Part 37

It is important to keep the patient on a soft, littered floor to prevent injury from his throwing himself down, and walking him around may be resorted to for the same purpose.

Prevention. After a non-fatal attack and in every case in which a horse is found to harbor the sclerostoma equinum in quantity, measures should be taken to expel those present in the bowels and to prevent the entry of embryos. The infested horse may be purged and put on two drachms each of tartar emetic and sulphate of iron every morning in a handful of feed half an hour before the first meal. After six doses he may take a second active purgative. In case of need the addition of 6 grains arsenious acid and a drachm of carbolic acid to each dose will render them much more effective. All water must be withheld that comes from streams running by farm-yards, from ponds or open wells in barn-yards, from uncovered cisterns and from any source which receives drainage or leaching from land occupied by solipeds or spread with their manure.

A course of vermifuge medicine should be given at intervals of two or three months to get rid of the worms which have passed in the interval from the cysts of the colon, into the intestine.

NON-VERMINOUS INTESTINAL CONGESTION IN SOLIPEDS.

Causes: sudden changes to green food, or leguminous fodder, newly harvested fodder, frosted food, iced water, microbian infection, toxin poisoning, intestinal fermentations, experiments, volvulus, invagination, strangulation, compression, atony. Symptoms: as in verminous aneurisms. Diagnosis: absence of worms, presence of other causes. Treatment.

Causes. Acute intestinal congestion apart from verminous aneurisms is ascribed to a variety of causes. Sudden changes of food especially to green food, in spring, or to some of the leguminous fodder plants (alfalfa, cowpea, clover, tares, vetches), newly harvested grain or hay, fodders covered with hoarfrost, iced water, and microbian infection or poisoning with toxins or other irritant products of intestinal fermentations. Experimentally the injection into the circulation of pyogenic toxins and putrid matters has determined intestinal congestion and hemorrhage. In the same way musty hay or grain have proved the occasion of these attacks. Finally mechanical blocking of the circulation of the intestine as by volvulus, invagination, strangulated hernia, or even compression by bulky food has seemed to operate in this way.

It ought to be borne in mind that the habitual microbes of the healthy bowel may become pathogenic when brought in contact with a mucosa which is the seat of irritation, atony or any condition of debility.

Symptoms and Lesions. The verminous aneurisms and thrombosis aside, the symptoms and lesions of this form of congestion so closely resemble those of the verminous affection that it seems needless to repeat them.

Diagnosis is difficult but the absence of worms in the affected animals and their fellows, and the presence of some one of the other recognized causes may lead to a fair conclusion.

Treatment of the affection is more hopeful than in the verminous affection, and may be conducted on the same general lines.

PSEUDOMEMBRANOUS (CROUPOUS) ENTERITIS IN SOLIPEDS.

Definition. Causes: As in ordinary enteritis, with added infections or toxins. Symptoms: As in enteritis, nervous symptoms, diarrhœa. Lesions: Congested mucosa, whitish or grayish false membranes, in patches or tubular casts, granular, mucous, albuminoid, fibrinous. Diagnosis: False membranes in stools. Treatment: Glauber salts, calomel, alkaline carbonates or tartrates, oils, antiferments, demulcents, careful diet, bitters.

Definition. An inflammatory affection of the bowels characterized by the ejection with the fæces of false membranes.

Causes. It has been long attributed to the causes which produce other forms of enteritis and indigestions, as youth, rich stimulating feeding, sudden change to green food in spring, sudden chills, over-fatigue, confinement indoors, and prolonged costiveness. In man it is found as a sequel of infectious diseases (pneumonia, pyæmia), in Bright’s disease, cirrhosis of the liver and cancer, and in poisoning by lead, mercury or arsenic (Osler). Cadeac, who found great numbers of streptococci in the false membranes in animals, is certain it is a microbian disease, and this is doubtless true, if qualified by the statement that the microbe as is so often the case with other intestinal affections, requires an occasion in the form of a diseased or debilitated condition of the mucosa to enable it to become pathogenic. The disease is not known to propagate itself indefinitely or without such a predisposing occasion.

Symptoms. There are dullness, prostration, langor, hyperthermia, accelerated pulse, and colics which may be slight or very severe. In some cases nervous symptoms have been observed, such as irritability or stupor and somnolence with icterus and fœtid stools. The fæces are usually semi-liquid, implying an excessive liquid secretion as well as the exudation of the membranous matter.

Lesions. There is a pink congestion of the intestinal mucosa more or less generally distributed. Whitish false membranes cover patches chiefly on the terminal portion of the small intestine, but frequently also on the cæcum and colon, covering an especially red and angry mucosa. They may occur as simple patches, as ribbon shaped pieces, or as hollow cylinders lining the entire circumference of the intestine. They appear as if fibrillated, but contain abundance of granular matter and seem to be composed mainly of mucus with albuminoid matter and probably a little fibrine. The deeper layers, in contact with the inflamed surface are soft and gelatinoid. It is alleged that coexisting wounds on other parts of the body become covered by a soft pultaceous false membrane.

Diagnosis is based on the presence of the false membranes of a considerable thickness, so that they can be distinguished from the film of mucus which covers the fæcal balls in constipation or enteric catarrh.

Treatment. Facilitate the secretion from the mucosa, and the separation of the false membrane by giving 1 lb. Glauber salts, or give this agent in doses of 5 or 6 ozs. per day. Calomel 1 dr. may be used instead and has the additional advantage of acting as a disinfectant. The alkaline carbonates or tartrates or even olive or castor oil may be used as substitutes. Antiferments like salol, naphthol, salicylic acid, and salicylate of soda have been prescribed to check the multiplication of the germ. Flaxseed tea, elm bark, and other mucilaginous agents may also be given. An easily digestible and laxative diet and a course of bitters may follow.

PSEUDOMEMBRANOUS (CROUPOUS) ENTERITIS IN CATTLE.

Causes: as in solipeds, youth, overfeeding, plethora, dietetic blunders, temperament, over-exertion, chill when heated, gestation, foul water, irritants, drastics, infections. Symptoms: as in enteritis with false membranes, complications. Duration. Lesions: false membranes, extent, color, structure, composition, congested mucosa. Treatment: Glauber and other salts, pilocarpin, potassium iodide, antiseptics, sulphites, sulphides, borax, bismuth, naphthol, creolin, muriatic acid, bitters.

Causes. The same causes are quoted as in solipeds, youth, extra high condition, rich feeding, sudden change to the green food of spring, climatic vicissitudes of the same season, a sanguineous (Reynal) or lymphatic (Friedberger and Fröhner) temperament, overwork, exhausting travel, suppressed perspiration, gestation, plethora, foul drinking water, special irritant plants (chicory, Huzard), and drastic purgatives. Cadeac suggests bacteria, quoting instances of a fifth or a fourth of a herd suffering at once. The same would come from any other cause acting on the whole herd and it seems probable that a microbian factor is present but can find occasion for its pathogenesis only in given morbid conditions of the mucous membrane. This would explain the failure of the affection to propagate itself like a plague, and at the same time its tendency to manifest itself extensively in given herds with a common predisposing condition.

Symptoms. There are indications of enteric inflammation and fever, rigors, slight hyperthermia, drying up of the milk secretion, impaired or suspended appetite and rumination, constipation, colicy pains, increasing dullness and prostration. As the disease advances the excrements become soft, pultaceous or watery, with floating hard baked pieces, dark and even glistening on the surface and more or less false membranes. These are sometimes stained with blood, which may also be mingled with the liquid debris. As in solipeds these membranes constitute the only true diagnostic symptom. They may appear as shreds, bands or complete cylindroid casts of the intestine.

Other complications, like pseudomembranous exudate on wounds, abortions and profound weakness are sometimes noted. The disease may last eight days before ending in recovery. When death takes place it is about the fourth or sixth day.

Lesions. The false membranes are found on the ilium and colon, in thin films or in thick masses, or tubular casts. In extreme cases the membrane has covered an extent of 24 feet in length, and if recent it is soft and friable. If older it may be firm, consistent and yellow or stained by the blood or ingesta. As in solipeds it shows a reticulated network and a fine granular structure, and is composed mainly of inspissated mucus with albuminoids and fibrine. The exudate covers a surface of extreme redness, with points of darker blood-staining and even abrasion or ulceration. The surrounding mucosa is also congested, the villi hypertrophied, the mucous follicles swollen.

Treatment. In the early stages a laxative of soda sulphate is of especial value in depleting from the inflamed mucosa, liquefying the secretions and dissolving and loosening the false membranes. Epsom salts, cream of tartar, Rochelle salts, calomel, and pilocarpin are more or less valuable substitutes. Iodide of potassium is most valuable in dissolving the exudate and acting as a microbicide (dose 3–4 drs.).

Other alkaline salts may be substituted or as antiseptics the sulphites, hyposulphites, or sulphides of potash or soda. Borax, bismuth, naphthol and creolin have also been recommended. Enemata of warm water are desirable.

In very adynamic conditions, muriatic acid (½ dr. doses) may be given with vegetable bitters and the same may be allowed during convalescence.

PSEUDOMEMBRANOUS (CROUPOUS) ENTERITIS IN SHEEP.