Part 34

W. Williams has resorted to rectal injections of 2 oz. aloes forced into the rectum by a syringe furnished with a long elastic tube, and repeated when expelled. Brusasco has used copious liquid injections poured into a rectal tube the end of which is raised at least ten feet above the croup, so as to gain the requisite force. Schadrin uses injections of cold water to stimulate the bowels to contractions. Injections of oils or mucilaginous matters when they can be carried far enough lubricate the walls and favor the passage of solid matters. Castor oil which acts to a large extent locally is especially applicable.

Mechanical applications are often valuable. If the obstruction is lodged in the rectum or floating colon it can usually be reached by the oiled hand and carefully extracted. If this is not successful, impactions in the floating colon or pelvic flexure may still be to a large extent broken up and loosened by the knuckles of the oiled hand in the rectum. I have often resorted to this with excellent effect. Impactions in the cæcum or elsewhere in the double colon are however inaccessible for such treatment. For these, external measures are available. Wilhelm wraps the abdomen in cold compresses. Causse and Lafosse recommend the electric current. Friction to the skin of the abdomen is a common resort. Rudofsky turns the animal on his side or his back, to remove the weight of the small intestines from the impacted cæcum or colon, and favor the exit by gravitation of the contents from the cæcum into the colon. Kneading of the abdomen with the fists or knee when in this recumbent position may also be resorted to.

As a dernier resort, Gaullet performed laparotomy but with no success as the animal died the following day. The horse was, however, in extremis at the time of the operation and a portion of the intestinal wall was blackish and gangrenous. To be successful such an operation should be practiced before there is any probability of gangrene, and while the patient is still in good condition for recuperation. But these are just the cases in which success is to be hoped for from less dangerous measures. Again the conditions for its success are best in case of obstruction of the pelvic flexure, as that could easily be drawn out through a spacious abdominal wound, incised, emptied and sutured with careful antiseptic precautions, and with little risk of infection of the peritoneum. But this is just the point where an obstruction can be efficiently dealt with in a less dangerous way, by kneading through the rectum for example. The operation, however, is not one to be utterly condemned, but in any case in which it is certain that the obstruction is otherwise irremediable, it should be adopted at as early a stage as possible, under anæsthesia, and with antiseptic precautions. The after treatment would consist in a restricted diet of milk or gruel with antiseptics to prevent fermentation and bloating.

IMPACTION OF THE COLON IN RUMINANTS.

Causes: Debility, hard, fibrous food, dry winter feeding, privation of water, astringents, smut, ergot. Symptoms: Hard, moulded, coated dung, blood-streaked, and in small quantity, tympany, dullness, debility, splashing sound when right flank is pressed, rectal exploration. Treatment: Laxative food, water, salt, strychnia, eserine, barium chloride, enemata, oils.

This is not a common affection in cattle, yet it does occur in weak and debilitated conditions, and in animals fed on fibrous and innutritious aliments. The ingesta are delayed in the gut, their liquid portion absorbed and the remainder accumulates in a hard mass, which distends and weakens the bowel. Dry winter feeding, with a scarcity of water strongly contributes to its production. Astringent plants in the hay, or smut or ergot may add to the tendency.

Symptoms. The fæces are hard and firm, glazed on the surface, coated with mucus and sometimes stained with blood. They are passed in small quantity and with much effort and straining, and finally the bowels become completely blocked, nothing whatever being passed. Tympany of the rumen now appears, especially after feeding, appetite and rumination fail, there is much dullness, debility, and loss of flesh and unless relieved, the animal dies in marasmus. Pressure on the right side of the abdomen made suddenly and forcibly produces a sound of liquid splashing in an air space, derived apparently from the accumulation above the obstruction. The oiled hand introduced into the rectum may feel the solid impaction, but in any case causes pain and moaning when the seat of the impaction is pressed upon.

Treatment. In the milder cases and earlier stages a change to sloppy food, green food, or boiled flaxseed, with plenty of salt, free access to water, and scruple doses of nux vomica may prove successful.

In the more advanced conditions with complete obstruction, give ½ lb. to 1 lb. each of sodium chloride, and sodic sulphate, and ½ dr. nux vomica, inject hypodermically 3 grs. eserine or 7 grains barium chloride, give water ad libitum, and frequent and large injections of soapsuds. If these latter are given cold they will still further stimulate the missing peristalsis. In obstinate cases a second dose of the salts, or 1 quart of castor oil may be given with the addition of 20 drops of croton oil.

When relief has been obtained, a laxative and nutritive diet and a course of bitters should follow.

INDIGESTION WITH OBSTRUCTION OF THE COLON IN SWINE.

Causes: green leguminosæ, dew, rain, dry indigestible food, lack of water or exercise, debility, torpid liver. Symptoms: firm, small, coated stools, obstruction, straining, tympany, rumbling, vomiting, anorexia, lies on belly, secludes himself, restless, grinding teeth, diarrhœa. Diagnosis from hog cholera. Treatment: laxatives, enemata, antiferments, rubbing, massage, mechanical unloading of rectum, puncture, dieting, bitters.

Causes. The leguminosæ in their green state are liable to produce indigestion and flatulence in the pig. If covered by dew or rain this tendency is increased. Dry, fibrous or indigestible food with privation of water and of exercise tends to intestinal impaction. Debility from any cause, by weakening the contractility and secretory power of the bowel strongly predisposes to this condition. Torpid liver with diminished secretion of bile is another common factor.

Symptoms. The defecations are infrequent, and small, and covered by a mucus film on a glazed surface. This increases steadily until they cease altogether, when straining, tympany, rumbling and vomiting follow. The animal refuses food, and lies on its belly, hiding under the straw when that is available. Restlessness with frequent change of place and grinding of the teeth are noticed. A spontaneous cure may take place by a free secretion of liquid in which the impacted mass is loosened, disintegrated and floated off, the costiveness being succeeded by diarrhœa. Once established this diarrhœa may become persistent, causing serious loss of condition, and simulating hog cholera. It may be distinguished by the fact that it occurred without the introduction of a contagium, is easily accounted for by the nature of the food and is not communicated to adjacent herds treated in a different way. There is also the absence of the petechiæ on the skin, and, on post mortem, of the specific round necrotic intestinal ulcers of hog cholera.

Treatment. The first object is to rid the intestines of the irritating impacted masses, and this may be secured by giving 1 oz. castor oil, 2 drs. jalap, or 3 grs. croton farina to a 150 lb. pig. This may be seconded by frequent and copious injections of soapsuds. If fermentation and tympany are troublesome 30 grs. chloral hydrate may be given and repeated as circumstances demand it. Active rubbing of the abdomen or kneading of the same will prove useful. If tympany becomes dangerous the gas may be safely evacuated by trochar and cannula, the point of puncture being selected by the clearness of the resonance. When the impaction has reached the rectum and prevents the use of enemata, it may be extracted with the oiled fore finger. An injection of sweet oil may then be given and the finger may be used again and again as the impacted fæces come within reach. When diarrhœa has set in it may be checked by doses of 30 to 60 drops of laudanum, and a diet of boiled milk, well boiled flaxseed or other starchy gruel or mush. A course of bitters with chalk, bismuth or antiseptics will prove serviceable during convalescence.

INTESTINAL INDIGESTION IN THE DOG WITH CONSTIPATION.

Usual seat. Causes: house life, neglect of call to defecate, lack of exercise, overdistension, atony, watch dogs, over feeding, obesity, ill health, debility, loss of teeth, paraplegia, spiced and sweet food, matting of hair over anus, tumors round anus. Symptoms: small, hard, white, glazed stools, straining, no stools, hot, tender, swollen, bulging anus, abdominal manipulation, dullness, laziness, seeking seclusion, colics, tender abdomen, stiffness, arched back, drooping head and tail, vomiting—sometimes feculent, fever. Lesions: impacted mass of hard, gritty particles, catarrhal congested or necrotic mucosa, and outer coats, perforating ulcers. Treatment: air, exercise, laxative diet, mechanical extraction, purgatives, enemata, demulcents, laparotomy, enterrectomy.

In the dog, atony and impaction are common especially in the rectum, where the fæces are unduly retained in connection with house life until accumulated and dried. The impaction tends to extension forward, the new material adding continually to the old, and the overdistended rectum becoming more and more atonic in proportion to the increase of the distension.

Causes. The most prominent factor is denial of nature’s call to defecate, on the part of house dogs trained to habits of cleanliness. The accumulated mass distends and weakens the rectum, enabling it to hold more without suffering, making the call of nature less imperious, and diminishing the power of expulsion. Lack of exercise usually operates in the same animals, as it also does in watch dogs, the movements of which are limited by the length of their chains.

Overfeeding contributes, in various ways, by increasing the amount of feculent matter passed on into the rectum, by hastening the food through stomach and small intestine imperfectly digested and therefore in a more irritating condition, and by contributing to obesity and lack of tone.

In mastiffs, hounds, bull-dogs, etc., which are naturally gluttonous and swallow animal food in large masses without tearing apart, or mastication, portions pass into the intestine undigested and tend to disturb and block the terminal bowel.

Dogs that are out of health, and which lack tone in general have usually torpid bowels and suffer from delay and impaction of contents. Hence all chronic and debilitating diseases are liable to become aggravated by this troublesome complication.

Old dogs with the teeth worn out and the general tone of the stomach and intestines low are habitual sufferers.

Paralysis of the posterior limbs is usually associated with paresis of the rectum and accumulation, and various other atonic nervous disorders act in the same way.

The sympathy between the skin and alimentary tract shows itself in common disorders, indigestions and catarrh becoming complicated by skin eruptions acute and chronic, by indigestions and impactions. To both conditions the nature of the food of house dogs largely contributes, the habit of eating abundantly at each meal time of the master, the consumption of highly spiced meats, of sweet cakes, pastry and puddings, and even the exclusive diet of white bread or farinaceous and starchy aliment.

In long haired dogs, the matting of these hairs together across the anus proves a factor by rendering defecation difficult and painful.

The formation of tumors around the anus, or inflammation and swelling of the anal glands are additional causes.

Symptoms. As in other animals this condition may be chronic, lasting for a long time without leading to complete obstruction. The fæces are passed in hard fœtid, whitish masses, often partly divided, in pellets, dry, and polished on the surface and covered with a film of mucus, sometimes blood. They are passed at considerable intervals, slowly and with painful effort and straining.