Part 66

=Tumors of Uncertain Kind= have been recorded by other observers.

Symptoms. As in the soliped the one diagnostic symptom is the discovery of the neoplasm and its effects by rectal examination, in those cases in which the tumor is within reach. Apart from this there are the general symptoms of ill health, anæmia, pallor of the mucosa and emaciation in malignant cases, and recurrent colics, tympanies, impaired rumination and appetite, with dark colored liquid or bloody fæces, or complete suspension of defecation. In Pritchard’s cases one animal was in the highest possible condition, having been in preparation for the Smithfield (London) fat stock show.

Treatment. If the tumor has been diagnosed with certainty, it may be removed by surgical means from its seat in the rectum, or even from other parts if not multiple or malignant. Laparotomy is better borne in cattle than in horses.

=Hyperplasia on the Intestinal Mucosa in Cattle.= In a Jersey heifer presented at the clinic of the New York State Veterinary College a hyperplasia of the mucosa of the duodenum, which blocked the lumen, was removed and the bowel resected. On examination the mass was found to be the result of productive inflammation, and undergoing necrosis and separation.

TUMORS OF THE INTESTINES IN DOGS.

Sarcoma: lymph glands. Epithelioma, intestine. Adenoma, rectum. Undetermined tumors. Diagnosis by abdominal palpation or rectal exploration. Removal by rectum or laparotomy. Chickens: Sarcoma. Epithelioma.

Cadeac records the frequent existence of sarcoma of the lymph glands, and epithelioma of the intestines and Friedberger an adenoma close to the rectum. Born describes a tumor of uncertain kind, and with a number of smaller adjacent rounded masses.

The diagnosis is usually easier than in the larger animals, the flaccid walls of the abdomen facilitating a satisfactory manipulation.

In the case of isolated and non-malignant growths, laparotomy should be resorted to without hesitation. Even resection of the intestine may be resorted to for the removal of a neoplasm the ends being reunited by sutures or by Murphy’s button.

TUMORS OF THE INTESTINES IN BIRDS.

In chickens it is no uncommon thing to find sarcomata, and other tumors of less determinate structure in connection with the intestine. Pommay and Bizard record a case of cylindroid epithelioma in an ostrich, almost completely blocking the intestine.

The treatment in birds may be very heroic, the tendency to infection by pyogenic and other common bacteria of wounds being reduced to a minimum.

STRANGULATION OF THE INTESTINE BY THE OVARIAN LIGAMENT IN SOLIPEDS.

Pediculated ovary in mare. Strangulation. Diagnosis by rectal exploration. Castration.

In most healthy animals the ovary is light and its situation in the anterior border of the broad ligament so firm that it is impossible for it to enwrap and constrict the intestines. In the mare, however, the healthy ovary may be almost as large as the closed fist, and when further enlarged by cystic or other degeneration, it drags upon and lengthens the ligament until that may form a long pedicle which can easily be wound round the floating colon or small intestine.

Diagnosis of this trouble can often be satisfactorily made by rectal exploration, and treatment will consist in the removal of the offending body by castration through an incision made in the anterior part of the roof of the vagina close behind the os uteri.

PERITONITIS.

Acute: Chronic; general; local; idiopathic; traumatic; surgical; accidental; perforation; strangulation; cachexia; microbian almost always; aseptic foreign bodies escape into bowel: Castration; gastric or intestinal rupture or ulcer, enteritis, obstructions, cold storms, draughts, chills, all lower resisting power of tissue; generalization through peritoneal serum. Non-infective peritonitis from chemical irritants. Paves the way for microbes of ingesta. Rheumatic peritonitis, tuberculous, actinomycotic, microbes differ.

All inflammations of the peritoneum go under this general name. At the same time clinical and pathological distinctions have been made with the view of distinguishing more precisely different classes of cases. Thus it is described as acute and chronic, general and local, idiopathic and traumatic, surgical, accidental, or by perforation, by strangulation and by cachexiæ.

The advance of bacteriology has greatly simplified our views of the disease, as microbes are found to be at work in practically all cases. If we could exclude microbes from this membrane, peritonitis would be practically abolished, portions of aseptic powdered glass, sponge or gauze can be left in the abdominal cavity with comparative impunity, the tendency being, as shown in the dog, to coat themselves with a fibrinous exudate, and to make their way into the intestines through which they escape (Sternberg, Jalaguier and Manclaire). Hence it is that peritonitis is to a very large extent the result of a traumatism (castration, penetrating wound of the abdomen, contused wound of the abdomen), or of a rupture or ulceration of the stomach or intestine, through which the microbes make their way into the peritoneal cavity. In enteritis, congestions, strangulations, intussusceptions and obstructions of the bowels, the cause is the same, the microbes making their way with greater ease through the coats of the bowels in which the circulation and nutrition are impaired and the power of resistance diminished. Finally the occurrence of the disease as a consequence of exposure to cold or wet, of exposure in a cold rain or snow storm, of standing in a draught when perspiring, or plunging into cold water when heated and fatigued, or drinking ice cold water when in a similar condition, may in most cases be explained on the same grounds. The germs in this case had already gained access to the blood, but were helpless to accomplish much harm, until by chilling, the resisting power of the system was lowered and an occasion furnished for their successfully colonizing the peritoneum. Parallel cases are found in the frog which is immune from anthrax until it is heated, and in the chicken which is immune from anthrax until chilled. Reduce the vitality of the system and the germ which was already present, and up till now harmless, takes occasion to colonize more or less destructively.

This view also furnishes an explanation of the tendency of local peritonitis to become generalized. In the scanty liquid which bedews the surface of the abdominal organs, the microbes grow, multiply and spread; by the constant peristaltic movements of the bowels and their rolling upon each other this extension is largely favored; and the tendency to generalization will be in ratio with the potency of the invading germ, and the general or local weakening of the invaded tissues. With a limited infection wound in an otherwise healthy peritoneum and system, and invasion by a pus coccus only, the infection may not succeed in extending from its primary centre, but with a debilitated system, an extended enteritis, or when the invasion is made by septic germs it is likely to become speedily and fatally generalized.

Pernice has shown, however, that peritonitis may occur independently of infection. The injection into the cavity of concentrated mineral acids, acetic acid, phenol, nitrate of silver and other powerful antiseptics determine inflammation by their purely irritant action. By weakening the tissues of the bowels these in their turn pave the way for the escape of the microbes from the contents, and to the occurrence of a secondary infective inflammation.

Cases occur as a manifestation of rheumatism, tuberculosis, actinomycosis and other affections which will be treated at greater length under these respective heads.

The microbes would seem to vary greatly. Soula attributes infection of castration wounds mainly to the bacillus of malignant œdema which is 3 to 3.5 μ long and 1 to 1.1 μ broad often bearing a refrangent spore at one end (is sporeless in the peritoneal cultures), and growing out into chains in artificial cultures. They are anærobic, liquefying, motile, easily stained by aniline colors, but bleached by iodine.

In other forms of peritonitis the bacillus coli commune is found and probably comes from the intestinal contents where it is present in all our domestic animals.

In man Fränkel found the bacillus coli communis 9 times, streptococcus pyogenes 7 times, bacillus lactis aerogenes 2 times, micrococcus pneumoniæ crouposæ 1 time, staphylococcus pyogenes aureus 1 time. Flexner found the proteus vulgaris.

ACUTE PERITONITIS IN SOLIPEDS.

Susceptibility to pyogenic bacteria, infection simple or complex. Traumatic injuries: accidental, omphalitis, operations, strangulation, wounds in rectum or vagina, coition, hernia, castration of mare, or horse, infected from 2d to 6th day, later granulation protects, ruptured stomach, perforating ulcer, perforation of parturient womb, ruptured abscess, microbes in circulation, debility. Symptoms: trauma with spreading swelling, œdema, tenderness, stiffness, arched back, tucked up abdomen, fever, prostration, colics, careful decubitus and rising, tense tender belly, ridge along flank, breathing short, inspirations catching, straddles, steps short, costive or later diarrhœa, enuresis, abdomen fluctuates, death in 1 to 8 days. With ruptured stomach or intestine prostration extreme, collapse, vomiting. Resolution. Ascites. Diagnosis: trauma, gastric or intestinal lesion, followed by specific symptoms. Lesions: trauma, rupture and escape of ingesta, congestion, ecchymoses, false membranes, adhesions, liquid effusion, bloody, pink, or straw colored, albuminous, fibrinous, granules, cells, salts, bacteria, pus, fœtor, bowels tympanitic, later fibrous bands, strangulations, degenerations. Prevention: fatal in solipeds, avoid abdominal congestions, inflammations, traumas, infections, accumulation of serum, blood, etc., also debility, ill health, chill. Treatment: old methods, by anodynes and checking peristalsis. Modern method: antisepsis, iodoform, carbolic acid, mercuric chloride, irrigation with boiled water, drainage; internally, saline laxatives, eliminates from bowels, blood, peritoneum, favoring phagocytosis, and innervation, antiseptics, sodium salicylate, chloral hydrate, morphia, enemata, hot fomentations, or ice, in suppuration drainage and washing with normal salt solution at body temperature, derivatives, laparotomy, puncture in tympany.