peuch, Leblanc, Neyraud), and shock or peritonitis. If the animal has passed hair balls even months before, the colics may with considerable confidence be attributed to other balls of the same kind.
Lesions. In case of death there are the usual lesions of gaseous indigestion, with or without enteritis, but with the accumulation of a great quantity of liquid contents, above the ball, which is felt as a firm body impacted in the gut. In other cases the distended bowel has given way and the liquid contents and often the hair ball as well are found free in the abdominal cavity. In such a case the edges of the laceration are covered with blood clots and thickened with inflammatory exudation, and there is more or less peritonitis.
Treatment. Relief may sometimes be obtained by the extraction of a hair ball lodged in the rectum or adjacent part of the floating colon. In other cases abundant soapy or oily enemata, and the employment of eserine or barium chloride subcutem are indicated.
From licking in skin disease. Symptoms: of obstruction. Treatment: manipulation, enemata, oil, antispasmodics, eserine, barium chloride, laparotomy, diet in convalescence.
The hair balls of dogs come mainly from licking themselves when affected with skin diseases or parasites. In pigs they are mostly attributed to depraved appetite.
The hair balls of the dog are small, open in texture, and easily disintegrated, having little mucus and no earthy salts in their composition.
The bristle balls of pigs take the form of straight or curved rods of firm consistency, but without earthy salts. The projecting ends of the bristles render them particularly irritating.
The symptoms are those of obstruction of the bowels, and the treatment consists in efforts to dislodge them. If situated near the anus they may sometimes be reached with the finger, or copious oily injections may facilitate their passage. Manipulations through the abdominal walls may be helpful in the dog. Oleaginous laxatives and antispasmodics may be tried, or these failing, eserine or barium chloride. As a last resort laparotomy may be performed, the ball abstracted and the intestine and abdominal wall carefully sutured (Siedamgrotzky). In such a case the diet should be restricted for a week to beef soups, buttermilk, and well boiled gruels, especially flaxseed.