Part 32

TUMORS OF THE STOMACH.

In horse—sarcoma, papilloma, lipoma, adenosarcoma, epithelioma, in cattle—scirrhus, in dog—sarcoma, lipoma, epithelioma. Symptoms: chronic gastritis, periodic indigestions, colics, vertigo, salivation, impacted gullet, blackened fæces, eructations, vomiting, rumbling, stiffness, emaciation. Treatment: laparotomy in dog.

The peptic stomach in the different animals is subject to a great variety of tumors. In many of the recorded cases, however, the true nature of the tumor has been left uncertain.

=Sarcoma.= In the =horse= this is the common tumor of the pylorus, and less frequently it is found on the cardia and body of the stomach, especially on the greater curvature. These are usually firm and resistant, though sometimes soft and friable; they tend to swell out in lobules, and show areas of ulceration, or even suppurating excavations opening through the mucosa. In some instances, however, they start under the serous coat, and the ulcerous surface may open into the peritoneum. At other times they are but a local manifestation of a general affection.

In the =dog= multiple sarcomata have been found on the stomach varying in size and easily mistaken for recent tubercles. In these cases the small round cells were especially numerous in the centre of the tumor rendering it soft and predisposing to degeneration.

=Papilloma.= In the horse these are found as branching or filamentous dependent projections from the mucosa of the left sac having evidently started from the sores formed by the attachment of the œstrus larvæ. They are also found around the pylorus and of such size as to seriously obstruct that orifice (Stadler).

=Lipoma.= Fatty tumors have been seen on the stomach of the =dog= and =horse= in the submucosa.

=Adenosarcoma.= This formation in the =horse= leads to a thickening of large patches of the mucosa. It also grows out in mushroom like masses, or is irregularly lobulated.

=Epithelioma.= In the =horse= epithelioma has been found at the pylorus and on the great curvature of the stomach. It usually grows out as a rounded mass varying in size from an egg to an infant’s head, and may be even a diffuse thickening of the mucosa. Microscopically the individual lobules, are composed of cylindroid cells surrounding a central mass of epidermoid cells. The stomach may be greatly contracted, and the surface of the neoplasm, ulcerated or even excavated. In the =dog= similar formations are found.

=Carcinoma.= In =cattle= Scirrhus of the abomasum is described. Small tumors rise to a height of ½ to 3 inches, and are closely packed together so as to assume polygonal forms. The surface is smooth, or perforated by orifices leading into ulcerous or suppurating cavities. On section the mass shows a fibrous or a lardaceous consistency. They are most common in the pyloric region, and may partially obstruct this orifice.

Symptoms. These are necessarily obscure. In the =horse= periodic gastric indigestions and colics may be the sole indications, which are certainly not pathognomonic. In other cases, have been noticed: vertigo, salivation, impacted gullet, and blackish, sanguinolent fæces due to ulceration and hemorrhage from the tumors.

In =cattle= have been observed variable and capricious appetite, imperfect rumination, tympany, eructations, vomiting, rumbling of the bowels, constipation, slow painful walk, progressive emaciation and debility. When blood is discharged by emesis or defecation the suspicion of gastric tumor may be strengthened.

In the =dog= there are the usual signs of chronic gastritis, thirst, anorexia, stiffness, a disposition to lie, sunken eye, dyspnœa, vomiting, often of blood. The discharge of blood by mouth and anus, the distended abdomen, the tumor usually easily detected by manipulation, and the progressive loss of condition are strongly suggestive.

Treatment of these cases is hopeless. In the dog alone for a circumscribed tumor, laparotomy, the removal of the tumor and closure of the wound may be tried.

ACUTE INTESTINAL INDIGESTION IN THE HORSE. INTESTINAL TYMPANY.

Definition. Causes: Debility—general and local, and its causes, fermentescible food, legumes, new grain, paralyzing seeds, musty fodder, defective teeth, jaws and salivary glands, iced water after grain, verminous embolism, chill. Symptoms: Anamnesis, colic, gaseous distension, stupor, death, diagnosis from spasmodic colic. Course: Fatal in two hours, or more. Recovery. Lesions: Distension of bowels with carburetted hydrogen, carbon dioxide, and nitrogen, redness of intestinal mucosa, anæmia of abdominal organs, congestion of cutaneous and surface vessels. Treatment: Stimulants, antiseptics, enemata, chloral hydrate, puncture, eserine, pilocarpin, friction, massage, exercise, dieting, bitters.

Definition. A gaseous overdistension of the intestines, from fermentations in the ingesta, but also in part from air that has been swallowed, and from carbon dioxide exhaled from the blood circulating in the intestinal mucosa.

Causes. These are to a large extent the same as those of gastric tympany. General and digestive debility resulting from former disease, from spare diet, from unsuitable or indigestible food, from anæmia, from parasites, from hemorrhages, is a potent predisposing cause.

Weakness of the alimentary canal from catarrh, or other persistent disease, from impaired innervation, from embolism of the vessels and imperfect circulation also predisposes, or again the lack of vermicular movement and of the mingling of the digestive fluids with the food, leaving the latter in a specially fermentescible condition. As direct exciting causes may be named:

Very fermentescible food in excess, such as the leguminous products (beans, peas, vetches, cowpea, alfalfa, sainfoin, clover) in their green condition. These contain an excess of protein compounds, which should be mainly digested in the stomach, and if passed rapidly in large quantity into the intestines, they fail to be sufficiently acted on by the trypsin, and are specially liable to fermentation. Very rapidly grown and aqueous grasses are similarly liable to decomposition.

New grain is specially liable to fermentation the more so that it sometimes contains a paralyzing agent, which acts like intoxicating ryegrass. The ripening seeds of many forage plants often act in this way, (annual and perennial ryegrass, millet, Hungarian grass, chick vetch, vetches generally). The same has been observed of the leaves of growing maize, grapevine leaves, and potato plants.

Musty and spoiled fodders of all kinds are very dangerous, the toxic principles of the fungi and bacterial ferments paralyzing the sympathetic nervous filaments.

Fodders that are imperfectly masticated and insalivated owing to defective teeth or diseased jaws or glands are liable to prove hurtful in a similar way.

A full drink of water and especially of ice cold water after a feed of grain is one of the most potent factors. The stomach and intestines are both roused to violent peristaltic action, the undigested food is washed on into the bowels, and too often the action of the cold induces congestion and partial paresis, and exposes the undigested mass to the uncontrolled action of ferments.

Circulatory troubles caused by verminous embolism (see intestinal congestion) is another very prolific factor. A sudden chill in an animal that is perspiring and fatigued may precipitate an attack, by causing a retrocession of blood from the skin to the intestines, with resulting paresis of their coats.

Symptoms. The condition is usually complicated with gastric tympany, so that we have a complication of symptoms. The history of the case is often diagnostic, showing one of the above mentioned causes, and above all a full drink after a feed of grain, speedily followed by abdominal pain, gaseous distension of the abdomen, causing death in two hours or upward. The distension of the abdomen usually shows more on the right than the left, and the resonance on percussion is greater. Colics are usually less violent than in intestinal congestion, and the actions of the animal are less precipitate or disorderly. He may lie down, roll and rise, but the constant restless movement, the sitting on the haunches, and the frequent agonized turning of the nose toward the flank are rarely shown. The animal is rather dull and prostrate, passing finally into a stupor, the face is pinched and anxious, the back arched, the head pendent, the walk slow and unsteady, and respiration and pulse accelerated. There is no complete intermission of pain, though it is more acute at one time than another, for some time there is rumbling in the bowels followed by complete silence, as they are fully paralyzed, fæces may be passed at first, but this ceases as the floating colon is emptied and the gaseous distension becomes extreme, and urination which may take place in the early stages is no longer effected in the advanced ones. The compression of the thorax causes severe dyspnœa, accompanied, when the patient is down, by a slight groan.

Course. In the advanced stages the animal may sink to the ground oppressed by the shock, poisoned by the carbon dioxide which can no longer be exhaled through the lungs, and by hydrogen sulphide and other toxic products of intestinal fermentation. Death may follow two hours after a hearty meal and is rarely long delayed in fatal cases.

Improvement may be recognized by the termination of the paresis, the lessening of the abdominal tension, the return of the rumbling in the abdomen, the passage of fæces and flatus, and of urine and by general relief.