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Full text of "Diseases of the dog and their treatment"

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NEGRI IJODIES (HIPPOCAMPUS.) 
St'itinn stuin,\l, follo-SKiiig the method of O. I.entz, Berlin. 



Carinine : Negri luuius. Light blue : Ganglion cells. 

Red: Red blood corpustUiX. Blue: Nuclei of cells. 

Deep blue : Nucleoli of cells. 



DISEASES OF THE DOG 



AND 



THEIR TREATMENT 



BY 

DR. GEORG MULLER 

PROFESSOR DIRECTOR OF THE CLINIC FOR SMALL ANIMALS AT THE VETERINARY 
HIGH SCHOOL AT DRESDEN 



AND 

ALEXANDER GLASS, A.M.. V.S. (McGill) 

LECTURER ON CANINE PATHOLOGY IN THE VETERINARY DEPARTMENT 
UNIVERSITY OF PENNSYLVANIA 



THIRD ILLUSTRATED EDITION 
REVISED AND ENLARGED 



i 



CHICAGO 

ALEXANDER EGER, PUBLISHER 

1911 



/ 



f 



Entered according to the Act of Congress, in the year 1896, by 

ALEXANDER GLASS, A. M., V. S., 
In the Office of the Librarian of Congress, at Washington, D. C. 

Copyright, 1908, by 
THE FRANKLIN PRESS 

Copyright, 1911, by 
THE FRANKLIN PRESS 



NOTE TO THIRD EDITION. 



The present edition of this work has been entirely re- written, a 
large amount of new material added, and every endeavor has been made 
to bring the work up to the standard of the present day. While pre- 
paring the manuscript of this edition the second edition of Dr. Mtiller's 
work has appeared and has been closely scrutinized and all valuable 
additions incorporated in this work. One portion of this work that 
differs materially from the German is that of therapeutics. In the 
practice of Canine medicine, where we must necessarily administer 
medicine by force, concentration of the dose is very essential; the writer 
cannot impress too strongly on the practitioner and student that the 
constant aim must be to administer all drugs in doses as small and 
compact as possible, for it frequently happens that the excitement caused 
by the repeated administration of large amounts of decoctions and 
infusions in nervous or highly bred animals does more harm than the 
original disease. 

The writer is under great obligation to Dr. Preston Hoskins for his 

suggestions and his careful reading of the proof; to Drs. Spang, Sommer 

and Jureasu for their assistance in translation, and to Dr. Meyer for his 

aid in the chapter on rabies. 
Philadelphia, Pa., 
September, 1, 1911, 

ALEXANDER GLASS. 



rill) 



PREFACE. 



In writing these pages tlie author has endeavored to give a short, 
accurate, and clear definition of the modern knowledge of diseases of 
the dog, and to adapt his treatise to the requirements of the profession. 

Speculations and hypotheses have been studiously avoided, while, 
on the other hand, plain facts have received careful consideration. 

Diagnosis has been given the most prominent place, as it deserves 
in a work of this kind, and the author has endeavored to establish the 
symptoms with their relation to the disease and to confine their thera- 
peutic treatment to a knowledge of normal and pathological anatomy 
and physiology, for he believes that it is on a clear and accurate knowl- 
edge of the normal and pathological structure of life the fundamental 
base of clinical science lies. 

The writer has also included some selected formulae which he 
considers of practical value to the reader. 

Due consideration has been given to modern literature whenever it 
appeared consistent, and a glance at the contents will also show that the 
author has added the results of his own researches and observations. 
These have been derived from his experience as director of the clinic of 
small animals in this locality. 

His space has been somewhat restricted, and he has had to dispense 
with the details of the bibliography of our literature, but this is not of 
much consequence when we have such works as Friedberger and Froh- 
ner's, Hoffmann's, Vogel's, and others at our disposal. 

The illustrations in this work are nearly all original. Some, however, 
have been obtained from other works, principally from Ellenberg and 
Baum's Anatomy of the Dog, edited by Paul Parey, and the author 
expresses his thanks for their use. 

The author would feel gratified if his work be favorably received 
by those who are interested in the diseases of the dog. 

G. MULLER. 



(iv) 



NOTE. 



While lecturing on the diseases of the clog the writer recognized the 
fact that there was not in existence a work that could really be called a 
text-book for the student and the practitioner; there were then, and 
have been issued since, a number of "popular" works that endeavored 
to fill the dual role of text-book for the veterinarian and a "Dog Book" 
for the layman; these, as a rule, have been inadequate for the former and 
confusing to the latter. With the purpose of supplying this want the 
writer, several years ago, began to write a book on the subject, but two 
3'ears ago read this work by Professor Mviller, and instantly recognized 
its value as a text-book: every detail in the diseases of the dog being 
carefully considered, and the whole so admirably arranged that the 
student can readily find and study any subject in a clear and condensed 
form. 

He secured from the author the right of translation, and has made 
it as exact as possible, perhaps in some parts too literal, but has done so 
in the endeavor to closely follow the original. He has also added, in 
the proper places, the results of his own observations, and also every- 
thing of value that has been added to veterinary science since the appear- 
ance of Dr. Muller's work, thus making a second and much enlarged 
edition. 

The metric system, as in the German work, has been followed, 
with the hope that its use may be a slight aid to the general adoption 
of what may be the future international system of measurement. 

ALEXANDER GLASS. 



(v; 



NOTE TO SECOND EDITION. 



Knowing that many active and enthusiastic observers are working 
constantly in the line of diseases of direct contagion this edition has 
been delayed in the hope that some new and important discovery of 
original research would be made, and to a certain extent we have been 
rewarded by the work of Babes and of Negri in respect to the quick 
diagnosis of Rabies. It has been thought possible that some one might 
be able to make a culture of Distemper in dogs that would by inoculation 
of the young animal render it either immune or at least slightly suscept- 
ible to this disease. This, however, has not yet been accomplished. 

While the plan of the work, the admirable arrangement of which is 
due to Dr. Muller, has not been changed a great number of alterations 
have been made. The articles on Distemper, Rabies and Tuberculosis 
have been remodeled, and the therapeutics throughout the work have 
been brought up to the standard of the present day, the tendency of 
which appears to be, and rightly, to use as little medicine as possible and 
in small and convenient doses; and to pay particular attention to hygiene, 
good nursing, and sanitation in kennels. 

I am indebted to Dr. John Reichel for assistance in the pathology 
of Rabies, and to Walter McDougall for drawings. Plates in color after 
my own photographs have been added. 

ALEXANDER GLASS. 



(vi) 



CONTENTS. 



PAGE 

General examination 1 

the physical condition 1 

the structure and constitution of the body 3 

the nutritive condition 3 

the mucous membranes of the head 4 

skin and subcutaneous membrane 5 

oedema 6 

emphysema 6 

the temperature 7 

increased temperature 7 

sul^normal temperature 9 

local temperature 10 

Diseases of the digestive apparatus 11 

the examination of the digestive apparatus 11 

the condition of the throat and niouth 12 

examination of the oesophagus 16 

examination of the stomach 17 

digestion of a meat-diet in the stomach 22 

the digestion of milk in the stomach 22 

action of digestion on hydronaceous food 22 

physical examination of the bowels 25 

the faeces 28 

physical examination of the liver 32 

examination of the spleen 33 

examination of the pancreas 33 

diseases of the mouth, tongue, and salivary glands 34 

inflammation of the mucous membrane of the mouth 34 

ulcerous inflammation of the mouth 34 

foreign bodies in the tongue 36 

gangrene of the tongue 36 

diseases of the teeth 37 

dentition 40 

malformations of the ca\'ity of the mouth 41 

warts in the mouth 42 

ranula 42 

inflammation of the salivary glands ' 43 

parotitis 43 

idiopathic parotitis 43 

abscess of the glands 44 

inflammation of the mucous membrane of the throat 46 

diseases of the oesophagus 48 

(vii) 



viii CONTENTS 

Diseases of the digestive apparatus — Continued. page 

foreign bodies in the oesophagus 48 

CESophagitis 50 

stenosis 50 

dilatation of the oesophagus 51 

paralysis of the oesophagus 51 

diseases of the stomach 52 

acute catarrh of the stomach 52 

chronic catarrh of the stomach 53 

other disorders of the stomach 54 

diseases of the intestines 58 

intestinal catarrh 58 

mycotic inflammation of the stomach and intestines 63 

constipation 64 

obstipation 65 

prolapsus of the rectum 74 

imperforate anus 78 

hemorrhoids 81 

intestinal parasites 82 

round worms 82 

tapeworms 84 

oxyuris vermicularis 93 

dochmius 93 

other parasites 94 

diseases of the peritoneum 95 

inflammation of the peritoneum 95 

abdominal dropsy 99 

diseases of the liver 104 

catarrhal jaundice 104 

hypersemia of the liver 107 

inflammation of the liver 108 

acute parenchymatous inflammation of the liver 108 

interstitial hepatitis 108 

abscess of the liver 109 

fatty liver 109 

neoformations of the liver and gallstones 110 

amyloid liver 110 

lardaceous liver 110 

poisons Ill 

Diseases of the respiratory organs 115 

the physical examination of the respiratory apparatus 115 

examination of the nose 115 

physical diagnosis of the larynx and windpipe 117 

physical diagnosis of the lungs 119 

shape of the cavity of the chest 119 

number and character of the respiratory movements 120 

percussion of the thorax 123 

auscultation of the thorax 125 

diseases of the nasal ca\'ities 128 

nasal catarrh 128 



CONTENTS ix 

Disease of the respiratory organs — Continued. page 

pentastoma taenioides 128 

epistaxis 129 

tumors 130 

diseases of the larynx 133 

acute laryngeal catarrh 133 

chronic catarrh of the larynx 135 

diseases of the upper air-passages and bronchial tubes 137 

catarrh of the windpipe and bronchia 137 

acuts catarrh of the large bronchia 138 

acute catarrh of the smaller bronchia 139 

parasitic bronchitis 140 

diseases of the lungs 141 

catarrhal inflammation of the lungs 141 

chronic interstitial pneumonia 143 

cedema of the lungs 144 

croupous inflammation of the lungs 146 

anthracosis pulmonum 146 

emphysema of the lungs 146 

diseases of the pleura 147 

pleuritis 147 

hydrothorax 151 

pneumothorax 152 

hjematothorax , 153 

Diseases of the circulatory apparatus 154 

examination of the circulatory apparatus 154 

examination of the heart 154 

position and size of the heart 155 

character of the heart-pulsations 156 

character of the heart-sounds and bruits 156 

character of the jjulse 157 

diseases of the heart 158 

valvular defects 160 

idiopathic hypertrophy of the heart 163 

diseases of the pericardium 165 

pericarditis 165 

dropsy of the pericardium 166 

hemorrhage of the pericardium 166 

filaria in the blood 167 

Diseases of the urinary and sexual apparatus 169 

examination of the urinary apparatus 169 

examination of the prepuce and urethra 169 

examination of the prostate 171 

examination of the bladder 172 

examination of the urine 173 

amount of urine 173 

color of the urine 174 

transparency of the urine 175 

the specific gravity of the urine 1"^ 



X CONTENTS 

Disease of the urinary and sexual apparatus — Continued page 

foreign substances in the urine 175 

diseases of the kidneys 181 

inflammation of the kidneys 181 

acute inflammation of the kidneys 182 

chronic inflammation of the kidneys . 184 

amyloid kidney ' 186 

abscess of the kidneys 187 

inflammation of the pelvis of the kidney 188 

hydronephrosis 189 

cysts of the kidneys 189 

nephritic stones 190 

tumors of the kidneys 190 

animal parasites of the kidneys 190 

diseases of the bladder 191 

catarrh of the bladder 191 

debilitated conditions of the bladder 195 

stone in the bladder 197 

urethrotomy 199 

Diseases of the male sexual organs 204 

diseases of the prostate 204 

inflammation of the prostate 204 

hypertrophy of the prostate 205 

tumor of the prostate 206 

diseases of the penis and prepuce 206 

phiniosis and paraphimosis 206 

gonorrhoea 207 

specific gonorrhoea 208 

neoformations of the glands and prepuce 208 

diseases of the testicle and its coverings 208 

inflammation of the scrotum 208 

injuries to the testicle and scrotum 209 

cuterebro emasculator 211 



Diseases of the female sexual organs 211 

diseases of the vagina and uterus 211 

inflammation of the vulva and vagina 211 

prolapsus of the vagina and uterus 212 

diseases of the uterus 215 

inflammation of the uterus 215 

catarrhal metritis 215 

septic metritis 216 

obstetrics 219 

irregularities of the sexual instinct 222 

castration of the bitch 223 

diseases of the mammary gland 225 

inflammation of the mammary gland 225 

neoformations of the mammarv gland 226 



COXTENTS xi 

PAGE 

Diseases of the nervous system 228 

examination of the nervous system 228 

disturbances of consciousness 228 

disturbances of sensitiveness 228 

disturbance of motility 229 

diseases of the brain and its coverings 235 

hyperaemia of the brain 235 

anaemia of the brain 236 

cerebral hemorrhage 237 

traumatic lesion 238 

inflammation of the brain 239 

comparatively rare diseases of the brain 241 

diseases of the spinal cord and its memlsranes 243 

cerebro-spinal meningitis 243 

inflammation of the spinal cord and its membranes 243 

paralysis of the nerves 252 

epilepsy 255 

chorea 259 

catalepsy 262 

bronchocele 264 

Diseases of true infection 267 

distemper 267 

infectious bronchial catarrh 267 

infectious hemorrhagic gastroenteritis 282 

Septic and pyaemic diseases 287 

septicopyaemia 287 

malignant oedema 288 

anthrax 289 

rabies 290 

tuberculosis 302 

hemoglobinuria and piroplasosis 307 

tetanus 309 

Constitutional diseases 312 

anaemia 312 

leukaemia 313 

diabetes mellitus 316 

diabetes insipidus 318 

obesity 319 

uraemia 320 

uraemia 320 

scurvy 321 

Priessnitz's bandage 322 

Diseases of the organs of locomotion 323 

diseases of the bones 323 

rhachitis 323 

fractures of the bones 325 



xii CONTENTS 

PAGE 

Diseases of the articulations 337 

inflammation of the joints 337 

acute synovial inflamniation of the joints 338 

chronic synovial inflammation of the joints 339 

purulent inflammation of the joints 339 

rheumatic inflammation of the joints 340 

disease-producing malformation of the joints 341 

Injuries of the joints 344 

wounds of the joints 344 

contusions of the joints 345 

distortions of the joints 346 

luxation of the joints 347 

dislocation of the lower jaw 348 

dislocation of the ell^ow 349 

dislocation of the patella 350 

Diseases of the muscles 353 

muscular rheumatism 353 

cysticercus and trichina 355 

diseases of tendons and bursa mucosa 356 

Wounds and their treatment 359 

wounds 359 

course and healing process in a wound 361 

diseases resulting from septic infection of wounds 361 

treatment of wounds 365 

ulcers and ulcerations 369 

contusions 370 

Diseases of the claws and foot-pads 378 

ingrowing claws 378 

inflammed claw 379 

contusions and wounds of pads 380 

Hernial rupture 381 

abdominal hernia 381 

description of hernia 381 

reducible hernia 382 

irreducible hernia 383 

inguinal hernia 387 

method of castration 388 

sarcocele 391 

hydrocele 391 

umbilical hernia 391 

femoral hernia 393 

perineal hernia 394 

Diseases of the eyes 395 

affections of the eyelids 395 

closure of the eyelids 395 

entropion 395 

ectropion 397 



CONTENTS xiil 

Disease of the Eyes — Continued page 

diseases of the conjunctiva 401 

inflammation of the conjunctiva . 401 

catarrhal conjunctivitis 402 

purulent conjunctivitis 403 

diseases of the cornea '. 406 

inflammation of the cornea 406 

keratitis superficialis 407 

keratitis profunda or parenchymatosa 408 

abscess of the cornea 409 

ulceration of the cornea 410 

dermoid of the cornea 413 

pterygium 414 

injuries to the cornea 414 

diseases of the lens, cataract 416 

diseases of the sclerotic membrane, of the nervous portion of the eye, 

and of the vitreous humor 422 

inflammation of the iris 422 

purulent inflammation of the eye 423 

dropsy of the anterior chamber (glaucoma) 423 

diseases of the optic nerve and the retina 424 

prolapsus of the eyeball 425 

Diseases of the ear 429 

serous cyst 429 

external canker 432 

internal canker (otitis) 434 

deafness, partial or complete 438 

prasitic canker of the ear 439 

Diseases of the skin 441 

inflammatory condition.s of the cutaneous membrane 441 

erythema 442 

urticaria 444 

eczema 445 

acne 455 

alopecia 458 

cutaneous affections caused by animal parasites 461 

ceratopsyllus canis 462 

haematopinus piliferus 463 

trichodectes latus 464 

Ixodes ricinus 465 

leptus autumnalis 465 

cutaneous diseases due to animal parasites 465 

sarcoptic mange 465 

follicular mange 469 

demodex follicularum 469 

filaria 474 

cutaneous affections caused by vegetables parasites 475 

favus 4/0 

herpes tonsurans 4/6 

trypanosomiasis 4/8 



xiv CONTENTS 

PAGE 

Tumors 480 

soft and hard fibroma 480 

lipoma 481 

sarcoma 482 

papilloma 483 

warts 483 

flat condyloma 483 

484 
carcinoma ^°^ 

myxoma 4oo 

adenoma 48o 

anojioma 48o 

487 
myoma • 

chondroma 487 

infectious genital tumors 488 



ILLUSTRATIONS. 



FIG. PAGE 

1. Dog ^^■ith a?dema of the skin 6 

2. Laryngoscope 12 

3. Pocket electric light 12 

4. Holding the mouth open with tapes 13 

5. Mouth speculum 14 

6. Gag 14 

7. Section through center of abdomen 18 

8. Position of stomach when empty 19 

9. Position of stomach when full 19 

10. Stomaeh-pumi3 20 

11. Contents of the stomach (four hours after eating) 21 

12. Intestinal canal of the dog 26 

13. Examnation of the lower bowel with speculum 28 

14. Microscopical examination of the fajces 30 

15. Eggs of intestinal parasites in fseces (round worm) 31 

16. Right side of the abdomen 32 

17. Gangrene of the tongue 37 

18. Longitudinal section through an incisor tooth 37 

19. Improvised gag 39 

20. Tumors of the gums 40 

21. "Wire 6craseur 41 

22. Warts of the mouth 41 

23. Glands of the head 43 

24. Abscess of the neck 45 

25. Mucous cyst 45 

26. SpirojDtera Sanguinolenta 51 

27. X-ray picture of coin in the stomach 56 

28. Dog ^vith obstruction of the intestines 67 

29. Mode of administering a clyster 69 

30. Lamlsert suture '^0 

31. Suture of the intestines "1 

32. Hairpin method of anastomosis 72 

33. Hairpin method of anastomosis, first stage 73 

34. Hairpin method of anastomosis, second stage 73 

35. Prolapsus of the rectum with invagination 75 

36. Stitching rectum (tobacco-bag stitch) ■ 77 

37. Method of suturing in amputation of the lower bowel 77 

38. Inflammation of the anal glands '9 

39. Pseudo-perineal hernia 80 

40. Ascaris mystax S2 

41. L^terus of the Taenia coenurus (enlarged) 85 

42. Taenia serrata ^^ 

43. Taenia marginata, posterior end of worm 86 

44. Taenia cucumerina, DipyUdium caninum 87 

45. Taenia ccenurus 88 

(XV) 



xvi ILLUSTRATIONS 

FIG. PAGE 

46. Tsenia echinococcus 89 

47. Taenia echinococcus 90 

48. Oxyuris vermicularis 93 

49. Anchylostomum uncinaria 94 

50. Wall of cajciim with trichocephalus depressiusculus 95 

51. Section through the abdomen 96 

52. Dog with ascites 99 

53. Diagramatic section of the pharynx 116 

54. Position of the frontal sinuses 117 

55. Right side of the thorax and abdomen 120 

56. Left side of the thorax and abdomen 121 

57. Pleximeter 123 

58. Field of percussion 124 

59. Stethoscope 125 

60. Dog Avith chronic catarrh 130 

61. Pentastoma taenoides 131 

62. Cross-section of the head of a dog 131 

63. Pentastomum denticulatum 132 

64. Egg of the Pentastomum tenoides 132 

65. Trocars for puncture of the thorax 151 

66. The heart in position 154 

67. Diagram of the blood circulation 160 

68. Heart, with filaria immitis in the ventricle 167 

69. Male catheter 169 

70. Passing the catheter 170 

71. Female catheter 171 

72. Median section through the pelvic cavity 171 

73. Speculums 172 

74. Section through the pelvis of the male 172 

75. Areapikometer 175 

76. Spectrum of urine in hajmoglobinuria 176 

77. Haematin crystals 176 

78. Epithelium found in the urine 178 

79. Uric cylinders 178 

80. Urine of a dog with cystitis 179 

81. Urine of a dog with cystitis 193 

82. Apparatus and method of irrigating the bladder 194 

83. Urethrotomy 200 

84. Enlargement of scrotum 210 

85. Vaginal speculum 212 

86. Prolapse of the vagina 213 

87. The genito-urinary organs of the bitch 214 

88. Double catheter for washing out the uterus 216 

89. Retractors, single and double 220 

90. Apparatus for the extraction of foetus 221 

91. Tumor of the mammary gland 226 

92. Diagram of the brain, showing the various motor centers 231 

93. Motor centre points of the dog 232 

94. Paralysis of the posterior extremities 244 

95. Paralysis of the cord 247 

96. Dog with })achymeningitis ossificans 248 



ILLUSTRATIONS xvii 

Fig. page 

97. Facial paralysis of the left side 253 

98. Malignant struma 265 

99. Blood of a dog affected with piroplasma canis 307 

100. Dog with tetanus 310 

101. The blood in leukocytha^mia 314 

102. Rixdius and ulna of dog affected with rickets 324 

103. Skiagraph of fracture of the humerus 327 

104. Diagram of union of fracture in the tibia of the dog 328 

105. Plaster splint on fracture with support around body 330 

106. Pitch plaster put on in layers 332 

107. Effects of tight bandaging of a sphnt 332 

108. Different methods of amputation - 333 

109. Skiograph of osteosarcoma of the radius with opening in upper part of the 

bone 335 

110. Skiagrajih of the ulna \vith middle and lower third of the bone nearly gone. 335 

111. A large hv]wdermatic syringe for puncturing enlarged joints 343 

112. Muzzle 349 

113. Dog with dislocation of the hip 351 

114. Skiograph of luxation of the hip 352 

115. Laceration of the tendo achilles 356 

116. Dog with elbow boil (hygroma) 357 

117. Apparatus for the antiseptic irrigation of wounds 366 

118. Different forms of stitches 367 

119. Muzzle 368 

120. Bandage for injuries or amputation of the tail 375 

121. Amputation of the tail 376 

122. Longitudinal section of the nail 378 

123. Diagram of the first and second phalanx 378 

124. Pads of foot 379 

125. Dog's shoes 380 

126. Scrotal hernia of right side 387 

127. Genital organs of the dog 389 

128. Inguinal hernia of bitch 390 

129. Umbilical hernia 392 

130. Plaster on umbilical hernia 392 

131. Middle section through the pelvis sho-\ving the organs 393 

132. Double perineal hernia 394 

133. Entropion operation of lower eyelid 396 

134. Diagrammatic position of sections and mode of stitching in operation for 

entropion 397 

135. Diagrammatic position of section in operation of entropion 397 

136. Entropion operation 398 

137. Entropion operation and mode of stitching 398 

138. Protrusion of the membrana nictitans 400 

139. Removal of the membrana nictitans 400 

140. Dermoid of cornea 413 

141. Leucoma 415 

142. Gray cataract of both eyes 417 

143. Instruments used in the cataract operation 418 

144. Discission of the lens 419 

145. Lobular extraction of lens 420 



i 



xviii ILLUSTRATIONS 

TIG. PAGE 

146. Lobular extraction of lens 421 

147. Dislocation of the lens 421 

148. Iris coloboma 423 

149. Dislocation of the eyeball 426 

150. Muscles of the left eye 428 

151. Hematoma of the ear 430 

152. Ear-cap 430 

153. Earhood or net 431 

154. Mode of bandaging the ear 432 

155. Mode of bandaging the ear 433 

156. Kramer's ear speculum 435 

157. Ear swab and mode of using it 436 

158. Moist eczema of the shoulder 447 

159. Chronic eczema of the back 448 

160. Acne of the nose 455 

161. Acne muzzle 456 

162. Head of the dog flea 462 

163. Female pulex pentranse 463 

l64a. Haematopinus filiferus 464 

1646. Trichodectes latus 464 

165. Ixodes ricinus 465 

166. Female sarcoptes of the dog 466 

167. Female sarcoptes burrowing in the skin 466 

168. Development of the acarus folliculorum 469 

169. Acarus folliculorum greatly magnified 469 

170. Hair follicle invaded by demodectes folliculorum 469 

171. Head of dog affected with demodectes folliculorum 472 

172. Favus spores 475 

173. Trichophyton tonsurans after treatment 476 

174. Dependent fibroma 481 

175. Multiple formation of warts 483 

176. Chronic ulcer 490 

177. AVire ^craseur 491 

178. Manner of tying the mouth 492 

FULL PAGE PLATES. 

Negri bodies (hippocamous) section stained, following the method of O. Lenz, 

Berlin Frontispiece 

Stomacace (necrotic gangrene of the jaw) 34 

Ranula (salivary cyst of the tongue) 42 

Spiroptera sanguinolenta (encysted in the oesophagus) 50 

Method of administering medicinal vapors 136 

Section of the hippocampus major, showing Negri bodies 298 

A smear of mucous from the bronchial membrane of a dog 306 

Cultivation of a tubercular bacilli 310 

Tetanus (lockjaw) 310 

Rachitis (rickets) 324 

Dermodectes folliculorum. (dermodictic mange.) a 470 

Infective tumor of dogs (natural size) 488 

Infective genital tumor of dogs (the initial stage) 488 

Infective genital tumor of dogs (the fully developed stage) 490 



DISEASES OF THE DOG. 



GENERAL EXAMINATION. 

In making an examination of the dog for the purpose of diagnosis it is 
best to class it under two heads: a general and a special examination. 

The general examination, used when the organism is considered as a 
whole, is the method generally followed in surgical diseases, as in the case 
of an injury where we first carefully examine the injured region and then 
direct our attention to the other parts of the body. 

The special examination is made when we consider single special 
organs of the body, particularly those of secretions and excretions. If 
our attention is called to some specially striking symptom, we at once 
examine a certain organ or group of organs. Frequently, for more cer- 
tain diagnosis, it is necessary to make a microscopical examination of 
the blood, urine, or faeces; or by means of a trocar obtain some of the con- 
tents of certain cavities or tissues of the body to ascertain their true char- 
acter and composition. The Rontgen rays are also used to obtain a 
photograph of some foreign body or pathological alteration of the inner 
structures; or the skin examined to detect the presence of parasites or 
their embryos; and it may be necessary in some instances to inoculate 
another animal or series of animals with the virulent material of some 
disease to confirm a diagnosis. 

In making a general examination the following points have to be 
observed: 1. The physicial condition; 2. the structure and constitution; 
3. the nutritive condition; 4. the mucous membranes of the head; 5. 
the skin and subcutaneous membranes; and 6, the temperature of the 
body. 

THE PHYSICAL CONDITION. 

The physical condition of the dog suffering from any bodily ailment 

presents more rapid and marked changes than any other animal. Even 

in slight indispositions, such as disturbances of the stomach and digestive 

apparatus, the animal will be downcast, irritable and nervous, and often 

1 1 



2 GENERAL EXAMINATION 

show a disinclination to move, or may change constantly from one place 
to another. Nervousness, a staring look in the eyes, great restlessness, 
constant barking or howling point to beginning of congestion of the brain. 
But these symptoms may also be found in a number of other diseases; 
for instance, in cases of pentastomes in the nose or cavity of the forehead, 
in cases of parasites of the intestines, in rabies and distemper. 

Howling is observed in a great many of the various painful diseases, 
particularly in disorders of the stomach and intestines. Colic of the intes- 
tines may present great nervous excitement; a nervous animal sometimes 
will swallow indigestible substances, foreign bodies, show a tendency to 
bite, but that does not necessarily mean that the animal has rabies; but 
if this is accompanied by a hoarse, howling bark and a staggering gait, 
it will change the existing suspicion to a certainty. 

Symptoms resembling rabies may appear from the presence of pen- 
tastomes in the nasal cavities, from taenia ecchinococcus in the intestines, 
foreign bodies between the teeth, in the pharynx, stomach and intestines, 
or as the result of continuous sexual excitement. Further, we may 
may have uncontrollable movements which are caused by changes in the 
physical condition; they appear in certain circumscribed diseases of the 
cerebrum and cerebellum or from cysts, tumors, abscesses, hemorrhages 
of the brain and in certain forms of poisoning or from distemper, 
slight convulsions, etc., but this subject will be taken up in detail 
later on. 

Dulness or total indifference to external influences, staring expres- 
sion of the eye, a slow staggering gait, sleepiness or coma (entire 
unconsciousness), are seen in the various diseases of the brain and its 
coverings, from injury to the skull, or to shock, in serious infectious dis- 
eases, such as distemper, septicaemia and infectious hemorrhage, gastro- 
enteritis, in poisoning by some narcotics, or uraemia, acute jaundice, 
acute anaemia and in all diseases that are terminating fatally. 

In some cases we see short attacks of unconsciousness brought on 
by great excitement and pain, as in surgical operations, cysts in the 
brain, anaemia, continued hemorrhage, abscess or tumors in the brain, 
effects of certain poisons, etc.; for further information on this subject see 
article on the examination of the nervous system. In making an exami- 
nation of the physical condition of an animal, we must always take into 
consideration the fact that the symptoms may be very much modified 
by the presence of strangers or the veterinarian; on the other hand, pet 
dogs may often hide certain symptoms, or from fear may present symp- 
toms that are very much exaggerated. 

Very sick animals will not rise when called by a stranger or even by 
the owner when a stranger is present, while a healthy animal will rise 
or bark, and show its presence in various ways. The position of the 



GENERAL EXAMINATION 3 

animal when lying down is to a certain extent a diagnostic symptom. 
Dogs which are affected by lateral or one-sided diseases of the chest, for 
instance, lateral pneumonia, pleurisy, or pneumothorax, ;vvill take a sitting 
position or lie on the sternum with the legs under the body. 

THE STRUCTURE AND CONSTITUTION OF THE BODY. 

The development of the skeleton may be used as a basis for deter- 
mining what sort of constitution an animal has, at the same time taking 
into consideration the great difference there is in form between the differ- 
ent breeds of dogs in the strength and shape of the bones; we can fre- 
quently obtain some diagnostic information concerning a defective con- 
stitution from the following indications: of softness of bones, there are 
flat non-arched ribs, a narrow chest, a marked change in the shape of the 
skeleton, the swelling of the ends of the ribs at the union of the bone to 
the sternum, by the contortions of long bones, and a swelling of the joints 
as seen in all rachitic animals. For further information on this subject see 
the article on the examination of the respiratory apparatus. In rare 
instances there is a marked deformity of the spinal column, an upward 
curvature (kyphosis) , a lateral curvature (skoliosis) , an upward and lateral 
curvature (kyphoskoliosis) , and a downward curvature (lordosis) . 

THE NUTRITIVE CONDITION. 

The general condition may depend, to a large extent, on the age of 
the animal, how he has been fed, and the amount of exercise he has had, 
but, as a general rule, if the animal's condition is poor, it is due to the 
presence of some disease. The skin, to a certain extent, is a diagnostic 
guide; if the animal is healthy the skin will be loose and pulled easily from 
the different parts of the body, whereas in disease it is tight and loses its 
softness and smooth feeling to the fingers. The body loses its symmetry, 
the eyes are sunken in their sockets. In slight cases of emaciation we 
must depend, to a certain extent, on the history of the cases from the 
owner. Weighing the animal is also useful to determine whether an 
animal is gaining or losing during the course of treatment; this is especi- 
ally valuable where the animal is being reduced in cases of plethora, or in 
convalescence from acute disease; the gain shows that the animal is im- 
proving; but at the same time we must not lose sight of the fact that we 
may have an increase of weight from csdema, or any dropsical condition. 
A rapid emaciation is seen in diseases of the digestive apparatus, in all 
acute and chronic feverish affections, in certain cases of poisoning, and in 
rabies. A gradual loss of flesh may be seen in cachexia, as a result of 
chronic infectious and constitutional diseases, such as tuberculosis, leu- 



4 GENERAL EXAMINATION 

kirmia, diabetes, carcinoma, and in chronic nephritis. A slight loss of 
flesh is also seen following surgical operations. As an opposite to ema- 
ciation, we may see a rapid accumulation of adipose tissue; this may 
occur from laziness, a disinclination to take exercise or resist it when 
forced to do so, or to close confinement where the animal is the pet of a 
sick person. Disturbances of the respiratory and circulatory apparatus 
have a tendency to produce accumulations of fat in the abdominal and 
thoracic walls, in the pericardium, and in the heart. 

THE MUCOUS MEMBRANES OF THE HEAD. 

In making a general examination, the first thing to do is to examine 
the visible mucous membranes, to see the color of them, the conjunctiva, 
and also of the mouth and throat. It is best to examine more than one 
mucous membrane, as the examination of one only may lead to an error 
in diagnosis. Rapid exercise, particularly in hot weather or in high wind, 
may produce a temporary congestion of the mucous membranes. Red- 
dening of the eyes is often a perfectly normal condition in some breeds of 
dogs. Abnormal paleness of the mucous membranes may be due to 
decrease in the amount of blood in the system from severe internal or 
external hemorrhage, or from slight but frequent hemorrhage internally. 
It may be due to decrease in the amount of haemoglobin in the blood 
corpuscles, in diseases peculiar to the blood, as in ansemia, leukaemia, 
pseudo-leukeemia, and in all diseases producing great loss of fluids, such 
as disease of the kidneys, disease of the stomach and the bowels, in tuber- 
culosis, carcinoma and also in slow pus formations that are accompanied 
with or without fever, in defective heart action, as in collapse, where the 
heart's action is, to a certain extent, paralyzed for the time, as in many 
acute diseases or violent poisons, or from depressing drugs; also in dis- 
eases of the heart and its covering, the pericardium. A blue or cyanotic 
coloring is sometimes seen where there is defective oxygenation of the 
blood and it is loaded with carbon dioxide. This is also seen where the 
blood in the lungs does not come in contact with oxygen, as in contract- 
ion of the trachea or larynx, or by the inflammation or swelling of these 
parts, foreign bodies, internal or external tumors, pressing on the air- 
passages; also in acute bronchitis, in the various forms of pneumonia, in 
large pleuritic exudates, in hydrothorax, in severe ascites where the dia- 
phragm is pressed on, in rigidity of the muscles, as in eclampsia in bitches, 
in strychnine poisoning, and in some heart affections; in cases of defective 
blood circulations in the capillaries, from disease of the heart, especially 
if there is fatty degeneration; from defective valvular action, from depos- 
its on them; from pericardiac exudates; from the action of poison acting 
directly on the heart; or from some injury or pressure on the jugular; in 



GENERAL EXAMINATION " 5 

diseases where there is a great accumulation of blood in the head, as in 
acute hypcrsemia of the brain and inflammation of the brain. In the 
latter case the redness of the mucous membrane is lighter in color or 
more of the arterial tint. A yellow color (icteric) generally denotes some 
disorder of the liver, such as gastro-duodenal catarrh, causing a swelling 
and obstruction of the ductus choledochus; occasionally, from calcareous 
deposits or foreign bodies in the bile-ducts or the presence of tumors that 
press on the bile-ducts. In rare instances these yellowish discolorations 
may be due to disturbances of the liver cells, or from such poisons as 
phosphorus and, in extremely rare cases, from mycotic meat poisoning 
and infectious diseases. The icterus which appears in phosphorus poison- 
ing is due to biliary engorgements, and decomposition of the blood. 
Various spots or red patches known as petechial spots are seen on the 
mucous membranes of the head. These are a valuable aid to diagnose 
certain internal diseases, such as phosphorus poisoning, scurvy, meat 
poisoning, and in septicaemia. 

The nasal and buccal discharges are treated fully under the head of 
Examinations of the Digestive and Respiratory Apparatus. We will 
only consider here such discharges from the eye as seen in very sick 
animals and are due to acute febrile disturbances. In some cases the pad 
of fat that fills the posterior part of the orbital cavity is very rapidly 
absorbed and the eye has a sunken look; the fever may produce an irrita- 
tion of the mucous glands surrounding the eye and cause the accumula- 
tion of a profuse mucous discharge, varying in color from gray to grayish- 
yellow, seldom pure yellow. This accumulates about the corners of the 
eyelids, or may even close and glue up the eyelids entirely; this is not a 
symptom of true conjunctivitis, but some acute disorder involving the en- 
tire system. For further information see chapter on Diseases of the Eye. 

SKIN AND SUBCUTANEOUS MEMBRANE. 

The skin presents a number of conditions which are diagnostic. 
Of course, there are a number of local diseases of the skin which are 
treated in detail in section on Skin Diseases. The skin-changes in color are 
seen mainly on the belly and inner fascia of the thigh; a reddened or 
slightly yellow color is to be classed under the same head as if it had been 
present on the mucous membrane; that is, if the skin is very red it indi- 
cates a high temperature or the commencement of some sympathetic 
skin eruption; or if it is yellow it indicates some disturbance of the liver or 
portal system. In cases of distemper we often see a pustular eruption on 
the abdomen and inner fascia of the thigh (the exanthema of distemper — 
dog-pox) ; this is a very prominent diagnostic symptom of the disease. The 
skin of a sick dog is very dry and hard, it is very hot in cases of intense 



I 



6 GENERAL EXAMINATION 

fever, and cold in animals that are very much debilitated, or after severe 
external or internal hemorrhage, or collapse from shock. In fat dogs the 
skin has a very unpleasant greasy feel to the touch. An unfavoraljle 
symptom of disease is when a fold of the skin is lifted by the hand and 
remains in the same position when released. Profuse perspiration is 
rarely seen in dogs except where they may have been badly frightened. 
Dogs do perspire constantly, but it is insensible perspiration. 

The hair is also a useful guide in diagnosis. In sick, badly fed, or 
neglected animals, or if they are infested with parasites, it loses its gloss, 
becomes dry and brittle, breaking easily, and in some cases falls out par- 
tially or entirely. As a rule, in all dogs that have undergone a severe 
illness, the hair falls out to a large extent; in bitches that have nursed a 
large litter of puppies, the hair falls out in large Ciuantities after weaning. 




Fig. 1. — Dog with a?deina of the skin. + marks indentation made bj' the pressure of the finger. 



The odor of the skin is sometimes very offensive, especially in dogs 
suffering with distemper and septicaemia, meat poisoning, infectious 
hemorrhagic gastro-enteritis, and certain skin affections, and in animals 
that are neglected and filthy. 

CEdema and emphysema of the skin are very important diagnostic 
points. By oedema or dropsy of the skin (anasarca) we understand it to 
be an abnormal accumulation of fluids in the skin and the subcutaneous 
cellular tissues. This condition is caused by the fluids not being reabsorbed 
by the lymph vessels in the same proportion that they come out of the 
blood vessels. We recognize oedema by a swollen or bloated, painless, 
cool condition of the skin, with the obliteration of all wrinkles; if the 
swelling is pressed with the finger, the indentation remains visible for 
sometime (Fig. 1) ; this may come from a number of diseased conditions, 
and it is seen sometimes over the entire body, but chiefly in the lower 



GENERAL EXAMIXATIOX 7 

portions of the body and extremities, testicles, prepuce, scrotum, abdomen, 
and chest. It occurs as a complication in diseases of the heart, especially 
where there is imperfect valvular action, in acute and chronic disorders 
of the kidneys and cirrhosis of the liver and in the majority of prolonged 
acute affections. In rare instances it is caused by true diseases of the 
blood — anaemia, leukaemia, and pseudo-leukaemia, abdominal dropsy, 
hydro-thorax, and dropsy of the pericardium. 

The oedema which appears in the locality of an inflammation (collat- 
eral cedema) is of special interest to the surgeon, as it is the only visible 
symptom of the inflammatory process that is going on under the skin. 
CEdema may be also seen as a result of the pressure caused by tight or 
improper bandaging. 

Emphysema of the skin is where the skin looks as if there was air in 
the subcutaneous tissue. As a rule it is confined to small circumscribed 
parts of the body, but it has been observed by the author where the whole 
body has been involved. There is an intense swelling of the parts, and 
on pressure with the finger the indentation, unlike oedema, immediately 
disappears. On rubbing over the parts with the hand a slight crackling 
sound can be heard and felt; on pressure, the air can be driven from the 
affected portion into the subcutaneous or other tissues beyond the border- 
line. This condition may be caused by the admission of atmospheric air 
from the outside into the subcutaneous tissues, by means of small wounds 
in the skin, especially in the neck, wall of the chest, and the head, and gas 
or air from some of the internal organs by a perforation of their walls, 
such as the larynx, trachea, oesophagus, the bowels, or stomach. In 
cases where there are perforating wounds of the chest, wounds of the 
larynx or windpipe, or from fractures of the ribs, with complicated in- 
juries of the lungs. Emphysema may also occur from gas formed by 
breaking down the contents of abscesses or hemorrhagic infiltrations. 
In malignant abscesses, we find the swelling is doughy and painful, the 
enlargement becomes crackly and septicaemia develops. 

Increased Temperature of the Body. 

The normal temperature of the dog taken at the rectum differs from 
37.5 C. to 39; as a rule, younger animals have a higher temperature than 
adults. The normal temperature in young animals is generally about 
39.2 and 39 in older animals. The vaginal and rectal temperatures are 
practically the same. The prepuce temperature is about 1.5, and the 
skin temperature at the warmest places on the body about 1° lower than 
the rectal temperature. 

The author, after a series of observations covering over a large num- 
. bcr of animals, finds the above to be correct and particularly as far as the 
prepuce, vagina and skin temperature is concerned. 



8 GENERAL EXAMINATION 

The following averages were obtained from a series of temperatures 
taken from both normal and feverish animals: 1, in the bitch the average 
difference between the rectum and vaginal temperatures was about 0.06 
and 2, in the male the difference between the rectum and prepuce was 1.43; 
some cases when the animal became nervous or excited, when the pre- 
puce temperature was taken and the penis became erected, this increased 
the temperature up to 40, so that it will be seen that it is not advisable 
to take the temperature from the prepuce, as the difference may range 
from 2 to 3 degrees. 

The average difference between the axilla and the rectal temper- 
ature is 0.93 and between the inguinal temperature and the rectal is 
0.81. The method for taking these temperatures is as follows: Place 
the thermometer in the so-called axillary groove (arm-pit) and inguinal 
groove (the hollow between the thigh and scrotum in males and between 
the thigh and mammary glands in the bitch), firmly hold the ther- 
mometer for five minutes so that the mercury end of the thermometer will 
be covered by the folds of the skin. Where you have to take the tem- 
perature in these two localities one degree should be added to the therm- 
ometer reading. As a rule the temperature of the normal animal is higher 
in the evening, and slightly higher after a hearty meal, violent exercise, 
lying in the sun or near the fire. The rectal temperature, so-called body 
temperature, is taken by means of a maximum or clinical thermometer, 
the thermometer is slightly oiled, or the anus may be oiled and the 
thermometer placed as far as possible into the rectum (allowing a small 
portion of the instrument to protrude to facilitate removal) ; allow it to 
remain for at least five minutes. Hard dry pieces of excrement or a 
highly inflammatory condition of the bowels may prevent the ther- 
mometer from giving the exact temperature of the body. In severe cases 
it is always advisable to take the temperature at least three times daily, 
morning, noon and in the evening, and care must be taken to carefully 
note any change in the reading of the thermometer. The temperature 
must be kept on a temperature chart, and can be watched with a great 
deal more certainty than trusting to the memory. Any change in the 
temperature as indicated on the chart, either rise or fall, indicates some 
change in the animal's condition, and should be considered a symptom. 
As soon as we detect an increase of the temperature of the body above 
the normal that we know is not due to overheating or too great exertion, 
we define it under the name of fever. 

The course and severity of a fever are regulated according to the 
amount and character of the fever-producing substances (pyrogenes), 
which have penetrated into the blood-circulation. In some cases we may 
have a rapid increase in the temperature (fever-paroxysm) ; this is often 
observed in the early stages of distemper or where some tissue has com- 



GENERAL EXAMINATION 9 

menced to suppurate. In cases where the temperature remains the same 
it is called a continuous fever, and if it does not change more than 1° 
(celsius) it is known as a remittent fever; but when it is found that it 
varies greatly, oscillating between a very low, subnormal and a very 
high abnormal temperature, it is called irregular or atypical fever. 

A constant and prolonged high temperature is very rarely seen in 
the dog. The temperature, as a rule, in early stages of all acute diseases 
rises ver}^ quickly, but it generally falls slowly as the disease advances, 
notwithstanding the complications, and may reach a normal or frequently 
a subnormal condition. In cases of septicaemia, which is rather a common 
disease in the dog, we may see an abrupt lowering of the temperature 
below the normal and continue so, the animal falling into a state of coma 
and death follows in a short time. 

A fever, as a rule, begins with a chill or a number of them; this is a 
shivering or quivering of the muscles and skin and finally of the whole 
body. These chills come on at intervals. The rise in the temperature is 
not always an accompaniment of the fever, as has been shown in cases of 
septicaemia; we must, therefore, always take into consideration the other 
symptoms of fever. These are: shivering, cold, increase in the number 
of the pulse and respirations; the digestion is immediately impaired and the 
urine is changed in quantity and composition. All the secretions and 
excretions are altered from the normal and the nerve-centres show 
increased irritability. The changes in the pulse and respiration are 
fully described under the head of Examination of the Circulatory Appara- 
tus. The changes in digestion are seen in the entire loss of appetite, con- 
stipation, and increased thirst. The kidneys show the effects of the 
disturbance by the decrease in the amount of the urine secreted, a much 
higher specific gravity, and a decreased amount of the chlorides in the 
urine, an increase in the amount of urates, and a high acid reaction. In 
nursing bitches the milk is much lessened in quantity, the skin becomes 
dry and firm, and the sebaceous glands almost cease secreting. The 
nerve-centres show the effect by the dulness of the animal and the indiffer- 
ence to surrounding objects or persons, and great restlessness and twitch- 
ing of the muscles. If the temperature is high, the animal becomes 
weak and falls away in weight very rapidly. 

A Temperature Below Normal (Subnormal) of the Body. 

A subnormal temperature is often observed in cases where the 
crisis or highest temperature has passed and the animal is going on 
toward recovery or convalescence. In the majority of cases, as the 
temperature goes down the pulse lessens, the respirations become even 
and regular, the appetite begins to return, and the animal shows more 



10 GENERAL EXAMINATION 

interest in its surroundings. In collapse there is a rapid fall of tempera- 
ture, and the heart's action, as shown by the pulse, becomes weak and 
fluttering and soon imperceptible; the mucous membranes are pale, and 
the animal weak and even paralyzed. There is also a subnormal tempera- 
ture in great hemorrhage, in acute and chronic diseases, in icterus gravis 
(acute congestion of the liver, with yellowness of the mucous membranes), 
in all acute diseases of the brain, in various cases of poisoning, in latter 
stages of distemper, and in septicaemia, in infectious hemorrhagic gastro- 
enteritis. 

In increase or decrease of the local temperature; increased heat of the 
part is generally due to some injury or some surgical disease, and, as a rule, 
has with it tenderness to the touch and swelling. A local heat can also be 
felt in all inflammations that are not located too far from the surface of the 
body. Coldness of any part indicates an impaired circulation in the part. 
In all cases of collapse the extremities are the first to become cold, because 
of the impaired action of the heart. In cases of compression of an artery 
by ligatures, or tumors, pressing on the blood vessels, an embolus, or 
thrombus, the part of the body that has thus lost its circulation becomes 
cold from impaired circulation. Paralyzed extremities are always slightly 
colder to the touch than active parts. 



DISEASES OF THE DIGESTIVE APPARATUS. 
EXAMINATION OF THE DIGESTIVE APPARATUS. 

In making an examination of the digestive apparatus we have to 
consider the following points: 

The appetite; the method of giving the food in different animals 
varies very much, also is influenced to a large extent by the quality of 
the food, the way in which it is presented to the animal. The age, the 
use to which an animal is put, such as a hunting dog or the laboring dog 
of Belgium and other European countries, the breed; size also has an 
influence on the amount of food eaten by the animal and the quantity of 
water it drinks. Some animals have a strong appetite, eat large quan- 
tities, digest it well, whereas others are dainty eaters, eat small quanti- 
ties, and are easily satisfied. 

A loss of appetite may result from a number of causes; mainly, from 
the presence of a fever in the system, by disorder of the stomach and 
digestive apparatus, lack of food, cold, chilliness, poisons, and in conse- 
quence of such diseases as distemper, infectious hemorrhagic gastro- 
enteritis and septicaemia. An abnormal increase of the appetite may be 
seen in diabetes mellitus and by the presence of tape-worm. A depraved 
appetite is seen in rabies, when the animal will eat straw, wood, stone, 
I'ags, and faeces, but we must also take into consideration the fact that 
young animals, particularly in puppies, when they are teething, between 
the ages of four and ten months, will pick up small indigestible objects, 
such as buttons, pieces of tape, muslin, coal, wood, etc. All dogs, par- 
ticularly if the stomach is upset, will eat grass, and also in some cases they 
show a depraved appetite by eating horse droppings or decayed objects, 
and the well-known habit dogs have of chewing bones. When the animal 
has great thirst, drinking large quantities of water, it may indicate 
diabetes insipidus, and mellitus, chronic nephritis, dropsy (ascites), or 
exudative pleuritis. As a result of acute and prolonged diarrhoea, 
decayed meat poisoning, catarrh of the stomach and in cases of irritation 
of the stomach, the animal drinks large quantities of water and immedi- 
ately vomits it again. 

In certain diseases, particularly of the mouth and throat, such as 
irritations of the mucous membrane of the mouth, stomatitis, decayed 

11 



12 



DISEASES OF THE DIGESTIVE APPARATUS 



teeth, tumors or foreign bodies in the cavity of the mouth, raniila, in 
di.seases of the masseter muscle, buccal membrane, maxillo-temporal 
articulation, the animal is unable to eat large pieces of food, taking only 
small finely cut-up food or liquids. 

Difficulty in swallowing may be present in all the conditions already 
mentioned and in some cases the animal will drop the food out of the 
mouth after it has taken it up. Inability to swallow may be seen in 




Fig. 2. — Larj'ngoscope. 



inflammation of the pharynx and larynx, in the paralytic stage of rabies, 
as the result of certain poisons, such as meat poisons, in periods of brain 
disease, injury to the mouth and throat, tumors or foreign bodies in the 
throat or larynx, contraction or ossification of the larynx, in tetanus, 
large swelling in the region of the neck and goitre. 



^m 




Fig. 3. — Pocket electric light. 



Condition of the Mouth and Throat. 



The examination of these parts requires a good light such as day- 
light, or a clear lamp when the posterior part of the throat has to be 
examined. This can be accomplished by means of a perforated laryn- 
geal mirror or any reflecting mirror (Fig. 2), or a portable electric 
lamp (Fig. 3). The best method of opening the mouth with the hands is 
to grasp the upper jaw with one hand, pressing the cheeks between the 
teeth, which forces the mouth partially open and prevents the animal 
closing the mouth, and with the other hand pull down the lower jaw. 
Another method to obtain a good view of the interior of the mouth is to 
put two strings or tapes around the lower and upper jaws (Fig. 4) ; lay the 



EXAMINATION OF THE DIGESTIVE APPARATUS 13 

dog on his side or, what is better, directly on his back and throw the light 
into the cavity of the mouth. The mouth and a large part of the throat 
can then be easily examined. In nervous or uneasy animals we can 
use a speculum (Fig. 5) or a gag if the mouth has to be kept open for 
some time; it is best to use a gag which can be placed between the teeth 
on one side, or by means of a wedge-shaped piece of wood. In certain 




Fig. 4. — Holding the mouth open with tapes. 

operations of the interior of the mouth and teeth a wooden bar held in 
place by means of a chain is used (Fig. 6). When the deeper portions 
of the mouth and throat are to be examined the mouth is opened, and by 
means of the finger, a spatula, or the handle of a spoon, the tongue is 
depressed. A good view of the posterior of the throat can be obtained by 
grasping the tongue with forceps and pulling it forward. 

In cases where the mouth remains partially open, the animal being 
unable to close it, we must examine it very carefully, as it may be a 
symptom of rabies; of some brain disease; secondai'y stages of distemper; 
in some bacterial poisons, severe injury of the mouth or in fracture of the 



14 



DISEASES OF THE DIGESTIVE APPARATUS 



inferior maxillary. It may also be due to some foreign bodies located 
between the teeth or some strain of the articulation of the inferior maxil- 
lary. In paralysis of the jaw, the mouth can be closed by putting a stick 




Fig. 5. — Mouth speculum. 



under the jaw and lifting it; this cannot be done in cases of luxation of 
the articulation or where there is some foreign body between the teeth, 
such as bones or pieces of wood. The mouth cannot be opened com- 
pletely in trismus (tetanus) or in partial anchylosis of the articulation; the 




Mjig^ 



Fig. 6.— Gag. 



introduction of the speculum being very painful in some cases of tooth- 
ache. In injuries of the various masticating muscles, disease of the ar- 
ticulation of the jaw and infectious hemorrhagic gastro-enteritis. If the 
speculum iy introduced frequently, the mouth may remain partially open. 



EXAMINATION OF THE DIGESTIVE APPARATUS 15 

On opening the mouth, if there is a very offensive odor coming from it, it 
indicates either an ulceration of the mouth, due to ulcerative stomatitis, 
which has erroneously been called scurvy, disease of the teeth and in cer- 
tain diseases of the stomach, in dyspepsia, foetid bronchitis, or in gan- 
grene of the lungs; it is frequently noticed in animals which are very sick, 
where the mouth is filled with unhealthy mucus or where particles of 
food lie in the mouth or throat. In infectious hemorrhagic gastro- 
enteritis, a very offensive odor is noticed. In cases of poisoning, by 
phosphorus, or prussic acid, the odor of the drug is frequently detected in 
the breath. On examining the teeth and gums we may see large ossific 
deposits of the alveolar process (dental alveolar periostitis) causing sepa- 
ration of the gums and loosening of the teeth. An intensely inflamed 
state of the gums, where they are bleeding and ulcerated, indicates 
ulcerative stomatitis, mercurial poisoning, or scurvy; very often tumors 
(epulides) are found on the inner border of the incisors and interfere 
more or less with eating. Very frequently foreign bodies lie between the 
teeth, causing increased flow of saliva. The cutting of the milk (tempo- 
rary) teeth and a change of dentition (cutting of the permanent teeth) 
may cause intense inflammation of the entire mouth. The tongue is 
examined; it may appear dry, paralyzed, and in some cases shrunken and 
lie on the floor of the cavity of the mouth; from paralysis of the tongue as 
a result of distemper, disease of the brain, or infectious hemorrhagic gas- 
tro-enteritis. The author has noticed paralysis of the tongue in acute 
convulsions. The tongue may be greatly swollen and enlarged in acute 
inflammation of the mouth, or from parenchymatous inflammation of 
the tongue. Foreign bodies, such as needles or sharp objects may pene- 
trate the tongue. Sometimes wounds and scars may be noticed on the 
edges of the tongue in dogs suffering from paralysis of the masseter muscle 
and by biting the tongue when the animal is in a convulsion. The color 
of the tongue is a deeper red from fevers, inflamed conditions of the mouth , 
and certain heart affections. A cyanotic (reddish-blue color) is seen 
when the animal is partially suffocated. The tongue is coated as a result 
of most fevers, but it is also observed in animals which are perfectly 
healthy. A heavy coating of the tongue is noticed in stomatitis, gastric 
catarrh, and in acute internal diseases; also in acute cases of distemper. 
In infectious hemorrhagic gastro-enteritis, the tongue is frequently 
covered with a dirty-brown coating. As a rule, a paralyzed tongue lies on 
the floor of the cavity of the mouth. In gangrene of the tongue that 
organ is swollen bluish-gray. The tip of the tongue may sometimes be 
bluish-black, caused by being bitten or being maliciously tied with a 
string. A bluish-red discoloration around the edge of the tongue may 
be due to distemper, stomatitis, infectious hemorrhagic gastro-enteritis 
and various other causes. 



16 DISEASES OF THE DIGESTIVE APPARATUS 

After administration of violent poisons the mucous membranes of 
the cheeks and inferior surface of the tongue are found to be gray in 
color, hanging in shreds, and intensely inflamed, and later abscesses form 
on the sloughed parts. This is observed in infectious hemorrhagic gastro- 
enteritis, stomatitis, and distemper, as a result of decayed teeth and 
formation of abscesses on the mucous membrane of the cheeks. Ranula 
appears on the floor of the mouth-cavity on one side of the tongue; it is 
long and oval, sometimes the shape of a goose egg; the sac is a fluctuating 
swelling with a thin wall. Small whitish enlargements resembling warts 
frequently appear on the mucous membrane of young dogs. They are, 
however, of little or no importance. The salivary glands are frequently 
swollen and abscesses form in their structure. As a result of these irrita- 
tions we may have colloid infiltration of the glands, and after 
inflammation, they become indurated, the secretion of saliva is some- 
times greatly increased and runs out of the mouth in long, thready 
strings; this is also seen in all inflammatory conditions of the mouth or 
where there is an abscess located in the mouth or throat during teething; 
in cases of mercurial poisoning, and from some caustic poisons, and 
after the hypodermic injection of pilocarpine. From inflammation of the 
pharynx, rabies, and by certain parasites burrowing through the tissues 
of the body. 

The secretion of saliva is lessened during all fevers, and from the 
effects of some poisons, fevers, diarrhoea, and after the injections of 
atropia. 

The saliva is bloody after injuries of the mouth. It may be slightly 
stained with blood from stomatitis, scurvy, infectious hemorrhagic gastro- 
enteritis, and gangrene of the tongue. The soft palate and pharynx are 
sometimes the seat of acute or chronic inflammations, and sometimes we 
find abscesses of these parts from the presence of foreign bodies (needles, 
splinters of bone or wood) . It is well to feel these parts when making an 
examination. The tonsils are affected, as a rule, in all cases of pharyn- 
gitis. It generally protrudes from the side of the base of the tongue in a 
dark-red, sausage-like formation. The subparotid lymphatics are invari- 
ably found to be swollen, in all cases of inflammation of the pharynx. 

Examination of the (Esophagus. 

The oesophagus protrudes from the pharynx on a level with the 
first cervical vertebra. The anterior part of it lies between the wind- 
pipe and the longus colli in the median line of the neck. It extends from 
there to the left side of the windpipe and passes to the right side of the 
aortic arch between both membranes of the mediastinum, in the shape 
of a flat arch, and perforates the diaphragm at the twelfth dorsal vertebra 



EXAMINATION OF THE DIGESTIVE APPARATUS 17 

and reaches the stomach at the left side. The width of the oesophagus is 
not regular in its entire length, being narrower at the region of the pharynx 
and at the cardiac and just before it unites with the stomach. 

The oesophagus is examined externally by the hand (palpation), 
or internally by the pharyngeal sound or probang, and we may find trau- 
matisms, tumors, foreign bodies (pieces of bone, wood, large pieces of food) 
which become lodged in the oesophagus generally just beyond the 
pharynx in the region of the neck, where they can be easily felt by the 
hand. The thyroid gland is sometimes enlarged from local inflamma- 
tion, struma, or carcinoma and care must be taken not to mistake this 
for a foreign body. Very frequently we find the lymphatics of this region 
are enlarged. Carcinomas or sarcomas are sometimes found along the 
course of the oesophagus. 

The introduction of the laryngeal probang is comparatively easy 
in the dog. The best probang is one less than the size of the little finger 
and it must not be too flexible, the length should be from 20 to 30 cm.; 
this size, of course, is for the ordinary sized dog; in very small animals 
the ordinary sized urethral catheter can be used. Care must be taken 
to have the probang perfectly smooth and uniform in diameter. If the 
probang is very stiff it may be made more flexible by rubbing it briskly 
with a towel or putting it in warm water for a few seconds. The 
method of introducing the probang is as follows: The mouth is held open 
as described on page 12; the head is extended and it is introduced along 
the upper wall of the throat, keeping it high up so as to avoid the larynx. 
If the probang should slide into the trachea instead of the oesophagus and 
cause dsypnoea, the instrument must be instantly withdrawn. The 
animal will attempt to swallow it, but that will assist the sounds. It will 
glide along easily until the obstruction is reached, or glide directly into 
the stomach. In cases where there is a foreign body in the oesophagus the 
probang will come against it, preventing the instrument going any 
farther. Great care must be taken at this juncture not to push the pro- 
bang too hard as it may lacerate the walls of the oesophagus, particularly 
if there is a stricture or a tumor; or if it is a foreign body, it may cause it 
to be more firmly imbedded or the probang may rupture (perforate) the 
w^alls of the oesophagus. 

Examination of the Stomach. 

Baum, who has made a careful study of the position of the dog's 
stomach, finds when the stomach is filled with food, its outlines can be 
easily recognized by palpation (Fig. 7). It lies in the left side of the 
abdominal cavity, the inferior portion resting on the liver and the ante- 
rior portion against the diaphragm, the left surface going toward the 
2 



18 



DISEASES OF THE DIGESTIVE APPARATUS 



abdominal wall, but between that and the wall lies the left lobe of the 
liver. This left lobe extends as far as the pelvis, coming close to the left 
kidney; the left or cardiac end of the stomach extends as far as the ninth 
rib and posteriorly as far as the thirteenth rib and the anterior border of 
the left kidney. The right or pyloric end of the stomach is directed on 
the median line to the right. The larger part of the stomach is enclosed 
by the liver and the diaphragm coming in contact with the anterior side. 
The cardiac end of the stomach is directed toward the median line and 
the pyloric toward the right. The empty stomach (Fig. 8) extends 
anteriorly as far as the left pillar of the diaphragm and toward the chest 
as far forward as the tenth rib and posteriorly as far as the twelfth rib, 




Fig. 7. — Section through centre of abdomen. 

and is completely covered by the liver on the left side. Only a very small 
part of it comes in contact with the diaphragm and the inferior face of the 
ninth and tenth dorsal vertebra. The pyloric opening is directed toward 
the right and very slightly forward (Fig 9). When the stomach is 
very much distended with gas or food, it comes almost directly in contact 
with the abdominal walls, and when greatly distended it extends as far as 
the umbilical region and lies against the ribs and the left abdominal wall 
and the left and ventral lobes of the liver being pushed almost entirely 
away from the surface of the stomach, depending on the amount of the 
distention. 

From the above anatomical details it can be readily seen that it is 
nearly impossible to make a reliable examination of the stomach when it 
is empty or even when it is fairly well distended. The cardiac and pyloric 



EXAMINATION OF THE DIGESTIVE APPARATUS 



19 



openings are so deeply seated they are extremely hard to examine. To 
make a manual examination of the stomach, the animal nmst be placed 




Fig. 8. — Position of stomach when empty. 



in a standing position or sitting in the favorite position of the dog, that is, 
resting on the hind legs. The finger is pressed into the abdomen back of 
the xiphoid cartilage or on the right side beneath the cartilaginous ends of 



Dorsal vertebrae. 



Lumbar vertebrae. 




Fig. 9. — Position of stomach when full. 



the ribs; the digital pressure at first may be gentle, but this can be in- 
creased until the stomach is outlined. 

When a very careful examination has to be made to detect the 



20 



DISEASES OF THE DIGESTIVE APPARATUS 



presence of foreign bodies or tumors in the stomach, the author proceeds 
in the following manner: Place the dog on his back and if difficult to 
handle, or vicious, narcotize it, and press the fingers on the abdominal 
walls; at the same time an assistant can bring the front and hind legs 
together, bending the spine as much as possible. This position relaxes 
the abdominal muscles and the stomach can be easily outlined and its size 
felt. A distended or engorged stomach can be recog- 
nized by palpation or when the abdominal walls are 
relaxed the stomach can be easily detected lying in 
the umbilical region and extending under the false 
ribs. If the distention is due to gas it can easily be 
recognized by the tympanitic sound on percussion; if 
the distention is due to the presence of some fluid it 
will be indicated by fluctuation. Great distention 
of the stomach by gas is found as a result of certain 
poisons, stenosis of the bowels and in alteration of 
the normal position of the stomach. Great ac- 
cumulation of gas is seen in the stomach in gastric 
catarrh, but it may also be present in an entirely 
healthy stomach. The contents of the stomach may 
feel soft or doughy according to the quality of the 
food, and how it was prepared, w^hen eaten. The 
normal condition of the stomach after eating is that 
of slight distention. Pyloric stenosis may also cause 
distention of the stomach. Tumors on the wall of 
the stomach are extremely difficult to diagnose, ex- 
cept perhaps in small animals where the tissues are 
more elastic and less dense. Foreign bodies of mod- 
erate size and of some dense structure can be felt in 
the stomach, by manipidation. Certain foreign 
bodies, such as needles, stones, etc., can be detected 
in the stomach by means of Rontgen or X-rays (see description of foreign 
bodies in the stomach) . Pain on pressure of the stomach may be produced 
by manipulation, but it is not always present; it may be noticed in acute 
gastric catarrh, toxic gastritis, infectious hemorrhagic gastro-enteritis. 
It must be remembered, however, that it is only the filled or distended 
stomach that can be felt, due to the lobe of the liver lying between the 
stomach and the abdominal wall and pain on pressure may indicate some 
disorder of the liver and not of the stomach. Consequently, in making a 
diagnosis we must include other observations, particularly an examination 
of the contents of the stomach. 

We can obtain the contents of the stomach either by the substance 
which the animal may vomit itself or by means of the stomach- 




FiG. 10. — Stomach-pump. 



EXAMINATION OF THE DIGESTIVE APPARATUS 



21 



pump. This has been recommended by Frick, and only for therapeutic 
purposes. 

The stomach-pump is operated in the following manner: In large 
dogs an ordinary horse catheter is used and in small dogs a large male 
human catheter or a small rubber hose. We pass the catheter, as de- 
scribed in the examination of the cesophagus, into the stomach and to the 
free end of the catheter or rubber hose, which' should be about 30 cm. 
long, we put a small funnel at the other end of the tube (Fig. 10). Pour 
a certain amount of water into the stomach through the tube, at the 
same time holding the tube high, and then manipulate the region of the 
stomach and next depress the tube, and the siphon which has been formed 
will soon empty the stomach of its contents. This method is to be used 







Fig. 11. 



-Contents of the stomach (four hours after eating) : Muscular fibre, starch cells, fat cr>-stals 
and cells, round cells, epithelium, vegetable cells, fungus. 



in very urgent cases where poison is suspected, but as a rule is very hard 
to do except in very quiet animals and where there is a trained assistant, 
such as in a hospital; but in private practice the easier wa}- is the better, 
that is, to administer an emetic. The best means is to give a dose of 
apomorphia hypodermatically. 

I^ .\pomorphia hydrochlorate, 0.04 

Aqua distil., 4.00 

Sig. — Ten to twenty drops hypodermatically. 



In a few minutes free vomiting occurs and the contents of the stomach 
can then be examined. Of course, you must take into consideration 
the time which has elapsed since the animal has taken the food and the 
character of the alimentary matter. It would be well, therefore, that 
you know the following facts concerning (Fig. 11) digestion in the dog's 
stomach: 



22 DISEASES OF THE DIGESTIVE APPARATUS 

Digestion of a Meat Diet in the Stomach. 

After taking a full meal of meat cut in small pieces the digestion 
in the stomach is veiy active and free; it increases until the third hour 
antl slowly decreases until the ninth, and is nearly over at the twelfth 
hour. After eating a very large meal the digestion is somewhat slower 
and lasts considerably longer, the different kinds of meat also vary in the 
t ime of their digestion. Pork is the easiest to digest and others are classified 
in the following order: mutton, veal, beef, and lastly the flesh of other 
animals (Astley Cooper) ; skin, tendon, sinew, cartilage, and bones are 
very hard to digest; the latter are digested from their surface and are 
reduced as the gelatinous parts are acted upon and dissolved and the 
lime salts remain unchanged. Fat meat is harder to digest than lean; 
fat undergoes no change in the stomach, but passes on and is digested 
in the intestines. The gastric juice acts on and reduces roasted meats 
and if raw meat is chopped up in small pieces the gastric juice acts on it 
much more quickly. It has never been satisfactorily settled whether raw 
or cooked meat is easier to digest. 

The Digestion of Milk in the Stomach. 

Milk is comparatively slow in digestion. After an animal had taken 
249 grammes of milk he was destroj^ed four hours later and 13 grammes 
of cheese and 1 gramme of fluid was found in his stomach. 

Action of Digestion on Hydrocarbonaceous Food. 

Five hours after a meal consisting of rice and potatoes the mass was 
liquefied and softened; the mashed portion of the potatoes had disappeared 
but the lumps remained. After a meal of rice, the following observations 
were made: After one hour 10 per cent, was digested, after two hours 
25 per cent., after three hours 50 per cent., after four hours 82 per cent., 
after six hours 90 per cent., after eight hours 99 per cent., and at the end 
of ten hours it had entirely disappeared (V. Hofmeister). 

Both Ellcnberger and Hofmeister have come to the conclusion that 
rice is chiefly digested in the intestines, as there is so much muriatic 
(hydrochloric) acid in the stomach immediately after eating that sac- 
charation cannot take place; and also that the dog swallows his food with 
so little mastication that the saliva has no time to make any change in 
the starch. 

The effect of the disturbance of gastric secretion on digestion is 
as follows: When, from any cause, the secretion of gastric juice is les- 
sened or altered the following changes are observed: The digestion 
of albumin, and the antiseptic and antizymotic action of the gastric 



EXAMINATION OF THE DIGESTIVE APPARATUS 23 

juice is much lessened, for there is no doubt that gastric juice can destroy 
the infectious bacteria that are carried into the stomach by the food; 
consequently, the secretion thus being much less acid, with the lessened 
digestion of albvimen, fermentation is easily started. When the gastric 
secretion is subacid it irritates the mucous membranes of the intestines 
and lessens the peristaltic action. Subacidity is frequently seen in all 
anaemic diseases, in fevers, in erosion of the mucous membranes, from 
the effects of corrosive poisons, in cancer of the stomach, and in chronic 
catarrh of that organ. 

The digestion of starch is impaired by an oversecretion of hydro- 
chloric acid; this condition, according to the researches of Ellenberger 
and Hofmeister, is not of great importance, although in man it is fre- 
quently seen in ulceration and in acute and chronic catarrh of the 
stomach. "Nervous dyspepsia," so common in man, does not seem 
to occur in the dog. 

In testing the contents of the stomach for free hydrochloric acid the 
best reagent is red paper and phloroglucin-vanillin solution. Moisten 
a small piece of this paper with a few drops of the filtered fluid-contents of 
the stomach. If free acid is present the red color of the paper will turn 
blue. This reaction may also occur if lactic acid is present. This, 
however, is rarely present in the contents of the stomach. In testing 
with phloroglucin (vanillin) place a few drops of the following solution: 
PhloroglucinS parts; vanillin 1 part; alcohol 30 parts; with equal quantity 
of the filtered fluid of the stomach. Put in a porcelain dish and heat but 
do not luring to a boil. If there is free hydrochloric acid present, it will 
produce a dark red precipitate; if it is present in a small amount, the pre- 
cipitate will be l^right red; if the acid is not present, the precipitate will 
be brown or reddish-brown. If methyl-violet solution is used, if a trace of 
free acid is present, it will color the solution sky-blue. The test is made 
in the following manner: Make a certain quantity of the solution, di- 
luting the water until it is light violet. Divide this into equal parts put- 
ting into two test-tubes. To one of the tubes add a few drops of the 
filtered gastric fluid and if any free acid is present, the solution changes 
to sky blue and by comparison with the other tube the amount of free 
acid can be approximated, being guided by the change in the color. 

Testing with lactic acid is much easier and more certain. The best 
method is that of Uffelman: 100 grammes of a 2 per cent, solution of 
carbolic acid are to be mixed with one drop of chloride of iron solution, 
which makes the mixture deep blue; if a few drops of the filtered contents 
of the stomach are added and muriatic acid only is present, it becomes 
clear as water; if lactic acid is also present, it becomes greenish-yellow 
in color. 

In summing up the preceding investigations it is readily seen that 



24 DISEASES OF THE DIGESTIVE APPARATUS 

the stomach may not be digesting all that the animal eats, but still the 
animal be in fairly good health; while, of course, it must also be under- 
stood that in fevers or any general disturbance, the digestive powers are 
greatly impaired. 

Albumin is almost entirely digested in the intestines, the stomach 
merely preparing it; fat and starch are digested only in the small intes- 
tines; muscular tissue must have a previous preparation in the stomach, 
or, if it reaches the small intestines without becoming saturated with 
gastric juice, it is not digested in the intestines. No digestion whatever 
takes place in the large intestines. 

No animal vomits more easily than the dog, and it may be produced 
from a number of causes, as a reflex irritation of the stomach, viz., 

1. By irritation of the mucous membranes of that organ by emet- 
ics, posions, splinters of bone, or even by overloading. Vomiting 
frequently is caused by the animal eating grass. 

2. By sympathetic irritation from other organs, intestinal parasites, 
uraemia, peritonitis, irritation of the intestines, or uterine inflammations. 

3. Vomiting may result from serious coughing spells, as a result of 
laryngitis, l^ronchitis, or liquids getting into the larynx. 

4. In obstruction of the bowels, foreign bodies blocking up the bowel, 
hernia or twisting of the intestines. In some cases of the latter con- 
dition excrement is vomited. 

5. In the early stages of distemper and infectious hemorrhagic gas- 
tro-enteritis, persistent vomiting is almost invariably present. 

6. From various brain-affections (meningitis, commotio cerebri). 
Very often in certain diseases of the pharynx and where foreign bodies 
have become imljedded or fixed about the root of the tongue, pharynx 
or oesophagus and in pharyngitis, movements of the throat resembling- 
vomiting are frequently noticed. 

The amount of vomited matter depends to a certain extent on the 
density of the material in the stomach, what it is composed of, and the 
cfuantity present in the stomach at the time of the vomiting. In cases 
where the animal vomits, when the stomach is full, the vomited material 
will either be the food in a uniform pulpy mass, or the mass may be 
largely fluid, with the food lying in it, with little alteration from when 
it was swallowed. It depends largely on how long it has been in the 
stomach and whether the stomach has digested it. When an animal 
vomits when the stomach is empty, there generally is a small quantity 
of water mixed with the mucus; the color varies greatly according to 
the circumstances, white, yellowish-gray, yellow or yellowish-green; 
this latter condition depends on staining from bile pigment. Other 
colors may also appear. It may be gi'cen from eating grass; violet as 
a result of licking a wound or eruption that has been treated with pyok- 



EXAMINATION OF THE DIGESTIVE APPARATUS 25 

tannin. The vomited material may be streaked with traces of blood, 
due to rupture of some capillary vessels of the stomach. For further 
particulars see the article on Ha?mostases. 

The vomited material varies according to the pathological condit- 
ions, from a thin watery fluid to thick mucus. In acute or chronic 
catarrh of the stomach it is stringy and glassy. The presence of blood in 
the vomited material may be due to the animal swallowing some sharp 
foreign body, the action of some corrosive poison, from infectious hemor- 
rhagic gastro-enteritis, ulceration of the stomach, gastric ulcer, or we may 
see it in hemorrhage of the mouth, trachea or pharynx, where the animal 
swallows the blood and vomiting it again may lead to a mistaken diag- 
nosis of infectious hemorrhagic gastro-enteritis. This may also occur 
when an animal licks a wound and thus swallows a large amount of blood 
and then vomits it. In hemoptysis (bloody cough from the respiratory 
organs) it is frothy and a bright color. In hematemesis (vomited blood) , 
the blood is dark, varying from a dark red-brown to a dark brown. In 
rare instances where abscesses form in the pharynx, oesophagus, stomach, 
or the region adjacent to that organ, when they break they may cause 
vomiting and the material vomited is stained with blood. Fa?cal ma- 
terial is sometimes vomited up in the latter stages of obstruction of the 
bowels and in acute diffuse peritonitis. 

Vomited material is generally acid in reaction but it is alkaline in 
poisoning by alkalies, and in severe hematemesis. Vomited material is 
generally pungent and unpleasant, particularly when there is a collection 
of fatty acids in the stomach, and very offensive when fsecal material 
or putrid meat is vomited. This also occurs in rare instances, from 
violent poisons, and in carcinoma of the stomach, etc. A foul odor may 
be given to vomited material in cases of injury of the pharynx and oesoph- 
agus. In cases of certain poisons, the characteristic odors of the drug 
can be detected, as in the case of phosphorous, carbolic acid, iodoform, 
or hydrocyanic acid. Internal parasites are frequently found in vomited 
material. 

Eructation of gas (belching) is frecjuently seen in perfectly healthy 
animals, particularly when they rise and stretch themselves. It is also 
seen in catarrh of the stomach. 

Physical Examination of the Bowels (Intestines). 

The examination of the intestines can either be made through 
the abdominal wall or the rectum. The situation and size of the various 
abdominal organs can be seen approximately in Fig. 12. 

The manual examination of the intestines is made in the following 
way: The animal is put in a standing position and placing one hand 



26 



DISEASES OF THE DIGESTIVE APPARATUS 



on the abdominal wall and the other hand on the other side of the body- 
directly opposite, a steady pressure is brought to bring the hands to- 
gether and the ends of the fingers are moved from one position to another 
and thus outline and palpate the different portions of the intestines. 
While doing this, attention must be paid to see if the animal winces or 
evinces pain, and whether it is slight or intense. By this means we dis- 
cover abnormal accumulations of fa?cal matter in the large intestines, 
also whether there are any foreign bodies or tumors in the intestines. 
Intense pain is shown in the early stages of diffuse peritonitis, and in a 
milder degree, but still very acute, in toxic enteritis, complete obstruction 
or stenosis of the bowel, and in infectious hemorrhagic gastro-enteritis. 




Fig. 12. — Intestinal canal of the clog. BZ, Caecum; Bs, pancreas; G, colon; H, ileum L, jejunum, 
M, stomach; md, large intestine; Z, duodenum; 1, curve of the duodenum; 1' flexures of the large in- 
testine; 2, convolutions of the small intestine; 3, anus; 4,4, anal glands; 4', opening of glands. 

If the bowels are pressed very hard, pain is evinced when there is acute or 
chronic catarrh of the intestines. A circumscribed or localized pain is 
seen in intestinal stenosis, tortion or volvulus of the intestine and from 
the presence of foreign bodies. One must remember in making such an 
examination that certain painful conditions of the abdominal muscles 
or even the pain that severe pressure may produce, when the muscles 
are stretched or compressed, must not be mistaken for intestinal pain. 
In certain long standing cases of chronic intestinal catarrh, the writer 
has found a certain amount of pain on pressing the finger tips between the 
loops of the intestines. 

An increase in the periphery of the abdomen may indicate collec- 
tions of adipose tissue in the abdomen, pregnancy in bitches, overload- 
ing of the stomach with food, or great accumulation of faeces in the large 
intestines. The same condition is observed from accumulations of gas 
in the stomach and intestines as a result of catarrh of the stomach and 



EXAMINATION OF THE DIGESTIVE APPARATUS 27 

intestines, certain poisons, stenosis of the intestines, peritonitis, paralysis 
of the intestines, escape of gas from the stomach and intestines into the 
abdominal cavity (meteorismus peritonis), and also when these organs 
are punctured by foreign bodies, from accumulations of fluid in the ab- 
dominal cavity, in peritonitis exudata, rupture of the bladder, or ascites. 
Particularly relaxv>d and flabby abdominal muscles may often make an 
animal look as if it had dropsy of the abdomen. In great accumulations 
of urine in the bladder, large tumors or cysts in the abdominal cavity, 
dropsy of the uterus and in hydronephrosis. Lateral (one-sided) disten- 
tion of the abdomen may be caused by hypertrophy of the liver, disten- 
tion of the stomach, various tumors, abscesses of the abdominal walls, 
hernise and other surgical diseases. A decrease in the periphery of the 
abdomen may result from continued diarrhoea, lack of proper or sufficient 
food, or consumption. 

Large accumulations of faecal matter in the colon and rectum is indi- 
cated by a large sausage-like mass the consistency of putty and is pitted 
by pressure. These obstructions cause painful irritation and swelling 
of the mucous membrane. These swellings are found under the spinal 
column. Foreign bodies that have been mixed with the food or if an 
animal in play catches certain objects in his mouth, such as glass, stones, 
hard or soft rubber balls, cork, etc., and accidentally swallows them and 
they become lodged in the intestines they are easily outlined by palpa- 
tion by the same means we outline tumors on the abdominal wall. Soft 
foreign bodies, such as hair balls, overloading of the intestines, or slight 
invagination are rather hard to diagnose. 

The rectum is examined in the following manner: The animal is 
placed either in a standing position or on his side, and the index fin- 
ger (or in small animals, the little finger), having been dipped in oil, is 
inserted into the rectum, the other hand being used to hold the tail to 
one side, or to keep the animal quiet. It is frequently necessary to 
muzzle the animal and in almost all cases an assistant holding the ani- 
mal greatly facilitates the examination. Very frequently after an ex- 
amination, the finger is stained with blood, or even blood in large quan- 
tities is observed. This is generally due to the venous engorgement 
of the rectal mucous membrane and the capillary vessels are easily 
ruptured. We examine the rectum when certain symptoms are shown 
in defecation or the faeces indicate some abnormal condition of the 
rectum, such as inflammation, abscesses, tumors, or dilation or con- 
traction of that organ. Or we may examine the rectum to remove 
foreign bodies or particularly hard pieces of faeces or to diagnose ab- 
normal conditions of the neighboring organs, or structures, such as the 
prostate gland, vagina, uterus, neck of bladder, or if tumors or abscesses 
are suspected in the pelvis. In very small animals the examination of 



DISEASES OF THE DIGESTIVE APPARATUS 
organs can be made easier by palpation of the abdominal 



28 

these 
wall. 

In certain cases where light has to be thrown on the rectal mucous 
membrane the necessary examination can be made by means of a specu- 
lum and then a mirror or an electric torch can be used to throw the light 
into the cavity. Inflammation of the rectum from any cause, such as 
hemorrhoids, fistulae, foreign bodies, or abscesses, can be readily exam- 
ined by this means. 




lio. i:j. — Examinatiou of the lower bowel with speculum. 



The Faeces. 



The number of times that an animal has an evacuation of the 
bowels depends on the two circumstances: The quantity and character 
of the food and the rapidity with which it passes through the bowels. 
Normally, an animal has two or three passages daily; sometimes even 
less. Diarrhcea, as a result of catarrh of the intestines, may be due to 
a variety of causes, such as irregular diet, cold, or to some infectious 
disease (distemper), latter stages of infectious hemorrhagic gastro-enteritis, 



EXAMINATION OF THE DIGESTIVE APPARATUS 29 

septicaemia, or some irritant in the food; but it may also be caused by 
a laxative independent of the catarrh. 

Constipation is common in all old dogs and in starved animals, in 
animals weakened from exhausting diseases, in animals that have not 
had sufficient exercise, or fed with constipating food, icterus, peritonitis, 
in the onset of all diseases with rise of temperature, in the majority of 
chronic affections of other organs, in all cases of obstruction of the bowels, 
such as collections of dry faeces in the large intestines, atresia ani, from 
large collections of internal parasites, tumors in the intestines or adjacent 
structures, hypertrophy of the prostate gland, too much hair around 
the anus, swelling of the anal glands, or from tumor of the anus. Animals 
suffering from lumbago frequently do not attempt to defecate on ac- 
count of the pain evacuation of the bowels causes them. 

Constipation alternated with diarrhoea is frequently a symptom 
of chronic intestinal catarrh — due to twisting of those organs — or in- 
vagination, hernia, foreign bodies, loss of the vermicular motion and 
in all copious exudations from the peritoneum. Pain during evacua- 
tion of the bowels (tenesmus) is seen in inflammation or obstruction of 
the lower bowels and in inflammation or ulceration of the rectum, or 
rheumatism of the abdominal muscles. Involuntary evacuation of the 
bowels is seen in prolonged attacks of diarrhoea, paresis of the cord, 
and when an animal is dying, from the presence of an abscess, from 
enlargement of the prostate, from splinters of wood in the lower bowel, 
or from enlargement of the rectal glands. 

The amount of excrement passed by an animal in a given time de- 
pends on the quantity and quality of the food that the animal has taken. 
A vegetable diet produces much more faeces than a meat diet. In an 
ordinary sized dog fed on bread, the amount of faeces passed amounts to 
20 per cent, of the amount eaten; but if the same animal is put on a meat 
diet the amount of faeces is only about 12 per cent. (Ellenberger), In 
diarrhoea the relative amount is changed, for in this condition the intes- 
tinal juices secreted to aid digestion are not reabsorbed, but remain with 
the faeces and are thrown out. 

After an obstinate constipation the amount of fluids is also greatly 
increased, and with it there is also a very offensive odor, due to decom- 
position of the faeces and to the various excrementary matters that have 
remained in the bowels. 

The shape, size and color of the stools are a rather important matter 
to consider. In normal health they are cylindrical in form, hard or soft, 
according to the diet; in meat diet they are black or brownish- black and 
of pitchy consistency. The faeces of sucking puppies resemble thick 
green pea soup; these are rarely seen as the mother invariably licks them 
up. Medicine changes the color of the faeces. Calomel and bismuth 



30 



DISEASES OF THE DIGESTIVE APPARATUS 



stain them greenish-black and iron preparations turn them black; on 
meat and fat mixed they are dark gray-brown, and on bread and milk 
diet they are yellow-brown or almost clay color. If the animal has eaten 
much bones, they are whitish. The alimentary matter cannot be dis- 
tinguished with the naked eye, except in the case of bread, which is passed 
almost as it is taken into the stomach. Bodies, such as wood, bones, 
hair, straw, earth, etc., can also be seen in the faeces. Under the mi- 
croscope (Fig. 14) we can see numerous particles of food that have 
passed without digesting in animals that have good health. In impaired 
digestion we see pieces of muscle, connective tissue, etc., with the naked 
eye. 

The following deviations in the appearance of the faeces may be 
observed : 

If the faeces contain large quantities of food that is ordinarily very 
easily digested, or of food that shows little or no evidence of having been 





■iW 




Fig. 14. — Microscopical examination of the fsece?. Vegetable matter, starch cells, muscular fibres, 
epithelial cells, and fungoid growths. 



digested, disorder of the stomach or intestines is indicated. This con- 
dition may also result from fevers, gastro-intestinal catarrh, from increased 
peristalsis, forcing the food through the intestinal canal before it has 
had time to digest, from fright, the presence of irritants in the food, 
from the administration of laxatives or in old, exhausted or weakened ani- 
mals. Biliousness will produce a stool that is yellow colored. Continuous 
diarrhoea produces a mucous or watery appearance of the faeces. In 
catarrh of the intestines the faeces contain a large quantity of mucus 
and have a peculiarly foamy appearance. Clrayish-white, or clayey, 
with a dull gloss indicates a plugging of the bile duct or some stoppage 
of the flow of bile (retentions icterus). The presence of pus indicates the 
bursting of some suppurative foci into the intestinal track, such as ab- 
scesses or ulceration of the large intestine, or the rectum. Bloody stools 
are frequently passed after a digital examination of the rectum, insert- 
ing the thermometer, from certain poisons, so-called hemorrhagic en- 



EXAMINATION OF THE DIGESTIVE APPARATUS 



31 



teritis, from proctitis (inflammation of the rectum), in rare instances, 
from distemper, infectious hemorrhagic gastro-enteritis, septicaemia, 
and in cases of mycotic meat poisoning. Blood may be found on the 
surface of the stool or mixed with the pus. Which portion of the intesti- 
nal track the blood comes from can be arrived at in the following way: 
If the blood is found to be mixed all through the material in the faeces it 
comes from the stomach or small intestines. But if the blood is in clots 
or streaks and lying on the surface of the stool, it has come from the 
lower part of the large intestine or the rectum. The color of the blood is 
diagnostic; when the blood has escaped into the intestine in the anterior 
portion, it is dark brown, a greenish-brown, or even black; but from the 
lower intestines the blood is hardly changed in color and in proctitis the 




Fig. 15.— Eggs of intestinal parasites in faeces (round worm). Magnified 70 times. 

blood is normal in color, and is easily detected in the faeces, either in the 
form of pure blood or bloody mucus. 

The odor of the faeces is unpleasant, nauseating or offensive, especi- 
ally when the animal has had a meat diet, and particularly so in cases of 
long-standing constipation from mycotic meat poisoning; or in the latter 
stages of septicaemia, in distemper, diarrhoea, toxic enteritis, or infec- 
tious hemorrhagic gastro-enteritis. Free bile in the faeces gives them a 
particularly offensive odor. 

The presence of the following objects in the faeces may aid in diag- 
nosis by giving an important clue to certain disorders; stones, sand, 
pieces of bone, straw, grass, splinters of wood, hair, portions of sloughed 
tissue, whole or portions of parasites (ascarides, oxyuris, taenia) (Fig. 15), 
and more minute examination by means of the microscope may determine 
the nature and some of the above-named objects if they should be in a 
state of fine division. 



32 



DISEASES OF THE DIGESTIVE APPARATUS 



Physical Examination of the Liver. 

The liver covers the posterior surface of the diaphragm and extends 
as far back on the abdominal wall as the umlnlical region. On the right 
side it extends posteriorly and laterally along the ribs. The gall bladder 
lies at about the height of the cartilage of the ninth rib, but does not 
extend as far as the abdominal wall. 

The physical examination of the liver is very difficult to make. 
Fortunately, the diseases of the liver in the dog are very rare and can be 
detected by symptoms other than the direct examination of the gland. 
The liver is examined by percussion and palpation (Fig. 16). The percus- 
sion area of the liver is where the liver lies against the abdominal wall and 




Fig. 16. — Right side of the abdomen, showing the position of the organs. 

the ribs; this takes in on the right side the lower third of the eighth, 
ninth and tenth ribs and upward and backward over the twelfth and 
thirteenth ribs, and on the left side the twelfth rib. Under normal 
conditions a dull hollow sound is heard on the percussion over the region 
of the liver. The liver, however, may vary a great deal in the different 
breeds of dogs and also in individual animals. 

The liver very frequently is in an abnormal position from various 
diseases, as a result of exudative pleuritis, emphysema of the lungs, 
pneumothorax, etc., also when the stomach and intestines are filled with 
gas from accumulations of fluid in the abdominal cavity. Increase in the 
size of the liver may indicate hyperaemia, fatty liver, amyloid degenera- 
tion, abscesses, carcinoma, parenchymatous hepatitis, or biliary engorge- 
ment. A decrease in the size of the organ is found in cirrhosis of the liver. 

The palpation of the liver is made in the following manner: the hand 



EXAMINATION OF THE DIGESTIVE APPARATUS 33 

is placed on the chest wall and the thumb extends back of the curvature 
of the ribs and is pressed in the region of the liver or the thumb can be 
placed on the last rib and with the tips of the fingers the region of the 
liver palpated. The usual position of the animal is to place it on its 
side. The palpation of the liver is particularly easy in an animal having 
very flabby abdominal w^alls, or where a collection of fluid, such as ascites, 
has just been removed. Pain on pressure of the liver is seen in cases of 
parenchymatous hepatitis, in hypersemia of the liver, and in early 
stages of cirrhosis of the liver. In cases of carcinoma of the liver, large 
uneven nodules are felt on palpation and in the latter stages of cirrhosis, 
small uneven nodules are detected on the surface of the liver. The liver 
is particularly firm and inelastic in cirrhosis, hyperaemia, and biliary 
engorgement. Abscesses may be detected by fluctuation, but only when 
they have attained a great size. 

The Spleen. 

The spleen is situated in the left hypochondriac region, is very diffi- 
cult to examine through the abdominal wall. Certain definite swellings 
or engorgements of the spleen may result from various affections of the 
liver, lungs, and heart, from tumors in the region of the porta hepatica, 
in various infectious diseases, such as distemper. When large splenitic 
tumors are present, in fat animals they are almost impossible to detect; 
in thin animals they are easily detected by palpation. Percussion in 
such cases can also be made about the last two intercostal spaces at the 
curvature of the ribs. 

The Pancreas. 

The pancreas, on account of its twisted right-angle position, makes 
a direct examination almost impossible (Fig. 16); enlarged pancreas may 
occur as a result of tumors, carcinoma or adenoma; they may be detected 
by palpation in the region of the twelfth dorsal to the third lumbar 
vertebra. But it is generally unsatisfactory, and a diagnosis is better 
made of diseases of the pancreas by finding undigested food in the faeces 
and the presence of sugar in the urine. 



34 DISEASES OF THE DIGESTIVE APPARATUS 



DISEASES OF MOUTH, TONGUE AND SALIVARY GLANDS. 
Inflammation of the Mucous Membrane of the Mouth. Stomatitis. 

Clinical Symptoms. — The first symptom the animal will show will 
be the slow, careful way in which it eats; it will leave any large, or hard 
pieces of food untouched, and swallow small pieces without mastication. 
The saliva is greatly increased in amount and frequently runs out 
of the corners of the mouth in thin, glass-like threads or strings. On 
making an examination of the mouth, all of the mucous membranes 
Avill be found swollen, red, and inflamed; the gums are especially so during 
dentition (gingivitis) ; the inner surface of the cheeks, the tongue, and 
soft palate are also inflamed; as a rule, the tongue is coated and covered 
with thick mucus and saliva. Ulcers sometimes appear in the different 
parts of the mouth and particularly on the tip and edge of the tongue. 

The duration of the disease depends largely on the causes producing 
it; as a rule, it is not of much importance and disappears without any 
medical interference. In some cases, where it is caused by diseased 
teeth, it is more obstinate, and if it becomes chronic it is apt to become 
a case of stomacace. 

Therapeutics. — The animal should be fed lightly, the principal diet 
being soup or liquid foods, beef extracts or juice of fresh meats, and the 
animal given plenty of fresh water to drink. This washes out the thick 
saliva and mucus off the tongue and between the teeth. Common salt, 
carbonate of soda, or Carlsbad salts or some such saline waters as Hunyadi, 
Apenta or Veronica, can be used with good results, and the mouth should 
be washed out with any of the following disinfectant and astringent solu- 
tions: 1 to 2 per cent, solution of boric acid, potassium chlorate, 5 per 
cent, solution of alum, 5 per cent, solution of permanganate of po- 
tassium, sol. of peroxide of hydrogen or red wine. Inflamed gums can be 
rubbed with tincture of myrrh, tincture of catechu, or with a solution of 
15 per cent, tannin in glycerine. 

Ulcerous Inflammation of the Mucous Membranes of the Mouth. Ulcera- 
tive Stomatitis (Stomacace). Necrotic Stomatitis. 

Etiology. — This is an inflammation and necrotic ulceration of the 
mouth, and is generally seen in delicate, weak and ansemic house dogs 
and is associated with the presence of decayed teeth (tartar, caries). 
It is seen, however, in a small proportion of cases where the teeth are 
perfecti}' sound, and where the animal seems to be in fairly good health, 




STOMACACE {necrotic gangrene of the Jaw.) 



DISEASES OF MOUTH, TONGUE AND SALIVARY GLANDS 35 

especially, when they are recovering from acute or exhausting diseases. 
This condition in some cases seems to be due to some bacterial infec- 
tion of the mucous membrane and the tissue directly surrounding the 
teeth; the true nature of this hypothesis has not as yet been settled. It 
is also a question if it is infectious, but if not, it certainly affects a 
certain number of animals at a time. Ulcerative stomatitis is also 
seen as a symptom in scurvy, infectious hemorrhagic gastro-enteritis, 
and in certain cases of poisoning, particularly mercurial. A simple case 
of stomatitis either from improper treatment or a weak nutritive con- 
dition, may become an acute case of stomacace. 

Clinical Symptoms. — At first the gums are swollen and red in the 
neighborhood of certain teeth, generally the incisors and more rarely the 
molars. The gums are very red and painful to the touch and bleed readily. 
After a few days the inflamed portion becomes green and dark purple 
on the dividing line (line of demarcation) with the other tissues. The 
hemorrhage from the affected parts is constant and deep abscesses form, 
involving the alveolar processes. This gangrenous inflammation ex- 
tends and the teeth become very loose and fall out. In extreme cases, 
the jaw becomes affected and necrosis sets in and large portions of the 
jaw exfoliate. This condition may also involve the neighboring tissues; 
but as a rule the tongue is rarely affected to any great extent. The 
odor of the stomach is very offensive; there is a bad-smelling, sticky mu- 
cus running from the corners of the mouth. Generally the appetite is 
fairly good, although it is very difficult for the animal to masticate or 
swallow, and bolting the food whole, while affected with this disease, 
has a tendency to upset the stomach. 

A favorable termination of this disease is only to be expected in 
young, strong, healthy dogs, provided it has not become too far ad- 
vanced. With proper treatment and favorable conditions the ulcers 
clean up gradually, and after two weeks they are usually all healed up; 
but sometimes the fever keeps on increasing and the disease becomes 
septic in character from absorption of the dead tissues, causing blood- 
poisoning and collapse, followed by death. The author has noticed 
a gangrenous lobular pneumonia from the aspiration of the purulent 
matter. 

Therapeutics. — The animal must be fed lilierally, but with easily 
digested food and soft as possible. Remove all the diseased tissues as 
soon as possible and prevent the spread of the ulcerated portions of 
the mucous membrane; wash the mouth freciuently Avith deodorizing or 
antiseptic mouth washes such as have been mentioned in the previous 
disease, being careful not to let the animal swallow any of the prepara- 
tions. This is done by holding out the animal's head in such a position 
during the application of the medicine that the fluid will run out of the 



36 DISEASES OF THE DIGESTIVE APPARATUS 

mouth. The purulent uk-crations are to be painted with tincture of iodine 
or touch the ulcers with any of the albuminous preparations of silver, 
which are better than the stick of nitrate of silver. As soon as the 
ulcerated surface begins to granulate, milder astringent mouth washes 
may be used, such as tincture of myrrh, or permanganate of potassium. 
Syringe the mouth with a solution of tannin and glycerine, 1 to 20. 
The general symptoms of septicaemia will be found under the head of 
that disease. 

Foreign Bodies in the Tongue. 

Foreign bodies, such as pins, needles, fish hooks, etc., frequently find 
their way into the tongue. It is always well to examine the mouth care- 
fully, when an animal appears to have ptyalism, where it is con- 
stantly moving the jaw as if it were chewing, swallowing or making 
efforts like vomiting or does actually vomit, or where the animal rubs the 
mouth with the paws, as if to drag something out of the mouth. We may 
find foreign bodies, sticks, needles, splinters of wood in or under the 
tongue. It is sometimes very difficult to find a foreign body, particu- 
larly when the tongue is greatly swollen and the animal keeps it con- 
stantly moving, and at the same time the mouth filled with thick saliva; 
too great care cannot be used to detect a foreign body. Go all over 
the body of the tongue with the finger. The writer has found needles, 
some of them threaded, at the base and on the ventral side of the tongue. 
In some cases the needles were completely reversed, the point being 
toward the tip of the tongue. To remove the foreign body, imbedded 
in the tongue, the free portion of the tongue should be pulled out as far 
as possible by means of a pair of forceps. In some cases such as fish 
hooks, the foreign body should be pulled out in the direction it enters 
the tongue, so that the barb will not further lacerate the tissues; in cases 
Avhere the fish hook is ringed in the shank, it must be cut by means of a 
wire cutter. No treatment is required after the foreign body is success- 
fully removed. 

Gangrene of the Tongue. 

This may occur from Ixnndaging the tongue or rubber bands put on 
the tongue, maliciously or otherwise, or if some of the larger blood 
vessels of the tongue are cut transversely. The tongue is greatly swollen 
and the gangrenous portion is separated from the healthy part by a 
sharply defined line of demarcation. The gangrenous portion is dark 
bluish-red or bluish-black and covered with more or less pieces of necrosed 
tissue mixed with thick mucus and saliva. This is cold and non- 



DISEASES OF THE TEETH 



37 



sensitive (see Fig. 1 7) . In some cases if we forcibly pull out the tongue 
the gangrenous portion becomes detached. Experience shows that 
the loss of a portion of the tongue does not interfere very much with 
the prehension of the food. The only evidence is seen in the animal 
eating and drinking more slowly. Generally these cases heal very 
rapidly, as soon as the gangrenous portions of the tongue either slough 
ofT or are amputated. It is remarkable that in cases where the tongue 
is liluish-black and cold, the animal will make a good recovery with 
little or no treatment other than the removal of the diseased portion. 





Fig. i; 



— Gangrene of the 
tongue. 



Fig. is. — Longitudinal section 
through an incisor tooth; a, 
cement; b, enamel; c, ivory or 
dentine; d, pulp cavity and alve- 
olar dental membrane; e, maxill- 
ary bone. 



For further treatment see page 34, under Treatment for Inflammation 
of the Mucous Membrane of the Mouth. 



DISEASES OF THE TEETH. 

Dogs are frequently subject to various dental disorders, such as ac- 
cumulations of tartar on the teeth, alveolar periostitis; rarely caries of the 
teeth, and still more rarely fistulae of the gums. 

We understand by tartar of the teeth, a calcareous deposit on the 
neck of the teeth at the border of the gums. This is gray, yellowish- 
gray, or greenish-gray and sandy or chalk-like in structure. This tar- 
tarous substance is deposited chiefly around the canine or molar teeth 
and gradually pushes the gums back and often loosens the tooth, which, 
acting as a foreign body, causes great irritation. Furstenberg found 



38 DISEASES OF THE DIGESTIVE APPARATUS 

tartar of the teeth of a dog contains calcium carbonate 50.79 per cent., 
calcium phosphate 41.4.3 per cent., sodium chlorate 1.02 per cent., po- 
tassium sulphate 1.02 per cent., mucus and food debris 4.05 per cent., 
water with traces of magnesium carbonate 2.71 per cent. The tartar 
can be removed by scraping it off with a small cup-shaped instrument 
or a sound with a leaf-like tongue. Some remove it with a hook-shaped 
pair of pincers. If there is a large quantity of tartar on the teeth, it is 
best to put the dog under ether and avoid struggling on the part of the 
animal, and also facilitate the removal of the tartar without injuring 
the soft structures of the mouth. The teeth can then be cleaned with 
such tooth powders as chalk, charcoal, using a tooth brush or a 
coarse cloth, Albrecht advises in cases of tatar formation to take a 
blunt stick, cover the end with a cloth, and dip it in pumice stone and 
alcohol and rub on the teeth. 

Alveolar Periostitis. — Inflammation of the alveolar periosteum or 
the so-called alveolar dental membrane in combination with suppura- 
tive periostitis alveolaris purulenta (periodentitis purulenta) is a very 
important disease, as it has a very important bearing on the value of 
certain breeds, particularly the terrier class. If it affects very young 
animals, it is apt to destroy portions of the enamel and leave the teeth 
unsightly and discolored. This condition is very apt to follow diseases 
of the blood in very young animals, particularly those that are anaemic, 
have persistent diarrhoea or have distemper at that period when the 
permanent teeth are just about or are coming through the gums. 

Caries of the Teeth. — This condition has been observed by a num- 
ber of authors (Moller, Hoffman), but is of very rare occurrence. 

Caries of the teeth may result from the teeth being broken by 
animals in play catching hard objects, stones, coal, etc., sharp bodies 
running into the gums or becoming imbedded between the teeth. 

By caries clentum, we define an active process of molecular de- 
struction of the enamel and bone of the teeth. This process always 
begins on the surface and mainly in the cavity of the crown of the tooth 
forming a grayish or blackish spot. This spot, which is the decayed 
part of the tooth, advances deeper into the tooth, going on toward the 
pulp. This penetrates into the tooth until it reaches the nerve, and 
thus exposes it to the atmosphere, inflames it and makes it very 
sensitive. 

There are certain microbes found in carious teeth, but whether they 
are directly connected with the decay of the teeth is not definitely 
known. True dental caries is very rare in the dog. Necrosis of the 
teeth is frequently mistaken for caries. In old dogs we often see an 
acute inflammation of the periosteum and the alveolar process becoming 
inflamed, the tooth is lifted out of its socket, and finally forced out entirely. 



DISEASES OF THE TEETH 39 

In these cases the alveolar periosteum is destroyed, and a necrotic condi- 
tion of the tooth causes it to become yellow; this is generally termed false 
caries of the teeth. Alveolar periostitis commences with the formation 
of an abscess at the root of the tooth, and the pus formed finds its way to 
the outside of the gums through the alveolar process. It forms a fluc- 
tuating swelling on the gums (abscess of the gums) ; the opening gener- 
ally remains so, and if it is in the superior maxillary open fistulous 
tracts may form under the eye just below the lower eyelid, and unless 
carefully examined may be mistaken for a lachrymal fistula. By means 
of a flexible probe the diagnosis can be made with certainty. 

In all these cases the animals seem to have a more or less severe 
toothache; they are irritable, eat very slowly and irregularly, drop more 
or less saliva, refuse to have the mouth examined, and, if the affected 
tooth is struck with something (a key is the best) , howl and evince great 
pain, keeping the mouth open for some time afterward. When the mouth 




Fig. 19. — Improvised gag (French). 

is examined, the gums are swollen and painful, and there is a very foetid 
unpleasant odor from the mouth. 

When there is more or less pus present, the radical treatment is 
to remove the offending tooth. For this purpose open the mouth by 
means of the method described on page 12, using the mouth speculum 
(Figs. 4, 5 and 6), or Fig. 19, which show's a mouth ga^" that is partic- 
ularly useful where the incisor or canine teeth are to be examined as it 
can be easily improvised and allows the mouth to be examined and at 
the same time the animal does not open the mouth and move around the 
tongue and interfere with the examination and an assistant can hold the 
head steady and with an ordinary molar-forceps extract the tooth, being 
careful to avoid breaking the crown. The tooth is seized with the for- 
ceps as far down on the root as possible; it is first loosened by twisting 
it several times from side to side and then drawn out with a strong pull. 
The mouth must be thoroughly cleansed with warm water and the gums 
pressed firmly together, so as to keep the cavity, if possible, from filling 
up with a blood clot. This should be done immediately after extraction. 
In cases of caries of the teeth, the tooth can be filled by first scraping 



40 



DISEASES OF THE DIGESTIVE APPARATUS 



out the cavity with the dental cutter then disinfect the cavity by means 
of a plug of cotton soaked in creosote, and washed out with alcohol or 
ether and plugging it with amalgam, cement or gutta-percha. Hobday 
has described a case where an artificial tooth has been bridged between 
two teeth. In the United States this bridge-work and filling is done 
frequently. 

Dentition. — Newly born puppies do not have any teeth through the 
gums. The first or temporary incisors appear a])out the third or fourth 
week and the first permanent teeth appear about the fifth month. The 
temporary canines appear about the fourth or fifth week after the tempo- 
rary incisors are all in. The permanent teeth begin to come through 
about the third or fourth month; the lateral and middle incisors 
appear about the end of five months, and at the same time the second, 




Fig. 20. — Tumors of the gums. 

third, and fouth molars, the fifth molar about five months, the sixth 
about six months, and finally the seventh about the end of the seventh 
month, so that the dog has his full masticatory apparatus at the end of 
seven months. 

Change from the normal rotation of temporary to permanent teeth 
varies; sometimes the permanent teeth will come through the gums and 
push the temporary teeth to one side, but the latter remain in the jaw. 
This is particularly noticeable in the very small breeds. This is gen- 
erally avoided by pulling out the temporary incisors as soon as possible. 
Very frec;[uently this allows the permanent teeth to come through the 
gums at once and assume their normal position. This irregularity is 
particularly noticeable when the animals are affected with some acute 
infectious disease, such as distemper. 

During the process of teething, the gums become very red and in- 
flamed, and there is an increased amount of saliva; in some cases the in- 
flammation is intense, with complete loss of appetite. Convulsions may 



DISEASES OF THE TEETH 41 

occur from reflex nervous irritation. This nervous irritation may pro- 
duce a cramp of the lower jaw that is very similar to the paralysis of the 
jaw in rabies. 

These cases are best treated by simple sedatives, and if the gums 
seem to be tough, they should be lanced with an ordinary gum lancet, 
and thus assist the tooth to come through to the surface. 

Malformations of the Cavity of the Mouth. — Malformations or growths 
on the buccal membrane are frequently seen in the dog, located about the 



Fig. 21. — Wire ecraseur. 

edge of the gums and on the inner cheek. They are generally classed as 
epulides. They vary in size from a pin-head to a walnut. They are 
invariably pedunculated; very rarely they are seen with an extended base, 
irregular on the surface; they are, as a rule, hard and elastic and deep 
red in color; they may occur in various characters — fibroma, carcinoma 
or sarcoma. The author observed a melanotic sarcoma in one case. 
These epulides grow sometimes to be very large, pushing the teeth to one 
side, making mastication very difl&cult, and preventing closure of the 
mouth (see Fig. 20) . 




Fig. 22. — Warts of the mouth. 

These tumors can be removed by ecraseur of wire (Fig. 21) or by 
cutting them out with a probe-pointed bistoury. The hemorrhage can 
be checked by the thermo-cautery or by a solution of chloride of iron, but 
the hemorrhage is generally so slight as not to require any styptic. 
Loose teeth, or teeth that are firm but interfere with the removal and 
eradication of the tumor should be extracted. If the tumor is firmly 
attached to the bone or directly in the bone substance itself, the affected 
bone should be removed with the knife or bone forceps and scraped with 



42 DISEASES OF THE DIGESTIVE APPARATUS 

a curette so as to prevent, if possible, the recurrence of the growth; 
but frequently they return in spite of every precaution. 

Warts in the Mouth. — In young dogs, generally under twelve 
months, we frequently find on the lips, buccal membrane, and under 
the tongue numbers of papilloma; these sometimes occur in enormous 
numbers. These are small whitish-gray, pink or pinkish-black, wart- 
like proliferations (see Fig. 22). These growths are generally of little 
importance. They may appear in a few days and cover the surface of the 
mouth and disappear as rapidly as they appear. No. treatment is re- 
garded unless they are in such masses as to interfere with mastication. 
If so, remove the largest with a curved pair of scissors and dress the 
mouth with some astringent wash, and administer, liq. potassii arse- 
natis (Fowler's solution) internally in the food. 

Ranula. — Besides these tumors of the membranes of the mouth we 
find a growth called ranula. It generally occurs under or on the side 
of the ventral surface of the tongue and rarely painful to the touch, thin 
walled, and more or less cylindrical. Often an animal will become very 
slow in eating, and if the mouth is examined, we find on one side of the 
tongue and under it a large-sized body, varying from the size of the little 
finger to a chicken's egg, a fluctuating swelling, reddish-blue in color 
and when opened with a knife it is found to be filled with a thick creamy 
glue-like liquid (see Plate, page 42) . Many theories have been advanced 
as to the cause of this disease; some consider it to be the formation of an 
ordinary cyst and others contend it is due to the plugging of the ducts 
of one or more of the salivary glands at the base of the tongue. In some 
cases the cause of the trouble is due to the obstruction of the duct of 
Wharton, which has its entrance into the mouth at the base of the lin- 
gual ligament, and in other cases it is a cystoid degeneration of a few 
glands at the base of the tongue, probably due to a plugging of the open- 
ing of their ducts and a consequent inflammation of the glands themselves. 
It therefore seems best to call all the cystoid formations under the tongue 
ranula. 

It is always advisable to operate on these cysts; cut down on the 
cysts with a lancet and make a good-sized opening, and by mean-s of a pair 
of curved scissors remove a portion of the upper part of the wall and 
cauterize the inner w\alls of the cysts with the thermo-cautery or stick of 
caustic silver. If Wharton's duct is involved, be guarded in the cauteriza- 
tion, confining it only to the anterior part of the cyst toward the point 
of the tongue. The injection of pilocarpine, which has been used with 
success in man according to Soffintini's method, has been tried in ani- 
mals by Hoffmann. It consists in creating a great amount of the salivary 
secretion, and the force of the collected fluid from the inside breaks the 
obstruction of the duct. 




RANULA (salivary cyst of the tongue.^ 



DISEASES OF THE TEETH 



43 



Inflammation of the Salivary Glands. 

{Parotitis; Mumps.) 

Inflammation of the glands of the ear (parotiditis) appears either 
as a consequence of some mechanical cause, or by infection from the cav- 
ity of the mouth, from some existing inflammation of that part, as a 
disease, due to the presence of a micrococcus which develops in the saliva 
in the form of a diplostreptococcus or by direct infection from the blood 
itself in the form of a diplococcus or from metastasis (septicaemia, pyaemia, 
or^ in rare instances, distemper) . The latter requires special mention as 




Fig. 23. — Glands of the head: 1, parotid gland; 2, submaxillary gland; 3, subzygomatic gland; 4, 
Wharton's duct; 5, Bartholin's duct; 6, palatine gland; 7, orbital gland; 8, Nuckian duct; 9, lachrymal 
gland. 

a primary idiopathic parotitis (mumps). The writer has frequently 
seen the gland in the region of the ear affected, more rarely the glands 
of the lower jaw, and, least of all, the glands of the eye. 

Etiology. — This disease is rather rare in the dog, but sometimes it 
may take the form of an epizootic (Hertwig, Schussele). In these cases it 
is probably due to some infecting virus that gets into the gland through 
Steno's duct. The exact nature and time of incubation of this disease 
are not known. 



44 DISEASES OF THE DIGESTIVE APPARATUS 

Symptoms. — The disease begins with a swelling of the gland and 
the adjacent structures on one side or both sides of the ear. The loca- 
tion of these glands is seen in Fig. 23. They swell rapidly and are very 
tender to the touch, changing the whole appearance of the head and 
neck. The animal is very droopy, carries the head and neck in a fixed 
position, eats with great difficulty, and will swallow only very small 
pieces. The saliva is very thick and forms tenacious bubbles at the 
corners of the movith. The fever is seldom high, and in the majority of 
cases in from five to eight days the swelling decreases and disappears 
entirely in fourteen days (Hertwig). 

In rare cases an abscess is formed in the gland, (abscess of the parotid,) 
and invariably in one only. The gland swells as in mumps, only is much 
quicker and surrounding tissues are much swollen and oedematous, 
8oon a fluctuating portion is felt, which later opens in one or more 
places and a thick, creamy pus escapes; the oedema of the surrounding 
tissues disappears quickly, and the fever, which is rarely of much conse- 
quence, goes down entirely and the wound closes in a short time. 

The inflammation of the glands of the tongue and lower jaw gen- 
erally forms abscesses which open in the month, the pus escapes, and the 
sore heals up in a short time. The submaxillary generally breaks 
through the skin and the sul^lingual into the cavity of the mouth. There 
is never any consequence in any of these cases. 

Therapeutics. — In the primary form of parotitis, where we do 
not have the formation of an abscess, we obtain good results with warm 
applications. Keep the animals as quiet as possible, and then rub on 
ointments, such as vaseline and lanoline, or paint with tincture of iodine. 

As soon as we see that the swelling is not going down within a cer- 
tain time, but increasing gradually, we must try and open the abscess 
as soon as possible and allow the pus to escape. If fluctuation can be felt, 
cut down on that point, but if not, a portion of the skin and fascia have 
to be carefully cut in the dependent portion, making a good-sized 
opening. The gland is now exposed, the pus can be detected and opened, 
a drainage-tube inserted and sewed to the tissues — if not sewed, the 
animal will shake it out — and cleanse daily with an antiseptic solution. 
It is better not to bandage the neck, as it interferes with the tube; in 
some cases it is not necessary to insert the tube, but to clear the 
opening daily and dilate it, if necessary. These abscesses heal rapidly if 
there is exit for the pus. 

Inflammations of the other salivary glands should be treated in 
the same way. The abscess of the sul)maxillary should be opened from 
the outside through the skin, and sublingual from the inside of the mouth 
cavity. In the submaxillary, it is not necessary to put in a drainage- 
tube, but simply to keep the wound clean. Frequently we have develop- 



DISEASES OF THE TEETH 45 

ing in this region intense localized inflammations and great oedema from 
traumatisms, such as fights, blows or contusions. The swelling may 
extend to the head and neck (Fig. 24). The treatment in such cases 
consists in making a free opening to allow the pus to escape and heal it 



Fig. 24. — Abscess of the neck. CEdema of the right side of the head. 

as an open wound or dress it with an antiseptic held in place by means 
of a Priessnitz compress. 

Occasionally we find cysts form in the glands of the tongue. These 
were first described by Siedamgrotsky as honey cysts. They are seen 
on the lower side of the mouth in the region of the larynx, and are covered by 
the muscles of the neck; or they may be on both sides of the larynx and 




Fig. 25. — Mucous cyst. 

appear as a conglomeration of small, crowded vesicles with thin, coarse 
walls filled with a thick, honey-like fluid (see Fig. 25). In some instances 
it is very thick, like cheese, and yellow or reddish. They originate in 
the glands of the tongue, and as the cyst walls extend into the tissue of 
that organ they must be classed under the head of ranula. 



40 DISEASES OF THE DIGESTIVE APPARATUS 

In treating these cysts the only practical method to pursue is to 
remove them entirely, for if they are simply cut into they return in a 
short time; but to cut out entirely a cyst located in this region is a rather 
dangerous operation, as the base of the tongue and the region of the 
larynx contain a large number of important blood vessels and nerves 
and even if the entire cyst is removed, we may injure the submaxillary 
gland, causing a salivary fistula that is impossible to heal. Consequently 
it is only advisable to attempt to remove the smaller cysts; the larger ones 
can be treated in the following manner: Make an incision into the cyst, 
then inject into it some mild corrosive such as diluted tincture of iodine, 
a weak solution of corrosive sublimate, or Lugol's solution of iodine. These 
sohitions act as irritants to the walls of the cysts, break them down, and 
destroy the secreting membrane and they soon heal up; the cicatricial con- 
traction draws the tissues together and only a trace is left. Another method 
is to use an aspirator or ordinary syringe, draw off the contents of the cyst, 
and inject into the cyst a 3 to 5 percent, dilution of Lugol's solution, in- 
jecting an amount equal to the original contents of the cyst. The object 
of this injection is to stimulate the formation of pus in the sac. If it does 
not produce the desired effect, inject it again. After the pus has formed, 
make a long incision through the cysts and treat it as a simple surgical 
wound. Frick advises after opening the cyst to cauterize it with the thermo- 
cautery and sew up the opening. This causes that portion to slough off, 
and the wound to heal by granulation. The method suggested by Siedam- 
grotsky has been very satisfactory to the author. It consists of making 
a good, big opening in a dependent part and injecting the parts freely 
with mild caustic solutions, such as caustic potash or tincture of iodine. 

Inflammation of the Mucous Membrane of the Throat. 

{Pharyngitis; Angina Catarrhalis; Sore Throat.) 

This disease in the dog is not by any means as important as it is in 
man, and as yet there have not been recognized any cases in the dog that 
could be compared with diphtheria, angina tonsillaris, and retropharyn- 
geal abscess of man; at least such is the experience of the writers. The 
general affections observed have been common catarrhal inflammations 
which involve the whole or part of the throat. 

Etiology. — The same causes that would produce stomatitis would 
bring on inflammation of the throat. The most common cause of angina 
catarrh is a continuation of the inflammatory processes from the neigh- 
boring organs; for instance, in catarrh of the nose, or in laryngitis, and it 
may appear as a complication of distemper and stomatitis. The chief 
cause is cold, particularly in hunting dogs, such as setters or pointei-s 
getting wet, when very warm, plunging into very cold water, or in house 
pets that run from very warm rooms into the cold and lie on cold bricks 



DISEASES OF THE TEETH 47 

or flag stones. This disease is very much more common in winter than 
summer and is more frequently seen in small or particularly fine bred 
delicate animals. Friedberger and Frohner describe an epidemical 
infectious pharyngitis that affects young animals when they are from 
one to two wrecks old, and sometimes goes through an entire kennel, 
attacking all ages. 

Pathological Anatomy, Clinical Symptoms and Cause. — The changes 
of the mucous membranes of the pharynx and soft palate are the same 
as are recognized in all catarrhal inflammations. The mucous mem- 
brane is a diffused red, sometimes spotted, and coated with a dirty 
yellow mucus, giving it a dull glairy appearance. The membrane puru- 
lent on its surface, except in very grave affections, when especially on 
its tlorsal surface there may be seen a number of small, irregular gran- 
ulations. As a rule, if the inflammation is at all severe, the tonsils 
are also swollen and protrude out of their membranous pouches in the 
shape of brownish-red enlargements, and occasionally the subparotid 
glands may be involved by the formation of an abscess. We very rarely 
see any fibrinous (croupal) membranes in any of the severe inflamma- 
tions of the throat. 

Clinical Symptoms. — The clinical symptoms of catarrh of the throat 
are similar to acute stomatitis, and it is only by making a careful exami- 
nation of the throat that we can make a correct diagnosis. In more 
severe cases, beside increase and alteration in the saliva, which is thick 
and tenacious, on manipulation in the region of the pharynx, it is pain- 
ful. The subparotid lymph glands also are swollen and painful, and 
there is a certain stiffness of the neck. The mucous membrane of the 
pharynx should be examined and its changes from the normal considered. 
The author has found, as a rule, that catarrh of the stomach accompanies 
all these cases. Catarrh of the nasal passages and pharynx, and slight 
fever is also seen in these cases, and in rare instances vomiting. The 
course of the disease, as a rule, is favorable, but Frohner says if the in- 
flammation of the pharynx extends into the Eustachian tube it may cause 
deafness. Chronic pharyngeal catarrh is rarely or ever seen, but some- 
times an ordinary case of catarrh of the pharynx may last three or four 
weeks and cases have been known to recur from time to time* 

Therapeutics. — First examine the larynx and see if there are any 
foreign bodies present. This can be done by forcing open the mouth and 
by means of a spoon handle or a spatula the tongue is depressed and the 
fauces examined. Always be sure, however, to determine that the animal 
is not suffering from dumb rabies. In these cases the owners are very apt 
to imagine the animal has something stuck in the throat or eaten some- 
thing that is poisonous. In a mild case give the animal milk, thin soup 
bouillon; in more severe cases, an external liniment, such as camphorated 



48 DISEASES OF THE DIGESTIVE APPARATUS 

oil or soap-linimcnt, .should be rubbed on the throat or the mouth held 
open and by means of a brush or an atomizer sprayed directly on the 
throat; apply such astringent and antiseptic throat washes as lime water, 
tannic acid 1 to 3 per cent., potassium chlorate of borax 2 to 3 per cent, 
solution. In more acute or chronic cases, wash the mouth out with a 
solution of permanganate of potassium, boric or salicylic acid, or paint 
the throat with nitrate of silver, 1 to 2 per cent., or tannite of glycerine, 
5 to 10 per cent. 

DISEASES OF THE (ESOPHAGUS. 
Foreign Bodies in the (Esophagus. 

The foreign bodies that become fixed in the pharynx or oesophagus 
of the dog in play or by gulping down their food as fast as possible, if an- 
other animal is near, are numerous and varied; they consist of portions of 
food, such as hard, irregular-sized pieces of meat that have been taken in 
one gulp; long, sharp pieces of bone, such as mutton or fish, pieces of wood, 
needles, or small stones; sometimes objects are swallowed by accident, 
such as stones, buttons, glass, or india-rubber balls, corks, etc., and lodged 
in the pharynx at the entrance of the oesophagus; or if the object is small, 
it may go a certain distance into the tube and lodge there. 

The symptoms may come on very suddenly and vary according to the 
general character and position of the foreign body. As a rule, the animal 
is restless and keeps the head and neck extended; it scratches itself on the 
throat with the paws over the spot where the obstruction is located. If it 
is in the pharnyx, the animal shows signs of choking or may vomit, from 
time to time, small quantities of mucus and saliva, which is dirty and 
frothy and may be stained with blood, and later pieces of undigested food 
which in the later stages becomes foetid. It coughs frequently, and if the 
obstruction is large, it refuses to eat or drink. If water is forced on the 
animal, it passes down the throat very slowly and evidently with diffi- 
culty, or may be vomited immediately after it is swallowed. If the 
foreign body is in the oesophagus, it may be felt externally with the finger 
or, opening the mouth and depressing the tongue, it may be seen lodged in 
the pharnyx; if it is in the cervical portion of the oesoiDhagus, it can be de- 
tected by making a careful examination along the course of the tube or by 
the probang introduced into it, as has been described on page 17. The 
latter method is the only way to positively determine the presence of a 
foreign body when it has lodged in the thoracic portion of the oesophagus. 
In introducing the probang it must be carefully inserted, and if it should 
come in contact with the foreign body too great pressure must not be made 
on it, as it is apt to pack the object more firmly or even cause perforation 



FOREIGN BODIES IN THE (ESOPHAGUS 49 

of the tube, "When making an examination of the tube externally, should 
we find a part that is painful, we must not consider it the obstruction un- 
less we find a hard swelling with it, as foreign bodies such as sharp splin- 
ters of bone or wood often go down the tube, lacerate the mucous mem- 
brane in its passage, and do not become imbedded. Needles, pins and 
small pieces of wood may not be detected, even with the probang; in such 
cases the Rontgcn or X-ray can be used to detect objects of certain den- 
sity, such as metals, coins, etc., with the greatest certainty. 

The object, if it goes into the stomach, passes through the intestines 
and is passed through the rectum and causes no further trouble. Some 
authors have observed needles passed per rectum in the faeces. It may, 
however, lodge in the stomach and cause irritation and finally convul- 
sions and death. If it is a sharp body, it may perforate the stomach, even 
find its way out again by perforating the abdominal wall. If it is in the 
thoracic portion of the tube, it may penetrate the wall, cause an abscess 
and escape, or it may penetrate the wall of the thoracic portion and set up 
septic pleuritis and result fatally. It is also probable that death may 
occur from the foreign bodies if they are sharp, by penetrating either the 
heart or one of the large blood vessels in the vicinity, and causing a hemor- 
rhage, or it may also occur from septic inflammation of the oesophagus. 

Therapeutics. — The treatment differs according to the character and 
situation of the foreign bodies. If the foreign body is in the pharynx or at 
the entrance of the oesophagus, it must be removed immediately either 
with the finger or a pair of curved forceps. If the obstruction is located 
in the lower portion of the tube, and it cannot be pushed down into the 
stomach with the probang, it is advisable to attempt to get it up by an 
emetic — a subcutaneous injection of apomorphia muriate, as per page 21. 
If that is not successful, then perform oesophagotomy as soon as possible, 
before the intense swelling interferes with the operation. If this opera- 
tion cannot be performed on account of the foreign body being situated 
too deeply in the thorax, it is best to give the animal small quantities of 
lubricating substances, such as olive oil or any fatty oil. It is better to do 
this than to use any great force to push the object into the stomach. If 
the foreign body goes so far into the oesophagus that it lodges in the cardiac 
portion of the stomach and by manipulation it can be detected, gastrec- 
tomy can be performed and the foreign body removed in that way. 
Porcher and Morey performed this operation successfully. 

In very rare instances we also find an inflammation of the oesophagus 
(oesophagitis) , with or without any ulceration. In the latter case it is due 
to the irritation of caustic poisons or lacerations of the foreign bodies 
going down the tube. This is best treated with lubricating oils, such as 
almond or sweet oil. We may see, occasionally, a constriction of the 
oesophagus (stenosis oesophagi) or a dilation (ecktasia and diverticulum), 
4 



50 DISEASES OF THE DIGESTIVE APPARATUS 

but these conditions are impossible to improve by any surgical means that 
we know of at present. 

OEsophagotomy. — This is not a very difficult operation to perform in a 
dog. The animal is laid on his right side, and if not too weak, is narco- 
tized or the locality sprayed with chloride of ethyl. The oesophagus is 
now exposed and examined to see if any portion is gangrenous from the in- 
j ury . After having shaved off the hair, and washed the surrounding tissues 
with antiseptics, the foreign body is located, and an incision is made in the 
skin parallel with the jugular vein and over the foreign body. The incision 
is now carried through the subcutaneous tissues and muscles, and the 
oesophagus is exposed. Where the foreign body is located in the lower por- 
tion of the cervical region, the incisions can be made on the median line 
and by separating the muscles the oesophagus which lies on the left side 
of the trachea can easily be distinguished. The incision made in the 
oesophagus should only be large enough to allow the removal of the foreign 
body. After the extraction of the foreign body, the wall of the oesopha- 
gus should be sewed up with cat-gut, and the muscles sewed with silk 
and the skin either left open or a drainage-tube placed in it. The ojxjning 
is then treated as an ordinary wound. No food must be given for 48 
hours, then only water or milk. The animal should be kept on liquid food 
for at least two weeks. When a large portion of the oesophageal wall is 
lost, that which is sloughed from necrosis, and the edges of the wound in 
the oesophagus cannot be brought together, the case is hopeless. 

Other Diseases of the (Esophagus. 

In very rare instances we find inflammation of the oesophagus (oesoph- 
agitis) . In this case it is due to the action of caustic poisons or a lacer- 
ation cavised by foreign bodies going down the tube or from foreign bodies 
becoming imbedded in the tube for a time and then dislodged, l:)y injuries 
to the wall from the probang, and in still more rare instances from swallow- 
ing hot or scalding food, by spread of inflammatory process from the 
pharynx, or the presence of parasites (spiroptera). Oesophagitis is recog- 
nized l)y great salivation, difficulty in swallowing, attempts at or true 
vomiting and great pain shown by the animal on manipulation of the 
oesophagus. The treatment consists in giving liquids, gruel or rice water 
and in severe cases, small pieces of ice at frequent intervals. 

Obstructions of the (Esophagus. 

(Ste nos is Q^suphagus . ) 

This may result from the subsequent irritation and cicatricial contrac- 
tion of the wall as a result of laceration by a foreign body. Occasionally 
we may find malformation of the wall by an inflammatory process of the 
same, from cyst formations, due to presence of spiroptera sanguinolenta, 




SPIROPTERA SANGUINOLENTA {encysted in the oesophagus.) 



PARALYSIS OF THE (ESOPHAGUS 51 

which grow between the muscles and muscuhir coat of the oesophagus 
(see Fig. 26 and Phite), or by a compression stenosis, from malignant 
goitre, and still less frequently by cicatricial contraction as a result of 
injuries, inflammations, etc., in the cervical region. The symptoms of 
such injuries have been already described on page 49. In cases where 
the stenosis gradually develops, the animal has more or less difficulty 
in swallowing. This becomes more and more difficult until finally food 
collects in a sausage-like mass, against the constriction. Examination 
by means of a probang makes a diagnosis more certain. The successful 
treatment of such a condition can only be expected if the cause is due to 




Spiroptera Sanguinolenta. 



the obstruction of the oesophagus by foreign bodies or the removal of 
tumors if they should be the cause of compression in the region of the 
oesophagus. 

Dilatation of the (Esophagus ; Ectasia and Diverticulum. 

This has been described liy a number of authors and is indicated by 
great difficulty in swallowing, vomiting, etc. If the dilatation is in the 
cervical region, along the line of the oesophagus, we find round elongated 
lumps, varying in size, and by manipulation this collection of food can be 
worked down into the stomach. The probang may be used to start it. 
Great care, however, should be taken not to use too great force, as it will 
only pack the food and fix it. The prognosis, as a rule, is unfavorable, 
but if the animal is kept on liquid food exclusively, it will li-^e for a long 
time. 

Paralysis of the CEsophagus. 

{Dysphagia Paralytica.) 

This is due to the paralysis of the nerves that supply the region of the 
neck, seen particularly in conjunction with paralysis of the larynx. 
It may occur as a result of certain brain diseases, from certain poisons, 
from intestinal mycosis, and also as a symptom of rabies. It is recognized 
by constant dribbling of saliva from the mouth. The animal may make 
efforts to drink water, but while the movements of the muscles of the neck 
would lead you to think the animal was doing so, on close observation of 



52 DISEASES OF THE DIGESTIVE APPARATUS 

the vessel from which the animal was drinking, it shows little or no 
diminution in the contents. 



DISEASES OF THE STOMACH. 

Acute Catarrh of the Stomach. 
Gastritis Catarrhalis; Gastricismus; Acute Dyspepsia. 

Etiology. — The following are generally the causes of this very common 
disease: hot, frozen, fermenting or decaying alimentary matters, over- 
feeding or gorging after a long fast, foreign bodies, such as sand, stones, 
buttons, splinters of w^ood, and undigestible food that is not adapted or 
intended to be eaten by dogs, and also from the presence of parasites. 
As regards toxic gastritis, that will be taken up later on. We find also 
that some diseases, such as distemper, some affections of the liver, and 
intestinal catarrh have acute gastritis accompanying them. Very often 
acute catarrh of the stomach is developed from simple colds, or clipping 
the animal, too frequent bathing, and not drying it properly. 

Pathological Anatomy. — The mucous membranes of the stomach are 
hyperaemic and swollen; the folds of the membranes are distended and 
covered with a thick tenacious mucus. At times there are seen small, 
hemorrhagic erosions on the membrane. 

Clinical Symptoms. — The first symptom of acute catarrh is loss of 
appetite. The animal will be very dainty and pick out certain pieces, 
generally meat, and eat them slowly, or, as is generally seen, refuse food 
altogether. The animal is always very thirsty, drinking large quantities 
of water. The animal vomits frequently, especially after eating or drink- 
ing, but may vomit without anything on the stomach. If after eating, it 
consists of masses of undigested food mixed with a tenacious mucus and 
saliva; if after drinking water, the water is tenacious and forms bubbles of 
thick mucus — this may be streaked with blood or more or less tainted 
with bile, according to the condition of the liver. The tongue is coated 
with a thick, white mucus and on pressure in the region of the stomach 
the animal evinces pain, and the stomach may be distended with gas (see 
page 20). The animal is irritable and wants to keep in the dark or 
in cool places and not be disturbed, or may give sharp short cries, 
change from place to place, and give every indication of stomachache. 
The nose is dry and the body temperature uneven, that is, body hot, ex- 
tremities cold, and there may be some rise of temperature. If the symp- 
toms are of an alarming character, they are generally caused by some 
toxic condition, due to the formation of poisons, generated in the 
stomach (ptomains). With this we have a putrid smell from the mouth, 
great depression, or even complete coma, and evidences of acute narcotic 



CHRONIC CATARRH OF THE STOMACH 53 

poisoning. See chapter on Mycotic Stomatitis, Catarrh of the Intestines, 
and Inflammatory Hemorrhagic Gastro-cnteritis. 

There are always some intestinal complications. There is increased 
excretion of faeces, generally diarrhoea, and occasionally icterus of a 
catarrhal nature. The animal, as a rule, makes a good recovery. In 
very rare cases the condition becomes chronic, but death never occurs 
except where some complication other than true catarrh of the stomach, 
is present. 

Therapeutics. — The treatment differs according to the exciting cause, 
and also the severity of the symptoms. If the cause has been the eating 
of some putrid matters and if you suspect some to be present in the stom- 
ach, it is best to give the animal an emetic, such as the hypodermatic in- 
jection of apomorphia, as described on page 21; such emetics as tartar 
emetic, ipecacuanha or antimonial wine are not advised, they are all 
very depressing. After the animal vomits and the vomited matter is 
putrid and offensive matter, it is well to give the animal 8 to 10 ounces 
of warm water with a small cjuantity of bicarbonate of soda in it. It is 
good practice to add a little creolin to the warm water. If it is not ad- 
visable to administer emetics in such cases where the animal is greatly 
depressed, calomel or Glauber salts can be given to sweep the intestinal 
tract. Keep the animal on a low diet in the beginning; let the animal 
do without food for a day, and then give small cpiantities of milk or 
finely cut-up meat, soup, or beef tea, a stomachic, such as tincture of 
rhubarb or nux vomica in small doses; if there is vomiting, carbonate 
of sodium or magnesium is to be given in small doses several times 
daily. Essence of pepsin is also useful to settle the stomach; it must 
be given in teaspoonful doses three times daily. 

Chronic Catarrh of the Stomach. 
Gastritis Catarrhalis Chronica; Chronic Dyspepsia. 

Etiology. — Chronic dyspepsia is rather common in the dog, especially 
if the aninuil has had several attacks of acute dyspepsia. It may also ap- 
pear as a secondary complication of various diseases, such as chronic dis- 
ease of the liver, lung or heart, cancer of the stomach, gastric tumors, and 
parasites. 

Pathological Anatomy. — The mucous membrane is covered with a 
tough, glassy mucus, dirty-white in color. In the early stages the 
mucous membrane is red, and as the disease continues the membrane 
becomes dark gray in color, due to pigment stains and more or less swol- 
len, especially if the gastric glands become atrophied and indurated 
from the constant irritation. 

CUnical Symptoms. — They are similar to those of the acute catarrh 



54 DISEASES OF THE DIGESTIVE APPARATUS 

of the stomach; Init the appetite, while it may be very irregular, is not en- 
tirely absent — one day very good and the next absent. Vomiting oc- 
curs generally a short time after eating, and consists of undigested food 
covered with quantities of tough, glassy mucus, sometimes streaked with 
blood, and the tongue is more or less coated. There is pain on pressure in 
the region of the stomach, especially after eating, although this is not a con- 
stant symptom by any means. The animal becomes thin and shows every 
S3^mptom of poor nutrition. 

We must always take into consideration that the mere loss of ap- 
petite does not always mean acute or chronic catarrh of the stomach, but 
is a symptom present in a number of pathological conditions, and every 
symptom must be carefully examined before coming to a definite 
conclusion. 

Therapeutics. — The washmg out of the stomach, so often resorted to in 
man, is fully explained on page 21. This treatment is not to be employed 
in all cases of this disorder; for in some cases it produces great irritation, 
and if persisted in does more harm than good. Try to get the animal to 
drink small portions of water, Avith some lime water in it, at frec|uent in- 
tervals; if it will not drink, pour fresh water down its throat; in 
anaemic animals, use tepid water, with a small ciuantity of a solution of 
bicarbonate of sodium, a pinch or a teaspoonfid of Carlsbad salt, in warm 
water, on an empty stomach. Hydrochloric acid well diluted can be 
given after meals and the treatment described on page 53. In very 
acute cases give naphthaline, salic3'lic acid, I'csorcin, menthol, or thymol. 
As a rule, however, it is advisable not to do this unless you suspect some 
irritant or poisonous material to be present. If the chronic catarrh 
occurs as a result of other diseases, we must treat the original cause, 
as very frequently when the other disease is treated successfully, the 
gastric mucous membrane returns to its natural condition without any 
other treatment. 

I> Extract! rhei; 2.0 

Sodii bicarhouatis, 100.0 

M. 
Sig. — A small pinch twice daily. 

I^ Mentholis, 2.0 

Sacchari lactis, 

Guinmi arahic, aa 1.0 

M. Et fiat pulv., No. x. 
Sig. — Give one twice daily. 

Other Disorders of the Stomach. 

Expansion or Dilatation of the Stomach (Gastrectasis , Dilatatio Ven- 
tricuU) . — This condition may occur in the acute or chronic form. In acute 
it is due to overloading the stomach with dry food and particularly when 



OTHER DISORDERS OF THE STOMACH 55 

the food is of a poor indigestible character. If the stomach is not 
emptied by an emetic, the abdomen becomes greatly distended, particu- 
larly in the epigastric region. The animal is restless, moving from one 
place to another, the expression is haggard and indicates pain, there is 
quick catchy respiration, and the pulse greatly increased in number. 
In severe cases the animals die with dyspnoea. In less acute cases the 
animals slowly recover or it is followed by an attack of acute gastric 
catarrh. 

The treatment consists in administration of an emetic, such as a 
hypodermic of apomorphia. 

A chronic dilatation of the stomach is frequently seen in dogs that 
are fed on poor food and in animals that gulp down their food, partic- 
ularly when they are only fed once daily. It may also occur from contrac- 
tion of the pyloric end of the stomach or duodenum, from cicatricial con- 
traction, the presence of carcinoma, or from weakness of the walls of the 
stomach; this latter condition is rarely seen. In chronic dilatation of 
the stomach there are all the indications of chronic catarrh with more or 
less distention of the abdomen, particularly in the epigastric region. 
On percussion of the region of the stomach a dull tympanic sound is 
heard, which disappears when the animal eats any food; then palpation 
of the stomach produces a splashing sound. 

The treatment consists in giving the animal smaller quantities at 
shorter intervals and the same medical treatment as is advised under 
chronic dyspepsia. If it is suspected or diagnosed that there is pyloric 
stenosis, you should try to remove it by surgical means. 

Reversion or Inverted Stomach, Torsio Ventriculi, Volvulus Ventric- 
uli. — This is observed where the stomach is turned on its axis and, as a 
rule, occurs in the larger breeds of dogs. The stomach is completely re- 
versed, so that the pyloric end is found in the left epigastric region instead 
of the right, and the large curvature, instead of being on the left, is found 
on the right and the oesophagus has a twist in it. On making an ab- 
dominal incision the stomach is found to be greatly distended and the 
spleen is greatly enlarged. The causes that may produce this condition 
are violent exercise, particularly running up and down steps with an 
empty stomach (Cadiac) , or the same exercise with a greatly distended 
stomach (Jensen) . The symptoms come on very quickly, great distention 
of the abdomen, dyspnoea, cyanosis, pain on pressure of the region of the 
stomach, colicky pains and vomiting. Death generally occvirs in from 30 
to 40 hours, either by suffocation or paralysis of the heart. The treat- 
ment recommended by Cadiac is to gradually remove the gas from the 
stomach by means of a trocar and opening the abdomen and returning 
the stomach to its original position. 

Foreign Bodies in the Stomach. — By this we mean stones, glass, 



56 



DISEASES OF THE DIGESTIVE APPARATUS 



balls, pieces of money, rubber balls, needles, hair balls. These produce 
the following symptoms: vomiting, loss of appetite, restlessness, animal 
screaming with pain or howling, animal attempts to bite all who touch 
him, colic and in the later stages great depression; where foreign bodies 
become lodged in the pyloric portion of the stomach (see Fig. 27) there 
may be no other symptom than acute catarrh of the stomach. We may 
detect the foreign bodies by palpation or by means of the Rontgen or 
X-rays. 




Fig. 27. — X-ray picture of coin in the stomach. 



Therapeutics. — If the foreign body is diagnosed, give an emetic. 
Moller advises giving a good meal before the emetic is administered so 
as to assist in holding the foreign body when the emesis occurs and this 
prevents it doing any harm to the tissues. If the emetic does not succeed 
in removing the foreign body, laparogastrotomy must be performed. 
This is described in detail under that head later. In performing that 
operation for this particular case, the incision should be made on the linea 
alba close up to the xyphoid cartilage and thus bring the incision close 
and parallel to the great curvature of the stomach; or, as Frick advises, on 
the diaphragmatic position of the stomach directly on the great curva- 
ture. In this operation, great care must be taken not to cut any of the 
large arteries of the stomach, which are located on the great curvature. 



OTHER DISORDERS OF THE STOMACH 57 

The animal must be fed on the lightest of liquid food for at least a week 
after the operation 

Ulceration of the Stomach (Ulcus Ventriculi). — When bleeding occurs 
from the stomach as the result of some acute inflammatory condition of 
that organ, it always leaves an erosion of the mucous membrane. As a 
rule, this heals up very rapidly in the dog, rarely leaving any cicatrix on 
the membrane; abrasions of the mucous membrane from sharp pieces of 
bone, splinters, or caustic agents also heal up very rapidly. 

Ocasionall}^, however, we see true ulceration of the stomach. The 
real cause of this condition has not yet been satisfactorily explained, 
although many investigations have been made on the subject. 

The ulcer in the beginning is an inflamed circular spot, from which 
the mucous membrane peels, and gradually disappears, extending to the 
deeper tissues where it forms a yellowish-red, unhealthy surface, with an 
irregular, hard, indurated border. Very often they heal up, leaving an 
irregular cicatrix, usually circular in shape. 

In the dog, as in man, we find that in rare instances the ulceration is 
so extensive as to perforate the stomach to the serous membrane and 
form adhesions to the adjacent organs. 

This condition may be present without presenting any symptoms 
that can be recognized, and it is only on post-mortem that it is rec- 
ognized, either by the presence of the ulcer, or a cicatrix is seen on the 
mucous membrane of the stomach. The symptoms recognized are 
generally those of gastric catarrh, with vomiting of blood at irregular 
intervals. The treatment consists in administering bicarbonate of 
sodium, argenti nitras or, better, some of the organic compounds of 
silver, or subnitrate of bismuth is useful, but the use of hydrochloric 
acid or a stomach-pump is contraindicated. 

Cancer of the Stomach : Carcinoma Ventriculi. — Cancer of the stom- 
ach is very rare. Symptoms consist of irregular attacks of gastric catarrh 
with possibly vomiting and gradual loss of flesh, and if the carcinoma is 
located in the pyloric end of the stomach, we would be apt to find pyloric 
stenosis and dilatation of the stomach. Eberlin describes a case in which 
a carcinoma was present in the pylorus and duodenum and accompanied 
with acute icterus. It is almost impossible to detect with any degree of 
certainty such a cancer by palpation. Parascandolo performed gas- 
trectomy and removed a cancer from the stomach with complete success. 

Parasites of the Stomach. — The spiroptera sanguinolenta is fre- 
quently the cause of stenosis of the cesophagus (see Fig. 20 and Plate). 
In the adult form this parasite is from 3 to 7 cm., the male 3 to 4 and the 
female 6 to 7 cm., and are blood red in color. They may be solitary, or 
several may occur in one ulcer. This nodule is frequently the size of a 
pigeon's egg. The parasite is found in the submucous tissue with a 



58 DISEASES OF THE DIGESTIVE APPARATUS 

small opening into the stomach. In rare instances, this parasite is found 
in the bronchial glands, the aortic wall, in the lungs, and in the neighbor- 
hood of the kidneys (Railliet). The general symptom of these parasites 
in the stomach is a catarrh of the stomach, gradual emaciation and 
sometimes great restlessness. Hunter describes a dog who was greatly 
emaciated and was destroyed as suspected of having rabies. On post- 
mortem, the mucous membrane of the stomach was very much congested, 
and he found six nodules the size of a walnut, in which there were 
numerous spiroptera sanguinolenta. 

Very rare instances are found where the larvae of the Gastrophilus 
equi are found in the mucous membrane of the dog. The egg may have 
been deposited in the hair of the dog, and by being licked off by the 
animal, reached the stomach or, from depraved appetite, the animal ate 
horse droppings. This mode of transfer was done experimentally by 
Railliet. 

DISEASES OF THE INTESTINES. 

Intestinal Catarrh. 

(Catarrh of the Bowels; Enteritis Catarrhalis.) 

Catarrh of the intestines originates freciuently from the same causes 
as catarrh of the stomach, when the animal has eaten some irritating sub- 
stance, and it frequently happens that the two diseases occur together. 

Intestinal catarrh is generally caused by the animal eating decayed, 
tainted, fermenting, or indigestible food, or from intestinal parasites or 
poisons. It also appears in an infectious form, attacking entire kennels 
and animals of all ages. It is freciuently caused by cold or certain in- 
fectious diseases and sympathetically in other disturbances of the in- 
testinal tract, such as distemper, septicaemia from disturbances of the 
circulation and from disorders of the liver, lungs, heart. Coccidia are 
supposed to cause this disease, but the waiter never found but one case 
in all his observations; in this one case the animal was greatly emaciated. 

According to the duration and severity of the disease, we determine 
whether we have acute or chronic catarrh of the intestines. The acute 
form of the disease lasts from one to two weeks; the chronic often for 
months. 

Etiology. — The causes of acute and chronic catarrh in the intestines 
are similar; the latter is frequently developed from the acute form and 
from frequent return of the disease, the system becomes weakened and 
the disease remains in a milder, but chronic form. 

The disease may be located cither in the small or large intestines, or 
in both. The small intestine is the common seat of the disease, but it is 



INTESTINAL CATARRH 59 

frequently found also in the large intestines. The various classifications, 
such as duodenitis, jejunitis, ileitis, typhlitis, colitis and proctitis, are 
useful only to the anatomist, but not to the observer. Proctitis is fre- 
quently seen in the dog in an isolated form. This is given with more 
detail on page 25. 

Pathological Anatomy. — The effects of catarrh of the intestines are 
practically the same as in all irritations of the mucous membranes. In 
the acute form, the membranes may be swollen and reddened through the 
entire intestine, or it may be confined to certain localities, where it is 
reddened and congested, and the membrane raised and covered over its 
surface with flaky, slimy epithelium. In very bad cases there is a large 
number of these epithelial masses, with desquamation of the mucous 
membrane. These masses of inflamed follicles become grayish-white 
in color and project from the membrane or finally become ulcerated. In 
some diseases, where there is severe catarrhal inflammation of the mucous 
membranes, we find a sympathetic inflammation of the intestine, in 
some cases even a necrosis from which follows ulceration of the bowel. 
The writer had one case under his observation, where a young dog died 
from a necrotic vdceration of the bowels. 

In the chronic form, the redness is less intense; the mucous mem- 
brane may even be pale or livid, grayish-red or dark red in color. In rare 
cases it is slate color. The swelling is more regular and covers a larger 
area, forming a true hyperplasia of the membrane; the inner surface 
of the bowel becomes irregular and uneven w'ith projections over the 
entire surface. In some cases the membrane shows true polypous forma- 
tions, due to circumscribed hyperplasia of the connective tissues. AVhere 
there has been cystoid degeneration of the follicles, the intestinal secre- 
tions are stopped entirely and the mucous membrane is thin and smooth. 

Clinical Symptoms. — The most prominent symptom of intestinal 
catarrh is diarrhoea, especially if it is confined to the large intestine, 
although there may l)e no diarrhoea whatever if the inflammation is con- 
fined to the small intestine, as it is well known that the absorption of the 
fluids and the formation of the faeces are confined to the large intestine, 
and we often find intense inflammation of the small intestine with pro- 
fuse diarrhoea without having the large intestine affected whatever. 
On the other hand, we often find inflammation of the rectum and no 
diarrhoea at all. 

In making a diagnosis it is well not to identify too closely diarrhoea 
and catarrh of the intestines — that is, consider each case of diarrhoea as 
being due to catarrh of the bowels — as there are many conditions that 
increase the peristaltic action and cause diarrhoea that are not directly 
due to inflammation, such as cold or a sudden chill, to an animal that has 
been kept warm, to poisonous substances, from the administration of 



GO DISEASES OF THE DIGESTIVE APPARATUS 

laxatives or cathartics, or great exertion in an animal, not accustomed to 
it. It is, however, impossible to draw a distinct line between intestinal 
catarrh and diarrhoea, but a conclusion can be arrived at by the number, 
amount, and character of the diarrhoeic discharges. 

The number of stools varies, to a certain extent, and their consist- 
ency, from pulpy to thin, water evacuations. At first the passages are 
clearer than natural, and yellower, and as the condition goes on they 
become gray; this color is due to the fact that the passages are so frequent 
that the liver is not able to furnish sufficient bile to color them, and in a 
number of cases, there is a certain amount of thick gelatinous mucus 
mixed in the excremental matter. In some cases the mucus becomes 
very copious, and sometimes the passages are nothing but mucus, fre- 
quently frothy, the stool being filled with small bubbles of gas and an 
intensely offensive odor, and in rare cases blood and pus are present; for 
further details see page 27. 

In intestinal catarrh the animal is restless, changing its position 
frequently, groans or cries, arches the back, or may rest the forepart of 
the body on the ground and have the hind quarters elevated. This is an 
indication of colicky pains. The examination of the abdomen externally 
does not furnish much information. Sometimes the abdomen is drawn 
up; in other cases it is distended. On applying the ear to the region of 
the abdomen, a great amount of gurgling or rolling is heard in the cavity; 
this may often be heard quite distinctly some distance from the animal. 
This is due to the increased peristaltic action. On pressing the posterior 
part of the abdomen, the animal often evinces pain. 

Tenesmus and relaxation of the rectum are generally present in the 
later stages of this disease. The animal makes prolonged and repeated 
efforts to pass the excremental matter, and finally passes only small 
amounts of mucus and blood, after great exertion. In some cases these 
prolonged exertions cause the lower bowel to be protruded. This, 
however, is generally seen in young puppies and only in very rare in- 
stances in older dogs. If the tenesmus is very great, it indicates that 
there is great irritation of the lower bowel (as regards the examination of 
the lower bowel, see page 28). 

The other symptoms of catarrh of the intestines are as follows: The 
color of the urine becomes dark from the tinting of the bile pigment and 
is lessened in quantity from the drain of fluids from the bowels. Fever 
is present, but it is generally slight. There is loss of appetite, vomiting, 
and yellow or icteric coloring of the mucous membranes, great thirst, and 
the animal becomes weak very quickly and shows great depression. This 
is specially noticeable when the inflammation is due to eating decayed 
meat. 

Chronic catarrh of the bowels resonil)los the acute form in many 



INTESTINAL CATARRH 61 

ways, but it is less severe in its symptoms. The faeces change from soft 
to firm, like the stools of cliarrhcEa, and vice versa, the animal becoming 
weak and thin, showing signs of anaemia; but in the chronic cases the ap- 
petite is generally very good. In some cases where the disease has been 
present a long time, when we examine the intestines by palpation, through 
the abdominal wall, the intestines are found to be firmer and less elastic. 

Prognosis. — In strong animals, this disease is generally not very se- 
rious, but in young dogs or puppies, it causes great exhaustion and they 
die from collapse before the diarrhoea can be checked; the chronic form 
in old animals is generally very hard to control and must be looked upon 
as a grave condition. Often attacks follow one after the other, com- 
pletely prostrating the animal and carrying it off finally. 

Therapeutics. — In slight cases the only thing to do is to keep the 
animal in an even warm temperature, regulate the food and, as a rule, 
lessen it in quantity and make it easier digested. Soup or broth, mixed 
with bread or biscuit, rice, etc., friction to the stomach and a small quan- 
tity of alcohol, in the form of whiskey or sherry, for weak, delicate dogs. 
It must be borne in mind that in all cases of this disease the treatment 
will depend entirely on the causes and symptoms that are observed. If 
the cause has been the ingestion of decayed or putrid substances, or 
internal parasites, the first thing to do is to clean the intestinal canal 
out by means of a purgative, such as calomel, Glauber salt, or in weak 
subjects or puppies, olive oil. If there is any indication that the liver is 
disturbed, it is best to first administer a dose of calomel and follow up 
with a saline purgative. Where there are copious and thin discharges 
and an indication of excessive peristaltic action, laxatives are contra- 
indicated; it is advisable to use narcotics, and in this instance opium is 
always indicated, powdered opium, laudanum, morphia or Dover's pow- 
ders. The attempt to substitute extract of belladonna or hyoscyamus 
and bromide of sodium in this disease has not proved to be very success- 
ful. Beside opium, we should also use the true astringents, such as tannic 
acid, calumbo root, and cascarilla bark. Certain preparations of bis- 
muth have a tendency to disinfect the intestinal canal and also to soothe 
the irritated mucous membranes. Xeroform (bismuth tribomphen- 
yticum) or bismuth subgallate or subnitrate. If ulceration of the bowels 
is indicated by symptoms, the albuminoid or organic preparations of 
silver or nitrate of silver are to be given, followed up by small doses of 
naphthalin, salicylic acid or creosote. If we suspect that there is a certain 
amount of putrid matter in the intestines beside, use saline laxatives to 
sweep out the decayed material; after doing this administer xeroform or 
resorcin (see treatment of mycotic gastro-enteritis) . It is well to make 
one or two irrigations of the bowels daily by means of a rubber funnel 
and a piece of rubber hose with a pipe of hard rubber at the end, which 



62 DISEASES OF THE DIGESTIVE APPARATUS 

is inserted in the rectum, as far as possible, and the fluid poured into the 
funnel and allowed to gravitate slowly into the bowel. The best solu- 
tions to use are a 1 to 2 per cent, solution of tannin, alum, or 1/2 to 1 
per cent, solution of silver nitrate or one of the various synthetical silver 
salts (argenol, argyrol, argentamine, picratol), the solution to be about 
30 per cent. The amount to use is about 1 to 2 litres. If this amount 
causes much irritation and straining, it must be discontinued; but it is 
well to give the animal at least one injection by this method, as it helps 
to clean out the lower bowel and facilitate the action of the medicinal 
agent. 

The treatment of chronic catarrh of the bowel is practically the same 
as the acute. Catarrh of the rectum may be caused by an extension of the 
irritant from the intestines, but this condition is more apt to result from 
mechanical irritants, very hard faeces, sharp splinters of bone or wood, 
rectal parasites; in male puppies that are housed with other older animals, 
particularly stud dogs, the rectum of the younger dog is frequently 
greatly irritated by attempted copulation on the part of the older male. 
Proctitis is recognized by difficult and painful defecation and the passage 
of small quantities of fseces covered with mucus and frequently bloody. 
When making a diagnosis, the rectum can be examined by means of the 
fingers previously oiled and introduced into the rectum or by means of a 
rectal speculum. After removing the cause, hard fseces or a foreign body, 
inject into the rectum, by means of a clyster apparatus already described, 
a thin mixture of starch with a small amount of opium in it or alum or 
organic silver solution. Tincture of nux vomica is very useful as a tonic 
in one or two-drop doses, before meals, twice daily. The quantity of 
food requires special attention. Give easily digested food and of a 
character that will not produce a large amount of fseces; bones, fat, tendi- 
nous, fibrous meat must be avoided. In order to counteract the loss of 
strength, give small quantities of rare or raw meat, finely chopped, milk, 
egg, rice and also the various peptone preparations. In young puppies 
the various infant foods so largely used in children practice are used as a 
substitute for milk. In persistent diarrhoea, give bismuth subgallate 
subnitrate or salicylate or the organic compounds of silver. In rare cases, 
where we find constipation present use a saturated solution of Glauber 
salt, in teaspoonful doses; Hunyadi, Apenta or other laxative waters may 
also be given. Any complication of the stomach will have to be treated by 
the method advised under Catarrh of the Stomach. 

The toxic and mycotic inflammations of the stomach will be 
described separately. 

Gastro-intestinal Inflammation. — Gastro-enteritis is caused by the 
absorption of various acids or irritating substances and also by the exces- 
sive use of drastic purgatives, such as aloes, calomel, croton oil. If the 



INTESTINAL CATARRH 63 

drug should be slowly soluble, or in the powder form, or contained 
intimately mixed with some other substance, it may reach the small 
intestines or even the large intestines and the rectum. 

The intensity of the disease depends on the amount of the drug taken 
and on the effect it has on the mucous membranes. The only result may 
be an attack of acute'catarrh, with some loss of the epithelium of the mu- 
cous membrane, or there may be also a gangrenous destruction of the 
w^alls of the stomach. It is seldom that irritating agents get any further 
than that organ, wasting their strength there and changing the wall of 
the stomach into a blackened or tinder-like mass, and all the surrounding 
tissues are swollen and reddened by hyperaemia or hemorrhages. 

We may safely conclude that we have a toxic gastro-enteritis to 
contend with when the symptoms of a serious gastric catarrh appear sud- 
denly, especially after eating, and if the grave symptoms increase rapidly 
and are accompanied by loss of appetite, salivation, vomiting, great 
restlessness, severe pains taking the nature of colic, and on pressure on 
the abdomen, it is painful and greatly distended, the vomited matter and 
the passages from the intestines being mixed with mucus and blood, 
tenesmus, great weakness and small frequent pulse. 

The treatment consists, first, in giving an emetic, or use a stomach- 
pump or wash the stomach, see page 21, and after that has had its effect, 
give a laxative, an oleaginous one (olive oil or linseed oil) is the best, 
rectal injections of warm w^ater, if there is much j^ain and irritation, small 
quantities of opium can be given in the oil, and if the poison can be dis- 
covered, use the proper antidotes, which are given in the chapter on 
Poisoning. 

Mycotic Inflammation of the Stomach and Intestines (Gastro- 
enteritis, Mycotic Decayed Meat Poisoning). — This is a variety of toxic 
inflammation, of the stomach and intestines. It is due to decayed meat 
poisoning. This is seen after the animal has eaten decomposed meat, 
offal or from drinking brine (Leisering), or eating cadavers of dogs or other 
animals that have died infected with bacteria, i.e., pus, septic metritis, 
mastitis, enteritis, nephritis; from drinking or licking the juices of de- 
cayed meat, putrified cheese, sausage; fish and all such matters that are 
filled with toxincs and tox-albumens, developed from the micro-organ- 
isms such materials contain, also from drinking from stagnant ponds 
and bodies of water containing decayed substances, or cadavers. This 
condition is seen in all sorts and conditions of animals, in the best fed and 
semi-starved, in the first from depraved appetite, due to indigestion. 
Even when they are well fed, they get into the habit, if they are allowed to 
roam in closely populated towns and villages, to go a regular route from 
one garbage pail to another and eat all sorts of decayed vegetable or 
animal matter. The active agent has a toxic principle present in it. The 



64 DISEASES OF THE DIGESTIVE APPARATUS 

symptoms of that form of poisoning are as follows: vomiting of an amount 
of very offensive matter, rotten masses of meat and with it quantities 
of bad-smelling mucus and sometimes accompanied by violent bloody 
diarrhoea, intense thirst and high fever, 40 to 42°. The writer has seen, 
however, instances where the temperature was subnormal, a small rapid 
pulse, great weakness, often complete paralysis, great depression and 
indifference to surroundings. Death generally follows with every symp- 
tom of collapse in 15 to 24 hours. If the symptoms are less acute, there 
is muscular or intestinal cramp, great difficulty in swallowing, disturbance 
of sight, dilatation of the pupils, bloody urine. When an animal makes 
a recovery, it is very weak for a long time, and it is almost impossible to 
get the animal to eat. 

After death, the process of decomposition begins almost imme- 
diately, and if a post-mortem is to be held, it must be made as soon as 
possible. If this is done, the stomach and intestines will present, an 
intense hemorrhagic inflammation of their walls, swelling of the follicles 
and mesenteric glands, as well as severe inflammatory changes in the 
adjacent organs, liver, spleen, heart, etc. 

The treatment has to be symptomatic. In the beginning give an 
emetic (apomorphia) subcutaneously, washing out the stomach, with 
warm water, or very weak solution of creolin, and the administration of 
purgatives, emulsions of castor, olive, or linseed oil, and tepid rectal injec- 
tions of creolin, and massage the abdomen with alcohol or a jDriessnitz 
compress, with tepid water or flaxseed poultice. The bodily strength 
of the animal should be kept up, with black cofTee, wine, whiskey, or 
brandy, spirits of camphor. When there is great depression, spirits of 
camphor may be injected subcutaneously. In mild cases we may treat 
them in certain lines as catarrh of the stomach and intestines. The 
animal should be fed on light foods, easily digested, and in small quantities, 
no solid meat the first forty-eight hours. 

Constipation, Costiveness. 

This condition may result, from the animal eating food that is diffi- 
cult to digest, i.e., potatoes, bread, beans, peas, dog biscuit, corn flour, 
bones, particularly calf bones, or where the animal has little or no exercise, 
animal kept on the chain or penned in a small yard, hunting dogs that 
have worked hard during the open season and during spring and summer 
do nothing, old dogs that have weakened digestions, particularly if they 
have suffered from chronic intestinal catarrh (see under that heading). 
Costiveness is also seen as a result of fever, rheumatism, peritonitis, 
catarrhal icterus, and diseases of the spine. 



OBSTIPATION G5 

Obstipation. 

(Occlusio Intestini; Ohturatio Intestini. 

Constrictions of the intestinal tract may be formed in any region and 
may vary in degree. They always produce more or less obstructions to 
the passage of the alimentary matter, and when the constriction becomes 
complete, the intestinal contents, being unable to pass, usually return 
toward the stomach again, and are expelled by vomiting. In such cases 
the animals die quickly. This is noticed in very rare instances, where a 
hernia has strangulated and completely blocked up the canal. (For 
further details see chapter on Hernia.) 

Constriction may be caused by abnormal conditions of the intestinal 
contents, from the alteration of the intestinal walls, by changes in the 
position of the intestines, and, lastly, from external pressure. 

The bowel is often blocked up by masses of excrement, as a result 
of improper food or feeding which is not digested in the stomach or 
intestine; these collections reach the lower bowel and from the constant 
accumulations of excrement coming down from the small intestines 
gradually blocks up the entire tract. We also see obstructions, caused 
by pieces of wood or splinters of bone, that collect masses of fseces around 
them and fill up the bowel, forming intestinal stones or calculi (copro- 
liths). These invariably have a nidus or centre consisting of a marble, 
pieces of cork, sponge, or other foreign bodies, or it may be caused by 
large pieces of bone, stones, glass or metal balls, nuts, pieces of leather, 
etc., some of which may be swallowed accidentally in the case of trick 
dogs, or in play. 

The constriction of the intestine, from being enclosed in a hernia 
and the impaction of the intestinal contents pressing into the part is fre- 
quently seen in the dog. The intestine frequently becomes twisted or 
knotted, or even invaginated. These complications, as a rule, occur in 
the small intestines. External compression of the intestines is frequently 
caused from enlarged prostate or sarcomas in the pelvic cavity, helminths 
or parasites that lie in cyst formations in the mucous membrane of the 
intestines. Sometimes enormous abscesses form in the abdominal cavity, 
and in rare instances they are caused by accumulations of fluids in the 
abdominal cavity, as in the case of ascites. In newly born puppies we 
sometimes see a congenital obstruction of the rectum (atresia ani). 
-Great masses of fsecal matter may accumulate in the anal pouch; this may 
be due in some cases to the swelling of the anal glands, or by the accu- 
mulation of masses of hair gluing around the rectum and preventing 
defecation; the same condition is seen in tumors of the anus or rectum. 
For further details see page 29. 
5 



66 DISEASES OF THE DIGESTIVE APPARATUS 

When a portion of the intestine becomes obstructed, the following 
changes take place: In front of the obstruction, an enlargement forms, 
due to the accumulation of gas and excrement matter, while the portion 
of the intestine beyond the obstruction is empty and constricted. The 
accumulation of gas and matter causes an intense inflammation of the 
mucous membranes, which extends to the muscular coat of the intestines 
and soon to the serous coat, and quickly the entire intestinal tract is 
involved in the inflammation, the constricted portion becomes mortified, 
and perforation follows, allowing the contents of the intestines to escape 
in the abdominal cavity, causing purulent peritonitis. 

Clinical Symptoms of Constipation. — The symptoms and course of 
constipation are due to so many different causes that they will be de- 
scribed separately. 

In mild cases of constipation the symptoms are not especially charac- 
teristic and resemble chronic catarrh of the stomach. At fii'st the animal 
is noticed to defecate irregularly, the stools are smaller and passed appar- 
ently with more or less difficulty, which is especially noticeable, consider- 
ing the stools are very much smaller than natural. 

When from having little exercise and living on highly spiced foods, 
(veal or game,) or eating quantities of bone that they are unable to digest, 
great accumulation of faecal matter gathers in the colon and rectum. The 
most marked symptom is the repeated attempts of the animal to defecate 
without any results or after great efforts only succeeding in passing a 
small cjuantity of faeces. These are coated with mucus or blood and are 
passed with more or less pain. The stools are small and are generally 
yellowish-brown in color, and in powder-like masses that break up easily, 
showing no moisture in them. The position of the tail is characteristic. 
It is carried so as to form a curve at the rectum, the curve being from 
the base to one-half of the tail. On pressing the fingers into the sides of 
the abdomen, at the entrance of the pelvis up toward the spinal cord, 
we find an elongated sausage-like body which is extremely sensitive to 
the touch. This hard mass is found to extend downward and forward 
toward the umbilicus. The intestines are greatly swollen on account of 
the accumulation of gas and vomiting is sometimes present (Fig. 28). 
On making an examination of the intestines by the hand, we may be 
able to detect the distention. The colon is found to be dilated, through 
its entire length, forming an enormous sac, filled with a putty-like mass; 
and during palpation the animal as a rule evinces pain and resists it. This 
examination should be carefully made, as it may lead to the discovery of 
the original cause of the constipation. Slight diarrhoea may sometimes 
be present in severe constipation; this is due to the mass lying in a sac 
or pouch in the intestine, the firmer material gradually accumulating and 
the fluid faeces passing over the collected mass. Long continued consti- 



OBSTIPATION 67 

pation (coprostasis) may cause infection of the blood from absorption, 
of the fsecal matter, enteritis, mortification, peritonitis and death. 

Symptoms of Obstruction of the Intestines. — In complete occlusion 
of the intestines, due to foreign bodies, invagination or tortion, the 
animal is irritable and cross and Trasbot has seen cases where the animal 
showed symptoms very similar to rabies or where it may present the 
other extreme, being dull and indifferent to the surroundings, refusing 
all food, but showing great thirst, with no passage of faeces whatever. 
The rectal temperature is slightly increased, the lower portion of the 
abdomen is inflated with gas and very painful, even on the slightest 
pressure; in some cases we may find decided icterus. 




Fig. 28. — Dog with obstruction of the intestines. 

The vomiting is constant and very severe, particularly in the later 
stages of the disease, the animal vomiting whenever it drinks any water. 
At first the vomited matter is normal, but later on it assumes a greenish 
color (bile) and finally putrid, containing pieces of faecal matter. 

By examining the abdominal region with the hand we can generally 
locate the obstruction, which is hard and exceedingly painful on pressure. 
The swelling can be moved about showing it to be part of the intestine. 

In ordinary cases of constriction of the intestines, no definite prog- 
nosis can be made with any degree of certainty as to its course and 
duration. The constriction of the intestine may go on gradually and not 
cause any serious symptoms for a long time, or it may progress very 
rapidly and cause a complete constriction in two or three weeks. Where 



C8 DISEASES OF THE DIGESTIVE APPARATUS 

the condition continues for some time, the animal becomes gradually 
weaker from day to day, loses flesh rapidly, pulse is smaller and finally 
imperceptible, the temperature may rise but frequently it remains normal, 
in a few days the animal may die in a condition of collapse. A favorable 
termination may result, and foreign bodies, such as pieces of cork, bone or 
wood may be macerated and passed out finally without any great trouble. 
It is not difficult, as a rule, to detect the existence of a foreign body in the 
intestines, but it is very difficult to tell its exact nature. By means of 
palpation of the abdomen, see page 25, we may be able to detect hard, 
foreign bodies, or objects, such as hair balls, but invagination or twisting 
of the intestines is, however, rather difficult to diagnose. Metallic ob- 
jects, stones, etc., can be diagnosed by means of the Rontgen or X-ray, or 
by performing laparotomy. Where the intestine is completel}^ obstructed, 
in front of the obstructed portion of the intestine, is greatly distended, 
due to the collection of faeces and gas, and the intestine immediately 
after the obstruction is contracted and empty. At the obstructed point 
there will be found great inflammation of the mucous membrane, which 
finally affects the muscular and serous coat and peritonitis, or the portion 
becomes necrosed and a purulent peritonitis follows and the animal at any 
of these stages may die of septicaemia. 

Therapeutics. — In an ordinary case of constipation give plenty 
of exercise and a carefully regulated diet. If it is advisable to give the 
animal very little food for a few days, give plenty of water and small 
quantities of soup, either beef or vegetable. In old animals, where diges- 
tion is more or less weakened, give easily digested food and no bones 
whatever. Clysters or mechanical laxatives, such as glycerine or soap 
suppositories, and massage of the abdomen is advised. As a laxative, 
oleum ricini 15.0 to 30.0 in a capsule or emulsion, Glauber or Epsom salts, 
10.0 to 20.0, Hunyadi Janos, or Apenta water, teaspoonful doses. 

When a case is very ol^stinate and does not respond to the previously 
advised treatment, especially where we find the large colon filled with 
fseces, and laxatives have no effect, the rectum must be emptied. The 
finger after being well oiled is introduced into the anus where there will 
be found hard fsecal masses in front of the sphincter. It is generally 
impossible to remove them, except by breaking them up, cither with the 
finger or having first injected a small quantity of oil or glycerine into the 
rectum, or the handle of a spoon can be used to break up the masses, 
taking care not to injure the mucous membrane. This is to be followed 
by the injection of the clysters by means of the hose and funnel (see Fig. 
29). The lower part of the bowel is filled with a coml^ination of luke- 
warm water and a small quantity of oil. These clysters should be re- 
peated frequently, at least several times a day, or even several days, until 
the whole canal is emptied. Or what is better, glycerine suppositories, 



OBSTIPATION 



69 



and later on administer a sharp purgative, followed by the administra- 
tion of drop-doses of tincture of nux vomica. 

The subcutaneous injection of such drugs as physostigmin, pilo- 
carpine and arecoline are not, as a rule, satisfactory and barium chloride, 





Fig. 29. — Mode of administering a clj'ster. 

ichthlargan, tallianine are not to be advised, as their results are not at all 
satifactory and at times actually dangerous to the animal. These latter 
drugs are administered by intravenous injection into the saphena vein. 
The vein is dilated by means of pressure and when filled, the hypodermic 
needle is thrust into it, taking care the needle punctures the vein, which 
will be indicated by a few drops of blood coming from the needle and con- 
tinuing to drop as long as the pressure is kept on the vein. If it is the 



70 



DISEASES OF THE DIGESTIVE APPARATUS 



cellular tissue no venous blood escapes. The injection is made and the 
opening closed with collodion. As in the case in strangulated hernia, 
or in the case of accumulation of the faeces in the rectum, due to faecal 
stagnation^ or from the ulceration of abscesses of the rectum, we will 
have to treat them as described above; but we may add to that the in- 
jection of large quantities of soapy water several times daily, which can 
be given with the apparatus illustrated in Fig. 29, and a dose of calomel 
followed by castor or olive oil or glycerine injections into the rectum, or 
suppositories in the form of glycerine, or a solution of glycerine and 
water 1 to 10. 

The stenosis of the bowel that is caused by the impaction of foreign 
bodies is best treated with laxatives and not with purgatives. A'ogel 
and others advise in the case of sharp or pointed objects, to feed the 





Fig. 30. — Lambert. suture. 

animal on thin liquid foods, soups of peas and vegetables, but if we do 
not succeed in getting rid of the foreign body and, if a positive diagnosis 
has been made, it is best to perform laparo-enterotomy as soon as pos- 
sible, and not wait until gangrene and peritonitis have set in. 

Laparo-enterotomy is performed in the following manner: the ani- 
mal is anaesthetized and placed on its back, the lower part of the abdom- 
inal wall shaved and washed with antiseptics. Make an incision, through 
the linea alba, posterior to the umbilicus, back to the margin of the pubis 
about 5 to 8 cm. long. First cut through the skin, then the muscles. 
Before going into the abdominal cavity, all the hemorrhage must be 
checked and the blood cleaned off, and then with the thumb and index 
jfinger go into the abdominal cavity and, having located the portion of 
the intestine wanted, pull it through the opening and hold the lips of the 
wound together; an assistant can hold the edges of the wound together 
and prevent the rest of the intestines from escaping, and also to prevent 
possible infection from the escaping fluids, when the incision is made in 



OBSTIPATION 71 

the intestine. Make the cut longitudinally, on the intestinal line, on the 
opposite side from the mesentery, remove the foreign body, taking care all 
through the operation to prevent the fluids escaping into the al)dominal 
cavity. "Wash the inside of the intestines with an antiseptic and unite it 
by means of Lambert's suture (see Fig. 30) or Czerny's double suture 
(see Fig. 31). For more exact detail on this subject, the reader is referred 
to the works on canine surgery by French or Hobday. The operator now 
takes a fine curved needle, and fine cat-gut suture and puts a number 
of stitches through the mucous membrane and serous tissues, taking care 
not to go through the mucous memljrane, so that when the thread is 
tightened the two edges of the cut will he brought so as to face into the 
intestine; these are tied, and another line of stitches is made over the 
first, as is illustrated in the accompanying Fig. 31. The intestine is 
returned to the cavit}', and the external wound sewed up with silk and 




Fig. 31. — Suture of the intestines {Czerny). 

dressed with an antiseptic dressing. In the male dog see that the dress- 
ing is not soiled with urine. 

The opening of the abdominal cavity is also to be performed in eases 
"where we can recognize a total constriction of the bowels. In these cases 
where the anatomical cause of the disease cannot be clearly established, 
we have no other way to proceed than to treat the symptoms as they 
present themselves, that is to give purgatives, or, in any case, do not 
neglect to give plenty of watery clysters. The general treatment must 
be directed toward keeping up the animal's strength. The first forty- 
eight hours only water must be given and in small quantities. Subcu- 
taneous injections of the spirits of camphor or ether are better than 
administering them by the mouth, as they are vomited immediately. 
Do not give the animal any food until the intestinal obstruction has been 
removed or at least until there have been free defecation and the pas- 
sage of the intestinal gas and the general condition is improved. And on 
the third day the animal may be given food; it must be of the lightest 
and easiest digested, such as soups, milk, bouillon with egg, meat, peptone, 
and on the fourth day finely scraped rare or raw beef, or some of the 



72 DISEASES OF THE DIGESTIVE APPARATUS 

various foods used as substitutes for milk. "Where the animal is subject 
to fffcal obstructions, it is well never to let him have bones if it can pos- 
sibly be avoided. 

Intestinal invagination occurs as a result of irregular or extraordinary 
poristalsis, particularly when the intestinal wall is in a relaxed, debilitated 
condition, as a result of intestinal catarrh from prolonged administration 
of laxatives. Death as a rule occurs from the fifth to tenth day. The 
symptoms of invagination are those of occlusion of the intestines, see 
the above, and more or less blood on the fa?ces. We may be able by pal- 
pation to detect the invaginated portion by feeling a circumscribed 
elastic, elongated, sausage-like portion along the intestinal tract. This 
is extremely painful on pressure. If it is detected, perform laparotomy, 
reduce the invagination by lifting out the loop of intestine and reducing 
the invagination, but if the irritation is too great, or necrosis has devel- 
oped, perform enterectomy. See further on under Enterectomy. 

Chronic Constipation. — This is seen occasionally in the dog. It is 
due to a weakened or lessened peristaltic action of the bowels. It is seen 
in all chronic diseases that are accompanied by emaciation and debility, 
as in chronic catarrh, fevers, icterus, chronic peritonitis and in many dis- 
eases of the nervous system; but it may be observed in many old but 
healthy dogs, caused by an atrophy of the mucous and muscular mem- 
branes of the intestines. This disease is frequently called chronic obsti- 
pation, for it causes a form of constipation which would, as can be readily 
understood, cause just such a train of symptoms as has been described 
above. 

These animals should be fed on non-stimulating, easily digested food 
with or without the admixture of vegetable soup, and also plenty of 
exercise and small doses of tincture of nux vomica. This treatment is far 
better than the frecjuent administration of purgatives, especially 
Glauber salt, jalap or aloes and cathartic pills. 

Enterectomy, Entero anastomosis. — This operation becomes necessary 
when a portion of the intestine becomes necrosed or where stenosis of a 



Fig. 32. — Hairpin method of anastomosis, showing the manner in which the pin is bent. 

certain portion causes accumulation of fa?cal matter anterior to the 
contraction. The operation is only possible where there is a small sec- 
tion of the intestine to be removed, as a section of any amount is apt, if 
the animal makes a recovery, to be followed very quickly by marasmus 
and terminate fatally in a very short time. 

French has devised a very simple mode of operation, the technique 
of which has proved very efficacious in the writer's hands. It is as follows : 



OBSTIPATION 



73 



The animal is put under ether after the familiar antiseptic precautions 
are used, cut down on the abdominal wall and having exposed the 
necrosed or the stenosed portion, as the case may be, and very carefully 
inspect the mesenteric blood supply, as great care has to be taken not to 




Fig. 33. — Hairpin method of anastomosis, first stage {French). 

ligate any vessel that would supply any but the portion removed. The 
vessels are ligated by means of a curved needle being passed around them 
through the mesentery, the anastomosing loop of the blood vessel being 
taken up as close to the point of incision as possible. Then an ordinary 




Fig. 34. — Hairpin method of anastomosis, second stage {French). 

lady's hairpin, bent as in the accompanying cut (Fig. 32), is taken and 
one prong is passed transversely across the intestine and the free ends of 
the pin are seized by a pair of hemostatic forceps or tied with sutures and 
another pin is inserted in a similar manner at the other point of resection; 



74 DISEASES OF THE DIGESTIVE APPARATUS 

this point of the operation is illustrated in Fig. 33. The intestine is 
now cut close to the pins, and the mesentery cut as shown in the dotted 
line, the severed ends with the pins brought together and the pins tied 
or held by forceps both top and bottom (Fig. 34), and the suture is com- 
menced at the mesentery, putting in the Lambert stitch on one side, then 
turn over the intestine and stitch the other side. The stitching is to be 
done very carefully and evenly, as on this depends the adhesion of the 
anastomosis. French recommends the ordinary milliner's instead of the 
surgical needle, as it makes a cylindrical hole that has no ragged edge 
and the opening adapts itself to the suture, preventing hemorrhage or 
leakage; the tops of the pins are now cut off by means of a pair of wire- 
cutters and withdrawn, one at a time, and the two openings left by the 
pins are sutured; great care is to be taken to keep the margins of the 
mesentery in apposition; the cut in the mesentery is now closed by means 
of a continuous suture. The after-treatment consists in keeping the 
animal on a strict liquid diet, juice of meat, clear soup, or bouillon for 
at least a week or ten days. 

Prolapsus of the Rectum. 

{Prolapsus Recti et Ani.) 

Etiology and Pathological Anatomy. — The lower bowel is kept in 
place by the peri-proctal connective tissue, the rectal ring, the levator 
ani and the sphincter ani. By relaxing or distending these supports, we 
find a prolapsus of the mucous membrane, or even the entire rectum 
may be protruded (prolapsus recti), or a certain portion of the intestine 
may become invaginated and only the invaginated portion protrude 
(prolapsus recti cum invaginatione) or the prolapsed intestine may cause 
a rectal hernia (hernia recti rectocele). If this prolapsus is not relieved 
soon, it inflames very quickly and becomes torn and ulcerated, forming a 
great swelling. It may become strangulated, and in rare cases gangre- 
nous. It generally results from a relaxed condition of the rectal mucous 
membrane or from excessive straining, from constipation, diarrhoea, or 
labor pains, from the continued use of hot or irritating clysters, from 
constitutional weakness of the sphincters and the peri-proctal connective 
tissues. It frequently occurs in young dogs that have catarrh of the 
lower bowel or as an accompaniment to distemper. 

Symptoms. — If the mucous membrane is slightly protruded, it is only 
noticed during defecation or urination. It is seen in the form of dark 
red wrinkles that protrude from the rectum as soon as the abdominal 
pressure has ceased. If the whole bowel is prolapsed, we find under the 
tail a cylindrical projection, which protrudes from where the anus was, and 
hangs downward. The mucous membrane that is exposed is wrinkled 



PROLAPSUS OF THE RECTUM 



75 



and congested, and at the centre of the dependent portion an indenta- 
tion is seen; this is the opening of the intestine. Through this we can 
introduce the finger into the intestine. At the anterior end, the mucous 
membrane passes directly into the skin and the anal opening. If there 
is any invagination, the membrane does not terminate at the anus, but 
seems to go into the rectum, and the protrusion can be lifted up and 
passed into the rectum between the swelling and the rectum (see Fig. 35). 
Therapeutics. — The first thing to do is to remove the cause, whether 
it be due to diarrhoea or constipation, by putting the animal under 




Fig. 35. — Prolapsus of the rectum with invagination. 

treatment suitable for such conditions. The most important thing to do 
is to reduce the prolapsus as soon as possible; place the dog on his front 
legs and elevate the hind ones, and having cleaned and oiled the inflamed 
portion, return it to its normal position and fill it with astringent solu- 
tion, and if it is a long-standing case, opium in suppository or 5 per 
cent, solution cocaine. If the mucous membrane is very much swollen 
and inflamed, it is best to scarify it slightly. If the folds of the mucous 
membrane are blackened and necrosed from prolonged exposure, they 
must be trimmed off with the scissors. The writer has generally suc- 
ceeded, even in very bad cases, in reducing the protrusions by bathing 



7G DISEASES OF THE DIGESTIVE APPARATUS 

them with cokl water or l)y compressing the protruded intestine on a 
rubber band, or muslin, commencing at the external end and winding 
toward the base of the swelling and while it is reduced by the pressure 
return it to its normal position. It is much more difficult to reduce an 
invaginated intestine, as the more you press on the protruded portion 
the more it packs into the end of the rectum. A large bougie or candle 
is inserted in the end of the protruded portion, and then it is pressed into 
its natural position; or if this does not succeed, perform laparotomy and 
draw the invaginated intestine back into position from the abdominal 
cavity. There is little danger from this operation, if it is performed 
with ordinary caution. The administration of a hypodermic injection 
of morphia will insure relaxation and less straining on the part of the 
animal. 

After replacing the intestine, it is generally necessary to place a stitch 
around the perineum, so as to prevent the recurrence of the protrusion. 
What is called a tobacco pouch stitch is carried around the anus, and when 
the strings are drawn it will be seen (as in the cut, Fig. 36) that it prevents 
a recurrence of the protrusion by drawing the anus together. The sewing 
of the rectum by this stitch closes up the opening sufficiently to prevent 
the bowel coming out, but n,ot enough to prevent the escape of liquid 
faecal matter. It is not advisable to apply cold irrigations or inject 
astringents, as the dog is very apt to strain more violently after applica- 
tion of either of these remedies. 

At the same time, if the trouble is caused by diarrhoea, give opium, 
and if caused by constipation, administer saline purgatives. Stockfelt 
advised that a series of pins should be placed around the rectum 
and united with threads, and thus produce a greater constriction 
from the cicatrix when the irritation heals, so as to hold the parts in 
position. 

Grey made an opening on the median line of the abdomen and drew 
back the intestine and stitched it to the opening with cat-gut sutures, 
taking care not to put the stitch through into the mucous membrane of 
the intestine. 

When the prolapsus has been of long duration and reduction seems 
impossible, it is best to take means to remove the protruded portion of 
the intestines. 

Amputation and Sewing by Means of the Double Suture. — Cut off 
the hair from the region of the anus, then wash the affected parts and 
region, with an antiseptic, put the animal under ether, the animal is laid 
on a table, the posterior part of the body is elevated, the prolapsed por- 
tion pulled out by means of forceps until normal mucous membrane is 
seen. Then wash off and apply a rubber band tourniquet as close up to 
the anus as possible, then a curved needle is passed through both layers, 



PROLAPSUS OF THE RECTUM 



and brought up to the surface. This is facilitated by inserting an ordi- 
nary thermometer into the lumen of the intestine (Hobday) or, better still, 
a cylinder of carrot (^"iborg). Tie this stitch and put another stitch be- 
side this, and continue around the intestine until 
it is stitched up. Cut off the portion posterior to 
the stitches, remove portion of carrot and push the 
stump back through the anus. 

Amputation by Means of a Cross Suture. — • 
The method advocated by Miller is performed in 
the following manner: the animal is etherized and 
the hair removed, the skin cleaned and two needles 
with linen or silk suture put crosswise, as in Fig. 
37, through the prolapsed portion, the portion pos- 
terior to the stitch, is cut off; the stitches are then 
pulled out from the lumen of the intestine and cut in 
the centre, thus making two threads. These should 
be tied, as in the second figure of the cut. 

Another method is to place the animal under 
ether, and having laid it on a table with the poste- 
rior extremities elevated, the prolapsed portion is 
pulled as far as possible out of the rectum. It 
must then be rubbed in the hands, to remove as 

much blood from it as possible, or a rubber band wound around it, from 
its extremity to its base, and finally ligated at its base, and then, by 
means of a bistoury, the protrusion is cut off about one-half of an inch 
from the ligation. 




Fig. 36. — Stitching rec- 
tum (tobacco-bag stitch); 
o, method of stitching; b, 
stitch tied. 




Fig. 37. — Method of suturing in amputation of the lower bowel. 



After the blood vessels have been taken up by means of an in- 
terrupted stitch (the interrupted stitch is much better, as it makes the 
union of the lips of the wound much closer), sew up the serous mem- 
brane, and afterward sew the muscular and mucous membranes; the 
rubber band is removed, and the stump is pushed back into the opening. 



78 DISEASES OF THE DIGESTIVE APPARATUS 

Malformations of the Rectum and Anus. 

Numerous malformations occur in the rectum; projecting polypus 
formations of the mucous membrane of the lower bowel may project from 
the rectum constantly, or may only be seen during defecation. We may 
also find fibroma, adenoma, and other forms of tumors. The writer had a 
particularly interesting case in a small dog that was cjuite old. The owner 
had observed a slight bleeding from the rectum for at least a year; the 
rectum was examined by means of a speculum and a carcinoma was found. 
It was located about 5 cm. from anus on the superior portion of the rectum. 
This tumor had hard raised irregular edges and depressed in the middle. 
In the peri-proctal connective tissue, we occasionally find adenoma, 
sarcoma and carcinoma. These growths are apt to cause considerable 
trouble, as they cause constriction of the mucous membrane and inter- 
fere with defecation. 

In the anus, we find several types of tumors which we class, m a 
general way, as anal cancers. They may either be adenomas or car- 
cinomas and, as a rule, present mushroom or fungus-like bodies growing 
firmly in the skin tissue itself, but having no attachment to the connective 
tissue. Generally they are firm, or slightly elastic, and when they reach 
a certain size, they are very slightly attached at their outer edge, and 
the majority of them can be lifted from their base. 

When they reach any size, they are apt to interfere with defecation. 
These tumors are easily removed, particidarly when they have reached 
a certain size. The only precaution to be observed is to remove the 
tumor in its entirety and to avoid injuring the sphincter, which would 
be apt to result either in paralysis of the sphincter or a rectal fistula. 
Frick advises early removal of tumors from the interior of the rectum. 
For information of the diseases of the rectum see page 74. 

Imperforate Anus, Inflammation of the Anal Pouches, Diverticulum of the 
Rectum and Hemorrhoids are classed under this Heading. 

Imperforate Anus (Atresia Ani and Atresia Ani et Reeti). — This is a 
congenital deformity and consists of a defective formation of the rectum 
and in some cases of the lower bowel. It is seen in newly born puppies, 
and it is usually confined to the cutaneous covering growing over the 
anus (atresia ani), or it may be the rectum is only partially developed 
and it ends in a blind sac some distance from the rectum (atresia ani et 
recti). In these cases, the faeces are not passed and an artificial opening 
must be made. The treatment is to cut the skin with a small knife, and 
the edge of the wound sewed back, so as to prevent it from uniting again; 



IMPERFORATE ANUS 



79 



but if it is found that the lower bowel is entirely occluded, it is better 
to destroy the puppy. But if treatment is to l)e tried as in a particularly 
valuable puppy, we can make a cross incision and by means of the index 
finger we locate the l^lind end of the floating colon then, l)y means of the 
forceps, draw it to the surface, open it and stitch the edges around the 
anal opening, as in an ordinary wound. 

Infiammation of the Anal Pouches. — These glands are located on both 
sides of the anus, lying between the anus and the mucous membrane. 




Fig. 38. — Inflammation of the anal glands. 

The interior of the pouch is filled with tubular shaped glandular tissue, 
ending in a short thin canal, see Fig. 38. The secretion of the gland is a 
yellowish brown fluid, with a very unpleasant odor and an acid reaction. 
From a variety of causes, such as local irritation, the accumulation of 
hard faeces, splinters of bone, etc., and from various irritations of the 
rectum, these glands become inflamed and the anus becomes swollen, on 
one or both sides, generally the latter. The region is warm, painful to the 
touch, and there is more or less fluctuation in the swellings. The animal 
makes repeated attempts at defecation and there is every evidence of ten- 
esmus. The animal is continually licking the anus and pulling and slid- 
ing the hind ciuarters on the ground. On pressing the swellings between 
the fingers, the contents of the anal pouches are emptied and are expelled 



80 



DISEASES OF THE DIGESTIVE APPARATUS 



from the anus; this is a thick yellowish-brown liquid, often stained with 
blood, and it has a very fcetid odor. In some instances the swelling 
breaks through the skin at the anus, forming an anal fistula. 

The treatment consists in pressing the engorged glandular tissue be- 
tween the fingers, either the two fingers externally, or putting the index 
finger into the rectum, and pressing on the pouches. If they cannot be 
emptied in this manner, they must l)e opened by means of a curved bis- 
toury, and Gutman injects tincture of iodine into the gland. In rare 




Fig. 39. — Pseudo-perineal hernia. 

instances it is necessary to curette the pouches. The general condition 
may be assisted by laxatives, to assist in easier defecation. 

Abscess of the Anal Glands. — The anal glands (acinos gland) which are 
situated in the sphincter, forming the anus, become inflamed and cause 
a swelling of the entire neighborhood of the anus, causing great inter- 
ference with defecation. These generally form pus, fluctuate and break. 
The treatment consists in opening the abscesses and treating them 
antiseptically. 

Diverticulum of the Rectum, Pseudo-perineal Hernia. — From the fre- 
quent accumulation of fa^'/cs in the rectum, particularly in old animals, 
the terminal portion of the floating colon and rectum becomes dilated and 
forms a sac, and when this diverticulum becomes filled, the neighboring 
structures are pushed out, and the condition may be mistaken for perineal 
hernia (Fig. 39.) It can be differentiated from hernia by the fact that 



HEMORRHOIDS 81 

in this case the tumor is hard and puttj^-like and introducing the finger 
into the rectum it is found to be filled with hard faecal matter. The 
treatment consists in breaking up the faecal matter and removing it either 
with the finger, instruments, or by means of clysters, gluten or glycerine 
suppositories, giving the animal food suitable for this condition. Lienaux 
operated by cutting the rectum, pulling out all the dilated portion, 
excising it, and sewing the intestine to the anus as in prolapsus of the 
rectum, (see Fig, 37). 

Hemorrhoids. 

These are diffuse or knot-shaped (varicose) distentions of the pos- 
terior veins of the lower bowel at the anus. According to their position, 
we may call them external or internal hemorrhoids. 

The former are located outside the sphincter ani and in the sub- 
cutaneous connective tissue. The latter are located inside the sphincter 
and under the mucous membrane. Sometimes these enlarged veins burst 
and cause considerable hemorrhage. This, however, rarely amounts to 
anything, as the mucous membrane is generally more or less inflamed all 
the time, and often the faeces are covered with mucous when they are 
passed. It is not a rare affection in older dogs. 

Clinical Symptoms. — The act of defecation is painful, the faeces covered 
with mucus and sometimes blood — either pure blood or blood and 
mucus mixed. On making a digital examination, which is very painful, 
the mucous membrane is found to be roughened and uneven, or we may 
see one knotty lump in the orifice of the anus. In rare instances they 
appear as bluish-red ulcers which encircle the reddened rectum. The 
animal is nervous, irritable, sliding the posterior part of the body on the 
floor, especially on the carpet, so as to rub the rectum, and licking the 
anus frequently. 

The causes can generally be ascribed to a stagnation of the veins, from 
irritation of the membranes, from bile or irritants dvie to poor or faulty 
digestion, too much food, and in the majority of instances it will be found 
that the liver is congested or inactive, from chronic constipation or lack of 
exercise (Vogel states it follows pregnancy), and carcinoma or stenosis 
in the posterior portion of the intestinal canal. In some cases it is due to 
a disturbance of the circulation, from disease of the heart or lungs, and 
from the irritation of habitual constipation. 

Therapeutics. — The best treatment to pursue is first to use saline laxa- 
tives, but not in large enough doses to purge, such as sulphate of mag- 
nesia or sulphate of sodium, and cold enema and the application of an 
ointment of lead plaster. Any knots may be removed by ligature, scarifi- 
cation, or by the scissors, and afterward touched by the thermocautery. 
6 



82 



DISEASES OF THE DIGESTIVE APPARATUS 



INTESTINAL PARASITES. 

(Hehninthiasis.) 

Round Worms, Maw Worms (Ascaris Mystax). 

Natural History. — The round worm of the dog, ascaris mystax, 
ascaris marginata, is Avhite or yellowish-white, slightly reddish in color 
and twisted in spirals; there is a difference in the two sexes (see Fig. 
40), the males are about 6 cm. and the female about 12 cm. Their 
thickness varies from 1 to 1.5 mm. The head is slightly flattened and 
fitted with two wing-shaped borders, which start from the mouth and 
enlarge slightly as they pass posteriorly. The mouth is a round small 
opening, and fitted with three to six small lips, which cover a number of 
proportionately large teeth. The caudal end of the male parasite is 

n o 




Fig. 40. — Ascaris mystax. 

curved and pointed and has numerous small papillae on each side. The 
caudal end of the female is pointed and straight. The vulva is about the 
end of the first fourth of the body from the head. In the genital organs 
there can generally be seen quantities of round eggs that on examination 
are found to have a thick, hard shell, which is marked by numerous 
small grooves. These eggs are found in enormous quantities in the 
fa*ces of all dogs affected with the round worm (see Fig. 15). The de- 
velopment of the embryo is not yet thoroughly understood, but from the 
experiments of Grassi, Penberthy, Albrecht, Frohncr, it has been dem- 
onstrated that the intestines of puppies that have never taken any- 
thing but the mother's milk, contain numerous ascarides, and they have 
demonstrated that an intermediate host is not necessary, but the worms can 
be developed directly from the eggs in another animal of the same species. 
As a rule, the round worms cause little trouble in the dog. Pem- 
bcrthy found 250 in a six weeks old puppy that had constant vomiting, 



T.£NIA 83 

intestinal catarrh, emaciation, anaemia and decreased temperature. 
But in some instances, large masses of these worms collect and cause 
considerable catarrhal disturbance of the intestines, or they may even 
cause symptoms of intestinal stenosis. In rare instances, the parasites 
produce numerous hemorrhagic furrows or indentations in the mucous 
membrane. There is no doubt that in some cases round worms cause 
considerable nervous disturbance, such as cramps or epilepsy, and may 
even perforate the intestinal wall, causing a secondary peritonitis. The 
penetration of the parasite into the bile duct has been observed in young 
animals — puppies under six months. From the observations of Kitt, 
Gasteiger, Mingazzini, there is no doubt that these parasites cause harm, 
not only by absorbing nourishment that should go to the host, but by 
producing and excreting certain toxic substances that cause both inflam- 
matory changes and nervous disturbances. These nervous symptoms 
generally disappear with the expulsion of the parasite. 

Therapeutics. — The principal agent used to remove the round worm 
is floris cinae and santonin, the alkaloid of the plant Artemisia santon- 
ica. Both can be administered and followed up by a dose of castor 
oil, or the oil may be given with them. The floris cinse is given in doses 
of 2.0 to 10.0 and the santonin in doses of 0.05 to 0.2 for the adult dog 
and from 0.01 to 0.05 for young or smaller dogs. For the young 
puppy give 0.025 rubbed up in a little sugar, or in triturate. Decoctions 
of garlic, thymol, areca nut, are all administered by their various ad- 
vocates. As a prophylactic measure, pregnant bitches that are about 
to whelp and are suspected of having ascarides should be put in another 
place, situated some distance from where they are to whelp and subse- 
quently nurse their puppies and are then given medicine to expel the 
parasites. This should be followed by a laxative, to wash out the para- 
sites and what eggs may be in the rectum; and after that the region of 
the anus should be washed to further remove the eggs that may be in that 
region. Then the bitch is returned to the place where she is to whelp. 

I^. Flor. cinje pulv, 
01. ricini, 
Sig. — To be given on an empty stomach. 
I^. Santonin, 

Chloroformum, 
01. ricini, 
Sacchanim, 
Sig. — One-half in the morning and other in the after- 
noon. 

I^. Santonin, 0.2 to 0.3 

Oh ricini, 45.0 to 60.0 

Shake the bottle before using. 

Sig — Divide into three portions and give one every 
four hours. 



10 


.0 


50. 





0. 


3 


5. 





50. 








.01 



84 DISEASES OF THE DIGESTIVE APPARATUS 

Tape-worm. 

Natural History. — The cestodes are flat tape-like worms without 
mouth or intestines. They grow from one parent or head scolex and 
adhere together, in a long ribbon-like colony. The head is furnished with 
sucking cups and hooks, by which means it adheres to the mucous mem- 
branes of the intestines. The parasite is narrow at the neck, gradually 
widening and at its termination it consists of a number of matured seg- 
ments that separate from the parent parasite, when they are fully de- 
veloped, and are carried out among the faeces. Each segment is complete 
in itself, having both male and female genital organs. This order are 
hermaphrodites and are peculiar from the fact that they produce the 
germs of the new nursing mothers, of the shape of eggs, while the nurse 
remains sexless. The ripe segments (proglottides) are soon detached and 
pass either into manure, or in water, plants or grass. The proglottides 
break up and the eggs scatter in all directions. The eggs are covered 
with a hard, tough shell, inside of which is a six-hooked embryo. If the 
egg is taken into the stomach, the acid gastric juice dissolves the shell; 
the embryo is liberated, and immediately fastens the hooks into the mucous 
membrane of the intestine and from there penetrates into the connective 
tissue of some of the adjacent organs, where it forms a sac-like cyst. 
These cysts contain fluid, and are termed bladder worms, when empty 
and cysticercus or cysticercoids when they contain fluid. In each of these 
bladders we find the individual taenia head furnished with hooks and the 
sucking caps. In some forms of the taenia these bladders divide and sul)- 
divide into numerous daughter-cysts or breeding buds, all of which pro- 
duce the little heads of the taenia. This is frequently seen in the echino- 
coccus, where enormous masses are found. If any animal, or proper 
secondary host, gets one of these ripe bladder worms into the stomach the 
gastric juice dissolves its covering and it finds its way to the duodenum, 
where it fastens itself by means of its hooks and sucking apparatus and 
instantly becomes a breeding parasite. 

The anatomical structure of the cestodes is very simple. The body 
parenchyma is divided into two layers, an external and an inner covering. 
In the latter, we find the sexual organs. The external layer is chiefly 
muscular, and contains also a mass of calcareous nodules that replace 
the defective bony structure of the cestodes. The surface of the head 
is covered with a skin or cuticle, from which the hooks originate. A 
digestive system and blood vessels are absent, but in the inner layer we 
find a system of very much branched water vascular sj^stem, which is 
connected with two elongated canals, united at each joint by a cross 
system of similar canals, which is said to serve as an excretory apparatus. 



T^NIA 



85 



The branches running into these canals end in a common orifice. Each 
link or segment has an independent male and female sexual appa- 
ratus. The male apparatus consists of numerous pear- 
shaped testicular bladders with a canal of exit. The 
end can be turned up into the female opening. In the 
female portion we find ovaries, uterus and vagina. The 
uterus is remarkably well defined in each segment (see 
Fig. 41). 

The following varieties are seen in the dog: 
Taenia Serrata (Fig. 42). — This variety is from 0.5 
to 6 m. in length and about 0.6 cm. in width when fully 
developed. The head is large, proportionately, bullet- 
shaped, often four-sided, and is fitted with about 40 
hooks in two rows and also sucking disks, wdiich are oval of the Tania coen- 
in shape. The first sections after the head are very nar- ^^^^ Cenarge 
row, and the middle sections are almost four-sided. The anterior bor- 




Fig 



Uterus 




Fig. 42. — Tienia Serrata. 

der of the segments is much narrower than the posterior. The edges 
are serrated or saw-like, hence the name. The genital orifice is situated 



86 



DISEASES OF THE DIGESTIVE APPARATUS 



on the border, alternatino; one on the right and next on the left. The 
full-grown segments are nearly square or may be broader than long. 
The uterus has a long central body, with eight branches on the side. 
These send out numerous subdivisions from each individual branch. 




Fig. 43. — Tiunia marginata, posterior end of worm. 

The eggs are indented on the sides and have a hard tough shell, 30 to 
40 mm. long 31 to 30 mm. wide. The bladder worm is found in the 
liver of the wild and domestic hare, called the cysticerus pisiformis. 
This grape-shaped cyst has been found to grow as large as a hazel nut, has 



T.€NIA 



87 



been found by Lesbre in the brain of a dog affected by taenia serrata. 
This was probably caused by self-infection. This animal exhibited 
symptoms resembling rabies, and was incessantly grinding the teeth and 
snapping the jaws. 

Taenia Marginata (Fig. 43). — This is the longest and widest tsnia 
of the dog, being from 1.5 to 3 m. in length. In rare instances it 
has been found to be 5 m. and the width of the developed segments is 
about 0.5 cm. Its head is nearly rounded with four small sucking disks 
and a double crown of 36 hooks. The segments are nearly square. In 
the middle of the colony they may even be broader than long, with ir- 
regular edges and partially overlap the following section. The sexual 
orifice which is situated on the margin may be alternately on the right 




Fig. 44. — Taenia cucumerina, Dipylidium caninum. 

or left side, the right sections are longer than their width, which are 14 to 
1(3 mm. and 5 to 7 mm. wide. The uterus has a short central body and 
has five branches on either side, which are intertwined. The eggs are 
irregularly round and enveloped in a tough thick shell. The bladder 
worm of the taenia marginata is the cysticercus tenuicoUis, and is found 
in the serous tissues of the sheep, cow, goat, pig, squirrel, and monkey 
in captivity, and occasionally in man (Dewitz). Frequently we find 
the cysticercus on the peritoneum and liver of the sheep and pig, vary- 
ing in size from a pea to the size of a man's fist. 

Taenia Cucumerina (Dipylidium Caninum) (Fig. 44). — This is a 
small taenia 10 to 40 cm. long and 3 mm. wide. It has a small elongated 
head, with sixty hooks with a retracted mouth or proboscis; the seg- 



88 DISEASES OF THE DIGESTIVE APPARATUS 

merits are rounded at the corners and are the shape of a cucumber, hence 
the name, and have a small sexual orifice at each end. The individual 
sections are about 8 to 10 mm. long and 3 mm. wide. These segments are 
easily detachable, and are reddish-pink in color. This coloration is due 




Fig. 45. — Tirnia coenurus. 



to the color of the shell of the egg. The uterus is irregular, with double- 
shelled, rounded eggs, six to fifteen massed together in elongated cocoons. 
The primary stage of this taenia which is very common in the dog, is in 
the abdominal cavity of the dog-louse (trichodectes canis) (Metchnikoff) 



TAENIA 



89 



and also in the common dog-flea (ccrtopsyllus canis) and in the flea of 
man (pulcx iiTitans). 

Taenia Coenurus (Fig, 45). — This taenia is generally about 40 cm. 
long, although in rare instances it may be 1 m. It has a small pear- 
shaped head, with twenty-four to thirty hooks and four sucking disks. 
The anterior links of the colony are always very short, and those at 
the extreme end are elongated and narrow, 7 to 13 mm. long and 3 to 
3.5 wide, white and shaped like a cucumber seed. The uterus has a long 
central body, wath eighteen to twenty-six side branches. The eggs 
have a hard shell, elliptical and 30 to 30 mm. diameter with an indurated 
border. The larval state of this taenia, which is the coenurus cerebralis 
(bladder worm) , varies in size from a small seed to a 
large egg, and has a numl^er of nursing or daughter- 
cysts or bladders on its inner wall. It is generally 
located in the brain, and in rare instances in the spinal 
cord. It is seen in all ruminants, especially sheep. 

Taenia Echinococcus (Fig. 46) . — This is the smallest 
taenia of the dog, most dangerous to man. Its greatest 
length is 4.4 mm., and it has three and in rare instances 
four segments. The last segment is the largest and the 
only one to possess sexual organs. The uterus is large 
and irregular, without any central border. The head is 
round and has four sucking bodies and twenty-four to 
forty-eight small imperfectly developed hooks, arranged 
in two rows. The eggs are round and slightly elongated, 
the shell being formed in several layers. The bladder 
worm is the echinococcus polymorphus: the bladder is echmococcus: a, tape- 

. worm, enlarged twelve 

filled With a nonalbuminous fluid and generally has times; h, cyst con tain- 
daughter-cysts on the sides. These cysts may assume '^^ ^^°-'^'' '^' ^mature 

. ... head. 

enormous proportions, ranging m size from a pea to a 
man's head or even larger and on the walls we find numerous ammen 
heads. There are two varieties of the echinococcus, the distinguish- 
ing characters being the length of the hooks and the arrangement of 
the eggs. It is found in the pig, cattle and sheep and very rarely 
in solipeds and carnivora. In man it is generally found in or attached 
to the liver or peritoneum, but it has also been found in the lungs, 
kidneys, spleen, muscular system, pleura, bones and the brain. 
The following parasites are occasionally found in the dog: 
Taenia Serialis. — This parasite, about 35 to 75 mm. long, resembles 
the Tsnia coenurus. The intermediate host of this parasite is found in 
the ral)l)it. 

Taenia Litterata, pscudo-cucumerina , Taenia lineata. This parasite re- 
sembles the Taenia cucumerina, is found in the fox, but rarely in the dog. 




Taenia 



90 DISEASES OF THE DIGESTIVE APPARATUS 

When animals live on the sea-shore we frequently find them affected 
with bothriocephalus latus. This parasite is found in its immature 
state in certain fish. 

Tape-worms are very common in dogs; some observers claim as high 
as 54 per cent, of all animals. In Europe all varieties of the parasites 
seem to occur according to different speaking countries. The record 
given by Schones is as follows: Hunting dogs 52.94 per cent, were affected 
mostly with Taenia serrata; butchers' dogs GG.6G per cent., mostly Taenia 
marginata; watch dogs confined to the yards and grounds around build- 
ings 40.44, mostly Taenia cucumerina; work dogs used to pull, 72.22, 
mostly Taenia marginata; sheep dogs, 57.14 were affected not only with 
Taenia coenurus to the extent of 7.14, but were also infected with Taenia 
marginata. Taenia serrata. Taenia cucumerina; pet dogs 70.37, of which 
36 had Taenia marginata. Taenia cucumerina and 15.74 Taenia serrata. 




Fig. 47. — Taenia echinococcus ; mucous membrane of a portion of the intestine covered with the 

parasites. 

The writer finds in the United States by far the most prevalent is the 
Taenia cucumerina, occurring in eighty-two of these cases. Taenia serrata 
ten, and marginata only in two instances, and Taenia echinococcus never 
observed. 

There is no question that one individual is attacked to a greater 
extent than others, and the parasite finds more favorable conditions in 
the mucous membrane of the intestine of certain animals. The parasites 
may be found in enormous numbers, particularly the Echinococcus 
when they cover the mucous membrane and give it a velvety appearance 
(Fig. 47). 

Clinical Symptoms. — "When tape-worms are present they generally 
cause more or less disturbance in the host, ^^cry decided symptoms, 
such as chronic intestinal catarrh, can sometimes be attributed di- 
rectly to the presence of the parasites. Infected animals, as a rule, are 
restless, great eaters, and in spite of the amount of food they cat -they 
remain thin. Often they produce the same symptoms as ascarides, 



T.EXIA 91 

but, as a rule, the tape-worm causes much more troul)le than the round 
worms. Schieferdecker found that in the duodenum, where the Taenia 
cucumerina are generally found, the mucous membrane had numerous 
small tunnels through which the taenia passed in and out, and caused a 
peculiar hypertrophy of the papilla?; in some cases they were four or 
five times their own length. In some cases Lieberkuhn's glands were 
sunken and collapsed and in several cases had completely disappeared. 
The Taenia echinococcus, when they are present in large numbers, 
cause great irritation of the intestines, with hemorrhagic infarction of 
the tissues. In nervous animals they cause epileptic spasms or even 
symptoms of rabies, such as a change of voice, paralysis of the lower 
jaw, dulness and indifference to surroundings; Friedberger and Froh- 
ner have also observed similar symptoms in dogs that have been af- 
fected with a Taenia cucumerina. In rare instances the taenia have been 
known to perforate the intestines. According to the observations of 
Cadeac, the perforation was made by two of the Taenia serrata. In a 
great number of instances it is impossible to say positively that the 
animal has tape-worm unless the segments are observed in the faeces, 
and the most dangerous to man (Taenia echinococcus) is extremely hard 
to find, on account of the small size of the segments. The other tape- 
worms are comparatively easy to find, as the segments are readily 
seen on the outside of the stools or catch in the anus and hang on the 
hair, the dog frequently drawing attention to them by licking the anus 
or drawing the hind extremity along the floor by means of the front 
legs. In doubtful cases it is well to give a small dose of some taeniafuge, 
and the animal will generally pass a few segments. 

Therapeutics. — The most important of the numerous taeniafuges 
recommended are as follows: 

1. Extract of Male Fern (extractum filix mas). — According to the 
experience of the author, it is the best agent to use. It is to be given 
on an empty stomach (in the morning being the best time). In smaU 
dogs in doses from 0.5 to 1.0 and in large animals 2.0 to 5.0, in pill form 
or in capsule. As this drug has no purgative properties, it must be followed 
up in one or two hours by a dose of castor oil (30 to 50 grammes). Male 
fern is very liable to deteriorate if kept any length of time. Therefore 
it is wise to procure it from a drug house that can guarantee it is fresh. 
It must be borne in mind that male fern in large doses is a poison, and 
the maximum (4.0) must not be exceeded in a large dog. Gesimer ad- 
vises filmaron in 0.2 to 1.0 capsules or a 10 per cent, solution of filmaron. 
This should be given in the morning on an empty stomach and followed 
by a dose of castor oil. 

2. Kamala.— This is to be given in doses of 2 to 8 gm., and in large 
animals up to 15.0. The powder may be rubbed in with a little ether 



92 DISEASES OF THE DIGESTIVE APPARATUS 

and given in capsule but when the powder is bulky, as in large doses, it 
may be mixed with honey or syrup. It must be repeated in one hour 
after the first dose. As it is a purgative, it is not necessaiy to follow it 
up with any other drug, which is an advantage, but to completely empty 
the intestines of the parasite, it is sometimes wise to follow it with a 
laxative. 

3. Kusso (Flores koso). — This is to be given in doses from 2.0 to G.O 
grammes, diluted with milk, repeated three or four times at intervals of 
three-quarters to an hour. OnJy a good result can be expected when 
the drug is fresh. This should be mixed with, or followed by, a small 
quantity of castor oil. 

4. Areca Nut. — The pulverized areca nut is administered in from 
1.0 to 4.0 in capsule mixed with honey or butter, followed by a laxative. 
Schiel advises a combination of areca nut and kamala. Areca nut is 
frecjuently vomited and must be given with raspberry syrup or some 
other sweet syrup, which generally prevents it Ijeing vomited. 

5. Chloroform. — 1.0 to 4.0 should be shaken up with castor oil and 
given at once; the chief objection is, it is very apt to be vomited. 

Pomegranate (Cortex granate). — In the shape of the macerated de- 
coctions, 25 to 00 seeds (pumpkin seeds crushed and macerated in hot 
water). Oxide of copper in doses of 0.01 to 0.05 daily for several days. 
Turpentine 2.0 to 4.0 beaten up in the yolk of an egg, daily for three days. 
Benzine pelletierum tannicum, strontium lacuticum, creolin, naphthol 
are taeniafuges, but are only used to a slight extent, as they are much 
less efficient than the first preparations mentioned. 

After the animal has passed the parasites they ought to be picked 
up on a shovel or other object and put in the fire to destroy the segments, 
especially if you have reason to suspect that the Taenia echinococcus is 
present, on account of the danger to man. 



I^. 01. resin, felix mas, 0.75 to 1.0 

Areca semina pulv., 1.0 to 2.0 

F. M. Capsule No. 1. 

Sig. — Give on an empty stomach followed l)y castor oil. 

I^. 01. re.sin. feli.x mas, 1.0 to 4,0 

F. M. Capsule No. 1. 

Sig — Give on an empty stomach. 

I^. Kamala, 1.0 to 2.0 

Anipsthesin, 0.15 to 0.2 

F. M. Capsule No. 1. 

Sig. — Give on an empty stomach 



T,t:xiA 



93 








7 




1 





[tc 


4 





to 


40 






I}. 01. res. fclix mas, 
Kamala, 

Ol. olivjp, 1 drop. 
F. M. Capsule No 1. 

I^. Chloroform, 2.0 

01. ricini, 30.0 

Sig. — Give in two doses one week apart. 
I^. Areca semina piilv., 1.0 [to 3.0 

Sig. — In capsule, honey or milk. 

I^. Kousso, 4.0 to 6.0 

Mel. 

G. S. teaspoonful. 
F. M. Electuray. 
Sig.— To be given in two doses, one week apart. 



Oxyuris Vermicularis. — By this name (Fig. 48) 
we mean a small, white, thread-like round worm. 
The female is from 9 to 13 mm. in length and the 
male from 3 to 4 mm. in length. This parasite is 
rarely found in the dog. They are generally located 
in the rectum and the lower large intestines. They 
cause great itching of the anus, and the animal is 
observed to lick that part constantly and also to 
frequently pull the hind-quarters on the floor. 

These harmless parasites are removed by cly- 
sters composed of solutions of salt water, quassia 
bark, vinegar or a weak solution (1-2000) of corro- 
sive sublimate. 

Dochmius. — Dochmius (Anchylostomum uncin- 
aria) (Fig. 49) is a small, thread-like parasite which 
belongs to the family of strongylides (palisade worm) . 
The end of its head is like a bell-shaped capsule, 
having two small, curved teeth on its dorsal border 
and four teeth on its ventral border. By means of 
the bell-shaped disk and the teeth on the inner part 
of its mouth it sucks and buries its head into the 
mucous membrane of the intestine and sucks blood. 
Three forms of this parasite are found in the small 
intestine of the dog and are described as follows: 
the Dochmius duodenalis, the male 10 mm. long, 
the female 12 to 18 mm. long; the Dochmius trigo- 
nocephalus, the male is 9 to 12 mm. wide, the 
female 15 to 20 mm. wide, and the Dochmius steno- 
cephalus, the male is G to 8 mm. long and the 



Fi<;. 48. — OxyurLs ver- 
micularis : a, magnified 
diagram of the female; b, 
the male, magnified; c, 
natural size of the female; 
d, natural size of the male 
{Vierordt). 



94 DISEASES OF THE DIGESTIVE APPARATUS 

female is 8 to 10 mm. long. The Dochmius duodenalis is the parasite 
that observers have named as causing the disease known as Egyptian 
chlorosis. This disease is indicated in man by general anaemia. The 
eggs, which are oval, are jsassed in enormous numbers in the faeces of 
affected persons, and lie on the leaves of acjuatic plants or the moist 
ground, and are taken up in the drinking water, food or eating of 
grass by dogs, reach the intestines of the animal and the parasite soon 
matures. One liranch of the Dochmius, seen in Austria, Italy and Japan, 
Dochmius uncincoriasis, causes great disturbance, particularly in hunt- 
ing dogs. 

Animals affected with this parasite become anaemic, weak and 
thin, develop hemorrhagic enteritis and catarrhal pneumonia and have 
a peculiar discharge from the nose, of a thin, bloody mucus (Megnin, 
Ilaillet). Peregand found these cases generally had piroplasma with 




'a- 



Fig. 49. — a, Male; b, female (natural size); c, magnified head (Jaksch). 

the other symptoms. There are also oedematous swellings, ulcerations 
or gangrenous swellings of the skin, with intense cachexia. 

Therapeutics. — The treatment consists in the administration of 
tseniafuges, felix mas, kamala, cadeot combined with calomel. Megnin 
uses calomel and arsenic, the latter in 0.005 to 0.01 doses. Besides this, 
give easily digested and nutritious food, milk, and eggs. The faeces of 
all affected animals should be burned and the stools and benches where 
the dogs sleep should be cleaned. Drinking water to be from a spring, 
or else filtered or boiled. 

The presence of this parasite is recognized in the same way as one 
would locate the taenia, that is, by the presence of the parasite or eggs 
in the faeces. They are easily recognized, the eggs being similar to the 
ascarides. 

Besides the already mentioned parasites, we also find the Distoma 
echinatum (Generali and Ratz) and the Distoma heterophytes, found by 
Jaiiyen in Japan and by Loots in Egypt, in the intestines. The Tri- 



PERITONITIS 



95 



chocephalus depressiusculus is found in the caecum (Fig. 50) . This parasite, 
according to a number of authors, may produce a catarrh or hemorrhagic 
condition of the intestines and invagination of the caecum. Animals af- 




FiG. 50. — Wall of the csecum with numerous Trichocephalus depressiusculus. 

fected with these parasites suffer from dochmiasis or anaemia. This 
distomum heterophytes was found in an animal presenting symptoms of 
rabies. 

DISEASES OF THE PERITONEUM. 

Inflammation of the Peritoneiun — Peritonitis. 

Etiology. — Peritonitis is comparatively rare in dogs and is generally 
seen as a secondary disease; due originally to some irritation or in- 
jury of some of the other organs of the abdomen, the stomach, intes- 
tines, spleen, liver, kidneys, bladder, prostate, or the uterus. From 
toxic gastro-enteritis, ulceration of the stomach or intestines, accumula- 
tions of faecal matter in the intestines; from metritis or parametritis 
after labor; from inflammation or abscess of the liver; from purulent inflam- 
mation of the kidneys, or from purulent pleuritis; from rupture of the ab- 
dominal viscera and the escape of food, faeces, gas, bile, pus, parasites 
perforating the intestinal mucous membrane, and in rare instances from 
the presence of parasites (Plerocerooides barletti) in the abdominal 
cavity. It may also occur from a general inflammation of all the ser- 
ous membranes of the body, as is sometimes observed in infectious dis- 
eases; to pyaemia or metastatic peritonitis; from the breaking down of 
tubercular masses that have collected on the peritoneum, or from can- 
cer. Primary peritonitis is always caused by some injury to the ab- 



96 



DISEASES OF THE DIGESTIVE APPARATUS 



dominal wall, shocks, blows, or by penetration of the abdominal walls, 
or after some opei'ations and from cold (rheumatic peritonitis). 

Pathological Anatomy. — According to the extent of the disease we 
call it either partial (circumscribed) or general peritonitis (diffused); 
according to its course, acute or chronic; and according to its character, 
we call the exudate serous, fibrinous, purulent, putrid, or hemor- 
rhagic. The purulent form of the disease is the most common and on 
account of the extensive irritation that any inflammation causes in the 
peritoneum, it is apt to take the diffuse form of the disease; and while 
it may start originally as circumscribed, the disease generally becomes 




Fig. 51. — Section through the abdomen of the dog showing the distribution of the peritoneum: 
a, kidney; b, aorta; c, vena cava; d, intestine; d' , duodenum; e, pancreatic gland;/, spleen; g, liver; h, 
subperitoneal fat. 



diffuse in a short time. The peritoneum is first injected and ecchymosed, 
becoming dull red and velvety, due to the removal of the endothelium 
and partially to the exudate, which contains more or less fibrinous sub- 
stances. This collects as a thick layer over the peritoneum and the 
exudate unites the intestines to each other or to the different organs 
in the abdominal cavity, or even to the sides of the abdominal wall. In 
recent cases these adhesions are easily pulled apart, but later on they 
become firmly united and are very hard to separate (adhesive i^erito- 
nitis). There is also a quantity of fibrinous exudate thrown out, which is 
accompanied by more or less liquid. This varies from a small quantity 
to several litres. There is always some oedema of the serous wall of 
the intestines, which becomes soft and friable (Fig. 51). 

The chronic form may start out as such at the onset, biit generally 
it follows an acute attack, the peritoneum becomes very much thickened 



PERITONITIS 97 

and adhesions form, with the intestines and the adjacent organs, at times 
contracting the intestinal walls and causing a lessening of the diameter of 
the intestinal canal. In the chronic form the exudate is not purulent, as 
a rule, but is composed of a thick, hemorrhagic serum. In the dog, we 
sometimes observe a form of ascites (see under that head) in which we 
have a chronic thickening of the peritoneum and a collection of a turbid, 
fibrinous exudate (inflammator}' ascites). 

Circumscribed Peritonitis may be caused by any irritation of the 
viscera, such as inflammatory and suppurative processes of the stomach, 
intestines or uterus, classed as perigastritis, perienteritis and perime- 
tritis and the irritation extend to the serous coat. We often find small 
circumscribed deposits on the liver, occasionally on the spleen and other 
alDdominal organs, that have originated from slight peritonitis. In 
cases where there is a small amount of purulent peritonitis, the inflam- 
mation remains in one locality and becomes encysted. As a rule, with 
the exception of circumscribed peritonitis, death generally occurs in the 
first stages of the disease, and it is only in the mild cases, where the 
exudation is very slight, that there is any chance of recovery. The exu- 
date breaks down and is re-absorbed but, as a rule, there is such an ex- 
tensive alteration and adhesion formed that it is only in rare cases that 
the animal ever is restored to perfect health. 

Clinical Symptoms and Course of the Disease. — (1) Acute diffuse 
peritonitis. When the disease is caused by some traumatism, by perfora- 
tion, either from the intestines or externally, the symptoms appear very 
rapidly. At first there is colic, great restlessness, and a stiff, unnatural 
gait. The posterior extremities are carried out from the body and are 
not flexed. The animal groans and cries. The pain is continual, the 
abdomen is very sensitive on manipulation, the slightest touch produces 
intense pain. There are some cases in this disease, however, where the 
animal shows very little pain, but this is only seen where there is 
great debility. The abdomen becomes distended in the early stages of 
the disease, due to inflation of the intestinal tract from gas and later on 
by the collection of the exudate. When the abdomen is distended, if 
gas is present, on percussion, the sound is hollow^, and when exudate is 
present, the sound is dull. The exudate, of course, lies on the floor of the 
abdominal cavity; but where the exudate forms very rapidly, the whole 
abdomen is filled up, pressing on the diaphragm, compressing the lungs 
and causing great dyspncea. 

In the early stages the abdomen is tucked up, the walls tense, firm 
and painful to the touch, and it is generally some time before the abdomen 
begins to enlarge from the collection of the exudate. As a rule, the bowels 
are constipated except where there has been some diarrhoea, or diar- 
rha'a alternated with constipation, present before the disease started, 
7 



93 DISEASES OF THE DIGESTIVE APPARATUS 

which is seen in those cases where there is ulceration and perforation of 
the mucous membranes. Vomiting is always present, the vomited 
matter being greenish-yellow mucus, and in the latter stages we fre- 
quently find faecal matter in the vomited material; the urine is lessened 
in amount and contains a large amount of indican. There is total loss 
of appetite. The temperature rises to 40° C. or above. If the disease is 
not so severe as to cause death in a day or two the temperature fluctu- 
ates, being high at one part of the day and then it becomes subnormal, 
its character being remittent. The pulse is fast, thin and wiry, and 
finally imperceptible. 

The majority of cases are fatal, the animals dying in from one day 
to a week, according to the intensity of the disease. They usually die in 
a condition of collapse; in rare cases from heart-failure or suffocation 
from the rapid collection of the exudate. The most rapidly fatal cases 
are those due to the perforation with septic infection. 

Circumscribed or Chronic Peritonitis produces less marked symp- 
toms and is harder to recognize, the symptoms of diffuse chronic peri- 
tonitis being those of ascites, and, as a rule, not diagnosed except on 
post-mortem. The best way to confirm a diagnosis is to puncture the 
abdomen with a small trocar and see the character of the fluid. 

Therapeutics. — Remove the cause if possible; if this cannot be ac- 
complished by surgical interference, acute diffuse peritonitis should be 
treated with constant applications of cold water compresses to the ab- 
domen, and, if the irritation is very intense, the application of a covmter- 
irritant such as frictions of camphor oil, mustard poultices or mustard oil; 
the latter is the best. Take 30 to 50 grammes, of a mixture composed of 
mustard oil, 10 parts and olive oil 100, rubbing it well into the abdomen; 
applications of hot water to the abdomen by means of the priessnitz 
compress are also useful. Opium is to be given internally in doses of 
0.1 to 0.5 grammes; laudanum 1.0 to 5.0, and where there is collapse 
give whiskey and spirits of camphor. If there is any obstruction of the 
bowels, give injections of warm water or subcutaneous injections of phy- 
siological salt solution. The exudate should be removed by puncture 
of the abdomen, but this is not to be done until the acute symptoms 
have subsided. It must always be borne in mind (and this holds good 
in inflammation of other serous membranes) that the production of a serous 
exudate is a process that tends to lessen the acuteness of the existing 
conditions, because the liquid helps to keep the intensely inflamed parts 
separate and prevents frictions and its complicating inflammation, hence 
it should not be removed too early but when the exudate is suspected to 
be purulent and by means of an explorative puncture has been proven to 
1)0 so, a laparotomy must be performed, and the whole abdominal cavity 
washed out with a weak solution of salicvlic or boric acid. When the 



ABDOMINAL DROPSY 



99 



animal shows signs of recovery, the diet must be carefully regulated, at 
first milk, or thin soup, as the animal is very apt to vomit. Then the 
lightest diet, soup, milk, juice of beef, a small quantity of lemon juice can 
be administered, a teaspoonful at a time, or a teaspoonful of essence of 
pepsin. 

Abdominal Dropsy. 

(Hydrops Ascites; Ascites; Hydrops Abdominis; Hydrops Peritonei.) 

By this is meant a collection of serous liquid in the abdominal cavity 
that originates without inflammatory symptoms, being due to transuda- 
tion. The amount of liquid collected varies very much. In some cases 
there are only a few spoonfuls, in others 15 to 20 litres of liquid. 

The color of the liquid is sometimes as clear as water, but generally 
it is reddish-yellow. It may also be filled w-ith flakes of fibrin, 




Fig. 52. — Dog with ascites. 

which indicate chronic peritonitis, or turbid as milk (chylous ascites). 
When exposed to the atmosphere it usually remains fluid and only in 
rare instances it becomes firm and jelly-like. It is thin and watery and 
slightly sticky when pressed between the fingers and about the specific 
gravity of blood serum. At first the peritoneum is normal, but, if this 
condition lasts some time, the peritoneum becomes macerated, is pale or 
dull white, and finally a general degeneration sets in. When the animal 



100 DISEASES OF THE DIGESTIVE APPARATUS 

has been repeatedly punctured, inflammatoi-y processes may take place, 
and are followed by adhesions. The abdominal organs become anaemic 
and freciucntly dropsical (Fig. 52). 

Etiology. — Ascites never appears as an independent disease, but 
must be regarded as a symptom of another disease. As the peritoneal 
veins belong to the mesenteric system, any obstruction of the portal 
veins cause these serous collections, for instance, in cirrhosis of the liver, or 
tumors of that organ, or from compression of the mesenteric veins by tu- 
mors, abscesses, etc. Ascites is also seen as a symptom of general dropsy of 
the kidneys or lungs, and from defective action of the heart. It may also 
be caused by local diseases of the peritoneum, such as tuberculosis, car- 
cinoma, or from chronic inflammation between transudate and inflam- 
matory exudates. In young animals ascites may develop without 
any other complications or cause and may make a complete recovery 
(Hutyra and Marek)- 

Clinical Symptoms. — The chief clinical symptom of this disease 
is the accumulation of fluid in the abdominal cavity. Small amounts 
very frequently are not noticed and in fact, cannot be determined by 
any means except by tapping. When there is a considerable collection 
of serous fluid, the abdominal wall is distended, and, from being in the 
lower portion of the abdomen, the cross-section outlines of the trunk 
resemble those of a pear. There is a peculiar sunken appearance of 
the flanks (see Fig. 52). When the tips of the fingers are struck against 
the distended abdomen, there is a fluctuating movement; and when there 
is a large quantity of fluid present, the splashing sound of the fluid can 
sometimes be heard when the side of the abdomen is struck sharply 
with the flat of the hand. By percussion, we can tell, to a certain 
extent, the amount of the fluid present. The animal should be made 
to stand, so that all the fluid lies in the base of the abdomen. By 
percussing, beginning at the lower part of the abdomen and moving- 
upward on the wall where there is fluid present, we will get a dull sound ; 
and when the line of fluid is passed, we get the intestinal or tympanic 
sound. It is very important that the animal should be in a standing 
position, as it can be readily understood that when the animal is lying on 
its side, the fluid gravitating to the lower side, we would get a clear tym- 
panic sound all over the abdominal wall on the upper side and still 
have a large quantity of fluid in the cavity. 

The higher the fluid collects, the greater is the pressure on the ab- 
dominal organs, and the consequent pressure on the diaphragm, causing 
interference with normal respiration. The urine is generally nor- 
mal, but reduced in quantity, and the quantity of the accumulated 
fluid pressing on the bladder may sometimes cause involuntary emp- 
tying of the bladder. In the later stages osdematous swellings appear 



ABDOMIXAL DROPSY 101 

in the extremities, or we may find a general dropsy, the digestion 
is impaired, and the bowels disturbed. In the majority of cases diar- 
rhoea is present, with occasionally vomiting. AVhile it seems very 
easy to make a diagnosis when the above symptoms are present, still 
the following diseases may present several or all of the symptoms above 
described. 

1. Acute or Chronic Peritonitis. — "\Mien one reads the sj'mptoms 
of acute peritonitis the diseases can be readily separated, but in the 
latter part of the disease, when the effusion has collected, or where the 
chronic stage of peritonitis is present, it is a little difficult to separate 
them, the only positive means being to puncture the walls with a small 
trocar (hypodermatic) and obtain a small quantity of the fluid, and it is 
rather common to see ascites associated with chronic peritonitis. 

2. Fatty Deposits in the Abdomen. — This disease is quite frequently 
present in old dogs; but a differential diagnosis can be made from 
the fact, that, where there are enormous collections of fat present, the 
abdomen is round in appearance, but does not become pendulous, whether 
the clog is standing or recumbent. It is well not to puncture in these 
cases, as it gives no information, and may cause internal hemorrhage. 

3. Abnormal Collections of Urine in the Bladder. — In these cases we 
feel a ball-shaped body in the posterior portion of the abdomen; this 
swelling does not follow the changes in the position of the body, and is 
not indicated by percussion. A good way to make a differential diag- 
nosis is to lift up the animal by the posterior extremities, and if it is as- 
cites the liquid will settle on the diaphragm and interfere with respira- 
tion; if the bladder is filled, we do not have the dull percussion sound. 

To further confirm the diagnosis pass the catheter. 

4. Distention of the Bowels with Gas (Meteorismus) . — In this in- 
stance, there is an absence of the fluctuation and the clear tympanic 
sound all over the abdomen. 

5. Collections of Urine in the Abdomen after Rupture of the Blad- 
der. — On the passage of the trocar, the clear urine is passed which can 
easily be recognized by the color and odor, with absence of urine on cathe- 
terization, and ursemic fever, or convulsions. 

6. In Advanced Gestation. — By careful manipulation the foetuses 
can be easily distinguished in the abdomen. 

Besides the above conditions, we may also have to distinguish be- 
tween ascites and tumors of the abdominal cavity (hydrometra, pyome- 
tra). All these affections can be recognized by carefully considering 
the history of the case and the accompanying symptoms. 

It is always well to carefully study the exciting cause of the disease, 
as the course of treatment depends on it. This, however, is rather 
hard to do, for, as a rule, the collection of fluid is caused by the dam- 



102 DISEASES OF THE DIGESTIVE APPARATUS 

ming or interference in the mesenteric system, by cirrhosis of the 
liver, or some interference in the portal system. These are likely to 
improve with tapping and symptomatic treatment. But in anasarca, 
hydrothorax, general dropsy due to a weak heart, or valvular affections 
of that organ, disorders of the lungs or kidneys, hydrsemia or marasmus; 
it depends to a large extent on whether we can either restore the af- 
fected organ to a normal condition, for if they are permanently affected, 
the condition is generally chronic. Quite often we find affections of 
the liver and spleen that are never recognized during life. To make 
an examination of these organs it is well to do it just after the animal 
has been tapped and the fluid has been removed; the walls of the 
abdomen are collapsed, and the organs can be manipulated with greater 
ease at that time. If tumors are present, they are readily recognized. 

Notwithstanding all the etiological conditions described, there are 
often cases where the cause can only be guessed at. 

Prognosis and Therapeutics. — As a rule, the prognosis is unfavor- 
able as we are unable to remove the exciting cause. The cases that re- 
cover are generally in young dogs and the dropsy is the only existing con- 
dition. In the majority of cases, the ascites disappears spontaneously. 
Our first effort is to remove the exciting cause, if it is recognized; and 
then to remove the dropsical effusion, either medicinally or surgically. 
At the same time the animal should be well fed on highly nitrogen- 
ous, easily digested food and tonics (see anaemia). This can be done in 
the following ways: 

1. By Laxatives. — This method is t;o be followed where there is con- 
stipation associated with the disease. Saline purgatives are the best, 
glauber salts, epsom or rochelle salts, such laxatives as jalap, podophyl- 
lum, castor oil, are contraindicated, as they irritate the stomach and 
destroy the appetite and weaken the animal. The salines are indicated, 
only in sufficient doses, to cause a slight laxative action, so as not to 
interfere with the appetite. 

2. Diuretics. — This form of treatment has always been popular to 
be given and is still much used. These are only used where there is posi- 
tive evidence that there is no previous irritation of the kidneys. The 
best are the vegetable diuretics, such as digitalis, strophanthus, caffeine, 
salicylate of soda, oil of juniper, liq. potassii acetas; among the more 
recent diuretics are theocin, theobromin, soda salicylate 4.0 to 6.0 in 
sol., diuretin 4.0 to CO; the best saline drugs are acetate of potassium 
and sodium. 

I^. Tine, digitalis fol., 1.0 

Liq. potas.sium acetate, 30.0 

Sig. — One tea.spoonful throe times daily. 



ABDOMINAL DROPSY 103 



. Agurin, 


0.1 


to .0-1 


Caffoine-sodium-salicylas, 


2.0 


to 5.0 


Sacharrum alba. 




5.0 


M. F. et divid charter No X. 






Sig. — One powder three times daily. 







I^. Agurin, 2 to 6.0 

Aqua menth. pip, 150.0 

Sig. — Tablespoonful three times daily. 

3. Hydrochlorate of Pilocarpine. — We may sometimes obtain very 
good results with this drug. The injection of the solution subcutane- 
ously is made once daily (0.005 to 0.01 of water). Zahn gave three drops 
of the 1 per cent, solution on the tongue, three times daily. The admin- 
istration of this drug causes the amount of saliva to be greatly increased, 
and the amount of fluid exudates to be very much decreased. Frohner 
recommends Arecolin. 

4. Tapping or Puncture of the Abdomen. — This is indicated where 
there is a large collection of fluid, that is pressing on the diaphragm, 
and also used as a diagnostic procedure. Whether it is best to re- 
move the fluid in all cases is a question that has not yet been decided; 
yet the writer is of the opinion that the fluid should be removed, pro- 
vided the animal is roljust and not too old, especially as the operation is 
comparatively harmless, and has the advantage over purgatives and 
diuretics in that the accumulation is removed ciuickl3\ In a great 
number of cases the fluid has not accumulated after one or more punc- 
tures. Friedberger and Frohner have seen old dogs that have died dur- 
ing, or shortly after, the operation. The method of puncturing or tap- 
ping is to take the ordinary trocar, a narrow caliber one is best, even if 
it takes a long time to drain out. We also avoid unconsciousness, which 
sometimes occurs where a large quantity is drained out too suddenly. 
During the operation the pulse, respiration, and general appearance 
of the animal must be watched carefully, in case the animal might col- 
lapse from the shock. In such an event, the trocar must be removed 
instantly and a subcutaneous injection of spirits of camphor must be 
given. The trocar should always be boiled, immediately before using. 

The method of operating is very simple. The place to insert the 
catheter is generally about the umbilical region, on or to one side of the 
linea alba. The animal should be placed in a standing position. Should 
the canula become plugged either by the omentum or intestines coming 
against the opening of the canula, it should be pulled downward, or moved 
to one side or introduce an elastic catheter and push them to one side. 
After the fluid has ceased to flow, remove the catheter and paint the 
opening with collodion. 



104 DISEASES OF THE DIGESTIVE APPARATUS 

The other changes in the peritoneum have no special value. Tu- 
bercular masses, sarcomas, and carcinomas have been already men- 
tioned; also parasites. Plerocercoides barleti are found free or partially 
encysted, also the pentastomum denticulatum was found by Rochcfon- 
taine in great numbers in the subperitoneal cyst of the liver and mesen- 
tery, and here also have been found the bladder cysts of the taenia 
echinococcus. 

DISEASES OF THE LIVER. 

Catarrhal Jaundice. 

(Icterus Catarrhalis; Icterus Gastro-duodenalis .) 

Etiology. — In catarrh of the stomach we often find symptoms of 
jaundice with that disease, especially where the inflammation of the 
mucous membrane extends to the duodenum, and the ductus cholcdochus 
l)ccomes closed by the swelling of its mucous membranes and prevents 
the exit of the bile. As soon as such an ol)st ruction occurs, the bile can 
no longer flow into the intestines; it becomes stagnant and dams back, 
causing a pressure on the bile-ducts, and being unable to escape, it finally 
enters the lymphatic vessels of the liver, from them into the blood through 
the thoracic duct. After this there follows a series of symptoms that 
have been named jaundice (icterus). In the early stages of the disease 
we have to deal with an icterus that is produced by stagnation of the 
bile. It has been found by observers that the pathological or artificial 
stoppage of the flow of the bile, and, consequently, damming back of 
the bile, will produce jaundice in forty-eight hours. This has a number of 
names — stagnating icterus, icterus of reabsorption, or hepatogenous 
icterus. While the swelling of the mucous membrane is generally the 
cause of this disease, still there are a number of other causes that may also 
produce it, such as foreign bodies in the ducts (parasites, gallstones, etc.), 
from ulceration of the mucous membrane, by the cicatricial contraction of 
tumors, or abscesses in or near the liver, from intestinal parasites invad- 
ing the bile-duct, from the bile being very dense and flowing slowly, by 
disturbance of the liver cells and the bile driven in an opposite direction 
(Minkowski), and diffuse icterus (icterus per paranedesen) , in disturbance 
of the blood circulation due to throml;)us in the portal artei'ies, the pres- 
ence of bacteria, from the eating of decayed meat and from certain in- 
fectious diseases, in cases of poisoning from phosphorus. The stop- 
ping of the flow of bile sets up an inflammation of the tissues and some- 
times forms abscess of the liver, but as the great majority of cases are 
caused by the catarrhal form, we will desci'ibc that. Any cause that 
will produce catarrh of the stomach will finally produce icterus, such as 



CA TA RRHA L J A UN DICE 1 05 

improper food, especially when it is frozen; cold drinks after over-heat- 
ing; salt meat, or salt fish. That form of icterus that is so often seen 
during distemper is very likely to be catarrhal. 

Pathological Anatomy. — The symptoms of catarrh of the duodenum 
are always present; the vessels are more or less injected, and the mucous 
membrane swollen. As a rule, the mouth of the duct is closed, and it is 
only by very strong pressure on the gall bladder that we are able to 
open it and force the bile out of the duct. In some cases a white clot of 
mucus is forced out and when the duct has been plugged up some time 
the bile is converted into a syrupy or semi-solid mass, but in the majority 
of cases it is due to swelling of the intestines and not to catarrh of the 
mucous membrane of the duct. 

In some post mortems, we may not find any swelling in the region of 
the duct, but very frequently the post-mortem changes are so cjuick as 
to be hardly recognizable at the autopsy. Another fact to be taken into 
consideration, is that the canal is so very narrow in the dog that it takes 
a very small amount of swelling to obstruct it. 

The body of the liver may be changed; it is generally enlarged and 
anaemic, and varies in color from a j^ellow to a yellowish-brown. The 
color is irregular and it is mottled like a nutmeg. The cells of the liver are 
infiltrated and filled with globules of fat, colored with brownish pigment, 
in the shape of granulated clots. The cadaver is generally anaemic; the 
Ijlood is clotted in the heart and large blood vessels or we find large 
lumps of hard reddish-yellow coagulate, or the blood may be stained 
yellow and contain white blood corpuscles in increased quantities. The 
red blood corpuscles are not much changed, but vary in size. All the 
tissues of the body, except the white substance of the brain, the spinal 
cord, the peripheral nerves and the corneal tissue, are stained more or less 
by the bile-pigment. The heart muscle undergoes a certain amount of 
fatty degeneration. The kidneys are anaemic; in the pale portion of the 
kidney we see extensive whitish stripes running in the direction of the 
urinary canals; this is caused by an irregular fatty degeneration and 
pigmentary infiltration of the canals (Siedamgrotsky). 

Clinical Symptoms and Course of the Disease. — As this disease is 
generally associated with catarrh of the stomach, the first symptoms in 
jaundice will be of that disease — loss of appetite, increased thirst, vomit- 
ing, coated tongue; in some rare instances, however, these may be absent, 
the first symptom being that of jaundice (yellowishness of the mucous 
membranes) . 

When the bile and liile acids enter the blood the following symptoms 
are observed: 

1 . By the entrance of the coloring matter of the bile into the tissues, 
they become more or less yellow, first yellowishness of the conjunctiva 



106 DISEASES OF THE DIGESTIVE APPARATUS 

and sclerotic coat; later the whole cutaneous covering becomes tinted. 
The yellowishncss may be very plainly seen on the abdomen, on the inner 
fascia of the thighs, and the mucous membrane of the mouth and throat; 
the color may range from a light yellow to a dirty orange-yellow; the 
latter color generally spreads over the entire body in the later stages of 
the disease. 

2. On account of the coloring matter being present in the urine, it is 
changed from the normal to a yellowish-green or to a dark greenish color; 
wdien put in a vessel and agitated it foams very quickly and if a piece of 
paper or linen is placed in it, it becomes tinted the color of the bile. It 
is also easy to detect the presence of bile color of the urine by chemical 
examination. (For further details, see the chapter on the Examination 
of the Urinary Apparatus.) Besides the bile acids, the urine almost 
always contains albumen, short hyaline casts, pigment granulations, and 
epithelium of the kidney. 

3. On account of the stoppage of the flow of bile into the intestines, 
the faeces become gray or clay-colored and contain much undigested fat, 
and hydrobilirubin is present. The fat substances not being digested, 
the fseces become very foetid; this change is due to the loss of the antiseptic 
effect of the bile, and as the food is passed along the intestine the tonic 
effect of the bile is absent. 

4. The bile acids present in the blood produce a certain amount of 
depression of the nerve-centres, and for this reason we find that the pulse 
and respiration are subnormal in action, and the temperature is reduced. 
Other symptoms of the narcotic effect of the bile are seen in some cases 
■where there is depression, great muscular debility, indifference to sur- 
roundings, somnolence and finally deep coma; we also find hemorrhagic 
conditions of the skin or mucous membrane. 

The local examination of the liver gives very, little satisfaction. 
The writer has never been able, except in one case, to find any percep- 
tible enlargement of the liver. Manipulation of the liver does not seem 
to give the animals pain in the later stages of the disease. The prog- 
nosis in the dog is generally unfavoral^le. The yellow coloration gradu- 
ally becomes deeper, the temperature falls to subnormal in the majority 
of cases, the pulse becomes weak and irregular, and finally death occurs with 
general paralysis. If the cases progress favorably, the first sign is a 
lessening of the coloration of the urine and a darker hue to the fseces; 
the pulse becomes fuller and more regular, the temperature increases, 
the animal shows more animation, and the color in the mucous membrane 
and the skin becomes lighter, until it finally disappears. If there is a 
relapse, it is generally by improper feeding. 

Therapeutics. — ^^'e must first aim to reduce the irritation of the 
duodenum also the bile-ducts. This is first effected by regulating the 



OTHER AFFECTIONS OF THE LIVER 107 

diet; small quantities of lean meat, milk, purees, gruel, and besides this 
giving saline laxatives and alkaline in the form of carbonates and car- 
bonic acid, if the constipation is persistent. Strong purgatives have 
been recommended, such as calomel, castor oil, and infusions of rhubarb; 
but they are of no particular value; in fact, in the majority of cases, they 
do more harm than good, as they have a tendenc}' to swell the mucous 
membrane. Enemas of warm water, two or three times daily are very 
useful. "We can also try to empty the gall bladder mechanically, by 
pressing the al^domen between the fingers in the region of the kidneys; 
also by faradization — a strong current is to be applied in the region of the 
liver on both sides of the abdomen; this must be kept up for ten minutes 
at a time, twice daily. Or we may use emetics, it being claimed that the 
compression of the liver during emesis, the violent contraction of the 
abdomen, will often empty the gall bladder. We can also try to carry 
the bile out of the system by the kidneys. The best drugs to use are 
diuretics, such as acetate of sodium or potassium. Where there is great 
debility or depression we can use spirits of camphor or ether. Boldine, 
the alkaloid of the Pennus boldos, hasrecently been spoken of as producing 
good results in jaundice; it is given in doses of 0.08 gramme daily with 
calomel. Great weakness or persistent sleepiness can be treated with 
camphor, ether, and caffeine. 

I^. Sal. CaroHn fact. 10.0 

Aqua, 150.0 

M. F, Sig. — One tablespoouful three times daily. 

I^'. Sodii salicylatis, 4 to 10.0 

Syrupi Rhei, 200.0 

M. F. Sig. — One tablespoonful morning and night. 

I^. Ac. Tartaric, 15.0 

Aqua distilata, 200.0 

M. F. Sig. — One teaspoonful three times daily. 

Other Affections of the Liver. 

The other affections of the liver are of slight importance and are 
rarely met with during life, consequently they will be only mentioned 
briefly. 

Hyperaemia of the Liver. — This may be caused either by an increased 
or obstructed flow of the bile, and therefore it is important to be able 
to distinguish between the two. 

Congestive hyperemia of the liver is a normal condition during 
digestion; it may be abnormally increased by eating large quantities 
of food, especially if it is rich and irritating, and from want of exer- 
cise; decayed or tainted food may also cause this condition. 



108 DISEASES OF THE DIGESTIVE APPARATUS 

Stagnating hypcripmia of the liver may be caused by defective 
valvular action of the heart or a weakened condition of that organ; 
in the later stages of acute diseases, such as the lungs; in cases where 
large numbers of the lung capillaries become atrophied and useless; in 
great pleuritic exudations; in extensive induration of the lungs, with 
emphysema; and also in dropsy of the pericardium. 

Pathological Anatomy. — The liver is greatly enlarged and very hard; 
when a section is cut in it, the blood seems to run out of it in large quanti- 
ties. This blood generally is dark colored, especially if the stagnation 
has been prolonged. The liver tissue may be spotted, the spots cor- 
responding with the central veins which are located in the centre of the 
lobules; or we may notice peripheric zones (nutmeg liver) alternating 
with lighter colored spaces. The liver gradually becomes smaller and its 
surface dull, and later on the parenchyma finely granular. 

Clinical Symptoms. — It is not possible to make a positive diagnosis 
of this disease, we can only suspect it by great tenderness on pres- 
sure in the region of the liver, and perhaps slight icterus, ascites may 
accompany hyperaemia of the liver; but as these symptoms may all be 
caused by catarrh of the bowels, it is well to be very cautious before 
making a positive diagnosis. 

Therapeutics. — Remove the cause if possible, regulate the diet and 
administer saline laxatives. 

Inflammation of the Liver (Hepatitis). — This disease appears in 
three forms — parenchymatous, interstitial and purulent. 

1. Parenchymatous hepatitis accompanies various infectious dis- 
eases, probably in the same way that we see congestion of the liver. 
It is seen as a symptom of acute phosphorus-poisoning, also as an ac- 
companiment of certain infectious diseases. 

The pathological-anatomical alterations are as follows: Enlarge- 
ment, softening, and a friable condition of the tissue, which breaks 
easily to the touch. At first it is dark red, but later on it becomes a 
yellowish clay color, due to the enlarged acini; the capsule is dull and 
thickened, due to a certain amount of perihepatitis. If the disease 
lasts any time, the volume of the liver is greatly lessened. 

The clinical symptoms are, evidences of catarrh of the stomach, 
pain on pressure in the region of the liver, icterus, and the liver is found 
on palpation to be enlarged. 

2. Interstitial Hepatitis (Cirrhosis of the Liver) (Hardening of 
the Liver). — This disease originates from causes that are at present un- 
known. There is no doubt that certain chemical or bacterial poisons 
which originate in the intestines have some part in causing this disease. 
Friedberger and Frohner surmise that it is caused by valvular disease 
of the heart. 



OTHER AFFECTIONS OF THE LIVER 109 

Pathological Anatomy. — There are two stages in this disease. In 
the first stage the liver is very much enlarged and hard, the edges of 
the lobes are blunt on the surface, there are a number of uneven de- 
pressions. On making a transverse section, we find a net-work of red- 
dish-gray tissues that surround the lobules; later on this involves the 
lobules themselves. In the second stage we find a cicatricial contraction, 
of newly formed tissue, and at the same time the disappearance of the true 
tissue of the liver. The liver then becomes gradvuilly smaller and has 
a very irregular surface; the capsule is thickened and in some places de- 
pressed; the tissue is hard and tough when cut with a knife. 

Clinical Symptoms. — The disease generally starts withovit any 
visible symptoms, although it is a common disease in old dogs that have 
lived well. When the disease has become pretty well advanced we find 
evidences of an interference in the portal circulation by the appearance 
of ascites and chronic catarrh of the stomach. "With these symptoms 
we also find a tendency to constipation with occasional changes to diar- 
rhoea. In rare instances a certain amount of icterus is present. This 
is due either to the interference with the passage of the bile from the 
gall bladder by catarrh of the duodenum or to a contracted condi- 
tion of the small bile-ducts. There is no pain on pressure in the region 
of the liver, even in the advanced stages of the disease. After removing 
the fluid, the outline of the liver can be felt by palpation. 

The disease is generally very slow, but ends fatally; when there is 
ascites and some oedema of the extremities present, the end is not far 
off. 

Therapeutics. — This consists in treating the case as if it were one of 
catarrh of the stomach, by means of saline purgatives and, if ascites is 
present, by puncture. The disease should be regarded as incurable. 

3. Purulent Inflammation of the Liver (Abscess of the Liver). — 
This may be caused by injuries, such as blows or kicks, externally, or 
from foreign bodies or perforating abscesses coming from the stomach, 
from metastasis from phlebitis and thrombus undergoing purulent de- 
struction, and from pyemia in abscess of the stomach, and in the bile- 
ducts from the presence of gall-stones or parasites. 

Pathological Anatomy. — Abscesses of the liver appear singly but 
may be present in large numbers; the traumatic abscess is generally 
solitary and the metastatic, multiple. The pus is cream-like and in 
some instances foetid and reddish-green in color. Small abscesses may 
heal by absorption, but the large ones open into the abdominal cavity 
and cause fatal peritonitis. 

Icterus symptoms, with frequent chills, point to abscess of the 
liver. Treatment is useless. 

Fatty Liver (Hepar Adiposum). — This is an abnormal diffuse fatty 



110 DISEASES OF THE DIGESTIVE APPARATUS 

infiltration of the cells of the liver. It is hard and seems anaemic when the 
section is made through the organ. The cells are found to be infiltrated 
with fatty globules and the nuclei pushed to one side. 

This condition is seen in old dogs that have been well fed and had 
little exercise, and is naturally a fatty infiltration. It must, however, 
be distinguished from the fatty degeneration that is found to follow sev- 
eral poisons, and in the later stages of consumption. In fatty infiltration 
the blood of the portal vein carries abnormal quantities of fat into the 
liver, which is deposited in the cells. In fatty degeneration the fat 
originates in the cells themselves; this is due to the albumin separating 
into two substances. One contains nitrogen, while in the other it is 
absent. This latter part undergoes fatty degeneration. 

The treatment of fatty liver is the same as for any adipose condition. 

Neoformations of the Liver and Gall-stones. — The neoformations 
found in the liver of the dog are sarcomas, carcinoma, adenoma, and lip- 
oma. These cause irregular enlargements on the body of the liver, and 
produce symptoms similar to those of cirrhosis of the liver. Some- 
times large tumors can be felt through the abdominal wall. 

Gall-stones are very rare in the dog. Frohner describes one case 
where the animal died with an icterus gravel. Immediately after death 
he found in the ductus choledochus a large bluish-black friable gall 
stone, the size of a pea. On section, this was brownish-yellow in the 
centre. Parascendolo described one case where the ductus choledochus 
was impacted with a mass of stones. The only way that they might 
be recognized would be the appearance of icterus, from retention, pre- 
ceded by intense colic. 

Treatment is the same as retention icterus; small gall stones may 
be present in the gall bladder without causing any peculiar symptoms, 
other than slight disturbance of the digestion. 

Parasites. — The following parasites have been found in the liver: 
distoma truncatum, distoma campanulatum, and distoma conjunc- 
tum (Ercolani). In the bile-ducts, ascarides have been found, Ercolani 
and Lissizin found a fully developed male eustrongylus gigas and coccidia 
(Rivolta), also the l)ladder cyst of the echinococcus. 

Amyloid and Lardaceous Liver. — Amyloid liver, as a rule, is a 
symptom of a general amyloid condition, developed from a cachectic 
state, from prolonged suppurating wounds or from chronic inflammation 
of the pectoral membranes. 

The liver is very much enlarged and blunt on the edges of the lolies. 
On section, the cut surface is speckled and grayish-brown in color. On 
microscopical examination the walls of the capillaries will be found to have 
undergone amyloid degeneration; when stained with Lugol's iodine solu- 
tion, the degenerated portions become mahogany-brown in color. 



POISONS 111 

Lardaceous liver is developed when we have a disease that has a 
tendency to produce amyloid degeneration. The liver becomes very 
large. With it we generally find amyloid kidney with albumin in the 
urine and we also are apt to find an amyloid spleen. 

POISONS. 

A short abstract on poisons with their symptoms and treatment 
is here given; it is not at all complete, and the student is referred to works 
on toxicology. 

Poisoning by Caustic Alkalies. — Caustic lime, soda or potassium, 
lye, sal. ammoniac, etc. These in their concentrated form may be ad- 
ministered accidentally, or may have been used in some external prep- 
aration and licked off by the animal. Caustic soda or potassium may 
be sw^allowed by animals that are very thirsty. The writer observed a 
dog that was poisoned eating meat that had caustic lime sprinkled on it. 

The lips, mouth, tongue, throat, and oesophagus are more or less 
cauterized, with salivation and vomiting of strongly alkaline materials, 
which is sometimes bloody. There is bloody diarrhoea. The potas- 
sium preparations cause paralysis of the heart. 

The treatment consists in the administration of vinegar or acetic 
acid, gruels of flour, oat meal, starch, emulsions of oil (olive, linseed, or 
cotton-seed). The giving of emetics or the use of the stomach pump 
is contra-indicated, as they are apt to cause perforation of the stomach. 

Poisoning by Caustic Acids. — This is of rare occurrence and is gen- 
erally caused by the insufficient dilution of medicinal preparations, or 
the vicious administration of acids. 

The mucous membrane of the mouth, throat, and cesophagus, is 
eroded or burnt brown. There is salivation and vomiting of a brownish- 
black material, with a strong acid reaction, which contains more or less 
blood, violent pain, small thready pulse, and finally collapse. 

Therapeutics. — Emetics and the stomach pump are contra-indicated, 
as there is danger of perforation, Limewater, dilute ammonia or 
soda solutions, emulsions of olive, linseed, or cotton-seed oils, small c{uan- 
tities of opium, and in case of collapse the subcutaneous injection of 
ether or camphor. 

Poisoning by Arsenic. — This is sometimes given intentionally on 
pieces of meat, or caused by eating some of the various rat poisons, the 
overdosing of Fowler's solution, or licking external preparations that 
contain arsenic. 

There is violent inflammation of the stomach and intestines, great 
restlessness, bloody diarrhoea, vomiting and dyspnoea, great weakness, 
and finally collapse and death in a few hours. 



112 DISEASES OF THE DIGESTIVE APPARATUS 

Therapeutics. — Emetics and iron preparations, the hydrated ses- 
quioxide of iron every quarter of an hour, carbonate of magnesia, a 
teaspoonful every twenty minutes, followed by alcoholic stimulants. 
The stomach pump can be used, if there is not prompt emesis. 

Poisoning by Hydrocyanic Acid; Prussic Acid. — This is generally 
given intentional}}', in the foi'm of cyanide of potassium, rarely the pure 
acid. There is an odor of bitter almonds on the breath. The symp- 
toms are vomiting, yelping cries, dyspnoea, convulsions of the legs, and 
death in a short time. If the dose should be small, there is restlessness, 
fear, dyspnoea, dilated pupils, convulsions of the extremities, fall in tem- 
perature until it is subnormal, marked slowness of the respirations and 
pulse, cyanosis and unconsciousness. 

Therapeutics. — Emetics, artificial respiration (rhythmic pressure 
of the lower abdominal walls, bathing in cold water, stimulants, chlo- 
rine water, and subcutaneous injections of atropia. 

Poisoning by Carbolic Acid. — This is quite frequently observed 
and is caused by the animal licking external preparations which con- 
tain the drug; this is frequently seen as a result of the use of some of the 
various preparations sold under the name of creolin, which are nothing 
more than crude carbolic acid, or some coal tar by-product, and 
the animal is bathed frequently in a strong solution of it. It may 
also be caused by the animal licking a wound or the wound absorbing 
carbolic acid, tar or creosote which has been applied as a dressing. It 
may also he absorbed following the injection of strong solutions of carbolic 
acid into the uterus. The urine is dark in color, frequently a dark olive 
green, there is slight colic, pain on pressure of the abdomen, vomiting, 
diarrhoea, great inflammation and redness of the mouth, marked weakness, 
decrease in the temperature, twitching of the muscles, paralysis, con- 
vulsions and collapse. 

Treatment. — White of egg, glaubcr salts, and stimulants. 

Poisoning by Iodoform. — This may be caused by licking wounds 
dressed with the drug and also from the injections into cysts of too 
strong solutions. In very large doses we find great gastric disturbance, 
small, frequent pulse, decrease in the internal temperature, suppression 
of urine, albuminuria, dulncss, and convulsions, alternated with great 
excitement and finally collapse. In smaller doses we find catarrh of 
the mucous membranes, emaciation, and skin eruptions. 

Therapeutics. — In the acute form give emetics followed by carbonate 
of potash, large quantities of starch, subcutaneous injections of atropia. 
In the milder forms saline laxatives, tonics and, of course, immediately 
remove the cause. 

Poisoning by Phosphorus. — This may be caused by the animal eating 
some of the various roach or bug poisons that have been spread on bread 



POISOXS 113 

and placed in a cellar or liuilding. There is constant vomiting, the odor of 
the ejected matter is that of phosphorus, and if taken into a dark room 
it is luminous. 

There is great restlessness, howling, whining, fever, and indications of 
intense irritation of the mouth and throat; and the saliva is thick and 
copious. After these symptoms have been present for some time, the 
animal becomes quiet, the mucous membranes become dirty yellow, 
great pain on pressure on the liver, stomach, and intestines. The faces 
are tinged with blood and there is albuminuria; and according to some 
authors, if there is any icterus in a suspected case, it is a clear indication of 
phosphorus poisoning; finally, there is paralysis and collapse. 

Therapeutics. — Use sulphate of copper as an emetic, and turpentine 
in emulsion as an antidote, and treat other symptoms as they appear. 
Permanganate of potash, nitrate of cobalt, heavy magnesia, are antidotes. 

I^. Cupri Sulphatis, 1.0 

Aquae distillatse, .50 . 

Sig. — Give a teaspoonful every ten minutes until eme- 
sis occurs. 

I^ 01. Terebinthinse, 20.0 

Sol. Acacia, 50.0 

Aqua. Distil., 200.0 
Sig. — A tablespoonful every fifteen minutes. 

Poisoning by Mercury. — 1. Acute poisoning by corrosive sublimate is 
very rare. The symptoms are intense inflammation of the entire intesti- 
nal tract, vomiting of blood and bloody diarrhoea, with intense local irri- 
tation followed by symptoms of paralysis and death. 

2. Mercurial Poisoning takes a slower course when caused by calomel 
or mercurial dressings, particularly w'hen mercurial (blue) ointment is 
applied for skin eruptions. We find salivation, catarrh of the stomach, 
profuse diarrhoea, emaciation, with marked muscular debility. 

Therapeutics. — In the acute form give gruels, milk, magnesia, water, 
sulphur, iodide of potassium, stimulants. In the slower form of poisoning 
give iodide of potassium, or sulphur. 

Poisoning by Strychnia. — This is frequently administered intention- 
ally, although it is often caused by the administration of too large doses of 
nux vomica, dogs being particularly susceptible to the action of strychnia. 
There are violent tetanic spasms, trismus, and opisthotonus. The convul- 
sions are clonic, having intermissions between them, and the longer the 
intermission the milder the attack and the more chance of a recovery. 

Therapeutics. — Give narcotics, chloral hydrate in clysters, 2.5 
grammes to 40.0 of water; morphia, tannin, and tincture of iodine. 

Poisoning by Chloroform. — This is caused either by the careless ad- 
8 



114 DISEASES OF THE DIGESTIVE APPARATUS 

ministration of chloroform during anaesthesia, or when animals are old or 
have weak hearts or lungs. It destroys sensibility, reflex action, ir- 
regular, weak pulse, dilated pupil, the blood becomes very dark and there 
is congestion and cyanosis of the visible mucous membranes, arrest of 
respiration and pulsation. 

Therapeutics. — Cease the inhalation immediately, put the animal in 
the fresh air, open the mouth, draw out the tongue by means of a pair 
of forceps, and perform artificial respiration. Dash cold water on the 
head, active friction of the skin, and the subcutaneous injection of 
atropia, skopolamin, or strychnia. 

ly. Atropia sulph, 0.05 

Aqua distil., 5.0 

Sig. — Inject a gramme of the solution subcutaneously. 

Poisoning with Gas (Coal, Carbondioxide, or Illuminating). — Great 
lassitude, insensibility, labored respiration, mydriasis, paralysis, and 
convulsions. 

Therapeutics. — Fresh air, artificial respiration, dash cold water on 
the head, active friction of the skin, smelling salts, bleeding, and the in- 
travenous injection of the physiological solution of chloride of sodium. 

Poisoning by Iodine. — This may residt from the licking or the absorp- 
tion of iodine, particularly when it is used in the injection of cysts in the 
form of iodine or Lugol's solution. 

The symptoms and course are very similar to iodoform. After a 
toxic dose there is stomatitis and pharyngitis, brown patches on the tongue 
and the vomiting of l)rown material, and if starch should be present in the 
stomach in any (quantity, the material is turned bluish in color. The free 
administration of starch solution, and sulphate of soda and sulphurette of 
soda in solution 1 to 20 of water, must be given freely in teaspoonful doses. 



DISEASES OF THE RESPIRATORY ORGANS. 

PHYSICAL EXAMINATION OF THE RESPIRATORY APPARATUS. 



In making an examination of the respiratory apparatus the following 
points are to be considered: 

Examination of the Nose. 



It is a rather hard thing to make an examination of the nose, on ac- 
count of the anatomical conformation of that part, and we are practically 
restricted to the aid a nasal mirror can give us and the character of the 
nasal secretions. The external portion of the nose is moist and cold in 
health, colder than any other part of the body, and dry and w^arm when 
a dog has any fever or elevation of temperature, in the first stages of nasal 
catarrh, and in fevers or acute disease. This should not be taken as a 
positive evidence, as frecjuently cases are seen where this is no guide, the 
nose being cold when there is great fever or the animal in a state of 
collapse. 

Swelling, redness, and excoriation at the entrance of the nasal cham- 
bers indicate an inflammatory and purulent condition of the nasal mucous 
membrane. 

Any discharge from the nose, beyond a natural moistness, indicates 
some diseased condition. In cases of acute nasal catarrh it is clear and 
thin, nearly pure serum in the beginning, but later on it becomes mucous 
and finally muco-purulent. In chronic catarrh it is firmer, sticky, and 
finally very tenacious, and sticks to the external opening of the nose, 
often entirely closing it up and eroding the skin, where it comes in contact 
with it. In distemper it is yellowish to yellowish-green in color; some- 
times it is streaked with blood or pus, and in rare cases it has a foetid odor. 

When the discharge is copious, especially when the head is jerked 
downward with a sneezing cough, it is generally a sign of some irritation of 
the frontal sinuses. A nasal discharge following coughing generally comes 
from some trouble in the deep sections of the air-passages, larynx, wind- 
pipe, bronchi, or the lungs; a rusty yellow discharge indicates croupous 
pneumonia; this is, however, very rare. Frequent sneezing, with a 
copious, purulent, bad-smelling discharge mixed with blood points to the 
presence of pentastoma taenioides in the frontal or nasal cavities. In cases 
of acute catarrh of the throat, foreign bodies, paralysis of the larynx, or 

115 



116 



DISEASES OF THE RESPIRATORY ORGANS 



large tumors in the throat, the discharge from the nose may be mixed with 
some of the contents of the stomach. These affections are extremely rare 
in the dog compared with other animals. True cases of bleeding of the 
nose are seen in hemorrhagic catarrh of that organ, in suppurating con- 
ditions of the nasal cavities from the pentastome, and also in distemper. 
Hemorrhage of the lungs is indicated when there are large masses of 
frothy blood discharged from the nose and mouth. Wheezy respiration is 
generally due to some contraction of the nasal cavities, for instance, as a 
consequence of violent nasal catarrh, tumors, fractures of the nasal bones, 
narrowing of the nasal passages, pressure from some of the neighboring 
organs, or solid collections of matter. In some breeds of dogs, such as 
pugs and bulldogs, the passage is so narrow that a slight contraction may 
cause them to breathe through the mouth. A simple method of detecting 
whether the nostril is entirely obstructed is to hold a lighted candle in 




Fig. 53. — Diagrammatic section of the pharynx: a, pharynx; b, palate; c, soft palate; d, epiglottic 
wall; e, fnpnum; /, entrance to wsophagus; /;, entrance to the mouth i, entrance to the Eustachian tube; 
k, entrance to the nasal passages; 1, epiglottis; 2, larynx; 3, cavity of the mouth; 4, epiglottis; 5, aryte- 
noid cartilage; 6, palate; 7, vomer; 8, base of skull. 

front of the nostril suspected and see if the flame is blown. If the nostril 
is clear the flame moves violently or may be blown out, but if the obstruc- 
tion is complete or partial the flame moves slightly or not at all. The 
nasal sound is like a snore when copious accumulations of mucus have 
collected on the mucous membrane, as in distemper, or the later stages of 
simple catarrh of the nose. In all the affections named, many animals 
seem to have an intense itching, which they indicate by rubbing the nose 
against solid objects, or wiping it with the paws. We must recollect, 
however, that the same symptoms may be observed in an animal infected 
W'ith intestinal worms. 

The naso-pharyngeal region can be examined by means of the laryn- 
geal mirror; when the presence of foreign bodies or pathological process, 
tumors, etc., is suspected, the mouth is held open by means of a speculum 
and the mirror introduced into the mouth; this method of examination 
should be made as quickly as possible as the instrument chokes the ani- 



PHYSICAL DIAGNOSIS OF THE LARYNX 117 

mal; the observer must act quickly and have a thorough understanding of 
the region and any pathological symptoms noted. 

Percussion of the nose and frontal sinuse is made with some light 
metal hammer such as the handle end of a key, percussing first one nasal 
bone and over the frontal sinuses, then the other, to note the difference in 
sound. A dull sound may indicate a catarrhal condition of the nostril, or 




Fig. 54. — Position of the frontal sinuses a, inferior; b, superior. 

frontal sinuses, the presence of a tumor, or some pathological alterations; 
on the other hand, the presence of a clear percussing sound should not be 
taken as indicating that these changes are not present. Large tumors by 
pressure cause changes or elevations on the nasal bones of the frontal 
sinuses; such alterations may also be seen in the hard palate see (Fig. 54). 

Physical Diagnosis of the Larynx and Windpipe. 

The symptoms include the bark, cough, and respiration, as well as the 
local symptoms. The bark is always rough, hoarse, or shrill in all affec- 
tions of the internal larynx, and is always of great importance in rabies 
(barking howl), or total loss of voice; this is particularly seen during or 
after dog shows. The cough is an accompaniment of all affections of the 



118 DISEASES OF THE RESPIRATORY ORGANS 

larynx; and in the later stages of catarrh, where there is much mucus, 
it is loose, moist, and rattling, and may be produced by slight pressure on 
either side of the larynx, by cold, pressure, or after drinking; in any chronic 
irritation of the larynx, any excitement, such as the pleasure of meeting a 
person they know, will start a severe coughing spell. The respiration is 
always dyspnoeic and accompanied by a stenotic bruit when from the results 
of some diseased condition there is a contraction of the larynx. Ausculta- 
tion of the larynx is performed by placing the ear directly on the larynx. 
Normally the sound is a slightly wheezy respiration. Rubbing, creak- 
ing, or rattling sounds indicate more or less liquid accumulations (mucus, 
pus, or blood) ; wheezy, gasping, snoring sounds indicate severe swelling 
of the mucous membrane or tough mucus (chronic catarrh) ; it may also 
indicate the presence of tumors, membranous accumulations, and par- 
alysis of the muscles of the larynx. 

A local external and internal examination of the larynx can be 
made. Externally the larynx can be examined to see whether it is 
swollen, as in acute laryngitis; for fracture or dislocation of the cartilages, 
for cedematous, phlegmonous, or emphysematous swellings of the part 
or its surroundings, and sensitiveness to pressure, always indicates some 
irritation of the larynx. 

The internal examination of the larynx is very easy and simple except 
in cases where the animal is very vicious; the method of keeping the mouth 
open is fully described on page 12, and then by means of a spatula, or the 
handle of a spoon, the tongue can be depressed or pulled out of the mouth 
with a pair of blunt forceps; the examination should be made near a win- 
dow or by means of a lamp or electric torch; the light can then be thrown 
into the posterior portion of the throat. Vicious animals may be put 
under ether or stupefied by morphine. When the mouth is opened and 
the tongue depressed, we can easily see the entire pharynx and the upper 
wall of the larynx and epiglottis, and in some cases a part of the windpipe, 
and swellings, discolorations, hemorrhages, ulcerations, new formations, 
foreign bodies, paralysis of the vocal chords can be readily diagnosed; a 
good knowledge of anatomy and a quick eye is necessary, however. In 
acute catarrh the mucous membrane of the larnyx is injected and red and 
covered with slimy white or yellowish mucus. In chronic catarrh it is 
not so red, but the mucous membrane has a number of bluish-red vessels 
running through it and covered with tough, glassy, or purulent mucus; 
the membranes are sometimes granular; we may also find at the entrance 
of the oesophagus foreign bodies, tumors, or abscesses. The trachea is 
examined externally by palpation to sec if there is any change or disloca- 
tion of the rings, cedematous or phlegmonous swellings of the surrounding 
structures and enlargement of the thvroid gland. 



PHYSICAL DIAGNOSIS OF THE LUNGS 119 

Physical Diagnosis of the Lungs. 

The lungs of the dog consist of a number of layer-like portions which 
are united by the bronchi and connective tissue; the anatomical posi- 
tions of the lungs are shown in Figs, 55 and 50. The left lung is divided 
into two portions or lobes, an anterior and a posterior; the former is 
again subdivided in two; this division is not very distinct in some eases. 
The section that divides the large loljes begins opposite the fourth and 
fifth vertebne and runs downward and backward as far as the sixth rib; 
the anterior lobe extends as far as the first rib, and anteriorly and pos- 
teriorly to the sixth rib; the large posterior lobe extends back as far as the 
eleventh or twelfth vertebra, where it extends upward and lies between 
the vertebra? and the diaphragm. The left lung has a small incision near 
the heart, called the heart incision. The right lung is somewhat larger 
than the left, and extends as far back as the twelfth or thirteenth verte- 
bra; it is divided into four lobes, the posterior lobe being considerably 
larger than the corresponding lobe of the left lung. The cardiac lobe lies 
upon the heart, almost surrounding that organ; the other lobes hold the 
same relation as they do in the left lung. The middle lobe of the lungs is 
a club-shaped portion that lies in a special groove in the mediastinum, ex- 
tending anteriorly as far as the heart and posteriorly to the diaphragm. 

In making an examination of the lungs we must take into considera- 
tion the shape of the cavity of the chest, sensitiveness to pressure, the 
number and character of the respiratory movements, the character of the 
cough, and the information dcM'ived from auscultation and percussion. 

Shape of the Cavity of the Chest. — In healthy animals the two sides of 
the chest should be symmetrical. A depression on one side means pain 
in that portion of the chest, dry pleuritis, recent fractures of the ribs, one- 
sided contraction of the lung after a rapid absorption of the exudate of 
pleurisy. In a case where there is a fractured rib there may be a protru- 
sion in one place, an inflammatory condition of the ribs, and tumors of the 
wall of the chest; when the whole chest seems swollen, it indicates doul)le 
pleuritis, with a great amount of exudate present; when only the posterior 
half of the thorax seems distended and we find the abdomen enlarged, it 
indicates ascites, tumors, or collections in the abdominal cavity. 

Sensitiveness to Pressure. — This is produced by a number of inflamma- 
tory conditions of the skin and subcutis, the ribs, or the intercostal mus- 
cles as in cases of muscular rheumatism, or in fracture of the ribs, and 
quite frequently in pleuritis; in this case there is pain on pressure between 
the intercostal spaces, and there may be great pain shown when there is 
no exudate; this is a verv common symptom. For further information 
see page 149. 



120 



DISEASES OF THE RESPIRATORY ORGANS 



Number and Character of the Respiratory Movements. — Normal 
breathing is performed in the dog, as in other animals, through muscular ac- 







.2 >> 



a " 



^5 

a ■- 

y. a 

>- rt 
c u 

*- a 

•I ^ 



tion in inspiring, and the elasticity of the tissue of the lungs and the walls of 
the chest in expiration; this is also aided by the pressure of the intestines 



PHYSICAL DIAGNOSIS OF THE LUNGS 



121 



on the diaphragm. It is only when the respiration is obstructed that the 
assistance of the muscles of respiration is required in expiration. The 
works on physiology give more minute details on this subject. The nor- 
mal respirations are from twelve to twenty-eight per minute, the size and 




0) bO 



-e.g 



« a 









o «> 

^ a 

"S 2 

hi M 

U5 53 



age of the animal making a slight difference, in the smaller dog, of course, 
being more f rec[uent. Various conditions tend to alter the above number, 
such as running, physical excitement, atmospheric temperature, the pres- 
ence of a stranger, particularly if they handle the animal, overloading of 



122 DISEASES OF THE RESPIRATORY ORGANS 

the stomach, and advanced pregnancy. While the respirations in the dog 
are regular, yet they are disturbed more quickly by physical excitement 
than in any other animal, and after any unusual exercise, the dog will open 
the mouth. 

A pathological lessening of the number of the respirations, may be 
seen in all serious affections of the brain and its membranes, in acute infec- 
tious diseases, such as septicaemia and distemper and in cases of contrac- 
tion of the air-passages. 

A slight increase in the I'espirations may follow any increase of tempera- 
ture; they are also increased, when any pain is present, in circumscribed 
pleuritis, in the commencement of peritonitis, in fractures of the ribs, and 
in rheumatism of the intercostals. Laborious respiration (difficulty in 
breathing, dyspnoea) is seen where there is any contraction of the phar- 
ynx, larynx, or windpipe; for instance, from the swelling and inflammation 
of the mucous membrane in those organs, foreign bodies, tumors, etc. 
We see laborious breathing, with great increase of the number of respira- 
tions, in any irritation of the bronchial tubes, where they become con- 
tracted or filled with mucus, and in all diseases of the true lung-tissue, in 
all exudates into the pleural cavity, or in diseases of the al)domen, 
where there are collections of solids or fluids in the abdominal cavity that 
press on the diaphragm in cramp or spasm of the muscles of respiration, 
as in strychnia poisoning, tetanus, or eclampsia in nursing bitches, in 
diseases of the heart where there is stagnation of the thoracic cir- 
culation. In all cases of dyspnoea in the dog the animal rarely lies 
down, but prefers to assume a sitting position with the front legs spread 
wide apart. 

Cough. — The nature and form of cough are very important symptoms 
in all diseases of the respiratory organs. Cough is produced by reflex 
action from all parts of the mucous membranes of the pharynx, windpipe, 
bronchi, and also by an inflamed pleura. The pulmonary tissue never 
produces cough by reflex irritation. The so-called "stomach cough" is 
only imaginary; no such thing can truly be said to exist. Cough is gener- 
ally absent in diseases of the brain or in certain cases of extreme weak- 
ness, and just before death from poisoning, as well as in cases where the 
glottis and the muscles of respiration are acutely inflamed. Where the 
sensitive ends of the vagus and particularly the supra-laryngeal nerves 
become paralyzed it is impossible to produce coughing liy manipulation 
of the throat. Dogs do not cough intentionally, and if it is very painful 
they can suppress it. 

An animal may ])e made to cough by pressing the sides of the pharynx 
between the fingers; if the throat is pressed hard an animal will cough and 
make motions very similar to those of vomiting. 

Occasionally an animal is found that the most severe pressure of the 



PHYSICAL DIAGNOSIS OF THE LUXGS 



123 




larynx will not produce any signs of coughing, although it may make a 
swallowing movement. 

Several spells of coughing, after a slight pressure of the pharynx, 
point to a diseased condition of that organ; if the same pressure is made on 
the windpipe, and the animal coughs violently, it also indicates a diseased 
contlition of those parts. In bronchitis and catarrhal pneumonia, cough- 
ing can be produced by tapping on the wall of the chest, indicating dis- 
eased conditions of the deeper air-passages, particularly bronchitis, bron- 
chopneumonia or catarrhal pneumonia. Spells of coughing may be 
produced as a result of unusual exercise, running, jumping, excitement, 
or from going out into cold air. 

In the beginning of acute bronchitis and in pleurisj^ the cough is dull, 
w^eak, usually frecjuent, dry, and husky. In chronic em- 
physema, bronchitis, catarrhal or croupous pneumonia the 
cough is soft and frequent. The cough in emphysema and 
oedema is very much the same, but not very frec[uent, and 
in tuberculosis it is hollow and dull. There are many ex- 
ceptions to this rule; for instance, in cases where foreign 
bodies enter the lung through the mouth or following vom- 
iting, the cough is convulsive and violent, resembling- 
whooping-cough (chronic pharyngeal catarrh) in its inten- 
sity. As a rule dogs cough more freciuently at night than 
during the day. 

The expectorations cannot be examined in the dog as 
in man, as the animal generally swallows all the secretions; 
in rare instances there may be a small portion of the mucus 
thrown out of the mouth or nose in coughing. We can 
often see the animal chewing or swallowing after a fit of 
coughing, which indicates that the animal has brought up 
a piece of mucus into the mouth or pharynx; this is seen 
when the cough becomes loose, moist, or rattling, and is 
what is termed "looseness" of the cough, being seen gener- 
ally in pharyngeal, tracheal, and bronchial catarrh. The 
largest amount of excretion is seen in bronchial and tubercular diseases, 
while in catarrhal and croupous pneumonia, and also in certain forms of 
bronchitis, we find the excretion is thick and firm and accompanied by 
dry, laborious coughing spells, and at the end of the cough there is a 
swallowing movement. In hemorrhage of the lungs the cough is accom- 
panied by more or less foamy blood from the nostrils and mouth and 
in some cases symptoms of choking; a slight hemorrhage may escape our 
observation, as generally all the blood is swallowed. 

Percussion of the Thorax. — Percussion (tapping) is performed by 
means of a percussion hammer and an ivory or metal plate (pleximeter) 




Fig. 57.— riex- 
iinetcr. 



124 



DISEASES OF THE RESPIRATORY ORGANS 



(Fig. 57). Lay the plate close to the wall of the chest, and, with the hammer 
in the other hand, strike the plate a number of light, quick taps; the fingers 
can also be used, and are preferred by some. Place the index or middle 
finger of the left hand firmly on the chest wall, and with the index finger 
of the right hand tap on the finger of the left hand. 

The limits of percussion arc given in Fig. 58, but it must be taken into 
consideration that on expiration the posterior limit of the lungs is carried 
forward of the dotted line and not extending to the last rib and also that 
when the stomach or intestines are very much filled with gas, and crowd 
the diaphragm forward, the extent of the lungs is lessened. The per- 
cussion area lies in a triangular space between the lower side of the mus- 




FiG. 58. — Field of percussion; x, location of heart beat. 

cles of the back, the posterior portion of the muscles of the forearm, and 
the ends of the ribs, and by pulling the forelegs forward, the extent of the 
chest wall can be increased for examination. In percussion we make the 
distinction between a clear, loud, normal lung sound and a tympanitic, 
dull, or solid sound of a diseased lung. The clear normal sound of the 
healthy lung is heard all over the thorax, the volume of sound depending 
on the thickness of the lung at the particular part being examined. The 
muscular layers of the chest have a certain effect on the sound, very thick 
walls lessening the sound to a certain extent; the soimd is more or less 
dull over the shoulder-blade, sterum, and back; the posterior borders of 
the lungs often have no perceptible sound, as they are so thin. 




PHYSICAL DIAGNOSIS OF THE LUNGS 125 

A dull, muffiod sound, which has been mentioned in the above classifi- 
cation, is heard in the following conditions: In the tissues of the lung, 
where the air cannot reach, as in hepatization; in croupous pneumonia; in 
tuberculosis, provided that the diseased centre is not entirely surrounded 
with tissue containing air; in tumors of the lungs; in hemorrhagic infarc- 
tion; in sections of the lungs that are compressed by pleuritic or pericar- 
dial effusions. (Edema of the lung is only accompanied with dulness 
when it is well advanced. 

The dull sound is present, when an abnormal medium is between the 
lungs and the pleximeter, as in the various pleural diseases; tumors of the 
pleura; pleuritic or dropsical effusions; and also in certain pathological 
alterations of the chest, as in oedema, or tumors. The more the tissues 
fill up near the walls of the chest and the greater the density of the 
medium between the pleximeter and the lungs, the more in- 
distinct and muffled the sound becomes. 

The tympanitic sound is heard where there is any cavity 
or hollow in the lungs, as in pneumothorax. In the alteration 
of the tension of the parenchyma of the lungs, we find the 
sound above pleuritic exudates and in the neighborhood of 
large tumors of the lungs, or in compression of the lungs 
from the pushing forward of the diaphragm due to tumors, or 
ascites. It is also heard in moistening of the alveoli by fluids 
and reduction of the contained air, as in the loose moist stage 
of croupous pneumonia; and where there are many small tuber- 
cular centres, in the tissue of the lungs, which are hollow in the 
centre and contain air, and it is sometimes heard in oedema of 
the lungs. Cutaneous emphysema of the walls of the chest ^^°- ^^•~* 

• • 1 mi Tn Stethoscope. 

gives a clear tympanitic sound. There are several modifica- 
tions of this sound, such as the cracked-pot or metallic, tinkling percus- 
sion sound, but these are not of much diagnostic value, as they appear 
only when there may be large cavernous spaces in the walls of the 
chest. 

Auscultation of the Lungs. — This is performed, either by putting the 
ear directly against the walls of the chest, over the affected region (direct 
auscultation), or by using a stethoscope (Fig. 59) (indirect auscultation). 
(A form of stethoscope called the " membranate stethoscope," a modifica- 
tion of the phonograph, has lately been introduced and used in the larger 
animals with considerable success, but the person using it must be thor- 
oughly familiar with the chest sounds and also with the instrument to 
get the best results, but the writer finds that on account of its size it is not 
of much practical use in the dog.) The first method is the best, especially 
with restless animals. 

The ear distinguishes the true respiratory and accessory sounds. In 




12G DISEASES OF THE RESPIRATORY ORGANS 

the former we hear a vesicular respiratory bruit, which has a hipping char- 
acter, and the bronchial respiratory bruit, which is a Jjlowing murmur, 
and, lastly, an indistinct respiratory bruit, which is a slight soft murmur. 

The vesicular respiratory bruit is heard when any portion of the lung 
that is filled with air lies against the wall of the chest. In normal inspira- 
tion the sound is a smooth, regular murmur, the air going directly into the 
alveoli without any resistance. This sound can be increased very much 
even during health by active movements or during excitement; it is also 
much clearer and louder in emaciated animals where the walls of the chest 
are thin. The vesicular murmur is always much louder in young animals, 
and especially in puppies; the murmur is also noted in expiration in 
animals under nine months. According to the amount of irritation, the 
vesicular murmur is lessened in bronchial catarrh where there is much 
swelling of the mucous membrane and secretions collected, in stenosis of 
the upper air-passages, in emphysema of the lungs, in certain stages of 
catarrhal pneumonia, in pleuritic or dropsical exudations, in thickening 
of the pleura from the deposit of lymph-masses, tumors or oedema. 

It disappears entirely in croupous pleuritic effusions, in pneu- 
mothorax, and in closure of one of the large bronchial tubes. 

The vesicular murmur is increased in dyspnoea in portions of the 
lungs that are healthy when other parts are diseased, the healthy portions 
doing all of the work; this is especially seen in bronchitis, where the 
smaller bronchi are plugged up with secretions. We occasionally find 
an irregular vesicular murmur in healthy dogs, but it is also heard in 
cases of bronchitis; this murmur is heard only on inspiration. 

The murmur of expiration is very slight; in normal cases it can hardly 
be heard; it is quite plain when the breathing is strong after excitement, 
action, etc., especially in young dogs and those animals that have a thin 
chest wall. According to the diseased condition, the sound is strength- 
ened, varied in tone, and prolonged. 

The bronchial respiratory bruit (bronchial breathing, wheezing 
sound) may be heard in the normal respiration of the pharynx, wind- 
pipe, and the anterior part of the chest in diseased conditions; it appears 
where any part of the lung is deprived of air, and the disease has plugged 
up the smaller bronchi and extended to the larger-sized bronchi. This is 
the case in the various pulmonary affections, where we find large sections 
of the lungs are obstructed, or in compression of the lung by a pleuritic 
exudate or by tumors, and in rare cases by the pressure of the diaphragm 
where it is pushed forward from the collections of fluids in the abdomen. 
It is also heard when a quantity of mucus is coming up the bronchial 
tubes; this sound disappears when the mucus is coughed up. Lastly, 
we find it in cases where the lung has large cavernous spaces in it. 

Indistinct respiratory bruits are heard in lobular pneumonia, where 



PHYSICAL DIAGNOSIS OF THE LUNGS 127 

the diseased lolndes are located among clear tissue that the air is passing 
into, and where the true character of the respiratory bruit is not heard on 
account of the loud rattling of the air going through the contracted 
bronchial tubes. Indistinct respiratory sounds are also heard where there 
is more or less mucus in the bronchial tubes, and after the animal has 
had a coughing spell the true bronchial sound is heard. 

Irregular bronchial sounds (rattling bruits) are caused by the move- 
ment of the mucus or fluids that are in the air-passages, being carried 
to and fro by the passage of air. The}^ are dry (snoring, wheezing) where 
a small ciuantity of sticky mucus collects in the bronchial tubes, as is seen 
in some catarrhal affections and in cases where the mucous membrane is 
considerably swollen. The snoring sound is generally heard in the large 
bronchial tubes. The wheezing sounds occur in the smaller bronchial 
tubes. A spell of coughing produces considerable change in the character 
of the slight, rattling sounds of the chest. The rattling sounds are moist 
Avhen the secretions are lic|uid; the thicker they are the duller the bruits 
become. We hear moist, rattling sounds when the secretions are col- 
lected in the large bronchi; this sound is also heard when there are caver- 
nous portions in the lungs. We find much less when this is the case in 
the middle bronchi, and a very low bronchial bruit when the small 
In-onchi are involved. By this means we can distinguish in what posi- 
tion the irritation lies in the bronchi; this is rather important in diagnos- 
ing a case of bronchitis. AVhen the fine bronchioles are involved it has a 
crackling or crepitant sound and sibilant bruits; these are only heard 
during inspiration. This sound may sometimes be heard in the alveolar 
passages and in the alveoli themselves, when they are filled with mucus 
or closed up, and where the air can reach them only by strong inspiration. 
This is seen in the first and third stages of croupous pneumonia, in oedema 
of the lungs, and in capillary bronchitis; in the last, the crepitation is 
mixed with an irregular rattling sound. We find also the friction sound 
of the pleura; this is not heard in the normal condition, but in disease; it 
is either crepitating, scraping, or scratching. It is heard in pleurisy; as a 
rule it is louder on inspiration than expiration. This sound is produced 
by collections of fibrinous accumulations on the pleura. These sounds 
are not heard when the pleura is separated by an exudate. The sound is 
plainest at the commencement of the disease, and when the exudate is 
being absorbed. This sound is not altered by coughing, and in this way 
can be distinguished from rattling sounds which are heard when it is a 
case of pleuro-pneumonia. The rubbing sound caused by the broken 
ends of a fractured rib is indicated by the crepitation on movement of the 
ends of the rib. 



128 DISEASES OF THE RESPIRATORY ORGANS 

DISEASES OF THE NASAL CAVITIES. 

Catarrh of the Nose. 

(Cold in the Head; Coryza; Rhinitis; Nasal Catarrh.) 

Etiology. — Catarrh of the nose (catarrhal inflammation of the nasal 
mucous membranes) occurs very frequently and originates from local 
causes (dust, smoke, pentastomum tsenioides, foreign bodies) or by cold. 
Coryza is also a symptom of distemper, and may appear secondarily 
in any inflammation of the other mucous membranes of the head. Where 
a large number of dogs are kept together, it may occur as an epizootic or 
may result from being bathed in cold weather and not being properly 
dried, clipping or shaving the hair, or from ulceration of the nasal 
passages. 

Clinical Symptoms and Course. — These are sneezing, wiping the nose 
with the paws, or rubbing it against some object. Later a nasal dis- 
charge, which is watery and liquid at first and later becomes turbid, 
thicker, and more tenacious; and it may become purulent, according 
to the complications that may appear later on. If the cavities in the 
upper chamber of the nose are affected, the discharge is very profuse and 
there is more or less disturbance of the general system. When the catarrh 
is confined to the anterior chambers the nasal cavities are often very 
much contracted and we hear a snuffling nasal bruit; and if the chamber 
is very much contracted we may see dyspnea, and the animal is then 
compelled to breathe through the mouth. This is apt to occur more in 
those dogs that have narrow, twisted, or curved nasal chambers, as in the 
case of the pug and bull dog. True bleeding of the nose (epistaxis), or 
mucus streaked with blood, is very seldom seen. The duration of a 
case of nasal catarrh is usually short; although we may occasionally 
see a case where there is a tendency to a chronic condition; in such a 
case, the secretion becomes purulent and has a tendency to dry around the 
nose, forming a dirty crust around the nostrils and the upper lip (see 
later under Pentastomum tsenioides) ; in such cases the mucous membrane 
is dry, corrugated and frequently gray in color, the breath may remain 
foetid, resisting all palliative treatment, and may continue as a chronic 
condition and affect the animal all through life. In very bad cases the 
secretion is purulent, with a very bad odor, and in rare instances streaked 
with blood. This is specially the case where the pentastomum tspnioides 
is the cause of the diseased condition of the mucous membrane. 

Therapeutics. — Xasal catarrh will generally disappear without any 
special treatment. To protect the neighboring tissue from the excoria- 
tion of the tissues caused by the discharge it is well to keep it clean 
with tepid water and a little borax, or to coat the part with vaseline or 



CATARRH OF THE NOSE 129 

oxide of zinc ointment. In all mucous, purulent, or chronic catarrhs 
spray the nose ^yith a 2 per cent, solution of creolin, or coat around the 
nostril with vaseline or oil. In acute catarrh it is best to spray the 
nostril with an atomizer, using either of the following solutions: creolin, 
2 per cent.; carbolic acid, 2 per cent.; boric acid, 3 per cent.; the inhala- 
tion can be given in the form of warm solutions, allowing the animal to 
inhale the steam from them by the method described in the treatment of 
chronic catarrh of the larynx on page 136, or with an atomizer; infusion 
of chamomile, carbolated water, tar water, and oil of turpentine have 
been used with good results. Foetid discharges from the nasal cavity may 
be treated by injections or local applications but, as a rule, animals resist 
treatment, and the excitement and irritation to the animal does much 
more harm than good. The vapor apparatus described on page 136, is 
much simpler and produces good results. Painting the nasal cavity 
with a 1 to 5 per cent, solution of cocaine will anaesthetize the mucous 
membrane and lessen the irritation of the animal; an atomizer maybe used 
or powder applied by means of an insufflator is useful to make local appli- 
cations to the nose; in making such local applications care must be taken 
to have the patient's head dependent and use very little force in the appli- 
cation, so the injection may traverse only the nasal cavity and not be 
driven into the larynx and into the lungs. The mild albuminous solu- 
tions of silver may also be used. 

Other Diseases of the Nasal Cavities. 
Bleeding at the Nose (Epistaxisj. 

This is a result of traumatic or mechanical causes, such as blows, bites, 
lacerations, or the entrance of foreign bodies into the nasal cavities; it 
also results from acute or chronic catarrh, pathological growths, parasites 
in the nasal cavity, congestion or rush of blood to the nasal region, infect- 
ious diseases, parasites (pentastomes) , or hemorrhage from the lungs. 

Violent bleeding at the nose can be controlled by injections of cold 
water or a 3 per cent, solution of chloride of iron into the nostril. It is 
very difficult to place a tampon in the dog's nose that will be efficient, on 
account of the anatomical peculiarities. 

AVhen the pentastomum is present, the only efficient way to get 
at it is to trephine the frontal bones, so that agents can be injected 
directly into the location of the parasites. For this operation refer to the 
text-books on surgery. 

Treatment. — Xo treatment is generally required, as the majority 
of attacks of epistaxis stop spontaneously if the animal is kept quiet. 
In persistent cases make applications of cold water to the head or solu- 
tions of ec|ual parts of vinegar and alum are injected into the nose, or in- 
9 



130 



DISEASES OF THE RESPIRATORY ORGANS 



j(>ctions of vinegar and water, equal parts, 3 to 5 per cent, solution of 
alum, tannin, chloride of iron or antipyrin. Tampons are rather difficult 
to apply, but if the bleeding is persistent they can be used. Use small 
pledgets of cotton steeped in chloride of iron, taking care the plug is not 
pushed in entirely, so that it can be removed later by means of forceps. 
The best means of applying the tampon is to use the rapid tampon. The 
so-called internal styptics are useless. The injection of gelatine solution, 
once so much in vogue, is not now used, as it is dangerous. Anaemia from 
exposure and persistent epistaxis is considered in the chapter on that 
subject. 




Fig. 60. — Dog with chronic catarrh and pus in the frontal sinuses. 

Tumors of the Nasal Cavities. 

These may be indicated by a swelling or alteration of the nostril or 
the adjacent structures; frequently osteo-sarcomas involve the nasal 
septum, palate or superior maxilla, the new growth absorbing or dis- 
turbing the normal anatomy of these structures and carcinomas convert- 
ing the bones into soft cellular structures. Polyps are sometimes pres- 
ent and are removed either by tortion or by removing the nasal bone 
and getting into the nasal cavity. 

Catarrh and Pus in the Frontal Sinuses. 



This may result from traumatisms or from pentastomes (see later) 
or new formations in the frontal sinuses, as a result of nasal catarrh, 
indicated by swelling and dulness on percussion of the frontal sinuses 
(see Fig. 60). Acute catarrh of the frontal sinus may result as a sequel 
of influenza; as a rule, however, it is spontaneously absorbed. If it is 



CATARRH OF THE NOSE 



131 



chronic, the pus may be lilxn-ated by trephining, and the cavities washed 
out with astringent solutions, peroxide of hydrogen, zinc, lead, or alum. 

Pentastoma and Pentastoma Influenza (Linguatula 
Taenioides). — This ta-nia-like })arasite, which l)elongs to 
the class of archnides, and ortler of Linguatukc, has a 
flat, tongue-like body, which is indented at its borders 
and composed of 90 to 100 segments, making the body 
have a saw-like appearance, and is whitish-yellow in 
color (see Fig. Gl). The female is 80 to 95 mm. and the 
male 18 to 20 mm, long, both sexes about 1 to 2 mm. 
wide. 

These parasites are found in the sinuses of the fore- 
head and the upper nasal chambers (Fig. 02) ; they may 
also find their way into the pharynx, where they are 
developed sexually. The eggs are yellowish-l:)rown, as 
many as 500,000 being found in one female; these eggs 
are attached to some vegetable substance eaten with the 
vegetable food by a herbivorous animal or man. In the 
stomach it becomes free when the shell is dissolved and 
reaches the liver in various ways. It is found in the 
spleen, kidneys, peritoneum, and in rare instances in the 
lungs, where it becomes encysted; this is the sexless larval form, 
pentastomum denticulatum (Linguatula denticulata) (Fig. 63). It re- 
sembles the sexed parasite in general shape, except that it is much 




Fig. 61.— Pen- 
tastoma taenioides. 




Fig. 62. — Cross-section of the head of a dog with pentastoma in the nasal cavity. 

smaller, from 4 to 5 mm. long, and in its anterior part about 1.5 mm. 
wide. It lies in a detached cyst which is about 5 mm. long. In 
six months it becomes sufficiently developed to break through the 
cyst-wall, and by direct migration finds its w'ay to the bronchial 
tubes; it is coughed up from the lungs of the host and finds 



132 



DISEASES OF THE RESPIRATORY ORGANS 




Fig. 63. — Pentasto 
mum denticulatum. 



its way into the nasal cavities of the dog through the food or is carried 
into the nose in respiration and crawls up into the nasal cavities. While 
the disease is rarely observed, numerous cases seem to occur in certain 
districts. 

The majority of observers consider the disease rather difficult to diag- 
nose and generally it is only when it involves a number 
of animals, such as a pack of hounds or carriers, or in 
one of the districts where it is prevalent, that it is 
noticed. The larger breeds of dogs are most frecjuently 
affected and show the symptoms of chronic nasal 
catarrh. 

Pentastomum catarrh differs from ordinary 
nasal catarrh, from the fact that in pentastomum 
catarrh there is a more or less bloody nasal discharge 
which is very purulent and putrid, and that the 
animal is greatly depressed. There is marked inter- 
ference with respiration, the animal appearing at 
times to almost suffocate; the sense of smell is gen- 
erally lost or is very slight; it becomes emaciated and 
sneezes a great deal oftener than in ordinary catarrh. 
An instance is recorded where the parasite pene- 
trated the hard palate, causing a great flow of saliva. 
In some cases the inflammation has extended from the nasal cavities to 
the cranial cavity and produced meningitis with severe cerebral symp- 
toms, great excitement, restlessness, and a tendency to biting or snap- 
ping, and also paralysis of the lower jaw and several symptoms very 
similar to those of rabies. 

Friedberger and Frohner advise that in all cases where there are 
symptoms of rabies, that the frontal sinuses he 
examined, as there are often cases where the pen- 
tastomum is present and it maj^ produce cerebral 
symptoms, and even death, without any marked 
alteration in the mucous membranes of the nasal 
passages. At the same time it is possible in rare 
instances to find a pentastomum in a dog that has ^^^ 64 —Egg of the pen- 
died from true rabies. The writer may mention tastomum ta>noides magni- 
that he has also found cerebral symptoms in an " " ""^^' 
animal that has been suffering from purulent (non-parasitic) nasal 
catarrh. 

Treatment of pentastoma consists in the injection into the nose of 
solutions (either by means of a syringe or ])y an atomizer) of boracic acid, 
creolin, chloroforhi, lienzine, carbolic acid, or liy the application of the 
vapors of chloroform, formaldehyde, etc. All these preparations are 




ACUTE LARYNGEAL CATARRH 133 

rather difficult to apply, on account of the narrowness of the nasal pas- 
sage in the dog. In very acute cases, the best method of procedure is to 
trephine the upper part of the nasal passage and going directly into that 
cavity inject it with solutions of turpentine, chloroform, corrosive subli- 
mate solution and wash out the parasite. This can be accomplished by 
using a good sized syringe filled with the solution (creolin 1, water 15, or 
emulsion of turpentine in linseed oil 1 to 10) and putting a small section 
of rubber hose on the end of the syringe; insert it into the opening and 
inject slowly, taking care to see that the animal's nose is depressed and so 
allow the flow to go over the location of the parasites. 

DISEASES OF THE LARYNX. 

Acute Laryngeal Catarrh. 

(Acute Laryngitis) . 

This is generally observed in the spring and autumn, and at times 
seems to be epidemic; it may be caused by lying in a draught, being 
bathed in cold weather, cutting the coat too early, or sudden changes of 
temperature. It is found more frequently in delicate or pampered 
dogs, these animals catching cold much more easily than hardier animals. 

Etiology. — The most common cause of catarrh of the larynx is cold; 
laryngitis rarely originates from direct irritation by agents that affect 
the mucous membrane of the larynx, such as inhalation of smoke, dust, 
irritating gases, foreign bodies, etc. It may result from constant barking, 
as when an animal is exhibited at a show and barks constantly, or through 
lying near a fire and getting very warm and then going and lying at the 
door, where the draught will come on the head and throat. Laryngitis 
appears as a secondary symptom of acute inflammation of the nose, 
trachea, and bronchi, and it is generally one of the precursory symp- 
toms of distemper. 

Pathological Anatomy. — The mucous membrane of the larynx is 
partially or entirely reddened, inflamed, and swollen, and covered with 
mucus over its entire surface; this mucus is rarely purulent; in serious 
cases, the membrane is eroded or ecchymosed in spots. 

Clinical Symptoms. — The first noticeable symptom is a cough; 
this may be very loud, according to the condition; it is always coarse, 
hard, and dry in the beginning; later it becomes softer and more moist 
as it is accompanied with the secretions of mucus, and the animal may 
retch and act as if going to vomit. 

By a slight pressure on the glottis we can make the animal cough, 
and the larynx seems to be painful on manipulation; running, excitement, 
drinking cold water, or the administration of medicine all produce 
coughing. Difficulty in respiration is seen in certain forms of laryngitis 



134 DISEASES OF THE RESPIRATORY ORGANS 

where there is intense inflammation and great swelling of the mucous 
membrane; it is accompanied by more or less wheezy or rattling sounds, 
which can be heard by placing the ear on the larynx. There is not much 
constitutional disturbance in the milder forms of this disease; in more 
acute cases, the animal is depressed and eats slowly; this is probably 
caused by a certain amount of irritation extending to the muscles of 
deglutition, and to swelling of the mucous membrane, or from some form 
of pharyngitis, which may be present at the same time; if so, it is generally 
accompanied by a slight rise of temperature and loss of appetite. This 
condition in young dogs should always be watched very carefully, as 
it may be one of the premonitory symptoms of an attack of distemper. 

The disease generally lasts only a few days, but if a case is neglected 
and does not receive care and proper treatment, it is apt to remain irri- 
table and become chronic. 

Therapeutics. — The first thing to do is to remove the animal from 
cold draughts and apply friction, with some mild liniment over the larynx, 
also the application of a moist warm compress over the larynx with the 
inhalation of medicated vapors, a pinch of belladonna leaves or a tea- 
spoonful of tincture of benzoin in boiling water, and internally the admin- 
istration of some expectorant or narcotic. These medicines should only 
be administered when the cough is persistent and the violence of it 
tends to aggravate the irritated condition of the mucous membrane; 
morphine is the best, as it lessens the cough and irritation; it can he 
administered with potassium cyanide and syrup of wild cherry. The 
following prescription is very useful where the animal is a small pet dog, 
that is, one kept in the room; it tends to prevent the cough, which is 
always worse at night: 

I^. MorphiiB sulph., 0.1 

Aq. amygdalis amarse, 24.0 

Sig. — Half a teaspoonful three times daily. 

I^. Morphise sulph., 0.12 

Potassii cyanitU, 0.15 

Syr. pruni virginianse, 9G.00 
Sig. — One teaspoonful four times-daily. 

I^. Ext. hyoscyami, 1.0 

Liq. ammon. acetatis, 20.0 

Sig. — Twenty drops every half hour. 

I^. Heroin hydrocliloratis, 0.1 

Aqua-, 150.0 

S. — One to two teaspoonfuls every six hours. 

Occasionally we may find a foreign body in the larynx presenting 
the following symptoms: Dyspnoea accompanied by loud coughing or 



CHRONIC CATARRH OF THE LARYNX 135 

whistling sounds mingled with the coughing, great anxiety shown on the 
animal's face; cyanosis of the mucous membranes. If the animal is 
actually choking, perform tracheotomy immediately, then endeavor 
to tlislodge the foreign body and if this is not successful laryngotomy is 
indicated. 

Chronic Catarrh of the Larynx. 

{Chronic Laryngitis; Convulsive Cough; Chronic Irritable Cough.) 

Etiology. — Chronic laryngitis generally results from one or repeated 
acute attacks of laryngitis, or from chronic catarrh of some of the other 
organs of the air-passages; the pharynx, trachea, or bronchi, etc. It 
may also follow swelling or ulceration of the pharynx, or from the forma- 
tion of a tumor in that organ. 

Pathological Anatomy. — The mucous membrane is thickened, but 
not so red as in acute laryngitis; it is marked with fissures and elevations 
due to thickening, caused by the chronic inflammatory processes; and here 
and there may be noticed a dirty bluish-red coloration. The surface is 
granular, on account of the swelling of the inflamed mucous glands; in rare 
cases, we may see small papilliform elevations or small eroded or ulcerated 
places which mark a breaking-down of some of the mucous glands; the 
secretion which covers the aff^ected parts is thick, slimy, and tenacious. 

Clinical Symptoms. — The symptoms are similar to acute laryngitis 
except that they are not so severe; the larynx is slightly sensitive to pres- 
sure, sho\\ing that some irritation is present; the animal will cough after 
manipulation, but not to such a marked degree, and he does not try to get 
away from the pressure, as Would be the case in the acute form, and 
there is no disturbance of the general system. The cough sounds dry, 
hoarse, and rough, sometimes moist, and is frequent, quite loud, and ac- 
companied by a wheezy inspiratory sound, with, in rare instances, retch- 
ing or even emesis, night being the time it is mostly heard, or when the 
animal runs about and plays and he is going to be taken out for a run. 
In some cases the cough resembles the whooping cough of children (tussis 
convulsiva). As a rule the respiration is not increased, but in chronic 
cases where one attack follows another the respiration is greatly in- 
creased with the slightest exertion. Some animals make a wheezy noise 
as though there was a decided contraction of the larynx. This latter 
condition may continue for years, and the cough in particular is con- 
stantly present. 

Therapeutics. — As a rule, the treatment of this disease is unsatis- 
factory; this, of course, depends to a large extent on the animal. Being 
removed from the conditions that have originally caused the disease, the 
first thing to do is to keep the animal indoors, perfectly quiet and pro- 



136 DISEASES OF THE RESPIRATORY ORGANS 

tected from cold, with rest, and avoiding excitement or prolonged howl- 
ing. Among the agents used in general treatment the following are best: 
Inhalations of hot medicated solutions, carbolic acid, tar, oil of turpentine 
or powdered salt, chlorate of potassium, alum, or tannic acid. Inhala- 
tions with these agents by means of an atomizer, or by vapor bath should 
be made twice daily for ten or fifteen minutes. 

It is readily understood that inhalations are rather hard to admin- 
ister in the dog, as the animal cannot be kept still while the medication is 
being made, and also because the dog breathes through the nose, and if 
prevented from doing so the vapor is carried into the throat and again 
into the mouth. The only practical way to get an animal to inhale a 
vapor is to put him in a close box and through an opening introduce 
steam that fills up the apartment; then the animal has to inhale it. This, 
however, can be practised only in a hospital. But where the animal is 
at home, the best method of procedure is to place him on a cane-seated 
chair, and having placed the medicated agent, steaming hot, under the 
chair, cover the animal with a sheet and hold him for ten or fifteen min- 
utes; or we may also hold the steaming vessel under his nose and cover the 
head. It is only with the greatest difficulty that the laryngeal mucous 
membranes can be painted with any medicinal agent. This is to be re- 
gretted, as it is the only direct way that the membrane can be treated with 
any certainty. In making local applications to the larynx an assistant 
holds open the mouth by means of tapes, the tongue is pressed down- 
ward by means of a spatula or the handle of a spoon, and the throat is 
sprayed by means of an atomizer or a brush or a quill. The intratracheal 
method of administration of medicinal agents is rather difficult to follow 
out, particularly in animals that are fat or have short necks; insert the 
needle beneath the larynx or through the crico-thyroid ligament, the solu- 
tions to be used are 1 per cent, solution of morphine or codeine. These 
injections should be made daily or every other day. 

Frequently in chronic catarrh we use narcotics to stop the severe 
cough produced by irritation of the membrane — morphine, codeine, 
heroin, and in rare cases bromide of potassium or chloral hydrate. 
Expectorants are not of much use in the dog. 

As to other affections of the larynx, with the exception of tuberculosis 
of the larynx and certain tumors described by Cadiot (both conditions 
which are extremely rare), the only one of practical importance is 

Hemiplegia Laryngis. 

This is occasionally observed. In this affection the animal has a pe- 
culiarly shrill bark, which is varied in tone, becoming harder and harsher 
and spasmodic, accompanied by great difficulty in respiration, marked 
dyspnoea and roaring sounds during respiration. The condition may be 




W. McDougall, del. 



MODE OF ADMINISTERING MEDICINAL VAPORS. 



BRONCHITIS 137 

produced by dragging on a collar, folloAv traumatisms, as in one case ob- 
served, that is, fracture of the first rib on the left side, and it is also seen 
following the pulmonary form of distemper. The treatment consists of 
the application of a galvanic battery over the region of the recurrent 
nerve, the administration of nux vomica internally, or of strychnia, 
sulx'utaneouslv. 



DISEASES OF THE AIR-PASSAGES AND BRONCHIAL TUBES. 

Catarrh of the Windpipe and Bronchia; Bronchitis. 

{Trachitis and Bronchitis Catarrhalis.) 

Etiology. — Catarrh of the air-passages and of the bronchia occurs 
very fretjuently in young, weakly, or debilitated dogs. It sometimes 
originates primarily, but, as a rule, it occurs as a secondary disease. It 
is caused by cold, especially by breathing cold air when the animal is 
warm; and in pet dogs we see it cjuite often where the animals will lie 
near the register or an open fire until they are very warm and then go to 
the outside door and lie on the floor where the draught can strike on 
them and so cool off very rapidly, and repeat this a number of times. 
It is also caused by mechanical or chemical irritants, such as smoke, 
dust, parasites, strong gases, or, secondarily, from the extension of in- 
flammations from neighboring organs, as the larynx or lungs, or from 
defective blood circulation of the lungs, produced by weakened heart 
action. Catarrh of the trachea and bronchia is very often seen as a com- 
plication of distemper, as well as many serious internal diseases, especially 
in affections of the l:)rain. The latter condition is generally traced to the 
fact that there is an accumulation of particles of food and secretions, 
which collect in the mouth ami throat, decompose, and are respired into 
the trachea and produce an irritation. 

There is no doul)t that infectious influences play a certain role in 
the cause of this disease. 

Pathological Anatomy. — In describing any catarrh of the trachea it 
should be classed under the head of bronchitis, as it is impossible to draw 
the line of distinction between the two. In bronchitis the mucous mem- 
brane is difi:"usely inflamed, swollen, and tears easily when touched. In 
the ealier stages of the disease, there is little mucus found on it, but as 
the disease goes on to the later stages the secretion becomes more copious 
and turbid, purulent, and filled with pus corpuscles; later on it becomes 
more or less colored with blood corpuscles. 

Chronic Catarrh. — In this condition, the color of the mucous mem- 
Ijranc is l^rownish-grey, and the membrane is frequently uneven and 
thickened; in circumscribed spots or covering the entire membrane the 



138 DISEASES OF THE RESPIRATORY ORGANS 

secretion is clammy, slimy, or shining, in some cases it is bad-smelling or 
even putrid, similar to atelekase. 

In old cases of chronic bronchitis, there may be some stenosis of the 
tubes, and also, from the constant irritation of the bronchia, emphysema 
of the lungs. In regard to this the reader is referred to works on patho- 
logical anatomy. 

Stenosis (contraction) of the bronchia may be caused either by swell- 
ing of the bronchial mucous membrane or by the collection of masses of 
thickened secretion in the tulje. In some cases, the two causes acting 
together exclude the air from the alveoli of that part of the lungs to 
which the affected l^ronchia carry the air, causing the lung-tissue 
to collapse. This condition, which originates in the manner de- 
scribed, does not change its structure, but soon becomes solidly filled 
with blood. 

In all chronic conditions, we also find the opposite of stenosis, that 
is, bronchiectasis (widening of the bronchial tubes) ; this is caused by a 
relaxed condition of the bronchial walls, due to the chronic irritation and 
also to the pressure of collections of the secretions. This dilatation of 
the tubes may be either cylindrical or spindle-shaped. 

Emphysema of the Lungs. — This is found near the atelectatic centres 
and on the borders of the lungs; this condition is supposed to be caused by 
violent coughing spells and also b}" bronchitis. The affected parts do not 
collapse, but appear soft, clear and bloodless; they will, however, coh 
lapse cpiickly on incision. 

Clinical Symptoms and Course. — These vary, according to the 
amount and location of the irritation, whether it is in the trachea, large, 
medium, or small lironchia, and whether it is acute or chronic. 

'1. Acute Catarrh of the Large Bronchia. — This commences with slight 
and frequent chills, accompanied by fatigue, indfference, depression, loss 
of appetite, and sometimes with a stiff and strained gait and slight rise of 
temperature, which may rise to 40° C. Soon afterward the animal com- 
mences to cough; this is one of the principal symptoms of the disease. In 
the beginning it is short, painful and dry, later it becomes moist and more 
frequent. It can easily be started by slight pressure on the trachea and 
also by tapping on the chest close behind the shoulder. 

Percussion, as a rule, does not reveal the full extent of the disease. 
On auscultation, in mild cases, we hear an increased A'esicular respiration 
in the trachea and large bronchia, and when the medium-sized bronchia are 
affected there is an accumulation of mucus in the tubes and the A'csicular 
murmur is increased. This is due to the fact that while the l:)ronchitis is 
in the dry stage the sounds are roaring or snorting in character, and when 
the fluid mucus has accunudated the sounds liecome rattling, as if the 
air was passing through a thick mucus (mucous rales.) 



BRO.XCHITIS 139 

2. Acute Catarrh of the Smaller Bronchia ; Bronchitis Capillaris ; Bron- 
chiolitis. — When the small bronchia are affected, these sounds are much 
more decided, and in this condition there is high fever and general disturb- 
ance of all the functions, and also a marked difficulty in respiration, and 
the disease takes a much more serious course, particularly in young dogs 
affected with distemper. One prominent symptom in the dog is the in- 
flation of the cheeks with each expiration. Any pressure on the walls of 
the chest will immediately produce a fit of coughing. The cough is first 
dull and weak, and as the disease increases it becomes looser and easier, 
the vesicular sounds being very wheezy. Capillary bronchitis in young 
animals is very apt to terminate in catarrhal pneumonia, but even if this 
grave complication does not occur, it is still a very dangerous disease and 
is apt to prove fatal. The course of the disease is never less than two 
weeks, and may often last several weeks before the animal makes a 
recovery. 

This disease, or the results of it, is what is generally termed asthma, 
so often seen in old, well-cared-for dogs. The disease is characterized by a 
certain amount of difficulty in respiration, which is increased by running 
or ]3y any excitement, and is generally accompanied by a severe attack of 
coughing, which in severe cases ends with every evidence of choking or 
even vomiting. The cough is generally moist, and may be accompanied 
by. a certain amount of rattling. In the majority of cases, where the 
disease is not far advanced, the animals enjoy good health and rarely ex- 
hibit any fever. In old cases, the expired air may be bad-smelling or f a?tid. 

Percussion gives no definite results. Auscultation gives sounds that 
depend on the number and size of the diseased bronchia and the character 
•of the mucus accumulated in them. We may find cither moist or rat- 
tling sounds, which vary in character, and a heightened vesicular respi- 
ration or else an indistinct mucous sound. 

Therapeutics of Tracheal and Bronchial Catarrh. — Keep the animal in 
a moderately warm ])ut well ventilated place, where it is dry and free from 
draughts. In the early stages of the disease give a mild expectorant, 
such as syrup of tolu or wild cherry. Local inhalation of vaporized drugs 
is not of much use, as very little of the drug is carried into the bronchial 
tubes, especially the small ones. We may administer medicinal vapors by 
putting a teaspoonful of tincture of benzoin, if the expressed air is foetid, 
or a weak solution of creolin, lysol, or carbolic acid in a quart of boiling 
water, and hold it so that the animal will inhale the steam, or a Priessnitz 
compress may be put around the thorax; this should be taken off and 
adjusted every three or four hours. 

In the chronic cases, we generally get good results from the adminis- 
tration of expectorants, such as apomorphia, ipecacuanha, and spirits 
of mindererus; and where there is a violent cough, add narcotics, such 



140 DISEASES OF THE RESPIRATORY ORGANS 

as morphia, extract of hyoscyamus, or dilute hydrocyanic acid or 
cyanide of potassium. When there is fever present, a few doses of antipy- 
rine (0.5 to 1.0 gramme, twice daily) will generally suffice. 

Tartar emetic, chloride of ammonium, and sulphuretted antimony are 
of little use; in fact, do more harm than good, as they often destroy the 
appetite and cause great depression. In the early stages of the disease 
the cough does not amount to much, but in the later stages, it is constant 
and very disagreeable, especially at night, and it is in such cases that 
expectorants are useful to remove the accumulations of mucus. The 
addition of morphia to the apomorphia solution has the tendency to 
counteract the emetic effects of the latter drug. 

One important factor in this disease is to keep up the general system 
by giving easily digested food of a mixed character and in concentrated 
form, and administer wine or brandy in small quantities. If the heart 
should give evidences of weakness, use stimulants, brandy, spirits of cam- 
phor, or digitalis. 

In chronic bronchial catarrh where a permanent cure is not to be ex- 
pected, we can alleviate the sufferings of the animal by inhalations of 
tincture of benzoin or balsam of Peru, one teaspoonful to a cup of boiling 
water, or by means of the vaporizer; inhalations of medicated vapors are 
very useful, and especially the vapors of turpentine, where there is a 
great accumulation of mucus and a foetid breath. Inhalations of the 
vapors of tar and creosote are also useful. The action of tar is a little 
irregular and occasionally destroys the appetite. Ichthyol and thiol are 
given in doses of 0.2 to 0.5 gramme several times daily. Narcotics should 
be administered only when the cough is very severe. 

I^ Morphise svilphatis, 0.09 

Potassii cyanidi, 0.13 

Syr. pruni virginianse, 88. 
Sig. — One teasijoonful four times daily. 

I^. Tine, aconiti, 0.05 

Tine, belladonnse, 0.03 

Tine, bryonise, 0.02 

M. F. Triturat No. 1. 

Sig. — One tablet three times daily. 

Parasitic Bronchitis. 

The following parasites produce bronchitis; parasitic bronchitis, how- 
ever, is very rare, 

Strongylus Bronchialis Canis (Osier); Filaria Tracheo-bronchialis 
(Blumberg Ral)e). — These parasites are very small and lodge in the mu- 
cous membrane of the trachea forming greyish-red globular protuberances 



CATARRHAL IXFLAMMATIOX OF THE LUXGS 141 

ranging in size from that of a small pen to a coffee Ijean (Tracheitis veru), 
Cosa verminosa (Rabe) . These parasites cause severe coughing, dyspnoea 
great weakness, fever, vomiting, and colicky pains. 

Strongylus Vasorum (Baillet). — These are long thread-like worms 
which lodge in the right side of the heart and the pulmonary artery. The 
eggs are carried by the blood into the lungs, and lie in the minute branches 
of the bronchi (bronchioles) forming fine nodules resembling those of 
tuberculosis; the embryo is liberated, gets into the bronchi, causing irrita- 
tion and coughing, and the young parasite is expelled with the mucus 
coughed up, or some of the parasites find their way into the alimen- 
tary tract, then into the veins, and are carried back to the heart. 
Animals afTectcd present the following symptoms: dyspncea, ascites, and 
emaciation. 

The Spiroptera sanguinolenta (see page 51) also find their way into 
the air-passages, causing chronic bronchitis. 

DISEASES OF THE LUNGS. 

Catarrhal Inflammation of the Lungs; Pneumonia. 

{Catarrhal Pntumonia; Lobular Pneumonia; Broncho-pneumonia.) 

Etiology. — Catarrhal inflammation of the lungs generally originates as 
a secondar}^ disease following Ijronchitis, by an extension of the inflamma- 
tion of the small bronchia into the alveoli, or from the obstruction of the 
bronchial tubes; it may originate primaril}' as pneumonia or in the pul- 
monary form of distemper. Certain animals, such as very old dogs, or 
young animals, undeveloped and underfed, as well as animals that have 
gone through some acute illness, are predisposed to the development of 
lobular pneumonia. Lobular pneumonia is caused by accumulations of 
mucus in the trachea which may be only imperfectly coughed up, or in 
very weak cases, lying in the tubes, become decomposed and putrid, and 
so act as an irritant. These particles of mucus are carried into the deep 
portions of the lungs, directly on the aveoli, and form a capillary bronchi- 
tis; it may become converted into a catarrhal pneumonia. In some cases 
particles of food, medicines, especially thick mixtures, get into the lar- 
ynx when the animal is unconscious or where there is partial paralysis of 
the throat. These substances penetrate into the lungs and are very 
difficult to dislodge from the bronchia. This form of the disease is gener- 
ally termed traumatic or aspiration pneumonia. 

Roberts has described catarrhal pneumonia in an epidemic form at- 
tacking all ages, developing a high temperature, and loss of 30 per cent. 
8avaresc has described a specific pneumococcus, but in all probability 
both observers have described a condition similar in nature. 



142 DISEASES OF THE RESPIRATORY ORGANS 

Pathological Anatomy.— In a lung affected with catarrhal pneumonia, 
we always find all the characteristics of bronchitis, and as the disease ad- 
vances, the group of alveoli that belong to the affected bronchia are 
rapidly filled with the catarrhal deposit, preventing the air from penetrat- 
ing into them. Soon we see an intense hypersemia of the walls of the 
alveoli and the exudation of a thin, non-coagulating fluid, and numerous 
white blood corpuscles, which soon become pus corpuscles, and the com- 
mencement of a fatty degeneration and detachment of the alveolar cells. 
The alveoli and the small bronchia become entirely filled with pus corpus- 
cles and a certain number of blood corpuscles and broken-down epithelial 
cells, and the inflamed portion of the lung can easily be distinguished 
from its healthy surroundings, forming firm, tough, roundish or lobulatcd 
lumps, which vary in size and number, projecting slightly above the sur- 
face of the lung, and on making a cross-section of the diseased portions, in 
the earlier stages of the disease, they are seen to be dark bluish-red and 
later on become gray, while the surrounding tissue that is not diseased is 
normal or, what is more frequent, is slightly congested with blood. The 
detached centres, which show plainly in the early part of the disease, soon 
become confluent, so that finally we find large sections of the lung in- 
volved. In rare cases we find fibrinous (croupous) centres in connection 
with the catarrhal pneumonic centres and extended vesicular emphysema 
in the neighborhood of the affected centres, and at the borders of the lungs 
it is often seen. We may also have subpleural and interstitial emphy- 
sema and sero-fibrinous or pussy pleuritis about the broncho-pneumonic 
centres. 

Clinical Symptoms. — It is very difficult to make a sharp distinction 
between capillary bronchitis and lobular pneumonia on account of the 
close relation between these two diseases. If the disease has affected the 
alveoli, there is a marked acceleration of the respirations, in some cases as 
high as 60 per minute, and also inflation of the cheeks with each expira- 
tion; the cough is short, frequent, and apparently very painful, the pulse 
running from 150 to 170, temperature rises quickly and remains high. 
On making a physical examination by percussion, there are a number of 
dull centres though the lungs; in some instances the whole of the lung 
gives dull sounds on auscultation. According to the stage of the disease, 
we hear rales of various characters, strong vesicular breathing, snoring, fine 
or loud bruits, and where there is extended infiltration, we hear bronchial 
respiration and certain spots where there is no respiratory murmur at all. 

The temperature often goes up to 40° or 41°; this high temperature 
usually commences early in the disease or it often makes a rise when the 
disease has become converted into catarrhal pneumonia. If this compli- 
cation does not occur, the temperature will not make any marked change, 
but will follow a regular course, which is to rise quickly at the onset 



CHRONIC INTERSTITIAL PNEUMONIA 143 

and gradually fall as the disease decreases and the animal goes on to 
convalescenre. 

Course and Prognosis. — The course of catarrhal inflammation of the 
lungs is rarely less than three weeks, and is often prolonged over three 
months, with varying degrees of intensity. Traumatic pneumonia is the 
only form of the disease that runs its course quickly. 

The evidences of termination of the disease arc: Recovery by 
resolution, in which the inflammatory products, which fill the smallest 
l)i'onchia and the alveoli, are changed into a form of emulsion and are 
either reabsorbed or coughed up, or develop into a secondary disease, 
for instance, chronic interstitial inflammation of the lung or, in rare cases, 
the formation of purulent gangrenous centres. Third, death, which may 
occur at any stage of the disease; in the early stages, as a conseciuence 
of great extension of lobular pneumonia or at any time as a result of 
cedema of the lungs, this is observed in very young animals that are 
very weak, particularly in the pulmonarj' form of distemper, but it may 
also occur in very old debilitated animals. Traumatic pneumonia, if 
it is acute, generally results fatally and little or nothing can be done 
to produce a favorable result. 

Chronic Interstitial Pneumonia. 

{Chronic Induration of the Lungs; Cirrhosis of ihe Lungs; Phthisis.) 

When the disease terminates in this pathological condition we find 
an inflammatory deposit in the interlobular and interstitial connective 
tissue. This deposit compresses the alveoli and small bronchia, and 
they lose their functions and are finally absorbed, and on section of the 
affected portion of the lung it is found to be coarse, rough, and irregu- 
lar on its surface, the tissue varying from yellow to yellowish-red in 
color and the lobules surrounded by connective tissue. The bronchia 
surrounding the affected portion are distended and pocket-shaped, 
and there are also a certain number of spots of localized emphysema. 

The clinical course of the disease shows very little fever, but the 
animal is never entirely restored to health; the respirations are short, 
labored, and with a quick, weak cough. The affected animal becomes 
emaciated, the condition is complicated wdth dropsical effusions, and it 
finally dies from exhaustion. 

In some cases of lobular inflammation of the lungs the inflamed 
portions form abscesses, or we may find portions of the lung that are 
gangrenous. These terminations depend on the nature of the irritant, 
and generally occur after traumatic pneumonia (foreign bodies). A^ hen 
suppuration commences in the alveoli, an abscess is formed and a pear- 
shaped body is found in the centre of the infiltrated lobule, and sur- 



144 DISEASES OF THE RESPIRATORY ORGANS 

roundino; it is a thin, delicate layer of yellowish tissue and over that 
a tough layer of red inflamed fibrous tissue; large abscesses may be 
formed by the fusion of all the infiltrated pulmonary tissue. 

When gangrene has developed, the inflamed catarrhal centre be- 
comes dirty greenish-brown in color, or in severe cases, almost black. 
In the early stages the diseased portion is hard and fibrous, l)ut it 
soon becomes soft and pulpy and filled with a turbid, foetid, greenish 
serum. When the disease is slow and chronic, the gangrenous spots are 
limited in size, but generally when the disease assumes the gangrenous 
form, it becomes diffuse and the animal dies rapidly from exhaustion. 

We recognize the gangrenous form when the breath becomes pu- 
trid, for in the dog it is almost impossil^le to get any of the discharge that 
is coughed up, the animal generally swallowing the mucus. Ausculta- 
tion of the lungs may detect tympanic or metallic sounds, mucous rales 
and increased bronchial sounds. When gangrene (necrotic pneumonia) 
has developed, the animal has a putrid breath and a series of alarming 
symptoms accompanying it — septic fever, chills, and a high tempera- 
ture, with weak, irregular pulse. If the sputa were examined, we would 
probaf)ly find numerous micrococci, bacteria, and portions of broken- 
down lung-tissue. 

(Edema of the Lungs. — This is apt to follow not only pneumonia, 
but all debilitating diseases that weaken the left side of the heart, and 
that organ is unable to force the venous blood through the lungs. There 
is a regurgitation of the blood, and the alveoli and bronchia become filled 
by a serous fluid which exudes from the blood vessels. The cedematous 
lung is distended and much larger than normal; on pressure with the 
finger the indentation remains some time. On section of the lung, a 
large quantity of reddish foamy fluid exudes from the tissues and the 
bronchial tulles. 

When oedema of the lungs follows catarrhal pneumonia it gener- 
ally begins with great difficulty in respiration, labored or stertorous in 
character, a short, faint cough, and in rare instances a quantity of thin 
reddish fluid comes from the nose or mouth. On making a physical 
examination, percussion gives no results but those found in catarrhal 
pneumonia. On auscultation, we hear rattling bruits all over the chest, 
especially in the anterior part, and also in the trachea; the blowing sounds 
may be very loud in some cases, and can be heard some distance from 
the animal. Death occurs in a short time. Some time before the ac- 
tual symptoms of oedema appear, the exhausted condition of the heart 
is indicated by the pulse being irregular, that is, weaker at inspiration 
than at expiration. 

Therapeutics. — In treating l()l)ular ])neumonia we follow the same 
eeneral course as we (,lo in broncliitis. Ihc writer obtained the best 



CHROXIC INTERSTITIAL PNEUMONIA 145 

results with Priessnitz's compress and from the remedies recommended 
under the treatment for bronchitis. The good effects of moist, warm 
compresses can be much increased by sharp friction with a small cjuan- 
tity of mustard oil to the sides but it must be applied only in young, 
strong, healthy animals. The best method of application is to make a 
liniment of 3 parts of oleum sinapis aethereum in 45 parts of olive oil and 
divide it into 2 parts and apply one-half to each side of the chest then 
wind a dry bandage around the chest walls and ten to twelve hours later 
apply Priessnitz's compress. Narcotics are to be given when the cough 
is constant and distressing. Where there is much debility stimulants 
such as wine or ether are indicated and the animal should be given small, 
often-repeated quantities of chopped meat, juice of meat pressed from 
raw beef, broth, milk, and the peptone preparations. 

Some good is to be derived from inhalations in this disease. When 
the breath is offensive we advise inhalations of benzoin, 4.0 to cup of 
boiling water. Inhalations of creosote are recommended, but on account 
of the danger of absorption and irritation of the kidneys by that drug 
they are to be used with extreme caution. In septic fever, after the 
appearance of gangrene of the lungs, give subcutaneous injections of 
ether or camphor. 

When oedema of the lung is recognized, it must be regarded as a 
grave symptom for it is generally fatal. We must, therefore, take very 
energetic measures — active stimulants, such as mustard oil to the sides, 
and also injections of ether or camphor subcutaneously. Bleeding and 
the use of cardiac stimulants, such as digitalis or caffeine, are useless. 

Other Diseases of the Lungs. 

Catarrhal pneumonia is the only important disease of the lungs in 
the dog; the others which are here described are of small importance 
and rarely seen. 

Congestion of the Lungs, Acute Hyperaemia of the Lungs. — This dis- 
ease is comparatively rare, generally being observed in the summer, as a 
result of very severe exercise; for example, in hunting dogs, in warm 
weather, or animals running after cars, wagons, or bicycles until ex- 
hausted, or as a result of infiltration of the lung in ascites, or from cold 
air, gas, great heat or smoke if the animal has been in a burning house 
or kennel, etc. 

The early acute symptoms are greatly accelerated respiration, 
mouth open, tongue deep blue to purple and hanging out, animal restless 
and excited, heart full, bounding, and easily felt through the chest wall, 
hard full pulse, cyanosed mucous membranes, and if the acute condition 
continues for any length of time, apoplectic cedema, apoplexy, or 
10 



146 DISEASES OF THE RESPIRATORY ORGANS 

acute pulmonary hemorrhage follows and death occurs in a very short 
time. 

Therapeutics. — Keep the animal in the air or a well ventilated room 
and let the animal rest, with no disturbing influences. In grave cases use 
venesection, cold baths and clysters, or massage of skin. If oedema 
threathens, treat accordingly. 

Croupous Inflammation of the Lungs ; Fibrinous Pneumonia. — This 
is a firm, hemorrhagic exudation in the alveoli of the lungs and small 
bronchia. Is very rarely seen in the dog. The writer has never seen a 
case of true lol)ular pneumonia, but has seen a few cases of croupal 
lobular pneumonia, the course of which is very similar to that of catarrhal 
pneumonia in all its symptoms, the difference being detected only on 
post-mortem. Roll makes the statement that croupous inflammation of 
the lungs is common in the dog, but he probably meant croupal lolnilar 
pneumonia. 

The clinical difference between croupal and catarrhal pneumonia 
is the rapid course in the onset of the former, the bronchial murmur 
is lost early, due to the filling up of the bronchial tulies, the frequent 
complication of pleurisy and the quick formation of a pleuritic exudate. 

Anthracosis pulmonum (blackening of the lungs), due to the inhala- 
tion of coal dust or coloring matter found in animals living in cities or 
kept as watch dogs in factories where dust is constantly in the atmos- 
phere, is quite common in the dog, but it has no pathological significance. 

Emphysema of the lungs is not such an important disease in the dog 
as it is in man and the horse. That form of emphysema which appears 
in bronchitis and pneumonia, characterized by an extreme distention of 
the alveoli, has been mentioned under these diseases. If the irritation is 
constant, the disease becomes chronic and a progressive atrophy of the 
alveolar walls takes place until they are entirely closed up, the neighbor- 
ing alveoli become absorbed or altered, and finally large cavities are 
formed, and the blood vessels become atrophied. On section of the lung 
the edges of the cavities are pale, soft, and the blood vessels are stained 
with pigment. Sometimes, as a result of severe exertion, such as 
vomiting, pregnancy, or laceration of the alveolar walls, air is allowed to 
penetrate into the interlobular, interstitial, or subpleural connective 
tissue; this is generally caused as a result of severe and continual cough- 
ing spells and where animals have died from some form of suffocation. 
Siedamgrotzky describes a case where an old emphysematous dog had a 
severe fit of coughing and the lung was lacerated, causing pneumothorax. 

Bronchial Asthma; Asthma. — Under tlie general term of asthma 
we understand dyspnoeas, accompanied with continued cough and labored 
spasmodic breathing. The true spasmodic asthma, as described in man, 
in which there are acute attacks of spasmodic respiration, can hardly be 



DISEASES OF THE PLEURA; PLEURISY 147 

said to occur in the tlog. Temporary dyspna?a occurs in heart disease, 
nephritis, and some other affections. In a general sense, asthma or 
bronchial asthma, as we designate the disease in man, is characterized 
by attacks of acute dyspnoea at irregular intervals, caused by temporary 
spasmodic contraction of the bronchi. While it was once generally 
thought that asthma was a pure neurosis (bronchiale neurosum), the 
inclination of the present clay is to believe that in the majority of cases 
reflex action from the nasal mucous membrane is one of the chief causes. 
The attack generally begins by constant sneezing and drawing inhala- 
tion with great effort as if the nose was entirely filled; o-are must be taken 
not to confuse this condition with congestion of the turbinated bones or 
nasal polypus. 

Neo -formations of the Lung. — "With the exception of tubercular 
alterations, changes in the lungs are exceeding rare. Carcinomas may 
occur, generally associated with carcinoma of the thyroid or the mammary 
glands; these appear in varying sized nodules in the lung tissue; those at- 
tached to cartilaginous layers of the bronchi grow to quite a large size. 
The clinical symptoms in the early stages of these formations are not very 
pronounced and rarely observed, but may present symptoms similar 
to chronic affections of the lungs, such as chronic bronchitis or interstitial 
pneumonia. There may be difficulty in respiration, oedema of the head 
and neck, due to pressure on the jugular. Frohner found one case of 
carcinoma of the lungs where the animal had frequent hemorrhage. 
Treatment is useless. Parascandolo, keeping up artificial respiration, 
removed a carcinoma through the chest wall from a large dog. 

DISEASES OF THE PLEURA. 

Inflammation of the Pleura; Pleurisy. 

{Pleuritis.) 

Etiology. — The disease is divided into two forms — primary and 
secondary pleuritis. The primary form may be caused by cold; it may 
also occur as a metastasis, or from the presence of certain bacteria in the 
l^lood, which find a favorable nidus in the pleura, lodge there and set up 
pleuritis. The secondary form results from traumatic causes, such as an- 
imal being kicked, stepped on, or receiving a violent blow on the thorax, 
from the extension of inflammations from the surrounding organs, as 
gangrenous pneumonia, pericarditis, or from peritonitis extendmg 
through the diaphragm, fractured ribs, injuries to the walls of the thorax, 
or perforation of the throat by foreign bodies. We also see it in all forms 
of pytemia and tuberculosis. Cadeac thinks that in nine out of ten cases of 
septicaemia following serous or fibrous pleuritis in the dog, it is of tuber- 



148 DISEASES OF THE RESPIRATORY ORGANS 

cular origin. Tumors of the pleura, chronic nephritis, and acute articuhir 
rheumatism may also develop pleurisy. Piana found bacilli and 
Hutyra and Marek found it caused by streptothrix (actinomyces) canis. 

Pathological Anatomy. — The exudation which collects rapidly 
crowds the lung of the affected side and finally presses it against the spinal 
column and mediastinum, pressing the lung into an inert mass (lung 
atelectasis). The opposite lung is the seat of considerable collateral 
hyperaemia, which ma}^ lead to oedema, according to the severity of the 
condition. When compression of a lung is continued for any length of 
time, the alveoli lose their functional activity, their walls collapse and 
become adherent even if the fluid exuded finally becomes absorbed. 
After this has occurred, it can readily be recognized by the depressed 
appearance of the ribs. In cases of primary pleuritis which have been 
seen by the writer, the inflammatory process was always restricted to one 
side, and that, as a rule, was the left side. The cases of secondary pleuritis 
were generally double-sided, but the inflammatory conditions are never 
of equal intensity on both sides, one side being always a little worse than 
the other. Besides having the results of pressure shown on the lungs, we 
also find the heart is pushed toward the healthy side of the mediastinum 
or the diaphragm. 

The conclusion of pleuritic inflammation depends on the intensity 
and duration of the disease and the character of the exudate. In favor- 
able cases the latter is reabsorbed and good results follow. In serious 
cases, only part of the liquid portion of the exudate is absorbed, while a 
fibrinous exudate covers the pleura; this becomes converted into a granu- 
lar tissue containing numerous vessels and later into a stringy cicatricial 
tissue, called a pleuritic sward, with more or less adhesions of the pleura 
between the lungs and inner wall of the thorax and between the lungs and 
diaphragm. Although the sward formations may be very extensive, it 
is possible for the lung to regain its normal extension, but this takes a 
long time. Thin adhesions sometimes tear; and extended adhesions offer 
a constant hindrance to the unrestricted use of the affected part of the 
lung. Purulent exudates are sometimes reabsorbed; but, as a rule, if the 
pus is not removed at the proper time by surgical interference it breaks 
out, either through the pleura into the lungs and then through the bron- 
chia, or it forms an abscess somewhere in the cavity of the chest, generally 
in the region of the sternum, by undermining the pleura and muscles of 
the chest. 

Clinical Symptoms. — In the primary form of pleuritis, when its 
origin is from cold, etc., it is ushered in with a rapid rise in temperature, 
the pulse increases in frequency, and at the onset the animal generally 
has a chill; the temperature remains high, and the pulse is small, weak, 
and thready. Primary pleuritis with purulent or putrid effusions is rare, 



DISEASES OF THE PLEURA; PLEURISY 149 

and when it does occur it is always accompanied by a high remittent 
fever. 

The general health is very much disturbed. The animal Is stiff 
and sore on moving about; has little or no appetite, but intense thirst. 
The visil^le mucous membranes are reddened and congested, and in cases 
where there is much exudation, the membranes are dark bluish-red. 
The faeces are dry and hard. The urine presents some symptoms that 
are diagnostic; for instance, while the exudate is forming and collecting, 
the urine is scanty and thick and albuminous in reaction. When the 
exudate is commencing to be reabsorbed the urine increases very much 
in quantity and is very clear or whitish-yellow (see chapter on Examina- 
tion of the Urine). 

There is also marked dyspnoea. In dry pleuritis the respiration is 
superficial and rapid, and where there is great exudation the respirations 
are short and painful and the animal has all the symptoms of smothering. 
A characteristic symptom is the way the animal endeavors to assist 
respiration by assuming a sitting position with the front legs spread out 
as far apart as possible and using the abdominal muscles, with show of 
pain on pressure of the abdominal muscles of the affected side. The 
animal has a soft, dry, weak cough; this may, however, be absent. 

The physical symptoms are characteristic. On percussion at the 
onset of the disease there is little change of sound, but when the exudate 
has reached a certain height, the lower parts of the chest give a dull 
sound which seems to be limited in a straight line, according to the posi- 
tion of the animal. Above the exudation the sound is tympanitic on 
account of the retraction of the lung. Auscultation gives a friction bruit 
in the onset, and when the fluid begins to be reabsorbed and the pressure 
of the exudate against the lungs is lessened, the respiratory bruit is 
altered. In the earliest stages of the disease the sounds are vesicular, 
but as the exudate collects the sounds become indistinct or blowing and 
finally only bronchial, and when the bronchial tubes are affected the 
sound is lost entirely. In the healthier parts of the lungs we find in- 
creased vesicular breathing. 

Course and Prognosis. — Primary pleuritis is generally slow in its 
course; the time taken by the exudate to become reabsorbed is very long, 
except in very young animals, unless it is removed in an operative way. 
When the exudate commences to be reabsorbed the percussion sound 
becomes less dull and the respiration bruit more distinct, and if the exu- 
date becomes quickly reabsorbed, the diseased side is lessened in cir- 
cumference, or it can be better described as being flatter. 

Death may occur during the critical period of the disease by col- 
lateral hypera^mia and cedema of the non-affected sections of the lungs, 
by carbon-dioxide poisoning, from defective function of the lungs, by 



150 DISEASES OF THE RESPIRATORY ORGANS 

total stagnation of the circulation of the blood, from pressure of the 
exudate on the large blood vessels and the heart, or later on ljy exhaus- 
tion and by seconclary diseases. To this class belong dropsy caused l)y 
stagnation of the blood circulation, from weakness of the heart, and amy- 
loid degeneration of the kidneys, liver, or spleen. Death may also occur 
from complicating diseases, such as bronchitis and lobular pneumonia. 

The prognosis is generally favorable; as a rule, very severe cases of 
primary pleuritis make good recoveries, depending largely on the aninud 
and character of the exudate and the realworption of the lymph, and there 
may at times be adhesion of the whole or part of the pleuritic surfaces. 
In secondary pleuritis the prognosis depends on the original disease. 

Therapeutics. — The treatment of secondary pleuritis is the same as 
the primar}', but in the former we must take into consideration the treat- 
ment of the original disease. In the early stages of the disease, when 
the exudate is collecting, we must apply counter-irritants, such as lini- 
ments or plasters of mustard. When a copious exudate has been formed 
we try to induce its real^sorption by stimulating the kidneys by means 
of acetate of potassium, acetate of sodium, with the Priessnitz compress. 
When the heart is weak we use digitalis and sciuiils. Small doses of 
calomel are also useful. 

1^. Hydrarg. chlor. mitis, 0.03 

Digitalis pulv., ' 0.05 

8accharum lactis, 0.5 

M. et fiat pulv. No. vi. 

Sig. — One i^owder three times daily. 

Diuretics and cardiac stimulants have only an indirect influence on 
the accumulations, and when the exudate is gradually absorbed one can 
hardly credit these drugs with accomplishing the results, as the exudate 
is usually reabsorbed, w^hen the acute inflammatory stage of the disease 
has passed. The best method of treatment is the removal of the secretion 
by surgical means, that is, by puncturing the chest wall. This operation 
is not at all dangerous in the dog, and is generally sucessful, unless the ad- 
hesions are too thick. 

The operation must be performed where there is a very large exudate 
and the dull sound can be heard over the entire lung, that is, where there 
is oedema of the lung and intense dyspnoea caused by the pressure of 
the exudate; or where there is deficient reabsorption as is seen where 
the fever has entirely disappeared and the fluid does not show any signs 
of becoming real^sorbed. 

Puncture of the Cavity of the Chest. — This must be on the side 
where the exudate; is higliest; this can be detected by auscultation. 

The trocar used in this opei'ation is an ordinary sized trocar, seen 
in Fig. 65, or, if we wish to make first an exploring punctvire, we use the 



DROPSY OF THE CHEST 



151 



needle of the ordinary hypodermatic syringe. The needle, after having 

been disinfected, is introduced into the lower third of the wall of the chest, in 

any of the interspaces between the fifth and ninth riljs, the patient being in a 

standing position or laid on a table and held by means of an assistant. The 

entrance of air into the thoracic cavity must be avoided, and to prevent 

this we must use a trocar that has a faucet, or else 

Avhere we use the ordinary trocar and canula when 

the flow of the fluid becomes stopped at any time 

from some obstruction at the end of the trocar, it is 

well to put the finger over the end of the opening 

to prevent the air from being sucked into the cavity. 

When the animal coughs violently the trocar must 

be withdrawn or the finger kept on the opening of 

the trocar or when the fluid becomes bloody or the 

point of the trocar is felt resting on the pleura. 

It is well to empty the cavity slowly and never 

entirely, as the two faces of affected pleurae coming 

in contact with each other and rubbing often causes 

acvite hemorrhage. After withdrawing the trocar 

it is well to paint the opening with some iodoform fig. 65.— Trocars for punL- 

collodion. t"""*^ «^ ^^^ ^^°''=^^- 

When the fiuid obtained is purulent, it generally requires several 
punctures to empty the cavity. The animal should have a nutritive 
but easily digested diet — soup, beef tea, or lean meat, and when the fever 
is high, antijoyrine in doses of 0.5 to 2.0, according to the size of the dog. 




Dropsy of the Chest. 

(Hydrothorax.) 

Any accumulation of serous fluid that is not dependent on an in- 
flammation of the pleura (that is, of a transudate) in the cavity of the 
thorax, is called hydrothorax. This is often a symptom of general dropsy 
or it may arise from chronic disease of any of the organs (see ascites). 
In such cases the effusion first shows itself in the chest when dropsy of 
the skin (anasarca) exists, or as a result of disturbance of the venous 
system, particularly of the portal. 

Pathological Anatomy. — Hydrothorax, as a rule, affects both sides 
of the chest, Frohner records a case where one side only was affected. 
We find in the cavity of the chest, a clear j^ellow fluid, sometimes stained 
with blood and distinguished from a pleuritic exudate by the absence 
of fibrin, very little cellular elements, little albumen, and by a low 
specific gravity. The pleura is oedematous and swollen, and in long- 
continued cases it has a flaccid or macerated look. The lungs do not 



152 DISEASES OF THE RESPIRATORY ORGANS 

present any change except the signs of jDartial compression. The other 
organs of the body are aneemic. 

Clinical Symptoms. — The physical examination of this disease pre- 
sents symptoms ver}- similar to pleuritic exudates, but the change takes 
place quickly, and fever and cough are absent, but in dropsical transudates 
both sides of the thoracic cavity are filled, and on changing the position 
of the animal the fluid moves about much more quickly than a pleuritic 
exudate would, and the sensitiveness of the animal to pressvire on the 
Avails of the chest and the rubbing or crepitating bruit of pleuritis is 
absent. 

Therapeutics. — The treatment, as a rule, is of a palliative character, 
as it is only in very rare instances that we succeed in removing the 
original disease; but we may use the same agents as in ascites. The op- 
eration of tapping the chest wall (see puncture of the cavity of the chest, 
page 150) is only to be resorted to when the fluid has collected in large 
quantities and the animal is threatened with suffocation; but this only 
affords temporary relief. 

Other Diseases of the Pleura. 

Pneumothorax. — Etiology. — The cause of pneumothorax, that is to 
say, the accumulation of air in the thorax, is produced in several ways; 
by perforating wounds of the chest, by the breaking into the pleural 
cavity of a collection of pus from the lung, by tearing of the lung tissue 
from great exertion, and from perforation of the oesophagus or pharynx. 
Careless puncture of the chest wall, fracture of ribs, perforation of the 
bronchi by a foreign body, which finds its way into that part, or it may 
also be caused by degeneration of the pleuritic effusion, causing the for- 
mation of gas. 

Pathological Anatomy. — On making an opening into the chest with 
trocar and canula, the air escapes with a hissing sound; if the collection of 
air is great, the lungs are pushed out of position, interfering greatly with 
respiration. If this condition exists for any length of time, a purulent, 
and, in rare cases, a sero-purulent, pleuritis is developed, caused by the 
presence of some irritant agents that have gained admittance into the 
cavity besides air. 

Clinical Symptoms and Course. — There is great difficulty in respira- 
tion, and the affected side of the chest wall is visibly distended, and during 
respiration it remains almost stationary. When the heart is pushed out 
of position there is a peculiar tympanitic sound, the pulsations have a 
metallic echo, and the respiratory bruit is absent. In some rare cases 
we hear a metallic bruit; this is caused by the entrance of air directly 
into the pleural cavity with each inspiration. 



PNEUMOTHORAX 153 

Animals in this condition generally die rapidly, although we may 
find rare cases where recovery takes place by an absorption of the air, or 
is followed by the accumulation of a fluid (pneumohydrothorax) which 
itself in turn becomes rapidly absorbed. The treatment consists in the 
administration of camphor or alcoholic stimulants and in tapping the 
chest wall. 

Hematothorax. — In consequence of the destruction of some large 
vessel or vessels in the lungs or the pleural cavity or from the presence 
of growths we find extensive hemorrhage into the thoracic cavity. The 
physical symptoms are similar to those of other pleural exudates, but 
this condition comes on very rapidly and in this condition the mucous 
membranes become very pale. When the symptoms are not pronounced 
the operation of puncture will determine the condition positively. Nor- 
mal hemorrhages are easily and quickly absorbed, but often where there 
is great dyspnoea, puncture of the chest wall is always advisable. 

Other Pathological Conditions of the Pleura. 

Besides tubercular deposits we find endothelial papillomas which are 
seen in the form of velvety or grape-like formations on both sides of the 
mediastinal coats of the pleura and on the pleuritic coat of the diaph- 
ragm. These formations frequently cause a low form of chronic pleuri- 
tis (Kitt). The writer has observed an intrathoracic chondroma of 
great size, which was attached to the ribs, filling up the left thoracic 
side and pushing the left lung and heart to the right side. There was 
severe dyspnoea and anasarca. 



DISEASES OF THE CIRCULATORY APPARATUS. 

EXAMINATION OF THE CIRCULATORY APPARATUS. 

Examination of the Heart. 

Anatomy of the Heart. — The normal position of the heart may 
be seen in Fig. GG. It lies on the left side, but not so far as is seen in 
other domestic animals. The direction of its axis is not vertical, l)ut 
extends slightly in a posterior direction, with a slight curve toward the 
left side. The base of the heart extends from the third to the seventh 
rib; the apex extends backward toward the diaphragm. Superiorly the 
heart lies close to the large vessels — the trachea and the oesoi3hagus — 
and close on all sides to the lobes of the lungs. In its inferior portion it 
lies close to the chest-wall, extending from the third to the seventh ril). 
In the heart-sections we find the following arrangement: the right 
section lies in a right anterior direction from its axis and the left lies 
in a left posterior direction. 




Fig. 66.— The heart in position: a. Right ventricle; b, left ventricle; c, left .auricle; d, right auricle;/, 
pulmonary artery; g, aorta; k, cesophagus; /, diaphragm. 



The size of the heart varies greatly in different animals, even when 
in a normal condition, and it is, therefore, impossible to lay down any 
relative rule as to its size or dimensions. According to Colan, the weight 
of the heart compared with that of the body is 1 to 90; and according to 

154 



POSIT lOX AXD SIZE OF THE HEART 155 

Rabe, it varies from 1 to 40 to 100, and taking relatively all the breeds 
of dogs, and also of sex and age, the relative size is O.G and 2.2 to 100. 

It is difficult to make an examination of the heart on account of its 
position, lying as it does hidden between the lobes of the lungs, with only 
a small portion of its surface exposed where it can be heard, and from 
the fact that it varies in size not only in the various breeds, but also in 
individuals. We find that in animals affected with the various heart 
affections and also in perfect health the pulmonary bruit may be so in- 
creased that it is impossiljle to detect when there are weak heart sounds, 
as the largest portion of the heart is covered by portions of the lungs, 
and as these parts also make sounds the ears cannot detect the sound. 
The restlessness of the animal during examination and the movements 
of the cutaneous muscles and the coat of the animal are all factors that 
assist in preventing a proper examination of the heart. 

The following details must, therefore, be looked upon to a certain 
extent as theoretical in character. 

In making an examination of the heart we must consider the posi- 
tion and size of that organ, its palpitation sounds, and character of the 
23ulsations. 

Position and Size of the Heart. 

Both are to be detected by percussion, but for the reasons above 
explained it rarely answers our expectations. In percussion over the 
position of the heart we find in normal conditions a dull sound which 
lessens in deep respiration. The position, either standing or recumbent, 
may make a decided difference. 

In animals having a small heart, the sound is often entirely absent. 
The sound of that section of the lung that lies between the heart and 
the chest wall is also a factor that makes the sound dull, and it is only 
by strong percussion that anj' sound can be detected at all, so that it 
may hardly be said to be of much diagnostic value. 

There may be an abnormal dulness in the heart's action in hyper- 
trophy, in dilatation, in exudates and transudates around the heart, and 
in retraction or contraction of the lobules of the lung surrounding the 
heart; but we may often be deceived by abnormal processes that surround 
that organ, such as thickening of the lung sections or swards on the pleura. 

The dull sound is absent in enlargement of the lungs by emphysema, 
when air has entered the pericardium, after injuries, in one-sided pleuritis, 
and in pneumothorax. The sound is anteriorly situated in the chest 
when there is intense metcorization of the stomach or intestines, and in 
ascites. 



156 DISEASES OF THE CIRCULATORY APPARATUS 



Character of the Heart Pulsations. 

The pulsations of the heart can be distinguished by putting the hand 
on the inferior portion of the chest near the sternum, about the fifth rib 
(on the right side the pulsation is situated a little more anteriorly) . The 
pulsation makes a distinct vibration of all the adjacent parts, and in 
emaciated animals there can be noticed with each pulsation a distinct 
swelling or motion of the lower portions of the ribs; this vibration may 
be greatly lessened by the presence of layers of fat on the sides of the 
"chest. After great exertion or excitement the strength of the pulsation 
against the chest- w\all is greatly increased. 

The pulsations of the heart are increased by disease in the following 
conditions: After considerable loss of blood, in any case of fever, in pal- 
pitation of the heart, in some forms of heart disease, in hypertrophy of 
the heart, or by the influence of some poisons, such as digitalis or aconite. 
It is almost imperceptible in degeneration of the muscle of the heart, 
in the later stages of acute diseases, in cases of poisoning, in fatty de- 
generation of the heart, and when the heart has become compressed by 
the effects of hydrothorax, pneumopericarditis, or emphysema of the 
lungs. It is distinguished only on the healthy side in lateral pleuritis. 

Character of the Heart Sounds and Bruits. 

In order to distinguish the heart sounds we must put the ear close 
to the side directly over the heart where the beats are loudest; it is better 
to cover the place with a handkerchief or cloth, or we may use a stetho- 
scope. We should hear two sounds in each heart beat — a systolic, 
which corresponds to the ventricular contraction, and a diastolic, which 
corresponds with the beginning of the diastole. Both these sounds follow 
each other with short intervals between. The pause between the first and 
second sound is short, but between the second and the next first the sound 
is much greater. The first sound is a mixed muscular and valvular 
sound of the mitrals and tricuspids, and the second is a semilunar val- 
vular sound. 

Unfortunately these sounds are indistinct and mcomplete in the 
dog, even in perfect health. In very fat dogs we may not hear any heart 
sound, or we may only hear the first one. In well-fed dogs it is not rare 
to hear the first sound, which is a great deal louder than the second, 
only on the left side. In thin animals we can hear the sound distinctly 
on both sides. AVith the respiratory bruit we lose to a certain extent the 
full strength of the sounds, and often only the first sound is heard. After 
great activity the heart's action is increased so much, and the sounds 



CHARACTER OF THE PULSE 157 

follow each other so rapidly, that it is impossible to distinguish one from 
another. 

In pathological conditions the heart sounds may be increased l)y 
a number of causes, as in the beginning of certain fevers; but generally it 
is an indication of hypertrophy. A lessened heart sound is found in 
any heart weakness, as in degeneration of the heart muscle, in accumula- 
tions of exudates around the heart in the pericardium, or in emphysema 
of the lung sections, etc. In such cases, as a rule, the heart sound is 
imperceptible. 

As can be readily seen, it is by no means easy to hear the heart beat 
in its normal condition, and the condition becomes more complicated 
when we have to distinguish pathological sounds — "heart bruits." We 
distinguish between endocardial heart bruits, which originate in the heart 
direct, and pericardial heart bruits, which come from the arterial part of 
the heart and its envelope. The former are divided into organic and 
inorganic bruits. The organic heart bruits are produced by stenosis 
(contraction) of the ring and by insufficient or imperfect closing of the 
valves, which may occvir either in systole or diastole, making the heart 
sound indistinct, or it may be entirely absent, and the bruit takes the 
place of the heart sound. The systolic bruit is buzzing or blowing in 
character, and indicates an imperfect closing of an arterio-ventricular 
valve (in most cases of disease of the mitrals). The diastolic bruit is 
rushing or wheezing in character, and indicates a stenosis of the arterio- 
ventricular ostia, or the imperfect closure of an arterial valve. The 
inorganic heart bruit is seen in all forms of anaemia, and occasionally in 
fevers. Pericardial bruits are very similar to pleuritic fi'iction sounds, 
that is, a scratching or scraping sound. They are located in a sharply 
defined locality and do not occur in direct rhythm with the heart sounds, 
but seem to occur between them. They are noticed in pericarditis as 
soon as there are any fibrinous deposits present and there is not sufficient 
pericardial fluid present to keep the folds free from contact with the 
heart. A change in the position of the animal makes quite a difference in 
the character of the bruit, and it may easily be distinguished from 
endocardial sounds. The pericardial friction sound is distinguished 
from the pleural friction sounds by the fact that it is entirely inde- 
pendent of the movements of respiration. 

Character of the Pulse. 

The pulse is best examined in the femoral artery, inside of the thigh, 
and it may be felt also, in the radial artery, inside of the forearm. In 
the examination of the pulse we must take into consideration its fre- 
quency, its cadence, and its quality. 



158 DISEASES OF THE CIRCULATORY APPARATUS 

The normal pulse varies greatly, according to the breed, age, and 
size of the animal, and is rapidly increased from such causes as phys- 
ical efforts, fear, fright, pleasure, etc. The general pulse is from 70 to 
120, in large animals being less and in very small animals having a cor- 
respondingly freciucnt pulse rate. The rhythm, (cadence) should be reg- 
ular in a healthy animal, and physical causes make it irregular; but an 
irregular pulse in perfect health is very common in the dog; in fact, perfect 
rhythm is rare, as can be easily demonstrated by taking the pulsations 
frequently, the irregularity being well marked in very young or old 
animals. In normal conditions the pulse must be similar in both thighs. 

We find a lessening in the pulse in some forms of poisoning, fol- 
lowing hemorrhages, in affections of the muscle of the heart, in starvation, 
diseases of the brain, meningitis, in hepatogenous icterus, also in collapse 
and in diseases characterized by a continued high temperature. 

An increase of the pulse is found in all fevers, in cases of valvular 
defects, in heart w*eakness and paralysis or collapse of that organ from 
continued high fever. When the temperature increases the pulse rises. 
The pulse is irregular (arhythmic) in some diseases of the heart (in- 
compensated valvular defects, myocarditis) after large doses of digitalis, 
and in heart weakness. It is only intermittent (as a forerunner of 
entire irregularity) in slight cases of valvular defects, in some diseases 
of the brain, and in gastricism. The pulse is full and bounding under 
great physical exertion, small and collapsed after severe hemorrhage 
and in enteritis. In intense heart weakness and collapse it becomes 
thread-like and imperceptible. 

The venous pulse — that is, the apparent increase in the amount 
of l)lood in the jugular at its entrance into the chest — is often seen in 
the dog. It is generally a symptom of some chronic heart affection, such 
as imperfect closing of the tricuspid valves, and of heart weakness. 

DISEASES OF THE HEART. 

Acute Endocarditis. Endocarditis Verucosa ; Endocarditis Ulcerosa. 

Etiology. — This disease is comparatively rare. Jensen ropoi'ts 
that ovit of a clinic of 3,240 dogs, he found 13 with ulcerative endocardi- 
tis. This condition may be caused by a sympathetic irritation of myo- 
carditis or mediastinitis, but this is extremely rare, it being caused by 
the presence in the blood of certain microorganisms which lodge on the 
endocardium, particularly in the vah^es and the deeper portions between 
the trabecule, causing inflammation of the tissues. Endocarditis can 
l)e produced experimentally by the introduction into the blood of vari- 
ous forms of bacteria (staphylococcus, streptococcus, etc.) particularly 



ENDOCARDITIS 159 

if the valves have been previously affected with inflammatory processes. 
Consequently it is very apt to appear in such diseases as distemper, 
septicaemia, pyemia, articular rheumatism, and in rare instances in tuber- 
culosis; it may also follow wound abscesses, chronic ulcerated inflam- 
mations of the skin (dermatitis), and as a consequence of some unknown 
bacterial invasion. Frohner and Jensen have observed an infectious 
malignant endocarditis. 

Pathological Anatomy. — "While we differentiate between endocar- 
ditis verucosa and endocarditis ulcerosa (endocarditis diphtherica, endo- 
carditis maligna), one may follow the other. The former (the milder 
form) commences with the formation of various sized wart-like protuber- 
ances on the free edges of the valves and their attachments, and also on 
the trabeculte and papillary muscles; when the latter are attacked, it 
may cause necrosis and tumefaction of the endocardium. This condition 
may cause the formation of eml)oli which get into the circulation, are 
liberated, and produce grave conditions in various organs of the body. 
The aortic and the bicuspid valves are more frequently affected; the 
pulmonary and tricuspid valves, very rarely. 

Clinical Symptoms and Course. — There may be little or no fever in 
the onset of the disease, but if there is fever present it is generally high. 
The general condition is greatly disturbed, increased irregular heart 
action, pulse Aveak and irregular; on ausculation the pulsation is heard 
and little change is noticed in the early stages before any material 
alteration has been made in the valves. Later, when the deposits become 
organized, the heart beat is muffled and the two sounds of the heart 
become one, or an early systole and diastolic murmurs. The respirations 
are more or less accelerated and labored, there is cyanosis of the visible 
mucous membranes and with these symptoms there may be certain met- 
astatic changes in other organs. 

The course of the disease varies; in some cases death occurs in a 
very short time, in the majority of cases, hoAvever, the disease progresses 
slowly, the symptoms may increase in severity; they may decrease in 
severity and the animal be comparatively well for w'eeks, and then the 
acute symptoms may recur and the disease become chronic. In mild 
cases animals may take complete recoveries, but this is comparatively 
rare. 

Therapeutics. — Rest, avoid any excitement, cold compresses, such 
as an ice-bag over the region of the heart; where there is a small irregular 
pulse we should administer digitalis, strophanthus, or caffeine. ^^ hen 
dangerous symptoms appear, subcutaneous injections of camphor, ether, 
or atropin. For the fever we should use salicylate of soda, aspirin, 
cinchona, antipyrin or antifebrin. 



160 DISEASES OF THE CIRCULATORY APPARATUS 

Valvular Diseases of the Heart; Chronic Endocarditis; Valvular Defects. 

General Notes on Valvular Defects. — By valvular defects we under- 
stand such anatomical alterations in the valves and openings as lead 
to an irregularity in the circulation of the blood, becoming apparent by 
visible symptoms in the pulse or general condition; but those slight val- 
vular defects so often seen in post-mortems and never noticed during 
life are not to be considered. 

Valvular defects appear in two forms: first, when the valves close 
impei'fectly; second, when the openings become contracted, causing 
stenosis. Imperfect closure of one valve causes a certain amount of 
blood to flow back into the portion of the heart from which it has just 
come; for instance, when there is imperfect action of the mitrals or of 
the tricuspids in systole, part of the contents of the ventricles rushes back 




Fig. 67. — Diagram of the blood circulation. 

into the auricles, and when there is insufficient action of the semilunar 
valve in the diastole, a part of the blood that has been thrown into the 
artery returns into the chamber again. 

Stenosis of one opening retards the passage of blood, when we have 
a contraction of an arterio-ventricular opening. At the time of diastole 
the blood is kept back at the entrance of the affected ventricle, and it 
is imperfectly filled, while in the aortic opening in pulmonic stenosis the 
exit of the blood out of the ventricles (Fig. 67) in the systole is retarded. 
In any of these conditions there is imperfect heart action; every defect of 
an arterial opening interferes with perfect ventricular action and every 
defect in a venous opening causes a corresponding lessening of power in 
the auricle. 

An abnormal pumping of the blood in this manner is sure to cause 
more or less disturbance of the entire organism, but there are certain 
compensatory processes in the heart itself that tend to overcome this. 
As a consequence of the impaired flow, the heart muscle is worked much 
harder and becomes hypertrophied (compensating heart hypertrophy). 



VALVULAR DEFECTS 161 

We often see cases where defects of the fiorta become equalized by a hy- 
pertrophy of the left ventricle. In valvular defects of the mitrals the 
stagnation of the blood occurs in the veins, capillaries, and arteries of the 
lungs, and as far back as the right ventricle, which becomes dilated and 
hypertrophied while trying to take up the extra work thrown on it. 
In course of time we also see hypertrophy and dilatation of the left 
ventricle; during diastole the stagnated blood runs in great quantities 
into it out of the dilated auricle. 

These compensating processes of the heart are apt to prevent for a 
long time any great functional disturbance provided the heart receives 
its proportional nutrition. If this is not the case, for instance, in anaemic 
and cachectic feverish animals, the compensating heart hypertrophy is not 
present or is only developed to a slight degree, and also in cases of insufh- 
cient nutrition, due to some alteration in the coronary artery, the heart 
is no longer able to satisfy the demands claimed from it and tires out, 
and all the effects of lilood-stagnation rapidly show themselves. 

Etiology of Deficient Valvular Action of the Heart. — The most com- 
mon causes of valvular defects are endocarditic processes, which are de- 
veloped on the valves and take an acute course, according to the amount 
of the irritation, and cause a fibrinous, rigid thickening of the valves. 
Sooner or later we find an imperfect closure of the valvular openings 
through cicatricial contractions and adhesions to the lobula of the valves 
or in their neighl)orhood. This condition is quite common in old 
dogs, and may appear as a result of great nervous excitement, cold, 
articular rheumatism, distemper, and other infectious diseases. Car- 
diac valvular changes are frequently seen as a result of chronic nephri- 
tis. The mitral valves are most frequently affected. Cadiot and Ries 
found out of thirteen cases, five of the mitral, four of mitral and tricus- 
pid, two of the tricuspid alone, and one of the valve of the aorta and one 
mitral and aorta. AVe may also see deposits of lime salts and a con- 
traction of the opening belonging to the alTected valve. In rare cases 
there is heart weakness and imperfect valvular action, which may be 
caused by a dilatation of the opening, and, thus becoming abnormally 
distended, the valves cannot meet and make a complete closure. Ath- 
eromatous processes may also produce this condition. . 

General Symptoms of Deficient Valvular Action of the Heart. — The 
symptoms which a})pear at a certain time in all valvular troubles are 
as follows: Increase of heart and pulse action (after slight exertion it is 
al)normally increased); palpitation of the heart; difficulty in respiration; 
vertigo after any exertion; cyanosis of the visible mucous meml)ranes, 
especially of the head; venous pulse; dropsical effusions, such as oedema of 
the legs, abdomen, or testicles; hydrothorax; hydropericartlium; ascites; 
allDuniinuria, with lessening of the amount of urine; complications of the 
11 



162 DISEASES OF THE CIRCULATORY APPARATUS 

digestive organs of various kinds, and, finally, general nutritive dis- 
turbances, such as ananiia, emaciation, etc. 

Symptoms of Valvular Deficiency in one Opening. Insufficiency 
of the Mitrals. — The imperfect closing of two of the valves occurs very 
frequently in the dog. Besides the alterations of the valves we find 
hypertrophy and dilatation of the left auricle of the heart, and in the 
later stages also of the right ventricle. 

The clinical symptoms are: Increase of the pulse and distention of 
the artery, systolic bruit heard on the left wall of the chest, increase of the 
second (pulmonic) sound, weak, frequent pulse, shortness of breath, and 
later dropsy, etc. 

Stenosis of the Left Venous Opening. — This is generally accom- 
panied by mitral insufficiency. It leads also to dilatation and hyper- 
trophy of the left auricle and the right ventricle, and in such cases the 
left ventricle is generally small, narrow, and contains little blood. 

The clinical symptoms are: Slight increase in the pulse, diastolic 
bruit (this is absent in some cases) ; considerable increase of the second 
(pulmonic) bruit, very small, irregular pulse; great difficulty in respira- 
tion, and dropsy makes its appearance early in the disease. 

Disease of the Aortic Valves. — This condition of the semilunar valves, 
causes a dilatation and hypertrophy of the left ventricle and flattening 
of the papillary muscles. 

The clinical symptoms are as follows: A very strong heartbeat; 
increase of the heart dulness on the left side, and a full, bounding pulse, 
is very frequently noticed. This character of the pulse is also noticed in 
small arteries that in normal conditions have no distinct pulse. We also 
find shortness of l)reath, oedema, and dropsy of the dependent parts. 

Stenosis of the Aortic Opening. — Rare in the dog. The clinical 
symptoms are a systolic bruit, a very slight sound of the aorta, small, 
weak pulse, general amemia, etc. 

Imperfect action and disease of the tricuspid valves cause distention 
of the right auricle and also a systolic murmur on the right side and a 
strong, venous pulse. Stenosis of the right venous opening and defects 
of the pulmonary valves are extremely rare. 

We very frequently have a combination of a contraction of an 
opening and also a deposit on, or retraction of, the valve at that opening, 
and also a single valvular defect; these two make a combination of symp- 
toms that are rather hard to separate. 

Prognosis and Therapeutics of Valvular Defects of the Heart. — A 
diseased valve must ha considered incurable, but it may exist for a long 
time without causing any decided disturbance of the general circulation. 
It is impossible to predict how long a " compensating" state will continue. 
Mitral defects seem to last the longest. This conculsion is arrived at 



DISEASES OF THE HEART MUSCLE 1G3 

from the fact that it is quite common to find serious heart defects 
in post-mortems on dogs that have been apparently heahliy during 
life. 

Compensating heart defects do not require any treatment. We 
try to aid the heart in its efforts by giving nutritive diet and removing all 
exciting causes, such as great or prolonged exertion. 

As soon as the heart begins to weaken and the difficulty in respiration 
increases, accompanied by oedema, palpitation, etc., we must use heart 
tonics, such as digitalis, strophanthus, caffeine, etc. 

■7. Tine, strophanthus, 15.0 

Sig. — Ten to twenty drops morning and evening. 
J\. Caffeine nitricum, 0.5 

M. F. charta Xo. x. 

Sig. — One powder morning and evening. 
I^. Caffeine citrate, .3.0 

Tinct. digitalis, 4.0 

AquiB, 64 . 

Sig. — One teaspoonful twice daily. 

If by medicinal treatment we succeed in reestablishing a compensat- 
ing action, the anlema gradually disappears; if, how^ever, we do not get 
the desired result and there should be any oedema remaining, Ave must 
treat it symptomatically, using those diuretics mentioned under the 
treatment of pleurisy, particularly theol:)romin (rather than calomel). 
AVhere there is decided palpitation, we must use cold compresses in the 
region of the heart, or subcutaneous injections of morphia. In milder 
cases use the salts of In-omine. Great weakness of the pulse must be 
treated with alcohol, ether, or camphor, etc. Tine, nux vomica may be 
given in doses of one drop three times daily when the appetite is poor. 

The symptoms alcove described are sometimes found in dogs that 
do not present any marked alterations in the valves or openings, either 
during life or on post-mortem; these are due either to simple idiopathic 
hypertrophy and dilatation or to alteration of the heart muscle. 

Diseases of the Heart Muscle. 

Idiopathic Hypertrophy and Dilatation of the Heart. — We find on 
post-mortem, as a rule, a hypertrophy of the left ventricle, but oc- 
casionally it is of both ventricles. At the same time we do not find 
any alteration of the lungs or kidneys which might produce secondary 
hypertrophy of the heart muscle. The causes are extreme and constant 
exertion, cold, abnormal excitability of the heart (in closely bred lap 
dogs), overfeeding, and too much rich blood (as in pet animals). 



164 DISEASES OF THE CIRCULATORY APPARATUS 

Chronic Myocarditis, Indurative Degeneration of the Heart, Inflam- 
matory Myocarditis. — This condition may follow an attack of acute 
distemper and is often mistaken for valvular defects. In this con- 
dition the heart is greatly enlarged and dilated, and the walls are 
hypertrophied. The body of the heart muscle is filled with a number 
of whitish hard bodies which on examination are found to be cicatricial 
connective tissue. 

The cause of the existence of these bodies has not been fully deter- 
mined, but they are due either to myocarditis or to defective nutrition 
of the heart muscle, as a consequence of contraction or atrophy of the 
coronary artery. 

The clinical symptoms presented are as follows: Weak heart, 
palpitation, dizziness, vertigo, increase in the numljer of pulse, and drop- 
sical effusions. 

Auscultation gives nothing but pure heart sounds, and with the above 
symptoms there may be a callous degeneration of the heart or a pure idio- 
pathic hypertrophy, as during life it is impossil^le to determine which, and 
treatment in both cases is the same. Treatment is of no practical value; 
it consists of protection against excitement or great bodily exertion; 
give nutritive, easily digested food, and, if the heart is irregular, heart 
tonics. 

Other Diseases of the Heart. 

Nervous Palpitation, Palpitation of the Heart. — In this condition the 
physical examination reveals no anatomical alteration of the heart. The 
heart beats with great force, so that it can be noticed distinctly 
on the external thoracic walls; the beat is clear and in cases where the 
palpitation is great, the heart makes only one sound; the respirations 
are accelerated and shallow, the animal is anxious and restless, but, as a 
rule, if kept quiet, the attack soon passes off. If continued apply cold 
compresses in the region of the heart and give a hypodermic solution of 
morphine or administer sodium bromide, chloral hydrate, etc. 

Tumors of the Heart. — These mentioned by a number of avithors are 
cither of sarcomatous or fibrous nature, are usually never diagnosed 
during life, but may be seen on the post-mortem of an animal dying 
suddenly. 

Parasite^ in the Heart Muscles. — Cysticercus or bladder worms are 
foiuid 1x1 ine heart. Lindmere found in the external strata of the tissue 
in the heart of a dog a number of cysts al:)out the size of a hazelnut 
which were filled with a clear fluid, which seemed to be the cysticercus 
cellulosse. There was nothing to indicate that these parasites caused the 
heart the sliohtest irritation. 



PERICARDITIS 165 

DISEASES OF THE PERICARDIUM. 
Pericarditis. 

{Inflammation of the Heart Envelope.) 

Etiology. — Inflammation of the pericardium may originate in a 
primary way by traumatisms or cold, or, secondarily, in connection 
with infectious or inflammatory diseases of the neighboring organs, es- 
pecially pleuritis, or disease of the endocardium and myocardium. It is 
a question whether this condition can originate from perforation of lung 
abscesses or from foreign bodies coming from the oesophagus. Tul^er- 
culosis seems to be the most frequent exciting cause of this disorder. 
Traumatisms such as gunshot wounds, fracture of ribs, may cause peri- 
carditis. Cold or rheumatism is said to be a predisposing cause of peri- 
carditis, but this theory is very doubtful. 

Pathological Anatomy. — Pericarditis occurs either in the acute or 
chronic form. The anatomical alterations that it produces on both sur- 
faces of the pericardium correspond to those on the pleura caused by 
pleuritis and occur in the following forms, fibrous, hemorrhagic, puru- 
lent or icteric. The most common form is serofibrinous pericarditis, 
with copious liquid exudates in the pericardium and masses of fibrinous 
Ij-mph attached to the surface of the pericardium; in very rare instances, 
the folds are attached to each other. When this condition has been 
present some time, the pericardium becomes dilated and relaxed and 
the heart-muscle shows more or less atrophy. 

Clinical Symptoms. — Slight pericarditis rarely shows itself to any 
marked degree, but in severe cases there is decided palpitation, the pulse 
becoming weak and indistinct, with marked irregularity in the rhythm. 
On auscultation there is great dulness all over the region of the heart; 
finally the heart sound is entirely lost or simply a pericardial rubbing 
bruit is heard. "When the pericardial folds are attached or when they 
are separated by effusions this sound disappears. 

There may be an increase of temperature, loss of appetite, and the 
slightest exertions cause marked increase in the respiration wuth cyanosis 
of the visible mucous membranes. As soon as the disease .becomes ad- 
vanced, the same symptoms that are seen in any case of defective heart 
action are noticed; the lessened arterial pressure causes irregularity in 
the action of the urinary apparatus, and from venous stagnation dropsy 
shows itself in different parts of the body, especially in the extremities. 
As a result of acute infectious diseases, pleuritis and pleuro-pneumonia, 
we may have acute inflammation of the pericardium and death as a 



166 DISEASES OF THE CIRCULATORY APPARATUS 

result. Chronic pericarditis may also produce death; its action^ how- 
ever, is slower. 

Therapeutics. — Keep the animal as quiet as possible; give nutritive, 
easily digested food (meat diet or milk) and such agents as will lessen the 
fever and tone up the heart. The Priessnitz compress and cold-water 
compresses might produce better effects, but they excite the animal and 
thus do more harm than good. Laxatives, such as sulphate of magne- 
sium or sodium, Epsom salts, calomel. As heart tonics give strophan- 
thus or digitalis, etc. When the exudate accumulates to an alarming 
extent, we must resort to surgical means and empty the pericardium by 
means of the trocar, as in pleuritic effusions, and must be careful to 
use as long and as thin a trocar as possible. (An aspirating syringe 
needle is the best.) Select a space over the dullest part of the heart 
and insert the trocar low down in the left .chest wall, taking care not to 
put the point in too deep and thus injure the heart itself. 

The treatment of pericarditis is generally symptomatic. If great 
weakness of the pulse is observed administer wine, alcohol, ether, or 
camphor; the latter seems to be best to use for this particular affection. 

Dropsy of the pericardium (hydropericardium) is a collection of 
fluid in the pericardium without any direct inflammation of the serous 
pericardium. 

In health the pericardium always contains a small amount of fluid, 
and it is only when we recognize, by physical means, a very much in- 
creased amount of fluid in the sac that it can be called hydropericarditis. 
Dropsy of the pericardium may appear as a symptom of various diseases 
(defects of the valves, inflammation of the heart muscle, diseased con- 
ditions of the coronary arteries or of the kidneys, and acute anaemia) 
as well as in connection with inflammation of the pericardium and is 
generally accompanied with all the symptoms of general dropsy. 

The clinical symptoms are those of pericarditis; the friction bruit 
and the increase of temperature are absent; however, the treatment 
consists in removing the original causes and, if this cannot be done, to 
puncture. Diuretics (digitalis) are to be administered, but these, as a 
rule, only produce temporary effect. 

Hemorrhage of the Pericardium (Haemopericardium). — This is rarely 
seen. It may be caused by gunshot wounds, by a bursting aneurysm, or 
by laceration of one of the coronary arteries (see also spiroptera san- 
guinolenta), rupture of heart, or the formation of tumors, etc., of the myo- 
cardium. Death by compression of the heart generally occurs in a 
short time. Where results are not fatal in a short time — that is, where 
the blood oozes out slowly and fills the sac gradually — it is impossible 
to make a certain diagnosis unless the diagnosis is based on the appear- 
ance of acute anaemia. This is also the case when air (pneumopericarditis) 



FI LABIA IN THE BLOOD 1G7 

or blood penetrates into the cavity from the lungs in eases of some 
traumatism of those organs. 

FILARIA IN THE BLOOD. 

Four kinds of parasites have l^een found in the lilood of the dog, 
namely Filaria immltis, Hsematozoon lewisi, Strongylus vasorum, and 
Spiroptera sanguinolenta. 

Filaria Immitis, Filaria Haematica. — (Males 10 cm. and females 35 
cm. long; both 1.5 mm. thick.) They lie inside of the heart; very rarely 
in the left, generally on the right, where they multiply in great num- 
bers, often hundreds massed in a ball (Megnin) ; they are rarely found 
in any other part of the vascular system; on the other hand, the eml^ryos 




Fig. 68. — Heart, with Filaria immitis in the ventricle (photograph) . 

measure 0.25 mm. long and 5 mm. thick, are found in the circulation in 
hundreds of thousands and can be readily seen under the microscope in a 
sample of blood of the affected animal (Delafond, Xocard, Gruby, Renther, 
Johne, Rieck, Deffe, and others). The mature filarise living in the 
heart (Fig. 68), cause disturbances of the circulatory system, dilatation 
and hypertrophy of the heart, endocarditis, formation of thrombi with 
all its results, and even rupture of the heart. The embryo may plug up 
the small arteries particularly of the lungs, brain, and spleen. The em- 
bryos seem to be excreted through the kidneys. This parasite is gener- 
ally found in Indian, Chinese, and American dogs, especially in the south- 
ern states. Wheeler rarely made a post-mortem that he did not find 
it, often without presenting any observable symptoms during life. It is 
rarely found in Europe. The clinical symptoms are not at all character- 
istic — emaciation, epileptiform convulsions, disturbance of the heart ac- 
tion, intestinal hemorrhage, and excitement — but frequently the filaria may 



1C8 DISEASES OF THE CIRCULATORY APPARATUS 

exist in great numbers and none of these symptoms be present — uncon- 
sciousness, cl3^spnoea, and rabiform symptoms. How the parasites find 
their way into the blood is rather interesting. The embryo is passed in the 
urine and carried by air or water into rice fiekls or swampy places, and 
the parasite finds its way into the system through the dog drinking the 
water. Some authors contend that the larvae get into the blood as the 
larvse of the Filaria sanguinis of man by being first absorbed by the mos- 
quito and then developed and passed again to the dog. 

Frohner tried to reinoculate a dog intravenously with blood con- 
taining the embryo, but with negative results. 

As to prophylactic or therapeutic measures, nothing has as yet been 
found to answer the purpose. In regions where the parasites exist, the 
administration of boiled or filtered water could be carried out only in the 
case of household pets; diuretics tend to wash the parasites from the 
kidneys. Frohner says that in Japan, where the parasite is prevalent, ar- 
senic is used with advantage. 

Hsematozoon Lewisi. — These parasites are very small, resembling 
Filaria immitis found in India, China, Italy, and France. Grassi thinks 
the larvse develop in the fleas and lice that infest the dog. 

Strongylus Vasorum (Haematozoon Subulatum). — These exist in 
France and in certain parts of Italy. Leisering found them in the blood, 
lungs, prostate, and the spongy portion of the penis. He considers 
Ha?matozoon subulatum to be identical with Strongylus vasorum or 
one simply to have taken a different form. These parasites produce 
anaemia, gradual emaciation, irregularity of the heart's action, and 
cough. 

Spiroptera Sanguinolenta (Filaria Sanguinolenta) . — This parasite 
has already been described on page 51. In its larval form it is found 
forming aneurysms which burst and form hemorrhages into the pericard- 
ium, or entering the pulmonary circulation incomplete are carried into 
the lungs. 



DISEASES OF THE URINARY AND SEXUAL APPARATUS. 

EXAMINATION OF THE URINARY APPARATUS. 

This comprises the examination of the prepuce, urethra, prostate, 
bhickler, kidneys, the vulva in the female, and especially of the urine. 



Examination of the Prepuce, Vulva and Urethra. 

If a glossy or purulent discharge comes from the prepuce, it indicates 
a catarrhal condition of the part (catarrh of the foreskin or gonorrhoea 
of the prepuce). If the discharge is purulent, bloody, and has a foetid 
odor, we will find wounds, ulceration, swellings, or new formations, on 
the prepuce or the glans. To make an examination of the 
penis, we must lay the animal on its side, take hold of the 
base with one hand and with the other retract the foreskin, 
so as to expose the penis as far back as the glans, and in 
this way it is comparatively easy to make an examination. 
If it is found impossible to expose the free portion of the 
penis, it indicates phimosis or an abnormally narrow open- 
ing of the prepuce, while paraphimosis is a condition in 
which the greatly distended glans is outside of the open- 
ing of the retracted prepuce. Catarrhal affections, (ure- 
thral or gonorrhceal) of the urethra are very rare in the 
dog. They are recognized by a discharge of purulent mucus 
from the urethra, by difficulty in urination, and the animal, 
on catheterization, may pass purulent mucus from the 
urethra. In cases where there is great difficulty in passing 
urine, or where it is retained entirely, it becomes necessary 
to pass the catheter or sound. When this retention of urine 
occurs, it is generally due to the presence of a stone in the 
bladder, a collection of stones in the urethra, or swelling of 
the prostate, but it may also indicate cicatricial strictures 
of the urethra, irritants, acute cystitis, distention of the 
bladder by prolonged retention of urine, stone of the bladder, or neo- 
formations in the bladder. 

Passing the catheter in the dog: It is best to use an ordinary rubber 
catheter in the male dog (about 2 to 5 mm. in diameter and the ordinary 

109 



Fig. 69.— 
Male catheter. 



170 DISEASES OF THE URINARV AND SEXUAL APPARATUS 

length), Fig. 69. The subject is laid on the left side or back and held in 
that position by an assistant. The prepuce is pushed back behind the 
swelling of the gians and held firmly with the left hand (see Fig. 70). 
Now grasp the catheter with the right, of course, first seeing that it 
has been well lubricated with some oil or cosmoline and that it contains 
the wire-stylet, and introduce it into the urethra; if it is pushed forward 
up the canal and meets with an obstruction at the posterior end of the 
bone of the penis, it is due to a flexure of the canal and also to the fact 
that the diameter of the urethra is less and the part at that portion 
has slight contractile properties. By a gradual pressure the stricture is 
overcome and the catheter passed upward to the arch of the perineum; 
here the wire-stylet must he withdrawn from the catheter at least one- 
third, so as to allow the catheter to round the curve of the ischial arch; a 




" Fig. 70. — Passing the catheter. 

gradual pressure soon brings it into the bladder, when the wire can be 
removed entirely. 

In the bitch catheterization is very difficult at times, for while the 
instrument should be introduced along the middle line of the vestibule, 
freciuently it is almost impossible to find the narrow opening of the 
urethra, and a vaginal speculum is sometimes necessary to locate the 
position of the opening; we generally use a metallic catheter, either 
silver or German silver (Fig. 71). The instrument is passed up on the 
floor of the vagina until it comes in contact with the urethral opening 
(see Fig. 72) ; this is closed with a slight sphincter (the so-called "urethral 
valve); this is soon overcome and the catheter passed into the bladder 
without difficulty, except in cases where the urethral opening is extremely 
small. 



EXAMIXATIOX OF THE PROSTATE 



171 



In the bitch it is rare that an examination of the urethra is necessary, 
but certain discharges from the vulva are of diagnostic vahie. During 
the period of "heat" (menstruation), which occurs normally twice a year, 
in June or July, and in December or January (this, however, is not a 
hard and fast rule, as it may occur in April or May and November or 
October), we have a copious bloody discharge, and during the preparatory 
stages of labor we see a thick, clammy discharge, and the lochia com- 



« 




Fig. 71.— 

Female catheter. 



Fig. 72. — Median section through the pelvic cavity; a, 
rectum; b, vagina; b', vulva; d, bladder; c urethr;a 1, pubic 
symphysis. 



mences with a non-foetid, serous, slimy discharge, which soon changes 
to a thick, yellowish fluid. Purulent, putrid, and bad-smelling discharges 
are generally found in inflammatory or ulcerative discharges from the 
vagina or uterus. It may also be observed when a carcinoma is present. 
In such cases it is best to introduce a mirror-speculum into the vagina 
and make a specular examination. The instrument to use is the so- 
called two-valved rectal mirror (Fig. 73). Digital examination of the 
vagina is often productive of more certain diagnosis. 



Examination of the Prostate. 

This body varies in size, but in the dog it is large in comparison to 
the relative size in other animals, varying from the size of a hazelnut 
to that of a walnut. It is a round, ball-like body cut into two portions, 
lying on the neck of the bladder where the urethra commences (Fig. 74). 
It lies about the anterior portion of the pubic bone, and being free to a 
certain extent, it can be pushed into the abdominal cavitj^ Avith the finger. 
In hypertrophy of the prostate, we find a painless hard body varying 
from the size of a walnut to that of a small orange. Acute prostitis is 
extremely painful and we find increased local temperature, prostatic 



172 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

abscess indicated by fever and fluctuation of the prostate. The pros- 
tate may be covered by a number of irreguhxr knob-like bodies, in- 
variably painless to the touch. A remarkable diminution of an enlarged 
prostate invariably follows castration in the male. 

Examination of the Bladder. 

The bladder is almost entirely covered by peritoneum and lies just 
anterior to the brim of the pelvis, or in some cases it lies entirely in the 
aljtlominal cavity. When the bladder is very much distended, it extends 
as far as the umbilicus and fills up the lower portion of the abdomen. 





Fig. 73. — .Speculums. Fig. 74. — Section through the pelvis of the 

male: 1, Bladder; 2, opening of the ureters into 
the bladder; .3, spermatic ducts; 4, prostate gland; 
5, urethra, showing Wilson's muscle; 6, arch of 
the urethera; c, pelvis. 

It can be distinguished by manipvilation. It is a round, distended, tumor- 
like body, giving a dull sound on percussion. On examination of the 
rectum we not only feel the neck of the bladder and the prostate, but 
the bladder itself can be easily distinguished. Percussion in the region of 
the bladder when it contains a very little urine or is empty gives a hollow 
sound. Tumor or stones in the bladder can be felt by pressing down 
toward the wall of the abdomen, provided the bladder is empty or only 
partially filled; pain on pressure in the region of the bladder indicates 
an inflammatory condition of the bladder (catarrh of the bladder), and 
in this condition the animal evinces more or less pain even when the blad- 
der is normally distended and any pressure put on it. 



EXAMINATION OF THE URINE 173 

Examination of the Kidneys. 

The kidneys are bean-shaped and are almost entirely covered by 
peritoneum; they lie in the lumbar region, the left kidney about the thir- 
teenth rib, the right kidne}^ about the twelfth rib; posteriorly the kidneys 
extend over the second, third, and fourth luml^ar vertel)rpe; in rare 
instances the left kidney may be still further back, both kidneys 
lying directly opposite each other. Frequently they are readily dis- 
tinguished by manipulation through the abdominal walls, and espec- 
ially one or the other kidney may lie free from its attachments or be ab- 
normally enlarged during life. The left kidney is always much easier 
to palpate than the right. The best position is to have the animal stand- 
ing, holding the thumb on the vertebra and with the other fingers ma- 
nipulating the abdominal walls until the outlines of the kidneys are 
recognized. Pain on pressure may indicate nephritis, pyelonephritis, 
or paranephritis; enlargement of the kidney would indicate tumors, ab- 
scesses, pyelonephritis, hydronephrosis or purulent nephritis; abnormally 
small kidneys may indicate a chronic interstitial nephritis. Change of 
the position or remarkable mol^ility would indicate floating or migrating 
kidney. 

Examination of the Urine. 

The urine has to be examined as to its amount, color, transparency, 
reaction, weight, odor, and the presence of certain foreign or chemical 
substances. 

Amount of Urine. — The amount of urine passed in one day depends 
largely, of course, on the size of the animal, the cjuantity of fluids it 
drinks, and the temperature of the atmosphere. It is difficult to estimate 
the exact amount of urine an animal A\'ill pass under normal circum- 
stances, as one animal may remain indoors, is house-broken and retains 
his urine until he is allowed to go outside, and other animals that are 
free urinate small quantities at every street corner. Friedberger and 
Frohner found dogs confined in cages urinated two or three times in 
twenty-four hours, but the amount even in individuals varies, exercise 
having great influence on the amount excreted. The average amount 
of urine passed by the larger kinds of dog is from 0.5 to 1.5 kilogrammes 
daily; in smaller breeds, one-half that amount. An increase in the fre- 
quency of the act of urination may indicate some irritation of the blad- 
der. A decrease in the amount of urine passed indicates that the water 
of the body is being taken up through some other channel, as in violent 
diarrhoea, great salivation, during the formation of pleuritic or pcrito- 



174 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

neal exudates, or in dropsy, in fevers, in decrease of the pressure of the 
heart, as in valvuhir defects, myocarditis, etc. An entire stoppage of 
the urine may occur in acute or subacute inflammation of the kichieys, 
in o]:)struction of the urethra, paralysis or rupture of the bladder, from 
calculi in the bladder or urethra, from stricture of the urethra, or from 
swelling and pressure of the prostate, or from certain poisons. 

An increase of the amount of urine (polyuria) may be clue to the 
presence of a large amount of water in the blood (anaemia, hydrsemia), 
in atrophy of the kidney, where there is great reabsorption of exudates, 
or in diabetes mellitus (a condition that corresponds to diabetes in- 
sipidus in man). This, however, is extremely rare in dogs. We may 
see it after the administration of the different diuretics. It is frec][uently 
seen in convalescence from acute diseases. 

Constant driljbling of urine indicates paralysis or weakness of the 
blad<ler. 

The Color of the Urine. — This varies in the healthy dog from pale 
yellow, when it has few chemical constituents, to dark reddish-yellow 
when it is concentrated and has a high specific gravity. Food also has 
a certain influence on the color. After eating fat it is reddish-yellow, 
and after meat it is light yellow; after eating sugar or bread it is dark 
yellow, and when the animal is starved it is deep yellow. Disease has 
also a great effect on the color. It is a deep yellow in fevers and jDale 
or colorless in diabetes mellitus or insipidus and in chronic interstitial 
nephritis. After the administration of diuretics it is light in color, and 
in disease of the liver the coloring matter of the bile may change the color 
of the urine to all shades of yellow, varying from lemon-yellow to deep or 
even brown-yellow (see icterus). A red color is produced by the coloring 
matter of the blood, general angemia, or atrophy of the kidneys; a green 
or light brown, by diseases of the liver and catarrh of the duodenum. 
Constant dril)bling or slow voiding of the urine without any apparent 
pain (incontinentia urina^) indicates weakness or paralysis of the sphincter 
or the bladder itself; it may occur from certain affections of the spine, 
in acute cystitis, or from tumors of the bladder. Difficult or painful 
urination (dysuria, retentio urinse) or even total retention of urine in- 
dicates urethral calculus or certain poisons. Hsemoglobinuria is found in 
piroplasmosis and following the administration of certain of the febrifuges 
such as chlorate of potassium, pyrogallol, chrysarobin, naphthol, analine, 
kairin, thallin, acids, etc. Also from intense burns, occasionally in 
septicaemia and in infectious hsemorrhagic gastro-enteritis, in acute cases 
of distemper, and from sudden chills. Rhubarb and senna turn the urine 
yellow, while the addition of an alkali turns it red. Cascara sagrada turns 
the urine greenish-yellow, santonin and cina produces a red-yellow. 
Analine also produces a blood red. Xaphthalin a brownish-red; carbolic 



EXAMIXATION OF THE URINE 



175 



acid, or cresote, salol, resorcin and the various coal-tar products produce 
a greenish-black urine, which on exposure to atmosphere becomes dark 
oilve-green. Thallin produces a bluish-green urine and a blue-red is pro- 
duced by pyoctanin. The appearance of blood in the urine indicates- 
grave conditions. In hsematuria we may see the urine like blood, the 
color corresponding to the number of blood corpuscles present, and in 
htemoglobinuria the coloring matter is granular or dissolved blood-coloring 
matter, actual blood corpuscles rarely being present, the urine then being 
dirty reddish-brown in color. Both the above conditions may exist 
simultaneously in some cases. 

Transparency and Reaction of the Urine. — When the urine has been 
passed recently it is clear and transparent, and has an acid reaction. 
After feeding with bread for some time it is turbid and 
alkaline. After feeding with fat it is alkaline. In patho- 
logical conditions when the urine has been passed recently 
it is turbid and filled with mucus and epithelium, pus cells, 
bacteria or triple phosphates. An alkaline reaction gener- 
ally indicates catarrh of the bladder, or we may see this 
condition in hsematuria, in reabsorption of exudates, trans- 
udates, or in hemorrhage into the abdomen or thorax. 

Odor of the Urine. — There is a slight penetrating odor 
in normal urine; sometimes it is slightly garlicky. Sul- 
phonal produces a fruity odor. In cases of catarrh of the 
bladder the urine has a strong ammoniacal odor, and when 
any amount of turpentine has been absorbed the urine has 
a faint smell of violets. If much ammonia is present 
when a glass rod is dipped in muriatic acid and held 
over the urine, a white cloud-like vapor arises from the 
urine. 

Specific Gravity of the Urine. — This varies in the dog 
between 10 IG and lOGO. It can be tested by means of the urinometer 
or if we have only a small quantity we can test it readily by the area- 
pikometer. This instrument the writer has found to be very useful. It 
is shown in Fig. 75. Place the urine to be tested into the receptacle C. 
Fill it full, taking care that there are no air bubbles in it. Close it and 
then sink it in water at 15° R. The specific weight of the urine will 
then be marked on the scale. 

As a rule it will be found that dark urine has a high and light- 
colored urine a low specific gravity. But there are exceptions to this, 
for in diabetes mellitus the urine is clear and high in specific gravity, 
while in nephritis it is dark in color and has a low specific gravity. 
Dark urine seen during starvation has a low specific gravity. 

Foreign Substances in the Urine. — The following substances appear 




Fig. 75.— 
Areapikometer. 



17G DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

in the urine under pathological circumstances. jMucus, blood, particu- 
larly red blood corpuscles, white and pus corpuscles, fat, epithelium, 
and tissues, urinary cylinders, animal and vegetable parasites, crystals, 
albumen, sugar, or coloring matter of bile and indican. 

a. Mucus is found in the bladtler under all conditions, either in 
health or disease of the urinary passages, and is found in particularly 
large fiuantities in catarrh of the bladder. 

b. Blood. — If the blood is mixed in the urine evenly and the corpus- 
cles are reduced in size and cylinders are present, it indicates hemoi'rhage 
from the kidneys. If blood is present it is called hsematuria and when 
the urine is stained with blood or blood-coloring matter it is called hcemo- 
globinuria or methtemogloljinuria. Heller's test or the spectroscope 
can be used to test urine for blood or lilood coloring matter. 

Heller's Test. — Add to the sample of urine a solution of caustic 
sodium or potassium, rendering it strongly alkaline; the solution is then 



Jfct Orange t^elh 




^rim. 



A aB C J) E b 

Fig. 76. — Spectrum of uriue in haemoglobinuria. 



Fig. 77 — Hsematin crystals. 



l)rought to a boiling point, and a flocculent reddish-brown deposit is 
thrown down. 

Spectroscope. — The spectroscope examination is made by means 
of an ordinary pocket spectroscope; it may be necessary to dilute the 
urine slightly with water if too concentrated. 

Microscopical examination will positively determine the presence of 
blood cells. 

Hsematuria is indicated by the presence of red blood corpuscles 
in the urine, and if the urine has been allowed to stand some time con- 
tracted or broken clown blood corpuscles may be found and the red 
coloring matter disappears. This condition is present in all diseases of 
the kidneys. 

Hsematuria is found in all diseases of the kidneys, acute nephritis, 
acute renal stasis, hemorrhagic infarction, travimatisms, tumors of the 
kidneys, diseases of the urinary passages, particularly the pelvis of the 
kidney, pyelitis, nephrolithitis, eustrongylus gigas, and in diseases of 
the bladder, such as cystitis, neoformations, calculus, inflammation of 
the prostate and urethra. 

The location of the hemorrhage may be indicated in the following 



EXAMINATION OF THE URINE 177 

manner. If from the kidney, by the presence of large quantities of epithe- 
lium and cylinder casts, while the absence of casts and the presence of epi- 
thelium peculiar to the bladder, would indicate it came from that organ. 
If the urine is bloody at irregular intervals, it indicates hemorrhage from 
the pelvis of the kidney. When the blood is not mixed with the urine, 
but comes down in a mass, the diseased condition must be in the blad- 
der. This indication is not always certain, as we may see the blood 
evenly mixed with the urine in diseased conditions of the bladder, such 
as cystitis. When the blood is passed just before the urine or follows 
after the last of the urine has passed, or is passed involuntarily, it indi- 
cates hemorrhage from the prostate or urethra. Haematuria may re- 
sult from certain infections or constitutional diseases, or as a result of 
the presence of certain filaria in the blood. 

c. White Blood Corpuscles, Pus. — White blood corpuscles are found 
in the urine and are found associated with red blood cells; they are also 
found in the majority of diseases of the kidneys and urinary organs. 
When a considerable quantity of pus is passed, it indicates the opening 
of an abscess in the prostate. When a smaller quantity is present it 
indicates the presence of some inflammation of the mucous membranes 
of the kidneys. We can obtain definite information as to this con- 
dition by making a microscopical examination of the epithelium to see 
whether any cylinders are present or not. 

d. Fat may be seen in drops on the surface of the urine or shortly 
after it has been passed. In very fat animals this may be seen as a 
normal condition, and where animals have had large quantities of fat 
given to them. It also indicates the fatty degeneration of epithelium 
of the kidneys. Friedberger and Frohner have seen a pathological 
lipuria associated with croupous pneumonia in animals with certain 
anemic and cachectic conditions. It is also present in the various dis- 
eases of the kidneys. Do not be misled, when you have passed a well- 
lubricated catheter and see oil floating on the urine, into thinking that 
it is a pathological condition. 

e. Epithelium and Broken-down Tissue. — In health a few epithelial 
cells are always passed, but when they are present in large quantities 
it indicates some active inflammation going on in some part of the uri- 
nary tract, and a microscopical examination of the cells to ascertain 
their size and shape will indicate the section of the urinary system they 
come from. Large quantities of squamous epithelium indicate an irri- 
table condition of the bladder, but it may also come from the uterus or 
pelvis of the kidney. Renal epithelium in any quantity indicates disease 
of the kidney; large quantities of glandular cells, mixed with pus corpus- 
cles and dumb-bell bacteria, indicate disease of the prostate. Broken- 
down tissues in the urine indicate renal tumors, suppurative or septic 

12 



178 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

nephritis, severe inflammatory processes, or carcinoma of the bladder or 
prostate (Fig. 78). 

/. Renal Cylinders. — "Where we find hyaline cylinders, granular 
cylinders, epithelial cylinders, or blood casts, then we can feel assured 
that there is some disease of the kidneys. Blood cylinders indicate 
hemorrhage of the kidneys. Epithelial cells in large numbers indicate 
great desquamation of the epithelium, as in acute parenchymatous neph- 




FiG. 78. — Epithelium found in the urine: a, From the bladder; b, from the ureters; c, fromthe pelvis of 

the kidney. 

ritis. Hyaline or epithelial cells when mixed with pus cells indicate 
suppurative nephritis. Hyaline and granular cells are present in all 
diseases of the kidneys and always in albuminuria and fevers (Fig. 79), 
g. Vegetable and Animal Parasites. — Vegetable parasites may be 
found in recently voided urine in the form of the split fungus, side by 
side with triple phosphates (Fig. 80). Siedamgrotzky found numerous 
ball bacteria and pus corpuscles in suppuration of the prostate. Animal 




Fig. 



79. — Uric cylinders; a. Hyaline cylinders; h, epithelial cylinders; d, granular cylinders; c, blood 

cylindera. 



parasites may l^c found, either the eggs of the eustrongylus gigas or the 
eml;)ryonic forms of the filaria immitis. 

h. Crystals. — We find collections of precipitates in the urine and in- 
dications of alkaline fermentation, the urine being alkaline in reaction 
and containing crystals of triple phosphate, phosphoric acid and am- 
moniacal magnesia; these crystals develop in ammoniacal urine and are 
coffin-shaped, they arc soluble in acetic acid, thus being distinguished 



EXAMIXATION OF THE URINE 179 

from calcium oxalate, and occur in large quantities in chronic cystitis. 
There are a numl_)er of abnormal substances found in the urine. The 
principal ones are albumin, sugar, and the coloring substances of the 
bile. 

i. Albumin. — The presence of albumin in the urine is always an 
indication of disease. The two most important forms of albumin are 
serum-albumin and serum-globulin; the two are generally in combina- 
tion, and both give the same reaction. 




Fig. 80.— Urine of a dog with cystitis, triple phosphate crystals, red and white blood corpuscles, and 

cystic epithelium. Bacteria. 

Koch's Test. — The urine to be examined must be carefully filtered 
before proceeding with the test. The urine is boiled in a test-tube, hav- 
ing been previously rendered acid in reaction by the addition of a small 
quantity of acetic acid. The urine may become opaque from two causes; 
from the presence of albumin or from phosphates; to this we add nitric 
acid drop by drop until the phosphate is all dissolved and the albumin 
remains opaque. 

Heller's Test. — The urine is rendered acid; then pour a small quan- 
tity of nitromuriatic acid down the side of the tulje, and if there is any 
albumin present there will be a pronounced opaque ring or line where 
the acid meets the urine. 

Test with Acetic Acid and Ferrocyanide of Potassium. — The urine is 
rendered acid with acetic acid and drop by drop a 5 to 10 per cent, solution 
of ferrocyanide of potassium is added; if albumin is present, a white 
turbidity indicates the presence of albumin. If the solution immedi- 
ately becomes turbid on the addition of a very small quantity of the solu- 
tion it is due to the presence of mucin and must be filtered immedi- 
ately before proceeding. Very concentrated urine must be diluted with 
a certain quantity of water. The quantitative test for albumin must 
be made by means of an albuminometer; if this is required the methods 
described in text-books on analytical chemistry should be consulted; as 
a rule the simple proof of the presence of albumin is sufficient for diag- 
nostic purposes. 



180 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

A]])innin occurs in the urine from two causes: in false or accidental 
albuminuria, and in true or renal all)uminuria. 

The first occurs when there is free albumin in the urine from ac- 
cidental causes, as where the albumin is added to the urine in its 
passage from hemorrhage, inflammatory conditions in the passages, 
or from purulent inflammations. In such cases the microscope will 
easily make the differential diagnosis. The quantity is always small. 

True all)uminuria is of much greater importance, as this condition 
is always a symptom of pathological alterations in the epithelium cover- 
ing the walls of the gland. Healthy epithelium wall always retain the 
albumin in the blood. 

We see true albuminuria in all forms of acute and chronic inflamma- 
tion of the kidneys, in fatty degeneration of the kidneys, in amyloid 
kidneys, and in any altered condition of the renal circulation, such as 
stagnating hypei'semias as a consequence of heart disease, and in chronic 
inflammatory conditions of the lungs, pleuritis, hydrothorax. The 
horizontal position of the dog does not, however, cause such a great dis- 
turbance in the posterior extremities when the smaller blood vessels 
are congested as it docs in man. 

Albumin will sometimes be found in the blood from ansemia, leu- 
kaemia, in acute poisoning, and from high fevers, acute infectious diseases, 
or violent muscular exertion. In acute nephritis a large amount of albu- 
min is found to be present, in smaller quantity in chronic nephritis, while 
in acute atrophy of the kidney very little albumin may be found, but 
in the latter condition we generally find that there is present more or 
less nephritis or a slight parenchymatous degeneration of the kidneys. 
And it is well to examine the urine under the microscope to see if cylin- 
ders are present. 

Sugar. — The grape-sugar test is generally made when an animal has 
a good appetite and polyuria and yet becomes generally emaciated, and 
when the urine is pale but of a high specific gravity. 

The tests are Trommcr's, the bismuth, and the fermentation test. 

Trommer's Test for Sugar. — Put a few c.c. of urine in a reagent glass, 
taking care to first see that there is no albumin in it, and if so coagulate 
it and filter it out. Take the urine and dilute it with an equal bulk of 
water, and render it alkaline with a small quantity of sodium hydrate; 
then add drop by drop a 4 per cent, solution of cupri sulphas until the 
li(piid is clear and the sediment dissolved, then heat it until it boils, 
and if sugar is present we see a reddish-yellow vapor appear at the sur- 
face of the fluid. 

Bismuth Test. — Ten parts of urine from which all albumin is re- 
moved has the following solution added to it: bismuth sul^nitrate 2 parts, 
Rochelle salt 4 parts, and a hundred parts of 10 per cent, solution of 



ACUTE INFLAMMATION OF THE KIDNEYS 181 

caustic soda; this mixture is boiled five minutes, and if sugar is present 
the mixture becomes bhick. 

Fermentation Test. — This test is always to be preferred in dul^ious 
cases; it is also useful to determine the quantity of sugar present. In 
this test the saccharometer is used. The method consists in adding a 
small quantity of yeast to a certain proportion of urine; for further de- 
tails the reader is referred to works on the chemical analysis of urine. 

In diabetes mellitus a large quantity of sugar is generally found 
in the urine. This disease, however, is extremely rare in the dog. It 
is also found when the animal has been fed on a pure sugar diet. A con- 
siderable amount of sugar has been found in the urine of bitches that 
were nursing, especially when the pups were prevented from nursing 
for some time. The writer cannot say whether it is found in the dog 
in certain cases of poisoning, or from some neurotic causes. 

Coloring Substance of the Bile. — The coloring substances of the bile 
are found quite frequently in the urine of the dog. The presence of 
these indicates an obstruction in the excretion of bile. It may often be 
seen in catarrh of the intestines and in the gastric form of distemper. 
Icterus is the most common cause of this condition. (For further in- 
formation, see icterus.) Frohner found this also in neurosis and bronchial 
forms of distemper, in some diseases of the kidneys, in pleuritis, and in 
great heart weakness. Voigt also found it in animals that were starved. 
Bile acids in the urine are of no diagnostic value in the dog, and will not 
be taken up in this work. 



DISEASES OF THE KIDNEYS. 
Inflammation of the Kidneys; Nephritis. 

It is impossible to accurately separate the different inflammatory 
conditions of the kidneys, and as a rule it is only on post-mortem that 
the condition can be properly diagnosed. Consequently, the practi- 
tioner has to be satisfied if he can recognize with certainty that the pnimal 
has some affection of the kidneys, and whether it is acute or chronic. 
In the dog it is only in chronic nephritis that we find a general atrophy 
of the kidney. 

Acute inflammation of the kidney may be traced to severe cold, 
to traumatisms, or to sympathetic irritation from adjacent organs, or 
to acute catarrh of an infectious or toxic character. 

The diseases of the kidneys in the dog do not pos-<\''^ that impor- 
tance that they do in man. 



182 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

Acute Inflammation of the Kidneys. 

(Acute Nephritis; Nephritis Acuta.) 

Etiology. — The most common causes of this condition are infec- 
tious diseases and poisons. By this is meant the effect produced l)y 
the absorption of infectious noxious agents, such as the various septic 
cUseases, or certain irritants that have originated in the body and are 
passed into the kithieys and cause great irritation while they are passing 
through these organs, and also certain micro-organisms that reach the 
blood and become located in the capillaries of the kidneys. Certain 
chemical substances, such as phosphorus, arsenic, lead, mercury, copper, 
cantharides, turpentine, colchicum, male fern extract, strong spices, 
carbolic and tar acids, naphthol, and chrysarobin, that are absorbed or 
taken into the stomach pass through the kidneys and cause great inita- 
tion. Some of these chemical substances are absorbed by the skin 
from various ointments that are applied in mange, such as carbolic acid, 
mercury, cantharides, balsam of peru, storax, etc. 

Acute nephritis may also originate from an extension of inflamma- 
tion from neighboring organs, and also from traumatic influences, such 
as blows, shocks, etc., in the regions of the kidneys. There is a condition 
called rheumatic inflammation of the kidneys that is supposed to origi- 
nate from cold. This occurs generally in young dogs during severely 
cold weather. 

Pathological Anatomy. — The alterations in the structure of the 
kidney depend on the intensity of the irritation, and the alterations 
are more or less distinctly marked. In slight cases the epithelium seems 
to be the only part affected, the connective tissue and the blood vessels 
show no pathological alteration other than a reddish-gray coloration 
of the covering, or sometimes a yellowish coloration (parenchymatous 
degeneration). AMien the irritation is great, there is true parenchyma- 
tous inflammation of the kidneys. The epithelium and the inter- 
mediate tissue become affected, as do the blood vessels, and all the 
exudation processes which accompany acute nephritis follow. The 
anatomical alterations that are fovmd are as follows: The epi- 
thelium has undergone extensive desquamation, as in parenchyma- 
tous degeneration, Ijut more acute in its type. The capsules of the glom- 
eruli and the small urinary canals are altered, and the connective tissue 
is filled with a liquid infiltration forming numerous coagulated masses 
containing large numbers of Icukoc^'tes rich in hydrogen and the urinary 
canaliculi are filled with hyaline and epithelial cylinders. The vessels 
are enlarged (hypenemic) and partially compressed by the surrounding 



ACUTE IXFLAMMATION OF THE KIDNEYS 183 

exudates. In the interstitial tissue and in MuUer's capsule we find small 
circumscribed hemorrhages. There are a number of circular-shaped 
inflammatory centres surrounded by liquid exudates. 

The inflamed kidney may present a variety of different appearances. 
It ma}" be enlarged or normal in size, soft or hard, reddened or very pale 
or yellowish-white, and on the surface of the kidney there may be found 
a number of hemorrhage spots that are slightly elevated from the sur- 
face of the gland. The capsule can easily be stripped from the body of 
the kidney. There are certain forms of acute nephritis and glomerulo- 
nephritis that present so little visible changes that they may escape the 
eye of the non-experienced practitioner. Concerning more accurate de- 
tails refer to the variovis text-books on pathological anatomy, particu- 
larly Kitt, who has made a special study of the pathological anatomy 
of domestic animals. 

Clinical Symptoms and Course. — Slight inflammatory conditions 
of the kidneys are rarely recognized in the dog, as the only diagnostic 
points are to be found on examination of the urine. This contains a 
small amount of albumin, some hyaline cylinders, and a few epithelial 
cells and leukocytes. 

In acute inflammatory conditions the animal has a peculiar stiff 
gait in w^alking, and in some cases staggering, with the hind legs carried 
straight, and tenderness on pressure in the regions of the loins; there 
may be pain on pressure in the region of the kidneys, and an exact knowl- 
edge of the anatomy will aid to discover whether these organs are enlarged; 
a quick full pulse, with loss of appetite, and persistent vomiting in the 
early stages of the disease; great lessening in the amount of urine se- 
creted, and what is passed is dark in color and contains small portions of 
coagulated blood, but the animal may make frequent attempts to uri- 
nate, and the faeces are dry and hard. The amount of urine passed in such 
conditions is small and contains a large amount of albumin. The urine 
is turbid, reddish-brown to dark red in color; if allowed to stand there is 
a thick nuicus-like sediment of a red-brown or, in rare cases, opaque 
red color, and the specific gravity is greatly increased; examined micro- 
scopically, it is found to contain numerous tube-cylinders, epithelium, 
and white blood corpuscles, also red blood corpuscles, which give the 
urine a variable color, according to the number of corpuscles present; 
chemically tested, large quantities of albumin are found to be present. 
There is generally more or less pain on urination; this is probably due to 
the acrid condition of the urine. There are also present more or less 
symptoms of uraemia, with great weakness, fatigue, and temperature 
generally subnormal, the pulse weak and thready, vomiting, dian-hcea, 
oedema of the lim1)s, convulsions, coma, and death. The result in an 
acute case is not often favorable if the disease lasts from 8 to 14 days. 



184 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

AVhen the symptoms are milder and the animal recovers, this is indi- 
cated by an increase in the amount of urine secreted and its becoming 
clearer; liut this condition may be followed by chronic nephritis. 

Therapeutics. — Medicine, as a rule, has little or no effect on these 
cases. Tannin, 0.1 gm. several times daily; tinct. fol. uvaursi, 1.0., or 
fuchsin, and iron preparations may all be used. 

The dietetic treatment is the most successful and consists principally 
of rest and food that is non-in-itating to the kidneys, such as milk, 
mutton broth, rice and gelatine soups, are especially useful. Meat 
may be given, in the acute stages, but only lean meat and in spare 
quantities, avoiding anything that is spiced or salted. The symp- 
tomatic treatment is to try to lessen the strain thrown on the kid- 
neys by trying to carry the fluids out of the body by some channel 
other than the kidneys, and we try to do this through the skin or the in- 
testines. This can be accomplished to a certain extent by giving the 
animal hot baths or using warm bandages (the Priessnitz compress) 
around the body, particularly around the kidneys, and also by active pur- 
gatives which have no action on the kidneys, such as cascara sagrada, also 
jalap and calomel. Where there is great pain in the region of the kidney 
and the animal moves about Avith the back arched, the application of a 
warm linseed poultice in the region of the kidneys is particularly useful. 
To relieve the kidney we can also try pilocarpine, which produces 
great salivary secretion in the dog. This, however, must be used with 
great care in'dogs that have any affections of the heart or lungs. Diuretics 
must not be used in nephritis, as they increase the secretion of salts, 
especially the alkalies. General debility should be treated by alcoholic 
stimulants, such as brandy, whiskey, or sherry, in the case of very small 
animals. Use inhalations of chloroform, clysters of chloral hydrate, or 
salts of bromine to counteract convulsions. Where acute nephritis occurs 
as a result of some infectious or toxic disease, the symptoms must be 
treated in connection with the exciting; cause 



Chronic Inflammation of the Kidneys. 

(Chronic Nephritis; Xephritis Clironica.) 

Etiology. — Chronic nephritis oi'iginates, as a rule, from acute nephritis 
or starts in a mild form and gradually becomes chronic; this is seen particu- 
larly when it originates from toxic or infectious causes, and in animals 
that are subjected to repeated colds or lie in damp kennels, so that it is 
very difficult to tell at times just how a chronic case may originate. 

Pathological Anatomy. — There are two forms of chronic inflammation 
of the kidneys; first the large white kidney (chronic parenchymatous 



CHRONIC INFLAMMATION OF THE KIDNEYS 185 

nephritis), and the atrophic or hard kidney (chronic interstitial nephritis). 
The first contlition is generally the forerunner of the second, but, as the 
hard kidney is most frequently found in post-mortem, it is possible 
that it niaj' develop as a primary condition. The white kidney is en- 
larged from the normal size, and has a smooth yellow or irregular yellow- 
colored surface. The cortical portion is yellowish in color, while the 
pyramids are red. In some cases we find the kidney large and red, or al- 
ternated red and yellow, or covered with hsemorrhagic spots. The 
atrophic kidney (shrunken or contracted kidney) results from an increase 
of the interstitial substance and atrophy of the parenchymatous substance. 
It is hard and tough on its surface, and has small, wart-like irregularities 
and granulations. The capsule is thickened and it is hard to strip from the 
body of the kidney; here and there we find small cysts of various sizes. 
The cortical substance is lessened in diameter and striated wdth layers of 
dark colored tissue. The pyramids are smaller and deep red in color. 

Clinical Symptoms and Course. — As a rule, very little that can be recog- 
nized in the clog during life. The quantity of urine passed is greatly in- 
creased and at much shorter intervals; this increase of the amount of 
urine passed is one of the first symptoms to attract the attention of the 
owner. The urine is very light in color, almost like water, the specific grav- 
ity being much lessened. Microscopically examined, we may find iso- 
lated hyaline cylinders, and a few blood corpuscles; albumin is never present 
in any great amount, frequently for a certain period small quantities of 
albumin may be present and then it entirely disappears. Palpation of the 
kidney may find it hard, and uneven on the surface. In such cases there 
is generally hj-pcrtrophy of the left ventricle, which can be recognized 
by palpitation of the heart (loud pulsations and a hard, full pulse). It 
is presumed that this high arterial pressure tends to keep up the action 
on the impaired kidney and prevent any serious disturbance in the secre- 
tion of the kidney. As the disease advances we soon recognize a change: 
the heart becomes weaker in its action, the pulse is small and frequent, the 
urine is scant, dark and very albuminous. This is followed by chronic 
inflammatory processes in various organs, especially the bronchia, and in 
the intestinal canal; and finally we have symptoms of uraemia. In the 
majority of cases the parenchymatous form can be recognized by the 
urine. This is very similar to acute nephritis. It contains much albu- 
min, and the urine is scant in quantity, and there are certain dropsical 
symptoms in the dependent regions; death may occur as a result of gen- 
eral dropsy or uraemia, or such complications as pneumonia, pleurisy, or 
pericarditis. There is also loss of appetite, great fatigue on taking any 
exercise, hypertrophy of the heart, which finally becomes weak, and then 
symptoms of ursmia follow as stated above. In rare cases the condition 
may change and the active symptoms cease; the urine gradually becomes 



18G DISEASES OF THE URINARY AND SEXUAL APPARATUS 

clean and of a lighter specific gravity, it increases in quantity and the 
dropsical regions return to their normal condition. 

Therapeutics. — The treatment of chronic nephritis is the same as in 
acute. As the course of the disease generally covers a long period and the 
affected animal suffers great loss of strength, the animal must be fed fre- 
quently on milk, rice, or meat, being careful to use no salt or spices. But the 
dropsical conditions can be treated by diuretics and aromatics; pilocarpin 
is also sometimes used, and when there is great anaemia give iron salts to 
assist absorption of the pathological neoformation resulting from the in- 
flammatory processes. Iodine, iodide of potassium, or sodium may l)e 
administered. 

Other Diseases of the Kidneys. 

There are in the dog a number of pathological conditions of the kidneys 
Avhich are of very little importance; the most important of these will 
here be described briefly. 

Renal Hyperaemia. — This follows as a result of arterial hypersemia and 
may be produced by the same causes as produced acute nephritis; fre- 
quently certain diseases of the circulatory or respiratory organs, interfer- 
ing with the venous circulation, produce passive hypersemia of the kidneys 
(renal stasis). Thrombus in the renal circulation or tumors pressing on 
the vessels may also cause it. In renal congestion there is a large amount 
of urine secreted, which is light in color and of a low specific gravity, 
whereas in renal stasis the urine is of high specific gravity, dark in 
color and contains a certain amount of albumin, hyaline, cylinders and 
blood corpuscles in small amount. The urine after standing some time 
forms a thick red precipitate of urates, which are readily redissolved 
by heat. 

The treatment consists in endeavoring to remove the active ca\ise of 
the hypersemia by treating the primary affection. 

Amyloid Kidney. 

Amyloid kidney gcncrall}' occurs in connection with amyloid degenera- 
tion of some other organs of the body. The kidney is slightly increased in 
volume, firm, smooth, with yellowish-white coloration of the cortex, and 
in the parenchymatous form the condition can usually be recognized by 
the character of the urine. This generally presents the same symptoms as 
those of acute nephritis. The urine is loaded with albumin and much 
lessened in quantity. 

The amyloid condition is seen not only in the kidneys, but also in 
the liver, pancreas, and intestines. 



ABSCESS OF THE KIDNEYS 187 

Pathological Anatomy. — A kidney thoroughly affected with amjdoid 
disease is slightly enlarged, hard, smooth, and shows at the intersections a 
deep yellowish-white coloration, easily distinguished on section. The 
glomeruli are easily distinguished with the naked eye as small glossy spots. 
On staining with Lugol's solution the affected parts are colored a mahog- 
any-brown and with methyl are colored purple-red. For further details 
see works on pathological anatomy. 

Clinical Symptoms. — The extremities are dropsical, with complete 
loss of appetite, coma, uraemia, and then death. In a case where the ani- 
mal was unsteady and weak, with paleness of the mucous membrane, Zim- 
merman found an amyloid kidney associated with hypertrophy of the 
left side of the cord. 

Therapeutics. — The treatment consists in following what is prescribed 
in nephritis. 

Abscess of the Kidneys. 

(Suppurative Nephritis; Pyelonephritis.) 

Etiology. — The direct cause of the formation of abscess of the kidney 
is direct injury of the kidneys or in the region of them, causing the forma- 
tion of purulent abscess in the urinary passages, the bladder, the urethra, 
or the pelvis of the kidney. In certain cases this condition is associated 
with ulcerous endocarditis, from the results of an embolus which may be 
liberated and get into the circulation. 

Pathological Anatomy. — Purulent nephritis occurs in various forms, 
according to its origin. When this condition is caused by an embolus it is 
seen in the shape of small abscesses which are easily distinguished by the 
naked eye. When a section is made through the kidney, these abscesses 
extending along the canaliculi present a peculiar appearance and are 
grayish-yellow in color, round or oblong in shape, and are generally sur- 
rounded by a red circle. When the spot is examined under the micro- 
scope there are swarms of micrococci in the centre of the mass, and it is 
reasonable to believe that these are the causes of the abscesses. Only in 
rare cases do the abscesses become confluent, and when they do they form 
large pus centres that, as a rule, cause death. When the abscess forms in 
the pelvis of the kidney the pus extends into the straight urinary canals, 
in some cases as far as the surface of the kidney, and is indicated by a pro- 
trusion or elevation of the external surface, which is yellowish in the cen- 
tre and surrounded by a circle of yellowish points. When large abscesses 
are formed from these and become confluent, the whole kidney may 
become altered into one large abscess. The covering capsule of the kidney 
then becomes thickened and holds the abscess with its contents (pyo- 



188 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

nephrosis). In the early stages, -where the micrococci have just collected 
in the urinary canals and have started to form abscess centres, a very 
interesting study is afforded. 

Clinical Symptoms. — The symptoms of abscess of the kidneys may not 
differ to any great extent from chronic nephritis, the diagnosis being 
based on local manifestations, by means of palpation of the abdomen in 
the region of the affected kidney; this may be greatly enlarged or even 
fluctuating if the abscess has formed pus. An examination of the urine 
may show it to contain numerous pus corpuscles, a large quantity of 
micro-organisms, and an excess of albumin and pus, blood cylinders, renal 
epithelium and, in rare cases, we may even find portions of broken-down 
renal tissue. It is possible, however, to find an acute case in which none 
of these symptoms are presented and where the urine is practically clear; 
this is particularly noticeable when the irritation is due to an embolus. 
The whole appearance of the animal presents all the symptoms of an acute 
wasting disease; the fever is irregular or intermittent and there is gener- 
ally rapid emaciation. 

Perinephritic abscesses may become so large that they form a tumor- 
like body in the lumbar region, and the pus can be detected under the 
skin, in some cases so large that the enlargement fluctuates. When such 
is the case, and we have confirmed our diagnosis by means of an exploring 
needle, the sac should be emptied by an aspirator or by making a fairly 
large opening and emptying the abscess of its contents. It should then be 
washed out daily with an antiseptic solution. If the kidney itself is not 
directly affected by the abscess, we may expect a quick recovery under 
good antiseptic conditions (see treatment of wounds). 

Treatment. — If the disease is confined to one kidney, the treatment 
should be surgical and the abnormal kidney removed, care being taken, 
however, to be sure the remaining kidney is normal and able to perform 
the duties of both. 

Inflammation of the Pelvis of the Kidney. 

(Pyelitis.) 

Etiology. — This is caused by the irritation or extension of certain in- 
flammations from the body of the kidney, from poisonous irritants passed 
from the blood through the kidneys, from foreign bodies that lie in the 
pelvis, from nephritic stones, or strongylus gigas, and this condition is 
also seen in infectious diseases that are acute in character, as well as in 
the extension of inflammation from neighboring organs (nephritis, cystitis) 
and from any of the various conditions that result in interference with the 
flow of urine, stricture of the ureters, from the presence of calculi, 



HYDRONEPHROSIS 189 

tumors, or abscesses of the prostate, paralysis of the bladder, as in spinal 
paralysis, or in hydronephrosis. 

Pyelitis occurs in a number of forms varying according to the intensity 
of the irritation and is generally part of other morbid processes. This 
disease is recognized by means of the microscope, particularly when we 
discover epithelium of the pelvis of the kidney in the urine, or by manual 
examination of the kidneys through the abdominal wall, when enlarge- 
ment of the pelvis ma}' be detected (see also parasites of the kidney) , or 
there may also be present some symptoms of inflammation of the kidney 
or catarrh of the bladder. The treatment consists in the attempt to 
remove the original irritant. 

Hydronephrosis; Dilatation of the Pelvis of the Kidney. 

Etiology and Pathological Anatomy. — Whenever there is a stenosis or 
stricture of the urinary passages and consequent obstruction, the urine 
is dammed back and presses on all the canals behind the point of obstruc- 
tion, and as a consequence the canals are distended and finally become 
enlarged. If the obstruction is in the urinary tube, the bladder, ureters, 
and the pelvis of the kidney become enlarged; but if one ureter only is 
afTected, the corresponding kidney becomes enlarged; and where the pelvis 
is much distended and after the condition has lasted some time, the body 
of the kidney becomes absorbed. The whole kidney becomes converted 
into a pouch-like mass of connective tissue, filled with liquid. This fluid 
at first is urine, but soon becomes converted into mucous secretion. In 
one case described by Siedamgrotsky, he observed, instead of a kidney, a 
large bladder or cyst, with walls formed of connective tissue, filled with a 
syrupy brownish fluid containing numerous cholesterin crystals. This 
condition is produced gradually, for any sudden interference or stoppage 
of the flow of urine would produce ursemia or rupture of the urethra and 
uraemia and death in a short time, but in hydronephrosis the condition 
comes on slowly and may result from periodic irritation and stricture of 
the urethra, from tumors of the prostate, the presence of calculi in the 
canals, or b}^ inflammation of the mucous membrane of the bladder. 

Clinical Symptoms and Therapeutics. — The cystic kidney in slight 
cases is rarely recognized; in more acute cases it is indicated by a fluctuat- 
ing painless tumor in the region of the kidney; in certain cases there is a de- 
cided enlargement in the size of the abdomen; by puncture and use of an 
exploring trocar we find the fluid described by Siedamgrotszky, "When 
there is double hydronephrosis the urine is suppressed and symptoms of 
uraemia are shown very quickly. The disease can only be treated success- 
fully when it is caused by obstruction of the urethra; for instance, where 
the obstruction is due to a calculus in the urethra and it is removed by 
surgical means. 



190 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

Nephritic Stones. 

(Nephroliihiasis; Renal Calculi.) 

Nephritic stones are formed in the pelvis of the kidney and range from 
the size of a mustard-seed to that of a pea. (Megnin found two stones 
each weighing six and seven grammes in the pelvis of a dog.) They are 
irregular, warty, or sharply irregular, and consist of phosphate and car- 
bonate of calcium; in rare instances the so-called cystic calculi are found; 
these, when first removed, are soft waxy bodies with a dull surface, com- 
posed of triple phosphate and uric acid. 

The formation of these collections is not thoroughly understood, but 
they are probably formed by some foreign body, such as mucus, blood, 
fibrin, epithelium, urinary cylinders, shreds of tissue, or collections of 
bacteria; and the salts are deposited on this medium in successive layers, 
so that finally a large mass is formed. 

Nephritic stones may produce pyelitis, pyelonephritis, or hemorrhage 
from the pelvis of the kidney. If the stone lies at the entrance of the 
ureter or even passes into that canal and becomes lodged, it will retard 
the flow of urine and even cause rupture of the ureter or pelvis of the kid- 
ney and death from peritonitis. Frccjuently the calculus is forced along 
the ureter, causing great agony, and finds its way into the bladder. These 
stones are not, as a rule, diagnosed with any degree of certainty during 
life. Symptoms of pyelitis wnth the continual passage of small stones from 
the urethra are about the only indications that will guide the observer. 

Tumors of the Kidneys. 

These neoformations can be determined only by a manual examina- 
tion of the kidney through the abdominal wall; they frequently cause an 
enormous increase in the size of the kidney, particularly so in carcinoma, 
the soft form of cancer being most frequently seen. In the pelvis of the 
kidney and the ureters we find irregular papilla-like formations (carcinoma 
papillomata, papilloma destruans (Kitt) ; these may obstruct the normal 
flow of urine and cause a distention and enlargement of the pelvis of the 
kidney and the renal ducts and an atrophy of the kidney itself. The 
only possible relief to such a condition is the surgical removal of the 
kidney. 

Animal Parasites of the Kidney. 

Of the various parasites of the kidney the strongylus gigas has a 
special interest. This parasite is not unlike the common earth-worm and 



CATARRH OF THE BLADDER 191 

about the thickness of a lead pencil. It is generally blood-red in color, and 
invariably found solitary. It is usually found in the pelvis of the kidney, 
causing great irritation of its mucous membrane, the pelvis of the kidney 
and even the kidney itself being converted into an enormous cyst in the 
middle of which lies the parasite, twisted in a round spiral mass. 

During life there are no symptoms which could be called characteristic 
and recognized with any ease. The animal may show evidences at times 
of great pain, quick respirations, moving from one place to another, utter- 
ing occasionally short cries of pain, scratching or digging with the 
paws in an aimless way, great depression, staggering gait, the back is 
arched or bent laterally; in rare instances there are severe cramps of the 
posterior extremities. The urine is generally turbid and contains pus; 
under favorable circumstances we may find the eggs of the parasite, these 
are brown in color, oval in shape, and their external surface is granular or 
pitted; they are about 70/i long and 40/^ wide. The presence of the eggs 
of the parasite is of course positive evidence of its presence. The parasite 
may find its way into the bladder, producing a cystitis, or into the urethra, 
obstruct that canal, or it may be passed out entirely. As a rule the para- 
site causes so much irritation locally as to cause the death of the host. 
Lacosta, however, had a case where the animal passed the parasite and 
made a complete recovery. The treatment consists in the administration 
of oil of turpentine in repeated small doses. 

DISEASES OF THE BLADDER. 

Catarrh of the Bladder; Inflammation of the Bladder. 

{Cystitis.) 

Etiology. — Catarrh of the bladder is generally caused by microbes such 
as coli bacilli and their kindred bacteria, and also Ijy the pyogenic cocci, 
staphylococci, streptococci, etc., which find their way into it, as a result of 
certain infectious diseases and are eliminated by the kidneys or by certain 
chemical irritants, such as oil of turpentine, cantharides, carbolic acid, or 
creosote, and also calculi. Septic instruments, such as catheters, Avhen 
introduced into the bladder, may set up an irritation of the mucous mem- 
l>rane. Cystitis is caused by the extension of an irritation from the 
urinary ducts. In septic or mycotic inflammations of the intestines, and 
thus the kidney carrrying off waste materials, from irritation of the 
pelvis of the kidney, from the uterus, and from retention of the urine, 
caused by stones in the urethra in bitches. From hypertrophy of the 
prostate, or in case of well "house-broken" dogs that retain the urine, 
being unable to get oustide, and as a consequence of retention produce 



192 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

a paralysis of the bladder, in bitches having a difficult or protracted 
delivery, from traumatisms, such as penetrating wounds, or contusions as 
a result of being run over by a wagon or automobile. Where the urine 
becomes very alkaline from the excess of ammonia, it produces an irritating 
effect on the bladder, as also does continual retention of urine, especially 
when it is heavily charged with salts. It has been said that cold will 
produce cystitis. Cystitis may also be produced by the extension of 
inflammation from neighboring regions, or in grave infectious diseases 
an irritation can be caused by the toxins of broken-down micrococci 
being carried away 

Pathological Anatomy. — There are quite a number of varieties of cys- 
titis — mucous, muscular, serous, croupal, ulcerous, diphtheritic, and gan- 
grenous — but, as a rule, it is very seldom that we can differentiate between 
the various forms, and it is best from a practical standpoint to distinguish 
the disease as acute and chronic catarrh of the bladder. In the acute 
form the mucous membrane of the bladder is colored in an irregular way 
by dark red spots. It is also more or less swollen and covered with mucus 
and detached epithelium. In the later stages of the disease, the mucous 
membrane may be covered with detached epithelium and covered with 
small hemorrhagic spots. In very severe cases we find a croupous mem- 
brane covering the bladder, and it may be so acute as to cause gangrene, 
and mucous membrane is sloughed off and extensive abscesses are formed. 
In such cases the muscular and serous coats of the bladder are also 
greatly inflamed; and if the irritation is extensive enough, we may also 
find evidences of peritonitis. 

In the chronic form the mucous membrane becomes very much thick- 
ened and covered with enlarged mucous glands. The surface presents a 
peculiar greenish or slate-gray color. This is due to the hemorrhages that 
occur in the tissues from time to time. On the surface we often find 
raised papilla-like formations, and the submucous tissues and muscles 
are hypertrophied. 

Clinical Symptoms and Course. — The first symptom noticed in this 
disease is the passage of an increased amount of urine, the animal empty- 
ing the bladder frequently, but passing only a small quantity of urine each 
time, at the same time showing evidences of pain. In rare cases there 
may be a retention of urine due to cramp of the neck of the bladder from 
irritation. On making an examniation of the bladder through the abdom- 
inal wall, the animal shows pain on pressure of that region. An examina- 
tion of the urine by the microscope will assist us in making a positive 
diagnosis. If there should be some disease of the kidneys present, while 
the specific gravity of the urine is not much changed, in the early stages of 
the disease, it is somewhat darker than usual, and there is an increase in 
salts and it contains only a normal amount of mucus, albumin, a few pus 



CATARRH OF THE BLADDER ' 193 

and perhaps a few blood corpuscles, and masses of bacteria and epi- 
thelium of the bladder. This condition may continue for a long time. 
The reaction of the urine depends on the nature of the bacteria present, 
and it is generally alkaline but may be acid, as in cystitis produced by the 
coli bacilli. Mild cases of cystitis are not diagnosed, but as the disease 
continues the urine becomes thicker and turbid, and on making a micro- 
scopical examination of the urine we find numerous pus cells and epi- 
thelium of the bladder; the urine rapidly loses its acid reaction and soon 
becomes neutral or alkaline, and has a strong ammoniacal odor. Urine 
from an animal in this condition ferments very rapidly and contains num- 
erous crystals of triple phosphate, ammoniacal phosphate of magnesia, 
and, in rare instances, uric acid crystals and numerous bacteria. 
(Fig. 81.) 

Fever as a rule is present in this disease, but is never intense, but is of 
rather an intermittent character. There is also severe depression and 
loss of appetite. The course of the disease, generally, is rapid, and in 




Fig. 81. — Urine of a dog with cystitis, triple phosphate crystals, red and white blood corpuscles, and 

cystic epithelium. Bacteria. 

slight cases the animal recovers in a few days; but in acute cases, the acute 
symptoms may last for weeks, and then the animal is liable to have relapses 
from time to time, and if the primary causes such as stone, urethral 
stricture, paralysis of the bladder continue, the cystitis becomes chronic. 
The chief danger in cystitis lies in the possibility of a complication of pye- 
litis, pyelonephritis, suppuration, paracystitis, etc., and death may finally 
be caused by perforation of the necrosed bladder and the animal dies of per- 
itonitis, gangrene, or uraemia. The most frequent termination of the 
acute form is into the mild chronic form. 

In the chronic form the symptoms are much milder, and for a long time 
the urine is the only guide to a diagnosis, as it is only in advanced cases 
that the animal will show any pain on pressure of the abdomen; the change 
in the urine characteristic in this condition is that it becomes strongly 
ammoniacal. The contractile power of the bladder is gradually lost, and 
the animal may present symptoms of incontinence of urine, passing small 
quantities of urine without any effort; or this is seen in well-trained house 
13 



194 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

animals that pass small quantities of urine although making every effort 
to retain it until they are outside; or it may pass away drop by drop when 
they are moving about or asleep. 

Therapeutics. — The treatment of cystitis may be dietetic, medicinal, 
or local, according to the symptoms presented. In slight cases it is only 
necessary to administer non-irritating agents, such as tartaric acid, dilute 
muriatic acid, liquor potassii acetatis, or infusions of juniper; and a liquid 
diet, such as milk or soups. This assists in increasing the amount of 
urine and also in lessening its specific gravity, and by that means cleans 
out the bladder. In the more acute conditions, we try to correct the con- 




FlG. 82. — Apparatus and method of irrigating the bladder in the dog. 

dition of the urine by means of disinfectants, such as salicylic acid, salol, 
boric acid, naphthalin, chloride of potassium, or urotropin several times 
daily in 0.5 doses, helmitol 1.0 three times daily, hetralin 2.0 three times 
daily, or a decoction of fol. uva ursi. The writer has always obtained 
good results from the administration of the last two agents. 

In the treatment of this chronic form, besides the various alkaline 
salts, we should use the resinous diuretics, such as oil of turpentine, 
balsam of copaiba, or oil of sandalwood. 

The local treatment of the bladder is very effectual. This is done 
when the urine is found to contain large quantities of bacteria and pus 
corpuscles, and when ammoniaeal decomposition appears very quickly. 



DEBILITATED CONDITIONS OF THE BLADDER 195 

This consists in introducing the medicinal agents directl}'' into the bladder 
by means of the catheter. The catheter is introduced into the bladder and 
the bladder emptied, and by means of a small hose the catheter is con- 
nected with a small funnel (see Fig. 82) , and a medicinal douche allowed to 
flow into the bladder, and then the hose is placed in a dependent position and 
the liquid allowed to trickle out. This can be repeated several times with- 
out removing the catheter. When the animal is very small and a very 
fine catheter is used, the fluid may not flow freely; in such a case a syringe 
is adjusted to the end of the catheter and the fluid forced into the bladder 
and again drawn out by means of the syringe, or an aspirator bottle 
may be used. 

The writer first cleans out the bladder with clean water, then washes 
with a solvition of boric acid, 2 per cent., or of tannin 2 per cent.; sulphate 
of zinc 1 per cent., resorcin 1 per cent., nitrate of silver 1 to 2 percent. 
Ginsiner recommends hydrargyrum oxycyanatum 1 to 100. Jahn had very 
good results with adrenalin (suprarenin in 1 to 10,000) in hemorrhagic 
cystitis. Pressnitz compresses or warm poultices to the hypogastric region, 
and morphine or bromide of soda in cases where there is involuntary or 
constant urination, also warm clysters to keep the intestines clear. 
"Where there is extensive hemorrhage, give an injection of 2 per cent, solu- 
tion of tannic acid. Creolin, 1 per cent., is also used, but is not as satis- 
factory as the former. The liquids must be tepid. In the dog, of course, 
this treatment is a little harder to perform than in the bitch, but with a 
little practice it is very easily accomplished and produces very satisfac- 
tory results. With the bitch a short metallic catheter can be used. It 
must l^e remembered that house dogs must be allowed to go out fre- 
quently as the retention of urine is a frequent cause of this condition. 

Debilitated or Paralytic Conditions of the Bladder. 
Paralysis and Paresis. Vesical Uremia. 

Etiology, Clinical Symptoms, and Prognosis. — Weak bladders, due to 
paralysis or paresis, are generally seen in old dogs, and are produced by a 
number of causes. One frequent cause of this condition is that house dogs 
that cannot get outside or are carried long distance on the trains, or are 
benched at a show, retain the urine for a long time, producing extreme 
distention of the bladder. Obstructions of various kinds which prevent 
the passage of the urine, such as the presence of a calculus at the neck of the 
bladder or in the urethra, as hypertrophy of the prostate, strictures of the 
urethra, by weakness of the muscular coat of the bladder, caused by 
chronic catarrh of that organ, and certain diseases of the nervous system 
al.<o produce this condition. 



196 DISEASES OF THE URIXARY AXD SEXUAL APPARATUS 

This condition ma}' also bo the result of fracture of the vertebrae, 
extensive hemorrhage of the spine, myelitis, spinal meningitis, tumors, 
poison and general debility. 

Clinical Symptoms. — There are two forms of this disease : Paralysis of 
the detrusor and paralysis of the sphincter vesicae. It is c^uite common 
to find both conditions present in one animal. In the first condition 
(ischuria, retentio urinae) the bladder becomes so distended that its elas- 
ticity is lost, and the muscular coat loses its power of contraction, and, fin- 
ally, when the bladder is so distended that the connective tissue alone 
holds it and presses on the sphincter vesicae and overcomes it, the urine 
trickles out in small quantities, the animal is uneasy, makes frecjuent at- 
temps to urinate and may or may not succeed in passing any urine; on pal- 
pation of the abdomen the bladder is found greatly distended, and mere 
manual pressure on the alxlominal walls in the region of the distended 
bladder may cause evacuation of that organ; the urine passed is foiuid to be 
highly concentrated and has a very unpleasant odor. The paralysis of the 
spincter vesicae is termed overflowing of the bladder (urination Ijy incon- 
tinence). When the sphincter is paralyzed the urine flows constantly or 
at very short intervals, the slightest contraction of the depressor being 
sufficient to expel it; this is painless to the animal. In this condition the 
bladder is nearly always empty. In making an examination of the blad- 
der through the abdomen, when paralysis of the detrusor is present, the 
bladder will be found distended, even when the animal has passed some 
urine only a short time before, whereas in paralysis of the spincter the 
bladder will be found to be empty. As a rule there is no great change in 
the animal's condition, except in these cases where the original cause is 
some disorder of the spine; then the appetite is scanty and the animal 
shows great disinclination to exercise. 

When cystitis accompanies this condition the animal shows more or 
less pain when it urinates. This, however, is seen only in rare instances. 
In the majority of cases the prognosis is unfavoral)le; the only cases in 
which a favorable termination is to l)e expected are those of simple dis- 
tention of the ])ladder, as in house dogs, when from overdistention of the 
bladder when the animal cannot get out, or when a calculus is in the blad- 
der or urethra and the cause is removed surgically. 

Therapeutics. — The treatment best adapted to relieve this condition is 
to regulate the passage of urine, as in catarrh of the ])ladder, by pressing 
the bladder through the al)dominal wall and emptying it, or catheteriza- 
tion and by injections into the bladder of claret wine, solutions of tannin 
1 to 2 per cent, internally, or tine, nux vomicae 5 to 10 drops once or twice 
daily, strychnia muriate 0.001 to 0.003 subcutaneously, or fluid ext. 
ergotae 0.50. We can also try faradization of the vertel)rae over the lumbar 
region or massage of the abelomen in the region of the bladder. 



STOXE IN THE BLADDER 197 

Stone in the Bladdeio 

(Lithiasis.) 

Etiology and Pathological Anatomy. — The various lithic formations 
found to originate in the pelvis of the kidney and the bladder are found 
either in the form of fine sand-like or gritty substances, or formed calculus; 
these may be s\i1)divided into urates, oxalates, phosphates, and cystates. 

Urates. — These consist of uric acid or uric acid salts, or both in com- 
bination. They are small, hard, yellowish or reddish-brown bodies, hav- 
ing a smooth surface; on cutting through the centre they are found to be 
formed in concentric layers or strata. 

Oxalates are composed chiefly of oxalic acid and lime salts, and are 
more or less mixed with uric and phosphoric acids. They are hard, 
brown in color, and have an irregular mulberry-like surface. 

Phosphates. — These are composed of phosphoric acid, lime, and triple 
phosphates. They are gray-white in color and, as a rule, are soft and 
friable. 

Cystic Stones. — These are soft, wax-like bodies, having a shiny 
crystalline, irregular surface. 

All these lithic deposits contain besides their inorganic elements, 
numerous organic elements, such as epithelium, blood cells, mucus, etc. 

Klemmer found on careful examination of 3301 dogs that 12 or about 
0.38 per cent, were affected with stone. The size to which these calculi 
may grow is considerable. In Dresden there is a calculus taken from a 
German boar-hound that is 11 cm. long and 7.5 cm. wide, 6 cm. thick, 
which weighed 490 grammes Avhen fresh. They are generally started in 
their formation in the pelvis of the kidney, and, generally, from some for- 
eign body, such as a blood clot, a piece of mucus, epithelium, etc., around 
which the sediment in the urine forms and gradually the crystalline ele- 
ments accumulate. This deposit is formed very quickly in cases of 
cystitis, Avhere the urine is undergoing alkaline fermentation and pro- 
duces a copious sediment in the urine. 

Paul Bert and Studensky found by experiments that the food and fluids 
that the animal takes may have a certain influence on the formation of 
stone in the bladder. The former mentions two cases in which one was 
fed exclusively on meat and the other on vegetables. On post-mortem of 
the animal fed on meat there was found a phosphatic calculus, but no 
trace of inflammation of the urinary organs. 

Studensky placed foreign bodies in the bladder and found that when 
the animal was allowed to drink only water that was thoroughly impreg- 
nated with lime salts that there was soon formed over the body a thick, 



198 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

heavy deposit of lime salts, and that results differed greatly in animals 
fed in the usual way, with pure water and meat. In the latter case the 
concretion was much smaller and deposited much more slowly. 

The irritation produced l^y stone in the pelvis of the kidney has 
l^een already pointed out (see page 190.) Stones in the bladder, as will be 
spoken of later, cause not only interference with the flow of urine, but 
by their weight and position may cause a hypertrophy of the walls 
of the l)ladd(>r. 

Clinical Symptoms and Course. — When the uric calculus lies in the 
bladder and has not attained any size, it may stay there a long time and 
not produce any marked symptoms, with the exception of a slight 
catarrh, and that is only noticed when the animal has had a long run, 
the urine then being voided with great difficulty, perhaps mixed with 
blood or mucus, and has a penetrating odor. Palpation through the 
alxlominal wall, even when the liladder is partially filled, may discover 
the stone as a hard l)ody lying in the bladder; in the Ijitch, the urethra 
l)eing very short, it is easily detected by means of a catheter. When the 
stone gets into the neck of the bladder or passes into the urethra and 
lodges at the posterior end of the bone of the penis very severe symptoms 
are noticed. Retention of urine is indicated by an entire suppression 
(ischuria), or urine is passed in a thin stream or only by a drop at a time, 
the animal showing great pain. A partial obstruction of urine is soon fol- 
lowed by a complete obstruction. 

The symptoms presented in the dog are very striking. The animals 
are very restless, looking frecjuently towards the region of the kidney and 
whining. They place themselves in the position to urinate and strain 
violently without any result, or perhaps a few drops are passed and these 
may be mixed with blood. The appetite is lost and the pulse is rapid and 
thready; they stand with an arched back or walk with a staggering gait 
and extended legs. The abdomen becomes distended and we can finally 
feel the bladder through the abdominal walls like a hard, distended body 
which is very painful on examination. When the catheter is passed it 
goes in easily enough until the neck of the bladder is reached, when it 
stops and cannot be passed any further, and no urine escapes from the 
catheter. 

Uric calculi lie on the floor of the bladder and can be felt through 
the abdominal walls liy manipulation, that is, of course, when they have 
reached a good size; the small ones escape detection, but they may be 
suspected when the urine has a gravel or sand-like sediment. 

The urine, when it is retained in the bladder, gradually accumulates, 
and if it is not drawn off in three days the bladder is ruptured; it may even 
burst in two days. AVhen this occurs it causes death in a few hours, with 
tlie following symptoms: the animal liecomes dull or comatose, with 



STONE IN THE BLADDER 199 

shaking or trembling of the muscles, and the restlessness and pain seem to 
have disappeared. Pressing on the abdomen may produce great evidence 
of pain, but in the majority of cases this is absent. After the first two 
hours the abdominal wall is covered with a cold sweat, and the bladder 
cannot be felt on manipulation. Soon a deep coma /rom which the ani- 
mal cannot be roused sets in and dies in a short time. In rare instances 
the animal may have convulsions, which occur with short intervals be- 
tween them. Death may also occur before the bladder is ruptured, as a 
consequence of extensive gangrenous cystitis with pyelitis. 

Therapeutics. — While the first procedure in treatment of stone is essen- 
tially surgical, however in cases where the animal passes very small cal- 
culi or sand-like particles and shows every evidence of the presence of 
cystic calculi or where an animal passes small stones which lotlge at the 
end of the penal bone and has to be operated on frequently, he should be 
given large quantities of liquids or w^aters that are supposed to have 
litholytic action — for instance, acids for dissolving phosphatic calculi, 
alkalines for breaking up uric calculi, or lithia mineral waters, such as 
A'ichy, Kissingen, Carlsbad. Or the l:)ladder may be washed out with 
various solutions (see cystitis). In oxalate and cystic stone the animal 
should be given all the water it will take. When the stone is present and 
is causing retention of urine, there is nothing left then but to remove the 
stone by means of an operation called urethrotomi) if the stone is lodged 
in the urethra at the posterior end of the bones of the penis, or cystotomif 
if the stone is located in the bladder; this operation is performed by open- 
ing the urethra at the ischial arch, and by means of a small pair of forceps 
introduced into the bladder, through the urethra, the stone is grasped and 
crushed and afterward washed out of the bladder. In the ])itch an 
incision is made into the short urethra and the stone is seized and 
crushed in a like manner. 

When ischuria or stoppage of urine is present, the treatment depends 
to a large extent on the location of the calculus — that is, whether it is in the 
neck of the bladder or whether it has gone into the urethra some distance 
and lodged there. In the first instance we can sometimes introduce the 
catheter and by a gradual pressure we can push the stone into the bladder; 
or if it is further in the urethra, we can push a well-lubricated catheter 
past the stone and allow the escape of urine and prepare for the operation, 
for if the stone is in the urethra this must be performed immediately. 

Urethrotomy. — This is usually performed from the posterior end of 
the bone of the penis, as the great majority of uric calculi pass down the 
urethra and lodge at the posterior end of the bone of the penis and can l)e 
detected by the catheter; when this is passed and comes against the stone 
there is a certain rough sound felt that resembles crepitation. Lay the 
animal on tlie side or back, and after having injected cocaine into the skin 



200 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

(or administered ether if the animal be very hard to handle, although this 
procedure is rarely necessary) insert a well-oiled catheter, make an incision 
about 3 cm, in length, cutting down on the median line on the skin making 
a free opening, then cut a second longitudinal incision on the urethra on the 
stone or on the end of the catheter (Fig. 83); calculus can then be pushed 
back toward the opening in the majority of cases, and by means of a pair 
of small forceps the stone is grasped and pulled out. In some cases it is 
necessary to enlarge the opening in the urethra; as a rule, however, do not 
make the opening any larger than is absolutely necessary. Occasionally 
when the stone lies in the canal just under the bone of the penis, it is ex- 
tremely hard to remove, and after making the incision it has to be forcibly 




Fig. S3. — Urethrotomy. Catheter introduced and end seen at the incision. 



dislodged by means of the catheter. It is well to leave the wound open 
unless it is a very large animal or the stone should be exceptionally large; in 
that instance do not put more than one stitch in it. For two days the 
lu'ine escapes out of the external opening, but soon closes up, and in about 
eight to ten days it has closed up completely and the urine is passed in the 
natural way. 

The wound of the operation is apt to leave a stricture in the course of 
the urethra, and in an animal that is predisposed to the formation of calculi 
examine the urethra occasionally with the catheter and if a stricture is 
present dilate it with a bougie. 

In cases where the stone is situated up in the urethra at the ischial 
arch it is nuich more difficult to oj^erate on account of the well-developed 



STONE IN THE BLADDER 201 

bulbus cavernosum. The incision must be made down on the catheter, 
which has been previously inserted as far up as possible. The higher op- 
eration must never be attempted unless this latter precaution is taken, as 
it is almost impossible to find the urethra unless the sound is in it. 

Another mode of operation is to introduce a catheter into the penis 
until it reaches the obstruction, and by means of a tape looped around 
the free end of the penis it is drawn away from the prepuce, which is 
held back ])y an assistant, and then cut down on the end of the catheter; 
the catheter is pulled back a short distance, but not entirely, and the 
penis bent over, and by means of a small pair of blunt forceps the stone 
can be removed; when this is accomplished pass the catheter into the 
bladder and wash out any calculi that may still remain in the bladder 
or urethra; by means of a small hose attach the catheter to a syringe and 
inject the bladder full of tepid water. 

In the bitch the operation is much more simple. The urethra is 
opened by means of a thin tenotome introduced on a grooved director 
and the opening enlarged, and then the forceps passed into the opening, 
the stone crushed, and the bladder washed out. It is generally necessary 
to introduce one finger into the rectum to guide the stone into the forceps 
before it can be grasped. Great care must be taken in such an operation 
to avoid crushing the tissues. In the bitch there is no after-treatment 
necessary. 

Cystotomy. — Laprocystotomy, or cutting through the abdominal 
wall is the only mode permissible on the dog, lithotripsy being pro- 
hibited on account of the size and anatomy of the urethra of the dog. 

Laprocystotomy, cystotomy suprapubica: Preparatory to the op- 
eration the urine is removed from the bladder and the bladder washed 
out with a 2 per cent, solution of boracic acid, the tissues in the neighbor- 
hood of the incision thoroughly cleansed and disinfected, the animal is 
put under ether and an incision is made in front of the pul^is parallel 
with the prepuce and directly on the median line (in the bitch cut 
directly on the linea alba); make an incision about 5 to 8 cm. long, 
take up the hemorrhage by means of absorl)ent cotton, then draw 
out the bladder, surround it with cotton compresses and an incision 
about 1 to 3 cm, is made in the bladder and by means of a pair of 
forceps the stone removed, if the stone is incysted it should be scraped 
out; the bladder is then washed out with boracic acid solution, the 
wound stitched with carbolized catgut, the muscular and serous coats 
are sewed with the edges turned inward, the stitches must be put very 
close together as distention with urine causes the very elastic bladder to 
open and allow the escape of urine into the peritoneal cavity; return the 
bladder after having first cleansed it with boracic acid solution, and 
the abdominal wall closed and the wound covered bv a bandage. As 



202 DISEASES OF THE URINARY AND SENUAL APPARATUS 

l:)lood clots are apt to form in the course of the urethra, French advises 
that the animal be catheterized at least twice daily until normal urina- 
ation is established. 

When the bladder is so distended that it is deemed dangerous to 
operate before emptying the bladder of its contents, we may empty the 
bladder by means of a fine trocar and canula. In the bitch the trocar 
should be introduced on the median line, at the brim of the pelvis, and 
in the dog, either on the right or left side of the flank, low down and as 
near as possible to the brim of the pelvis. 

Sometimes ruptures of the bladder are caused bj^ accidents, such as 
being run over by wagons when the l;)ladder is full. The animal dies, 
as a rule, in forty-eight hours, from collapse, before peritonitis has devel- 
oped. On post-mortem, the !)ladder is found to be infiltrated with 
blood and very much swollen at the lacerated i-egion only. In injuries 
to the lumbar region, where the animal is dull or even comatose, it is 
always well to consider the prognosis doubtful, and Siedamgrotzky 
deems it advisable to consider the prognosis doubtful in injuries to that 
region, even w^here there are no acute symptoms presented. 

Stricture of the Urethra. — Indications of painful retention of urine 
are often presented when there is a stricture of the urethra caused liy 
injuries to the urethra from calculi or by cicatricial contraction following 
the operator's knife, from intense nephritis, or by torsion following co- 
itus. An examination by means of the catheter generally gives some 
information as to the character of the stricture; the practitioner must, 
however, rememl^er that there is always more or less normal stricture 
at the posterior end of the bone of the penis. The sound must be passed 
each day and allowed to remain about twenty minutes if the stricture 
will admit of it. The size of the catheters must be gradually increased; 
great care being taken to thoroughly disinfect the catheters after each 
insertion. This method has been used with success in a number of cases 
of stricture, but it must he continued for several weeks. 

Hoffman cured a case of stricture of the posterior end of the bone 
of the penis l)y opening the urethra at the spot of stricture and ampu- 
tating al)Out 2 cm. of the bone of the penis with a pair of bone forceps. 

Other diseases of the bladder. 

The following are comparatively rare and unimportant diseases of 
the l)ladder. 

Cramp of the Bladder, Cystospasmus. — This is seen following severe 
cystitis, calculi, diseases of the prostate, etc. This condition is also ob- 
served as a symptom from the effects of certain poisons, decayed food, 
from disease of the spine and from unknown causes. It is indicated by 



OTHER DISESES OF THE BLADDER 203 

persistant cramp of the sphincter antl retention of the urine (retentio 
iirinse). The treatment consists in friction in the region of the bladder, 
luke-warm clysters to Avhich chloral hydrate may be added, subcutane- 
ous injection of morphia and the administration of boldine. 

Neoformations of the Bladder. — The tumors of the bladder worth 
special mention are papilloma villosum and the carcinoma papillomato- 
des. The early symptoms are profuse hemorrhage which occurs from 
time to time, producing acute anaemia and often causing death. These 
tumors are generally associated with chronic cystitis. In the region of 
the bladder we are sometimes able to detect these neoformations in the 
form of a soft tumor-like mass and in rare instances we may find some 
portions of the broken-down tissue in the urine. In some instances in- 
stead of a solitary tumor we may find a diffuse mass spreading over the 
wall of the bladder which on palpation feels like a hard irregular body. 
Other pathological growths may be sarcoma, carcinoma or myoma. It 
may be possible under very favorable circumstances, to remove these 
tumors by means of cystotomy, but it is very rarely done, for generally 
when we make the diagnosis the tumors have reached considerable size 
and involve the entire bladder. 

Retroflection of the Bladder. — This condition may be found as a 
result of constipation or disease of the prostate, and from constant strain- 
ing and tension, a distended bladder may be retroverted and lie be- 
tween the rectum and the prostate and may cause the development 
of a perineal hernia. If pressure is made on the soft fluctuating hernial 
tumor, the animals are apt to place themselves in a position to urinate. 
The treatment consists in attempting to remove the original cause by 
means of laxatives, warm baths, rectal enemas (see Diseases of the 
Prostate) . If these methods do not succeed and the distention of the blad- 
der becomes very pronounced, first try to empty the bladder by means of 
the catheter and if that cannot be accomplished, on account of the twist 
in the urethra, then empty the bladder by means of a trocar; the punc- 
ture is to be made in the upper part of the tumor. Generally when the 
bladder is emptied it falls back into position, but the condition may re- 
turn if the exciting causes return. To obtain a permanent fixture of 
the bladder, we must perform cystopexia (after Hendrix). This con- 
sists in making an incision into the abdominal wall on one side of the 
penis as near the median line as possible; insert the finger into the cavity 
and return the bladder to its normal position and suture it to the ab- 
dominal wall, so that the centre of the posterior wall of the bladder will 
.lie on the anterior margin of the pubis. 

Inflammation of the Urethra — Urethritis. — This is very rarely ob- 
served, being invariably caused by some traumatism, calculus or other 
foreign bodies, improper catheterization, injuiies during coitus (see 



204 DISEASES OF THE URIXARY AXD SEXUAL APPARATUS 

gonorrhoea of the prepuce). The symptoms consist in the constant 
flow of a muco-puriilent fluid from the urethra, redness and tumefaction 
of the external orifice, the animal places himself in a position to urinate 
and if he does succeed in urinating he shows great pain. On making 
any pressure on the urethra, a few drops of a muco-purulent discharge 
comes from the external opening. The treatment consists in the in- 
jections of astringents, claret wine, sulj^hate of zinc, and 1 to 2 per 
cent, solutions of nitrate of silver. 



DISEASES OF THE MALE SEXUAL ORGANS. 

DISEASES OF THE PROSTATE. 
INFLAMMATION OF THE PROSTATE. 

{Prostatitis.) 

A number of causes lead to inflammatory processes in the prostate 
which produce hypertrophy or neoformations of that organ; the enlarge- 
ment may be temporary or permanent, but as a rule it invariably pro- 
duces more or less interference with the evacuation of the faeces, and ob- 
struction of the free passage of urine. 

Inflammation of the Prostate. — This may result as a complication 
of cystitis, urethritis, urinary calculi, from careless or ignorant catheter- 
ization and from the pressure of hard masses of faeces lying in the rectum 
in persistent constipation, proctitis, etc. Prostitis is also observed in 
stud dogs that have served a large number of bitches within a compara- 
tively short space of time or have been in the stud for a number of years, 
and it also results from pyaemia. 

Symptoms and Course. — The disease may occur in the acute or 
chronic form; the latter is discussed under hypertrophy of the prostate. 

The acute form is rare and causes the animal to walk with back 
arched and a stiff, stilted gait, and show evidence of great pain when 
either urine or faeces are passed. In cases where there is great enlarge- 
ment of the prostate the animal may hold the faeces and cause constipa- 
tion by not putting any pressure on the abdominal muscles or may also 
retain the urine. On making an examination of the gland, by introduc- 
ing the finger, well luliricated, into the rectum, we find it very much en- 
larged, hot and painful to the touch, and the animal shows great de- 
pression, loss of appetite and fever. The animal exhibits great pain 
during catheterization when the instrument passes the prostate. 

The terminations of this acute condition are as follows: 

The prostate may break down and suppurate, forming a fluctuating 



INFLAMMATION OF THE PROSTATE 205 

tumor in the pelvic cavity; accompanied by great difficulty in urination, 
or it may assume the chronic form and develop cysts; this latter condi- 
tion, however, is rarely diagnosed during life. Sometimes these cysts 
are seen on post-mortem, ami the animal previous to that was with- 
out any fever or acute symptoms, or the inflamed prostate may ulti- 
mately form abscesses which break through into the urethra, or the 
rectum, and in very rare cases into the connective tissue of the pelvis. 
In the latter termination we find a gradual tumefaction and formation 
of an abscess in the perineal region, which suppurates and breaks, 
or there may be the formation of small abscesses which become encapsu- 
lated in the prostate. 

Therapeutics. — This consists in giving the animal small quantities 
of non-irritating food, cold clysters and cold or luke-warm applications 
to the perineum; also the frequent passage of the catheter to prevent 
overretention of urine in the bladder; and also the administration of 
saline purgatives, such as sulphate of magnesium, Carlsbad salt, etc. 
When pus has formed, which can be determined by digital examina- 
tion per rectum, introduce a speculum into the rectum and cut down on 
the fluctuation by means of a sharp-pointed bistoury. The hemorrhage 
which follows is very slight, and no attention should be paid to it. Hen- 
drix introduces the finger into the rectum and puts considerable pressure 
on the fluctuating prostate and breaks the abscess into the urethra. 
Where the swelling extends to the perineum and distends it, it is best to 
apply warm applications until the pus has formed, and then cut down 
and evacuate the sac. 

Chronic Prostitis (Hypertrophy) of the Prostate. — This is the form 
of the disease most frequently seen, and develops from the acute form, 
but in the majority of cases the disease starts in at the onset, as the chronic 
form. It is a common disease in old dogs, and is indicated by a hyper- 
trophy of the whole organ; as a rule, the swelling is symmetrical, but 
sometimes one side of the gland is larger than the other. It varies in 
consistency; in some cases very hard, in others, soft; in the former case 
it is due to a hyperplasia of the fibro-muscular tissue; in the latter it 
is due to an infiltration of the gland with a purulent fluid as a consequence 
of chronic purulent inflammation. 

The symptoms of a hypertrophy of the prostate are irregular; in 
some cases there is difficulty in urination (dysuria, strangury), and also 
more or less cystitis and pyelitis, etc., or constipation due to the animal 
making no effort to evacuate faeces. The surest means of diagnosis is to 
make a digital examination of the prostate per rectum. It is dis- 
tinguished from the acute form by the absence of heat and sensitiveness, 
but is very much larger than the normal gland. Rossi contends that 
hypertrophy of the prostate does not affect the urinary canal to any great 



206 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

extent; the tissues of the prostate only are affected and situated as it is 
on the floor of the pelvis, it has plenty of room to expand. Lienaux 
observed one case where there were intermittent hemorrhages, and finally 
interference in urination and evacuation. 

Therapeutics are not productive of much good results. For the 
constipation give saline laxatives; if the urine is retained, catheterize 
the bladder and administer internally ergot or iodide of potassium. The 
remedy that has given the best results has been the hypodermic injection 
into the gland of a solution of iodine (iodide of potassium, 2 parts; tincture 
of iodine, 2 parts; and water, 60 parts) at intervals of fourteen days. The 
solution is injected through the rectum directly into the gland by means 
of a small hypodermic syringe. 

Castration has been repeatedly tried; in a number of cases it has pro- 
duced very good results and the animal was greatly relieved from active 
symptoms, the prostate being reduced to its normal size, but in certain 
cases the animal steadily failed, lost flesh, and in three or four weeks 
became a skeleton and died apparently from inanition. 

Tumor of the Prostate. — Tumor of the prostate is generally carci- 
nomatous in character, causing an irregular enlargement of the gland, 
differing from the symmetrical enlargement seen in hypertrophy of the 
gland; this aids materially in reaching a diagnosis. It is rather diflficult 
at times to make a diagnosis where only the general indications of hyper- 
trophy of the prostate are seen, that is difficulty in defecation and uri- 
nation, and conclusions can only be based on the general health of the 
animal, which shows a gradual want of nutrition. Lienaux recommends 
extirpation of the prostate (prostotomy) even in simple hypertrophy. 
Other anomalies, such as prostatic calculi, tuberculosis of the prostate, 
have no particular interest and need not be taken up here. 



DISEASES OF THE PENIS AND PREPUCE. 

Phimosis and Paraphimosis. — By phimosis we mean a contraction 
of the prepuce over the free end of the penis. It is often of congenital 
origin, and is occasionally caused by injuries and consequent cicatricial 
contraction; l;)ut as in the dog, the foreskin is rarely withdrawn, it is of little 
importance; if , however, the contraction is so complete as to cause retention 
of a certain amount of urine; the retained urine decomposes, and 
acts as an irritant, causing inflammation and tumefaction of the pre- 
puce. Phimosis prevents copulation, and as soon as the penis is erected, 
causes paraphimosis. Treatment consists in making a longitudinal 
incision on the median line of the prepuce and removing a certain amount 
of the tissue and sewing back the mucous membrane. Paraphimosis is the 



DISEASES OF THE PEXIS AND PREPUCE 207 

condition where the penis passes through the narrow opening of the 
prepuce the gLans becomes swollen, and the prepuce becomes tightened 
behind the glans penis, the narrow ring of the prepuce causes venous 
engorgement, becomes oedematous, causing a great swelling and purple 
coloration of the glans, and if this is allowed to remain some time, causes 
partial gangrene. The above phenomenon is seen during coitus or from 
erection in attempting copulation, from traumatic causes, from neoforma- 
tion, or paralysis of the penis. 

The therapeutics of paraphimosis consists in reducing the glans as 
soon as possible with friction and careful manipulation; this is accom- 
plished by careful lubrication of the parts with some bland oil and putting 
a steady pressure on the glans, at the same time pressing forward the pre- 
puce over the enlarged part; with a little patience it is reduced. If this 
is not successful, bathe the glans with cold water or alum applications, 
lead water, sulphate of zinc, or wrap the protruding portion of the penis 
in a cold bandage, beginning at the outer end and quickly wrapping it 
around the distended penis, thus forcing the blood out of the engorged 
glans, then as the bandage is removed the penis is returned, drawing the 
prepuce over it. If we do not reduce it by this means, then cut the ring 
with a curved probe-pointed bistoury or a pair of scissors. It can then 
be returned immediately; scarification of the penis is rarely necessary. 
In extensive necrosis of the glans, paralysis, tumors, etc., it may be neces- 
sary to remove the penis; this is removed by a circular sweep of the knife. 
If the penal bone is to be cut through it may be done by means of a 
pair of bone forceps or sawed through. To overcome stenosis of the 
urethra from cicatricial contraction of the wound the urethra is opened 
about 0.5 cm. and sewed back of the wall of the penis. It is well, how- 
ever, not to resort to this until you have tried every other method. 

Gonorrhoea of the Prepuce. Preputial Catarrh. — By this term we 
mean catarrhal or purulent inflammation of the mucous membrane of 
the prepuce; it is rather common in dogs that are well fed; it is harmless 
but unsightly from the discharge of yellow mucus constantly dripping 
from the end of the prepuce, and some cases are extremely obstinate to 
treat. It may be caused by retention of urine, phimosis, calculi of the 
bladder, prolonged coitus, dirt, uncleanliness, or masturbation. It is 
frequently observed in old dogs, due in their case to stagnation of the 
veins of the prostate. The symptoms consist in slight redness, and 
swelling of the prepuce and glans, and the secretion of a thin, purulent 
mucus, which is generally licked off by the animal. On pushing back 
the prepuce, the lymph-follicles are generally found to be swollen, 
and can be felt on manipulation with the finger as small bodies about 
size of a seed or pea. In rare cases the inner wall of the prepuce and the 
bulbous portion of the glans are covered with papillary excrescences. 



208 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

Rarely or over in this condition is there any pain on pressure of the 
affected parts. The treatment consists in the injection of acetate of lead 
water or 1 per cent, solution of zinci sulphas or argenti nitras, 1 per cent., 
or claret wine. Before making the medicinal injection it is well to 
thoroughly clean out the prepuce, with repeated sluicings of luke-warm 
water. 

The disease has no correlation with the specific gonnrrhan of man, l)ut 
in rare cases we may find an animal affected with gonorrhcsa which has 
extended from the foreskin into the urethra and an enlargement of the 
inguinal lymphatics, forming a bubo. In one of the cases observed by 
Siedamgrotzky, the gonorrhoea was accompanied by intense inflammation 
of the eyes. 

Neoformations of the Glans and Prepuce. — Xeoformations are some- 
times found on the dog and are either papilloma, carcinoma, or sarcoma. 
These appear in a variety of forms — warty or corrugated, sometimes 
pedunculated but generally with broad bases, hard or soft and bleeding 
easily to the touch, situated on the penis or prepuce, visible only when 
the prepuce is retracted except in rare cases when they are situated on the 
external opening of the prepuce and protrude beyond the opening. There 
may be a more or less abundant discharge of purulent mucus, stained 
occasionally with blood. (For infectious genital tumors, see under that 
head.) The papilloma can be removed by the scissors or a small pair of 
forceps, and the blood stopped by compression or a solution of alum, or, 
what is much better, the thermo-cautery. Albrecht recommends that 
the tumor he touched daily with a solution of chromic acid 1 to 30. Car- 
cinoma and sarcoma generally require the removal of a portion of the 
glans. (See chapter on Neoformations.) 



DISEASES OF THE TESTICLE AND ITS COVERINGS. 

Inflammation of the Scrotum. — We frequently see inflammatory 
conditions of the scrotal covering as a result of contusions; they may, 
however, be caused by eczema, which sometimes causes great swelling 
and sensitiveness, the animal walking with a peculiar stradling gait; this 
condition may involve the entire scrotal sac, and on account of the irrita- 
tion of the tissues from the animal constantly licking and biting affected 
part, it is very slow in healing, and frequently covers over a long period of 
time before making a complete recovery. Occasionally partial necrosis 
occurs, followed by sloughing of a portion of the scrotum. (See Diseases 
of the Skin, under Eczema.) Moller has also seen serpentine varicosis of 
the scrotum with ulceration and accompanied with profuse hemorrhage. 
Treatment: Keep the animal in a dry kennel or let it He on a cushion and 



INJURIES TO THE TESTICLES AND SCROTUM 209 

prevent the rulilnng on an}- rough ol)ject and apply oxide of zinc, talcum 
powder, bismuth preparations, or boracic acid, and the animal must be 
restrained from licking or irritating the affected portions, either by means 
of a muzzle or the scrotum covered by a Priessnitz bandage. If necrosis 
develops as a result of the condition just described or from traumatisms or 
freezing, etc., and the sloughed portion is very extensive it may be neces- 
sary to castrate the animal as well as remove the necrosed portion. 

Inflammation of the Testicle — Orchitis. — Orchitis without any other 
injury is very rarely seen in the dog; it may be caused by a kick, or a blow, 
or from crushing or by metastasis from acute inflammatory conditions of 
the adjacent urinary organs. The testicle is hot, swollen and smooth on 
its surface and very sensitive to the touch; the animal walks with its hind 
legs wide apart, and sometimes there is fever and loss of appetite. In the 
majority of cases, the irritation subsides quickly, and the animal is well in 
a few days; in rare instances, the irritation is followed by suppuration and 
the formation of more or less pus, the abscess points, breaks through the 
scrotum and discharges. In acute cases, on the subsidence of the acute 
symptoms it is followed by induration of the testicle and that body becomes 
firm and irregular on its surface. In one case that the writer observed the 
epididymis was also greatly swollen (epididymitis). The therapeutics 
consists of warm applications and rest, paint with tincture of iodine and 
apply a well-padded suspensory bandage over the scrotum. When the 
effects of the iodine have passed off apply salicylic acid ointment. If sup- 
puration has commenced, it should be encouraged as much as possible with 
warm applications and poultices and opened as soon as the abscess has 
pointed, cleaned out with corrosive sublimate solution, and treated as an 
open wound. There is no treatment that will have any permanent 
effect in chronic orchitis. 

Injuries to the Testicles and Scrotum. 

As a rule, the wounds of these parts are caused by fighting with other 
dogs, and are either lacerations or perforated wounds. In the majority 
of cases, try to get drainage and keep the w^ound clean by means of anti- 
septics; this is best accomplished by putting a piece of absorbent cotton 
saturated with the solution on the scrotum, and by means of a long-tailed 
bandage tied around the body the cotton can be kept in place. Where 
the testicle is badly injured, the gland had better be removed by castra- 
tion, as it is only in favorable cases that the animal makes a good recovery 
and the seminal power is retained. 

(For further details on the subject consult the chapter on Hernia of 
the Testicles and Castration.) 

Neoformations of the Testicles. — Omitting tuberculous deposits, we 

14 



210 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

find fibroma, sarcoma and carcinoma; the former can easily be felt on the 
surface of the testicle as distinct circumscribed elevations; the latter two 
on the other hand are indicated by a hypertrophy of the testicles and the 
spermatic cord may be involved, and in rare cases both testicles are affected. 
The testicle may be greatly enlarged, the surface smooth or it may 
be uneven and irregular. Rarely do these neoformations involve the 
scrotum; when they do, they form adhesions and if they make an external 
opening in the scrotum Kitt has observed that it is extremely difficult to 
distinguish by microscopical examination the true pathological character 
of these hypertrophied testicles and place them in their proper class 
(Orchidarm, Orchidoblastom). Fig. 84 represents one of these tumors. 




Fig. 84. — Enlargement of scrotum. — Orchitis. 



Castration is the only radical method to remove these malignant tumors 
and it should be done early before the entire region becomes involved. 

Castration of the Male. — The animal is prepared by washing the 
region of operation with an antiseptic solution, put the animal under 
ether or inject the region with 4 per cent, cocaine, turn him on his l:)ack, an 
incision is made in a longitudinal direction through the skin of the scrotum 
and vaginal tunic, and the posterior portions of the cord are cut through 
and the anterior or vascular portion is ligated with silk and cut through 
just below the ligature and the other testicle treated in the same manner 
(Fig. 92); in young animals the cord is simply scraped through or 
twisted off by means of tortion, and the opening in the scrotum closed by 



INFLAMMATION OF THE VAGINA 211 

means of a stitch, and covered with a (Hsinfectant dusting powder, and a 
truss bandage apphed. The wound is dressed ch^ily, it heals up rapidly. 
It is well not to allow the bandage to remain on too long, as it is apt to 
irritate the animal. Another znode of procedure is to make an incision on 
the median line of the scrotum, but before doing so tie a string around 
the scrotum just above the testicles, so that when the incision is made the 
testicle will not be tlrawn beyond reach; having made the incision on the 
median line, cut through the tunica, draw out both testicles, twist them 
round several times, making a spiral of the cords, then cut the cords as 
high up as possible with the ecraseur or a pair of emasculating scissors. 
The hemorrhage is slight and much better than the complication of the 
ligature hanging in the wound. 

Cuterebro Emasculator. 

(Emasculating Bot Fly.) 

This parasite which is frequently observed in squirrels and occasion- 
allv in rabbits has been observed in two cases in the dog where the grulj of 
the parasite was found imbedded in the scrotum. These were in English 
setters and the dogs had been in the Southern states for some time. 

The scrotum swells slowly, beginning at the dependent portion, until 
a round, firm mass, resembling in size and shape of the ordinary " warble'' 
seen in cattle's backs, but not quite so large; it apparently gives the ani- 
mal no discomfort unless the parasite should act as an irritant and form 
an abscess; when this occurs it is followed by great irritation of the parts, 
and subseciuently sloughing of a portion of the scrotum and destruction of 
the testicle. The treatment consists in finding the opening or vent of the 
parasite in the skin and carefully enlarging it, taking care not to penetrate 
the larva, when it can be pushed out and the wound cleaned with a solu- 
tion of peroxide of hydrogen. If the grub is punctured and it collapses, 
the remaining portion of the parasite must be carefully removed, as it 
causes great irritation if allowed to remain. Dress daily with a 1 to 3000 
solution of corrosive sublimate. 

DISEASES OF THE FEMALE SEXUAL ORGANS. 

DISEASES OF THE VAGINA AND THE UTERUS. 
INFLAMMATION OF THE VULVA AND VAGINA. 

{Vulvitis and Vayinitis.) 

Inflammation of the vulva and vagina results, as a rule, from difficult 
labor or unskilled assistance during delivery, and in rare cases as a result 
of improper copulation, or when young bitches or very delicate animals 




212 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

are having their first littoi-s. In the acute form the Labia pudendi are 
tumefied and painful to the touch. The condition is indicated by a 
whitish, purulent discharge, in some cases being foetid, which is generally 
licked off by the animal. The examination in the larger animals can be 
made by means of a speculum (Fig. 85) . On examination of the vagina 
we find it intensely red and inflamed and covered with a gray- 
ish, mucous discharge; the mucus is also grayish in color, and 
has in some cases striated lines or petechial patches. In 
chronic cases there is a constant discharge from the vulva of 
a whitish-yellow muco-purulent fluid which agglutinates the 
hair in that region, and the animal is constantly licking the 
discharge; the mucus is sometimes grayish in color, and car- 
cinoma is often present. (8ce chapter on Tumors for further 
details.) 

The therapeutic treatment consists of daily injections and 
irrigations of astringent or disinfectant washes of sulphate of 
zinc (1 per cent.), or permanganate of potassium solution, 
boric acid, or creolin, lysol, bacillol, etc., or a solution of acacia (mucil- 
age) is useful. In chronic cases use nitrate of silver, 1 per cent, solu- 
tion, or sulphate of zinc, 2 to 100 solution. 



Prolapse of the Vagina and Uterus. 

{Prolapsus Vagince; Prolapsus Uteri.) 

Prolapse of the vagina is more common than prolapse of the uterus; 
it is seen especially in young bitches, frequently at the termination of heat 
and occasionally at the latter period of pregnancy; it rarely occurs as a 
result of parturition. In some instances it is accompanied by serious 
alterations of the vagina, especially hypertrophic alterations, and also in 
rare cases we find polypus formations. As a rule there is more or less 
protrusion of the vagina through the vulva, appearing in the form of pear- 
or flap-shaped, red, inflamed tissue covered with mucus (Fig. 86). In 
very rare instances the prolapse is so great that the os of the vagina can 
be seen through the external opening. When the vagina has been parti- 
ally prolapsed for some time, the exposed portion becomes so infiltrated 
and hypertrophied that it becomes impossible to reduce it. Care must 
be taken to differentiate between a pedunculated fil^roma and the pro- 
lapsed vagina, and instances are not rare where the vagina is prolapsed 
and a tumor whose existence is never suspected also accompanies it. 

The prolapse of the uterus in the dog is practically impossible, for the 
reason that the uterus itself is merely a body in name, and really the uterus 



PROLAPSUS OF THE VAGINA AND UTERUS 



213 



consists in the horns, the true body of the uterus being a small body from 
which the horns bifurcate almost at the os (Fig. 87). 

The therapeutics of prolapse of the vagina is practically that used in 
prolapse of the anus and rectum. In slight cases after copulation, the 
animal should be kept quiet, and it will then soon disappear; the applica- 
tion of vaseline or boracic acid ointment, however, may be used. The 
retention of the vagina is much more difficult than returning it to its nor- 
mal position; the protruded portion is carefully washed with warm water 
and an antiseptic solution of boracic acid or creolin solution and the 




Fig. 86. — Prolapse of the vagina. 



animal placed so that the hind quarters are elevated for at least an hour. 
If there is great tumefaction, the protruded portion must be massaged 
for some time to lessen the volume of the enlargement before attempting 
to reduce it. If that is not sufficient, and the protrusion recurs in a short 
time, it is well to introduce a tampon into the vagina or pack the vagina 
with antiseptic gauze or cotton and stitch the lips of the pudenda in such a 
manner as not to interfere with the normal passage of urine, and assist 
defecation and prevent straining by the administration of laxatives or 
using glycerine suppositories. The writer generally uses the following 
method: After returning the vagina to the normal position, he puts two 
stitches in the pudenda and leaves them there for three days, when 
they are removed. 

In one case where there was great thickening of the walls of the vagina 



214 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

and reduction of the prolapse was impossible, and another where the 
vagina prolapsed immediately after the stitches were removed after being 
there for several days, the writer performed a partial amputation, taking 
out an elongated piece of mucous membrane and sewing it up by a continu- 
ous stitch of cat-gut, which was followed by good results. 




Fig. 87. — The genito-urinarj' organs of the bitch: a, ovary covered M^ith capsule; b, capsule of ovarj^; 
c, ovary; d, horns of the uterus; e, body of the uterus; /, os uteri; g, vagina; g, opening of the urethra; 
h, clitoris; i, i, vulva; /, bladder; ??;, urethra. 



Reduction of the uterus is much more difficult, and in the majority of 
cases it is impossible except by laparotomy. The prolapsed portion 
should be lubricated and gradually worked back, and after the fingers can- 
not reach any further, a tallow-candle must be inserted and the horn pushed 
back as far as possible. If this method is not successful, laparotomy 
should be performed in the manner spoken of in hernia. An incision is 



DISEASES OF THE UTERUS 215 

made into the abdominal wall and the finger inserted until the Fallopian 
tube is felt, and then the animal is held up by the posterior extremities, 
and by gradual tension the horn of the uterus is pulled back into position 
and the opening in the abdomen is closed. The rules named for retaining 
the vagina are then to be followed. The viterus can be retained in 
position In' making an opening in the median line of the abdomen and 
pulling the horn into position and then stitching the horn to the upper 
part of the abdominal wall. It is needless to say that the stitch must be 
of cat-gut. 

Neoformations of the Vagina. — The tumors found in the uterus are 
fibroma, papilloma, and carcinoma. The fibrous are frequently observed; 
they may appear either singly or multiple, varying from the size of a pea 
to as large as an egg; they are hard, smooth on the surface and usually 
pedunculated, occasionall}' protruding from the vaginal opening, and are 
not at all sensitive. 

The papilloma are rarer, found generally at the interior of the vagina 
and in the form of warty, irregular elevations resembling a raspberry, or, 
if larger, a cauliflower; the tumors closely resemble true carcinoma, so rare 
in the dog. Of true cancer the writer has observed only one case in a St. 
Bernard; this neoplasm occupied the inferior lateral floor of the vestibule 
of the vulva; it was soft and spongy, irregular in form, bleeding easily to 
the touch, foetid in odor, the cancer had a broad base, was hard and indu- 
rated, and extended some distance into the tissues. True cancer is very 
rare and is indicated by a foetid ichorous discharge from the vagina. The 
vagina can either be examined by the introduction of the index finger, or 
using a speculum. Frohner advises digital examination. The cancers 
occur in single or multiple groups, soft excrescences attached to the mu- 
cous membrane of the vagina which are not painful to the touch but bleed 
easily on manipulation. These cancers vary in form; some are rough 
with irregular elevations like a cauliflower; they may be polypus in shape, 
or they may occur as a diffuse mass of irregular infiltrations spread over 
the mucous membrane of the vagina. Where it can be clone these 
tumors should be removed as early as possible. 

DISEASES OF THE UTERUS. 

Inflammation of the Uterus (Metritis). — It is a common occurrence 
to have inflammation of the uterus after protracted labor. The disease 
can be subdivided into the following varieties, catarrhal and septic, 
according to the exciting causes: 

(1) Catarrhal Metritis. Superficial Metritis, Catarrh of the Uterus. — In 
this condition the disease is limited to the mucous membrane and presents 
the same symptoms as are seen in all catarrhal inflammations of mucous 



216 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 



membranes; the course may be acute or become chronic; the causes are 
miechanical injuries which the uterus may be subjected to during labor 
or immediately after; cold may be said to be a predisposing cause. 

The clinical symptoms are as follows: The vulva is slightly red- 
dened and swollen, and there is a copious discharge from the vulva; this is 
purulent, sometimes bloody or slightly putrid, and is much increased in 
quantity after the passage of feces or urine; but the animal licks it off so 
soon that the observer must look immediately after each evacuation or it 
may escape his notice. Some bitches carry their tails in a 
curved position when suffering from this condition, are 
uneasy and occasionally strain; some animals have com- 
plete loss of appetite, and in some cases slight fever is 
present. As a rule, the discharge lessens and disappears in 
a few weeks or it may become chronic, and there is an abun- 
dant discharge of white or whitish-yellow purulent creamy 
fluid (leukorrlnea, fluor albus) ; the animal becomes emaci- 
ated, loses flesh and has a stairy, rough coat. In some 
cases there is a gradual swelling and obstruction of the os 
uteri, the purulent material is held in the uterus (pyo- 
metra), pyemia develops, and death occurs in a short time. 
External manipulation through the abdominal wall may 
find the uterus greatly increased in volume, and on digital 
examination per rectum the vagina is found to be drawn 
into the abdominal cavity. 

The therapeutics consist in tepid injections of non- 
Double catheter poisonous autiscptic fluids, such as permanganate of po- 
^"th'e^'u'tiL"''^ tassium (1 per cent, solution), boric-acid (2 per cent.), and 
creolin (1 per cent.), tannic acid (2 percent.), solution of 
corrosive sublimate (1 to 2000.) In using these solutions it is best to use 
the irrigator with the two catheters (Fig. 88) ; in one opening the fluid is 
forced through into the uterus and allowed to circulate and flow out of 
the other opening. The uterus must first be thoroughly rinsed out with 
luke-warm water before the medicinal irrigations are applied. If the os 
uteri is contracted, it can be dilated by means of a bougie. In the 
chronic form (dysmenorrhcea) we should use injections of ergot or sabine 
oil. In chronic cases, with persistent foetid discharge, the uterus should 
be removed. 

(2) Septic Metritis. Gangrenous, Ichorous Inflammation of the Uterus 
{Puerperal Fever). — Septic inflammation of the uterus should be con- 
sidered a disease of wound infection in which we find intense irritation of 
the uterus and vagina, accompanied by violent constitutional disturbances. 
During and after labor septic materials find their way into the uterus 
and, owing to the condition of the uterus at that time, when it is practi- 




Fig. SS. 



DISEASES OF THE UTERUS 217 

call}^ in the same condition as an open wound, the septic materials are 
taken up very quickly and every condition is favorable for their propaga- 
tion. Collections of blood, decidual tissue, etc., exposed to the air decay 
very ciuickly, and where there is any erosion of the mucous membrane of 
the vagina or the cervix, or even the uterus at the points of placental at- 
tachment, the poison is taken up and enters the tissues and is carried into 
the circulation. The eroded portion of the uterus that has taken up any 
of the septic material soon presents an ulcerated surface which is covered 
by a necrotic or diphtheritic coating, and in some cases the vagina be- 
comes intensely swollen, is dark brown or reddish-brown in color, and 
covered with spots of diphtheritic ulcerations. 

The inflammatory process extends rapidly from the mucous mem- 
])rane into the deeper tissues, affecting the muscular and the pelvic cellu- 
lar tissues, and also the lips of the pudenda, and from the internal surface 
of the uterus it extends to the uterine muscles and the broad ligament, 
and in acute cases to the serous covering of the uterus and the peritoneum. 
When the acute symptoms are present (perimetritis and parametritis) 
ptomaines and septic material enter the circulation and cause acute septic 
fever. The prognosis is generally unfavorable. 

Clinical Symptoms. — The vulva and the mucous membrane of the 
vagina are swollen and livid red, and discharge copious masses of dis- 
colored, fcEtid pus. In the earlier stages the animal shows great pain on 
pressure to the abdomen; the pulse is very fast, thready and finally be- 
comes imperceptible. The respirations increase in number. The tempera- 
ture in the early stages is increased, but soon falls, becoming subnormal 
toward the end. The mucous membranes of the mouth and conjunctiva 
are livid, an offensive diarrhoea commences, and the expired air from the 
lungs smells of decayed tissue. 

When the animal presents the acute symptoms early and does not eat 
or drink from the onset, it soon becomes comatose and dies in from twelve 
to twenty-four hours. 

Therapeutics. — In such cases to get any favorable results treatment 
must be prompt and energetic. The uterus and the vagina must be 
thoroughly irrigated with antiseptic fluids, and also the general treatment 
indicated in septicaemia. For antiseptic irrigating fluids we use creolin, 
2 per cent, solution; lysol, 1 to 100; actol (1 to 1000) ; formalin (2 to 50); 
corrosive sublimate, 1 to 2000 solution. First irrigate the uterus with warm 
water using the double catheter shown in Fig. 88, and clean it thoroughly 
until there is no discoloration in the escaping fluids; then inject the medi- 
cated solution into the uterus several times; repeat this several times daily. 
As a stimulant, use whiskey, brandy, camphor, either internally, or sub- 
cutaneously; the latter is best, as you are apt to get quicker results, and 
you also avoid the danger of the animal vomiting it, which it is very apt to 



218 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

do. Ergot or caffein are used with some success where there is great 
weakness of the heart. 

I^. Camphor pulv., 0.2 

Gummi acacia, 0.6 

F. chart. No. xii., 
S. — One powder every two hours. 

Prolapse of the Uterus. Prolapsus Uteri. — This condition is ex- 
tremely rare and occurs only during or immediately after delivery. From 
very severe traction during labor or awkward assistance, particularly of 
the last foetus, the horn of the uterus everts, passes beyond the os uteri 
and vagina (invertio uteri without prolapse, incomplete prolapse of the 
uterus) or passes entirely beyond the vulva and generally carries also a 
portion of the uterus with it. It protrudes out of the vulva in the form of 
a tumor-like mass, the mucous membrane being tumefied and livid 
in color. The membrane may be excoriated in places and in ex- 
treme cases gangrenous. 

Treatment. — This is practically the same as prolapse of the vulva or 
rectum. The protruded portion is carefully bathed with mild antiseptic 
solutions such as boracic acid and endeavor to return it to its normal 
position by even pressure of the fingers; if this succeeds, place the 
animal so that the hind quarters will be slightly elevated, inject a solution 
of boracic acid into the uterus, and followed by a hypodermic injection of 
morphia which tends to overcome straining on the part of the animal. If 
the prolapse recurs it may be reduced and a sponge or oakum tampon 
inserted into the vagina and the orifice closed with sutures (see page. 213). 
If the uterus persists in resisting the above mentioned treatment, the 
animal should be etherized, the abdomen opened on the median line, and 
the uterus or Fallopian tube drawn down to the opening and tied to the 
abdominal opening by means of sutures, taking care not to include the 
mucous coat of the intestines in the stitch. If gangrene has set in, the 
exposed uterus must be amputated. The exposed portion of the uterus 
is drawn out, ligatured with strong silk thread, and the dependent portion 
cut off just below the suture; care must be taken not to include the 
bladder or the urethra, and the stump pushed back into the pelvic cavity; 
some operators advise an elastic ligature. Cutting off the prolapsed, por- 
tion by means of an ecrasour is not to be advised. 

Neoformations of the Uterus. — Fibromas are found most frequently in 
the uterus and sometimes reach to a considerable size. Cyst sarcoma and 
carcinoma are also seen; the latter are generally found in the form of soft, 
loosely organized masses, filling up the entire lumen of the uterus, occasion- 
ally involving the adjacent organs (the intestines and bladder) . The only 
radical means of treatment is to extirpate the entire uterus. The sub- 



OBSTETRICS 219 

cutaneous injection of ergot in had been found to check the growth of 
myofibroma and in some cases to remove it. 

Obstetrics. 

As a rule, the Intch has her pups without any difficulty. The period 
of pregnancy varies from fifty-eight to sixty-two days (Dun kept a 
record of 189 bitches and found the average period Avas 03.28 days, the 
maximum being seventy-one days and the minimum being fifty-three 
days) when she generally seeks a cjuiet place and drops from one to eight 
(sometimes more) blind pups, which open their eyes in from ten to twelve 
days, the period of whelping being from one to six hours (quite frequently 
lasts ten to twelve hours), in rare eases eighteen to twenty-four hours. 
The labor pains generally appear from three to ten hours before birth, and 
are indicated by the bitch being very restless, going into dark corners, or 
scratching as if to make a bed, she whimpers, moans, groans, assumes the 
position as if urinating or defecating, and frequently passes small amounts 
of urine, and on putting the hand on the abdominal walls, the foetuses are 
found to be showing considerable movement. The retention of the whole 
or a portion of the placenta is very rare in the bitch, and when it does occur 
it is indicated by the following symptoms: — great depression; no milk in 
the mammse; the bitch pays no attention to the pups; frequent contraction 
of the uterus similar to labor pains; entire loss of appetite; pain on pres- 
sure of the abdomen. The temperature was normal at first, l;)ut gradually 
increased; the pulse was c^uick and hard, and a fcetid discharge from the 
vulva. 

The short but strong umbilical cord is torn during labor or bitten off by 
the bitch immediately after birth, and the entire mass of placenta and 
amnion is eaten by the mother. After the birth of the pups there is slight 
lochial discharge, bloody in the onset and finally purulent; this discharge 
lasts for several days. 

The normal course of birth may be changed by the following condi- 
tions: 1. The labor pains may not be strong enovigh. 2. There may be a 
narrow, contracted pelvis. 3. The vagina may be lessened in diameter 
])y cicatricial contractions, tumors, etc. 4. The foetus may be very 
large, a monstrosity. 5. Foetus may be presented in an irregular posi- 
tion. 6. Torsion of the horn; this is extremely rare. As a rule, the 
bitch does not require the assistance of the veterinarian, although very 
small animals and the higher bred animals may need some assistance, 
Init it is best to leave the bitch as quiet as possible and not to interfere 
with her in any way. Small bitches sometimes have very large pups, 
the size of the male has also an effect on a litter. When the labor pains 
are weak or entirely absent, an examination of the uterus is made by 



220 DISEASES OF THE URINARY AND SEXUAL APPARATUS 



introducing the index finger, well oiled, into the vagina, the other hand 

putting pressure on the abdominal wall; and if we find the foetus is in 

position, the head is felt in the dilated os (the breech presentation is 

also seen, but is rare) and the pelvic cavity normal, artificial assistance 

is contraindicated, at least for an hour or two; if at the end of that time 

the head has not advanced, ergot must be given inter- 

'tfT a^ nally or, subcutaneously, massage of the uterus through 

ij the abdominal wall, and applications of warm cloths to 

' ' the abdomen. 

One writer speaks very highly of glycerine in 1 to 
10 solution with warm w'ater as an agent to encourage 
the contraction of the uterus in cases of difficult part- 
urition; it is injected directly into the uterus. If the 
animal is depressed and weak, administer stimulants — 
whiskey, wine, or alcohol or spirits of camphor internally 
or subcutaneously — and if these fail to produce the birth 
of the foetus it may have to be removed by forceps, of 
which there are a variety, the simplest of which are the 
most useful, hooks — (Fig. 89). — or the foetus may be 
noosed by means of a coj^per wire or cotton cord held in 
a tube (see Fig. 90) . 

Fluid extract of ergot 1.0 to 2.0 every half hour, or 
if the animal vomits give 0.50 to 0.75 of ergot hypoderm- 
ically every half hour. 

In some cases where the bitch is observed by the 
veterinarian, it is well to irritate the vagina and uterus 
between the birth of each puppy, and particularly so 
after the animal has delivered the last foetus; the best 
solution is a mild solution of corrosive sublimate 1 to 
3000, or boracic acid solution. "When the foetus is dead 
and the membranes are commencing putrefaction, the 
constant application of antiseptics must be made until 
either the foetus and memln-ane are expelled or removed surgically. 

When the foetus is in an irregular position, and after failing to remove 
it by means of forceps, finger, loop, etc., or if the foetus is so very large 
that it is impossible to get it through the pelvic opening, or if it cannot be 
reached, so that it can be cut into sections, or if the pelvis is contracted, 
due to permanent cicatricial contractions, or a tumor present in the 
uterus or vagina, we must perform the Caesarean section. 

Caesarean Section, Hysterotomy, Secto Caesarea. — This is a very 
dangerous operation. To have any chance of success the operations 
should be performed before the animal is in a state of collapse, or the 
foetus is dead and commencing to decay, or the temperature has not 



Fig. S9. — Retrac- 
tors, single and 
double. 



OBSTETRICS 



221 



risen much above normal. Empty the bladder and the lower bowel; and 
having washed out the genital passages with an antiseptic solution, put 
the animal under ether. The bitch is laid on her back, the legs are held 
by an assistant, the forelegs together and the hind legs wide apart. The 
region where the incision is to be made should be thoroughly washed and 
the hair removed from the part. Make an incision on the median line of 
the linea alba anterior to the umbilicus with a sharp-pointed bistoury, 
and cut into the abdominal cavity, taking care not to injure the intestines 
or uterus; then insert a probe-pointed bistoury and make the opening 




Fig. 90. — Apparatus for the extraction of the foetus and method of extraction: a, Brulet's apparatus; 
b, method of application.; c, Defay's apparatus. 

larger, cutting toward the pubis; then cut through the omentum; the 
uterus is now visible and can be lifted out and the foetuses can be felt in 
the uterus, separated by a constriction of the body of the horn. Pull the 
uterus out of the opening as far as possible and have an assistant keep the 
opening of the abdominal wall closed, so as not to allow the intestines to 
escape, and also to avoid any of the fluids from the uterus falling into the 
cavity; and by means of a bistoury open the uterus by making an incision 
through its wall; the opening should not be any larger than is necessary to 
get the foetus and the membranes out. It is not necessary to make an 
incision in the horn over each foetus, but after one foetus is removed the 
others can be pushed toward the opening and removed through it, taking 
care to remove the membranes also. The uterus is now thoroughly dis- 
infected with corrosive sublimate solution (1 to 5000) or boric acid, 2 per 



222 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

cent., or creolin; and close the incision by means of a Laml)erts' suture 
(using the stitch illustrated in Fig. 20, page 70), using catgut ligature. 
If the other horn of the uterus contains fcetus, it must be treated in a 
similar manner, irrigated and closed, then sew up the abdominal muscles 
by an interrupted suture, using silk. The abdomen is covered with a 
piece of absorbent cotton soaked in a mild solution of corrosive sublimate 
and held in position by an eight-tailed bandage of muslin tied over the 
back. This has to be dressed daily. The animal must have absolute rest 
and be fed on food that is easily digested and not apt to constipate or 
ferment. Meat juice or extract is the best; vegetables are contraindicated. 
Removal of the Uterus, Hysterectomy. — This operation is performed 
in inguinal hernia of the l)itch, with strangulation, in uterine tumors, 
and chronic catarrh of the uterus, and when after the abdomen is 
opened as in tlie operation just described and it is found that the 
uterus is either lacerated, necrosed or that the uterus is in such condi- 
tion that if it is not removed it will endanger the life of the animal. 
Open the abdomen on the linea alba or the flank, the former is much more 
satisfactory and to be preferred, and the uterus is brought down out of 
the opening, and a douljle ligature is put on the horn close to the ovary, 
or, better still, remove the ovary, then a double ligature is put on the uterus, 
close to the vagina. When the uterus is filled with foetus, it is best to 
empty the uterus, taking care not to allow the escaping fluids to flow into 
the abdominal cavity; the ligated horn and uterus are cut between the 
doul)le ligatures, and the broad ligament separated, and it is wise to 
apply the thermo-cautery to the stumps of the horn and the uterus, then 
close the abdominal wound, bandage the abdomen and treat the animal 
as in any grave surgical case. 

Irregularities of Sexual Instinct. 

Absence or Loss of Sexual Desire. — This condition may result from 
a variety of causes: (1) general debility, (2) ana?mia, (3) irregular or 
improper food, (4) phlegma, especially in over-fed animals, (5) too fre- 
ciuent sexual intercourse, as dogs in the stud, that have suddenly become 
popular and have a great number of bitches sent to them, (G) onanism, 
where animals have no intercourse, and learn to masturbate on objects 
slightly elevated from the ground, a rung of a chair, the shaft of a wagon, 
and in the kitchens of families, where small pet animals are kept, the 
servant maids hold vip their foot and encourage the dog to masturbate 
on that until they are exhausted, (7) from disease of the spine or of the 
genital organs. In the l^itch sterility may result from catarrh of the 
uterus or vagina, causing a discharge of acid mucus, that destroys the 
spermatozoa. In certain male dogs they become so violently excited 



CASTRATION OF THE BITCH 223 

that the}' arc unable to perform the act properly, or there may be partial 
loss of erectile power in the corpus cavernosum and the dog does not hold 
long enough, for the sperm to be secreted and it is ejaculated after they 
separate. 

Therapeutics. — If there are any pathological alterations they should 
either be alleviated or the case may be such as to be impossible to alle- 
viate, or we may administer an aphrodisiac to the animal for some time 
previous to the time the animal is to serve the bitch. Tincture of can- 
tharides 2 to 10 drops once or twice daily in wine or barley water or hydro- 
chlorate of yohimbin two or three times daily, a fourth to a half tablet 
which contains 0.01 in solution of acacia. In the bitch yohimbin should 
be administered for five days and then the bitch is put with another bitch 
in heat, this as a rule, produces sexual excitement in ten days. If ster- 
ility is due to acidity of the secretion of the vaginal mucous membrane, 
irrigations of alkalines are advised such as carbonate of soda, 1 per cent, 
bicarbonate of soda 2 to '3 per cent. 

Excessive Venereal Excitement. Satyriasis and Nymphomania. — 
This may occur as a result of certain diseases of the genital organs, but 
frequently occurs in the male, from unknown causes, (see also priapismus). 
Venereal excitement is a common thing in male dogs, their actions, in 
play or in excitement all tend toward stimulation of the sexual act, and 
frequently dogs learn to practice onanism, gradually becoming emaciated, 
accompanied by dulness of the senses, weakness or loss of sexual power, 
and frequently, partial or complete paralysis. 

Therapeutics. — If the venereal excitement is not due to any patho- 
logical alteration of the genital organs, the animal should be kept on low 
diet, very little meat, and the administration of saline laxatives, and the 
salts of bromide of soda or potassium, and if these methods fail, resort to 
castration. 

Castration of the Bitch {Ovariotomy). 

This operation is generally performed to avoid the trouble that 
owners have when a bitch is in " heat," and also tends to make them good 
quiet house clogs. The operation is a very simple one and not attended 
by any great danger if the proper antiseptic rules are followed, provided 
the animal is not too fat, pregnant or in ''heat" at the time of operation, 
or there are no tumors of the ovaries, that by either greatly increasing the 
size of the ovary or adhering to the adjacent tissues interfere with their 
removal. Xormally the ovaries are small, elongated, somewhat irregular 
bodies about the size of a small bean, lying posterior to the kidney and 
cncapsuled in a pouch and generally surrounded by fat. The operation is 
either performed through the flank or on the linea alba, while the animal is 



224 DISEASES OF THE URIXARY AND SEXUAL APPARATUS 

either narcotized with morphia or ana?sthotizecl with ether. Before operat- 
ing the animal shoukl have food withheld for twenty-four hours, and the 
region of the incision carefully prepared, first by shaving all hair in the 
immediate region, and then carefully disinfecting it. 

Operation on the Linea Alba. — The bitch is given a narcotic, or ether- 
ized, or both, and placed on a table on her back and an incision made 
in the linea alba at the umbilicus, with a sharp-pointed bistoury, and 
then the opening is enlarged by means of a probe-pointed bistoury, cutting 
toward the diaphragm, the size of the opening is just large enough to 
freely admit the index finger. Some operators introduce a sound into 
the uterus previous to the operation, but this as a rule, is unnecessary, as 
familiarity with anatomy, will easily detect the difference Isetween intes- 
tine and the fallopian tubes. The finger is introduced into the abdomen 
close against the wall and the horn of the uterus is felt, the end of the 
finger is hooked under it and drawn toward the opening, and by careful 
traction, the ovary is drawn toward the opening and cut ofT with the 
scissors; sometimes it is necessary to tear the ovary from its attachments 
to get it to the surface. The same procedure is followed in the other 
ovary and the wound closed with an interrupted silk stitch. 

Many operators perform castration in very young and even in older 
dogs, by opening the abdominal cavity at the linea alba and ligating the 
uterus by two catgut ligatures about an inch apart on the body of the 
uterus, and cut through between the ligatures. This method has the 
advantage of being very simple, and there is little or no danger connected 
with it, but the writer has tried a number of cases for experiment and 
found in a short time a great collection of creamlike matter, gathered at 
the ligated end of the uterus toward the ovary, and distended that portion 
very much, which was noticeable by an enlargement of the abdomen. 
This result can be prevented to a great extent, by ligating and cutting each 
horn separately, and as high and near the uterus as possible. This compli- 
cates the operation, and as the prime ol;)ject of the operation is to pre- 
vent the recurrence of the periods of ''heat," as the ovary is not removed 
• by this mode of operating the phenomenon recurs at the regular periods 
and while it is true it is impossible for the animal to become pregnant, 
it still is not an operation to be desired. 

Castration by Flank Operation. — Many operators advise castration 
through the flank, and jM'ocecd in the following manner: Make an inci- 
sion in the flank about 4 cm. long, midway between the last false rib and 
the thigh and the transverse process of the vertebra, in an anterior direc- 
tion, cutting through the skin and muscular layer; then tear the peri- 
toneum by means of the finger or knife, or lifting the peritoneum by 
means of a pair of forceps, cut it through with a scissors, then the index 
finger is introduced into the abdominal cavity, the fallopian tube is 



MAMMITIS MASTITIS 225 

found, hooked with the finger the ovary is pulled down to the opening 
and cut off either by scissors or twisted off with forceps, care being taken 
to remove the ovary entirely. Some authors recommend removing a 
portion of the horn with the ovary; this, however, is not really necessary. 
After removing the ovary, the Fallopian tube is traced back to 
the bifurcation at the uterus, the other tube found and followed back to 
the other ovary, which is removed in the same manner. In cases where 
the remaining ovary cannot be reached, laparotomy is made on the other 
flank, and the ovaries pulled through the opening and then cut off with 
the scissors, and the wound sewed up as described in the other operation. 
Friedberger has operated on hundreds of bitches in the above-described 
manner; he removes both ovaries through the one opening in the left 
flank. Gunther makes an opening in both flanks, taking one ovary out 
of each. The subsequent treatment consists of feeding the animal on 
small quantities of easily digested food, and treating the wound with the 
regular antiseptics. 

DISEASES OF THE MAMMARY GLAND. 

INFLAMMATION OF THE MAMMARY GLAND. 

MAMMITIS. MASTITIS. 

True inflammation of the mammary gland, due to bacterial infec- 
tion is extremely rare. It may occur, however, in an acute or chronic 
state as a result of traumatisms, kicks, blows, cuts, orinjuries incident to 
suckling puppies, or congestion of the udder from caking or drying of the 
milk, and consequently retention and tumefaction, and finally, the for- 
mation of abscess of the gland. This condition may be caused by sudden 
removal of the puppies, or the pups born dead and the udder filled with 
milk. 

The udder may be swollen through its entire length or certain sec- 
tions may be affected. It is warm and painful to the touch, the affected 
part is deep red or in white animals, purple red, and the swelling cede- 
matous. Pressure on the nipple causes the milk to flow, and it is thin, gray- 
ish white, sometimes very thick and creamy, the latter generally containing 
pus or is streaked with blood. In more acute cases, there is fever, loss of 
appetite, the tissues become purple red and it forms an abscess, which 
fluctuates, points and allows the escape of creamy pus, streaked with 
blood; it may in some cases become gangrenous and a portion slough out, 
and in rare cases cause death. Occasionally cases become chronic and 
certain portions of the gland atrophy, or become corded or nodulated. 

Treatment. — The puppies must be removed as soon as possible, the 
gland bathed frequently with warm water and lead water solution applied, 
15 



226 DISEASES OF THE URINARY AND SEXUAL APPARATUS 

or an ointment of extract of belladonna, 0.05 lanoline 3 . 0. This is to be 
rubbed in or if the abscess is commencing to form pus, apply poultices or 
hot-water cloths, by means of the Priessnitz compress; when the abscess 
forms pus open freely. The resulting hardening of the gland after an 
acute attack of inflammation maybe removed by the application of iodine 
painted on once daily for several days, then apply an ointment of 
iodide of potassium in lanolin one to twenty. This is to be rubbed in and 
daily massaging of the gland is recommended. If the gland is swollen 
and hard from loss of puppies, or if one gland is not emptied by the pups, 
rubbing with camphorated oil, or an ointment consisting of belladonna 
extract one part and lanolin fifteen parts, with low diet, and mild saline 
laxatives. The gland may be milked slightly, this procedure must be 
done very carefully, and then only when absolutely necessary, as it is not 
advisable to stimulate the secretion of milk. Bitches that are not preg- 
nant frequently have a swelling and enlargement of the udder, six to eight 
weeks after the "heat" is over. This invariably disappears without any 
treatment and it is not necessary to treat it in any way, but in very rare 
cases, if the udder should become congested, it is to be treated as if 
it were a case of congestion of the gland. Very rare cases have been 
known where bitches suck the nipples and stimulate the milk, a haint 
that is impossible to control, except by putting on a spiked muzzle, or 
getting the bitch pregnant will sometimes overcome the habit. 



Neoformations of the Mammary Gland. 

Various tumors and enlargements form in the mammary gland, such 
as fibroma, lipoma, chondroma, osteoma, adenoma, myxoma, sarcoma 




Fig. 91. — Tumor of the mammary gland. 



and carcinoma, and frequently mixed tumors, such as adenosarcomas 
fibrochondromas, fibrosarcoma, chondrosarcoma, etc., and there may 



NEOFORMATIONS OF THE MAMMARY GLAXD 227 

also be cyst formations. Some of these mammary tumors reach enor- 
mous sizes, hang down and sometimes touch the ground, (Fig. 91). As 
a rule these tumors are round; flat tumors as a rule, are rare, these tumors 
may be round or apple-like externally or they may be nodulated and 
irregular and fluctuate at certain parts of the tumor. These fluctuating 
portions may or may not open, and discharge their contents and form an 
ugly, raw, unhealthy cancerous ulcer, which is constantly licked by the 
animal and generally we find enlarged infected lymphangitis in the sur- 
rounding tissues. Carcinoma is frequently found on bitches that are 
beyond middle age, in the form of carcinoma fibrosum, or carcinoma 
schirrosum, or partially as carcinoma medullare or myxomotodes and 
calcification, or ossification, as well as cyst formations. 

Treatment. — These must be operated on when the tumor is well de- 
fined, they can be operated on and removed with comparative ease. 
When the tumor infects the interior of the gland and is malignant, the 
entire gland should be removed, and also any infected lymphatics. 
Frohner found that some of the tumors (carcinoma) become calcareous 
and unless they are very large are best left alone. Small benign tumors 
should not be interfered with if they are not growing. 



DISEASES OF THE NERVOUS SYSTEM. 

EXAMINATION OF THE NERVOUS SYSTEM. 

Disturbances of the nervous system are marked by impairment of 
consciousness, sensitiveness, and motility. Besides these, there are 
complications in the functions of the eyes, ears, taste and smell, and also 
the digestive system. 

1. The Disturbances of consciousness are variously defined according 
to their intensity. Dulness (indifference to any external influences), 
somnolence (drowsiness, sleepiness, when the patient is awakened easily), 
stupor (deep sleep, with difficulty in arousing the patient), coma (entire 
unconsciousness, where the animal is not disturbed by external influences) . 
In extreme cases of unconsciousness, all sphincters of the body become 
relaxed. Such cases are found in the various diseases of the brain and 
its coverings and in cases of injury and concussions of the brain; it is also 
seen in poisoning by narcotics, in uraemia, in acute anaemia, and in all 
diseases accompanied by intense fever and pain. Short attacks of un- 
consciousness may occur in the form of dizziness, and are seen occasion- 
ally as the result of great excitement or pain (in operations) ; and also 
idiotism, which occurs in rare instances as a result of distemper, when it 
assumes the nervous form. 

2. . Disturbance of Sensitiveness. — This is not easily recognized in 
the dog. In all instances it is advisable to cover the patient's eyes, and 
compare the sensitiveness of the affected side with that of the healthy one. 
In cases of haemaphraic diseases, we test the sensitiveness of the skin by 
pricking it slightly with a needle or letting cold water drop upon it, so as to 
produce some irritation or symptom of pain. A test may also be made 
by means of a battery; still this method is not as reliable and practical as 
the needle and cold-water test. 

Total anaesthesia occurs, as a rule, from poisoning, and must not be 
mistaken for a want of reaction, when in a comatose condition. Local 
anaesthesia — that is to say, a more or less circumscribed or disturl)ed 
zone of sensibility — may be found in any part of the body. In such a 
case, if anaesthesia corresponds with a region of a special nerve or mixed 
nerve, or if it is extended over several nervous regions, or if it is 
even double-sided, we can distinguish it as peripheric amesthesia. Periph- 
eric anaesthesia indicates an injury of the terminal ends of the sensitive 
nerves and originates through local influences, intense cold, acids (es- 

228 



EXAMINATION OF THE NERVOUS SYSTEM 229 

pecially carbolic), also alcohol and certain narcotics (especially cocaine). 
Peripheric aniPsthesia may be caused by some traumatism, compression, 
malformation, or inflammatory exudates; also through inflammations, 
such as degenerating process, etc., of the peripheric nerves. Spinal 
anaesthesia is seen and, as a rule, is double-sided; due to compression of 
the nerve or the spinal cord. Cases of cerebral ansesthcsia are caused by 
hemorrhages, tumors, inflammations, etc., in the zone of the sensitive 
nerves. It may also be caused by the effects of various poisons — chloro- 
form, ether, alcohol, morphia, or bromine. 

Hyperaesthesia. — This is an increased sensitiveness of the cutaneous 
nerves, and is, as a rule, found in the early stages of certain diseases of the 
spinal cord. It is very rarely seen in the later stages of such diseases. In 
rabies it is indicated by gnawing of certain portions of the body, and in 
neuritis and secondary paralysis. 

3. Disturbances of motility appear in paralysis and convulsions of 
the affected muscular system. 

Paralysis. — We generally make a distinction between paralysis 
and lameness, that is to say, an entire loss of movement, and paresis or 
weakness, which is simply due to debility. In the first ease there is not 
the slightest movement performed in a muscle or a whole group of muscles. 
In some cases, there are slight muscular movements, but they are weak, 
wit hout strength, and do not last very long. In order to determine the origin 
of paralysis, it is necessary to have some knowledge of the psychomotor 
centres. These centres are located in the cerebrum, and are called the 
cortico-muscular leading tracts. Up to the present time they have 
definitely located the following motor centres in the external surface of 
the cerebrum, the position of which is indicated in figure 92: 1 is the centre 
for the movements of the muscles of the neck; 2 is that of the extensors 
and adductors of the anterior limb; 3 is for extending and turning the 
anterior limbs; 4 controls the movement of the posterior limbs; 5, the 
facial muscles; and 6, the lateral movement of the tail; 7, for the re- 
traction and adduction of the anterior limbs; 8, for elevating the shoulders 
and stretching the front legs (walking) ; 9, for dilating and contracting the 
orbicularis palpebrarum and zygomaticus muscles. In the front of 9 we 
also find the centre for the movements of the tongue. Between the 
anterior and middle portion of 9 is for closing the jaw. On irritating 
9 we have a retraction and elevation of the corners of the mouth. By 
irritating 6 the mouth is opened and the tongue is moved. c,c causes a 
retraction of the corners of the mouth; c lifts the corners of the mouth 
and half of the facial muscles as far as the closing point of the eyelids. 
The middle e (on irritation) opens the eye and dilates the pupil. 

Any disease which becomes located in any portion of this cortico- 
muscular brain centre and inflames or stops the power of these centres 



230 DISEASES OF THE NERVOUS SYSTEM 

must lead to paralysis of the centre which it controls. "VVe therefore can 
locate any disturbance in the motor centres of the brain by the paralysis 
which occurs in certain parts of the body. A diseased condition of the 
covering of the brain, if not very extensive, generally causes the paralysis 
of one part of the body, as the single motor centres are separated and 
very distinct from one another. Diseases of the brain, when they occur 
in the inner surface between the capsules and the pyramids, where all 
the motor fibres are close together, cause a more or less complete paralysis 
of one side of the body. That is to say, a hemiplegia (affecting one side 
of the brain) causes the paralysis of the muscles of the other side of the 
body. For instance, if the disease is located on the left side of the brain, 
the muscles of the right side become paralyzed. In diseases of the spinal 
cord the muscles affected are on the same side, except in the case of 
diseases of the cervical portion of the spine, when, as a rule, paralysis is 
seen in all the extremities, and in disease of the lumbar region paralysis 
of the posterior extremities is seen. We therefore summarize in a general 
way that hemiplegia is usually a form of cerebral paralysis (of the con- 
trolling centres); paraplegia indicates a diseased condition of the spine; 
and monoplegia is due to a paralysis of the brain as well as the spine. 
This description gives only the fundamental theories on this subject. 
Concerning more precise details we would direct our readers to some one 
of the various physiological text-books. 

The most important peripheric paralyses which have been observed 
in the dog (by traumatism, compression, or exudation, inflammatory or 
degenerating processes of the affected nerves) are as follows: 

1. Motor Trigeminal Paralysis. (Paralysis of the lower jaw.) — 
The lower jaw hangs down; mastication is impossible; saliva runs out 
of the mouth. This condition occurs very frequently as a symptom of 
rabies. In rare instances it has been observed as a result of some other 
disease. 

2. Paralysis of the Anterior Limhs. — The front legs hang inert and 
all the joints flex very easily. 

3. Paralysis of the Posterior Limbs. — The hind legs are dragged along 
the ground, the paws being flexed and drawn backward. If the paws 
are drawn forward and this flexion overcome, the animal is able to stand 
on its legs if the body is held. 

4. Paralysis of the Cruralis. — In this condition the animal does not 
use the posterior limb. All the joints become flexed abnormally, and 
the thigh bends backward. This condition may also be due to some 
disease of the spine. 

The electrical current is very useful to determine how much certain 
muscles and nerves can be excited by the current and is particularly 
useful in the diagnosis of paralysis of the nerves and muscles and nutritive 



EXAMINATION OF THE NERVOUS SYSTEM 



231 




Fig. 92. — /., shows superior portion of the cerebrum; II., the lateral surface; and /., //., ///., IV. 
are the four convolutions.; .S', is the sulcus cruciatus; F, the fissure of Sylvius; o, the bulbus olfactorius; 
p, is the optic nerve. The motor centres are; 1, for the muscles of the neck; 2, for the extensors and 
adductors of the anterior limbs; 3, for the flexors and rotators of the anterior limb; 4, for the muscles 
of the posterior Umbs; 5, for the facial muscles; 6, for the lateral movements of the tail; 7, for the re- 
traction and adduction of the anterior limbs; 8, for the lifting of the shoulder and extension of the front 
limb (walking); 9, 9, for the orbicularis palpebrarum, zygomaticus, and closing of the eyelid; /., t, the 
heat-centre of Eulenberg and Landois. (Landois.) 

Fig. 92. — //., a, a, retraction and elevation of the corners of the mouth; b, opening of the mouth 
and movements of the tongue; d, the opening of the eyelids. 



232 



DISEASES OF THE NERVOUS SYSTEM 



disturbances of the same. The faradic or the open circuit can be used. 
One electrode is placed on the body, generally along the spine and the 
other is placed on the muscle to be stimulated. The first electrode, 
that is placed along the spine should be of large size and the other that 
is to be placed on any particular nerve of muscle, must be comparatively 



31 3^ 33 3*3^ 




Fig. 93. — Motor centre points of the clog (after Nahrich): 1, caninus muscle; 2, levator; labii super- 
ioris; 3, orbicularis oris; 4, levator naso labialis; 5, currugator supercilii and orbicularis palpebrarum; 
6, corrugator supercilii and orbicularis palpebrarum; 7, orbiculo-palpebralis nerve; 8, masseter; 9, 
zygomaticus muscle; 10, superior lateral retractor of the ear; 11, sterno-hyoideus; 12, sterno-cephalicus; 
13, trapezius; 14, omotransversarius; 15, cleidocervicalis; 16, thoracic portion of the trapezius; 
17, scapular portion of the deltoid; 18, axillary nerve; 19, acromian part of the deltoideus; 20, anconeus 
longus; 21, anconeus lateralis; 22, ramus profundus with radial nerve; 23, extensor digitalis communis; 
24, adductor poUicis longus; 25, extensor digitalis lateralis; 26, extensor carj^i ulnaris; 27, anconeus 
brevis; 28, cutaneus maximus; 29, latissimus dorsi; 30, obliquus abdominalis externus 31, illiohy- 
pogastric nerve; 32, illioinguinalis; 33, sartorius; 34, tensor fascia lata; 35, gluteus medius 36, gluteus 
superficialis; 37, biceps femoris; 38, semitendinosus; 39 peroneus nerve; 40, extensor digitalis 
lateralis; 41, peroneus brevis, 42, tibial nerve. 

small so as not to cover more than the part to be stimulated. The 
electrode must be covered with linen or woolen cloth and moistened with 
a weak solution of common salt. The reflex movements are prompter 
when the electrode is placed on the so-calletl motive points which (Fig. 93) 
will give some idea of their location. 

When a muscle is in normal condition it will answer promptly, when 



EXAMINATION OF THE NERVOUS SYSTEM 233 

the electrode is put on it, by a quick quiver. In a degenerated or atrophied 
muscle, the reaction is a slow vermicular cjuiver or in old cases where 
the paralysis has existed for a long time there may be no motion at all. 
The constant or open current will frequently stimulate muscular con- 
traction, when the faradic current will give no movements whatever. 
AMien degenerative muscular atrophy has set in for any length of time 
no reaction can be obtained from either current. For further details 
see special work on this subject. 

The most important test of paralyzed muscles is their size. In all 
cases of prolonged paralysis the muscles atrophy ciuickly. The muscle 
gradually becomes smaller and smaller until it resembles a cord or tendon. 
In cerebral paralysis this does not occur, while in spinal paralysis it is 
always present. Of course, in some instances an inactive muscle will 
atrophy without any actual disease being present. The amount of 
atrophy which may occur in certain cases is indicated by a communication 
given to the author l^y Goubaux. In this instance the paralyzed anterior 
limb of a dog weighed 103 grammes, while the perfect limb weighed 148 
grammes. 

Convulsions. — Convulsion of the controlling muscles is the very 
opposite of paralysis. Convulsions are diseased contractions of the 
muscles which are independent of the will. There are several varieties 
of them. Clonic convulsions are short muscular contractions that occur 
at intervals, and between the intervals the affected portion of the body 
quivers constantly. Tonic convulsions are muscular contractions in 
which the muscle remains constantly contracted. It may occur for a 
minute or two, or may last several days. Tonic clonic convulsions are 
the medium form of the two conditions before described. A mild form 
of clonic contractions is noticed in the original muscular twitchings. 
Trembling and shaking convulsions, seen in chill, fear, or sudden cooling 
after being very warm, epileptiform convulsions, or eclamptic convul- 
sions, are seen and extend over the whole body. In very rare instances 
they may be restricted to one portion, such as the head or neck. These 
generally come on suddenly and disappear in a few minutes. They 
are generally seen in the early stages of distemper, in teething, in 
irritated conditions of the bowels, or from noxious and poisonous food 
and from parasites; in cases of pentastomum in the nasal cavities, in 
encephalitis, meningitis, or uremia, and occasionally in acute ansemia; 
they also occur from some injury or irritation of the peripheric centres, 
and are very prominent in epilepsy. Rhythmic twitchings are seen in 
some muscular regions where the afTected part of the body makes regular 
motions; for instance, in the muscles of mastication, in the muscles of 
the chest during sleep, and also in the twitching of certain limbs. They 
are very often mistaken for chorea, and appear as a result of distemper 



234 DISEASES OF THE NERVOUS SYSTEM 

or some disease of the I)rain. They may also occur from disorder of the 
spine. These so-called cataleptic attacks consist of a rigid and contracted 
condition of all the muscles of the body, but are subject to passive move- 
ments. Nothing is known concerning their etiology. Tetanic convul- 
sions are tonic convulsions of the whole muscular system of the body, 
They appear in tetanus and in some cases of poisoning (strychnine, 
brucine, caffeine, etc.). A variety of these tetanic convulsions is some- 
times observed in the so-called cases of eclampsia in bitches who are 
nursing a large litter of puppies. Forced irregular actions of the body, 
such as walking backward or in a circle, or the animal rotating on its 
own axis, are seen as a rule in diseases of the cerebellum and in some 
cases of poisoning (cocaine). In rare instances we see, in the above 
mentioned, symptoms of '' ej^ileptif orm attacks," w'hich we will refer to 
further on. 

Ataxia is due to disturbance of motility or an interference in the co- 
ordination of muscular action. Animals are unsteady on their legs, 
stagger from one side to another, and their action in walking is irregular. 
Ataxia is undoubtedly found in some diseases of the cerebellum, and may 
also be seen in disease of the pons and the fore ventricles, and, in very rare 
instances, of the spinal cord. Ataxia occurs very often as a result of dis- 
temper, and it occurs without any previous brain or spinal symptoms. 

Concerning disturbances of vision, hearing and the action of the 
sphincters, they will be described under their special chapters. 

Disturbance of Reflex Irritability. — Reflex action is those movements 
that arc caused by some stimulus or irritation that produce a movement 
that is entirely independent of the will, unless the will is concentrated to 
oppose the movement. In this instance we call particular attention to what 
is known as patellar reflex. The animal is laid on his side with the hind 
leg to be examined on the upper side, the leg is slightly flexed and with 
the index finger or a percussion hammer a cpick blow is made on the 
patellar ligament below the patella; under normal circumstances the 
quadriceps femoris muscle makes a quick contraction, the muscles of the 
leg contract and the leg is sprung forwards. The same reflex but to a 
lesser extent is also seen at the anterior face of the carpal articulation, the 
Achilles tendon, skin of the sole of the foot and the abdominal wall. An 
increase of the reflex is seen in the course of chronic diseases of the brain, 
in myelitis transversalis, spinal paralysis (first observed by Dexter) pois- 
oning with strychnia, tetanus. A diminution of the reflex is sometimes 
found in acute diseases of the lirain, which have been verj' rapid in their 
development, in certain diseases of the spinal substance, in disease of the 
peripheric nerves (in which case it is confined to the territory of the corre- 
sponding nerve) and in coma. The brain reflexes to be particularly con- 
sidered are the conjunctival and corneal reflex seen by the closure of the 



HYPEREMIA OF THE BRAIN 235 

eyelids on touching the conjunctival ]nill)i or the cornea and the puj^il 
with 'its contraction or dilatation on the impression of light. 



DISEASES OF THE BRAIN AND ITS COVERINGS. 
Hyperaemia of the Brain. 

Etiology. — There is an active and passive hyperaemia. Active hy- 
pera?niia of the brain is caused by an increase of the circulation as the 
result of increased heart-action. This occurs in hypertrophy of the left 
ventricle, from excitement, in young animals, from heat (sunstroke), in 
great bodily exertion, in teething, high temperture; blows, nervous tem- 
perament, from overeating, the effects of certain narcotics, and as a 
secbndary symptom of certain diseases. 

Passive hyperaemia (stagnation) occurs in compression of the jugular 
veins by tumors, such as large goitres, by obstructed respiration, from 
tight collars, in acute bronchitis, and in compressed conditions of the lung 
due to hydrothorax, extended indurations of the lungs, defects in the ve- 
nous openings of the heart. Hypersemia of the brain accompanies various 
acute internal diseases, and as a secondary symptom of a large number of 
disorders; it is also seen as a result of various poisons, such as alcohol, 
certain narcotics, etc. 

Pathological Anatomy. — As a rule, hyperemia of the brain occurs in 
connection with congestion of the coverings of the brain, especially the 
pia mater. When hyperaemia is very intense, or where it has existed 
for a long time, we cannot definitely separate the conditions. We find 
the dura mater distended, but very little changed. The vessels of the pia 
mater are much injected, the torsions of the vessels are flattened, and the 
sulci are perfectly flat as if pressed out of shape. We find the gray matter is 
darker than usual, while the white brain substance is dull gray or yellow- 
ish red, and presents numerous bloody spots which may be easily removed. 
In chronic conditions of this disease, we find venous hyperaemia. The 
brain appears in such cases pale and anaemic, very moist and soft, and on 
section has a brilliant, mirror-like lustre. It is lessened in size and doughy 
in consistence and the subarachnoidal fluid is increased. 

Clinical Symptoms. — The symptoms of active hyperaemia of the 
brain are characterized by a sudden development of excitable symptoms. 
These consist in great restlessness, running around, making frequent 
changes of position, irritability, a tendency to biting and attacks of de- 
lirium, partial or general convulsions, and an increased activity of the act- 
ion of the heart. The pulse is quick and irregular; the respirations are 
short. There is congestion of the mucous membranes of the head, and the 
upper portion of the head is warm to the touch. There is contraction of 



23(3 DISEASES OF THE NERVOUS SYSTEM 

the pupils and sometimes vomiting. These symptoms of excitement 
rarely last very long, and generally disappear quickly; although in rare 
instances, they may last some time without leaving any trace on the gen- 
eral system. They may, however, alternate with periods of apparent rest 
to recur again in a short time. The writer has observed this in cases of 
apoplexy of the brain. In this condition there is dulness, unsteady gait 
and if there is entire stupor, stertorous respiration is apt to be present 
with this last symptom. It is doubtful in such cases, if we have to deal 
with actual hypcrsemia; more likely, a more of less serious alteration in 
the brain. 

Therapeutics. — Bleeding, as a rule, is contraindicated on account of 
the debilitated condition of most dogs when they develop hyperaemia. 
We would, however, recommend enemas (soap and water) and purgatives 
with quick action, such as sulphate of magnesium in large dcses, senna 
leaves, or castor oil. Cold compresses (ice bags) around the head are also 
useful, while violent purgatives such as croton oil, are not advisable, as 
they excite the animal, produce great irritation and generally do more 
harm than good. The animal should be put in a cool room and kept as 
quiet as possible, avoiding excitement or heat and also feed the animal 
very light. In cases where marked symptoms show themselves, an 
injection of morphine is generally indicated. 



Anaemia of the Brain. 

Etiology. — The most common cause of anaemia of the brain, is im- 
poverished blood, acute hemorrhage, prolonged debilitating disease, or 
from some obstruction of the arterial system, such as tumors, hemor- 
rhages, or inflammatory exudations within the skull; also compression of 
the carotid arteries by emphysema, and in some instances from contrac- 
tion of the small arteries of the brain, caused by excitement. Chronic 
anaemia of the brain may be caused by the presence of intercranial tumors, 
or hemorrhage, chronic hydrocephalus pachj'^meningitis. 

Pathological Anatomy. — The white substance in rare instances has a 
few bloody points. As a rule, however, the brain appears on section dull 
white, the gray matter being unusually bright, without any trace of col- 
oration. The meninges and coverings of the brain may possess their nor- 
mal quantity of blood, even in intense anaemia. 

Clinical Symptoms. — Acute anaemia, especially when it has been 
caused by hemorrhages, is indicated by a small, weak pulse, dilatation of 
the pupils and a coldness of the extremities, with attacks of dizziness, and 
loss of conciousness. Convulsions are rarely present in chronic anaemia 
of the brain, and very often stupidit}', (luivering of the muscles, great 



CEREBRAL HEMORRHAGE 237 

fatifiTio on the slightest exertion, loss of appetite, and a tendency to vom- 
iting is noticed, and even general convulsions. 

Therapeutics. — The therapeutic treatment consists in stimulants, 
such as wine, ether, camphoi', atropia, caffein, friction to the skin, smelling 
spirits of ammonia, stimulation of the phrenic nerve by the faradic 
battery, etc. In the chronic form nutritive diet, blood-producing food, 
and tonics. 



Cerebral Hemorrhage. 

(Apoplcxia Sanguitiijc; Hemorrhagica Cerebri.) 

Etiology. — The chief cause of cerebral hemorrhage is an increased 
pressure on the vessels containing the l)lood, and where the walls of these 
vessels present some abnormal condition by which they are debilitated or 
weakened. This condition of the walls of the vessels may be caused l^y 
atheromatous degeneration, or by some disturbances in the nutritive 
process of those parts, as in serious diseases of an infectious nature, such 
as distemper, leuka?mia, and also in certain forms of poisoning. Great 
exertion, intense physical excitement, or great heat may also produce this 
condition. 

Pathological Anatomy. — Hemorrhages appear, as a rule, on the cere- 
brum, and occur from a capillary hemorrhage and are indicated by a slight 
red coloration which cannot be wiped off; but in the most serious forms 
you may find a distinct number of spots which Ijecome confluent. In 
some cases there is a considerable bloody discharge, indicating the l)reak- 
ing down of some large blood-vessel. If the blood-vessel is located in the 
hemisphere near the surface, the dura mater appears distended at the 
affected location; the convolutions of the brain are flattened and the fur- 
rows depressed. The substance of the brain is always more or less de- 
stroyed, and, if the animal does not die quickly, the discharged blood lying 
in the tissues forms clots very rapidly. Its fluid parts become absorbed, 
fibrinous substances are formed, and the blood-corpuscles destroyed, 
being altered into a chocolate-colored emulsion which finally becomes ab- 
sorbed. The coloring matter of the blood remains on the brain as a rose- 
colored pigmentation. The centre becomes smaller and smaller, until the 
development of numerous connective-tissue adhesions unite it to the 
wall, or an apoplectic cyst is formed, which has a smooth inner wall filled 
with serum. This cyst takes the shape of the surrounding tissues. 

Clinical Symptoms. — Capillary hemorrhage appears occasionally in 
some of the grave infectious diseases, and may cause little or no disturb- 
ance of the general system that can be recognized during life, or there may 
be slight manifestations of the condition, such as dizziness, partial loss of 



238 DISEASES OF THE NERVOUS SYSTEM 

consciousness, staggering or giddiness, and in some cases, vomiting; these 
however, are only temporary. In extensive hemorrhage, on the contrary, 
there is the sudden appearance of grave cerebral symptoms. The animal 
falls down without any premonitory symptoms, or else shows, for a short 
time, dizziness, staggering, trembling and uncontrollable movements, 
or convulsions, and then loses entire consciousness. The pulse becomes 
weak or irregular, or rapid and very small. The respirations are deep, 
stertorous, and irregular. The mucous membranes of the head are in- 
tensely reddened, and in the early stages of the attack, convulsions are 
very frequently noticed and involuntary evacuation of urine and fseces. 
This is followed by partial or complete paralysis, which is due partially 
to destruction of the brain substance, and partially to the blood pressing on 
the brain. This paralysis may affect the extremities, both anterior and 
posterior, that half of the body which is opposite to the extravasation in 
the brain being the one affected. The animal may also become blind. 
This disease may result: 1, in death, which occurs either in a few mo- 
ments or may take days; 2, in complete recovery — this however, only 
occurs where there is a small hemorrhage, and in one of the centers of 
the hemispheres; 3, in complete recovery, with partial or complete 
paralysis, according to the amount of hemorrhage. 

Great hemorrhages of the cerebral membranes are marked by the 
same symptoms as apoplexy of the brain. Apoplexia meningia, occurs 
generally in connection with violent traumatisms of the skull, such as 
shocks, concussions, fractures, etc. The blood is generally found in the 
cerebral membrane, between the dura mater and the skull. It may 
also be observed in the subarachnoidal chamber and in the brain- 
cavities. The symptoms are similar to those of apoplexy of the brain, 
but, as a rule, convulsions appear earlier, and the animal, while he may 
present symptoms of coma, makes a much quicker recovery. 

Therapeutics. — Absolute rest, cold compresses on the head, stimulants 
when the pulse is weak, ether and camphor, either internally or subcu- 
taneousl}^ after the coma disappears, purgatives and injections of soapy 
water per rectum to stimulate evacuations of the bowels. To relieve 
congestion of blood vessels, administer iodide of potassium. 

Traumatic Lesion and Concussion of the Brain. 

Concussion and Commotis Cerebri. 

Etiology and Pathological Anatomy. — The cause of this condition is 
some traumatism to the skull bcjiics, such as butting the head against a 
wall when running fast, Ix'ing hit with a stone or quoit, or struck with 
some vehicle, or falling on the head out of a window. 8ome portion of the 



INFLAMMATION OF THE BRAIN 239 

skull is depressed, cracked or splintered, pressing on the brain substance, 
and causing more or less extensive hemorrhage of the interior of the cavity 
of the brain. The hemorrhage is generally most extensive in the dura 
mater, between it and the cranium, but it may also be observed between 
the pia mater and the cerebral cortex or even in the brain substance itself, 
and while under the microscope we may not find any change in the brain 
substance in spite of the fact that there is grave cerebral disturbance, it 
has been called concussion of the brain and is due to a mechanical displace- 
ment of the brain substance and the fluids of the brain are compressed in 
the ventricles. 

Clinical Symptoms and Therapy. — Any pronounced traumatism of this 
kind generall}' causes death. There may be bleeding from the nose or ears, 
with acute congestion of the conjunctiva. Give the animal absolute rest, 
cold local applications, surgical treatment of the injured portion of the 
skull, and also the injured soft tissues, evacuation of the faeces and the 
administration of stimulants. 

Inflammation of the Brain. 

From a pathological standpoint we have to make a distinction be- 
tween inflammation of the hard cerebral substance (pachymeningitis) 
and that of the soft cerebral membrane (leptomeningitis). This classi- 
fication, however, need not be used in a clinical way, because in the dog, 
the described forms run their course with the same symptoms. 

Etiology. — Inflammation of the brain may be the result of some trau- 
matism, or from sunstroke, great physical excitement, over-exertion, etc. 
This condition also occurs secondarily from disease, such as distemper and 
pyaemia, causing suppuration within the skull, in inflammation of the frontal 
cavities as a result of the irritation caused by the presence of parasites; in 
purulent inflammation of the ear (in connection with external otitis), 
and from abscess of the middle ear and orbital cavity. Inflammation of 
the brain is seen in certain infectious diseases, especially distemper, and is 
also associated in rare instances with pharyngitis, bronchitis, gastritis, 
and also from unknown causes. In dogs that died from inflammation of 
the brain, Trolldenier found a pathogenic streptothrix, allied to the group 
of actinomycetes. Over-exertion and great physical excitement are also 
said to be predisposing causes of this disease. 

Pathological Anatomy. 1. Inflammation of the Dura Mater. Pachy- 
meningitis. — The tlura mater is covered with a numl)er of small hemor- 
rhages. It is loose, easy to tear, and over the surface is a collection of 
bloody, purulent masses of exudation. In the later stages of the disease 
we see a circumscribed or extended thickening and adhesion of the cov- 
ering to the base of the skull or to the soft cerebral-membrane. 



240 DISEASES OF THE NERVOUS SYSTEM 

2. Inflammation of the soft Cerebral Membrane. Leptomeningitis. — 

The arachiiuicl is looseiu'd aiul dull. The subarachnoid chambers are filled 
with more or less turbid fluid. The pia mater is hypersemic, loosened, 
and covered by fibrinous exudation. The coverings of the brain are al- 
most always infiltrated and detached from the pia mater with difficulty 
and in some cases we find a serous or purulent fluid in the ventricles. In 
a chronic case we find a circumscribed thickening of the cerebral mem- 
branes and adhesions uniting the coverings with the brain, etc. 

3. Inflammation of the Brain Mass. Encephalitis. — This disease, as 
a rule, involves single centres and causes a general irritation of the healthy 
tissue without any distinctly marked limit. In the affected regions the 
substance of the brain is swollen, hypenemic, and frequently filled with 
small hemorrhagic centres. In the course of time, the inflamed cerebral 
substance becomes softened and pulpy. This condition may be present 
without any hemorrhage, but as a rule, the brain matter becomes red and 
finally yellowish. This latter color is due to metamorphosis of the color- 
ing substance of the blood or to fatty degeneration. These conditions are 
divided into white, red, or yellow — softening of the brain. Finally cic- 
atrices and cysts are formed, as in apojDlexy, or an abscess may be devel- 
oped which is filled with thick yellow or greenish pus, which later becomes 
encysted and sometimes solidified (calcareous). In some cases small en- 
cephalitic centres may heal without leaving any trace. Occasionally we 
see the development of a (non-inflammatory) softening of the brain with 
thrombosis and embolus of the arteries; and, as a general rule, we find 
symptoms which resemble apoplexy. 

Clinical Symptoms. — The symptoms of inflammation of the brain in 
its early stages resemble those of hyperaemia. The animals are excited; 
they run aimlessly from one side to the other, and are fretful and irritable. 
They whine and howl constantly. The head is hot; the conjunctiva is 
more or less reddened, the pupils are contracted, and reflex action is very 
slight. The appetite is lost; constipation is generally present, with more 
or less vomiting. The patient is indifferent to the impressions of external 
objects, being sleepy and apathetic. Soon the disease changes in char- 
acter. We see acute convulsions, especially those of the jaw, or eclamptic 
convulsions. The animals cry and howl. At the same time the sphinc- 
ters are relaxed, the animal apparently having no control of them. 
Then there is an interval of quietness, in which the animal falls back into 
a deep semicomatose contlition, and between these periods of quietness, 
we very often see automatic movements, such as ([uivering or twitching of 
one or two of the legs; also the corners of the mouth may be retracted. 
Many cases either howl constantly, and at the same time seem to be semi- 
comatose, or tliey may bark hoarsely (delirium). As a rule, the temper- 
ature is a little above normal. Within a short time the aninuil becomes 



COMPARATIVELY RARE DISEASES OF THE BRAIN 241 

gradually paralyzed, losino; all power of the muscles. The patient is dull 
and unconscious of external influences. The breathing is rattling and 
stertorous. The pulse is increased a number of beats, but is almost im- 
perceptible to the touch. The temperture now begins to rise. In some 
cases the temperature may remain normal, and in rare instances falls below 
normal. As a rule, the animals die shortly after the convulsions make 
their appearance. Complete recovery is very rare, and slight attacks ter- 
minate as a rule either with paralysis (partial or complete), idiotism, or 
blindness. 

The course of this disease varies greatly in affections of the cere- 
bellum. If the hemispheres are affected, we may have extensive altera- 
tions of the brain, which may run their course without any decided symp- 
toms being shown; but as soon as the cerebellum and one or both hemi- 
spheres become affected, we then see the various symptoms peculiar 
to this disease, and a diagnosis can be made with almost absolute certainty. 
In disease of the cerebellum there is generally an unsteadiness of the 
gait in walking and peculiar movements, such as walking around in a 
circle and rolling on the ground, when both hemispheres are involved. 
We may also find paralysis of the posterior extremities. In rare instances, 
however, these symptoms may also be presented in cases of poisoning 
(by cocaine or apomorphia). 

The differential diagnosis betw^een inflammation of the brain, con- 
gestion of the brain and rabies is taken up under another head. 

Very similar symptoms to those already described appear in cases 
W'here the cysticercus cellulosse is present in the brain or its membranes. 

Therapeutics. — The treatment of inflammation of the brain cor- 
responds with that of hypersemia of the brain. Rest, confinement in a 
dark, but not warm, room, cold applications to the head, clysters, laxa- 
tives, especially calomel and in cases of great excitement, sedatives (mor- 
phia sulphas 0.02 subcutaneously, chloral hydrate 2.0 to 4.0, by the 
mouth, or per rectum, in the form of clysters). The violent irritants 
which were formerly used on the skin, such as croton oil or cantharidal 
ointments rubbed on the inner fascia of the thighs and along the spine, 
are of no particular benefit, in fact do more harm than good. Food 
should be light, and easily digested, such as soup, broth, etc., and to as- 
sist in the reabsorption of the exudate, iodide of potassium may be ad- 
ministered internally. 

Comparatively Rare Diseases of the Brain. 

The following diseases of the brain are rarely seen, but a description 
may be useful to the practitioner. 

Chronic Hydrocephalus. — This condition is similar to what is known 
IG 



242 DISEASES OF THE NERVOUS SYSTEM 

as a " dummy " in the horse, and it may be congenital or it may follow dis- 
temper. Frohner found twenty-nine cases in 70,000 dogs. The follow- 
ing symptoms are observed: dulness, head inclined to one side, uncertain, 
irregular gait, with a tendency to go to one side, amaurosis, deafness, and 
loss of the sense of smell. On post mortem, the brain on section is 
found to have a sero-lepto-meningitis, with large collections of fluid 
in the ventricles; in some cases only a pachymeningitis has been observed. 
The treatment consists in giving laxatives. Injections of pilocarpin, as a 
rule, only produce a slight amelioration of the symptoms. 

Sunstroke. — This is very rare, but it is occasionally seen in the 
working dogs of European countries, wdiere on extremely warm days the 
animals pull very heavy loads. In cases where the animals die, we find 
the same phenomena observed in congestion or inflammation of the brain. 
In one case the entire muscular system was filled with small hemorrhagic 
centres, much hypenemia, and a considerable quantity of sero-sanguinous 
fluid. Between the dura mater and the arachnoid the surface of the brain 
was covered with small hemorrhages, the lungs were congested, the heart 
dilated and flabby, and full of dark coagulated blood. Occasionally an 
animal may die without any premonitory symptoms, or may collapse 
suddenly, having a very strong throbbing pulse, dyspnoea, mouth open and 
tongue hanging out, and an increase of temperature. 

Treatment. — This is similar to the treatment of congestion and in- 
flammation of the brain; rest, cool room, cold compresses to the head and 
if there is great depression, stimulants may be administered. 

Turning Disease. — This condition is indicated by the animal turning 
in circles. These movements are involuntary and are due to some morbid 
process of the brain particularly in the cerebellum, especially its peduncles, 
such as hemorrhage, inflammation, embolus, etc., and it may also result 
from blows, injuries to the skull, it may result from nervous distemper, or 
it may also be from some reflex action. Frohner observed it in constipa- 
tion, and he also found this disease in twenty-nine animals in an observa- 
tion covering 70,000. The treatment consists in keeping the animal 
perfectly (juiet and the adminstration of sulphonal, hypnon and urethan. 

Edema and Parasites of the Brain. — Edema is generally found on 
post mortem and is especially interesting, for as a rule there is not the 
slightest indication of this condition seen during life; in rare cases edema 
is found to be the cause of a variety of symptoms during life, such as 
monoplegia, hsemiplegia, hemianaisitasia, involuntary muscular move- 
ments, ataxia, convulsions, and from the increased pressure on the brain 
we may find stupidity, clumsiness, giddiness, and fainting spells. 

Parasites produce certain ])rain phenomena and particularly from the 
presence of the cysticercus cellulosa', such as great nervous excitement, 
attacking persons without cause, involuntary movements, great depres- 



INFLAMMATIOX OF THE SPINAL CORD AXD MEMBRANES 243 

sion, coma and hlindnoss, and frecjucntly every sign of rabies is present. 

Progressive Paralysis of the Medulla Oblongata. — This is called in 
man a progressive atrophy of the medulla oblongata. This condition 
presents partial paralysis of the tongue, of deglutition, of the larynx, 
of the lips. It is extremely doubtful if this condition does, per se, occur 
in the dog, it being due to some other condition being present in the 
brain. Hutyra and Marek have, however, seen a number of cases of 
acute paralysis of the medulla, particularly paralysis of deglutition and 
paralysis of the tongue (see further under that head). 

Cerebro -spinal Meningitis (Meningitis Cerebro -spinalis). Etiology. — 
Nothing is definitely known of the causes of this disease. It is extremely 
rare in the dog. Renner and Kempen have made several observations 
on the subject, and the writer had one case of his own. 

The anatomical foundation of the disease seems to be an acute 
suppurating inflammation of the brain and spinal membranes, a purulent 
exudation in the arachnoid, especially on the hemispheres and the base 
of the brain, which is infiltrated by a quantity of serous fluid. The same 
condition is also found in the spine. 

The symptoms are disturbances of the sensory nerves, in some 
cases the animal becoming unconscious. There were loss of appetite, 
fever, and after a few days a marked unsteadiness of the gait, beginning 
with a slow, dragging walk, and difficulty of deglutition, becoming com- 
plicated with tonic convulsions which finally became epileptic, staggering 
gait, convulsive movements of the muscles of the neck, opisthotonos, and 
lastly stupor, coma, and death. 

The treatment consists in the administration of sedatives such as 
chloral hydrate, sulphonal or hedonal. 



DISEASES OF THE SPINAL CORD AND ITS MEMBRANES. 

Inflammation of the Spinal Cord and Its Membranes. 

{Myelitis and Spinal Meningitis.) 

Etiology. — A common cause of myelitis and spinal meningitis is trau- 
matisms of some kind causing direct injuries to the spine, such as violent 
blows, shocks to the vertebral column by falling out of a window, etc., 
and further by concussions of the spinal cord, such as being struck by an 
automobile or wagon. Violent muscular exertions frequently produce 
this condition. In very rare instances, the disease may follow the pres- 
ence of an abscess on the outside of the spinal canal, liy extension of the 
suppurating process through an orifice of the vertebra, and occasionally 



244 DISEASES OF THE NERVOUS SYSTEM 

you see it originate, in connection with some infectious or toxic disease 
(distemper, rabies, pyaemia) due to the specific toxic material locating 
in the cord. It may also be caused by cold, being continually wet and 
frozen, as in retrievers. 

Pathological Anatomy. — The inflamed pia mater appears thickened, 
infiltrated, and may be injected in some places and, as a rule, adherent to 
the vertebra, due to the organization of the exudation. It is covered 
on its upper surface by a serous, fibrinous, or purulent exudation. The 
arachnoid exudation is covered by a milky, false membrane and greatly 
thickened. The dura mater is rarely involved, but when such is the case 
it becomes thickened and loosened and covered with a thin serum. The 
spine itself shows the inflammatory process either extended over large sur- 
faces or else confined to small centres. In the early part of the disease, 




Fig. 94. — Paralysis of the posterior extremities. 

the cord is slightly swollen; the gray substance is somewhat reddened, 
dark and soft. Later the cord becomes a yellowish-red, breaks down and 
undergoes white, yellow, or red degeneration. In the chronic course of 
the disease we see atrophy of the nerves as a conscc{uence of nuilforma- 
tions of the connective tissue. 

Clinical Symptoms. — As a rule the symptoms of alteration of the spinal 
cord appear gradually and become more intense as the disease progresses. 
Where the disease is due to violent traumatisms, producing a direct 
destruction or laceration of the nervous centres, or pressure, caused by 
hemorrhage and blood l)eing discharg(Ml and pressing upon the spine the 
symptoms are immediately seen or appear in a very short time. In all 
diseases of the spinal cord it is very inij)ortant to recognize the fact that 
consciousness is rarely affected. We will take up all these symptoms in 



INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 245 

the following description, which may be observed in affections of the 
spinal cord: 

Motor symptoms of paralysis are, as a rule, the first symptoms pre- 
sented. The patients have a dull heavy look, staggering gait, but not 
irregular (in this the condition differs from disease of the cerebellum). 
Finally, they begin to drag their hind legs after them (Fig. 94), the poste- 
rior extremities are invariably the parts paralyzed. When they are placed 
on their legs they stand with them spread apart, or they may simply drop 
sideways on their hind cjuarters. In rarer cases, not only the posterior ex- 
tremities but also the anterior are paralyzed, and it is evident that in 
cases of paralysis of all the members the spinal substance of the cervical 
region must be affected, while paralysis of the posterior extremities follows, 
no matter what part of the cord is affected. In these cases we always 
have the double-sided paralysis, and in very rare cases the paralysis may 
be more intense on one side than the other; but in such a case we can 
only suppose that in one-half of the spinal cord the disease is more ad- 
vanced than in the other. 

In the early stages of the disease there are slight, irregular twitchings 
of the extremities, rarely of any great consequence, and seldom leading 
to convulsions. There may be marked hypersesthesia and the animal 
gnawing continually at certain points of the body, muscular twitchings, 
drawing in of the hind legs toward the abdomen. There may also be a 
continual erection of the penis, and the evacuation of the urine and faeces 
may be interfered with on account of the convulsive contraction of the 
sphincter or paralysis of the detrusor urinae and muscles of the intestine. 
We also observe disturbances of sensitiveness either in the form of hy- 
persesthesia or of anaesthesia. The former is invariably observed in the 
early stages of the disease; the patients show intense pain, especially when 
touched, lifted, or pressed upon the spinal cord. (This they indicate by 
biting, howling, etc.) In the latter case they do not show the slightest 
reaction in the affected regions, even when subjected to serious irritations 
of the skin. It must be remembered, however, that symptoms similar 
to hyperaesthesia may also be present in rheumatism. 

In mild stages of this disease the sphincters, such as the bladder 
and rectum, appear slightly affected. In the more serious stage we ob- 
serve complete paralysis, loss of control of the sphincters, and frequently 
complete paralysis of the sphincter vesicae. More details will be found on 
this subject under Diseases of the Bladder. Such paralytic conditions of 
the bladder may occur in all diseases of the spine. There is difficulty in 
the passage of faecal matter, producing constipation, caused to a certain 
extent by the loss of abdominal pressure. Paralysis of the sphincter is 
evinced by a gaping rectum and the involuntary escape of faecal matter 
which accumulates in the lower bowel. Through want of active exercise, 



246 DISEASES OF THE NERVOUS SYSTEM 

the muscular system of paralyzed animals, especially the extremities, be- 
comes flabby, soft and atrophied. The temperature is reduced in the par- 
alyzed portion, the extremities being cold and anaemic. In cases 
where there is paralysis of the spinal cord caused by compression, and in 
cases of atrophy due to hemorrhage on the spinal cord, and also in certain 
luxations or fractures of the vertebrae, we practically see the same symp- 
toms. Paralysis of the extremities, particularly the posterior, may result 
from the following conditions: 

a. Paralysis of the spinal cord caused by compression may result 
from thickening of the membranes and pressure on the spine itself. It 
may also occur in some diseases of the vertebra?, for instance in exostosis, 
but both of these conditions are very rare. In such cases the symptoms 
come on very slowly and gradually increase in intensity. 

d. Apoplexy may occur, due to the presence of some blood escaping 
on the spine and causing pressure. In these cases the paralysis appears 
very suddenly, but may gradually disappear after some time. 

c. Luxations of the spinal column only happen in the vertebra of the 
neck, and cause a peculiar oblique position of the head, as if it were twisted 
to one side. This is due to displacement of the ligaments. At the 
same time there is present a series of what might be called " special symp- 
toms," which are not very pronounced in any of their characters. 

b. Fractures of the spine: These are generally recognized by some 
change in the position of the region in which they are located (bending 
inward, flattened depressions, and in rare instances slight distortions of 
the spinal cord), and also by the extensive sensitiveness to pressure in 
this location. In certain instances there may be an al^normal mobility of 
the part. Crepitation, as a rule, is absent. In fractures of the cervical 
vertebrae, we generally notice an ol^liciue position of the head. If the 
symptoms just described are absent, when an animal has had a severe fall 
on the spine, unless paralyzed, or remains without loss of consciousness, 
it is always doul)tful if there is a fracture of the vertebnp or a hemorrhage 
within the vertebral canal. In such cases we simply have to await develop- 
ments, or if paralysis docs not immediately follow the injury, but comes 
some time afterward, it is due to compression of the spine from a grad- 
ually increasing hemorrhage, ^^'e must I'emember, however, that a fall, 
shock, or blow upon the back, or ordinary irritations of the spinal sub- 
stance may occur, like a concussion of the brain, in which there is not the 
slightest alteration to be found in the spinal substance or its memliranes. 
In many cases we may expect a recovery as long as there are no myelitic 
complications. 

Chronic Inflammation of the Spinal Cord. — This condition follows as 
a sequence to the acute foi'm or it commences at the onset as a gradual 
progressive affection. It has been contended that overstimulation of the 



INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 247 

sexual organs is an exciting cause, but this is not admitted by all ob- 
servers. Chronic inflammation of the cord is indicated by disturbances of 
mobility, the animal is easily tired on very slight exertion, shows a want 
of coordination in walking, great difficulty in rising after lying down for 
some time, regular or irregular twitching of the muscles in the affected 
extremities, or complete paralysis of the hind quarters and in very rare 
instances of the anterior limbs, more or less disturbance of the sphincters, 
and gradual atrophy of the affiected muscles. The appetite is invariably 
good and there is no rise of temperature. 

Pachymeningitis spinalis ossificans, that peculiar disease indicated by 
a gradual ossification of the spinal membranes, is not at all uncommon in 




Fi3. 95. — ParalysLs of the cord. 



dogs of an advanced age. This disease consists of a gradual inflamma- 
tory process of the dura mater, in which that tissue gradually becomes 
filled with numerous irregular or massed collections of tolerably firm 
bony scales, situated on the ventral surface of the tissue, particularly 
in the region of the cervical and lumbar regions of the cord. The 
whole dura mater may become converted into a hard bony tube, and in 
exertion of the body the roots of the nerves may be torn from the spine. 
The ossific hardening of the dura may be present for a long time be- 
fore any actual clinical symptoms are present (Cadeac) and are gener- 
ally produced by laceration of the sensory nerve fibres, by violent or 
unusual movements, or movements in a certain direction of the spine. The 
voluntary movements of the animal are cautious, stiff, or stilty, either on 
walking about, lying down, getting up or climbing up stairs; the latter he 
may refuse to do, and on forcibly bending the spinal column the animal 



248 



DISEASES OF THE NERVOUS SYSTEM 



may evince pain. The back is turned or crooked to one side, the hind legs 
being carried forward under the abdomen (Fig. 95). Frec^uently the 
animal may cry out, howl or show great pain on certain movements or 
positions of the body, the same movement apparently he may have done 
a few moments before without showing the slightest pain. This condition 
is frequently mistaken for acute muscular rheumatism. In rare cases the 
animal carries the hind quarters in the air and balances the body on the 
anterior limbs (Fig. 90) , and gradually there is a great increase in the mus- 
cular development of pectoral and thoracic muscles; as a rule there is a 
tendency to retention of the fseces and urine, but there may also be invol- 
untary passage of urine and faeces. The appetite is generally impaired, 
the reflexes are impaired and the penis may either be erected or protruded 




Fig. 96. — Dog with pachymeningitis ossificans. Characteristic position of body in walking. 



beyond the prepuce. The disease may vary to a certain extent in inten- 
sity, but sooner or later the paralysis increases, either involving one leg 
more than another or the entire hind quarters are affected; gradually the 
sensibility decreases and the animals show entire loss of muscular power 
and pain in the affected parts. 

Therapeutic Treatment of the Diseases of the Spinal Cord. — In the 
early stages of the disease when fever, hypersesthesia, and convulsions 
give pronounced evidence of the disease, it is advisable to give anti- 
phlogistic treatment, consisting of cold compresses (ice bags) upon the 
spinal cord, and vigorous purgatives (calomel), saline purgatives, and 
lastly enemas. In cases where the paralytic symptoms predominate, 
we use irritants along the spinal column, such as painting with can- 
tharidal, collodion, or dilute croton oil, viz., oleum crotonis 0.5, ol. tere- 
binthin 15.0; this j^reparation is rubbed into the skin along the vertebral 



INFLAMMATION OF THE SPINAL CORD AND MEMBRANES 249 

column by means of a woolen cloth; blistering with biniodide of mer- 
cury or the use of the actual cautery, in the form of pin-point firing 
along the spine. Sometimes in mild cases use an inunction of mustard 
oil. If great pain is present use morphine, chloral hydrate, or sul- 
phonal. If we succeed in lessening the convulsions, or if the paralytic 
symptoms predominate, we must use stimulants such as strychnia and 
electricity. The first should be used internally in the form of tincture of 
nux vomica, from five to twelve drops, or subcutaneously in a strychnia 
solution; the latter method is better. We must remember that one daily 
injection is sufficient, and that a medical pause of from thirty-six to 
forty-eight hours ought to be made every four or five days in order to 
prevent the cumulative influence of this drug. 

TJ. Strychnia muriate, 0.005 

Aqua, 5.0 

Electricity is applied in the following method: after having pre- 
viously dampened the region with a concentrated saline solution one 
pole of the battery is placed on the spine and the other at the termination 
of the paralyzed limb. For instance, one is put on the foot and the 
other in the middle or side of the spine, gradually increasing the current. 
In such cases, besides administering a purgative and cleansing the bowels, 
we must also see that the bladder is emptied by means of a catheter. 
Electricity is also a useful agent in peripheral paralysis, which has been 
mentioned. The faradic current is preferable. Place one of the poles as 
close as possible to the point of central location of the affected nerves 
and gently run over the paralyzed muscles with the other pole. This 
treatment should be renewed every day for ten or fifteen minutes. 
Alcoholic frictions, such as spirits of camphor, tincture of arnica, bay rum, 
opodeldoc liniment, are to be recommended when used in connection 
with true massage (pinching, friction, and massage of the paralyzed 
muscle in its proper direction). Warm baths are said to be useful. As 
a means to promote reabsorption, administer iodide of potassium 0.09 
internally. Subcutaneous injections of eserine and pilocarpine, or pilo- 
carpine alone may be used if it is suspected that a large amount of fluid 
exudate is on the cord. On account of the toxic properties of these 
drugs, great care must be used in their administration. The bladder 
must also be emptied by either pressure on the abdominal wall or by 
catheterization, and the rectum emptied by means of clysters and the 
food must be such as will digest easily. 

In cases of ossific pachymeningitis, Cadeac and others recommend 
friction with strong liniments, actual cautery, or setons, along the spinal 
column as well as painting the spine with tincture of iodine, and also 
the internal administration of iodide of potassium, salicylate of soda, 



250 DISEASES OF THE XERVOUS SYSTEM 

salol, salophen, antipyrin, etc. As a tonic strychnia should be used in 
combination with arsenic or quinine and lastly the galvanic current 
has produced good results in some cases. 

I^. Strychnine muriate, 0.005 

Aqua distil., 5.0 

M. F. 
Sig. — As a hypodermic of 1.0 to be injected once daily. 

I^. Physostigmin sulph., 0.05 

Pilocarpin muriate, 0.1 

Aqua distil.. 20.0 

M. F. 

Sig. — 1.0 injected every three days. 

Certain Diseases of the Spinal Cord. 

The following diseases are caused directly and indirectly by some 
change or morbid condition of the spinal cord. 

Compression of the Spinal Cord. Myelitis by Compression. — By 
this name is understood a slow compression of the cord; due to a patho- 
logical process which alters and straightens the vertebral canal; this may 
be due to thickening of the membranes as in pachymeningitis spinalis 
ossificans, already mentioned, from tumors of the vertebra or meninges, 
exostoses or inflammations of the intervertebral discs. As to tumors in 
the vertebral column very little is known in dogs; sarcoma; cholestea- 
toma, and melanoma have been found by a number of observers, ex- 
ostoses projecting into the vertebral column may be caused by periostitis 
of the intervertebral discs of the lumbar region; this is frequently seen in 
old clogs. Inflammation of the intervertebral discs is caused by violent 
and continued jumping, particularly in performing dogs. These forma- 
tions are at first soft formations, which later become hard and project 
into the vertebra and in advanced cases project from one vertebra to 
another in spine-like processes. While the dorsal lumbar vertebrae are 
the most frequently afTected, it has also been observed in the cervical 
portion of the column. 

Clinical Symptoms. — The symptoms are those we would find as a re- 
sult of compression of the spinal cord and the origin of the nerves. The 
animal at intervals shows pain, moaning, barking or howling, stiff cautious 
movements, and evidence of partial or complete paralysis of certain mus- 
cles of the body, also motive disturbance of the bladder and rectum, erec- 
tion of the penis. Certain valvular diseases of the heart, causing a venous 
hypersemia, arterial anaemia of the medulla spinalis or thrombus of the 
femoral arteries produce symptoms similar to this disease, and it is well 
to carefully examine the heart in a case of spinal paralysis. The treat- 
ment is useless, as it is incurable. 



CERTAIX DISEASES OF THE SPINAL CORD 251 

Hemorrhage of the Spinal Cord. Apoplexia Spinalis. — Hemorrhage 
maj' occur between the membranes of the cord as well as in the cord itself, 
and in most instances is due to traumatic influences. One observer found 
in a dog that fell while running very fast a profuse subdural hemorrhage 
extending from the second cervical vertebra to the sacrum; there was 
also more or less hemorrhage in the central sections of the spine of the 
cervical and lumbar regions; the animal lived three days. 

The clinical symptoms either as convulsive twitching or paralysis 
appear, but may disappear very quickly if the blood is reabsorbetl, or 
the animal dies in a short time. In some cases partial or complete paraly- 
sis may follow as a result of the hemorrhage. 

The treatment consists in absolute rest, cold compresses to the spine, 
and the internal administration of iodide of potassium. Much better 
results are to he expected if the case is treated at its onset. 

Fractures, Luxations, Diastasis of the Vertebral Column. — Fracture 
of the vertebral column is caused by blows, falls, being run over by a 
wagon or automobile, and is detected by deformity or curve of the 
vertebral colunni, by pain on pressure and want of mobility of the spine. 
It is extremely difhcult in fracture of the spine to get actual crepitation. 
In fracture of the lumbar vertebra and of the sacrum, the place of fracture 
may sometimes be felt by introducing the finger into the rectum and 
feeling along the column. Fracture of the cervical vertebra invariably 
causes death in a very short time, that is if the arch of the vertebra is 
broken, but frecjuent recoveries are made where the fracture is of the 
transverse or oblique processes. If the latter are injured, the}- heal 
leaving a torsion or crookedness (torticollis). Fractures of the lumbar 
or sacral region, while not necessarily fatal, cause such helplessness and 
misery that the animal should be mercifully destroyed. 

Luxations (diastasis) of the spine without fracture are extremely 
rare, although we may occasionally find distortion or sprain of the cord 
with compression and tearing of the vertebral discs. In such cases the 
prominent symptoms are great rigidity of the vertebral column, stilted 
gait, local pain on pressure. The symptoms may disappear quickly or 
they may increase rapidly and develop into acute inflammation of the 
intervertebral discs (see page 250). Rest, Priessnitz compress on the 
lumbar region, later on local friction or massage of the afTected part. 

Concussion of the Spinal Cord. Commotis Medullae SpinaUs. — This 
is apt to occur from the same causes as produce commotis cerebri. This 
condition may be present and the animal be completely paralyzed and no 
change is found in the vertebral column. Frequentl}'' animals affected 
in this way make a very speedy recovery and it is not wise in doubtful 
cases to destroy the animal too hastily. 

Tabes Dorsalis. — This disease is a degeneration and atrophy of the 



252 DISEASES OF THE NERVOUS SYSTEM 

spinal cord, found as a result of syphilis in man. Friedberger and Froh- 
ncr thought they found it in the spinal cord of several dogs that had 
ataxia. The writer is of the opinion that it does not occur in the canine 
race, for among the thousands of dogs he has posted he has yet to see a 
case that he could consider was affected with the disease. 

Syringomyelia. — Lienaux describes one case of this peculiar disease, 
which is characterized by fissures and hollows in the cord. The disease 
developes very slowly; at the onset we find disturbances of mobility, 
weakness, paralysis of the posterior extremities, the animal has a peculiar 
hyena-like walk, urination and defecation remain normal, the appetite 
is good, sensation in the posterior extremities and later in the anterior 
extremities is gradually lost. On examining the spine, it is found to 
contain a number of cavities filled with clear serum; these cavities are in 
the gray matter, particularly in the posterior section, and in the com- 
missures of the anterior section of the cervical and dorsal regions. 

Paralysis of the Nerves. 

Paralyzed nerves may be due to some morbid process of the central 
nervous system, also to traumatisms, such as tearing or bruising of the 
nerves, or compressing the nerves by neoformations, hemorrhagic ex- 
travasations, exudates, enlarged lymphatic glands, swollen tissues, dis- 
located bones, etc. Inflammation and subsequent paralysis of the nerves 
may also be caused by cold (neuritis rheumatica), by paralysis or paresis, 
causing an atrophy of a muscle or group of muscles, and in the case of a 
mixed nerve going to a certain part, to have disorder of sensation, neu- 
ralgia, or anaesthesia. Convulsions are extremely rare and if they appear 
would indicate some central pathological process. 

We will take up particularly paralysis of the peripheric nerves. 

Paralysis of the Facial Nerve. — The most frequent cause of this 
condition is disease of the middle ear, caries of the petrous bone, neo- 
formations or inflammatory processes of the region of the parotids, 
traumatisms at the place where the nerve goes around the maxillary 
or the periphery of the nerve, cold — this latter cause, however is rare; 
also to pathological processes in the skull and base of the brain, or it may 
follow as a result of distemper. Generally the affection is unilateral 
(monoplegia facialis). A bilateral paralysis (diplegia facialis) is in- 
variably of central origin. 

In the case shown in the accompanying figure (Fig. 97) the symptoms 
were as follows: The end of the nose, the superior and inferior lip and 
the chin turned to the right side, the left eye was wide open and could 
not be closed, the left cheek was relaxed and sunken, the left ear hung 
downward and backward and could not be lifted by the animal, as was 



PARALYSIS OF THE NERVES 



253 



the right ear when the animal was called, or his attention attracted, the 
animal ate with difficulty but drank water normally. The cause of this 
condition was not defined. The animal was treated with the faradic 
current and in ten days was discharged cured. A number of observers 
report favorable recoveries. 

Motor Paralysis of the Trigeminus. Paralysis of the Masseter Muscle. 
Submaxillary Paralysis. — This form of paralysis is a common symptom 
of rabies; therefore all cases of this kind must be regarded with suspicion. 

It is observed following distemper, in hemorrhagic gastro-enteritis, 
and also as a result of certain forms of bacterial poisons, and also in some 







Fig. 97. — Facial paralysis of the left side. 



affections of the brain, morbid processes at the base of the cranium, such 
as hemorrhages, neoformations, gliosarcoma. It would appear at times 
as if the motor nuclei of the trigeminus are sciueezed by the muscles of mas- 
tication, for instance when great effort is made to bite and crush partic- 
ularly large bones. Rheumatic influences are also said to cause it. 

The chief symptoms are as follows: the mouth remains open, the in- 
ferior maxillary hanging limp; if paralysis continues for any length of 
time, the muscles atrophy. Recovery is rare. 

Paralysis of the Radial Nerve. — This is very rare and occurs as a re- 
sult of traumatism or a sequela to distemper or cold. As the radial nerve 
controls the muscles of extension of the leg, the anconeus muscle and 
extensor muscles of the forearm the animal is unable to extend the leg but 



254 DISEASES OF THE NERVOUS SYSTEM 

keeps it bent with the foot turned back and steps on the front of the foot 
in walking as it is dragged along, the muscles of the leg become atrophied, 
and the animal stumbles and staggers when walking. Partial paralysis 
may result from tumors or fractures of the scapula or to injuries to the 
region of the shoulder, particularly when an animal going at great speed 
strikes the shoulder against some hard object. Recoveries from this 
condition are quite common. 

Paralysis of the Ischiadicus. — This is rare and occurs as a result of 
blows, falls, as a result of distemper, and from unknow^n causes; there may 
also be observed a cross paralysis of the hind quarters and also one ante- 
rior limb. The hind leg is dragged and the skin worn off the dorsal face of 
the toes, but the animal can sit on the affected leg if it is brought into 
position. One observer has seen paresis of the peroneus in a hunting dog; 
in walking about every ten or twelve steps the animal made an extra long 
step and when the animal sat down the hind leg was turned backward and 
upwards. One case was caused by the animal being injured while creeping 
under a Ijed. 

Paralysis of the Cruralis Nerve. Paralysis of the Femoralis and Quad- 
riceps. — In this case the animal cannot step with the hind leg as the 
articulations flex abnormally; this condition is quickly followed by 
atrophy of the quadriceps. One observer could define no cause for the 
condition, and the animal made a good recovery in five weeks. 

Paralysis of the Obturator Nerve. — One case of this kind was described 
by .Schimmel in which a ladder fell on the animal. When the animal 
walked, the one leg was curved and at each step it was thrown outw^ard 
and forward and there was great atrophy of the adductor muscles. Reg- 
ular exercise led to a gradual improvement of the condition. 

Prognosis and Treatment of Paralysis of the Nerves. — The prognosis 
can never be regarded as favorable; it is true certain cases already men- 
tioned have recovered, but the majority of cases are always to be regarded 
as doubtful, particularly when their peripheric nerves have undergone 
some pathological change. 

The first thing to endeavor to do is to try and remove the cause of 
the irritation of the nerve; if this is due to the presence of a tumor, ex- 
travasation of blood or serum, cicatricial tissvie or dislocation of an 
articulation we endeavor to remove the exciting cause or lessen the in- 
flammatory or purulent conditions in the neighborhood of the nerve. 
If a rheumatoid cause is suspected, administer salicylic acid, salol, aspirin, 
or antipyrin. Massage may also be used combined with a certain amount 
of well regulated exercise. The electric current may be eniployed, the 
negative electrode being applied as near the root of the nerves as pos- 
sible, and the positive pole is moved along the branches of the nerve and 
the affected muscles. 



, EPILEPSY 255 

Polyneuritis Infectiosa. — Under this name Sellman describes a case 
of an adult terrier which is similar to primary multiple neuritis in man. 
The posterior extremities of the animal were completely paralyzed, and 
their temperature was slightly lower than the rest of the body, the spinal 
reflexes were gone, with slight opisthotonos, and hyperesthesia in various 
parts of the body, the heart being weak. As the disease advanced, a herpes 
eruption appeared, and nodules appeared along the course of the following 
nerves: tibialis, ischiadicus, peroneus and cruralis. The animal was given 
warm baths, later cold showers and massage, and gradually the symptoms 
disappeared and in three months the dog had entirely recovered. 

Facial Twitchings. Facial Spasms. — Muscular twitchings occur in 
the region of the facialis, as a sequence to distemper and also in chorea; 
and occasionally they occur in meningitis and certain forms of en- 
cephalitis; one case described by Cadiot, Gilbert and Rogers was named 
"Tic de la face," where the twitching followed distemper, and was cured 
by the removal of the bulbus (original nuclei) of the facialis. There is no 
relationship between facial twitchings of the dog and the *' tic convulsiva " 
of man. 

Epilepsy. 

(Falling Sickness.) 

Epilepsy is a disease of the brain, which is not rare in the dog. It is 
chronic in its course, and appears to be hereditary. Its chief symptoms 
are irregular attacks of unconsciousness and in older cases accompanied by 
acute characteristic muscular convulsions. True idiopathic epilepsy, gen- 
erally incurable, is frequently confounded with the so-called symptomati- 
cal epilepsy, that is the epileptiform convulsions which appear as a 
symptom of grave pathological conditions of the brain, or some other 
change in the skull such as reflex irritation of the peripheral nerves. 

Etiology and Pathological Anatomy. — The causes of epilepsy are un- 
known, but at the same time there is no doubt that certain diseases of the 
brain and its membranes, especially chronic diseases, have recently been 
demonstrated by Otto to be hereditary. This disease may appear at any 
time during life, and even in advanced age; great excitement and fear 
seem to play some part in its development. Wasting diseases very fre- 
quently cause epileptiform seizures which are similar to true epilepsy, and 
we may also observe in some cases a reflex epilepsy which does not re- 
semble true epilepsy in any way except in some general symptoms. These 
will happen after traumatic lesions of the peripheral nerves, in animals 
harboring intestinal parasites, and in animals having poisonous sub- 
stances in the intestines. We may also observe epileptiform convulsions 
in distemper. 



256 DISEASES OF THE NERVOUS SYSTEM 

In true epilepsy there are no anatomical alterations to be found in 
the brain itself. Whenever they are found they cause epileptiform con- 
vulsions. It is therefore certain that in a case of epilepsy it is only due to 
some temporary irritating condition, and that the membranes of the 
brain are the starting-point of the irritation. 

The experiments which have been made upon dogs in connection with 
this disease by Ferrier, Eulenberg, Landois, and others, are very interest- 
ing. They found that with great irritation of the motor regions of the 
large brain (the cerebrum) a complete attack could be produced. This 
begins with twitching of the muscles which belong to that centre. It 
then becomes extended over the corresponding group of muscles on the 
other side, producing shocks and twitching of the whole muscular system 
of the body from tonic and, later, clonic convulsions. The convulsions 
extend from centre to centre, and they never miss any region, but run 
consecutively from one to the other. If the chief centre is cut out, the 
convulsions will not be present in that region during the epileptiform 
attacks. Irritation of the subcortical white substance of the brain also 
causes epilepsy. This begins, however, in the muscles of the same side. 
Bromide of soduim administered for some time has been found very 
valuable in preventing epilepsy caused by membranous irritation. 

From the above experiments it can be readily understood that the 
cortex of the cerebrum is the original centre of epileptic attacks. It is 
hard to explain, however, the actual cause of this irritation. Epilepsy 
can hardly be caused by overstimulation or feeding, for, as a rule, the 
largest number of true epileptic subjects are weak, delicate, and anaemic; 
but at the same time we often see vigorous, well-fed dogs of all ages suffer- 
ing from this disease. There are many cases in anaemic animals which, 
under treatment, gradually improve, at the same time the epileptiform 
attacks becoming less and less as the animal improves. It is doubtful if 
these cases can 1)0 called true epilepsy. 

Clinical Symptoms and Course of the Disease. — In acute attacks of 
epilepsy the symptoms begin suddenly, or they may start with slight 
premonitory symptoms, or we may see both forms alternately in dif- 
ferent seasons in the same individual. In the early stages the animals 
run in a circle, are restless, have a staring look out of their eyes, or remain 
standing with outstretched legs and shake their heads from side to side. 
We have seen clonic convulsions followed by loss of consciousness, and in 
some cases a rapid change into tonic convulsions. The muscles of masti- 
cation are especially affected, the jaws are clamped, the saliva turned to 
froth, the tongue may be bitten, and the l)lood turns the saliva red. Single 
muscle contractions follow one another with astonishing rapidity, so 
that the saliva which lies in the mouth is turned into foam. The convul- 
sions which are now tonic extend over the whole muscular system. The 



EPILEPSY 257 

body and neck are drawn backward or sideways; thei'e is twitching of the 
ears, the legs are stretched ; the respirations seem to cease. This tonic form 
of convulsion lasts but a short time. A few seconds after its appearance it 
has altered into clonic cramps of the muscles, especially noticed in the legs, 
which are frequently twitched, and the legs may move rapidly as if the 
animal was running. After a few minutes these twitchings stop; the ani- 
mal lies on the ground for some time; it finally rises and recovers very 
quickly; some animals, however, are dazed and everything seems strange, 
they are afraid of their owner, or do not recognize him. They creep 
around and hide in dark corners, and after the attack has passed off they 
are greatly fatigued, frequently sleeping several hours at a time, and in rare 
instances show a tendency to bite. The pulse and temperature during 
an attack of this kind present no alteration of any consequence. The 
mucous membranes of the head are reddened and congested, sometimes 
cyanotic. This is noticed at the termination of an attack, and is probably 
due to the interruption of respiration, and the slight respiratory move- 
ments, and frequently an involuntary passing of faeces and urine is noted 
during these convulsions. 

There are also certain forms in which the animal is restless, running 
from side to side, or having fainting spells (dropping on one side), slight 
muscular twitchings of the head or extremities, and occasionally, in mild 
attacks, a very slight twitching of the jaw, rolling or winking of the eyes. 
The duration of these attacks varies, as a rule not lasting very long, 
generally only a few minutes, although severe attacks have been known to 
last for five or six hours. Their frequency is very uncertain; some animals 
have had several attacks daily, while in others they have appeared at 
intervals of months. A peculiar feature of some cases of true epilepsy 
■was the frequent attacks on the slightest excitement. In the interval 
between the attacks, the animal seems perfectly normal, and only in very 
rare instances are the animals subject to these attacks dull or stupid. 
This disease is rarely fatal but an animal may either injure itself during an 
attack or a very severe attack may cause death by suppression of respira- 
tion or paralysis of the heart. The differential diagnosis between this 
condition and a simple fit, or convulsion, is easily made on getting an 
exact history of the case. 

In connection with this disease we must devote a few words toepilepti- 
form convulsions in young animals. We very often see epilepsy in weak, 
debilitated animals which are backward or poorly fed, and which have 
rickets; they also occur as a consequence of reflex irritability during the 
course of catarrhal diseases of the digestive tract and of the nasal cavi- 
ties. We also notice them after the absorption of large quantities of 
fermenting, indigestible food, in constipation, from the presence of pen- 
tastoma, and in cases of intestinal parasites, at the time of teething, 
17 



258 DISEASES OF THE NERVOUS SYSTEM 

in acute affections of the car, or parasites of that organ, and also as a conse- 
quence of great physical excitement. We often see spontaneous convul- 
sions; these are very similar to epilepsy, and are probably of reflex origin. 
In some of these cases we may have to deal with true epilepsy, but, as a 
rule, they may be ascribed to an undeveloped form of distemper, or to 
some poisons, or uraemia. In some cases it may be due to some brain 
affection, such as congestion of the membranes. It cannot be denied, 
however, that there are a great number of convulsive attacks for which 
the cause remains obscure. 

We may therefore conclude that we can only obtain an approxima- 
tive insight into these convulsions by the symptoms which are presented. 
Frec^uent occurrence of eclamptic attacks with a short interval between 
must be considered as a very serious symptom. 

Therapeutics. — No agent seems to have any decided effect upon 
epilepsy. The writer has tried a number of remedies, one after another, 
without result. Bromide of sodium seems to be the best (this is prefer- 
able to bromide of potassium, as it has no detrimental effect upon the 
appetite) , provided it is given in substantial doses and kept up for months. 
With this drug it is always possible to prolong the interval between 
attacks; they are also shortened and relatively less serious. Sometimes 
bromide of potash, soda, and ammonia are administered together in the 
proportion of 2-2-1 and seem to have a more desirable effect. Other 
agents such as oxide of zinc, arsenic, nitrate of silver, belladonna, hyoscya- 
mus, valerian, bromohydrate, cold water, and electricity are now rarely 
used. 

The therapeutic treatment during the convulsions consists in the use 
of applications of cold water to the head; prevent the animal from injuring 
itself. If one attack follows closely after another, use inhalations of 
chloroform, or clysters of chloral hydrate; and give internally large doses 
of bromide of sodium, morphia, or similiar sedative agents, and endeavor 
to keep the animal as quiet as possible after the attack. 

J\. Bromide of sodium, 15.0 

Afiua, 150.0 

S. — One tablespoouful three times daily. 

In epileptiform convulsions in young animals we endeavor to remove 
the cause and administer the salts of bromine, chloral hydrate, sulphonal 
(0.5 to 4.0), hedonal (1.0 to 4.0), hypnon (0.5 to 2.0), veronal (0.5 to 1.5). 

I^. Chloral hydrate, 5.0 

Mucilage acacia, 

Syr. aurcnti cort., aa, 20.0 

Aqua distillata, 100.0 

F. M. 
Sig. — A tablcspoonful every two hours. 



CHOREA 259 

I>. Hedonal, 12.0 

F. M. capsule ct divid. No. 12. 
Sig. — One daily. 

Chorea. 

(St. Vitus's Dance.) 

Etiology. — Chorea we no longer consider an independent disease, but 
the result of a number of complications which should really be classed 
under other heads; for instance, in young dogs that are insufficiently fed, 
or from obscure cerebral diseases. It is also seen in myelitis, and some 
cases of symptomatic chorea, but in the majority of cases it must be 
attributed to some pathological change as a result of distemper. 

In true chorea of man we do not see any pathological alterations of 
the lirain, and in the few cases which the writer had to consider as true 
chorea on account of the anaemia, absence of any symptoms of distemper, 
or other diseases of the brain and spine. The toxic effect of bacteria 
present in the intestines has been advanced as a possible cause by some, 
but there is little probability that the convulsions were restricted to cer- 
tain special muscular groups, and not, as in human chorea, to irregular 
regions — that is to say, in the various muscular centres of the body. In 
some of these cases the animals were destroyed, and their post-mortems 
gave an entirely negative result, there being no apparent pathological 
change in the central nervous system. As a rule, the affected animals are 
in an ansemic condition and show all the effects of bad nutrition, and, 
after some ol)servation, we are convinced that with improvement in the 
general system the choreic symptoms become very much lessened. 
Joest in the Zeitschrift fur Tiermedizin, 1904, gives a detailed account of 
the disease. 

Clinical Symptoms and Course. — We define this disease as a persistent 
clonic convulsion of some muscular group in certain parts of the body. 
For instance, we see shaking of the head, twitching movements with one 
or two legs, regular, and also an automatic opening and closing of the 
mouth, irregular movements of the tongue, and an undulating action or 
movement of the whole body. If the patients are left to themselves, the 
twitching action is generally less marked, and under physical excitement 
becomes much more aggravated; and are also increasetl when eating, and 
during catarrhal conditions of the air-passages, or the intestines, stomach, 
etc. The clonic movements lessen during sleep and under the influence 
of ether, chloroform, and bromo-ether, but morphia and chloral have 
little or no influence upon them. The course of this disease is slow, and 
may extend for months and years; but, as a rule, the symptoms lessen 



260 DISEASES OF THE NERVOUS SYSTEM 

and in very rare instances may disappear entirely. A fatal termination 
is only to l)c feared when complications arise. 

Therapeutics. — The author has tried all the various agents recom- 
mended in this disease, but without any decided results. Arsenic, either 
in the form of Donovan's or Fowler's solution, or alternated with some 
preparation of iron, has given the best results. Schimmel recommends 
cacodylate, but these di'ugs must be given for some time, and it is only 
after prolonged administration of salines that any favoral^le result is ob- 
served. The writer thinks that more benefit is derived from quiet and 
nutritive diet, particularly meat, than anything else. 

Antipyrine, which is used in man, is of not much service in the dog. 
Electricity in one case produced decided lessening of the symptoms after 
regular application of slight galvanic stimulation of the head and along 
the vertebral column. 

Eclampsia. 

Eclampsia, which is not a very good definition, is a tonic-clonic con- 
vulsive spasm which is olxserved in bitches, and, as a rule, during the 
attacks the animal is perfectly conscious. 

Etiology. — The causes of this disease are very little known. Accord- 
ing to Hertwig it ma}' be caused by cold, stagnation of the milk in the 
udder, taking away the young too soon, and sometimes by worry. In 
two-thirds of the cases of true eclampsia all the young are still with the 
mother, and invariably we find the animals attacked to be excellent 
mothers, and the litters are generally strong, and healthy, and lay on 
flesh very quickly while the mother loses it. The onset of the disease is 
generally seen at the end of the second or third week, but the animal may 
be dull and not right for several days before the acute symptoms show 
themselves. In some cases observed, the disease developed after either 
one or more pups had been taken away from the mother. In the onset 
of the disease the mammary glands contain much milk, and the bitches 
most frequently attacked are small, delicate (house dogs and pet animals), 
and, as a rule, have a light coat. Friedberger and Frohner are of the 
opinion that the disease may originate from anaemia of the spinal cord or, 
in a reflex way, from the mammary glands and uterus, as they found 
anaemia of the papilla of tlu^ nerve by making an examination of the retina 
with the ophthalmoscope. Hutyra and Marek state it may also be pro- 
duced by the direct action of toxines on the sexual organism or on the 
motor cells of the antei-ior horns of the spinal cord, and other observers 
think that there is a similarity between this condition and puerperal fever 
of the cow. With this last theory the writer is inclined to agree. Accord- 
ing to the statements of several authors, severe anatomical disturbances 



ECLAMPSIA 261 

of the brain may be caused directly from the mammary ghmds. Fried- 
berger has observed two bitches that had echimpsia without having 
puppies. 

Clinical Symptoms. — The disease may appear in from forty-eight 
hours to thirty days after whelping; very rarely later than this time; in 
the majority of cases appearing at or about four weeks. In one case of 
Friedberger's fifty days elapsed. It comes on suddenly without any 
marked symptoms. The aninuils become restless and anxious; they have 
a staring expression of the eye, short, rapid respiration, reddened mucous 
membranes; they show no pain on pressure on the walls of the chest, neck, 
or abdomen. After a short time (about a quarter of an hour after the 
appearance of increased respiration) they become paralyzed, are no longer 
able to stand on their feet, and remain for some time with their legs 
stretched from them. A slight increase of temperature has been observed 
in several instances at the onset of the disease. The dog lies on her side 
with her legs firm and tense; the muscles of the body hard and quivering 
to the touch; the joints are stiff and hard to bend; and at intervals we see 
clonic convulsions of all the muscles, especially those of the extremities, 
and the respiratory muscles are especially involved. The respirations 
become more rapid as a consequence of this, and finally the mouth is opened 
and the tongue protrudes, while the animal breathes with great difficulty. 
The pulse is small, firm, and sometimes irregular, and always cpiick; the 
e3'es are staring and protruded, and there is an anxious look in the face. 
All the visible mucous membranes are cyanosed. The saliva which ac- 
cumulates in the mouth is either swallowed convulsively at certain in- 
tervals, or, as is generally the case, it dribbles out of the corners of the 
mouth. As a rule, consciousness is not disturbed. The pupils are normal 
in size; reflex action is present. The animal seems to notice external ob- 
jects or impressions, such as calling the patient, or noticing one it knows 
coming into the room. The appetite is lost; the normal discharges are en- 
tirely suppressed; although the urine and fseces may be involuntarily 
voided during the attack; the urine, after such an attack, gives an album- 
inous reaction. The attack may last for twenty-four hours, but generally 
varies a little in intensity. If the attack is very acute, the animal falls 
into a deep comatose condition and dies in about forty-eight hours after 
the onset of the disease from apoplexy and paralysis, or the cases 
commence to recover, regain consciousness, and frec^uently make good 
recoveries. 

Therapeutics. — Taken in time and treated energetically the animal 
invariably makes a good recovery. The first thing to do is to remove the 
puppies, and either feed them artificially or get a foster mother for them. 
Any of the narcotics can be used, and, as a rule, produce good results. 
Give morphia, 0.002 to 0. 005 gm. of the muriate, diluted with water. 



262 DISEASES OF THE NERVOUS SYSTEM 

As a rule, a few minutes aftei- the hypodermatic is administered the animal 
becomes quiet and rests easily. Inhalations of chloroform, chloral hydrate, 
bromide of potassium, etc., are also recommended. Warm baths and 
friction produce relaxation of the tense muscles; the ''cold pack" is also 
particularly useful; take a bed sheet or some such large piece of muslin, 
saturate it with cold water, wring it out thoroughly and wrap the animal 
up in it, enclosing the whole body, of course, letting the head free, allow 
the animal to lie in this for two or three hours. Valerianate of zinc in 05. 
gm. dose evei'y two hours. Urethane 5 to 20.0. Hypnon 0.25. 

Divers Diseases of the Nerves. 

Diseases of the nerves in which there is no anatomical change. 

Catalepsy. — Catalepsy, or "cataleptic rigidity," is a rare disease in 
which there is a peculiar rigidity of the muscles, and the animals may l)e 
placed in certain positions and remain perfectly rigid. Consciousness and 
sensitiveness seem to be suppressed entirely. Such an attack lasts for hours 
and recurs daily, this condition lasting for weeks. The rigidity may start in 
the muscles that are in action at the time the animal is seized with the 
attack, and rapidly extend to all the muscles of the body, until the animal 
remains fixed like a statue, and may finally die of starvation, being unable 
to eat or drink. In many cases they finally relapse and die in a short 
time, or they have been known to die in six or seven days, or the condition 
was followed by general muscular weakness, in which the muscular walls of 
the bladder and intestinal tract were also involved. There is invariably 
subnormal temperature and coma. If this is really a disease, or merely a 
symptom of some br-ain complication, the writer has not been able to 
positively determine. 

Hertwig mentions as causes of catalepsy, cold, fright, overloading the 
stomach with indigestible food, and metastases in various diseases. 
Frohner considers this disease as a purely functional neurosis of the brain 
and spine; he could not find any definite alterations in the central organs, 
in catalepsy, but he found occasionally certain secondary alterations in 
the muscles; namely, hemorrhages, dark venous swellings, and fatty 
degeneration of the muscles, also degeneration of the fibres of the heart. 

No practical thcrapevitic treatment is known. Sedatives such as bro- 
mide of potassium and morphine, electricity and cold douches, are used as 
a means of restoring the disturbed reflex irritability of the nervous system. 

Psychosis. — It is a question whether psychological disturbances can 
occur in the dog which has not intellectual elements of the cerebrum 
possessed by man, but it is reasonably certain this question can be an- 
swered in the negative. It is evidently some disturbance in the sphere of 
the will. In one case of a dog ten years old, the muscles affected were the 
limbs and those of mastication. If the animal had a portion of food in his 



DIVERS DISEASES OF THE NERVES 203 

month and an attack came on, he couhl not masticate it, but if it was small 
he would swallow it. The attack lasted about a minute and during that 
time the animal kept his eyes half closed, and the pupils remained normal, 
as was sensation and consciousness. The attack could be produced if the 
animal was struck on the lumbar region. Gradually the attacks became 
more frequent, until the animal lost power of the limbs, became emaciated 
and was finally destroyed. Careful microscopical examination of the 
cerebrum failed to find any change from normal. 

Convulsions of the Diaphragm, Convulsive Hiccough. — A convulsion 
of the diaphragm, similar to hiccough in man, may be caused by a central 
or peripheral irritation of the phrenic nerve, or by reflex irritation from 
the digestive tract. It is rarely seen in the dog; in one case the animal had 
catarrh of the stomach, and the contractions of the diaphragm were the 
same in number as the heart beats, certain muscles of the head, neck, and 
extremities were also affected. The treatment consisted in the sub- 
cutaneous administration 0.01 of morphia, if the convulsion continues 
over any length of time, but as a rule, the attack lasts only from fifteen 
to thirty minutes. 

Basedow's Disease. — A disease similar to that found in man, has 
been observed several times in the dog. The three following symptoms 
are characteristic: Exopthalmus (staring or bull's eye), tachycardia 
(palpitation and acceleration of the pulse) and struma (enlargement of 
the thyroid gland, with an altered secretion of that organ). It must be 
regarded as a general neurosis. In an animal not quite a year old, the 
eyes protruded from the orbit, movement of the eyelid (lowering and eleva- 
tion) was absent; the patient was restless, moving from place to place, the 
pulsations were 130 and the respirations 30 to 35. The pulsations of the 
heart could be easily felt through the thorax. The appetite was irregular. 
The animal had quite a large, goitre. After being treated eight days the 
animal was destroyed. The brain was anaemic and the thyroid gland 
was greatly increased in volume and there were three secondary glands, 
and the right ventricle of the heart was greatly dilated. 

Treatment of this disease, which is generally chronic, consists in rest, 
the animal must be kept aw^ay from any excitement given food of a nour- 
ishing and substantial kind, and must be easily digestible. Administer 
iodide of potassium, bromide of potassium or iodide of sodium. In one 
case in an old pug dog, the animal made a good recovery after four months 
treatment. Iodine in the form of tincture of iodine by inunction, has 
given good results in some cases. Iron preparations. Fowler's solution, 
thryoid serum or rodagen, both prepaired in animals that have had the 
cultivated serums of the thyroid gland, injected intravenously. If this 
method of treatment does not produce results either remove the enlarged 
thyroid (struma) or ligate the thyroid arteries. 



264 DISEASES OF THE NERVOUS SYSTEM 

Cachexia Strumipriva. — When the thyroid gland is removed, there 
appear certain pathological phenomena that are the opposite to Basedow's 
disease. In two or three days after removal of the gland, sometimes a 
later period, the extremities become stiff, clonic muscular twitching and 
convulsive movements of the muscles of mastication are seen with trem- 
bling, dyspnoea, acceleration of the heart, stupor, albumen in the urine, 
emaciation and death in al)out a month. In cases where only one-half 
of the gland was removed, there is no systemic disturbance, and the same 
occurs if there should be secondary thyroid glands which perform the func- 
tions of the extirpated gland. It is possible to prevent a fatal termina- 
tion by injecting the animal with thyroid preparations, or administering 
the preparation internally. 

Bronchocele, Hypertrophy of the Thyroid Gland, Goitre, Struma. 

As Morbus basedowii and Cachexia strumipriva belong to the group 
of true diseases of the nerves, and Goitre has so many characteristics in 
common with these diseases, it, will be classed with them. Goitre is a 
chronic hypertrophy of the thyroid gland. It may either be a simple hy- 
perplasia of the gland (struma simplex, struma parenchymatosa, struma 
f ollicularis) or it may be more or less of a cystoid degeneration with the 
formation of cavernous cysts, filled with gelatinous contents (struma 
cystica) or it may be of a fibrous character, united by connective tissue 
(struma fibrosa) , or an enlargement of the veins (struma vasculosa, struma 
varicosa) or finally we may have a carcinomatous or even sarcomatous de- 
generation of the gland (struma maligna). One observer found ossifica- 
tion of the gland (struma ossea). In young dogs when the first named 
condition, simple hyperplasia, is found to be soft, it is termed struma 
mollis, and it is said to be congenital, while in older dogs we more fre- 
Cjuently find the hard fibrous goitre and the struma carcinomata. In 
Switzerland 30 to 40 per cent, of all dogs over middle age are affected 
with goitre, and generally of the cancerous type. Goitrous degeneration 
generally involves the whole gland, but in fibrous or the malignant types 
■\ve frequently find only one-half is affected, or may be unequally distributed 
over both halves of the gland. Malignant forms frequently involve not 
only the gland but also the surrounding tissues, affecting the lungs, called 
struma aberrans. In two such cases, the enlargement was in the mediasti- 
num in one, and in the other, in the middle third of the neck. These growths 
Avhich originated from the secondary thyroid were cancerous in structure. 

Etiology and Clinical Symptoms. — The true cause or origin of goitre 
has not as yet been defined: In man, horses and cattle, it is supposed to 
be due to the effect of mountains and the absence of sun in deep valleys, or 
to the soil (rich in calcium and magnesia, and the absence of the iodides), 
but in the dog this cause can hardly be said to hold good, as in canines, it 



BRONCHOCELE, GOITRE, STRUMA 



265 



occurs in all countries and conditions, and appears where goitre in other 
species is extremely rare. One observer is inclined to think it is caused by 
the straining of a collar in harness, or to any active exercise; chronic 
heart disease seems to have some bearing on the disease, but why, has not 
up to the present time been definitely stated. Without a doubt, heredity 
is a predisposing cause (struma congenita). Young animals have propor- 
tionately a very large thyroid and it becomes reduced gradually as the 
animal grows older, but occasionally the opposite occurs, and instead of 
growing less it gradually increases. 

Goitre is very easily recognized, directly below the larynx on both 
sides of the trachea. It is painless, there is no local increase in tempera- 






&Ps<--V.^ 




Fig. 98. — Malignant struma. 



ture, it may be hard or soft, sometimes irregular, sometimes as large as 
a closed fist, and in extremely large ones from its weight it hangs down 
from the throat. If the goitre is very large it may interfere to a certain 
extent with deglutition. In cystic goitre the cysts can be easily distin- 
guished on manipulation. The malignant forms are frequently uneven, 
irregular and nodulated, and vary in consistence (Fig. 98).- 

Treatment. — It is either medicinal or operative. Medicinal treat- 
ment is only useful in the parenchymatous or cystic goitre, the latter only 
when it is not too far advanced and consists in the administration of 
iodine either internally in the form of iodide of potassium, or iodide of 
sodium in moderate do.ses, (0.1), or friction externally, iodine or iodide of 
potassium ointment, oleates of iodine, or Lugol's solution of iodine. In 



266 DISEASES OP THE NERVOUS SYSTEM 

one case a 10 per cent, solution of papayotin (vegetable pepsin) was in- 
jected into the tumor and in forty-eight hours the digested parenchyma 
of the gland was aspirated in the form of a milk-like liciuid. The inter- 
parenchymatous injection of Lugol's solution of iodine are rather 
dangerous, but the writer has found a solution of iodoform 1.0 in ether 
and olive oil 7.0 much better. 

Recently, preparations have been made from the thyroid gland of 
cows, thyroidin tablets (Merck) , thyradin taljlets (Knoll) ; these tablets are 
prepared commercially, each tablet contains 0.3 of normal thyroid gland, 
and we give 1 to 3 tablets daily. In weak animals at first give the smallest 
dose and carefully watch the animal. In the administration of too large 
doses you may have all the symptoms of Basedow's disease. Frequently, 
when the treatment is continued for some time and with favorable results, 
if the treatment is stopped, immediately the gland commences to enlarge 
again. 

When medicinal ti'eatment has no results, or the struma is malignant, 
surgical treatment is necessary. In cystic goitre that is well developed, 
it can be opened, drained and filled with iodoform gauze. The malig- 
nant and fibrous goitre must be removed, but it must always be remem- 
bered that entire removal of the gland generally causes death in a short 
time (see Cachexia strumipriva). Only one-half of the gland must be 
removed, and in a case of bilateral, the one that is affected the more, as 
it is a question if iodothyrin or any of the thyroid preparations will arrest 
cachexia strumipriva, if it follows removal of the gland. On account of 
great vessels, recurrent nerve etc., in the neighborhood of goitre, the 
operation must be classed as one of the most dangerous operations in 
the dog. 

Inflammation of the Thyroid Gland. Thyroiditis, Struma Acute. — This 
condition is extremely rare, and is generally of traumatic origin (bites, 
gunshot wounds, etc.). It forms large c{uantities of pus. This condi- 
tion must not be confounded with those enlargements of the thyroid that 
occur in young dogs and are the result of catarrh of the larynx and 
pharynx. The periodical swelling of the thyroid that is seen in very young 
dogs, that swells and in a few days returns to normal size, is not in any way 
related to thyroiditis. The treatment of inflammation of the thyroid 
gland is to treat it as a surgical wound. 



DISEASES OF TRUE INFECTION. 



Distemper and Contagious Catarrhal Fever. 

The definition of the word ''distemper" describes a disease which is 
peculiar to the canine race, and it is caused by a specific poison which 
finds its way into the system, as a rule, through the lungs and air-pas- 
sages. It generally attacks young animals and runs its course as a 
catarrhal fever, affecting all the mucous membranes of the body, and is 
almost invariably accompanied with certain nervous symptoms, and 
pustular skin eruptions. 

Etiology. — Distemper is a disease which is contagious in the highest 
degree, and is only communicated by infection. It does not seem to have 
been recognized or described by the ancients or the writers of the middle 
ages. An animal aflfectecl with distemper can remain but a short time in 
any locality and affect every animal there, or it may be transmitted from 
a person or object that has been in contact with an affected animal. As a 
rule, few young animals escape distemper, generally contracting it before 
they are a year old, and dogs over that age very rarely take the disease. 
That, however, may be accounted for from the fact that dogs having 
arrived at that age have either come in contact with, the disease previous 
to that and they have had it in a mild form, or the system was in such a 
condition, that they did not contract it. The disease affects animals but 
once during life, although a few exceptions are presented where animals 
have contracted it a second time. As a rule, delicate, weak, poorly-fed 
animals (vegetable diet), or animals which have been affected by some 
catarrhal disorder of the respiratory mucous membranes, contr!ict the 
disease in its acute form; while, on the other hand, dogs which have lots of 
exercise, especially animals in the country or small cities, are mildly 
affected with the disease, and the rate of mortality is much less. 

Distemper exists in all countries of the world. In the large cities it is 
found at any season of the year, while in the country it is generally more 
prevalent during the warm weather. The specific poison of distemper is 
not definitely known. It is undoubtedly a fixed and volatile virus* 
which enters the system by the mouth and nose, and it exerts its first 

*By a " fixed and volatile virus" we understand a fixed virus that when secreted in the 
lungs, is carried out in fine division, in the particles of moisture in the expired air, and easily- 
held in suspension in an atmosphere that contains a slight quantity of humidity. 

267 



268 DISEASES OF TRUE INFECTION 

influence on the res})iratorv passages. Vaccination of young animals l)y 
means of the mucous secretions from animals affected with the disease 
has been tried, and, as a rule, reproduces the disease. 

Semmer believes that he has definitely defined the contagious germ in 
the blood, and also found it in the lungs, liver, and spleen, in the form of 
small, dagger-shaped microbes, which he calls the "bacilli of distemper." 
Rabe has found in the secretion of the nose and connective tissue, also in 
the blood, small cocci, which accumulate in heaps, or were connected 
together in small groups of three or four in a line, or they may hang to- 
gether like a string of beads. These he considers the specific conta- 
gious matter of distemper; but Friedberger does not agree with this 
theory. Mathis found in the contents of the pustule a diplococcus which 
could be colored with fuchsin. He used bouillon cultures of this diplo- 
coccus for the inoculation of ten dogs. These dogs were affected by 
symptoms which resembled very closely those of distemper. Marcone 
and Meloni found a micrococcus in a dog which was affected by distem- 
per, and considered that this was the true pathogenic agent, as it 
produced the skin eruptions, broncho-pneumonia, and gastro-enteritis 
in dogs which had been inoculated with pure cultures. Legrain and 
Jafjuet obtained pure cultures of micrococci, Avhen held in certain media, 
from fluid obtained from the pustules in the exanthema of distemper. 
These were gathered together in the form of diplococci and chains. In 
dogs vaccinated with these cultures only the skin eruption, with the 
development of pustules, was seen, but the subjects so treated seemed to 
enjoy immunity from the disease. Millais made cultures from the nasal 
excretion of the dogs affected by distemper upon gelatinous media, of two 
different bacilli, which mixed together, on inoculation, produced distem- 
per. Galli-Valerio has isolated ovoid bacilli, 1.25-2.5/t. in length, which 
grows freely in gelatin. These he found in abundance in the lungs and 
central nervous system, but did not find them in the blood. The inocula- 
tion of the cultivations produced characteristic distemper in puppies, but 
did not give the same results in adult dogs. Jensen is of the opinion that 
the pneumonia of distemper is caused by a streptococcus, but he has found 
in the bronchial mucous membranes other bacteria, particularly the bac- 
terium coli. Babes and Bazanesco, in two cases isolated from the lung, 
liver and blood, found a very fine short motile bacillus, about 0.3 to 
0.4/i. long. Nine young dogs were inoculated and seven died in from 
ten to eighteen dayc of typical distemper, and the various oi'gans con- 
tained the bacilli inoculated. Zelinski, Xeucki, and Karapinski, maintain 
they are positive distemper is communicable to man, and give as the 
mediary cause a microorganism similar to the white staphylococcus of 
Resenbach, but differing from the same in its bio-chemical properties. 
Taty and Jaccjuine have found in the spine and cord of a dog that died 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 2G9 

of nervous distemper a peculiar diplococcus to which they ascribe import- 
ant pathogenic action. Jess cultivated a bacillus, found in the conjunc- 
tival, nasal and other mucous membranes and organs of the body, which 
was 1.3//. long and 0.6u. wdde. Injections of the culture were made both 
intraperitoneally and subcutaneously; three or four days afterwards a 
fever appeared which was accompanied by great flow of tears, and diar- 
rhcea, and in the vicinity of the inoculated spot there appeared isolated 
red spots. Petropawloski found, in all cases of distemper, a bacillus which 
resembled that described by Galli-Valeris, and also that described by 
Babes and Barzanesco but differed from the first by its negative action to 
Gram's coloring method and, from the latter by its easy cultivation on 
potato. j\Iari thinks that the baccilli of Petropowlowsky as well as those 
of Schantyro are in all probability coli-bacilli and really not related in any 
way etiologically to the baccilli of distemper. Casol claims to have 
found a micrococcus, which is both isolated and in groups, and claims it is 
colored by Gram's method. From these he made pure cultivations and 
transmitted it successfully. Lignieres places distemper among the 
hemorrhagic septicaemias and calls it Pasteurellosis canum, and is due to 
a particularly virulent bi-polar bacillus (Pasteurella canis). Trasbot, on 
the other hand, thinks that the microorganism cultivated by Lignieres is a 
pneumo-inciter and only produces the secondary phenomena in the disease 
and is not the original cause of the development of the disease. Wunsch- 
heim has isolated a short rod, very similar to the bacteria of chicken 
cholera. Piorkowski found in the spleen and lung a small staff bacillus, the 
cultivations of which when inoculated, developed the disease and death 
in two or three w^eeks. Ceramicola cultivated an ovoid polymorphus 
taken from dogs which had died, particularly of virulent distemper, and 
the bacteria possessed all the morphological properties of the inciter of 
hemorrhagic septicaemia, and the animal inoculated died with all the 
characteristics of true distemper. Carre is of the opinion that none of 
the organisms visible to the microscope can be considered the exciters of 
distemper in the dog; he took nasal mucus from an infected dog, passed 
it through a filter, the filtrate when spread on different nutritive media 
remained sterile, and the defibrinated blood of an animal inoculated with 
the filtrate produced fever of the nostril and pustules. This blood was 
also spread on various nutritive media and also remained sterile. Cadiot 
and Breton and others are of the opinion that in distemper there is an 
ultra-microscopical organism which can be filtered, and with this microbe 
there is also a microorganism which may have some influence on the course 
of the disease (foetid bacillus and Pasteurella canis). 

Direct vaccinating methods have been practised by various practi- 
tioners. For instance, Trasbot transferred secretions from the nose and 
pustules of animals affected with the disease, by means of a number of 



270 DISEASES OF TRUE INFECTION 

small incisions in the abdominal wall of healthy young animals. The 
disease appeared after eight days. 

Krajewski vaccinated numerous young animals with secretions of 
the nose and pustules, these inoculations being on the mucous mem- 
brane of the nose, and under the skin, and arrived at the following 
conclusions: 

1. The contagious germ of distemper is confined to the secretion of 
the nose and eyes, and the blood. 

2. The germ does not lose its virulent properties in any degree when 
dried at a normal temperature, or frozen at 18° to 20° of cold. However, 
its virulence becomes attenuated when kept for any length of time in a dry 
place. 

3. The disease, when it is produced by vaccinating, runs a very mild 
course, and kills, as a rule, from 10 to 15 per cent, while the ordinary 
disease kills from 32 to 70 per cent. Laosson has obtained the same results 
after vaccinating ninety-eight animals, and found also that the contents 
of these pustules are generally inactive, and that the nasal secretion 
loses its virulence after eight days. Friedberger's observations are dia- 
metrically opposite, for he contends that he has caused infection by means 
of the contents of the pustules. He also recognized in cases where the 
disease originated from vaccination that there was a short intervening 
stage of incubation and, as a rule, was much less in intensity, ran a veiy 
rapid course, and that the groups of pustules were confined to the region 
of vaccination. 

Schantyr has lately published certain observations concerning the 
microbes of distemper. He agrees with Putz that distemper of the dog 
resembles distemper in horses to a remarkable degree, and his theory of 
the subject is that distemper may be classified into three diseases, accord- 
ing to the presence of three microorganisms of different characters. 
These diseases are: Abdominal typhus, true distemper of the dog, 
and canine typhoid. Their clinical as well as their pathological 
symptoms have a great similarity with one another, and it is only 
with a careful microscopical examination that the specific microorgan- 
isms can be separated. The bacilli of typhoid (small, slender bacilli, 
which are almost exactly like the typhoid bacilli in man) are generally 
found separate in the blood, while the bacilli of distemper (small, and 
somewhat curved) and the bacilli of typhoid (typhoid are very small and 
slender) are generally arranged in groups. The bacilli of typhus are hard 
to color with fuchsin, and become colorless with Gram's test. This is 
not the case with distemper and the bacillus of typhoid. Typhus and 
typhoid bacilli give characteristic cultures upon agar, gelatin, and potato, 
while the bacillus of distemper is extremely hard to cultivate under any 
circumstances. Megnin divides distemper into two groups. Cadiot and 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 271 

Breton describe another contagious broncho-pneumonia, but present no 
pustular rash, probably In'ing infectious bronchial catarrh. 

Clinical Symptoms and Course. — The stage of incubation of distemper 
is generally from four to seven days. In rare cases it may linger, for 
eight to twelve days, after contact with the diseased animal, and 
Krajewski states that cases of infection through cohabitation may some- 
times take from two to two and a half weeks to develop. The first actual 
symptom is an increase of temperature. In the initial stage it rises to 40°, 
and in some cases 41° and over. An increase in temperature has been oIj- 
served by the writer in all cases of distemper, when the examination was 
made early in the disease. Later on the temperature falls slightly, but in 
some cases very rapidly, and it may even go below the normal point, ac- 
cording to the individuality of the anmial, and to the intensity of the at- 
tack. Yery mild cases have little or no elevation of temperature, but as a 
rule there is a regular increase and decrease of temperature, as the disease 
runs its course. In fatal cases toward the end the temperature is invari- 
abl}- subnormal. In cases developed by inoculation we occasionally find a 
marked increase in temperature. The next symptom is the disturbance 
of the general condition. The animal is depressed, restless, has little or 
no appetite, seeks the heat, becomes easily fatigued, is chilly and shivering, 
the nose is hot and dr}^ the skin is inelastic, and the hair becomes harsh 
and dry, the animal refuses to play or to go out for a walk, lies most of 
the time and gets into dark places. In some instances vomiting occurs, 
but can hardly be called a characteristic, initital symptom of the disease. 
This stage of the disease is short, from 24 to 48 hours; the symptoms in- 
crease rapidly, and develop the four characteristic forms, which are as 
follows: 

1. Catarrhal distemper (eyes and nose and lungs), muco-purulent 
discharge of the nose and eyes, cough, which is very persistent and may be 
so severe as to cause great depression or vomiting, more or less increase of 
respiration, which in some cases may be labored. 

2. Gastric distemper (intestinal distemper), coated tongue, loss of 
appetite, thirst, vomiting mucous in thick tenacious masses, diarrhoea, 
yellow in color and fseces that are muco-purulent, and may even contain 
blood. 

3. Nervous distemper (irritation of the brain and spinal cord). 
Fear, uneasiness, great irritability, dulness or sleepiness, twitching of the 
muscles of mastication, or epileptiform convulsions, chorea and complete 
paralysis. 

4. Exanthematical distemper (distemper pustuia, dog pox), pustules 
on the abdomen and internal surface of thigh. 

The following phenomena of distemper may appear during the course 
of the disease: 



272 DISEASES OF TRUE INFECTION 

1. Symptoms on the External Membranes. — These appear in the ma- 
jority of cases and are of great importance in diagnosis. We see a number 
of small red spots upon the inner fascia of the thighs, the abdomen and, in 
rare instances, the mouth and eyes, on the internal surface of the ear flap 
or even on the vestibule, and still more rarely covering the entire body. 
They are generally scattered, very rarely confluent. They rapidly form 
small bladder-like blisters filled with serum, and later on this serum 
changes to pus. They are about the size of a lentil or small bean, and 
soon dry up, forming yellowish scabs and crusts. When the eruption is 
very extensive, the animal gives off a very unpleasant odor from the 
affected parts. These pustules are rarely itchy, and if so, it is only to a 
very slight degree. After these scabs fall off (generally in about one 
week) , they leave a red circular spot on the skin which disappears slowly. 
In other cases we find more or less depth to the cicatrix, leaving pit-like 
ulcerations. They are probably due to the animal scratching or gnawing 
the sore. In rare cases the rash has appeared on the lips, extended over 
on the mucous membrane and caused extensive ulcerative processes of 
the mouth or it may spread all over the body and in occasional cases it 
is found in the prepuce causing purulent catarrh of that organ. This is 
the only skin eruption that characterizes this disease and it dries up very 
quickly, so that in from eight to fourteen days we see no other marks 
except those light, granulating spots (exanthema of distemper, distemper 
pox). Hertwig and Friedberger have observed some cases in which this 
eruption made its appearance without any other symptom of distemper. 

2, Symptoms Indicated by the Eyes. — There is generally more or less 
purulent catarrhal conjunctivitis. The animal avoids the light. There 
is redness and swelling of the conjunctiva. In the early stages the secre- 
tion is serous and very fluid. Later on it becomes a muco-purulent se- 
cretion, either light gray or yellowish in color. This sometimes occurs in 
large masses (blennorrhoea of the eyes). This fluid collects in the corner 
of the lower eyelid or trickles down over the face, drying in yellowish 
crusts in the edges and borders of the eyelids, frec|uently gluing them to- 
gether. The corrosive action of these secretions, and also the inflamma- 
tion of the surrounding membranes, may cause lesions of the cornea, some- 
times from the animal scratching and rubbing the eye, especially in ani- 
mals with prominent eyes (such as pugs and King Charles spaniels). In 
some cases it may be due to deficient nutrition of the cornea. This 
ulceration starts with a slight swelling on the external surface of the 
cornea and the subsecjuent formation of an ulceration. (Other details 
will be found in the chapter on Diseases of the Eye) . 

We see cases where there is a deep pericorneal injection of the cornea, (ker- 
atitis parenchymatosa), in which a blue grey, blue white, or milky white 
opacity commences at the outside edge of the cornea and spreads over its en- 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 273 

tire surface. It may affect one or both eyes at the same time, and the opac- 
ity may disappear leaving no trace or it may go away slowly and in rare 
cases leave permanent white star-like spots on the surface of the cornea. In 
rare cases keratitis parenchymatosa and some fever may be the only 
symptoms observed during the course of the disease The ulcerations are 
apt to appear in the middle or most prominent part of the cornea, and pene- 
trate into the corneal tissue, and the pit-like depression on the cornea may 
become vascular, and it may also perforate the cornea, evacuate the con- 
tents of the anterior chamber, cause prolapse of the iris, and formation of 
staphyloma. Loss of the eye, by purulent panophthalmitis, is very rare, 
the eye clearing up and leaving more or less pigmentation of the cornea. 
Diseases of the interior of the eye, by extension of the inflammation 
of the cornea, are very rare in distemper. This may be complicated 
with a permanent opacity of the sclerotic membrane, and in rare cases the 
whole eye becomes acutely inflamed and breaks down (see Diseases of 
the Eye). 

3. Symptoms of the Respiratory Apparatus. — These are generally a 
catarrhal inflammation of the mucous membranes of the upper air pass- 
ages, and, if the disease is acute, the finer sections of the bronchi become 
inflamed. The first symptom is a catarrh of the nose, which is marked 
by sneezing and the animal rubbing or wiping his nose with his front paws. 
This discharge increases. In the early stages it is simply serous; later it 
becomes mucous, grayish-white or grayish-yellow, sometimes bloody, and 
in some cases even purulent, with more or less odor. We also see a " snift"- 
ling" respiration. This is particularly noticeable in short-headed dogs 
(such as pugs or bulldogs) . In all cases there is catarrh of the larynx, and 
bronchioles. Catarrh of the larynx is generally marked by a loud, 
hoarse, dry cough, which is particularly distressing to the animal, especi- 
ally at night. As the disease advances it becomes moist and looser, and is 
easily produced by a slight pressure on the larynx. Where there is 
simple laryngitis, we do not generally see any visible increase or difficulty 
in respiration. This is changed, however, as soon as the large bronchial 
tubes become involved. In such cases we see a marked increase in res- 
piration, wdiich gradually becomes more intense as the inflammatory pro- 
cess goes downward into the finer bronchi. Any pressure on the sides or 
tapping upon the walls of the chest causes a very distinct, painful, dis- 
tressing cough. On auscultation we hear an increased vesicular breath- 
ing, as well as dry and moist rattling bruits, which are of various forms 
and intensity. 

If the inflammatory process has extended to the fine bronchi it is 
not rare to see the formation of lobular pneumonic centres — that is to say, 
catarrhal pneumonia. Difficulty in respiration now appears more pro- 
nounced; respiration is superficial but laborious, as is proved by the infla- 
18 



274 DISEASES OF TRUE INFECTION 

tion of the cheeks. The number of respirations may increase from GO to 
80 or even more. The cough is very painful, dull, and weak; the pulse is 
greatly increased, and the temperature may increase to a marked degree, 
but it is remittent. On ausculting we hear in the lungs, snoring, groan- 
ing, and wheezing sounds and rattling bruits (these last are moist and 
numerous), also more or less blowing sounds in different regions. We 
notice an increased vesicular respiration with sharp, prolonged, expir- 
atory bruits, of a mixed character. In the same region we may notice 
bronchial respiration. Percussion, as a rule, is not very instructive. 

4. Symptoms of the Digestive Tract. — The chief of these is catarrh of 
the stomach, which may vary in intensity. There is entire loss of appetite, 
vomiting of a thin, frothy, turbid lic{uid Avhich is shiny or muco-puru- 
lent. There are frecpient discharges from the bowels of a thin, muco- 
purulent fluid, occasionally streaked with blood, and always accompanied 
by a painful tenesmus. We may also find the abdomen very painful on 
pressure, and, as a rule, contracted and tense. Yellow coloration of the 
visible mucous membranes (icterus) is occasionally observed. 

5. Symptoms of the Nervous System. — The animal is very dull, espe- 
cially its senses. There is a marked apathy and depression, and in some 
cases deep coma. In a great many cases this condition may be accom- 
panied by periods of excitement, nervousness, great restlessness, and even 
true delirium. These periods, which might possibly be mistaken for rab- 
ies, are not of any great length, as a rule, the animal sooner or later show- 
ing signs of marked depression. Motor disturbances, such as twitching of 
various groups of muscles, mostly the head and extremities, are noticed, 
and, in some cases, convulsions or true eclamptic attacks. These follow 
one another at long intervals, or keep the animal irritated for days. 
Clonic convulsions of the maxillary muscles are very frec{uently seen. 
They consist of a rapid and regular twitching of the muscles of the lower 
jaw, sometimes confined only to chattering of the teeth, and occasionally 
sufficiently strong to make a foam of the saliva. Besides this, we may see 
symptoms of motor paralysis. The patients are unsteady and irregular 
in their actions. In some instances they drag their hind legs, or occa- 
sionally their posterior extremities lose their power and the animal is un- 
able to stand; in rare instances, due to paralysis of the sympathetic, the 
bladder and the lower bowel lose the power of their sphincters and urine 
and fgeces are evacuated involuntarily. 

Other General Symptoms. — As has already been observed, the tem- 
perature may rise or fall, and follow an irregular course, and it is apt to be 
subnormal in the majority of fatal cases. When bronchitis increases in 
intensity and a catarrhal pneumonia develops, it is apt to be accompanied 
by considerable increase in temperature. In some cases, due to paren- 
chymatous degeneration of the cardiac muscle, the pulse is small, thready 



DISTEMPER AND COXTAGIOUS CATARRHAL FEVER 



2/0 



and irregular. The urine frequently contains more or less bile coloring 
matter, sometimes albumin and tube casts are found. In some cases the 
general nutrition and condition may* keep up well all during the disease and 
in other cases the animal at the onset of the disease rapidly loses his vital 
force, even when it is eating a fair amount of nutriment, goes down in 
strength each day. Frequently the expired air has a particularly 
unpleasant penetrating odor. 

The anatomical alterations of the nervous system, produced by this 
disease, which are shown in the section of the brain, are sometimes very 
slight, and it is rather remarkable to find such acute nervous symptoms 
with so little pathological alterations. The microscopical examination 
shows little change, or few alterations you might expect from many of 
the infectious diseases of other animals. We must, therefore, admit that 
the microbes of distemper are not as yet well known. Like all other path- 
ogenic micro organisms, they prodvice "ptomaines." It has been proven 
that the severity of the nervous symptoms depends to a certain extent 
upon the natural disposition of the animals, and also their bodily health. 
When they take the disease, as weak, anaemic, poorly fed animals, they 
are very apt to be severely attacked with a nervous form of the disease. 
Occasionally symptoms appear in this disease which should be mentioned, 
such as serious weakness of the heart. This may be due to a parenchyma- 
tous degeneration of the heart muscle. It is generally fatal, as it 
produces oedema of the lungs. Albuminuria is produced by paren- 
chymatous degeneration of the kidneys, and in rare instances from true 
nephritis; decubitus is seen occasionally in severe cases in the elbow- 
and knee-joints, also at the femoro-tibial articulation. This sometimes 
causes septicaemia and produces death. 

The large number of the above-described symptoms show how com- 
pletely the whole body may be affected with this disease; generally, how- 
ever, the gastri-catarrhal forms predominate and run a regular course. 
We also observe in some instances peculiarities and symptoms which may, 
to a large extent, come from a general want of nutrition, or want of resist- 
ance in some cases, while in others, especially in the terrier classes, they 
seem to be able to throw off the disease and stand more acute attacks than 
other animals. There are some forms of the disease which are so mild in 
character as to almost escape observation. Thus we may have a mild 
exanthema or a slight respiratory or intestinal catarrh which may be 
difficult to recognize. The duration of this mild form of the disease may 
be from half to one week. Of the different forms of the disease the catar- 
rhal and gastric forms are most frequently seen, the nervous next, and the 
exanthema least.- 

Coui-se and Prognosis. — Distemper generally runs its course in two or 
three weeks, although we occasionally see cases where the disease is, as we 



276 DISEASES OF TRUE INFECTION 

have just stated, particularly mild which runs its course in one week to a 
week and a half, and in severe cases is prolonged for a much longer period. 
In such cases this prolongation is not due to the influence of the disease 
directly, but rather to secondary complications. We may count among 
these, certain nervous diseases which frequently remain or appear after 
the disease has run its course. For instance, paralysis of some of the mus- 
cles, of the hind-quarters, or of all the extremities, and rhythmic move- 
ments resembling St. Vitus's dance in some of the muscular groups, 
especially the muscles of the face or of the legs, and is indicated by a con- 
stant twitching, clonic in character, sometimes severer at one time than 
another, but more especially after excitement. Blindness, loss of sense 
of smell, or bark may also result from alteration of the nerves; or the an- 
imal becomes an idiot, has hallucinations (thirion), difficulty in respira- 
tion, persistent anaemia, and a chronic catarrh. Amaurosis and deafness 
may occur in some cases. 

Prognosis. — The prognosis of distemper, as a rule, should be regarded 
as unfavorable even in those cases which are apparently mild, for in this 
disease the symptoms may change in one day, from the mildest to the 
most acute. Of course, the danger of the disease increases with the in- 
tensity of the nervous symptoms, and especially if the symptoms are pro- 
longed, and with them a persistent high temperature, and even in cases 
where we have a subnormal temperature. Another series of cases which 
must be regarded as unfavorable are those which are in their course com- 
plicated by serious nervous symptoms or by symptoms of catarrhal pneu- 
monia. Young dogs which are delicate (especially when not fed on meat) 
anaemic, or rachitic, will succumb to the disease sooner and, as a rule, 
present severer symptoms than those which have been fed with meat and 
have had plenty of open-air exercise. A marked decrease of temperature, 
without a similar improvement in the general condition, is always to be 
looked upon as an extremely serious symptom. Death may occur in two 
ways: through paralysis of the brain or oedema of the lungs, and occasion- 
ally from septictemia or from general exhaustion. From the experience 
of the writer, the death-rate is from 20 to 30 per cent. It depends to a 
great extent whether there are a number of cases together or solitary cases 
— in the former the percentage is much higher; but at the same time it is 
impossible to give any positive statistics, because in cities the death-rate 
is much higher, and in small towns and in the country, where distem- 
per runs a comparatively mild course, the death-rate is much smaller. 
The writer finds that in a large city the death-rate amounts to 60 to 70 per 
cent. 

Pathological Anatomy. — The most prominent and constant anatom- 
ical alterations found at post-mortem are those in the respiratory and 
digestive organs. In the former there are all the phenomena of an acute 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 277 

catarrhal inflammation of the Larynx, trachea and bronchi, and also of 
lobular pneumonia and catarrhal inflammation of the stomach and intes- 
tines. For details, see under their respective chapters. 

We find also more or less pathological alteration in the central ner- 
vous system, such as hypersemia and small hemorrhages in the coverings of 
the brain; cedema of the brain is sometimes present with flattening of the 
convolutions and serous infiltration into the subarachnoids. In the ven- 
tricles and base of the skull we have more or less marked venous hyper- 
semia. As a rule, the spinal cord shows nothing abnormal except that it 
is pale and seems soft in consistence. 

Under the miscroscope decided changes have been noticed in the 
brain. Kolesnikoff detected an infiltration of brain-matter and walls 
of the brain vessels with lymphoid cells as well as a distention of the 
capillaries and smaller arteries. These were filled with red and white 
blood corpuscles. In the infiltrated walls of the vessels of the brain were 
found dark-colored, homogeneous granulations and accumulations. 
Krajew^ski found also the perivascular spaces and the ganglionic cells 
filled with lymphoid corpuscles, and he mentions particularly that those 
cases had died without showing any prominent nervous symptoms. 
Muzulewitsch found inflammation of the spinal cord in acute nervous 
distemper, in which there w^as marked hypersemia. He also found al- 
terations in the walls of the vessels, and an albuminous exudation in the 
upper third part of the spinal cord along the blood vessels, as well as in 
the interstitial tissue of the gray substance. As a sequence of the acute 
nervous form we have a chronic interstitial myelitis with partial atrophy 
of the spinal cord. 

Carougeau found an infiltration of leucocytes in the gray matter of 
the entire cord, particularly in the anterior horns, a myelitis disseminate 
which he believes was originated by the toxic action of distemper contagio- 
sum ; this observation was made on a dog affected with chorea as a sequence 
of distemper. Bohl and Rexter have reached the same conclusion from 
their observations of the central nervous systems of dogs affected with 
distemper. 

Other abnormal conditions are found in distemper, such as anaemia, 
parenchymatous or fatty degeneration of the heart, liver, kidneys, and 
an abnormal swelling of the lymphatic glands and changes in the skin 
and eyes. 

Prophylaxis. — The animal affected with the disease should be kept 
away from all animals that have not already had the disease, j^articularly 
young animals; strict disinfection of the kennels or sleeping places of the 
affected animals and also the various articles used by them. Prevent- 
ive vaccination, while it cannot be called a success, is worth considera- 
tion. Dogs that are not too highly bred, but bred on rational lines, and 



278 DISEASES OF TRUE INFECTION 

are well kept and substantially fed, are better al^le to stand the disease 
and, after it has run its course, come out of it stronger and make quicdc 
I'ecoveries; it cannot be said, however, that in this disease this always 
holds good, for frequently an animal that is in perfect health and fine 
physical shape may contract the disease and die, and another animal in 
not nearly so good condition throws off the disease and makes a very 
c|uick and prompt recovery. 

Preventive Vaccination. — In the last century numerous attempts 
have been made to find some inoculating material which would produce 
immunity to distemper, either entire immunity or at least for a certain 
period, and the results of certain observers have been mentioned already, 
notably Krayewski. Ligniere, who considers distemper should be classed 
among the hemorrhagic septicaemias, recommends a serum which he 
prepares and calls polyvalent immune serum. Phisalix vaccinates with 
greatly diluted cultures of the bacilli of distemper. The immunizing 
action of the vaccine has been confirmed by Grey, Spiccr, Howtakcr, 
who claim that this vaccine when injected into the animal at the time 
it is affected with the disease has to a certain extent the property 
of lessening both the intensity and course of the disease. Ligniere, 
Jewell, Hobday, Parker and a committee appointed in England to test 
this vaccine obtained unfavorable results. An immunizing agent called 
antidistemper serum, prepared by the Jenner Institute of London, has 
been sold commercially. Meyer, who has used a large quantity of the 
serum, reports that after the animal is vaccinated it produces a mild form 
of distemper which is catarrhal in form, and after the acute symptoms 
disappear there may be nervous del)ility, unstead}- g'^it, and in one 
case the animal became deaf. The vaccinated dogs, when brought in 
contact afterward with dogs affected with acute distemper, either did 
not contract it at all or they had a very mild attack. This serum in- 
jected into an animal affected by distemper seems to have in certain 
cases a decided beneficial effect. 

An antidistemper serum prepared by the bacteriological insti- 
tute of Piorkowski in Berlin, does not seem to produce the results 
claimed for it. This serum is recommended not only for immunization 
(5 to 10 c.c. is injected subcutaneously in any part of the bod}', the best 
location being the neck) but also for curing the disease (in doses of 20 
to 50 c.c), and according to the statement of Piorkowski 85 per cent, of 
animals having both catarrhal and nervous forms are cured. 

Baden used a large quantity of this serum and came to the conclu- 
sion that in some cases it produced very good results, but these were 
generally in the mild catarrhal gastric forms and when the treatment 
was commenced immediately after the onset of the disease. In moi-e 
acute cases when the disease had gone on for some time, and there were 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 279 

either convulsions or chronic twitchings or catarrhal diarrhtea, the injec- 
tion of the serum produced no effect whatever. 

Wagner and Pinkammer declare it is valueless, while Lange and 
Creutz claim to have had very good results when used in the early stages 
of the disease. Opinions are also divided in regard to other serums, 
for instance that of Gans, as well as what is known as Dutchman's serum, 
obtained from animals fed with yeast. This latter serum is used only as 
a therapeutic agent; some observers claim good results from it. 

Numerous tests have been made by the writer, but it cannot be said 
positively that the results are such as to say the serums are of any prac- 
tical value, and when we consider that up to the present time the active 
agent in the production of the disease has not been definitely isolated, or 
its actual nature and structure known, we can hardly cultivate a serum 
to combat it. 

Some of the agents mentioned as being specific for distemper are 
Gurnine (ganglionary serum) which has not been found to produce any 
beneficial results. Yeast and yeast preparations, furonculine (dis- 
temper antigurmine, creolin, etc.) , seem to have some influence in control- 
ling intestinal catarrh. Calomel has also a certain effect in the early 
stages of gastric distemper. Creolin inhalations are good in pulmonary 
and bronchial forms of distemper, as also inhalations of benzoin and 
balsam of Peru. Trichloride of iodine which Ellerman, de Brun and 
others injected subcutaneously, 3 to 5 cm. in a solution of 1 to 100, has 
a very favorable influence when administered in the early stages of the 
disease, but in the more advanced stages of the disease it has little or no 
influence. Ichthargan in 3 per cent, solution, iodipin, tallianine, 1 to 
5 cm. intravenouvsly. 

Therapeutics. — No special therapeutic treatment can be given for dis- 
temper — that is, no agent has been found up to this time which has the 
property of destroying or rendering harmless the specific micro-organisms 
present in this disease. Certain antiseptic and antibacterial remedies, 
like quinine, salicylic acid, antipyrine, etc., may generally reduce the 
fever, but they produce no influence on the general course of the disease. 
The use of agents for reducing the temperature is objectionable, as they 
not only deprive us of the symptom of temperature, which is of the great- 
est importance during the course of the disease, but cause more or less 
depression of the heart. According to Frohner's experiments, calomel 
is supposed to have a slight claim as a universal agent, but this is on the 
same order as black coffee, which was formerly advocated by Trasbot. 
Common salt has been recommended by Zippelius, and ergotin was 
highly recommended and frequently used a few years ago. None of 
these remedies, while they prove beneficial in some cases, is to be laid 
down as a specific for the treatment of the disease, therefore we must 



280 DISEASES OF TRUE INFECTION 

continue to treat it in a purely symptomatic manner. Antipyrine, which 
was advocated as an absolute specific, does not in the least deserve this 
recommendation. The diet must be easily digested food, but at the same 
time as nutritious as possible. Milk, bouillon, soup, and scraped raw 
meat (which is generally taken with a relish) have much to commend 
them. In grave cases where there is entire loss of appetite, we must use 
concentrated food, such as peptonized meat, extract of beef, and clear 
broth. This may be given with some mild alcoholic stimulant, wine, etc. 
There are some forms of extract of beef which are not to be recommended, 
on account of their slight nutritive value and as they also contain a 
large proportion of sodium salts. When the temperature rises above 
40° we must try to reduce it by means of frictions of alcohol and mild 
antiseptics. 

The "antipyretic'' treatment can only be used in rare instances in 
the dog. The chief medicinal agents are quinine, salicylate of sodium, 
antifebrine, and antipyrine. The older remedies (digitalis, veratrum, etc.) 
have been abandoned for some time on account of their direct action on 
the heart. This is also the case with kairin, thallin, and phenacetin. 
The writer, as a rule, does not advise the use of Cj[uinine on account of 
its action upon the heart. 

It must be said, however, that in this disease good nursing, attention 
to dietetics, fresh air and cleanliness are the greatest factors in producing 
good results. The animal must be kept in a dry, clean, warm (not hot) 
well lighted and ventilated kennel, but avoid the slightest suspicion of a 
draught or dampness, and to prevent the spread of the disease through 
contagion, disinfect the place when the animal has recovered, as well as 
the surroundings used by the animal from time to time. The food should 
be substantial and easily digested, such as milk, sago, egg and milk, 
mutton broth and eggs, thick soups and small quantities of raw meat 
must be given at short intervals. 

When the animal refuses to eat, he must be given food in concentrated 
form, such as thick meat broth, with a yolk of egg in it, extract of meat, 
extract of malt, hamatogenc, hsemo-albumen, or use some of the various 
extracts of beef. 

To maintain the strength, or when the acute symptoms have sub- 
sided but the animal is weak, the digestion poor, or the mouth sore and 
solid particles of food cannot be eaten, we use concentrated food, such as 
some of the various meat extracts and peptonized products, commercial 
meat juice and liquified peptone; nutritive preparations containing 
albumen, such as samatose, plasmon, etc. If the stomach cannot retain 
food but is vomited up immediately after it is given, nutrition can be 
administered by means of clysters. This can be meat broth, yolks of 
egg, and thick starch water, to make it of enough consistency to be 



DISTEMPER AND CONTAGIOUS CATARRHAL FEVER 281 

retained in the rectum. Very frequently by this means an animal can 
be carried over the grave stages of the disease, and it is surprising how 
long an animal's life can be sustained by this means. Albrecht mentions 
one dog that had chronic nephritis, and was nourished for forty-two days 
by this means. In the administration of a nutritive clyster, the rectum 
must be first cleansed by an injection of luke-warm water, and in about 
ten minutes, not sooner, the nourishing clyster is given; the amount 
varies from a tablespoonful to a cupful, according to the size of the animal. 
The injection must be made slowly and carefully, care being taken not to 
excite the animal any more than is necessary, and when the nozzle of 
the injection pipe is withdrawn the anal opening must be held closed 
for a short time, and, if possible, elevate the hind cjuarters of the 
animal. 

The following nutritive clysters are recommended: 

1. Two or three beaten up eggs, 250.0 thick bouillon. 

2. Two beaten up eggs, 200.0 concentrated bouillon and a spoonful of 
starch. 

3. Two beaten eggs, 10.0 peptonoids, 120.0 sherry wine, 250.0 
bouillon. 

4. One beaten egg, 600.0 bouillon, 150.0 port wine, 0.5 bicarbonate of 
soda, 0.02 common salt, and 60.0 peptonoids. 

5. Two beaten eggs, 4.0 salt, 20.0 port wine, 250.0 milk. 

6. Two or three eggs beaten up with a little cold water, and a pinch 
of starch; these are laid to one side, then a tablespoonful of sugar, a half 
cup of milk and a wineglassful of port wine are mixed together and boiled 
for a short time, when it is allowed to cool. When it is nearly cold add the 
combination to it with a small pinch of salt, care being taken to see that 
the solution is not warm enough to coagulate the milk. 

In the early stages of the disease, the stomach can be emptied by 
means of an emetic, such as the subcutaneous injections of apomorphia, 
antimonial wine, etc. It is a ciuestion whether an emetic by its subse- 
cjuent depression does not do more harm than good. As a rule, constipa- 
tion is not present and the bowels had better be left alone; if the animal 
commences to eat and the intestinal canal returns to its normal condition, 
the lower bowel will be emptied naturally without the assistance of drugs; 
if, however, it is necessary to evacuate the rectum, use a glycerine sup- 
pository. 

Other therapeutic measures will have to be employed as the symptoms 
arise, and we would refer you to the diseases of the nose, larynx, bron- 
chia, and air-passages, also to those of the stomach and intestine, par- 
ticularly where there is persistent diarrhoea, and lastly diseases of the 
brain, spinal cord, and eyes. As a rule, no treatment should be used for 
the skin eruption in distemper. If any irregularity arise, however, this 



282 DISEASES OF TRUE INFECTION 

may be treated according to the methods recommended under Diseases 
of the Skin. 

Conjunctivitis is general!}' treated by a solution of sulphate of zinc 
(1 to 100), or painting the diseased membranes with a solution of nitrate 
of silver (1 to 70). This must be followed afterward by a 1 per cent, so- 
lution of chloride of sodium. " Blennorrhoea of the eyes" should be 
treated by bathing the parts with some antiseptic solution, such as creolin 
(1 to 100), corrosive sublimate (1 to 2000), or boric acid (1 to 40), or by 
painting the mucous memlirane by means of a camel's hair pencil with a 2 
per cent, solution of sulphate of copper. Ulceration of th^ cornea should be 
treated with a 3 or 4 per cent, solution of boric acid. Parenchymatous 
keratitis may be treated with a few drops of a 1 to 100 solution of atropine. 
After the acute inflammatory symptoms of the eye have subsided blowing 
calomel directly on the cornea produces good results. 

Infectious Bronchial Catarrh. 

(False or Bench-show Disteinj)cr.) 

Within the last twenty years bench shows have become very numer- 
ous, and kennels both large and small ai-e legion, and from each kennel one 
to ten or more of the dogs are being exhibited from time to time, we 
freciuently observe in these kennels shortly after dogs return from the 
shows a disease that resembles and is frecjuently taken for distemper. 
This disease for a better name has been called " Bench-shoAV Distemper." 
It is decidedly infectious and attacks the large bronchi producing catarrhal 
bronchitis and a muco-purulent discharge from the nostrils and eyes; 
with this there is also catarrh of the intestines. The writer has also felt 
that there may possibly }:)e such a condition, and has intimated that fact 
under the head of Catarrh of the Bronchia (page 137). 

Etiology. — It is generally seen in large kennels, attacking one animal 
after another or several at once. It may also be o])served where several 
dogs have been sent to a bench show, developing shortly after they return. 
The period of inculjation is three to five days. Another peculiarity is that 
one attack does not insure immunity from another. The writer has ob- 
served several dogs that have developed this disease, and the next year 
repeated the attack after returning from a show. 

Pathological Anatomy. — The lesions found are very similar to those 
of true distemper, but milder in character. The alterations in the lungs 
are those of catarrhal i)neumonia. The most frequent condition oljserved 
is great irritation of the nnicous membrane of the intestines, with more or 
less swelling of the whole intestinal tract. The follicles and glands of the 
intestines may be swollen or enlarged, and in rare instances ulcerated, but 
not to the marked degree seen in distempei'. 



INFECTIOUS HEMORRHAGIC GASTROENTERITIS 283 

Clinical Symptoms. — The animal is dull and listless for two days, 
when the temperature will be found to be 39° or 40°; slight running fi-om 
the eyes; and invariably diarrhtea. This last symptom is generally olv 
served from the first, the stools being liciuid the first few days, and later 
filled with gelatinous mucus. At the end of a week there way be some 
passed in the stools, but this is not commonly seen. 

The appetite may be very poor or even lost, but generally in three or 
four days the animal will commence to eat, but stop again if the diarrha-a 
should be severe, or eat very small quantities. Vomiting is rarely seen 
except at the onset. 

The discharge from the nose and eyes is difficult to distinguish from 
distemper, except that it is thinner and muco-purulent. The cough is 
stronger, and not the soft, shallow cough observed in distemper. Fre- 
quently we find acute laryngitis or bronchitis. The exanthema of dis- 
temper is absent but the hair is dry and harsh, and freciuently the hair 
falls out very rapidly in the long-coated dogs, especially collies. 

The mouth very frequently becomes sore and the gums may ulcerate. 
In rare cases a series of aphthous ulcers are seen on the lips and around the 
free end of the tongue. This condition rarely causes death unless the 
diarrhoea is persistent and the animal will not eat; and any attempt at 
forced feeding is folloAved by vomiting. 

In some cases shortly after the acute symptoms commence there may 
be evidences of congestion of the brain, accompanied by severe and con- 
tinued convulsions, which frequently cause death. 

The treatment is practically the same as in distemper. Keep the ani- 
mals warm and dr};, give easily digested food, lean meat, carefully remov- 
ing all fat, and quinine, iron, and some of the pepsin preparations, and 
allow them to run if they are not too weak. Penning them up closely 
does harm. 

I^. Ferri et quininae citras, 12.0 

Elixir simplex, 96.0 

S. — One teaspoonful three times daily. 

If the diarrhoea is severe, give 

I^. Bismutli subgallate, 0.75 

F. cliarta No. xii. 
S. — One powder three times daily. 

Infectious Hemorrhagic Gastroenteritis. 

{Canine Typhus, Stuttyort Day Disease, Dog Plague.) 

This disease may be descril)ed as a grave infectious disease, having 
some of the characters of distemper. The characteristic lesion being an 



284 DISEASES OF TRUE INFECTION 

acute hemorrhagic inflammation of the intestinal mucous membrane 
and frequently accompanied l)y an ulcerative stomatitis. This disease 
attacks animals of all ages; occasionally a milder form is observed, in- 
dicated by severe pharyngitis and gastric catarrh and is differentiated 
from simple gastric catarrh by the more acute symptoms and the fact 
that it does not respond to the ordinary treatment used in simple catarrh. 

The disease was described by Hoffer in 1850 as dog typhus; and dur- 
ing the latter portion of the nineteenth century it spread over the greater 
part of Europe and destroyed numlicrs of animals. Then the outbi'eak 
lessened in severity and only sporadic cases were observed, but recently 
it appears with increased severity. 

Etiology. — The disease attacks animals of all ages, but seems to pre- 
dominate in older animals. Klett made a record of 100 cases and found 
five cases in animals under one year, sixteen in second year, twenty-one in 
third year, eleven in fourth year, nine in sixth year, seven in seventh 
year and eighth year, two in ninth, six in tenth, etc. Sex, constitution 
and breed do not seem to hinder or have any bearing on the course or 
severity of the disease although Rabus observed the delicate, highly 
nervous animals that are very carefully housed seem to be more suscepti- 
ble and succumb to attacks of the disease. 

The actual cause of the disease or medium of infection has not been 
definitely described. Some oliservers think the faeces is the medium of 
the infection, some the urine, some the vomited material, others the 
urine, blood, or other tissue fluids, but the majority of observers agree 
that the disease gains entry into the system by means of the digestive 
tract. It is not definitely known if it is directly transmissible to 
another animal, and the direct inoculation of the disease is only accom- 
plished with great difficulty and after repeated experiments, and even 
then it is governed l)y certain favorable circumstances. Albrecht injected 
a healthy dog with blood taken from an animal affected with the disease. 
Into a second dog he injected subcutaneously a certain amount of bile 
from the gall-bladder of another infected animal. Into the third animal 
he administered a quantity of the contents of the stomach of a diseased 
animal. The animal that had the subcutaneous injection of bile developed 
a severe abscess at the point of puncture and made a good recovery. 
The other animals were not afTected at all. Scheibel fed finely cut up 
portions of the stomach and intestines of affected animals without any ill 
affects, but when he had given an animal a solution of bicarbonate of soda, 
rendering the mucous mem]:)rane of the stomach alkaline, the animal 
developed the disease two days later. Scheibel came to the conculsion 
that a mixed infection of the coli-bacteria and micrococci was more apt 
to reproduce the disease. Pirl found in the blood taken from the heart 
of the diseased animal an oi'ganism which was similar to the bacterium 



INFECTIOUS HEMORRHAGIC GASTROENTERITIS 285 

hemorrhagiciim. Zschokke found in the serum of the kichieys of an 
animal that had just died numerous sk^nder cocci-bacteria. The majority 
of French observers beheve that the disease must be classed under the 
head of the pasteurellas. Bimis and Seris contend that this disease is 
simply a very malignant form of distemper. Hutyra obtained from the 
mucous glands of the mucous meml^rane of the intestine and from the in- 
testinal contents virulent coli-liacilli. The intravenous injection of an 
experimental bouillon culture produced fatal hemorrhagic gastro-enteritis, 
whereas, if the stomach was previously neutralized, the bouillon could be 
fed to the animals and produce no effect whatever. 

Pathological Anatomy. — Severe inflammatory alterations will be 
found along the digestive apparatus. The stomach is found to be 
be contracted to very small compass and rarely contains any food of any 
kind. The mucous membranes are swollen, red to black-red, containing 
more or less hemorrhagic spots and covered with a foetid brown colored 
mucus which is alkaline in reaction. Similar changes but not so severe 
are found in the duodenum. The rest of the intestinal tract may be 
affected but it is the exception; the rectum, however, is freciuently in- 
flamed. The peritoneum is injected, the liver and kidneys are more or 
less hyperoemic. Zschokke found the kidneys presenting all the symp- 
toms of metastatic suppurative nephritis. The bladder is usually dis- 
tended and filled with urine, the mesenteric glands and spleen are gener- 
ally slightly enlarged. The cavity of the mouth is ulcerated with necrotic 
processes in various places, particularly about the gums, and there are more 
or less inflammatory changes of the mouth and swelling of the tonsils. 

Clinical Symptoms and Course. — The first symptom is a want of 
appetite, which is soon entirely lost, great depression and want of anima- 
tion, frequent vomiting and great thirst. The vomited matter is at first 
streaked with bile but frequently it is brownish-red or the color of blood 
and in the latter stages the vomited matter is very foetid, brownish in 
color. The animal defecates with difficulty, and if the temperature is 
taken the thermometer is found to be streaked with l^lood. After a few 
days the animal has a bloody diarrhoea with an intensely offensive odor. 
The urine is decreased in quantity and frequently the urine is passed with 
more or less difficulty. It is found on examination to contain albumin 
and bile coloring matter. The abdomen is drawn and tucked up and 
palpation of the abdomen, particularly in the region of the stomach, is 
very painful. The eyes are sunken deep in their sockets. The conjunc- 
tiva is intensely injected and in severe cases the congested conjunctiva is 
brownish-red and the pupils are fixed and dilated. There is more or 
less discharge of tenacious yellow mucus from the nostrils, the pulse is 
small and thready, and the heart has a full throbbing beat. The tem- 
perature is not particularly high, generally about 40 degrees; only in 



286 DISEASES OF TRUE INFECTION 

rare instances it rises above that and in cases of a fatal termination it is 
invariably subnormal. The mouth is frequently kept tightly shut by 
the animal and efforts made to open it cause the animal great pain. The 
mouth and breath have a particularly fcetid odor, particularly when the 
disease is well developed, and we find the gums and jaws and cheeks covered 
with deep ulcerous patches. The tongue varies; it may be brownish- 
red, bluish-gray, or extremely pale and on the upper surface of the tongue 
it is coated by dirty brownish-red mucus. Frequently the tongue lies 
on the floor of the mouth apparently paralyzed. In some cases the 
mouth, throat, and mucous membrane of the tongue are covered by sticky 
moist, purulent mucus and occasionally we find necrosis of the tip of the 
tongue. In some fatal cases we find little change in the mouth and 
pharynx other than deep redness of the mucous membranes. 

When the disease goes on rapidly to a fatal termination, the animal 
becomes emaciated very rapidly, lies motionless in one position and dies 
within a week. In rare instances the animal may have convulsions before 
death. Mettel found pneumonia and haematuria and Richta found hem- 
orrhage in the anterior chamber of the eye. If the disease lasts over ten 
days without fatal results, the mouth commences to clear up, the ulcers 
become covered with a brownish scab, the vomiting ceases, the appetite 
returns, and in two or three weeks the animal has fully recovered. Par- 
alysis of the body and extremities may result, and deafness may occui- as 
an after-result of this disease. In milder cases there are generally all the 
symptoms of acute gastric catarrh with pharyngitis. It is rather difficult 
in sporadic cases to diagnose between this disease and simple attacks of 
gastric catarrh and pharyngitis, but when we find a number of cases and 
where the odor from the mouth is particularly offensive and also the faeces, 
the chances are it is hemorrhagic gastro-enteritis. 

The prognosis is very unfavorable. The mortality is from 50 to 70 
per cent., and even the milder forms of the disease seem extremely 
hard to treat and frequently terminate fatally; young animals seem to be 
able to throw off the disease better than older animals, and young animals 
are much more apt to have a milder attack. 

Therapeutics. — Treatment in well-developed cases is generally hope- 
less. As a rule it is well to give the animals easily digested food, keep 
the animal in a warm place free from draughts, and if there is abdominal 
pain apply the Priessnitz compress. In case of persistent vomiting, use 
hot applications to the region of the stomach, or wash out the stomach 
with weak solution of creolin, alum, borated water or .8 per cent, sodium 
chloride. Small quantities of broken up ice frequently administered may 
check the vomiting, also morphia (-Klett), tincture of iodine and chloform, 
aa5.0 in 3 to 10 drop doses in water or milk (Cadiot). Creasote solution, 
(one drop in ess. of pepsin). For stomach and intestinal irritation, salicylic 



SEPTICOPY.EMIA 287 

acid, salol, tincture of rhul-);!!'!), iclitargan, calomel and opium, bismuth sub- 
nitrate, adrenaline solution, all have been recommended for this condition. 
For lessening the fever, phenacetin and quinine have been recommended. 

For the local treatment of the ulcerated mucous meml^rane, washes 
of permanganate of potash, 1 to 200, creolin 1 to 100, peroxide of hydrogen 
solution. 

To combat extreme weakness give camphor, caffeine, atropia. Klett 
used a subcutaneous injection of physiological salt solution. Alcohol, 
pure or in spirits, is not recommended. For violent foetid diarrho'a give 
pinch of tannoform, tannothymol or xeroform. For intestinal cramps or 
colic give salts of bromine, morphia or sulphonal. 

The treatment of the paralysis that may follow as a sequel is taken 
up under Diseases of the Spine and its Coverings. 

SEPTIC AND PYEMIC DISEASES. 

Septicopyaemia. 

Etiology. — This disease is caused by staphylococci or streptococci, 
frequently by the bacterium coli, and occasionally by proteus or micro- 
organisms related to them. The microbes may collect in a wound or they 
may accumulate in some centre in the body, later find their way into the 
blood and give rise to the characteristic symptoms of the disease, that is, 
high fever and great depression and these pus-forming organisms settle in 
the capillaries and form metastatic abscesses which appear in different 
organs of the body, and pyiemia when accompanied by the formation of 
abscesses and suppuration. It is termed septicaemia when there is high 
fever and general depression. It is extremely hard, however, to make a 
sharp distinction between the two, for undoubtedly the nature and in- 
tensity of the disease depends not only on the nature of the bacteria, but 
also on the toxic effects of the same and the individual resistance of the 
animal affected. 

This condition can originate from purulent, ichorous, or gangrenous 
wounds, ulcers, circumscribed or diffuse phlegmons, complicated frac- 
tures, decubitus, puerperal diseases, putrid abscesses of the stomach 
and intestines, acute inflammation and sloughing of the buccal cavity and 
pharynx, abscess of the prostate. In many cases the original cause can- 
not be discovered. 

Clinical Symptoms. — Fever, ushered in by chills, high temperature — 
this may fluctuate and towards the end it may be subnormal — small ac- 
celerated pulse, great weakness of heart, livid red mucous membranes; in 
rare instances the mucous membranes are yellowish (icteric) ; sometimes 
hemorrhages of the mucous membrane and skin, great dulness and then 



288 DISEASES OF TRUE INFECTION 

complete prostration, no appetite, skin cold and inelastic. When the 
skin is drawn from the body it remains in position instead of flying back 
as healthy elastic skin will do; foetid stools, albuminuria. As a rule death 
comes quickly. In less acute cases we find symptoms of nephritis, 
hepatitis, endocarditis, or evidences of localization of the condition in 
the formation of abscesses of the lungs, liver, or in the articulations. 

Therapeutics. — There has been no specific serum that seems to have 
any effect on the disease, so the symptoms must be treated as they appear. 
Try to keep up the strength of the patient, administer alcohol in the form 
of wine, whiskey, or brandy frequently, and strong liquid foods. Digi- 
talis and strophanthus have not given good results in keeping up the heart's 
action in septic diseases; to cut down the fever use antipyrin, antifebrin or 
Cj[uinine; the latter should not be given if the heart is particularly weak. 
To assist in eliminating the microbes, administer a hypodermic injection 
of from 30 to 300.0 c.c. of an 8 per cent, solution of chloride of sodium. 
It is well to keep in mind the importance of antiseptics in all wounds and 
operations, and any ^^I'ocess of disease that will tend to produce 
septicopysemia. 



Malignant CEdema. 

{CEdemu Maligna.) 

This disease is extremely rare in the dog. It is an acute infectious 
disease caused by a specific bacterium (bacillus oedematis malignae). It 
begins at a certain infected point in the form of a hot, painful oedematous, 
pitty swelling which afterwards becomes an emphysematous (crepitating) 
swelling which extends very rapidly into the surrounding tissues. This 
crepitation is peculiar to the disease, and can be separated from simple 
emphysema by the fact that in simple emphysema there is no fever pres- 
ent. Immediately after death the bacilli are found in the serum of the 
oedematous swellings and in the blood. 

This Bacillus oedematis malignse is not only found in animals but also 
in garden soil, dust, putrid organic materials, excrement of herbaceous 
animals, etc. It has been demonstrated recently that the oedema bacillus 
only develops when in combination with other bacilli such as the staphylo- 
cocci, diplococci, etc. 

The treatment of malignant oedema must be very energetic, as the 
disease causes death in a very short time. It consists in opening and 
breaking down the infected connecting tissues and thoroughly disinfecting 
them, first cleaning them out with peroxide of hydrogen, and then 
washing with a 1 to 3000 solution of corrosive sublimate. 



ANTHRAX 289 

Anthrax. 

{Charhon. Malignant Pustule. Splenic Fever.) 

Anthrax is rare in the dog, and when it occurs it is generally caused 
by the animal eating portions of cadavers of animals that have had this 
affection. This is an acute infectious disease which is caused by the 
Bacillus anthracis, and is accompanied by high fever and local mani- 
festations in the skin and mucous membranes. All forms of anthrax 
have been observed in the dog, but generally the seat of the disease is in 
the mouth, throat and in the intestines, and generally there is more or 
less tumefaction of the head. One observer saw a typical case of anthrax 
of the tongue and lips caused by an animal licking the l^lood of an animal 
that had that disease. Another case observed was where a terrier had 
eaten a bone of an animal affected with anthrax. Lupke found on the 
inferior wall of the throat a carbuncle, which was probably caused by an 
erosion of the epithelium, in which there was great inflammatory oedema 
of the adjacent regions. In regard to the susceptibility of the dog to an- 
thrax, one case is cited where 150 dogs ate the flesh of a horse that had 
died of anthrax; 100 had swelling of the lips, throat, forehead and head, 
and sixty of them died. Young dogs seem much more susceptible than 
older animals. Different breeds of dogs are said to be less susceptible 
to anthrax than others; this, however, is a question. When a number of 
animals are affected wdth symptoms of anthrax, particularly packs of 
hounds, when the dead cadaver is fed to the hounds, the proper method 
of diagnosis would be to examine the blood microscopically and make 
a trial inoculation of an animal that had not been near the infected 
animals. 

Therapeutic treatment is generally useless on account of the rapid pro- 
gress of the disease. If any treatment is attempted it may be in the line 
of the internal administration of antiseptics, creolin, carbolic acid, salicylic 
acid, and preparations of iodine particularly Donovan's solution. AVhere 
the carbuncle is formed then local incisions and the injection of corrosive 
sublimate solution, 1 to 1000, and tincture of iodine. The actual cautery 
has been recommended to destroy the tissue of the carbuncle. Concern- 
ing sanitary laws, the following apply to this disease: 

Animals which suffer from or are suspected of anthrax cannot be 
slaughtered for consumption. 

Any operation that will cause bleeding of the animal suspected of 
anthrax can only be performed under the supervision of the official 
veterinarian. 

All cadavers of animals which are affected or suspected of having 
19 



290 DISEASES OF TRUE INFECTION 

anthrax must be rcnderetl harmless by burning the cadavers. Skinning 
the animal is strictly forbidden. 

Rabies. 

{Hijdrophobia.) 

This is an acute disease of the entire nervous system caused by a 
specific poison, and distinguished by a variable period of incubation, as 
well as by an absence of any marked anatomical alteration. 

Etiology. — Rabies is a true infectious disease, and never occurs 
spontaneously, but is only transmitted by direct infection through the 
bite of affected animals. This disease, as a rule, is confined to the canine 
race (dog, wolf, fox, hyena, and jackal). It is seen in rare instances in 
the cat, horse, cattle, sheep, goat, deer, guinea-pig, rabbit, rat, mouse, 
chicken, pigeon, and in man. The dog is the animal that contracts the 
disease quicker than any other. Country, climate, care, nursing, age, 
and sex do not seem to have any influence upon it. The disease is more 
frequently seen in central Europe and in New England and Middle States 
than anywhere else. This may be accounted for by the fact that dogs in 
large numbers run at large, and also to the fact that the owners do not 
conform to the rules of sanitary police. Rabies does not seem to be in- 
fluenced to any great extent, by the seasons of the year, but cases are more 
frequently seen in the spring and summer than in the autumn and winter. 
The poison of rabies is as yet unknown, or at least it has not been definitely 
described. It is reproduced in the body of the animal only; never outside 
of it. It is mixed with blood, saliva in the salivary glands, and in the 
secretions of the lachrymal glands. It is also said to occur in the mam- 
mary glands. From direct inoculations, this disease appears in its most 
concentrated form in the brain, spine, and in the ganglionic nerves. 

This poison is virulent in the spine and brain, during the incubative 
period, and retains its full strength for several days after the death of the 
affected animal. Roux and Nocard have found that the saliva is infectious 
two or three days before any symptoms of the disease appear, and one 
case recorded by Pampouki, in which a woman was infected by a dog 
eight days before the actual symptoms appeared in the dog. The actual 
excitant of the disease does not appear to be present in the muscles, the 
lymphatic glands, liver or spleen, and the urine or spermatic fluid has not 
been found virulent and the rabic poison has been found in very rare 
instances in the aqvicous humor. The true cause of rabies has not as yet 
been isolated and described, probably it is an ultra-microscopical organism, 
at least it seems so to a large number of observers (Rimlinger, Riffet, 
Rey, Schander, C'clli, Blase, etc.) , who have passed a brain emulsion through 



RABIES 291 

specially fine filters, and an inoculation with the filtrate has successfully 
reproduced the disease. 

In 1903 Negri found both in inoculated and rabid street dogs, in certain 
parts of the cerebral nervous system, particularly in the horns of the amnion, 
in the Pur kin je cells of the cerebellum, in the nerve cells of the pons, in the 
cord and the central cortex, when sections of these parts were stained by 
Mann's method, (methyl blue-eosin), certain bodies which took up the 
stain, and appeared a brick red, these bodies being round or slightly 
oval, periform, or even irregular triangles, and varying greatly in size, 
from 1 to 27 tx; either isolated or grouped in the cells. These were found 
in dogs affected with rabies, as well as other rabid animals and man. 
They retain their characteristics even when the cadaver was in a 
state of advanced putrefaction and remain perfect in glycerine. Negri 
regards these as the various stages of evolution of a parasite which 
should be classed with the "protozoa" and claims these as the true 
excitors of rabies. It is true that for some time before Negri had an- 
nounced his theory, a number of observers thought that the origin of rabies 
must be due to the protozoa, particularly Dijestal, who had described 
having seen in the spine and ganglionic nerves, small bodies like 
protozoa. 

These bodies are to-day generally known as Negri's corpuscles or 
bodies, (see plate) , and have since been observed and described by a num- 
ber of other observers, and studied particularly with regard to their 
minute structure ( Volpino, Williams, Bohn) , and it must be admitted that 
they are found with great regularity in rabid dogs and their presence is 
regarded as diagnostic. 

In 1903 to 1905, 457 dogs suspected of rabies were examined 
by Italian scientists; 297 were proved by inoculation to be rabid and in all 
but nine the corpuscles of Negri were found. 

The claim of Negri that this specific parasite (protozoon) is the true 
and only cause of rabies is a question that is opposed by those observers 
who have filtered the emulsified brain substance of an affected animal 
and the filtrate reproduced the disease by inoculation; there is a possibility, 
however, that certain of these corpuscles may be so infinitesimal as to 
pass through the filter and so small as to be beyond the power of the 
microscope to render them visible. 

Pasteur has demonstrated that a rabid brain loses its infectious 
virulence only when that part has become partially decomposed, that is 
to say, after four or five days; while it remains virulent in air-tight tubes 
or in moistened carbolic gauze. Neustube found that the brain of a 
rabid dog retained its virulent properties when kept under a slightly 
elevated temperature for ten or twelve days. Mergel found the virulence 
as strong as ever in the putrid brain of a rabid wolf fourteen days after 



292 DISEASES OF TRUE INFECTION 

the animal had ])een killod. Galticr noticed the same conditions in the 
decayed brain substance of a rabid dog, when kept under a low tempera- 
ture (12° Celsius). An affected brain was not rendered harmless even 
when exposed for three weeks at a time, but its virulence was attenuated 
wdien kept some time at a temperature of 61° Celsius. Bluml)erg found 
that an affected brain is rendered harmless when it has undergone a freez- 
ing process at 20° or 30°. Galtier was able to destroy the virulence of af- 
fected cerebral matter in four to twenty days by placing it upon plates and 
allowing it to become dry. Saliva and blood are much less resistant than 
brain matter. Both su])stances as a rule, lose their harmful properties 
twenty-four hours after leaving the animal. Dried saliva is inactive 
fourteen hours after it comes from the mouth of the animal, the gastric 
juice destroys it in five hours; bile kills it in a few minutes, and it is de- 
stroyed quickly by corrosive sublimate, chlorine water, permangate of 
potash, sulphuric acid, creolin, etc. The X-rays seem to retard the 
development of the virus. 

As a rule, it is necessary to make a natural or artificial inoculation in 
order to obtain any successful transmission of the rabid poison, as no in- 
fection will take place if an animal is given the saliva, flesh, brain or spinal 
cord of an affected animal, or if the inoculation is simply rubbed on the 
cutaneous or mucous membranes; but if the mucous membrane is scarified 
first it can be reproduced. The most certain method to reproduce the 
disease is to introduce the virus directly on the dura mater of the brain 
or spinal cord, or in the anterior chamber of the eye. Heredity — that is, 
transmission of rabies by the mother to puppies or the production of the 
disease by infected saliva being in food — is very questionable. The most 
common method, of course, is the bite of the rabid animals; more rarely 
licking of a wound. In many cases the bite may not be severe enough to 
cause its development in dogs or in man. Deep bites, however, are 
certainly the most dangerous, especially when made on the unprotected 
parts of the body (hands and face in man). Wounds which bleed much 
are less dangerous, as the poison may be washed out of the wound by the 
flowing blood. Bites of dogs which have bitten numerous others are 
less dangerous than the first or second bite made by a rabid animal. 

Infectious wounds which were made by biting or inoculation, accord- 
ing to Hertwig's observations, showed only 37 per cent, of positive results, 
and Renault's 67 per cent. Of 137 animals which were bitten by rabid 
dogs under observations for the last five years at the Veterinary College of 
Berlin, six only ultimately developed the disease. Zundel finds that 
about 25 per cent, of inoculated animals become affected, while Haubner 
found 40 per cent. At Alfort they have found the proportion to be about 
33 per cent., and at Lyons, 26 per cent. In man 50 per cent, of the 
bitten subjects develop the disease, but if we sum together the cases of 



RABIES 293 

true rabid and ''suspected" dogs, the proportion is reduced to about 8 
per cent. 

The most dangerous bites seem to be those directly into a nerve or upon 
nerve tissue, even if it is on the smaller branches of nerves, whereas a bite 
on blood vessels or the lymphatic system is less so, and artificial inoculation 
proves that if it is made as near to the central nervous system as possible 
the disease makes its appearance more quickly, and the injection directly 
on the dura mater produces the disease in shorter time and more certainly 
than any other part of the bod}-. Pasteur claimed that if there is the 
largest proportion of virus in the brain, it produces furious rabies, and if 
the virus predominates in the spine it causes dumb rabies. It is possible 
that the results of the material changes on the animal economy produced 
by the disease ''toxines" may have some effect on the character and 
severity of the disease, the nature of which is at present really not 
known. Anrep prepared a serum from the brain of guinea-pigs affected 
with furious rabies; this serum injected into animals produced lowering of 
temperature, paralysis of the extremities, salivation, and death by para- 
lysis of the respiratory centres. 

Pathological Anatomy. — The post-mortem results are generally nega- 
tive and vary in different animals, but, as a rule, specific alterations are 
noticed. These are as follows: 

Great emaciation with very distinct muscular rigidity and a rapid 
tendency to decay; collections of mucus upon all the natural orifices, 
such as the mouth, nose, and the prepuce; prominence of the cutaneous 
veins, which are found to be filled with thick, imperfectly clotted blood; 
redness and swelling of the mouth and mucous membranes. The throat 
is covered with a whitish-gray mucous exudation; intense inflammation of 
the glands of the pharynx; in some cases slight swelling and hyperaemia of 
the salivary glands. In the cavity of the throat and mouth we find for- 
eign bodies, such as hair, straw, coal, wood, etc.; they may also be found 
in the oesophagus, which is frequently very red and covered with clammy, 
gray mucus. This condition is seen in the stomach which contains little 
or no food but, as a rule, numerous indigestible objects of various kinds 
and sizes — straw, hair, wood, stones or pieces of leather or rags. The 
mucous membrane is reddened and swollen, especiall}' on the surface of its 
folds, and marked with hemorrhagic erosions, which Johne describes as 
sepia-colored. The intestine may be empty or it may contain some of the 
foreign bodies. The mucous membrane of the pharynx is always very 
red, swollen, and covered with mucus in its anterior portions. These alter- 
ations are also seen in the trachea and the large bronchia. The lungs are, 
as a rule, filled with blood, but otherwise normal. In rare instances we 
find circumscribed centres of irritation due to foreign bodies being inhaled 
through the bronchial tubes. The heart and its envelope are generally 



294 DISEASES OF TRUE INFECTION 

normal. The inner surface of the pericardium may show hemorrhagic 
spots. The chambers of the heart, as well as the large blood vessels, are 
filled with dark, imperfecth^ clotted l^lood. The liver and kidneys are 
hypersemic. The spleen is always filled with blood, enlarged, and oc- 
casionally streaked with hemorrhagic spots; the bladder is found to contain 
little urine, and this on test is found to contain svigar. Cadiot was inclined 
to consider glycosuria as a regular symptom of rabies and of patholog- 
ical importance, but Rabreaux and Nicholas took the ground that while 
sugar is apt to be in the virine of rabid animals, still its absence did not 
mean the animal did not have rabies. 

The condition of the brain and spine was formerly supposed to pre- 
sent some reliable indications of the disease, but according to the investi- 
gations of the last few years it cannot be said that they present any constant 
pathological alterations. They vary greatly and in some cases may pre- 
sent no noticeable change at all. We frequently find hypersemia of the 
covering of the brain and spinal cord, accompanied by slight hemorrhages, 
and the brain and spinal matter itself contains more blood than usual and 
is in a more or less oedematous condition. 

Kolesnikoff found on microscopic examination of the walls and neigh- 
boring vessels of the brain (of dogs which have died with rabies) an accu- 
mulation of lymphoid cells and extravasated red blood corpuscles. The 
accumulation of discolored cells and red corpuscles in the small blood ves- 
sels of the walls and perivascular chambers indicates to a certain extent a 
condition which in rabies is of pathological importance. They are un- 
doubtedly symptoms of inflammation. These changes vary in different 
cases. According to Czoker, it was noticed to a very slight degree in dogs 
affected with the furious form of rabies, but it was noticed to a marked 
degree as soon as the disease developed the dumb form (the perivascular 
spaces and their neighliorhood were filled with leukocytes). 

Babes found nodulated infiltration in the spinal cord of dogs that he 
called nodules rabirjues (rabid nodules). Other observers have, however, 
found them in distemper, ^'an Gehuchten and Xelis found in the cerel^ro- 
spinal and sympathetic ganglion of a street dog that died of rabies defi- 
nite lesions, such as infiltration, tumefaction and ecchymosis, and great 
proliferation of the endothelial cells of the capsule that covers the gang- 
lionary cells, and emigration of the mononuclear cells and a destruction 
of the ganglionary cells (ncurophagy). The plexus nodus vagi is fre- 
quently attacked. These alterations in the nerve tissues are not always 
present in the disease and cannot be used as positive evidence of the dis- 
ease. Valleea and Manonelian found similar infiltrations of the ganglia 
in very old dogs, and other observers found these modifications in less 
degree in other diseases, i^imilar alterations have been noticed in other 
diseased conditions, such as chorea, tetanus, distemper and meningitis. 



RABIES 295 

Clinical Symptoms and Course. — The period of incubation lasts in 
the majority of cases from three to six weeks. In very rare instances the 
disease maj^ appear in one week. According to Haubner's observations 
upon nearly 200 dogs, in 83 per cent, of the cases the disease developed in 
two months; in 16 per cent, of the cases within three months; and in 1 
per cent, four months, or even later. Zundel has calculated that in 264 
dogs 1 per cent, became affected within twenty-four hours after being 
bitten; 11 per cent, between the second and third day; 33 per cent, be- 
tween the fifteenth and thirtieth clay; 19 per cent, between the thirtieth 
and forty-fifth day; 10 per cent, between the forty-fifth and sixtieth day; 
16 per cent, between the sixtieth and ninetieth day, and 10 per cent, 
after three months. The longest period of incubation was observed by 
Leblanc; this case developed in 364 days. The period of incubation is 
shorter in young than in older dogs. In the human race it is generally 
admitted that the average period of incubation is seventy-two days 
(this average covers over 510 cases). 

There are two forms of rabies — a furious and mute (or dumb) form. 
The first is more frequent, but there are numerous transitions between 
the two forms; dogs that are at liberty or vagrant dogs are more apt to 
have the violent or furious form, while dogs kept as house pets or who 
are restrained are more frequently affected with the mute or dumb 
form, and in dogs that are well trained and under control and have lived 
in close contact with man, the tendency to bite is only present when they 
have reached the point of true delirium and mental control is gone. 
Pasteur found that intracranial injection produced furious rabies, while 
subcutaneous injection almost invariably resulted in the dumb form. 

Furious Rabies. — This comprises three distinct stages, between which 
there is a very distinct line of demarcation — namely, the prodrome or 
melancholic, the stage of irritation, and the paralytic stage. 

In the melancholic stage the dogs seem to change in their disposition. 
They are capricious, and at other times irritable or depressed. They show 
symptoms of anger, are easily excited, fretful, change from one place to 
another, are easily frightened on the slighest cause or may become very 
affectionate. They soon show a tendency to gnaw or swallow indigestible 
substances. They refuse their usual food, or they may take such food as 
they have a special taste for, holding it in their mouth for a few moments 
and then let it drop out of the mouth again. They will lick and gnaw, in a 
greedy manner, various objects, such as wood, coal, furniture, and eat sti'aw, 
earth, stones-, wood, blankets, and even their own fieces. In one case 
observed by Govard, the animal would howl loudly, have an evacuation 
of faeces and immediately eat it. There is commencing evidence of 
paralysis in difficulty in deglutition, cough, and labored respiration. 
The sexual desire is very much increased, and we see in the first stage an 



29G DISEASES OF TRUE INFECTION 

uncertainty in the gait and a weakness in the hind-quarters. Constipation 
is invariably present. After a short space of time, generally from one to 
three days, the second stage appears. This is the irritable or maniacal 
stage. This is characterized: 1. By a tendency to escape and run away; 
2. by a great irritation and an inclination to bite animals, objects, or 
man; 3. by a strange alteration in the voice, or bark. 

The inclination to run off is very marked. They will eat through 
wooden boxes or floors, tear chains apart, or dig great distances through 
earth. As soon as they get their liberty they will run about aimlessly, 
covering very much ground in a short space of time, and return in one or 
two days, showing every indication of great excitement or of having 
travelled long distances. When they return they are covered with dirt 
and utterly exhausted, and may be very quiet and well behaved for a 
short time. During this condition they bite any object that comes 
in their way. Soon the delirium increases and they run around in an 
insane way, attacking and biting anything that is within their reach, 
snarling or biting all the time, and if they are confined they bite at the 
bars and frequently break their teeth, and if a stick is held toward them 
they attack it furiously. As a rule these cases do not tear or mutilate 
their own bodies, and, if they do, they generally bite the region of the 
wound where they were formerly bitten or the toes of the posterior ex- 
tremites. In the first stage of the disease we have often noticed that they 
will lick and bite places where they have had wounds before. The 
patients snap frequently, as if they were catching flies, and, as a rule, will 
bite any animal that will come within their reach. 

The biting and delirium are not constant, but appear after alternate 
periods of rest, followed by uncontrollable delirious attacks, especially 
if another dog should come near. These attacks may occur at intervals 
varying from one to four hours. The peculiar change in the voice is due 
to a paralysis of the vocal cords, and the sound of the bark is prolonged 
into a higher vocal sound, so that it makes a combination between a howl 
and a bark, which has been described by different authors as a "howling" 
bark. This is harsh and shrill. Repugnance to water does not exist 
in the dog as in man, but toward the end of the second stage, from 
paralysis of the muscles of deglutition, we see great difficulty in swallow- 
ing, and very often see an animal pick up some indigestible object, at- 
tempt to swallow it, and, not svicceeding, drop it from its mouth. Fre- 
quently the animal will lap out of his bowl, but it is seen if observed 
closely that he does not swallow any of it, on the other hand animals 
may cower and draw away from water that has been spilled on the floor 
of the cage. Vomiting sometimes occurs. There is great difficulty 
in defecation, which seems to produce evident pain. There is very little 
alteration in respiration, l)ut it may Ix' slightly increased. The pulse is 



RABIES 297 

increased; the temperature also rises, but falls toward the end of the 
course of the disease. 

The duration of the second stage, which does not always present 
all of the characteristic symptoms of this condition, may last from 
three to four days. After the paroxysms have increased in intensity 
and the intervals between them grow shorter, the paralytic, or last, 
stage begins. The animals rapidly become emaciated; the eyes are 
staring, dull, and the eyeball is retracted into the skull. The conjunc- 
tiva is generally hypersemic, the cheeks are sunken; the hair is erect; 
and we begin to see symptoms of paralysis. As a rule, the first sign of 
this is a paralysis of the muscles that close or raise the lower jaw. This 
allows the saliva to run out of the corners of the mouth and form threads 
which hang down, and we easily recognize the fact that the tongue and 
lower jaw have lost their power. The tongue becomes lead-colored and 
hangs out of the mouth. Soon we see paralysis of the posterior extrem- 
ities. This begins with a staggering, unsteady gait, and finally total 
inability to use the posterior half of the body. Then the animals stretch 
themselves out and become completely paralyzed, or in the last stage 
we may see convulsions, but that is very rare. Death, as a rule, occurs 
in the fifth to the seventh day after the onset of the disease. In rare 
instances it may last ten days. Variations may occasionally occur in 
the regular course of the disease; for instance, paralysis of the posterior 
extremities has been the first symptom observed, and in others the 
paralysis of the jaw has not been observed, and dyspnoea has been 
observed for hours before death. 

Dumb Rabies. — The mute or dumb form of rabies, according to Bol- 
linger, comprises about 15 to 20 per cent, of all cases. The average 
given of this form of rabies is entirely too small, and should be at least 
50 per cent., the great majority of cases observed being the dumb form. 
This is distinguished from furious rabies by the fact that the irritating 
or nervous symptoms are less marked, and in very rare cases entirely 
absent, also that the paralytic symptoms appear early in the disease. 
First, we see paralysis of the muscles of the lower jaw. The mucus or 
saliva runs out of the opened mouth, and an inclination to bite is entirely 
absent, although under certain conditions when the mouth is forcibly 
opened the animal will be able to bite. The voice is also changed, but 
it is very rarely heard. We see a loss of appetite, the animal being 
unable to seize or swallow foreign bodies. In this quiet form the three 
stages follow very closely on each other, the course of the disease being 
very rapid, and death, as a rule, appears in two or three days, never 
over five. 

These two forms of rabies in rare instances may merge one into 
the other so that it is intensely difficult at times to separate the different 



298 DISEASES OF TRUE IXFECTIOX 

forms, for instanco a case which we will cite illustrates this. The affected 
animal twenty-four hours l^efore his death had a hoarse bark, no appe- 
tite, and the muscles of the mouth appeared normal, he allowed the 
mouth to be examined and the tongue pressed down to see the throat, 
there was not the slightest inclination to bite or show any signs of deli- 
rium or mental aberration; when the animal died he showed great 
sexual excitement. On post-mortem the stomach was found to contain 
hay, straw, as well as hair that did not come from his own coat. 

This disease must always be considered fatal. 

The diagnosis of rabies may be complicated by certain conditions 
present, due to other diseases. This is especially noticed in the mild 
form and in well-trained affectionate animals which obey their masters 
to the last. Two instances in which the English setter was under com- 
plete control; hunted in the field, obeying the whistle and call instantly, 
and at the same time had every symptom of dumb rabies. Often we 
see cases where the history is either insufficient or the owner can give 
none at all. On the other hand, in the furious form, a history, as a rule, 
is not required, as the disease can be instantly recognized from the 
appearance of the animal. Great excitement- and restlessness, a ten- 
dency to escape, biting and delirious actions, rapid emaciation, and 
debility are characteristics of the furious form of this disease, while 
great depression and paralysis of the lower jaw are characteristic of the 
dumb form. In both forms there is a great inclination to gnaw objects. 
Sexual desire, in the early stage, is prominent. A depraved appetite and 
altered l^ark, more or less rapid symptoms of paralysis, and the cases 
being invariably fatal. The post-mortem confirms the disease when 
we find acute hypersemia of the throat, pharynx, and hemorrhagic 
erosions on the mucous membrane, also foreign bodies, etc., in the 
stomach. 

Regarding the presence of sugar in the urine of rabid dogs, that 
cannot be said to be of special significance, as it is found to be present 
in other diseases. The presence of the corpuscles of Negri in a suspected 
animal, on the other hand, must be regarded as a diagnostic symptom of 
great importance, particularly as it is a means of making a quick diag- 
nosis. The horn of Ammon is where these corpuscles are found in the 
largest quantities, and it requires one to be thoroughly familiar with 
these bodies to recognize them quickly and easily. They are 
found in particles of the horn of Ammon fixed in Zenker's fluid, and 
treated with a 10 per cent, solution of osmic acid, then washed thoroughly 
and then laid in absolute alcohol; this method has the disadvantage of tak- 
ing some time to accomplish it . The method of Bohne seems to be the most 
desirable. Mode of procedure: sections one-half to three-fourths mm. 
thick are cut from the horn of Ammon and put in 15 c.c. of acetone and 




A SMEAR PREPARATION OF THE HIPPOCAMPUS MAJOR SHOWING NEGRI BODIES, 
STAINED BY THE METHOD OF VAN GIESEN, ENLARGED looo DIAMETERS. 

[St-e RaHes]. 



Pink : Stained tissue. 
Blue : Cells. 



Brick : Negri bodies. 
Red : Blood corpuscles. 



RABIES 299 

left at a tcmporatiiro of 37° until they become hardened^ then the sec- 
tions are transferred to liquefied paraffine and left there for an hour at a 
temperature of 60°, then the sections are put in cold water to which a 
small quantity of gum aral3ic is added and put in a stone and the paraffine 
carried off, then the sections are colored by means of Mann's process, 
which is to put the sections for one-half to four minutes in a coloring 
solution consisting of 35 c.c. of 1 per cent, aqueous solution of methylene 
blue and 35 c.c. of 1 per cent, aqueous solution of eosin and 100 c.c. 
of distilled water. The sections are rinsed with water and then put 
in absolute alcohol for 15 to 20 seconds, to which has been added 
some caustic soda (to 30 c.c. of alcohol add 5 droi>? of 1 per cent, 
solution of absolute alcohol). The sections are again put in alxsolute 
alcohol for a few moments and then washed in water for a minute; the 
sections are now put in water slightly acidulated with acetic acid, 
drained and sealed with canada balsam. 

The following procedure has been the method employed for the 
rapid diagnosis of rabies in the laboratory of the Veterinary school of 
the University of Pennsylvania for several years: As soon as the 
animal's head arrives at the laboratory the entire brain and the 
plexiform ganglia, with the adjacent sympathetic ganglia are removed. 
A portion of the cerebellum is placed in sterile glycerine, in which the 
})rain tissue may be preserved and retain the virus for many weeks. 
These glycerine-immersed specimens are only referred to for the animal 
inoculation test when the microscopic examination is unsatisfactory. 
Aside from preventing decomposition, the glycerine will also destroy 
bacteria and check decomposition of the specimens. From the fresh 
brain tissue, smears are usually made from the hippocampus major and 
cerebellum. A piece 1 mm. thick and several millimetres in diameter 
cut from the freshly exposed surface, after an incision is made through 
the hippocampus major at right angles to its length, or of the cerebellum 
in which an incision has been at right angles to the convolutions, is 
placed upon a slide near one end. Instead of using a cover-slip, another 
slide is placed over the small piece of tissue and gentle pressure is applied 
and the opposite ends of the slides are moved toward one another. The 
smears are then placed in alisolute alcohol for two to five minutes, 
whereupon the alcohol is allowed to evaporate and the smears then stained. 
The stain as recommended by Van Giesen is used. 

Loeffler's alkaline methylene blue, 1 part. 

Distilled water, 1 part. 

Saturated alcoholic solution of fuchsin added in drops 
until the mixture has a purple tinge, or initil a metallic 
scum is seen on the surface. 

The mixture kept at a low temperature can be used for an unlimited 



300 DISEASES OF TRUE INFECTION 

length of time, ])ut it is apt to change quickly at room temperature, and 
for this reason a new l)atch of stain is usually made each day or as each 
specimen is prepared for examination. A smear properly fixed on a 
slide is taken up with a pair of forceps and completely covered with 
stain. The slide is passed through the flame of a Bunsen burner several 
times until steam arises from the heated stain, which is permitted to 
remain on the smear for five to thirty seconds. The smear is then 
washed in running water, and if the color of the smear is blue where the 
brain tissue is thickest, and red where the smear is thin, the slide is 
placed between filter-paper and dried. As soon as the slide is dry a 
search is made for large nerve cells with a low-power lens under the 
microscope. The protoplasm of the nerve cells should be stained a light 
blue, the nucleus a shade of purple, and the nucleolus a dark blue. If 
the cells are stained too deeply the stain may be weakened by the 
addition of more distilled water or in heating the staining fluid on a 
smear for a longer time, the intensity of the staining of the fuchsin will 
be increased at the expense of the blue of the Loeffler's alkaline methylene 
blue. "When a nerve cell is found properly stained, it is examined with 
an oil immersion lens. Xegri bodies with this staining fluid show the 
inner bodies a bluish black and the structure around the inner bodies a 
maroon-red. They are found within the cell, outside of the nucleus of 
the cytoplasm in the nerve cells of sections, but not infrequently in the 
smear preparations, a few Negri bodies not Avithin the nerve cells are 
seen, which have been forced out of the nerve cell as the smear is made. 
In searching a smear for Negri bodies, only those bodies within the nerve 
cells should be considered. 

In doubtful cases the disease can only be accurately diagnosed by 
vaccination — that is to say, by the injection of small quantities of horn 
of Ammon or a section of the cord, which have been diluted with distilled 
water, and emulsified and filtered through fine linen. The following 
methods are used at present: 

(1) The Intercranial Subdural Inoculation (Pasteur). — The inoc- 
ulating material (1 or 2 drops of the emulsion) should be injected into 
the dura mater of a dog or rabbit, after it has been trephined, by means 
of a small hypodermic syringe, and the wound sewn up. The operation 
is easily performed, and is especially valuable when the suspected animal 
may have bitten not only other dogs, but man. As this inoculation 
from the spinal matter of a suspected dog takes at least two or three 
weeks, sometimes longer, the animal develops all the phenomena of the 
disease, paralysis, etc., on the quiet. Leclainche recommends intra- 
cerebral inoculation, that is, direct injection of the inoculating substance 
into the brain itself; the persons bitten should not delay, while waiting 
for development, but all measures should be taken as soon as possible. 



RABIES 301 

(2) The Intraocular Inoculation (Gibier, Nocard, Johne). — The 

emulsion (1 to 2 dropt^) wliit-h is thus obtained is filtered through a 
piece of linen antl injected directly into the anterior chamber of the eye 
of the animal which is to bo inoculated. They do this by means of a 
small hypodermic syringe, having first placed cocaine on the cornea, 
and then inject the solution directly into the anterior chamber. If the 
suspected animal is raliid, we will see the development of the disease in 
from twelve to twenty-three days, even if the chaml)er should suppurate 
from the irritation of the injected solution. Gal and Klimmer oppose 
this procedure by pointing out the fact that the stage of incubation 
may be much longer than this. 

(3) The Intraspinal Method (Labell). — The emulsion is injected 
directly in the cord; this method takes somewhat longer to develop than 
the subdural inoculation. 

(4) Intramuscular Inoculation. — One c.c. of the emulsion is 
injected into the masseter, the dorsal or the posterior crural. Klimmer 
finds that the active symptoms are developed somewhat earlier than by 
the intraocular method. 

There are other methods of inoculation used l3ut they are much 
less reliable, such as nasal, subconjunctival, subcutaneous and intravenous. 

It is always w^ell to inoculate two animals, because it frequently 
happens that an animal is immune to the disease or dies shortly after 
the inoculation (cerebral hemorrhage, etc.). 

The following diseases are sometimes mistaken for rabies: Certain 
affections of the brain, such as teething, epilepsy, eclampsia, distemper, 
angina, intestinal parasites, inflammation of the intestines, pentastoma 
in the nose and frontal cavities, foreign bodies in the mouth (between 
the teeth) or in the throat, paralysis of the lower jaw, luxation of the 
lower jaw, due to irritation of the tiigeminus, intense excitement in 
latches that have had their young taken from them, great sexual excite- 
ment in male dogs, long confinement in cages or kennels, and from 
certain poisons. The course of the disease, however, and the after- 
symptoms always enal^le one to make a differential diagnosis. 

Therapy and Prophylaxis. — As soon as the disease has reached a 
point where there is no question as to its character, the animal should 
be destroyed as soon as possible. When man is bitten it is a question 
whether thorough disinfection or cauterization of the wound is of much 
benefit unless it is done within a few minutes. In reference to the pre- 
ventive inoculation of Pasteur, it is not necessary to enter into detail in 
this work, beyond the fact that it is the inoculation of an attenuated virus 
cultivated from rabies. A large number of experimenters have made 
repeated inoculations with a view of obtaining immunity to the disease, 
but they have not had very satisfactory results. 



302 DISEASES OF TRUE INFECTION 

The most effective method of preventing the spread of rabies is to 
register all dogs claimed by owners, and all stray dogs should bo destroyed, 
and when there is a case of rabies or a suspicion of such, all dogs should 
be put under observation, nuizzknl or put on a leash, and any dog 
known or suspected of having been bitten by a rabid dog should be 
confined and watched by a competent veterinarian and if found to 
develop the active symptoms it should be immediately destroyed and 
the head sent to the local live stock sanitary board laboratory for 
examination. 

In the largo cities all dogs, if they are worth keeping as pets, should 
be taxed and all vagrant mongrels taken up and destroyed. In America 
and England where they have made a close study of the spread of rabies 
and have reached the conclusion that while muzzling is a protective 
measure, it is by far the least point of danger, for an owner that Vvill 
take the trouble to muzzle his dog is one who closely observes his animal 
and at the first sign of the disease has him examined. Invariably the 
outbreaks of disease originate either in the slums of cities or little villages, 
where the low class of ignorant shiftless masses live, who protect and 
have around their places a number of mongrel curs that are valueless; 
the owners or protectors of these pariahs will neither observe their animals 
nor restrain them when they develop rabies, but drive them off, or 
allow them to go on their travels to bite and tear every animal that 
comes in contact with them. Taxation has been tested out in Europe and 
in every case where mongrels were gathered up and destroyed rabies 
decreased one-half or more — in some cases not a single case was recorded. 

Tuberculosis. 

Under this name we class all affections w^hich owe their origin to a 
peculiar specific bacterium known as "tubercle bacillus," discovered by 
Koch. These are found in all tubercular deposits in man or in animals, 
whether they occur spontaneously or are inoculated. Under the micro- 
scope they appear in the shape of very narrow non-flagellated rods often 
slightly curved, fi-om 2 to 4/( long. The organism shows many variations 
in its morphology under different conditions. It often occurs in isolated 
clumps, either in cultures or in tissues. In certain cultures and in ani- 
mal tissues it grows in the form of longer or shorter branching threads 
(Ricketts). 

The tubercle bacilli should be considered as true parasites which 
multiply and live in the body only, but they also seem to possess the 
property of living outside of the body for a certain length of time, as 
the excretions of tuberculous animals can be used successfully to in- 
oculate other animals. ^^'e therefore conclude that tuberculosis is only 



TUBERCULOSIS 303 

produced In' infection, or a better term would be transmission of tubercle 
bacilli, direct or indirect, from one subject to another. 

While it is well known that tuberculosis of man and of certain 
domestic animals, such as cattle, is very common, it is rather rare in dogs. 
A number of schools have found that only from 2 to 5 per cent, of all of the 
animals brought to the clinics were affected with tuberculosis. Dogs seem 
to possess more power of resistance and are able to throw off the disease. 

Certain experiments by inoculation and inhalation have demon- 
strated the fact that one-third of the cases develop the disease, and the 
feeding of tubercular matter in the food invariably produced negative 
results. Considering the rarity of this disease in the dog, we will not 
give any detailed explanation of any length concerning its etiology, 
pathological anatomy, etc. 

Etiology and Pathological Anatomy. — A number of observers agree 
to the fact that, as a rule, an animal affected with tuberculosis has been 
at some time near or in the vicinity of some person who was in an ad- 
vanced stage of consumption. In such cases the bacilli may be intro- 
duced in the form of fine dust and be respired into the lungs or may be 
taken up by the intestines, finding their way into the bowels mixed with 
food. In one ease which the writer observed there Avere tuberculous 
ulcers in the parotid region, and also tubercular deposits in the lymphatic 
glands of the neck. The disease appears in the dog in the form of an 
acute or local tuberculosis. The disease may be found in the lungs, 
the mesenteric glands, the intestines, liver, kidneys, and peritoneum, and 
in rare instances affecting the entire body. 

Pulmonary Tuberculosis. — This presents numerous anatomical alter- 
ations: over the entire lung we may find firm round gray nodules (miliary 
tuberculosis), or they may break down, forming caseous nodes and 
cavernous hollows or there may lie a chronic indurated broncho-pneu- 
monia; more rarely we find chronic interstitial indurating pneumonia 
with secondary alterations, acute and chronic bronchitis, peribronchitis, 
bronchiectasis, pulmonary hypera^mia, emphysema, and frecjuently 
adherence of the lung to the pleural wall. 

In nearly 50 per cent, of all cases, the lymphatic glands of the 
thorax, especially the bronchial glands and the glands which are located 
above and behind the mediastinum, are invariably infected to a marked 
degree with tubercular deposits, and are found to be very often enlarged, 
forming large tumor-like masses. These consist of a lardaccous tissue, 
grayish-white in color, and generally contain a centre cavity filled with 
a cheese-like mass. True cheesy tuberculosis is rather rare in the dog, 
but, on the other hand, we find a peculiar process of absorption of the 
tissues, foi-ming white masses, which on examination are found to be 
tuberculous deposits. 



304 DISEASES OF TRUE INFECTION 

Pleural Tuberculosis. — "When the process of breaking down, or 
disintegration, has gone on to any marked degree, the tuberculous 
mass forms a tumor-like body containing in its centre a whitish fluid 
held in fibrinous tissue. This was noticed in 50 per cent, of the cases 
observed in the dog where the lymphatic glands had undergone this de- 
generation. In the other half of the cases, the serous meml)ranes of the 
abdominal cavities were covered with tubercular masses, the pleura being 
the most common seat of the disease. In the majority of cases of pleural 
tuberculosis it takes the form of what is known as the " pearl " tubercular 
masses. These are found to be deposits of soft connective tissue, 
occurring in the form of numerous conglomerating granulations or in 
large round tumors. In some cases there is extensive exudative in- 
flammation present (sero-fibrinous and purulent pleuritis). Tubercular 
inflammation is found in the pericardium, with extensive adhesion to the 
heart, and a very pecviliar alteration of the mediastinum has been 
deserved in several cases. The heart rarely presents any tubercular 
formations. 

In the digestive organs, the lymphatic glands of the head and neck 
are rarely invaded; and the writer found the submaxillary and retro- 
pharyngeal lymphatics to l)e afTected in only one instance. On the 
other hand, the mesenteric glands were particularly affected, some cases 
presenting large tumor-like masses containing broken-down centres. 

Tuberculosis of the intestines is rare, and is restricted to slight 
ulcerations or abscesses. The liver, as a rule, is generally involved to a 
marked degree, its substance being filled with small nodules or large 
granular masses which are milky W'hite in color. In the centre of these 
is found a broken-down opaque fluid, the result of fatty degeneration. 
The spleen was found by the writer to be tubercular in two cases, and that 
only to a slight degree. In the liver are found numerous firm white 
fibrous nodules ranging from the size of a pea to the size of an egg. The 
kidneys are frequently the seat of more or less tubercular deposits, and 
in twelve cases scattered granulations were found in the spinal and mem- 
branous substance, but cheesy abscesses and centres were also found. 
These were accompanied by chronic indurative nephritis. Ulceration of 
the pelvis of the kidney w^as observed in one case. One dog showed Init 
a slightly tubercular ureter and bladder. The sexual organs are, as a 
rule, found healthy and very rarely attacked by the disease. In rare 
instances a tubercular testicle is noticed. 

Tuberculosis of the prostate has been o]:)served, also in the ovary, 
the bones, articulations and in the brain. A tuberculous ulceration of 
the skin has also been seen. For further particulars as to the patho- 
logical character of tuberculosis, consult the numerous works on the 
subject. 



TUBERCULOSIS 305 

Clinical Symptoms and Course. — On account of the various ways 
in which tuborcuhj.sis ai)])ears, no postive line of symptoms can be made. 

Acute miliary Tuberculosis is very rare and runs its course with 
intense rapidity, and generally it is only by the presence of the tuber- 
cular bacilli in the blood that it can be recognized. 

Chronic Tuberculosis. — The animal is easily fatigued, short breath, 
particularly after any slight exertion, irregular appetite, there is a dry 
hollow cough, generally on rising after resting or after eating, later the 
cough becomes more frequent and painful, and there may be a muco- 
purulent discharge from the nose, difficulty in respiration — this at first 
is slight, but sooner or later it is very pronounced; on auscultation 
there is a vascular murmur, and later bronchial rales of diverse forms and 
intensity; later a pleuritis and a hydrothorax. Valuable animals pre- 
senting these symptoms may have the diagnosis made positive by in- 
oculating a rabbit (intraperitoneally) with the pleural exudate, and if 
the exudate was tubercular, three weeks afterward the spleen and the 
peritoneum of the rabbit will show the tubercular lesions, or w^e find a 
tubucular mass on the liver. 

Tuberculosis of the lungs only will show marked symptoms after 
it has made considerable progress, and as the symptoms are ver}^ similar 
to chronic catarrh of the lungs or chronic lobular pneumonia, it is apt 
to be confounded with these two diseases (see this disease). Notwith- 
standing a good appetite, when there is rapid emaciation and a quick 
loss of strength we should suspect the animal has tuberculosis of the lungs 
but we can only be positive of our diagnosis by recognizing the tubercle 
bacilli in the secretions, although it is very difficult to find the bacilli as 
it is not only extremely difficult to obtain sputa from a dog, but to find 
the bacilli if we do get some of the sputa (see later, tuberculin test). 

Tuberculosis of any of the abdominal organs is very difficult to 
recognize. The only way we might succeed is by manipulation of the 
abdominal cavity, recognizing swollen lymphatic glands or tubercular 
masses on the liver. We do find, however, great emaciation and symp- 
toms of chronic catarrh of the intestinal tract. These last two symptoms 
are generally sufficient to make us suspect intestinal tuberculosis. In 
one case of tubercular ulceration of the intestines which was observed 
by the writer, the dog was very thin and had shown this emaciation for 
some time. There were also present symptoms of catarrh of the lungs, 
and upon the upper portion of the neck a deep abscess had formed. 
This was ciuite large and contained ciuantities of thin pus. In the region 
of the neck near the abscess we observed a granular mass the size of a 
chestnut. This could be pushed under the cutaneous membrane and 
moved about freely. There were also present a few enlarged lymphatic 
glands in the upper portion of the neck. 

20 



306 DISEASES OF TRUE INFECTION 

A very important and constant symptom of tuberculosis is the grad- 
ual emaciation of the affected animal, accompanied by exhaustion on 
the slightest exertion, the hair is hard, dry and bristly, the eyes are 
sunken, the face drawn and wrinkled, the visible mucous membranes 
pale or yellowish, the mucous membranes are dry, the pulse small, 
accelerated, and the heart throbs, the temperature is elevated from 
time to time, the appetite is irregular but generally small, constipation 
alternates with obstinate diarrhoea, and finally the animal becomes a 
skeleton and dies in a state of collapse; at this stage the temperature is 
apt to be subnormal. The average duration of the disease is from six to 
eight months. 

Microscopical Demonstration of the Tubercle Bacilli. — The tubercular 
matter is placed on a glass and allowed to dry in the air; it is then covered 
with Ziehl's carbol fuchsin solution (1.0 fuchsin, 10.0 absolute alcohol, 5.0 
carbolic acid, 95.0 distilled water) and heated over the flame for two 
minutes. Then it is allowed to cool, then washed with distilled water 
and then put in Gabbet's solution (2.0 methylene blue, 100.0 of 25 per cent, 
solution of sulphuric acid) ; after lying in this for two minutes it is rinsed 
with water and is ready for examination. The tubercle bacilli are 
stained red, the other substances being blue; an oil immersion lens gives 
the best results. Where the examination must be made as soon as pos- 
sible, if the preparation is thoroughly dried, it gives almost as good 
results (see Plates). 

Tuberculin Test. — The inoculation of Koch's tuberculin to deter- 
mine whether a dog is affected with the disease may be tried, but as a 
rule is unsatisfactory, the reaction is seldom very pronounced in char- 
acter, and in the acute stages of the disease it may even give a subnormal 
temperature; in several instances an animal gave a reaction, but careful 
examination failed to give any evidences of tuberculosis. Recently the 
ophthalmic test has come into popular favor in diagnosing tuberculosis 
in the dog. The method is quite simple. It consists in dropping into 
the conjunctival sac 1 or 2 drops of tuberculin, especially prepared for 
this test. If the animal is suffering from tuberculosis, a reaction will be 
manifest by the development of a conjunctivitis in from eight to twelve 
hours. There will be excessive lachrymation, injection of the capil- 
laries of the conjunctiva and even slight suppuration at the inner 
canthus. In chronic cases the reaction may be overlooked unless the 
animal is kept under close observation, inasmuch as the acute symp- 
toms come on and pass off very rapidly. In cases of recent infection 
the reaction may last for at least twenty-four hours. 

Therapeutic Treatment. — When you have once established the fact 
that the aninuil is aff(H-t(Ml with the disease, it is the duty of the veterin- 
arian to warn the owner of the tubercular or suspected dog, of the danger 



HEMOGLOBINURIA AND PIROPLASMOSIS 



307 



of infection, and advise him to destroy the animal. In the early stages 
of the disease and when there are no other animals kenneled with it, 
the animal can be fed with highly nutritious food and given inhalations 
of creolin or l^enzoin. 



Hemoglobinuria and Piroplasmosis. 

When there is any decomposition of red corpuscles in the body 
(hemogiol)inannia) the coloring substance is eliminated through the 
kidneys, staining the urine and producing hemoglobinuria. In this 
condition the urine is characterized by a dark red, dirty brownish or 
brick-red coloration. 

This condition occurs when from some cause the coloring matter 
of the blood becomes liberated, either from destruction of the blood 
corpuscles or separation of the coloring matter from the stroma of the 
corpuscle or a delixiviation of the erythrocytes. If only a small quantity 
of coloring matter is freed it is taken up by the liver, but if a large 




Fig. 99. — Blood of a clog affected with piroplasma canis, magnified 350 times. (Kastner.) 

quantity is free in the circulation, it is also taken up by the urine. 

The hemoglobin test consists of drying a certain quantity of urine in 
a small saucer, and with the dry mass we mix a small quantity of finely 
pulverized chloride of sodium, placing it on a plate. Then add two 
drops of cold glacial acetic acid. Now slowly heat the cup over an alcohol 
lamp and allow it to cool. As it does so, you will see a quantity of dark- 
brown crystals. If these are not easily distinguished by the eye, they 
are with a magnifying glass. While we cannot distinguish the presence 
of the coloring matter of the blood in the urine with the aid of the micro- 
scope, we may detect the presence of blood corpuscles in the fluid. Wo 
may also find by this means uric casts and epithelium of the kidneys, and 
small red granulations. These may be considered hiemoglobin. As to 
the causes of this condition we will mention piroplasma. 



308 DISEASES OF TRUE INFECTION 

Piroplasma Canis, Malignant Jaundice. — This is an infectious, 
not contagious disease, due to the presence of a protozoon, piroplasma 
canis, in the red corpuscles; this disease is generally found in warm 
climates, particularly South Africa; it is very rare in Europe. 

Etiology. — The cause of this disease was first described JDy Plana and 
Gali-Valerio as a protozoon of the order of hemosporidia, and was carried 
into the blood of the dog by means of ticks — in France by the Dermacenter 
reticulatus, in South Africa by the Hemophysalis leachi, and in Germany 
and Hungary by the Ixodis ricinus reduvious. The disease appears 
about thirty-six hours after infection of the red blood corpuscles; the 
corpuscle being colorless, the protozoa can easily be recognized if the 
blood is fixed with absolute alcohol and stained with methylene blue (Fig. 
99). The size of the parasite varies from 0.7 to 3.4/i. They multiply 
very rapidly, particularly when the fever is high. After the destruction 
of the erythrocytes, the parasites appear in the plasma, and are more 
rounded in form, and then they appear in greater numbers in the in- 
ternal organs, particularly in the lung tissue, than in the blood. Trans- 
mission, either by subcutaneous or intermuscular injection of the de- 
fibrinated blood containing the parasites, reproduces the disease and 
the animals die in a week; recoveries are very rare. The blood if kept 
in a cool place retains its full activity for twenty-five days, in warm 
weather the infected blood loses its activity in fourteen days, at a 
temperature of 44° it loses its power in one and one-half hovirs, and at 50° 
in one-half hour. Young dogs seem more receptive of the disease 
than older animals; bitches which have had the disease give their 
puppies a certain amount of immunity from the disease. 

Pathological Anatomy. — If the disease is very acute, and runs a 
short course, with the exception of the alteration of the blood, very little 
change is noticed. In more gradual cases there is anaemia, jaundice and 
great enlargement in the volume of the spleen — it is frequently found 
to be four times its natural size — hypersemia of the liver, kidney and 
marrow of the bones, extravasations in the pericardium and in the lungs, 
catarrh of the stomach and of the intestines, especially the duodenum. 
In the kidneys, spleen, marrow of the bone, as well as the blood, 
numerous piroplasma are found. 

Clinical Symptoms. — The disease occurs in both acute and chronic 
forms. The acute form is ushered in by listlessness, depression, want 
of appetite, and increase of temperature to 40-43°, and a few days 
later by a rapid fall of temperature to sulmormal; the visible mucous 
membranes are cyanotic, sometimes yellow, icteric; the pulse and 
respirations are increased and frequently labored; the gait sluggish 
and staggering, and finally there is complete paralysis. The urine con- 
tains albumin and biliary i)igment, and in the majority of cases from 



TETANUS 309 

3 to 5 per cent, of haemoglobin. The blood is thin, light red, and coagulates 
very slowly; the number of erythrocytes is diminished by half, 
and the leukocytes are greatly increased in number. Death occurs in 
from three to ten days. 

In the chronic form the temperature is slightly increased or may even 
remain normal, the animal shows great muscular weakness, lassitude, 
want of appetite and rapid emaciation, urine contains albumin and 
biliary pigment, while haemoglobin is rarely found, and there is a diminu- 
tion of the red blood corpuscles and a corresponding increase of the white 
corpuscles. The duration of this disease is from three to six weeks; 
recovery is not at all rare. The diagnosis is easily ascertained by the 
presence of the piroplasma in the blood. Nocard suggests that where 
there is every evidence of the disease, but microscopical examination 
fails to detect the piroplasma, a young animal should be inoculated 
experimentally. 

Therapeutics. — As there is no specific agent that can be said to 
have any beneficial effect on the disease, we must give good nursing, 
careful but nutritious diet. When animals, particularly hunting dogs, 
are taken to regions infested with ticks, such as woods, wet swampy 
ground, or low scrub pasture, the animals should be rubbed with emul- 
sions of lysol, creolin or petroleum to protect them from invasions of the 
tick. 

Preventive Inoculation. — When a dog has overcome the disease 
and become immune, the l^lood of this animal possesses the property 
of destroying the piroplasma; these immune animals are inoculated 
repeatedly with the virulent blood, and a serum is obtained w^hich is 
used. Care must be taken to see that this serum retains its activity. 

Tetanus. 

(Lockiaw.) 

This is a specific infectious disease characterized by tonic muscular 
contractions and caused by the tetanus bacilli. These organisms are 
rather long, slender — from two to four microns long — with a globular spore 
at the end; this is larger than the bacillus and gives the latter a drumstick 
shape. The organism is strictly an anaerobe and is obtained in pure cul- 
ture with some difficulty; morphologically it is difficult to distinguish from 
the bacilli of malignant oedema and systematic oedema (Ricketts) . These 
spores possess great powers of resistance and are found in soil, particularly 
in garden earth and rich meadows, and in the excrement of healthy 
horses, dogs, cattle and other animals; this explains why animals are 
so, prone to develop the disease from wounds of the extremities, tail, etc. 



310 



DISEASES OF TRUE INFECTION 



"\Micn these microbes invade a wound they midtiply with great rapidity 
and produce toxines which cause a strychnine-like convulsive contraction 
of the muscles. The virulence of the bacilli is in all probability influenced 
by the simultaneous invasion of other germs. 

This very rarely occurs in the dog. The figure here presented (Fig. 
100) is the only one the writer has seen, and was taken twenty-four 
hours l:)efore death; the muscles w^ere contracted to such an extent 
that the animal could be lifted bodily by holding up one anterior limb. 
Tetanus may originate from a wound in any part of the body. No special 
class of wound can be said to be favorable to the production of tetanus. 




Fig. 100. — Dog with tetanus. 



It may originate from a scratch or from a very large wound. The 
temporary trismus seen in young animals that have eaten decayed meat 
should be classed under ptomaine poisoning, and not under tetanus. 
The anatomical examination is almost always negative; hypera^mia 
and congestion of the cord which is occasionally seen is of secondary 
importance as it seems to have no actual bearing on the true cause of the 
disease. 

Symptoms. — The period of inctd)ation in a dog is not known posi- 
tively, as the cases are so rare, but probably it is about the same as a 
horse — from five to twenty days — depending probably on the vir- 
ulence of the bacilli. The general symptoms are stiff stilty gait, the neck 
and head are extended, the expression is staring and anxious, the ears are 
drawn forward and pointed, the membrana nictitans is draw^n over the 
eye, wrinkling of the skin of the f9rehead, retraction of the angle of the 



TETANUS 311 

mouth, with difficulty in eating and drinking, the penis is erect and the 
muscles of the body are hard and outlined, the animal is nervous and 
anxious; the pulse and temperature are generally little altered. In one 
case there was an elevation of temperature; the case recovered. The 
duration of the disease is about a week, but it may vary. As recoveries 
are recorded from time to time, it cannot be regarded as always incurable. 

Therapeutics. — The treatment is generally palliative. The wound 
must be examined and treated with antiseptics, and use such sedatives 
as morphine, dilute hydrocyanic acid, chloral; it must be remembered 
the most important matter is to keep up the animal's strength with 
easily digested food — scraped meat, beaten up eggs. Where the trismus 
makes it impossible to administer food by the mouth, it should be given 
in the form of nutritive clysters. 

Tetanus antitoxin may be tried; the dose is 5 c.c. daily. 



CONSTITUTIONAL DISEASES. 

Anaemia and Chlorosis. 

By ansemia in the strict sense of the word, we mean a lessening or 
thinning of the blood. This is especially noticeable after great hemor- 
rhages. At the same time much greater importance must be placed on 
that condition of the blood where the number of red corpuscles is very 
much decreased. This diminution of the number of red blood corpuscles 
is the most important form of anaemia. 

Etiology. — The disease occurs frequently in young, delicate animals 
of the improved or closely bred classes, in animals that are weaned too 
early, or when they are not properly nourished when puppies. It seems 
to be hereditary in some of these animals — litters from feeble, delicate 
bitches — and may depend to a certain extent on the defective development 
of the arterial system and an abnormally small heart. Anaemia occurs 
most frequently from the lessening in c^uantity of the vital fluids, such as 
the albuminous, or after a large or long-continued slight hemorrhage; 
from prolonged suppuration of the kidneys; and lastly a want of proper 
nutrition — for instance, young animals in a poor condition should be fed 
on meat. Very often impaired digestion prevents an absorption of 
certain nutritive substances in chronic disease, in fever, intestinal worms, 
dochmius, taeniae or ascarides, or parasites in the blood (filaria), piro- 
plasma, and from certain poisons in the blood, etc. 

Clinical Symptoms. — The symptoms of the disease consist in a re- 
duction of the coloring elements of the blood and a general condition 
of debility, showing every indication of loss of blood. The skin and 
visil:)le mucous membranes are very pale in color. 

The animals are easily fatigued and have a draggy w^ay of walking; 
the pulse is often small and generally rapid. The temperature in many 
cases is below normal; in other cases it may be normal or even higher. 
Auscultation of the heart at times gives a soft, booming, systolic murmur. 
The respiration is increased with the pulse, and especially after very 
slight physical exercise. Reflex excitability of the brain in anaemic 
subjects is increased to such an extent that the animal will go into con- 
vulsions on the slightest provocation. Impaired digestion is a frequent 
symptom and naturally assists in complicating the disease. It is gen- 
erally chronic, but proper treatment will often produce very good 
results. 

312 



LEUKAEMIA 313 

Therapeutic Treatment. — The treatment must all tend to one 
object — that is, the formation of more blood. This may be obtained 
by proper hygienic measures, feeding with light, easily digested sub- 
stances, especially meat (not milk, which does not agree with the animals 
for any length of time), as well as medicinal substances — that is to say, 
ferruginous preparations. Among the latter, carbonate of iron, saccha- 
rated oxide of iron, and lactate of iron. These should be given in 0.4 
to 0.5 gramme three times daily. Tincture chloride of iron, 10 to 20 
drops daily. In many cases these iron preparations do not agree well 
with the patients, as the drug irritates the stomach and their appetite 
becomes impaired. These preparations should have some vegetable 
tonic added to them, the bitter principle stimulating digestion and 
counteracting the irritant effect of the iron. A very useful preparation 
in this disease is citrate of quinine and iron. This preparation is valu- 
able not only for the iron it contains, but the tonic properties of the 
quinine, and also the very slight tendency it has to irritate the stomach. 
Arsenic, either in the form of Fowler's solution or the red sulphide, is 
useful as a general tonic. 

Leukaemia. 

This disease, which is generally chronic, is one that is characterized 
by an altered condition of the blood, due to the presence of an increased 
quantity of white blood corpuscles, which is the result of some path- 
ological change in the blood-forming organs, viz.: the lymphatic glands, 
spleen, and marrow of bones. Formerly the disease was classified in 
three divisions: Lymphatic, lineal and myelogenic forms; according to 
the origin of the disease, the lymphatic glands, the spleen or the marrow 
of the bones. This, however, is now classified by Ehrlich into two 
chief divisions, namely (1) lymphatic leukaemia, which is the result of 
some pathological change in the lymphatic glands and causes the appear- 
ance in the blood of numbers of lymphocytes, i.e., isolated cells the size 
of a red l)lood corpuscle, and (2) myelogenic leukaemia in which thereis some 
pathological activity of the marrow of the bones in which there is an 
enormous increase of the ordinary polynuclear leukocytes and also 
large mononuclear cells which are only found in the marrow of bones. 
These distinctions are of no special value to the practitioner, and both 
these forms, as a rule, are combined in the dog as in other domestic 
animals. The myelogenic form has never been observed alone (Seidam- 
grotsky and others). 

Etiology. — The cause of this disease is not definitely known at present. 
In the human race we find that middle-aged men are mostly affected 
with the disease; in the dog, while the middle or advanced period of age 



314 CONSTITUTIONAL DISEASES 

seems to show the greatest number of cases, still young animals are 
frequently attacked, and the disease invariably runs an acute course. 
It is apt to follow certain traumatisms, but whether, in dogs, it follows 
as a result of grave infectious disease is a question. Attempts to produce 
the disease by transfusion of leukaemic blood in healthy animals gave 
negative results but produced a swelling of the gians penis and the 
lymphatic glands in its immediate neighborhood, and catarrh of the 
prepuce. 

Pathological Anatomy. — The most important alteration always 
observed in this disease is an increase of white blood corpuscles and a 
lessening of the amount of the red corpuscles in the blood. This may 
become so great in the dog that we find the proportion of white to red 
blood corpuscles is 1 to 5 (Bollinger). "We find the blood possesses a 
much lighter color than it does normally, has a lighter specific gravity. 
We also notice a great tendency to emaciation and a characteristic 
alteration of the spleen, which is greatly enlarged, and increased pro- 
portionately in weight. It is not rare to find it weighing at least 1000 
grammes, and we find on section of the enlarged spleen, marks of 
true hyperplasia. Fenereissen found in a bulldog affected with this 
disease a spleen that weighed 3 kilogrammes. We also see at times 
enlargement of the lymphatic glands due to circumscribed hyperplasia 
of the glandular tissues. The marrow of the bones is occasionally 
involved and appears dark red. In serious cases the color is yellowish- 
gray, becoming soft and plastic. In very rare 
cases hyperplasia is seen in other organs, such as 
the tonsils, liver, and lungs. 

Clinical Symptoms and Course. — The symp- 
toms of the disease are similar to those of intense 
anaemia. First, there is a characteristic alteration 
of the blood, and, second, the symptoms presented 
by the spleen and lymphatic glands. In mild 
Fig. 101.— The blood in cases a microscopic examination of the l^lood and 

leukocythaemia. . <■ i i i mi • 

counting the number of blood corpuscles will insure 
a diagnosis. The best way to obtain a small quantity of blood for the 
purpose of making an examination is to make a slight slit in the upper 
surface of the outside of the ear. Place it under the microscope without 
adding any other substance to it, and we will recognize not only an 
enormous increase in the number of white blood corpuscles, but a differ- 
ence in their normal size (Fig. 101). 

While we may be able to correctly diagnose the disease from the 
condition of the blood during life, we may also notice certain alterations 
in the size of the spleen and lymphatic glands. In the glands of the" 
head and neck we frequently find considerable enlargement. Normally, 




LEUK.^MIA 315 

the proportion of blood corpuscles in the blood is one white l)lood cor- 
puscle to three or four hundred of the red blood corpuscles, but in 
leukiemia the proi)0]'tion is frequently one white to fifty red nnd in 
extreme cases one to five. In making a count of the white l)lood cor- 
puscles there is one point that must not be forgotten, and that is that 
there is a normal physiological increase of the white blood corpuscles 
when the animal has had a great loss of blood, immediately after the 
digestion of a heavy meal, where there is chronic inflammation and 
suppuration and in the bitch during pregnancy; hence a marked increase 
in the number of white blood corpuscles, unless there are other symptoms 
that confirm it, does not mean the animal has leukaemia. The altera- 
tion in the lymphatic glands is easily detected in those glands that are 
near the surface of the body. The lymphatic ganglions are found to l)e 
enlarged, round, and sometimes irregular and are generally painless on 
pressure. In some cases we may find solitary enlarged lymphatics in 
different parts of the body. Frequently the region of the enlarged 
lymphatics is oedematous. It is only when the spleen has reached a 
considerable size that it can be outlined by palpation of the abdomen. 
Another symptom of leukaemia is the marked increase in the pulse. 
There is redness of the mucous meml^ranes oi the mouth, coated tongue, 
disordered stomach, irregular attacks of diarrhoea, dropsical swellings, 
ascites or chyle stasis, as a result of the acute hypertrophy of the 
abdominal lymphatic glands, and we may occasionally see intestinal 
haemorrhage. 

The course of this disease is invariably chronic with a gradual 
increase of the severity of the symptoms, the condition of the animal 
continually getting worse until finally the animal dies of exhaustion. 

Therapeutics. — The treatment of leukaemia is practically the same 
as that of anaemia. Give very nutritious food and arsenic, iron or 
quinine. The inhalation of oxygen as well as the transfusion of 
blood recommended in the treatment of this disease in man has been 
tried in the dog and found unsatisfactory. The administration of certain 
organic therapeutical preparations, such as spleen (lienaden) tablets, 
lymphatic gland tablets, or bone-marrow tablets, has also been found 
to be valueless. 

I^. Ferri et quininse citratis, 0.2 

Saccharum, O.G 

M. F. pulv. divid charta, No. xx. 

Sig. — One jjowder three times daily. 

Pseud oleukaemia. Lymphadenia, Hodgkin's Disease. — This disease 
appears more frequently in the dog than leukaemia. It is due to a 
hyperplasia of the blood-forming centres, particularly the lymphatic 



3 1 G CONS TI T U TIONA L DISEASES 

glands; these become greatly enlarged. The proportion of white over 
red blood corpuscles is also greatly increased. Cadiot found four cases 
where the proportion was 1 to 183 to 1 to 200. The cause of this disease 
has not been clearly demonstrated. Some observers ascribe it to tuber- 
cular processes in the lymphatics. The course is generally rapid, and 
while in the early stages there is no great alteration in the general con- 
dition; anaemia soon commences, and in consequence of the hyperplasia 
of the bronchial lymphatics we find dyspnoea, and as a result of the 
abdominal glands being in the same state of hyperplasia we have 
dropsy of the abdomen, later general cedema, and finally death. 

Treatment is the same as anaemia and leukaemia. Arsenic is gen- 
erally used; if it has no effect, iodide of potassium. 

Diabetes Mellitus. 

Etiology. — By diabetes mellitus we understand a peculiar chronic 
abnormal condition of the urine wdiich contains a large quantity of grape 
sugar. The true cause of this peculiar disease is not exactly known, 
but from recent observations which have been made on dogs and other 
animals this disease seems to have some connection with diseases of the 
pancreas. Minkowski found that on removal of the entire pancreatic 
gland, sugar appeared in the urine in twenty-four hours — the amount of 
sugar was 10 per cent. — and death in a few weeks. A removal of a 
portion of the pancreas caused slight traces of sugar in a short time, and 
if the greater part of the gland is extirpated, leaving only a very small 
portion, sugar was immediately formed in the urine in large quantities, 
and resulted in death in a very short time. Lepine seems to think the 
pancreas has the property of taking up the sugar in the blood and when 
this gland is destroyed or its functions become impaired in any way, the 
sugar in the blood is eliminated by the kidneys. This is further con- 
firmed by diabetic dogs, where one part of the pancreas is invariably 
found to be atrophied, either from functional loss of power or from car- 
cinoma. Gebier mentions a case of transitory glycosuria, where a bitch 
of a very affectionate disposition and accustomed to be with other 
dogs, when separated from the other dogs and confined by herself, imme- 
diately had sugar appear in large amount in her urine. 

While this disease is comparatively rare, and is more frequently 
seen in old dogs, occasionally large number of cases may be seen in 
certain localities; sex seems to have no influence on the disease, as it is 
seen equally in ])oth sexes. Eber found it to occur most frequently in 
small pet dogs that have little or no exercise. 

Clinical Symptoms and Course. — The disease develops gradually; the 
most important symptom is the gradual emaciation notwithstanding 



DIABETES MELLITUS 317 

the fact that the animal may have an enormous appetite and be fed 
with the most nutritious food. The animal is easily fatigued, is made 
to take exercise with effort, and in some cases moves about with more 
or less difficulty. The animal shows great thirst and drinks enormous 
quantities of water, at the same time passing large quantities of urine, 
which in most cases is pale and colorless and, as a rule, the specific 
gravity is particularly high (1030 to 1060) and it is only in very rare 
cases that the specific gravity is as low as normal. The odor of the 
urine is very characteristic; it resembles that of fresh fruit (aceton). 
The tests already described can be used to demonstrate the presence of 
sugar in the urine, the fermentation test being the best to use. Consult 
special works. The quantity of sugar present in the urine may vary in 
amount. Eichhorn states that in one case he found 11 per cent, and 
Haltenhof found 12 per cent, in another case. When an animal is fed 
on a pure meat diet it seems to lessen the amount of sugar in the urine, 
although there are certain cases where even this diet has little or no 
effect on the amount of sugar present. Albumin is sometimes found in 
the urine in this condition. 

In many cases cataract may develop (opacity of the lens, gray 
cataract), appearing simultaneously in both eyes, causing total blindness, 
in some cases we find ulcerative keratitis. In other cases the hair falls 
out; vomiting, persistent diarrhoea, falling out of the hair, and some have 
noticed an inflammation and ulceration of the skin and bleeding of the 
mucous membrane terminating in chronic bronchial catarrh of the 
lungs. The course of the disease is gradual; emaciation and debility 
increase until finally the animal sinks into a deep coma, accompanied, as 
a rule, with convulsions, and finally death. The prognosis in all cases 
should be unfavorable. Post-mortem generally shows atrophy of the 
pancreas and hypertrophy and fatty degeneration of the liver. 

Therapeutics. — The treatment of diabetes consists of feeding the 
animal on food which does not contain any carbon, or as little as possible. 
This may be accomplished to a certain extent by a meat-diet, and even 
this diet cannot be followed up for any great length of time. Give eggs 
and bran bread, vegetables and in cases where it cannot be avoided, milk; 
but wheat bread, sweets, sugar in the form of candy, cakes, rolls, rice, 
peas, lentils, potatoes, or any food containing starch in large quantity, 
must be avoided. A pinch of carbonate of soda must be given three 
times daily in the drinking water. Other preparations such as arsenic, 
salines, salicylate of soda, carbonate of ammonia or acetate of ammonia 
are useful. Where the animal is in a state of coma, use subcutaneous 
injections of ether or camphor in combination with the intravenous 
injections of normal saline solutions. It is always wise not to change the 
animal's abode, because animals sent to a hospital, affected with this 



318 CONSTITUTIONAL DISEASES 

disease, show the effects of worry immediately, by the increase of the 
amount of sugar, if sent away from their habitual surroundings. 

Diabetes Insipidus. 

This condition is a chronic one in which there is no elevation of 
temperature, and a marked increase in the amount of clear urine secreted, 
which is of a low specific gravity and contains no sugar. The animal is 
constantly thirsty, drinking large quantities of water. This disease is 
less frequently seen in the dog than diabetes mellitus and must not be 
mistaken for ordinary polyuria which is seen where an animal drinks very 
large quantities of water, or as a result of the administration of diuretics 
or certain poisons or spices, or from atrophy of the kidneys after the 
rapid reabsorption of extensive exudates or transudates. It is also seen 
in a more or less pronounced degree in convalescence of an animal from 
many acute diseases, and it is also observed in certain organic diseases 
of the central nervous 'system. In this last group of sympathetic dia- 
betes belong the case described by Holzmann; this dog was a very much 
emaciated hound three years old, having a pale mucous membrane and 
rectal temperature of 38.° The animal drank 12.57 c.c. of water daily, 
and passed about 12.79 c.c. of urine. The urine was yellowish, had a 
weak acid reaction, its specific gravity was l.OOG, and contained nothing 
abnormal. On post-mortem nothing of any great consecjuence was 
found, except a myxoma hyalinum, which appeared in the shape of a 
yellowish, transparent, coagulated mass between the periosteum and 
the dura mater, entirely surrounding the spine with the exception of a 
small portion of the neck. There was also some hyperemia and slight 
bleeding in the gray substance of the lumbar region. Five elongated 
osteoid sarcoma masses were found pressing on the dura mater. Holz- 
mann could not decide which of these two conditions was the true cause 
of the disease. If we eliminate polyurias due to some organic alteration 
of the cerebral nervous system, as a result of chronic interstitial inflamma- 
tion of the kidneys, then polyuria is distinguished from diabetes insipidus 
l)y the fact that the former is transitory in its character, and still it is 
only by close observation, lasting for some time, that Ave can distinguish 
between the two conditions; polyuria lasts only for a short interval 
and does not produce any great tissue changes, whereas, diabetes insipi- 
dus gradually progresses, becoming chronic, and is accompanied by 
great emaciation. The urine is pale, of low specific gravity, and contrary 
to chronic nephritis, contains no albumin. In all the cases observed by 
the writer which he took at first for genuine diabetes insipidus, he 
found where he could follow them closely, that after some time the 
polyuria and increased thirst gradually disappeared. Schindelka de- 



OBESITY. ADIPOSITAS UXIVERSALIS 319 

scribed one case where the animal developed cataract and abscesses in 
different parts of the bod}', and other complications which are seen in 
diabetes mellitus. 

Therapeutics. — The animal should be put on a strong easily digested 
diet and be more or less restricted in the quantity of fluid that it drinks; 
of course it is not only cruel but almost impossible to restrict the animal 
as to the quantity of water that it drinks if it is thirsty, but the food 
should be dry, and soup or other liciuid foods should not be given. 
Medicinally the following drugs are recommended: bromide of soda, 
preparations of iron, opium, boldo root, antipyrin, ergot, extract of 
hydrastis, hydrastin and other vascular alteratives. Tannopin may 
also be tried. The treatment of symptomatic polyuria consists in 
attempting to remove the cause. 

Obesity. Adipositas Universalis. 

Etiology. — This disease is due to the absorption of large quantities 
of carbohydrates, and also to a lack of proper exercise, and in some cases 
as a consequence of improper oxidizing processes in the body. It may 
also be hereditary in some cases. This disease is especially seen in lap- 
dogs or pet animals, and is also noticed in bitches after ovariotomy, 
and in dogs that have been castrated. 

Clinical Symptoms. — The common location of fatty deposits is in 
the panniculus adiposus, around the region of the abdomen, and sur- 
rounding the internal organs — for instance, in the mediastinum, the 
pericardium, and the capsules of the kidneys. The circumference and 
weight of the body increase very much, and round prominences form in 
different parts of the body, especially the neck, shoulders, back, and hips. 
The abdomen is round and distended. The animals are lazy, dull, 
awkward, and tired on the slightest physical exertion. When this con- 
dition becomes very marked, and there is a large deposit of fat in different 
parts of the body, especially when it has accumulated in the thorax and 
neighborhood of the heart, we have a lessened heart-action and more or 
less difficulty in respiration, sometimes from the pressure of quantities 
of fat on certain blood-vessels, decreasing their size and thus requiring 
gi-eater effort of the heart 's action, until finally the heart becomes over- 
taxed, and we have symptoms of heart-failure, bronchitis, chronic 
catarrh of the stomach, and oedema. 

Therapeutic Treatment. — The most important factor in the treatment 
of obesity is abundant and regular exercise in the open air and restricted 
feeding^ the food must be albuminous, and fat and carbo-hydrates 
avoided. Sugar in any form, candy, sweets, etc., must be prohibited. 
Meals must be given at regular intervals, in a young dog three times 



320 CONSTITUTIONAL DISEASES 

daily, a dog over a year, two meals daily; a small meal in the morning 
and the good meal at night; dogs that have very little exercise, one meal 
daily is sufficient, and as a rule they seem to do very nicely on it. Slight 
laxatives, especially the salines, such as Apenta, Hunyadi, or Veronica 
waters, in teaspoonful doses once daily, and a pinch of phosphate of 
soda in the morning. There seems to be some value in the administration 
of the preparations of the thyroid glands (thyroid, thyroidin, or iodothyrin 
tablets), these tablets contain the equivalent of 0.3 of fresh thyroid 
gland and are to be given according to the size of the animal, from 1 to 
3 tablets daily. Seven clogs were treated with thyroidinum depuratum 
in doses of 0.15 daily, and in from one to four weeks the animals were 
reduced in amounts varying from 350 to 3460 grams. But these prepara- 
rations must be used with great care, beginning with a very small dose 
and gradually increasing it. Iodide of potassium, boracic acid and borax 
are not to be recommended as they are apt to cause disorder of the 
digestion. 

Uraemia. 

As a consequence of this disease and impaired activity of the kid- 
neys, certain substances, that should be thrown out in the urine, remain 
in the blood; also the watery excretions of the body, acting as a poison, 
produce a condition known as ''ursemia." The exact nature of the 
materials that cause this disturbance is not definitely knowai, but in all 
probability it is not due to one, but to several substances, such as albu- 
minous decompositions and certain end-products. Ursemia is usually 
Been as a result of acute inflammation of the kidney, hydronephrosis, 
obstruction of the neck of the bladder, or urethra, by calculi; from 
tumors of the prostate, paralysis of the detrusor, and rupture of the 
bladder. The disease may be acute or chronic, and one form may merge 
into the other. The acute form is seen in acute inflammation of the 
kidney and retention of urine in the bladder, in this case there is j^er- 
sistent vomiting, convulsive twitching of the muscles, convulsions, coma 
and subnormal temperature. The chronic forms may appear following 
chronic nephritis, and from partial retention of the urine, it is seen par- 
ticularly in stone in the urethra, when the passage is not completely 
obstructed, but only allows a very small quantity of urine to escape, 
when this is present there is depression, loss of appetite, irregular vomit- 
ing, occasional convulsions, diarrhcra. Certain experiments have been 
made on the dog to artificially produce these ura}mic symptoms — 
for instance, by removing both kidneys or ligitating the ureters. Voit 
observed that when healthy animals were fed on food containing uric 
acid, and at the same time deprived of water, these conditions pro- 



SCURVY 321 

duced the disease. Grehant and Qiiinwuaud produced death in dogs 
when urea was injectetl into them subcutaneously to the amount 
of 1 per cent, of the whole weight of the body. This produces convul- 
sions, apparently from suppression of respiration. Feltz and Ritter 
produced uraemic symptoms in the dog with injections of salts of ammo- 
nium. It is of practical interest to know that uraemia may also occur in 
acute nephritis, in cases of enlargement of the prostate and obstruction 
of the passage of urine, or from uratic stones filling up the urethra or the 
neck of the bladder. 

The clinical symptoms have been described by Roll and others as 
high temperature alternating with chills, constant vomiting, convulsions, 
paralysis, coma, decrease in the temperature, and death within a few 
days. Roll also states that dogs which have suffered with hypertrophy 
of the prostate showed the same symptoms of this disease, but these were 
produced gradually and the symptoms were not so acute. In such cases 
we find dulness, disturbance of the intestinal canal, and convulsions. 

Treatment. — The treatment of uraemia is based on an endeavor to 
remove or lessen the original cause (nephritis, etc.). If there is a calculus 
present, it must be removed as soon as possible; and to eliminate the 
poisonous materials from the blood, use mild saline laxatives and treat 
symptoms. 

Scurvy. 

It is doubtful if true scurvy occurs in the dog — that is to say, a 
hemorrhagic diathesis marked by a spontaneous bleeding of the mucous 
membranes of the mouth, and also from the muscles, joints, etc. 
This may occur as an epidemic; sporadic cases are extremely rare. 
It is a question, however, whether true scurvy does occur and whether 
it is not an attack of ulcerative stomatitis, which in the older text 
books was described as pesu do-scurvy, or it is possible that it is dis- 
temper, or septic or some condition due to the toxins in the blood. It 
may result from the feeding of tainted or decayed meat or particularly 
in packs of hounds where the dogs are fed, entirely on meat, and 
never any vegetables. Seltzner described one case that in some re- 
spects resembled Basedow's disease; a haemorrhagic diathesis and in 
other respects it was similar to rickets. 

There were numerous haemorrhagic centres in the skin and cellular 
tissues. The buccal mucous membrane was somewhat swollen and 
filled with haemorrhagic spots, or even necrotic. The gums were also 
in the same condition. There was loosening and falling out of the teeth, 
horrible odor from the mouth and salivation, bleeding from the mouth, 
bloody urine, and sometimes blood was vomited, in one case there was 

21 



322 CONSTITUTIONAL DISEASES 

blood in the anterior chamber of the eye, and an extravasation of the 
epiploon. Animals generally die of exhaustion, and post-mortem may 
show extensive hemorrhage of the intestinal tract, pneumonia and 
pyaemia. 

Treatment. — Local treatment of the mouth with astringents, lis- 
terine, permanganate of potash, regulation of diet. Where animals like 
packs of hounds have been fed on nothing but meat, a combination with 
vegetables seems to be advantageous; the regular diet of cooked meat 
should have greens such as spinach or the ordinary dandelion, root and 
leaves cooked with it. General tonics, such as gentian or nux vomica, 
and when there is general hemorrhage the internal administration of 
hemostatics is useful. 

Priessnitz's Bandage or Compress. 

This compress is mentioned a number of times in the work, and as 
it has special advantages in the treatment of dogs, the translator will 
attempt to describe it, as the author has not done so, probably due to the 
fact that it is so very well known in German therapeutics that it needed 
no explanation, but to English-speaking veterinarians this is the reverse. 

The object of the compress or bandage is to keep up a continual 
heat, either dry or moist, to certain parts of the animal's body. We 
first apply against the part afTected a piece of absorbent cotton, thick 
W'ool, or dry felt; or if moist heat is recfuired, it is soaked in warm water 
or a medicated solution and wrung out to remove the excess of fluid; 
this is then held in position by a covering of some light material — a wide 
bandage of cheese-cloth is the best — and next a layer of oiled silk or 
rubber cloth (the object of this is to retain the heat and in case of a wet 
compress, the moisture), and finally over this is placed a compress or 
bandage of flannel. This last is to prevent loss of heat by radiation. 
Sometimes the inner layer of cheese-cloth is omitted, or else it is put on 
the outside of all. 

The above procedure may seem to the hurried practitioner a rather 
long and unnecessary method, but after one has tried it and found the 
great advantages it has in the retention of heat, especially in diseases of 
the lungs, in hastening the maturing of an abscess, or in the lessening of 
a tumefaction by the constant and direct application of heat and moisture, 
he will realize its benefits. 



DISEASES OF THE ORGANS OF LOCOMOTION. 

DISEASES OF THE BONES. 

Rachitis. 

(Rickets.) 

Etiology. — The different theories -which have been advanced con- 
cerning the origin of rachitis do not seem to answer in all cases. These 
theories are as follows; it is due to a deficiency of lime-salts as a conse- 
quence of disturbances of digestion; to excessive formation of lactic acid, 
in the blood and to salts of potassium in the milk or to a lack of hydro- 
chloric acid in the gastric juice, which would dissolve the lime-salts; an 
alteration of the general nutritive condition on account of abnormal 
influences in young animals; inflammatory hypersemia and an increase in 
the number and size of blood-vessels in the osteogenetic tissues, so that 
the lime-salts continue to circulate in the blood instead of being deposited 
in the bones. Xone of these theories stands the test of close observation, 
we therefore do not know positively anything relating to the character 
and origin of rachitis. It is, perhaps, better to admit that it is a specific 
etiological change (which has not as yet become positively known). We 
know positively, however, that rickets can be developed in the dog by 
deficient, improper food, by want of meat, and especially bones, as it has 
been demonstrated that animals with this disease if given these articles 
of diet seem to improve immediately. Insufficient food to the bitch 
during gestation, or trying to raise too large a litter, or early weaning, 
improper food, keeping animals in cellars or in dark, damp places are all 
factors that tend to cause rickets. A proper amount of exercise is 
especially important for puppies kept in a small place. 

Rickets generally appears in young animals in the first few months 
of their life. It is often hereditary, as is frequently seen as a result of 
very close breeding and also in breeds where color or conformation is the 
chief object, such as bull terriers, collies, or great danes, and where a 
breed is not old enough to be established, as Boston terriers. The 
symptoms appear relatively in proportion to their growth. If the puppy 
grows quickly, rickets appears quickly; if it grows slowly, the disease 
comes on gradually. 

Pathological Anatomy. — Rickets consists of a peculiar disturbance 

323 



324 



DISEASES OF THE ORGANS OF LOCOMOTION 



of the bones of the whole system, which can easily be distinguished on 
looking at the animal. It seems to be due to a deficiency of lime-salts 
in the bones, making them soft and flexil;)le. At the same time the 
nutritive process in the periosteum seems to be changed. The bones are 
light and soft enough to cut with a knife, and the epiphyses of the long 
bones are very much thickened; the marrow and periosteum are reddened. 

When the periosteum is forcibly removed from 
the bones of the animal in this condition, cer- 
tain portions of the bony tissue come away 
and remain attached to the membrane. This 
is especially noticeable between the epiphyses 
of the vertebrse. The inner layer of the peri- 
osteum is thickened and the diseased tissue 
seems to have undergone a spongy degener- 
ation. Inside of the bone we find it soft and 
cavernous. In the normal dog the bones of the 
skull are joined evenly, but in the rachitic dog 
interosseous spaces (fontanels) have been 
found. 

Clinical Symptoms and Course. — Omitting 
the animals that are born with rickets, the first 
appearance of rickets is gradual, and generally 
the veterinarian is not consulted in the early 
stages, but only when the skeleton shows 
marked alterations of form, especially the 
bones of the extremities and back. The ani- 
mals are dull, walk very carefully and with 
more or less effort, have no desire to run about, 
but lie down as long as they can. We find peri- 
osteal alterations in the frontal bones and 
bones of the temple, so that the head shows 
a peculiar marked alteration in conformation. 
Schutz has found that in rachitic animals the 
bones of the skull are extremely thin and the 
sutures separated. In the thorax there is a 
weakening of the walls of the chest, and the 
animals present that one-sided or " chicken- 
chest" condition. There is a peculiar knot-like swelling of the ribs both 
at their upper extremities where they unite with the vertebrae, and in their 
inferior extremities where they unite with the sternum and false ribs. 

In this latter condition there forms a series of small, round nodules 
known as ''rachitic rosary." In acute forms of this disease the spinal 
cord is twisted or bent in different directions (kyphosis, lordosis or 




Fig. 102. — Radius and ulna of a 
dog afifected with rickets. 



FRACTURES OF THE BONES 325 

skoliosis). The most striking alterations are ol)served in the extremities. 
The long bones are thickened at both ends and bent on account of the 
softness of the bone and pressure of the weight of the body, when stand- 
ing (Fig.. 102). The upper portion of the front legs bends inward, rarely- 
outward, and the animals have a peculiar, unsteady, awkward gait. 
The}' stand on the hind legs with the leg twisted under them, and in 
aggravated cases, the bones are bent in a circle, the bend of the astragalus 
coming down on the ground (Plate, Rachitis). As a consecpience of the 
altered position of the bones, the ligaments Ijecome distended and stretched, 
causing an inflammation of the joints and consequently more or less 
enlargement of them. At the same time we ol^serve emaciation, loss of ap- 
petite, and in some cases, catarrh of the stomach and air-passages, changes 
in the shape of the teeth, which are aljnormally small and frequently 
devoid of enamel, or placed irregularly in the gums. The disease, as a 
rule, is chronic and the prognosis unfavorable. If the disease is taken 
early, it may be checked to a certain degree by means of proper feeding; 
but when the deformity is once formed, it is only in extremely rare cases 
that it does not show as the animal grows to an adult age either in the 
form of a peculiar bending or bow-legged appearance of the front legs, 
or a twisting, or show halt-shape in the hind-legs. 

Therapeutic Treatment. — The treatment of rachitis consists of 
improving all the nutritive conditions and encouraging digestion as 
much as possible. Give the animal plenty of meat and bones, adding 
to them certain amount of phosphate of calcium, egg-shells, and lime- 
water in the drinking water. Phosphorus, while medicated, generally 
causes irritation of the intestines. Improve the digestion as much as 
possible by tonics, nux vomica, gentian, etc.; keep the animal in a clean, 
dry place and see that there is good ventilation. If there is diarrhoea, 
give bismuth subnitrate. To avoid bending of the articulations, the 
animal must be prevented from taking unusual exercise, running, jump- 
ing, etc. Splints are sometimes used to correct the curving of the long 
bones. 

I^. Ferri lactis 5.0 

Calcium phos., 

Calcium carbonate, 

Saccharum lactis, aa 20.0 

F. M. pulv. 

Sig. — One small teaspoonful in the food twice daily. 

Fractures of the Bones. 

By a "fracture of the bone'' we mean a breaking or disunion of a 
bone or a bony cartilage; fracture is quite common in the dog, particu- 



326 DISEASES OF THE ORGANS OF LOCOMOTION 

larly the bones of the extremities, femur, radius, tilna and filuila, uhia 
and humerus and metacarpus and pelvis being the commonest, less 
frequently seen are the metatarsus; the sternum, ribs, cranium, vertebrae, 
and scapula are very rarelj' seen. 

Etiology and Prognosis. — IMost fractures are caused by external 
forces, and the bone fractured is at the region where the force or shock 
has expended most of its force — for instance, from blows or being run 
over, hit with a stone, or in some instances a fracture may be some 
distance from the region where the greatest amount of force has been 
made, such as falling for some distance, or concussions. We also see 
fractures of small projections of bones caused Ijy great muscular exertion. 
Very old and very young dogs have a predisposition to fractures and 
rickets, or a tendency that way may also produce fractures from a 
weakened or softened condition of the bone. 

We separate fractures under different names according to their 
position, severity, and the complications accompanying them. 

In the first class belong infractions, splits or cracks, impressions or 
depressions. 

In the second class belong obliciue, transverse, longitudinal, and 
fissure fractures. 

In pups the epiphysis and diaphysis are sometimes fractured through 
the symphysis, due to traumatic influences. This fracture, which is 
rather common, especially in the humerus and radius, is always confined 
to the immediate neighborhood of the symphysis. The general course 
of these fractures is the same as ordinary fractures, and no special men- 
tion is necessary regarding fractures of the soft bone, which in the young 
animal has not yet hardened. 

The condition of the soft tissues in the neighborhood of the fractures 
and the amount of injury that they have had are of great importance 
in the prognosis. All fractures in which the soft tissues are not very 
much injured, and where the skin has not been torn, heal very much more 
quickly than those where there is an open wound extending into the 
fractured end of the lione. The first are termed simple fractures, and 
the latter, compound fractures. Where the fracture has involved a joint, 
it is called an intra-articular fracture. The compound and intra-articular 
fractures are very slow and difficult to treat, and present such symptoms 
as synovitis, either with or without serous or purulent inflammations. 
In such fractures, even when we have union of the broken ends of the 
bone we may have as an after result a stiff joint or ankylosis from com- 
plications in the joint. 

Clinical Symptoms. — The symptoms of fractures are generally 
indicated by partial or complete loss of the use of the whole or part of a 
limb. There is pain on pressure, deformity in the symmetry of the broken 



FRACTURES OF THE BONES 



327 



bones of that part of the body, and on moving the fractured ends 
there is a rubbing sound (crepitation) similar to rubljing two hard, 
rough surfaces against each other. The amount of loss of power in a 
broken bone depends to a great extent on the amount and s(n-crity of 
the fracture. This is ver}^ marked in fractures of the extremities; great 
pain on pressure, especially on the line of the fractured bones. This 
may also be of especial diagnostic importance in case of cracks or fissures 
of the bone. In such a case, while the symptoms are all present, the 
ends of the bones are not displaced. This is generally seen in the longi- 
tudinal form and in very young animals where the bone pi^'ots on the 




Fig. Wo. — .Skiagraph of fracture of the humerus. 

fractured epiphysis. Crepitation and an abnormal movement are 
easily recognized by taking hold of the part above and below the frac- 
ture and moving it in different directions. Both of these symptoms 
are absent in incomplete fractures and in such fractures where the bones 
will close together with very little displacement. This is especially seen 
in longitudinal fractures of the short compact bones. We occasionally 
find a mild, rubbing loruit or sound produced by dry blood-extravasations 
or fibrinous coagulations between the surfaces of joints. In cases of 
fracture where the periosteum has not been torn, we will have a certain 
amount of swelling in the fractured region, pain on pressure, loss of 
appetite, and a certain amount of fever. This last symptom, however, 
is rarely noticed. When there is any uncertainty about the cUagnosis 



328 



DISEASES OF THE ORGANS OF LOCOMOTION 



it is well to have a skiagraph (X-ray) made of the affected part (Fig. 103). 
Where there is an external wound which becomes rapidly closed 
by the blood and the purulent agents cannot penetrate between the 
fractured ends of the bone, we have a form of fracture that is not so 
difficult to treat; but if any septic materials should have penetrated 
into the wound and found their way between the ends of the bones, 
the condition is generally indicated in the following manner: There is a 
marked inflammatory sweUing in the neighborhood of the wound. At 
first the discharge from the wound is blood-colored, then rapidly becomes 
pus-like, and finally purulent in character. If the discharge becomes 
ol)structed in any way, we quickly notice a purulent, oedematous swelling 
all around the part, which is always a very grave symptom. If the 

course is favorable, the injured part becomes 
rapidly filled with red, granulating tissue, 
which finally dries, becomes hard, and forms 
a scab. By means of strict antiseptic treat- 
ment this is possible, and we can reduce 
the danger and time of an open fracture by 
strictly following the usual antiseptic forms 
of treatment. In the dog, however, this is 
always rather difficult to accomplish, as the 
animals are hard to confine, moving about 
constantly and pullirtg or tearing the band- 
ages. 

The Phenomena of Union in Fractures. 
— The healing and union of the fractured 
ends of a bone are very similar to those of 
wounds, either by first intention (primum 
intentionem) or by second intention (secun- 
dum intentionem) . In simple fractures we 
generally get union by first intention, and in compound fractures, unless 
the union be extremely small, we get union by second intention (Fig. 
104). In both cases the union is accomplished by means of a callus 
growing around the ends of the bone — that is to say, a soft cellular 
tissue which forms an envelope surrounding the bone and gradually 
becoming hard through the ossific action of the periosteum and the 
marrow of the bones. The ring-shaped or external callus surrounds the 
fractured parts. This cellular tissue is formed of osteoblasts. The 
inner callus is formed by the marrow, forming a peculiar plug-shaped 
body and filling up the open ends. The periosteum is the true factor 
in making union between l)roken ends of bones. This is especially noticed 
in fractures where the periosteum is exposed, and where that envelope 
is torn or injured, union is almost twice as long as where the peri- 




FiG. 104. — Diagram of union of frac- 
ture in the tibia of the dog: a, outer 
callus; b, periosteum; c, inner callus: d, 
inflammatory deposit. 



FRACTURES OF THE BONES 329 

ostcum is prcsorvetl. Tho extravasation of blood found in the early 
stages of a fracture which hes in the surrounding parts does not in any 
way assist in the actual union, but helps to a certain extent in holding 
the bones together until the callus is formed. The callus, in the begin- 
ning, is a spongy mass, especially in bones containing a large quantity of 
marrow. This gradually changes into a bony cicatrix or callosity. This 
becomes thinner and denser, lessening in diameter, and finally becomes 
smooth on its surface, forming what is known as ''final callus." Reab- 
sorption commences at the same time until the body masses, which 
are useless after the bone is united, finall}' disappear, l)ut there is always 
a certain amount of enlargement around the fractured ends of a bone 
at the point of union. Cracks and fissures undergo the same process. 

Period of the Process of Union in Fractured Bones. — The time required 
to obtain complete union of a fracture — that is to say, until the animal 
can use the part without any pain or difficulty — depends largely on the 
size and position of the bone, the age of the animal, and the amount of 
use the patient makes of it. According to the observations of the 
writer and others, in fractures in which the periosteum is not torn, or 
simple fractures of the large bones containing marrow, the time is from 
eighteen to twenty-four days in adult healthy animals. Fractures of 
the ribs unite in from ten to fifteen days; in metacarpal and metatarsal 
bones, ten to eighteen days. In young animals the process is a few days 
shorter; in very old animals it is much longer. After the union of the 
fracture, as a rule, the affected leg is not used with as great freedom as 
it was before. This is especially noticeable in young animals that are 
growing. Very often there is a subsequent atrophy and impaired 
development of the muscles of that part. While this may be due to a 
certain extent to the inactivity of the muscles, when tied up in the splint, 
and also to pressure of the dressing, it is often noticed after the dressing 
is removed, and sometimes for weeks afterward, the animal walks stiff 
or is even lame; massage of the affected leg is useful. 

Therapeutic Treatment. — In simple fractures the treatment con- 
sists of returning the broken ends of the bone to their proper anatomical 
position, and holding them securely in place. 

The bringing together of the fractured ends of the bones must be 
done as soon as possible, and it is accomplished by pulling or extending 
them in a longitudinal direction until the fractured ends fit together. In 
some instances where the tissue is loose they have to be pressed back in • 
their normal position. The animal should be held by an assistant while 
the operator manipulates the ends into position. In cases where there 
is extreme pain and in order to keep the animal from struggling, it is 
advisable to etherize, or better, give the animal a sulx-utaneous injection 
of morphine. In such cases as fractures of the metacarpal bones, bones 



330 



DISEASES OF THE ORGANS OF LOCOMOTION 



of the face, etc., reduction can be made without an assistant. ^Vhen 
the bones have been placed in position as neai- as possil^le to their normal 
shape, we must then apply a dressing which will keep the fractured ends 
in their position until they have united. 

The best dressing for fractures in dogs are those which dry rapidly, 
such as plaster or silicate of sodium solutions. In some cases it becomes 
necessary to apply a temporary splint apparatus for a few days. This 
temporary splint apparatus must be used where there is great swelling, or 
where the condition of the wound or part w^ould lead you to expect much 
swelling. The writer finds the best thing for fracture dressings is a 




Fig. 105. — Plaster splint on fracture with support around body. 



broad pasteboard splint. This should be dipped in water and kneaded 
by the hand until flexible. There are various other materials for making 
splints — gutta-percha, wire gauze, spongio-piline, felt, sheet tin or zinc, 
wood, etc. In some cases where there is an open wound wire gauze may 
be used, fastened above and below the fractured ends of the bone, 
leaving the wounds exposed. This gives it sufficient support, and 
admits of proper antiseptic methods being followed. A plaster-of-Paris 
or silicate of sodium dressing may be applied immediately after the frac- 



FRACTURES OF THE BOXES 331 

tiire, provided thci'c arc no wounds. Where there are wounds or swellings 
we must wait until the swelling is absorbed. 

\\'c apply a permanent dressing, or a temporary dressing may be 
put on in the following manner: Cover it thoroughly with cotton wadding 
and apply the ordinary bandage, taking care not to make it too tight. 
In plaster-of-Paris dressings, the ordinary gauze, crinoline, or cheese- 
cloth may be used, and the plaster, in powder form, rubbed into the 
bandage while it is being rolled. Then rub a small amount of oil (swdet) 
into the skin about the point of fracture to prevent the bandage 
sticking. At the same time place the plaster bandage in water for a 
few minutes and then wrap it carefully around the splint, following the 
methods adopted in ordinary bandage rolling, being careful not to place 
it too tightly. Smoothe the water out of the part, making the bandage 
as level as possible. In some cases where you want a very stiff ban- 
dage, it is advisable to put a certain amount of plaster between the 
folds of the bandage and finally give a good coating over the 
entire bandage. After the dressing has been applied, the animal 
must be kept perfectly quiet for at least ten to twenty minutes 
to allow the dressing to become hard. A plaster dressing will dry 
and harden a little more quickly by the addition of a small quantity of 
alum or common salt; a little glycerine added to plaster makes it much 
harder. A pair of curved scissors are the most practical for the removal 
of the dressing. Tripolith dressing (a mixture of plaster-of-Paris and 
soot) can be applied in the same manner as the plaster. Its composition 
is said to be much lighter and it dries much more rapidly. Silicate of 
sodium dressing has the advantage of lightness, durability, and of being 
removed easily, but it has one disadvantage, and that is it dries slowly, 
sometimes taking a couple of hours. The writer likes this form of 
dressing best, and to overcome the drawback of slow hardening has 
placed thin layers of wire gauze between the dressings. Flannel may be 
used as an under layer. Another dressing is a mixture of benzoate of 
sodium and silicate of sodium. In fractures situated in the upper 
sections of the leg where the extremity is cone shaped, it is necessary to 
build up the bandage in numerous layers to give it body so as to hold to 
the position of the leg, in other cases the bandage should be carried around 
the bod}^ so as to make the bandage firmer (Fig. 105). 

The starch bandage (common boiled starch) is very useful, easily 
made and can be used in the. smaller dogs, the bandage being put on first 
in one layer, this carefully covered with the starch, this covered with a 
layer of muslin, then starch over this and finally the third layer covered 
with starch and allowed to dry. This bandage takes longer to di-y than 
the plaster. 

Pitch plaster bandages are put on those parts of the body where an 



332 



DISEASES OF THE ORGANS OF LOCOMOTION 



ordinary bandage cannot be applied, as in fracture of the scapula, femur 
and humerus. The pitch can be spread on strips of coarse muslin, and 
heated and applied to the injured part (Fig. 106). Burgundy pitch 
100.0 wax 50.0, mix this into a plaster. The dressing may be left in 
place until we feel sure that union has taken place. In cases where the 
dressing has been too tight, or if the patient shows restlessness, whining, 
crying, loss of appetite, or fever, indicating that something is wrong in 
the fractured region, the dressing must be removed at once (Fig. 107). 

"When the average period of union of fracture has passed remove 
the dressing carefully and see that the fragments are united. If we 
recognize any mobility in the fractured region, we then understand that 
we have a slow, callous formation, and nothing else is to be done but to 

renew the dressing as soon as possible, hav- 
ing first rendered the parts antiseptic by 
means of sublimate, soap and Avater. Put 
on the l^andage again and let it remain 
for two or three weeks more. If we do 
not obtain a cure at the end of that time 





Fig. 106. — Pitch plaster put on 
in layers. (.Cadiot- Breton.) 



Fig. 107.— Effects of tight 
bandaging of a splint. 



we may conclude that we have a false joint (pseudarthrosis). 

The methods pursued in man of introducing ivory or bone pins into 
the Ijone or screwing it together by means of clamps or resecting the 
ends with a saw, is hardly practicable in the dog. If, however, we dis- 
cover that there is any danger of the formation of a false joint, we may 
daily irritate the ends of the wound by rubbing the broken ends together, 
and tying a thick elastic band around the leg above the fractured ends 
of the bone for one-half to one hour each day to allow an engorgement of 
blood around the fracture, this bandage should not be made too tight so 
as to interfere with the arterial circulation but sufficient to cause venous 
engorgement aliout the fracture; others recommend injections of 3 per 
cent solution of carbolic acid, or GO per cent, of alcohol, and appl3dng a 
dressing, giving the animal phosphate of lime or phosphoric acid. 



FRACTURES OF THE BONES 



333 



In complete fractures we follow the same rules as in the subcutaneous 
forms — that is to say, we endeavor in one way or another to hold the 
broken ends of the bone together while the wound is healing, and at the 
same time to dry up the wound with antiseptic applications. This is 
rather difficult to do in the dog, but it may be accomplished by making 
a " window " or hole in the dressing. The wound must first be thoroughly 
cleansed, dressed antiseptically, and then we apply a plaster dressing, 
according to the usual method, and place a piece of wadding upon the 
Avound. "When the dressing becomes hardened, we cut a hole over the 
wound by means of a probe-pointed bistoury, coating the edges of the 
opening with a small quantity of plaster-of-Paris or collodion in order 
to prevent the discharge of pus, etc., from running under the dressing. 




Fig. 108. — Different methods of amputation: a, straight section; b, flap operation; c, method of sewing 

the wound. 

The rest of the operation is performed according to the general rules 
followed in the treatment of wounds. In cases where the fracture is 
fresh and the wound is very small, we cover it with an antiseptic dressing 
(for instance, tincture of iodine and several layers of corrosive sublimate 
gauze). Then apply the closed dressing of plaster-of-Paris entirely 
over it. If the wound is slight, as a rule you do not have to remove 
the bandage. Care must be taken, however, to take the temperature 
and watch the leg to see if it swells, and if the animal is restless and uneasy. 
In cases where there is a wound and several broken bones, makmg a 
compound, comminuted fracture, the patient can only be saved by 
amputating the leg. Amputation of the leg, as well as exarticulation, 
has been performed a number of times in the dog, and generally success- 



334 DISEASES OF THE ORGANS OF LOCOMOTION 

fully, the animals soon becoming accustomed to the loss of the leg, using 
the other three with almost as much ease as they did the four. 

Amputation. — Before the operation clean the affected leg with soap 

and with a Inrush; then disinfect with powerful antiseptics (5 per cent. 

solution of carbolic acid, 1 to 1000 solution of corrosive sublimate, or 

2 per cent, solution of creolin). In operating, the animal is put under 

ether or narcotized in some way; do so with as little loss of blood as 

possible. To accomplish this, use a rubber bandage as a tourniquet. 

All of the rules of antisepsis must be strictly adhered to, and at short 

intervals, during the operation the wound must be irrigated \\\i\\ some 

antiseptic. Avoid any serious manipulation or compression of the soft 

parts, The skin must always be cut in such a manner as to cover the 

stump when the two ends or flaps are united. All the vessels, arteries 

as well as the veins, which have been cut must be taken up separately 

with the forceps, and ligated with catgut or silk. All stumps of nerves 

which lie loose upon the wound are to be drawn out with the forceps and 

cut off as close as possible. The bandage must not be removed until all 

the blood vessels have heen ligated (Fig. 108). The wound and its 

neighborhood are then thoroughly irrigated with an antiseptic solution 

and closed with stitches, as illustrated on page 333, Fig. 108, c; and 307, 

Fig. 118, a and b. The whole wound is to be covered with a permanent 

antiseptic dressing. For further details, see Treatment of Wounds. 

There are three methods at the disposal of the operator. 

(1) Amputation by Means of a Circular Section. — Cut through the 

skin of the affected extremity to the fascia, making a complete circle 

around the member. Pull back the skin and have it held by an 

assistant, he pulling the skin toward the body as far as possible. It may 

be necessary in some instances to dissect a small portion of the skin and 

the cellular tissue from under the layer of the skin. After that make a 

sharp, clean circular cut, close to the edge of the skin which is pulled 

back, amputating all the muscles, and then cut the bone with bone forceps 

(Fig. 108, a), or saw through the bone. "While cutting through the bone 

it is necessary for the assistant to pull back the soft tissues as far as he 

possibly can toward the body, either with his hands of by means of a 

linen compress which has been dipped in an antiseptic solution. In 

cases where amputation of the extremities is to be performed, where 

there are two bones, as in the forearm, it is necessary to cut the soft 

tissues that are located between the bone. 

Flap Amputation. — This is made by cutting two half-moon-shaped 
flaps of the skin and separating them from the fasciie in which they are 
located as far as their base, turning them upward and backward. The 
muscles are cut close to the flaps, the tissues pulled back, and the bones 
sawed through and the ends of the fjap carefully stitched (Fig. 108, h). 



MINOR DISEASES OF THE BONES 



335 



Exarticulation. — Separate the soft parts exactly as in amputation 
by means of a circular or flap operation. Then open the affected joint 
by bending it, producing a tension of the ligaments which are located in 
front of it; then cut through them with a bistoury. To get quicker 
adhesion of the tissues it is best to scrape the cartilage on the face of the 
articulation. Exarticulation is finished by separating the other liga- 
ments and the capsule of the joint; then proceed exactly as we do in 
ordinary amputation. The operation of removal of the tail is taken 
up later. 

Minor Diseases of the Bones. 

Other disease of the bones in the dog are of slight importance but 
the following are mentioned: 





Fig. 109. Fig. 110. 

Fig. 109. — Skiagraph of osteosarcoma of the radius with opening in the upper part 

of the bone. 
Fig. 110. — Skiagraph of the ulna with middle and lower third of the bone nearly gone. 

Osteomalacia. Softening of the Bone. — This condition has no con- 
nection with rickets, but a softening of a l:)one after the bone has become 
hard and perfectly formed. It is a question if this disease really ex- 
ists in the dog. Zscholke states he has seen numbers of cases where 
there was great loss in the substance of the bone, but at the articulatory 
surfaces there was no evidence of rickets; another observer treated a dog 



33G DISEASES OF THE ORGANS OF LOCOMOTION 

■with an enormous swelling of the inferior maxillary and on minute ex- 
amination of the bone there was lacunary atrophy. 

Ostitismus Universalis and Hyperostosis et Myostosis Universalis 
Progressiva. — This is a peculiar affection of young clogs. It is indicatetl 
])y numerous nodules of bone at the insertion of many muscles of the body, 
and great increase in the lime salts of bones and also of weight of the 
skeleton. It has been observed by Kitt where an animal had an enor- 
mous swelling of the head the lower jaw and the bones of the legs partic- 
ularly the bones of the forearm, while the other bones of the body were 
entirely free from any sign of the disease. The animal suffered no in- 
convenience from the condition, had no fever, appetite good and general 
health was excellent. The deformity of the skeleton made walking 
irregular and difficult, and the animal moved around with a wave like 
motion of the body. 

Multiple Periostitis. — This condition is extremely rare, there is 
generally more or less rheumatism and deposits in the articular ends 
of the bones, probably a complication of gout. 

Neoformations of the Bones. — Osteophytes and exostoses, so often 
seen in other of the domestic animals, are extremely rare in the dog. 
Sarcomata (osteo sarcoma), on the other hand, appear in a variety of 
ways developing from the periosteum or directly from the marrow canal 
of bones, or in the inferior maxillary causing a tumefaction of the gum. 
The writer has observed two cases in the radius and ulna, which were 
illustrated by means of the Rontgen rays (X-rays), the destruction and 
alteration of the bones could be readih^ distinguished, numerous cases 
have been observed by other observers. 



DISEASES OF THE ARTICULATIONS. 
INFLAMMATION OF THE JOINTS. 

General Pathological Anatomy of Inflammation of the Joints. — A 

common aft'cction of the joints is synovitis. In a simple case of in- 
flammation of the joints, we see an increase of blood vessels, an in- 
filtration of the small cells, and even disintegration of the endothelial 
cartilage; the tissue under it becoming granular. We find cjuite freciuently 
an accumulation of fibrinous or " croupal-like " membranes, followed by 
a cicatrization of the synovial membrane. In all acute forms of synovitis 
we see hemorrhages in the form of small, tick-like bodies. In inflamma- 
tion of the joints, when it takes a chronic form, the synovial membrane 
becomes thickened, is tougher, with marked indentations on the membrane 
which are tree-like in form. The synovia appears in large quantities, 
is yellowish, clear, or slightly turbid, and dulled l^y cells or fibrinous 
flakes. If the synovia is gathered in a large quantity, we find a dis- 
tention of the capsule, producing a hernia-like protrusion of those parts 
of the joint, where there is the least resistance. Occasionally we find 
the synovial membrane covered with thick clotted masses. These oc- 
cur from the excessive secretion of synovia in the joints. Sometimes 
small bodies appear in the joints due to some parts of the hard cartilage 
becoming detached and in rare instances by a breaking off of small 
pieces of bone, and, finally, we may see the development of a cicatricial 
contraction of the synovial membrane; which is due to an acute or 
chronic inflammation of the joints, or when for any cause (for instance, 
dressing of fractures) a healthy joint is rendered immovable for some 
time. This condition may produce a temporary stiffening of the joint, 
but this, as a rule, is overcome in a short time. 

The fibrous capsule of the joint is occasionall}^ inflamed, but, as a 
rule, in acute and chronic inflammation of the joint it remains unaffected. 
"Where there is suppuration present the capsule may become detached 
from the periosteum with the bone, and also may be perforated by the 
pus. The ligaments also become impregnated with the pus from a 
purulent inflammation, but, they are rarely destroyed. Occasionally, 
however, we may see chronic inflammation of the joints in which there 
is a cicatricial contraction, where the joints become firm and united, 
and their mobility is lost. Sometimes from traumatisms we find only the 
soft parts which surround the joint, such as the external ligaments or 
the neighboring tendons, become involved in the inflammatory process, 
while the inner joint seems to be very little affected. 
22 337 



338 DISEASES OF THE ARTICULATIONS 

The cartilage of the end of the joints is rarely affected by the various 
inflammatory conditions. In acute cases of suppuration of the joints, 
the cartilage may he softened, perforated, or partially destroyed, so 
that the bone is bare in some places. In many chronic cases of inflam- 
mation of the joints the cartilage becomes macerated and dissolved into 
fibres, or it may be overgrown with abnormal synovial extensions. As 
soon as the bone proper becomes involved in the inflammatory process, 
extensive granulations form, causing a peculiar spongy growth on the 
cartilage. These granulations crowd and perforate the bone here and 
there and also affect a cartilage of the opposing bone, leading to a cic- 
atricial growth on the end of the joint. In some cases we also see the 
fibres and cells of the cartilage becoming soft and finally growing up with 
numerous raised cartilaginous cells, and presenting an acute inflammation 
of the ends of the joints. From these periodical conditions we may find 
a marked alteration in the form of the joint in which the edges of the 
joint protrude, and the inner surface is hollowed and grooved. A 
peculiarity of deforming inflammation of the joints is an inflammation of 
the synovial membrane, with abnormal excretion of synovia and a great 
enlargement of the free or loose portion of the membrane which may 
develop into papilla-shaped masses. 

The bone, as a rule, does not become affected in acute inflammation 
of the joint; but if it should become uncovered from suppuration of the 
cartilage, the inflammation extends to the spongiosa, and we see occasion- 
ally the formation of purulent or granular centres on the surface of the 
bone. In rare cases the periosteum becomes covered with osteophytes. 

Acute Synovial Inflammation of the Joints. 

{Synovitis Acuta Serosa.) 

The joint is swollen and hot, and the animal shows pain on pressure 
or movement of it. These symptoms indicate an inflammation of the 
synovial membrane and a lessening of the secretion of synovial fluid 
in the joint. It is very rare that we see intense fibrinous excretions 
(synovitis sero-fibrinosa) , and still more rare are those cases of colorless 
blood-cells mixed with detached epithclia. The animals are lame when the 
joint is moved, especially at the beginning and toward the end of any 
movement of the joint. Very frequently small dogs will only walk on 
three feet, carrying the inflamed member. 

The following causes may produce synovitis: Crushing or con- 
cussion of the joint, ])lows, sprains (such as falling from a height). In 
cases of injuries of the joints, we may expect only a simple synovitis 
when the injuring object is clean and the wound is cleansed immediately 
after the injury (removing the blood-clots and applying antiseptic 



INFLAMMATION OF THE JOINTS 339 

dressing). According to tho olx-^orvations of the writer, acute synovitis 
occurs most frequently in the carpal joint, joints of the toes, in the knees, 
and hip-joints. Paint the affected joint with iodine and keep the leg at 
rest as much as possible. After the acute symptoms have subsided, mas- 
sage the joint and allow light exercise. 

There are several irritations of the joints that are observed in the 
work dogs of Europe that are not of interest to the English speaking 
reader. 

The course of synovial inflammation of the joints is, as a rule, rapid. 
If the patient receives proper treatment, in a short time we see an im- 
provement (especially if the animal gets complete rest) . In other cases 
the disease takes a chronic form — that is, it may form one of the follow- 
ing conditions: (1) Chronic Serous Inflammation of the Joints (Synovitis 
Chronica Serosa). In this the joint is slightly swollen and painful, 
also very feverish. In some cases we may see a fluctuating sw^elling as 
a result of enlargement of the capsule by serous secretion. If the disease 
is still more acute, we may have a thickening of the fibrous capsules, and 
very frec^uentl}' qviite an enlargement starting from the edge of the joint. 
Chronic synovitis may appear in the onset of the disease, but, as a rule, 
it results as a consequence of the acute form. The writer has seen 
these cases in the carpus and knee-joint. The lameness is not especially 
marked, l^ut any active movements increase it very much. (2) Purulent 
Inflammation of the Joints: Suppuration of the Joints (Py arthrosis). 
While the two forms which have before been descriljed are rarely accom- 
panied by fever, it is quite different in suppuration of the joint. In this 
there is great fever from the onset, which is ushered in by a chill. We 
may see a more or less rapid swelling of the joint, which is extremely 
painful. The joint is kept in a bent or flexed position, and the patient 
walks on three feet. We may also see an oedematous swelling extending 
both above and below in the neighborhood of the joint. The temperature 
is considerably increased in some cases; the skin appears either normal or 
reddened, sometimes even bluish red. The pus may eventually break 
through the skin in the neighborhood of the joint or it may lie in the 
joints, become absorbed, and cause pya'mia. 

This termination will occur even when the pus has broken out ex- 
ternally, and in some cases where the inflammation has been very acute 
we may have a subsequent adhesion of the joint (ankylosis). 

Suppuration of the joints is frequently produced by infected wounds 
at or near the joint. In rare instances it may be the result of a phleg- 
monous inflammation in the neighborhood of the joint; concussion or 
crushing may also cause it, or it may occur in a metastatic way. Such 
inflammations of the joints may also occur as a purely suppurative in- 
flammation; but, as a rule, the inflammations are sero-fibrinous or sero- 



340 DISEASES OF THE ARTICULATIONS 

purulent, and with it we may see purulent centres of abscesses, and 
followed by pyteniia; or the development of the disease in several joints 
at the same time, or developing one after the other at short intervals. 
The writer saw metastatic suppuration of the joints of the knee, carjDus, 
and toes. 

Rheumatic Inflammation of the Joints. 

(Rheumatic Arthritis.) 

Articular Rheumatism, Polyarthritis Rheumatica. 

This condition is evidently an infectious disease accompanied by 
more or less fever, being rare in the dog, and indicated by a sero-fibrinous 
synovitis of several of the articulations. 

Etiology. — The actual cause of the disease has not been separated 
and described, some observers are inclined to think that it is not due to a 
specific microorganism^ but that it is produced by a series of different 
bacteria, particularly the streptococci and staphylococci, and these 
produce a mild septic infection. If this theory is correct, then this 
disease is closely related to these inflammations of the articulations 
which occasionally follow infectious disease. It is caused by cold, es- 
pecially in shooting clogs, if used in cold weather or during winter, 
when they become very wet and lie around in a draught or from cutting 
the hair off in cold weather and keeping animals in cold kennels. 

Clinical Symptoms and Course. — There are two forms of this disease: 
an acute and a chronic form. The former appears suddenly, the animal 
becoming very lame in one or more of the articulations in which there 
appears a serous, but more rarely sero-purulent synovitis accompanied 
by great pain, high fever, loss of appetite, great depression, and consti- 
pation. The lameness is much greater than in any other form of joint- 
irritation, Very often several joints become diseased at one time, or 
the disease may go from one joint to another; if the joint is moved, or 
the animal disturbed it causes great pain, sometimes agony; and while 
any articulation in the l)ody may he attacked, the elbow and the carpal 
articulations seem to be attacked most frequently, less so the ankle and 
hip. Occasionally we find as complications of this disease, pericarditis, 
pleuritis and peritonitis. 

When the disease takes a chronic form, either from the onset, or 
merges into the chronic from the acute stage, it resembles very much 
chronic sero-synovitis. There is gi'eat thickening of the capsule, and 
sometimes the formation of adhesions between the surfaces of the joints 
and the connective tissue, and in I'ure instances we may have ankylosis 
of the joint. AVhile the diagnosis is rather difficult where the disease 
is confined to one joint it is easily distinguished when you see it appear 



MALFORMATION OF THEJOINTS 341 

in several joints at once, and also from the fact that it may move from one 
joint to another. 

Therapeutics. — The treatment is the same as in muscular rheum- 
atism. Keep the animal warm, quiet, and wrap the affected joints 
in flannel, raw cotton, and frictions of spirits of camphor, oil of camphor, 
ichthyol, or thigneol ointments. Internal adminstrations of salol, salipy- 
rin, salophen, plenacctin, and mild saline laxatives. When the case is 
chronic, joints may be painted with tincture of iodine, and when the 
fever lessens daily massage the joints. A careful examination of the 
heart should be made from time to time during the course of the disease. 

Disease Producing Malformation of the Joints. 

(.1 rthritis DeJ'onnans.) 

The cause of this disease is very little known. It is very probably 
due to a chronic rheumatism, or to some inflammation of the joint. It 
may also be due to great exertion, and is especially seen in Holland or 
Canada and Alaska where animals are used to pull carts and vehicles or 
sleds and in coach dogs that run after carriages, and occasionally seen 
in pointers and setters that are constantly hunted. The first symptom of 
this disease is a slight lameness in the diseased joint. This lameness 
may be overlooked, as it is generally very slight, and after the animal has 
taken a little exercise it gradually disappears, although in some rare 
cases the lameness may continue, or even with exercise become ag- 
gravated. In the early stages of the disease there is no indication of 
pain on movement or pressure of the joint, but later on, pain on pressure 
and motion begins to show itself. At the same time there is a gradual 
swelling and thickening of the capsule of the joint, with apparently a 
loss of the normal amount of synovia. Sometimes we notice a slight 
heat. A peculiar symptom of this disease, which is noticed from the 
very onset, is a peculiar creaking or crepitating sound when the joint is 
moved. After a time stiffness of the joints becomes more marked. 
There are hard swellings on the cartilaginous borders, also a tendency 
of the ends of the joint to enlarge, and finally marked alteration in the 
form of the joint. By these changes we are enabled to distinguish be- 
tween arthritis deformans and chronic serous inflammation of the joints. 

The anatomical alterations have already been mentioned. Ar- 
thritis deformans, as a rule, occurs in the knee-joint, the elbow and 
shoulder. The prognosis of this disease is always to be unfavorable, be- 
cause it seems to defy medical treatment, going on until finally the 
joint becom<'s a large unsightely mass. 

Therapeutic Treatment of Inflammation of the Joints.— In all cases, 
except those of slight synovitis, the joint must be kept as quiet as pos- 



342 DISEASES OF THE ARTICULATIONS 

silile. In simple cnses the animal should be kept in a kennel or in a 
room for several days. In serious cases where no operation seems to 
be required, and there is no danger of poison breaking through the joints, 
and where the inflammatory swelling is not very great, it is best to ap]:)ly 
the l)andage of cotton and dress over that with a plaster or silicate of 
sodium bandage, treating it. the same as a fracture. The writer has 
ol)tained very good results with this method in the carpal, tarsal, and toe- 
joints. Albrecht advises that the joints should be rubbed with a thick 
layer of citrine ointment before applying the dressing. (For further 
details, see under head of Dressings, etc.) 

It is well, however, to take into consideration one point: that the 
dressing must be in such a position as not to interfere with the use of the 
leg. With the alcove treatment we generally obtain good results in a 
short time. In the serious forms of the disease, and where the tlressing 
cannot be used on account of the position of the joint, we must apply 
such local applications as will al)ate the inflammation. As a rule, the 
best treatment is cold-water applications containing lead or arnica. In 
cases where there are great pain and acute rheumatic inflammation of the 
joint, it is better not to apph' too much cold water, but use instead 
Priessnitz's compress. Wrap the joint in a piece of linen which has been 
folded several times, similar to. a handkerchief, and then cover it with 
some impervious object, such as oil-cloth, silk, rubber, or a woolen cover. 
If, for some reason, neither the cold nor moist treatment is practicable, 
we must paint the part with tincture of iodine once or twice daily, and the 
fluid must be rubl)ed into the skin by means of a rag. The writer has 
never had very good results from this method of treatment, but painting 
with iodine produces better results than any of the liniments, such as 
camphor or soap liniment. Massage has been found to produce good 
results in many diseases of the joints in dogs, although it has not been 
used very extensively by canine practitioners. In chronic cases where 
there are great thickening and a large qiuintity of secretion of the capsule, 
as in cases of acute inflammation of the joint, or in purulent arthritis, 
massage with cocoanut oil is particularly adapted. In cases of rheumatic 
inflammation of the joint, which have been recognized as such, we 
must use internal remedies, such as recommended in muscular rheu- 
matism. 

In many traumatic and purulent inflammations of the joint we can 
only get good results by an operation which varies acconling to the con- 
dition. The general procedure is as follows: 

Puncturing. — This method of treatment is indicated in all chronic 
serous secretions of the joint. As soon as we find that the measures 
which encourage reabsorption, such as tight dressing and massage, do 
not produce good results, and where the secretion causes great distention 



MALFORMATION OF THE JOINTS 



343 



of the capsule, and where there are great lameness and indications of 
suppuration, we proceed in the following manner: 

(a) The part to be punctured must be rendered strictly aseptic; (b) 
the part must have a particularly tight dressing over it for a few days 
after the o])eration. 

If this latter method is not practicable on account of the position of 
the joint or some other circumstance, puncturing the joint will not give 
favorable results and maj^ even lead to very serious conditions (suppura- 
tion, etc.). The method of operation is very simple. 

After having removed the hair from the region of the joint and wash- 
ing with sublimated soap, disinfecting it with a 5-pcr cent, solution of 
carbolic acid and 2 per cent, of creolin or 1 per cent, 
of corrosive sublimate, we then puncture the part with 
a good-sized hypodermatic needle and slowly evacuate 
the sac by drawing it into the syringe. If the syringe 
becomes filled and the joint is not entirely emptied, the 
syringe must be detached from the needle and the 
opening closed at once by means of the finger, as any 
air that may find its way into the joint will produce bad 
results. Empty the syringe and proceed as before. 

This method, as a rule, is absolutely harmless, 
evacuating the sac in cases of serous secretions. If, 
however, we find in the fluid withdrawn from the joint 
many cellular elements — that is to say, if it possesses a 
marked purulent character — we must use at the same 
time an injection of antiseptic fluid directly into the 
joint, so as to make it aseptic. For that purpose we 
use a slightly warm solution of corrosive sublimate 1 
to 1000 or a 2-per cent, solution of carbolic acid and a 
Lugol solution of iodine (1 per cent, tincture of iodine, , ^°: ^^^■~' ^^^^ 

~ ^ i ' hypodermatic syringe 

2 per cent, of iodide of potassium, and 5U per cent of for puncturing en- 
water). Either of these solutions ma}' be injected ^'^^^ jomts. 
through the needle into the joint; then, by manipulation, try to work 
this solution inside of the capsule by means of careful pressure, 
allowing it to flow out through the needle in one or two minutes. The 
needle is then withdrawn and the perforated opening is closed at once 
by means of an iodoform tampon, and over that an antiseptic dressing- 
is placed. This should be allowed to remain on the wound for a few 
days. 

(For further particulars, see the chapter on Treatment of Wounds.) 

In chronic inflammations or great secretions we may also use simple 

injections of disinfecting solutions, such as iodide of potassium, as a means 

of reducing the inflammation or destroying its products. "We perforate 




344 DISEASES OF THE ARTICULATIONS 

directly into the cavity of the joint by means of a hypodermatic needle and 
with a syringe inject a quantity of fluid in proportion to the size of the 
joint. This operation has to be repeated every three or four days, fol- 
lowing the same procedure before and after the operation as has been 
already described. 

The joint may he opened by means of a puncture ivith a lancet. This is 
advisable where there is extensive suppuration going on in the joint and 
where the diseased part shows every indication of a septic condition. 
The joint to be opened should be punctured by means of a lancet or bis- 
toury, making a wound just sufficient to empty it freely. It must then l)e 
cleansed with an antiseptic solution and any clots or detached portions of 
tissue washed out; then close the wound by means of sutures. In some 
cases it is well to leave one corner open for drainage, that, of course, being 
the lower one. We then place an antiseptic dressing over the whole part. 

Injuries of the Joints. 

These may l^e divided into several groups — true wounds of the 
joints, contusions, distortions, and luxations. 

Wounds of the Joints. — Wounds of the joints — that is to say, 
injuries which expose the joint proper to the atmosphere — are divided 
into perforating or cutting wounds, being produced by laceration, con- 
tusion, and shot. 

Clinical Symptoms and Course. — The first symptom of injury to the 
joint, as a rule, is a discharge of synovia from the wound. This, however, 
may be absent in cases where the wound is very fine, or where the punc- 
ture runs in an oblique direction; the amount of discharged synovia, as a 
rule, is very slight at the beginning, and of normal consistency. If the 
wound is not closed immediately, it increases in amount and becomes 
thinner. In some cases it is difficult to tell positively whether the syno- 
via comes from the joint or from the sheath of a tendon. In the latter 
case, however, the amount of synovia is generally very slight. Blood 
may accumulate in the cavity of the joint and develop a haemarthrosis. 
In some cases where there is hemorrhage, the wound may be very small 
and close up quickly, or it may lie in an o]:)lique direction and prevent 
the escape of blood. This flows into the joint and ffils it up. Hannar- 
throsis is distinguished from serous or purulent secretions by appearing 
shortly after the injury, and the absence of all inflammatory symptoms — 
that is, at the onset of the disease. 

The other symptoms of wounds of the joints are acute sensitive- 
ness, the animal limping and showing great pain, holding its leg in a 
flexed condition. Generally the external opening of the wound can 
also be distinguished. 



IXJURIES OF THE JOIXTS 345 

The course of this disease differs greatly according to the character 
of the wound and whether the object that caused it was clean or not. 
ymall perforating wounds heal quickly, and the animals limp only for a 
few days. In serious wounds where the joint has been exposed, and 
dirt or other foreign l^odies have obtained entrance into the joint, the 
prognosis is less favorable. In such cases we notice a great discharge of 
synovia. This is clear in the early stage of the disease, but soon be- 
comes turliid by the addition of pus-corpuscles and fibrinous clots. It 
then becomes flaky and finally purulent. At the same time there is 
great fever around the joint, which is swollen very much, and the neigh- 
boring tissues become cedematous, extending in all directions. We may 
see numerous abscesses forming all around the joint or in the inter- 
muscular connective tissue, and finally the animal dies from general 
exhaustion or pyaemia. 

According to the circumstances and condition of the wound, the 
course may be much more rapid. The synovia becomes purulent in a 
short time; septic fever shows itself ciuickly; there is a rapid pulse; the 
animal sinks into a coma, and dies from septicsemia. This may even 
occur in slight wounds, if they have not been treated properly, and 
where thorough disinfection has not been followed. 

Therapeutic Treatment. — The first thing to do after an injury has 
occured is to thoroughly disinfect the wound and its immediate neighbor- 
hood. Clip the hair from all around the part, then wash it with a solu- 
tion of corrosive sulDiimate, and, in cases where the puncture is very 
narrow, clean it out by means of a syringe with a 2 per cent, solution of 
creolin and a 5 per cent, solution of carbolic acid, or a 1 per cent, solution of 
corrosive sublimate. If you find the object which caused the puncture 
was very dirty, the wound must be enlarged and thoroughly washed with 
any of the above-named solutions. The wound should then be closed 
by means of sutures, taking care when stitching it up not to include the 
synovial membrane or any part of the joint in the sutures. It is well, 
however, in some cases, to place a small piece of catgut or silk in the 
lower surface of the wound in order to assist in emptying the joint. We 
then place the joint in an antiseptic dressing and cover it up. 

If we have to deal with a wound that has been neglected and where 
suppuration has been going on for some time, and the owner does not 
wish to destroy the animal, we must enlarge the wound at once, and 
all pockets, or sacs, in the joint must be emptied and washed with a solu- 
tion of corrosive sublimate. Any clots, masses, or pieces of tissue must 
he removed, and the operation finished as before described. In all 
these cases the animal must have absolute rest, and the dressing be 
renewed frequently. 

Contusions of the Joints. — Under this head we class injuries to the 



34G DISEASES OF THE ARTICULATIONS 

joints which have Iseen caused by compression of the soft parts against 
the bones or from shocks, such as jumping or leaping from a height, 
kicks, and where the extremities have been run over by vehicles. In 
this we may have a series of results, such as crushing or laceration of the 
capsule of the joint, with formation of ha^narthrosis, or a concussion or 
crushing of the bone with little escape of blood. In rare instances we 
may see a laceration of the cartilage. 

Clinical Symptoms. — The animal shows great sensitiveness and pain 
on manipulation of the joint, and, as a rule, carries it in the air. There 
is a rapid swelling of the joint and oedema of the surrounding parts, also 
a high temperature. 

Therapeutic Treatment. — The treatment consists in cold-water 
applications, if the position of the joint admits, renewed constantly. 
The best method is to soak a piece of absorbent cotton in water, lay 
it on the joint and bandage it up lightly, moistening it in cold water 
from time to time. In old cases use friction (massage) of the joint 
in a circular direction (twice daily for ten or fifteen minutes), or use a 
tight bandage. Any stimulating liniments, such as camphor, soap, or 
arnica, may be used, but it is questionable whether the good effects are 
not due more to the massage than to the drugs themselves. 

Distortions of the Joint (Sprains). — By this is meant a twisting or 
temporary displacement of the joint, as a rule, in a lateral direction, 
caused by slipping or sliding, or falling out of a window and landing on 
the feet, tumbling over the side of a chair, bed or step. The capsule and 
the ligaments may be partially torn and in some cases entirely ruptured 
on one side. The round ligament of the hip-joint is sometimes torn, 
as are also the tendons of the knee-joint; there is extravasation of blood 
in the injured region. "NMth rest, the disease may disappear in a few 
days, or it may remain, causing partial loss of power of the legs for the 
rest of the animal's life. 

Clinical Symptoms. — When the sprain occurs there is violent pain. 
The animals use the joint irregularly, or may carry the member. The 
lameness increases, and in the region of the joint swelling soon appears. 
Any manipulation of the joint produces great i)ain, and we may be able to 
recognize a laceration of some of the ligaments, and the joint shows 
greater mobility on one side than the other. Where there is tearing 
of the broad ligaments of the hip-joint there is nothing indicated l^eyond 
the lameness and symptoms of pain when the joint is turned or twisted. 

Therapeutics. — The treatment of distortions, or sprains, is the same 
as that for contusions — compresses of cold water, lead water, lead 
water and laudanum, fuller's earth or antiphlogistine and wraj) up the 
joint in warm flaimel. If the swelling is gnnit, paint it with tincture 
of iodine, and when the swt'Uing subsides, use massaging and rul)l)ing 



INJURIES OF THE JOINTS 347 

with spirits of camphor or soap Hniment, ak-ohol, etc., but it must be 
borne in mind that rest is the most important treatment. 

Luxations of the Joint (Dislocations). — While distortions of the 
joints disappear in a short time when the luxation is reduced, if it is not 
reduced it is lasting, for soon some anatomical change occurs that it is im- 
possible to reduce. If both surfaces of the joint are no longer in contact, 
it is called an entire dislocation. If they are partially in contact, it is 
called an incomplete luxation (subluxation). 

The causes of dislocation are, as a rule, mechanical, from falling out 
of windows, jumping from high objects, getting the foot caught, and 
hanging, as in jumping over a fence; concussions and blows by being 
run over by vehicles, etc. In all dislocations there is invariably laceration 
of the capsular ligament. This membrane only remains intact in dis- 
locations of the lower jaw. As a rule, the accessory ligaments are seldom 
torn except in such cases where a portion of the bone is torn with them. 
The cartilage of the joint may be torn or detached in some cases by 
the subsequent inflammation. The ends of the bones may be unaffected 
and in some cases broken. Other alterations are seen in the muscles and 
tendons in the neighborhood of the joint. They are abnormally ex- 
tended on one side and flabl^y on the other side. They may be torn, 
lacerated, or even crushed. It is only in rare instances that the large 
blood vessels and nerves are lacerated. The joints which are dislocated 
are surrounded by a large quantity of blood which infiltrates the tissues 
and is gradually reabsorbed. 

When the reduction is not performed quickly — that is to say, the 
displaced end of the joint remains in its abnormal position — we have 
what is called nearthrosis as a consequence of the irritation which it 
produces in the immediate neighborhood of the joint. In such a case 
there is slight immobility due to partial adhesions of the affected part, 
and also due to a certain extent to atrophy of the muscles surrounding it. 
In some cases motion of the joint is entirely lost. 

Clinical Symptoms and Prognosis. — When a dislocation has just 
occurred, and Avhen it has been there for some time, the symptoms are 
more marked than they are in the intermediate stage, for the reason 
that the hemorrhage produces so much swelling as to render obscure, 
to a certain extent, the position and character of the luxation. In 
some cases the condition can be very easily recognized by comparing it 
with the perfect joint on the other side; at other times, it is only by 
careful manipulation in the region of the joint that the alteration can l)e 
felt. We may find a projection of bone at one place and depression in 
another, where they do not occur in the healthy side. We may even feel 
the luxated end of the joint. In some cases where the deformity has been 
concealed by the rapid swelling of the surrounding tissues, the leg may 



348 DISEASES OF THE ARTICULATIONS 

he shorter, or it may be on a longitudinal axis with the other leg. An- 
other characteristic symptom is the loss of movement in the luxated 
joint, especially when the case is seen early, although in some cases 
where the ligaments have been lacerated or torn, or where a piece of 
bone has been broken off, there is abnormal flexion in that part. This 
is especially important, as it enables us to locate a fracture of the bone 
that is in the neighborhood of the joint. There is also a slight crepita- 
tion. This, however, is soft, and not the hard, rough crepitation that 
we find in fractures. 

Luxations are not dangerous to life except those of the vertebrae, 
but they are very troublesome, and, as a rule, make slow recoveries. 
Dislocations can be reduced quickly where the animal is seen a short 
time after the injury; but in rare cases, on account of the lacerated 
condition of the capsule and ligament, it is rather difhcult to hold the 
injured joint in position after it has been reduced. 

Therapeutic Treatment. — The treatment consists of: 1. Reduction 
of the dislocation. 2. In holding the joint in position after the reduction 
has been made. 

It is rather hard to lay down any rule to be followed in all cases, 
but try if possible to return the joint to the same position as before, 
comparing it with the joint of the opposite leg, following, as a rule, 
the same procedure as that followed in fractures of the bone. As soon 
as the reduction is made the joint must he dressed and allowed to remain 
if possible for a period of three weeks (further particulars will be found 
in the chapter relating to fractures of the bones and wounds), so that 
the soft parts which are lacerated — the capsule and the ligaments — may 
have an opportunity to grow together and return the joint to its normal 
position. If the dressing cannot be applied in cases of dislocation of the 
hip, the animal must be kept in a cage or in a small room, in order to 
keep it as quiet as possible. We may find more or less stiffness of the 
joint when the dressing is removed. This can be assisted to a certain 
extent by means of massage. 

The following dislocations appear more frequently in the dog and 
require special mention: 

Dislocation of the Lower Jaw. — This is extremely rare, and may 
occur in some instances where a setter or retriever endeavors to carry 
a very large bird, opens his mouth, and distends it in such a way that it 
is dislocated. In some cases this luxation is confined to one side, and 
in others both articulations are out of joint. The lower jaw projects 
forward, the incisors project beyond the upper incisors, giving the animal 
an "undershot" appearance, while in a lateral direction the jaw is pushed 
to one side, the mouth remains wide open, and cannot be closed except 
with great exertion. In many cases, on account of the pressure which is 




INJURIES OF THE JOINTS 349 

caused by the coronoid process pressing on the posterior portion of the 
eye, it is bulged, causing what might be termed an incomplete prolapsus 
of that organ. Other symptoms are salivation, great pain, restlessness, 
blue coloration of the tongue. (For differential diagnosis of paralysis 
of the lower jaw, see Diseases of the Mouth.) 

Therapeutic Treatment. — According to Stockfleth, the animal must 
be held by an assistant. The best method is to hold him between the 
legs and steady his head while the operator by means of a lever-like 
action upon the lower jaw endeavors to reduce the dislocation. To 
accomplish this, wrap a cloth around the hand, place the thumbs on 
both teeth of the lower jaw, and by means of external pressure attempt 
to reduce the bone into its normal condition. Another method which 
the author finds is not so reliable, consists in placing a strong stick 
between the jaws, as far back as possible, then by 
pressure on the anterior portion of the jaws, allow- 
ing the stick to act as a fulcrum, the jaw will 
very often fly into position. In order to prevent 
a recurrence of this, the dog for some time should 
w^ear a particularly (Fig. 112) tight-fitting muz- 
zle and should receive nothing but soft food. 

Dislocation of the Elbow. — In the dog the bone of the forearm 
forms a pivot joint with the elbow. Each of these joints has a capsular 
ligament. The upper is fitted with a ring-like band, and in the lower 
portion the radius is kept in position by means of transverse ligaments. 
A slight rotation of the radius may occur independent of the elbow-joint 
itself. A dislocation of this articulation may occur from jumping 
from tallies, chairs, falling from some height. In the former case the 
bone of the forearm is dislocated backward and outward. In dislocation 
of the lower pivot joint the bone of the forearm way project forward as 
well as backward. If dislocation of the upper joint occurs in the dog, 
the forearm is kept flexed; it becomes immobile in the elbow-joint, the 
animal using three legs and carrying one in the air. The joint is wider, 
and the dislocated portion of the forearm may be felt distinctly, also 
more or less marked sensitiveness or swelling may be seen. If, on the other 
hand, we have a certain amount of movement on extension of the elbow- 
joint and great elasticity in the joint, too much for the normal condition, 
the animal evinces great pain on movement. This dislocation is easily 
corrected. The joint may be moved freely, but as soon as the animal 
stands upon its feet again the displacement occurs. This is due to the 
annular ligament, which holds the joint to the forearm in place, being 
torn. If this dislocation is not reduced and left for some time, the leg 
will be held constantly in a flexed position, and the animal will not use it. 

In cases of lower dislocation of the joint the animal walks upon 



350 DISEASES OF THE ARTICULATIONS 

three legs, and on examination we find that the lower end of the bone 
of the forearm is displaced in a posterior direction, and more rarely in 
an anterior direction. This dislocation is easily reduced, but on the 
slightest movement reappears again. The prognosis is not favorable, 
as it is a rather difficult condition to treat. The weak ligaments (the 
annular ligament and transverse ligaments) do not heal quickly, and the 
dislocation has a tendency to become chronic, especially in the upper 
joint. 

Treatment. — In the treatment of the upper joint the forearm 
becomes extended and the legs should be crossed and an attempt be 
made to push the forearm backward and outward into its normal position. 
It must then be held there by means of a tight bandage. This bandage 
must be changed once a clay, as it is apt to produce tenderness of the 
skin from being so tight. If the dislocation affects the lower joint, the 
bone of the forearm will have to be pushed into its normal condition 
with more or less force and a silicate of sodium bandage applied. 

Dislocation of the Patella. — This is only seen in small dogs. Stock- 
fleth states that the patella may become dislocated on both sides, but 
not upward, and that the dislocation is generally on the inner side, on 
account of the forced extension of a very much flexed tarsus and a ten- 
dency of the muscles to turn inward. This is seen occasionally in circus 
dogs (grayhounds) making high jumps. In cases of inside dislocation the 
patella lies on the inner side of the joint where it moves on the tibia, and 
in external dislocation it lies on the outside of the external condyle. 

Inner Dislocation of the Patella. — In the early stages, shortly after 
the dislocation occurs, the animal holds its leg in a very flexed position. 
The hock is flexed and the heel turned outward. At the joint the jDatella 
may be found lying sideways, and is easily moved laterally. If we take 
hold of the foot and flex or extend it, the animal evinces great pain. The 
leg must be bent backward and straightened as much as possible, then 
by means of manipulation of the fingers the patella can be made to slip 
into position. This is very easily performed, and the animal walks away 
as if nothing had occurred. This dislocation, however, may recur when 
the animal jumps any distance. When the disease becomes chronic and 
dislocation occurs often, the animal runs on three legs, or walks lame on 
the affected leg. The stifle-joint is uneven, thick, and the patella can 
be dislocated, or put into position simply by pressure of the fingers. If 
the dislocation affects both legs, these are kept in a flexed position, 
the animal making peculiar jumping movements, using both legs at the 
same time, when he attemj^ts to walk. If he lies down, the hind legs 
are extended backward and crossed. The prognosis is favorable in new 
cases, but unfavorable in old ones. 

Treatment. — The tarsus must be extended in order to overcome 



INJURIES OF THE JOINTS 



351 



the tension in the straight ligaments and extensors, and the patella may 
be easily shoved into position. If the animal is then kept quiet for 
several days, as a rule, no after-treatment is required. If the disloca- 
tion of the patella is old, treatment is useless. 

Stockfleth has used a dressing in this disease which he describes as 
follows : 

He attached a broad linen bandage around the tibia, and fastened 
a wide girth around the abdomen, and a breast-piece to prevent it from 
slipping backward. The bandage w^as then fastened to the tibia, close 
to the girth around the abdomen. The affected leg was then pulled up 
close to the abdomen, so that the animal must stand on three legs. The 
dressing remained on for twenty days, and when it was removed the 




Fig. 113. — Dog with dislocation of the hip. 

animal was entirely cured. In another case he had a double-sided 
dislocation of the knee. After returning the patellie to their position, 
the knee- and ankle-joint were covered with thick wadding, and a capsule 
of gutta-percha, which had previously been soaked in hot water, was 
applied to each leg, surrounding the leg from the knee to the toes. In 
order to prevent l^ending of the gutta-percha, before it was sufficiently 
hardened, a wooden support was fastened to the outside. The dog, 
which had formerly crept upon its hind legs, walked upright as if on 
stilts. The dressing was left on the animal for two weeks, and on 
removal of the dressing the dislocation did not recur. 

External Dislocation of the Patella.— This accident is very rare. 
Stockfleth saw Init one chronic case in both legs in a small dog. The 
subject was lively, walked rapidly, but had very flexed ankle-joints, 
giving him very much the appearance of a weasel. The tarsus appeared 
thick and uneven; the patella, which was located in the muscles of the 



352 



DISEASES OF THE ARTICULATIONS 



outside, could easily be pushed back into its normal position; but if left, 
it immediately slipped out of position, and became dislocated again. 
This was due to the fact that the crest of the joint had disappeared, 
offering no resistance to dislocation. Treatment is useless, as the tissues 
are relaxed and will not hold the patella in place. 

Dislocation of the Hip. — Other luxations occur in the dog — for 
instance, in the hip-joint. In this the head of the femur becomes pushed 
upward after laceration of the capsular ligament, and out of the acetab- 
ulum, and being drawn upward and by the muscular contraction the 
leg is shortened (Fig. 113). 

The animal must be held by the assistant, keeping the body firm, 
then grasping the leg at the tarsus and drawing it along from the body 






iM^ 



Fig. 114. — Skiagraph of luxation of the hip upwards and backwards. 

downward and outward as far as possible, and keep moving the leg 
forward and backward; at the same time, with the other hand, seize the 
trochanter major in the finger, or use the flat of the hand, to manipulate 
the joint into position. It is impossi])le to keep a bandage on this part 
unless it is a pitch plaster, which should be applied and the animal kept 
as cpiet as possible. 

The joints of the phalanges sometimes become dislocated. These 
do not possess any special symptoms that may not be easily recognized 
by the indications stated under Clinical Symptoms of Luxations. 



DISEASES OF THE MUSCLES. 

Muscular Rheumatism. 

(Muscular Pains, Rhcuniatismus Musculoruw.) 

Muscular rheumatism is a primary affection with more or less 
complication of the muscular system. In some cases there is little or no 
inflammation present, no fever, and the only indication of rheumatism 
being present is stiffness of gait and pain on pressure; it may occur as 
acute, subacute, and chronic. 

Etiology. — The cause of rheumatism, which has been described as 
a certain poisonous substance, may also be due to cold, atmospheric 
influences, etc., or dampness, animals lying in kennels that do not get 
the sun, or being kept in the cellar, particularly with asphalt floors 
hunting dogs becoming wet, and after great exertion, sleeping with wet 
coats. We have, undoubtedly, a number of diseases of the muscular 
system which do not develop from rheumatism — for instance, abnormal 
muscular exertion and consequent laceration of some of the muscular 
fibres — also from disturbances of the circulation, from chronic toxic 
influences, etc., from some infectious agent as in acute articular rheuma- 
tism, certain affections of the spinal cord, also pleuritis, nephritis and 
other affections. It would be much better to discard the name ''mus- 
cular rheumatism" and simply call it "muscular pain." Experience 
has taught the writer that muscular rheumatism is seen frequently in 
old, delicate, or fat dogs, and is oftener observed in winter than in 
summer. 

Pathological Anatomy. — It is very difficult to make any definite 
statement as to the cause of rheumatism. We speak of rheumatic 
muscular inflammation, but at the same time we do not, as a rule, find 
any different muscular alterations on post-mortem from animals which 
have suffered from muscular rheumatism. VCe may find slight altera- 
tions which have occurred from other causes, such as hyperaemia, slight 
exudations in the muscles, tendons, and fascia. Deposits occur in the 
connective tissue (rheumatic callosities). These occur in a man who 
has suffered for a long time from muscular rheumatism, and in old 
rheumatic dogs we may also observe characteristic alterations in acute 
or chronic inflammations and the' connective tissue between the muscular 
fibres has increased. 

CUnical Symptoms and Course. — Muscular pain is a most marked 
symptom. This is observed in slight cases by the muscles in an affected 
23 353 



354 DISEASES OF THE MUSCLES 

animal having a contracted appearance, or when by pressure upon them 
they are found hard and tense. We also observe that dogs affected with 
this disease move with fear, showing great disinclination for any move- 
ment, and occasionally they cry out with pain when touched or lifted in 
certain parts of the body or if any portion of a particular muscle is 
touched. If compelled to rise, they do so in a slow, fatigued way. 
Their movements are stiff and strained, and when foeces are passed the 
animals do so with pain, frec^uently crying or howling, or it may be they 
make no effort to evacuate the bowels, which results in obstinate 
constipation. 

As rheumatism is generally located in the regions of joints, these 
symptoms become modified in certain parts of the body and intensified 
in others. We very often see rheumatism of the back and loins, when 
rising and stretching of the extremities and all movements of the trunk 
are very painful. The region of the back and loins is very sensitive, so 
that the animals cry at the slightest movement. The muscles in the 
neck are also subject to this disease (myalgia cerviculis, torticollis 
rheumatica). Animals show great pain while eating on account of 
being compelled to bend their neck in stooping down to reach their 
•food. The muscles are distended and painful to the touch. If the 
head is bent, the animal shoAvs great pain. In rare cases we see rheuma- 
tism in the masseters (a great difficulty in mastication). Only in very 
rare cases is any fever noticed. 

The course of the disease is sometimes acute and occasionally 
chronic. In the former case the disease runs its course very quickly, 
and may disappear without any special treatment, but there is always 
a tendency to relapse. In the latter form the disease may be prolonged 
for months, varying in degrees of intensity, also showing a tendency for 
the pain to move from one part of the body to another, this peculiarity 
enables one to readily distinguish the condition from one of traumatic 
origin. 

Therapeutics. — When the disease is limited to a certain group of 
muscles, it is only necessary to keep the animal in a warm dry kennel, 
and feed with easily digested food and rub the affected parts with 
stimulating ointments such as oil of camphor, aconite and soap liniment. 
In rare instances the animal requires to be muzzled to prevent it from 
biting the affected part. Where the pains are violent, morphine should 
be administered hypodermically. As far as the use of electricity 
is concerned, the opinions concerning it are much divided. The 
writer has never been able to obtain any very marked results by using 
this form of treatment. "N'ibratory massage, however, seems to produce 
very good results in the milder and chronic cases. Internally the agents 
recommended for the dog are salicylic acid, salol or salipyrin, aspirin, 



CYSTICERCUS AND T RICH IX A 355 

tinctvire of colchiciim, or antipyrin. The first three drugs produce the 
most favorable results. 

In the chronic form of the disease, various cutaneous stimulants 
have been used, such as spirit of camphor, opodeldoc, spirit of mustard, 
but we must remember that their influence is more due to the massage 
than to anything else. It is advisable to rub the stimulating embroca- 
tion into the skin, either by the hand or with a woolen rag. Albrecht 
has found that this therapeutic treatment may be greatly improved by 
putting the patient into a bath of 28°, rubbing it dry and wrapping it in 
hot blankets. 

Cysticercus and Trichina. 

Cysticercus. — Reference has already been made to the presence of 
cysticercus in the brain and they also appear in numerous other organs, 
particularly the muscles, and there is special interest in the fact that 
their presence in large numbers in the muscles may cause symptoms 
very similar to those of muscular rheumatism. One dog which was 
very stiff during life and kept the head bent to one side after death, in a 
section of the psoas muscle about an inch square there were found eight 
or ten cysticerci the size of a pea. Trasbot found in a dog that during 
life showed violent pain on touching the skin, pressing the muscles and 
on making certain movements of the body, after death numerous cysti- 
cerci of the Taenia solium in the entire muscular system. (For further 
details concerning cysticercus, see Internal Parasites). 

Trichina. — Trichina is extremely rare in the dog. It is observed more 
in some countries than in others. Of 858 dogs examined in one clinic, 11 
or i per cent, were found infected with trichina. In 2910 post-mortems 
one-half of 1 per cent, were found effected with trichina. The symp- 
toms which appear after a dog has eaten meat containing trichina 
in large numbers are for two weeks a bloody diarrhoea, loss of appetite, 
pain, convulsions, and after the animal was destroyed on microscopical 
examination of the muscles they were found to contain numerous mi- 
grating trichina. Leistikow fed three dogs with trichinous meat which 
afterward developed diarrhoea, great exhaustion and then became normal; 
they were killed six weeks later and the flesh was found to contain 
incapsulated trichina. Paroncito obtained similar results from feeding 
dogs with meat containing trichina, and two were killed after a few days 
and the others died in four weeks. In all cases trichina was found in 
the muscles. 



356 



DISEASES OF THE MUSCLES 



Diseases of the Tendons and Bursa Mucosa. 

Of the pathological processes of the tendons and Inirsa mucosa, we 
will onl}' take up the laceration of the achilles tendon and hygroma. 

Laceration of the Achilles Tendon. — This condition is occasionally 
met with as a result of violent exercise or injuries caused by falling out of a 
window, or having the tendon cut either by jumping on glass, particularly 
on green-house sash, scythes, reaper knives, or maliciously cut by some 
person, etc. Occasionally it results from the bites of other dogs, causing 



r-*' 




Fig. 115. — Laceration of the tendo achillis. 

wounds which are followed by necrosis of the tendon. On the tendon 
being completely severed, the ends are drawn violently apart and the 
animal cannot step or put any weight on the other leg without putting 
the posterior surface of the astragalus as well as the whole of the meta- 
tarsus flat on the ground (Fig. 115). On local examination we may find 
either an open wound or the skin intact, but there is a complete separation 
in the continuity of the tendon. The appearance of the animal is very 
similar to congenital plantigrade or in cases of general rickets. The 
articulation of the knee is excessively extended (Fig. 115). 

Boyer saw in a mastiff a complete severance of the tendon just at 
its union with the gastrocnemius muscle. The ends of the ruptured 
tendon were drawn apart al)0ut 5 cm. In incomplete laceration we 
find more or less exaggeration of the a.stragulas and bending of the knee. 

The prognosis is generally favorable. In case of a wound with 
severance of the tendon, the wound should be thoroughly disinfected, 



DISEASES OF THE BURSA MUCOSA 



357 



the two ends should be sewed together by means of catgut or silk, and 
the joint should be covered by a splint, plaster or silicate of soda, so as to 
hold it imniova])le. "Where there is no injur}^ to the skin, l)ut a rupture 
of the tendon, a splint should be put on and the leg held in the normal 




Fig. 116. — Dog with elbow boil (hygroma). 

position for at east two weeks. If this is not successful the skin should 
be opened over the lacerated tendon, the ends freshened by scarification 
and united by a stitch. This is generally successful. 

Hygroma of the Elbow. — Large heavy dogs, particularly mastiffs, 
St. Bernards and Great Danes, have a habit, when recumbent, of lying 
on the point of the elbow, causing pressure and a gradual thickening 
and swelling of the skin and frequently serofibrinous inflammation of 
the bursa olecrani. This is shown in a round oval protuberance at the 
elbow, varying in size from a hazel nut to a goose egg. It is generally hot, 
painful and frequently fluctuating and contains a cpantity of serous 
sometimes serofibrinous fluid (Fig. 116). As it is a great eye-sore, 
affecting the appearance of the animal and at the same time interfering 
more or less with the animal when in a. recumbent position it generahy 
is emptied by making an incision in a dependant part of the serous 
sac, and heals very rapidly with local treatment. It is very apt, however, 
either to fill up again as soon as the opening closes, or to leave more or 
less thickening of the skin or a hard fibrinous mass. If, however, it fills 
up again it should be injected with dilute tincture of iodine, or Lugol 's 



358 DISEASES OF THE MUSCLES 

.'Isolation. Sometimes it is necessary to open the tumor and to curette the 
inside of the sac to get it to heal properly. If the tumor still remains, 
it should be removed by complete extirpation of the enlargement. The 
operation is not particularl}^ difficult, the only thing to contend against 
is that some animals by extreme flexion of the elbow are apt to burst the 
stitches. The operator must first shave off all the hair in the immediate 
region of the tumor, thoroughly disinfect it and make a long incision in 
a longitudinal direction through the skin over the body of the tumor, 
taking care not to penetrate into the body of the tumor. The tumor is 
now carefully dissected out and the inside of the wound carefully washed 
with an astringent solution, such as lead or zinc, and having cjeaned out 
the blood clots, the freshly cut surface should be carefully touched with 
a pledget of cotton soaked in pure carbolic acid; this application tends to 
lessen slow hemorrhage and frequently heals the wound very quickly. 
The edges of the opening are then united by sutures. In dissecting out 
the tumor, care must be taken not to remove the periosteum of the ulna. 
A l^andage should l^e applied if possible: it is, however, very difficult to 
hold it in position. The animal should rest on deep straw or some other 
elastic material. 



WOUNDS AND THEIR TREATMENT. 



By a wound we mean any injury which lacerates or punctures the 
skin, no matter what is the depth. Wounds are chissified according to 
various authors in the following manner: 

1. Their location, whether they are in the head, neck, chest, or 
extremities. 

2. According to their depth into the muscles or l^ones, they are 
called penetrating or non-penetrating. Those that injure the skin 
slightly are called lacerations or excoriations. 

3. They are also termed longitudinal, transverse, or oblicjue, accord- 
ing to their direction or length. Regular or irregular — that is, indented 
or -flap wounds. 

4. Their cause is also considered, whether produced by cuts, blows, 
lacerations, concussions, bites, or gunshot. These causes, however, are 
of no special importance. 

Clinical Symptoms. — All wounds are accompanied by three symp- 
toms: the open, gaping condition of the edges of the wound, hemorrhage, 
and pain. As a rule, the wider the wound the deeper it is. If the wound 
is long but does not gape, it corresponds with the direction of the muscle or 
the tissue beneath it. On the other hand, wounds across muscles are 
much wider and gape more, this being due to the retraction of the 
muscles. 

The bleeding is either arterial, venous, or capillary. The former may 
be recognized by the fact that the blood from the wound is mixed with 
more or less light-colored arterial blood. The danger of such arterial bleed- 
ing depends on the size of the arteries and how severely they have been 
injured. In small arteries the bleeding generally stops of its own accord, 
due to contraction of the severed blood vessels; but in large arteries the 
animal will frequently bleed to death unless surgical interference stops 
it. In cases where the artery is cut in a transverse wound the hemorrhage 
is more severe than when it is in a longitudinal wound. There is more 
bleeding in cleanly cut wounds than there is in those produced by lacera- 
tion or concussion, but the latter present more complications than the 
former, due to consecutive hemorrhages. In venous bleeding dark-red, 
evenly colored blood flows out of the wound. Hemorrhages in small and 
medium-sized veins generally stop without any surgical interference, 
but the large veins, especially those in the neighborhood of the heart, 
are dangerous and should ])e taken up cjuickly. Capillary bleeding 

359 



300 WOUNDS AXD THEIR TREATMENT 

consists in a slow tricklino- of blood, which, as a rule, lasts for a very 
short time and is of no great importance. 

A serious hemorrhage endangers the animal 's life, and the more 
rapid it is the greater the danger. The following symptoms are pre- 
sented: general coldness of the skin and extremities; paleness of the 
mucous membranes, especially the mouth and eye; great prostration; 
staggering gait; and often inability to rise from weakness. In some 
cases we have unconsciousness, dyspnoea, enlargement of the pupils, 
uncontrollable evacuation of urine and fseces, finally slight convulsions, 
and death. This conclusion is to be expected if about half or even one- 
third of the blood contained in the body is lost in a very short time. 

Many experiments have been made upon the dog in order to find 
what are the consequences of slight hemorrhages. One-fourth of a 
dog's blood may be withdrawn without causing any appreciable lessening 
of the blood-pressure in the arteries. The pulse may become very 
indistinct while the l;)lood is withdrawn, but it is soon restored to its 
ordinary pressure if the hemorrhage is stopped, from the fact that the 
arteries contract in proportion to the smaller quantity of blood. The 
rapidity of the current and the number of contractions of the heart 
remain the same as before the hemorrhage. Any loss of blood amounting 
to more than one-third of the blood-mass reduces the blood-pressure 
very much. The current becomes slow and contractions of the heart are 
much less. At the same time the composition of the blood is changed. 
At first we observe a compensation of the water of the blood, and 
the salts which are thereby being reabsorbed from the tissues when this 
is exhausted; then albumin is drawn into the blood. It requires a much 
longer time to form new blood cells after the animal has been bled an 
amount of blood ec^ual to one-fourth of the weight of the body. The red 
l)lood corpuscles become normal and return to their original number in 
from seven to thirty-four days. 

The pain of a wound is indicated in the dog liy howding and crying 
when the injury occurs, or later when the wound is examined. The pain 
evinced by the patient also depends upon the individuality of the animal. 
Some dogs are great cowards and show great sensitiveness to the slightest 
pain, while others will stand any amount of it; and we must, therefore, 
always carefully examine a wound, seeing its depth, situation, and 
character, and not in any way be guided in making a diagnosis by the 
symptom of pain indicated by an affected animal. Wounds of the lips, 
lower extremities, external genitals, and of the bones are the most 
painful. In the dog we see occasionally a series of symptoms which are 
identical with what is known in man as "shock." This, as a rule, occurs 
immediately after any painful injury, such as extensive crushing of 
tissues or bone, and during or after operations. The visible mucous 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 301 

membranes in the skin become pale, then cold; the eyes are fixed, the 
pupils dilated; the pulse becomes irregular, reduced in volume; and the 
respiration weak and irregular. The animal appears indifferent or 
unconscious. These symptoms may disappear very rapidly or in some 
cases go on until the animal dies without rallying in spite of any form 
of treatment that may be tried. 

Symptoms of a very similar character, as a result of extensive 
hemorrhage, are sometimes presented, and must not be mistaken for 
"shock." The same may be said to occur occasionally in the dog when 
under the influence of chloroform. It is believed that the symptoms of 
"shock" presented are due to an irritation or concussion of the sensitive 
nerves, producing reflex paralysis of the vasomotor center of the medulla 
oblongata. 



The Course of the Healing Process in a Wound. 

The healing of a wound depends to such a large extent on its form, 
condition, location, and treatment, that from a practical standpoint we 
may generally separate the processes into, first intention, or healing by 
primar}' union; second, healing by second intention or suppuration; 
third, healing under a dry scab; fourth, healing under a moist scab; the 
various processes of wound healing can be studied in works on surgery. 

Diseases Resulting from Septic Infection of Wounds. 

There are a number of conditions which appear in wounds that are 
due to microbes or germs, producing certain irritations of the tissues 
surrounding the wounds, especially the blood vessels and the lymphatics. 

Phlegmon. — By this we mean the inflammation of the soft tissues 
which has a tendency to formation of pus, especially in the loose sub- 
cutaneous connective tissue between the muscles and under the fasciae. 
There are two forms of this condition — a circumscribed and a diffused 
phlegmon. 

Circumscribed Phlegmon. — The symptoms are very prominent, 
especially Avhen it is near the skin. We find in a certain circumscribed 
region a hot, painful, very red swelling, firm and tense in the early stages, 
but soon becoming soft, doughy, and finally fluctuating, due to the tissue 
breaking up and forming a purulent licjuid. From the pressure of the 
pus the skin becomes gradually thinner and thinner, until the pus finally 
makes its exit through the skin and escapes. If, for some reason, the 
skin is too tough, or if the pus has not been allowed to escape by means 
of an incision, it may cause a purulent infiltration of the surrounding 
tissues, which is very serious and ends with necrosis of the parts, espe- 



3G2 WOUNDS AXD THEIR TREATMENT 

{■[ally of the fasciee, tendons, muscles and bones, and it may be taken up in 
the blood, and portions of the diseased tissues are carried in the circula- 
tion to different parts of the body. 

Diffuse phlegmon is generally a very serious condition. The local 
symptoms are the same as the circumscribed, but the fever is much 
higher, and the purulent pus rapidly extends in all directions in the 
loose connective tissue, undermining and frequently causing extensive 
necrosis of the skin, fasciae, muscles, tendons, etc. Death occurs, as a 
rule, from septicamiia or pyaemia. 

The treatment of diffused phlegmon consists of scarification and 
incisions. Numerous slight incisions are made to reduce the inflamma- 
tory tension of the tissues and to encourage the pus to escape, also to 
prevent it from burrowing in different directions, and to make an opening 
into the parts so that they can be disinfected by means of injections or 
irrigations of 1 to 1000 solution of corrosive sublimate, 3 to 5 per cent, 
of carbolic acid, or 2 per cent, of creolin. In circumscribed phlegmon 
it is better, as a rule, to wait until the abscess is in that condition known 
as "ripe," or until it" points." This can be distinguished from the fact 
that the swelling fluctuates or is soft in the centre. In a light skin it may 
be even yellow. As soon as the incision is made it should be emptied and 
irrigated and injected with an antiseptic solution, afterward treated as 
an ordinary wound. 

Inflammation of the Lymphatics {Lymphangitis). — This is caused 
by poison absorbed from an unclean, unhealthy wound, although in 
some instances it may be caused by a high nitrogenous condition of the 
blood due to overfeeding. The author has observed several cases in 
dogs where one or more of the legs was hot, painful, and swollen, and 
there were also lameness and an increase of temperature. On examining 
the subcutaneous lymphatics they were found to be enlarged, presenting a 
peculiar corded appearance and running in the direction of certain of 
the lymphatics. These were enlarged and very tender to the touch. 
In cases of this kind we may see two terminations: first, a rapid recovery; 
second, the formation of an abscess containing a large amount of purulent 
pus in the swollen lymphatic glands, producing extensive inflammation, 
blood-poisoning, and the animal eventually dying from septicaemia. 

The therapeutic treatment consists first in the iri'igation of the parts 
with cooling applications, and, if the glands show indications of forming 
abscesses, apply hot poultices and open as soon as possible. 

Inflammation of the Walls of the Blood Vessels (Phlebitis). — This is 
especially interesting to the veterinarian, as it is quite frequently seen in 
the dog. Purulent inflammations of the blood vessels are seen in con- 
nection with infectious purulent wounds, and originate as a secondary 
symptom by extension of the suppurating process from the surrounding 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 363 

tissues. This is especially noticeable where the wall of the vessel is 
crushed, forming a thrombus, and this thrombus, lying in the IjIoocI vessel, 
becoming infected from the wound, produces suppuration and breaks 
down, and is carried into the general circulation and deposited in some 
part or organ of the body, setting up an irritation, and a consequent 
formation of an abscess. This condition is termed "metastatic abscess." 

The therapeutics are the same as those of lymphangitis. Open 
the wound as soon as possil)le and thoroughl}' disinfect the abscess. 

Fever. — Concerning the clinical symptoms of fever, we have giA^en 
all necessar}' details on page 9. The fever which accompanies wounds 
varies greatly in intensity according to the cause. The following are 
the different varieties of wound fever: 

1. Aseptic Wound Fever. — This is produced by entrance into the 
circulation of the blood of harmless substances (water, irrigating fluids, 
non-decomposed wound secretions, and fibrinous ferments). This 
occurs in the majority of cases shorti}' after the animal receives the 
wound, and causes very slight disorder in the general condition. The 
rise of temperature is generally the only visible symptom in the dog. 
There is no alteration in the appetite, and the temperature is reduced 
within a few hours; in very rare cases it may be slightly increased for 
two or even three days. 

2. Septic Wound Fever and Septicaemia. — As soon as putrid or 
decayed sul)stances find their way into the system by means of a wound 
the symptoms of fever appear rapidly. If they are mild in character, 
it is called "septic wound fever;" if they are acute, presenting symptoms 
which may endanger the life of the animal, it is called "septicaemia." 
Septic wound fever and septicaemia are only separated by their degree of 
intensity, otherwise they are similar. There is one difference that we 
will point out between septic poisoning and septic infection, and that is, 
in the first form, the micro-organisms which produce putrefaction are to 
be found only in the centre of infection and not in the blood, while in the 
second form the centre of infection is in the blood and in the tissues. 

Septicaemia appears, as a rule, thirty-six to forty-eight hours after 
the injury with an increase of temperature as high as 40.5°, rarely above, 
and showing a remittent character marked by depression, fatigue, and 
loss of appetite, the last being very rare. If the wound is treated quickly 
and rendered thoroughly antiseptic, the symptoms rapidly disappear. 
The most dangerous forms of septicaemia which occur most frequently in 
the dog ajDpear two to four days after the injury, showing a general disturb- 
ance of the system, and frequently without presenting any unusual 
symptoms in the wound itself. The temperature is rarely increased to 
any extent. Move often it is normal or subnormal. "We are not able, there- 
fore, to place any dependence on the temperature as far as prognosis 



304 WOUXDS AXD THEIR TREATMENT 

is concerned, the onh' value being when the normal temperature is pre- 
sented and the acute symptoms already described begin to abate. 

We sometimes see very peculiar cases — for instance, the author has 
observed a case of septicaemia with normal temperature the first day 
accompanied by weakness, depression, loss of appetite, etc. In the next 
few days the temperature gradually increases; sleepiness, fatigue, and 
rapid emaciation; the symptoms increase in intensity; the pulse becomes 
weak, rapid, and much slower, until it falls below the normal rate, and 
finally ends in the death of the animal. In many cases diarrhoea is 
present, and in rare cases convulsions. 

Therapeutics. — Antiseptic solutions must be used vigorously and 
the wound irrigated frequently. If there is any dead tissue that is hard 
to loosen, the thermo-cautery should be used to render it aseptic. The 
animal must be stimulated by means of ether, alcohol, and camphor. 
The writer finds subcutaneous injections (4.0 to 6.0 doses) of spirit of 
camphor or camphorated ether, 1 to 10, of great value in such cases. 
This drug he is inclined to call a specific agent in septicaemia. It must 
be injected every two or three hours under the skin until the alarming 
symptoms have disappeared. Slight muscular contractions which 
sometimes follow the use of camphor are not to be regarded as anything 
especially serious. 

3. Purulent Fever and Pyaemia. — When a suppurating wound 
becomes very much inflamed and infects the surrounding tissues, it is 
generally followed by the entrance into the blood of some microorganisms. 
If the symptoms of fever are slight, the patients may recover, wdth only 
a chill and a slight increase of temperature. If the fever is very serious 
and the temperature rises high, it is called pyaemia. In this disease you 
will find that the majority of cases are follow^ed by metastatic suppura- 
tion in various organs of the body. This is due to the fact that the throm- 
bus undergoes purulent destruction in the blood vessels, breaks down, 
and the infectious matter is carried into the circulation, and from there 
it fintls its way to different organs or locations in the liody. The symp- 
toms of pyaemia in the dog are not very easily distinguished from those 
of septicaemia, and it is very hard in the majority of cases to make a 
positive diagnosis. Very frequently we see symptoms of septicaemia 
and pyaemia combined, forming what is known as septico-pyaemia. In 
this case the animal dies before any deposit of the suppurating poison 
has produced abscesses. In pyaemia the symptoms are marked by chills 
in the early stages, and by intermittent fever. The appetite is often 
good, and, as a rule, rarely cntii'ely absent, as in septicaemia. Later the 
disease presents much more serious symptoms: the fever loses its inter- 
mittent character, the temperature remaining high; the appetite disap- 
pears; fatigue and weakness may occur; the patients become rapidly 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 305 

emaciated and finally die. AVith these symptoms we see metastatic 
suppuration in the internal organs. 

The therapeutic treatment of pysemia is similar to that of septicaemia. 

Treatment of Wounds. — In the treatment of wounds we must pursue 
the following directions to obtain good results: 1. That the edges of the 
wound must be brought together as soon as possible to encourage union. 
2. That in the treatment of wounds we must protect them from all kinds 
of irritation, and especially from the invasion of micro-organisms. 

A wound may be infected with microl:)es through the hair, or by 
direct infection from unclean hands, instruments, dressing materials, 
or septic fluids. It is also possible to infect a wound from the blood. 
The main point in the treatment of wounds should be to prevent the 
direct entrance of microbes into it, or to destroy the infectious substances 
which have entered the wound, and finally to put it in such a condition 
as to prevent the fui'ther development of any microbes that may still 
remain there. The first is rather difficult in the dog even under ordinary 
circumstances; the last can be followed out to a certain extent, as the 
treatment of wounds is greatlyinfluenced in the dog by two facts : first, many 
dogs will not allow a dressing to remain in place; and, second, a wound is 
interfered with to a certain extent by the tendency that all dogs have to 
lick the injured part. For this reason we frequently have to modify the 
treatment of wounds in the dog. We must, however, apply a dressing 
in all cases where we can keep the patient quiet and prevent him from 
removing it. The veterinarian has t^^■o powerful agents at his disposal 
for the treatment of wounds: the first is, primary disinfection of the 
wound and its neighborhood; second, keeping the wound as dry as possible. 

1. The First Disinfection of Wounds. — This is of special importance, 
and especially during and after operations where there is much blood lost. 
The wound and everything coming in contact witli it, also the tissues 
surrounding it, should be carefully rendered antiseptic. The hair has to 
be shaved or cut very close, the skin washed with ether or benzine in 
order to remove all the fatty matter lying in the skin. Follow this by 
washing with antiseptic fluids (1 per cent, solution of sublimate, 3 per 
cent, carbolic acid, 2 per cent, crcolin). Any existing wound has to be 
treated in the same manner. If there is a wound the shape of which 
forms a cavity, an antiseptic solution must be injected into it and come 
in contact with all parts. The irrigator shown in Fig. 117 is especially 
adapted to that purpose. For cleansing wounds do not use sponges 
unless they are thoroughly aseptic, also disinfect the gauze and dressings 
(tampons). Instruments and the operator's hands must also be care- 
fully attended to. The former should be placed in an antiseptic solution 
of carbolic acid, 5 per cent., or a 2 per cent, solution of creolin. Do not 
use corrosive sublimate solution for instruments, as it leaves an insoluble 



366 



WOUNDS AXD THEIR TREATMENT 



coating of mercury on the steel. The hands and nails have to be brushed 
and washed with carbolic solution, or sublimate soap. During the 
operation the wound should be disinfected from time to time — that is to 
say, it should be washed or wiped with the solutions referred to above. 
2. Future Treatment of the Wound. — This consists of various 
measures, according to whether there is hemorrhage and the condition 
of the wound. 

Stopping all Hemorrhage. — If the blood which runs into a wound is 
left there, it has a bad effect, preventing an adhesion of the surfaces of 
the wound, and also being a favorable ground for 
the development of microbes. 

Drainage of the Wound. — By this we mean the 
removal of wound secretions, especially pus, by 
means of drainage-tubes. The regular drainage- 
tubes are made of rubber, having numerous holes 
cut in them. These are placed in the deepest part 
of the wound, and fastened by means of a stitch 
in the skin, or the wound closed around it. In 
small wounds, instead of the rubber tube we use 
small pieces of silk thread or catgut which have been 
twisted together in the shape of a cord. In wounds 
which are not deep, but cavernous, and where it is 
difficult to get ciuick adhesion in order to insure pro- 
per drainage, it is best to leave the wound open, 
covered with antiseptic powder, such as sulphonal, 
boric acid, naphthalin, salicylic acid, etc. The first- 
named agents possess special properties for the 
treatment of surgical wounds, drying them rapidly 
and depriving the microbes of a proper medium to 
develop in, and thus rendering it impossible for in- 
fection to extend. 

It is advisable to use some material that wall take up the secretions 
of the wound c{uickly, and assist in drying them. For this purpose, we 
cover the wound with salicylic- or carbolic-acid or corrosive sul)limate 
gauze. In a wound where there is a deep cavity, it is well to fill it for 
twenty-four to forty-eight hours after the operation with a tampon of 
sublimate gauze, then, having removed the gauze, clean the wound and 
by means of sutures bring it together and cover it with antiseptic gauze. 
The following is the ordinary treatment of wounds: 
I. Controlling the Hemorrhage. — This may be accomplished in various 
ways. The best method is by means of a ligature. As a rule, this is 
performed by carefully ligating the bleeding blood vessel, either directly 
on the vein or artery, or taking up a certain portion of the tissue wdth a 




Fig. 117. — .\pparatus 
for the antiseptic irriga- 
tion of wounds. 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 



367 



pair of forceps, including the blood vessels, and tying it behind the 
point of the instrument with a ligature. When the bleeding end of a 
blood vessel is located in very firm tissue, out of which it cannot be 
drawn far enough to ligate, we pick up the blood vessel with the end of 
the forceps, draw it out as far as possible, and twist it in a spiral direction; 
by this means we usually succeed in controlling the hemorrhage. If, 
however, the above does not answer, we pass a thread through the 
tissue underneath the blood vessel and tie it tightly, and by this means 
close the opening. 

Compression is sometimes used as a means of stopping hemorrhage. 
This we can accomplish by pressure of the finger above the bleeding 
region, or, if it is an extremity, ligate the member above the part by 




Fig. 118.— Different forms of stitches used in the dog and method of tying: a, head-stitch; 6, 
cjntinuous oblique stitch with cross-stitch; c, deep continuous cross stitch; d, mattress-stitch; e, but- 
ton and interrupted stitch. 

means of a rubber band or tube, or even a handkerchief. Another means 
of stopping a hemorrhage is by using a cauterizing iron (thermo-cautery). 
These, however, should only be used in wounds where you do not expect 
healing by first intention. All agents which have the property of stopping 
hemorrhages, as a rule, coagulate or draw the tissues in such a way as to 
prevent healing by first intention. 

Capillary or slight subcutaneous hemorrhages can be stopped by 
pressure or irrigation with cold water. Hot water is also sometimes used 
to control hemorrhage. 



368 WOUNDS AND THEIR TREATMENT 

Wounds which can heal by first intention, such as all operative 
wounds which have been thoroughly disinfected according to the method 
described above, and where the hemorrhage has been stopped, we 
bring together by stitches or ligatures (Fig. 118). As a rule, the 
ordinary knot-stitch with antiseptic silk is used, although we may con- 
nect it with other forms, such as the extension stitch (Fig. 1 18). Small 
wounds do not, as a rule, reciuire drains. The wound should be com- 
pressed for several minutes by means of an antiseptic sponge, and after 
that covered with collodion. If the position of the wound allows, we 
must apply a firm, compact dressing over every wound that is stitched; 
if it is a simple one, the dressing may remain until it is entirely healed — • 
that is, for about one week. If we have a large wound, however, with 
flaps, caverns, etc., it is advisable to place drains in the wound and 
change the dressing after three or four days. Instead of collodion dress- 
ing in such wounds, use antiseptic powders, such as sulphonal, der- 
matol, bismuth subnitrate and boric acid. These should be dusted on 
the wound itself, directly on the line of the severed skin. 

The writer has been in the habit of covering ordinary sewed wounds 
with a thin layer of antiseptic gauze, and covering over that a dry, 
antiseptic muslin bandage, and finally over these two covers a damp 
starched gauze bandage. The latter has the advantage of forming a 
stiff envelope, becoming dry on account of its starchy contents, and 
exerting a certain hold on the injured member. If a serious rise in 
temperature takes place, the dressing must be immediately removed and 
the directions followed which are given under the head of "Wound 
Fever." When the bandage has been displaced, 
and when it has been moistened by the wound 
secretion, it must also be changed. 

Wounds which heal under a dry scab are gen- 
erally superficial. These do not require to be 
closed by means of stitches, and they seldom are 
119.—. uzzc. hcked or irritated by animals. In these cases 

we use the following method of treatment. 

After thoroughly disinfecting the wound and its neighborhood with 
some antiseptic solution — dilute corrosive sublimate or creolin solution — 
allow it to dry, and b}^ means of a camel's hair brush paint the irritated 
dermis. We produce an artificial scab, or we cover the wound surface 
with collodion. The latter is recommended in common lacerations. As 
a rule, no dressing is used. The scab loosens after some time and falls 
off. When we are obliged under certain circumstances to leave a wound 
open it is advisable to muzzle the animal (Fig. 119), not only to prevent 
the patient from licking the wound, l)ut in order to properly apply a 
sprinkling powder, and get good results from it. The best powder to 




DISEASES FROM SEPTIC INFECTION OF WOUNDS 369 

use is boric-creolin (1 part of ci-eolin to 40 or 50 parts of boric acid), 
naphthalin or sulphonal (1 part to 5 parts of starch), dermatol, airol, 
aristol, bismuth subnitrate or zinc oxide. An open wound generally 
recpires antiseptic washings daily. It frequently happens that granu- 
lating wounds, especially when they have been subjected to exposure to 
air or are constantly irritated by the animal, may at some period lose 
their power of healing and become converted into ulcers. 

Ulcers or Ulcerations. — By this we understand a granulating surface 
which does not heal on account of the purulent destruction of the granular 
tissue. Wounds are changed into ulcers when they are continually 
irritated by some mechanical or chemical irritant, or as a consecjuence of 
the skin becoming inflamed or necrosed from pressure (muzzling, etc.). 
Callous ulcers and fistulous ulcers are the most difficult to treat. The 
former are superficial ulcers with hard, callous centre, having raised 
edges, and a whitish, hard, bacon-like surface. This is covered with a 
thin unhealthy secretion. They may form sinuses or canals, which very 
often contain, at the bottom of the sinus, a foreign body or necrosed 
tissue. They may also lead to some of the glands. These pipes are 
called fistulse or fistular canals. 

The treatment of ulcers is, to a certain extent, the same as that of 
wounds — that is, to follow all the antiseptic rules. The use of dermatol, 
airol, aristol, subnitrate of bismuth, salicylic acid, naphthalin, powdered 
camphor, or boric-acid ointment is advisable. We may also remove 
callous ulcers by surgical means and convert them into fresh wounds by 
taking a knife, paring the tissue at the bottom of the ulcers, and treat 
them as indicated in cases of fresh wounds. Caustic agents produce 
little or no good effects. If the tissue surrounding the ulcers is hard and 
rigid, preventing contraction of the ulcerated area and the healing 
process, we must perform circumcision of the part, as transplantation 
is not practicable in the dog. We cut about 1 cm. from the border of the 
ulcer over its entire thickness, keeping the wound open by means of 
vaselin. When we treat a fistulous canal and the location of the fistulous 
sinus admits of it, we split open the fistulous passage and convert it into 
an open wound. When the fistulous canal is not very deep we may also 
try to produce healthy granulations by means of actual cautery, or the 
injection of caustic fluids or the introduction of crayons of caustic 
(nitrate of silver or caustic potash). Always try to slit open the canal, 
if possible, as it produces the best effects. Nitrate of silver or any of 
the mineral acids, and in obstinate cases a small piece of corrosive sub- 
limate, is pushed down into the bottom of the wound; these caustics 
produce more or less irritation and consequent sloughing of the wall of 
the canal and allow the growth of healthy granulations. 

Contusions. — In subcutaneous wounds of the soft tissues (bruises 
24 



370 WOUNDS AXD THEIR TREATMENT 

and contusions) we find a different condition of the tissues. These 
injuries are generally caused by some blunt object — for instance, a blow, 
kick, shock, or fall. The soft parts are bruised and injured according 
to the intensity of traumatism; very slight resistance is offered by the 
loose connective tissue; small blood vessels are ruptured from crushing 
or bruising the soft parts, and the hemorrhage that follows percolates all 
through the torn tissues. The greatest amount of resistance is found in 
the skin, face, sinews, and large blood vessels. 

Clinical Symptoms of Contusions. — One of the first symptoms of 
a subcutaneous bruise is a swelling in the region of the injury. This 
appears, as a rule, immediately after the injury, and is due to the blood 
running out of the torn vessels. The fluids in the enlargement always 
contain lymphatic substances on account of the laceration of certain 
lymphatic glands. In rare cases Ave see a lymphatic secretion only, 
which is distinguished from the blood secretion by being very slowly 
absorbed. The fluid which appears lies either in. the loose connective 
tissue under the skin or between the muscles, and, as a rule, is irregularly 
divided, or we may find the condition presented in a number of ways; 
for instance- we may find a ''doughy" swelling in one case, or it is accu- 
mulated in centres in another, or we see a fluctuating swelling or a 
"blood boil" (hematoma), or it may run into a cavity, and we have a 
bloody secretion of the joint (hemarthrosis) , or we find a bloody secre- 
tion in the cavity of the chest (hematothorax). The swellings, as a rule, 
occur shortly after a contusion, and in the early stages rarely show any 
inflammatory symptoms. Later, however, inflammatory symptoms 
may appear. 

Beside the swollen condition of the tissues, the animal may present 
symptoms of pain, especially at the time of the injury, and later on we 
find the injured region very tender to the touch. 

The further course of the wound depends to a great extent on the 
amount of the injury. If the skin is crushed in such a manner that all 
the vessels are torn, it will become necrosed from deficient nutrition, and, 
as a result, is indicated in the discharge, which contains septic blood and 
broken doAvn tissue. 

In the treatment of contusions, to get good results we must have one 
object in mind — that is, the rapid reabsorption of the secretion. For 
that purpose we use cooling compresses soaked in lead-water (Goulard 's 
extract), or arnica-water, or we may try to get absorption by means of 
massage — that is to say, make a centrifugal friction with the thumbs, 
fingers, or hand for fifteen or twenty minutes at a time. We may also 
squeeze the excreted blood into the tissues and lymphatic passages, and 
apply a tight bandage immediately afterward to prevent any recurrence 
of the subcutaneous bleeding. This latter treatment is not to be 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 371 

practised unless the swelling is very small and there is very little fluid 
in it. 

The therapeutic treatment is not simple in all contusions. In large 
"fluid-boils" we rarely can wait for an absorption of the secretion, Init 
are compelled to open the swelling at the point where it is soft and where 
the skin is thinnest. In animals we must always try to make an opening 
in the dependent part of the enlargement, so as to get perfect drainage. 
After having opened the tumor, clean it out, removing all clots, etc., and 
treat the inner surface of the wound according to the usual method, 
applied in such cases. If the location of the wound prevents such a pro- 
cedure, the fluid may be emptied by means of a hypodermic syringe, and 
an antiseptic solution injected in its place, and, if possible, this should 
be followed up afterward by a compress-dressing. 

In all cases where the skin is very much injured, or w^here extensive 
destruction of the soft parts has taken place, or even fracture of the bone 
has occurred, we cannot use massage, but instead compressing antiseptic 
dressings must be applied. As a rule, treat the slightest injuries of the 
skin according to the l:)est antiseptic methods. 

Inflammatory symptoms are observed as soon as fever appears. 
The skin becomes hot and painful; finally fluctuation is found in some 
parts. Then we must immediately remove the secretion, clean out the 
wound, and by drainage keep the cavity empty, at the same time inject 
into the wound a 1 to 1000 solution of corrosive sublimate or a 5 per cent, 
solution of car])olic acid, and use an antiseptic bandage. 

Bums and Scalds. — In cases where a high degree of temperature acts 
on the skin it causes hypersemia in milder cases, to necrosis and sloughing 
in severe cases. For convenience of descriptions, we divide burns into 
three classes or degrees. The first degree of burning is indicated by 
great pain, redness and swelling of the skin; the second degree causes 
violent serous exudation in the stratum mucosa and is indicated by the 
formation of blisters containing a yellowish serous fluid which dries or 
may bui*st the vesicle when it is followed by more or less suppuration. 
Burns of the third degree are indicated by more or less extensive necroses 
of the skin. The necrosed portion of flesh forms a scab which is separated 
from the surrounding healthy tissue by a demarcating line of granulating 
tissue. Extensive burns may cause death in a few hours. In such cases 
the animal shows violent pain, is greatly excited and restless, the pulse 
is very high, hard and wiry. The respirations are increased, subnormal 
temperature and death follows in a short time. Sometimes there is violent 
vomiting, followed by convulsions; the prognosis depends on the severity 
of the burns or scalds. Very frequently a scalded animal is disfigured 
for life as a result of the extensive destruction and subsequent necrosis 
of the epidermis, which destroys the han- bulbs and prevents future 



372 WOUNDS AXD THEIR TREATMENT 

growth of hair. Treatment in all cases consists in applying cooling 
applications that prevent the air from reaching the burned surface, 
such as flour, starch, boracic acid, or talcum powder, applications of solu- 
tions of lead water, acetate of alum or cresol, or unction of petrolatum, 
zinc or lead oxide ointments, also ointments of ichthyol or thigenol (1 to 
10), lead liniment 1 part of acetate of lead and 10 parts of olive oil, 
calcium liniment (so-called carron oil), lime water and linseed oil equal 
parts, or mixture of equal parts of carron oil and carbolized oil (1 to 20) 
or a mixture of a beaten up egg and linseed oil. Blisters of very large 
size should be opened with a fine needle, taking care to make a very small 
opening in the covering of the blister and endeavor to prevent it from being 
rubbed off. In case the epidermis — that is to say, the covering of the 
blister — is rubbed off, the above-mentioned salves and liniments can be 
used, but drying powders such as dermatol, airol, aristol, subnitrate of 
bismuth, oxide of zinc are much to be preferred. These drugs are 
generally rubbed up with starch or talcum and dusted on the sore by 
means of a pledget of absorbent cotton, a perforated tin dusting box or 
blown on by means of an insufflator. Powders of salicylic acid or 
magnesia in combination with talcum powder should be employed where 
there is suppuration or scalding of the third degree. Some recommend 
a solution of picric acid 1 to 100, or a 5 per cent, solution of nitrate of 
silver. Where the animal is in very violent pain, we should use cocaine 
in solution as a local application. A bandage of absorbent cotton is 
put over the scalded portion. This is rather difficult, however, to keep 
in position, as in cases of severe scalding the animal constantly moves 
or twists the body in endeavoring to lick or bite the wounds. This must 
be prevented if possible. In cases of acute or extensive scalds the animal 
must be covered with cotton batting and given some of the various 
stimulants such as alcohol, camphor, or ether, and also the subcutaneous 
solution of common salt is to be recommended. 

Frost Bites. — Freezing is comparatively rare, prol^ably due to a 
certain extent to the fact that frost bites, if they happen to be mild in 
character, are either overlooked or mistaken for other affections. Frost 
bites occur in hunting dogs, in the work dogs of Europe, and also the sled 
dogs of Canada and Alaska. Freezing generally appears in the feet. 
Muller and Frick found freezing to be rather common in hunting dogs, 
but, except when it is more or less extensive, is not observed by the 
attendants of the animal. Schneidermuhl observed a bitch that had a 
frozen udder. Schindelka saw one case where a clog had his ear frozen. 
As in burning, we divide freezing into three degrees depending on the 
severity of the symptoms. In freezing of the first degree we find 
in the frozen portion slight dark red or blue colored swellings. In 
freezing of the second degree, there appear a number of bladders or 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 373 

blisters, containing yellow hemorrhagic serum, and after the vesicles 
burst there is more or less loss of tissue and the wound heals very slowly 
leaving a very pronounced cicatrix. Freezing of the third degree is 
accompanied by more of less gangrenous mortification of the frozen portion. 
Chilblains (perniones) are seen occasionally in dogs that are kept 
chained in yards and pointers that hunt in the snow or over frozen 
ground. The treatment of frost bites of the first degree consists in 
attempting to remove the venous stasis by means of friction or a liniment, 
such as spirits of camphor or aconite or paint the affected portion with 
tincture of iodine. The application of moist, warm compresses is also 
beneficial. For freezing of the second degree, in which blisters have 
been formed, apply drying powders already mentioned and if gangrene has 
commenced, the wound must be treated with antiseptics. Where the 
animal is completely frozen, as is indicated by the rigidity of the body, 
avoid warming the animal too quickly. The animal must first be rubbed 
with a cloth which has been dipped in cold water or given a bath in cold 
water and gradually the heat of the water increased up to the bodily 
temperature; at the same time the body is to be rubbed constantly. 
Subcutaneous or intervenous injections may be administered, such as 
ether or camphor. Artificial respiration may also be resorted to. 

Snake Bites. — In Europe there are three species of venomous snakes 
which may bite dogs. They are the common viper (vipera berus), the 
asp (vipera aspis radii) and the sand viper (vipera ammodytes). The first 
serpent is found all over Europe, the asp in Switzerland, the sand viper 
in Dalmatia. ■ In America we find the rattlesnake (crotalus) and the 
copperhead (trigonocephalus contort rix) and moccasin (toxicophis 
piscivorus) and puff adder. The poison of the snake lies in two glands 
which lie at the base of the long teeth. Sporting dogs and shepherd dogs 
are generally bitten on the legs and sometimes on the mouth. A short 
time after the animal is bitten, we find about the bitten portion a bluish- 
red tumefaction which is extremely painful and has a doughy-like feel to 
the finger. The pulse is small and thready, the respirations frequent. 
The animal attempts to vomit and finally may become totally paralyzed. 
As a rule the animal makes a good recovery and it is only in rare instances 
that it results fatall3^ The treatment consists in putting a tight ligature 
immediately al)ove the affected portion and this must be left on until 
the effects of the poison have passed off. Subcutaneous injections of spirits 
or ammonia diluted with three parts of water. The following drugs are 
also recommended to be applied directly to the wound: calcium chlorate, 
chloral water, tincture of iodine, hydrate of potassium or nitrate of silver. 
The thermocautery can also be used. It is to be understood that any 
of the preparations to be of any service, must be used immediately after 
the animal has been bitten. Karlinski recommends subcutaneous 



374 WOUXDS AXD THEIR TREATMENT 

injections of solution of cliromie acid (1 to 100). Lacerda advises sub- 
cutaneous injections of pei-manganate of potash (1 to GO). Where the 
animal exhibits great weakness, we should administer alcoholic stimu- 
lants — Ijrandy, whiskey, or sherry — and to these add a few drops of spirits 
of ammonia. Ether, camphor, atropia are all advised as stimulants. 
A serum has been prepared to combat the effects of a snake bite. 

Wounds of the Tip of the Tail. — Wounds or injuries to the tip of the 
tail are generally found in short-haired dogs with long tails, particularly 
great danes, pointers, and beagles. Wounds of this character are caused 
l\v the dog shaking the tail and hitting against solid objects, particularly 
where dogs are kept in narrow kennels and wag their tails and strike the 
sides of the kennel. It is a peculiar fact that while injury of the tip of the 
tail is insignificant, it is one of the most difficult to treat and cure. This 
is caused by several facts; first dirt and scabs collect on the wound which 
causes the animal to constantly lick and gnaw the sore. Another fact 
i':; an animal will keep gnawing at the tail when there is apparently no 
reason for it. The tail seems sometimes to be intensely itchy, due prob- 
ably either to neuritis or to itching eruptions of the skin. The animal 
gnaws and bites the tail as if in a fury of pain or irritation until the vertebra 
is exposed causing necrosis of the bone and slough of portions of the tissue 
or even one or two bones of the coccyx. Sometimes we find certain ecze- 
matous eruptions that extend from the back and root of the tail along the 
entire body of the tail, and the animal is constantly licking and biting it. 

The first line of treatment is to endeavor to lessen the irritation and 
to heal the sore. First clean the tail carefully and thoroughly with warm 
Avater and soap and remove all dirt, scabs, etc., from the injured or 
irritated portions, and after drying the tail, dust on antiseptic powders 
such as boracic acid, airol, dermatol or tannoform or even paint the 
injured portion with collodion or compound tincture of benzoin. Where 
there is an ulcerated portion of the skin, it should be stimulated with a 
stick of' nitrate of silver or in cases where there is deep ulceration it may 
be necessary to touch the affected portions with the thermocautery. 
After applying the antiseptic dusting powder it is necessary to apply a 
bandage on the tail and for this purpose there is nothing better than a 
bandage held in place with carpenter's glue. This is applied in the fol- 
lowing way: Strips of muslin or linen are covered with glue (ordinary 
glue that is warmed slightly to render it more liquid) then the affected 
portions are covered with tlie antiseptic dusting powder and a small 
portion of absorbent cotton filled with the powder is applied. The 
strip of muslin covered with the glue is laid on lateral sides of the tail 
from the root of the tail around the tip and back and the glue-covered 
side directly on the hair (Fig. 120). Another strip may be put on, cover- 
ing the superior and inferior surfaces of the tail, then strips are wound 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 



375 



around the tail to hold on these strips, either at the root and tip, as shown 
in Fig. 120, or along the entire tail as shown in Fig. 120. Care should 
be taken not to wind the circular strips too tight as the bandage is apt to 
contract c^uite consideral)ly when the glue dries. The bandage sticks 
closely to the hair and has many advantages over adhesive plaster. It 
is impo8sil:)le for the animal to shake it off, and if he should show an 
inclination to gnaw at it a muzzle should be put on the animal. The 
bandage should be changed every five or six days. The bandage is 
removed by putting the tail in warm water or covering the bandage with 





Fig. 120. — Bandage for injuries or amputation of the tail. 

a cloth saturated with warm water and allowing it to remain for ten 
minutes, when the strips are easily taken off; the tail washed, dressed 
and another bandage "applied, taking the precaution to have the tail dry 
before re-applying the glue bandage. A leather cone for the protection 
of the tail, called a "tail-muzzle," generally causes great irritation and the 
animal is in a constant state of irritation while it is on and is constantly 
trying to get it off. 

Amputation of the Tail. — The necessity of amputation of a portion 
of the tail may not only originate from the causes already enumerated 
but from the tail being run over by a wagon wheel, from being caught 



37G WOUNDS AND THEIR TREATMENT 

between swinging doors, or being tramped on. It may also be caused 
from fracture of the tail or from malformations. Occasionally it may 
be the seat of a diffuse swelling as a result of phlegmons or from septi- 
caemia from the wound of the end of the tail becoming infected. In such 
cases, however, it is best to make a series of longitudinal incisions in the 
tail where the swelling is greatest and allow the serum to escape and at 
the same time give an energetic course of antiseptic applications and 
if these measures do not succeed, then we have to resort to amputation. 
Amputation of the tail is also performed in pointers to shorten the tail 
and prevent them from getting the tail sore going through brush and 
lacerating the end. And lastly certain breeds of dogs have their tails 
amputated when young as a matter of fashion. 

When local applications do not have the desired effect and the tail 




Fig. 121. — Amputation of the tail (circular operation). 

becomes gradually worse or the vertebra becomes necrosed the only 
means left is to amputate the affected part. 

The operation is a form of exarticulation. An amputation between 
two of the vertebrae is much better than cutting through one of the bones. 
The operator must distinguish the slightly enlarged portion (Fig. 121) 
where the articulation lies. Put the animal under ether or give a hypo- 
dermic injection of morphine or a subcutaneous one of cocaine; have tied 
an elastic band around the tail above the point of operation, then proceed 
by means of the flap or round operation, whichever is preferred. As the 
vessels bleed slightly they can easily be stopped by means of a thermo- 
cautery. The circular operation, cutting posterior to the bony pro- 
tuberances of the articulation; pull the skin back, cutting through the 
muscles and tendons just below the articulation; then, with the help of 
an assistant, pull up the tissues and cut between the cartilaginous discs. 
Then bandage the tail as shown in Fig. 120. In cases in older dogs 
where there is much hemorrhage the artery may be taken up by means 
of a catgut ligature or touched with the thermo-cautery. The edges of 



DISEASES FROM SEPTIC INFECTION OF WOUNDS 377 

the skin are united l)y interrupted suture and an antiseptic dressing is 
applied, talving care not to make it too tight. The flap operation is the 
same as has ah-eady been described. 

The operation of cutting puppies' tails in fox terriers, spaniels, 
poodles, is best done just before the puppies are weaned. When, after 
judging the proper length the tail is to be, in proportion to that of the 
body, the tail should be cut through with a sharp knife. It is not neces- 
sary at that age to attempt to cut exactly through the articulation. 



DISEASES OF THE CLAWS AND FOOT PADS. 



The claws, the third phalanx, of the toe (the bone of the claw) 
articulates with the second phalanx; near the articulatory surface is an 
annular fold (claw fold) which receives the free border of the claw. 
The phalanx tertia is covered by the cutis vera. This develops and 
grows from the matrix of the claw plate (coronet), the claw bed, and the 
muscular sole which is an extension of the corium which extends over 
the third phalanx after dipping into the circular furrow at the base of 
the bone (Fig. 1 22) . In order to protect the ends of the claws when not 





Fig. 122. — Nail. Longitudinal section of 
nail. «, Matrix of nail horn; a', papillary 
zone of nail horn: b, bed of na^l; c, mnt'ix 
of cushion; d, cushion; e, nail. (.Siedain- 
grotzlcy.) 



Fig. 123. — Diagram of the first and 
second phalanx. a, Tubercle of pad; 
b, horn groove; c, groove of sole; d, 
third phalanx; e, dorsal ligament. 
(Siedamgrotzky.) 



in use there is an elastic tendinous band which draws back the nail and 
when the foot is on the ground the nail is retracted (Fig. 123) and the 
v/eight of the body carried on the pads, those pillow-like elastic bodies, a 
large one in the centre and four radiating in front of it, corresponding to 
each toe, the thumb toe being too high up, does not get pressure (Fig. 124). 

Ingrowing Claws. Incarnatio Unguis. — Animals that are house pets 
and have little or no exercise do not wear the nails properly and they 
become long and are apt to strike the ground when walking. Occasion- 
ally these nails l)ecome so long as to turn under and the weight of the 
animal presses the claw into the pad and the claw is gradually buried in 
the flesh. The dew or spur claws on the posterior extremities frequently 
grow entirely round and grow into the pad, causing great irritation, 
swelling and suppuration. It is extremely painful, the animal constantly 
licking the affected pai't. It can be cut through by a pair of jeweler's 
wire clippers, care being taken not to cut it too close and involve the 
matrix. 

Splintei'ing, cracking and breaking of the claws are generally due to 
some traumatism, although occasionally the claw falls off from purulent 

378 



DISEASES OF THE CLAWS AND FOOT PADS 



379 




Fig, 124.— Pads of foot. 
a, Carpal pad: b, .sole; c, 
1 to 5, toe pads. 



inflammation of the matrix. The broken ends of the claws must be filed 

or pared down to make the surface smooth and prevent it catching in 

carpets, rugs, etc., and tearing it further. Occasionally a dog with long 

crescent-like nails, due to want of wear, catches it in a carpet or rough 

boards in a floor when he is running and the claw is 

torn loose from the matrix, hanging l^y a small piece 

of very sensitive flesh, and every time the animal 

moves or it touches an object, it causes extreme 

pain. As it is generally hanging by a small portion 

of flesh it can be seized by the fingers and quickly 

torn off, or if it is more firmly fixed, it can be cut off 

by means of a pair of small wire cutters, care being 

taken not to cut too close to the matrix. 

Where there is extensive injury to the matrix, 
it may be necessary to exarticulate the part. 

Where the nail is torn from the matrix and that 
is exposed, it is not advisable to bandage it. Paint 
it once daily Avith compound tincture of benzoin. 

Inflamed Claw. Panaritium. — This may origin- 
ate from traumatisms, such as being stepped on, 
crushed between doors, or the extension of inflam- 
matory process from the leg, from unknown causes 

which develop an inflammation of the matrix of the claw, and is 
also seen in dogs that are very highly fed and are plethoric. 
There frequently appears a gouty inflammation of the second phalanx 
and the matrix, causing considerable congestion, pus and sloughing of 
the nail. Eczematous eruption of the local epidermis is also com- 
mon in overfed dogs; the two conditions are apt to recur in 
these plethoric dogs from time to time. In rare cases pus is found 
and may burrow under the tissues, causing fistula or after the 
acute inflammation subsides, a thickening of the toe. Occasionally one 
toe is attacked and when the acute symptoms sulxside, then another is 
attacked; it has been thought to be contagious, but this condition is so 
frequently seen in overfed animals that it evidently is gouty in character. 
Frick found that salt water produced irritation of the claws in animals 
that were at seashore places during the autumn and winter. Ral:)e 
ascribes this condition to a microbe which he calls Cladothrix canis. 

In acute inflammation of the claw the animal is very lame and on 
examination of the toe it is found hot, swollen and very tender to the 
touch; the skin surrounding the affected toe is tumefied and congested; 
the claw is very painful; the animal gives evidence of acute agony if it is 
touched; the claw is dull, the natural lustre having entirely disappeared, 
and frequently the claw may have changed its position, that is, it may 



380 



DISEASES OF THE CLAWS AND FOOT PADS 



curl under or turn to one side; in one case observed the claw was flattened 
like the nail of a man. 

Treatment. — Fomentations and poultices, painting the affected toes 
with tincture of iodine. It generally is best to repeat this application 
two or three times. If the claw is purulent, it must be treated with an 
antiseptic dressing of corrosive sublimate, 1 to 2000 solution; when the 
claw is loose, it must be removed, taking care not to injure the matrix 




Fig. 125. — Dog's shoes: Laced leather shoe showing shape of sole, and rubber shoe. 

or the skin at the edge of the nail and destroy the secreting power of 
the claw. Frick has prevented the further extension of the disease by 
intraparenchymatous injections of tincture of iodine, the internal 
administration of Fowler's solution, and touching the affected claw with 
nitrate of silver. The nail can be protected by means of the shoe illus- 
trated in Fig. 125. 

Contusions and Wounds of Pads. — Contusions of the pads are most 
frequently ol:)served in sporting dogs, particularly in animals that have 
not been used for active work or when they are first trained, going over 
stubble fields, or in dogs going over long distances on snow or frozen roads. 
Occasionally we find extensive oedema and sloughing caused by the 
presence of an clastic band placed around the foot or toes by a child in 
play. 

The animals walk very stiff, or in some cases it may be almost 
impossible to get them to walk. The pads are hot and painful on 
pressure; if the pad is very much worn the dark external skin is worn off 
antl the red tissue shows on the surface; in cases of extreme wear there 



ABDOMINAL HERNIA 381 

is suppuration and sloughing of the pad. Occasionally foreign liodies, 
nails, glass, stones, tacks, splinters of brass wire, etc., stepping in acids, 
particularly when emptying electrical batteries, or stepping in fresh 
slacked lime. In the latter case the external portion of the pad is fre- 
quently entirely sloughed of!". 

Treatment. — In simple contusions rest is all that is needed; in more 
severe conditions, paint the pad several times daily with compound tincture 
of benzoin, or use compresses of sugar of lead water or acetate of alum. 
"When the skin is separated, clean it with an antiseptic wash and remove 
the loose portion of tissue and cover it with tincture of benzoin and apply 
a compress. In the first examination of an animal in this condition it 
is always necessary to make a careful examination of the part to see if 
there are any foreign bodies buried in the pads. When the soles are 
very tender the shoe shown in Fig. 125 is very useful. Sole protectors 
are also made of chamois leather. 

HERNIAL RUPTURE. 

Abdominal Hernia. 

By the word ''hernia" we understand a protrusion of a certain 
portion of the abdominal contents through a normal or abnormal open- 
ing in its walls, and where the displaced portion is covered, or partially 
covered, by the peritoneum. In the majority of cases hernia appears 
under the external skin, although we may find it in other parts, such as 
hernia of the diaphragm. There are several different forms of hernia. 

We distinguish the following parts in a hernia: first, the intestines 
or contents which protrude from the abdominal cavity; second, the 
hernial pouch; third, the envelope, or covering of the rupture; and, 
fourth, the entrance or constricted portion of the rupture, or where the 
intestine passes through the abdominal wall. By "hernial pouch" we 
mean that part of the peritoneum which is around the part protruding 
from the abdominal cavity, and we distinguish it where it is near the 
constricted portion by forming at the neck. The portion which lies in 
the hernial sac is the body and lower portion. The hernial pouch is 
absent in some cases — as a result of some injury, and the injury has been 
severe enough to tear the peritoneum, or where the hernial pouch col- 
lapses or draws together. Hernial coverings of the pouch are the names 
given to that portion of the skin and subcutaneous cellular tissues which 
cover that part; in some instances we also include the muscles and apo- 
neuroses. The contents of the hernia consist of some portion of the 
abdominal organs enclosed in the hernial pouch. As a rule, it is the 
intestines, in most cases the duodenum, and in some cases the jejunum. 
Very frec^uently the duodenum may be found lying in the hernia with 



382 HERNIAL RUPTURE 

some portion of the large intestine or uterus, and more rarely the bladder 
or stomach. Under certain conditions we find a certain cjuantity of 
fluid lying in the sac. This is generally serum and originates from 
venous stagnation. 

According to the location of the hernial orifice we distinguish 
umbilical, ventral, inguinal, scrotal, and hernia of the diaphragm. 

The causes of hernia are generally described as dii-ect and indirect. 
In the former we have a certain number of abnormalities which are due 
to diseased conditions. For instance, an umbilical hernia is due to an 
imperfect closure of the opening of the umbilical ring. The latter may 
occur from the abdominal walls being flaccid, from cicatricial contrac- 
tions after operations, and occasionally from great abdominal pressure in 
prolonged straining, vomiting, etc., the muscular wall is ruptured, or 
from kicks or blows on the abdomen. 

In traumatic hernia which has been caused by blows, the hernial 
pouch is sometimes absent and its contents are surrounded by a hernial 
envelope — in most cases by the skin — and in rare instances certain 
muscles are included in the sac. 

Clinical Symptoms and Course. — The symptoms as well as the 
course show a marked difference, according to the character of the hernia, 
and it depends to a large extent on the ''possibilities" — that is to say, if 
the hernia can be reduced and replaced in the abdominal cavity or not. 

Reducible Hernia. — This is generally seen in the region of the wall 
of the abdomen. AVe find a swelling which does not present any inflam- 
matory symptoms, and is especially prominent when the animal is 
walking or standing. It is also seen during abdominal pressure, espe- 
cially after the dog has eaten a hearty meal. If the animal is turned 
in such a way that the hernia occvipies a superior position, as a rule it 
immediately disappears, as the contents fall back into the abdominal 
cavity, or they may do so on a slight pressure of the hand. If we exam- 
ine the abdominal walls the orifice of the hernia can be distinctly felt, 
and we may even be aljle to penetrate the abdominal cavity with the 
finger. 

Further symptoms depend upon the nature of the prolapsed intes- 
tines. This intestine will l)e recognized as a soft, elastic swelling, 
having to a certain extent the round or tubular form of an ordinary 
intestine. It may also l)e further distinguished by a slight distention 
wdiich is generally due to gas or air. The omentum is soft and doughy 
to the touch, having an uneven surface and dull on percussion. Hernias 
of the horns of the uterus are only distinguished from a loop of intestine 
after conception and during whelping. 

Mechanical influences, such as bites, blows, contusions etc., may 
cause inflammation of the hernia with a thickening of the pouch, and 



ABDOMIXAL HERXIA 383 

an adhesion between it antl the contents of the hernia. If the injury 
is severe enough, we may have suppuration in the pout-h. In such 
cases we may have a subsequent mechanical contraction and reduction 
of the hernia, especially when the pouches are small, or in some cases 
the hernia has only been large enough to admit a fold of the omentum. 

Irreducible Hernia. — This may be due to an adhesion of the intes- 
tinal contents with the hernial pouch, the union of the intestinal 
contents with each other (for instance, adhesion of the intestines), 
from thickening of the omentum which lies in the hernial pouch, 
or from strangulation of the hernia. This is especially important, as it 
may occur in all cases of abdominal hernia and at any time. 

Concerning the causes of strangulation there are three important 
groups: Strangulation by extreme distention of an intestinal tube by 
fiecal matter; a distention of the opening of the hernia, which subse- 
quently closes on the intestine and strangulates it; by the intestines 
becoming twisted in the sac. Invagination is very frecpently seen in 
young animals. 

In many cases we distinguish three stages of hernia, according to 
the anatomical alterations produced as a consequence of strangulation 
in the prolapsed parts. First, we have a venous hypersemia, then 
inflammation, and lastly suppuration. In the first stage the veins and 
capillaries are engorged with blood, and serum is exuded in different 
directions. In the second stage we observe inflammation of a septic 
character, which extends from the mucous membrane to the serous 
membrane, as a consecjuence of the noxious or poisonous contents of the 
intestines. In the third stage the prolapsed parts become necrosed, 
due to the stricture of blood circulation. The intestinal portion becomes 
lilack, easily torn, dull in color, and covered with gray or greenish spots 
on its surface; the hernial fluid becomes purulent, and the inflammatory 
processes in the intestine above the strangulation cause septic peritonitis. 

The clinical symptoms of strangulated hernia are very marked 
in most cases. The hernia can no longer be reduced or pushed back 
into the cavity, or a swelling suddenly appears after any traumatism, 
or after great abdominal pressure, and cannot be reduced even with 
careful manipulation. The hernia is distended, harder and fuller than 
usual, becoming very sensitive to pressure, and especially so as the in- 
flammation becomes more intense. The skin covering the hernia is normal 
in the beginning, but later becomes red, swollen, and warm to the 
touch. Another symptom generally present is vomiting. This may 
be so constant and violent toward the later stages that the animal will 
vomit faeces. At that period symptoms of severe intestinal obstruction 
present themselves. The hernial swelling becomes cold, insensilile to 
pressure, and symptoms of collapse appear, and death occurs in from 



384 HERNIAL RUPTURE 

twenty-four to forty-eight hours after strangulation first appears. The 
temperature can hardly be said to have any diagnostic value, as we very 
often find it normal or even subnormal up to the time of death. 

In rare instances we have the formation of a fsecal abscess; this is 
caused by the sloughing of a certain portion of the intestine, allowing 
the contents of the intestine to escape into the sac; this is due to the 
circulation being cut off and subsequent mortification of the part; this 
is quickly followed by purulent inflammation of the hernial covering. 
If an incision is made in the hernial swelling, faecal matter and pus flow 
out externally without being followed by any grave symptoms, except 
that it may svibsequently form a false anus in the cavity. 

Fsecal fistula, intestinal fistula, or preternatural rectum is seen in 
very rare instances. The expression "fsecal fistula" or "intestinal 
fistula " is used where there is an external intestinal orifice, but the greater 
mass of fsecal matter is passed through the rectum. The term " preter- 
natural rectum" (anus praeternaturalis) is used when all the fsecal matter 
passes through this opening. Such an opening may also be produced 
by penetrating wounds or the entrance of foreign bodies. 

In strangulation of the omentum the symptoms are less marked, 
but there is great pain on pressure. We frequently find adhesions 
between the omentum and the orifice of the hernia. This inflammation 
produces a complete immobility of the hernia and gangrene, followed 
by the formation of an abscess, and finally the escape of pus externally. 
Death is rare in such conditions, and if it should occur it is caused by 
septicsemia. 

The prognosis of irreducible hernia depends greatly on the length 
of time that the strangulation has been present and also on the character 
of the contents of the hernia. In cases where a loop of intestine is strangu- 
lated and is gorged wuth fsecal matter the results are generally serious; 
but, on the other hand, strangulation of the omentum is not serious. 

Therapeutics of Hernia. — In cases of reducible hernia we cannot 
use a truss, which is the favorite mode of treatment in man, it being 
impossible to keep a hernial bandage steady in any position for any length 
of time on the dog. AVhen hernia has been caused in a traumatic way, 
and followed by a subcutaneous rupture of the abdominal wall, or in 
umbilical hernia of very young animals, we may close the orifice in such 
cases by means of a dressing, and the hernia may be entirely removed 
by the following method: 

Place the animal on its back or in such a position that the hernia 
is placed as high as possible. Then reduce the sac by working the con- 
tents back into the abdomen. In some cases this is accomplished very 
easily, but in others it requires a certain amount of careful and patient 
manipulation. Then place a tampon of wadding or a small piece of 



ABDOMINAL HERNIA 385 

cardboard upon the hernial orifice. This will have to extend over the 
borders of the hernia far enough to entirely cover the opening. Now 
fix small pieces of adhesive plaster across the cardboard and attach 
them in a circle around the piece of cardboard. These will adhere easily 
if the skin has l)een cleansed and any fat or other material has been 
removed by means of ether or benzine. [Ordinary shoemaker's wax 
made liquid is put on the end of the plaster strips.] We now place a 
gauze bandage around the adhesive-plaster dressing and the whole 
posterior part of the body, in order to protect the dressing from being 
torn or shifted by the animal. The dog should be fed on light, easily 
digested food, avoiding any that has a tendency to flatulency or consti- 
pation, at the same time assisting defecation by means of laxatives. The 
safest and most certain method, however, of removing hernia is the 
operation of herniotomy, or hernial section. 

Where we have strangulated hernia we must attempt to reduce it 
by pushing the contents of the hernia back into the abdominal cavity. 
This may be accomplished either by means of taxis or by hernial section. 
The former method is only to be used when the strangulated intestines 
have not yet undergone any serious alterations, namely, when they are 
not affected by gangrene, and when there are no serious symptoms of a 
local or general character. In the operation of taxis the patient must 
be placed in such a position that the hernia occupies the highest region 
in the abdomen and assists the relaxation of the abdominal covering 
and the orifice of the hernia as much as possible. We first try by manip- 
ulation upon the orifice of the hernia with one hand, and by pressure of 
the flat of the other upon the periphery of the swelling to push the contents 
of the hernia back into the abdominal cavity. When the animals are 
under the influence of ether or a narcotic, the reduction is easier. Taxis 
must be considered successful when the swelling of the hernia has dis- 
appeared and when the aperture of the hernia can be felt, and also when 
the symptoms of distention have gone. If the latter still continue, 
notwithstanding the fact that the contents of the hernia seem to have 
disappeared, we have a false reduction — that is to say, the hernial con- 
tents and pouch have been shoved entirely through the orifice into the 
al)dominal cavity, or we have to deal with a volvulus or invagination 
of the intestinal portion in the cavity; or it may be that the hernial 
contents are crowded between layers of the abdominal muscles. In the 
first instance the orifice of the hernia seems free, and in the latter instance 
it is closed. 

If the attempts at taxis to produce reduction fail, or if the above- 
mentioned contraindications are present — that is, where the hernia has 
been left too long — we must proceed at once to perform herniotomy, 
which must be done under the strictest antiseptic rules. 



386 HERNIAL RUPTURE 

Herniotomy is, as a rule, a rather easy operation in the dog. It 
may be performed in two ways: with or without opening the hernial 
pouch. The former is especially used in recent eases of hernia with 
wide orifices and in old cases of hernia wdth extended adhesion of the 
hernial contents, where the whole mass is firmly fastened together. The 
latter method of operation is used in cases of hernia which are not com- 
plicated with a hernial pouch, in strangulated hernia with considci-alile 
alteration of the contents, or with a very narrow hernial opening. These 
conditions, however, are only distinguished during the course of the 
operation, and we are then forced to change from the first to the second 
method of operation. In both methods the skin of the operated region 
must be shaved and carefully disinfected. We then lift up a fold of the 
skin corresponding with the axis and the length of the hernia and split 
it open with a longitudinal incision. This must be made very carefully 
until we reach the hernial pouch. This is recognized by its irregular 
surface, which is of a grayish-yellow color; also by the fact that it is 
impossible to get an ordinary sound directly into the abdominal cavity, 
and when the sac is pressed by the fingers, the hernial contents will 
slip back, if the hernia is an old one, it is whitish-gray in color but if 
strangulated, it is deep purple-red in color. 

Having carefully dissected out the sac until it is completely sepa- 
rated from the surrounding tissue, taking care not to injure the contents, 
we follow one of the two methods before spoken of — that is, not opening 
or opening the hernial pouch. 

In the former case we introduce by means of the index finger a 
probe-pointed bistoury or herniotome between the neck of the hernia 
and its orifice, turning the cutting edge of the knife toward the neck or 
restricted portion, the dull side of the knife being toward the hernia 
pouch. By means of a very small incision the tension becomes greatly 
relaxed, and reduction is easily accomplished. If the opening of the 
hernial pouch is required, we hold up one of its folds with a pair of forceps 
and split it by means of a knife held flat or a pair of scissors. After the 
discharge of the fluids in the hernial sac a notch is cut in the hernial 
pouch by means of the herniotome. The exposed loop of intestine is 
reduced by the method just described, by cutting through the constricted 
portion and working the intestine back in such a way that the portion 
of the intestine which was prolapsed last must be reduced first. 

If the intestine is much distended by gas, it may be emptied by 
means of a puncture of a very fine trocar (or the canula of a large hypo- 
dermic syringe). Any degenerated portions of the epiploon must be 
amputated after being ligated. If the intestine is intensely inflamed or 
gangrenous, we must either resect it or make an artificial anus. 

After reducing the hernia we must close the hernial orifice. This is 



INGUINAL AND SCROTAL HERNIA 



387 



forcibly drawn out and twisted round and round in a spiral direction, and 
a single or doul)le ligature applied as high up as possible. In cases where 
no hernial pouch is presented or it has been shoved back into the abdom- 
inal cavity it is advisable to freshen the borders of the orifice by means 
of a blunt knife or curette; then stitch it up by a continuous suture of 
catgut. After thoroughly disinfecting it for the second time, the external 




Fig. 126. — Scrotal hernia of right side. 

wound is to be stitched and covered with an antiseptic dressing held in 
position by niBans of a bandage (eight-tailed) around the body. 

Inguinal and Scrotal Hernia. 

{Hernia Inguinalis and Scrotalis.) 

The inguinal canal of the dog is located in the abdominal muscles 
with the seminal cord, and runs from the testicles into the abdominal 
cavity. In the bitch we find a round ligament from the end of the Fallo- 
pian tube toward the subcutis. Inguinal hernia may be produced by a 



388 HERNIAL RUPTURE 

portion of the intestine passing from the abdominal cavity into the 
inguinal canal. If this is the case in the dog, and the loop of the intestine 
goes as far as the scrotum, we call it scrotal hernia. If it simply lies in 
the canal, it is called inguinal hernia. 

Clinical Symptoms of Inguinal and Scrotal Hernia in the Male Dog. 

This condition is very rare in the male; most cases are congenital; 
the contents are generally small intestine and omentum. In an ordinary 
case of inguinal hernia, we must understand that from the external 
abdominal ring as far as the scrotum the canal is almost cylindrical, 
and we find tnat when this canal is filled either with a loop of 
small intestine or omentum it has a peculiar elastic softness and 
"doughy" feel under the skin. There is generally no local increase 
of temperature. In large hernias we may reduce this partially or alto- 
gether by placing the animal on its back and holding up the hind 
quarters and gently pressing or rul^bing with the finger upon the hernial 
swelling. If the intestine has entered the scrotum (Fig. 126) , the affected 
side appears full and large, and may be reduced by the manipvdations 
indicated above. In hernias of this character the testicle is apt not to 
descend into the scrotum, and is soft, immature, and can be distinguished 
in the canal. The abdominal ring is found to be larger than natural. 
In cases of strangulation the symptoms which have been descril^ed before 
become apparent, and, if the symptoms are very acute and all attempts 
at reduction are futile, we must perform the operation of castration. 

Castration of the Male. — In normal conditions — that is to say, when 
no hernia is present — castration of the dog must be performed by laying 
the animal on his side, rendering all the parts aseptic, and holding the 
skin tightly over the testicle, compressing it between the finger and 
thumb. Then make an incision the entire length of the scrotum, cutting 
through the scrotum, the tunica dartos, and tunica vaginalis, so that 
the testicle is exposed (compare with Fig. 127). 

The testicle is drawn out and then the common intersecting membrane 
is opened up as far as possible by means of a pair of scissors; then place 
a strong silk suture around the seminal cord, close up to the inguinal 
ring, and ligate it. "When this is done, the seminal cord, with all the 
superfluous portions of the interstitial membrane, is amputated aliout 1 
cm. below the ligature. The other testicle must be removed in the same 
manner. After carefully cleansing the wound with a strong non-irritant 
disinfectant, the wound of the scrotum has to be closed Avith an ordinary 
stitch, and it is advisal)le to place a small drain, like a silk thread, into 
one of the corners of the wound. No dressing is recjuired provided the 
animal is muzzled. Ilealing occurs generally within a few days. If, 
however, we have a case in which we wish to operate for inguinal or 



INGUINAL AND SCROTAL HERNIA 



380 



scrotal hernia, we deviate from the above-described method of castration 
by ligating the intersecting membrane externally and as close as possible 
to the external inguinal ring, having first twisted the sac several times, 
the wound is sewed up and a bandage put on for several days. In valu- 
able breeding animals the testicle of the affected side only is removed. 

Inguinal Hernia in the Bitch. — This is generally observed in bitches 
that have had puppies, although it has also appeared early in life from 
no apparent cause. It is also congenital. Gutman saw a bitch three 
months old that had an inguinal hernia. This condition is either lateral 




Fig. 127. — Genital organs of the dog: 1, Scrotum opened; 2, right testicle; 3, body of the epididy- 
mis; 3', globus major and, 3", globus minor; 4, spermatic cord; 5, vas deferens; 6, prepuce (partially 
dissected); 7, free portion of the penis; 7', posterior attachment of the penis; 8, erectile masses (bulbous 
bodies); 8', size of erectile masses when distended by blood. 

or bilateral. The hernial sac in this condition is doul^le, the internal 
being peritoneum, the external the skin and part of the mammary 
gland. In a hernia of any size we find it invariably contains the 
uterus, particularly when that organ is heavy with foetus, or other 
abdominal organs, for instance the bladder, loops of intestine, or the 
omentum. Cadeac found in a unilateral inguinal rupture the size of 
a child 's head on the right side, the entire intestinal tract and on the 
left side the omentum, the spleen, uterus and the bladder. An 



390 



HERNIAL RUPTURE 



inguinal hernia in the l)itch if it is of any size is easily recognized (Fig. 
128) . It is found in the posterior part of the mammary gland, an enlarge- 
ment varying in size, elastic, painless, with no increase of the local tem- 
perature. When the animal is placed on her back, it either returns to 
its normal position by natural gravitation or else it is reduced with very 
little manipulation. On the return of the contents of the hernial sac the 
abdominal ring is found to be very much dilated above normal. In 
rare instances it may be found impossible to reduce the hernia entirely, 
and this is found to be due to certain adhesions of the abdominal contents 
to the pouch or else to a pregnant uterus; in the latter case the fcBtus can 




Fig. 128. — Inguinal hernia of bitch. 

easily be detected by manipulation. In certain cases where there is a 
doubt as to the exact nature of an enlargement in the position of inguinal 
hernia, if it is the uterus in the sac, on introducing the finger into the 
vagina, that is found to be elongated and deviated to one side, due to 
the stretching and weight of the uterus, and it is also found that it is 
impossible to reach the os uteri with the end of the finger. In very rare 
cases when the round ligament of the uterus (false inguinal hernia) is 
greatly hypertrophied, it might be possible to mistake it for inguinal 
hernia. (False inguinal hernia.) As a rule inguinal hernia in the bitch 
is rarely involved in strangulation, and if s^hc should be in whelp, she 
has her puppies without trouble. 

A bitch affected with inguinal hernia nuist be carefully fed, avoiding 



UMBILICAL HERNIA 391 

food that is hard to digest, or has a tendency to cause flatulence or to con- 
stipate. If it becomes necessary to remove the hernia, either from size or 
strangulation, herniotomy should be performed with the animal under an 
anajsthetic, and operated on as already described (see Herniotomy). 

Sarcocele. — This is a collective name for all kinds of tumors of the 
testicles, especially for sarcoma, carcinoma, enchondroma, and cysts. 
The testicles are swollen, the swelling, as a rule, being hard, tough, and 
sometimes fluctuating; never warm or very painful. The condition 
can only he remedied by castration. 

Hydrocele. — By this we define an accumulation of fluid (serum) in 
the scrotum. The affection is often associated with oedema of the lower 
extremities and of the scrotum. It is frequently seen with ascites, 
hydrothorax, etc., appearing in the shape of a fluctuating swelling of 
the testicular pouch, Avhich disappears when the animals lie on their backs. 

Therapeutic Treatment. — This consists of puncture and emptying 
of the sac, also injection with any of the following stimulating fluids; 
alcohol, Lugol's solution, carbolic acid (1 to 40), etc. Of course, these 
are only to be used when castration is not performed. 

A variety of hydrocele is seen where we have oedema of the spermatic 
cord. This appears as a fluctuating swelling which may be easily moved 
from one side to the other. It occupies the whole length of the spermatic 
cord, and, as a rule, is never interfered with. When the fluid of the 
hydrocele, which is discharged by puncture, consists of bloody serum, 
we call it haemorrhagic hernia, or hsematocele. Any other complications 
of the testicles and their membranes may be found on page 208. 

Umbilical Hernia. 

{Hernia U»ibiliculiti). 

The hernia ring is formed by the umbilical ring. The contents 
may consist of the omentum, duodenum, and in rare cases of the large 
intestine. In the hereditary form the intestines are located in the 
umbilical cord, and are not covered by the abdominal membrane (hernia 
of the umbilical cord). In accidental hernia of the uml:)ilicus, we always 
have a hernial pouch, originating from the peritoneum. As a rule, 
umbilical hernia occurs a few days after birth. It may increase gradually 
and beeome eventually strangulated, but it often disappears without any 
surgical interference. Hernia of the omentum we see occasionally, but 
generally it cures itself by an adhesion between the hernial pouch and 
the hernial ring. Umbilical hernia is easily recognized (Fig. 129). We 
find a swelling under the umbilical rin