Part 16

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.