Part 35

In the more advanced and violent cases defecation becomes absolutely impossible, though the animal strains violently and frequently. The anus and rectum bulge as a rounded swelling and the congested and bleeding mucous membrane may be exposed, but nothing is passed. The anus is hot and tender to the touch and the anal glands swollen. Manipulation of the abdomen between the two hands can detect the impacted gut extended forward for a considerable distance, and even implicating the colon. The oiled finger in the rectum may detect the impacted matter as a conglomerate mass of gritty materials. If the appetite continues this becomes all the more extensive. The affected animal is dull, prostrate and indisposed to exertion, seeking a dark retired place where he can rest undisturbed curled up into a ball. Sometimes he starts with a sharp yelp. Especially does he shrink and complain when the belly is handled. If made to walk, he does so stiffly, hangs head and tail, arches the back and tucks up the belly. The face and eyes express severe suffering. Vomiting is a frequent complication, the rejected matters being often feculent. Colicy pains are indicated by yelping or moaning, enteritis and peritonitis by hyperthermia and extreme abdominal tenderness. The acute disease may last from one to two weeks, and death may be preceded by auto-infection, by nervous symptoms of various kinds or by enteritis or peritonitis.

Lesions. These may be stated shortly as impaction, catarrh or necrotic changes of the mucosa, more or less extensive inflammations of the bowels and peritoneum, perforations, and congestions of the liver and kidneys.

Treatment. In the milder cases plenty of open air exercise and a laxative diet may succeed. In the more severe cases it is usually requisite to unload the rectum mechanically. The dog is laid on a table, and the oiled finger introduced through the anus, lubricates the mucosa as far as it can be reached. Then little by little the firm mass may be disintegrated and removed being steadied by the other hand applied on the abdomen. The handle of a teaspoon or a special spoonshaped curette may at times replace the finger to advantage, but must be used with due judgment, in view of the thinness and friability of the walls of the gut.

When the gut has been emptied in this way, or in the less severe cases without this preliminary, purgatives and frequent injections can be used to advantage. Jalap ½ dr. and calomel 5 grains, or castor oil ½ oz., or syrup of buckthorn have been usually employed. The impaction is usually too firm for the transient action of eserine or pilocarpin. As injections, castor oil, soapsuds, decoctions of flaxseed, mallow or elm bark may be employed being repeated as often as they are expelled and supplemented by the mechanical removal of all solid matters that come within reach.

In cases so extensive as to resist the above measures we can resort to laparotomy. The incision can be made close and parallel to the linea alba, the rectum, or floating colon drawn out through the wound, the other intestines being carefully held back by an assistant, the gut is then incised longitudinally and its solid contents removed. The wound is thoroughly cleansed, washed with an antiseptic (mercuric chloride 1:2000), and sutured with catgut, the mucosa being carefully turned in and the muscular and peritoneal coats kept in accurate contact. Finally the abdominal wound is closed by silk sutures. The patient must be placed for a week or ten days on well boiled gruels and the rectum frequently emptied by injections of tepid water.

In case the bowel is found to be necrotic, the gangrenous section may be excised and the ends brought together by Murphy’s button, or simply sutured with catgut over a hollow tube of raw potato.

INTESTINAL INDIGESTION AND OBSTRUCTION IN BIRDS.

Causes: Age, debility, atony, matting of feathers, dry or indigestible food, lack of water, diseased oviducts, sand or gravel, lack of pebbles or power in gizzard. Lesions: masses of egg, uric acid, or fæces in cloaca, implicating colon and cæca. Symptoms: dullness, stupor, vertigo, staggering, erect plumage, trailing wings and tail, bulging anus, covered with matted feathers, impaction felt by finger. Treatment: extract mass, castor oil, laudanum, chalk, bismuth, pepper, demulcents, phenol, exercise, silage, green food, pebbles.

Causes. These resemble those already noted for the dog. Old age, debility, and atony of the bowel, the matting together of feathers across the anus, dry feeding, indigestible food, scarcity of water, and lack of exercise are especially to be noted. Malformations or other changes lead to obstruction of the cloaca, and of defecation. Sand and gravel passing from an atonic gizzard accumulate in the small intestine or in the cæca distending them to great excess. Imperfect trituration in the gizzard, from lack of pebbles, may prove a factor in stoneless prairies.

Lesions. The most common seat of obstruction is at the cloaca, and the impacted matter may be yellow partaking of the nature of yolk of egg, or it may consist of feculent matters and uric acid in various proportions, white, hard and fœtid. As in the dog this distension may be continued forward blocking the colon and cæca as well. Lucet mentions a case in which the impacted mass measured seven inches long, and eight in circumference at its posterior and larger end.

Symptoms. The bird is dull, sluggish, stupid, giddy or unsteady on its limbs, with feathers erect, wings, tail and head pendent and loses flesh rapidly. Often a felted mass of feathers and fæces cover the anus. In its absence there appears the rounded swelling or on manipulation the impacted cloaca or rectum can be felt firm and resistant.

Treatment. Soften and remove the external mass of fæces by the aid of tepid water, clip off the feathers, which would tend to restore it, then by the oiled finger and warm water injections break up and extract the contents of cloaca and rectum. If impaction remains farther forward give a teaspoonful of castor oil. If diarrhœa has already set in, give 5 drops laudanum, and mix chalk or bismuth and pepper in a mush to be fed to the patient. Injections of slippery elm containing a teaspoonful of carbolic acid in the pint will prove useful.

The bird should be allowed plenty of exercise, its grain being fed on a floor covered lightly with straw to encourage scratching, and silage or green food should be allowed. On the prairies where pebbles cannot be secured, imported gravel or vitrified brick broken into small pieces should be allowed.

COLIC IN SOLIPEDS FROM VERMINOUS EMBOLISM. INTESTINAL CONGESTION.

Definition. Causes: presence of sclerostoma in arteries, form, habit, nature, immature, biology, life in bowel, in submucosa, in arteries, outside the mammal, pathogenesis, blood-sucking, verminous cysts, verminous aneurisms, seats of latter, coagula, embolism, stagnation of blood, œdema and thickening of intestine, mesentery, fermentations, tympany, infective inflammations, blood extravasations, infection of liver and spleen. Symptoms: sudden attack, violent colics, reckless movements, frequent defecation followed by its arrest, palsy of peristaltic movement, of pain, prostration. Course: two to twenty-four hours, death from indigestion, tympany, obstruction, hemorrhage, poisoning, recovery, sequelæ, laminitis, intestinal catarrh or atony, debility. Treatment: aneurism worms beyond reach, treat lesions, venesection, anodynes, stimulants of peristalsis, antiseptics, compresses, sinapisms. Prevention: expel intestinal worms, exclude embryos, tartar emetic, iron sulphate, arsenic, phenol, pure water, occasional vermifuges.

Definition. Congestion and spasms of the intestines in connection with blocking (thrombus or embolism) of the mesenteric arteries, and verminous aneurism.

Causes. The essential cause is the migration of the sclerostoma equinum (strongylus armatus, Rud.) into the mesenteric arteries in its agamous condition. It seems appropriate therefore to here notice the life history of this parasite.

The =sclerostoma equinum= (strongylus armatus) is one of the common pin worms of the horse. It is distinguished by its dull gray or reddish brown body, thickest at the cephalic end and tapering off toward the caudal, but ending in a blunt point; by the round, open mouth furnished with several firm chitinous rings, of which the outer bears six short symmetrically arranged papillæ, an intermediate row of rounded blunt tooth-like projections, and the innermost a row of fine, closely aggregated and very sharply pointed teeth for penetration of the mucosa. Male ¾ to 1½ inches long, with caudal membranous alæ in two lateral lobes, joined by a rudimentary central lobe: two delicate spicula. Female ¾ to 2 inches long, blunt pointed tail, vulva in posterior half of the body. Eggs ovoid with slightly raised ring around the centre: oviparous.

Habitats. They are found in solipeds in two stages of existence, the mature worms in the cæcum and colon, and the immature in the same organs encapsuled in little pellets of manure, and in cysts in the mucosa but also apart in the arterial system especially in the anterior mesenteric artery and other gastric or intestinal trunks.

The =mature sclerostomata= are found attached to the mucosa of the large intestine into which the head is sunk for the purpose of sucking the blood, and they may be gray, brown or red according to the quantity of blood which they have imbibed. The author has found them in little hernial sacs of the mucosa hanging from the peritoneal surface.

The =sexually immature sclerostomata= are found in little pill-like masses of ingesta in the large intestines and from which they project part of the body through a narrow opening. Another habitat is in cysts of the mucosa of the cæcum and colon and less frequently of the small intestine, individual cysts varying in size from a pin’s head to a hazel nut, and containing the young worm rolled upon itself, and varying in size but always less than the intestinal worm and always asexual. In some cases the cyst is found empty but with a small opening toward the lumen of the bowel showing the means of escape of the parasite. A third habitat of the immature worm is in the blood-vessels, especially the posterior aorta and its divisions, and still more constantly the anterior and other mesenteric arteries.

=Biology.= The ova of the sclerostoma are segmented in the oviduct but are hatched out after they have been laid. The hatching may be effected in the intestine or in manure or water external to the body. When hatched out in the intestine they may pass out at once with the manure or they may envelop themselves in pellets of the finer ingesta and remain for a time in the bowel and finally pass out in this condition. Baillet has traced their development out of the body. In a watery or damp medium they are hatched out in a few days as a cylindroid worm ¼ to ⅓ mm. long, thick in front and with a filiform tail. In moist environment but especially in damp manure they grow to 1 mm. or 1.5 mm. and continue for months in this condition, but remain small and asexual, until taken in, in the drink or green food of the soliped. Reaching the intestine and especially the cæcum and colon they bore their way into the mucosa and encyst themselves, or if they happen to perforate a blood-vessel they make a habitat of that. In the cyst, development proceeds and when it has reached a certain stage the worm once more bores its way through the mucosa and reaching the intestine becomes sexually mature.

In this last migration the young worm is liable to perforate a blood-vessel in which case it is destined to a period of existence in the blood. It may, however, have blundered upon a blood-vessel at an earlier stage when seeking a temporary home in the mucous membrane, so that the sclerostomata of aneurisms may be derived from two separate sources. In the blood-vessels the parasite attains a length of 1 to 8 lines, whereas in the mucous cysts it does not exceed 3½ lines. Yet Neumann holds that after leaving the blood-vessels they may again encyst themselves in the mucosa before escaping into the intestine.

Several moultings take place in the asexual condition.

Other views have been advanced as to the development of the sclerostomata. Colin believed that the ova deposited in the ducts of the mucous glands and in the perforations made by the parasite in blood-sucking, hatched in this situation and the embryo at once encysted itself in the mucosa.

Leuckart imagines that the embryo found in the fæces or in water outside the body of the soliped, should pass through an intermediate host before it can return to gain sexual maturity in the horse. But no evidence of the existence of such intermediate host is furnished, and the encysted intestinal worms show no indication of a special development which would have been accomplished in such host.

Willach holds to a hermaphrodite stage passed in the intestine of the soliped. He found in the bowel small worms apparently related to the sclerostomata by the appearance of the head and the caudal membrane, but not exceeding three to five lines in length. Some were evidently females and contained not only eggs with soft shells, but in one case embryos. Others had the caudal membrane of the male, yet contained also a few eggs. There is no vulva and the embryos escape by rupture of the oviducts. These embryos he supposes are developed in the same host into the familiar mature sclerostomata.

Whatever may be said of those alleged modes, the first described series of changes and migrations may be taken as the usual and regular method of development.