Part 97

SYMPTOMS OF ARTICULAR RHEUMATISM IN SWINE.

Climatic influences. Rheumatoid. Joints attacked. Muscles. Decubitus. Stiff, rigid, steps on toes, grunts, swelling, heat, tenderness, chaps, cracks, suppurations, inappetence, emaciation, metastasis, cardiac disorder. Duration; course. Chronic form. Muscular form. Diagnosis from trichinosis. Connection with arthritis. Metastasis. Remissions.

The pig which shows an extreme sensitiveness to climatic vicissitudes and cold winds, fleeing instantly to his lair on their advent, is yet protected by his subcutaneous fat, so that he is not a frequent victim of simple rheumatism. Leblanc attributes it to unwholesome pens. Chaussade to too rapid fattening (overfeeding). Rheumatoid attacks are very common at the onset of hog cholera, swine plague and other infectious diseases, when they are probably but local manifestations of the general infection.

The lesions are mainly concentrated in the stifle, hock, knee and fetlock. In some cases the dorsal and lumbar muscles suffer and there is arching of the back with great tenderness on manipulation. In other cases the muscles of the quarter or shoulder are involved as shown by their stiffness and extreme sensibility to touch.

The pig is found down, indisposed to rise, and when up, stands drawn together with limbs rigid and feet resting on the toes. He will often point one toe to the ground repeatedly, before resting on the foot, or shift the weight uneasily from foot to foot. If moved he grunts plaintively and if handled squeals.

The affected joints may be surrounded by hot tender swellings or they may be nearly normal in outline, but they are always very sensitive to pressure and above all to flexion and extension, and the skin is usually hyperæmic and red. There may be engorgements of the lymphatics on the inner side of the limbs, and chaps and cracks in the flexures of the joints. Suppurations may follow (Graignard) suggesting a complex infection.

There is little appetite and though the disease becomes subacute or chronic there is a steady loss of condition or at least a failure to thrive.

Benion’s reference to a coincident or sequent inflammation of the respiratory or digestive organs and Spinola’s similar reference to pleurisy are strongly suggestive of swine plague and hog cholera. Any manifest disposition to shift from one part to another and any concurrent disorder of the heart, other than simple palpitation is strongly confirmatory of rheumatism.

The disease tends to recovery in from four to twenty days, or to pass into the chronic form. In this state the symptoms are materially mitigated. Fever is absent, but the appetite, digestion and assimilation are poor, the animal remains stunted, emaciated or unthrifty, there is a disposition to lie most of the time under the litter, and when up it moves stiffly with short steps, semi-flexed joints and upright digits. Sometimes the joints are permanently swollen and rigid by reason of thickening and shortening of the binding ligaments, by the organization of false membranes or by anchylosis.

=Muscular Rheumatism in Swine.= This appears to be rarely seen as an independent disease, but appears at times to coincide with the arthritic form. In such cases the back is arched and very sore to the touch or to pressure. It must be distinguished from the muscular soreness of trichinosis which occurs in infested localities, after trichinous food or water, is preceded by digestive disorder and diarrhœa, and by the passage of the nearly microscopic worms in the stools, and is independent of arthritis.

Muscular rheumatism leads to atrophy of the muscles, especially those of the quarters, and this may resemble, somewhat, partial paraplegia from disease of the spinal cord. Its connection with arthritis, its tendency to shift from place to place, to undergo ameliorations and relapses, and its exquisite tenderness, serve to distinguish it from paralysis.

SYMPTOMS OF ARTICULAR RHEUMATISM IN THE DOG.

Articular rheumatism rare. Femoro-tibial joints, bilateral, remissions. Exudation, swelling of joint; muscular atrophy, weakness, swaying, staggering, falling, paresis. Chronic, muscular rheumatism common, back, loins, neck, general, stiff, painful movement, decubitus, muscles tender, yelps, stiff neck, wry-neck. Masseteric. Painful defecation and urination. Metastasis. Cardiac symptoms. Pleurodynia. Digestive troubles. Emaciation, weakness, atony, paraplegia. Diagnosis from strongylus, stephanurus, and cysticercus.

This affection seems to be rare in the dog. What is known as rheumatism in this animal, consists in an inflammation with hyperplasia around the articular ends of the long bones, the new material being partly fibrous and partly calcified. It shows a special predilection for the femoro-tibial and confines itself mainly to the inner side of the head of the tibia. Here the swelling may reach the size of a walnut, The whole head of the tibia and lower end of the femur are however often involved, entailing a general enlargement of the joint. It follows the general rule of rheumatism in usually attacking both stifle joints at once, and also in alternate ameliorations and relapses. Less frequently other joints are affected. In all such cases the joints become overdistended and swollen, partly by synovia, and partly by surrounding exudate, the muscles of the quarter and thigh become atonic, soft and flaccid, and are steadily atrophied. The dog shows a lack of strength in the hind parts, swaying, staggering or even falling, and advancing to a marked paresis. The malady follows a chronic course, lasting for months, a year, or more.

SYMPTOMS OF MUSCULAR RHEUMATISM IN THE DOG.

Muscular rheumatism is common in dogs. It is most common and most marked in the back and loins, though the neck may suffer, or the disease may be generalized. It is painful to move and the subject seeks to be as much as possible undisturbed. He walks stiffly and slowly, carrying the limbs with as little movement of the joints as possible, and in bad cases yelps occasionally from sudden pain. He can no longer be tempted to go up or down stairs or to make any special effort. When touched on the back or loins he will wince, cry out, or even snap at the offender. In some cases the pain is so acute that even a feint to touch the back will draw out a yelp. If the neck is affected it may be held so stiffly that the dog can barely reach the ground to find his food, or if unilateral the head is turned to one side. Even the muscles of the jaws may be affected, causing prehension and mastication to be difficult and imperfect. Defecation and urination are also interfered with and the straining may draw forth plaintive cries.

The rapid shifting of the morbid process from one group of muscles to another is often very striking, and if one pronounces on the exact seat of the disease, it is liable to be speedily rendered inexact by a sudden change of place. There is further a great disposition to the implication of the heart and especially the valves. This is shown by irregularity and inequality of the pulse by intermissions and palpitations, by a blowing murmur with the first heart sound and by oppressed breathing.

Short, shallow breathing is also caused when the intercostal muscles are attacked (pleurodynia). Various digestive troubles are also common, to which the difficult defecation and impacted rectum largely contribute.

Emaciation makes more or less progress, and the muscles of the hind parts especially become weak and atonic until marked paresis or actual paraplegia sets in, and the hind limbs are extended backward and dragged helplessly. In fat, sluggish, overfed and pampered animals the lack of control of the hind limbs may come on at an early stage. Stiffness due to strongylus gigas in the kidney or stephanurus or cysticercus cellulosa in the lumbar muscles must not be mistaken for rheumatism.

PREVENTION AND TREATMENT OF RHEUMATISM.

Prevention. Avoid known causes, untimely clipping, exposed buildings, over-fatigue, chills, cold rains, dews and frosts, disorders of liver and bowels, sweets, spiced food, overfeeding, constipation, torpid liver, injuries to joints or tendons. Treatment: warm stall and clothing, laxative food in moderation, purgatives, aloes, castor oil, jalap, saline enemas, colchicum, alkalies, trimethylamine, acetate of ammonia, salicylic acid, salicylates, salicine, oil of gaultheria, salicine for debilitated. Large doses hourly or every two hours. Less effective in chronic cases. Heart failure. Salol. Salophen. Phenocoll. Antipyrin. Acetanilid. Pilocarpin. Tartar emetic. Dover’s powder. Ammonium acetate. Chamomile. Boneset. Hot baths and packs, with cold on head. Hand-rubbing. Hot drinks. Nauseants. Hot iron. Anodyne liniments. Rubefacients. Blisters. Salicylate of methyl and other salicylates. Quinine and potassium iodide. Tincture of muriate of iron. In chronic cases, tonics, cod liver oil, arsenic, guaiacum, potassium iodide. Essential oils. Electricity.

Prevention. This consists in the avoidance of all known causes of the disease and must vary to some extent for different genera of animals. The avoidance of cold and exposure, of clipping at unsuitable seasons, of exposed sites for buildings (north and northwest exposures, narrow valleys and ravines), of over-fatigue, of perspiration and subsequent chilling, of cold rains, dews and frosts, of inactivity, or habitual overloading of the liver and bowels, and of local injuries of joints or tendons. House dogs especially should be protected from sweets, spiced food, frequent feeding, constipation and torpid liver.

Treatment. One of the most important considerations is a warm stall or building, or warm clothing including loose woolen bandages on the legs, in the horse. Laxative food is called for.

In acute cases and especially in fat pampered dogs, and in all cases associated with torpid or disordered liver, a preliminary laxative will be of great service, and others should be given later as demanded. The horse may have aloes or salines, and saline enemata may be given to all animals when called for throughout the progress of the disease. Pigs may take 1 or 2 drops croton oil, or like dogs they may be given castor oil or jalap. Torpid liver and constipation must always be carefully guarded against.

To cut short the attack much reliance was formerly placed on colchicum which increases the elimination of solids in the urine, and on alkalies, which beside the theoretic antagonism to acidity are at once chologogne and diuretic. The action was somewhat slow but on the whole satisfactory, usually abating the suffering very materially in the course of a few days. To the horse or ox ½ dram doses of colchicum were given daily in combination with 4 to 6 drams of bicarbonate of soda; pigs of 100 lbs. may take 1 grain of the former to 10 grains of the latter; a shepherd’s dog may take half the amount just named. Trimethylamine proved even more effective than colchicum, and acetate or citrate of ammonia, soda, or potassium was often substituted for the carbonate.

But the modern treatment of rheumatism dates from 1876, when the introduction of salicylic acid and later sodium salicylate, salicine and ol. gaultheriæ gave to such treatment an efficacy previously unknown. Salicylic acid acts very harshly on the gastric mucosa, and with sensitive stomachs is advantageously replaced by sodium salicylate, into which it is transformed in any case in the blood. Salicine which is held to be transformed into salicylic acid in the system, is specially recommended for its bitter and tonic action exercised in the stomach and prior to such transformation. In debilitated subjects, therefore, and in those that suffer from the characteristic rheumatic reduction of the red blood globules it would be somewhat preferable. As a prompt and effective anti-rheumatic agent however it appears to be somewhat less reliable than sodium salicylate or ammonium salicylate. Ol. gaultheriæ may be better borne by the stomach of the dog and pig than the salicylates, the dose being 10 to 15 drops thrice a day.

The secret of success with all of these salicylate compounds, lies in the speedy saturation of the system with the drug, rather than in its moderate and continuous administration. The horse or ox may take ½ oz. repeated every two hours for ten hours if relief is not obtained earlier. The pig may take 20 grains, and the dog 5 to 10 grains at similar intervals. It is not desirable, however, to continue this indefinitely, and therefore when immediate relief has been secured it is well to give the agent but twice or thrice a day, and resort in part to the alkaline treatment. If the salicylates fail to relieve when pushed energetically for ten hours, there is reason to fear that the case is not one of genuine rheumatism.

The salicylates are less applicable to chronic cases and may be even dangerous when the heart is affected, as they tend to render the heart’s action slower and weaker, and thus add to the dangers of hypo-hæmoglobin, and heart failure. A similar caution applies to an excessive use of alkalies and especially of compounds of potassium which depress the heart action.