Part 19

Course. Termination. Many cases recover in connection with a restoration of the contractions of the rumen, the eructation of gas, in some rare cases vomiting or spasmodic rejection of quantities of the ingesta, and the passage of gas by the bowels. This may be associated with a watery diarrhœa, and loud rumbling of the right side, which may continue for twenty-four hours or longer. With the subsidence of the diarrhœa there comes a return of health, or there may remain slight fever, inappetence, suspended or impaired rumination, dullness, listlessness, and a mucous film on the fæces. This indicates some remaining gastro-enteritis.

In some instances there is rupture of the diaphragm with marked increase in the abdominal pain and the difficulty of breathing. In others there is a laceration of the inner and middle coats of the rumen so that the gas diffuses under the peritoneum and may even be betrayed by an emphysematous extravasation under the skin.

Diagnosis. From tympany this is easily distinguished by the general dullness on percussion, the persistence of the indentation caused by pressure, the outward and downward rather than the upward extension of the swelling, and the slower development of the affection.

It is far more likely to be confounded with pneumonia, which it resembles in the hurried, labored breathing, the moans emitted in expiration, in the dullness on percussion over the posterior part of the chest, it may be even forward to the shoulders, and in the cyanotic state of the mucosæ. The distinction is easily made by the absence of hyperthermia, and of crepitation along the margins of the nonresonant areas in the lungs, by the fact that the area of chest dullness covers the whole posterior part of the thorax to a given oblique line, and by the history of the case and the manifest symptoms of overloaded stomach, not with gas but with solids. From gastro-intestinal catarrh it may be distinguished by the more rapid advance of the symptoms and by the absence of the slight fever which characterizes the latter.

Treatment. Slight cases may be treated by hygienic measures only. Walking the animal uphill, injections of cold water, friction on the left side of the abdomen to rouse the rumen to activity, antiseptics as in tympany to check further fermentation, and stimulants to overcome the nervous and muscular torpor, may be employed separately or conjointly. When it can be availed of, a rubber hose may be wound round the abdomen and a current of cold water forced through it.

When further measures are demanded we should evacuate any gas through the probang or a cannula, as in tympany, and thus relieve tension and then resort to stimulants and purgatives. Common salt 1 ℔. is of value in checking fermentation, and may be added to 1 ℔. Glauber salts in four or five quarts of warm water. A drachm of strong aqua ammonia or 2 oz. oil of turpentine and ½ drachm of nux vomica may be added. Bouley advocated tartar emetic (2 to 3 drachms), and Lafosse ipecacuan (1 oz. of the wine) to rouse the walls of the rumen, and more recently pilocarpin (ox 3 grs.), eserine (ox 2 grs.) and barium chloride (ox 15 grs.), have offered themselves for this purpose. The three last have the advantage of adaptability to hypodermic use, and prompt action. The repetition of stimulants and nux vomica may be continued while there appears any prospect of restoring the normal functions of the paunch, and when all other measures fail the only hope lies in rumenotomy.

=Rumenotomy.= The warrant for this operation is found in the entire lack of movement in the rumen, the absence of eructation, the cessation of rumbling and motion of the bowels, and the deepening of the stupor in which the patient is plunged. The longer the delay and the deeper the stupor and prostration the less the likelihood of a successful issue from the operation. The animal is made to stand with its right side against a wall, and its nose held by the fingers or bulldog forceps. If judged necessary a rope may be passed from a ring in the wall in front of the shoulder around the animal to another ring behind the thigh and held tight. Or a strong bar with a fulcrum in front, may be pressed against the left side of the body, and well down so as to keep the right side fast against the wall. A line may be clipped from the point of election for puncture in tympany down for a distance of six inches. A sharp pointed knife is now plunged through the walls of the abdomen and rumen in the upper part of this line, and is slowly withdrawn, cutting downward and outward until the opening is large enough to admit the hand. The lips of the wound in the overdistended stomach will now bulge out through to the wound in the abdominal walls, and three stitches on each side may be taken through these structures to prevent displacement as the stomach is emptied and rendered more flaccid. A cloth wrung out of a mercuric chloride solution may be laid in the lower part of the wound to guard against any escape of liquid into the peritoneal cavity. The contents may now be removed with the hand, until the organ has been left but moderately full. Two or three stable bucketfuls are usually taken, but it is by no means necessary nor desirable that the rumen be left empty, as a moderate amount of food is requisite to ensure its functional activity. As a rule at least fifty pounds should be left. Before closing the wound and especially in cases due to dry feeding, it is well in a tolerably large animal to introduce the hand through the demicanal to ascertain if impactions exist in the third stomach and to break up these so far as they can be reached. This done, the edges of the wound in the stomach are to be carefully cleansed, washed with the mercuric chloride solution and sewed together with carbolated catgut, care being taken to turn the mucosa inward and to retain the muscular and peritoneal layers in close contact with each other. It will usually be convenient to cut first the two lower stitches through the abdominal walls, and suture from below upward. When finished the peritoneal surface of the gastric wound may be again sponged with the mercuric chloride solution, together with the edges of the wound in the abdominal walls. Finally the abdominal wound is sutured, the stitches including the skin only or the muscular tissues as well. The smooth surface of the paunch acts as an internal pad and support, and with due care as to cleanliness, antisepsis and accuracy of stitching, it is rare to find any drawback to continuous and perfect healing. It is well to restrict the animal for three days to well boiled gruels, and for ten days to soft mashes in very moderate amount lest the wound in the paunch should be fatally burst open before a solid union has been effected.

RUMINITIS. INFLAMMATION OF THE RUMEN.

Prevalence in different genera. Causes, as in tympany and impaction, irritants, specific fevers. Symptoms: impaired rumination, tympanies, impactions, depraved appetite, fever, nervous disorders. Lesions: hyperæmia, petechiæ, exudates, ulcers, desquamation, swollen or shrunken papillæ. Treatment: remove cause, mucilaginous food, or gruels, sodium sulphate, or chloride, bismuth, bitters, mustard cataplasm, electricity.

This is not a prevalent disease but affects animals at all periods of life and is a cause of tardy and difficult digestion and rumination. It usually shows itself as a catarrhal inflammation and by favoring fermentation in the food, and torpor of the muscular walls of the organ contributes to tympany and impaction. It is more common in the ox than in the sheep owing, perhaps, to the more habitual overloading of the stomach and to the hurried, careless manner of feeding. In the goat it is rare.

Causes. Among the causes may be named tympany and overloading, so that all the dietary faults that lead to these may be set down as causes of inflammation. Irritants taken with the food, whether in the form of acrid plants (ranunculaceæ, euphorbiaceæ, etc.), musty fodder, irritant products in spoiled fodder, aliments which are swallowed while very hot or in a frozen state, and foreign bodies of an irritating kind are especially liable to induce it. Congestions of the paunch are not uncommon in specific infectious diseases like Rinderpest, malignant catarrh, anthrax, and Texas fever, and specific eruptions sometimes appear in aphthous fever and sheeppox.

Symptoms. Rumination is slow and irregular, appetite capricious, tympanies appear after each feed, and there is a marked tendency to aggregation of the ingesta in solid masses, which resist the disintegration and floating which is necessary to rumination, and favor the occurrence of putrid fermentation. There is usually a tendency to lick earth, lime from the walls, and the manger, and a depraved appetite shown in a desire to chew and swallow foreign bodies of many kinds. Vomiting or convulsive rejection of the contents of the rumen is not unknown (Vives, Pattaes). There is slight fever with heat of the horns and ears, dry muzzle, and tenderness to pressure on the left flank. The bowels may be alternately relaxed and confined, and bad cases may end in a fatal diarrhœa. In other cases the disease may become acute and develop nervous symptoms, as in tympany and impaction. When the disease takes a favorable turn, under a careful ration, recovery may be complete in eight or ten days.

Lesions. These are violet or brownish patches of hyperæmia on the mucosa of the rumen, circumscribed ecchymoses, exudates in the sense of false membranes and even pin’s head ulcerations. On the affected portions the mucosa is swollen, puffy, dull and covered with mucus, and epithelium may desquamate. The papillæ are often red, and thickened or shrunken and shortened. In the specific affections like aphthous fever and sheeppox the lesions are rounded vesicles containing liquid. The ingesta is more or less packed in masses.

Treatment. If irritant foreign bodies have been taken rumenotomy is demanded. If caustic alkalies, acetic or other mild acid. If acids, lime water or magnesia. Feed well boiled flax seed, or farina gruels, and wheat bran or middlings in limited quantity. Solids may be at first withheld, coarse or indigestible food must be. It may be necessary to rouse the organ by 10 or 12 ozs. of sulphate of soda with a little common salt and abundance of thin gruels as drink. As a tonic the animal may take nitrate of bismuth ½ oz., powdered gentian ½ oz., and nux vomica 20 grains, twice a day. The application of a mustard pulp or of oil of turpentine on the left side of the abdomen may also be resorted to. A weak current of electricity through the region of the paunch for twenty minutes daily is often of great service.

HAIR BALLS IN THE RUMEN AND RETICULUM. EGAGROPILES.

Balls of hair, wool, clover hairs, bristles, paper, oat-hair, feathers, chitin, mucus, and phosphates. Causes: Sucking and licking pilous parts, eating hairy or fibrous products. Composition. Symptoms: Slight, absent, or, gulping eructation, vomiting, tympany, in young putrid diarrhœa, fœtid exhalations, emaciation. Diagnosis. Treatment.

Definition. The term egagropile, literally goat-hair, has been given to the felted balls of wool or hair found in the digestive organs of animals. The term has been applied very widely, however, to designate all sorts of concretions of extraneous matters which are found in the intestinal canal. In cattle the hair licked from their skin and that of their fellows rolled into a ball by the action of the stomach and matted firmly together with mucus and at times traces of phosphates, are the forms commonly met with. In sheep two forms are seen, one consisting of wool matted as above and one made up of the fine hairs from the clover leaf similarly matted and rolled into a ball.

In pigs the felted mass is usually composed of bristles, (exceptionally of paper or other vegetable fibre), and in horses felted balls of the fine hairs from the surface of the oat, mingled with more or less mucus and phosphate of lime make up the concretion. These are found in the stomach, and intestines. In predatory birds the feathers and in insectivorous birds chitinous masses are formed in the gizzard and rejected by vomiting.

Causes. Suckling animals obtain the hair from the surface of the mammary glands hence an abundance of hair or wool on these parts favors their production. The vicious habit of calves of sucking the scrotum and navel of others is another cause. In the young and adult alike the habit of licking themselves and others especially at the period of moulting is a common factor.

Composition. Hair, wool, and the fine hairs of clover are the common predominant constituents, but these are matted together more or less firmly by mucus and phosphates, the ammonia-magnesian phosphate uniting with the mucus and other matters in forming a smooth external crust in the old standing balls of adult animals. The centre of such balls is made up of the most densely felted hair. In balls of more recent formation the external crust is lacking and the mass is manifestly hairy on the surface, and the density uniform throughout. These have a somewhat aromatic odor, contain very little moisture, and have a specific gravity approximating .716 (sheep) to .725 (ox). Ellagic, and lithofellic acids, derivatives of tannin, are usually present, and are abundant in the egagropiles of antilopes.

In the balls of recent formation, as seen especially in sucking calves, the hair is only loosely matted together, and often intermixed with straw and hay, and is saturated with liquid and heavier than the old masses. These are usually the seat of active putrefactive fermentation, and being occasionally lodged in the third or even the fourth stomach, the septic products act as local irritants, and general poisons. They are therefore far more injurious than the consolidated hairballs of the adult animal, and often lay the foundation of septic diarrhœas and gastro-enteritis.

The balls may be spherical, elliptical, ovoid, or, when flattened by mutual compression, discoid.

Symptoms. Generally these balls cause no appreciable disturbance of the functions of the stomach. This is especially true of the large, old and smoothly encrusted masses. The museum of the N. Y. S. V. College contains specimens of 5½ inches in diameter, found after death in a fat heifer, which had always had good health and which was killed for beef. This is the usual history of such formations, they are not suspected during life, and are only found accidentally when the rumen is opened in the abattoir.

The smaller specimens, the size of a hen’s or goose’s egg, or a billiard ball, have produced severe suffering, with gulping, eructation, vomiting and tympany from obstruction of the demicanal or gullet, and such symptoms continued until the offending agents were rejected by the mouth. (Caillau, Leblanc, Prevost, Giron). Again they may block the passage from the first to the third stomach (Schauber, Feldamann, Adamovicz, Tyvaert, Mathieu).

In calves on milk they are especially injurious as beside the dangers of blocking the passages already referred to, the unencrusted hairs and straws irritate the mucous membranes and still worse, the putrid fermentations going on in their interstices, produce irritant and poisonous products, and disseminate the germs of similar fermentations in the fourth stomach and intestine. Here the symptoms are bloating, colics, impaired or irregular appetite, fœtid diarrhœa, fœtor of the breath and cutaneous exhalations, and rapidly progressive emaciation.

Diagnosis is too often impossible. Tympanies, diarrhœa, colics, etc., may lead to suspicion, but unless specimens of the smaller hair balls are rejected by the mouth or anus there can be no certainty of their presence. If arrested in the cervical portion of the gullet they may be pressed upward into the mouth by manipulations applied from without. The looped wire extractor may be used on any portion of the œsophagus. If lodged in the demicanal the passage of a probang will give prompt relief. If retained in the rumen and manifestly hurtful, rumenotomy is called for as soon as a diagnosis can be made.

FOREIGN BODIES IN THE RUMEN AND RETICULUM.

Common. Harmless or injurious. Perforating objects. Traumatisms of contiguous organs. Causes; hurried primary mastication, morbid appetite. Bodies found. Lesions; catarrh, perforations, congestions, ulcerations of mucosa, abscess, trauma of liver, spleen, diaphragm, abdominal and thoracic walls, lung, pleura, pericardium, heart. Symptoms; absent, or, indigestion, tympany, eructations, hepatic, respiratory or circulatory disorder, colics, local tenderness, crepitation, substernal exudate, costiveness, difficult urination or defecation, bloody fæces, nervous disorder. Treatment; Prevention; avoidance of causes, gravitation methods, incision.