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Mis
DISEASES OF THE DOG
AND THEIR TREATMENT
BY =e
SS
DR. GEORG MULLER
!
PROFESSOR
DIRECTOR OF THE CLINIC FOR SMALL ANIMALS AT THE VETERINARY HIGH SCHOOL AT DRESDEN
TRANSLATED, REVISED, AND AUGMENTED BY
ALEXANDER, GLASS, A.M., V.S.
LECTURER ON CANINE PATHOLOGY AT THE UNIVERSITY OF PENNSYLVANIA
WITH NINETY-THREE ILLUSTRATIONS
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(APR Bo 1897 ] BS
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PHILADELPHIA
W. HORACE HOSKINS
13°97
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Entered according to the Act of Congress, in the year
ALEXANDER GLASS, AM. VS,
In the Office of the Librarian of Congress, at Washington
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Thi, as, ;
NOTE.
WHILE lecturing on the diseases of the dog 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 rdle of text-book for the vet-
erinarian 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 years ago read this
work by Professor Miiller, 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 obser-
vations, and also everything of value that has been added to
veterinary science since the appearance of Dr. Miiller’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 adop-
tion of what may be the future international system of measure-
ment.
ALEXANDER GLASS.
(iii)
PHILADELPHIA, April 11, 1897.
PREFACE.
In writing these pages the 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
therapeutic treatment to a knowledge of normal and_ pathological
anatomy and physiology, for he believes that it is on a clear and
accurate knowledge of the normal and pathological structure of
life the fundamental base of all clinical science lies.
The writer has also included some selected formule 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 dis-
pense with the details of the bibliography of our literature, but
this is not of much consequence when we have such works as
Friedberger and Frohner’s, Hoffmann’s, Vogel’s, and others at
our disposal.
(v)
vi PREFACE.
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.
DRESDEN, October, 1891.
CONTENTS.
General examination .
the physical condition
the skeleton
the constitution
the mucous membranes aad the oy
cedema
emphysema
the temperature
increased temperature
subnormal temperature .
local temperature
Diseases of the digestive apparatus .
the examination of the digestive apparatus .
the condition of the throat and mouth
examination of the esophagus
examination of the stomach :
digestion of the stomach on a meat-diet .
physical examination of the bowels and peritoneum
the feces .
physical Eeeaeaiion of te ae :
examination of the spleen
diseases of the mouth, tongue, and rilivite enn
inflammation of the mucous membrane of the mouth
aphtha
parenchymatous el ease ae the Saya
ulcerous inflammation of the mouth
diseases of the teeth
dentition
malformations of tlie aay of the oath
ranula .
inflammation of the alr biaade
parotitis
idiopathic Aceh
abscess of the glands . 5
inflammation of the mucous membranes & the these
( vii)
PAGE
iW
avg
18
19
tS
22
22
28
23
25
26
27
27
27
30
31
34
o7
38
41
42
43
43
43
45
44
45
47
47
48
49
49
49
49
51
wii CONTENTS.
Diseases of the digestive apparatus — Continued.
diseases of the cesophagus
foreign bodies in the cesophagus
cesophagitis
stenosis
diseases of the Opes
acute catarrh of the stomach
chronic catarrh of the stomach
ulceration of the stomach
diseases of the intestines
intestinal catarrh . :
toxic inflammation of the eomnet ad tthe
mycotic inflammation of the stomach and intestines
hemorrhoids . :
contraction or stenosis of the eras:
chronic constipation .
prolapsus of the rectum
imperforate anus
intestinal parasites
round worms
tapeworms . .
oxyuris vermicularis .
dochmius
other parasites
diseases of the peritoneum .
inflammation of the peritoneum
dropsy of the abdomen .
diseases of the liver
catarrhal jaundice .
hyperemia of the liver ,
inflammation of the liver
acute parenchymatous dnaeapees st of te yee
chronic interstitial hepatitis
abscess of the liver
fatty liver
neoformations of ie liver aad pulleys
amyloid liver
lardaceous liver
poisons
Diseases of the respiratory organs . ,
the physical examination of the reapiraroey apparatus
examination of the nose
physical examination of the ees and windpipa
physical examination of the lungs
shape of the cavity of the aheee
PAGE
53
58
50
55
5d
50
57
58
59
59
64
64
65
66
71
71
74
74
74
75
81
81
82
83
83
86
91
91
94
95
95
95
96
oF
97
97
97
98
101
101
101
102
103
106
CONTENTS. ae
Diseases of the respiratory organs— Continued. ire
number and character of the respiratory movements <1) LOG
percussion of the thorax . : : ; : : aoe
auscultation of the thorax : z : ; : Epa 4)
diseases of the nose. : : : ; : : 5 Bree 3
nasal catarrh. - : , ‘ - : : ; & 1s
pentastoma tzenioides : : : 2 ; ‘ Rey ne:
diseases of the larynx . : é : : : . ; = RG
acute laryngeal catarrh . é : ‘ ; ’ ; “16
chronic laryngeal catarrh : ' wh EES
diseases of the upper air-passages and eadciae ; : : = (£20
catarrh of the windpipe and bronchia . : : - i, 220
acute catarrh of the windpipe and bronchia . : d - .. £20
chronic catarrh of the windpipe and bronchia_ _.” 1 ~~ hk
acute catarrh of the bronchia , , , ; ; pee (y-5|
chronic bronchial catarrh : : ; ‘ é i) 22,
diseases of the lungs . ‘ : : : : . 124
catarrhal inflammation of the ines ois ‘ ‘ . 124
chronic interstitial inflammation of the these ; : . 226
chronic induration of the lungs ; : ‘ : 5 £26
cedema of the lungs . : : : : , Tay 47 /
croupal inflammation of the ieee : : ; : . 129
anthracosis of the lungs. : , 5 : ‘ de)
emphysema of the lungs . : ; : : : 2 29
diseases of the pleura . ; : : : d ; : - tad
pleuritis 3 ‘ p ; ‘ : i : TIS
hydrothorax . : ‘ ; : : : : : . 184
pneumothorax : : : : ; : : : . 135
hematothorax : : ; 3 : : : : Bra ol0
Diseases of the circulatory apparatus. ; : : : 5 37
examination of the circulatory apparatus. : ‘ 5 a 18s
examination of the heart . : : ‘ : ; len
size and position of the heart : ; : : - wie koe
character of the heart-pulsations . : ‘ : ‘ «~ 159
character of the heart-sounds and bruits 4 : ‘ i, hoo
character of the pulse . : : : : : : «eal
diseases of the heart . : : ‘ ° A ‘ ' . 142
valvular defects. ; : : : : pit dae
idiopathic hypertrophy of the heart oe fetes : : . 146
diseases of the pericardium . é . é , : ‘ . 147
pericarditis . : ‘ , : : - ‘ AE
dropsy of the ven eacae a : of Moe tine - ; mae |
hemorrhage of the pericardium . ; ‘ - . . 148
filaria in the heart j . 7 , ‘ 3 ss : . 148
x CONTENTS.
PAGE
Diseases of the urinary and sexual apparatus . : : : . a2
examination of the urinary apparatus . Z : : : + OZ
examination of the prepuce and urethra. : : ; « 162
examination of the prostate . ‘ ‘ : ; d . 154
examination of the bladder . ; ; : ; pai W515)
examination of the urine. . : . : : : _. 156
amount of urine. : ; ; : ‘ : ; . 156
color of the urine. ‘ : ; : : . oS6,
transparency of the urine . : : : ; : .- Ghent,
the specific gravity of the urine é : : ; oe hee
foreign substances in the urine . : : : : ma B33)
diseases of the kidneys : 5 ; : : : . 162
inflammation of the eas ; ; : : ‘ , . 162
acute inflammation of the kidneys . : : é . 162
chronic inflammation of the kidneys. : ; ‘ «6S
amyloid kidney . , : : : ‘ : : . 166
abscess of the kidneys . i , E ‘ Phas 7
inflammation of the pelvis of the ee : : ; ~, hee
cysts of the kidneys. : ‘ 5 ‘ : : . 469
nephritic stones. : : : ; ; : ‘ * 270
diseases of the bladder i ‘ ; : : ; : { KO
catarrh of the bladder . : : 3 ah eee sO L7G
debilitated conditions of the piadder : : 5 : - WS
cystic cramp . ; : : : ; : : ; : TS
stone in the bladder . : ; ‘ é : : «ae
urethrotomy : F ‘ : : 3 ; : ct ae
diseases of the prostate ; ; : : : : okt
inflammation of the aveati : : ‘ b ; eee
hypertrophy of the prostate : ; ; : : « 162
cancer of the prostate . ; 5 : : 4 : ~ SahS2
diseases of the penis and prepuce é F : : : . 18s,
phimosis and paraphimosis . : : : 4 ; : 285
gonorrhea. : : ; : : . ; : -» LSS
specific gonorrhea ‘ : : : . 184
neoformations of the glands and Peas ; : : . 184
diseases of the testicle and its coverings . ‘ 5 ¢ . 184
inflammation of the testicle . A : : 3 : RS 02
injuries to the testicle and scrotum ‘ ; : : cle:
cuterebro emasculator . ‘ : ‘ : ‘ F « 18d
diseases of the vagina and uterus ‘ ‘ : ; : . 185
inflammation of the vagina . 5 ; : : : . 185
prolapsus of the vagina ; ; ; : : : = * 186
inflammation of the uterus . : : ° : : . 18s
catarrhal metritis : d ‘ : . 2 : . 488
septic metritis . : ¢ ‘ ; k . bsg
obstetrics and castration in hs bitch : f : : . Lo
CONTENTS.
Diseases of the nervous system
examination of the nervous system
disturbances of consciousness
disturbance of sensitiveness .
disturbance of motility
diseases of the brain and its coverings
hyperemia of the brain
anemia of the brain
cerebral hemorrhage
inflammation of the brain
diseases of the spinal cord and its Pesatieatie:
cerebro-spinal meningitis ‘
inflammation of the spinal cord aaa its edornes
epilepsy
chorea
catalepsy
tetanus .
eclampsia
Diseases of true infection .
distemper .
infectious bronchial cael
rabies
tuberculosis
anthrax
Constitutional diseases
anemia
leukemia .
pseudo- Sah ets
diabetes mellitus
diabetes insipidus
obesity
hemoglobinuria
uremia
scurvy
Diseases of the bones and articulations
rhachitis
diseases of the joints
inflammation of the joints :
acute synovial inflammation of the uote :
chronic synovial inflammation of the joints
purulent inflammation of the joints .
rheumatic inflammation of the joints
disease-producing malformation of the joints
Xli CONTENTS.
PAGE
Diseases of the bones and articulations— Continued.
injuries to the joints. : ; : ; : é Ate
wounds of the joints . : : : ; : : - ee
contusions of the joints. : : S : : . pen
distortions of the joints. ‘ : ; a . 280
luxation of the joints : : : : : . - 280
dislocation of the lower jaw . : ; : ‘ . 282
dislocation of the elbow. : é : : oo. ees
dislocation of the patella : : ; : 7 . 284
diseases of the bursa mucosa : ‘ i : Z é . 286
muscular rheumatism : ; F Z ‘ : 3 - 287
fractures of bones. ‘ , : ; , : : >, 2290
amputation and exarticulation of bones : : - oe
Wounds and their treatment . . ; : ' ; E . 300
wounds . ; : : : : F : ; : - 600
course and healing process in a wound. : : : . 803
diseases resulting from septic infection of wounds . : - 3805
treatinent of wounds 4 : : : , : : . 310
ulcers and ulcerations : , : ; ; : : Soles
contusions : ; : : : ; ‘ : F Sao
Hernia : ; : , : ; ‘ ; : 2 ; . 819
description of hernia 3 ; 5 : . : : - sol?
reducible hernia 5 : 5 3 : ; : ; . 320
irreducible hernia . é : : 5 : ; A m aonil
inguinal hernia : : ‘ : : ; : . 826
method of castration : ‘ : : ; ; ; . 826
sarcocele . : ; P é ; : : ; : iS aonh
hydrocele . ; é ‘ , “ : 3 : ‘ ~» 828
umbilical hernia : ; ; y ; : j : (29:
femoral hernia . : : ; : 3 é : 3 . 3880
perineal hernia : ‘ : ; : : ; ; . 3830
Tumors : . s : : ; 5 ; ; : é “pees
soft and hard fibroma 3 . 3 : : : : +4382
lipoma . ‘ : ’ : ‘ : ; : : . 3832
enchondroma . : ; j : : : ‘ : . oo2
* osteoma . ; . 2 : é ‘ ¢ ; : . 3833
sarcoma . : " : é . : : : : . 30d
angioma . : : : A i ‘ : ‘ : . 334
papilloma . : : . : ; F : : : . 98084
warts . . # : ; : : ; : : . 384
flat condyloma . 5 4 3 : : 5 3 . 300
adenoma . ; ‘ : : ; ? : : ‘ . 835
tumors of the anal glands . : ; , : : . 336
goitre : : ‘ . ; : . : : =) Sey,
in ee eee ee eee
CONTENTS. Xill
PAGE
Tumors— Continued.
cysts 3 ; : : 2 p 2 : : . 340
dermatoid agate ‘ ‘ , ‘ j : : : . 3840
retention cysts . F : : : : : Z . 340
extravasation cysts. : : : : : : . 93840
carcinoma : 3 : : ; ‘ ‘ : : aaa
squamous cancer , fs ; : ; : : . d41
cylindrical cell cancer ; ; . ; ‘ ‘ . 341
anzesthetics : ‘ : ‘ , : 3 : ‘ . 3845
Diseases of the eyes . ; i : : : A : ; . 849
affections of the eyelids ‘ j : : ‘ , : . 93849
closure of the eyelids. : ; - ‘ : : . 93849
entropion. : ‘ ; , : ; : ; . 3849
ectropion ‘ P , : ; : 7 ‘ (ASO
diseases of the poerancians ‘ : : 302
inflammation of the conjunctiva . : 5 : ; . 802
catarrhal ophthalmia_ . ; : : : i , . 3538
purulent ophthalmia. , ‘ , ; . 3804
diseases of the sclerotic coat of fhe ae ; : : , 3 S07
inflammation of the sclerotic coat : 4 : ; . B07
keratitis superficialis . } : : : » 808
keratitis profunda or parenciaeaGad : ; : . 9308
abscess of the sclerotic membrane. : é , . B09
ulceration of the sclerotic membrane k : ‘ . 360
dermoid of the cornea. : : : : : é . 863
pterygium. ‘ . : : : , : . 363
injuries to the cornea. : : : : : ub te 2 o0e
diseases of the lens, cataract : ‘ 364
diseases of the sclerotic membrane, of the nervous paren a the
eye, and of the vitreous humor . ; : : ‘ . 368
inflammation of the iris : : 2 é : : ., 809
purulent inflammation of the eye : ; ; : . 869
dropsy of the anterior chamber (glaucoma) . ; : . 3870
diseases of the optic nerve and the retina. : : ey!
prolapsus of the eyeball. ‘ : ; : : : ‘oie
Diseases of the ear . : ; : ‘ , A : : . 874
serous cyst 5 : é 4 : : F ; : <-, ol
external canker d f : : , : ; : a ae
internal canker (otitis) . . 4 d : ‘ ; MEY Wi
parasitic canker of the ear ‘ , ; ‘ ‘ ; . 380
Diseases of the skin . ; 3 : . 383
inflammatory conditions of fie qiemends apetibearie : : . 383
erythema ‘ : : ; : ; : : . 385
xiv CONTENTS.
PAGE
Diseases of the skin— Continued.
urticaria ; : : : : : - : : » 386
eczema . : ; : : 3 : : : . 886
burning and eeaine ; : 5 ; . : F . ook
gangrene of theskin . : : : ; : 4 . “eo2
acne: : : : ; . 393
cutaneous teers ue e Amel qa ; : : . 894
ceratopsyllus canis. : ‘ : ; : : . 895
hematopinus piliferus 5 ‘ . : : ‘ . 896
trichodectes latus ‘ é : ; : : ‘ . 3896
ixodes ricinus. : ; : : : : ; "Ook
leptus autumnalis . : : ; A . ; y oot
sarcoptic mange. : : , ; y : 5 At)
sarcoptes canis . ‘ , 3 : ; ‘ . 398
demodex follicularum ' : ‘ : : ; . 401
filaria ; : 5 : : : d , ‘ . 408
cutaneous affections caused by vegetable parasites , . 404
favus . ; ‘ : 5 ; , ; : . 404
herpes ere 5 : : : . 405
atropic conditions of the ananaare Sateecs ; 5 ; . 406
alopecia. : ‘ ; ‘ é : : : . 406
ie
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Or
ILLUSTRATIONS.
. Thermometer
Temperature-chart
. Method of holding open the path
. Laryngoscope ; :
. Mouth-gag ‘
. Transverse section of the eertuaeal iene. ;
. Diagram showing the position of the stomach when son
Diagram showing the position of the stomach when full
Stomach-pump
. Contents of the Seotech ee ne ee ee
. Rectal dilators
Microscopical aoe of ee
. Right side, showing the position of the various te
: Lengitndinal section through a tooth and portion of the jaw
Dental forceps
. Wire écraseur
Salivary glands of the head and ote,
. Clyster apparatus . :
. Method of stitching the hae :
. Stitch for prolapse of the rectum .
. Ascarides ‘
. Magnified section of ike tenia coenurus
Teenia serrata
. Tenia marginata (natural size)
. Teenia cucumerina (natural size) .
. Tznia ccenurus (natural size)
. Tenia echinococcus
. Oxyuris vermicularis faeries ad naeital es
. Dochmius duodenalis . 4
. Section through the middle of the inten Guviby
. Abdominal trocars
. Diagram showing the ton af the eae on ae ane ae of
the body
33. Diagram showing the potition of ithe ongais. on the left fda
. Pleximeter and percussion hammer
. Stethoscope .
. Pentastoma teenioides
(xv)
PAGE
28
24
27
28
28
dl
32
32
33
34
38
40
4]
45
46
48
50
63
70
73
74
76
rai
77
78
78
79
81
82
87
90
104
105
109
110
114
xvi ILLUSTRATIONS.
FIG, PAGE
37. Pentastoma denticulatum . : : : : : ; . 114
38. Trocar for puncture of the chest . : ; : : ‘ dle
39. Position of the heart . ; : : : 5 é : x ten
40. Diagram of the circulation . : : é : z : . 148
41. Heart containing filaria immitis . : ‘ : : 3 . 150
43. Catheters for dog and bitch . : ; ; : : :\ 162
42. Method of passing the catheter in the dog : : : ; « 208
44, Position of the bladder and urethra in the bitch . ‘ : . 153
45. Bladder, prostate, and urethra in the floor of the pelvis. . 154
46. Urinometer . : é 3 : ? : ; Lan
47, Epithelium found in tie urine. : : ; : é > alee
48. Cylinders found in the urine . : : : ; ; Boe (5)
49. Crystals and blood-corpuscles ; ‘ , F é : . 160
50. Bathing apparatus ‘ : : , . 164
51. Crystals and blood- ainameee: finals in the urine . : : 5° oie
52. Method of irrigation of the bladder . , : 5 : ee
53. Vaginal speculum : : . : é : »’ £86
54. Diagram of the female penaial organs . fae : : 2 Lae
55. Double catheter. 2 ; . 188
56. Extraction of the fetus by Defay’ 8 aa Brulet’s pe oe : Paget US) 8
57. Diagram of the brain, showing the various motor centres. of
58. White icadtsepuscien é ‘ : 4 : ‘ : Rei,
59. Spectrum of blood ; : ; : : : : : . 264
60. Heematin crystals . : : 3 ; : P : . 264
61. Large hypodermatic syringe . : : : : : : BIE
62. Muzzle . ‘ 3 : ; 3 : ; 4 : : . 284
63. Bath-tub 5 : : : ; ; : ee |
64. Method of union in a Reneee : : ‘ : , . 294
65. Plaster-cutting scissors and bone eae : : ; : . 296
66. Effects of tight bandaging . . : : : : : M2
67. Different forms of amputation. : ‘ : , : . + 298
68. Amputation of the tail ; : ' : d : : » 299
69. Wound-irrigation apparatus : : : : «> obs
70. Different stitches used in the closing of Gee A : : . 814
71. Nose- and mouth-gag . : ‘ : : q : . 316
72. Diagram of the male genital fonts : : : 5 ; . 328
73. Right side of the pelvis : : : ; : : E «3020
74. Wire écraseur 5 : : : ; , e . 345
75. Thermo-cautery (Paguehnee : ; : : J ; . 846
76. Methods of muzzling . : : : : ; : ; . 347
77. Inhalation-mask and apparatus. . : : : ; » o47
78. Method for incisions in entropion : : : 5 : . 8052
79. Eye-cap ? : : : : . 3863
80. Instruments nsed in the senna pectic : ; : , . 367
81. Method of puncturing the lens. , : é : ‘ . 3868
82. Muscles of the eyeball . : : ; : 3 : . oul
FIG.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
ILLUSTRATIONS.
Ear-cap
Dilator for the ear
Ear syringe .
Head of the faeedes
Heematopinus piliferus
Trichodectes latus
Ixodes ricinus
Sarcoptes of the dog
Acarus folliculorum
Bath-tub
Favus spores
XVil
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DISEASES OF THE DOG.
GENERAL EXAMINATION.
THE examination of the sick dog is divided into a general and
special one. The former refers to symptoms which involve the
whole organism, the latter considers the single organs of the body,
the secretions, and the excretions. We proceed either by begin-
ning at the head and moving gradually backward, or, if our
attention is called by some specially striking symptoms, we may
examine at once a certain part or organ or group of organs; this
is chiefly in surgical diseases, in which we examine first the in-
jured region and afterward direct our attention to the other parts
of the body, or to the whole organism, or pass that altogether,
according to the general condition of the animal.
In making a general examination the following points have to
be observed: 1. The physical condition. 2. The constitution
and nutritive condition. 3. The mucous membranes and the
skin. 4. The temperature of the body and the extremities, and
the pulse.
The physical condition presents more rapid and marked changes
in the dog than in any other animal. Even in slight indisposi-
tions, such as disturbances of the stomach or digestive apparatus,
the animal will be downcast, irritable, or nervous, and often
show a disinclination to move, or may constantly change from
one place to another. Nervousness, a staring look in the eye,
great restlessness, constant barking or howling, point to begin-
ning congestion of the brain; but these symptoms may be found
in other diseases—for instance, in cases of pentastomes in the nose
or the cavity of the forehead, or in cases of parasites in the intes-
tines, or rabies. Howling is observed in a great many of the vari-
ous painful diseases. A tendency to biting or destroying may lead
to a suspicion of rabies; a hoarse, howling bark, a craving for
2 (17)
18 GENERAL EXAMINATION.
indigestible objects (wood, coal, bits of cloth) or even gnawing or
licking them, with a staggering gait, will change an existing sus-
picion to a certainty
Further, we have the uncontrollable movements which are
caused by changes in the physical condition; they appear in dis-
eases of the cerebellum, and in certain forms of poisoning—for
instance, when cocaine is used. Dulness or total indifference to
external influences, a staring expression of the eye, a slow, stag-
gering gait, sleepiness or coma (entire unconsciousness) are recog-
nized in the diverse diseases of the brain and its coverings, from
injury or shock of the skull, in serious infectious diseases (dis-
temper and septicemia), also in poisoning by some narcotics, in
uremia, and during the acute period of many diseases. In some
instances we see a short attack of unconsciousness, which occurs
during great excitement or pain; we may also see an impaired
condition of the senses as a secondary complication in diseases of
the brain. For further information on this subject, see the article
on Examination of the Nervous System. In making an ex-
amination of the physical condition we must always take into
consideration the fact that symptoms may be very much modified
by the presence of strangers or the veterinarian, so as to hide
very serious symptoms from the professional man.
Very sick animals will not rise when called by a stranger, or
even by the owner if the stranger is present; while a healthy ani-
mal will rise or bark or show its presence in various ways. The
position of the 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, pleu-
risy) like to lie on the affected side, but they may also lie on the
healthy side; while those cases where there is difficult or labored
respiration, as in pleurisy and hydrothorax or double pneumonia,
they take a sitting position or lie on the sternum with the legs
under the body.
The development of the skeleton may be used as a basis for
determining what sort of constitution the animal has; at the same
time, taking into consideration the great differences there are in
form between the different breeds of dogs, in the strength and
shape of the bones, we can frequently obtain some diagnostic in-
formation concerning a defective constitution from the following
GENERAL EXAMINATION. : 19
indications of softness of the 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 a contortion of the long bones, and a swelling
of the joints, as is seen in all rhachitic animals. In very rare
instances there is a marked deformity of the spinal column, a
lateral contraction of the column, an upper contraction (kyphosis),
a side contraction (skoliosis), an upper and side contraction (kypho-
skoliosis), and a downward contraction (lordosis).
The general condition of the constitution 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 some disease being present.
The skin is, to a certain extent, a diagnostic guide: if the animal
is healthy, it will be loose and pulled easily from different parts of
the body; whereas in disease it is tight; the skin loses its soft-
ness and smooth feel to the fingers; the eyes are depressed and
sunken in their sockets. In very slight cases of emaciation we
must depend to a certain extent on the history of the case 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 especially valuable where an animal is being
reduced, as in cases of plethora, or in convalescence from acute
disease the gain shows that the animal is improving, but at the
same time the fact must not be lost sight of that we may have
increase of weight from cedema 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 poison-
ing, in rabies, and in that very rare disease in the dog—diabetes.
A slight loss of flesh is seen in all internal diseases and following
surgical operations.
In making a general examination the first thing to do is to ex-
amine the visible mucous membranes to see the color of them, the
conjunctiva, and also the mouth and throat. It is best to ex-
amine more than one mucous membrane, as the examination of
only one may lead to an error in the diagnosis, as the conjunc-
tival tissue is often red and inflamed in some breeds of dogs. Ab-
normal paleness of the mucous membranes may be caused by a
decrease in the amount of blood in the system, as in severe internal
20 GENERAL EXAMINATION.
or external hemorrhage or in slight but frequent hemorrhages in-
ternally; it may be due to decrease in the amount of hemoglobin
in the blood-corpuscles in diseases peculiar to the blood, as in
anemia, chlorosis, leukeemia, pseudo-leukeemia; in all diseases
producing great loss of fluids, especially of a chronic nature, such
as diseases of the kidneys and bowels, and also slow pus-forma-
tions that are accompanied with or without fever; in defective
heart-action, as in collapse, where the heart’s action is, to a cer-
tain extent, paralyzed for the time, as in many acute diseases or
violent poisoning from some depressing drugs; also in diseases of
the heart and its covering (pericardium). A blue (cyanotic) col-
oring is sometimes seen in cases where there is defective oxygena-
tion of the blood, and it is loaded with carbon dioxide. This
is seen where the blood in the lungs does not come in contact with
oxygen, as in some contraction of the trachea or larynx produced
by an inflammation or swelling in the parts, foreign bodies, inter-
nal 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 diaphragm
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-circulation in the capillaries from disease
of the heart, especially if there is fatty degeneration; from de-
fective valvular action, from deposits on them, from pericardiac
exudates, from the action of a poison acting directly on the heart,
or from some injury or pressure on the jugular; in diseases where
there is great accumulation of blood in the head, as in acute hyper-
eemia 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 an arterial tint. A yellow color (icteric) generally de-
notes some disorder of the liver, such as gastro-duodenal catarrh,
causing a swelling and obstruction of the ductus choledochus;
occasionally from calcareous deposits in the bile-ducts or the pres-
ence of tumors that press on the biliary ducts. This coloring
may be due to a decomposition of the blood as a result of certain
poisons in the system, such as phosphorus.
It is seen as a result of the effects of certain infectious diseases.
The reddening of the mucous membrane may be due in some in-
stances to phosphorus-poisoning (Miiller), to true scurvy (Siedam-
GENERAL EXAMINATION. 21
grotzky, Friedberger and Frohner), and occasionally in cases of
decayed meat poisoning (Miiller).
The nasal and buccal discharges are treated fully under the head
of Examination of the Digestive and Respiratory Apparatus.
We will only consider here such discharges as are 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 irritation of the mucous glands surround-
ing the eye and cause the accumulation of a profuse mucous dis-
charge, varying in color from gray to grayish-yellow or yellow.
This accumulates about the corners of the eyelids, or may even
close and glue up the lids entirely. This is not a symptom of
true conjunctivitis, but some acute disorder involving the entire
system.
The skin presents a number of conditions which are diagnostic.
Of course, there are a number of local diseases of the skin, the
symptoms of which must be kept separate from those of a general
febrile disturbance. The skin-changes in color are seen mainly
on the belly and the 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 membranes. ‘That is, if the
skin is very red, it indicates a high temperature or the commence-
ment of some sympathetic skin eruption; or if it is yellow, it in-
dicates some disturbance of the liver or portal system. In cases
of distemper we often see a pustulous rash on the abdomen and
inner fascia of the thigh (the exanthema of distemper—dogpox);
this is a very prominent diagnostic symptom of the disease. The
skin of a very sick dog is dry and hard; it is very hot in cases
of intense fever, and cold in animals that are very much debili-
tated, or after severe external or internal hemorrhage, or in col-
lapse from shock. In fat dogs the skin has a very unpleasant,
greasy feel to the touch. Profuse perspiration is rarely seen in
dogs except where they may have been badly frightened.
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 partially or entirely. As a rule, in all dogs
that have undergone a severe illness the hair falls out to a large
22 GENERAL EXAMINATION.
extent; the odor of the skin is sometimes very offensive, especially
in dogs suffering with distemper.
(Edema and emphysema of the skin are very important diag-
nostic points. By cedema or dropsy of the skin (anasarea) 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 in the same proportion
that they come out of the bloodvessels. We recognize cedema by
a swollen, bloated, cool condition of the skin, with the obliteration
of all wrinkles; if the swelling is pressed with the finger, the
indentation remains visible for some time ; this may come from a
number of diseased conditions, and it is seen sometimes over the
entire body, but chiefly in the lower portion of the body and ex-
tremities, testicles, prepuce, abdomen, and chest. It occurs as a
complication in diseases of the heart, especially where there is
imperfect valvular action, in acute disorders of the kidneys, and
in the majority of prolonged acute affections. In rare instances
it is caused by true diseases of the blood—anemia, leukemia, and
pseudo-leukeemia.
The cedema which appears in the locality of an inflammation
(collateral cedema) is of special interest to the surgeon, as it is
often the only visible symptom of the inflammatory process that
is going on under the skin. Cidema 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 under it. 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, un-
like oedema, immediately disappears. On rubbing over the parts
with the hand a slight crackling sound can be heard ; on pressure
the air can be driven from the affected portion into the other tissues
beyond the border-line. This condition may be caused by the
admission of atmospheric air from the outside into the subcuta-
neous tissues by means of small wounds in the skin, especially in
the neck, wall of the chest, and head, or gas or air from some of
the internal organs by a perforation of their walls, such as the
larynx, trachea, cesophagus, the bowels, or stomach, in cases where
there is perforating wounds of the chest, wounds of the larynx
GENERAL EXAMINATION. 23
or windpipe, or from fractures of the ribs, with complicated inju-
ries of the lungs. Emphysema may also occur from gas formed
by breaking down of the contents of abscesses or hemorrhagic
infiltrations.
Temperature. The temperature of the body in dogs is very
uniform, being 38.5° Celsius. It may, however, vary from 38°
to 39° C. Asa rule, younger animals have a slightly higher tem-
perature than older subjects.
The temperature is generally taken by means of what is known
as the blood-thermometer (Fig. 1). The thermometer is intro-
duced into the rectum as far up as possible. Hard,
dry pieces of excrement or a high inflammatory con-
dition of the bowel may prevent the thermometer giv-
ing the exact temperature of the body, and it should
be allowed to remain at least four or five minutes,
according to the sensitiveness of the instrument. The
thermometer can also be introduced into the vagina of
the bitch; and from a number of observations made
by M. Tempel, of Dresden, the lower bowel-tempera-
ture is slightly lower than that of the vagina. It is
better, as a rule, in severe cases to take the tempera-
ture at least twice daily—in the morning and the early
evening (from three to five o’clock, when the tem-
perature is highest in the day); or, if you wish to
follow minutely the course of the temperature, it can
be taken hourly. [The translator believes that this
does more harm than the results gained, as the hourly
insertion of the thermometer and the irritation of a
very sick animal make it restless and afraid of the
attendant.|] The temperature should always be kept
on a temperature-chart (Fig. 2), and can be watched
with much more certainty than trusting to the mem-
ory. Any change in the temperature as indicated
in the chart, either rise or fall, indicates some change in the
animal’s condition, and should be considered a symptom.
INCREASED TEMPERATURE OF THE Bopy. 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.
Thermometer,
94 GENERAL EXAMINATION.
The course and severity of a fever are regulated according to
the amount and character of the fever-producing substances (pyro-
genes) 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.
In other cases when the temperature changes very slightly it is
called a constant fever, and if it does not change more than one
degree (Celsius) it is known as a remittent fever; but when it is
found that it varies greatly, vacillating between a very low nor-
mal and very high subnormal temperature, it is called an inter-
mittent fever. ;
Fie, 2,
Fever chart, showing rise and fall of temperature.
A constant and prolonged high temperature is very rarely seen
in the dog. The temperature, as a rule, in the early stages of all
acute diseases rises very 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
septicemia, which is rather a common disease in the dog, we may
see an abrupt lowering of the temperature below the normal and
GENERAL EXAMINATION. 95
continue so, the animal falling into a state of coma and death 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
the entire body. These chills come on at intervals. The rise in
the temperature is not always an accompaniment of fever, as has
been shown in cases of septicemia; we must, therefore, always
take into consideration the other symptoms of fever. These are:
increase in the number of the pulse and respirations; the diges-
tion 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 Apparatus. The
changes in digestion are seen in the entire loss of appetite, consti-
pation, and increased thirst. The kidneys show the effects of the
disturbance by a decrease in the amount of 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 the nursing-bitch the milk is much lessened in quan-
tity, 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 indifference to surrounding objects
or persons; great restlessness and twitching of the muscles. If
the temperature is high, the animal becomes weak and falls away
in weight very rapidly ; the muscles become very tender to the
touch and firm; in walking the movements are stiff, inelastic, and
with an effort.
A TEMPERATURE BELOW NorMAL (SUBNORMAL) OF THE
Bopy. <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 respi-
rations become even and regular, the appetite begins to return,
and the animal shows more interest in its surroundings. In col-
lapse there is a rapid fall of temperature, 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 or even paralyzed. There is also a subnormal temperature
26 GENERAL EXAMINATION.
in great hemorrhage, in icterus gravis (acute congestion of the
liver, with yellowness of the mucous membranes and dark color-
ing of the mucous membranes), in all acute diseases of the
brain, in various cases of poisoning, in cases of distemper, and
in septicemia. |
INCREASE OR DECREASE OF LOCAL TEMPERATURE. Increased
heat of a part is generally due to some injury or a surgical dis-
ease, and, as a rule, has with it tenderness to the touch and swell-
ing. <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 be-
come cold, as they are furthest from the heart. In cases of com-
pression of an artery by ligatures, or tumors, or an embolus, or
thrombus, the part of the body that is cut off 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, besides the loss of appetite, the following points :
The Condition of the Mouth and Throat. The examination
Fie. 3.
SHEN STE S/R SLE TS INT
Holding the mouth open with tapes.
of these parts requires a good light, such as daylight, or a clear
lamp. This can be accomplished by means of a perforated laryn-
geal mirror (Fig. 4) or any reflecting mirror.
(27)
a8 DISEASES OF THE DIGESTIVE APPARATUS.
To obtain a good view of the interior of the mouth it is best to
put two strings or tapes around both the lower and upper jaw ;
lay the dog on his side, or, what is better, directly\on his back,
and throw the light into the cavity of the mouth (page 27, Fig.
3). The tongue can be pressed down by means of a spatula or
the handle of a spoon; the mouth and a large part of the throat
can now be easily examined. If the mouth has to be kept open
for some time, it is best to use the gag (Fig. 5), which can be
placed between the teeth on one side, or by means of a piece of
wood.
Fig. 4.
ity
Laryngoscope.
In cases where the mouth remains partially open, the animal
being unable to close it, we must examine it carefully, as it may
be a symptom of rabies; it may be due to some foreign bodies
located between the teeth or to some strain of the articulation of
the inferior maxillary. In paralysis of the jaw the mouth can be
closed by putting a stick under the jaw and closing it; this can-
not 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 in trismus (tetanus) or in
inflammation of the articulation, in some cases of toothache, and
in injuries to the various masticating muscles.
EXAMINATION OF THE DIGESTIVE APPARATUS. 29
On opening the mouth there is often a very offensive odor from
it. This indicates either an ulceration of the mouth due to ulcer-
ative stomatitis, which has erroneously been called scurvy, or it
is seen in any disease of the teeth, in dyspepsia, fetid bronchitis,
or in gangrene of the lungs; it is frequently noticed in very sick
animals where the mouth is filled with unhealthy mucus or par-
ticles of food in the mouth and throat. In cases of poisoning by
phosphorus or prussic acid the odor of the drug is frequently de-
tected in the breath. On examining the teeth and gums we may
find large ossific deposits or caries of the alveolar process (dental
alveolar periostitis), causing separation of the gums and loosening
of the teeth. An intensely inflamed state of the gums, bleeding
and ulcerated, indicates ulcerative stomatitis or mercurial poison-
ing; very often tumors (epulides) are found on the inner border
of the incisors, and interfere more or less with eating. The cut-
ting of the milk (temporary) teeth and the change of dentition
(cutting of the permanent teeth) may cause intense inflammation
of the entire mouth. The tongue is now examined; it may be
drawn to one side, indicating paralysis, but must not be confounded
with a normal ‘‘lolling’’ of the tongue so often seen in pugs and
king charles spaniels. A slight enlargement of the tongue may
be noticed in all inflammations of the mouth; it may show scars
or wounds from an animal biting it while ina spasm. The tongue
will be found to be enlarged in all fevers, in most cases dry; and
where there is difficult respiration and large quantities of carbon
dioxide in the blood this organ is dark blue in color (cyanotic). A
slight white coating is seen on the posterior part of the torgue of
the majority of healthy animals; if, however, it is very copious
and covers the greater part of the organ, it indicates acute or
chronic disease of the stomach; a brownish-red coating indicates
some grave internal disease, such as an acute case of distemper.
The mucous membranes of the cheeks and inferior surface of
the tongue after the administration of violent poisons are found
to be gray in color, hanging in shreds, and intensely inflamed,
and later on abscesses form on the sloughed parts. Elongated
swellings, about the thickness of the finger, are often found on the
inferior surface of the tongue, and run parallel with the frenum.
The salivary glands frequently form abscesses, and after inflam-
mation become indurated. The secretion of saliva is sometimes
30 DISEASES OF THE DIGESTIVE APPARATUS.
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 the re-
sults of some poisons, and after the hypodermic injection of pilo-
carpine.
The secretion of saliva is lessened during all fevers, and from
the effects of some poisons and after the injection of atropia.
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 with the finger when
making an examination. The tonsils are affected, as a rule, in all
cases of pharyngitis. It generally protrudes from the side of the
base of the tongue in a dark-red sausage-like formation.
Examination of the Gisophagus.
The cesophagus projects from the pharynx on a level with the
first cervical vertebra. The anterior part of it lies between the
windpipe and the longus colli in the median line of the neck. It
extends from there to the left side of the windpipe and runs into
the cavity of the chest behind that organ; from there it again
goes to the dorsal surface of the windpipe and passes to the right
side of the aortic arch between both membranes of the medias-
tinum, in the shape of a flat arch, and perforates the diaphragm
and reaches the stomach. The width of the cesophagus is not
regular in its entire length, being narrower at the region of the
pharynx and the heart.
The cesophagus can be examined externally by the hand or in-
ternally by the pharyngeal sound or probang. Foreign bodies
(pieces of bone, wood, large pieces of food) become lodged in the
cesophagus generally just beyond the pharynx in the region of the
neck, where they can be readily felt by the hand. The thyroid
gland is sometimes enlarged, and care must be taken not to mis-
take this for a foreign body. Carcinomas or sarcomas are some-
times found along the course of the cesophagus.
Introduction of the Laryngeal Sound (Probang). The
best sound is a large, flexible catheter (7 or 14, according to the
size of the animal).
EXAMINATION OF THE DIGESTIVE APPARATUS. 31
i
The mouth is held open as described on page 28; the head is
extended, and, having the sound well lubricated with oil, it is
introduced along the upper wall of the throat, keeping it high
up, so as to avoid the larynx. The animal will attempt to swal-
low it, but that will assist the passage of the sound. It will glide
along easily until the obstruction is reached. (For further details,
see Foreign Bodies in the Ctsophagus.)
Examination of the Stomach.
Baum has made a thorough examination of the position of the
dog’s stomach. When the stomach is filled with food, the form
of which can be easily recognized (Fig. 6), it lays in the left side
Fic. 6.
Section through the centre of the abdomen.
of the abdominal cavity, the inferior portion resting on the liver,
and the anterior portion against the diaphragm, the left surface .
going toward the abdominal wall, but between that and the wall
lies the left wing of the liver. This left lobe extends as far as
the pelvis, coming close to the anterior edge of the left kidney ;
the larger part of the stomach is inclosed 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.
39 DISEASES OF THE DIGESTIVE APPARATUS.
The empty stomach extends anteriorly as far as the left pillar
of the diaphragm and toward the chest, as far forward as the tenth
Fic. 7.
Sy 19) A041 42. 43 4 2 3 ©
Position of stomach when empty.
rib, and posteriorly as far as the twelfth rib, and is completely
covered by the liver on the left side. Only a very small part of
Fig. 8.
Dorsal vertebrie. Lumbar vertebre.
|
a
Za
|
D t
a
———
@
Position of stomach when full.
it comes in contact with the diaphragm. The pyloric opening is
directed toward the right (Fig. 7). In a stomach that is very
EXAMINATION OF THE DIGESTIVE APPARATUS. 33
much distended with gas or food the organ 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 left abdominal wall, the liver being pushed almost entirely
away from the surface of the stomach (Fig. 8).
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
openings are so deep seated they are ex-
tremely hard to examine; it is impossible to
make a manual examination from below, as
the shovel-like end of the sternum prevents
it; the only method of examination is by
digital pressure, and that when the stomach
is moderately filled by pressing on the left
lobe of the liver, push it to one side, and by
that means get pressure on the stomach. In
cases of poisoning we may get evidences of
pain; but it might be some disturbance of
the liver, and is not a safe way to get a sure
diagnosis. The examination of the contents of
the stomach would be advisable in such a case.
We can obtain the contents of the stomach
either by the substances which the animal may
vomit itself or by means of the stomach-pump.
This has been recommended by Frick, and
only for therapeutic purposes (Fig. 9).
The stomach-pump is operated in the fol-
lowing manner: In large dogs an ordinary Stomach-pump.
male horse-catheter, and in small dogs a
large male human catheter or a small rubber hose. We pass the
catheter as was described in the examination of the cesophagus,
and put a small funnel at the end of the tube. Pour a certain
amount of water into the stomach through the tube, at the same
time holding the tube high; 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 in very urgent cases where poison is suspected; but,
3
34 DISEASES OF THE DIGESTIVE APPARATUS.
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 way is the best—that is, to administer
an emetic. The best means is to give a dose of apomorphia hypo-
dermatically.
R.—Apomorphia hydrochlorate . ‘ ° : . 0.04
Aqua destil. . : : 4 : ~ 2200
S.—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 had
taken the food and the character of the alimentary matter. It
would be well, therefore, that you know the following facts con-
cerning (Fig. 10) the digestion of the dog’s stomach:
Contents of the stomach (four hours after eating): Muscular fibre, starch-cells, fat-crystals
and cells, round cells, epithelium, vegetable cells, fungus.
Digestion of the Stomach on a Meat-diet. After taking
a full meal of meat cut in small pieces the digestion in the
stomach is very active and free ; it increases until the third hour
and slowly decreases until the ninth, and is nearly over at the
twelfth hour. After eating a very large meal the digestion is
somewhat slower; the different kinds of meat also vary in the
time of their digestion. Pork is the hardest to digest, and the
others are classified in the following order: Mutton, veal, beef,
and lastly the flesh of other animals (Astley Cooper). Skin,
sinew, cartilage, and bones are very hard to digest; the latter are
EXAMINATION OF THE DIGESTIVE APPARATUS. 35
digested from their surface, and are reduced as the lime-salts are
acted upon and dissolved. Fat meat is harder to digest than lean;
fat undergoes no change in the stomach, but passes on and is
digested in the intestines. It has never been satisfactorily settled
whether raw or cooked meat is easiest to digest.
The Digestion of Milk in the Stomach. Milk is compara-
tively slow in digestion.
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 Ellenberger
and Hofmeister have come to the conclusion that rice is chiefly
digested in the intestines, as there is so much muriatic (hydro-
chloric) acid in the stomach immediately after eating that saccha-
ration cannot take place; and also that the dog swallows his food
with so little mastication that the saliva has not time to make any
change in the starch.
The Effect of the Disturbance of Gastric Secretion on
Digestion. When from any cause the secretion of gastric juice
is lessened or altered the following changes are observed: The
digestion of albumin, the antiseptic and antizymotic action of the
gastric juice is much lessened, caused by the secretion being much
less acid, and with the lessened digestion of albumin fermenta-
tion is easily started. When the gastric secretion is subacid it irri-
tates the mucous membranes and lessens the peristaltic action.
Subacidity is frequently seen in all anemic diseases, in fevers, in ero-
sion 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 over-secretion of muri-
atic acid; this condition, according to the researches of Ellenber-
ger and Hofmeister, is not of great importance, although in man
it is frequently 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.
36 DISEASES OF THE DIGESTIVE APPARATUS.
In testing the contents of the stomach for free hydrochloric
acid the best reagent is tropzolin paper and phloroglucin-vanillin
solution. Moisten a small piece of this paper with a few drops
of the filtered fluid-contents of the stomach, and it is then placed
in a watch-glass and slowly heated; if muriatig acid is present, it
will turn lilac; if the acid is in large quantities, the paper will
color without heating. In testing with phloroglucin (vanillin)
place a few drops of the following solution: Phloroglucin, 3 parts;
vanillin, 1 part; alcohol, 30 parts, with an equal quantity of the
filtered fluid of the stomach. If there is free hydrochloric acid
present, it will produce a dark red precipitate; if it is present in
small amount, the precipitate will be bright red; if the acid is
not present, the precipitate will be brown or reddish-brown. _Un-
fortunately this test is not reliable with either of the above reagents
if albumin or phosphates are present in any quantity.
Testing for lactic acid is much easier and certain. The best
method is that of Uffelman: 100 grammes of a 2 per cent. solu-
tion 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 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 be also understood that in fevers or any general disturb-
ance 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
intestines; 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 easier 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
emetics, poisons, splinters of bone, or even by overloading. Vom-
iting frequently is caused by the animal eating grass.
2. By sympathetic irritation from other organs, nephritis,
EXAMINATION OF THE DIGESTIVE APPARATUS. 37
uremia, peritonitis, irritation of the intestines, or uterine inflam-
mations.
3. Serious coughing spells will cause it, from laryngitis, bron-
chitis, or liquids getting into the larynx.
4. In obstruction of the bowels (foreign bodies blocking up
the bowel, hernia or twisting of the intestines) excrement is
vomited up. |
5. Beginning of distemper.
6. From various brain-affections (meningitis, commotio cerebri),
Very often in certain diseases of the pharynx movements of the
throat resembling vomiting are frequently noticed.
The vomited matter of an empty stomach in acute or chronic
catarrh is a thin, watery mucus; in chronic catarrh, however, the
matter is slimy and thick. Coming from an empty stomach it is
always slightly green in color, indicating the presence of bile. In
cases of repeated vomiting pure greenish bile may be thrown out.
Sometimes the vomited matter is tinged with blood, or the blood -
may be in clots, due to a laceration of the mucous membranes of
the stomach, from the swallowing of sharp objects, such as bones,
pieces of wood, or the presence of an abscess in the stomach.
There may, however, be a hemorrhage of blood that may come
from the mouth or the throat. Sometimes an abscess may form
in the region of the cesophagus and break into it, and from the
vomiting of blood looks as if it was from the stomach.
The vomited matter is generally acid in reaction, and if there
is much acid present the smell is sour and penetrating; very offen-
sive when excrement is vomited and putrid when the animal has
eaten decayed meat, or a carcinoma or an abscess is present. In
cases of poisoning the matter may correspond in odor with the
poison itself, as phosphorus, carbolic acid, or hydrocyanic acid.
Physical Examination of the Bowels and Peritoneum.
In making an examination of the abdomen it is best to make
‘the animal stand if possible, and by the pressure in the abdomen
we can tell if there is any tenderness present, which will be
evinced by the animal trying to escape, or by groans, or even
attempting to bite. There is intense pain on pressure in perito-
nitis or carcinoma of the peritoneum. In enteritis the pain is
very severe, especially from the effects of some poisons; also in
38 DISEASES OF THE DIGESTIVE APPARATUS.
constipation. In chronic catarrh of the bowels the pain is not
very severe on pressure. In twisting of the bowel, foreign bodies,
and the presence of tumors, abnormal growths on the intestines or
the abdominal walls can be detected either by pain on pressure or
also by manipulation of the hand.
The circumference of the abdomen is increased by accumula-
tions of gas in the intestines in fat animals and in bitches in
whelp ; it is also observed in chronic
Fie. 11, catarrh of the intestines and all peri-
toneal inflammations, or, in rare in-
stances, where air has escaped from
the intestines or stomach by perfora-
tion of abscesses, accumulations of
fluids, as in exudative peritonitis or
ascites, or by bursting of the bladder,
or where the bladder is abnormally
distended.
The circumference of the abdomen
is lessened where the animal has been
starved, or in obstinate diarrhoea or
dysentery.
The lower bowels can be examined
per rectum by means of the finger.
This method of examination is used to
Speculums. determine any diseased condition of the
bowel and to see the character of the
feces or to examine the neighboring organs—prostate gland, vagina,
uterus, or the floor of the pelvis. To make this examination the
author frequently uses a mirror in conjunction with the apparatus
illustrated in Fig. 11. The bowel is first emptied by means of
enemas or a glycerin suppository; the apparatus is introduced
into the rectum, and then the mirror can be used to throw the
light into the cavity. Inflammation of the rectum from any
cause, such as hemorrhoids, fistulee, foreign bodies, or abscesses,
can be readily examined by this means.
The Feces. The number of times that an animal has an
evacuation of the bowels depends on two circumstances: the
character of the food or the rapidity with which it passes through
the bowels. Normally an animal has two or three passages daily,
EXAMINATION OF THE DIGESTIVE APPARATUS. 39
some even less. Diarrhcea is a catarrh of the intestines, and may
be due to a variety of causes, such as irregular diet, cold, or to
some infectious disease (distemper), some irritant in the food; but
it may also be caused by laxative agents independent of catarrh.
Costiveness. Constipation is common in all old dogs and in
starved animals; it is also frequently seen in animals that vomit
their food and in all peritoneal inflammations.
Complete constipation is seen in all cases of obstruction of the
bowels due to twisting of those organs, invagination, hernia, for-
eign bodies, loss of the vermicular motions, and in all copious
exudations from the peritoneum. .
Pain during evacuation of the bowels (tenesmus) is seen in
inflammation or obstruction of the lower bowels or from the
presence of an abscess, from enlargement of the prostate, from
splinters of bone or wood in the lower bowel, or from enlarge-
ment of the rectal lymphatic glands.
The amount of excrement passed in a given time by an animal
depends on the quantity and quality of the food that the animal
has taken. In an ordinary sized dog fed.on bread the amount of
feces passed amounts to 20 per cent. of the amount taken; but if
the same animal is put on a flesh-diet the amount of feces is only
about 5 per cent. (Ellenberger). In diarrhea the relative amount
is changed; for in this condition the intestinal juices secreted to
aid digestion are not reabsorbed, but remain with the feces 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 smell,
due to decomposition of the feces and to the various excrementary
matter that has remained in the bowels.
The shape and size 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; on meat-diet they are 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 distinguished with the naked eye, except bread,
which is passed almost as it is taken into the stomach. Of course,
there are bodies, such as wood, bony matter, hair, earth, etc.,
which can also be seen in the feces. Under the microscope
40 DISEASES OF THE DIGESTIVE APPARATUS.
(Fig. 12) we can see numerous particles of food that have passed
without digestion in animals that have good health. In impaired
digestion we see pieces of muscle, connective tissue, etc., with the
naked eye.
Microscopical examination of the feces. Vegetable maiter, starch-cells, muscular fibres,
epithelial cells, and fungoid growths.
The following deviations in the appearance of the feces may be
observed :
1. Pieces of food (muscles and connective tissue) that are easily
digested may be seen in the fecal matter. This points to a dis-
ordered stomach or may be the entire intestinal canal, as in fevers,
catarrh of the lining membrane of the stomach, or from increased
peristaltic action due to the effects of purgatives.
2. The feces being thin and light indicate obstinate diarrheea;
they may be yellow, greenish-yellow, or greenish-gray; all point
to some disorder of the liver.
3. The presence of mucus, giving the feces a slimy appearance,
indicates catarrh of the intestine. If the mucus is mixed with
the feces in clot or lumps, it indicates an intense irritation of the
intestinal.mucous membrane. In this condition the feces are
thin; where there are more or less hard fecal lumps mixed with
clots of mucus, it is an indication that the large intestine is
principally involved.
4, Where the feces are light gray-white or clay-like in color and
have a dull gloss (due to the undigested fat they contain) on the
outside, it indicates an obstruction of the secretion of bile. When
this condition is noticed the mucous membranes, as a rule, are
tinged with yellow.
EXAMINATION OF THE DIGESTIVE APPARATUS. 41
5. Blood mixed in the feces occurs from a number of causes.
If the feces are of normal size and firm, the hemorrhage comes
from the large intestine; or if coated only on the outside with
blood and mucus, it indicates the presence of bleeding hemorrhoids
(piles). If the blood is in clots and mixed with the feces, it in-
dicates a hemorrhage of the stomach or small intestines. The
blood-clots may vary in color from light red to almost brown-
black. Asa rule, the further the blood comes the darker it is;
if it came from the stomach it would be nearly black, but from
the large intestine it is red in color.
6. Pus is sometimes seen in the stools, and indicates the pres-
ence of an abscess in the large intestine or perforating into it
from some of the adjacent organs.
Physical Examination of the Liver.
It is very hard to make a careful manual examination of the
liver, as there is only a small portion of the organ posterior to
the ribs that can be reached, and then only in cases where the
Fig. 13.
Right side of the abdomen, showing the position of the organs.
animal is thin. Fortunately the diseases of the liver in the dog
are not numerous and can be detected by other symptoms than
that of a direct examination of the gland. Fig. 13 gives a clear
42 DISEASES OF THE DIGESTIVE APPARATUS.
illustration of the position of the liver. We may find great ten-
derness on pressure, which is present in stagnation of bile in car-
cinoma and in the early stages of cirrhosis or atrophy. Enlarge-
ment or displacement of the liver may be seen when cancer,
abscesses, or tumors are present; but in making a diagnosis we
must take into consideration that the liver varies a great deal in
different breeds, and even in individual dogs.
The Spleen.
The spleen of the dog is an organ that is very readily examined
by manipulation, as shown in Fig. 8, although in well-fed animals
that are fat it is sometimes hard to find. It is frequently enlarged
and swollen; this is seen in the majority of infectious diseases,
especially distemper. It is seen in leukemia, or from the pres-
ence of tumors or carcinoma.
DISEASES OF THE MOUTH, THE TONGUE, AND
SALIVARY GLANDS.
Inflammation of the Mucous Membrane of the Mouth.
(Stomatitis. )
Errotocy. The most common cause of inflammation of the
mucous membranes of the mouth is by chemical, mechanical, or
thermic irritants. The most violent inflammations are caused by
poisonous substances of a caustic nature. It may also be seen in
all slow fevers and in inflammatory conditions of the surrounding
organs, in diseased conditions of the throat, and during ‘‘ teething ”
in young animals; mercurial stomatitis is also seen as a result of
the absorption from the use of preparations containing the drug.
CLINICAL Symproms. The first symptom the animal will show
will be the slow, careful way it eats; it will leave any large or
hard piece of food untouched and swaliow small pieces without
mastication. The saliva is greatly increased in amount and runs
out of the corners of the mouth in thin, glass-like threads or
strings. On making an examination of the mouth all the mucous
membranes will be found swollen, red, and inflamed; the gums
|
;
INFLAMMATION OF MUCOUS MEMBRANE OF MOUTH. 43
are especially so during dentition; the tongue and soft palate are
also inflamed; the tongue is also coated, as a rule. Ulcers some-
times appear in different parts of the mouth.
The duration of the disease depends largely on the causes pro-
ducing it; as a rule, it is not of much importance and disappears
without any medical interference. In some cases where it is caused
by bad teeth it is more obstinate, and if it becomes chronic it is
apt to become a case of stomacace.
THERAPEuUTICS. The animal should be fed lightly, the prin-
cipal diet being soup or liquid foods, and the mouth should be
washed out with permanganate of potassium solution, composed
of permanganate of potassium, 1 part; alum, 3 parts; chlorate of
potassium, 5 parts, in 100 parts of water; or a solution of boric
acid in honey, 1 to 30 parts. Inflamed gums can be rubbed with
tincture of myrrh or tincture of catechu, or with a solution of
tannin and glycerin, 1 to 20.
Hertwig describes under the name of aphtha, or buccal fungi,
a diseased condition of the buccal membrane which is seen in
young dogs. it commences by the formation of a number of
small pustules on the lips, gums, and tongue, about the size and
shape of a small pea. They burst in from twenty-four to forty-
eight hours and leave a bare, ulcerated surface, which heals up
very slowly, often taking from twelve to fourteen days to get
well. It is best treated with any of the ordinary mouth-washes.
The author has never observed this disease.
Serious parenchymatous inflammation of the tongue is
frequently seen. It is generally caused by caustic substances, by
wounds on the tongue, splinters of bone, and frequently chil-
dren put threads, rubber bands, or horse-hair on the tip of the .
tongue. With the general swelling and inflammation of the part
the tip of the tongue is reddish-blue in color, and the color seems
to be confined to a certain circumscribed location.
Injuries of the tongue heal very rapidly. If there is much in-
flammation, it is best to paint the parts with any of the above-
named tinctures.
44 DISEASES OF THE DIGESTIVE APPARATUS.
Ulcerous Inflammation of the Mouth.
(Stomacace.)
Er1otocy. This is a serious inflammation of the mouth, and
is generally seen in old, debilitated dogs and associated with the
presence of decayed teeth. It is seen, however, in a small pro-
portion of cases where the teeth are perfectly sound and where the
animal seems to be in fairly good health. !
CririnicaL Symptoms. At first the gums are swollen and red
in the neighborhood of certain teeth—generally the incisors and
later on 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 with the
other tissues. The hemorrhage from the parts is constant and
deep abscesses form, involving the alveolar process. This gan-
grenous inflammation extends, 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 very rarely affected to any great extent. The
odor of the mouth is very offensive; there is a bad-smelling,
sticky mucus running from the corners of the mouth. Gen-
erally 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
advanced. With proper treatment the ulcers clean up gradually,
and after two weeks they are all healed up; but sometimes the
fever keeps on increasing and the disease becomes septic in char-
acter from absorption of dead tissues, causing blood-poisoning
and collapse, followed by death. The author has noticed a
gangrenous tubular pneumonia from the aspiration of the puru-
lent matter.
THERAPEUTICS. The animal must be fed liberally, but with
easily digested food and as soft as possible. Remove all the dis-
eased teeth as soon as you can; wash the mouth frequently with
deodorizing mouth-washes, such as permanganate of potassium, 1
DISEASES OF THE TEETH. 45
to 200. The purulent ulcerations are to be painted with tincture
of catechu. Syringe the mouth with a solution of tannin and gly-
cerin, 1 to 20. Chlorate of potassium, 1 to 25, may also be used
with safety, as Frohner has demonstrated that this drug is com-
paratively harmless in the dog.
Diseases of the Teeth.
Dogs are frequently subject to various dental disorders, such as
accumulations of tartar, caries of the teeth, and, rarely, fistule of
the gums.
We understand by tartar of the teeth a calcareous deposit on
the neck of the tooth at the border of the gums. This tartarous
substance is deposited chiefly around the
canine or molar teeth, and, constantly Fra. 14.
accumulating, gradually pushes the gums
back and often loosens the tooth, which,
acting as a foreign body, causes great
irritation.
The tartar can be removed by scraping
it off with a small cup-shaped instrument
or a sound with a leaf-shaped tongue.
Some remove it with a hook-shaped pair
of pincers. If there is a large amount of
tartar, it is best to put the dog under
ether, as it can be easier removed and
avoid struggling on the part of the animal
(see chapter on Removal of Tumors).
Caries of the Teeth. This condi-
tion has been observed by a number of
Ps . e Longitudinal section through
authors (Moller, Hoffmann), but is of 4) incisor tooth: a, cement : 5,
very rare occurrence. enamel 3 ¢, ivory or dentine ; d,
: A pulp cavity and alveolar dental
By caries dentum we define an active membrane; ¢, maxillary bone.
process of molecular destruction of the .
enamel and bone of the teeth. This process always begins on
the upper surface and mainly in the cavity of the crown of the
tooth, forming a grayish or blackish spot. This spot, which is the
decaying part of the tooth, advances deeper into the tooth, going
on toward the pulp. This penetrates into the tooth until it reaches
46 DISEASES OF THE DIGESTIVE APPARATUS.
the nerve, and thus exposing it to the atmosphere, inflames it and
makes it very sensitive. .
There are certain microbes found in calcareous teeth ; but whether
they are directly connected with the decay of the teeth is not defi-
nitely known. True dental caries is very rare in the dog. Necro-
sis of the teeth is frequently mistaken for caries. In old dogs we
often see an acute inflammation of the periosteum, and the alve-
olar process becoming inflamed the tooth is lifted out of its socket
and finally thrown out. In these cases the alveolar periosteum is
destroyed, and the necrotic condition of the tooth causes it to be-
come 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 through the alveolar process and the gums. It forms a
fluctuating swelling on the gums (abscess of the gums) ; the open-
ing generally remains so, and if it is in the superior maxillary open
fistulous tracts may form under the eye, just below the lower eye-
lid, and unless carefully examined may be mistaken for a lachry-
mal fistula. By means of a flexible probe the diagnosis can be
made with safety.
In all these cases the animals seem to have a more or less
severe toothache; they are irritable, eat very slowly and irregu-
larly, drop more or less saliva, refuse to
have the mouth examined, and, if the af-
fected tooth is struck with anything (a key
is the best), howl and evince great pain,
keeping the mouth open for some time after-
ward.
When there is more or less pus present
the radical treatment is to remove the
offending tooth. For this purpose open
the mouth by the method described on page
27, or a wedge, and with an ordinary molar-
forceps (Fig. 15) extract the tooth, being
careful to avoid breaking the crown. The
tooth is firmly seized with the forceps as far
down on the root as possible; it is first loos-
ened by twisting from side to side several times and then drawn out
with a strong pull. The mouth must then be thoroughly cleansed
Fie. 15.
Tooth forceps.
MALFORMATIONS OF THE CAVITY OF THE MOUTH. 47
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.
Dentition.
The first incisors and the eye-teeth (caninea), and the second,
third, and fourth molars appear in the dog at the end of five
weeks. The permanent teeth begin to come through about the
third or fourth month; the canine and middle incisors come
through about the fourth month; the remaining incisors about
the end of five months, and also the second, third, and fourth
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.
During the process of teething the gums become very red and
inflamed, with an increased amount of saliva; in some cases the
inflammation is intense, with complete loss of appetite. Convul-
sions may occur from reflex nervous irritation. This nervous irri-
tation may produce 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 through to the surface.
Malformations of the Cavity of the Mouth.
Malformations or growths on the buccal membrane are frequently
seen in the dog, especially located about the edge of the gums and
on the inner cheek. They are generally classed as “‘ epulides.”
They are of various sizes, from the size of a pin-head to a walnut.
They are generally pedunculated; very rarely they are seen with
an extended base. As a rule, they are hard; they occur in various
characters—fibroma, carcinoma, or sarcoma. The author observed
a melanotic sarcoma in one case.
The tumors can be removed by the écraseur of wire, as in Fig.
16, or by cutting them with a probe-pointed bistoury. The hemor-
rhage can be checked by the thermo-cautery or by a solution of
48 DISEASES OF THE DIGESTIVE APPARATUS.
chloride of iron; but the hemorrhage is generally so slight as not
to require any styptics. It is best to thoroughly cauterize the
base, so as to prevent, if possible, the recurrence of the growth;
but frequently in spite of it they return.
Wire écraseur.
Besides these tumors of the membranes we have a growth called
ranula, Often an animal will become very slow in eating, and
if the mouth is examined we will find on one side of the tongue
and under it a large-sized, fluctuating swelling, reddish-blue in
color, and filled with a thick, creamy liquid. 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 that it is
due to the plugging up of the ducts of one or more of the salivary
glands at the base of the tongue. The author has had five cases
under observation which he believes to be ranula. In three of
these cases the cause of the trouble was due to the obstruction of
the duct of Wharton, which has its entrance into the mouth at
the base of the lingual ligament, and in the other two cases it
was a cystoid degeneration of a few glands at the base of the
tongue, probably due to a plugging of the opening 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 cyst with a lancet and make a good-sized opening, and by
means of a pair of curved scissors remove a portion of the upper
part of the wall, and cauterize the inner walls of the cyst with
the thermo-cautery. If Wharton’s duct is involved, be guarded
in the cauterization, confining it only to the anterior part of the
cyst, toward the point of the tongue. The injection of pilocar-
pine, which has been used in man with success, according to Soffin-
tini’s method, has been tried in animals by Hoffmann. It con-
sists in creating a great amount of the salivary secretion, and by
force of the collected fluid from the inside break the obstruction
of the duct. The author, however, has not tried it.
INFLAMMATION OF THE SALIVARY GLANDS. 49
Inflammation of the Salivary Glands.
(Parotitis ; Mumps.)
Inflammation of the salivary glands may be caused by the pas-
sage of microbes up the duct into the body of the gland through
traumatic causes and by direct infection from the blood itself.
The author 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 tongue; he has never seen the glands of the
eye affected.
Inflammation of the glands of the ear (parotitis) appears either
as a cousequence of some mechanical cause, or by infection from
the cavity of the mouth from some existing inflammation of that
part, or as a disease. The latter requires special mention as a
primary idiopathic parotitis (mumps).
Errotocy. This disease is rather rare in the dog, but some-
times it may take the form of an epizootic (Hertwig, Schiissele).
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.
Symptoms. The disease begins with a swelling of the glands
on one or both sides of the ear. The location of these glands
is seen in Fig. 17. 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 stiff, eats with great
difficulty, and will swallow only small pieces. The saliva is very
thick and forms tenacious bubbles at the corners of the mouth.
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 and always in
one. The gland swells as in mumps, only the course is much
quicker, and the surrounding tissues are much swollen and
cedematous. Soon a fluctuating part is felt, which later opens
in one or more places, and a thick, creamy pus escapes; the
cedema of the surrounding tissues disappears quickly, and the
fever, which is rarely of much consequence, goes down entirely
and the wound closes in a short time.
The inflammation of the glands of the tongue and lower jaw
50 ° DISEASES OF THE DIGESTIVE APPARATUS.
generally forms abscesses which open, the pus escapes, and the
sore heals up in a short time. The submaxillary generally breaks
through the skin and the sublingual into the cavity of the mouth.
There is never any serious consequences in any of these cases.
Fic. 17.
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.
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 vaselin and yellow oxide of
mercury.
As soon as we see that the swelling is not going down within a
certain time, but increasing gradually, we must try and open the
abscess as soon as possible and allow the pus to escape. If fluc-
tuation can be felt, cut down on that point; but if not, 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
INFLAMMATION OF MUCOUS MEMBRANE OF THROAT. 5]
sewed to the tissues—if not sewed, the animal will shake it out—
and cleansed daily with an antiseptic solution. It is better not
to bandage the neck, as it interferes with the tube and is a bad
place to keep it on. These abscesses heal rapidly if there is exit
for the pus.
Inflammations of the other salivary glands should be treated the
same way. The abscess of the submaxillary should be opened
from the outside through the skin, and the sublingual from the
inside of the mouth. In the submaxillary it is not necessary to
put in a drainage-tube, but simply to keep the wound clean.
Occasionally we find cysts form in the glands of the tongue.
These were first described by Siedamgrotzky 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 appear as a conglomera-
tion of small, crowded vesicles with thin, coarse walls filled with
a thick, honey-like fluid. In some instances it is very thick, like
cheese, and yellow or reddish. They originate in the glands of
the tongue, and as their cyst-wall extends into the tissue of that
organ they must be classed under the head of ranula.
THERAPEUTICS. 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. The method sug-
gested by Siedamgrotzky 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 caus-
tic potash or tincture of iodine. If a drainage-tube is inserted into
the opening, it is much more satisfactory.
Inflammation of the Mucous Membranes of the Throat.
(Pharyngitis ; Angina Catarrhalis ; Sore Throat.)
This disease is very rare in the dog and not by any means as
important as it is in man, and as yet there have not been recog-
nized any cases in the dog that could be compared with diphtheria,
angina tonsillaris, and retropharyngeal abscess of man, at least
such is the experience of the author. The general affections
observed have been common catarrhal inflammations which in-
volved the whole or part of the throat.
52 DISEASES OF THE DIGESTIVE APPARATUS.
Ertotocy. The same causes that would produce stomatitis
would bring on inflammation of the throat. The most common
cause of anginal catarrh is by a continuation of the inflammatory
processes from the neighboring organs—for instance, in catarrh
of the head, or in laryngitis, and it may appear as a complication
of distemper.
PATHOLOGICAL ANATOMY, CLINICAL SYMPTOMS AND COURSE.
The changes of the mucous membranes are the same as are recog-
nized in all-catarrhal inflammations. The mucous membrane is
a diffused red, sometimes spotted, and coated with a dirty yel-
lowish mucus. It is rarely purulent on its surface, except in very
grave affections, when especially on its dorsal region there may be
seen a number of small, irregular granulations. Asa rule, if the
inflammation is at all severe, the tonsils are also swollen and pro-
trude out of their membranous pouches in the shape of brownish-
red enlargements. We very rarely see any fibrinous (croupal)
membranes in any of the severe inflammations of the throat.
The clinical symptoms of ‘catarrh of the throat are similar to
acute stomatitis, and it is only by making a careful examination
of the throat that we can make a correct diagnosis. 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 are also seen in these cases. The author has never observed
true chronic catarrh of the throat.
THERAPEUTICS. Considering the mild course of the disease
little medicinal treatment is desired; a liniment, such as cam-
phorated oil or soap-liniment, should be rubbed on the throat,
and sedative mouth-washes, such as boric acid and glycerin.
Keep the animal in a dry temperature, not too hot, and give
easily digested food.
Sometimes acid or irritating agents may cause acute inflamma-
tions of the throat, and if they are so severe as to ulcerate they
may be mistaken for diphtheria or croup. In such cases wash
the mouth out with a solution of permanganate of potassium, boric
or salicycic acid, or paint the throat with nitrate of silver or tan-
nate of glycerin.
FOREIGN BODIES IN THE GSOPHAG US. 53
DISEASES OF THE CGSOPHAGUS. ~
Foreign Bodies in the Gisophagus.
The foreign bodies that become fixed in the cesophagus of the
dog 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, ete., and lodged in the pharynx at the entrance
of the esophagus; or if the object is small,-it may go to a certain
distance into the tube and lodge.
The symptoms vary according to the general character and posi-
tion of the foreign body. As a rule, the animal is restless and
keeps the neck and head extended; it scratches itself 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 even vomit
small quantities of mucus and saliva from time to time. 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 difficulty, or may be vomited im-
mediately after it has been swallowed. If the foreign body is in
the pharynx, it can be felt externally with the finger, or opening
the mouth and depressing the tongue it can be seen lodged in the
pharynx; if it is in the cesophagus, it can be detected by making
a careful examination along the course of the tube or by the pro-
bang introduced into it, as has been described on page 30. 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 esophagus. 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 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 unless
we find a hard swelling with it, as foreign bodies, such as sharp
splinters of bone or wood, often go down the tube and lacerate the
mucous membrane in its passage and do not become imbedded.
54 DISEASES OF THE DIGESTIVE APPARATUS.
Needles, pins, and small pieces of wood may not be detected even
with the probang.
The object, if it goes into the stomach, passes through the intes-
tines and is passed through the rectum, and causes no further
trouble. Some authors have observed needles passed per rectum
(Friedberger, Kohlhepp). It may, however, lodge in the stomach
and cause great irritation and finally convulsions and death. If
it is a sharp body, it may perforate the stomach and 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 and set Up
septic mediastinitis.
Siedamgrotzky relates a very curious case in a dog in which a
piece of bacon-rind, 6 centimetres long and 3 wide, lacerated the
cesophagus in the thorax so much as to cause fatal pleuritis. The
author has seen the same thing from a splinter of bone. 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 hemorrhage, or it may also
occur from septic inflammation of the cesophagus.
THERAPEUTICS. If the foreign body is in the pharynx or at
the entrance of the cesophagus, it must be removed immediately
either with the finger or a pair of 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 34. If that is not successful, then perform
cesophagotomy as soon as possible, before the intense swelling inter-
feres with the operation. If this operation cannot be performed
on account of the foreign body being located too deeply in the
thorax, it is best to give the animal large quantities of lubricating
substances, such as olive or any fatty oil. It is better to do this
than to use any great force to push the object into the stomach.
(EsopHAGOTOMY. This is not very difficult to perform in the dog; the
point of operation is directly over the location of the foreign body ; the
hair is shaved over the part and the first incision is made behind the jugu-
lar, making the opening no larger than is necessary to get out the obstruc-
tion ; the wound in the cesophagus is first sewed up with a continuous suture
of catgut ligature, being careful to include the mucous membrane (Hoff-
mann dves not sew the muscular tissue), or the wound can be left open. Our
experience has been that we never get union by first intention, even if it
ACUTE CATARRH OF THE STOMACH. 55
is sewn up at once. The external wound is to be left open and filled up
with a tampon of oakum and a bandage carried around the neck to keep it
in place, and to be changed daily (see treatment of wounds); the bandage
must be carefully fixed so that the animal will not injure the wound by
scratching it, and must be kept from all food for at least thirty-six hours.
These wounds heal up very rapidly, and it is seldom that there is any con-
sequent stricture of the esophagus or a fistule.
We have also in very rare instances an inflammation of the
cesophagus (cesophagitis), with or without any ulceration. In the
latter case it is due to the irritation of caustic poisons or the lacera-
tion of foreign bodies going down the tube. This is best treated
with lubricating oils, almond or sweet oil. We may see occasion-
ally a constriction of the cesophagus (stenosis cesophagi) or a dila-
tation (ektasie and divertikel), but these conditions are impossible
to improve by any surgical means that we know of at present.
DISEASES OF THE STOMACH.
Acute Catarrh of the Stomach.
(Gastritis Catarrhalis Acuta ; Gastricismus ; Acute Dyspepsia.)
ErroLtoey. The following are generally the causes of this dis-
ease: hot, fermenting, or decaying alimentary matter; overfeed-
ing; foreign bodies, such as sand, stones, buttons, splinters of
wood ; and indigestible food, and also parasites. As regards toxic
gastritis, that will be taken up later on. We find also that some
diseases, such as distemper and some affections of the liver, have
acute gastritis accompanying them. It is a question if acute
eatarrh of the stomach is developed from simple cold.
PATHOLOGICAL ANATOMY. The mucous membranes of the
stomach are hyperemic and swollen ; the folds of the membrane
are distended and covered with a thick, tenacious mucus. At
times there are seen small, hemorrhagic erosions, but often the
acute symptoms of intense catarrh are not seen on post-mortem.
CxirsicaL Symptoms. ‘The first symptom of acute catarrh is
loss of appetite. The animal will be very dainty or pick out cer-
tain pieces, generally meat, and eat them very slowly, or, as is gen-
erally seen, refuse food altogether. The animal is always very
thirsty, drinking large quantities of water. The animal vomits
56 DISEASES OF THE DIGESTIVE APPARATUS.
frequently, especially after eating or drinking, but may vomit
without anything on the stomach. If after eating, it consists of
masses of undigested food mixed with a tenacious mucus; if
after drinking, the water is tenacious and forms bubbles of thick
mucus—this may be streaked with blood or more or less tinted
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. The animal is irritable
and wants to keep in the dark and in cool places. The nose is
dry, and there may be some rise of the 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 in
the mouth, great depression or even complete coma, and evidences
of acute narcotic poisoning.
There are always some intestinal complications. There is in-
creased excretion of feces, 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,
death never occurring except where some complication other than
true catarrh of the stomach is present.
THERAPEUTICS. If the cause has been the eating of some putrid
matters, and if you suspect some to be present in the stomach, it
is best to give the animal an emetic, such as the hypodermatic
injection of apomorphia. Keep the animal on a low diet in the
beginning; let the animal do without food for a day, and then
give small quantities of milk or finely cut-up meat, soup, or beef-
tea; a stomachic, such as tincture of rhubarb or tincture of nux
vomica, in small doses; if there is much vomiting, carbonate of
sodium or magnesium is to be given in small doses several times
daily. We must not administer opium unless the vomiting is per-
sistent. Never give chloral hydrate, as it irritates the mucous
membrane of the stomach. Any complication from the intestines
will have to be treated according to the directions given later under
Diseases of the Intestines. In cases of diarrhcea give tincture
of calumbo and subnitrate or subgallate of bismuth. If con-
stipation is present, give small doses of calomel, sulphate of mag-
nesium, and tincture rhei comp.
CHRONIC CATARRH OF THE STOMACH. 57
Chronic Catarrh of the Stomach.
(Gastritis Catarrhalis Chronica ; Chronic Dyspepsia.)
Errotoey. Chronic dyspepsia is rather common in the dog,
especially if the animal has had several attacks of acute dyspepsia.
It may also appear as a secondary complication of various diseases,
such as cancer of the stomach, gastric tumors, and disorders of the
liver.
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 blackish-gray in color and more or less
swollen, especially if the gastric glands become infected and in-
durated from the constant irritation.
CLiInIcAL Symptoms. They are similar to those of acute
catarrh of the stomach ; but the appetite, while it may be very
irregular, is not entirely absent—one day very good and the next
absent. Vomiting occurs, but only a short time after eating, and
consists of undigested food covered with quantities of tough,
glassy mucus, sometimes streaked with blood. Pain on pressure
in the region of the stomach, especially after eating, although this
is not a constant symptom by any means. The animal becomes
thin and shows every symptom of poor nutrition.
We must always take into consideration that mere loss of appe-
tite does not always mean acute or chronic catarrh of the stomach,
but is a symptom present in a number of diseases, and every symp-
tom must be carefully examined before coming to a conclusion.
THERAPEUTICS. The washing out of the stomach, so often
resorted to in man, is fully explained on page 33. After so doing
it is well to irrigate the stomach with fresh water; in anzmic
animals with tepid water or with a solution of bicarbonate of
sodium, permanganate of potassium (in weak solution), or a weak
solution of salicylic acid. As a rule, however, it is not advisable
to do this unless you suspect some irritant or poisonous material
to be present.
Give the animal a carefully regulated diet, as prescribed on
page 56, and internally alkalines, such as bicarbonate of sodium
or sulphate or magnesium, a pinch three times daily, and also
58 DISEASES OF THE DIGESTIVE APPARATUS.
some anti-fermenting agent, such as dilute nitric acid, creosote,
salicylic acid, or a bitter tonic, such as rhubarb combined with
bicarbonate of sodium. Calumbo root also gives excellent results.
The other bitters are apt to disturb the stomach and digestion, as
is also the case with the various agents that are used to counteract
catarrh, for instance, zinc oxide, silver nitrate, and bismuth sub-
nitrate.
k.—Rhei rad. pulv. : : ; ‘ mare
Sodium bicarbonas . ; F ‘ : . 40.0
M. fiat. pulv. No. x. S.—One three times daily.
R.—-Naphthalin . : : , ‘ : : 5 Ose
Saccharum alba . ; : : 5 = ORG
M. fiat. pulv. No. x. §8.—Give one powder three times daily.
Ulceration of the Stomach.
(Uleus Ventricult.)
When any 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.
Occasionally, however, we see the true ulceration of the stomach.
The real cause of this condition has not yet been satisfactorily ex-
plained, although many investigations have been made on the
subject.
The ulcer is generally at the beginning 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, generally
circular in shape.
In the dog, as in the 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.
CiinicAL Symptoms. Ulceration of the stomach undoubtedly
occurs in the dog, as cicatrixes have been seen on the stomach
INTESTINAL CATARRH. 59
on making a post-mortem, but during life no symptoms were pre-
sented that would enable the observer to make a diagnosis.
The symptoms are irritation of the stomach and occasional
vomiting of blood.
THERAPEUTICS. Bicarbonate of sodium, argenti nitras, and
bismuth subnitrate. The use of the stomach-pump is contraindi-
cated in this disease, as it tends to increase the hemorrhage.
R.—Bismuthi subnitras . ; : : : se 1Ole
Saccharum alba. ‘ ‘ : : : ; ) O65
M. fiat. pulv. No. xii. S.—One powder three times daily.
R.—Argentii nitras. ; : : ‘ ; » / 10:6
Argillee : - : : ; u : 2 108
F. pilule No. xl. S.—One pill three times daily.
DISHASES OF THE INTESTINES.
Intestinal Catarrh.
(Catarrh of the Bowels ; Enteritis Catarrhalis.)
Catarrh of the intestines originates frequently from the same
causes as catarrh of the stomach, and it frequently happens that
the two diseases occur together.
Intestinal catarrh is generally caused by decayed, tainted, fer-
menting, or indigestible food, and by intestinal parasites or poisons.
It also appears in an infectious form, attacking entire kennels and
animals of all ages. It is frequently caused by cold or other
causes, such as distemper, and from disturbance of the circulation
and from disorders of the lungs, liver, or heart.
According to the duration and severity of the disease we deter-
mine whether we have acute or chronic catarrh of the intestines.
In the acute form the disease lasts from one to two weeks; the
chronic often for months.
Errotocy. The causes of acute and chronic catarrh of the in-
testines are similar; the latter is frequently developed from the
acute form, and from a frequent return of the disease the system
becomes weakened, and at last, unable to throw off the disease, it
remains in a milder but chronic form.
The disease may be located either in the small or large intes-
tine or in both. The small intestine is the most common seat
60 DISEASES OF THE DIGESTIVE APPARATUS.
of the disease, but it is frequently found in the large intestine.
The various classifications, such as duodenitis, jejunitis, ileitis,
typhlitis, colitis, and proctitis, are useful only to the anatomist,
but not to the clinical observer. Proctitis is frequently seen in
the dog in an isolated form.
PatHoLtocicAL ANATOMY. The effects of catarrh of the in-
testines is 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 spots where it is reddened and congested and the membranes
raised and covered over its surface with flaky, slimy epithelium.
In very bad cases there is a large number of these epithelial masses
or spots. 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 in-
flammation of the mucous membranes we find a sympathetic
inflammation of the intestine, in some cases even a necrosis from
which ulceration of the bowels follows. The author had one case
under his observation where a young dog died from a diphtheritic
ulceration of the bowels.
In the chronic form the redness is less intense; the mucous
membrane may even be pale or livid gray in color. In rare cases
it is slate color. The swelling is more regular and covers over
more area, forming a true hyperplasia of the membrane; the inner
surface of the bowel becomes irregular and uneven with projections
over the entire surface. In some cases the membrane forms true
polypus formations, due to circumscribed hyperplasia of the con-
nective tissue. Where there has been cystoid degeneration of the
follicles the intestinal secretions are stopped entirely. It is from
the chronic form that ulceration of the stomach generally origi-
nates.
CLINICAL Symptoms. The most prominent symptom of intes-
tinal catarrh is diarrhcea, especially if it is confined to the large
intestine, although there may be no diarrhcea whatever if the in-
flammation is confined to the small intestine, as it is well known
that the absorption of the fluids and the formation of the feces are
confined to the large intestine, and we often have intense inflam-
mation of the small intestine, with profuse diarrhcea, without
having the large intestine infected whatever. On the other
INTESTINAL CATARRH. 61
hand, we often have inflammation of the large intestine with no
diarrhoea at all.
In making a diagnosis it is well not to identify too closely
diarrhcea and catarrh of the intestines—that is, consider each case
of diarrhcea as being due to inflammation of the bowels—as there
are many causes that increase the peristaltic action and cause
diarrhcea that are not due to direct inflammation, suchas colds or a
sudden chill to an animal that has been kept warm, to poisonous
substances, from the administration of laxatives or cathartics, or
great exertion in an animal that is not accustomed to it. It is,
however, impossible distinctly to draw the line, but a conclusion
can be arrived at by the number, amount, and character of the
diarrheic discharges.
In all animals the number of daily stools varies to a certain ex-
tent, and their consistency from pulpy to thin, watery 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 that form is passed almost entirely, and in rare cases
blood and pus (for further details, see page 40).
In this condition the animal is restless, changing the 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 examina-
tion of the abdomen externally does not furnish much information.
Sometimes the abdomen is contracted; in other cases it is dis-
tended. On applying the ear to the region of the abdomen a
great amount of gurgling or rolling is heard in the cavity. This
is due to the increased peristaltic action. On pressing the poste-
rior 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 latterly
passes only small amounts of mucus after great exertions. In
some cases these great exertions cause the lower bowel to be pro-
truded. This, however, is generally seen in young puppies and
62 DISEASES OF THE DIGESTIVE APPARATUS.
only in very rare instances 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 38).
The other symptoms of catarrh of the intestines are as follows:
The color of the urine becomes dark from the tinting of the bile ~
and is lessened in quantity from the drain of. fluids from the
bowels (Fréhner), Fever is present, but it is generally slight.
There is loss of appetite, vomiting, and yellow or icteric color-
ing 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 inflammation of the bowels resembles the acute form
in many ways, but it is less severe in its symptoms. The feces
change from soft to firm, and vice versa, the animal becoming
weak and thin, showing all the signs of anemia; but in the
chronic cases the appetite is generally very good.
Prognosis. In strong, healthy animals this disease is gener-
ally not very serious, 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 adult animals is generally very
hard to control. Often attacks follow one after another, com-
pletely prostrating the animal and carrying it off finally.
THERAPEUTICS. In slight cases the only thing to do is to
regulate the food, and, as a rule, lessen it in quantity and make
it easily digested. Soup or stock mixed with bread or biscuit,
_ rice, ete., friction to the abdomen, and a small quantity of alcohol
in the form of whiskey or sherry in 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 ob-
served. If the cause has been due to the ingestion of decayed or
putrid substances, internal parasites, the first thing to do is to
clean the intestinal canal out by means of a purgative, such as
castor oil or syrup of cascara sagrada, 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 or blue-mass and follow
up with an oleaginous purgative. Where there are copious and
thin discharges and an indication of excessive peristaltic action it
is advisable to use narcotics, and in this instance opium is always
indicated. The attempt to substitute extract of belladonna or
INTESTINAL CATAREH. 63
hyoscyamus and bromide of sodium in this disease has not proved
to be very successful. Besides opium we should also use the true
astringents, such as tannic acid, calumbo root, and cascarilla bark.
If ulceration of the bowels is indicated by the symptoms, acetate
of lead or nitrate of silver is to be given, followed up by small
doses of naphthalin, salicylic acid, creolin, or creosote. The last
drug I have found to be specially useful.
R.—Opii pulv. Sis
ae sare axe ; ; as ace
Sacchar. album. ‘ 2 0.5
M. fiat pulv. No. xii. S. shag Pigyden every two or three hours.
R.—Acidum tannicum : : : : ; 1.0
Vinirhei . ; ; : =) 200.0
S.—One teaspoonful sepeci ante deal:
R.—Creosote ‘ : ‘ ; é : ‘ ; 0.5
Aq. destil. . : ‘ : : : : » 120.0
Mue. acaciz ‘ ! » 8020
S.—One tablespoonful Lace ates or four none
When the catarrh has affected the lower intestines, it is well to
make one or two irrigations of the bowels daily by means of a
funnel and a piece of rubber hose with a
pipe of hard rubber at the end (Fig. 18),
which is inserted into the rectum as far
up as possible and the fluid poured into
the funnel and allowed to gravitate slowly
into the bowel. The best solution to use
is a 1 per cent. solution of tannic or sali-
cylic acid in water, the water to be about
30° C. The amount to use is about one
or two litres. If this causes much irrita-
tion 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.
Styptics are generally used, naphthalin,
and nitrate of silver, and followed up by subnitrate of bismuth.
Tincture of nux vomica is very useful as a tonic in one- or two-drop
Clyster apparatus,
64 DISEASES OF THE DIGESTIVE APPARATUS.
doses, before meals twice daily. The quality of the food requires
special attention. In order to counteract the loss of strength give
small quantities of rare or raw meat finely chopped, and also the
various peptone preparations. In young puppies the various in-
fant-foods so largely used in children’s practice are used as substi-
tutes for milk. 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.
Toxic Infammation of the Stomach and Intestines. Gas-
tro-enteritis is caused by the absorption of various acid or irri-
tating substances and also by the excessive use of drastic purga-
tives, such as aloes, calomel, croton oil.
The intensity of the disease depends on the amount of the drug
taken and on the effect it has had on the mucous membranes.
The only result may be an attack of acute catarrh, with some loss
of the epithelium of the mucous membrane, or there may also be
a gangrenous destruction of the walls 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 hyperemia or hemorrhages.
We may safely conclude that we have a toxic gastro-enteritis
when the symptoms of a serious gastric catarrh appear suddenly,
especially after eating, and if the grave symptoms increase rapidly
and are accompanied by severe pains taking the nature of colic,
and on pressure on the abdomen it is painful, the vomited matter
and the passages from the intestines being filled with mucus and
blood. (For further details, see chapter on Poisoning.)
The treatment consists, first, in giving an emetic, and after that
has had its effect give a laxative—an oleaginous one (olive or lin-
seed oil) is the best; and if the poison can be discovered, use the
proper antidotes, which are given in the chapter on Poisoning.
Mycotic Inflammation of the Stomach and Intestines.
This is a variety of toxic inflammation of the stomach and intes-
tines. It is due to decayed meat poisoning. This is seen after
the animal has eaten decomposed meat, offal, or from drinking
brine (Leisering). The active agent in decomposed meat is not
definitely known, but it certainly has a toxic agent present in it.
HEMORRHOIDS. 65
The symptoms of that form of poisoning have been studied very
thoroughly by Siedamgrotzky, and are as follows: vomiting of
an amount of very offensive, rotten masses of meat and with it
quantities of bad-smelling mucus and sometimes bloody passages,
intense thirst, and high fever. The author has seen, however,
instances where the temperature was subnormal, a small, rapid
pulse, great depression, and indifference to the surroundings.
Death generally follows with every symptom of collapse. When
a case makes a recovery it is very weak a long time, and it is
almost impossible to get the animal to eat.
After death the process of decomposition begins almost immedi-
ately, and if a post-mortem is to be made it must be made as soon
as possible. If this is done, the stomach will present an intense
hemorrhagic inflammation of its walls, especially in the dependent
portion, 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), washing out the stomach, and direct
the administration of purgatives, emulsions of castor, olive, or
linseed oil. The animal should be fed on light foods easily
digested and in small quantities.
Hemorrhoids.
We mean by this name diffuse or knot-shaped (varicose) dis-
tentions of the posterior veins of the lower bowel at the anus.
According to their location, we 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 feces
are coated with mucus when they are passed. It is a very com-
mon affection in the dog.
CuryicaAL Symproms. The act of defecation is painful, the
feces covered with mucus and sometimes with blood—either pure
blood or blood and mucus mixed. On making a digital examina-
tion, which is very painful, the mucous membrane is found to be
5
66 DISEASES OF THE DIGESTIVE APPARATUS.
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 ner-
vous and irritable, sliding the posterior part of the body on the
floor, especially on the carpet, so as to rub the rectum, and lick-
ing the anus frequently.
The causes can generally be ascribed to a stagnation of the
veins from irritation of the membranes from bile or irritants, such
as frequent purgation, and in the great majority of instances it
will be found that the liver is congested or inactive. 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.
TuHeERAPEvUTICS. The best treatment to pursue is first to use
saline laxatives, but not in large enough doses to purge. Sulphate
of magnesium or sulphate of sodium and cold enema and the appli-
cation of an ointment of lead plaster. Any knots may be removed
by ligature, scarification, or by the scissors and afterward touched
by the thermo-cautery. .
Contraction or Stenosis of the Intestines.
ErioLoGgy AND PaTHoLocicaL ANATOMY. Constrictions of
the intestinal tract may be formed in any region and may vary in
degree. They always produce more or less obstruction to the
passage of the alimentary matter, and when the constriction be-
comes complete the intestinal contents, being unable to pass, usu-
ally return toward the stomach again and are expelled by vomit-
ing. In such instances the animals die very 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 alterations 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 col-
lecting in the lower bowel, gradually blocking up the entire
tract from the constant accumulations of excrement coming down
from the small intestine. We also see obstructions caused by
CONTRACTION OF THE INTESTINES. 67
pieces of wood or splinters of bone that collect masses of feces
around them and fill up the bowel—intestinal stones, or calculi
(coproliths). These have a nidus consisting of marbles, corks,
sponges, or other foreign bodies (Siedamgrotzky). As another
cause that frequently causes stenosis of the bowels we must men-
tion ulceration in one case observed by Friedberger. There was
an cedema of the mucous membrane of the large intestines, and
after extensive ulceration the consequent cicatrix drew the bowel
together and caused it to be much less in diameter.
The constriction of the intestine from being inclosed in a hernia
and the impaction of the intestinal matters pressing into the part
is frequently seen in the dog. The intestine frequently becomes
twisted or knotted or even invaginated. This will, however, be
taken up under the head of Hernia. 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 pel-
vic cavity. Sometimes enormous abscesses form in the abdominal
cavity, and in very rare instances they are caused by accumula-
tions of fluids in the abdominal cavity, as in the case of ascites.
In newly born puppies we see sometimes a congenital obstruction
of the rectum (atresia ani). Great masses of fecal matter may
accumulate in the anal pouch. This may be due in some cases to
a swelling of the anal glands or by the accumulation of masses of
the hair gluing around the rectum and preventing defecation. (For
further details, see the chapter on Chronic Constipation. )
When a portion of the intestine becomes obstructed the follow-
ing changes take place: In front of the obstruction an enlarge-
ment forms, due to the accumulation of gas and excremental mat-
ter, 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 intestine to
escape in the abdominal cavity, causing a purulent peritonitis.
CuintcAL Symptoms. The symptoms of constriction and
obstruction of the bowels are so different that they will be
described separately.
68 DISEASES OF THE DIGESTIVE APPARATUS.
Symptoms of Constriction of the Bowels. They are not especially
characteristic, and resemble chronic catarrh of the stomach. At
first the animal is noticed to defecate irregularly; the stools are
smaller and passed apparently with more or less difficulty, which
is specially noticeable, considering the stools are smaller. The
intestine is greatly swollen on account of the accumulation of gas;
vomiting is sometimes present. On making an examination of
the intestines by the hand we may be able to detect the enlarge-
ment. .
Symptoms of Obstruction of the Intestines. The animal is irri-
table and cross, and Trasbot has seen cases where the animal
showed symptoms very similar to rabies; or there may be the other
extreme, being dull and indifferent to the surroundings, refuse all
food, but show great thirst, with no passage of feces 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.
The vomiting is constant and very severe, 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, and finally putrid, containing small pieces of fecal
matter.
By examining the abdominal region by the hand we can gen-
erally locate the obstruction, which is hard and exceedingly pain-
ful on pressure. The swelling can be moved about, showing it to
be part of the intestine.
CoursE AND Prognosis. In an ordinary case of constriction
of the intestine no definite prognosis 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 symp-
toms for a long time, or it may progress very rapidly and cause
a complete constriction in two or three weeks The prognosis is
always serious and generally ends fatally, with the exception of
the form of obstruction that will be described below. Foreign
bodies, such as pieces of cork, bone, or wood, may be macerated
and passed finally without causing 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.
There is one form of intestinal stenosis that is due to great accu-_
CONTRACTION OF THE INTESTINES. 69
mulations of fecal matter in the large intestines. This requires
special mention, as it is frequently seen and always in old animals
that have little exercise and live on highly spiced food—veal or
game—or eat quantities of bones that they are unable to digest.
Great accumulation of fecal matter gathers in the colon and rec-
tum. The most marked symptom is the repeated attempts of the
animal to defecate without any results or only succeeding in pass-
ing a small amount of feces. These are coated with mucus or
blood and 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. When the finger, after being well oiled, is
introduced into the anus, there will be found hard fecal masses in
front of the sphincter. It is generally impossible to remove them,
except to break them up, either with the finger or having first
injected a small quantity of oil or glycerin 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 up by
the injection of clysters, or, what is better, glycerin suppositories,
and later on administer a sharp purgative, followed by the admin-
istration of drop-doses of the tincture of nux vomica.
THERAPEUTICS. As soon as the symptoms of obstruction have
been clearly defined, if the stenosis can be removed in a direct
way, as would be the case in strangulated hernia, or in the case
of accumulations of feces in the rectum due to fecal stagnation, or
from ulceration or abscess of the rectum, we will have to treat
them as described above; but we might add to that the injection
of large quantities of soapy water several times daily, which can
be given with the apparatus illustrated in Fig. 18, and a dose of
calomel followed by castor or olive oil. The author has not gotten
very good results from the use of physostigma or the use of gly-
cerin injections into the rectum. [The translator has either in the
form of glycerin suppositories or a solution of glycerin 1, water 10. ]
70 DISEASES OF THE DIGESTIVE APPARATUS.
The stenosis of the bowel that is caused by the injection of for-
eign bodies is best treated with laxatives and not with purgatives;
and, if a positive diagnosis has been made, it is best to perform
laparotomy with enterotomy as soon as possible, and not to wait
until gangrene and peritonitis have set in.
According to Siedamgrotzky, enterotomy is performed in the following
manner: Make an incision on the linea alba, and, having located the part
of the intestine, pull it through the opening and hold the lips of the wound
together. Make the cut longitudinally on the intestinal line, remove the
foreign body and prevent at the same time any of the fluids escaping into
the abdominal cavity. The operator now takes a fine curved needle and
fine catgut and puts in a number of stitches through the muscular and serous
tissues, taking care not to go through the mucous membrane, so that when
the thread is tightened the two edges of the cut will be brought so as to
face into the intestine; these are tied, and another line of stitches is made
Fic. 19.
Suture of the intestines.
over the first, as is illustrated in the accompanying cut (Fig. 19). The
intestine is returned to the cavity, and the wound sewed up with silk and
dressed with an antiseptic dressing.
The opening of the abdominal cavity is also to be performed in
cases where we can recognize a total constriction of the bowels.
In all those 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, if there are great irritation and fever, give opium or
morphine; but in any case do not neglect to give plenty of watery
clysters.
The general treatment must be directed toward keeping up the
PROLAPSUS OF THE RECTUM. 71
animal’s strength. Subcutaneous injections of tincture of cam-
phor 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 passage of the intestinal
gas, and the general condition is improved. When the animal
does receive food, it must be of the lightest and easily digested,
such as soups, milk, finely scraped rare or raw beef, or some of
the various foods used as substitutes for milk. Where an animal
is subject to fecal obstructions, it is well never to let him have
bones if it can possibly be avoided.
Chronic Constipation. This is seen occasionally in the dog.
It is due to a lessened or weakened peristaltic action of the bowels.
It is seen in all chronic diseases that are accompanied by emacia-
tion and debility, as in chronic catarrh, fevers, icterus, chronic
peritonitis, and in many diseases of the nervous system; but it
may be observed in many old but healthy dogs, caused by an
atrophy of the mucous and muscular membranes of the intestines.
This disease is frequently called chronic obstipation, 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 digest-
ible food, with or without the admixture of rice-soup, and also
plenty of exercise and small doses of tincture of nux vomica.
This treatment is far better than the frequent administration of
purgatives, especially castor oil, jalap or aloes, and cathartic pills.
Prolapsus of the Rectum.
(Prolapsus Recti and Ani.)
PATHOLOGICAL ANATOMY AND Errotocy. The lower bowel
is kept in place by the peri-proctal connective tissue, the rectal
ring and the coceygeus and obturator internus, and the sphincter
ani. By relaxing or distending these supports we have a prolap-
sus of the mucous membrane, or even the entire rectum may be
protruded. If this prolapsus is not relieved soon, it inflames very
quickly and becomes torn and ulcerated from great swelling. It
may become strangulated and in rare cases gangrenous. It gen-
1 DISEASES OF THE DIGESTIVE APPARATUS.
erally results from a relaxed condition of the rectal mucous mem-
brane, or from excessive straining from constipation or diarrhea,
or labor-pains (Hertwig). It is generally seen in young dogs that
have catarrh of the lower bowel.
Symptoms. If the mucous membrane is protruded, it is only
noticed during defecation or urination. It is seen in the form of
dark red wrinkles that protrude from the rectum and return 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 and congested,
and at the centre dependent portion an indentation is seen; this is
the opening of the intestines. Through this we can introduce the
finger into the intestine. At the anterior end the mucous mem-
brane passes directly into the skin at 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.
THERAPEUTICS. The first thing to do is to remove the cause,
whether it be due to diarrhcea or constipation, and treat it with
astringents. ‘The most important thing to do is to reduce the pro-
lapsus 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. If the mucous membrane
is very much swollen and inflamed, it is best to scarify it slightly.
If the folds of mucous membrane are blackened and decayed from
prolonged exposure, they must be trimmed off with the scissors.
The author has generally succeeded even in very bad cases in re-
ducing the protrusions by bathing them with cold water or by
compressing the protruded intestine by winding on a rubber band,
commencing at the external end and winding toward the base
of the swelling. It is much more difficult to reduce invaginated
intestine, as the more you press on the protruded part it packs
into the end of the rectum. A large bougie or candle is inserted
in the end of the protruded portion, and it is pressed into its natu-
ral position ; or, if this does not succeed, perform laparotomy and
draw the invaginated intestine back into position from the abdom-
inal cavity. Degive has proven that there is little danger from
this operation if it is performed with ordinary caution.
PROLAPSUS OF THE RECTUM. 73
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. 20), that it prevents the
protrusion by drawing the anus together.
The sewing of the rectum by this stitch
closes up the opening sufficiently to pre-
vent the bowel coming out, but not enough
to prevent the escape of liquid fecal matter.
It is not advisable to apply cold irrigations
or inject astringents, as the dog is very apt to
strain more violently after application of
either of these remedies. At the same time,
if the trouble is caused by diarrhea, give
opium; and if caused by constipation, ad-
minister saline purgatives. Stockfleth ad- stitching rectum (tobacco-
vises that a series of pins should be placed pach ae Bl tg e
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 catgut
sutures.
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 intestine.
ah |
\ Mi
The best method is to place the animal under ether, and having laid it
on a table with the posterior 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 ligature.
After the bloodvessels are taken up, by means of a continuous stitch
sew up the serous membrane; then afterward sew the muscular and
mucous membranes, taking care not to penetrate the mucous membrane
entirely through ; the continuous stitch is much better, as it makes the union
of the lips of the wound much closer; the rubber band is removed, and the
stump is pushed back into the opening.
74 DISEASES OF THE DIGESTIVE APPARATUS.
Imperforate Anus.
(Atresia Ani.)
This is a congenital deformity, and consists of a defective forma-
tion of the rectum and in some cases of the lower bowel. It is
sometimes seen in newly born puppies, and it is usually confined
to the cutaneous covering growing over the anus. It can be cut
with a small knife and the edge of the wound sewed back so as
to prevent it uniting again; but if it is found that the lower bowel
is entirely occluded, it is better to destroy the puppy.
INTESTINAL PARASITES.
(HELMINTHIASIS. )
Round Worms. (Ascaris Mystaz.)
Naturat History. The round worm of the dog is white or
yellowish-white in color, and twisted in spirals; there is a differ-
ence in the two sexes (see Fig. 21): the males are about 45 to
Fig. 21,
Ascaris mystax: a, male; b, female; c, head.
60 mm., and the females from 102 to 130 mm. Their thickness
varies from 1 to 1.7 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
TANIA. 75
small, round opening and fitted with three to six small lips, which
cover a number of proportionately large teeth. The caudal end
of the parasite is curved and has twenty-six small papille on each
side. The female is pointed and straight. The sexual organs of
the female are peculiar. The vulva is about 36 mm. from the
head. In the genital organs there can generally be seen quantities
of eges that on examination are found to have a thick, hard shell,
which is marked by numerous small grooves. These eges are
found in enormous quantities in the feces of all dogs affected
with the round worm. The development of the embryo is not
yet thoroughly understood, but it is generally believed that the
embryo passes through several stages before it is ready to enter
into the dog’s system.
As a rule, the round worm causes little trouble in the dog, but
in some instances large masses of these worms collect in a ball 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 indenta-
tions in the mucous membrane (Weiskopf). There is no doubt
that in some instances round worms cause considerable nervous
disturbance, such as cramps or epilepsy. This is generally ob-
served in young animals—puppies under six months old. These
nervous symptoms generally disappear with the expulsion of the
parasite.
THERAPEUTICS. The principal agent to remove the round
worms is santonin, the alkaloid of the plant Artemisia santonica.
This is administered and followed up by a dose of castor oil, or
the oil may be given with it.
R.—Santonin ; : 4 : : : : af Ore
Ol. ricini ‘ : : 5 : : ; . 60.0
S.—Divide into three portions and give one every third (8) day.
Teenia.
Naturau History. The cestodes are flat, tape-like worms, with
or without intestines. They grow from one parent or head and
adhere together in a long, ribbon-like colony. The head is fur-
nished with sucking cups and hooks, by which means it adheres to
the mucous membrane of the intestine. The parasite is thin at the
neck, and at its termination it consists of a number of matured seg-
76 DISEASES OF THE DIGESTIVE APPARATUS.
ments that separate from the parent parasite when they are fully
developed and are carried out among the feces. 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 new nursing mothers in the shape of eggs,
while the nurse remains sexless. The ripe segments (proglottides)
are soon detached and passed either into manure or in water where
there are aquatic plants. They then go through several forms
and are taken up by a new host. The eggs are covered with a
hard, tough shell, inside of which is a six-hooked embryo. If
this 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, and from there perforate into
the connective tissue of some of the adjacent organs, where they
lose their hooks and form a sac-like cyst. These contain fluid,
and are termed bladder-worms. These cysts form bladder-like
excrescences on their sides, which develop and increase in size, and
are named, from their shape and size, ccenurus when empty, and
cysticercus or cysticercoid when they contain fluid. In each of
these bladders we find the individual tenia head, furnished with
the ring of hooks and the sucking cups. These bladders divide
and subdivide into numerous daughter-cysts or breeding buds, all
of which produce the little heads of the teenia.
This is frequently seen in the echinococcus, where
enormous masses are formed. If any domestic
animal gets one of these ripe bladder-worms into
the stomach, the gastric juice dissolves its cover-
ing and it finds its way to the duodenum, when
it fastens itself by means of its hooks and suck-
ing apparatus and instantly becomes a breeding
parasite.
The anatomical structure of the cestodes (Figs.
22, 23, and 24) is very simple. The body is di-
vided into two layers, an external and an inner
covering. In the latter we find the sexual organs.
The external layer is chiefly muscular, and con-
tain 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. The
Uterus of the tenia
ccenurus (enlarged).
TENIA. 77
digestive system and bloodvessels are absent, but in the inner
layer we find a system of very much branched vessels which
connect with two elongated canals united at each joint by a cross
system of similar canals, which is said to serve as an excretory
apparatus. The branches running into these canals end in a
common orifice. Each link or segment
has an independent male and female
sexual apparatus. The male apparatus
consists of numerous pear-shaped testi-
cular bladders with a canal of exit. The
end can be turned up into the female
opening. In the female portion we can
distinguish ovaries, uterus, and vagina.
The uterus is remarkably well defined
in each segment.
The following varieties are seen in
the dog :
Teenia Serrata. This variety is from
0.5 to 1 m. in length and about 0.5 em.
in width when fully developed. The “{™" Nasi < Debate tae cei
head is large proportionately, often four-
sided, and is fitted with two rows of hooks and also sucking disks,
which are oval in shape. The anterior border of the segments
is much narrower than the posterior. The
edges are serrated or saw-like, hence the name.
The genital orifice is situated on the border,
sometimes on the right and sometimes on the
left. The full-grown segments are nearly square,
or may be broader than long. The uterus has
a large central body, with eight branches on
each side. The eggs are indented on the sides
and have a hard, tough shell. The bladder-
worm is found in the liver of the hare, called
cysticercus pisiformis. This club-shaped cyst,
which is from 8 to 13 mm. in length and 4 to
6 mm. in width, has been found by Lesbre in
the brain of a dog affected by tenia serrata. This was probably
caused by self-infection.
Tenia Marginata. This is the largest tenia of the dog, being
Tenia marginata
(natural size).
78 DISEASES OF THE DIGESTIVE APPARATUS.
from 1.5 to 3m. 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 square, with four small, sucking
disks and a double crown of thirty-six hooks, The segments are
nearly square. In the middle of the colony they may even be
broader than long, with irregular edges. The sexual orifice,
which is mobile, may be alternately on the right
as or left side. The uterus has a broad central body
./ and has five branches on either side, which are
intertwined. ‘The eggs are oval and enveloped in
a tube-cast. The bladder-worm of the tenia mar-
ginata is the cysticercus tenuicollis, and is found in
the serous tissues of the sheep, cattle, goat, and pig.
Tenia Cucumerina. (Fig. 25.) This is a
small tenia from 5 to 30 em. long and 2 mm.
wide. It has a small, elongated head, with sixty
hooks ; the segments are rounded at the corners and
are the shape of a cucumber, hence the name, and
have a small sexual orifice at each corner. The
uterus is irregular, with double-shelled, rounded
eggs, six to fifteen massed together in elongated cocoons. The
primitive stage of this tenia, which is very common in the dog,
is in the abdominal cavity of the dog-louse (tricho-
dectes canis) (Melnikoff) and also in the common
dog-flea (ceratopsyllus canis).
Tenia Coenurus. (Fig. 26.) This tenia is
generally about 40 cm. long, although in rare
instances it may reach 1 m. It has a small,
pear-shaped head, with twenty-eight to thirty-
six hooks and four sucking disks. The anterior
links of the colony are always very short, and
those at the extreme end are elongated and nar-
row. The uterus has a long central body, with
eighteen to twenty-six side branches. The eggs
have a hard shell, with an indurated border. The
larval state of this tenia, which is the ccenurus
cerebralis, varies in size from a small seed to a large egg, and
has a number of nursing or daughter-cysts or bladders on its
inner wall. It is generally located in the brain, and in rare
Teenia cucumerina
(natural size).
Fic. 26.
Teenia ccenurus
(natural size).
TANIA. 79
instances the spinal cord. It is seen in all ruminants, especially
sheep.
Tenia Echinococcus. (Fig. 27.) This is the smallest tenia
of the dog. 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 body, and a
sexual orifice which is located at the border.
The head is round and has four sucking disks
and twenty-eight to forty-six small, imperfectly
developed hooks, arranged in two rows. The
eges are round and slightly elongated, the shell
being formed in several layers. The bladder-
worm is the echinococcus polymorphus; the
bladder is filled with a non-albuminous fluid,
and generally has daughter-cysts on the sides.
These cysts may assume enormous proportions,
ranging in size from a pea to 2 man’s head or
even larger. Itis found in the pig, cattle, and
sheep, and very rarely in the horse, but quite
frequently in man, especially in Iceland and
Australia. It is generally found in or attached , ‘anewoun, eclared
to the liver or peritoneum, but it has also been _ twelve times; 6, cyst
found in the lungs, kidneys, spleen, muscular bekr nee: ite Fe
io 2 d 3 Immature head,
system, pleura, bones, and the brain.
CLINICAL Symptoms. When tapeworms are present they gen-
erally cause more or less disturbance in the host. Often they pro-
duce the same symptoms as ascarides, but, as a rule, they cause
much more trouble than the round worms. Schieferdecker found
that in the duodenum, where the tenis cucumerina are gener-
ally found, the mucous membrane had numerous small tunnels,
through which the teniz passed in and out, and a peculiar
hypertrophy of the papilla. In some cases they were four or five
times their own length. In other cases Lieberkiihn’s glands were
sunken and collapsed and in several cases had completely disap-
peared. The teenize echinococcus, when they are present in large
numbers, cause great irritation of the intestines, with hemorrhagic
infarction of the tissues. In irritable animals they cause epileptic
spasms or even symptoms of rabies, such as change of voice, paral-
80 DISEASES OF THE DIGESTIVE APPARATUS.
ysis of the lower jaw, dulness, and indifference to surrounding
objects. Friedberger and Frohner have also observed similar
symptoms in dogs that have been infected with tenia cucume-
rina. In rare instances the tenis have been known to penetrate
the intestine. According to the observations of Cadéac, the per-
foration was made by two of the teenie serrata. In a great number
of instances it is impossible to say positively that the animal has
tapeworm unless the segments are observed in the feces, and the
most dangerous to man (the tenia echinococcus) is extremely hard
to find on account of the small size of the segments. The other
tapeworms are comparatively easy to find, as the segments are
readily seen on the outside of the stools or catch in the anus and
hang out, the dog frequently drawing attention to them by licking
the anus or drawing the hind extremities along the floor by means of
the front legs. In doubtful cases it is well to give a small dose of
some teeniafuge, and the animal will generally pass a few segments.
THERAPEUTICS. The most important of the numerous tenia-
fuges recommended are as follows:
1. Evtract of Male Fern (extractum filix mas), according to the
experience of the author, is the best agent to use. It is to be
given on an empty stomach (in the morning being the best time),
in doses of from 1 to 4 grammes in pill-form or in capsules. As
this drug has no purgative properties it must be followed up three
hours afterward by a dose of castor oil (80 to 50 grammes). It
must be borne in mind that male fern in large dose is a poison,
and the maximum (4 gms.) must not be exceeded in the largest dog.
2. Kamala, This is to be given in doses of 2 to 8 gms., mixed
with honey or syrup. It must be repeated in one hour after the
first dose, as it has purgative properties, and it is not necessary to
follow it up with any other drug, which is an advantage.
3. Kusso (flores koso). This is to be given in doses of from
3 to 5 ems., diluted with milk, repeated three or four times at
intervals of three-quarters to one hour. This should be mixed
or followed with a small dose of castor oil.
Pomegranate (cortex granati), in the shape of the macerated
decoctions of 30 to 100 gms. ; pumpkin-seeds crushed and macer-
ated in hot water; areca-nut grated up fine, in from 20 to 30 gms. ;
oxide of copper, picronitrate of potassium, turpentine, chloroform,
are all teniafuges. These agents are only used to a slight extent,
DOCHMIUS. 81
as they are much less efficient than the first three preparations
mentioned.
The preparation of the animal for the teniafuge is always an
important proceeding, and must always be followed. It consists
in letting the animal go hungry for at least Fic. 28.
one day and giving him also a mild purga-
tive to cleanse the intestines, making a clear
way for the expulsion of the parasite. After
the animal has passed the parasites they
ought to be picked up on a shovel or other
object and the passage put in the fire to
destroy the segments, especially if you have
reason to suspect that the tsenia echinococ-
cus is present, on account of its danger to
man.
R.—Kamala : : : 3 8.0
Meliy i. 4 : ‘ 7 ys Se
Fiat elec. S.—To be given in two doses.
R.—Ext. filix mas. . : : 2.0
Capsule gelatine No.1. 8.—To be given
in one dose.
Oxyuris Vermicularis.
By this name (Fig. 28) 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. They are gen-
erally located in the rectum and lower large
intestines. They cause great itching of the ioe
- % Oxyuris vermicularis: a,
anus, and the animal is observed to lick that magnified diagram of the
part constantly and also to frequently pull ee ee ee
the hind-quarters over the floor. the female ; d, natural size
These harmless parasites are removed by ‘° MHS: (VIFRORP®.)
clysters composed of solutions of salt-water, quassia bark, vinegar,
or a weak solution (1 : 1000) of corrosive sublimate.
Dochmius.
Dochmius (anchylostomum) (Fig. 29) is a small, thread-like
parasite which belongs to the family of strongylides. The end of
6
82 DISEASES OF THE DIGESTIVE APPARATUS.
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 into the mucous membrane of
the intestine and sucks blood. The three forms of this parasite
found in the small intestine of the dog and described are as fol-
lows: the dochmius duodenalis; the male is 10 mm. long and 1 mm.
thick; the female is 12 to 18 mm. long; the dochmius trigono-
cephalus; the male is 8 mm. long and 0.3 mm. thick; the female
is 12 mm. long and 0.5 mm. thick; and the dochmius stenoceph-
alus; the male is 6 to 8 mm. long and 0.24 mm. thick; the female
is 8 to 10 mm. long and 0.38 mm. thick.
Fic. 29.
Dochmius duodenalis: a, male; b, female (natural size); c, magnified head. (JAKSCH.)
Animals affected with this parasite become anzemic, weak, and
thin, and have a peculiar discharge of a thin, bloody mucus from
the nose (Mégnien, Raillet).
The presence of this parasite is recognized in the same way as
one would locate the teenia—by the presence of the eggs in the
feces. They are easily recognized, the eggs being similar to the
ascarides.
Besides the already mentioned parasites we also find in the intes-
tines the trichocephalus depressiusculus in the cecum and the both-
riocephalus latus, cordatus, fuscus, reticulatus, and bubius in the
small intestines; and we also find a coccidium (the coccidium per-
forans), which may produce a diphtheritic inflammation of the
intestines (Rivolta and the author). They have been known in
rare instances to produce rabiform symptoms.
PERITONITIS. 83
DISEASES OF THE PERITONEUM.
Inflammation of the Peritoneum—Peritonitis.
Erto.ocy. Peritonitis is generally seen asa secondary disease due
originally to some irritation or injury of some of the other organs of
theabdomen: From toxic gastro-enteritis, ulceration of the stomach
or intestines, accumulations of fecal matter in the intestines; from
metritis or parametritis after labor ; from inflammation or abscess
of the liver; from purulent inflammation of the kidneys or from
purulent pleuritis; from rupture of the intestines and the escape
of food or feces into the abdominal cavity. It may also occur
from a general inflammation of all the serous membranes of the
body, as is sometimes observed in infectious diseases ; to pyzemia
_ or metastatic peritonitis ; from the breaking down of tubercular
masses that have collected on the peritoneum, or from cancer.
Primary peritonitis is always caused by some injury to the abdom-
inal wall—shocks, blows, or by penetration of the abdominal
walls, or after some operations. It is a question whether cold will
cause the disease ; the author doubts it very much.
PaTHoLogicaL ANAToMy. According to the extent of the
disease we call it either partial (circumscribed) or general perito-
nitis (diffused); according to its course acute or chronic ; and accord-
ing to its character we call the exudate serous, fibrinous, purulent,
putrid, or hemorrhagic. 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 when it starts originally as circumscribed
the disease generally becomes diffused in a short time. The peri-
toneum 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 substances. This
collects as a thick layer over the peritoneum; the exudate unites
the intestines to each other, to the different organs in the abdom-
inal cavity, or to the sides of the abdominal walls. In recent cases
these adhesions are easily pulled apart, but later on they become
firmly united and very hard to separate (adhesive peritonitis).
There is also a quantity of a fibrous exudate thrown out, accom-
panied by more or less liquid. This varies from a small quantity
84 DISEASES OF THE DIGESTIVE APPARATUS.
to several litres. There is always some cedema of the serous wall
of the intestine, which becomes soft and friable.
The chronic form may start out at the onset, but generally it fol-
lows an acute attack; the peritoneum becomes very much thickened
and adhesions form with the intestines and the adjacent organs,
at times contracting the intestinal walls and lessening the diameter
of the intestinal canal. In the chronic form the exudate is not
purulent, as a rule, but is composed of thick, hemorrhagic serum.
In the dog we sometimes observe a form of ascites (see page 86) in
which we have a chronic thickening of the peritoneum and a col-
lection of a turbid, fibrinous exudate (inflammatory ascites).
A circumscribed peritonitis may be caused by a local ulceration
of the intestine or stomach and the irritation extend to the serous
coat. We often find small circumscribed deposits on the spleen
and liver 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 mild
cases, where the exudation is very slight, that there is any chance
of recovery. The exudate breaks down and is reabsorbed, but, as
a rule, there is such an extensive thickening and adhesions formed
that it is only in rare cases that the animal ever is restored to per-
fect health.
CLINICAL SYMPTOMS AND CoURSE OF THE DISEASE. When
the disease is caused by some traumatism, by perforation either
from the intestines or externally, the symptoms appear very rap-
idly. At first there are colic, great restlessness, and a stiff, unnat-
ural gait. The posterior extremities are carried out from the body
and not flexed. The animal groans and cries. The pain is con-
tinual; the abdomen is very sensitive on manipulation, the slightest
touch producing great pain. The author has seen several cases,
however, where the animal showed very little pain in this disease,
but it has been in cases where there was great debility. The
abdomen becomes distended in the first 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, on
percussion, if gas is present, the sound is hollow, and when the
exudate is present the sound is dull. The exudate, of course,
PERITONITIS. 85
lies on the floor of the abdominal cavity; but where the exudate
forms very rapidly the whole abdomen is filled up, causing great
dyspneea.
In the early stages of some cases the abdomen is tucked up,
the walls are tense, firm, and painful to the touch, and it is 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 diarrhcea present before the disease
started, which is seen in those cases where there is ulceration of
the mucous membranes. Vomiting is always present, the vom-
ited matter being greenish-yellow mucus. There is total loss of
appetite. The temperature rises to 40° C. or above. If the dis-
ease is not so severe as to cause death in a day or two, the tem-
perature fluctuates, being high at one part of the day, and then it
becomes subnormal, its character being remittent. The pulse is
fast, thin, or wiry, and finally imperceptible.
The great 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 collection of the exudate.
Circumseribed or chronic peritonitis produces less marked symp-
toms and is harder to recognize, the symptoms of diffuse chronic
peritonitis being those of ascites. The best way to confirm a
diagnosis is to puncture the abdomen with a small trocar and see
the character of the fluid.
TuERApevtics. Acute diffuse peritonitis should be treated
with constant applications of cold-water compresses to the abdo-
men, and, if the irritation is very intense, the application of a
counter-irritant, such as 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. Opium is to be given internally in doses of 0.1 to 0.5
gramme, and when there is collapse give whiskey and spirits of
camphor. If there is any obstruction of the bowels, give injections
of warm water. The exudate can only be removed by puncture of
the abdomen, when the acute symptoms have subsided. It must
be always borne in mind (and this holds good in inflammation of
other serous membranes) that the production of a serous exudate
is a process that assists the existing conditions because the liquid
86 DISEASES OF THE DIGESTIVE APPARATUS.
helps to keep the intensely inflamed parts separated and prevents
friction and its complicating inflammation.
Abdominal Dropsy.
(Hydrops Ascites ; Ascites; Hydrops Abdominis ; Hydrops
Peritonii.)
By this is meant a collection of a serous liquid in the abdom-
inal cavity that originates without inflammatory symptoms, being
solely due to transudation. The amount of liquid collected varies
very much. In some cases there are only a few spoonfuls collected,
while in a very large dog the author found 21 litres of fluid.
The color of the fluid is sometimes as clear as water, but it is
generally reddish-yellow. It may also be filled with fibrinous
flakes, which indicate chronic peritonitis. When exposed to the
atmosphere 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 pale
or dull white, and finally a fatty degeneration sets in; when the
animal has been repeatedly punctured inflammatory processes take
place, and are followed by adhesions.
Errotocy. Ascites never appears as an independent disease,
and can only be regarded as the symptom of another disease. As
the peritoneal veins belong to the mesenteric system, any obstruc-
tion of the portal veins causes these serous collections, as in cirrho-
sis of the liver or tumors of that organ, or from compression of
the mesenteric veins by tumors, abscesses, etc. Ascites is also seen
as asymptom of general dropsy from disease of the kidneys or luugs,
and from defective action of the heart. It may also be caused by
local diseases,of the peritoneum, from tuberculosis, carcinoma, or
from chronic inflammatory conditions. Itis, therefore, best to draw
a direct line between transudate and inflammatory exudates.
Friedberger and Frohner could not find a trace of ascites in a
dog ten years old that had carcinomas in nearly all the abdominal
organs and peritoneum.
CuinicaAL Symptoms. The chief clinical symptom of this dis-
ease is the presence of fluid in the abdominal cavity. Small
amounts very frequently are not noticed, and in fact cannot be
ABDOMINAL DROPSY. 87
determined by any means except by tapping When there is a
considerable collection of serous fluid the abdominal wall is dis-
tended, and, from the fluid being in the lower portion of the abdo-
men, the outlines of the trunk resemble those of a pear; there is a
peculiar sunken appearance of the flanks. When the tips of the
fingers are struck against the distended abdomen there is a fluctu-
ating movement, and when there is a large quantity of fluid
present the sound of the fluid can be heard when the side of the
abdomen is struck sharply with the flat of the hand. With per-
cussion we can tell to a certain extent the amount of fluid present.
The animal should be made to stand, thus having the fluid lying in
Fig. 30.
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.
the base of the abdomen. By percussing, beginning at the lowest
part of the abdomen and moving upward on the wall, where there
is fluid, we will get a dull sound, and when the line of fluid is
passed we get the intestinal or tympanitic sound. It is very im-
portant that the animal should be in a standing position, as it can
be readily understood when the animal is lying on its side, the
fluid being beneath, we would get a clear tympanitic sound all over
the 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
88 DISEASES OF THE DIGESTIVE APPARATUS.
abdominal organs and the diaphragm, interfering with regular
respiration. The urine is generally normal but reduced in quan-
tity, the digestion impaired, and the bowels disturbed. In the
majority of cases diarrhoea is present, and occasional vomiting.
While it seems very easy to make a diagnosis when the above
symptoms are present, still the following diseases may present sev-
eral or all of the symptoms above described.
1. Acute or Chronic Peritonitis, When one reads the symptoms
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 diffi-
cult to separate them, the only positive means being to puncture
the walls with a small trocar (hypodermatic) and obtain a small
portion of the fluid; and it is rather common to see ascites associ-
ated with chronic peritonitis.
2. Fatty Deposits in the Abdomen. This disease is present quite
frequently 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, and does not become
pendulous whether the dog is standing or recumbent. It is well
not to puncture in these cases, as it gives no information.
3. Abnormal Collection of Urine in the Bladder. In these cases
we feel a ball-shaped body in the posterior portion of the abdo-
men; 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 diagnosis is to lift up the animal by the poste-
rior extremities, and if it is ascites the liquid will settle on the
diaphragm and interfere with the respirations; if the bladder is
filled we do not have the dull percussion-sound. To further con-
firm the diagnosis pass the catheter.
4. Distention of the Bowels with Gas. In this instance there is
an absence of the fluctuation and the clear tympanitic sound all
over the abdomen.
5. With Collections of Urine in the Abdomen after Rupture of the
Bladder. On the passage of the trocar the clear urine is passed,
which can easily be recognized by the color and odor.
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
ABDOMINAL DROPSY. 89
between ascites and tumors of the abdominal cavity (hydrometra,
pyometra). All these affections can be recognized by carefully con-
sidering 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-treatment depends on it. This, however, is
rather hard to do. If it is the heart or lungs, it can be recognized ;
but often we have 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 are then collapsed, and the organs
can be manipulated at the same time. If tumors are present, they
can be recognized.
Notwithstanding all the etiological conditions described, there
are often cdses where the cause can only be guessed at.
Proanosis AND THERAPEUTICS. As a rule, the prognosis is
unfavorable, as we are unable to remove the exciting cause. The
cases that recover are generally in young dogs (Friedberger and
Frohner, and author). Our first effort is to remove the exciting
cause, if it is recognized, and then remove the dropsical effusion.
This can be done in the following ways :
1. By Purgatives. This method is to be followed where there
is constipation associated with the disease. Saline purgatives are
the best, and those only in sufficient doses to cause a laxative action,
so as not to interfere with the appetite.
2. By Means of Diuretics. These must only be used where
there is positive evidence that there is no previous irritation of the
kidneys. The best diuretics are the vegetable, such as digitalis,
juniper berries ; the only saline drugs are acetate of potassium and
sodium.
R.—Tine. digitalis fol. : : : : ‘ ayeet.0
Sodium acetate. : : : : : Leva O
Oxymel scille ; : ? : ; 20:0
S.—One teaspoonful three times aaa
R.—Potassium acetate . : Z : : : at ileG
Spiritus juniperi . , : : F . 20.0
S.—One teaspoonful three times daily.
3. Hydrochlorate of Pilocarpine. We sometimes obtain very
good results with this drug. The injection of the solution subcu-
taneously is made once daily (0.005 to 0.01 of water). Zahn gave
90 . DISEASES OF THE DIGESTIVE APPARATUS.
three drops of the 1 per cent. solution on the tongue three times
daily. With this drug the amount of saliva is greatly increased,
and the amount of fluid exudated greatly decreased. This must
never be administered where there is any disease of the lungs or
air-passages.
4. Tapping or Puncturing the Abdomen. This is indicated where
there is a large collection of fluid that is pressing on the dia-
phragm, and also as a diagnostic procedure.
Whether it is best to remove the fluid in
all cases is a question that has not been de-
cided; yet the author is of the opinion that
the fluid should be removed, provided the
animal is robust and not too old, especially
as the operation is comparatively harmless,
and has the advantage over purgatives and
diuretics in that the accumulation is re-
moved quickly. In a number of cases the
fluid has not accumulated after one or more
punctures. Friedberger and Frohner have
seen old dogs that have died during or
shortly after the operation. The method
of puncturing is to take the ordinary tro-
ear (Fig. 31); a narrow calibre one is the
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 suddenly.
Fig. 31.
Trocars for ascites.
The method of operating is very simple. The place to insert the cathe-
ter 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 is best to introduce an elastic catheter and
push them to one side.
DISEASES OF THE LIVER.
Catarrhal Jaundice.
(Icterus Catarrhalis; Icterus Gastro-duodenalis.)
Eriotocy. In catarrh of the stomach we often have symp-
toms of jaundice with that disease, especially where the inflamma-
CATARRHAL JAUNDICE. 91
tion of the mucous membranes extends to the duodenum, and the
ductus choledochus becomes closed by the swelling of its mucous
membranes and prevents the exit of bile. As soon as such an
obstruction occurs the bile can no longer flow into the intestines;
it becomes stagnant and dams back, causing a pressure in 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 earlier stages of the disease we
have to deal with an icterus that is produced by stagnation of the
bile. This has a number of names—stagnating icterus, icterus of
reabsorption, or hepatogenous icterus. While the swelling of the
mucous membranes 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), and also from
ulceration of the mucous membrane, by the cicatrix of tumors,
abscess in or near the liver. The stoppage of the flow of bile sets
up an inflammation of the tissues and sometimes forms abscess of
the liver; but as the great majority of cases are caused by the
catarrhal form, we will describe that. Any cause that will produce
catarrh of the stomach will finally produce icterus—improper food,
especially when it is frozen; cold drinks after over-heating, decayed
meat, salt fish. That form of icterus that is 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. Asa 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 out the bile in the
duct. In some cases a white clot of mucus is forced out, but
Siedamgrotzky has found that in the great 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 quick as to be hardly recognizable at the autopsy. Another
fact to be taken into consideration is that the canal is so very nar-
row in the dog that it takes a very small amount of swelling to
obstruct it.
92 DISEASES OF THE DIGESTIVE APPARATUS.
The body of the liver may be changed ; it is generally enlarged
and anemic, and varies in color from a yellow to a yellowish-
brown. The color is not regular, but spotted like a nutmeg. The
cells of the liver are infiltrated and filled with drops of fat, colored
with brownish pigment in the shape of granulated clots, The
cadaver is generally anemic; the blood is either clotted, and in
the heart and large bloodvessels we find large lumps of hard red-
dish-yellow coagula, or the blood may be stained yellow and con-
tain 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, and the corneal tissue, are stained more or less by
the bile-pigment. The muscles of the heart undergo a certain
amount of fatty degeneration. The kidneys are anemic; in the
pale portion of the kidney we see extensive whitish stripes run-
ning in the direction of the urinary canals; this is caused by an
irregular fatty degeneration and pigmentary infiltration of the
canals (Siedamgrotzky).
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,
vomiting, coated tongue; in some rare instances, however, these
may be absent. The first symptom being that of jaundice (yel-
lowness of the mucous membranes), when the bile and bile acids
enter the blood the following symptoms are observed :
1. By the entrance of the coloring-matter of the bile into the
tissues these become more or less yellow, the first being the yel-
lowness of the conjunctiva and the sclerotic coat ; later the whole
cutaneous covering becomes tinted. The yellowness may be very
plainly seen on the abdomen, on the inner fascia of the thighs, and
the mucous membranes 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-brown color ; when put in a vessel and agitated it foams
very easily; and if a piece of paper or linen is placed in it, it
becomes tinted the color of bile. It is also easy to detect the
CATARRHAL JAUNDICE. 93
presence of bile color of 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 con-
tains albumin, short hyaline casts, pigment granulations, and
epithelium of the kidneys.
3. On account of the stoppage of the flow of bile into the intes-
tines the feces become gray or clay colored and contain much
undigested fat, and hydrobilirubin is present. The fat substance
not being digested, the feces become very fetid ; this change is
also due to a certain extent to the antiseptic effect of the bile, and
as the food is passed along the intestine the tonic effect of the bile
is wanting.
4. The bile acids present in the blood produce a certain amount
of depression on the nerve-centres, and for this reason we find that
the pulse and respirations are subnormal in action, and the temper-
ature is reduced. Other symptoms of the narcotic effect of the
bile are seen in some cases where there are depression, great mus-
cular debility, indifference to surroundings, somnolence, and finally
deep coma.
The local examination of the liver gives little satisfaction. The
author has never been able, except in one case, to find any per-
ceptible enlargement of the liver. Any manipulation of the
liver does not seem to give the animals pain even in the later stages
of the disease. The prognosis in the dog is generally unfavorable.
The yellow coloration gradually becomes deeper, the temperature
falls in the majority of cases, the pulse becomes weak and irreg-
ular, and finally death occurs with general paralysis. If the case
progresses favorably, the first sign is a lessening in the coloration
of the urine and a darker hue to the feces, the pulse becomes
fuller and more regular, the temperature increases, the animal
shows more animation, and the color in the mucous membranes and
skin becomes lighter until it finally disappears. If there is a
relapse, it is generally caused by improper feeding.
THERAPEUTICS. We must first aim to reduce the irritation of
the duodenum, also the bile-ducts. This is first gotten at by reg-
ulating the diet: Small quantities of lean meat and alkalies in
the form of carbonates and carbonic acid. 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
94 DISEASES OF THE DIGESTIVE APPARATUS.
of cases, they do more harm than good; but 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 abdomen 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 is to be kept up for ten minutes at a
time twice daily. Or by emetics, it being claimed that the com-
pression of the liver during emesis by 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 mild
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 Penmus boldus, has recently
been spoken of as producing good results in jaundice ; it is given
in dose of 0.08 gm. daily. ]
The other affections of the liver are of slight importance and
are rarely met with during life, consequently they will be only
mentioned briefly.
Hyperemia of the Liver.
This may be caused by either 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 isa normal condition during
digestion, but it may be abnormally increased by eating large quan-
tities of food, especially if it is rich and irritating, and from want
of exercise ; decayed or tainted food may also cause this condition.
Stagnating hyperemia 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 quantities. This blood is generally dark colored,
especially if the stagnation has been prolonged. The liver tissue
may be spotted, the surfaces corresponding with the central veins,
INFLAMMATION OF THE LIVER. 95
which are located in the centre of the acini; 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 becomes finely granular.
CiixicaAL Symptoms. It is not possible to make a positive
diagnosis of this disease, we can only suspect it by great tender-
ness on pressure in the region of the liver, and perhaps slight
icterus ; 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. This consists in mild purgatives followed by
saline laxatives. .
Inflammation of the Liver.
(Hepatitis. )
This disease appears in two forms—acute parenchymatous and
chronic interstitial.
1. Acute parenchymatous hepatitis accompanies various in-
. fectious diseases, probably in the same way that we see congestive
hyperemia of the lungs; it is also seen as a symptom of acute
phosphorus-poisoning.
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, with a roughened appearance of the external
surface, due to the enlarged acini; the capsule (Glisson’s) is dull
and thickened, due to a certain amount of peri-hepatitis. If the
disease lasts any time, the volume of the liver is greatly lessened.
The clinical symptoms are: Evidences of catarrh of the stom-
ach, pain on pressure in the region of the liver, icterus.
The therapeutic treatment consists of light, easily digested food,
with little fat, and saline laxatives.
2. Chronic Interstitial Hepatitis (Cirrhosis of the Liver).
This disease originates from causes that are at present unknown.
Friedberger and Fréhner surmise that it is caused by valvular
disease of the heart. |
PATHOLOGICAL ANATOMY. ‘There are two stages of change
in this disease. In the first stage the liver is very much enlarged
96 DISEASES OF THE DIGESTIVE APPARATUS.
and hard, the edges of the lobes are blunt, on the surface there are
a number of uneven depressions. On making a transverse section
we find a network of reddish-gray tissue that surrounds the acini;
later on this involves the acini. In the second stage we find a
cicatricial retraction of the newly formed tissue, and at the same
time a disappearance of true tissue of the liver. The liver then
becomes gradually smaller and has a very irregular surface; the
capsule is thickened and in some places depressed ; the tissue is
hard and tough when cut with a knife.
CurnicAL Symproms. The disease generally starts without any
visible symptoms, although it isa common disease in old dogs that
have lived well. When the disease becomes 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 occa-
sional changes to diarrhcea. In rare cases a certain amount of
icterus is present. This is due either to interference with the passage
of bile from the gall-bladder by catarrh of the duodenum, or to
a contracted condition 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.
The disease is generally very slow, but ends fatally, and when
there are ascites and some cedema 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
the ascites by puncture.
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 the thrombus
undergoing purulent destruction, and from pyzmia in abscess of
the stomach.
PaTHoLocicaL ANatTomy. Abscesses of the liver appear
singly or in large numbers; the traumatic abscess is generally
solitary and the metastatic multiple. The pus is cream-like, and
in some instances fetid and reddish-green in color. Small ab-
scesses may heal by reabsorption, but the large ones open into the
abdominal cavity and cause a fatal peritonitis.
NEOFORMATIONS OF THE LIVER AND GALLSTONES. 97
CiinicaL Symptoms. Icteric symptoms, with frequent chills,
point to abscess of the liver. Treatment is useless.
Fatty Liver.
(Hepar Adiposum.)
This is an abnormal diffuse fatty infiltration of the cells of the
liver. It is hard and seems aneemie when a section is made through
the organ. The cells are found to be filled with numerous fatty
drops.
This condition is seen in old animals that have been fed well
and had little exercise, and is a natural fatty infiltration. It must,
however, be distinguished from the fatty degeneration that is found
to follow several 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 atoms. One contains
nitrogen, while in the other nitrogen is absent. This latter part
undergoes fatty degeneration.
The treatment of fatty liver is the same as any adipose condi-
tion.
Neoformations of the Liver and Gallstones.
The neoformations found in the liver of the dog are sarcomas,
carcinoma, and adenoma. ‘These cause irregular enlargements on
the body of the liver, and produce symptoms similar to those of
cirrhosis of the liver.
All treatment is useless.
Gallstones are very rare in the dog; the only way that they
might be recognized would be the appearance of icterus, produced
by retention, with intense colic, which disappears in a short time.
The following parasites have been found in the liver: Distoma
lanceolatum and distoma campanulatum. In the bile-ducts
Ercolani and Lissizin found a fully developed male strongylus
gigas in the liver of a young dog which had died of severe con-
vulsions.
98 DISEASES OF THE DIGESTIVE APPARATUS.
Amyloid and Lardaceous Liver.
Amyloid liver, as a rule, is a symptom of a general amyloid
condition developed from a cachectic state from prolonged suppu-
rating wounds or from chronic inflammation of the pectoral mem-
branes.
The liver is very much enlarged and blunt on the edges of the
lobes. It is tough and firm on section, the cut surface speckled
and grayish-brown in color. On microscopical examination the
walls of the capillaries will be found to have undergone amyloid
degeneration; the cells are atrophic and show partial fatty degen-
eration. These parts become blue when brought in contact with
iodine or sulphuric acid, reddish-brown with tincture of iodine,
and methyl-violet turns them intensely red.
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 have amyloid kidney with albu-
min in the urine, and we also may have amyloid spleen.
This disease is generally impossible to diagnosticate and useless
to treat.
POISONS.
A short abstract on poisons, together with their symptoms and
treatment, is here given :
Poisoning by Arsenic. The poison may be given intention-
ally or by eating some of the various rat poisons. There is a
violent inflammation of the stomach and intestines, with great
restlessness, bloody diarrhoea, vomiting, and dyspnoea, great weak-
ness, and finally collapse, death occurring in a few hours.
THERAPEUTICS. Emetics and ferruginous agents, the hydrated
peroxide of iron in water every quarter of an hour; carbonate of
magnesium, a teaspoonful every fifteen minutes, followed by alco-
holic stimulants. The stomach-pump can also be used if there is
not prompt emesis.
Poisoning by Hydrocyanic Acid (Prussic Acid). This is
generally given intentionally in the form of cyanide of potassium or
the pure acid. There is an odor of bitter almonds on the breath.
The symptoms are vomiting, yelping cries, dyspnea, convulsions
of the legs, and death in a short time. If the dose should be
POISONS. 99
small there are great restlessness, fear, vomiting, dyspnoea, dilated
pupils, convulsions, especially of the extremities, fall in the tem-
perature, marked depression of the pulse and respirations, cyanosis,
and unconsciousness.
THERAPEUTICS. Emetics, artificial respiration (rhythmic pres-
sure of the lower abdominal walls), bathing in cold water, stimu-
lants, chlorine water, and atropia.
Poisoning by Carbolic Acid. This is generally produced by
licking applications containing carbolic acid, tar, or creosote that
have been applied to the skin, or through absorption through the
skin from a wound, or through some mucous membrane (uterus),
and by mistakes in giving it internally. The urine is a dark olive-
green; there are light colic, pain on pressure of the abdomen, vom-
iting, diarrhea, great inflammation and redness of the mouth,
weakness, slight decrease in temperature, twitching of the muscles,
total paralysis, convulsions, and collapse.
THERAPEUTICS. Glauber’s salt, white of eggs, stimulants.
Poisoning by Iodoform. This may be caused by licking
wounds dressed by the drug (Albrecht, Frohner, and author), and
injections of iodoform solutions into cysts. In the acute form we
have great gastric disturbances, small and frequent pulse, decrease
of the internal temperature, suppression of urine, albuminuria,
dulness, and convulsions, alternated with great excitement, col-
lapse. In the slow form we have catarrh of the mucous membranes,
emaciation, and skin eruptions.
THERAPEUTICS. In the acute form, first give emetics, followed
by carbonate of potash, large quantities of starch, atropia; in the
slow form, saline laxatives and tonics, and remove the cause.
Poisoning by Phosphorus. This may be caused by eating
some of the various roach or bug poisons that have been spread on
bread and eaten by the animal. There is constant vomiting; the
vomited matter has an odor of phosphorus; if taken into a dark
place it is luminous. There are great restlessness, howling, whin-
ing, great heat, and indications of intense irritation of the mouth
and throat; 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 of
the liver, stomach, and intestines. The feces are tinged with blood
and albuminuria, and, according to some authors, if there is any
100 DISEASES OF THE DIGESTIVE APPARATUS.
icteric coloration, it is a positive symptom; finally paralysis and
collapse.
THERAPEUTICS. Use sulphate of copper as an emetic, turpen-
tine in emulsion, and treat any other symptoms as they appear.
R.—Cupri sulph. . . ; : : : : - So
Aqua destil. . : : ; 2 : : . 90.0
Sig.—A tablespoonful every ten minutes until you get emesis.
Poisoning by Mercury. 1. Acute poisoning by corrosive
sublimate is very rare; the symptoms are intense inflammation of
the entire intestinal tract, vomiting of blood, and bloody diarrhcea,
with intense local irritation, symptoms of paralysis, and death.
TuHerAPevtics. Albumin and iron preparations, followed by
stimulants.
2. Mercurial poisoning taking a slower course may be caused by
calomel or mercurial dressings, especially from mercurial ointment
when it is applied externally. We have salivation, catarrh of the
stomach, profuse diarrhcea, emaciation, with marked muscular
debility.
THERAPEUTICS. Sulphur, iodide of potassium, stimulants, and
nutritious food, and clean the mouth with a wash containing chlo-
rate of potassium.
Poisoning by Strychnine. This is generally administered
intentionally, although it may be caused by giving repeated small
doses of nux vomica, the dog being particularly susceptible to this
poison. There are violent tetanic spasms, trismus, and opisthot-
onus. The convulsions are clonic, having intermissions between
them.
THERAPEUTICS. Give narcotics, chloral hydrate in clysters,
2.5 grammes to 50 of water; morphia, also tannin and tincture
of iodine. Never administer chloroform or ether.
Meat- and chloroform-poisoning will be mentioned later on.
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
account 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 damp and cold in health, and dry and warm when a dog has
any fever or elevation of temperature, in the first stages of nasal
catarrh, and any inflammatory condition of the eyes. This should
not be taken as a positive evidence, as frequently cases are seen
where this is no guide, the nose being cold when there is great
fever.
Swelling, redness, and excoriation at the entrance of the nasal
chambers indicate an inflammatory and purulent condition of the
nasal mucous membrane.
Any discharge from the nose, beyond a natural moistness, indi-
cates 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 compact, sticky, and finally very tenacious, and sticks to the
external opening of the nose, often entirely closing it up and erod-
ing the skin where it comes in contact with it. In distemper it is
yellowish to yellowish-green in color ; sometimes it is streaked with
blood or pus, and in rare cases it has a fetid odor. (For further
particulars, see chapter on Distemper. )
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 follow-
(101)
102 DISEASES OF THE RESPIRATORY ORGANS.
ing coughing generally comes from some trouble in the deep sec-
tions of the air-passages, larynx, windpipe, bronchia, 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 teenioides in the frontal or nasal cavities. In cases of
acute catarrh of the throat, foreign bodies, paralysis of the larynx,
or large tumors in the throat, the discharge may be mixed with
some of the contents of the stomach. These affections are ex-
tremely 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 conditions of the nasal cavities from the pen-
tastome, and also in distemper. Hemorrhage of the lungs is indi-
cated 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 conse-
quence of violent nasal catarrh, tumors, fractures of the nasal
bones, narrowing of the nasal passages, pressure from some of the
neighboring organs, 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.
The nasal sound is like a snore when copious accumulations of
mucus have collected on the mucous membranes, as in distemper,
or the later stages of simple catarrh of the nose. In all the affec-
tions named many animals seem to have intense itching, which
they indicate by rubbing the nose against solid objects or wiping
it with the paws.
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 affections of the internal larynx, and is always of
great importance in rabies (barking howl). The cough is an
accompaniment of all affections of the larynx ; it is generally loud
and either short, raw, hoarse, bark-like ; and in the later stages of
eatarrh, 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 irrita-
tion of the larynx, any excitement, such as the pleasure of meeting
PHYSICAL DIAGNOSIS OF THE LUNGS. 103
a person they know, will start a severe coughing spell. The
respiration is always dyspneeic and accompanied by a stenotic
bruit when from the results of some diseased condition there is
a contraction of the larynx. Auscultation of the larynx is per-
formed by placing the ear directly on the larynx. Normally the
sound is a slightly wheezy respiration. Rubbing, creaking, 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 ca-
tarrh); it may also indicate the presence of tumors, membranous
accumulations, and paralysis of the muscles of the larynx.
A local examination of the larynx can be made both externally
and internally. Externally the larynx can be examined for frac-
tures or dislocation of the cartilages, for ceedematous, phlegmonous,
or emphysematic 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 27, 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 window or by means of a
lamp ; the light can then be thrown into the posterior portion of
the throat. In vicious animals, they can 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 in some cases a part of the windpipe. In acute
catarrh the mucous membrane of the larynx 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 cesophagus foreign bodies,
tumors, or abscesses.
Physical Diagnosis of the Lungs.
The lungs of the dog consist of a number of layer-like portions
which are united by the bronchia and connective tissue; the ana-
104 DISEASES OF THE RESPIRATORY ORGANS.
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tomical positions of the lungs are shown in Figs. 32 and 33. The
left lung is divided into two portions or lobes, an anterior and a
105
PHYSICAL DIAGNOSIS OF THE LUNGS.
The section that divides the large
posterior; the former is again subdivided in two; this division is
not very distinct in some cases.
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lobes begins opposite the fourth or fifth vertebra and runs downward
and backward as far as the sixth rib; the anterior lobe extends as
106 DISEASES OF THE RESPIRATORY ORGANS.
far as the first rib, and anteriorly and posteriorly 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 ver-
tebra ; it is divided into four lobes; the posterior lobe is consider-
ably larger than the corresponding lobe of the left lung. The
cardial 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, extending anteriorly as far as
the heart and posteriorly to the diaphragm.
In making an examination of the lungs we must take into con-
sideration 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 derived 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 protrusion 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
double 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
inflammatory conditions of the skin and subcutis, the ribs, or the
intercostal muscles in cases of muscular rheumatism, in fracture
of the ribs, and quite frequently in pleuritis.
Number and Character of the Respiratory Movements.
Normal breathing is performed in the dog, as in other animals,
through muscular action 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 on the diaphragm. It is
PHYSICAL DIAGNOSIS OF THE LUNGS. 107
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 normal
respirations are from twelve to eighteen per minute, the size of the
animal making a slight difference, in the smaller dog of course being
more. Various conditions tend to alter the above number, such
as running, physical excitement, overloading of the stomach, and
advanced pregnancy. While the respirations in the dog are regu-
lar, yet they are disturbed more quickly by physical excitement
than in any other animal.
A pathological lessening of the number of the respirations may
be seen in all serious affections of the brain and its membranes;
in acute infectious diseases, such as septicemia and distemper; and
in cases of contraction of the air-passages.
A slight increase in the respirations may follow any increase of
temperature; 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. Labor-
ious respiration (difficulty in breathing, dyspnea) is seen where
there is any contraction of the pharynx, larynx, or windpipe ; for
instance, from the swelling and inflammation of the mucous mem-
brane in those organs, foreign bodies, tumors, ete. We see laborious
breathing, with great increase of the number of respirations, in any
irritation of the bronchial tubes where they become contracted or
filled with mucus, and in all diseases of the true lung-tissue ; in all
exudates into the pleuritic cavity, or in diseases of the abdomen
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 strychnine-poisoning, tetanus, or
eclampsia in nursing bitches; in diseases of the heart where there
is stagnation of the thoracic circulation. In all cases of dyspnoea
in the dog the animal rarely lies down, but prefers to assume the
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 pro-
duced by reflex action from all parts of the mucous membranes of
the pharynx, windpipe, bronchia, 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
108 DISEASES OF THE RESPIRATORY ORGANS.
thing can truly be said to exist. Cough is generally absent in
diseases of the brain or in cases of carbonic-acid poisoning, as well
as in cases where the glottis and the muscles of respiration are
paralyzed; in such cases it is impossible to produce coughing by
manipulation of the throat. Dogs do not cough intentionally, but
if it is very painful they can suppress it.
An animal can be 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 of the throat very similar to
those of vomiting.
Occasionally an animal is found in whom the most severe pres-
sure will not produce any signs of coughing, although it may make
a swallowing movement.
Several spells of coughing after a slight pressure on 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 condition of those parts. In bronchitis and
catarrhal pneumonia coughing can be produced by tapping on the
wall of the chest.
In the beginning of acute bronchitis and in pleurisy the cough
is dull, weak, usually frequent, dry, and husky. In chronic
bronchitis, catarrhal or croupal pneumonia, emphysema and cedema
it is very much the same, but not so frequent, and in tuberculosis
it is hollow and dull. There are many exceptions to this rule ;
for instance, in cases where foreign bodies enter the lung through
the mouth or by vomiting, the cough is convulsive and violent,
resembling whooping-cough (chronic pharyngeal catarrh) in its
intensity. Asa rule, dogs cough more frequently at night than
during the day.
The expectorations cannot be examined in the dog as they are
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 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 generally in pharyngeal, tracheal, and bronchial catarrh. The
largest amount of excretion is seen in bronchial and tubercular
PHYSICAL DIAGNOSIS OF THE LUNGS. 109
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 hemor-
rhage of the lungs the cough is accompanied with more or less
foamy blood from the nostrils and mouth, and in some cases symp-
toms of choking ; a slight hemorrhage may escape our observation,
as the blood is generally all swallowed.
Percussion of the Thorax. Percussion (tapping) is performed
by means of a percussion-hammer and an ivory or metal plate
(pleximeter) (Fig. 34). 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 fin-
ger 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 are given in Figs. 32
and 33; 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 ex-
tending to the last rib; and, also, when the stomach
or intestines are very much filled with gas, crowd-
ing the diaphragm forward, lessens the extent of
the lungs. In percussion we make the distinction
between a clear, loud, normal lung sound and a
tympanitic, dull, or solid sound of disease. The
clear normal sound of the healthy lung is heard
all over the thorax, the volume of sound depend-
ing on the thickness of the lung at the particular Pléximeter
part being examined. The muscular layers of the
chest have a certain effect on the sound, very thick walls less-
ening the sound to a certain extent; the sound is more or less
dull over the shoulder-blade, sternum, and back; the posterior
borders of the lungs often have no perceptible sound, as they are
so thin.
A dull, muffled sound, which has been mentioned in the above
classification, is heard in the following conditions: In the tissues
110 DISEASES OF THE RESPIRATORY ORGANS.
of the lung where the air cannot reach, as in hepatization; in
croupal pneumonia; in tuberculosis, provided that the diseased
centre is not entirely surrounded with tissue containing air; in
tumors of the lungs; in hemorrhagic infarction; in sections of
the lungs that are compressed by pleuritic or pericardial 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 cedema, 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 indistinct 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 it above pleu-
ritic exudates and in the neighborhood of large tumors of the
lungs, or in compression of the lungs from the pushing for-.
ward of the diaphragm due to tumors, ascites; also moistening
of the alveola by fluids and reduction in the contained air, as
in the loose moist stage of croupal pneumonia ; also where there
are many small tubercular centres in the tissue of the
lungs, which are hollow in the centre and contain air,
and sometimes in cedema of the lungs. Cutaneous
emphysema of the walls of the chest gives a clear
tympanitic sound. There are several modifications
of this sound, as the cracked-pot or metallic tinkling
percussion-sound ; but these are not of much diagnos-
tic value, as they appear only when there may be
large cavernous spaces in the walls of the chest.
Auscultation of the Thorax. 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. 35) (indirect ausculta-
tion). [A form of stethoscope called the ‘‘ Phonendo-
Stethoscope. scope,’’ a modification of the phonograph, has lately
been introduced and used in the larger animals with considerable
success, but the translator finds that on account of its size it is
Fig. 35.
PHYSICAL DIAGNOSIS OF THE LUNGS. Tit
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 the former we hear a vesicular respiratory bruit, which has a
lapping character; and the bronchial respiratory bruit, which is
a blowing 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 inspiration the sound is a smooth, regular murmur, the air
going directly into the alveola without any resistance. This sound
can be increased very much even during health by active move-
ments 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 irrita-
tion, 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 cedema.
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 dyspneea 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 bronchia are plugged up with secre-
tions. We occasionally find an irregular vesicular murmur in
healthy dogs, but it is also heard in cases of bronchitis; this mur-
mur is only heard 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 strengthened, varied in tone, and pro-
longed.
The bronchial respiratory bruit (bronchial breathing, wheezing
112 DISEASES OF THE RESPIRATORY ORGANS.
sound) may be heard in the normal respiration of the pharynx,
windpipe, 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 bronchia and extended to the
larger-sized bronchia. This is the case in the various pulmonic
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.
Indistinet respiratory bruits are heard in lobular pneumonia,
where the diseased lobules 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
movement of the mucus or fluids that are in the air-passages,
being carried to and fro by the passage of air. They are dry
(snoring, wheezing) where a small quantity of sticky mucus
collects in the bronchial tubes, as is seen in some catarrhal affec-
tions, and in cases where the mucous membrane is considerably
swollen. The snoring sound is generally heard in the large bron-
chial 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 when the secretions are liquid; the thicker they
are the duller the bruits become. We hear moist, rattling sounds
when the secretions are collected in the large bronchia; this sound
is also heard when there are cavernous portions in the lungs. We
find much less when this is the case in the middle bronchia, and a
very low bronchial bruit when the small bronchia are involved.
By this means we can distinguish in what position the irritation lies
in the bronchia; this is rather important in diagnosing a case of
CATAARH OF THE NOSE. 113
bronchitis. When the fine bronchioles are involved it has a crack-
ing or crepitant sound and sibilant bruits; this is only heard
during inspiration. This sound may sometimes be heard in the
alveolar passage and in the alveoli themselves when they are filled
with mucus or closed up, and where the air can only reach them
by strong inspiration. ‘This is seen in the first and third stages
of croupal and catarrhal pneumonia, in cedema of the lungs, and
in capillary bronchitis; in the last the crepitation is mixed with
an irregular rattling sound. We have 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;
it is produced by collections of fibrinous accumulations on the
pleura. These sounds are not heard when the pleura is separated
by the presence of an exudate; the sound is plainest at the com-
mencement 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.
DISEASES OF. THE NASAL CAVITIES.
Catarrh of the Nose.
(Cold in the Head; Coryza; Rhinitis ; Nasal Catarrh.)
ErroLogy. Catarrh of the nose (catarrhal inflammation of
the nasal mucous membranes) occurs very frequently and origi-
nates from local causes (dust, smoke, pentastomum tznioides) or
by cold. Cold in the head is also a symptom of distemper, and
may appear secondarily in any inflammation of the other mucous
membranes of the head.
CiinicaL SyMPToms AND Course. These are sneezing, wiping
the nose with the paws, or rubbing it against some object. Later,
a nasal discharge, 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
8
114 DISEASES OF THE RESPIRATORY ORGANS.
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 dyspnoea, and the animal is 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 bulldog. True bleeding of the nose (epis-
taxis), or mucus streaked with blood, is very seldom seen. The
duration of a case of nasal catarrh is about a week; we may, how-
ever, 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 dirty crusts around
the nostrils and the upper lip. 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
teenioides (Linguatula tenoides) is the cause of the diseased condi-
Fig. 37.
Pentastoma tznioides. Pentastoma denticulum.
tion of the mucous membrane. This tenia-like parasite, which
belongs to the class of arachnides, has a flat, curved body which
is indented at its borders, and fitted with hook-shaped claws, which
can be extended forward, and between them it has a buccal orifice,
CATARRH OF THE NOSE. 115
which is surrounded by a horny ring; there are no organs of sight,
respiration, or circulation; the female is 26 to 130 mm. long and
3 to 4mm. wide; the male is about 20 mm. long and the same
width as the female; toward the posterior part of the body both
sexes are about 1 to 2 mm. wide. (See Fig. 36.)
These parasites are found in the sinuses of the forehead and the
upper nasal chambers; they may also find their way into the phar-
ynx, and are developed sexually. The eggs are yellowish-brown,
as many as 500,000 being found in one female; these eggs are
mixed with the nasal mucus and passed out where they become
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 off and reaches the liver in various
ways. It may be found in the spleen, kidneys, peritoneum, where
it becomes encysted; this is the sexless larva-form, pentastomum
denticulatum (Lunguatula denticulata) (Fig. 37). It resembles the
sexed parasite in general shape, except that it is much smaller,
from 4 to 5 mm. long, and in its anterior part about 1.5 mm.
wide. It lies ina 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 way to the bronchial
tubes; it is coughed up from the lungs by the host, and finds
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. Hering has seen the disease but once; Fried-
berger and Frohner have seen it in a few cases; but Colan has
seen sixty-four cases, and found from one to eleven parasites in
the nasal chambers of each case.
Pentastomum catarrh is different from ordinary nasal catarrh
from the fact that there is a more or less bloody nasal discharge
which is very purulent and putrid, and that there is a great depres-
sion noticed in the animal; it becomes emaciated and sneezes a
great deal oftener than in ordinary catarrh. An instance is
recorded where the parasite penetrated 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 menin-
gitis, with severe cerebral symptoms, great excitement, restlessness,
and a tendency to biting or snapping, and also paralysis of the
lower jaw and several symptoms very similar to rabies.
116 DISEASES OF THE RESPIRATORY ORGANS.
Friedberger and Frohner advise that in all cases where there
are symptoms of rabies that the frontal sinuses be examined, as
there is often a case where the pentastomum is present and it may
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 to accidentally find a pentastomum in
a dog that has died from true rabies. The author may also men-
tion that he has found cerebral symptoms in an animal that has
been suffering from purulent (non-parasitic) nasal catarrh.
THERAPEUTICS. Nasal catarrh will generally disappear with-
out any special treatment. To protect the neighboring tissue from
the excoriation 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 oxide of zine ointment. In all mucous,
purulent, or chronic catarrhs spray the nose with 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.; car-
bolic acid, 2 per cent.; boric acid, 3 per cent.; the inhalation can
be given in the form of warm solutions, allowing the animal to
inhale the steam from them by the method described in the treat-
ment of Chronic Catarrh of the Larynx, on page 119, or with an
atomizer; infusions of chamomile, carbolated water, tar water, and
oil of turpentine have been used with good results.
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 impossible to place a tampon in the dog’s nose that
will be efficient on account of the anatomical peculiarities.
When 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 parasite. For this operation we
would refer you to the text-books on surgery.
DISHASES OF THE LARYNX.
Acute Laryngeal Catarrh.
(Acute Laryngitis. )
Eriotoay. The most common cause of catarrh of the larynx
is cold; laryngitis rarely originates from direct irritation of agents
ACUTE LARYNGEAL CATAREH. 117
that affect the mucous membrane of the larynx, such as smoke,
dust, ete. It may result from constant barking, as when an ani-
mal is taken to a show and barks constantly, or lying near a fire
and getting very warm, and then going and lying at the door, when
the draft will come on the head and throat. Laryngitis appears
as a secondary symptom of acute inflammation of the nose, throat,
and large bronchials, and it is generally present in distemper.
PaTHOLOGICAL ANATOMY. The mucous membrane of the
larynx is reddened and inflamed, swollen, and covered with mucus
over its entire surface; in some cases the membrane is eroded or
ecchymosed.
CiinicAL Symptoms. The first symptom isa cough; this may
be very violent, 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.
By a slight pressure on the larynx we can make the animal
cough, and it seems to be painful to manipulation; running, excite-
ment, drinking cold water, or the administration of medicine all
produce pees Difficulty in respiration is seen in certain forms
‘of laryngitis where there are intense inflammation and great swell-
ing of the mucous membrane; it is also 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 this disease; the animal is depressed and eats slowly; this is
probably caused by a certain. amount of the irritation extending
to the muscles of deglutition and swelling of the mucous mem-
brane, 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.
The disease generally lasts only a few days, although we find
some cases that do not respond to treatment, and pee are apt to
remain irritable and become chronic.
THERAPEUTICS. The first thing to do is to remove the animal
from cold or draughts and friction with some mild liniment over
the larynx; also the application of a moist warm compress over
the larynx and the inhalation of medicated warm water, such as
chlorate of potassium, 0.50 ; water, 20.0; or Listerine diluted one-
half with water, from an atomizer, and internally the administra-
tion of some calmative or narcotic ; of the latter, morphine is the
118 DISEASES OF THE RESPIRATORY ORGANS.
best, as it lessens the cough and irritation. The following pre-
scription is very useful where the animal is a small pet dog—that
is, kept in the room ; it is very useful to prevent the cough, as it
is always worse at night:
R.—Morphie sulph. . ; ‘ : : : aio gO
Aq. amygdale amare . : : ‘ ; ey Al)
S.—Half a teaspoonful three times daily.
—Morphie sulph. . : : : ; : Rae ( Bs
Potassii cyanid. . : 5 . : : eae
Syr. pruni Virgin. : : : ‘ ; . 96.00
S.—One teaspoonful four times daily.
R.—Ext. hyoscyamus ; : , : ‘ ot, aD
Liq. ammon. acetatis . ; : : : “2020
S.—Twenty drops every half hour.
Chronic Catarrh of the Larynx.
(Chronic Laryngitis ; Convulsive Cough ; Chronic Irritable Cough.)
Errotogy. Chronic laryngitis generally results from an acute
attack of laryngitis or from some severe irritation of some of the
other organs of the air-passages ; it generally comes on gradually,
the cough getting more frequent; it may also follow ulceration of
the larynx or the formation of a tumor in that part.
PatTHoLogicaAL ANATOMY. The mucous membrane is thick-
ened, but not so red as in acute laryngitis; it is marked with
fissures and elevations from enlarged tissue; and here and there
may be noticed a dirty bluish-red coloration. The surface is gran-
ular on account of the swelling of the inflamed mucous glands ; in
rare cases we may see small papilliform elevations or small eroded
ulcerative places which mark a breaking down of some of the
mucous glands ; the secretion which covers the parts is thick, slimy,
and tenacious ; in some cases it is yellow, like pus.
CuintcAL Symproms. The symptoms are similar to acute
laryngitis, except that they are not so severe; the larynx is slightly
sensitive to pressure; still the irritation is there; the animals will
cough after manipulation, but not to such a marked degree ; they
do not try to get away from the pressure.as they do in the acute
form ; there is no disturbance of the general system. The cough
sounds dry, hoarse, and rough, seldom moist ; the cough, which is
CHRONIC CATARRH OF THE LARYNX. 119
frequent, is quite loud, and accompanied by a wheezy inspiratory
sound, the night being the time it is mostly heard, or when the
animal runs about and plays, and his master is going to take him
out for a run; in some cases the cough resembles the whooping-
cough of children (tussic convulsiva).
THERAPEvUTICS. As a ruie, the treatment of this disease is
unsatisfactory ; of course, this 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 per-
fectly quiet and protect it from cold. Among the agents used in
general treatment the following are best: Inhalations of hot medi-
cated solutions, carbolic acid, tar, oil of turpentine or powdered
salt, chlorate of potassium, alum, and tannic acid. Inhalations
with these agents by means of an atomizer should be made twice
daily for ten or fifteen minutes. When the larynx is very sensi-
tive powdered bromide of potassium should be blown up the nose.
It is readily understood that inhalations are rather hard to
administer 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 prac-
tical 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 apart-
ment, and the animal has to inhale it. This, however, can only be
practised ina hospital. But where the animal is at home the best
method of procedure is to place the animal 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 minutes; 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 regretted, as it is the only direct
way that that membrane can be treated with any certainty. The
intratracheal method of administration of medicinal agents which
has so largely been used by Dieckerhoff in the horse has been
tried by the author, but has not been of much value, and espe-
cially in animals that are fat or have short necks.
Frequently in chronic catarrh we use narcotics to stop the
severe cough produced by irritation of the membrane—morphine
120 DISEASES OF THE RESPIRATORY ORGANS.
and extract of hyoscyamus, and in rare cases bromide of sodium or
chloral hydrate. Expectorants are not of much use in the dog.
The laryngeal inflammation so frequently observed in man, namely,
Croupal and Diphtheritic Laryngitis, has not been observed in
the dog. Esser and Friedberger have each seen a case of partial
paralysis of the laryngeal muscles which was accompanied with
great difficulty in breathing and roaring sounds during inspira-
tion. On post-mortem there was great hypertrophy of the muscles
on the posterior side of the larynx, and the atrophied muscle was
produced by pressure on the left recurrent nerve. The author has
-also seen such a case of laborious respiration in a large-sized
German bulldog.
DISEASES OF THE AIR-PASSAGES AND BRONCHIAL
TUBES.
Catarrh of the Windpipe and Bronchia; Bronchitis.
(Trachealis and Bronchial Catarrhalis.)
Eriotocy. Catarrh of the air-passages and of the bronchia
occurs very frequently in young, weakly, debilitated dogs. It
sometimes originates primarily, but, as a rule, it occurs as a sec-
ondary disease. It is caused by cold, especially by breathing cold
air when warm; and in pet dogs we see it quite 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 get cool very rapidly, and re-
peat this a number of times. It is also caused by mechanical or
chemical irritations, such as smoke, dust, parasites, strong gases,
or, secondarily, from the extension of inflammations from neigh-
boring organs, as the larynx or lungs, or from defective blood-cir-
culation of the lungs produced by weakened heart-action. Catarrh
of the trachea and bronchia is very often seen as a complication of
distemper, as well as many serious internal diseases, especially in
affections of the brain. The latter cause is generally traced to the
fact that there is an accumulation of particles of food and secre-
tions which collect in the mouth and throat, decompose, and are
respired into the trachea and produce an irritation.
There is no doubt that infectious influences play a certain réle in
BRONCHITIS. 121
the cause of this disease, for there are often cases occur where it
cannot be due to cold or exposure, especially in the spring and fall
months, and it is sometimes seen where a number of puppies are
housed together, or in some cases attacking older dogs. In some
of these outbreaks it is quite difficult to distinguish it from dis-
temper. (See Infectious Bronchial Catarrh.)
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 membrane is diffused, red, swollen, and
tears easily to the touch. In the earlier 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 or yellow
with pus-corpuscles; later on it becomes more or less colored with
blood-corpuscles. é
Chronic Catarrh. In this condition the color of the mucous
membrane is brownish-red or violet and the membrane is fre-
quently uneven and thickened; the secretion is clammy, slimy, or
shining, in some cases bad-smelling or even putrid.
In old chronic cases of bronchitis there may be some stenosis
of the tubes, and also, from the constant irritation of the bronchia,
emphysema of the lungs.
Stenosis (contraction) of the bronchia may be caused either by
swelling of the bronchial mucous membrane or by the collection
of masses of thickened secretion in the tube. In some cases the
two causes acting together exclude the air from the alveoli of that
part of the lungs to which the affected bronchia carry the air,
causing the lung-tissue to collapse. This condition, which origi-
nates in the manner described, does not change in 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 atelectasic
centres and on the borders of the lungs; this condition is supposed
to be caused by violent coughing spells and also by bronchitis.
132 DISEASES OF THE RESPIRATORY ORGANS.”
The affected parts do not collapse, but appear clear and bloodless,
soft, and collapse quickly on incision.
CruricaL Symproms AND Coursr. ‘These vary according to
the amount and location of the irritation, whether it is in the
trachea, large, medium, or small bronchia, and whether it is acute
or chronic.
Acute Catarrh of the Large Bronchia. This commences
with slight and frequent chilly spells, accompanied by fatigue,
indifference, depression, and sometimes with a stiff and strained
gait and slight rise of temperature. Soon afterward the animal
commences to cough; this is one of the principal symptoms of the
disease. In the beginning it is dry and dull; later it becomes
moist and more frequent. It can easily be started by slight pres-
sure on the trachea, and also by tapping on the chest close behind
the shoulder.
Percussion gives negative results. On auscultation in mild
cases we hear an increased vesicular respiration in the trachea
and large bronchia, and when the medium-sized bronchia are
affected and there are large accumulations of mucus in the tubes
the vesicular murmur is increased. This is due to the fact that
while the bronchitis is in the dry stage the sounds are roaring
or snorting in character, and when the fluid mucus has accumu-
lated the sounds become rattling, as if the air was passing through
a thick mucus. When the small bronchia are affected these sounds
are much more decided, and in this condition there are high fever
and general disturbance of all the functions, and also a marked
difficulty in respiration. One prominent symptom in the dog is
the inflation 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
eatarrhal 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 a favorable termination is reached.
Chronic Bronchial Catarrh; Asthma. This disease is com-
mon at two periods of an animal’s life—when it is very young
and after it becomes old—and is a consequence of acute bronchial
BRONCHITIS. 123
catarrh. In old animals it very often takes the chronic form at
the onset.
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 any excitement, and is generally accom-
panied 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 with a certain amount
of rattling. In the majority of cases, where the disease is not far
advanced, the animals enjoy good health and rarely exhibit any
fever. In old cases the expired air may be bad-smelling or
fetid.
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
either moist or rattling sounds which vary in character; and a
heightened vesicular respiration or else an indistinct mucous
sound.
THERAPEUTICS OF TRACHEAL AND BRONCHIAL CATARRH.
Keep the animal in a moderately warm place where it is dry and
free from draughts, but well ventilated. 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, espe-
cially the small ones. We may administer medicinal vapors by
putting a teaspoonful of turpentine in a quart of boiling water
and hold it so that the animal will inhale the steam.
In the chronic cases we generally get good results from the
administration of expectorants, such as apomorphia, ipecacuanha,
and spiritus ammonia mindererus ; and where there is a violent
cough add narcotics, such as morphia, extract of hyoscyamus, or
dilute hydrocyanic acid and cyanide of potassium. When there is
fever present a few doses of antipyrine (0.5 to 1.0 gramme, twice
daily) will generally suffice.
Tartar emetic, chloride of ammonium, and sulphuretted anti-
mony are of little use; in fact, do more harm than good, as they
often destroy the appetite. In the early stages of the disease the
cough does not amount to much, but in the later stages it is
124 DISEASES OF THE RESPIRATORY ORGANS.
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.
R.—Apomorphia ide ; ‘ : : “Ovo
Morphie hydrochlor,. . ae fay ‘ ‘ | 0:06
Ac. hydrochlor. dil. . j ; : : sv. NOSE
Aqua destil. : ; : ‘ : : . 100.0
S.—One-half to one tablespoonful every three hours.
R.—Inf. seneger rad. . : : i : : ood
Liq. ammon. acetas. ; ; : : . 4.00
Syr. simplex : : : _ ; 3 2. 1b:0
S.—One tablespoonful every four hours.
k.—Syr. ipecacuanhee aa 20.0
Syr. althzeze : ald
S.—One small teaspoonful every three hours.
In chronic bronchial catarrh inhalations of medicated vapors are
very useful, and especially the vapors of turpentine, where there
are great accumulations of mucus and a fetid breath. Inhalations —
of the vapors of tar and carbolic acid are also useful. Internally
the author has found that a small pinch of bicarbonate of sodium
or Rochelle salt given daily in a teaspoonful of warm water is very
useful. In broncho-blennorrhcea the oil of turpentine has given
very good results. The action of tar is a little irregular and
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. Intratracheal
injections, which are used by Dieckerhoff in the horse, after Levi's
method, may be used in the dog (solutions of iodide of potassium
or nitrate of silver); but the author has found that form of medi-
cation very difficult.
k.—Terebene . : : : ; ; : : . -2.0
Spts. vini rect.
Aqua destil. - . F . : : . aa 500.0
Spts. menth. )
S.—Several dessertspoonfuls daily.
CATARRHAL INFLAMMATION OF THE LUNGS. 1
bo
Or
DISEASES OF THE LUNGS.
Catarrhal Inflammation of the Lungs; Pneumonia.
(Catarrhal Pnewmonia ; Lobular Pneumonia ; Broncho-pneumonia.)
Errotocy. Catarrhal inflammation of the lungs generally
originates as a secondary disease following bronchitis, by an exten-
sion of the inflammation of the small bronchia into the alveola,
or from the obstruction of the bronchial tubes. The causes of
lobular pneumonia are from 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 act as an
irritant. These, on inspiration, are carried into the deep portions
of the lungs directly on the alveoli, and from a capillary bronchitis
it may become converted into a catarrhal pneumonia. In some
cases particles of food, medicines, especially thick mixtures, get into
the larynx, 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 generally termed traumatic or aspiring pneumonia.
ParnotocicaL Anatomy. Ina lung affected with catarrhal
pneumonia we always find all the characters of bronchitis, and
as the disease advances the groups of alveoli that belong to the
affected bronchia are rapidly filled with the catarrhal deposit,
preventing the air from penetrating into them. Soon we see an
intense hyperemia of the walls of the alveoli and the exudation
of a thin, non-curdling fluid and numerous white blood-corpuscles
which soon become pus-corpuscles, and the commencement of a
fatty degeneration and detachment of the alveolar cells. The
alveoli and the small bronchia become entirely filled with pus-
corpuscles 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. They form
hard, tough, roundish or lobulated lumps which vary in size and
number, projecting slightly above the surface 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
126 DISEASES OF THE RESPIRATORY ORGANS.
detached centres which show plainly in the early part of the disease
soon become confluent, so that finally we have large sections of
the lung involved. In rare cases we find fibrinous (croupal) cen-
tres 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, is often seen. We may
also have subpleural and interstitial emphysema and sero-fibrinous
or pussy pleuritis about the broncho-pneumonic centres.
CriinicAL 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 expiration; the cough is
short, frequent, and apparently very painful; the pulse running
from 150 to 170. On making a physical examination by percus-
sion there are a number of dull centres through the lungs; in some
instances the whole of the lung gives dull sounds. According to
the stage of the disease, strong vesicular breathing, snoring, fine
or loud bruit, and where there is extended infiltration we hear
bronchial respiration.
The temperature often goes up to 40° or 41°; this high temper-
ature usually commences early in the disease, or it often makes a
rise when the disease has become converted into catarrhal pneu-
monia. If this complication does not occur, the temperature will
not make any marked change, but follow a regular course, which
is to rise quickly at the onset, and gradually fall as the disease
decreases and the animal goes on to convalescence.
CoursE AND Prognosis. The course of catarrhal inflamma-
tion of the lungs is rarely less than three weeks, and often pro-
longed over several months, with varying degrees of intensity.
Traumatic pneumonia is the only form of the disease that runs its
course quickly.
The terminations of the disease are: Recovery by resolution, in
which the inflammatory products which fill the smallest bronchia
and the alveoli are changed into a kind of emulsion and are either re-
absorbed or coughed up. Or in the secondary disease, for instance;
chronic interstitial inflammation of the lung, or in rare cases the
formation of purulent gangrenous centres. Third, death, which
CHRONIC INTERSTITIAL PNEUMONIA. 197
~
may occur at any stage of the disease, in the early stages as a con-
sequence of great extension of lobular pneumonia, or at any time
as a result of cedema of the lungs.
Chronic Interstitial Pneumonia.
(Chronic Induration of the Lungs; Cirrhosis of the 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 irregular on its surface, the tissue varying from
yellow to yellowish-red in color. 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. They finally become
emaciated, complicated with dropsical effusions, and finally die
from exhaustion.
In some cases of lobular inflammation of the lungs the inflamed
portions form abscesses, or we may find gangrenous portions. These
terminations depend on the nature of the irritant, and generally
occur after traumatic pneumonia (foreign bodies). When an
abscess is formed a pear-shaped body is found in the centre of the
infiltrated lobule, and surrounding it is a thin, delicate layer of
yellowish tissue, and over that a tough red layer of inflamed
pulmonary material; large abscesses may be formed by the fusion
of all the infiltrated pulmonary tissue.
When gangrene is formed the inflamed catarrhal centre becomes
dirty greenish-brown in color, or in severe cases almost black. In
the early stages the diseased portion is hard and fibrous, but it
soon becomes soft and pulpy and filled with a turbid, fetid, green-
ish 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 animals die rapidly
from exhaustion .
We recognize the gangrenous form when the breath becomes
128 DISEASES OF THE RESPIRATORY ORGANS.
putrid, for in the dog it is almost impossible to get any of the
discharge that is coughed up, the animal generally swallowing the
mucus. When the animal has a putrid breath we always find a
course of alarming symptoms accompanying it—septic fever, chills,
and a high temperature. If the sputa were examined, we would
probably find numerous micrococci, bacteria, and portions of
broken-down lung and elastic tissue.
Gidema of the Lungs. This is apt to follow 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 tubes.
When cedema of the lungs follows catarrhal pneumonia it gen-
erally begins with great difficulty in respiration, labored or ster-
torous 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 actual symp-
toms of cedema appear the exhausted condition of the heart is in-
dicated by the pulse being irregular—that is, weaker at inspiration
than at expiration.
THERAPEUTICS. In treating lobular pneumonia we use the
same general course as we do in bronchitis. |The author obtained
the best results with Priessnitz’s compress, and by 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 quantity of mustard-oil to the sides; but it must only
be applied in young, strong, healthy animals. The best method
of application is to make a liniment of 3 parts of oleum sinapis zethe-
reum in 45 parts of olive oil, and divide it into two parts, and
apply one-half to each side of the chest, then wind a dry bandage
CHRONIC INTERSTITIAL PNEUMONIA. 129
around the chest-walls, and ten to twelve hours later apply Priess-
nitz’s compress.
In cases where there is great accumulations of mucus it is
advisable to give the animal an emetic (apomorphia is the best).
Narcotics are to be given when the cough is constant and distressing.
Where there is much debility stimulants are indicated, such as
wine, ether, and give the animal small, often-repeated quantities
of chopped meat, broth, milk, and the peptone preparations.
Very little good is to be derived from inhalations in this disease.
When the breath is offensive we advise inhalations of turpentine
or a 1 to 50 solution of creolin. Inhalations of carbolic acid are
recommended, but on account of the danger of poisoning 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 cedema of the lung is recognized, it must be regarded as
a grave symptom and 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.
Catarrhal pneumonia is the only grave important disease of the
lungs in the dog; the others are of small importance.
Croupal inflammation of the lungs, as we understand it, is a
firm, hemorrhagic exudation in the alveoli of the lungs and small
bronchia. This is very rare in the dog. The author has never
seen a case of true lobar pneumonia, but has seen a few cases of
croupal lobular pneumonia, the course of which is very similar to
catarrhal pneumonia in all its symptoms, the difference only being
detected on post-mortem. Roll makes the statement that croupous
inflammation of the lungs is common in the dog, but he probably
meant croupal lobular pneumonia.
Anthrakosis pulmonum (blackening of the lungs) 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
9
130 DISEASES OF THE RESPIRATORY ORGANS.
chronic, and a progressive atrophy of the alveolar walls takes place
until they are entirely closed up, the neighboring alveoli become
absorbed or altered, and finally cavities are formed, and the blood-
vessels become atrophied. On section of the lung the edges of the
cavities are pale, soft, and the bloodvessels are stained with pig-
ment. Sometimes laceration of the alveolar walls allows air to
penetrate into the interlobular, interstitial, or subpleural connective
tissue; this is generally caused as a result of severe and continual
coughing spells, and where animals have died from some form of
suffocation. Siedamgrotzky describes a case where an old emphy-
sematous dog had a severe fit of coughing and the lung was lacer-
ated, causing pneumothorax.
DISHASES OF THE PLEURA.
Inflammation of the Pleura; Pleurisy.
(Pleuritis.)
Errotocy. The disease is divided into two forms—primary
and secondary pleuritis. The primary form may be caused by
cold, from traumatism, etc.; the secondary from the extension of
inflammations from the surrounding organs, as in pneumonia, gan-
grenous pericarditis, peritonitis extending 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
pyzmia and tuberculosis.
PatHoLocicAL ANATOMY. ‘The pleura is dull and swollen
and very much injected, rough on the surface, due to it being coy-
ered with fibrinous accumulations (small button-like elevations),
and in the advanced stages large masses of fibrinous substances.
When there is no accumulation of fluids it is called pleuritis
fibrinosa. But generally we find a more or less copious secretion
of fluid from the capillaries. This fluid (pleuritic exudation)
accumulates between the pleural folds in copious fibrinous masses;
it is usually serous or sero-fibrinous, appearing as a slightly yel-
lowish turbid fluid, with more or less fibrinous coagula swimming
in it. Chemically it is almost like blood-serum. This liquid
contains red blood-corpuscles and round cells; if the former is in
large numbers, the hemorrhagic exudation is found; but if the cells
INFLAMMATION OF THE PLEURA: PLEURISY. 131
are present in quantities, the purulent or suppurating form is seen.
True purulent exudation is always caused by the presence of a
specific purulent poison, and becomes fetid as soon as decayed or
gangrenous agents find their way into the pleural cavity, as in gan-
grene of the lungs, perforation of the throat by foreign bodies, in
deep wounds of the chest, and in perforation of the cesophagus in
the thoracic cavity.
The excretion 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. The opposite
lung is the seat of considerable collateral hyperemia, which may
lead to cedema, according to the severity of the condition. When
compression of a lung is continued for any length of time the
alveoli lose entirely their functional activity, their walls collapse
and become adherent if the fluid exudated 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 were
seen by the author 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 inflamma-
tory 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 have the heart
pushed toward the healthy side of the mediastinum or the dia-
phragm.
The conclusion of pleuritic inflammation depends on the inten-
sity and duration of the disease and the character of the exudate.
In favorable 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 granular tissue, containing numerous vessels, and
later into a stringy cicatricial tissue, called a pleuritic sward, and
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 pos-
sible for the lung to regain its normal extension, but it takes a long
time. Thin adhesions sometimes tear; extended adhesions offer a
constant hindrance to the unrestricted use of the affected part of
the lung. Purulent exudates are sometimes reabsorbed; but, as
132 DISEASES OF THE RESPIRATORY ORGANS.
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 bronchia, or it forms abscess somewhere in
the cavity of the chest, generally in the region of the sternum, by
undermining the pleura and muscles of the walls of the chest.
CuLiInicAL Symptoms. In the primary form of pleuritis, when
its origin is from cold, etc., it is ushered in with more or less fever
and increase of temperature, the pulse increases in frequency, and
at the onset the animal generally has a chill; the temperature
remains high, and the pulse small, weak, and thready. Primary
pleuritis with purulent or putrid effusions is rare, and when it does
occur it is always accompanied with a high intermittent fever.
The general health is very much disturbed. They are stiff and
sore in moving about; little or no appetite, but intense thirst.
The visible mucous membranes are reddened and congested, and
in cases where there is much exudation the membranes are dark
bluish-red. The feces are dry and hard. The urine presents
some symptoms that are diagnostic: 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 and white
(see chapter on Examination of the Urine).
There is also a marked dyspnea. In dry pleuritis tie respira-
tion is superficial and rapid, and where there is great exudation the
respirations are short and painful and the animal has all the symp-
toms of smothering. A characteristic symptom is the way the
animal endeavors to assist respiration by assuming a sitting posi-
_ tion, with the front legs spread out as far apart as possible, and
using the abdominal muscles, and shows pain on pressure of the
abdominal muscles of the affected side. The animal has a dull,
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 position of the animal. Above the excretion the
sound is tympanitic on account of the retraction of the lung. Aus-
cultation gives a friction bruit in the onset, and when the fluid
begins to be reabsorbed and the pressure of the exudate against the
DISEASES OF THE PLEURA: PLEURISY. 133
lungs is lessened the respiratory bruit is altered. In the earliest
stages of the disease the sounds are vesicular, but as the exudate
cullects the sounds become indistinct or blowing and finally only
bronchial, and when the bronchial tubes are affected sound is lost
entirely. In the healthier parts of the lungs we have increased
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, 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 exudate becomes quickly reabsorbed the diseased side is less in
circumference, or it can be better described as being flatter.
Death may occur during the critical period of the disease by
collateral hyperemia and cedema of the non-affected sections of the
lungs, by carbon-dioxide-poisoning from defective function of the
lungs, by total stagnation of the circulation of the blood from
pressure of the exudate on the large bloodvessels and the heart ;
later on by exhaustion and by secondary diseases. To this class
belong dropsy caused by stagnation of the blood circulation from
weakness of the heart, and amyloid degeneration of the kidneys,
liver, and 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. In secondary
pleuritis the prognosis depends on the original disease.
THERAPEUTICS. The treatment of secondary pleuritis is the
same as the primary; but in the former we must take into consid-
eration the treatment of the original disease. In the early stages of
the disease, when the exudate is collecting, we must apply counter-
irritants, such as liniments or plasters of mustard. When a
copious exudate has been formed we try to get its reabsorption by
stimulating the kidneys by means of acetate of potassium, acetate
of sodium, and juniper berries. When the heart is weak we use
digitalis and squills. Small doses of calomel are also useful.
R.—Hydrarg. chlor. mite . F ; : : 210.05
Digitalis pulv. ; ; : : ; : 7 VOL0D
Saccharum lactis. ; : L , } fare, 5
Fiat pulv. No. vi. S.—One powder three times daily.
134 DISEASES OF THE RESPIRATORY ORGANS.
Diuretics and cardiac stimulants have only an indirect influence
on the accumulations, and when the exudate is gradually absorbed
we can hardly credit these drugs with accomplishing the results, as
the exudate is usually re-absorbed when the acute inflammatory
stage of the diseases has passed. The best method of treatment is
the removal of the secretion by surgical means—that is, to punc-
ture the chest-wall. This operation is not at all dangerous in the
dog, and is generally successful unless the adhesions 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;
where there is cedema of the lung; in intense dyspncea caused
by the pressure of the exudate; and where there is deficient reab-
sorption, as is seen when the fever has entirely disappeared and
the fluid does not show any signs of becoming reabsorbed.
Puncture of the cavity of the chest: The trocar used in this operation is
an ordinary sized trocar, seen in Fig. 88, or, if we wish to make first an
exploring puncture, we use the needle of the
Fig. 38. ordinary hypodermaticsyringe. The needle, after
having been disinfected, is introduced into the
lower third of the wall of the chest, between the
fifth and ninth rib, the patient being in a stand-
ing position. 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 when
the flow of 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.
It is well to empty the cavity slowly and never
entirely, as the affected pleure come in contact
with each other and rub, often causing acute
hemorrhage. After withdrawing the trocar it is
well to paint the opening with some iodoform
collodion.
Trocars for puncture ot
the thorax.
When the fluid 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, lean meat; and when the fever is high, anti-
pyrine in doses of 0.5 to 2.0, according to the size of the dog.
PNEUMOTHORAX. 135
Dropsy of the Chest.
(Hydrothoraz.)
Any accumulation of serous fluid that is not dependent on an
inflammation 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.
ParnoLtocicAL ANAtTomy. MHydrothorax, as a rule, affects
both sides of the chest. Frdhner records a case where one side
only was affected. We find in the cavity of the chest a clear
yellow fluid, sometimes mixed with blood; the pleura is cedematous,
swollen, and in long-continued cases it has a flaccid or macerated
look. The lungs do not present any change, except the signs of
partial compression. The other organs of the body are aneemic.
CurxtcaL Symptoms. The physical examination of this dis-
ease presents symptoms very similar to pleuritic exudates, 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 sensi-
tiveness of the animal to pressure on the walls of the chest and
the rubbing or crepitating bruit of pleuritis are absent.
THERAPEUTICS. The treatment, as a rule, is of a palliative
character, as it is only in very rare instances we succeed in remov-
ing the original disease; we use the same agents as in ascites. The
operation of tapping the chest-wall (see Puncture of the Cavity of
the Chest, page 134) 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.
Pneumothorax.
Errorocy. 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, tearing of the
lung-tissue from great exertion, and from perforation of the
cesophagus.
136 DISEASES OF THE RESPIRATORY ORGANS.
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 with the
air. -
CLINICAL SymMproms AND CoursE. ‘There is great difficulty
in respiration, and the affected side of the chest-wall is visibly dis-
tended, 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, which
is caused by the entrance of air directly into the pleural cavity
with each inspiration.
Animals in this condition generally die rapidly, although we
may find rare cases where recovery takes place by an absorption
of the air or by the accumulation of a fluid, which in turn becomes
rapidly absorbed itself. The treatment consists in tapping the
chest-wall.
Hematothorax.
In consequence of the destruction of some large vessel or vessels
in the lungs or the pleural cavity, from the presence of growths,
we have 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 also in this condition
the mucous membranes become very pale. When the symptoms
are not pronounced the operation of puncture will determine the
condition positively. Normal hemorrhages are easily and quickly
absorbed, but often there is more or less pleuritis connected with
them. Where there is great dyspnoea puncture is always advis-
able.
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. 39. 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, but 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
The heart in position :.a, right ventricle; b, left ventricle; ¢, left auricle; d, right auricle
f, pulmonary artery ; g, aorta ; k, esophagus ; J, diaphragm.
vessels—the trachea and the cesophagus—and lies 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 rib. 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.
The size of the heart varies greatly in different animals, even
when in a normal condition, and it is, therefore, impossible to lay
(137)
138 DISEASES OF THE CIRCULATORY APPARATUS.
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 Rabe, it varies from 1 to 4 to 100,
and taking relatively all the breeds of dogs, and also sex and age,
the relative size is 0.6 and 2.2 to 100.
Tt 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,
and 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 increased that it is impossible
to detect when there are weak heart-sounds, as the largest portion
of the heart is covered by portions of the lungs, and these parts
making sounds the ears cannot detect the sound, as the restlessness
of the animal during examination and the movements of the cuta-
neous 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 as theo-
retical in character to a certain extent.
In making an examination of the heart we must consider the
position and size of that organ, its palpitation sounds, and char-
acter of the pulsations.
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
where the heart lies we find in normal conditions a dull sound,
which lessens in deep respiration, and also the “position, either
standing or recumbent, may make a decided difference.
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 dull sound, and
it is only by strong percussion that any 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,
in retraction or contraction of the lobules of the lung surrounding
the heart; but we may often be deceived by abnormal processes
CHARACTER OF THE HEART-SOUNDS AND BRUITS. 139
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 emphy-
sema, when air has entered the pericardium, after injuries, in one-
sided pleuritis, in pneumothorax, and the sound is anteriorly
situated in the chest when there is intense meteorization of the
stomach or intestines, and in ascites.
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 a little more ante-
riorly situated). 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 por-
tions 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-wall is greatly increased.
The pulsations of the heart are increased by disease in the fol-
lowing manner: After considerable loss of blood, in any case of
fever, in palpitation of the heart, in some forms of heart-disease,
in hypertrophy of the heart, by the influence of some poisons,
like digitalis or aconite. It is almost imperceptible in degen-
eration of the muscle of the heart, in the later stages of acute
diseases, in cases of poisoning, in fatty degeneration of the heart
and when the heart has become compressed by the effects of hydro-
thorax, pneumo-pericarditis, 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 loud-
est; it is better to cover the place with a handkerchief or cloth,
or we may use a stethoscope. We should hear two sounds in each
heart-beat—a systolic, which corresponds to the ventricular contrac-
tion, 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,
140 DISEASES OF THE CIRCULATORY APPARATUS.
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
valvular sound.
Unfortunately these sounds are indistinct and incomplete 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. With the respira-
tory 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 that the sounds
follow each other so rapidly that it is impossible to distinguish one
from another.
In pathological conditions the heart-sounds may be increased by
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 accumulations of exudates around the heart in
the pericardium, or in emphysema of the lung-sections, ete. 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 com-
plicated 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 occur
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 charac-
ter, 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 man in all
CHARACTER OF THE PULSE. 141
forms of anemia, and occasionally in fevers. The pericardial
bruits are very similar to pleuritic friction-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 is 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 they may easily be distinguished
from endocardial sounds. The pericardial friction-sound is dis-
tinguished from the pleural friction-sounds from the fact that it
is entirely independent 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 also be felt inside of the forearm. In the exam-
ination of the pulse we must take into consideration its frequency,
its cadence, and its quality.
The normal pulse varies greatly, according to the breed, age,
and size of the animal, and is rapidly increased from such causes
as physical efforts, fear, fright, pleasure, ete. The general pulse
is from 70 to 120—large animals being less, and very small
animals having a correspondingly frequent pulse-rate. The rhythm
(cadence) should be regular 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 irregu-
larity 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,
following hemorrhages, in affections of the muscle of the heart, in
starvation, diseases of the brain, meningitis and hydrocephalus,
in hepatogenous icterus, also in collapse and in diseases charac-
terized by a continued high temperature.
An increase of the pulse is found in all fevers, in cases of
valvular defects, in heart-weakness and paralysis or collapse of
that organ from continued high fever. When the temperature
increases the pulse rises. The pulse is irregular (arhythmic) in
142 DISEASES OF THE CIRCULATORY APPARATUS.
hol
some diseases of the heart (incompensated valvular defects, myo-
carditis), 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 gastrocism. The pulse is full and distended where great
physical exertion is used; small and collapsed after severe hem-
orrhage 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 blood 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.
DISHASES OF THE HEART.
Valvular Defects.
GENERAL NoTES ON VALVULAR DeEFeEctTs. By valvular
defects we understand 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 valvular 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 imperfectly; or, secondly, when the openings become con-
tracted, causing stenosis. Imperfect closure of one valve causes a
certain amount of blood to flow back into the portion of the heart
from whch it has just come; for instance, when we have imper-
fect action of the mitrals or of the tricuspids in systole, part of
the contents of the ventricles run back into the auricle, 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. 40) in systole is retarded. In any of these conditions there
VALVULAR DEFECTS. 143
is imperfect heart-action; every defect of an arterial opening in-
terferes with perfect ventricular action and every defect in a venous
opening causes a corresponding lessening of power in the auricle.
Fic. 40.
Diagram of the blood-circulation.
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 (com-
pensating heart hypertrophy). We often see cases where defects
of the aorta become equalized by a hypertrophy of the left ven-
tricle. 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, and 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 anemic and cachectic, feverish animals, the com-
pensating heart hypertrophy is not present or is only developed to
a slight degree, and also in cases of insufficient 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 blood-stagnation rapidly show themselves.
144 DISEASES OF THE CIRCULATORY APPARATUS.
ErroLoGy oF DEFICIENT VALVULAR ACTION OF THE HEART.
The most common causes of valvular defects are endocarditic pro-
cesses, which are developed 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 have an im-
perfect closing of the valvular opening through cicatricial retrac-
tions; also adherences to the lobula of the valves or in their
neighborhood. We may also see deposits of lime salts, and a
contraction of the opening belonging to the affected valve. In
rare cases there are heart-weakness and imperfect valvular action ;
it may be caused by a dilatation of the opening, and, becoming
abnormally distended, the valves cannot meet and make a com-
plete closure. Atheromatous processes may also produce this con-
dition.
GENERAL SYMPTOMS OF DEFICIENT VALVULAR ACTION OF
THE Heart. The symptoms which appear at a certain time in
all valvular troubles are: Increase of heart- and pulse-action (after
slight exertion it is abnormally increased); palpitation of the heart;
difficulty in respiration; cyanosis of the visible mucous membranes,
especially of the head; venous pulse; dropsical effusions, such as
ceedema of the legs, abdomen, or testicles; hydrothorax; ascites;
albuminuria, with lessening of the amount of urine; complica-
tions of the digestive organs of various kinds; and, finally, gen-
eral nutritive disturbances, anzemia, emaciation, etc.
SYMPTOMS OF VALVULAR DEFICIENCY IN ONE OPENING.
Deficiency 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 aur-
icle of the right heart, and in the later stages the right ventricle
also.
The clinical symptoms are: Increase of the pulse and disten-
tion of the artery, systolic bruit of the left wall of the chest, in-
crease of the second (pulmonic) sound, weak, frequent pulse,
shortness of breath, and later dropsy, ete.
Stenosis of the Left Venous Opening. This is generally accom-
panied by mitral insufficiency. It leads also to dilatation and
hypertrophy of the left auricle and the right ventricle, and the
left ventricle is generally small, narrow, and contains little blood.
The clinical symptoms are: Slight increase in the pulse, dias-
VALVULAR DEFECTS. 145
tolic bruit (this is absent in some cases) ; considerable increase of
the second (pulmonic) bruit; very small, irregular pulse; great
difficulty in respiration; 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 heart-beat;
increase of the heart-dulness on the left side; a full, bounding
pulse is very frequently noticed. This character of the pulse is
also noticed in small arteries that in normal conditiqns have no
distinct pulse. Shortness of breath, cedema, 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 anzemia, ete.
Imperfect action and disease of the tricuspid valves cause dis-
tention of the right auricle, and it also has 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, and the two make a
combination of symptoms that are rather hard to separate.
PROGNOSIS AND THERAPEUTICS OF VALVULAR DEFECTS OF
THE Hearr. A diseased valve must be considered incurable,
but it may exist for a long time without causing any decided dis-
turbance of the general circulation. It is impossible to predict
how long a ‘‘ compensating ’’ state will continue. Mitral defects
seem to last the longest. This conclusion is arrived at from the
fact that it is quite common to hold post-mortems on dogs that have
been apparently healthy during life and find serious heart-defects.
Compensating heart-defects do not require any treatment. We
try to aid the heart in its efforts by giving nutritive diet and re-
moving all exciting causes, such as great or prolonged exertion.
As soon as the heart begins to weaken and the difficulty in res-
piration increases, accompanied by cedema, palpitation, etc., we
must use heart-tonics—digitalis, strophanthus, caffeine, ete.
10
146 DISEASES OF THE CIRCULATORY APPARATUS.
k.—Tinct. strophanthus sem. F ; : i > La
S.—Ten to twenty drops morning and evening.
R.—Caffeine citrate : : : 3 3 0.05
Fiat M. No. x. S.—One powder morning and evening.
R.—Tinct. digitalis ‘ ; i : : ; < ARG
Aquse 64.0
S.—One teaspoonful twice daily.
If we succeed in re-establishing a compensating action, the
symptoms gradually disappear, and we need not use diuretics;
if, however, we do not get the desired result and there should
be any oedema, we must treat it symptomatically. (See Dropsy
of the Abdomen.)
The symptoms above described are sometimes found in dogs
that do not present any marked alterations in the valves or open-
ings either during life or on post-mortem. These are due either
to simple idiopathic hypertrophy and dilatation or to alteration of
the heart-muscle.
Idiopathic Hypertrophy and Dilatation of the Heart: On post-
mortem we find, as a rule, a hypertrophy of the left ventricle;
but occasionally it is in both ventricles. At the same time we do
not find any alteration of the lungs or kidneys which might pro-
duce secondary hypertrophy of the heart-muscle. The causes are
extreme and constant exertion, cold, abnormal excitability of the
heart (in closely bred animals), overfeeding, and too much rich
blood (as in pet animals).
A condition called Callous Indurative Degeneration of the Heart
is often mistaken for valvular defects. In this condition 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 con-
nective tissue. The left ventricle is the favorite seat of these
bodies.
The cause of these bodies has not been fully determined, but
they are due either to Myocarditis or to defective nutrition of the
heart-muscle as a consequence of contraction or closing of the cor-
onary artery.
The clinical symptoms presented are as follows: The heart
becomes weak, palpitation, increase in the number of pulse,
dropsical effusions.
PERICARDITIS. 147
Auscultation gives nothing but pure heart-sounds, and with the
above symptoms you may have a callous degeneration of heart or
a pure idiopathic hypertrophy; during life it is impossible to de-
termine which; as the treatment in both cases is the same, it is of
no practical value. This consists of protection against excitement
or great bodily exertion; give nutritive, easily digested food ; and,
if the heart is irregular, heart-tonies.
DISHASES OF THE PERICARDIUM.
Pericarditis.
(Inflammation of the Heart-envelope.)
Errotocy. Inflammation of the pericardium may originate in
a primary way by traumatisms or cold, or, secondarily, in connec-
tion with infectious or inflammatory diseases of the neighboring
organs, especially pleuritis or pleuro-pneumonia.
PaTHoLocicAL ANATOMY. It either occurs in the acute or
chronic form. The anatomical alterations that it produces on both
surfaces of the pericardium correspond to those on the pleura
caused by pleuritis. The most common form is sero-fibrinous
pericarditis, with copious liquid exudates in the pericardium and
masses of fibrinous lymph attached to the surface of the pericar-
dium; in very rare instances the folds are attached to each other.
When this condition has been present some time the pouch becomes
dilated and relaxed and the heart-muscle shows more or less atrophy.
CiinicaL Symptoms. Slight pericarditis rarely shows itself to
any marked degree; but in severe cases there is decided palpita-
tion, the pulse becoming weak and indistinct, with marked irregu-
larity 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 attacked or when they are separated this
sound disappears.
There may be an increase of temperature, caused by the com-
pression of the lungs, and the slightest exertions cause marked
increase in the respiration (Siedamgrotzky and others). As soon
as the disease becomes advanced the same symptoms that are seen
in any case of defective heart-action are noticed; the lessened
148 DISEASES OF THE CIRCULATORY APPARATUS.
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.
THERAPEUTICS. Keep the animal as quiet as possible; give
nutritive, easily digested food (meat-diet), and such agents that
will lessen the fever and tone up the heart. The Priessnitz com-
press and cold-water compresses might produce better effects, but
they excite the animal and produce more harm than the good they
do. Laxatives (sulphate of magnesium or sodium, calomel), As
heart-tonics give strophanthus, 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 (see Fig. 38), using 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 injure the heart itself.
The treatment of pericarditis is generally symptomatic.
Dropsy of the pericardium (hydro-pericardium) is a collection _
of serous fluid in the pericardium without any direct inflam-
mation of the 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 increased amount of fluid in the sac that it can be called
Hydro-pericarditis. Dropsy of the pericardium may appear as a
symptom of various diseases (defects of the valves, inflammation
of the heart-muscle, diseased conditions of the coronary arteries,
disease of the kidneys, and acute anemia) as well as in connec-
tion with inflammation of the pericardium, and is generally accom-
panied 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 cured, to puncture; diuretics (digitalis) are to be admin-
istered; but these, as a rule, produce only a temporary effect.
Hemorrhage into the pericardium (hemopericardium) is rarely
seen. It may be caused by gunshot-wounds, by a bursting aneu-
rism, or by laceration of one of the coronary arteries. Death gen-
erally occurs in a short time by compression of the heart. Where
FILARIA IN THE BLOOD. 149
fatal results do not occur for a short time—that is, where the blood
oozes out slowly and fills the sac gradually—it is impossible to
make a certain diagnosis. This is also the case when air or blood
(pneumocarditis) penetrates into the cavity from the lungs in cases
of some traumatism of those organs.
Filaria in the Blood.
Three kinds of parasites have been found in the blood, namely,
filaria immitis, spiroptera ‘sanguinolenta, and strongylus vasorum.
Filaricee Immitis (males 130 mm. and females 250 mm. long;
both 1.5 mm. thick). They generally lie in the right side of the
heart ; very rarely in the left. Its embryos, which are 0.25 mm.
long and 0.05 thick, inhabit the blood directly in the circulation
(Delafond, Nocard, Gruby, Ruether, Johne, Rieck, Deffe, and
others). This parasite is generally found in Indian, Chinese,
and American dogs, especially in the Southern States. Wheeler
rarely made a post-mortem that he did not find it, often with-
out presenting any observable symptoms during life. It is
rarely found in Europe. The characteristic symptoms are
emaciation, epileptiform convulsions, unconsciousness, dyspncea,
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-fields or swampy
places, and the parasite finds its way into the system by the
dog drinking the water. Some authors contend that the larve
get into the blood like the larve of the filaria sanguinis, by being
first absorbed by the mosquito and then developed and passed
again to the dog. The only case observed by the author was a
dog which had been imported from India and brought to the hos-
pital to be treated for a large wound. The subject was emaciated
and anemic, but seemed to be very healthy otherwise ; he had a
good appetite, so that we did not consider it necessary to make an
examination of the circulatory apparatus. One morning the
patient died in his box. On post-mortem there were all the
symptoms of imperfect circulation of all the veins of the poste-
rior extremities, distention of the base of the heart, and disten-
tion of the right ventricle, the wall being thickened about 1 or
2 cm.; the chamber was filled with dark red blood-clots, and in
150 DISEASES OF THE CIRCULATORY APPARATUS.
this clot was found five fully developed filaria—three females and
two males. The number of embryo filarize found in the blood was
enormous; Reicke estimated them to be about one million. The
affected heart is shown in Fig. 41.
Heart, with filaria immitis in the ventricle (photograph).
The clinical symptoms of this disease were very plainly seen in
a case described by Deffe. This was a five-year-old Japanese dog.
On post-mortem the right heart showed several dark red blood-
clots and thrombus and nearly fifty examples of the filaria immitis,
ranging from 12 to 30 cm. in length and gathered in balls. He
found also enormous quantities of the embryos in the blood ; as
many as fifty could be counted under one microscopic glass-slide.
The following changes were found in the right heart: Hyper-
trophy, thrombus, endocarditis, and thrombus in the arteries of
the lungs; chronic interstitial nephritis in the kidneys, and a
number of embryos in Bowman’s capsule and the canals hollowed
and distended in different portions.
The most important clinical symptoms were great emaciation,
notwithstanding plenty of good food and a good appetite (the
appetite afterward disappeared) ; cough, weakness of the heart’s
action (small, irregular pulse, varying in force); polyuria (the
urine was light and contained epithelium of the kidneys and blad-
der) ; hyaline and granular cylinders; albumin; triple phosphate
crystals; pain in the posterior portion of the body, especially
in the region of the kidneys, and slight paralysis.
FILARIA IN THE BLOOD. La
Spiroptera Sanguinolenta (Filaria Sanguinolenta) (male 30 to
40 mm., female 60 to 70 mm., and about 0.5 mm. in width).
These have been found by Megnin, Raillet, and others in aneurism
of the aortaand (very rarely) in the blood. This parasite is occa-
sionally found in the walls of the stomach and the mucous mem-
brane of the cesophagus, and in the bronchial lymphatic glands.
Eggs and embryo are found in great numbers in the blood. The.
intermediate host of the spiroptera, according to Grassi, is the
kitchen moth (blatta orientialis). When the spiroptera locates
itself in the walls of the cesophagus it causes more or less dis-
turbance of the system and rapid emaciation (Driessen, Little-
wood, and others).
Strongylus Vasorum (Hematozoon Subulatum) (male about
1.5 mm., female 1.5 to 2 mm., and 0.080 thick). According to
Laulanié, they are located in the right ventricle and the pulmo-
nary artery. The eggs reach the capillaries of the lungs through
the circulation, and from these the liberated embryos enter the
alveoli and bronchioles and form transparent nodules which look
like tuberculous masses. Leisering found sexually ripe parasites
in these nodules in the alveoli and also in the prostate and spongy
portion of the penis. Both observers found numerous embryos
in the blood.
DISEASES OF THE URINARY AND
SEXUAL APPARATUS.
EXAMINATION OF THE URINARY APPARATUS.
THIs comprises the examination of the prepuce, urethra, prostate,
bladder, and especially the urine.
Examination of the Prepuce and Urethra.
If a glossy or purulent discharge comes from the prepuce, it in-
dicates a catarrhal condition of the part (catarrh of the foreskin
; or gonorrheea of the prepuce). If the discharge
Ee is purulent, bloody, and has a fetid odor, we
| will find wounds or ulceration on the prepuce
or the glans. Catarrhal affections (urethral,
gonorrheeal) 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 shows great pain
on catheterization. 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.
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 length). The
subject is laid on the left side or back and held in
J that position by an assistant. The prepuce is shoved
Catheters:a,male back behind the swelling of the glans and held firmly
semen >, female with the left hand (see Fig. 48). Now grasp the cath-
eter with the right, and, of course, first see 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
(152)
EXAMINATION OF THE PREPUCE AND URETHBRA. 153
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 passes upward to the arch of the perineum; here the
Fig. 43.
Passing the catheter.
wire-stylet must be withdrawn from the catheter at least one-third, so as
to allow the catheter to make the curve; a gradual pressure soon brings it
into the bladder, when the wire can be removed entirely.
Fie. 44.
ee aes
Median section through the pelvic cavity; a, rectum ; b, vagina; b’, vulva; d, bladder;
é, urethra ; /, pubic symphysis.
In the bitch we generally use a metallic catheter, either silver or Ger-
man silver (Fig. 42, B). The instrument is passed up on the floor of the
vagina until it comes in contact with the urethral opening (see Fig. 44);
this is closed with a slight sphincter (the so-called urethral valve) ; this is
154. DISEASES OF THE URINARY AND SEXUAL APPARATUS.
soon overcome and the catheter passes into the bladder without difficulty,
except in cases where the urethral opening is extremely small.
It is only in exceptionally large animals that we have an oppor-
tunity to make an examination of the urethra. In the bitch cer-
tain discharges from the vagina are of diagnostic value. During
the period of ‘‘heat’’ (menstruation) we have a copious, bloody
discharge, and during the preparatory stages of labor we see a
thick, clammy discharge, and the lochia commences with a non-
fetid, serous, slimy discharge, which soon changes to a thick, yel-
lowish 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.
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. It is a round, ball-like body
Section through the peivis 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 urethra; c, pelvis.
cut into two portions, lying on the neck of the bladder where the
urethra commences. It lies about the anterior portion of the pubic
=
EXAMINATION OF THE URINE. 155
bone, and being free to a certain extent it can be pushed into the
abdominal cavity by the finger. When we have hypertrophy of
that organ we distinguish it by a hard enlargement extending in
all directions in the pelvic cavity.
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 en-
tirely in the abdominal cavity. When the bladder is very much
distended it extends as far as the umbilicus and fills up the lower
portion of the abdomen ; it can be distinguished by manipulation.
It is a round, distended, tumor-like body, with a dull sound on per-
cussion. On examination per rectum we not only feel the neck of
the bladder and the prostate, but the bladder itself can be easily
distinguished. Tumor or stones in the bladder can be felt by
pressing down toward the wall of the abdomen, and the animal
evinces more or less pain when the bladder is distended and any
pressure put on it.
It is very hard to make any examination of the kidneys that is
of any practical value, as will be seen from the plates on Figs.
32 and 33, as they lie high up toward the spine and are well pro-
tected and covered by the intestines and also by large collections
of fat. In some animals with loose, flabby abdominal walls, or
when a large collection of fluid has been removed from the abdom-
inal cavity, we can examine the kidneys. We can, however, dis-
tinguish any specially large body, such as tumors of the kidneys
or perinephritic abscesses, by manipulation.
Examination of the Urine.
The urine has to be examined as to its amount, color, transpar-
ency, reaction, weight, odor, and the presence of certain foreign
or chemical substances.
The properties of normal urine are described in all works on
physiology, and concerning pathological urine the author would
refer you to such works as the Treatise on Microscopy and Chem-
ical Diagnosis of Diseases of Domestic Animals, by Siedamgrotzky
and Hofmeister; the Comparative Physiology of Domestic Animals,
by Ellenberger; and also a Text-book of Clinical Methods of Exami-
nation, by Friedberger and Fréhner. The author will confine
156 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
himself to a slight summary of the distinguishing characters of
urine, both normal and pathological.
Amount of Urine. The amount of urine passed in one day
depends largely, of course, on the size of the animal, the quantity
of fluids it drinks, and the temperature of the atmosphere. The
average amount of urine passed by a dog is from 0.5 to 1.5 kilo-
grammes daily. 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 diarrhcea, great salivation, during the for-
mation of pleuritic or peritoneal exudates, or in dropsy, in fevers,
in decrease of the pressure of the heart, as in valvular defects,
myocarditis, ete. An entire stoppage of the urine may occur in
inflammation of the kidneys, in obstruction of the urethra, paral-
ysis 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.
An increase of the amount of urine (polyuria) may be due to the
presence of a large amount of water in the blood (anemia, hydree-
mia), in atrophy of the kidney, where there is great reabsorption
of exudates; in diabetes mellitus (a condition that corresponds to
diabetes insipidus in man). This, however is extremely rare in
dogs. We may see it after the administration of the different diu-
retics. It is frequently seen in convalescence from acute diseases.
Constant dribbling of urine indicates paralysis or weakness of
the bladder.
The Color of the Urine. This varies in the healthy dog from
pale yellow when it is thin, to dark yellow when it is concen-
trated. 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 and bread it is dark yellow, and when the ani-
mal is starved it is deep yellow. Disease has also a great effect
on the color. It is a deep yellow color in fevers, and pale or
colorless in diabetes, general anzemia, and atrophy of the kidneys;
a green or light brown in diseases of the liver and catarrh of
the duodenum; a greenish-black color after the absorption of tar
preparations or carbolic acid ; a red color from santonin, rhubarb,
and senna (in these cases there is always an alkaline reaction). The
appearance of blood in the urine indicates graye conditions. In
hematuria we may see the color vary from bluish-red to almost
EXAMINATION OF THE URINE. 157
black, the color corresponding to the number of blood-corpuscles
present, and in hemoglobinuria the coloring-matter is granular
or dissolved blood-coloring matter, actual blood-corpuscles rarely
being present. Both the above conditions may exist simultane-
ously in some cases. (The test for coloring from blood is to be
be found under hemoglobinuria).
Transparency and Reaction of the Urine. When the urine
has been recently passed 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 isalkaline. In patholog-
ical conditions when the urine is recently passed it is turbid and
filled by mucus and epithelium, pus-cells, triple phosphates. An
alkaline reaction generally indicates catarrh of the bladder, or we
may see it in hematuria, in reabsorption of large exudates, and
in hemorrhage into the abdomen or thorax.
Odor of the Urine. There is a slight penetrating odor in
normal urine. In cases of catarrh of the bladder the urine has a
strong ammoniacal odor, and when there is any
amount of turpentine absorbed the urine has a
faint smell of violets.
The Specific Gravity of the Urine. This da
varies in the dog between 1016 and 1060. It i
can be tested either by means of Vogel’s uri- \__# /
nometer or if we have only a small quantity we 2 S2
ean test it readily by the areapikometer. This ==
instrument the author has found to be very use-
ful. It is shown in Fig. 46. 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 arule, it will be found that dark urine has
a high specific gravity and light-colored urine = Areapikometer.
has a low specific gravity. But there are ex-
ceptions 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.
158 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
Foreign Substances in the Urine. The following substances
appear in the urine under pathological circumstances :
Mucus. This is found in the urine under all conditions, both in
health and disease, and when any of the urinary passages are
inflamed it appears in larger quantities, especially in catarrh of
the bladder.
Blood-corpuscles. If the blood is mixed in the urine evenly
and the corpuscles are reduced in size and cylinders are present, it
indicates hemorrhage from the kidneys. This condition is always
present in acute nephritis, in the early stages of the disease. If
the urine is bloody at irregular intervals, it indicates hemorrhage
from the pelvis of the kidney, generally as a result of calculi.
When the blood is not mixed with the urine, but comes down in
a mass, the diseased condition must be in the bladder. This indi-
cation 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, it indicates hemorrhage from the
prostate or urethra.
Pus or White Blood-corpuscles. When there is a considerable
quantity of pus passed it indicates the opening of an abscess in
the prostate. When a smaller quantity is present it indicates
the presence of some inflammation on the mucous membranes of
the urethra, and it is also seen in some inflammations of the
kidneys. We can obtain definite information as to this condition
by making a microscopical examination of the epithelium, and see
whether any cylinders are present or not.
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 the
epithelium of the kidneys. It is also present in the various dis-
eases of the kidneys. Do not make a mistake when you have
passed a well-lubricated catheter and see oil floating on the urine
to think it is a pathological condition.
Epithelium. In health there are always a few epithelial cells
passed, but when they are present in large quantities it indicates
some active inflammation going on in some part of the urinary
tract, and a microscopical examination of the cells to ascertain
EXAMINATION OF THE URINE. 159
their size and shape will indicate the section of the track that they
come from. Large quantities of squamous epithelium indicate an
‘rritable condition of the bladder. (Fig. 47.) Where we find
Fia. 47.
Epithelium found in the urine: a, from the bladder ; b, from the ureters ;
c, from the pelvis of the kidney.
hyaline cylinders, granular cylinders, epithelial cylinders, or casts
of blood, 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 nephritis. Hyaline
or epithelial cells when mixed with pus-cells indicate nephritis.
Hyaline and granular cells are present in all diseases of the kid-
neys and always in albuminuria. (Fig. 48.)
Uric cylinders : a, hyaline cylinders ; b, epithelial cylinders ; d, granular
cylinders ; ¢, pblood-cylinders.
Orystals and Bacteria. When we find collections of precipitates
in the urine and indications of alkaline fermentation, the urine
being alkaline in reaction, and containing erystals of triple phos-
phate and in rare instances crystals of uric acid, it indicates a
severe irritation of the bladder. Elongated strings of bullet-like
bacteria and numerous pus-cells indicate a purulent condition of
160 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
the prostate (see Fig. 49). There are a number of abnormal sub-
stances found in the urine. The principal ones are albumin,
sugar, and the coloring substances of the bile.
Urine of cystitis in the dog, containing cystic epithelium, blood-corpuscles,
triple phosphate crystals, and bacteria.
Albumin. The presence of albumin in the urine is always an
indication of disease. The best method to indicate its presence is
by Koch’s test. The urine is boiled in a test-tube, having been
previously rendered acid in reaction by a small quantity of acetic
acid. It may become opaque from two causes: from the presence
of albumin or from phosphates. We pour a small quantity of
nitromuriatic acid down the side of the tube, and if there is any
albumin present there will be a pronounced opaque line where the
acid meets the urine.
Albumin occurs in the urine from two causes: first, in false or
accidental albuminuria, and true or renal albuminuria.
The first occurs when there is free albumin in the urine from
accidental causes, 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.
True albuminuria is of much greater importance, as this condi-
tion is always a symptom of pathological alterations in the epithe-
lium covering the walls of the gland. Healthy epithelium will
always retain the albumin in the blood.
We see true albuminuria in all forms of acute and chronic
inflammation of the kidneys, in fatty degeneration of the kidneys,
in amyloid kidneys, and in any altered condition of the circula-
tion, such as stagnating hyperemias as a consequence of heart-
disease, chronic inflammatory conditions of the lungs, pleuritis,
EXAMINATION OF THE URINE. 161
hydrothorax. The horizontal position of the dog does not, how-
ever, cause such a great disturbance in the posterior extremities
when the smaller bloodvessels are congested as it does in man
(Dieckerhoff).
Albumin will sometimes be found in the blood from anzmia,
leukemia, in acute poisoning, and from high fevers, but in the
latter condition we generally find that there is more or less nephritis
or a slight parenchymatous degeneration of the kidneys present.
Sugar. The grape-sugar test is generally made when an animal
has loss of appetite and polyuria and becomes generally emaciated.
The test is Trommer’s.
Trommer’s test for sugar: Put a few cc. 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 quan-
tity of sodium hydrate, then add drop by drop a 4 per cent. solution
of cupri sulphas until the liquid 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 surface of the fluid.
In diabetes mellitus a large quantity of sugar is found. This
disease, however, is extremely rare in the dog. It is also found
when the animal has been fed on a pure sugar diet. Sinety
observed it in bitches that were nursing, especially when the pups
were prevented from nursing for some time. The author cannot
say whether it is found in the dog as in man, in certain cases of
poisoning, and from some neurotic causes.
Coloring Substances of the Bile. The coloring substances of the
bile are found quite frequently in the urine of the dog.
The presence of the coloring substances in the bile indicates an
obstruction in the excretion of bile. It may often be seen in
eatarrh of the intestines and in the gastric form of distemper.
Icterus is the most common cause of this condition. (For further
information, see Icterus.) Fréhner 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 diag-
nostic value in the dog.
11
162 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
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
practitioner has to be satisfied if he can recognize with certainty
that the animal has some affection of the kidneys, and whether
it is acute or chronic. In the dog it is only in chronic nephritis
that we have a general atrophy of the kidney.
The diseases of the kidneys in the dog do not possess that impor-
tance that they do in man.
Acute Inflammation of the Kidneys.
(Acute Nephritis ; Nephritis Acuta.)
ErroLtocy. The most common causes of this condition are infec-
tious diseases and poisons. By this is meant the effect produced
by the absorption of infectious noxious agents, such as the various
septic diseases, or certain irritants that have originated in the body
and are passed by the kidneys 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 that are absorbed or taken
into the stomach pass through the kidneys and cause great irrita-
tion, such as phosphorus, arsenic, mercury, copper, cantharides,
turpentine, carbolic and tar acids, naphthol, pyrogallic acid, and
chrysarobin. Some of these preparations are absorbed by the skin
from various ointments that are applied in mange, such as carbolic
acid, mercury, cantharides, ete.
Acute nephritis may also originate from an extension of inflam-
mation 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 originate from cold, but this disease has not been
observed in the dog.
PaTHoLoGicAL ANATOMY. The alterations in the structure of
the kidney depend on the intensity of the irritation, and the alter-
ACUTE INFLAMMATION OF THE KIDNEYS. 163
ations are more or less distinctly marked. In slight cases the
epithelium seems to be the only part affected, the connective tissue
and the bloodvessels show no other pathological alteration than a
reddish-gray coloration of the covering (parenchymatous degenera-
tion). When the irritation is great there is true parenchymatous
inflammation of the kidneys. The epithelium and the interme-
diate tissue become affected, and also the bloodvessels and all the
exudation processes follow which accompany acute inflammation.
The anatomical alterations that are found are as follows: The
epithelium has undergone the same alteration as in parenchymatous
degeneration, but more acute in its type. The capsules of the
glomeruli and the small urinary canals are altered, and the con-
nective tissue is filled with a liquid infiltration, forming numerous
coagulated masses containing large numbers of leucocytes. The
vessels are enlarged (hyperemic) and partially compressed by the
surrounding exudates. In the interstitial tissue and in Miiller’s
capsule we find small circumscribed hemorrhages.
There are a number of circular-shaped inflammatory centres sur-
rounded by liquid exudates. The inflamed kidney may present a
variety of different appearances. It may be enlarged or normal
in size, soft or hard, reddened or very pale, yellowish-white, and
on the surface of the kidney there may be found a number of
hemorrhagic spots that are slightly elevated from the surface 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. Concern-
ing more accurate details the author would refer you to the various
text-books on pathological anatomy.
CLINICAL Symptoms AND Course. Slight inflammatory con-
ditions 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 leucocytes.
In acute inflammatory conditions the animal has a peculiar stiff
gait in walking, and in some cases staggering, with the hindlegs
carried straight. Tenderness on pressure in the regions of the
loins; a quick, full pulse; great lessening in the amount of urine
secreted, and what is passed is dark in color and contains small
164 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
portions of coagulated blood; the feces are dry and hard. In
toxic nephritis in dogs the author has had special opportunities to
make observations. The amount of urine passed in such condi-
tions is small and contains a large amount of albumin. The urine
is turbid, containing numerous tube-cylinders, epithelium, discol-
ored blood-corpuscles, and also red blood-corpuscles, which give
the urine a variable color, according to the number of corpuscles
present. There is generally more or less pain in urination, which
is probably due to the acrid condition of the urine. There are also
more or less symptoms of uremia present; great weakness, fatigue;
temperature is generally subnormal; the pulse weak and thready;
» vomiting, convulsions, coma, and death. When the symptoms
were milder the animal recovered, or this condition was 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. uva
ursi, 1.0, or fuschin. Iron preparations may all be used to try
to eliminate the irritating substances from the kidneys.
l
T
|
i
al
I)
!
1) Tn Ei
q
qe |
The dietetic treatment is the most successful, and consists prin-
cipally of rest and food that is non-irritating to the kidneys. Milk
and broth are especially useful. Meat may be given, but only lean
meat, and in spare quantities, avoiding anything that is spiced.
Small quantities of salt, however, are beneficial. The symptomatic
=n
Fes
i
ees
——
_——
——————
Bath-tub.
CHRONIC INFLAMMATION OF THE KIDNEYS. 165
treatment is to try to lessen the strain thrown on the kidneys by
trying to carry the fluids out of the body by some other channel
than the kidneys. (Fig. 50.) This can be accomplished to a
certain extent by giving the animal hot baths or by warm bandages
around the body, and by active purgatives, like senna or cascara
segrada, also jalap and calomel.
R.—Res. jalape . : : ‘ - . rip! a
Hydrarg. chlor. mae : . A : : . 0.05
Sacchar. alba : : : - : : £2056
M. F. puly. No. vi. §.—One three times daily.
We can also try pilocarpine, which produces great salivary secre-
tion in the dog. Diuretics must not be used in nephritis, as they
increase the secretion of salts, especially the alkalies. Heart-weak-
ness must be counteracted by means of heart-tonics. General
debility should be treated by general stimulants, such as brandy,
whiskey, or sherry, in very small animals. Use clysters of chloral
hydrate to counteract convulsions.
Chronic Inflammation of the Kidneys.
(Chronic Nephritis ; Nephritis Chronica.)
Errotocy. Chronic nephritis originates, as a rule, from acute
nephritis, or starts in a mild form and gradually becomes chronic.
PatrHotocicAL ANAToMy. There are two forms of chronic
inflammation of the kidneys: first the large white kidney (Chronic
Parenchymatous Nephritis), and the atrophic or hard kidney
(Chronic Interstitial Nephritis). The first condition is generally the
forerunner of the second, but, as the hard kidney is most frequently
found in post-mortems, it is possible that it may develop as a pri-
mary condition. The white kidney is enlarged 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 alternated red
and yellow, or covered with hemorrhagic spots. The atrophic kid-
ney (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. It has small, watery-like
irregularities and stodulations, The capsule is thickened, and it
is hard to strip from the body of the kidney. The cortical sub-
166 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
stance is lessened in diameter and striped with layers of dark
colored tissue. The pyramids are smaller and deep red in color.
CLINICAL SyMpToMS AND CoursE. As a rule, there is very
little that can be recognized in the dog during life, and the author
has held posts on animals that have had chronic nephritis of both
kidneys that did not present the slightest symptoms of the disease
during life ; and even the urine may not contain any albumin, the
only symptom being the amount of urine secreted. This is greatly
increased in amount, the specific gravity being much lessened.
In such cases there is generally hypertrophy of the left ventricle,
which can be recognized by palpitation of the heart (loud pulsa-
tions and a hard, full pulse). It is presumed that this high arte-
rial pressure tends to keep up the action on the impaired kidney
and prevent any serious disturbance in the secretion 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 symp-
toms of uremia. In the majority of cases the parenchymatous
form can be recognized by the urine. This is very similar to
acute nephritis. It contains much albumin, and the urine is scant
in quantity, and there are certain dropsical symptoms in the depend-
ent region. There are also loss of appetite, great fatigue on taking
any exercise, hypertrophy of the heart, which finally becomes
weak, and then symptoms of uremia follow as stated above.
THERAPEUTICS. The treatment of chronic nephritis is the same
as in acute, but the dropsical conditions can be treated by digitalis
and strophanthus, and when there is great anemia give iron salts.
Amyloid Kidney.
Amyloid kidney generally occurs in connection with amyloid
degeneration of some other organs of the body. The kidney is
contracted, and in the parenchymatous form the condition can gen-
erally be recognized by the character of the urine. This generally
presents the same symptoms as acute nephritis. The urine is
loaded with albumin and much lessened in quantity.
The amyloid condition is not only seen in the kidneys, but also
ABSCESS OF THE KIDNEYS. 167
in the liver, pancreas, and intestines. Rabe only saw one case
where the kidney was the only organ affected. He observed, as a
rule, the liver was also affected.
PatHo.LocicaL ANATOMY. A kidney thoroughly affected with
amyloid disease is slightly enlarged, hard, smooth, and shows at
the intersections a deep yellowish-white coloration, easily distin-
guished on section. The glomeruli are dull, glairy in color.
On staining with Lugol’s solution the affected parts are colored
a mahogany brown, and with methyl are colored purple.
CuinicAL Symproms. Rabe made the following observations :
Where the kidney was the only portion affected the animal was
emaciated, the temperature 35.9°, the pulse 72. The extrem-
ities were dropsical, complete loss of appetite, coma, and death.
Where the liver was affected the animal was unsteady and weak,
paleness of the mucous membrane, temperature 38°, ascites,
appetite good. Where the kidney and liver were affected there
was great weakness, indifference, unsteady gait, temperature 39.6,
pulse 96, respirations 50, appetite good, and the urine was acid
and free from albumin.
With the above symptoms, which are rather meagre and liable
to be very difficult to distinguish from other diseases, it still might
be a guide in making a diagnosis. (In man in this disease there
is always more or less albuminuria. )
THERAPEUTICS. The treatment consists in following what is
described in nephritis.
Abscess of the Kidneys.
(Suppurative Nephritis ; Pyelonephritis.)
Errotocy. The direct cause of the formation of abscess of the
kidney is from direct injury of the kidneys or in the region of
them, causing the formation of purulent abscess in the urinary
passages, the bladder, the urethra, or the pelvis of the kidney.
In certain conditions it is associated with ulcerous endocarditis.
ParHoLocicAL ANATOMY. Purulent nephritis occurs in various
forms, according to its origin. When they are caused by an em-
bolus they appear in the shape of small spots, which are easily
distinguished by the naked eye. When a section is made through
the kidney they are grayish-yellow in color, round or oblong in
168 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
shape. They are generally surrounded by a red circle. When
the spot is examined under the microscope there are swarms of
micrococci in the centre of the mass, and it is reasonable to believe
that these are the cause of the abscess. 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 protrusion or elevation of the external surface, which
is yellowish in the centre and surrounded by a circle of yellowish
points. When large abscesses are formed from these, becoming
confluent, the whole kidney may become altered into one large
abscess. The covering capsule of the kidney becomes thickened and
holds the abscess with its contents (pyonephrosis). In the early
stages, where the micrococci have just collected in the urinary
canals, and have started to form abscess-centres, it makes a very
interesting study.
Where there is a formation of a perinephritic abscess in the region
of the kidney caused by traumatic causes, from purulent abscess,
from purulent pyelitis, or abscess in the neighboring organs, it may
lead to the formation of considerable pus.
CLINICAL SYMPTOMS AND THERAPEUTICS. The symptoms of
abscess of the kidneys may not differ to any great extent from
chronic nephritis. The abscess of the kidney occurring in pysemia
is only seen on post-mortem. The symptoms of pyelonephritis are
also completely disguised by the preceding symptoms of purulent
cystitis. Treatment is, therefore, useless.
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 it 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 make a fairly large opening and empty the abscess of its con-
tents and fill it with an antiseptic dressing. 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. )
CYSTS OF THE KIDNEYS. 169
Inflammation of the Pelvis of the Kidney.
(Pyelitis. )
Errotocy. This is caused by the irritation or extension of
certain inflammations from the body of the kidney, from poisonous
irritants passed from the blood through the kidneys, from foreign
bodies that lie in the pelvis, nephritic stones, strongylus gigas;
and it is also seen in diseases that are acute in character and in
hydronephrosis.
PatHoLocicAL ANATOMY. Pyelitis occurs in a number of
forms according to the intensity of the irritants. From catarrh,
where it forms purulent or diphtheritic pyelitis.
CiinicAL SyMpToMS AND THERAPEUTICS. This disease is
only recognized by means of the microscope, when we detect cer-
tain forms of epithelium in the urine. There are also some symp-
toms of inflammation of the kidney or catarrh of the bladder.
Cysts of the Kidneys.
(Hydronephrosis ; Enlargement of the Pelvis of the Kidney.)
ErioLogy AND PAaTHoLoGicAL ANATOMY. Whenever there
is a stenosis or stricture of the urinary passages and obstruction
of the urine it is dammed back and presses on all the canals
back of it, and as a consequence the canals are distended and
become finally 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 affected, the corresponding kidney becomes
enlarged ; and where the pelvis is much distended the body of the
kidney becomes absorbed after the condition has lasted some time.
The whole kidney becomes inverted into a pouch-like mass of con-
nective tissue, filled with liquid. This fluid at first is urine, but
from the alteration soon becomes converted into mucous secretion.
In one case described by Siedamgrotzky, he observed, instead of'a
kidney, a big bladder or cyst with walls formed of connective
tissue, and filled with a slimy, brownish fluid, containing numer-
ous cholesterin crystals.
CLINICAL SYMPTOMS AND THERAPEUTICS. The cystic kidney
is generally recognized only when it is indicated by a fluctuat-
170 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
ing mass in the region of the kidney. When there is double
hydronephrosis the urine is suppressed and symptoms of uremia
show very quickly. The only condition where the disease can be
treated is when it is caused by obstruction of the urethra.
_Nephritic Stones.
(Nephrolithiasis. )
Nephritic stones are formed in the pelvis of the kidney and
range from the size of a mustard-seed to that of a pea. (Meguin
found two stones weighing six and seven grammes each in the
pelvis of a dog.) They are irregular, watery, yellowish or yel-
lowish-brown in color. In rare cases they become very large and
fill up the pelvis or greatly distend it. They are the shape of the
pelvis, and on section they are found to be in layers, and consist of
phosphoric acid, carbonic acid, triple phosphate, and uric acid.
The formation of these collections is not thoroughly understood,
but they are probably formed by a small piece of epithelium or
mass of cells becoming fastened together, and the salts are deposited
on this medium in successive layers, and finally a large mass is
formed.
DISHASES OF THE BLADDER.
Catarrh of the Bladder.
( Cystitis. )
Errotoey. Catarrh of the bladder is generally caused by cer-
tain mechanical or chemical influences or by microbes 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, and also foreign bodies.
These irritate the mucous membrane. Septic instruments, such as
catheters, when introduced into the bladder, may set up an irrita-
tion, and also by the extension of an irritation from the urinary
ducts, the pelvis of the kidney, from the uterus, and from reten-
tion of the urine, caused by stones in the urethra, from hypertrophy
of the prostate. The last two are the most frequent causes of
cystitis. Where the urine becomes very alkaline from the excess
CATARRH OF THE BLADDER. 171
of ammonia it produces an irritating effect on the kidney ; continued
retention of urine, especially when it is heavily charged with salts,
acts as anirritant. It has been said that cold will produce cystitis,
but it is not positively known.
PATHOLOGICAL ANATOMY. ‘There are quite a number of varie-
ties of cystitis—mucous, muscular, serous, croupal, ulcerous, diph-
theritic, and gangrenous—but, as a rule, it is very seldom that we
can distinguish the various forms, and it is best from a practical
standpoint to distinguish the disease in its different forms by 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. Itis 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 membrane covering the bladder, and it may be so
acute ag 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 peri-
tonitis.
In the chronic form the mucous membrane becomes very much
thickened 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 sub-
mucous 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 emptying the bladder frequently, but passes only a small
quantity of urine each time, at the same time showing symptoms
of pain. On making an examination of the bladder through the
abdominal wall the animal shows pain on pressure of that region.
An examination of the urine by the microscope will assist us in
making a positive diagnosis. If there should be some disease of
the kidneys present, the specific gravity of the urine is not much
changed, but in the early stages of the disease it is somewhat
increased in salts and contains only a normal amount of mucus, a
few colorless blood-corpuscles, and epithelium of the bladder. This
172. DISEASES OF THE URINARY AND SEXUAL APPARATUS.
condition may continue for a long time. Mild cases of cystitis
are not diagnosed, but as the disease continues the urine be-
comes thicker and turbid, and on examination of the urine micro-
scopically we find numerous pus-cells and epithelium of the blad-
der; 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. It contains
numerous crystals of triple phosphate, and in rare instances uric-
acid crystals and also numerous bacteria. (Fig. 51.)
Fie. 51.
Urine of a dog with cystitis, triple phosphate crystals, red and white blood-corpuscles, and
eystic epithelium. Bacteria.
Fever, as a rule, is present in this disease, but is never intense,
but rather shows an intermittent character. There are also severe
depression and loss of appetite. The course of the disease, gene-
rally, is rapid, and in slight cases the animal recovers in a few
days, but in acute cases the case may last for a month or more,
and death may finally be caused by perforation of the bladder and
the anima] dies of peritonitis, gangrene, or uremia. 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 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 animals that pass small quantities
of urine while making every effort to retain it until they are out-
side, or it may pass away drop by drop when they are moving
about or asleep.
DEBILITATED CONDITIONS OF THE BLADDER. 173
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 such non-irritating agents,
such as tartaric acid, nitric acid, liquor potassii acetatis, infusions
of juniper, and a liquid diet, such as milk or soups. This assists
in increasing the urine and also in lessening its specific gravity,
and by that means cleans out the bladder. In the more acute con-
ditions we try to correct the urine by means of disinfectants, such
as salicylic acid, boric acid, naphthalin, chloride of potassium,
or a decoction of fol. uva ursi. The author has always obtained
good results from the administration of the last two agents.
R.—Potassii chloras . ‘ P : : ‘ Paty aed AK)
Aqua destil. : ; , ; : : . 300.0
M. S.—One teaspoonful three times a day.
R.—Decoe. fol. uvya ursi . ; d : . 15.0: 180.0
S. Several teaspoonfuls or tablespoonfuls daily.
In the treatment of this chronic form, besides the various
alkaline salts, we should use the resinous diuretics, such as oil of
juniper, oil of turpentine, or juniper water.
The local treatment of the bladder is very effectual. This con-
sists in introducing the medicinal agents directly into the bladder
by means of the catheter. The catheter is introduced into the
bladder, and by means of a small hose is connected with a small
funnel (see Fig. 52), and a liquid emptied 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 without
removing the catheter.
The author first cleans out the bladder with clean water, then
allows a solution of boric acid, 2 per cent., to flow in. Creolin,
1 per cent., is also used, but is not as preferable as the former.
The liquids must be tepid. In the dog, of course, it is a little
harder to do than in the bitch, but with a little practice it is very
easily performed and produces very satisfactory results. In the
bitch a short metallic catheter can be used.
Debilitated Conditions of the Bladder.
Eriotogy, CiuinicAL Symptoms, AND Prognosis. Weak
bladders, due to paralysis or paresis, are generally seen in old dogs,
174. DISEASES OF THE URINARY AND SEXUAL APPARATUS.
and are produced from a number of reasons. One frequent cause
of this condition is seen in house dogs that cannot get outside, and
retain the urine for a long time, producing extreme distention of
the bladder. It is also caused by obstructions of various kinds,
which prevent the passage of the urine, such as hypertrophy of the
prostate, strictures of the urethra, and by weakness of the muscular
coat of the bladder, caused by chronic catarrh of that organ.
Certain diseases of the nervous system also produce this condition.
Fig. 52.
gg
Apparatus and method of irrigating the bladder in the dog.
There are two forms of this disease: Paralysis of the Detrusor
and Paralysis of the Sphincter Vesice. It is quite common
to find both conditions present in one animal. In the first con-
dition the bladder becomes so distended that its elasticity is lost,
and the muscular coat loses its power of contraction, and, finally,
when the bladder is so distended that the connective tissue alone
holds it and presses on the sphincter vesice and overcomes it,
the urine trickles out in small quantities. This is termed over-
flowing of the bladder (urination by incontinence). When the
CYSTIC CRAMP. 175
sphincter is paralyzed the urine flows constantly or at very short
intervals, the slightest contraction of the depressor being sufficient
to expel it. In this condition the bladder is nearly always empty.
In making an examination of the bladder through the abdomen,
when paralysis of the detrusor is present, the bladder will be
found distended, even when the animal has passed some urine a
short time before that, whereas in paralysis of the sphincter the
bladder will be found to be empty.
When cystitis accompanies this condition the animal shows more
or less pain when he urinates. This, however, is only seen in rare
instances. The prognosis is unfavorable in the majority of cases.
The only case in which the author has seen a favorable termina-
tion was one of simple distention of the bladder.
THERAPEUTICS. The treatment best adapted to relieve this
condition is to regulate the passage of urine, as in catarrh of the
bladder, by cold injections into the bladder of tinc. nucis vomice,
5 to 10 drops once or twice daily; strychnia muriate, 0.001 to
0.003 subcutaneously ; and fluid ext. ergote 0.50. We can also
try faradization of the abdomen in the region of the bladder.
Cystic Cramp.
(Cramp of the Bladder.)
There can be no doubt that cramp or spasm of the bladder
(cystospasmus) may occur in the dog, although we have no
literature on the subject. By this condition we mean an extreme
irritability of the bladder, causing an extreme contraction of the
muscular coat of the bladder, and small quantities of urine, in
some cases only a drop at a time, are passed with great difficulty.
In some cases all the symptoms of uremia are observed. On
passing the catheter, which is extremely painful, we easily
recognize it by the bladder being empty, or, if the contraction
is at the neck, the urine is passed in a quick stream as soon as the
catheter overcomes the contraction. Morphia hypodermatically
is the best drug to insure relief ; tinc. valerian is also very useful.
176 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
Stone in the Bladder.
(Lithiasis.)
ETIoLoGy AND PATHOLOGICAL ANATOMY. The various lithic
formations that are found in the bladder may be subdivided into
urates, oxalates, phosphates, and cystates.
Urates. These consist of uric acid, or uric acid salts, or both
incombination. They are small, hard, yellowish or reddish-brown
bodies, having a smooth surface, and on cutting through the centre
are found to be in concentric layers or strata.
Oxalates are chiefly composed of oxalic acid and lime salts,
and also more or less mixed with uric and phosphoric acids. They
are hard, brown in color, and have an irregular mulberry surface.
Phosphates. These are composed of phosphoric acid, lime, and
triple phosphate. 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 ele-
ments numerous organic elements, such as epithelium, blood-
cells, mucus, ete.
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 em. long and 7.5 cm. wide, 6 cm. thick, and weighed 490
grammes when fresh. They are generally started in their forma-
tion in the pelvis-of the kidney, and, generally, from some for-
eign body, such as a blood-clot, a piece of mucus, epithelium,
ete., around which the sediment in the urine forms and gradu-
ally the crystalline elements accumulate. This deposit is especially
favored in cases of cystitis, where the urine is undergoing alkaline
fermentation and produces 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.
STONE IN THE BLADDER. 177
Studensky placed foreign bodies in the bladder and found that
when the animal was allowed to drink only water that was thor-
oughly impregnated with lime salts that there was soon formed
over the body a thick, heavy deposit of lime salts, and differed
greatly in animals fed in the usual way, with pure water and meat.
In this case the caleretion was much smaller and deposited much
more slowly.
CiinicAL 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 severe symptoms, with the excep-
tion of a slight catarrh, and that is only noticed when the animal
has had a long run, the urine being voided with great difficulty,
perhaps mixed with blood or mucus, and has a penetrating odor.
As soon, however, as 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 there is a series of severe symptoms. The urine
is retained, which is indicated by an entire suppression, or it is
passed in a thin stream or only by a drop at a time. A partial
obstruction of urine is soon followed by a complete obstruction.
The symptoms presented in the dog are very striking. The
animals are very restless, looking frequently towards the region of
the kidney and whining. They place themselves in the position
to urinate and strain violently without any result, or it may be a
few drops are passed; this may be mixed with blood. The appe-
tite 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
that 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 by manipulation—that is, of course,
when they have reached a good size; the small ones escape detec-
tion, 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 accu-
mulates, and if it is not drawn off in three days the bladder is
12
178 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
ruptured and it may even burst in two days; when this occurs it
causes death in a few hours, with the following symptoms: the
animal becomes dull or comatose, with shaking or trembling of the
muscles; the restlessness and pain seem to have disappeared.
Pressure on the abdomen may produce slight 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; the blad-
der cannot be felt on manipulation. Soon a deep coma sets in,
from which the animal cannot be roused, and dies in a short time.
In rare instances the animal may have convulsions, which occur
with short intervals between them. Death may also occur before
the bladder has ruptured, as a consequence of extensive gangrenous
cystitis. .
THERAPEUTICS. It has been thoroughly established that it is
impossible to produce any good results from the injection into the
bladder of any of the various agents that are supposed to have
the property of dissolving calculi; for instance, acids for dissolving
phosphatic calculi, alkalines for breaking up uric calculi, or the
drinking of mineral-waters, such as Vichy, Wildung, Carlsbad.
There is nothing left then but to remove the stone by means
of an operation, called urethrotomy, if it is lodged in the urethra,
which consists in opening the urethra in the dog at the posterior
end of the bone of the penis, or cystotomy if the stone is in the
bladder ; this is performed by opening 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 bitch an in-
cision 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 in-
stance we can sometimes introduce the catheter, and by a gradual
pressure we can push the stone into the bladder; or, if it is fur-
ther in thé urethra, we can push a well-lubricated catheter past
the stone and allow the escape of urine and prepare for the opera-
tion, for if the stone is in the urethra this must be performed
immediately.
a ae
STONE IN THE BLADDER. 179
Urethrotomy 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 be detected by the cath-
eter; when this is passed there is a certain rough sound that resembles
crepitation. Lay the animal on the side, and after having injected the skin
with cocaine or administered ether—if the animal be very hard to handle,
although the latter procedure is rarely necessary—make an incision about
3 cm. in length, cutting down on the urethra. The 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 can be grasped and pulled out. In some
cases it is necessary to enlarge the opening in the urethra; as a rule, how-
ever, do not make the opening any larger than is absolutely necessary. It
is well to leave the wound open except it is a very large animal or if the
stone should be exceptionally large; in that instance do not put more than
one stitch init. For two days the urine escapes out of the external open-
ing, but soon closes up, and in about eight to ten days it has closed up com-
pletely and the urine is passed in the natural way.
Cystotomy: when the stone is located in the bladder the catheter is
passed directly into it, and an incision is made into the urethra down on
the catheter at the arch of the urethra, and then a well-oiled pair of for-
ceps is introduced into the bladder and the stone grasped and crushed, if
possible, and the bladder and urethra washed out with tepid water. In
some cases the entire tract of the urethra is packed with small uric cal-
culi, starting from a fairly large stone at the posterior end of the bone
of the penis, and it is only necessary to remove the larger stone, when the
others will be passed out by the force of the urine Friedberger mentions
one case where there were forty packed in the urethra; these varied in size
from a small seed to a pea, and the whole mass weighed about 28 grammes.
The operator cut down on the urethra on the ischial arch and washed the
stones from the end of the penis, and then by injections filled the bladder
with warm water and washed out that part, assisting the emptying of the
bladder by pressure on the abdominal walls. The animal made a complete
recovery.
[The translator finds that quite frequently calculi accumulate in the con-
stricture of the urethra at the posterior end of the bone, and operates in the
following manner: 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 by 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
180 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
crushed, and the bladder washed out. It is 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. |
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 by accidents, such
as being run over by wagons when the bladder is full. The ani-
mal dies, as a rule, in forty-eight hours from collapse before peri-
tonitis has developed. On post-mortem the bladder is found to
be infiltrated with blood and very much swollen at the lacerated
region only. In injuries to the lumbar region where the animal
is dull and 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 where there are
no acute symptoms presented.
Indications of painful retention of urine are often presented when
there is a stricture of the urethra caused by injuries to the urethra
from calculi or by cicatricial contraction following the oper-
ator’s knife, from intense nephritis, or by torsion following coitus.
An examination with the catheter generally gives some informa-
tion as to the character of the stricture; the practitioner must,
however, remember that there is always more or less normal stric-
ture 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 must be taken to thor-
oughly disinfect the catheters. This method has been used with
success in a number of cases when it has continued for several
weeks.
Hoffmann cured a case of stricture of the posterior end of the
bone of the penis by opening the urethra at the spot of stricture
and amputating about 2 cm. of the bone of the penis with a pair
of bone forceps.
INFLAMMATION OF THE PROSTATE. 181
DISEASES OF THE PROSTATE.
Inflammation of the Prostate.
(Prostatitis. )
This disease appears in both acute and chronic forms; the causes
have not been sufficiently investigated up to the present date to
state positively what is the exciting cause of the disease.
The acute form is rare and causes the animal to show evidence
of great pain when either urine or feces are passed. In cases
where there is great enlargement of the prostate the animal may
hold the feces back by not putting any pressure on the abdominal
muscles or may retain the urine. On making an examination of
the gland, by introducing the finger, well lubricated, into the rec-
tum, we find it very much enlarged and hot and painful to the
touch. The animal shows great pain during catheterization when
the instrument passes the prostate.
The terminations of this acute condition are as follows: The
prostate may break down completely and cause death, or it may
assume the chronic form and ultimately form abscesses which break
through into the bladder, the urethra, or the intestines, and in very
rare cases into the connective tissue of the pelvis.
THERAPEUTICS. This consists in giving the animal small quan-
tities of non-irritating food, cold clysters, and cold applications to
the perineum; also the frequent passage of the catheter to prevent
the stagnation of the urine in the bladder ; and also the adminis-
tration of saline purgatives, such as sulphate of magnesium, Carls-
bad salt, ete. When pus has formed, which can be determined
by a digital examination 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. Where the swelling ex-
tends to the perineum and distends it the author has cut down
from there and evacuated the sac.
Chronic prostatitis (Hypertrophy) is the form of the disease
most frequently seen, and develops from the acute form, or in the
majority of cases starts in the onset as the chronic form. It isa
common disease in old dogs, and is indicated by a hypertrophy of
the whole organ; as a rule, one side of the gland is larger than the
182 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
other. It varies in consistency; in some cases it is very hard, in
others it is soft; in the former case it is due to a hyperplasma 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 a chronic
purulent inflammation.
The symptoms of a hypertrophy of the prostate are irregular;
in some cases there is difficulty in urination (dysuria, stranguria),
and also cystitis, pyelitis, ete., or constipation due to the animal
making no effort to evacuate feces. The best means of diagnosis
is to make a digital examination per rectum of the prostate.
It is distinguished from the acute form by the absence of heat
and sensitiveness, but is very much larger than the normal
gland.
Therapeutics are not productive of much good results. Saline
laxatives, ergot, and iodide of potassium have been tried by the
author. The remedy that has given the best results has been to
inject into the gland a solution of iodine (iodide of potassium, 2
parts ; tincture of iodine, 2 parts; and water, 60 parts) at in-
tervals of fourteen days. The solution is injected through the
rectum directly into the gland by means of a small hypodermatic
syringe.
[The translator has recently tried castration, but has not had
enough experience to say whether it is to be recommended. Ina
number of cases it has produced very good results and the animal
was greatly relieved from active symptoms; but, on the other
hand, in several cases the animal has steadily gone down, lost
flesh, and in three or four weeks become a skeleton and died
apparently from inanition. |
Cancer of the Prostate.
Cancer of the prostate is generally carcinomatous in character,
causing an irregular enlargement of the gland. It is difficult to
make a diagnosis, and conclusions can only be drawn from the
general health of the animal, which shows a gradual want of
nutrition. It is impossible to remove the prostate, and therefore
treatment is useless.
a
GONORRHG@A—GONORRHGA OF THE PREPUCE. 183
DISHASES 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 fre-
quently caused by injuries and consequent inflammatory swell-
ings; but as the foreskin is rarely withdrawn in the dog it is of
little importance, for as soon as the penis passes through the nar-
row opening of the prepuce during coitus or from erection the
prepuce becomes tightened behind the glans penis and causes what
is termed paraphimosis; the narrow ring of the prepuce causes
venous stagnation and a swelling and purple coloration of the
glans, and, if this is allowed to remain some time, causes partial
gangrene.
The therapeutics of paraphimosis consists in reducing the glans
as soon as possible with friction and careful manipulation; this is
accomplished by careful lubricating of the parts with some bland
oil and putting a steady pressure on the glans, at the same time
pressing forward the prepuce 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. If we do not reduce it by
this means, then cut the ring with a probe-pointed bistoury or a
pair of scissors. The last means will reduce it immediately. It
is well, however, not to resort to this until you have tried every
other method.
Gonorrhcea—Gonorrhea of the Prepuce.
By this term we mean the catarrhal inflammation of the skin of
the prepuce, which is similar to mucous membrane. It is prob-
ably caused by retention of urine, dirt, uncleanliness, or mastur-
bation; it is frequently observed in old dogs, with stagnation of
the veins of the prostate (Siedamgrotzky). The symptoms con-
sist in slight redness, swelling of the prepuce and glans, and the
secretion of a thin, purulent mucus, which is generally licked off
by the animal. The lymph-follicles are generally swollen, and
ean be felt by manipulation with the finger as small bodies about
the size of a seed or pea. The treatment consists in the injection
184 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
of acetate of lead water or 1 per cent. solution of zinci sulphas
or argenti nitras.
In rare cases we may have an animal affected with specific gon-
orrhcea which has extended from the foreskin into the urethra and
an enlargement of the inguinal lymphatics, forming a bubo (Sie-
damgrotzky and author). In one of the cases observed by Siedam-
grotzky the gonorrhea was accompanied by intense inflammation
of the eyes (gonorrhceal ophthalmia).
Neoformations of the Glans and Prepuce.
Neoformations are sometimes found on the dog and bitch, and
are either condyloma, carcinoma, or sarcoma. The former can
be removed by the scissors or a small pair of pincers and the
blood stopped by compression or a solution of alum, or, what is
much better, the thermo-cautery. Carcinoma and sarcoma gen-
erally require the removal of a portion of the glans. (See chapter
on Neoformations. )
DISEASES OF THE TESTICLE AND ITS COVERINGS.
We frequently see inflammatory conditions of the scrotal coy-
ering as a result of contusions; they may, however, be caused by
eczema, which sometimes causes great swelling and sensitiveness.
(See Diseases of the Skin.) Moller has also seen serpentine vari-
cosis with ulceration and accompanied with profuse hemorrhage.
Inflammations 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. The
testicle is swollen and smooth on its surface and very sensitive to
the touch. In one case that the author observed the epididymis
was also greatly swollen (epididymitis). The therapeutics consists
of cooling applications and rest.
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
—————— “
INFLAMMATION OF THE VAGINA. 185
the majority of cases try to get drainage and keep the wound clean
by antiseptics ; this is best accomplished by putting a piece of
absorbent cotton on the testicle, and by means of a long-tailed
bandage tied around the body the cotton can be kept in place. If
the testicle is injured, the gland had better be removed by cas-
tration, 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. )
[Cuterebro Emasculator.
(Emasculating Bot Fly.)
This parasite, which is common in rabbits and squirrels, was
described by French as occurring in the scrotum of the dog, and
since then the translator has observed two cases in setters where
the grub has been present in the scrotum.
The scrotum swells slowly, beginning at the dependent portion,
until a round, firm mass, resembling in size and shape the ordi-
nary ‘‘ warble” seen in cattle’s backs, but not quite as large; it
apparently gives the animal no discomfort, unless the parasite
should act as an irritant and form an abscess, which is followed
by great irritation of the parts, and subsequently sloughing of
a portion of the scrotum and destruction of the testicle. The
treatment consists in finding the opening or vent 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 solution 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. |
DISEASES OF THE VAGINA AND THE UTERUS.
Inflammation of the Vagina.
( Vaginitis. )
Inflammation of the vagina (catarrh of the vagina) results, as
a rule, from difficult labor, and in rare cases as a result of im-
proper copulation. The condition is indicated by a whitish,
186 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
Fie.53. purulent discharge, in some cases being fetid, which
is generally licked off by the animal. The examina-
tion can be made by means of a speculum in the larger
animals (Fig. 53). On examination of the vagina we
find it intensely red and inflamed and covered with
a grayish, mucous discharge; the mucus is also grayish
in color; carcinoma is often present. (See chapter on
Tumors for further details. )
The therapeutic treatment consists of the daily injec-
Vaginal tions of astringent and disinfectant washes: Nitrate
speculum, Z C Z
of silver (1 per cent. solution), sulphate of zinc (1 per
cent.), alum, permanganate of potassium solution, boric acid, and
creolin.
Prolapsus of the Vagina and Uterus,
(Prolapsus Vagine ; Prolapsus Uteri.)
Prolapsus of the vagina is more common than prolapsus of the
uterus. In some instances it is accompanied by serious alterations
of the vagina, especially hypertrophic alterations, and also, in
rare cases, polypus formations. These alterations are generally
caused by difficult whelping. As a rule, there is more or less pro-
trusion of the vagina through the vulva, appearing in the form of
pear- or flap-shaped, red, inflamed tissue covered with mucus. In
very rare instances the prolapsus is so great that the os of the
vagina can be seen through the external opening. When the
uterus is prolapsed the protruded portion is forced out of the
vulva, and we see a pear-shaped body, intensely red, with salient
borders. One horn of the uterus is protruded only; the author
has never heard of a case where both horns were protruded.
The prolapse of the uterus in the dog is practically impossi-
ble, for the reason that the uterus itself is merely a body in name,
and really the uterus consists in the horns, the true body of the
uterus being a small body from which the horns bifurcate almost
at the os. (Fig. 54.)
The therapeutics of prolapsus of the vagina is practically that
used in prolapsus of the anus and rectum. The retention of the
vagina is much more difficult than returning it to its normal
position. Hertwig advises that the vagina be returned, and for
several hours it is held in position by the fingers, and if that is
PROLAPSUS OF THE VAGINA AND UTERUS. 187
not sufficient, to introduce a sponge into the vagina or pack the
vagina with gauze or cotton and stitch the lips of the pudenda.
The author generally uses the following method: After returning
the vagina to the normal position he puts two stitches in the
pudenda and leaves them for three days.
Fic. 54.
The genito-urinary organs of the bitch: a, ovary covered with capsule; 6, capsule of ovary;
¢, ovary ; d, horns of the uterus; ¢, body of the uterus; f, os uteri; g, vagina ; 9’, opening of
the urethra; h, clitoris ; 7,7, vulva; 1, bladder; m, urethra.
In one case where there was great thickening of the walls of
the vagina 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 author per-
188 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
formed a partial amputation, taking out an elongated piece of
mucous membrane and sewing it up by a continuous stitch Bes cat-
gut, which was followed by good results.
Reduction of the uterus is much more difficult, and in the ma-
jority of cases it is impossible. 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 suc-
cessful, laparotomy should be performed, in the manner spoken
of in hernia. An incision is made into the abdominal wall and
the finger inserted until the ovary 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 closed up. The rules named for retaining the vagina
are then to be followed. An English veterinary journal says that
the uterus can be retained in position by making an opening in
the median line of the abdomen and pulling the horn into posi-
tion and then stitching the horn to the upper part of the abdom-
inal wall. It is needless to say that the stitch must be of catgut.
Amputation of the uterus by ligating or crushing the pro-
lapsed portion is done in the following manner: Ligate tightly
the base of the protruded portion and amputate the free portion
of the uterus—not too close to the ligated portion, as the ligature
might slip and push the stump back into the pelvic cavity. An-
other method is to remove the ligated portion by means of an
écraseur ; this latter operation is by far the best.
Inflammation of the Uterus.
( Metritis. )
It is a common occurrence to have inflammation of the uterus
after protracted labor, and the disease can be subdivided into the
following varieties, according to the exciting causes:
Catarrhal Metritis. 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 membranes; the
causes are mechanical injuries which the uterus may be subjected
to during labor or immediately after.
The clinical symptoms are as follows: The vulva is slightly
Lee eee Oe re rr
INFLAMMATION OF THE UTERUS. 189
reddened and swollen, and there is a copious discharge from the
vulva, which 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 fre. 5s.
the observer must look immediately after each evacua-
tion or it may escape his notice. Some bitches carry
their tails in a curved position when suffering from
this condition; some animals have complete loss of
appetite, and in some cases slight fever is present.
The therapeutics consist in tepid injections of non-
poisonous antiseptic fluids, such as permanganate of
potassium (1 per cent. solution), boric acid (2 per cent.),
and creolin (1 per cent.). In using these solutions it
is best to use the irrigator with the two catheters that
have been already mentioned (Fig. 55). In the chronic
form (dysmenorrhcea) we should use injections of ergot.
R.—Ext. ergote . ; : : i Pape Si
Spts. vini dil. : tape
Glycerinum ‘ »
M. §.—Inject a small portion several times daily. Double cathe-
ter for washing
Septic Metritis (Puerperal Fever). Septic in- out the uterus.
flammation of the uterus should be considered 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 practically in the same condition as an open wound, the septic
materials are taken up very quickly and every condition is favora-
ble for their propagation. Collections of blood, decidual tissue, etc.,
exposed to the air decay very quickly, and where there is any erosion
of the vagina or the cervix, or even the uterus at the points of pla-
cental attachment, the poison is taken up. The eroded portion 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 becomes intensely swollen, dark brown
or reddish-brown in color, and covered with spots of diphtheritic
ulcerations.
The inflammatory process rapidly extends from the mucous
membrane into the deeper tissues, affecting the muscular and the
190 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
pelvic cellular tissues and 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 ptomaines and septic substances.enter the circulation and
cause acute septic fever. (For further information, see chapter on
Wound Infection.) The prognosis is generally unfavorable.
CLINICAL Symptoms. The vulva and the mucous membrane
of the vagina are swollen and livid red, and discharges copious
masses of discolored, fetid pus. In the earlier stages the animal
shows great pain on pressure to the abdomen ; the pulse is thready
and finally becomes imperceptible and very fast. The respirations
increase in number. The temperature in the early stages is in-
creased, but soon falls to normal and frequently becomes subnor-
mal toward the end. The mucous membranes of the mouth and
conjunctiva are livid.
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 treatment must be prompt and
energetic to get any favorable results. The uterus and the vagina
must be thoroughly irrigated with antiseptic fluids, and also the
general treatment indicated in septicemia. or antiseptic irri-
gating fluids we use creolin, 2 per cent. solution ; corrosive sub-
limate, 1 to 2000 solution. First irrigate the uterus with warm
water, and clean it thoroughly until there is no discoloration
in the escaping fluids; then inject the medicated solution into
the uterus several times; repeat this several times daily. As a
stimulant use camphor, either internally or hypodermatically; the
latter is the 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 todo. Ergot and salicylic acid are also used with some suc-
cess (Letzerich).
Rk .—Camphor puly. ‘ 3 : : , 5 Ose
Gummi acacia : 5 4 : ; ; . 2056
F. chart. No, xii. S.—One powder every two hours.
OBSTETRICS AND CASTRATION OF THE BITCH. 191
Obstetrics and Castration of the Bitch.
Asa rule, the bitch has her pups without any difficulty. The
period after conception varies from fifty-eight to sixty-two days
[Dun kept a record of 189 bitches and found the average period
was 63.28 days, the maximum being 71 days, and the minimum
being 53 days], when she generally seeks a quiet place and drops
from one toeight blind pups, the period of whelping being from
one to six hours (quite frequently lasts ten or twelve hours). The
labor-pains generally come on from three to ten hours before birth,
and are indicated by the bitch being very restless and going into
dark corners or scratching as if to make a bed, and on putting the
hand on the abdominal walls the foetuses are found to be very
lively.
Immediately after the birth of each pup the placenta is passed
out and is eaten by the bitch.
The retention of the whole or a portion of the placenta is very
rare in the bitch, and must not be mistaken for a dead fcetus.
Violet has seen three such cases, and describes them as follows:
Great depression ; no milk in the mamme; the bitch pays no at-
tention to the pups; frequent contraction of the uterus similar to
labor-pains ; entire loss of appetite ; pain on pressure of the abdo-
men. ‘The temperature was normal at first, but gradually in-
creased; the pulse was quick and hard; and a fetid discharge from
the vulva.
The treatment consists in constant irrigations of antiseptic solu-
tions, ergot, warm poultices around the abdomen, and stimulants.
After the birth of the pups there is slight lochial discharge, bloody
in the onset and finally purulent. 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.
The normal course of birth may be changed in some instances
by certain circumstances. 1. The labor-pains may not be strong
enough ; there may be a narrow, contracted pelvis; the vagina
may be lessened in diameter by cicatricial contractions, tumors, etc.
The fcetus may be very large or may be presented in an irregular
position. Extract of ergot is the best preparation to increase the
contractions of the uterus. [Several writers have recently spoken
192 DISEASES OF THE URINARY AND SEXUAL APPARATUS.
very highly of glycerine as an agent to encourage the contrac-
tion of the uterus. In cases of difficult parturition it is injected
directly into the uterus; in 1 to 10 solution with warm water the
translator has had very good results from it.] If the animal is
depressed and weak, administer stimulants, such as whiskey, wine,
or alcohol; and if these fail to produce the birth of the foetus, it
may have to be removed by forceps, hooks, or the foetus may be
noosed by means of a copper wire held in a tube (see Fig. 56),
Fic. 56.
Apparatus for the extraction of the foetus and method of extraction: a, Brulet’s apparatus ;
b, method of application. ; c, Defay’s apparatus.
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 hypodermatically every
half-hour.
When the foetus is in an irregular position, and after failing to
remove it by means of forceps, 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 or a tumor present, we must perform the
Cesarean operation (gastro-hysterotomy). This is not a very dan-
gerous operation, provided it is performed before the animal is in
a state of collapse or the foetus is not dead and commencing to
OBSTETRICS AND CASTRATION OF THE BITCH. 193
decay. Empty the bladder and the lower bowel, and having
washed out the genital passages with an antiseptic solution, the
bitch is laid on her back, the legs are held by an assistant, the
forelegs together and the hindlegs wide apart. The region whére
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 from 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 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
in 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 ab-
dominal 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 feetus, but after
one foetus is removed the others can be pushed toward the opening
and removed through it, taking care to take the membranes also.
The uterus is now thoroughly disinfected with corrosive subli-
mate solution (1 to 5000) or boric acid, 2 per cent., and by means of
a continuous suture, (using the stitch illustrated in Fig. 19, page
70), using catgut ligature, 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 ex-
tract is the best, but not vegetables.
Castration of the Bitch (Ovariotomy). This operation is gen- _
erally performed to avoid the trouble that owners have when a bitch
is in ‘‘heat.’”’ and also that they make good house dogs. The
operation is a very simple one and not attended by any great
danger if the proper antiseptic rules are followed and the animal
is not too fat or in ‘‘heat.” The bitch is given a narcotic or
13
194. DISEASES OF THE URINARY AND SEXUAL APPARATUS.
ether 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 made larger by means of a probe-pointed bis-
toury, cutting toward the diaphragm. The operator can find the
uterus easier by putting a sound into the uterus previous to the
operation. The finger is introduced into the abdomen close against
the wall and the horn of the uterus is felt and drawn toward the
opening, and by careful traction the ovary is drawn toward the
opening and cut off with the scissors; the same procedure is fol-
lowed in the other ovary and the wound closed with an inter-
rupted silk stitch.
The ovaries of the dog are small, round, elongated bodies
located at the posterior edge of the kidneys and are imbedded in
a deep fatty covering or pocket (see Fig. 54).
Hoffmann cuts through the broad ligament and ligates the ovary
both above and below and cuts off the ovary with a blunt pair
of scissors.
The abdominal wound should be stitched with a double row of
stitches. We first sew the muscular coat with a continuous catgut
suture, and then sew the skin with an interrupted suture of silk;
an antiseptic dressing is useful, but not absolutely necessary.
The animals should be muzzled.
Many operators perform castration in very young and old 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 author has tried a number of
cases for experiment and found in a short time a great collection
of cream-like matter gathered at the ligated end of the uterus,
and distended that portion very much, which was noticeable in.
the animal.
Many operators advise castration through the flank, and proceed
in the following manner: Make an incision in the flank about
4 em. long, midway between the last false rib and the thigh, in an
anterior direction, cutting through the skin and muscular layer;
then tear the peritoneum by means of the finger and pull the
ovaries through the opening and cut them off with the scissors,
and sew up the wound as described in the other operation. Fried-
OBSTETRICS AND CASTRATION OF THE BITCH. 195
berger 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 the
ovary out of each. The subsequent treatment consists of feeding
the animal on small quantities of easily digested food, treating
the wound in the regular antiseptic way.
DISEASES OF THE NERVOUS SYSTEM.
EXAMINATION OF THH NERVOUS SYSTEM.
DISTURBANCES of the nervous system are marked by impair-
ment of consciousness, sensitiveness, and motility. Besides these
there are complications in the functions of the eyes, ears, and the
digestive system.
1. The Disturbances of Consciousness are variously defined
according to their intensity. Dulness (indifference to any exter-
nal influences), somnolence (drowsiness, sleepiness, the patient
may be awakened easily), stupor (deep sleep, difficult to arouse
the patient), coma (entire unconsciousness, the animal is not dis-
turbed by external influences). In extreme cases of unconscious-
ness all sphincters of the body become relapsed. 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 uremia, in acute anemia, and in all
diseases accompanied by intense fever and pain. Short attacks
of unconsciousness may occur in the form of dizziness, and are
seen occasionally as the result of great excitement or pain (in oper-
ations); 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 recog-
nized 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 hemaphraic 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 has failed to be as reliable
and practical as the needle and cold-water test have been to the
author.
Total anesthesia occurs, as a rule, from poisoning, and must not
be mistaken for a want of reaction when in a comatose condition.
Local anesthesia—that is to say, a more or less circumscribed or
disturbed zone of sensibility—may be found in any part of the
(196 )
EXAMINATION OF THE NERVOUS SYSTEM. 197
body. In such a case, if anesthesia corresponds with a region of
a special nerve or a mixed nerve, or if it is extended upon several
nervous regions, or if it is even double-sided, we can distinguish
peripheric anesthesia. Peripheric anesthesia indicates an injury
of the end organs of the sensitive nerves and originates through local
influences—intense cold, acids (especially carbolic), also alcohol
and certain narcotics (especially cocaine). Peripheric anesthesia
may be caused by some traumatism, compression, malformation,
or inflammatory exudates; also through inflammations, such as
degenerating processes, etc., of the peripheric nerves. Special
anesthesia is seen and, as a rule, is double-sided; due to compres-
sion of the nerve or the spinal cord. Cases of cerebral anesthesia
are caused by hemorrhages, tumors, inflammations, ete., in the
zone of the sensitive nerves. It may also be caused by the effects
of various poisons—chloroform, ether, alcohol, morphia, and
bromine.
Hypercesthesia. This is an increased sensitiveness of the cuta-
neous 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. Siedamgrotzky observed in one dog with
lameness in the hind-quarters such intense hyperssthesia in the
paralyzed centres that the animal gnawed his hindlegs to the bone,
notwithstanding all the precautions that were taken to prevent him.
3. Disturbances of Motility appear in paralysis and convul-
sions of the affected muscular system.
Paralysis. We generally make a distinction between paral-
ysis and lameness—that is to say, an entire loss of movement—and
paresis or weakness, which is simply due to debility. In the first
cease 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, without 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 cor-
tico-muscular leading tracks. Up to the present time they have
definitely located the following motor centres in the external sur-
face of the cerebrum, the position of which is indicated in Fig. 57:
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
198 DISEASES OF THE NERVOUS SYSTEM.
Fig. 57, I., shows superior portion of the cerebrum; JJ., the lateral surface; and J., JI.
ITI., IV. are the four convolutions. ; S, is the suleus 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 limbs; 4, for the muscles of the posterior limbs; 5, for the facial
muscles; 6, for the lateral movements of the tail ; 7, for the retraction 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; J., ¢, the heat-
centre of Eulenberg and Landois. (LANDOIS.)
Fig. 57, II, 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.
EXAMINATION OF THE NERVOUS SYSTEM. 199
for extending and turning the anterior limbs ; 4 controls the move-
ment of the posterior limbs; 5 the facial muscles; and 6 the
lateral movement of the tail; 7 for retraction and adduction of
the anterior limbs; 8 for elevating the shoulders and stretching
the front legs (walking); 9 for dilating and contracting the orbic-
ularis 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, 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 cen-
tres must lead to paralysis of the centre which it controls. We
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 ina general
way that hemiplegia is usually a form of cerebral paralysis (of the
controlling 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
200 DISEASES OF THE NERVOUS SYSTEM.
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 Limbs. 'The front legs hang inert
and all the joints flex very easily.
3. Paralysis of the Posterior Limbs. The hindlegs 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 abnor-
mally, and the thigh bends backward. This condition may also
be due to some disease of the spine.
The most important test of paralyzed muscles is their size. In
all cases of prolonged paralysis the muscles atrophy quickly. 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 in-
stances an inactive muscle will atrophy without any actual disease
being present. The amount of atrophy which may occur in cer-
tain cases is indicated by a communication given to the author by
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 convul-
sions are muscular contractions in which the muscle remains con-
EXAMINATION OF THE NERVOUS SYSTEM. 201
stantly 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 con-
tractions is noticed:in the original muscular twitchings. Trem-
bling and shaking convulsions seen in chills, fear, or sudden
cooling after heat. Epileptiform convulsions, or eclamptic con-
vulsions, 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,
uremia, and occasionally in acute anemia; they may 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 affected 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 or some disease of the brain.
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 movements.
Nothing is known concerning their etiology. Tetanic convulsions
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
observed in the so-called cases of eclampsia in bitches who are
nursing a litter. 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 ‘‘ epileptiform attacks,’’ which we
will refer to further on.
Ataxia is due to disturbance of motility or an interference in
the coordination 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 dis-
902 DISEASES OF THE NERVOUS SYSTEM.
eases 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 distemper,
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.
DISEASES OF THE BRAIN AND ITS COVERINGS.
Hypereemia of the Brain.
Errotogy. An active congestion 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,
from heat (sunstroke), in great bodily exertion, in teething, and
high temperature.
Passive hyperemia (stagnation) occurs in compression of the
jugular veins by tumors, such as large goitres, by obstructed
respiration in acute bronchitis, and in compressed conditions of
the lungs, extended indurations of the lungs, defects in the venous
openings of the heart. Hyperemia of the brain accompanies
various acute internal diseases, and as a secondary symptom of a
number of disorders; it is also seen as a result of various poisons,
such as alcohol, certain narcotics, ete.
PaTHoLogicaL ANATOMY. Asarule, hyperemia of the brain
occurs in connection with congestion of the coverings of the brain,
especially the pia mater. When hyperemia is very intense, or
where it has existed for a long time, we cannot definitely sepa-
rate 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 vessel are flattened, and the sulci are perfectly
flat as if pressed out of shape. We find the gray matter is darker
red than usual, while the white brain-substance is dull gray or
yellowish-red, and presents numerous bloody spots which may be
easily removed. In chronic conditions of this disease we find
venous hyperemia. The brain appears in such cases pale and
anemic, very moist and soft, and on section has a brilliant,
mirror-like lustre. It is lessened in size, and the subarachnoidal
fluid is increased,
HYPERAMIA OF THE BRAIN. 203
In a dog which had died suddenly from sunstroke Siedamgrotzky
found all through the entire muscular system a number of small
hemorrhages. Inside the skull was hyperemic. Between the dura
mater and the arachnoid he found considerable accumulations of
bloody serous liquid. The surface of the brain was greatly injected
and covered with hemorrhages, and here and there small hemor-
rhages in the brain and medulla. The chambers were normally
filled with fluid. The lungs were congested and cedematous. The
heart was collapsed, flabby, and filled with dark, clotted blood.
CuinicaL Symptoms. The symptoms of hyperemia of the
brain are characterized by a sudden development of excitable
symptoms. These consist in restlessness, running around, frequent
changes of position, irritability, a tendency to biting and attacks of
delirium, partial or general convulsions, and an increased activity
of the action of the heart. The pulse is quick and irregular; the
respiration is short. There is congestion of the mucous membrane
of the head, and the upper section of the head is warm to the
touch. There is contraction of the pupils and occasional vomiting.
These symptoms of excitement rarely last long; they generally
disappear quickly, although in rare instances they may last some
time without leaving any trace on the general system. They may,
however, alternate with periods of apparent rest to recur again in
a short time. We have observed this in cases of apoplexy of the
brain. In this condition we have dulness, unsteady gait, and if
there is entire stupor we have stertorous respiration with this last
symptom. It is doubtful in such cases if we have to deal with
actual hyperemia; more likely a more or less serious alteration in
the brain.
THERAPEUTICS. Bleeding, as a rule, is contraindicated on
account of the debilitated condition of most dogs. We would,
however, recommend enemas (soap and water) and purgatives with
quick action, such as sulphate of magnesium in large doses, senna-
leaves, or castor oil. Cold compresses around the head are also
useful, while violent purgatives such as croton oil, are not advis-
able, as they excite the animal and do more harm than good. The
animal should be put in a cool room and kept as quiet as possible,
avoiding excitement, heat, and also feed the animal very little.
In cases where marked symptoms of excitement show themselves
an injection of morphine is generally indicated.
204 DISEASES OF THE NERVOUS SYSTEM.
Anzeemia of the Brain.
Errotocy. The most common cause of anemia of the brain
is from impoverished blood, acute hemorrhage, prolonged and
debilitating disease, or from some obstruction of the arterial sys-
tem, such as tumors, hemorrhages, or inflammatory exudations
within the skull; compression of the carotid arteries by emphy-
sema, and in some instances from contraction of the small arteries
of the brain caused by excitement.
PaTHOLOGICAL ANATOoMy. The white substance in rare in-
stances has a few bloody points. Asa rule, the brain appears on
section dull white, the gray matter being unusually bright, without
any trace of coloration. The meninges and coverings of the brain
may possess their normal quantity of blood even in intense anzemia.
CirnicAL Symptoms. Acute anzmia, especially when it has
been caused by hemorrhages, is indicated by a small, weak pulse,
distention of the pupils and a coldness of the extremities, attacks
of dizziness, and loss of consciousness. Convulsions are rarely
present in chronic anzemia of the brain, and very often stupidity,
quivering of the muscles, great fatigue on the slightest exertion,
loss of appetite, and a tendency to vomiting are noticed.
THERAPEUTICS. The therapeutic treatment consists in stimu-
lants, such as wine, ether, camphor, etc. In the chronic form
nutritive diet, blood-producing food, tonics.
Cerebral Hemorrhage.
(Apoplexia Sanguine ; Hemorrhagia Cerebri.)
Ertotocy. The chief cause of cerebral hemorrhage is an
increased pressure on the vessels containing the blood, 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 by atheromatous degeneration,
or by some disturbances in the nutritive process of those parts, as
in serious diseases, except specific diseases, such as distemper, leu-
keemia, and in certain forms of poisoning.
PaTHOLOGICAL ANATOMY. Hemorrhages appear, as a rule,
on the cerebrum, and occur from a capillary hemorrhage, and
CEREBRAL HEMORRHAGE. 205
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 become confluent. In some cases there is a consider-
able bloody discharge, indicating the breaking down of some large
bloodvessel. If the bloodvessel is located in the hemisphere near
the surface, the dura mater appears distended at the affected loca-
tion; the convolutions of the brain are flattened and the furrows
depressed. ‘Fhe substance of the brain is always more or less
destroyed, and, if the animal does not die quickly, the discharged
blood forms clots very rapidly. Its fluid parts become absorbed,
fibrinous substances are formed, and the blood-corpuscles de-
stroyed. The blood-substance is altered into a chocolate-colored
emulsion and finally becomes absorbed. The coloring matter of
the blood remains on the brain as a rose-colored pigmentation.
The centre becomes smaller and smaller until we see the develop- —
ment of numerous connective-tissue adhesions uniting 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 surround-
ing parts.
CuinticAL Symptoms. Without any premonitory symptoms
we suddenly see serious cerebral symptoms—that is to say, apo-
plexy. The animals drop,’and immediately, or in a short time
afterward, walk unsteadily for a distance, and then lose entire con-
sciousness. 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 intensely reddened, and
in the early stages of the attack convulsions are very frequently
noticed. This is followed by partial or complete paralysis which
is due to a direct destruction of the brain-substance, by the
blood pressing on the brain. This paralysis may affect the extrem-
ities, 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 ina few moments or may take days;
2, in complete recovery—this, however, only occurs where there is
a small hemorrhage, and in the centre of the hemisphere; 3, in
complete recovery with partial or complete paralysis, according to
the amount of hemorrhage. The treatment of hemorrhage of the
brain is connected closely with congestion of the brain, and it
206 DISEASES OF THE NERVOUS SYSTEM.
consists of applications of cold compresses around the head, of
enemas, and, when there is a weak, irregular pulse present, of
cardiac stimulants.
Great hemorrhages of the cerebral membranes are marked by
the same symptoms as apoplexy of the brain. Apoplexia men-
ingia 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. The treatment is similar to that
of cerebral apoplexy.
Inflammation of the Brain.
From a pathological standpoint we have to make a distinction
between inflammation of the hard cerebral substance (pachymenin-
gitis) and that of the soft cerebral membrane (leptomeningitis).
However, this classification need not be used in a clinical way,
because in the dog the described forms run their course with the
same symptoms.
ErroLtocy. Inflammation of the brain is primarily a result of
traumatism, such as sunstroke, great psychical excitement, over-
exertion, etc. This occurs secondarily from disease, such as dis-
temper and pyzmia, also with suppuration in the skull,in inflam-
mation of the frontal cavities from parasites, and purulent in-
flammation of the ear (in connection with external otitis).
1. Inflammation of the Dura Mater. Pachymeningitis. The
dura mater is covered with a number of small hemorrhages. It
is loose and 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 adhe-
sion of the covering to the base of the skull or to the soft cerebro-
membrane.
2. Inflammation of the Cerebral Membrane. Leptomeningitis.
The arachnoid is loosened and dull. The subarachnoid chambers
are filled with more or less torpid fluid. The pia mater is hyper-
INFLAMMATION OF THE BRAIN. * 207
aed
zemic, loosened, and covered by fibrinous exudation. The cover-
ings of the brain are almost always infiltrated and detached from
the pia mater with difficulty and according to the amount of
inflammation and purulent fluid that may be found in the ven-
tricle. Ina chronic case we have a circumscribed thickening of
the cerebral membranes and adhesions uniting the coverings with
the brain, ete.
3. Inflammation of the Brain Mass. Encephalitis. This dis-
ease, as a rule, involves single centres and causes a general irrita-
tion of the healthy tissue without any distinctly marked limit.
In the affected regions the substance of the brain is swollen,
hyperemic, 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 con-
ditions are divided into white, red, or yellow—softening of the
brain. Finally cicatrices and cysts are formed, as in apoplexy,
or an abscess may be developed which is filled with thick yellow
or greenish pus, and becomes encysted and sometimes solidified
(calcareous). In some cases small encephalitic centres may heal
without leaving any trace. In some cases 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 very much.
CuinicaAL Symptoms. The symptoms of inflammation of the
brain in its early stages resemble those of hyperemia. The ani-
mals 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 the reflex action is very slight. The
appetite is lost; constipation is generally present, and more or less
vomiting. The patient is indifferent to the impressions of exter-
nal objects, being sleepy and apathetic. Soon the disease changes
in its character. We see acute convulsions, especially those of the
jaw, or eclamptic convulsions. The animals cry and howl. At
the same time the sphincters are relapsed, the animal apparently
having no control of them. Then there is an interval of quiet-
208 DISEASES OF THE NERVOUS SYSTEM.
ness, in which the animal falls back into a deep semicomatose con-
dition, and between these periods of quietness we very often see
automatic movements, such as quivering 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
semicomatose, or they may bark hoarsely (delirium). As a rule,
the temperature is a little above normal. Within a short time
the animal becomes gradually paralyzed, losing all power of the
muscles. The patient is dull and unconscious of external influ-
ences. The breathing is rattling and stertorous. The pulse is
increased a number of beats, but is almost imperceptible to the
touch. The temperature now begins to rise. In some cases the
temperature may remain normal, and in rare instances has fallen
below. Asa rule, the animals die shortly after the convulsions
‘make their appearance. Complete recovery is very rare, and
slight attacks terminate as a rule either with paralysis (partial or
complete), idiotism, or blindness.
Very similar symptoms to those already described appear in
cases of cysticercus cellulose in the brain or its membranes. Sie-
damgrotzky found in the dura mater of both hemispheres of a
dog, which had suddenly developed symptoms of encephalitis and
which died in twenty-four hours, twenty-three sacs the size of a
pea. This is peculiar from the fact that the animal had been per-
fectly healthy up to twenty-four hours before its death, and had
not shown the slightest loss of intelligence or in muscular move-
ment.
THERAPEUTICS. The treatment of inflammation of the brain
corresponds with that of hypersmia of the brain. Rest, cold
applications to the head, clysters, laxatives, especially calomel.
In cases of great excitement sedatives (morphine, sulphate 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 rubbed on the inner
fascia of the thighs and along the spine, or cantharidal ointments,
are of no particular benefit.
The course of this disease varies greatly in affections of the
cerebellum. If the hemispheres are affected, we may have exten-
sive alterations of the brain, which may run their course without
any decided symptoms being shown; but as soon as the cerebellum
CEREBRO-SPINAL MENINGITIS. 209
and one or both hemispheres become affected we then see the various
symptoms peculiar to this disease, and a diagnosis can be made
with almost absolute certainty. In diagnosing disease of the cere-
bellum there is generally an unsteadiness of the gait in walking.
There are peculiar movements, such as walking around in a circle
and rolling on the ground, when both hemispheres are involved.
We may have paralysis of the posterior extremities. In rare
instances, however, these symptoms may be presented in cases of
poisoning (by cocaine or apomorphia).
The therapeutic treatment of this disease is not very definite.
In cases of simple unsteadiness of the gait the author has been
able to secure good results by means of laxatives and collodium of
cantharides applied to the neck. Where the animal turns ina
ring constantly, or rolls on the ground, such agents as morphia,
chloral, and bromide are often used.
DISEASES OF THE SPINAL CORD AND ITS
MEMBRANES.
Cerebro-spinal Meningitis.
(Meningitis Cerebro-spinalis.)
Etiotocy. Nothing is definitely known of the causes of this
disease. Itis extremely rare inthe dog. Renner and Kempen have
made several observations on the subject, and the author had one
ease of hisown. In this the disease seemed to be related, in some
way, with a wound on the anterior extremity.
PATHOLOGICAL ANATOMY. The anatomical foundation of the
disease seems to be an acute suppurating inflammation of the brain
and spinal membranes, for Renner, as well as the author, found
purulent exudation in the arachnoid, especially on the hemi-
spheres and the base of the brain, which was infiltrated by a quan-
tity of serous fluid. The same condition was also found in the
spine.
CLINICAL SyMpToMS AND THERAPEUTICS. The symptoms
which were observed by Renner and the author were disturbances
of the sensitory nerves, in some cases the animal becoming uncon-
scious. There were loss of appetite, fever, and on the fifth day a
marked unsteadiness of the gait, beginning with a slow, dragging
14
210 DISEASES OF THE NERVOUS SYSTEM.
walk, and becoming complicated with tonic convulsions which
become finally epileptic, and, lastly, stupor, coma, and death.
Renner treated two cases with calomel, opium, and purgatives.
The author did not have good results, although he treated a case
in the same way.
Inflammation of the Spinal Cord and its Membranes.
(Myelitis and Spinal Meningitis.)
Errotocy. A common cause of myelitis and spinal meningitis
is traumatisms of some kind causing direct injuries to the spine.
It may also be caused by simple contusions, violent blows, shocks,
falling out of a window, ete., and further by concussions of the
spinal cord. Violent muscular exertions frequently bring it on.
In very rare instances the disease may follow the presence of an
abscess on the outside of the spinal canal (for instance, in one case
which was observed by the author, in the long muscle of the back),
by extension of the suppurating process through the orifice of the
vertebra, and occasionally you see it originate in connection with
some infectious disease (distemper, rabies, pyemia). It may also
be caused by cold.
PaTHoLocicaL ANATOMY. ‘The inflamed pia mater appears
thickened, infiltrated, and injected in some places, and, as a rule,
adherent by means of the exudation to the spine itself. 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 surfaces or
else confined to small centres. In the early part of the disease
the spine is slightly swollen; the gray substance is somewhat red-
dened, dark, and soft. Later the spine becomes a yellowish-red,
breaks down and undergoes white, yellow, or red degeneration.
In the chronic course we see atrophy of the nerves as a conse-
quence of malformations of the connective tissue.
CurnicAL Symptoms. The symptoms of alteration of the
spinal cord appear gradually, and become more intense as the dis-
INFLAMMATION OF SPINAL CORD AND MEMBRANES. 211
ease progresses, where the disease is due to violent traumatisms,
producing a direct destruction or laceration of the nervous centres,
or pressure, which is caused by the blood being discharged and
pressing upon the spine. In all diseases of the spinal cord it is
very important to recognize the fact that consciousness is present.
As a rule, the symptoms appear either slowly or quickly, accord-
ing to the amount of irritation present on the spine itself, and in
eases where the spinal cord is very much involved and compressed
by masses of exudated serum we find complete paralysis. We
will take up all these symptoms in the following description, which
may be observed in affections of the spinal cord :
1. Motor Symptoms of Paralysis. These are, as a rule, the first
symptoms presented. The patients have a heavy, dull look ; stag-
gering gait, but not irregular (in this it differs from disease of the
cerebellum). Finally, they drag their hindlegs ; as a rule, these
extremities are 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-quarters. In rarer cases, not only
the posterior extremities but also the anterior are paralyzed, and
it is evident that in cases of paralysis of all the members the
spinal substance of the neck must be affected, while paralysis of
the posterior extremities must occur no matter what part of the
spine becomes affected; it may be in any part of the spinal column.
In these cases we always have the double-sided paralysis; and in
very rare cases paralysis is marked more intensely on one side than
the other; but, as a rule, it is very rarely present, and we can only
suppose that in one-half of the spinal cord the disease is more
advanced than in the other.
2. Motor Symptoms of Irritation. 'These appear in the shape
of slight, irregular twitchings, rarely of any great consequence,
and seldom leading to convulsions. They are generally noticed
in the early stages of the disease upon the extremities.
3. Disturbances of Sensitiveness. We observe more rarely dis-
turbances of sensitiveness in the shape of hyperesthesia than in
the form of anesthesia. In the former it may invariably be
observed in the early stages of the disease that patients show
intense pain, especially when touched, lifted, or pressed upon the
spinal cord. (This they indicate by biting, howling, ete.) In
romp)
the latter case they do not show the slightest reaction in the
DAP. DISEASES OF THE NERVOUS SYSTEM.
affected regions even when subjected to serious irritations of the
skin.
4, Disturbances of the Sphincters. In mild stages of this disease
the sphincters, such as the bladder, appear slightly affected. In
the serious stage we observe complete paralysis, loss of control of
the sphincters, and complete paralysis of the sphincter vesice.
More details will be introduced 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
fecal matter, as a consequence, producing constipation and paralysis
of the intestines, caused to a certain extent by the loss of abdom-
inal pressure. This is evinced by a gaping rectum and escape of
fecal matter which accumulates in the lower bowel.
5. Nutritive Disorders. Through want of active exercise the
muscular system of paralyzed animals, especially the extremities,
becomes flabby, soft, and atrophied. The temperature is reduced
in the paralyzed portion, the extremities being cold and anzmic.
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 verte-
bre, we see the same symptoms.
(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 are very rare. In such
cases the symptoms come on very slowly and gradually increase
in intensity.
(6) 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 cord 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 symptoms,’’ which are not very pro-
nounced in any of their characters.
(d) Fractures of the spine: These are generally recognized by
some change in the position of the region in which they are located
INFLAMMATION OF SPINAL CORD AND MEMBRANES. 213
(bending inward, flattened depressions, and in rare instances slight
distortions of the spinal cord), and also by the extensive sensitive-
ness to pressure in this location. In certain instances there may
be an abnormal mobility of the part. Crepitation, as a rule, is
absent. In fractures of the cervical vertebrae we generally notice
an oblique 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 so without loss of consciousness, it is
always doubtful if there is a fracture of the vertebra or a hemor-
rhage within the vertical canal. In such cases we simply have to
await developments, or if paralysis does not immediately follow
the injury, but comes some time afterward, it is due to compres-
sion of the spine from a gradually increasing hemorrhage. We
must remember, however, that a fall, shock, or blow upon the
back, or ordinary irritations of the spinal substance 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 membranes.
In many cases we may expect a recovery as long as there is no
myelitic complications.
THERAPEUTIC TREATMENT OF THE DISEASES OF THE SPINAL
Corp. In the early stages of the disease when fever, hyperemia,
and accompanying convulsions give pronounced evidence of the
disease, it is advisable to give antiphlogistic treatment, consisting
of compresses upon the spinal cord, and vigorous purgatives (calo-
mel), and lastly enemas. In cases where the paralytic symptoms
predominate we use irritants along the spinal cord, such as can-
tharides, croton oil, or biniodide of mercury. Sometimes in mild
cases mustard oil. 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 the better. We must
remember that one daily injection is sufficient, and that a medical
pause of from thirty-six to thirty-eight hours ought to be made
every four or five days, in order to prevent the cumulative influ-
ence of this drug.
R.—Strychnia muriate ; F : , g . 0.005
Aqua . 3 , : ; : : E 2 od
214 DISEASES OF THE NERVOUS SYSTEM.
Electricity is applied in the following method: 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 after having previously dampened the region with a con-
centrated saline solution. 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. Llectricity 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 the central location of the affected
nerves and rub the paralyzed muscles with the other pole. This
treatment should be renewed every day for ten or fifteen minutes.
Alcoholic frictions, which are so popular among the general public,
are of slight value and only to be recommended when connected
with true massage (pinching, friction, and massage of the paralyzed
muscle in its proper direction).
Epilepsy.
Epilepsy is a disease which is rare in the dog. Its chief symp-
toms are irregular attacks of unconsciousness accompanied by acute
convulsions in older cases.
ErroLtocy AND PATHOLOGICAL ANATOMY. The causes of epi-
lepsy are unknown, but at the same time there is no doubt that
certain diseases of the brain and its membranes, especially chronic
diseases, very frequently cause epileptiform seizures which are
similar to true epilepsy, and we may also observe in some cases a
reflex epilepsy, which does not resemble true epilepsy in any way
except in some general symptoms. These will happen after trau-
matic legions of the peripheral nerves, in intestinal parasites, in
poisonous substances in the intestines (for further particulars, see
page 201). We may also observe epileptiform convulsions in dis-
temper.
In true epilepsy there are no anatomical alterations to be found
in the brain. Wherever they are found they cause epileptiform
convulsions. 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.
EPILEPSY. 215
The experiments which have been made upon dogs in connection
with this disease by Ferrier, Eulenberg, Landois, and others are
interesting. 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 corre-
sponding 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. Ifthe chief centre is cut out, the convulsions
will not be present in that region during the epileptiform attacks.
Trritation of the subcortical white substance of the brain also causes
epilepsy. This begins, however, in the muscles of the same side.
Bromide of sodium 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 membranes of the cerebrum are the original centres of epileptic
attacks. It is hard to explain, however, the actual cause of this
irritation. Epilepsy can hardly be caused by over-stimulation or
feeding, for, as a rule, the largest number of true epileptic subjects
are weak, delicate, and anemic; but at the same time we often see
vigorous, well-fed dogs of all ages suffering from this disease.
There are many cases in anemic animals which, under treatment,
gradually improve, at the same time the epileptiform attacks be-
coming less and less as the animal improves. It is doubtful if
these cases can be called true epilepsy.
[The translator is inclined to think that quite a number of these
cases should be classed under the head of hysteria; in two cases in
particular where he advised to have them castrated (ovariotomy),
he found in one case a large cyst attached to the ovary, and in the
other intense hyperemia of the ovary (the left). After the oper-
ation both animals made good recoveries; one, however, had slight
attacks for three months afterward. A third was operated on that
had been affected for two years, and the ovaries were found to be
hypertrophied and congested. In this case the attacks were
lessened, but not entirely cured. ]
CLINICAL SYMPTOMS AND CouRSE OF THE DisEASE. In acute
attacks of epilepsy the symptoms begin suddenly, or they may start
916 DISEASES OF THE NERVOUS SYSTEM.
with slight premonitory symptoms. In the later stages the ani-
mals 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 soon see clonic convulsions followed
by loss of consciousness, and in some cases a rapid change into
clonic tonic convulsions. The muscles of mastication are especially
affected. Single muscle-contractions follow one another with aston-
ishing rapidity, so that the saliva which lies in the mouth is
turned into foam. The convulsions, which are now tonic, extend
over the whole muscular system. The body and neck are drawn
backward or sideways; 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. After a few minutes these twitchings stop ;
the animal lies on the ground for some time; it finally rises and
recovers very quickly. 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. This
is noticed at the termination of an attack, and is probably due to
the interruption of perspiration and the slight respiratory move-
ments. In very rare instances an involuntary passing of feces
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. 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.
THERAPEUTICS. No agent seems to have any decided effect
upon epilepsy. The author has tried a number of remedies, one
after another, without result. Bromide of sodium seems to be the
best (this is preferable to bromide of potassium, as it has no detri-
mental effect upon the appetite), provided it is given in substantial
CHOREA. 217
doses. With this drug it is always possible to prolong the inter-
vals between attacks; they are also shortened, and relatively less
serious. Other agents, such as oxide of zinc, arsenic, nitrate ot
silver, belladonna, hyoscyamus, valerian, bromo-hydrate, cold
water, and electricity.
R.—Bromide of sodium . A Q : 3 5 ee,
Aqua . Z , : 5 . 1650.0
S.—One tablespoonful three times daily.
- In connection with this disease we must devote a few words to
convulsions of young animals. We very often see weak, debili-
tated animals which are backward or poorly fed, but which have
rickets as a consequence of reflex irritability during the course of
catarrhal diseases of the digestive tract or of the nasal cavities.
We also notice them after the absorption of large quantities of
fermenting, indigestible food, in constipation, and in cases of
‘intestinal parasites, at the time of teething, and also as a conse-
quence of great psychical excitement. We often see spontaneous
convulsions; 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. 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 approx-
imative insight into these convulsions by the symptoms which are
presented. Frequent occurrence of eclamptic attacks with a short
interval between must be considered as a very serious symptom.
The therapeutic treatment of convulsions consists in the use of
applications of cold water to the head; large doses of bromide of
sodium, morphia, and similar sedative agents. We must also take
into consideration the causes of the disease and keep the animals
as quiet as possible.
Chorea.
(St. Vitus’s Dance.)
We define this disease as a persistent clonic convulsion of some
muscular group in certain parts of the body. For instance, shak-
218 DISEASES OF THE NERVOUS SYSTEM.
ing of the head, twitching movements with one or two legs, reg-
ular, rhythmic contractions of the mouth, and also an automatic
opening and closing of that part; regular 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 gener-
ally less marked, and under physical excitement becomes much
more aggravated. or instance, when eating, if any pain is
present, and during catarrhal conditions of the air-passages, or
the intestines, stomach, ete. The choreic 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. Sensitiveness and consciousness are not disturbed in
any way whatever, but are perfectly normal. The course of this
disease is slow, and may extend for months and years; but, as a
rule, the symptoms lessen, and in rare instances may disappear
entirely. A fatal termination is only to be feared when compli-
cations arise.
Errotoagy. Under the name of chorea there are a great many
complications of the dog which should really be classed under
another head; for instance, nervous distemper, or obscure cerebral
diseases, also myelitis, and some cases of symptomatic chorea.
In true chorea of man we do not see any pathological alterations
of the brain, and in the few cases which the author had to con-
sider as true chorea on account of the anzmia, absence of any
symptoms of distemper, or other diseases of the brain and spine,
the convulsions were restricted to certain 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 anemic condition and show all the effects of
bad nutrition, and, after some observation, we are convinced that
with improvement in the general system the choreic symptoms
become very much lessened.
THERAPEUTICS. The author has tried all the various agents
recommended 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
Ee ee eee eee eee
TETANUS. 919
results, but these drugs must be given for some time, and it is
only after prolonged administration that any favorable result is
observed. The author thinks that more benefit is derived from a
nutritive diet than anything else.
Antipyrine, which is used in man, is of not much service in the
dog. Bromide of potassium, chloral hydrate, oxide of zinc,
nitrate of silver, electricity, and hydropathy can all be used.
Catalepsy.
Catalepsy, or ‘‘ cataleptic rigidity,” is understood to be a pecu-
liar rigidity of the muscles in which the animals may be placed in
certain positions and will remain so. Consciousness and sensitive-
ness seem to be suppressed entirely. Such an attack lasts for hours
and days, and (according to Hertwig) for weeks. In many cases
they finally relapse and die in a short time. If this is really a
disease, or merely a symptom of some brain complication, the
author has not been able to positively determine.
Hertwig mentions as causes of, catalepsy cold, fright, overload-
ing the stomach with indigestible food, and metastases in various
diseases, while Fréhner considers this disease as a purely func-
tional neurosis of the brain and spine. He found it impossible
to recognize any definite alterations in the central organs, either
in catalepsy, eclampsia, or tetanus, but he found occasionally
certain secondary alterations in the muscles, namely, hemorrhages,
dark venous swellings, and fatty degeneration of the muscles,
also waxy degeneration of the fibres of the heart.
No practical therapeutic treatment is known. Frohner advises
electricity and cold douches as a means of restoring the disturbed
reflex irritability of the nervous system.
Tetanus.
(Lockjaw. )
This very rarely occurs in the dog. The symptoms consist
(according to Hertwig and Siedamgrotzky) in a stiff, stilt-like
gait, the head and neck being distended and drawn, the eyes fixed,
the ears more or less retracted and stiffened; prolapsus of the
nictitating membrane; wrinkling of the skin of the forehead ; con-
220 DISEASES OF THE NERVOUS SYSTEM.
vulsive closing of the mouth, making the animal utterly unable
to eat, bark or drink; great fretfulness, and hardness of the mus-
cles, which when touched no symptoms of pain are shown by the
animal. Consciousness is not affected, and the temperature is
generally normal. [The translator has observed two cases in
which the temperature rose to 43°. ] |
The therapeutic treatment consists in lessening the irritation by
narcotics, especially morphia, clysters, chloral; and if there is any
wound present, it must be treated with poultices or anything to
lessen the irritation. It is almost certain that a great majority of
cases are due to diseased wound-infection and the presence of
microbes (tetanus bacilli). These bacilli remain in the wound or
in the neighborhood of it. It is generally advisable, therefore, to
cauterize, or, better still, to excise the wound with its entire sur-
roundings. The author does not consider it impossible for the
bacillus of tetanus to enter the organism in other ways than directly
through the skin.
Hclampsia.
Eclampsia, which is not a very good definition, is a tonic-clonic
convulsive spasm which is observed in bitches, and, as a rule,
during the attacks the animal is perfectly conscious.
ErroLocy. The causes of this disease are very little known.
According to Hertwig, it may be caused by cold, stagnation of
the milk in the udder, taking away the young, and sometimes by
worry. In one-third of the cases of true eclampsia which were
observed by the author, all the young were still with the mother.
[The translator has observed a large number of cases of this
disease, and invariably found the animal weak, inclined to be
delicate, light in bone, but to be excellent mothers, and the litters
were generally strong, healthy pups. They laid on flesh very
quickly while the mother lost it. The onset of the disease was
generally at the end of the second or third week.| In the rest of
the cases, either one or more had been taken away from the
mother. In the onset of the disease the mammary glands contain
very much milk. The animals are generally small, delicate
(house dogs and pet animals), and, as a rule, have a light coat.
Friedberger and Fréhner are of the opinion that the disease may
originate from anemia of the spinal cord, or in a reflex way from
eo u
a — eS eee eee
eS ee ea
ECLAMPSTIA. 221
the lacteal glands. With this last theory the author is inclined
to agree. According to the statements of authors, deep anatomical
disturbances of the brain may be caused directly from the mam-
mary glands. Friedberger has observed two bitches that had
eclampsia without having puppies.
CiinicAL 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 animals become
restless and anxious; they have a staring expression of the eye,
short, rapid respiration, reddened mucous membranes; they show
no pain from pressure on the walls of the chest, neck, or abdomen.
After a short time (about a quarter of an hour after the appear-
ance 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, hard, and sometimes irregular, and
always quick; the eyes are staring and protruded, and there is an
anxious look in the face. All the visible mucous membranes are
cyanosed. The saliva which accumulates in the mouth is either
swallowed convulsively at certain intervals, or, as is generally the
case, it dribbles out of the corners of the mouth. As a rule, con-
sciousness is not disturbed. The pupilla are normal in size; reflex
action is present. The animal seems to notice external objects or
impressions, such as calling the patient, or noticing one it knows
coming into the room. The appetite is lost; the normal discharges
are entirely suppressed; the urine, after such an attack, gives an
albuminous 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
299 DISEASES OF THE NERVOUS SYSTEM.
about forty-eight hours after the onset of the disease from apoplexy
and paralysis.
THERAPEvTICcS. Any of the narcotics can be used, and, as a
rule, produce good results. Here they use injections of morphia,
which were first recommended by Siedamgrotzky; the quantity is
0.002 to 0.005 gm. of muriate of morphia diluted with water.
As a rule, a few minutes after the hypodermatic is administered,
the animal becomes quiet and rests easily. Inhalations of chloro-
form, chloral hydrate, bromide of potassium, etc., are also recom-
mended. Warm baths and friction produce relaxation of the
tense muscles. Valerianate of zinc in 0.5 gm. dose every two
hours.
DISEASES OF TRUE INFECTION.
Distemper and Contagious Catarrhal Fever.
THE definition of the word ‘‘ distemper’ means a disease which
is peculiar to the canine race, and it is caused by specific poison
which finds its way into the system, as a rule, through the lungs
and air-passages. It generally attacks young animals and runs its
course as a catarrhal fever, affecting all the mucous membranes of
the body, and almost invariably accompanied with certain nervous
symptoms, also skin eruptions.
Eriotocy. Distemper is a disease which is contagious in the
highest degree, and is only communicated by infection. An animal
affected with distemper can remain but a short time in any locality
and affect every animal there. 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 ina 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 the second time. As
a rule, delicate, weak, poorly-fed animals (vegetable diet), or ani-
mals which have been affected by some catarrhal disorder of the
respiratory mucous membranes, contract the disease in its acutest
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.
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 present during the warm weather. The specific poison
of distemper is not definitely known. It is undoubtedly a fixed
and volatile poison which enters the system by the mouth and
nose, and it exerts its first influence on the respiratory passages.
Vaccination of young animals by means of the secretory fluid
( 223 )
224 DISEASES OF TRUE INFECTION.
from animals affected with this disease has been tried, and often,
as a rule, produces the disease artificially.
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 are generally together in small
groups of three or four in a superficial sac-like manner, or they
may hang together like a string of beads. In some cases they
take the form of a light, thin membrane, which is easily colored
by methyl-violet. He considers these as the specific infecting
agent of distemper, but this theory is one that Friedberger does
not agree with. Mathis found in the mucus contained in a pustule
a diplococcus which could be colored with fuchsine. He used
bouillon cultures of this for the inoculation of dogs. These
were affected by symptoms which resembled very closely those of
distemper. Marcone and Meloni found a micrococcus in the
dog which was affected by distemper, and considered that this
agent was the true pathogenic fluid, as it produced the skin
eruptions, broncho-pneumonia, and gastro-enteritis in dogs which
had been inoculated with pure cultures. Legrain and Jaquot
obtained pure cultures of micrococci, when held in certain medi-
ums, from fluid obtained from the bladder in the exanthematic
form of distemper. These were gathered together and in the form
of diplococci and short chains. In dogs vaccinated with these
cultures the skin eruption, with the development of pustules, was
seen only, 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 cocci of two
various bacilli, which, on inoculation, produced distemper. [Galli-
Valerio has isolated ovoid bacilli two micro-millimetres in length
which grow freely in gelatin. These he found in abundance in
the lungs and central nervous system, but did not find them in
the blood. The inoculation of the cultivations produces charac-
teristic distemper in puppies, but did not give the same results in
adult dogs. This he accounts for in that they may have had pre-
vious attacks of the disease, and were thus protected. |
Direct vaccinating methods have been practised by various prac-
DISTEMPER AND CONTAGIOUS CATARRHAL FEVER. 9225
titioners. For instance, Trasbot placed secretions from the nose
and bladder of animals affected with the disease 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 pustule, these inoculations being on the mucous mem-
brane and under the skin, and arrived at the following conclusions :
1. The contagious germ of distemper sticks to the secretion of
the nose and eyes, and the blood is also contagious.
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, which 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. Fried-
berger’s observations are diametrically opposite, for he contends
that he has caused infection by means of the contents of the pus-
tules. He also recognized in one case that the disease originated
from vaccination passed through a short intervening stage, and, as
a rule, was much less in intensity, ran a very rapid course, and
that the group of pustules was confined to the region of vaccina-
tion.
Schantyr has lately published certain observations concerning
the microbes of distemper. He agrees with Piitz 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, according to the presence of three micro-
organisms 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 sim-
ilarity with one another, and it is only with a careful microscopical
examination that the specific micro-organisms can be separated.
The bacilli of typhoid (small, short bacilli, which are almost ex-
actly like man’s bacilli) are generally found separate in the blood,
while the bacilli of distemper (small, somewhat bead-shaped) and
15
226 DISEASES OF TRUE INFECTION.
the bacilli of typhoid (typhoid are very small and thin) are gen-
erally arranged in groups. The bacilli are hard to color with
fuchsine, and become colorless with Graham’s test. This is not the
case with the bacillus of typhoid. Typhus and typhoid bacilli
give characteristic cultures upon gelatin and potato, while the
bacillus of distemper is extremely hard to culture under any cir-
cumstances.
CLINICAL SyMpToMs AND Course. ‘The stage of incubation
of distemper is generally from four to seven days. In rare cases
it may linger, after contact with the diseased animal, until eight
or twelve days, and Krajewski states that cases of infection through
cohabitation may sometimes take from two to two and a half weeks
to develop. The first actual symptom is an increase of temper-
ature. In the initial stage it rises to 40°, and some cases 41° and
over.
An increase in temperature has been observed by the author 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 to the normal point, accord-
ing to the condition of the animal. In cases developed by inocu-
lation 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 heat,
becomes easily fatigued, is chilly and shivering, the nose is hot
and dry, the skin is hard, and the hair becomes harsh and dry.
In some instances vomiting occurs, but that can hardly be called
a characteristic, initial symptom of the disease. This stage of the
disease is short; the symptoms increase rapidly, and have many
characteristic points, which are as follows:
1. Symptoms on the External Membranes. These appear in the
majority of cases and are of great importance. We see a number
of small red spots upon the inner fascia of the thighs, the abdo-
men, and in rare instances the mouth and eyes, and still more
rarely covering the entire body. They are generally scattered,
very rarely confluent. They rapidly form small bladder-like blis-
ters 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. After these scabs fall off
(generally in about one week), they leave on the skin a red, cir-
DISTEMPER AND CONTAGIOUS CATARRHAL FEVER. 9227
cular spot 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.
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 (exan-
thema of distemper, distemper-pox). Hertwig and Friedberger
have observed some cases in which this eruption made its appear-
ance 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 are redness and swelling of the conjunctiva. In the
early stages the secretion is serous and very fluid. Later on it
becomes a muco-purulent secretion, either light gray or yellowish
in color. This sometimes occurs in large masses (blennorrhcea 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, frequently gluing them together.
The corrosive action of these secretions and also the inflammation
of the surrounding membranes may cause lesions of the cornea,
sometimes from the animal scratching and rubbing the eye, especially
in animals 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 subsequent formation of an
ulceration. (Other details will be found in the chapter on Diseases
of the Eye.)
We see in rare cases keratitis parenchymatosa by extension of
the inflammation of the cornea. 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-passages, 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,
9228 DISEASES OF TRUE INFECTION.
grayish-white or grayish-yellow, sometimes bloody, and in some
cases even purulent, with more or less odor. We also see a
‘¢ sniffling’’ respiration. This is particularly noticeable in short-
headed dogs (such as pugs or bulldogs). In all cases there is
catarrh of the larynx, bronchi, and bronchioles. Catarrh of the
larynx is generally marked by a loud, hoarse, dry cough, which
is particularly distressing to the animal, especially at night. As
the diseases 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 respiration, which gradually becomes
more intense as the inflammatory process goes downward into the
finer bronchi. Any pressure on the sides or tapping upon the
walls of the chest causes a very distinct, painful, distressing cough.
On auscultation we hear an increased vesicular breathing, 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 pronounced; respiration is superficial but laborious,
as is proved by the inflation of the cheeks. The number of respi-
rations may increase from 60 to 80, and 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 remit-
tent. On auscultating we hear in the lungs snoring, groaning,
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,
expiratory bruits, and alternating 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 turbid liquid, shiny or muco-puru-
lent, which is frothy. There are frequent discharges from the
bowels of a thin, muco-purulent fluid, occasionally streaked with
DISTEMPER AND CONTAGIOUS CATARRHAL FEVER. 9229
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.
5. Symptoms of the Nervous System. The animal is very dull,
especially its senses. There is a marked apathy and depression,
and in some cases deep coma. In a great many cases this con-
dition may be accompanied by periods of excitement, nervous-
ness, great restlessness, and even true delirium. These periods,
however, are not of any great length, as a rule, the animal sooner
or later showing 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 inter-
vals, or keep the animal irritated for days. Clonic convulsions of
the maxillary muscles are very frequently 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 occasion-
ally sufficiently strong to make a foam of the saliva. Beside this,
we may see symptoms of motor paralysis. The patients are
unsteady and irregular in their actions. In some instances they
drag their legs, or occasionally their posterior extremities lose
their power, and the animal is unable to stand ; in rare instances,
due to paralysis of the sympathetic, the bladder and the lower
bowel lose their nervous control, and urine and feces are evacuated
involuntarily.
The anatomical alterations produced by this disease of the ner-
vous system, 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 showed little change, or what alter-
ations 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 pathogenic
micro-organisms, they produce ‘‘ 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 on
their bodily health. When they take the disease, as weak, anze-
mic, poorly-fed animals, they are very apt to be severely attacked
with a nervous form of the disease. Occasional symptoms appear
230 DISEASES OF TRUE INFECTION.
in this disease which should be mentioned, such as serious weakness
of the heart. This may be due to a parenchymatous degenera-
tion of the heart-muscle. It is generally fatal, as it produces
cedema of the lungs. Albuminuria is produced by parenchymatous
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 septiceemia and produces death in this way.
The large number of the above-described symptoms shows how
completely the whole body may be affected with this disease. We
also observe in some instances pecidliarities and symptoms which
may to a large extent come from a general want of nutrition, or want
of resistance in some cases, while in others, and 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 may be said to deviate from the reg-
ular course. These are as follows:
1. Distemper with a Mild Termination. In such cases we have a
mild exanthema which may be difficult to recognize. A slight
respiratory or intestinal catarrh. The duration of this mild form
of the disease may be from half to one week.
2. Distemper with Severe Termination. In these cases we have
for a long time separated the disease under the following divisions:
‘“ pulmonal,” ‘‘ nervous,’’ ‘‘ gastric,’’ according to the acuteness
with which the symptoms may appear in the respiratory tract, the
neryous system, or the digestive apparatus.
3. Acute Distemper with a Protracted Course. Distemper lasts
generally for two to three weeks, although we occasionally see cases
where the disease is prolonged for a much longer period. In such
case this prolongation is not due to the influence of the disease
directly, but rather with secondary complications. We may count
among these certain nervous diseases which frequently remain or
appear after the disease has run its course. For instance, paral-
ysis of some of the muscles, of the hind-quarters, or of all the ex-
tremities, and rhythmic movements resembling St. Vitus’s dance;
in some of the muscular groups, especially the muscles of the face
or of the legs, and indicated by constant twitching, clonic in charac-
ter, sometimes severer at one time than another, but more especially
after excitement. Amaurosis (deafness) may occur in some cases.
DISTEMPER AND CONTAGIOUS CATARRHAL FEVER. 23] —
Proenosis. The prognosis of distemper, as a rule, should be re-
garded as unfavorable even in those cases which are apparently mild.
Of course, the danger of the disease increases with the intensity of the
symptoms, and especially if the symptoms are prolonged 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
pneumonia. Young dogs which are delicate (especially when not
fed on meat), anemic, or rhachitic, 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 the temperature, without a similar improve-
ment 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 cedema of the lungs, and occa-
sionally from septicemia or from general exhaustion. From the
experience of the author, the death-rate is from 20 to 30 per cent.
[The translator’s experience does not admit of such a favorable
percentage; he would say about 50 to 60 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 distemper runs a comparatively mild course, the
death-rate is much smaller. The author finds that in a large city
the death-rate amounts to 60 to 70 per cent.
PATHOLOGICAL ANATOMY. The most prominent and constant
anatomical alterations found on the post-mortem are those in the
respiratory and digestive organs. The lesions of the respiratory
tract are as follows : The pituitary membrane is injected, infiltrated,
and covered with a muco-purulent exudate; numerous ecchymosed
spots are found on the membrane. The mucous membrane of the
larynx, trachea, and bronchi shows various degrees of inflammatory
alterations—the large bronchi are filled with bloody mucus, the
smaller bronchi are filled with a thick, tenacious exudate ; with
this condition we frequently have evidence of lobular pneumonia;
the tissue is firm, and gangrenous masses are found in the centre
of the lobules. The pleura is covered with a rose or citron-colored
932 DISEASES OF TRUE INFECTION.
exudate. The bronchial lymphatics are infiltrated and tumefied,
and in rare cases purulent.
The lesions of the digestive tract are principally confined to the
small intestine; the mucous membranes are red, and numerous
ecchymosed spots are found, and decided hemorrhages in the sub-
mucous tissue. The follicles of the patches and solitary glands of
Payer are tumefied, sunken in the inflamed mucous membrane, and
superficial ulcerated spots are found over the entire length of the
intestine (Nocard and Leclainche).
We find also more or less pathological alteration in the central
nervous system, such as hypereemia and small hemorrhages in the
coverings of the brain; cedema of the brain is sometimes present,
and serous infiltration into the subarachnoids. In the ventricles
and base of the skull ‘we have more or less marked venous hyper-
emia, and in rare cases purulent meningitis. As a rule, the
spinal cord shows nothing abnormal except that it is pale and
seems soft and bloody in consistence.
Under the microscope 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 dis-
tention of the capillaries and arteries. These were filled with red
and white blood-corpuscles. In the infiltrated walls of the vessels
of the brain were found dark-colored, brittle, homogeneous gran-
ulations and accumulations. Krajewski found also the perivas-
cular spaces and the ganglionic cells filled with lymphoid corpuscles,
and he mentions particularly that those cases had died without
showing any prominent nervous symptoms. Another observer
found inflammation of the spinal cord in acute nervous distemper,
in which there was marked hyperemia. He also found alterations
in the walls of the vessels, and an albuminous exudation in the
upper third part of the spinal cord along the bloodvessels, as well
as in the interstitial tissue of the gray substance. In ‘“ chronic”’
distemper we have found an interstitial myelitis with partial
atrophy of the spinal cord. [The translator questions very much
whether there is a condition that can truly be termed ‘‘ chronic’’
distemper; if so, he has failed to observe it. The conditions that
the author speaks of should more properly be called sequences of
the disease. |
Other abnormal conditions are found in distemper, such as
—
DISTEMPER AND CONTAGIOUS CATARRHAL FEVER. 9233
anemia, parenchymatous or fatty degeneration of the heart,
liver, kidneys, and an abnormal swelling of the lymphatic
glands -
TuHeErAPeEvtTics. No special therapeutic treatment can be given
for distemper—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 deprive us of the symp-
tom of temperature, which is of greatest importance during the
course of the disease. According to Froéhner’s experiments, calo-
mel is supposed to have a slight claim as a universal agent, on the
same order as black coffee, which was formerly advocated by Tras-
bot. Common salt has been recommended by Zippelius, and
ergotin was highly recommended and frequently used a few years
ago. All of these remedies, while they prove beneficial in some
cases, are not to be laid down as a specific for the treatment of the
disease, therefore we must continue to treat it in a purely symp-
tomatic manner until it is possible to discover some specific which
may be ultimately found in the altered products of the bacilli.
Antipyrine, which has lately been 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 pos-
sible. Milk, bouillon, soup, and scraped raw meat (which is gen-
erally taken with a relish) have much to commend them. In grave
cases where there is entire loss of appetite, we must use concen-
trated 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 containing a large proportion of sodium salts. When the
temperature rises above 40° we must try to reduce it by means of
cold compresses and mild antiseptics. It is best, however, not to
try to reduce a normal increase of temperature, as this is necessary,
as a rule, to restrict the growth of bacilli, or even impair their
vitality, and in this way lessen or destroy their virulence. The
nutritive medium upon which the bacteria have developed may
234 DISEASES OF TRUE INFECTION.
possibly undergo some alteration, so that they can no longer
multiply.
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) 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 author, as a rule, does not advise
the use of quinine on account of its action upon the heart. [The
translator cannot agree with this. ]
R.—Antipyrine ‘ ‘ : ‘ : : : ae 2)
F. chart. No. v. S.—One powder in a little water twice daily.
R.—Antifebrine ‘ : 5 5 : . : - 0.5
Sacchar. alb. . ‘ : ; : . 2 14 ale
F. pulv. No. v. S.—One powder twice daily.
R.—Ferri. et quinine citratis : : : : + ALSO
Elixir simplex. ; . 4 : : ; 7 96:0
S.—One teaspoonful three times daily.
Good, nutritive food and slight alcoholic stimulants, as a rule,
produce good results. These assist in stimulating the digestive
powers, preventing loss of tissue, and assist in reducing the tem-
perature. Other therapeutic measures will have to be treated as
the symptoms arise, and we would refer you to the Diseases of the
Nose, Larynx, Bronchia, and Air-passages, also to those of the
Stomach and Intestine, and lastly Diseases of Brain, Spinal Cord,
and Eyes. Asa rule, no treatment should be used for the skin
eruption in distemper. If any irregularity arise, however, this
may be treated according to the methods recommended under Dis-
eases of the Skin.
Conjunctivitis is generally treated by a solution of sulphate of
zinc (1 to 100), or painting the diseased membranes with a solu-
tion of nitrate of silver (1 to 70). This must be followed after-
ward by a 1 per cent. solution of chloride of sodium. ‘‘ Blen-
norrhcea of the eyes’’ should be treated by bathing the parts with
some antiseptic solution, such as creolin (1 to 100); corrosive sub-
limate (1 to 2000), or boric acid (1 to 40), or by painting the mucous
membrane by means of a camel’s-hair pencil with a 2 per cent. solu-
tion of sulphate of copper. Ulceration of the cornea should be
treated with a 3 or 4 per cent. solution of boric acid. Parenchy-
ee EE ee
INFECTIOUS BRONCHIAL CATARRH. 935
matous keratitis may be treated with a few drops of a 1 to 100 solu-
tion of atropine. After the inflammatory symptoms of the eye
have subsided blowing calomel] directly on the cornea produces good
results. [The translator finds it also useful in the early stages,
when the ulcer is acutely inflamed.] In catarrh of the upper air-
passages make the animal inhale vaporized solutions of creolin,
carbolic acid, or infusions of calomel and tar-water. In catarrh
of the lungs and lobular pneumonia we use expectorants, such as
have been described under Diseases of the Lungs. Catarrh of the
stomach is to be treated with opium, tannic acid, and creosote.
In the acute nervous form of the disease we may produce good
results with bromide of potassium, chloral hydrate, or subcutaneous
injections of morphia, while motor paralytic symptoms should be
treated with strychnia and electricity. In severe depression stim-
ulants, such as ether and hypodermatic injections of camphor, may
be used.
[Infectious Bronchial Catarrh.
(False or Bench-show Distemper.)
Within the last ten years bench shows have become a regular
institution, and also where large kennels have increased in number
the translator has frequently observed a disease that resembled
canine distemper in a great many of its characters, but the general
symptoms and course were such as to lead the observer to think
that it is not the true contagious distemper, although it is decidedly
infectious, and for a better name has called it ‘‘ bench-show dis-
temper’ or ‘‘ kennel distemper.’? Since making the translation
he has noticed that the author has also felt that there may possibly
be such a condition, and has intimated that fact under the head of
Catarrh of the Bronchia (page 120).
ErioLtoey. It is generally seen in large kennels, attacking one
after another or several at once. It may also be observed where
several dogs have been sent to a bench show, developing shortly
after they return. The period of incubation is three to five days.
Another peculiarity is that one attack does not insure immunity
from another. The writer has observed several dogs that have
developed this disease, and the next year repeat the attack after
returning from a show.
PatHoLogicaAL ANATOMY. The lesions found are very similar
236 DISEASES OF TRUE INFECTION.
to those of true distemper, but milder in character. The alterations
in the lungs are those of catarrhal pneumonia. The most frequent
condition observed is great irritation of the mucous 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 distemper.
CurnicAL Symptoms. The animal is dull and listless for two
days, when the temperature will be found to be 39° or 40°; slight
running from the eyes; and invariably diarrhoea. This last symp-
tom is generally observed from the first, the stools being liquid the
first few days, and later filled with gelatinous mucus. At the end
of a week there may be some blood 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 diarrhoea 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. There is no rash on the skin, but the hair is dry and
harsh, and frequently 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 diarrhcea is persistent and the animal will
not eat; and any attempt at forced feeding is followed by
vomiting.
In some cases shortly after the acute symptoms commence
there may be evidences of congestion of the brain, accompanied
by severe and continued convulsions, which frequently cause
death.
The treatment is practically the same as in distemper. Keep
the animals warm and dry, give easily digested food, lean meat,
carefully removing 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.
RABIES. 237
R.—Ferri et quinine citras . ’ : a _ a eG)
Elixir simplex ‘ : ; : “ , o 96.0
S.—One teaspoonful three times daily,
If the diarrhoea is severe, give
R .—Bismuth subgallate ; : 0.75
F, charta No. xii. S.—One powder fines jimce oat
Rabies.
(Hydrophobia.)
This is an acute disease of the entire nervous system caused by
a specific poison, and distinguished by a variable period of incu-
bation, as well as by an absence of any marked anatomical alter-
ation.
Errotoey. 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 prairie dog). 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 the New England and Middle States than
anywhere else. This may be accounted for by the fact that dogs
in larger numbers run at large, and also to the fact that the
owners do not conform to the rules of the sanitary police. Rabies
seems to be influenced, to a certain extent, by the seasons of the
year, as cases are more frequently seen in the spring and summer
than in the fall 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
mammary glands. From direct inoculations, this disease appears
in its most concentrated form in the brain and spine.
This poison is virulent in the spine and brain during the incu-
bative period, and retains its full strength for several oe after the
death of the affected animal. Pasteur has demonstrated that a
238 DISEASES OF TRUE INFECTION.
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 the animal had been killed. Galtier noticed the same condi-
tions in the decayed brain-substance of a rabid dog, when kept
under a low temperature (12° Celsius). An affected brain was not
rendered harmless even when exposed for three weeks at a time,
but its virulence was attenuated when kept some time at 61°
Celsius. Blumberg found that an affected brain is rendered harm-
less when it has undergone a freezing process at 20° or 30°.
Galtier was able to destroy the virulence of affected 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 substances, as a rule, lose their harmful property
twenty-four hours after leaving the animal.
As a rule, it is necessary to make a natural or artificial inocula-
tion in order to obtain any successful transmission of the rabid
poison, as no infection will take place if the inoculation is simply
rubbed on the cutaneous or mucous membranes. ‘The most com-
mon 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,
according 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 observation 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
RABIES. 239
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 true rabid and ‘‘ suspected’? dogs, the proportion is re-
duced to about 8 per cent.
It has not up to the present time been definitely determined
that the disease can be transmitted through the medium of milk
and meat, or by any other intermediate agents. The period of
incubation between the time of the actual bite and the appearance
of the disease is not as yet definitely fixed. This peculiar fact
may be explained in different ways. Some have contended that
there is a form cf encysting of the poison in the inoculated region
which takes place.
This is supported by the following facts: 1. That by a rapid
destruction of the inoculated region, and even when this is per-
formed some time after the bite, the disease may be prevented.
2. In animals and man there are a peculiar itching and swelling of
the bitten cicatrix before the appearance of the true disease. This
‘‘encysting theory,’’ however, is opposed by the observations of
Galtier upon rabbits. These he inoculated in the ear with a
rabic virus, and they afterward became affected with the disease,
notwithstanding the fact that the ear was amputated three or four
hours after inoculation.
Another explanation of the various lengths of the period of
inoculation is the theory that a small amount of poison enters the
body, and that this has to be reproduced according to the quantity
inoculated until there is sufficient virus in the body to develop the
disease. Pasteur has positively demonstrated that the period of
inoculation is much longer when the amount inoculated is in very
small quantities, and also in cases where the poison is very much
weakened. The disease may not be developed at all. This theory,
however, does not thoroughly explain the varying length of the
period of incubation, and some observer may yet be able to give
us a more thorough and reliable explanation.
The character of the rabic poison is as yet unknown. We have
to accept the theory that it is a micro-organism, for Paul Bert was
able to render the infectious material innocuous by filtering it
through tablets of gypsum. Hiallier claims to have found a micro-
coccus in the blood of rabid dogs and horses. Ziirn, Frank, and
24050." DISEASES OF TRUE INFECTION.
Bollinger obtained negative results. Pasteur has found fine gran-
ulations in the brains of rabid animals, which could be colored with
aniline, and he is inclined to consider this as a specific organism
of rabies, but he was not able to make any cultures from them.
Chamberland and Roux noticed micro-organisms in the blood of
rabid animals, which were shaped like fine network. Rabbits
which had been inoculated with such cultures became very sick,
but did not show any symptoms of rabies. Babes noticed in the
brain and spinal cord of rabid subjects microbes which were crowded
together, forming shiny granulations. These were colonies of
diplococci or egg-shaped corpuscles which could be cultivated in
blood-serum at 37°. Dodeswell found in the spine and medulla
a coccus, and Rivolta noticed a ‘‘ coccobacterium lysse.’? Aurep
produced a very poisonous alkaloid with the brains of 100 rabbits
(affected by furious rabies).
Notes on Pasteur’s Methods of Vaccination. (Preventive
Inoculation.) Within the last ten years Pasteur has made a series
of very remarkable observations which have led him to reeommend
a special method of prophylactic inoculation of rabid virus. The
observations which he made were as follows:
1. The rabid poison is most concentrated and purest in the brain
and spine.
2. If the brain is the particular seat of the rabid poisoning, the
affected animal has furious rabies. If the spine is affected the
most, we see the quiet (or dumb) form of rabies.
3. After direct inoculation of rabic poison on the brain-surface,
under the dura mater (intracranial inoculation), the disease appears
much more rapidly than it does from cutaneous or subcutaneous
inoculations. With direct brain inoculation the disease may
appear in from six to ten days.
4, After cutaneous or subcutaneous inoculation of the poison
the rabid symptoms appear after a much longer time, and seem to
depend on the fact that the further the inoculated region is from
the brain the longer it takes to develop the disease.
5. The disease appears more rapidly if the virus has been intro-
duced directly into the circulation than cutaneously or subcuta-
neously. In the latter case it generally takes the form of quiet or
dumb rabies.
6. A spontaneous cure of rabid inoculation may occur after the
RABIES. 241
appearance of the first symptoms of the disease, provided the first
symptoms are extremely mild. We can never expect any good
termination when the symptoms are very violent in the early stages
of the disease. An injection of blood or saliva of a rabid animal
into the veins does not, as a rule, terminate fatally, but at the same
time it does not appear to protect an animal, in the future especially,
if it is inoculated again under the dura mater with rabid virus.
7. The intensity of the poison may become very much modified
by inoculation through the medium of other animals. The rabid
poison loses its intensity if it is inoculated into monkeys. After
a series of generations of inoculation through different monkeys,
it is much weakened and does not produce rabies in dogs, either
by subcutaneous or intracranial inoculation, but this ‘‘ weakened ”
virus, if injected into the dog, renders the animal proof against
further inoculations of the most active virus. On the other hand,
rabid virus increases in intensity if it is inoculated from one rabbit
to another, and the period of incubation is lessened until the dis-
ease shows itself positively in seven days. By experimental trans-
mission over forty to fifty generations, Pasteur has obtained a
fixed virus which has a constant and regular virulence. This he
obtained from the rabbit’s spine, and is even more intense than
the rabic poisoning of a furious dog, and he was able to produce
the disease from eight to ten days after inoculation.
8. If the brain and spinal cord are cut into small portions and
mixed with fixed virus, and subjected to a careful and slow drying
process under 20° Celsius, the infectious substance gradually loses
its activity and becomes perfectly harmless at the end of fourteen
days. We may thus obtain an inoculating substance which possesses
varying degrees of intensity, and it is possible to inoculate ani-
mals with weakened virus, rendering them proof against direct
inoculation from a rabid dog. This inoculation is made by means
of a hypodermatic syringe directly under the abdominal muscles.
After twelve or thirteen mild inoculations, each inoculation being
increased in intensity, the subjects become proof against the inoc-
ulation of the disease in any form whatever. When Pasteur first
made these inoculations, using the material in varying degrees of
strength, and at periods which took at least ten days, he was able
later on to make all the inoculations within twenty-four hours,
making each inoculation two hours apart.
16
242 DISEASES OF TRUE INFECTION.
These observations within the last year or two have been proved
correct by scientists in different parts of the world. Pasteur con-
cludes from his observations that man may be protected against
rabies by inoculation, and this is even possible when infection has
already taken place. As is well known, Pasteur, before his
death, applied this theory for some years upon inoculated people,
and he stated that he reduced the mortality, which varied from
16 to 60 per cent., down to $ to 1 per cent. Similar results have
been obtained in lie ston established in different parts
of the world by following the same methods ordinarily practised
by Pasteur. In the year 1888 they had 454 cases of patients
inoculated by rabid animals, which were afterward treated with
weakened virus, only 1 to 14 per cent. of which died.
Pasteur’s system has been opposed by several authors. For
instance, Frisch claims that it is impossible to prevent the devel-
opment of rabies after infection by means of Pasteur’s preventive
inoculation, as the poison has reached the cranium, and it is too
late to do anything. This opinion is indorsed by Amoroso and
de Renzi; and Babes, after numerous experiments, arrived at the
conclusion that it is very difficult to protect dogs from intracranial
infection, even after following Pasteur’s method. Nevertheless,
we cannot but admit that there is great value in the experimental
observations made by Pasteur; but, on the other hand, they still
require a great deal of improvement to make them perfect. The
method of obtaining the lymph is yet very primitive, and it has not
been accepted by other countries as a method for general adoption.
Pasteur’s observations, however, have shown the way, and there
is no doubt that in the future, with improved appliances and close
observation, the disease may be prevented or cured with success,
as we know that vaccination of splenic fever and tuberculosis
belong to the same class, and they are still very incomplete.
Other vaccinating methods, like, for instance, Hogyes’s, who
uses a virus which was weakened with 1 per cent. of a saturated
solution of chloride of sodium, have been very little used.
PatrHoLtogicaL ANATOMY. ‘The post-mortem results are gen-
erally negative and vary in different animals, but, as 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
RABIES. 243
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 hyperemia of the salivary
glands. In the cavity of the throat and mouth we find foreign
bodies, such as hair, straw, coal, wood, etc.; they may also be
found in the cesophagus, 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 indigest-
ible objects of various kinds and sizes—straw, hair, wood, stones,
or pieces of leather or rags. The mucous membrane is reddened
and swollen, especially on the surface of its folds, and marked
with hemorrhagic erosions. 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 alterations 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 or irritation due to foreign bodies being
inhaled through the bronchial tubes. The heart and its envelope
are generally normal. The inner surface of the pericardium may
show hemorrhagic spots. The chambers of the heart, as well as
the large bloodvessels, are filled with dark, imperfectly clotted
blood. The liver and kidneys are hyperemic. The spleen is
always filled with blood, swollen, and occasionally streaked with
hemorrhagic spots.
The condition of the brain and spine was formerly supposed to
present some reliable indications of the disease, but, according to
the investigations of the last few years, it cannot be said that they
present any constant pathological alterations. They vary greatly,
and in some cases may present nothing at all. We frequently find
hyperemia of the covering of the brain and spinal cord, accom-
panied by slight hemorrhages, and the brain and spinal matter
itself contains more blood than usual and is in a more or less
cedematous condition.
Kolesnikoff found on microscopic examination of the walls and
neighboring vessels of the brain (of dogs which have died with
244 DISEASES OF TRUE INFECTION.
rabies) an accumulation of lymphoid cells and extravasated red
blood-corpuscles. Wassilieff observed also dull masses which were
considered by Weller as peculiar fatty bodies present in rabies,
while Czokor and others have demonstrated that these corpuscles
are products of involution which are found in other animals in the
normal state. He also found that these were entirely absent in
the early stages of rabies. The accumulation of discolored cells
and red corpuscles in the walls and perivascular chambers of the
small bloodvessels indicates to a certain extent a condition which
in rabies is of pathological importance. They are undoubtedly
symptoms of inflammation. These changes vary in different cases.
According to Czokor, 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 neighborhood were filled
with leucocytes). Similar alterations have been noticed in
other diseased conditions, such as chorea, tetanus, and menin-
gitis.
CLINICAL SyMpToMs AND Course. The period of incubation
lasts in the majority of cases from three to five weeks. In very
rare instances the disease may 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. Ziindel 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. between
the fifteenth and thirtieth day; 19 per cent. between the thirtieth
and forty-fifth day; 10 per cent. between the forty-fifth and six-
tieth day; 16, 18, and 10 per cent. over three months. The
longest period of incubation was observed by Leblanc; this case
developed in 364 days. In the human race it is generally admitted
that the average period of incubation is seventy-two days (this
average covers over 510 cases).
During the period of incubation nothing abnormal may be
observed in the affected animal, but Hogyes, Babes, Ferré, and
others have observed in rabbits which were inoculated with virus
a slight increase of temperature on the fourth or fifth day, and
Babes has noted that the time this fever is observed there are no
RABIES. 245
nervous symptoms presented, the animals remaining healthy for
weeks until finally the disease appears.
There are two forms of rabies—a furious and quiet (or dumb)
form. Both forms are fatal.
Furious Rabies. This comprises three distinct stages, namely,
the melancholic, the irritating, and the paralytic stage.
In the melancholic stage the dogs seem to change in their dispo-
sition. They are capricious, and at other times irritable or de-
pressed. They show symptoms of anger, are easily excited, fretful,
and rarely 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. They will
lick and gnaw in a greedy manner various objects, such as wood,
coal, furniture, and eat straw, earth, stones, wood, blankets, and
even their own feces. The sexual excitement is very much increased,
and we see in the first stage an uncertainty in the gait and a weak-
ness in the hind-quarters. 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 ten-
dency to escape and run away; 2. By a great irritation and an
inclination to bite animals, objects, or man; 3. By a strange alter-
ation in the voice, or bark.
The inclination to run off is very marked. As soon as they
get their liberty they will run about aimlessly, covering very
much ground ina short space of time, and return in one or two
days, showing every indication of great excitement or of having
travelled long distances. 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. Asa
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. 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 or man that will
come within their reach.
The biting and delirium are not constant, but appear after
alternate periods of rest, followed by uncontrollable delirious
246 DISEASES OF TRUE INFECTION.
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 raw. 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 swallowing, and very often see an animal
pick up some indigestible object, attempt to swallow it, and, not
succeeding, drop it from its mouth. Vomiting sometimes occurs.
There is great difficulty in defecation, which seems to produce
evident pain. There is very little alteration in respiration, but it
may be slightly increased. The pulse is increased; the tempera-
ture also rises, but falls toward the end of the disease.
The duration of the second stage, which does not always present
all of the characteristic symptoms, may last from two 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 conjunctiva is
generally hyperemic; the hair is erect; and we begin to see symp-
toms of paralysis. Asa 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 extremities. 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.
The quiet or dumb form of rabies, according to Bollinger,
comprises about 15 to 20 per cent. of all cases. [The translator
thinks that the average given of this form of rabies is entirely too
! RABIES. 247
small, and should be at least 60 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 symp-
toms are less marked, and in very rare cases entirely absent, also
that the paralytic symptoms appear rarely 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 appe-
tite, 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.
The diagnosis of rabies may be complicated by certain condi-
tions 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. [The translator knows of two in-
stances in which the English setter was under complete control ;
hunted in the field, obeying 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 constantly recognized
from the appearance of the animal. Great excitement and rest-
lessness, a tendency 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 bark; more or less
rapid symptoms of paralysis, and the cases being invariably fatal.
The post-mortem confirms the disease when we find acute hyper-
emia of the throat, pharynx, and mucous membrane, hemorrhagic
erosions, and foreign bodies, etc., in the stomach. In doubtful
cases the disease can only be accurately diagnosed by vaccina-
tion—that is to say, by the injection of small quantities of brain
or spinal substance which have been diluted with distilled water.
This should be injected into the dura mater of a dog or rabbit
IAS DISEASES OF TRUE INFECTION.
after it has been trephined. 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, the persons bitten should not delay, while waiting for
development, but all measures should be taken as soon as _possi-
ble.
Another method of vaccination for diagnostic purposes is recom-
mended by Nocard and others, and is used at Alfort at the present
time. This consists of making a solution of the spinal matter of
the suspected animal in distilled water. The emulsion which is
thus obtained is filtered through a piece of linen and brought in
contact with the anterior chamber of the eye of the animal which
is to be inoculated. They do this by means of a small hypodermatic
syringe, having first placed cocaine on the cornea, and then inject
the solution directly into the anterior chamber. If the suspected
animal was rabid, we will see the development of the disease in
from fourteen to seventeen days, even if the chamber should sup-
purate from the irritation of the injected solution. Gal opposes
this procedure by pointing out the fact that the stage of incuba-
tion may be greatly delayed. According to Di Veste and Zagari,
the inoculation of the rabbit is more reliable than dogs or guinea-
pigs, and it is much more certain when a direct inoculation is made
on the dura mater. He also proposes that a small cutaneous
wound can be made, exposing a nerve-trunk, and the rabie poison
placed in contact with the cut end of the nerve.
The following diseases are sometimes mistaken for rabies: Cer-
tain affections of the brain, teething, 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, intense excitement in bitches that have had their young
taken from them, and poisoning. The course of the disease, how-
ever, and the after-symptoms always enable one to make a differ-
ential diagnosis. Concerning the prophylactic measures, which
are of great importance, relating to the prevention of the spread
of this disease (that is, muzzling, taxing, etc.), we must limit our-
selves to the publication of the German law on the subject, as
follows:
RABIES. 249
Dogs or any domestic animals which are suspected of rabies
must be killed immediately by their owners or keepers, or kept
safely locked up until the arrival of the police.
No attempts at medication of suspected animals may be made
before obtaining the consent of the police officials.
It is forbidden to sell or use any portion of a suspected animal,
or, if it is a cow, to consume its milk.
If the existence of rabies is established in a dog, the animal
must be destroyed at once, as well as all dogs, cats, or other ani-
mals which are suspected of being bitten. If any other domestic
animals are suspected, they must immediately be placed under
police observation.
If they show any symptoms of rabies, they have to be destroyed
at once.
In exceptional cases suspected dogs may remain under obser-
vation and confinement for a period of three months. This, how-
ever, is left tu the judgment of the police officials, provided the
owner of the animal is willing to bear the expense.
If a rabid animal has been running loose, the police authorities
of that district must see that all dogs therein shall be muzzled, or
held by a leash, for at least three months. If any dogs are allowed
to run about loose during that period, the police have instructions
to kill them at sight.
The cadavers of dead, or killed rabid subjects, must immediately
be burned, and no animal suspected of this disease shall be skinned,
or any portion of its hide retained.
Instructions of the Veterinary Congress of February 24, 1881.
The stables and other premises in which rabid animals have been
kept, as well as the utensils and other objects with which the ani-
mals may have come in contact, must be disinfected according to
rules and regulations. Vehicles and other means of transporta-
tion which have been used for the removal of dead animals
must undergo the same cleansing. Straw and the kennels of dogs
must be burnt.
Disinfection must be made according to the direction of the
official veterinarian and under police supervision.
The owner or keeper of the premises must satisfy the author-
ities that these orders are obeyed without delay.
The official veterinarian must send his report to the police
250 DISEASES OF TRUE INFECTION.
department certifying that the above orders were executed to the
letter.
Tuberculosis.
Under this name we class all affections which owe their origin
to a peculiar specific bacteria known as ‘‘ tubercle bacilli.’’
These are found in all tubercular deposits in man or in animals,
whether they occur spontaneously or are inoculated. Under the
microscope they appear in the shape of very thin tube-like casts,
showing a certain activity of movement. They multiply by means of
transverse sections, and under certain conditions oval-shaped spores.
form in the body, which ultimately develop new bacilli. The tuber-
cle bacilli should be considered as true parasites which multiply
and live in the body only, but they also seem to possess the prop-
erty of living outside of the body for a certain length of time, as
the excretions of consumptives can be used successfully in inocu-
lating animals, after having been dried for several weeks. We
therefore conclude that tuberculosis is only produced by infection,
or a better term would be transmission of tubercle bacilli 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. They seem to possess more power of resistance and
are able to throw off the disease. [In the last three years the
translator has seen a great number of cases of tuberculosis, and
has been surprised to find such a large number, especially in
fine-bred animals, and in a number of instances could trace the
cause of the disease directly to women that were affected with tu-
berculosis, and had the animals as pets; in one instance a woman
had three dogs; one after the other died with symptoms of the
disease, which was confirmed on the post-mortem of two of them. }
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 con-
cerning its etiology, pathological anatomy, ete.
ErroLocgy AND PaTHoLOGicAL ANATOMY. <A number of
observers agree in the fact that, as a rule, an animal affected with
TUBERCULOSIS. 251
tuberculosis has been at some time near or in the vicinity of
some person who was in an advanced stage of consumption. In
one case, particularly, which was observed by the author, the
affected dog had been an inseparable companion of a woman who
had died of phthisis. In another, the dog had frequently licked
the expectorations of a man in the last stages of consumption. In
such cases the bacilli may be introduced in the form of fine
dust and be respired into the lungs, or they may be taken up by
the intestines, finding their way into the bowels mixed with food.
In one case which the author observed there were tuberculous
ulcers in the parotid region, and also tubercular deposits in the
lymphatic glands of the neck. It is demonstrated that it is pos-
sible to absorb the poison through the skin. 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 intes-
tines, liver, kidneys, and peritoneum, and in rare instances affect-
ing the entire body. This has been shown by post-mortems made
by a number of observers, and especially by Jensen. He has
made post-mortems of twenty-eight tuberculous dogs, and in nine
cases he found the lungs involved. In the same cases he found
accumulations of miliary tubercles. These masses were scattered
and were of a cheesy character. The tubercular mass varied in
size between that of a millet-seed and a bean. In two cases he
found collections as big as an egg which had undergone slight de-
generation in their centres. In some cases tuberculosis has taken
the form of lobular pneumonia, separating certain sections in the
lungs. In these cases cheesy masses of tubercular matter were
generally found. The hepatized tissue of the lungs often breaks
down, and large sections of the lungs remain, while the broken-
down portion is coughed up, leaving a series of irregular, cavern-
ous spaces, frequently hollow and at other times filled with pus-like
masses. In one case they were directly against the large bronchia,
although this condition, as a rule, is rare. 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 lar-
daceous tissue and generally contain a centre cavity filled with a
252 DISEASES OF TRUE INFECTION.
cheese-like mass. True cheesy tuberculosis is rather rare in the
dog, but, on the other hand, we have a peculiar process of absorp-
tion of the tissues, forming white masses, which on examination
are found to be tuberculous deposits, or have undergone fatty
degeneration.
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 degeneration. In
the other half of the cases the serous membranes 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
‘‘ earl’? tubercular masses. These are known to be deposits of
soft connective tissue, of numerous conglomerating granulations,
or in large round tumors. In some cases there is extensive exuda-
tive inflammation present (sero-fibrinous and purulent pleuritis).
Two cases of tubercular inflammation were found in the pericar-
dium, and a very peculiar alteration of the mediastinum has been
observed in several cases. This part was changed into a large,
thick, partially folded, or twisted leaf-like body. This consisted
of tubercular tissue with tubercular masses in enormous quantities
lying on its surface. The heart, as a rule, rarely presents any
tubercular formations. In the digestive organs the lymphatic
glands of the head and neck are rarely invaded; also the submax-
illary and retro-pharyngeal were only noticed to be affected in one
case. 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. 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 sub-
~ stance being filled with small knots, also large granular masses
which are milky white in color. In the centre of these is found
a broken-down opaque fluid, the result of fatty degeneration.
The spleen was only noticed to be tubercular in two cases, and
that only to a slight degree. The kidneys are frequently the seat
of more or less tubercular deposits, and in twelve cases scattered
TUBERCULOSIS. 253
granulations were found in the spinal and membranous substance,
but cheesy abscesses and centres were also found. These were
accompanied by chronic indurative nephritis. Ulceration of the
pelvis of the kidney was observed in one case. One dog showed
but a slightly tubercular ureter and bladder. The sexual organs
are, as a rule, found healthy and very rarely attacked by the dis-
ease. In rare instances a tubercular testicle is noticed.
Tuberculosis of the prostate has been observed in two cases by
Cramer. The same author observed a tubercular ovary in one case.
CLINICAL SYMPTOMS AND CoursE. On account of the various
ways in which tuberculosis appears, no positive line of symptoms
can be made. ‘Tuberculosis of the lungs only will show marked
symptoms, especially if it has made considerable progress, and is
very similar to chronic catarrh of the lungs or chronic lobular
pneumonia (see this disease). There are rapid emaciation, notwith-
standing a good appetite, and a quick loss of strength, to suspicion
tuberculosis of the lungs. We can only be positive of our diag-
nosis by recognizing tubercle bacilli within the secretions, although
it is very difficult to obtain such.
Ehrlich advises that the observer place the secreted matter in a
very thin layer upon a covered plate, and allow it to dry in the
open air. When this is done pass the glass three times slowly over
the flame of a gas- or alcohol-lamp. Then place it in a watch-
glass which contains a colored solution of sputa. This can be
prepared previously in a small reagent-glass, in which we mix six
parts of water and one part of aniline, then filter. The filtered
liquid is placed in the watch-glass and diluted with six or eight
drops of concentrated alcoholic solution of fuchsine. The covered
glass with the dried sputa must be left as long as possible, say
twenty-four hours, in this coloring solution, or it may be heated,
but not to the boiling-point. Then it has to be left standing ten
or fifteen minutes, and after that the covering should be removed.
This is then quickly washed in water and placed for a short time
(six or seven seconds) in a solution of one part of nitrate of
sodium to three parts of water, and the agent again thoroughly
washed. This preparation is now ready for examination.
The tubercle bacilli will be found to be colored intensely red,
and the rest of the material is either colorless or a very dull red.
Another method is to place, for a short time (one or two minutes),
254 DISEASES OF TRUE INFECTION.
some sputum in a watery solution of Bismarck brown. This ren-
ders the bacilli still more distinct. Other coloring methods are
known, but the reader is advised to follow the above method, as
it is the best.
M. Tempel, of Dresden, injected Koch’s tuberculin into two
apparently healthy dogs, and in one dog which was affected with
the pulmonal form of distemper, doses from 0.006 to 0.1, without
observing any rise of temperature. The post-mortem of the dogs,
which were killed some time later, showed no tuberculosis present.
[There have been a number of suspected animals inoculated at
the University of Pennsylvania, and in all the cases that after-
ward proved to be affected with the disease the reaction was most
pronounced, rising to 40° and 41°. ]
Tuberculosis of any of the abdominal organs is very difficult to
recognize. The only way we might succeed is by pressure, or
manipulation, of the abdominal cavity, recognizing swollen lym-
phatic glands or some external manifestation of this in this region.
We find, however, great emaciation and symptoms of chronic
catarrh of the intestinal tract. These last two symptoms would
be sufficient to make us suspect intestinal tuberculosis. In one
case of tubercular ulceration of the intestines which was observed
by the author, the dog was very thin and had shown this for some
time. There were also present symptoms of catarrh of the lungs
upon the upper portion of the neck and a deep abscess was formed.
This was quite large and contained numerous masses 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 cutane-
ous membrane and moved about freely. There were also present a
few enlarged lymphatic glands in the upper portion of the neck.
THERAPEUTIC TREATMENT. When you have once established
the fact that the animal is affected with the disease, it is the duty
of the veterinarian to warn the owner of a tubercular or suspected
dog of the danger of infection, and advise him to destroy the
animal, The successful treatment of this disease is as yet
unknown. It may be that Koch’s inoculating method will pro-
duce favorable results, but up to the present date nothing positive
has been done. Koch’s lymph or tuberculin has been tried thor-
oughly, and while it has no apparent value in curing the disease,
it has fairly established itself as a reliable diagnostic agent.
ANTHRAX. 255
Anthrax.
Anthrax is quite rare in the dog, and when it occurs it is gen-
erally caused by the animal eating portions of cadavers of animals
that have had this affection. All forms of anthrax have been
observed in the dog, but generally the seat of the disease is in the
mouth and throat and in the intestines. Therapeutic treatment
is useless on account of the rapid progress of the disease. Con-
cerning 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 in an 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 anthrax must be rendered harmless by burning the ca-
davers. Skinning the animal is strictly forbidden.
CONSTITUTIONAL DISEASES.
Anemia; Chlorosis.
By anemia we mean a lessening or thinning of the blood.
This is especially noticeable after great hemorrhages. At the same
time much greater importance must be placed on that condition of
the blood where it contains a very small quantity of albumin, and
where the number of red blood-corpuscles is very much decreased.
This is the most important form of anemia.
Eriotoay. The disease occurs frequently in young, delicate
animals of the improved or closely bred classes. It seems to be
hereditary in some of these animals, and may depend to a certain
extent on the defective development of the arterial system and an
abnormally small heart. Anzemia occurs most frequently from
the lessening in quantity of the vital fluids, such as the albuminous,
or after a large or long-continued slight hemorrhage; from pro-
longed suppuration in chronic, persistent diarrhoea; chronic inflam-
mation 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, ete.
CiurntcaAL Symptoms. The symptoms of the disease consist in
a reduction of the coloring elements of the blood and a general
condition of debility, showing every indication of loss of blood.
The skin and visible mucous membranes are very pale in color.
The animals are easily fatigued and have a draggy way of walk-
ing; the pulse is often small and generally rapid. The tempera-
ture in many cases is below normal, in other cases it may be normal
or even higher. The respiration is increased with the pulse, and
especially after very slight physical exercise. Reflex excitability
of the brain in anzemic subjects is increased to such an extent that
the animal will go into convulsions at the slightest provocation.
Impaired digestion is a frequent symptom and naturally assists in
complicating the disease. It is generally chronic, but proper
treatment will often produce very good results.
( 256 )
LEUKAMIA. 257
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 substances, 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, saccharated 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 im-
paired. 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 prepa-
ration in this disease is citrate of quinine and iron. This prepa-
ration is valuable not only for the iron it contains, but the tonic
properties of the quinine, and also the very slight tendency it has
to disorder the stomach. Frequently arsenic is useful as a general
tonic.
Leukemia.
This disease is one that is characterized by an alteration of the
blood, due to the presence of an increased quantity of white blood-
corpuscles which must be due to some disorder of the lymphatic
organs. ‘The pathological anatomist distinguishes two conditions
in the affected lymphatic—a lienal and myelogenic form—accord-
ing to the origin of the disease: the spleen or the marrow of the
bones. ‘This, however, is of no special value to the practitioner,
as both of these forms, as a rule, are combined in the dog, as in
other domestic animals. The myelogenic form has never been
observed alone (Siedamgrotzky and others).
Errotocy. The causes of this disease are not definitely known
at present. In the human race we find that middle-aged men are
mostly affected with this disease; in the dog, the middle or ad-
vanced period of age seems to show the greatest tendency, but
young animals frequently show very acute cases. This disease
was observed in 1878 by Siedamgrotzky. From his own sta-
tistics with those of many physicians he was inclined to consider
leukemia an infectious disease. Attempts to produce the disease
17
258 CONSTITUTIONAL DISEASES.
by transfusion of leukemic blood in healthy animals always gave
negative results. The same observer saw two cases of secondary
leukemia. In both there was a virulent catarrh of the prepuce.
This soon produced a swelling of the glans and of the lymphatic
glands in its immediate neighborhood. This is accompanied by
a marked increase in the white blood-corpuscles.
ParHoLocicAaL ANATOMY. The most important alteration
always observed in this disease is an increase of white blood-
corpuscles in the blood. This may become so great (in the dog)
that we find the proportion of white to red blood-corpuseles is 1
to 5 (Bollinger). We find in this ‘‘ leucocythemia’’ the blood
possesses a much lighter color than it does normally. We also
notice a great tendency to emaciation and a characteristic altera-
tion of the spleen, lymphatic glands, and the marrow. This
alteration is especially found in the spleen, which is very much
enlarged in all directions, and is also increased proportionately in
weight. It is not rare to find it weighing at least 1000 grammes,
and in among the sections marks of true hyperplasia. We also
see at times circumscribed hyperplasia of the spleen in dogs. As
a rule, the lymphatic glands are enlarged, and in other cases very
slightly. This is caused by a 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.
CrryicaL Symproms AND Course. The symptoms of the
disease are similar to those of intense anemia. First, there is a
characteristic alteration of the blood, and, second, the symptoms
presented by the spleen and lymphatic glands. In mild cases a
microscopic examination and counting the number of blood-cor-
puscles 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 difference in their normal
size.
While we may be able to correctly diagnose the disease from
the condition of the blood during life, we may also notice certain
DIABETES MELLITUS. 259
alterations in the size of the spleen and lymphatic glands. In
the glands of the head and neck we may find considerable enlarge-
ment, as is also the case with the testicles. It is somewhat hard
to really detect an abnormal enlargement of the mesenteric lym-
phatic glands; while tumors of the spleen may occasionally be
detected by manipulation, it is only when
they have reached a very much enlarged
condition (Fig. 58). Various observers : GC
have mentioned other symptoms, such as ~ BO
increase of the pulse (130 to 140 per min- Es ]
ute); loss of appetite; the buccal mucous By ®
membrane is red and inflamed, and the 56) _9
tongue is coated. In rare instances, diar- 6® @G @ ©
rhea and dropsical symptoms may be
present. The disease is generally chronic,
and death may occur after several months as the result of total
exhaustion.
THERAPEUTIC TREATMENT. The agents generally used by
physicians in the treatment of this affection are iron, quinine,
iodine, and bromine, but, as a rule, none of these produce favor-
able results. Arsenic seems to have answered better than any
of the others, and is, therefore, to be recommended for dogs.
Besides the disease just described, we have a condition which is
very rarely seen in a dog—‘‘ pseudo-leukeemia.’’ In this condi-
tion we see exactly the same hyperplasia of the lymphatic glands
as in true leukeemia, but there is no increase in the white blood-
corpuscles (Fréhner). One case which was observed by the
author was that of an old setter dog which showed considerable
hyperplasia of the lymphatic glands of the neck and trunk; also
acute anemia. There was not any enlargement of the spleen or
the lymphatic glands of the abdominal cavity.
The blood in leucocythemia.
Diabetes Mellitus.
Errotocy. By diabetes mellitus we understand a peculiar
abnormal condition of the urine which contains a large quantity of
sugar. The true cause of this peculiar disease is not exactly known,
but from observations which have been made on dogs and other
animals it is supposed to be due to a partial paralysis of the vaso-
260 CONSTITUTIONAL DISEASES.
motor nerves going to the liver—‘“‘ glycosuria.’”’ The same results
may be produced by certain poisons—coal-gas, amyl nitrite, prussic
acid, and in some cases it is produced by morphia and chloral
hydrate. Another peculiar condition is also seen in cases of con-
cussion of the brain, fracture of the skull, and epilepsy, in which
sugar may be found in large quantities in the urine as a result of
this disease. Some observers have noticed it in true infectious
diseases, such as distemper.
CLINICAL SyMpToMs AND Course. The author has not been
able to find any sugar (grape-sugar) in the urine of dogs, notwith-
standing the fact that he has made a large number of tesis.
According to our text-books, the symptoms of diabetes are as fol-
lows: Depression, dulness, great emaciation, in spite of the fact
that the animal has an enormous appetite; there is increased thirst,
and the animal passes an ordinary amount of urine with a high
specific gravity, containing from 7 to 12 per cent. of sugar. (The
method used for the detection of sugar in urine will be found under
Examination of Urine.) In many cases cataract may develop in
both eyes, causing total blindness. In other cases the hair falls
out; chronic bronchial catarrh, phthisis of the lungs, persistent —
diarrhoea, and some have noticed an ulceration of the skin and
cornea.
The course of the disease is gradual; emaciation and debility
increase until finally the animal sinks into a deep coma, accom-
panied, as a rule, with convulsions, and finally death. The prog-
nosis in all cases should be unfavorable.
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.
Diabetes Insipidus.
This form of diabetes is extremely rare in the dog [the trans-
lator has been fortunate enough to have observed six cases in
the last ten years], as we find but one case of this disease de-
scribed in veterinary literature (Holzmann). In this disease we
have an abnormal increase of the urine without the presence of
any sugar. It is more frequently found in young than in old
DIABETES INSIPIDUS. 261
animals, and may be ascribed to be due to some disease of the
nervous system. Claude Bernard has demonstrated that simple
polyuria (without sugar) may be produced on a certain location on
the left side of the brain, immediately in front of the diabetic
centre. Peyrani was able to obtain the same effect by intersection
of the splanchnic nerve, and by an irritation of the sympathetic
nerve of the neck. Kahler produced polyuria in rabbits by inject-
ing a solution of nitrate of silver into the medulla oblongata. In
man this disease occurs very frequently in those cases where
brain-tumors, meningitis, encephalitis, and concussion or injury
of the brain is present. ‘This disease is frequently seen in man
without any apparent cause, and may be frequently found in the
dog, and should be observed, as was proved in Holzmann’s case.
The dog shown to him was three years old, having a pale mucous
membrane and rectal temperature of 38°. This animal drank
12.76 c.c. of water daily, and passed about 12.760.c.c. of urine. The
urine was yellowish, had a weak acid reaction, its specific gravity
was 1.006, and contained nothing abnormal. On_ post-mortem
nothing of any great consequence 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 por-
tion of the neck. There was also some hyperemia and slight
bleeding in the gray substance of the lumbar region. Five elon-
gated osteoid sarcoma masses were found pressing on the dura
mater. Holzmann could not decide which of these conditions was
the true cause of the disease. [Of the translator’s cases the disease
followed recovery from distemper in three of them, two had no
definite history, and one had an enormously enlarged thyroid gland.
All the cases passed large quantities of urine so pale that it could
only be said to be tinted with yellow; the reaction was not taken;
the mucous membranes were pale and blanched, especially the in-
side of the lips and tongue, which was yellowish-white. The ap-
petite was good, and it was noticed that bread and rice aggravated
the condition, whereas meat seemed to lessen the amount. They
drank large quantities of water, and gradually became thin, with
the exception of one which kept in fairly good condition. One
recovered and two died; three were lost sight of. On holding a
post-mortem in two there was nothing particular found, except the
262 CONSTITUTIONAL DISEASES.
mucous membranes of the body were very pale and anemic; the
liver was enlarged in both cases, and in one there was a greatly
enlarged thyroid gland, which was a sarcoma. ‘The treatment
consisted of belladonna and iodide of potassium. |
The therapeutic treatment of diabetes in man consists of a meat-
diet, open-air exercise, suppression of all physical or nervous excite-
ment, small doses of opium, belladonna, valerian, and ergotin.
Obesity.
Errotocy. ‘This disease is due to the absorption of large quan-
tities of hydrate of carbon, 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 dis-
ease 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 surrounding the internal organs—for instance, in the medias-
tinum, the pericardium, and the capsule 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 condition 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 bloodvessels, decreasing their size and
thus requiring greater effort of the heart’s action, until finally the
heart becomes overtaxed, and we have symptoms of heart-failure,
bronchitis, chronic eatarrh of the stomach, and cedema.
THERAPEUTIC TREATMENT. The following causes which pro-
duce fat in the body must be understood, so that we may be able
to properly treat the animal:
1. The source of fatty deposits may be due to albuminous or
carbonaceous substances, or to fat itself. The nutritive fat, if not
taken up, is deposited in the fat-cells of the body.
OBESITY. 263
2. Albumin is a factor in the formation of fat in the animal,
while carbonaceous substances are very easily digested, and pre-
vent a disintegration of reabsorbed fat which comes directly out
of the food and favors its accumulation.
3. Hydrate of carbon and fat may act as substitutes, so that an
animal eating albumin and fat, or albumin and carbon hydrate,
may become fat.
4, A purely fat or hydrate of carbon diet cannot sustain the
body for any length of time. In the first case it gains fat but loses
flesh; in the latter it loses flesh and also fat. A pure lime-diet is
also insufficient, although it has been demonstrated that lime may
replace to a certain extent albuminous substances in the food.
5. A dog can be kept in this abnormal fat condition when fed
on lean meat or when he is given large quantities of fat (one-
twentieth to one-twenty-fifth of his own weight daily) ; but if a fat
dog receives less meat than the quantity mentioned above, he will
lose flesh.
From the above indications it will be seen that, besides medical
treatment, we have two ways of reducing obesity:
1. By reducing the quantity of fat. 2. By feeding with lean
meat. The choice of the method employed is left to the practi-
tioner. The author’s experience has been that both are practica-
ble, and must be applied according to circumstances. As a rule,
the first method should be tried, as it generally corresponds with
the owner’s ideas. The animal should be weighed from time to
time, as this is the only way in which we may ascertain whether
the treatment is producing the desired effect.
The animal must also be exercised regularly, as muscular exer-
cise increases the destruction and use of fat in the body. It
also increases the heart-action, the heart-muscles thus becoming
strengthened and the circulation improved.
A method employed by a number of practitioners is similar to
that followed in man, viz., suppressing as much as possible the
use of all fluids. This, however, is hardly practicable in dogs,
as the only fluid they drink, as a rule, is water, and, if this treat-
ment is carried to any extent, it is actual cruelty. The pilocar-
pine treatment might be useful. According to experiments made
by various authors, subcutaneous injections of pilocarpine were
found to produce good effects (0.006 of pilocarpine daily); but
264 CONSTITUTIONAL DISEASES.
this must be used very carefully, as in old, fat dogs we frequently
find a chronic bronchitis, and from the increased respiration and
amount of fluids thrown out by the lungs it may produce death
by suffocation. Sulphate of magnesium and sulphate of sodium
are useful to increase the action of the intestines and to carry
away a certain quantity of fluid out of the body. They should be
given on an empty stomach, a teaspoonful at a dose, diluted in a
small quantity of warm water.
Hemoglobinzemia and Hzemoglobinuria.
When there is any decomposition of red blood-corpuscles in
the body (hemoglobinemia) the coloring substance is eliminated
through the kidneys, staining the urine and producing hemoglo-
binuria. These conditions occur as the result of the action of
certain chemical poisons, such as large doses of naphthol, chloride
of potassium, carbolic acid, and by certain infectious, poisonous
substances, transfusion of blood, and sterilized water. Influences
of extremes in temperature also produce it. In this condition the
urine is characterized by a dark red, brownish, or brick-red color-
ation, and when examined through the spectroscope shows streaks,
a and f, of the hemoglobin in yellow and green (Fig. 59), and
Fig. 59. Fic. 60.
Louie Orange SS Grin
x
| ' } i i
i
j
ne a
Aah C D Lb
Spectrum of urine in hemoglobinuria, Hematin crystals.
close to it is a narrow methemoglobin streak in orange. If we
cannot examine it by means of a spectroscope, we may use the
following tests: First, by means of the guaiac treatment or Teich-
mann’s heminprobe. The first method consists in placing a small
portion of a mixture composed of equal parts of tincture of guaiac
and oil of turpentine in a reagent-glass and covering it with the
urine which is to be tested. If any coloring substance of the blood
is present, we immediately notice the formation of a dirty white
URZMIA. 265
segment surrounded by an indigo-blue ring ; and if the test-tube is
agitated, the whole solution becomes a light blue opaque fluid
(Fig. 60).
The hemin-test consists of drying a large drop 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 microscope, we may
detect the presence of blood-corpuscles in the fluid. We may also
find by this means uric casts and epithelium of the kidneys, and
small red granulations. These may be considered hemoglobin.
The therapeutic treatment of hemoglobinuria consists of the use
of various diuretics, and an attempt must be made, as soon as pos-
sible, to remove the coloring matter from the blood and the kidneys.
Ureemia.
As a consequence of 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, pro-
ducing a condition known as ‘‘uremia.” Certain experiments have
been made on the dog to produce these uremic symptoms artifi-
cially—for instance, when both kidneys are removed or the ureters
ligated. Voit observed that when healthy animals were fed on
food containing uric acid, and at the same time deprived of water,
these conditions produced the disease. Grehant and Quinquaud
produced death in dogs when urea was injected into them subcu-
taneously to the amount of 1 per cent. of the whole weight of the
body. This produces convulsions, apparently from suppression
of respiration, Feltz and Ritter produced ursemic symptoms in
the dog with injections of salts of ammonium. It is of practical
interest to know that urzemia may also occur in acute nephritis, in
cases of enlargement of the prostate and obstruction of the pas-
sage of urine, or from uric stones filling up the urethra or the
neck of the bladder.
266 CONSTITUTIONAL DISEASES.
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 symp-
toms of this disease, but they were produced gradually and the
symptoms were not so acute. In such cases we find dulness, dis-
turbance of the intestinal canal, and convulsions.
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
cutaneous and mucous membranes, and also from the muscles, joints,
etc. Siedamgrotzky described a case of a two-year-old dog which
died suddenly with symptoms of hemorrhage of the brain after
being under treatment for four days. Numerous hemorrhagic
centres were found in the skin and cellular tissues. The buccal
mucous membrane was somewhat swollen and filled with hemor-
rhagic spots. The gums were also in the same condition. The
intestinal canal was filled with spots of hemorrhage from one end
to the other, the mucous membrane of the pylorus being espe-
cially affected. It was much swollen by a bloody infiltration.
The mesenteric glands were filled with blood; the spleen was very
much enlarged and weighed 107 grammes. On section it con-
tained apparently a normal amount of blood. The liver and
kidneys were healthy and normal. The lungs showed small hem-
orrhagic spots under the serous membrane and were slightly cede-
matous. The heart was flabby, light in color, and contained a
quantity of non-coagulated blood. The frontal cavities were filled
with blood-clots. The dura and arachnoid upon the left side also
contained small hemorrhages. On the brain itself there were
numerous flea-like spots, especially on the base of the brain. The
blood on chemical examination was very deficient in salts of
potassium. .
Friedberger and Frohner observed a case of scurvy in which
there was bleeding of the gums and nasal mucous membrane, also
in the retina of the eye. Friedberger found numerous hemor-
rhages in the cutaneous membrane of the hunting dog, in the
PRIESSNITZS COMPRESS. 267
neighborhood of the joints, in the serous membrane, and in the
mucous membranes of the various organs, and an enlargement of
the spleen to twice its normal size. He was of the opinion that
this condition very much resembled the morbus maculosus Werl-
hofii of man (a variety of scurvy). The treatment consists in
nutritive feeding, stimulants, and in following out the treatment
given under the head of Ulcerative Stomatitis.
| Priessnitz’s 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 therapeu-
tics that it needed no explanation, but to English-speaking veter-
inarians 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 affected a piece of absorbent cotton,
thick wool, or dry felt; or if moist heat is required, 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 out-
side 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, espe-
cially 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 BONES AND
ARTICULATIONS.
Rhachitis.
(Rickets.)
Eriotocy. The different theories which have been advanced
concerning the origin of rhachitis do not seem to answer in some
cases (a deficiency of lime-salts as a consequence of disturbances
of digestion ; excessive formation of carbonic or lactic acid, which
would dissolve the lime-salts; an alteration of the general nutritive
condition on account of abnormal influences in young. animals;
inflammatory hyperemia and an increase in the number and size
of bloodvessels in the osteogenic tissues, so that the lime-salts con-
tinue to circulate in the blood instead of being deposited in the
bones). We therefore do not know positively anything relating
to the character and origin of rhachitis. It is, perhaps, better
to admit that it is a specific disorder (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. A proper amount of exercise is specially
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. The symptoms
appear relatively in proportion to their growth. If the animal
grows quickly, rickets appears quickly; if it grows slowly, the
disease comes on gradually.
PaTHOLOGICAL ANATOMY. Rickets consists of a peculiar dis-
turbance of the bones of the whole system. It seems to be due to
a deficiency of lime-salts in the bones, making them soft and flex-
ible. At the same time the nutritive process in the perios-
teum 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
( 268 )
—_-
RHACHITIS. 269
the latter is removed from the bones of an animal in this condi-
tion certain portions of the bony tissue come away and remain
attached to the membrane. This is especially noticeable between
the epiphyses of the vertebree. The inner layer of the periosteum
is thickened and the diseased tissue seems to have undergone a
spongy degeneration. Inside of the bone we find it soft and
cavernous.
CLINICAL SyMpTOMS AND CoursE. 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 in the bones of the extremities.
We find periosteal inflations in the frontal bone and bones of the
temple, so that the head shows a peculiar marked alteration.
Schiitz has found that in rhachitic 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 vertebre, 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 ‘‘ rhachitie bead-string.’’ In acute forms of
this disease the spinal cord is twisted or bent in different directions.
The most striking alterations are observed 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
standing. The upper portion of the front legs bends inward,
rarely outward, and the animals have a peculiar, unsteady, awk-
ward gait. They stand on the hind legs with the leg twisted
under them, and in aggravated cases the bones are bent ina circle,
the bend of the astragalus coming down on the ground. Asa
consequence of the altered position of the bones the ligaments
become distended and stretched, causing an inflammation of the
joints, consequently more or less enlargement of them. At the
same time we observe emaciation, loss of appetite, and in some
cases catarrh of the stomach and air-passages. The disease, as a
rule, is chronic and the prognosis is unfavorable. If the dis-
ease is taken early, it may be checked by means of proper feeding;
but when the deformity is once formed, it is only in extremely rare
270 DISEASES OF THE BONES AND ARTICULATIONS
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 rhachitis con-
sists of improving all the nutritive conditions and encouraging
digestion as much as possible. Give the animal plenty of meat
and bones, adding to them a certain amount of phosphate of cal-
cium, egg-shells, and lime-water to drink. Improve the digestion
as much as possible by tonics.
Canine literature does not show that osteomalacia exists in dogs,
and it is not likely that they are affected by this disease, which
affects the middle-aged or old animals. It is a progressive disin-
tegration of the phosphates and softening of the bones. Kitt
described, in 1890, a peculiar diseased condition of a German bull-
dog, and compared it with myositis ossificans progressiva. The
head of the affected dog was disfigured by enormous osteophytes
on the lower jaw and by prominences of the frontal bones. The
bones of the forearm and thigh were covered with large osteophytes
which had accumulated, particularly around the muscular centres,
while, on the other hand, around the joints there was very slight
indication of the disease. The whole spinal vertebree, as far as
the last one in the tail, as well as the ribs, chest, and shoulder-
blades, were normal and well formed, abnormalities being confined
entirely to the bones before mentioned. During life the animal
seemed lively and free from any fever, had a good appetite, but
walked in a peculiar, undulating way, giving it a very awkward
and unsteady appearance.
Multiple periostitis has been observed by Siedamgrotzky in a
dog. This was very different from the case described above. The
animal during life showed marked symptoms of general muscular
rheumatism, the disease affecting the periosteum of the entire
body, especially the joints.
DISEASES OF THE JOINTS.
Inflammation of the Joints.
GENERAL PaTHoOLoGicAL ANATOMY OF INFLAMMATION OF
THE Jornts. The most common affection of the joints is syn-
ovitis. Ina simple case of inflammation of the joints we see an
INFLAMMATION OF THE JOINTS. DTA
increase of blood, an infiltration of the small cells, and even disin-
tegration of the endothelial cartilage, the tissue under it becoming
granular. We find quite frequently an accumulation of fibrinous
or ‘‘ croup-like’’ membranes, followed by a cicatrization of the
synovial membrane. In all acute forms of synovitis we see hem-
orrhages in the form of small, tick-like bodies. Inflammation of
the joints, when it takes a chronic form, makes the synovial mem-
brane thick, tougher, with marked indentations which present a
tree-like form. The synovia appears in large quantities, is yel-
lowish, clear, or slightly turbid, and dulled by cells or fibrinous
flakes. It is very rarely thick. If this synovia is gathered in a
large quantity, we see a distention of the capsule, producing a
hernia-like protrusion in the parts of the joint where there is the
least resistance. Occasionally we find the synovial membrane
covered with thick masses of clotted fibres. These occur from the
excessive formation of secretion of synovia in the joints. Some-
times small bodies appear in the joints due to some parts of the
hard cartilage becoming loose, and in rare instances by a breaking
off of small pieces of bone, and, finally, we may see the develop-
ment of a peculiar cicatricial contraction of the synovial mem-
brane. This 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 con-
dition 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 occasionally inflamed, but, as
a rule, in acute and chronic inflammation of the joint it remains
unaffected. Where there is suppuration present it may become
detached from the periosteum with the bone, and also perforated
by the pus. The ligaments are also impregnated with the pus
from a purulent inflammation, but they are rarely destroyed.
Occasionally, however, we may see in chronic inflammation of the
joints a cicatricial contraction where the joints become firm and
united, immobility being lost. Sometimes from traumatisms we
find only the soft parts which surround the joint, such as the exter-
nal ligaments, and the neighboring tendons become involved in the
inflammatory process, while the inner joint seems to be very little
affected.
The cartilage of the end of the joints is very little affected in
272. DISEASES OF THE BONES AND ARTICULATIONS.
all conditions. In acute cases of suppuration of the joints the
cartilage may be softened, perforated, or partially destroyed, so
that the bone is bare in some places. In many chronic cases of
inflammation of the joints the cartilage becomes macerated and
dissolved into fibres, or it may be overgrown with abnormal syn-
ovial extensions. As soon as the bone proper becomes involved
in the inflammatory process extensive granulations form, causing
a peculiar spongy growth. These crowd and perforate the bone
here and there, and also affect a cartilage of the opposing bone,
leading to a cicatricial 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 an acute inflammation of the ends of the joints. From
these periodical conditions we may have a marked alteration in
the form of the joint. Edges of the joint protrude, the inner
surface being hollowed and grooved. A peculiarity of deforming
inflammation of the joints is an inflammation of the synovial mem-
brane, with a normal 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 inflam-
mation of the joint; but if it should become uncovered from suppu-
ration of the cartilage, the inflammation extends to the spongiosa,
and we see occasionally the formation of purulent or granular
centres on the surface. In rare cases the periosteum becomes
covered with osteophytes.
In tubercular diseases the joints of the dog may become diseased,
but as yet such cases have not been demonstrated in veterinary
literature.
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 inflam-
mation of the synovial membrane and a lessening of the secretion
of synovial fluid into 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 epi-
PURULENT INFLAMMATION OF THE JOINTS. a fe.
thelia. The patients 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.
Errotocy. The following may cause synovitis: Crushing or
concussion of the joint, blows, 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 (by blood-clots or an anti-
septic dressing). According to the observations of the author,
acute synovitis occurs most frequently in the carpal joint, joints
of the toes, in the knees, and hip-joints.
Its course is, as a rule, rapid. If the patient receives proper
treatment, in a short time we see an improvement (especially if the
animal gets complete rest). In other cases the disease takes a
chronic form—that is, it may form one of the following condi-
tions:
Chronic Serous Inflammation of the Joints.
(Synovitis Chronica Serosa.)
In this the joint is slightly swollen and painful, also very fever-
ish. In some cases we may see a fluctuating swelling 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 cap-
sules, and very frequently quite an enlargement starting from the
edge of the joint.
This chronic synovitis may appear in the onset of the disease,
but, as a rule, it results as a consequence of the acute form. The
author has seen these cases in the carpus and knee-joint. The
lameness is not especially marked, but any active movements
increase it very much.
Purulent Inflammation of the Joints; Suppuration
of the Joints.
(Pyarthrosis. )
While the two forms which have before been described are rarely
accompanied by fever, it is quite different in suppuration of the
joint. In this there is great fever from the beginning, which is
18
974 DISEASES OF THE BONES AND ARTICULATIONS.
ushered in by a chill. We may see a more or less rapid develop-
ment of a 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 cedematous swelling extending
both above and below in the neighborhood of the joint. The
temperature is considerably increased in some cases; the skin ap-
pears normal or reddened, sometimes even bluish-red. The pus
may eventually break through the skin in the neighborhood of the
jomt, or it may lie in the joints, become absorbed, and cause
pyzmia.
This termination will perhaps occur even when the pus has
broken out externally, and in some cases where the inflammation
has been very acute we may have a subsequent adhesion of the
joint (ankylosis).
Errotoacy. 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 phlegmonous 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 suppurating inflammation; but, as a rule,
they are sero-fibrinous or sero-purulent, and with it we may see
purulent centres of abscesses, or pyzemia, abscesses forming in the
glands, or the development of the disease in several joints at the
same time, or at short intervals. The author saw metastatic sup- .
puration of the joints of the knee, carpus, and toes.
Rheumatic Inflammation of the Joints.
(Rheumatic Arthritis.)
This form of disease of the joints seems to be caused by cold,
especially in shooting dogs, if used in cold weather or during winter,
when they become very wet and lie around in a draught. It has
also been ascribed to be due to a specific infectious substance, and
this is brought out in animals that take cold. There are two
forms of this disease: an acute and chronic form. The former
appears in a serous, but more rarely sero-purulent synovitis, accom-
panied by great pain and high fever. 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
DISEASE PRODUCING MALFORMATION OF JOINTS. 275
part to another. As a rule, if the animal is kept in a warm place,
the disease abates in severity in a few days. 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 great thickening of the capsule, a formation
of adhesions between the surface of the joints and the connective
tissue, and in rare instances we may have ankylosis of the joint.
The most common seat of this disease is in the knee-joint, and still
more rarely in the ankle and hip. While the diagnosis is rather
difficult where the disease in confined to one joint, it is easily dis-
tinguished when you see it appear in several joints at once, and
also from the fact that it may move from one joint to another.
Disease Producing Malformation of the Joints.
(Arthritis Deformans.)
The cause of this disease is very little known. It is very prob-
ably 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, where animals are used to pull carts and vehicles.
The first symptom of this disease is a slight lameness in the dis-
eased joint. ‘This lameness may be overlooked, as it is generally
very slight, and after the animal has taken a little exercise it grad-
ually disappears, although in some rare cases the lameness may
continue, or even with exercise become aggravated. 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 are a gradual swelling and
thickening of the capsule of the joint, with apparently a loss of
the normal amount of synovia. Sometimes we notice 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 ten-
dency of the ends of the joint to enlarge, and finally marked alter-
ation in the form of the joint. By these changes we are enabled
to distinguish between arthritis deformans and chronic serous
inflammation of the joints.
The anatomical alterations have already been mentioned. Arth-
276 DISEASES OF THE BONES AND ARTICULATIONS.
ritis deformans, as a rule, occurs in the knee-joint, the elbow, and
shoulder. The prognosis of this disease is always to be unfavor-
able, because it seems to defy medical treatment, going on until
finally the joint becomes a large unsightly mass.
THERAPEUTIC TREATMENT OF INFLAMMATION OF THE JOINTS.
Tn all cases, except those of slight synovitis, the joint must be kept
as quiet as possible. In simple cases 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 apply the bandage of cotton and
dress over that with a plaster or silicate of sodium bandage, treating
it the same as a fracture. The author has obtained very good
results with this method in the carpal, tarsal, and toe-joints.
Albrecht advises that the jomts should be rubbed with a thick
layer of citrine ointment before applying the dressing. (For
further details, see under head of Dressings, ete.)
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 above treatment we generally obtain
good results in a short time. In the serious forms of the disease,
and where the dressing cannot be used on account of the position
of the joint, we must apply such local applications as will abate the
inflammation. Asa rule, the best treatment is cold-water applica-
tions containing lead or arnica. In cases where there are great pain
and acute rheumatic inflammation of the joint, it is better not to
apply 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 imper-
vious object, such as oil-cloth, silk, rubber, or a woollen cover. If,
for some reason, neither the cold nor the moist treatment is prac-
ticable, we must paint the part with tincture of iodine once or twice
daily, and the fluid must be rubbed into the skin by means of a
rag. The author 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
among canine practitioners. In chrenic cases where there are great
DISEASE PRODUCING MALFORMATION OF JOINTS. 277
thickening and a large quantity 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 rheumatism.
In many traumatic and purulent inflammations of the joint we
ean only get good results by an operation which varies according
to the condition. 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 of the capsule, and where there are great
lameness and indications of suppuration, we
proceed in the following manner: Fig 61
a. The part to be punctured must be rendered
strictly aseptic; 6, the part must have a particu-
larly tight dressing over it for a few days after the
operation.
If this latter method is not practicable on account
of the position of the joint or some other circum-
stance, puncturing the joint will not give favorable
results and may even lead to very serious conditions
(suppuration, etc.). The method of operation is very
simple.
After having removed the hair from the region of
the joint and washing with sublimated soap, disin-
fecting it with a + per 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 be-
comes filled and the joint is not entirely emptied,
the syringe must be detached from the needle and PS
the opening closed at once by means of the finger, as _4 large hypodermatic
any air that may find its way into the joint will syringe for puncturing
produce bad results. .Empty the syringe and pro- @nlatsed joints.
ceed 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 puru-
lent character—we must use at the same time an injection of antiseptic
278 DISEASES OF THE BONES AND. ARTICULATIONS.
fluid: directly into the joint, so as to make it aseptic. For that purpose we
use a slightly warm solution of 1 to 1000 solution of corrosive sublimate or a
2 per cent. solution of carbolic acid and a Lugol solution of iodine (1 per
cent. tincture of iodine, 2 per cent. of iodide of potassium, and 50 per
cent. of water). Either of these solutions may be injected 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
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 be opened by means of a puncture with 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 be
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 be 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, contusion, and shot.
CirinicAL Symproms 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 puncture runs in an oblique direction;
INJURIES OF THE JOINTS. 279
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 synovia
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 hemarthros. In some cases where there is hemorrhage,
the wound may be very small and close up quickly, or it may lie
in an oblique direction and prevent the escape of blood. This
flows into the joint and fills it up. Heemarthros 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.
The course of this disease differs greatly according to the char-
acter of the wound and whether the object that caused it was clean
or not. Small perforating wounds heal rapidly, and the animals
limp only for a few days. In serious wounds where the joint has
been exposed, and dirt or other foreign bodies 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 becomes turbid by the addition
of pus-corpuscles and fibrinous clots. It then becomes flaky and
finaily purulent. At the same time there is great fever around the
joint, which is swollen very much, and the neighboring 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 gen-
eral exhaustion or pyzemia.
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 quickly; there is a rapid
pulse ; the animal sinks into a coma, and dies from septicemia.
This may even occur in slight wounds, if they have not been treated
properly, and where thorough disinfection has not been followed.
280 DISEASES OF THE BONES AND ARTICULATIONS.
THERAPEUTIC TREATMENT. The first thing to do after an
injury has occurred is to thoroughly disinfect the wound and its
immediate neighborhood. Clip the hair from all around the part,
then wash it with a solution of corrosive sublimate, 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 5 per cent.
solution of carbolic acid, or a 1 per cent. 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 solution of corrosive sublimate. Any clots,
masses, or pieces of tissue must be 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 joints which have been caused by compression of the soft
parts against the bones or from shocks, such as jumping or leap-
ing 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 forma-
tion of hemarthros, or a concussion or crushing of the bone with
little escape of blood. In rare instances we may see a laceration
of the cartilage.
CuiryicAL 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 cedema 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
INJURIES OF THE JOINTS. 981
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 stimu-
lating 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 twist-
ing or temporary displacement of the joint, as a rule, in a lateral
direction. 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.
CiinicaL Symproms. 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 pain, 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 beyond 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. It is well, however, to be careful
to put the joint, by means of the bandage, as near as possible to
its original lines.
Luxations of the Joint (Dislocations). While distortions of
the joints disappear in a short time in cases of luxation, if it is
not reduced it is lasting. 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 (subluxa-
tion).
The causes of dislocation are, as a rule, mechanical, 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, ete. In all dislocations there is invari-
ably laceration of the capsular ligament. This membrane only
remains intact in dislocations of the lower jaw. As a rule, the
982 DISEASES OF THE BONES AND ARTICULATIONS.
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 inflam-
mation. The ends of the bones may be unaffected and in some
cases broken. Other alterations are seen in the muscles and ten-
dons in the neighborhood of the joint. They are abnormally
extended on one side and flabby on the other side. They may be
torn, lacerated, or even crushed. It is only in rare instances that
the large bloodvessels 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 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 Proenosis. When a dislocation has
just occurred, and when it has been there for some time, the symp-
toms 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 recog-
nized 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 be 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 be
shorter, or it may be on a longitudinal axis with the other leg.
Another 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 so lacerated or torn, or
where a piece of bone has broken, 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.
INJURIES OF THE JOINTS. 283
and
There is also a slight crepitation. 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 vertebre,
but they are very troublesome, and, as a rule, make slow recoy-
eries. 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
difficult 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 in the same position as it
was before, comparing it with the joint of the opposite leg, follow-
ing, as a rule, the same procedure as that followed in fractures of
the bone. As soon as the reduction is made the joint must be
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
Jacerated—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 especial mention:
Dislocation of the Lower Jaw. This is extremely rare, and
may occur in some instances where a setter or retriever endeavors
to earry 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’’ position,
while in a lateral direction the jaw is pushed to one side, the mouth
remains wide open, and cannot be closed except with great exer-
tion. In many cases, on account of the pressure which is caused
984 DISEASES OF THE BONES AND ARTICULATIONS.
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, rest-
lessness, 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 ani-
mal 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
as 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, allowing 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 wear a par-
ticularly (Fig. 62) tight-fitting muzzle
SSR ~ and should receive nothing but soft food.
a Dislocation of the Elbow. In the
: gt, LD dog the bone of the forearm forms with
aN the elbow a pivot joint. 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 cf the radius
may occur independent of the elbow-joint itself. A dislocation of
this articulation may occur from jumping from tables, chairs, fall-
ing 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 may 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 may see more or less marked sensitiveness or swell-
ing. If, on the other hand, we have a certain amount of move-
ment on extension of the elbow-joint and great elasticity in the
Fig. 62,
Muzzle.
INJURIES OF THE JOINTS. 285
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 recurs. This is due to the annu-
lar 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
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
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 day, 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 sili-
cate of sodium bandage applied.
Dislocation of the Patella. Stockfleth 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 tendency of
the muscles to turn inward. This is seen occasionally in circus
dogs (grayhounds) making high jumps. In cases of inside dislo-
cation 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 patella may be found lying sideways, and is easily
986 DISEASES OF THE BONES AND ARTICULATIONS.
moved laterally. If we take hold of the knee 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 manipula-
tion 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 has 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 ina flexed position, the animal making peculiar jumping move-
ments, using both legs at the same time when he attempts 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
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.
Tf the dislocation 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 was 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 animal was entirely cured. In another
case he had a double-sized dislocation of the knee. After returning
the patellee to their position, the knee- and ankle-joint were covered
with thick wadding, and a capsule of gutta-percha, which had pre-
viously been soaked in hot water, was applied to each leg, sur-
rounding the leg from the knee to the toes. In order to prevent
bending 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.
DISEASE OF THE BURSA MUCOSA. I87
External Dislocation of the Patella. This accident is very rare.
Stockfleth saw but 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 outside, could easily be pushed back into its
normal position; butif 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 dislo-
cation.
Moller states he has seen external dislocation of the patella quite
often, especially in Skye-terriers, while Hoffmann believes that an
external luxation of the patella in dogs is impossible for anatomical
reasons, because of the straight ligaments. The middle one is the
only one of any consequence, and for another reason the patella is
extremely small.
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 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.
DISHASE OF THE BURSA MUCOSA.
Diseases of the mucous capsules which lie under the skin—for
instance, in the acromion, olecranon, and at the ankle. These
are not of any special importance in the dog, although we occasion-
ally see them affected.
These diseases are developed in the form of circumscribed, fluc-
tuating swellings, either caused by hemorrhage, sero-fibrinous or
purulent inflammation of the mucous surfaces. These may be caused
by blows, jars, or by some other traumatism. The purulent form
is generally caused by some injury produced externally. It is easy
to recognize these enlarged bursee. We find a large fluctuating
swelling, accompanied by acute inflammatory symptoms. There
is much pain on pressure, and the fever, when it has been caused
by active inflammation and not through hemorrhage, is very acute.
Purulent secretions, as a rule, perforate the skin and escape.
288 DISEASES OF THE BONES AND ARTICULATIONS.
Serous or sero-fibrinous secretions are rarely entirely absorbed, but
leave a slight, fluctuating tumor with thickened walls, which is to
be termed a ‘‘ cystic abscess. ”’
When the condition comes on gradually, continuing to swell and
increase, taking a chronic form from the first, the walls of the
pouch become very much thickened. There is a gradual accumu-
lation of a mucus-like fluid. As a rule, true inflammatory symp-
toms are not present ; but if they are, only very slightly.
TREATMENT. In cases of large fluid secretions (blood or serum)
it is best to puncture, following the antiseptic rules. Purulent
secretions may be removed by opening the pouch, making a par-
ticularly large opening, and using a draining-tube. Cystic abscesses
may be removed by means of tincture of iodine injected in them,
or by cutting them open, but best of all by excising them. The
author has found good results from first opening them, using the
drainage-tube, and applying such stimulating agents as tincture of
cantharides, creosote, solution of nitrate of silver 1 to 10.
Diseases of the tendons or sheaths are of no importance in the
dog, and need not be discussed.
MUSCULAR RHEUMATISM.
Muscular rheumatism is a primary infection 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.
ErioLtocy. The cause of rheumatism, which has been described
as a certain poisonous substance, may also be due to cold, atmos-
pheric influences, etc., or dampness, animals lying in kennels that
do not get the sun, or being kept in the cellar. We have, undoubt-
edly, a number of diseases of the muscular system which do not
develop from rheumatism, for instance, abnormal muscular exer-
tion and consequent laceration of some of the muscular fibres;
also from disturbances of the circulation, from chronic toxic in-
fluences, ete. It would be much better to discard the name
‘‘muscular rheumatism’? and simply call it ‘‘ muscular pain.’’
Experience has taught the author that muscular rheumatism is
seen frequently in old, delicate, or fat dogs, and is oftener ob-
served in winter than in summer.
MUSCULAR RHEUMATISM. 289
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. We
may find slight alterations which have occurred from other causes,
such as hyperemia, slight exudation in the muscles, tendons, and
fascia. It is well known that slight inflammations of the mucous
membrane are not generally recognized during life. On the other
hand, we find cases in veterinary literature where very distinct
alterations have been observed in the affected muscles. Deposits
occur in the connective tissue (rheumatic callosities). These occur
in aman who has suffered for a long time from muscular rheuma-
tism, and in old rheumatic dogs we may also observe characteristic
alterations in acute or chronic inflammations.
CLINICAL SYMPTOMS AND Course. Muscular pain is a most
marked symptom. This is observed in slight cases by the animal
having a contracted appearance of the muscles, or when by pres-
sure 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 movement, 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 feces are passed the animals do so with
pain, frequently crying or howling, or it may be they make no
effort, producing obstinate constipation.
As rheumatism is generally located in the joint regions, these
symptoms become modified in certain parts of the body and inten-
sified in others. We very often see rheumatism of the back and
loins. 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 move-
ment. The muscles in the neck are also subject to this disease.
Animals show great pain while eating on account of being com-
pelled 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 shows great pain. In rare cases we see rheuma-
19
290 DISEASES OF THE BONES AND ARTICULATIONS.
tism in the masseters (a great difficulty in mastication). Only in
. very severe 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 is noticeable in chronic rheumatic
conditions.
THERAPEvUTICS, The agents recommended for the dog are sali-
cylic acid, antipyrine, tincture of colchici, morphia, friction, mas-
sage, and electricity. The first three drugs produce the most
favorable results:
R.—Salicylie acid : : : : i : « 3Oe0
Aqua destillata . 5 : ; ; : «O00
S.—One tablespoonful three times daily.
R.—Antipyrine . ; ; : ; F ; yp aoe
Syrup. simplex. : ; : . : 20
Aqua destillata . : : 3 ‘ : . 50.0
5.—One teaspoonful three times daily.
R.—Tincture of colchici, 10 to 20 drops several times daily.
R.—Salicin . ‘ : ; : : : 4 io)
Potassii iodidi i : é ; ° to)
Fiat divid. charta No. viii. §.—One powder twice daily.
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 embrocation into the skin, either by the hand or with
a woollen 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. (Fig. 63.)
The opinion concerning electricity is much divided. The author
has never been able to obtain any very marked results by using
this form of treatment.
Muscular rheumatism in some cases may be confounded with
those of cysticercus cellulosus. In the latter case parasites should
FRACTURES OF THE BONES. 291
appear in very large numbers. Pauli found, for instance, in one
dog a peculiar, stiff, flexed condition of the head, a surface one
inch square in the psoas muscles which was filled with cysticercus
cellulosus the size of a pea; and Trasbot found, at the post-mortem
| Pa :
rn
ee iM
a
mi 4
q
i es =
Bath-tub.
x
of a dog which had shown great pain during life, especially
when touched or moved, all the muscles filled with cysticercus of
teenia solium.
(For further details concerning cysticercus, see Internal Para-
sites. ) /
FRACTURES OF THE BONHS.
Eriotocy. By a ‘‘ fracture of the bone’’ we mean a breaking
_or disunion of a bone or a bony cartilage. Most fractures are
caused by external forces, and the bone fractured is at the region
where the force or shock has expended most of its foree—for
instance, from blows or being run over; 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 by great muscular exertion. The author saw a fracture of
the olecranon in a hunting dog, which could not have originated
in any way than by enormous muscular strain. Very old and
992 DISEASES OF THE BONES AND ARTICULATIONS.
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.
General Classification of Fractures. We separate fractures
under different names according to their position, severity, and the
complications accompanying them.
General Classification of Complete and Incomplete Frac-
tures. In the first class belong infractions, splits or cracks,
impressions or depressions.
In the second class belong oblique, transverse, longitudinal, and
fissure fractures; in pups where the epiphysis and diaphysis would
sometimes have 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 neigh-
borhood of the symphysis. The general course of these fractures
is the same as ordinary fractures, and no special mention is neces-
sary regarding fractures of the soft parts.
The condition of the soft tissues in the neighborhood of the frac-
tures 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 quicker than those where there is an open
wound extending into the fractured end of the bone. 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. They are very slow and difficult to treat, and present
such symptoms as synovitis, either with or without serous or puru-
lent inflammations. In such fractures, even when we have union
of the broken ends of the bone, we may have either a stiff joint or
ankylosis from complications in the joint.
CrinicaL Symproms. The symptoms of fracture 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 sym-
metry of the broken bones of that part of the body, and on moving °
the fractured ends there is a rubbing sound (crepitation) similar to
rubbing 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 severity of the fracture. This is very marked in frac-
tures of the extremities; great pain on pressure, especially on the
FRACTURES OF THE BONES. 293
line of the fractured bones. This may also be of especial diag-
nostic 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 longitudinal
form and in very young animals where the bone pivots on the
fractured epiphysis. Crepitation and an abnormal movement are
easily recognized by taking hold of the part above and below the
fracture and moving it in different directions. Both of these symp-
toms 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 bruit 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.
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 pene-
trated 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 swelling in the neigh-
borhood 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 obstructed in any way, we
quickly notice a purulent, cedematous swelling all around the part,
which is always a very grave symptom. If the course is favor-
able, the injured part becomes rapidly filled with red, granulating
tissue, which finally dries, becomes hard, and forms a scab. By
means of strict antiseptic treatment this is possible, and we can
reduce the danger and time of an open fracture by strictly follow-
ing 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 pulling or tearing
the bandages.
The Phenomena of Union in Fractures. The healing and
994. DISEASES OF THE BONES AND ARTICULATIONS.
union of the fractured ends of a bone are very similar to those of
wounds, either by first intention (primum intentionem) or by sec-
ond intention (secundum 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 in-
tention. (Fig. 64.) 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 mak-
ing union between broken ends of
Diagram of eaters of fracture in the bones. This is especially noticed in
tibia of the dog: a, outer callus; 6, fractures where the periosteum is ex-
periosteum; c, inner callus; d, in- .
Gacnintam ena posed, and where that envelope is
torn or injured union is almost twice
as long as where the periosteum is preserved. The extravasation
of blood found in the early stages of a fracture which lies 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 beginning 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.’? Reabsorption
commences at the same time until the bony masses, which are use-
less after the bone is united, finally disappear, but there is always
a certain amount of cnlargement around the fractured ends of a
bone at the point of union. Cracks and fissures undergo the same
process.
FRACTURES OF THE BONES. 295
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 diffi-
culty—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 author 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. .
THERAPEUTIC TREATMENT. In simple fractures the treatment
consists of returning the broken ends of the bone to their proper
anatomical position, and holding them in position.
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. In
such cases as fractures of the metacarpal bones, bones of the face,
ete., a reduction can be made without an assistant. When the
bones have been placed in position as near as possible to their
normal shape, we must then apply a dressing which will keep the
fractured ends in their proper position until they have united.
The best dressing for fractures in dogs are those which dry
rapidly, such as plaster and silicate of sodium solution. In some
996 DISEASES OF THE BONES AND ARTICULATIONS.
cases it becomes necessary to apply a temporary splint apparatus
for a few days. This splint apparatus must be used where there
is great swelling or where the condition of the wound or part
would lead you to expect much swelling. The author finds the
best thing for these dressings is a 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, ete. In some cases where there is an open wound wire
gauze may be used, fastened above and below the fractured ends,
~ leaving the wound exposed. This gives it sufficient support, and
proper antiseptic methods can be followed. A plaster-of-Paris or
silicate of sodium dressing may be applied immediately after the
fracture, provided there are no wounds. Where there are wounds
or swellings we must wait until the swelling is absorbed.
We 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 cheesecloth may be used,
and the plaster, in powder form,
rubbed into the part. Then oil the
point of the fracture to prevent the
bandage sticking. At the same time
place the plaster bandage in water for
a few minutes and then wrap it care-
fully around the part, following the
methods adopted in ordinary bandage
rolling, being careful not to place it
too tight. Smooth the water out of
the part, making the bandage as level
as possible. In some cases where you
want a very stiff bandage, it is ad-
visable to put a certain amount of
plaster between the folds of the ban-
a, Bandage-cutting scissors. dage and finally give a good coating
b. Bone forceps. 6
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
Fic. 65.
FRACTURES OF THE BONES. 297
quicker by the addition of a small quantity of alum or common
salt. The scissors shown in Fig. 65 (a) are the most practicable
for the removal of this dressing. ‘Tripolith dressing (a mix-
ture 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 author likes this form
of dressing best, and to overcome the drawback of slow hardening
has placed thin layers of wire gauze between the dressings. Flan-
nel may be used as an under layer. Another dressing is a mixture
of benzoate of sodium and silicate of sodium. 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. 66.)
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 antiseptically.
This is rather difficult to do in the dog, but
it may be accomplished by making a ‘‘ Win peects of tight bandaging
dow’’ or hole in ‘the dressing. The wound of a splint.
must first be made thoroughly clean, dressed
antiseptically, and then we apply a plaster dressing according to the
usual method, and place a piece of wadding upon the wound. 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.
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
Fic. 66
j ag
Seri,
998 DISEASES OF THE BONES AND ARTICULATIONS.
layers of corrosive sublimate gauze). Then apply the closed dress-
ing of plaster-of-Paris entirely over it. If the wound is slight, as
a rule, you do not require 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, making a com-
pound comminuted fracture, the patients can only be saved by
amputating the leg. Amputation of the leg, as well as exarticu-
lation, has been performed a number of times in the dog, and gen-
erally successfully, the animals soon becoming accustomed to the
loss of the leg, using the other three with almost as much ease as
they did with four.
Amputation. Before the operation clean the affected leg with suap and
a brush; then disinfect with powerful antiseptics (6 per cent. solution of
carbolic acid, 1 to 1000 solution of corrosive sublimate, and 2 per cent.
solution of creolin). In operating do so with as little loss of blood as pos-
sible. To accomplish this use Esmarch’s rubber bandage. Al] of the rules
Fic. 67.
Different methods of amputation: a, straight section ; b, flap operation ; c, method
of sewing the wound.
of antisepsis must be strictly adhered to, and at short intervals during the
operation the wound must be irrigated with some antiseptic. Avoid any
serious manipulation or compression of the soft parts. The skin must
FRACTURES OF THE BONES. 299
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 veins, which have
been cut must be taken up separately with the forceps and ligated with cat-
gut 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 ban-
dage must not be removed until all the bloodvessels have been ligated (Fig,
67). The wound and its neighborhood are then thoroughly irrigated with an
antiseptic solution and closed with stitches; the skin is also stitched at the
same time. The different forms of stitching are illustrated on page 314.
The whole wound is to be covered with a permanent antiseptic dressing.
(For further details, see Treatment of Wounds.)
Amputation by means of a Circular Section. Cut through the skin of the
affected extremity to the fascia, making a complete circle around the mem-
ber. Pull this back and have it held by an assistant, he pulling the skin
toward the body as far as possible. It may be necessary to dissect the skin
and the cellular tissue from the under layer of the skin. After that make
a sharp, clean cut, entirely circular, close to the edge of the skin which is
pulled back, amputating all the muscles, and finally cut with bone forceps
(Fig. 65, 6, page 296), 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 or by means of a linen
compress which has been dipped into an antiseptic solution. In cases where
amputation of the extremities has to be performed, where there are two
bones, as in the forearm, it is necessary to cut the soft tissues which are
located between the bones.
Flap Amputation. We cut two half-moon-shaped flaps of the skin and
separate them from the fasciz 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.
Fig. 68.
Amputation of the tail.
Exarticulation. Separate the soft parts exactly as in amputation by means
of a circular or flap cut. We then open the affected joint by bending it,
300 DISEASES OF THE BONES AND ARTICULATIONS.
producing a tension of the ligaments which are located in front of it; then
cut through them with a bistoury. Exarticulation is finished by separating
the other ligaments and the capsule of the joint; then proceed exactly as
we do in ordinary amputation.
Amputation of the tail is one form of exarticulation: This operation,
which is comparatively harmless, is sometimes required in cases of necrosis
of the bones of the tail after serious injuries to the soft parts or from frac-
ture of the caudal appendage. An amputation between two of the vertebre
is much better than cutting through the bones. The operator must distin-
guish the slightly enlarged point (Fig. 68) where the articulation lies; then
proceed by means of the ‘‘ flap” or ‘“‘ round” operation, whichever is pre-
ferred. As the vessels are slight they can easily be stopped by means of a
thermo-cautery. The author generally uses the circular operation, cutting
posterior to the bony protuberances 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 carti-
laginous disk. In cases where there is much hemorrhage the artery may
be taken up by means of a catgut ligature. The edges of the skin are united
by an interrupted suture and an antiseptic dressing is applied, taking care
not to make it too tight.
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 under-
stand that we have a slow, callous formation, and nothing else is
to be done but to renew the dressing as soon as possible, having
first rendered the parts antiseptic by means of sublimate soap and
water. Put on the bandage again and let it remain for two or
three weeks more. If we do not obtain a cure at the end of that
time we may conclude that we have a false joint (pseudoarthrosis).
The methods pursued in man of introducing ivory pins into the
bone or screwing it together by means of clamps or resecting the
ends with a saw are hardly practicable in the dog. If, however,
we discover that there is any danger of the formation of a false
joint, we may irritate the ends of the wound by rubbing the broken
ends together and applying a dressing, giving the animal phosphate
of lime or phosphoric acid.
Other diseases of the bones in the dog are of so slight importance
that the author has omitted them.
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 classified
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 bones, 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 oblique,
according 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.
CiinicAL Symproms. All wounds are accompanied by three
symptoms: the open, gaping condition of the edges of the wound,
hemorrhage, and pain. As a rule, the wider the wound the deeper
itis. If the wound is long but does not gape, it corresponds with
the direction of the muscle or the tissues 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 of blood being 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 bloodvessels; 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 laceration or concussion,
but the latter present more complications than the former, due to
consecutive hemorrhages. In venous bleeding dark-red, even col-
(301 )
302 WOUNDS AND THEIR TREATMENT.
ol
ored, blood flows out of the wound. Hemorrhages in small and
medium-sized veins generally stop without any surgical interfer-
ence, but the large veins, especially those in the neighborhood of
the heart, are dangerous and should be taken up quickly. Capillary
bleeding consists in a slow trickling 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
presented: general coldness of the skin and extremities ; paleness
of the mucous membranes, especially the mouth and eye; great
prostration ; staggering gait; and often from weakness inability
to rise. In some cases we have unconsciousness, dyspneea, enlarge-
ment of the pupils, uncontrollable evacuation of urine and feces,
finally slight convulsions, and death. This conclusion is to be
expected if about half 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 les-
sening of the blood-pressure in the arteries. The pulse may become
very indistinct while the blood 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 contrac-
tions 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 of
one-fourth of the weight of the body. The red blood-corpuscles
become normal and return to their original number in from seven
to thirty-four days.
The hemorrhage is stopped by the closing of the bloodvessel by
a clot or thrombus. The blood within the walls of the bloodvessels
is only kept in a liquid condition as a result of its contact with
WOUNDS AND THEIR TREATMENT. 303
the endothelium, and if from any diseased condition the endothe-
lium is changed, or if the blood runs off through another opening,
or if the circulation is obstructed by a ligature, the blood becomes
coagulated, and we quickly have the formation of a thrombus.
This not only closes the bloodvessel externally, but it is more or
less extended into the bloodvessel until it reaches the first branch
where there is an active current of the blood. These useless ves-
sels soon become converted into solid cellular connective tissue.
We shall refer later to the puriform, pussy, and purulent degen-
eration of the thrombus.
It is readily understood that the formation of a thrombus may
occur rapidly when the ends of bloodvessels which have been
detached have their opening reduced by contraction or twisting
of the coats (media and intima), as in the case of crushing or lacer-
ating, especially in the capillaries or small veins. In partial injuries
of the bloodvessels the bleeding may be stopped without com-
plete obstruction of the bloodvessel. In favorable conditions the
lacerated wall of the bloodvessel becomes coated with a solid
coagula. This becomes organic, so that the only result is a
slight thickening of the wall.
The pain of a wound is indicated in the dog by howling and
erying when the injury occurs, or later when the wound is exam-
ined. 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 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
304 WOUNDS AND THEIR TREATMENT.
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 or centre of the medulla oblongata.
In connection with the above symptoms we occasionally see dis-
turbance of a function—that is, when certain muscles are injured
and their nerves are separated, or when any of the joints or cavities
of the body are opened. The symptom which appears when the
muscles are divided or cut is a loss of power in that region covered
by the affected muscle. The symptoms after the separation of
peripheric nerves consist in the loss of movement and a partial
loss of sensation. The latter is extremely hard to recognize in the
dog on account of the numerous anastomoses which occur between
the branches of the fine nerves of the skin and also of the injured
nerves in the immediate vicinity. We also observe a marked
decrease in temperature in the paralyzed or partially paralyzed part.
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, healing by tem-
porary union; second, healing by second intention or suppuration ;
third, healing under a dry scab; fourth, healing under a moist scab.
Healing by First Intention. This may only be expected when
the edges of the wound are smooth and sharp, due to cuts with
sharp objects that are clean or surgical wounds which can be easily
closed with stitches and covered by dressings. The microscopical
examination shows that the healing of such wounds often occurs
within twenty-four hours, and the adhesions form so quickly that
the edges of the wound can only be separated by exerting a certain
amount of strength. The wound is covered by a narrow, thin
blood-scab; its edges appear normal or only slightly swollen or
inflamed. The scab drops off after a period of five or six days,
leaving a somewhat depressed, pale-red cicatrix. This gradually
COURSE OF HEALING PROCESS IN A WOUND. 305
loses its color, and in a short time it is difficult to distinguish it
from the surrounding tissues.
Flealing by Suppuration or Second Intention. 'This appears when
the wound is left to itself, and, if the animal does not lick it, it
becomes quickly covered with dry blood and lymph, also a thick
crust, which varies in color between red and dark-brown, covering
over the edges of the wound. If the wound is licked from time
to time, we have a discharge of bloody, watery fluid. After this
the wound becomes covered with a veil-like gray covering, the
secretion becoming more and more copious and thicker, then yel-
lowish-gray, and finally pure yellow (pus). The edges of the
wound become swollen and red, the gray covering of the edges
drops off in pieces, carried away by the pus or licked off by the
animal. From the second to the fourth day we see the appearance
of small red granulations from the wound. ‘These increase in
number and finally fill up the spaces in the surface of the skin.
Now the active secretion of pus begins to stop. The skin grad-
ually contracts around the wound, the neighboring epithelial
border rises above the edges, and eventually forms a cicatrix.
The granulating surfaces, as a rule, shrink, contracting and draw-
ing together the cutaneous borders from all directions, finally
leaving a whitish somewhat depressed cicatrix. This is more
irregular, broader, and thicker than the cicatrix formed in wounds
healing by first intention.
Healing under a dry scab occurs, as a rule, in small wounds
which are not exposed to infection or have not been licked.
Under this head we may class excoriations, cauterizations, various
small incised or superficial wounds which have been covered in
their early stages by antiseptic powders, such as boric acid, iodo-
form, or antiseptic collodion. The same effect is seen after the
use of the thermo-cautery. Dried blood, tissue fluid, etc., form a
scab which becomes adherent, and only when this scab is removed
by force does it produce bleeding. If it is not interfered with, it
drops off in from eight to fifteen days, according to the size of the
wound, and as a result we see a reddened, non-resistant cicatrix
which soon becomes pale and hard. If the scab drops off at an
early period from some other cause, we generally see distended, red,
irritable granulations, surrounded by a cicatricial wall.
Healing under a Moist Scab. This may be produced by follow-
20
306 WOUNDS AND THEIR TREATMENT.
ing the antiseptic method of healing wounds. In closing an
entirely clean wound with a strictly antiseptic dressing, the wound
having been produced as a result of an operation, and which is no
longer bleeding, after having been closed it becomes filled with
blood which coagulates. This coagulation, if perfectly antiseptic,
fills in the cavity for a short time, when it is soon crowded out by
the quick formation of granulations, and soon undergoes a change,
becoming yellowish, due to an alteration of the coloring matter in
the blood. This healing process is distinguished from that which
occurs with the formation of pus by the fact that the constant loss
of cells used in building up the tissues is not required, and that
the cellular elements which are destroyed as a consequence of the
injury are not detached to any great extent by the cleansing process
of the wound, but they undergo a quick molecular destruction,
and are then as quickly reabsorbed.
Notwithstanding the fact that under the microscope the healing
processes of wounds seem to differ greatly, still the histological pro-
cess is the same in all. The formation of a deficient vascular
cicatrix is the main point in all forms of wound treatment. This
is accomplished by neoformation of bloodvessels, by the appearance
of numerous wandering cells, and by alteration of these cells into
fixed bodies of connective tissue with a rigid interlaying sub-
stance. The various modes of healing already described depend
on the degree of irritation that the wound has been exposed to.
The most marked symptom of acute irritation under the usual
conditions is granulation with suppuration, and we must also
point out that it may be well, from a practical standpoint, to con-
sider suppuration as an abnormal condition due to infection. We
must also state that the regenerative power of the disconnected
tissue varies. The skin and mucous membrane are always closed
by a cicatrix, and it usually heals by first intention because the
epithelium unites quickly. Compensation tissues which fill up
wounds that have been accompanied with a loss of a certain amount
of tissue, it either being cut out or destroyed, especially when they
contain few or no bloodvessels, seem to fill up very rapidly.
Diseases Resulting from Septic Infection of Wounds.
There are a number of conditions which appear in wounds that
are due to microbes and germs, producing certain irritations of
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 307
the tissues surrounding the wounds, especially the bloodvessels
and the lymphatics.
Phlegmone. By this we mean the inflammation of the soft
tissues which has a tendency to formation of pus, especially in the
loose subcutaneous connective tissue between the muscles and under
the fascia. There are two forms of this condition—a circum-
scribed and a diffused phlegmone.
Circumscribed phlegmone. The symptoms are very prominent,
especially when it is near the skin. We find in a certain circum-
scribed region a hot, painful, very red swelling, firm and tense in
the early stages, but soon becoming soft, doughy, and finally fluc-
tuating, due to the tissue breaking up and forming a purulent
liquid. From the pressure of the pus the skin becomes gradually
thinner and thinner, until it 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-
cially of the fasciz, tendons, muscles, bones, and it may be taken
up in the blood, and portions of the diseased tissues are carried
in the circulation to different parts of the body.
Diffused phlegmone 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 direc-
tions in the loose connective tissue, undermining and frequently
causing extensive necrosis of the skin, fascize, muscles, tendons,
etc. Death occurs, as a rule, from septicemia or pyzmia.
The treatment of diffused phlegmone consists of scarification
and incisions. Numerous slight incisions are made to reduce the
inflammatory 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 disin-
fected 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 phlegmone it is better, as a
rule, to wait until the abscess is in that condition known as
‘‘ vipe,’’ or ‘‘ 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
308 WOUNDS AND THEIR TREATMENT.
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 over-feeding. 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 lym-
phatics 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 contain-
ing a large amount of purulent pus in the swollen lymphatic
glands, producing extensive inflammation, blood-poisoning, and
the animal eventually dying from septiczemia.
The therapeutic treatment consists first in the irrigation 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 Bloodvessels (Ph/lebitis).
This is especially interesting to the veterinarian, as it is quite fre-
quently seen in the dog. Purulent inflammations of the blood-
vessels are seen in connection with infectious purulent wounds, and
originate as a secondary symptom by extension of the suppurating
process from the surrounding tissues. This is especially noticeable
where the wall of the vessel is crushed, forming a thrombus, and
this thrombus, lying in the bloodvessel, 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 possible and thoroughly disinfect the abscess.
Fever. Concerning the clinical symptoms of fever, we have
given all necessary details on page 23. The fever which accom-
panies wounds varies greatly in intensity according to the cause.
The following are the different varieties of wound fever :
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 309
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 shortly 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 tempera-
ture 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 Septicemia. As soon as putrid or
decayed substances 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 ‘‘ septiceemia.’’ Septic wound fever and septicemia are
only separated by their degree of intensity, otherwise they are
similar. They are both produced by ptomaines which are devel-
oped in putrid wounds finding their way into the circulation.
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.
Septiceemia 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 de-
pression, fatigue, and loss of appetite, the last being very rare.
If the wound is treated quickly and rendered thoroughly anti-
septic, the symptoms rapidly disappear. The most dangerous
forms of septicemia which occur most frequently in the dog
appear 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. In many cases, however, we may
then distinguish symptoms of putrefaction. The animal suddenly
refuses food, becomes weak, somnolent, the mucous membranes
become livid, and death occurs in a few hours, or more rarely after
some days. The temperature is rarely increased to any extent.
More often it is normal or subnormal. We are not able, there-
fore, to place any dependence on the temperature as far as prog-
310 WOUNDS AND THEIR TREATMENT.
nosis is concerned, the only value being when the normal temper-
ature is presented and the acute symptoms already described begin
to abate.
We sometimes see very peculiar cases—for instance, the author
has observed a case of septiczemia 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 diarrhcea 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, alco-
hol, and camphor. The author 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 calla
specific agent in septicemia. It must be injected every two or
three hours under the skin until the alarming symptoms have disap-
peared. Slight muscular contractions which sometimes follow the
use of camphor are not to be regarded as anything especially serious.
3. Purulent Fever and Pyemia. 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
micro-organisms. If the symptoms of fever are slight, the patients
may recover, with only a chill and a slight increase of tempera-
ture. If the fever is very serious and the temperature rises high,
it is called pyzemia. In this disease you will find that the majority
of cases are followed by metastatic suppuration in various organs
of the body. This is due to the fact that the thrombus undergoes
purulent destruction in the bloodvessels, breaks down, and the
infectious matter is carried into the circulation, and from there it
finds its way to different organs or locations in the body. The
symptoms of pyzemia in the dog are not very easily distinguished
from those of septiceemia, and it is very hard in the majority of
cases to make a positive diagnosis. Very frequently we see symp-
toms of septiczemia and pyzemia combined, forming what is known
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 8311
as septico-pyzmia. In this case the animal dies before any deposit
of the suppurating poison has produced abscesses. In pyzemia the
symptoms are marked by chills in the early stages, and by inter-
mittent fever. The appetite is often good, and, as a rule, rarely
entirely absent, as in septicemia. Later the disease presents much
more serious symptoms: the fever loses its intermittent character,
the temperature remaining high; the appetite disappears; fatigue
and weakness may occur; the patients become rapidly emaciated
and finally die. With these symptoms we see metastatic suppura-
tion in the internal organs.
The therapeutic treatment of pyzemia is similar to that of septi-
ceemia.
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 microbes through the hair, or
by direct infection from unclean hands, instruments, dressing ma-
terials, 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 further 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 greatly influenced 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 veterina-
rian has two 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 impor-
312 WOUNDS AND THEIR TREATMENT.
tance, and especially during and after operations where there is
much blood lost. The wound and everything coming in contact
with 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 and benzoin 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. creolin). Any existing wound has to be treated in the
same manner. If there isa 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. 69 is especially adapted to that purpose.
For cleansing wounds do not use sponges un-
less they are thoroughly aseptic, also disinfect
the gauze and dressings (tampons). Instru-
ments aud the operator’s hands must also be
carefully 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 in-
struments, as it leaves an insoluble coating of
mercury on the steel. The hands and nails
have to be brushed and washed with carbolic
solution, or sublimate soap. During the oper-
ation 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 con-
dition 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
Apparatus for the antisep-
tie irrigation of wounds.
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 313
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 we use instead of this
small pieces of silk thread or catgut, which have been twisted
together in the shape of a cord. Wounds which are not deep, but
cavernous, and where it is difficult to get quick adhesion in order
to insure proper drainage, it is best to leave the wound open, coy-
ered with antiseptic powder, such as iodoform, sulphonal, boric
acid, naphthalin, salicylic acid, ete. The first-named agents pos-
sess 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 them to extend.
It is advisable to use some material that will take up the secre-
tions of the wound quickly, and assist in drying them. For this
purpose, we use iodoform, salicylic-, or carbolic-acid gauze. Cover
the wound with the gauze, and in wounds with cavities fill them
with a tampon of the same material. In a wound where there
is a deep cavity it may be well to fill it in with a tampon of
iodoform for twenty-four to forty-eight hours after the operation,
then, having cleaned it, by means of sutures bring it together and
cover it with iodoform-gauze.
The following is the ordinary treatment of wounds :
(1) Controlling the Hemorrhage. 'This may be accomplished in
various ways. The best method is by means of a ligature. Asa
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 with a pair of forceps, including the blood-
vessels, and tying it behind the point of the instrument with catgut
or silk. When the bleeding end of a bloodvessel is located in
very firm tissue, out of which it cannot be drawn far enough to
ligate, we pick up the bloodvessel 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 bloodvessel and tie it tightly, and by
this means close the opening.
Compression is sometimes used as a means of stopping hemor-
rhage. This we can accomplish by pressure of the finger above
the bleeding region, or, if it is an extremity, ligate the member
314 WOUNDS AND THEIR TREATMENT.
above the part by means of a rubber band or tube, or even a hand-
kerchief. Esmarch’s rubber bandage is the best. If there is a
cavity, we may also fill the wound with a tampon of aseptic wad-
ding of gauze or oakum., Another means of stopping a hemor-
rhage is by using a cauterizing iron (thermo-cautery), a solution of
chloride of iron, vinegar, alum, and tannin. 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 hem-
orrhages, as a rule, coagulate or draw the tissues in such a way as
to prevent healing by first intention. Oil of turpentine is some-
times used, and is a particularly reliable styptic.
Capillary or slight subcutaneous hemorrhages can be stopped
by pressure or irrigation with cold water. Hot water is also used
to control hemorrhage.
i
|
.
\
1
"
ve
Different forms of stitches used in the dog and method of tying : a, head-stitch ; 6, con-
tinuous oblique stitch with cross-stitch ; c, deep continuous cross stitch ; d, mattress-stitch ;
e, button and interrupted stitch.
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
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 315
stopped, we bring the wound together by stitches or ligatures
(Fig. 70). Asa rule, the ordinary knot-stitch with antiseptic silk
is used, although we may connect it with other forms, such as the
extension-stitch (Fig. 70). Small wounds do not, as a rule,
require drains. The wound should be compressed for several
minutes by means of an antiseptic sponge, and after that covered
with iodoform-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 dressing in such wounds, use
antiseptic powders, such as sulphonal, iodoform, and boric acid.
These should be dusted on the wound itself, directly on the line of
the severed skin.
Lister’s dressing in its original form is very rarely used at the
present time. The author has been in the habit of covering ordi-
nary sewed wounds with a thin layer of salicylic or carbolic gauze,
and over it a dry, aseptic muslin bandage, and over this 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 of 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 generally superficial.
These do not require to be closed by means of stitches, and they
seldom are licked or irritated by animals. We use in these cases
the following method of treatment :
After thoroughly disinfecting the wound and its neighborhood,
by means of caustic agents (nitrate of silver, chloride of iron,
burnt alum, or with a thermo-cautery), we produce an artificial
scab, or we cover the wound surface with collodion. The latter
is recommended in common lacerations. Asa 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
316 WOUNDS AND THEIR TREATMENT.
it is advisable to muzzle the animal (Fig. 71), not only to prevent
the patient from licking the wound, but in order to properly apply
the sprinkling powder, which is less dan-
gerous than iodoform. The best powder
to use is boric-creolin (1 part of creolin to
40 or 50 parts of boric acid), naphthalin
or sulphonal (1 part to 5 parts of starch).
An open wound generally requires
antiseptic washings daily. It frequently
happens that yvranulating wounds, espe-
cially when they have been subjected to exposure to air, 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 irri-
tant, or as a consequence 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 callus, 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 a foreign body or ulcerated tissue. They may also lead to
some of the glands. These pipes are called fistule 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
iodoform, 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, such
as nitrate of silver, tincture of iodine, etc., as a rule, 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 trans-
plantation is not practicable in the dog. We cut about 1 em. from
the border of the ulcer over its entire thickness, keeping the wound
Muzzle.
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 317
open by means of vaseline. When 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 and introduction of cray-
ons of caustic (nitrate of silver or caustic potash). Always try to
slit open the canal, if possible, as it produces the best effects, Ni-
trate of silver or any of the mineral acids, and in obstinate cases a
small piece of corrosive sublimate, 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 and contusions) we find a different condition of the tissues.
These injuries are generally caused by some blunt object—for in-
stance, 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 of 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 bloodvessels.
CiinicaL Symptoms oF Contusions. One of the first symp-
toms 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 we
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, so that we
may have a ‘‘ doughy ’’ swelling in one case, or it is accumulated
in centres in another, and we see a fluctuating swelling or a ‘‘ blood-
boil’’ (hematin), or it may run into a cavity, and we have a bloody
secretion of the joint (hemarthrosis), or we find a bloody secretion
_ in the cavity of the chest (hamatothorax). The swellings, as a rule,
occur shortly after a contusion, and in the early stages rarely show
318 WOUNDS AND THEIR TREATMENT.
any inflammatory symptoms. Later the inflammatory symptoms
may appear.
Beside the swollen condition, 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. We may also find
a crushed muscle which will no longer contract, or a torn nerve
that does not convey sensation or motion.
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 man-
ner that all the vessels are torn, it will become necrosed from
deficient nutrition, and, as a result, we see a putrid process going
on as indicated in the discharge, which contains septic blood and
broken-down tissue. The same is to be expected if the skin is
deprived of nutrition, caused by the destruction of the bloodvessel
supplying it.
This condition is materially different from a contusion where
the skin has been removed; but if the integrity of the skin is
maintained, the subcutaneous secretions under it are generally
absorbed very rapidly. The soft parts which are lacking in
vitality are absorbed, and are gradually replaced by a new con-
nective tissue in exactly the same way as healing under a moist
scab. Exceptions to this termination occur occasionally, and we
may sometimes find a cyst, which is a hollow cavity filled with
a yellowish-red liquid and enclosed in a capsule of connective
tissue. In very rare instances this may be filled with calcareous
concretions. This, however, is only seen in rare instances and is
the result of a chronic irritation of the tissues at that particular
locality.
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 absorp-
tion by means of massage—that is to say, make a centrifugal fric-
tion with the thumbs, fingers, or hand for fifteen or twenty minutes
atatime. 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 subcutaneous bleeding.
This latter treatment is not to be practised unless the swelling is
very small and there is very little fluid in it.
DISEASES FROM SEPTIC INFECTION OF WOUNDS. 319
The therapeutic treatment is not simple in all contusions. In
large ‘‘ fluid-boils’’ we rarely can wait for an absorption of the
secretion, but 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 proced-
ure, the fluid may be emptied by means of a hypodermatic 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 where
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. Asa
rule, treat the slightest injuries of the skin according to the best
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 it a 1 to 1000 solution of corrosive sub-
limate or a 5 per cent. solution of carbolic acid, and use an anti-
septic bandage.
ABDOMINAL HERNIA.
Hernial Rupture.
By the word ‘‘ hernia’? we understand a protrusion of a certain
portion of the abdominal contents through a normal or abnormal
opening in its wall, 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 in-
testines 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 rup-
ture, 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—
for instance, in a hernia which has occurred in a traumatic way,
as a result of some injury, and the injury has been severe enough
to tear the peritoneum; or where the hernial pouch collapses or
draws together. Hernial coverings of the pouch are the names
given to that portion of the skin and subcutaneous cellular tissues
which coyer that part; in some instances we also include the mus-
cles and aponeuroses. 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 frequently the duodenum may be found
lying in the hernia with some portion of the large intestine or
uterus, and more rarely the bladder or stomach. Under certain
conditions we find a certain quantity 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.
(320)
HERNIAL RUPTURE. 321
The causes of hernia are generally described as direct and indi-
rect. 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 umbili-
cal ring. The latter may occur from the abdominal walls being
flaccid from cicatricial contractions after operations, and occa-
sionally 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 ‘‘ possibili-
ties’? 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. We find a swelling which does not present
any inflammatory symptoms, and is especially prominent when the
animal is walking or standing. It is also seen during abdominal
pressure, especially after the dog has eaten a hearty meal. If the
animal is turned in such a way that the hernia occupies 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 pres-
sure of the hand. If we examine the abdominal walls the orifice
of the hernia can be distinctly felt, and we may even be able to
penetrate the abdominal cavity with the finger.
Further symptoms depend upon the nature of the prolapsed
intestine ; this intestine will be recognized as a soft, elastic swell-
ing, having to a certain extent the round or tubular form of an
ordinary intestine. It may also be further distinguished by a
slight distention which is generally due to gas or air. The omen-
tum is soft and doughy to the touch, having an uneven surface and
dull on percussion. Ruptures of the bladder may be distinguished
by the acute symptoms of hernia and also by the entire absence of
urination. Hernias of the horns of the uterus are only distinguished
from a loop of intestine after conception and during whelping.
21
322 ABDOMINAL HERNIA.
Mechanical influences, such as bites, blows, contusions, etc.,
may cause an inflammation of the hernia with a thickening of the
pouch, and an adhesion between it and the contents of the hernia.
If the injury is severe enough, we may have suppuration in the
pouch. In such cases we may have a subsequent mechanical con-
traction 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. 1. This may be due to an adhesion of
the intestinal contents with the hernial pouch.
2. The union of the intestinal contents with each other (for in-
stance, adhesion of the intestines).
3. From thickening of the omentum, which lies in the hernial
pouch.
4, From strangulation of the hernia. This is especially impor-
tant, as it may occur in all cases of abdominal hernia and at any
time.
Concerning the causes of strangulation there are three important
groups:
1. Strangulation by extreme distention of an intestinal tube by
fecal matter.
2. A distention of the opening of the hernia, which subse-
quently closes on the intestine and strangulates it.
3. By the intestines becoming twisted in the sac. Invagination
is very frequently seen in young animals.
In many cases we distinguish three stages of hernia, according
to the anatomical alterations produced as a consequence of strangu-
lation in the prolapsed parts. First, we have a venous hypereemia,
then inflammation, and lastly suppuration. In the first stage the
veins and capillaries are gorged with blood, and serum is exuded
in different directions. In the second stage we observe inflamma-
tion of a septic character, which extends from the mucous mem-
brane to the serous membrane, as a consequence of the noxious or
poisonous contents of the intestines. In the third stage the pro-
lapsed parts become necrosed, due to the stricture of blood-cireu-
lation. The intestinal portion becomes black, 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.
HERNIAL RUPTURE. oe
—_
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 aswelling suddenly appears after any trau-
matism, 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 inflammation 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 which is
generally present is vomiting. This may be so constant and vio-
lent toward the later stages that the animal will vomit feces. At
that period symptoms of severe intestinal obstruction present them-
selves. The hernial swelling becomes cold, insensible to pressure,
and symptoms of collapse appear, and death occurs from 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 fecal 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,
fecal matter and pus flow off externally without being followed by
any grave symptoms, except that it may subsequently form a false
anus in the cavity.
Fecal fistule, intestinal fistule, or preternatural rectum is seen
in very rare instances. The expression ‘‘ fecal fistule’’ or ‘‘ intes-
tinal fistule’’ is used where there is an external intestinal orifice,
but the greater mass of fecal matter is passed through the rectum.
The term ‘‘ preternatural rectum ’’ (anus preeternaturalis) is used
when all the fecal 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 inflam-
mation produces a complete immobility of the hernia and gan-
324 ABDOMINAL HERNIA.
grene, followed by the formation of an abscess, and finally the
escape of pus externally. Death is rare in such conditions, and
if it should oceur it is caused by septiceemia.
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 strangulated and is gorged with fecal matter
the results are generally serious; but, on the other hand, strangula-
tion 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 posi-
tion for any length of time on the dog. When 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 ani-
mals, we may close the orifice in such cases by means of a dress-
ing, 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
contents back into the abdomen. In some cases this is accom-
plished very easily, but in others it requires a certain amount of
careful and patient manipulation. Then place a tampon of wad-
ding or a small piece of 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 been cleansed and any fat or other material has been removed
by means of ether or benzine. [The translator finds that the
plaster adheres a great deal better than the ordinary adhesive plas-
ters sold, if, after the hair has been shaved off, ordinary shoe-
makers’ wax made liquid is put on the end of the plaster strips. |
We now place a gauze bandage around the adhesive-plaster dress-
ing 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 constipation, at the same time assisting
defecation by means of laxatives. The safest and most certain
HERNIAL RUPTURE. B15)
method, however, of removing hernia is the operation of herniot-
omy, or hernial section, which will be discussed later.
Where we have a 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 abdo-
men 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 pres-
sure 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 disappeared 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 contents and pouch
have been shoved entirely through the orifice into the abdominal
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.
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 fresh cases of hernia with wide orifices and in
old cases of hernia with extended adherences 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 complicated with a hernial pouch,
in strangulated hernia with considerable alteration of the contents, or with
326 ABDOMINAL HERNIA.
a very narrow hernial opening. These conditions, however, are only dis-
tinguished 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.
Having opened the sac, 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 ori-
fice, turning the cutting edge of the knife toward the neck or restricted
portion, the dull side of the knife being toward the strangulated portion of
the intestine. By means of a small incision the tension becomes greatly
relaxed, and reduction is very easily accomplished. If the opening of the
hernial pouch is required, we hold up one of its folds with a hooked-shape
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 intestines, which is
intensely red and inflamed, must be cleaned by means of warm boric-acid
water (4 per cent.) or creolin (2 per cent.), taking care not to allow the
cleansing fluid to get into the abdominal cavity. This exposed piece 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 prolasped 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 hypodermatic 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. Such operations, however, are ex-
tremely rare in the dog. We therefore will not enter into minute details
on the subject.
After reducing the hernia we must close the hernial orifice. For that
purpose we place a tight catgut ligature around the entire hernial pouch,
which, if necessary, must be isolated, or, better still, we close the pouch and
orifice by means of a continuous stitch after having amputated the super-
fluous portions of the hernial sac. In cases where no hernial pouch is
presented or it has been shoved back into the abdominal cavity it is advis-
able 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 disin-
fecting it for the second time the external wound is to be stitched and coy-
ered with an antiseptic dressing, held in position by means of a bandage
(eight-tailed) around the body.
INGUINAL AND SCROTAL HERNIA. 327
Inguinal and Scrotal Hernia.
(Hernia Inguinalis and Scrotalis).
The inguinal canal of the dog is located in the abdominal mus-
cles 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 Fallopian tube toward the subcutis. Inguinal hernia may
be produced by a portion of the intestine passing from the abdom-
inal 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 ScroTau HERNIA IN
THE Doc. According to Hertwig, from the external abdominal
ring as far as the scrotum the canal is almost cylindrical, and we
find this filling up with an abnormally warm swelling, which has
a peculiar elastic softness and ‘‘ doughy ’’ feel under the skin. In
large hernias we may reduce this partially or altogether by placing
the animal on its back, holding up the hind-quarters, and gently
pressing or rubbing with the finger upon the hernial swelling. If
the intestine has entered the scrotum, the affected side appears
full and large, and may be reduced by the manipulations indicated
above. In cases of strangulation the symptoms which have been
described 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. 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, which is covered
by the tunica vaginalis, is exposed (compare with ‘Fig. 72).
This must be removed, and after that 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 about 1 cm. below the
ligature. The other testicle must be removed in the same manner. After
carefully closing the wound with a strong non-irritating disinfectant, the
328 ABDOMINAL HERNIA.
wound of the testicle has to be closed with an ordinary head-stitch, and it
is advisable to place a small drain, like a silk thread, into one of the cor-
ners of the wound. No dressing is required, provided the animal is muz-
zled. Healing occurs generally within a few days. If, however, we have
Fie, 72.
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.
a case in which we wish to operate for inguinal or 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.
In valuable breeding animals the testicle of the affected side only is
removed.
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 pain-
ful. The condition can only be remedied by castration. °
:
:
:
INGUINAL AND SCROTAL HERNIA. 329
Hydrocele. By this we define an accumulation of serum in
the scrotum. The affection is often associated with cedema 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, which disappears when the animals
lie on their back.
THERAPEUTIC TREATMENT. This consists of puncture and
emptying of the sac, also injection with any of the following stim-
ulating 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 cedema 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 hemorrhagic hernia,
or hematocele. Any other complications of the testicles and their
membranes may be found on page 184.
Fie, 73.
Middle section through the pelvis, showing the organs: a, pelvis; b, coccygeal vertebra;
cv, broad pelvic ligament; d, anterior and, d’, posterior portions of the rectum; e, bladder;
f,f, seminal vesicles; g, fold of the peritoneum.
CuincAL Symproms or IncuinaL Hernia rn THE Bircu.
The contents of the hernial pouch are generally the uterus, and it
330 ABDOMINAL HERNIA.
may either be one or both horns; in some cases the gravid uterus
may form the hernia.
Cadéac saw a great accumulation in a bitch which was affected
by double-sided inguinal hernia. Each pouch had attained the
size of a child’s head; the right side contained the whole intestinal
tube ; the left side contained the epiploon, spleen, uterus, and blad-
der. The hernial covering was formed by one-half of the mam-
mary glands and the external membrane.
This condition is easily distinguished. In the posterior sections
of the mammary glands we find an elastic, painless swelling which
disappears generally after manipulation, when the animal is placed
on its back ; provided, of course, that we find the uterus which is
located in the hernia is not gravid. In that case the progeny may
be distinguished by manipulation externally. It is hardly possible
to confound this form of hernia with hypertrophic conditions of
the round ligaments, or the so-called false inguinal hernia. <A
radical operation of double-sided hernia is to be performed accord-
ing to the general rules already described.
Umbilical Hernia.
(Hernia Umbilicalis.)
The hernial ring is formed by the umbilical ring. The contents
may consist of the omentum, duodenum, and in rare cases part 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 umbilicus 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 become eventu-
ally strangulated, but it often disappears without any surgical inter-
ference. Hernia of the omentum we see occasionally, but, gener-
ally, it cures itself by an adhesion between the hernial pouch and
the hernial ring. Umbilical hernia is easily recognized. We find
a swelling under the umbilical ring, which may vary in size from
a hazelnut toa walnut. Treatment consists, as a rule, in replacing
the contents of the umbilicus into the abdominal cavity and ligat-
ing the umbilical cord.
PERINEAL HERNIA. 331
Femoral Hernia.
(Hernia Cruralis.)
Femoral hernia is extremely rare in the dog. The ring is
formed by the upper end of the so-called femoral canal, and is
formed of the crural fascia, the external membrane forming the
hernial covering. The femoral canal of the dog is a long, three-
cornered cavity in the median surface of the upper part of the leg,
which is surrounded front and back by the inverted muscles of the
upper thigh—that is to say, in the front by the sartorius muscle,
and back by the long adductor, the large and short adductor, and
on its upper surface by the ileo-psoas, while the floor of the cavity is
formed by a portion of the muscles of the thighs and by the crural
fascia. Below the borders of the sartorius the adductors run
together at an acute angle. This canal, asa rule, is filled with
masses of fat, nerves, and bloodvessels. In cases of fracture of
the pelvis the intestines which leave the abdominal cavity, after
having followed the direction of the large bloodvessels, locate them-
selves in this cavity and are covered by the peritoneum, the crural
fascia, and external membrane; but they may also under certain
conditions penetrate directly under the skin through an opening of
the crural fascia.
In the inner fascia of the thigh we find a soft swelling which
has more or less pain when the condition is examined before the
disease has been of recent origin, and in cases of strangulation.
In the latter cases, however, we see also a peculiar dragging motion
of the thighs, with lameness and symptoms of intestinal obstruc-
tion, such as vomiting, etc. Herniotomy has to be performed
according to the rules mentioned before, but must only be done in
extreme cases. In making incisions into this region great care
must be taken to avoid the large bloodvessels which pass into and
through the femoral canal.
Perineal Hernia.
Perineal hernia occurs in both dogs and bitches. In the former
it is récognized by a peculiar bulging or lifting of the recto-vesi-
calis, and in the latter by a bulging of the vesico-uterina. In both
332 ABDOMINAL HERNIA.
cases we observe a prolapse of the duodenum or lower bowel, and
sometimes in the dog we observe a prolapse of the bladder.
In the dog we recognize perineal hernia by a soft swelling the
size of an egg or the sizeof a hand. This appears in the side and
above the anus, between the root of the tail and the tuber ischii.
In the bitch this hernial swelling is seen under the vulva and on
the peritoneum. This hernia can only be removed by means of
an operation.
TUMORS.
A THOROUGH description of tumors with the different varieties
and forms cannot be discussed here as explicitly as the author
would like, and he therefore will confine himself to such tumors
as are met with in general practice, and for further details would
direct the reader to books on general pathology and morbid anat-
omy. The following tumors have been found in the dog:
Tumors of the Connective Tissue.
Soft and Hard Fibroma. A soft fibroma consists of connective
tissue containing bloodvessels and cavities. These are filled with
a serous or mucous fluid. They are generally found lying in the
skin, and form round, soft, inelastic bodies, not especially cireum-
scribed, flabby in consistency, and generally with a broad base. A
hard fibroma consists of a very firm body made up of closely united
fibrinous tissue, and forms rounded or oblong, distinctly circum-
scribed hard tumors, which originate, as a rule, in the skin or
subcutis.
Fibromas belong to the class called ‘‘ mild tumors,’
easily removed.
Lipoma (Fatty Tumor). A lipoma is formed exactly like nor-.
mal fatty tissue, but possesses larger fat cells. It is also flabby and
soft, but no fluctuation is present. As a rule, it is very distinctly
circumscribed, being separated from the neighboring tissues by a
layer of connective tissue. Very rarely do we find it diffused in
different directions. Asa rule, it is found in the dog around the
synovial folds of the joints, in tendons and their sheaths, as well
as in the internal organs.
Lipomas occur in the lower cellular cutaneous tissue, and, as a
rule, can be easily removed by an operation. After the removal
of fatty tumors which had not been distinctly circumscribed the
author saw several recurrences of the tumors; also septic inflam-
mation in the neighboring tissues as a result of the wound.
Enchondroma (Cartilaginous Tumor). Enchondroma consists
(333 )
? and are
334 TUMORS.
of cartilaginous tissue, either hyaline or mucous. We find it in
a normal condition in the bony system and quite frequently in the
lacteal glands.
True enchondroma is considered as a very mild form of tumor,
and may be recognized by its round or nodulated body, distinetly
circumscribed, hard and cartilaginous character.
Osteoma (Tumor of the Bones). Osteoma is a compact or
spongy bony tissue, consisting of a tumor generally developed
on the body of a bone. Asa rule, it occurs on the periosteum;
more rarely in the muscles, fasciz, tendons, and still more rarely
in the thyroid glands. (This last condition was described by
Siedamgrotzky, and may be generally recognized by its location
and bony consistency.) The author has seen an old dog in which
he found osteomata nearly as large as a hen’s egg. These were
remarkable for their extremely irregular surface, and were attached
by distended tendinous tissue to the left of the transverse prolon-
gation of the fifth cervical vertebra, but were removed without
any bad results. As a rule, osteomas are removed only when they
are closely connected with the bone, and when they are likely to
cause a great deal of trouble.
Sarcoma. By sarcoma we mean a tumor which originates in
the connective tissue, which is developed from a certain type of
embryonal connective tissue, and formed with numerous cells.
It originates in various parts of the body, such as cartilages,
bones, periosteum, connective tissue, fatty tissue, ete. We may
also observe it in the form of mild tumors. Their histological
formation and their different varieties are better described in text-
books of pathological anatomy.
Sarcomas are generally considered as malignant tumors: 1, be-
cause they possess a great tendency to become large; 2, because
they are apt to reappear after removal; and, 3, because under cer-
tain conditions they are apt to form in other parts of the body.
Their malignant character is generally much greater in proportion
to the size of their cells and the softer their intercellular substance.
The external anatomical appearance of a sarcoma does not always
present characteristic symptoms. In most cases these tumors are
round, distinctly circumscribed, and sometimes they form encysted
knots, which are of different consistency and color. We may
recognize fibrin and even bone in sarcomas, and some that are soft
ee ee eee
EPITHELIAL TUMORS. 335
as gelatine or mucus. Their color depends, as a rule, on their
vascular condition, and any blood extravasations which may have
occurred also produce certain alterations, so that on section a sar-
coma may appear white, yellow, brown, gray, dark red, and even
entirely black (melanotic sarcoma).
The metamorphoses which occur in the sarcoma are of some diag-
nostic value, especially the mucous softening, which leads to the
formation of cysts, and sometimes to bony deposits. This is fre-
quently noticed in sarcoma, and the ulceration in sarcoma of the
skin and mucous membranes occurs without producing any active
disintegration of the tumor.
There are very rare forms of osteosarcoma, or myeloid tumors,
which occur in the marrow cavity of bones. They have been
noticed in the forearm, also in the shoulder-blade, the bone of
the arm, and femur (Siedamgrotzky and others). Circumscribed
nodules are developed in the medullary cavity which gradually
crowd out the bone by their growth, and, when new bone is formed
from the periosteum, filling up the entire cavity. In this manner
we find enormous lumps, or masses, possessing the hardness and
firmness of bone, and in the centre is found a soft tumor sur-
rounded by a bony cyst. Sooner or later the soft parts penetrate
the bony envelope and certain of the fluid escapes.
The treatment of sarcoma consists in removing it as soon as
possible, and always endeavor to remove the entire tumor, as a
small portion allowed to remain may form a nidus for the com-
mencement of a new growth. There is a group of tumors of
the connective tissue which we see occasionally, called angioma.
These are mostly in the form of fibro-angioma, small, ball-like,
tough, cutaneous tumors, which on section are generally colored
bluish-black.
Epithelial Tumors.
Papilloma. Papilloma originates by hyperplasia of the cover-
ing epithelioma of the cutaneous and mucous membrane, with a
proportionate formation of connective tissue. These are separated
as follows :
(a) Warts. A wart is a neoformation of the papille of the skin
and: of the epidermis. Warts vary very much in size, from a
lentil to the size of a pea. The external covering of a wart is very
3936 TUMORS.
often hard and firmer than that of the connective tissue, so that
the surface is surrounded by a firm, hard, horny covering (horny
warts). The reverse is found in the case of soft, fleshy warts.
These little formations are found on the skin of dogs of all ages,
as a rule, on the head and back, but also in other regions, and they
often disappear without any treatment. Now and then these
horny warts grow to a very large size and form what are called
‘‘cutaneous horns.’’ Such are found on the forehead, the ear,
and flanks; they are generally seen in old dogs. Enormous num-
bers of warts are sometimes seen in the mouth on the buccal
membrane.
(b) Flat Condyloma. By this we mean certain marked malfor-
mations which have the shape of a papilla, but, as a rule, are
ramified and divided, forming coxcomb-like collections. They also
appear in some cases as true papilloma, particularly as a sarcoma-
tous formation. Asa rule, they appear upon other regions than
the skin, such as the lips, cheeks, and prepuce, also upon the mu-
cous membranes in the buccal cavity. They are generally salient
and easily made to bleed. This is due to the large number of
bloodvessels they contain, their softness, and very thin epithelial
covering. The author has noticed that dogs affected with con-
dyloma of the vulva or penis also show these formations quite
frequently on the edges of the lips. Gratin has often seen the
obscure transmission of condyloma from one dog to another.
This would tend to establish the fact that this disease is con-
tagious.
All varieties of papilloma may be removed by a curette or a
pair of scissors. The use of caustics, ligatures, or amputations
is also recommended.
Palm recommends the following:
R.—Acid. salicylicum 5 ; : : . 1 part
Acid. lactic. Us
i 2 part
Collodion-ether ; sae
S.—Apply twice daily.
Adenomata. These are malformations of the true glandular
tissue, which always originate in some gland and can be distin-
guished from simple glandular hypertrophy by the fact that they
stand out from their surroundings, are knotty, tough, or sometimes
soft tissue. Their growth is slow; their metamorphoses consist,
EPITHELIAL TUMORS. 337
as a rule, in the formation of cysts; and in those cases that are
superficial we may have ulcerations externally somewhat resem-
bling carcinoma. While adenoma is not malignant, it may become
so in certain cases and change into a carcinoma. We have observed
adenoma in most of the various glandular organs, upon the skin,
in the mucous membranes, in the mammary glands, in the salivary
glands, and thyroid gland. Tumors of the anus and stomach
deserve special mention.
(a) Tumors of the Anal Glands. The rectum of the dog has
beside the ordinary cutaneous glands: 1. Glands of the anal
pouches. These are glands having a branch tube-shaped form,
located in the walls of the anus. 2. Acinous glands, which are
formed in the so-called anal protuberance. 3. Anal glands, which
are small, grape-like bodies located between the lower bowel and
the anal mucous membrane.
All these glands may become the seat of adenoma, but the latter
is mostly developed in the circum-anal glands. Sarcoma and
carcinoma occur quite frequently in the rectum of the dog.
Tumors of the cireum-anal glands, which are generally found in
old dogs, have been carefully studied by Siedamgrotzky. They
appear as round or irregular, firm tumors which are connected
closely with the skin, and produce more or less enlargement of
that part ; otherwise they are connected with their neighborhood
by a loose connective tissue, In the transverse section they appear
to be formed of yellowish-white or yellowish-red tissue, which is
similar to the cireum-anal glands. As a rule, they are easily
removed.
In some cases we have acute inflammation of the circum-anal
glands with a formation of abscess. The tumors may be easily
distinguished by the presence of pain, heat, and later fluctuation.
We also see on these occasions an inflammation of the anal pouches.
The anal pouches represent the cecal pouches, which vary in
size from a hazelnut to a walnut, and lie between the mucous
membrane and the muscular membrane. They contain within their
walls the above-mentioned glands and have only an external exit
by means of a very narrow canal. Inside we have a yellowish-
brown, thick fluid, which, as a rule is fetid. Various influences,
generally of a traumatic character, may cause inflammation of
these pouches and a retention of their contents. The anus be-
22
338 TUMORS.
comes swollen considerably on one or both sides. The membrane
over the swelling is red, feverish, and painful to pressure. The
animal makes frequent attempts to defecate without any result. A
local examination shows the presence of a discharge of purulent
matter from the orifice. This condition is soon relieved by means
of cooling applications and frequent emptying of the pouch.
(b) Goitre; Struma. Goitre is a non-inflammatory swelling of
the thyroid gland, and is frequently seen in the dog as a simple
hyperemia and enlargement. In some cases we find an adenoma
of the thyroid gland (true goitre). In very rare cases we find a
sarcomatous or carcinomatous deposit of the thyroid gland (false,
malignant goitre). It has been observed that in 30 or 40 per cent.
of tumors in old dogs the disease is a cancerous degeneration of
the thyroid gland.
The thyroid gland in the dog consists of two portions, lying on
each side of the trachea, separated by the median line, a short dis-
tance below the larynx, and connected in the larger animals by a
narrow isthmus. In small dogs this connection may be absent.
We generally speak of two thyroid glands in the dog, and more
so because we occasionally find only one side diseased, and very
frequently find one portion more affected than the other.
We divide goitre into three varieties: the hard, soft, and cystic
forms. A tumor of the neck is the symptom of all three varieties,
which may sink downward as far as the entrance of the chest.
As soon as goitres reach any development they may cause alarm-
ing symptoms, such as difficulty in respiration by pressure on the
trachea, and, in rare cases, dysphagia. Leisering saw a goitre in
a poodle dog which extended from the larynx to the sternum, and
covered almost the whole lower surface. It was about 16 em. long,
10 cm. wide, and 3 em. thick.
The hard goitre (struma fibrosa) is a fibrous hypertrophy of the
gland and a disappearance of the glandular substance. The swell-
ing is hard and firm. In the soft form of goitre (struma mollis)
there is more or less hyperplasia of the glandular tissue. In the
cystic goitre (struma cystica) the gland is altered into one or more
fluctuating cavities, which, as a rule, are filled with a colloid fluid.
There are other varieties of this tumor, but the writer refers you
to the text-books on pathological anatomy.
Carcinoma and sarcoma of the thyroid gland are distinguished
EPITHELIAL TUMORS. 339
from true goitre by the fact that the swelling does not possess the
smooth surface seen in the ordinary form, but is uneven and irreg-
ular, becoming developed into a goitrous degeneration of the gland.
The etiology of the mild form of goitre is very obscure, notwith-
standing numerous researches. In man, as well as in horses and
cattle, the appearance of goitre has been found to be due to their
existence in certain districts, especially in mountainous ranges, and
on that account its cause has been looked for in local conditions
of the soil and water, especially where they contain large quanti-
ties of lime. In the dog no such reason can possibly be ascribed,
as in the regions where man, horses, etc., are rarely affected, many
affected dogs of various ages and different nutritive conditions are
found. The observation made by Maumeni of feeding fluor cal-
cium to dogs was of no especial value. The fact has been pointed
out by Schrauz that goitre is due to or may accompany certain
affections of the heart; this is a much more important cause,
according to the author’s opinion. Schrauz has found that ina
goitre district of the Tyrol in 66 per cent. of cases of heart-disease
the people were affected with goitre. It is advisable therefore to
make an examination of dogs affected with this trouble, following
the same procedure as is described under Diseases of the Heart.
We do not know if this affection is hereditary, but we question
it, although some authors claim that it is.
THERAPEUTIC TREATMENT. The treatment of goitre may be
medicinal or operative. As soon as the enlargement occurs, or
signs of development appear, we obtain satisfactory results with
preparations of iodine. Use iodine internally in the form of iodide
of potassium in small doses, and externally in the shape of oint-
ment of iodide of potassium, tincture of iodine, or ointment of
iodoform (Siedamgrotzky). Also injections into the gland of tine-
ture of iodine, or alcohol and iodine, equal parts, are very success-
ful, but are sometimes dangerous from subsequent fever in cases
of parenchymatous goitres. These injections must be strictly
aseptic in order to avoid suppuration. After thoroughly disinfect-
ing the cutaneous region, we thrust a hypodermatic needle into the
goitre, and first see if any bloodvessel has been injured. With
this syringe inject into the gland equal parts of tincture of iodine
and pure alcohol. In large goitres the injections must be repeated
at intervals of several days. In all cystic and fibrinous goitres
340 TUMORS.
the parenchymatous injections are generally useless, as is also the
internal treatment with iodine. We must treat these forms like
any other cystic tumor—that is to say, by puncture, opening it
freely, tamponing with iodoform-gauze or wadding, and encourag-
ing the formation of true granulations to fill up the cavity.
The removal of a thyroid gland which is affected by goitrous
degeneration is performed in the same manner in the dog as the
removal of any other tumor. We must, however, consider three
very important things during the operation:
1. The large number of bloodvessels in the immediate vicinity
requiring careful incision and subsequent ligation.
2. The fact that after removal of both parts of the thyroid
gland we often have the appearance of serious constitutional symp-
toms and death.
3. Any uncleanliness during or after the operation always pro-
duces severe septic irritation in the remaining portion of the gland
and its surroundings.
We have found from the observations made on a number of
these cases that removal of one part of the gland does not affect
the animal materially; but if both are removed, or the whole gland,
we might say, the dog dies within three or four days, with symp-
toms resembling those of acute poisoning, or it becomes affected by
marasmus, becoming depressed, will not eat, emaciation follows,
the number of white blood-corpuscles in the blood increases to an
enormous extent, the animal becomes unsteady and uncertain in
walking, there are muscular twitchings and convulsions, and
finally general paralysis, and death occurs in three or four days
after the acute symptoms make their appearance.
It is only in rare cases that the dog survives removal of the
whole gland. We can, therefore, conclude that if the dog is
affected on both sides we should remove the one that is affected the
most. In rare cases we see a goitrous degeneration and enlarge-
ment of the thyroid gland. The symptoms of this inflammation
invariably occur in young animals, and may be due to traumatic
influences. In these cases we find a traumatic swelling over the
region of the gland, sensitiveness to pressure, increased tempera-
ture, slight fever, generally followed by the formation of an ab-
scess. The treatment is to be that advised under the treatment of
abscesses.
EPITHELIAL TUMORS. 341
Cysts (Cutaneous Tumors). A cutaneous tumor generally con-
sists of a closed sac or pouch, which is lined with epithelial cells,
and contains more or less liquid. Cysts are divided into several
varieties :
Dermoid Cysts. These consist of cutaneous tissue, sebaceous
glands, sweat-glands, and hair-follicles forming in the centre a
pulpy-like sebaceous mass. Esser found dermoid cysts in the
ovaries.
Retention Cysts. These are described as accumulations of sweat
in the glandular passages or follicles, as a consequence of an
obstruction of the canal at its exit. Atheroma originates as a
result of these accumulations in the sebaceous glands. They are
generally small, round cysts, lying in the skin, and filled with a
grayish-white, fatty, or pasty mass. Secretory accumulations in
the salivary glands cause mucous cysts or mucous polypi. These
are small formations having a soft, elastic feel externally, and
filled with watery or mucous secretions. In the large secretory
glands, when the canals of exit have become plugged up, we have
the formation of true retention cysts. There are two forms, called
the ‘‘ honey-pouch”’ cyst and “‘ glandular.’’? These have already
been described (page 51).
Extravasation Cysts. These cysts are developed in all loose
tissue, especially the cellular tissue under the skin; and in cases
where the inflammation is acute and the secretion becomes encysted
we generally find an accumulation of bloody, lymphatic fluid.
The therapeutic treatment of cysts varies greatly, and depends to
a certain extent on their formation and location. Entire removal
is, of course, the best method, and this is generally adopted in
cases where the pouch or sac has been uninjured, while in cases
where the fluid has been allowed to escape it is almost impossible
to remove the follicle entirely. There are some cases where a sim-
ple puncture with a scalpel is effective. The puncture must be
followed by an injection of tincture of iodine for the destruction
of the cyst wall. Where we simply make an incision and evacu-
ate the sac, we clean it out and follow it up by applications of
creosote solution, oil of turpentine, tincture of cantharides, or
nitrate of silver solution (1 to 10), or we may “‘ touch it up”
with the thermo-cautery. This, however, as a rule, takes a long
time to heal.
342 TUMORS.
Carcinoma, or Cancerous Tumor. We call ‘‘ carcinoma”’ a
neoformation which has originated by an accumulation of epithelial
cells. These cells possess the peculiar property of forming meta-
stases through the various lymphatic glands, and producing a gene-
ral cancerous infection of the body, and are, therefore, considered
malignant. Almost all the cancerous forms are distinguished by
their tendency to regressive metamorphoses. These are mucous,
colloid, and fatty degeneration with cystic formation, calcification,
cicatricial contraction, and in superficial carcinoma of the skin
and mucous membranes ulcerous disintegrations with formation of
a purulent centre are called ‘‘ phagedenic ” tumors.
We recognize the following forms of carcinoma :
Squamous Cancer, or Cellular Epitheliona. This occurs in the
cutaneous membrane and in all the mucous membranes containing
squamous epithelium, as the mouth, throat, larynx, external gen-
itals, bladder, and urethra.
This affection in the cutaneous membrane, cutaneous cancer or
cancroid, is very often seen in old animals, and occurs in any
part of the body. It originates as diffused, thickened, or warty
growth of the skin, becoming rapidly extended over its surface,
and finally altered into cancerous tumor (ulcus rodens). It is a
peculiar fact that this cancerous growth may accumulate rapidly
for a short time, and then remain stationary without increasing
any more.
Squamous cancer or cellular epithelioma, which appears in the
mucous membranes, especially in the vagina, which deserves spe-
cial mention, has a great tendency to extend superficially, followed
by a cancerous disintegration, also by a constant, bloody, purulent
discharge.
Cylindrical-cell Cancer. We observe this in the mucous mem-
brane of the digestive tract and the uterus. Cancer of the stomach
is of some importance, as it has been recognized in a number of
post-mortems. Its existence during life can only be guessed at by
frequent vomiting of more or less blood.
Cancer of the Glandular Tissue. This is found in all glandular
organs and especially in the mammaries of old bitches. This
cancer of the mammaries is marked by the following character-
istics:
It is of slow growth, is particularly hard and firm, and has a
EPITHELIAL TUMORS. 043
tendency to remain stationary for a long time. In some regions of
the glands we may see a small, hard knot developed, which is not
sensitive to pressure, and shows no signs of inflammatory action.
This enlargement gains slowly and may be accompanied by other
knots in the immediate neighborhood, which finally unite and form
one mass. The carcinoma at this stage is found to be a hard,
irregular, circumscribed tumor, and united, as a rule, with smaller
masses by a thin, cord-like enlargement that lies in the integu-
ment. When this enlargement is located very near the skin it
shows a peculiar cicatricial contraction, and especially if it is near
the teat this may be drawn entirely into the skin. This is quite
common. We also observe great distention of the cutaneous veins,
which may even be varicosed.. As a rule, the enlargement is
rarely confined to one, but we may find scattered through the
gland numerous lumps or knots of various sizes. The author
has counted twenty scattered through a gland. We also see in
the mammaries of the dog fibromas, chondromas, adenomas, sar-
comas, and cysts, but these are much rarer than carcinoma.
It is hardly possible to confound these tumors of the mammaries
with inflammation of the lacteal gland. True acute mammitis
occurs very rarely in the bitch, and is indicated by a circumscribed,
painful, very sensitive reddened swelling of a definite glandular
section. The section may undergo complete disintegration, forming
an abscess and sloughing, or we see chronic inflammation with a
formation of knotty lumps, and a peculiar cicatricial contraction.
A rapid improvement generally results from the use of acetate of
lead solution. True mammitis must not be confounded with inflam-
mation of the lacteal glands, which may appear in bitches that are
nursing and deprived of their young. The swelling disappears in a
few days by itself, but it may be hastened by a light diet and saline
purgatives. In very rare instances there is a peculiar condition of
the lacteal glands that is seen in bitches that have had several litters
of pups; about forty-five days after they have been in ‘‘ heat’’ we
may find a general enlargement and filling up of the entire glands,
also the appearance of a thin milk or colostrum in the glands,
and every appearance of active lactation. This might lead the
practitioner to believe that the bitch was in whelp.
The tendency of carcinoma to become malignant and cause a
general infection of the whole body is especially marked in the
344 . TUMORS.
soft forms of cancer, particularly those having a tendency to
ulcerative degeneration, while the hard forms, such as above
described in cancer of the mammaries, may remain months and
even years after producing no other effect than a gradual enlarge-
ment. The process is generally developed in the lymphatic glands,
but we may see the appearance of secondary tumor centres which
swell up without being accompanied by any pain or inflammation.
A large part of the body may become affected in this manner—
that is to say, the gradual development of the process through the
entire body, these various tumors being supplied from the primary
tumors, or carried into the circulation and scattered in all direc-
tions, forming new centres of development. We may see this occur
in cancerous masses in the liver, kidneys, and lungs, producing
very little irritation of the surrounding tissues beyond the centre
tumor, but we find the animal falling away quickly, becomes
emaciated, has weak heart-action, and presents all the symptoms
of what is known as cancerous cachexia.
The prognosis is always unfavorable. Removal of a cancerous
tumor may only be made when the neighboring lymphatic glands
have not become affected, and where the animal is in good nutri-
tive condition. Cases of ulcerated carcinoma must always be con-
sidered unfavorable, except in the form of cancroid, which has
been already described. The treatment of cancer consists of speedy
removal and keeping the animal in as healthy condition as possible.
GENERAL THERAPEUTICS OF Tumors. The internal medicinal
treatment by preparations of iodine may be used in cases of goitre.
In carcinoma and sarcoma we may give arsenic in the form of a
solution of mercury, iodine, and arsenic (Donovan’s solution),
and the treatment advised under Chorea (page 218).
Surgical Treatment. This is generally palliative in cases
where the tumor is difficult to reach, being restricted to the
prevention of hemorrhage, suppuration, and a fetid odor. The
therapeutic measures used by Fricker and Hertwig are as follows:
Tampons of tow which have been saturated in a solution of
chloride of iron and injections (where there is an opening) of sub-
sulphate of iron, 1 to 90.
This palliative method is only indicated where a radical opera-
tion cannot be performed from some cause or location of the tumor
and where the owner wishes to keep the animal alive as long as
EPITHELIAL TUMORS. 345
possible without surgical interference. The methods of radical
removal of tumor are as follows (these do not include torsion or
twisting):
Ligation. This method may be applied in all cases where the
base of the tumor is not too broad, and if it has not penetrated
deeply into the tissues. It is useful in many forms of warts,
fibromas, and sarcomas; but, as a rule, it is objectionable because
it acts slowly, is extremely painful, produces great inflammation
with suppuration, and the tumor has a tendency to return. Ligate
the base of the tumor with a strong silk thread or a rubber band.
Another method which is more rapid is the use of the écraseur,
either by chain or wire. The chain of the écraseur is put around
the base of the tumor, and greatly tightened by means of the
instrument, when the tissues are gradually crushed. The author
Fig. 74.
Wire écraseur.
has used the wire-loop, shown in its simplest form in Fig. 74, for
the removal of epulides. The bleeding, as a rule, is very slight
if the crushing is done slowly, but there is always a danger of
recurrence of this condition. We must, therefore, touch the
open space left after the removal of the tumor with a thermo-
cautery.
Caulerization. We may destroy tumors of the cutaneous or
mucous membrane, flat warts, ete., by means of Paquelin’s thermo-
cautery, or we may use some of the various cauterizing substances.
The best form of using this treatment is by the instrument illus-
trated in Fig. 75 (page 346). This instrument is based on the
fact that platinum, under certain conditions, very readily takes a
red-heat at a low temperature. The instrument is made in the
form of a pipe or cylinder, with different forms of platinum fitted
on the end. By means of an ordinary blowpipe or hand-bulb
a fine spray of benzine or rhigolene is thrown on the heated plati-
num end, causing constant combustion, and if the flame is kept
steady it reaches a white heat. This instrument has the advantage
of being kept at an even heat for a long time, and on account of
this steadiness is especially valuable in controlling hemorrhages.
The caustic chemical substances, such as burnt alum, caustic
346 TUMORS.
potash, blue-stone, chromic acid, chloride of zinc, and nitric acid,
are not especially valuable in the therapeutic treatment of tumors.
Paquelin’s thermo-cautery.
Removal—Extirpation. This method is the best one to follow
in all large tumors which are easily reached. Various modifica-
tions are possible, according to the form and location of the tumor,
but the following is the general mode of procedure:
1. The incision: The cut should be made by an ordinary scalpel
between the tumor and soft parts; making the incision, if possible,
in the direction of the hair and of the large bloodvessels.
2. After the extirpation of the tumor the cavity should be cleared
of all loose tissue by means of a pair of scissors or scraped with
a curette.
3. Ligate all the bloodvessels.
4, Tie up, or bring together by means of sutures, the edges of
the wound.
5. Place over the wound an antiseptic dressing.
Anesthesia. We have already given information as regards
the last three points of the operation. We must confine the
animal, in all operations, in such a way as to prevent him from
biting or from moving that part of the body which is operated upon.
It is best to place a leather strap or bandage around the mouth (see
Fig. 76), and have an assistant hold it. This method is preferable
to strapping with cord, etc. Berdez, Arnold, and others have con-
structed special operating-tables which are to be used in hospitals.
In very serious operations, accompanied by great pain, it is
advisable to place the animal under the influence of some anes-
EPITHELIAL TUMORS. 347
thetic (except in slight operations of the eye, in which *‘ local”’
anzesthesia with cocaine is sufficient). We generally use chloral,
ether, chloroform, or bromo-ether. It is advisable to give chloral
Fic. 76,
Manner of tying the mouth.
in the form of a clyster. We inject the following solution in the
rectum of a medium-sized dog, fifteen minutes before the operation:
Chloral hydrate . : : : : i : ; 8.0
Aqua . 3 : : : : ; : ; . 100.0
Mucilage ; j E ; : : d , a 320.0
The other agents are inhaled by means of an anesthetic cover-
ing—a flannel mask. The mask is made of wire netting shaped
like a muzzle, covered with flannel, and held under the ani-
mal’s nose (Fig. 77, a). We must
take care that a certain amount of
air is inhaled with the vapor of
the anesthetic. The pulse, respi-
ration, and reaction of the eyelids
must be watched at the same time.
After a few inhalations we notice
a period of excitement which is
marked by great restlessness, howl-
ing, groaning, and, in rare cases,
delirium. This is followed in a
short time by a period of depress-
ion, and after that the narcotic con- =
dition is completely established. ¢, innalation mask; b, inhalation bottle.
The cornea has now become insen-
sible—that is to say, there is no reflex action or closing of the eye-
lid when touched. The muscles are now entirely relaxed, feces and
348 TUMORS.
urine are discharged involuntarily. This result is not always even
or regular, but depends to a large extent on which of the above-
mentioned remedies-is used. For instance, in using ether the stage
of excitement is usually prolonged (twenty to forty minutes) [this is
not the translator’ s experience with a good assistant—ten minutes at
the most], and in the stage of depression reflex excitement does not
disappear immediately. Chloroform produces much quicker results,
and, as a rule, answers fairly well, but it has one disadvantage: the
attendant or administrator must be very careful not to push it too
far, or it is apt to produce paralysis of the lungs or stop the action
of the heart, or perhaps act on both parts at the same time, causing
death. We prefer to use a combined narcotic in the form of an
injection about ten minutes before the operation. This injection
consists of 0.03 to 0.06 of morphia muriate dissolved in water.
Afterward administer a mixture of equal parts of ether and chlo-
roform. The narcotic stage is mild, the period of excitement short,
and death is very rare. |
But even by this method, if there is any acute disease of the
heart, it is apt to be dangerous. For this reason the author has
lately used bromo-ether after having repeated]|y tested its reliability.
The author uses an inhalation of bromo-ether by means of an
apparatus shown in Fig. 77 (6), which, of course, may be used to
administer any anzsthetic. The funnel is placed under the ani-
mal’s nose so that he is compelled to breathe through the bottle.
The sponge in the bottle is impregnated with bromo-ether; a double
curved tube serves to supply the requisite amount of atmospheric
air. The amount of bromo-ether necessary varies from 10 to 40;
the stage of excitement is short but very marked; the narcotic
effect is deep but lasts a few moments only, so that it is not advis-
able to discontinue the inhalation at any time during the operation.
The stage of excitement may be reduced to a minimum by means
of morphia injections. Asa rule, the temperature of the rectum
drops from 1° to 3° after this narcosis. The lowest the author
ever observed was 35.5°.
[The translator has recently used an inhaler suggested by
Professor Hobday, of the London school, that has a number of
advantages over the methods suggested by the author, but at
the same time it must be admitted that it is really an improved
modification of the apparatus suggested in the author’s work, the
EPITHELIAL TUMORS. 349
mask and the bottle being greatly improved in ‘‘ Hobday’s”’
apparatus.
It consists of a mask that has the form of an elongated blunt
cone, having a stopcock at one end where the tube enters that
carries the anesthetic into the apparatus. This is fixed on the
head by means of a collar, and a circular continuation of the cone
made of soft cloth, which is adjustable, is fitted over the face. A
container with a broad base to prevent any chance of it being over-
turned contains the anesthetic. This container has two openings—
one to connect the tube and the other to allow the admission of air to
mix with the vapor of the anzesthetic. Connecting the container and
the mask is a bulb apparatus usually seen on the thermo-cautery.
The muzzle apparatus is fixed on the animal’s head, and by
means of the bulb the mixed vapor is blown into the muzzle and
directly on the animal’s nose, thus preventing the irritation of the
direct contact of the ether or chloroform. By means of the stop-
cock the supply of vapor can be stopped instantly, or, if need be,
the whole apparatus can be slipped over the animal’s head or the
rubber tube can be pulled from the container and a supply of pure
air blown directly on the animal’s nostrils. ]
The most important requirement, after the use of the anesthetic,
is controlling the hemorrhage in large operations. In operations
on the extremities we may use for that purpose the bandage recom-
mended by Esmarch. The member must be held high and the
blood removed by frictions made by the hand from the periphery
toward the proximal end, then place a rubber bandage around the
limb above the part that has to be operated upon. This method
not only gives us a clean field for operation, but it enables us to
find numerous little arteries which may have been overlooked, and
which begin to bleed as soon as the bandage is removed. We find,
as a consequence, fewer consecutive hemorrhages than were for-
merly noticed. This method must not be practised under any
circumstances where there is any risk of introducing pus or puru-
lent matter into the blood. For instance, in purulent cellular
inflammation of the tissues, gangrene, etc. In such cases we avoid
any manipulation of the part. Place a simple compressing bandage
above the operating region in order to prevent hemorrhage during
operation. We must not use friction in order to carry or empty
the blood from the affected member.
DISEASES OF THE EYES.
AFFECTIONS OF THE EYELIDS.
Closure of the Hyelids.
Iv is a well-known fact that puppies are born blind—that is
to say, the palpebral fissure is closed at birth. This is not a simple
agglutination of the eyelids, but a true adhesion of membranes.
This has been proven from the fact that if they are forcibly sepa-
rated after birth the cornea has an opaque look and the edges of
the eyelids bleed. Asa rule, the fissure opens itself in from seven
to twelve days. It is very rare that we have an obstinate closure
of the eyelids. If this should be the case, we try to produce sep-
aration by means of emollients, tepid water, and normal tension
upon the eyelids. If these are not successful, the eyelids must be
separated by means of a pair of scissors; then we rub the edges of
the wound with vaseline, or, if they persist in uniting, with caus-
tics in order to prevent an adhesion.
Entropion—Turning in of the Eyelid.
By this term we understand a turning or wrinkling of the eyelid
in such a manner that the edge of the lid is directed toward the
eyeball, and the eyelashes come in contact with the conjunctival
tissues and cornea. Entropion occurs quite frequently, especially
in bulldogs, Newfoundlands, and setters, although it may be
present in all breeds. In some cases it is present at birth, or it
may be developed by constant convulsive closing of the fissure of
the eye, due to some irritating conditions of the cornea or conjunc-
tiva. It is occasionally caused by cicatricial contraction of the
conjunctiva of the lid, after injuries, caustic substances in the eyes,
burns, or some chronic inflammatory condition. The looser the
cutaneous tissue may be in the neighborhood of the eyelid, the
more obstinate the diseased condition is to treatment. Haltanhoff
considers that the tendency to entropion is hereditary.
(350)
ENTROPION—TURNING IN OF THE EYELID. 351
CuinicAL Symptoms. As a rule, the inversion of the lid occurs
more frequently in the upper than the lower eyelid, but we may
also-see both affected at the same time. Sometimes we see a lateral
inversion of the eyelid. This is extremely rare, however. A symp-
tom observed is constant irritation, which is caused by the hair of
the lashes being directed toward the cornea. We also see a marked
lachrymal secretion, a twitching and convulsive compressing of
the eyelids, and a thick, gray mucus accumulates in the corners of
the eyes. The hairs of the eyelashes become adherent, and the
eyelids may become completely glued together. Besides this we
see an intense inflammatory condition of, the connective tissue, and
in some cases inflammation of the cornea, and in extremely bad
cases suppuration.
PROGNOSIS AND THERAPEUTICS. The prognosis may be favor-
able when we operate at the proper time, but relapses are not rare,
especially in dogs which show a peculiar wrinkled condition of the
facial membrane. We may expect a relapse in such cases where
we do not entirely remove the conjunctivitis (primary or secondary)
at the same time as the entropion.
It is only in fresh and very mild forms of the disease that we
obtain any favorable results by means of medicinal treatment, and
this must be directed toward removing the conjunctivitis which
exists in conjunction with entropion, otherwise an operation alone
will answer.
The following methods of operation are suggested:
1. Simple removal of the turned-up eyelid by means of scissors. This is
undoubtedly the simplest method, but it is very evident that the appear-
ance of the animal is very much impaired by it, and that the eyeball may
be.affected in some manner on account of the insufficient closure of the lid.
2. Incision of the eyelid in the neighborhood of the internal corner of the eye.
This method, which was formerly described by Stellway and recently by
Zirin, is not thought by the author to be advisable. This operation con-
sists in taking a wedge-shaped piece from the lid through its whole thick-
ness. We cannot advise this, however, as we doubt if the lid will become
thoroughly united.
3. Ligation of small portions of cutaneous membrane in different parts of the
Zid. Stockfleth describes this method in the following manner: We in-
troduce a number of needles through the fold of the skin in the eyelid,
drawing the portion of skin together by means of a thread in the form of
a figure-of-eight. This will act as a ligature. The points of the needle
must be cut short, and a small piece of wax put on the ends to prevent
352 DISEASES OF THE EYES.
either slipping or puncturing the skin. After the ligated portion of the
skin has become inflamed and detached we see a series of round, cutaneous
wounds near the eyelid, which heal by granulation. The eyelids turn out
of their normal position by means of a contraction of the cicatricial tissue.
4, Excision of a portion of the cutaneous membrane from the eyelid. This
is the best and most common mode of operation. It may be performed in
two different ways :
a. Take up a horizontal fold of about 0.5 to 1.0 em. by means of a strong
pair of pincers (Fig. 78, a), or what are known as entropion forceps, about
Fie. 78.
Operation for entropion by means of excision: a, elliptical incision ; b, triangular incision.
5 to 8 mm. from the edge of the eyelid, cutting it off closely by means of
a pair of scissors (Fig. 78, a) ; and
6. Take up and cut out a triangular or heart-shaped piece, instead of an
elliptical one (Fig. 78, 6). We then close the wound by a united or con-
tinuous suture, and paint over this suture with collodium. While we do
not, as a rule, obtain union by first intention, the wound closes very quickly
and gives satisfactory results.
Ectropion—Turning Out of the Hyelid.
This condition is, as a rule, in the lower lid, the free edge of
the lid being turned out from the eyeball toward the external side
of the eyelid. This is generally noticed in bulldogs, St. Bernards,
and setters, especially so in the animals that have sunken eyeballs.
It may be due to an alteration or partial paralysis of the palpebral
muscles. Sometimes it may occur from the shape of the cartilage,
whieh does not consist of a firm disk, but of bunches of connective
tissue mixed with elastic fibres. In some cases it may be caused
by a contraction of the membranes of the face, especially cicatricial
contraction, such as results from wounds or burns, It may also be
INFLAMMATION OF THE CONJUNCTIVA. 353
due to a loosening or softening of the tarsal cartilage as a result
of prolonged conjunctivitis.
CirinicaL Symptoms. The affected eyelid is turned up and out,
so as to show the conjunctiva. The latter is inflamed from the
action of the air and is more or less reddened, and at the same
time there is considerable secretion of mucus and tears along the
cheeks (lachrymal eyes).
THERAPEUTIC TREATMENT. We must first endeavor to reduce
by ‘‘ touching’’ the connective tissue of the eyelid with a pencil
of nitrate of silver or sulphate of copper, or by removing.a portion
of the eyelid. This, however, is extremely hard to do, and, as a
rule, it is not advisable. If these measures are useless, or if they
seem doubtful from the onset, Moller recommends to excise from
the external half of the affected lid an arch-shaped piece of skin,
0.5 to 1 em. broad, the arched edge standing from the edge of the
lid. Placing a few stitches is advisable, but is really not necessary.
Concerning other diseases of the eyelids, we would refer you to
text-books on ophthalmology.
DISEASES OF THE CONJUNCTIVA.
Inflammation of the Conjunctiva—Conjunctivitis.
(Conjunctivitis ; Syndesmitis.)
Inflammatory conditions of the conjunctiva are the most frequent
affections of the eye in the dog, and appear in various ways accord-
ing to their cause. Under ordinary circumstances we see the
development of a simple catarrh of the conjunctiva, which, like
all catarrhs of the mucous membrane, causes swelling, great red-
ness, and formation of loose folds of tissue. The redness may
vary from a slight injection to a dark or bluish-red coloration.
This is, as a rule, regular and rarely spotted with blood extrava-
sations. The secretion of the mucous membrane is sero-mucous
in the beginning, but later on becomes muco-purulent, and in some
cases there is a peculiar grayish secretion. This secretion becomes
agglutinated to the interstices and corners of the eyelids, producing
a gluing together of the lashes, and during the night, when the
animal is asleep, it dries up, forming a grayish-yellow adhe-
sive mass. The inflammation is usually restricted to the conjunc-
23
354 DISEASES OF THE EYES.
tiva of the lid, the transition fold and the bulb of the conjunctiva
being very rarely affected. The follicles of the connective tissue
are generally swollen in all prolonged forms of catarrh of the eyes.
Sometimes they protrude here and there from the reddened con-
nective tissue in the shape of a millet-seed or a sago granule.
In cases where the irritation is due to the influence of some
infectious substance we notice a marked cellular infiltration of the
tissues of the mucous membrane, with proportional swelling of the
connective tissue, and the production of a copious, thick, yellowish-
green secretion. Under the influence of chemical irritants we have
the formation of grayish-white or transparent membranous accu-
mulations upon the surface of the mucous membranes, and some-
times we have ulcers which may lead to trichiasis (turning in of the
hair of the lashes toward the bulbs; the mildest form of entropion).
In some cases it may cause a natural entropion or symblepharon
adherence between the lid and bulbs of the conjunctiva).
The following forms of conjunctivitis are noticed in the dog :
Catarrhal Ophthalmia (Conjunctivitis). By this we mean
an acute catarrh with intense redness and loosening of the con-
junctiva, also copious mucous or muco-purulent secretion. The
local disturbances do not seem to be very marked, but we see in
rare cases irritation and itching, the patients attempting to rub
their eyes with their paws. The course may be acute or chronic.
Conjunctivitis follicularis is a variety of this disease (catarrh of
the eyes). Frdhner says that this is indicated by the appearance
of large quantities of lymphatic follicles upon the internal surface
of the membrana nictitans. These stand out distinctly in the
form of rounded millet-seed bodies upon the surface of the mucous
membranes. They are dark-red and transparent, consisting of
ball-shaped accumulations of lymphoid cells. Soon they appear
in numerous masses, giving the membrane the appearance of a
granulating wound surface, and in such cases the membrana nicti-
tans is detached from the bulbus and extended over the cornea.
The question, is follicular conjunctivitis to be accepted as a dis-
ease sui generis or not, we have not been able to determine fully,
but we know that the presence of numerous lymphatic follicles
prolongs indefinitely the course of conjunctivitis. We ought, there-
fore, to always expose the membrana nictitans by means of a pair
of forceps, especially in catarrh of the connective tissue. Accord-
INFLAMMATION OF THE CONJUNCTIVA. 355
ing to Frohner, 40 per cent. of all dogs are affected more or less
by conjunctivitis follicularis.
Errotoey. Catarrh of the eyes may occur at any period of the
animal’s life, and, as a rule, affects both eyes; in very rare in-
stances only one. It is generally the result of exposure to cold or
the influence of sharp, cold winds. It is, therefore, apparent why
it appears at certain seasons of the year more than at others—that
is, in the spring and fall. Mechanical and chemical influences
also produce a certain effect, such as foreign bodies (dust, hair,
etc.), eyelashes turned in, smoke of soft coal, ete.
Catarrh of the conjunctiva is intimately connected with catarrh
of the respiratory organs, especially cold in the head, distemper,
and all serious internal diseases which have a prolonged course.
Purulent Ophthalmia (Purulent Conjunctivitis; Blennor-
rhea). This form of conjunctivitis is marked by considerable
swelling of the membrane. This is sometimes spotted red by
hemorrhages, sensitiveness to light, and photophobia, the animal
constantly winking or convulsively closing the eye. The secretion
of the eye is changed into a muco-purulent mass, becoming filled
with a thick, yellowish-green fluid with pus, and in this condition
complications of the cornea are generally present. The latter be-
comes dull in the centre, showing erosions in some cases. This
opacity of the cornea gradually increases, becoming darker, more
opaque, and then taking a yellowish-gray coloration. We may
see in some cases ulceration of the cornea.
This blennorrhcea of the conjunctiva is a rare and dangerous
disease, causing extensive inflammation and ulceration of the cor-
nea, the condition being prolonged in some cases from four to eight
weeks, and in extremely bad cases the eye is lost.
Errotocy. It is admitted that this disease is due to a specific
infectious substance in the course of some epizootic disease. This
may or may not be present. It is possible to produce the same
form of the affection by inoculating the conjunctiva of a healthy
dog with this purulent material. Guilmot observed that by placing
dogs in a kennel which had been previously used by a dog affected
with this disease that they soon became similarly affected. In many
cases we see no ulceration, simply the development of the conjunc-
tivitis. Frohner states that he has observed purulent conjunc-
tivitis, which he found to be due to the transmission of gonorrheal
356 DISEASES OF THE EYES.
secretion from the affected person placed on the conjunctiva of the
dog. Guilmot says that gonorrhceal secretion of the dog itself is
the cause of this disease, but this assertion is combated by Moller,
whose experiments with secretions of preputial gonorrhcea in the
dog have always given negative results.
THERAPEUTIC TREATMENT OF INFLAMMATION. If the disease
is produced by foreign bodies, an eruption, etc., we have to remove
the cause first. If we have to deal with dirt, coal-dust, or small
bodies, it is sufficient to wash out the eye with a little syringe, such
as a hypodermatic without a needle. If the bodies are adherent,
such as iron fragments, sand, etc., accompanied by convulsive
movements of the lids and intense secretion of tears, we must
apply a certain amount of cocaine to the eye, remove the foreign
bodies, or wipe them off by means of a blunt probe or sound, coy-
ered by a handkerchief. Then keep the animal away from strong
light, smoke, ete.
In ophthalmic catarrh we must use astringents, such as sulphate
of zinc, sulphate of copper, and nitrate of silver. These must be
used in mild solutions, such as 0.2 to 0.75 per cent. These solu-
tions may be applied by means of a camel’s-hair pencil put between
the lids and washed off in a short time with clean water; or we
may apply nitrate of silver, following it up a few minutes after-
ward with a 2 per cent. solution of chloride of sodium. Alum
solutions are also useful for washing or painting the inflamed
membrane. In pronounced photophobia we may paint the con-
junctiva with a solution of cocaine or tincture of opium and gum
arabic. In chronic cases apply ointments of calomel, 10 to 20 per
cent. ; oxide of mercury, 3 to 5 per cent.; or iodoform, 20 per cent.
In chronic catarrh of the eyes a very effective method of reduc-
ing the irritation is to blow small quantities of calomel directly on
the membrane. Follicular conjunctivitis may be removed by
astringents, but in the acute forms which occur on the surface of
the membrana nictitans we can only remove them by surgically
removing the membrane. This is cut out in the following manner:
Removal of the Membrana Nictitans. We first place the eye
under the influence of a few drops of a 4 per cent. solution of
cocaine, then by means of a light suture needle we run a thread
through the membrane and lift it up as far as possible from the
eye. By means of a pair of scissors we then cut the enlarged
INFLAMMATION OF THE CONJUNCTIVA. 357
membrane from the eye. The incision does not require any further
treatment except to bathe it with cold water. The author has
never seen any bad results from this operation, which has been
especially recommended by Frohner, Moller, and others.
The influence of cocaine upon the conjunctiva and cornea renders
these parts insensitive and permits a number of small operations
without producing any feeling of pain or convulsive irritation of
the eyelid. We pour a little 5 per cent. solution of cocaine into
the eye and obtain in this manner, from two to three minutes, an
absolute insensibility to pain, both in the cornea and conjunctiva.
This does not, as a rule, last more than ten minutes, and must
therefore be renewed every five minutes if necessary. In order
to reduce blepharospasm, as a consequence of violent conjunctivitis,
we should apply solutions of cocaine every two or three hours.
THERAPEUTICS. In ophthalmic blennorrhcea we must endeavor
to prevent it before it goes too far. We must treat it with anti-
septic agents, and it is especially important to keep the conjunctiva
clean with water or some non-irritating antiseptic fluid, such as
boric acid, 3 per cent.; corrosive sublimate, 0.02 per cent.; per-
manganate of potassium, 0.05 per cent.; creolin, 1 per cent.;
salicylic acid, 1 per cent. These must be introduced into the
pouch of the lid by means of a syringe, brush, or sponge. When
it is necessary we must irrigate the eye with strong solutions of
nitrate of silver (1 to 3 per cent.), taking care to observe the rules
mentioned on page 356. We may also use diluted alcohol (equal
parts), covering the conjunctiva with calomel ointments or oxide
of mercury, or blowing on it powder of iodoform or calomel.
Aniline (pyoktanin) is also advised by some authors.
The treatment may also be materially altered by complications
of the cornea, for which we would refer to page 359 for further
details.
Besides the inflammatory condition which has just been de-
scribed, we may have tumors of the conjunctiva, but, as a rule,
these occur on the membrana nictitans. Their treatment depends
on general rules which have been already described. It may be
advisable to remove them in the manner described.
358 DISEASES OF THE EYES.
DISEASES OF THE SCLEROTIC COAT OF THE EYE.
Inflammation of the Sclerotic Coat.
( Keratitis.)
Notwithstanding the fact that the sclerotic coat does not contain
any bloodvessels, it is frequently the seat of inflammatory pro-
cesses which become present through a pericorneal injection due
to intense irritation of the bloodvessels which surround the border
of the sclerotic coat, and further by an opacity of the cornea form-
ing an obstruction that prevents the admission of rays of light into
the eye itself. This clouding or opacity may extend over the
entire sclerotic coat, or it may only involve a small portion. It
varies in color from a grayish-blue to a pure gray. It is yellowish-
gray in some cases, but never pure white in coloration (cicatricial
dulness). On careful examination it seems to be diffuse, forming
spots or stripes. The lustre of the membrane is dull on its surface
and a partial loss of the epithelium is noticed. The other symp-
toms are avoidance of light, convulsive movements of the eyelids,
and discharge of thin water from the corner of the eyelids, visual
deficiencies, and in some cases the animal may be partially or even
totally blind. This is especially seen when the opacity of the
sclerotic membrane is in the region of the visual line that is
opposite the pupil.
PaTHoLoGicaL ANATOMY. We have in other cases of keratitis
the appearance of large quantities of round cells in the sclerotic
membrane. These come from the bloodvessels of the neighboring
membranes and conjunctiva. These are wandering cells which
find their way into the sclerotic coat. As long as the round cells
in the sclerotic membrane are not crowded together it remains
unaltered in its true structure (infiltration of the sclerotic mem-
brane), and complete recovery follows after the cells have disap-
peared. But as soon as the cells are packed too closely together
the sclerotic tissue is partially destroyed by maceration and
necrosis, followed by a loss of actual substance. If this is sur-
rounded by intact tissue of the sclerotic membrane, it forms an
abscess; if it is open externally, it is an ulcer. We consider as
ulcers small superficial openings in the cornea which are always
round in the early stages, and are caused by infiltrations located
INFLAMMATION OF THE SCLEROTIC COAT. 359
closely under the epithelium, forming little bags or sacs, and finally
bursting through the epithelial covering. In the dog, as a rule,
they heal without leaving any cicatrix. Still, many cases are seen
where they finally close up, leaving a white cicatrix, or else they
lead to perforation of the cornea or to a total destruction of the
eye by extending into the anterior chamber.
We find the following forms of inflammation of the sclerotic
membrane:
(1) Keratitis Superficialis. The cornea is clouded and opaque,
being of a diffuse grayish-blue or grayish-white coloration, appear-
ing with a slightly irregular surface, but under certain circum-
stances it may also be covered with small epithelial masses. In
this affection the eyes are watery, and this may disappear in a few
days or last for weeks. In the latter case we observe the forma-
tion of bloodvessels at the borders. These bloodvessels increase
in size and the edges become very vascular. Moller found that
during vascularization of the cornea it is not rare to see hemor-
rhages in that organ followed by a number of brownish-black
pigment-spots.
Eriotocy. Superficial inflammation of the sclerotic membrane
is caused by slight irritations of various kinds (superficial injuries,
inversion of the eyeballs or entropium). It may also originate,
secondarily, with acute conjunctivitis, the inflammation extending
from the conjunctiva to the cornea.
THERAPEUTICS. The treatment is the same as in inflammation
of the conjunctiva—that is, washing and painting with a solution
of sulphate of zinc, corrosive sublimate, alum, or sulphate of
copper. Avoid all use of lead solutions in such cases where there
is any loss of substance of the cornea, as the lead is deposited in
the cornea and produces black-colored spots. If there is any
ulceration, we must apply the therapeutic treatment as indicated
on page 362, and in cases where the spots on the sclerotic mem-
brane remain use the treatment given on page 363.
(2) Keratitis Profunda or Parenchymatosa. The surface
of the cornea has an opaque, dull, slightly grooved condition, the
color bluish-gray or gray, rarely grayish-white, accompanied by
watery eyes, sensitiveness to light (but only to a slight degree), and
also the formation of new vessels, which extend from the borders
of the cornea toward the centre. Abscesses and ulcerations, as a
360 DISEASES OF THE EYES.
rule, are rare. This form, however, must not be mistaken for
ulcerative keratitis.
The course of this disease is generally favorable. After several
weeks the dulness disappears and the new vessels become thinner,
disappearing entirely in a short time.
THERAPEUTICS. We remove the irritation to a certain extent
by applications of compresses. Also irrigate with warm water or
boric acid, and drop atropia into the eyes. If the inflammatory
symptoms are reduced, we then follow it up by stimulant irritants,
such as calomel powder or ointments of red oxide of mercury.
(8) Abscesses of the Sclerotic Membrane. When there is
intense dread of light and great increase of tears, and when we see a
pericorneal injection and the cornea colored a gray, yellow, or straw
yellow, and a certain spot on that part which is sharply defined
from the tissue of the normal sclerotic membrane, or may be sur-
rounded by a more or less dull zone, we then can safely conclude
that it is the formation of an abscess. Its location varies; some-
times it is on the edge of the cornea, at other times in the centre;
then, again, we may find it close to the surface of the membrane
or deep in the centre of it. It may be very small in dimension,
such as the size of a pin-head, or it may even include the whole
sclerotic membrane.
The course varies also. In small abscesses it may disappear by
simple absorption, while in large ones the acute inflammation sub-
sides, frequently leaving an intensely white spot, or it may break
out externally, forming an open ulcer. ‘This latter conclusion, or
termination, is the most common, and in rare instances it may
break in a posterior direction toward the anterior chamber of the
eye, causing an accumulation of pus in it, and producing further
inflammatory processes in the internal part of the eyeball.
Eriotocy. Abscesses of the sclerotic membrane appear after
some traumatism, especially contusions or bruises of the mem-
brane, also after non-aseptic operations, in connection with blennor-
rheea or conjunctivitis, or during distemper, and very frequently
appear without any appreciable cause.
THERAPEUTICS. This is closely related to that of. ulcerations
of the sclerotic membrane—that is, to incise the abscess after using
cocaine in the cornea, make a broad cut and turn up the borders
of the wound. This has to be done to expose the bottom of the
INFLAMMATION OF THE SCLEROTIC COAT. 361
abscess. It is then dried with corrosive sublimate or iodoform-
gauze and washed out with a solution of corrosive sublimate and
dusted with iodoform or calomel until it dries up.
(4) Ulceration of the Sclerotic Membrane. In this condition
we find a loss of substance in the cornea which varies in size and
depth, showing a grayish-white or grayish-yellow ground, and, as
a rule, has short, abrupt borders with a bluish-gray, gray, or
grayish-yellow opacity in the immediate neighborhood of the ulcer-
ation. When the ulceration of the sclerotic membrane begins to
heal it is indicated by a lessening of the infiltration in the imme-
diate neighborhood of the ulcer, the dull circle surrounding it
becomes clearer, the color shiny, and the pericorneal injection
less. The dread of light begins to disappear. In rare instances
the bloodvessel will shoot from the edge of the cornea toward the
ulcer, and an epithelial covering is now formed over the pit-like
ulcer, which resembles very much the normal tissue of the sclerotic
membrane, but it is not as transparent in color as it was before.
Tf the ulceration has not been very deep, we see the dulness grad-
ually disappearing, leaving only a very thin white veil ; or, if the
ulceration is deep, we have as a result a distinct white spot which
remains permanent (cicatrix of the sclerotic membrane, macular
cornea). This cicatrix of the membrane may become clearer in
the course of time, but, as a rule, it never disappears entirely.
When the ulcer does not take a favorable termination we find the
inflammation increases, the ulceration becomes deeper, and we
have a perforation of the membrane in a few days. The contents
of the anterior chamber escape through the opening, and in rare
instances the iris and the lens push forward and may also escape
if the opening is large enough. After perforation occurs the ulcer
begins to heal, and we have an adhesion of the iris and lens to the
posterior wall of the sclerotic membrane. In other cases where
the opening of the ulcer is very narrow the anterior chamber fills
up again, is forced forward, forming a clear bladder-like body,
forming dropsy of the sclerotic membrane, or keratocele. If the
ulceration is large, the whole ground of the ulcer becomes embossed
—that is, it stands out from the surrounding membrane in a pecu-
liarly distended manner. As a consequence of rupture we may
have a series of ulcers of the membrane. The opening may close
up quickly, the fluid of the anterior chamber may collect, and the
362 DISEASES OF THE EYES.
lens and iris may be pushed back into their normal position. In
large ulcers the iris is generally forced into the orifice, filling up
the opening and causing adhesions. When the fluid of the ante-
rior chamber collects again the lens and iris may be pushed back
from the cornea into their old position, but the section of the iris
which has united at the orifice remains adherent, so that the pupil
is pulled forward to the cicatrix of the sclerotic membrane, and the
power of vision of the eye is greatly impaired. Externally the
iris, which is drawn into the orifice, becomes covered with cicatri-
cial tissue, and by its contraction it forms a lobule of the iris. This
finally contracts into a peculiar club-shaped body over the anterior
surface of the membrane (iris staphyloma). We must not confound
this condition with staphyloma pellucidum. By it we mean a
change of form in the sclerotic membrane, where it becomes more
or less opaque, and is forced outward in the shape of a grape-like
body by the dropsical condition of the anterior chamber. When
there is great irritation of the sclerotic membrane in some cases
we may have a prolapsus of the lens, and the eyeball subsequently
collapses, forming an opening in the centre of the eye which finally
becomes closed up by a whitish-gray cicatrix.
Eriotocy. Besides the causes already mentioned in the forma-
tion of abscesses, the following also produce them : cauterization,
foreign bodies which adhere to the membrane, wounds in some
cases, etc. This disease may appear in the epizootic form with or
without distemper, and generally in connection with blennorrhea
of the connective tissue.
PROGNOSIS AND THERAPEUTIC TREATMENT. The prognosis
depends to a large extent on the irritation of the ulcer and the
rapidity of its progress. Ulcers which are small and located on
the borders are easier to treat than those which are larger and
located in the centre of the sclerotic membrane. In weak, badly
fed young animals and in pugs the prognosis is more unfavorable
than in healthy old animals.
The treatment requires cleanliness and strict antiseptic remedies.
The use of a dressing is of great advantage, but few dogs can
be made to submit to one. In canine hospitals, as a rule, they
use a specially constructed leather cap (seen in Fig. 79). The
various antiseptic agents which are used are corrosive sublimate,
0.1, or chlorine water (either pure or mixed with two or three
INFLAMMATION OF THE SCLEROTIC COAT. 363
parts of water), to be applied with a brush, and iodoform as a
powder blown from a quill directly on the eye. The author has
obtained very satisfactory results with hot fomentations of boric
acid (3 parts to 100). These should be applied three times daily,
ten minutes at a time. They are far
better than cauterizations with nitrate of Ss
silver or painting with aniline.
Besides the antiseptic treatment we
can use atropine or eserine solution, of
which a few drops are put in the eye.
The first-named agent should be applied
when the ulcer is located centrally, as
it dilates the iris, and consequently the
pupil is enlarged, and the latter when the ulceration is located
on the borders, as it contracts the pupil and draws it away from
the seat of irritation. The iris is dilated or contracted by these
drugs and removed from the neighborhood of the ulcer, so that
if the perforation does occur the iris will be drawn far enough
out of the road to prevent any adhesion.
Good results have been obtained with cocaine, alternating with
atropine :
Br
ti
Eye-cap.
R.—Atropine sulphate . : 4 : . : a Oat
Aqua destil. . ; : : ; : . AG
M. S.—In order to produce a dilatation of the pupil we must intro-
duce five drops of this remedy into the conjunctiva, drop by drop,
by means of a brush or a dropper.
R.—Eserine salicylate : : ‘ ; ‘ - 0.05
Aqua destil. . : : : : : : 10.0
M. S.—To be used like the atropine solution.
When a keratocele is developed we may prevent rupture by
puncturing the membrane with a needle and allowing the water in
the chamber to escape. In prolapsus and adhesion of the iris we
can do very little, as it is impossible to push back the iris into place.
We must dust it with iodoform; at the same time we may reduce
the enlargement by means of nitrate of silver, sulphate of copper
solutions, or a powder of oxide of mercury blown on the eyeball.
If we have an iris staphyloma, it is best to remove it carefully by
means of the scissors.
We must try to remove any spots on the sclerotic membrane by
364 DISEASES OF THE EYES.
means of irritants, such as the mild chloride or oxide of mercury or
massage. According to Bayer, massage of the cornea has to be
performed in the following manner: The points of the fingers are
placed on the closed-up eyelids and by a constant circular or cen-
trifugal friction move the eyelid for some time. In some cases
we may also apply the above-mentioned ointments and powders.
The author has obtained far the best results from calomel than
anything else. He placed daily a small amount of powder com-
posed of equal parts of calomel and sugar (grape sugar) on the
cornea, and applied it by massage for some time.
The following other alterations have been observed in the scle-
rotic membrane of the dog:
Dermoid of the Cornea. We occasionally find a peculiar
abnormal collection of true membranous tissue on the cornea which
is covered with hair and interferes with the direct action of light,
and also produces irritation in the cornea and conjunctiva. The
hair should be cut off by means of scissors. Thierry observed the
same abnormality on the sclerotic membrane of both eyes in a
three-months-old dog. There was a slight swelling and enlargement
above the surface of the membrane, which was covered with fine
hair. This trichiasis bulbus was removed with the scissors.
Pterygium, By this we mean a malformation of the connective
tissues containing bloodvessels and branching over the cornea
toward the centre. This growth can be removed by means of
caustics or by an operation.
Injuries to the Cornea. It is not uncommon to observe injuries
to the sclerotic membrane of dogs where the epithelium is removed
slightly, or where they may have a deep penetration of the mem-
brane, and in such cases, such as injuries from cats’ claws, it is
entirely perforated. Immediately after the injury we observe a
great fear of light, closing of the eye, and copious tears. Wounds
which have not entirely perforated the sclerotic membrane are
rapidly followed by an opacity and swelling in the neighborhood
of the injury. When the membrane is perforated the symptoms
and results are very similar to ulceration. Superficial and very
small wounds which penetrate deeply heal very quickly after a
few days, leaving scarcely any opacity. This, of course, must be
expected in wounds that have been caused by some object that was
clean, while septic large wounds, caused by some unclean object,
CATARACT. 365
frequently produce great irritation, and penetrating ulceration
results, ending in panophthalmia and destruction of the eye.
The therapeutic treatment of wounds of the sclerotic membrane
is identical with that of ulcers. |
DISEASES OF THE CRYSTALLINE LENS.
Cataract.
All diseases of the lens, either of its substance or of its capsule,
as a rule, cause a certain amount of opacity, and may form one
or more star-like gray bodies in the centre of the lens itself (cata-
ract). It is not possible to enter into a description of the various
forms of cataract and its pathological alterations, but we will
only take up one form (gray) of cataract that can be subdivided
into two forms—soft, which may be congenital; or traumatic and
hard or contracted cataract, which is senile. The softening process
generally begins in the equator of the lens, and becoming diffused
soon causes a total opacity of light gray color. This may be streaked
with darker lines or it may have a mother-of-pearl discoloration,
with enlargement or distortion of the lens and a contraction of the
anterior chamber. This is very often seen in young animals. The
contracting process, on the contrary, begins in the shape of a num-
ber of small whitish striz, or dull opacities, in the peripheric layers
of the lenticular nucleus, and extend gradually over the cortical,
giving the lens a yellowish-white or yellow aspect after some time.
This is generally observed in old dogs (hard nuclear cataract, senile
cataract). The so-called capsular cataract does not, as a rule, de-
pend on true opacity of the capsule, but on an accumulation of
products of the same, which have been developed from disease-
processes which have gone on in its immediate neighborhood. For
instance, in inflammation of the iris. In some cases they appear
in small, star-like or streaked pigmented dull spots, which are
distinctly marked.
Eriotocy. Gray cataract, as a rule, is a senile or old-age
affection, but it appears quite frequently in young dogs, and now
and then it is congenital. The author saw one case of hereditary
star cataract in connection with microphthalmus. The develop-
ment of cataract which occurs in advanced age—that is to say,
366 DISEASES OF THE EYES.
after ten or twelve years—is what is known as senile cataract;
this is slow in its development, while cases of opacity of the lens,
which are observed in young animals, appear frequently without
any marked cause. Haltenhoff was able to recognize traces of
sugar in the urine of a dog which became very thin and anemic
in a short time, and developed cataract. The author has tested the
urine of many dogs affected by blindness caused by cataract, but
has never been able to find any sugar.
Inflammatory Process of the Eye. There is no doubt that
cataract is also caused by inflammatory processes of the eye, and
the nutritive supply of the lens becomes disturbed and its normal
condition impaired, such as ulcerations of the cornea with central
perforation, inflammation of the membrane of the veins and iris,
and also bleeding into the anterior chamber. Injuries of the
lens and concussions of the eye also cause a number of cases of
cataract.
Certain conditions are developed as the result of concussion of
the eye and appear quite frequently; they may be thus briefly
described :
The lens either sinks downward with the capsule or becomes
laterally displaced. It may lean against the iris or it may drop
forward into the anterior chamber of the eye, and it may finally
crowd into the vitreous humor, If the lens has undergone but
slight displacement (subluxation), it may remain clear for some
time, but the vision is much impaired. If it has fallen into the
anterior chamber or has been forced into the vitreous humor, we
see a rapid development of the cataract, and in the later stages
considerable inflammation of the choroid membrane, of the iris, or
of the whole eyeball.
CLINICAL Symptoms. In cases where the disease is somewhat
advanced, and the cataract is fully developed into one of the fol-
lowing forms: punctiform, streaked, spotted, or complete opacity
of a whitish-blue, brownish-blue, or mother-of-pearl color, it is
easily recognized ; but, on the other hand, where there is a mere
cloudy dimness and small spots of cataract, we must use candle-
light or some illuminating power such as an ophthalmoscope and
a strong light to see the action of the lens in the eye itself.
Before doing so, however, we must dilate the pupil with atropia.
The prognosis is rather difficult to make, and, as a rule, it
CATARACT. 367
should be an unfavorable one. Hereditary cataract shows little
inclination to enlargement, as is also the case in senile cataract.
In soft cortical cataracts we may see a rapid opacity of the lens in
afew days or weeks. The sight is entirely lost and medical treat-
ment is of little use.
THERAPEUTIC TREATMENT. A cataract may be removed by
an operation, and this is much more advisable in the dog because
it is, as a rule, attended without any great danger, and its results
are generally beneficial, producing a partial restoration of the vision.
It is advisable to perform the operation of cataract after having
first dilated the pupil by means of atropia, and then performing the
operation under ether, The author has tried cocaine alone, but
he finds it unsatisfactory. The animal must be tied up, placed
on a table, and ether or chloroform administered. The operation
is performed by one of the following methods:
Opening of the Capsule. The anterior capsule of the lens
has to be opened in a transverse way with what is known as a dis-
cission needle. (Fig. 80, a.) The fluid
in the anterior chamber causes a gradual Fic. 80.
breaking up and reabsorption of the lens.
An assistant holds the eyelids open and
the operator seizes a fold of the conjunc-
tiva with a small tenaculum, holding the
eye firmly with the left hand, while hold-
ing the needle in the right hand placed
on the animal’s head to steady it. The
needle is then introduced into the cornea,
in the middle of the lower external quad-
rant, in such a direction as to meet the
ciliary insertion of the iris and as far as
the upper internal quadrant. Before the
point of the needle has reached this latter
point, however, it is placed firmly on the Ne
Gapente of the lens, and this is cut 4 stop-discission needle; 0,
= Graefe’s cataract knife; ¢,
through in a transverse direction with a _ payiel’s cataract spoon.
lever-like movement of the needle (Fig.
81). The instrument must then be removed in the same way that
it was introduced in perforating the cornea. After the operation
the animal must be placed for some time in a dark place and
368 DISEASES OF THE EYES.
the eye treated twice a day with atropine. We must treat all irri-
tating symptoms of the eye by means of cold compresses, and some-
times we use purgatives. After six or eight weeks the reabsorption
of the lens is complete. We generally perform discission in young
Fic, 81.
Discission of the lens; a, form and size of the cross-incisions; 6, method of insertion of
the needle.
animals affected with soft cataract. The result of this operation,
however, is not always satisfactory, as reabsorption is slow and in
many cases requires a second operation. Several months may also
elapse before the cataract is absorbed. Schlampp advises in such
cases puncturing the cornea, and by this means allowing the fluid
of the anterior chamber to escape, leaving the lens untouched.
Anterior displacement of the lens enlarges or ruptures the opening
which has been made in the capsule. Reabsorption follows, as
a rule, more quickly when this is performed, probably due to the
fact that the fluid which contains the elements of the lens has been
discharged and replaced by fresh fluid. The process is not danger-
ous, and may be repeated oftener than discission itself.
Linear Extraction. After having prepared the dog for this
operation (indicated on page 367), we fix the membrana nictitans
by means of a pair of forceps. With another forceps we seize the
conjunctiva of the eyeball in the neighborhood of the median line
of the eyeball, at the same time everting the upper eyelid. We
then make an incision by means of Graefe’s cataract knife (Fig.
80, 6), about 5 mm. broad, through the cornea, about 2 or 3 mm.
from the border of the sclerotic membrane. We then pass a dis-
cission needle through the wound, split the anterior capsule, as
CATARACT. 369
in discission, and empty the soft parts of the cataract by means
of Daviel’s spoon (Fig. 80, ¢). Any remnants of the cut capsule
which may not be removed at the time are left to be reabsorbed.
If during the operation we observe prolapsus of the iris, we must
try to restore it to its position by means of Daviel’s spoon (Fig.
80, c). If this is not possible, we may cut it off close to the
wound of the cornea.
It is very evident that linear extraction is only to be performed
in cases of complete softening of the lens. This may be recog-
nized by total opacity of the lens and alteration of the iris, and
also when the anterior capsule is pushed toward the cornea.
Lobular Extraction. Lobular extraction is indicated in
shrunken cataract, which is generally senile, where the lens has
prolapsed into the anterior chamber and where discission will only
produce an imperfect result—that is to say, where reabsorption of
the lens does not progress properly. It is performed in the fol-
lowing manner :
Make an incision into the cornea exactly as in linear extraction,
by means of Graefe’s cataract knife, but it must be enlarged to
8or1l0mm. After that the capsule of the lens is split by the
discission needle, the fluid of the anterior chamber is allowed to
escape, and at the same time the lens must be detached by means
of an even, but not too energetic, pressure upon the other side of
the eye from the wound, and by means of the spoon the lens is
scooped out of the opening. The consecutive treatment is the same
as in linear extraction.
Dislocation of the Cataract. This operation, which has been
abandoned lately on account of the impairment of the choroid
membrane and retina, was performed in the following manner:
By means of a bent or straight needle pushed through the scle-
rotic membrane, and at other times through the cornea, steady
pressure was made on the upper part of the lens, and it was
pushed down into the lower posterior part of the vitreous chamber
of the eye.
24
370 DISEASES OF THE EYES.
DISHASES OF THE SCLEROTIC MEMBRANE, OF
THE NERVOUS PORTION OF THE HYE, AND
ALSO THE VITREOUS HUMOR OF THE
POSTERIOR CHAMBER.
These diseases are generally not of any great importance com-
pared with the diseases before described, and therefore we will not
go into minute details.
(1) Inflammation of the Iris (Jritis). This affection is very rare
in the dog (Moller). It may be recognized by contraction and
difficulty of movement of the iris, change in the color of the iris,
fibrous accumulations in the shape of a gray veil-like coating, and
dulness of the fluid of the anterior chamber, and slight dimness
of the cornea. The cure for this disease consists in complete rest,
keeping the animal in a dark place, and solutions of cocaine and
atropine.
(2) Purulent Inflammation of the Eye (Panophthalmitis).
This is produced by serious concussion of the eye itself. It may
also be due to septic wounds of the cornea and sclerotic mem-
brane, as well as to the large perforating ulcers of the cornea.
We recognize the following acute symptoms:
The eyelids are constantly closed ; great redness of the con-
junctiva; total opacity of the cornea; purulent accumulations in the
anterior chamber of the eye; myosis; great hardness and enlarge-
ment of the bulbus. After a short time we may have perforation
through the cornea, and, in rare cases, through the sclerotic mem-
brane. The lens and vitreous humor are ejected through the
opening with the purulent mass; the eyeball collapses, becomes
contracted, and forms a knob-shaped mass in the eye; the lids com-
pletely collapse and form a hollow in the face. The only thing
to do in such a case is to perform enucleation, or removal of the
eye.
Fnucleation. Removal of the eyeball should be performed under a narcotic
or ether. We pull out the eyeball by means of a tenaculum, cut through the
conjunctiva with a pair of small, pointed scissors closely behind the cornea,
snipping the scissors around the eye, keeping as close to the bulb of the
eye as possible, and by this means separate the muscles and cut through
the optic nerve. The author thinks it is advisable to remove the membrana
nictitans at the same time (Fig. 82).
DISEASES OF OPTIC NERVE AND RETINA. Sit
After enucleation, the cavity of the eye is washed out with an anti-
septic fluid and the bleeding stopped by means of a tampon; it should be
powdered with iodoform or sulphonal. Mller advises to pack the orbit
Fic. 82.
Muscles of the left eye: a, superior; b, external; c, inferior straight muscles of the eye;
1, eyeball; 2, orbital arch cut through. '
with absorbent cotton and stitch the eyelids. Dogs are not badly dis-
figured by the loss of one eye, as the orbit becomes contracted and partially
filled with granulations. It is not advisable to use artificial eyes, as the
animal generally rubs them out.
(3) Dropsy of the Anterior Chamber (Glaucoma). Moller has
observed this a number of times in the dog. The anterior cham-
ber is very much enlarged, hard, and tense, so much so that the
eyelids cannot be closed. The bloodvessels of the conjunctiva and
the sclerotic membrane are injected, the cornea more or less
opaque, the pupil much contracted and greenish in color. The
animal cannot see. On post-mortem of one case Méller found
total cataract and a partial luxation of the lens, liquefaction of
the vitreous humor of the eye, swelling of the papilla, and injec-
tion of the vessels of the retina. He was inclined to consider this
condition as identical with glaucoma in man. A number of authors
have seen similar conditions in dogs.
(4) Diseases of the Optic Nerve and the Retina. These occur
very frequently in the dog, and may be recognized at first by
symptoms of what is known as ‘‘ black cataract ’’—that is, impair-
ment of visual power (amblyopia), or complete blindness (amau-
rosis). Total blindness in the dog may be recognized by anyone,
372 DISEASES OF THE EYES.
although it is difficult to detect blindness in one eye. The veter-
inarian may recognize blindness by the unaltered condition of the
pupil when in contact with or close to light. It is necessary to
cover up one eye of the animal in order to test the other, as the
influence of light may act in a reflex way from the healthy organ.
We must especially point out that in very rare cases we may see
a certain amount of reaction in the pupil under the influence of
light, notwithstanding the fact that complete blindness exists.
The author has observed this in a dog which had become blind
from nervous distemper. Later symptoms, however, are not
‘known; the author was unable to make any further observations.
The brain of the animal had, however, probably undergone cer-
tain alterations in its hemispheres, although the patient did not
seem to be affected with any cerebral complications. This is one
of the so-called cases of ‘‘ spiritual blindness.”
Moller and Eversbusch have recognized pathological alterations
in the visual nerve and retina in the form of small red spots and
opacity of the retina (symptoms of retinitis), also a lifting or
enlargement of the papilla. The author had two cases in which
he observed papillo-retinitis from its beginning till it entirely dis-
appeared. All these processes may be recognized by means of the
ophthalmoscope. |
For therapeutic treatment of inflammation of the eye, which is
not given in this chapter, we refer you to the text-books on oph-
thalmology. It consists, as a rule, in rest, keeping the animal in
the dark, the use of atropine or eserine, and an occasional laxative.
Prolapse of the Hyeball.
(Exophthalmus ; Prolapsus Bulbi Oculi.)
There are a number of causes that produce prolapse of the eye-
ball; it may be crowded out of the cavity of the eye, or exposed
in its external circumference by the swollen and distended eyelids
which are closely adherent to its posterior surface. This condi-
tion occurs especially in bulldogs, although it may occur in any
breed. The dog does not possess any bony arch of the eye
(zygomaticus), the space being filled up by a ligament, and the
muscles are also very weak. Occasionally, from any mechanical
force, such as blows in the region of the eye, or bites in its
PROLAPSE OF THE EYEBALL. 373
neighborhood causing hemorrhage and a large amount of blood to
collect in the posterior part of the orbit, it is pushed out of posi-
tion; frequently the entire eyeball is crowded out, standing out
on the face clear of the orbit (Hertwig). This condition has also
been noticed in very rare instances to be due to inflammatory pro-
cesses inside the eye, and by the formation of tumors in the orbits.
The prognosis of a prolapsed eyeball depends largely upon the
circumstances and condition of the organ. If the prolapse is of
recent origin, if the muscles of the eye and optic nerve are not
torn, and if the eye itself has not been very much injured, we
may expect complete recovery in a short time without any disturb-
ance of sight. If the prolapse is recent and the muscles are not
torn, or only partially so, but abnormally distended, we must expect
there is some irritation of the optic nerve, and while the eye may
be restored the animal may remain blind. If the muscles of the
eye and optic nerve are lacerated and the eye proper is injured,
or if any of the chambers of the eye are filled with blood, or if
the prolapse has been sufficiently long that the irritating influence
of the air is marked by an opacity and a dry look of the cornea,
which has a horny appearance, the eye must be considered as lost.
The therapeutic treatment consists in returning the eyeball as
soon as possible, especially when the organ appears to be in such
a condition as would encourage you to think it can be saved; but
if otherwise, it must be removed as soon as possible.
We try to return the eye to its position in the following manner :
First clean it thoroughly by means of an antiseptic that is not
irritating, such as a 2 per cent. solution of boric acid or a 1 to 2000
solution of corrosive sublimate. Place the flat of the hand or
the points of the fingers on the eyeball, at the same time an assistant
distending the eyelids as much as possible, and by gentle pressure
endeavor to push the eye back into the orbital cavity.
If it is impossible to return it by this means, the fissure of the
eye must be distended by making a small incision in the external
corner, or the anterior chamber of the eye may be perforated by
means of a cataract-needle or pointed bistoury, so as to empty the
eye to a certain extent and thus allow it to return to the chamber.
After returning the eye we must try to prevent another prolapse
by placing a bandage over the eye, taking care not to compress it
too much. If the animal will not allow it to remain, we must
374 DISEASES OF THE EYES.
join the fissure of the eye by one or two stitches. Hertwig says
that after stitching the eye we generally see great inflammation of
the lids and the eye itself, but the author has found that these bad
effects may be easily prevented by taking care not to carry the
stitch through the entire lid, but only through the external mem-
brane. At the same time it is advisable to keep the animal with-
out food for at least twenty-four hours, as the use of the jaw, and
especially the pressure of the prolongation of the crown of the
inferior maxillary, may push the injured eye out of position. Cold
applications are useful if the eyeball cannot be saved, or if reduc-
tion is impracticable for some reason or other, on account of
tumors in the orbit, etc., there is nothing left to do but enucleate
the eyeball. (See page 37.)
DISEASES OF THE BAR.
Serous Cyst.
(Othematoma ; Hematoma.)
By this term we mean a blood or lymphatic excretion lying
between the skin and cartilage of the ear, and forming a tumor
in the external or internal part of the lobe. It generally occurs
on the inside. This swelling is fluctuating, and when the skin of
the animal is white it may have a bluish coloration.
Eriotocy. This condition is probably due to some irritation
or traumatic cause—for instance, by striking the ear against the
collar or muzzle, pulling the ear, concussions, and injuries through
biting. It is always seen in the lobe of the ear. If the sac is
not emptied, after a few weeks the secretion is reabsorbed and it
may leave quite a thickening and even malformation of the exter-
nal ear. In some cases when the fluid suppurates it makes a
perforation of the skin internally; this, however, is very rare.
CxiinicAL SymMproms AND Proenosis. The swelling, as a
rule, is on the internal part of the ear. The lobe, which generally
hangs downward, is pushed upward in a peculiar manner. The
swelling is hard, and in white animals it has a blue color. It is
very sensitive to pressure and shows distinct fluctuation. The
animal carries its head in an oblique manner, the affected ear
_ being held downward, and the fact that it gives the dog more or
less pain is indicated by the careful way that the animal shakes its
head or scratches its ear.
The prognosis is favorable provided proper treatment is applied,
although it may take some time before they are entirely cured.
In many cases where no dressing is applied, we may have as a
sequence a slight thickening of the lobe of the ear. This, how-
ever, is of very little importance.
THERAPEUTIC TREATMENT. The methods of treatment which
the author considers advisable are as follows:
1. We perforate the swelling with a large-sized hypodermatic
( 375)
376 DISEASES OF THE EAR.
syringe or aspirator. The secretion is then removed and a solution
of iodoform and ether (10 to 20 per cent. of iodoform) is injected.
The needle must remain in the cavity for some time in order to
allow the vapor of ether to escape. We then apply a compressing
dressing in the following manner :
The ear is turned up and laid on the top’of the head and coy-
ered with antiseptic wadding on both surfaces. It is then held in
position by means of an ear-cap
(Fig. 83). This dressing must
not be displaced, but allowed to
remain for eight days.
[Hobday has recently intro-
duced a very practical method of
treatment for this condition. He
carefully removes the hair from
the ear and renders it aseptic,
and either paints the ear with
Ear-cap, cocaine or administers chloroform
(the translator prefers ether). A
longitudinal incision is made into the sac and it is completely
emptied ; sutures are then inserted, about one-third of an inch apart,
directly through the ear and tied on the outer or hairy side, thus
producing a firm pressure between the two surfaces of the sac and
by that means get prompt union; the ear must then be irrigated
with an antiseptic solution, carefully removing all blood, etc., and
dressed with antiseptic wadding, and further covered with an ear-
cap. It should be dressed every second day. |
2. The second method is to be resorted to if the first does not
answer the requirements, or if we find pus in the swelling.
The swelling is opened at both ends—that is to say, at the base
and inferior line of the lobe—and a drainage-tube placed in it,
which must be kept in place by means of a tape or rubber fasten-
ing. The irritation caused by this seton is generally sufficient,
and it is not necessary to inject any stimulating liquid like tinc-
ture of cantharides or nitrate of silver, but simply remove the
seton twice daily, cleaning out the cavity and disinfecting it by
means of antiseptic irrigations. After a certain time we replace
the drainage-tube by a smaller one, and finally we remove it
altogether.
EXTERNAL CANKER. 347 60
3. The third method, which is generally the most successful,
provided it is performed under antiseptic rules, is as follows:
Shave and thoroughly disinfect the lobe. A long incision in
a longitudinal direction of the ear must be made, and the clots
and remains of tissue removed. The cartilage must be scraped
carefully, so that we see a fresh wound surface. Sew it up with
catgut ligatures, keeping as close as possible to the cartilaginous
surface. Place the drainage-tube in the ear, turn the ear up on
the top of the head and dress it with antiseptic cotton. Examine
the dressing every day to be certain that it is in its proper place.
This, as a rule, cures the wound entirely in from three to six days,
provided that the antiseptic rules are followed very carefully; but
it is generally advisable to leave the dressing stay on from eight
to ten days, as the union between the two. surfaces is not strong
enough to stand the energetic shaking of the head which every
dog does for some time after the removal of an ear bandage which
has been on for several days.
External Canker.
By this we mean a purulent or ulcerative process on the edge
of the external ear. This, however, is not confined to the edge,
but may spread over different parts of the lobe.
Errotocy. The chief causes of this trouble are injuries and
lacerations of the skin. Dogs are liable to scratch or shake the
ears violently against the muzzle or collar, producing an inflam-
mation. It may also be developed from the ear itself, as in cuta-
neous inflammations of the external auditory passages. We may
also see this as a result of wounds or lacerations of the ear caused
by bites of other dogs, which from neglect or improper treatment
become ulcerated, and do not heal readily on account of constant
shaking of the ear. This affection is almost entirely confined to
animals with long ears.
CxiryicaAL Symptoms. The animals hold their heads to one
side, shaking the ear frequently, sometimes keeping it up so long
that the ulcerated surface bleeds and the blood is thrown in all di-
rections. They attempt to scratch the affected ear with their paws,
and are very sensitive about having them touched. On making
an examination we find at the edge of the external ear, generally
its extreme end, an ulcer or a number of them which are covered
378 DISEASES OF THE EAR.
with a blackish loose scab with turned-up edges, and the tissues
of the immediate neighborhood are cedematous.
THERAPEUTIC TREATMENT. There is no doubt that the
quickest results may be obtained by cutting off a portion of the
diseased lobe of the ear; this, however, disfigures the animal very
much. This is the easiest method of cure, and the operation
is generally performed on animals under the influence of ether.
First remove the hair and thoroughly disinfect the parts, and
eut off a circular piece from the ear that will include the torn
portion, being careful not to remove any more of the lobe than is
actually necessary. Another method is to cut out of the edges of
the slit ear a thin section about one-eighth of an inch in thickness,
so as to insure two raw fresh surfaces; the two edges of the wound
must then be drawn together by means of sutures; these should
not be inserted too close to the edge of the wound, as they are apt.
to tear through. The stitched line is then powdered with iodo-
form or sulphonal. The external ear is covered with wadding,
turned over the top of the head, and held in position by means
of a bandage, as indicated on page 376 (Fig. 83).
If the animal is one that you cannot see and dress the part every
day, instead of sewing the wound after the lobe has been cut,
touch it up by means of the thermo-cautery, and by means of the
consequent cicatricial contraction draw the edges together.
Hoffmann deviates from the above-described method, which was
practised by Siedamgrotzky, by using cocaine and cutting a three-
cornered piece out of the external integument, then stitching it
together without any attempt to control the hemorrhage. The
author has been able to obtain satisfactory results in slight cases
of external ear-canker by covering the ulcer with oxide of mer-
cury and tying the ear up. On the other hand, he was much dis-:
appointed by caustics, such as acids, nitrate of silver, and corrosive
sublimate, as they gave only negative results.
Inflammation of the External Har—Internal Canker.
(Otitis Externa.)
This consists of an inflammatory irritation of the external canal
of the ear. It is generally of an eczematous nature and appears
in a diffuse form, extending over a larger part of the lining of the
ear. It is accompanied by redness, swelling of the membrane,
INFLAMMATION OF THE EXTERNAL EAR. 379
and an exudation of a serous and, later, a purulent secretion, in
the chronic course. We may also have the formation of abscesses
and contraction of the meatus (caused by thickening of the cutis,
by granulations, and by polypous malformations). Although we
may have acute inflammation of the canal extending deep into the
lining, it is very rare that the tympanic membrane becomes ulcer-
ated and perforated.
Eriotocy. The causes are similar to those mentioned under
eczema. It is due to an accumulation of cerumen, dirt, and cuta-
neous scabs. It is also recognized that otitis is produced by acari.
(See Parasitic Otitis, page 381.) Hoffmann states that he has
observed serious suppuration in cases where dogs’ ears have been
clipped too close to the head.
CLINICAL SyMPTOMS AND Proenosis. The animals shake
their head, and, as the disease is almost invariably located in one
ear only, they hold their head in an oblique position, trying to
scratch the head against the base of the ear or to
rub it against some object. They avoid carefully
any attempt which is made to touch the ear, and
show great pain when the tube of a concha is
touched. In examining the external ear we use a
forceps-shaped speculum or ear-mirror (Fig. 84).
If we distend the canal, we generally find it filled
with a fetid, grayish-green, or reddish liquid consist-
ing of glandular secretions, fungi, cutaneous scabs,
pus, acari, ete. After the organ is cleaned out we
find an intensely red, swollen, sometimes ulcerating
surface of the skin. In advanced cases the meatus
is almost entirely closed by thickening of the cutis.
Numerous granulations appear quickly, and in some
cases where both ears are affected we may have
symptoms of impaired hearing or deafness. According to Hoff-
mann, in deep suppurating conditions we hear a characteristic
smacking or sucking liquid sound, which is produced by side
pressure or rapid compression on the base of the ear.
The general condition is very seldom affected. Vomiting is
only observed in exceptional cases. Vertigo, spasms, and epilep-
tiform symptoms sometimes follow where acari are present in
enormous numbers.
Kramer’s ear
speculum.
380 DISEASES OF THE EAR.
THERAPEUTIC TREATMENT. The treatment which corre-
sponds with that of eczema is generally followed. We must
thoroughly clean the external ear. This is best performed by a
syringe fitted with an acorn-shaped point so as to prevent injuring
the ear (Fig. 85) [the translator finds the best ear syringe is one
made entirely of soft rubber with a long flexible point that
can be pushed into the meatus without any great danger
of injuring the canal; the flexible point adapts itself to
the turns of the canal], and by using applications of
warm water injected into the meatus. The duct is
then dried with absorbent cotton introduced into the ear
on the end of a small pair of forceps. As the meatus
is elongated, narrow, and slightly curved, there is not
much danger of injuring the tympanic membrane. In
very slight affections of this character, which may be
recognized by a slight redness of the membrane, itch-
ing, and the presence of a certain amount of fluid, it
is only necessary to clean the meatus several times,
using solutions of lead-water, phosphate of lime, acetate
of zine, ete. The author has found that simply powder-
ing with lycopodium, amylum or talcum, filling up the
ear, is much preferable to any of the above-mentioned
liquids.
[The translator generally avoids syringing in mild
cases. It causes a great deal of irritation, exciting the animal un-
duly. He generally cleans the ear with wood alcohol, filling in the
cavity and working the alcohol into the canal by manipulation of the
base of the ear. It is then to be dried thoroughly with absorbent
cotton until all trace of brown coloration, characteristic of this
condition, is removed. He then fills up the ear with powdered
boric acid, working it thoroughly into the canal, and covering all
the inflamed portions. This should be repeated every third day
until the irritation is lessened, and then once a week. With this
treatment he also prescribes a laxative, such as cascara sagrada.
If there is eczema present, he adds to the treatment two drops of
Donovan’s solution, morning and evening. |
In serious diseased conditions where there is much ulceration,
we may treat them in two different ways:
By syringing the ear with solutions of disinfecting and astrin-
Ear syrin ge.
PARASITIC CANKER OF THE EAR. 381
gent agents, such as salol in alcohol (1 to 40), tannin in glycerin
(1 to 30), nitrate of silver (1 to 100), carbolic acid in glycerin (1
to 10). This must be repeated several times, and we may also dry
up the secretion by means of oxide of zinc or boric acid. Hoff-
mann advises us touse subnitrate of bismuth or sulphate of cop-
per in starch. Imminger uses a 3 per cent. aqueous solution of
chromic acid in auricular catarrh, cleans the ear with tepid water,
and drops ten to twenty drops of the solution into the ear, and
then massages the base for several minutes; this he repeats every
second day. As a rule, the general treatment with powders is
preferable to that with liquids, but the latter must be used when the
meatus is much contracted and the ulcers located deeply. An
ear-cap is only necessary when the animal is constantly shaking
its head and the organ is very sensitive. We remove the numer-
ous granular accumulations by means of nitrate of silver. If
there are polypous enlargements, they may be touched with a
thermo-cautery. Hoffmann states that in a very obstinate case
he exeised the entire lower region of the meatus, introduced a
drainage-tube, and treated the wound with disinfecting powder.
External otitis may sometimes produce either partial or entire
deafness. Both of these conditions are due to the entire closure
of the external auditory canal, either by swelling and filling up
with granulations or by polypous formations, etc., and more rarely
by extension of the inflammatory process in the middle ear, destroy-
ing the tympanic membrane. Of course, any disturbance of the
sense of hearing or entire deafness which comes from old age or
is hereditary will not show any of the symptoms already described.
When a dog is getting deaf he changes his manner very much: he
seems strange, does not answer to the call of his master.
As a general rule, there is very little result from treatment.
We have a contraction of the external meatus, and may try to
dilate it by means of the introduction into the canal of cylindrical
compressed tampon sponges.
[Parasitic Canker of the Ear.
(Parasitic Otitis.)
The symbiotes auricularis (canis) is a parasite that inhabits the
ear of the dog, causing an aggravated form of canker (Nocard and
382 DISEASES OF THE EAR.
Sewell). The parasite which is common to the dog and cat is said
to produce a peculiar form of vertigo.
The parasite differs from the common symbiot by the absence
of abdominal lobes in the male, which are represented by a notch
which has three bristles; the pubescent female has four pairs of
legs which are simple knobs. The male is 30 mm. long and 23
mm. wide, and the female is 42 mm. long and 29 mm. wide (Neu-
mann).
Hering found this parasite in an ulcer of the ear which was
accompanied by a deep-seated otitis. Nocard describes minutely cer-
tain epileptiform fits in which the dog hasa peculiar husky ery and
rushes about violently, running into various obstacles, and finally
falls insensible, and after a number of such attacks becomes totally
deaf. Sewell describes the condition as finding a collection of
brown or sooty-colored cerumen in the ear, or as looking dirty.
If the inside of the ear is examined closely a number of tiny white
specks, the size of the eye of a needle, are seen to be rapidly
moving about the ear, and he believes that the tickling sensation
caused by these movements and the biting of the parasite are what
produce the irritation of the lining membranes of the ear.
Symptoms. The ear is hot and slightly swollen, and on exam-
ination it is hardly distinguishable from ordinary otitis ; there is,
however, less discharge in this condition; the head is carried to one
side, and the animal will scratch the base of the ear very gently
with its paw and whine in a plaintive way. The translator has
observed a number of animals infected with the parasite, and is
inclined to think that the carrying of the head on one side and the
gentle scratching of the ear are characteristic of the disease, although
it is quite frequently seen in non-parasitic otitis. He has never
observed the epileptiform symptoms described by Nocard, although
he has made numerous examinations of animals that have presented
similar symptoms.
TREATMENT. Nocard recommends naphthol 1 part, ether
sulph. 3 parts, and olive oil 10 parts. This should be injected
into the external auditory canal once daily, and the ear plugged up
with cotton to prevent the escape of the ether. The translator
does not think the latter procedure advisable, for if the ether
is confined in the ear it causes great irritation, and has found from
experience where he has followed this procedure that while he may
pa
PARASITIC CANKER OF THE EAR. 383
not have observed epileptiform fits before the treatment, he has
had symptoms simulating them very much after the ear was in-
jected with ether and the cotton plug put into it.
Sewell advises the application of the following liniment:
k.—Ung. hydrarg. nit. é ¢ ‘ ‘ ; =, 240
Oleum amygd. : t : : : ; . 982.0
M. S.—Apply a small amount to the inner surface of the ear with a
camel’s-hair pencil.
The translator thinks it advisable to first clean the ear out with
wood alcohol, and then inject the above. |
DISEASES OF THE SKIN.
INFLAMMATORY CONDITIONS OF THE CUTANEOUS
MEMBRANE.
INFLAMMATORY symptoms of the skin vary according to their
intensity, character, or location. The slightest irritation may pro-
duce redness, either with or without swelling—this is defined as
erythematous inflammation; or we may have a formation of circum-
scribed, solid, firm protuberances, papille, fistules, boils, or gran-
ulations. These are ascribed to exudations originating partially
in the papillary body, in the Malpighian membrane, and also in
the neighborhood of the follicles.
The inflammatory exudation may become reabsorbed in certain
cases, so that after the acute period of the disease has passed the
epidermis, which has become loosened, is gradually desquamated in
the form of scabs or crusts. We also occasionally see a dark pig-
mentation after the disease has run its course. ‘This originates
from the hemoglobin of the extravasated red blood-corpuscles.
If the inflammatory processes and exudations increase gradually
in the cutaneous tissue, we may observe two different results.
The inflamed location may become covered with a moist, liquid
exudation, or the horny layer of the epidermis is raised up by the
fluid, and we may have vesicles which raise the granular layer of
the mucous strata, and also the deeper layer of the membrane
becomes destroyed in the affected region. In the first case it is
covered by the deep layers of the membrane; in the latter case
the upper surface of the corium is exposed, having lost its vesicu-
lar covering.
The liquid which fills the small or large vesicles is deficient in
cells in the early stages of its formation, and the liquid is clear
or slightly yellow. Later it becomes turbid by the addition of
leucocytes, and a number of whitish-yellow cells fill the fluid. In
some cases it has this appearance from the very onset. When the
liquid contained in the vesicle is yellow and filled with cells it is
called a pustule. Sooner or later the covering of the pustules
( 384 )
INFLAMMATORY CONDITIONS OF THE SKIN. 385
becomes ruptured, and the fluid dries up ina yellow, gray, or
brown crust, under which the regeneration of the lost epidermic
layer goes on rapidly.
Now and then the inflammatory process shows it is in the neigh-
borhood of a follicle and its sebaceous glands, and we have the
formation of a dark-red, very sensitive nodule, and finally suppu-
ration of the same membrane and its adjacent tissues. As a con-
sequence of that we find that the glands and canal of exit are
filled with purulent or bloody matter. Soon the internal follicles
become involved; the masses of matter can be easily pressed out
of the orifice of the follicle, and we may have an elasticity of the
purulent cavity surrounded by infiltrated cutis in which we find
the hair has become entirely detached from the follicle and falls
out. This condition is generally a rather serious affection in the
dog, as in this animal there are always several follicles which are
accumulated into one group with a common orifice, and in every
case of cutaneous disease we find a group of affected sebaceous
glands.
In very bad eases peri-glandular and peri-follicular inflamma-
tion may become so acute that we see the formation of an extended,
nodule-shaped, dark-red swelling, forming a so-called ‘‘ boil.’’
This is marked after a certain period by a yellowish-green, necrotic
thrombus, which becomes detached by purulent disintegration of
the surrounding tissue, and is sloughed after the pus has been dis-
charged. In such cases we find that not only is the external sur-
face of the skin impaired, but the corium is affected, and as the
follicles are destroyed the hair does not return. The formation of
abscesses and ulcerations, also inflammations of the skin, will be
discussed further on.
In chronic cutaneous inflammation we may see the formation of
hypertrophic as well as atrophic conditions. In the former case
we find as a consequence of the constant increase and congestion
of blood to the part the formation of superfluous connective tis-
sue, whereby the skin may be thickened several times its normal
size, and may form large folds or callosities, and in rare cases
club-shaped or warty elevations; in the latter case the corium
becomes thinner. This is also the case with the epidermis. Its
tissue is either greatly reduced or greatly increased in size, and in
the latter case the epidermic cells which proceed from the deep
25
386 DISEASES OF THE SKIN.
part of the tissues do not undergo any horny degeneration, but
rather a drying, mummifying process, covering the membrane in
the shape of numerous whitish, or white-gray scabs.
We recognize the following inflammatory conditions :
Erythema.
Erythema is the mildest form of inflammation of the cutaneous
membrane, and consists either of normal hypereemia of the corium
in its upper layers (erythema simplex), or it may be due to a slight
sero-cellular infiltration of the membrane of Malpighi (dermatitis
erythematosa).
Eriotocy. Erythema originates as the result of various cuta-
neous irritations which may be mechanical, chemical, or thermic—
for instance, by friction of the collar upon the skin, by rubbing
together two cutaneous surfaces, by ether, oils, chloroform, tar
preparations applied to the skin, bites of insects, by ammoniacal
urine (in catarrh of the bladder), and by slight burning or freezing.
Erythema may also appear in connection with various cutaneous
diseases, such as eczema, scab, and canine varioloid.
CLINICAL SyMPTOMS AND CourRSsE. ‘The symptoms consist of
a bright arterial redness of the cutaneous membrane, which disap-
pears under pressure of the finger, but reappears immediately after,
and may be complicated by slight swelling in a few cases. Asa
rule, the affected portion is reddened, but not irritable. The course
is usually short, depending to a large extent on the cause. When
this is suppressed erythema disappears, especially after the itching
and rubbing have discontinued, and in certain conditions by con-
secutive desquamation of the upper membrane. There is, how-
ever, a more or less dark-red spot left after the acute symptoms
of the disease have lessened. These finally disappear, but very
slowly.
THERAPEUTIC TREATMENT. There is not, as a rule, any great
irritation. It will be sufficient to remove the cause in order to
remove the erythema. If there is a certain amount of irritation,
we must lessen it by bathing the animal with cold water and
sponging the parts with any of the following solutions: lead-
water, ichthyol, or salicylic acid, soap, rubbing with salicylic oil
(1 part of salicylic oil dissolved in 35 to 40 parts of olive oil and
ECZEMA. 387
heated slightly), or a mixture of 1 part of glycerin and 5 of
water; 1 part of carbolic acid, 10 of alcohol, 10 of water; 4 parts
of creolin, 100 of water; 1 part of ichthyol, 10 of glycerin, 30
of water ; 10 parts of nitrate of silver, 100 of water (Friedberger).
In very obstinate cases we may also use laxatives or purgatives
(aloe, jalap, salines, etc. ), also the internal administration of arsenic
in the form of Fowler’s or Donovan’s solution.
Urticaria.
(Nettlerash.)
Nettlerash was only seen in three cases by the author. The
subjects were all small, well-fed, middle-aged dogs, which were
covered over the entire body with circumspect, flat, beet-like eleva-
tions, about one and one-half inch in diameter, only slightly red,
and which had originated spontaneously. They were rapidly
lessened by the administration of purgatives.
Eczema.
(Red Mange.)
By this we mean an inflammatory condition of the cutaneous
membrane indicated by redness, swelling, nodules, pustules, vesi-
cles, scabs, and crusts, which are generally accompanied with
more or less itching. In the first stages development of a hyper-
emia is seen, thus reddening the skin superficially, and accom-
panied by a serous exudation. If the inflammatory irritation
stops, or if proper therapeutic measures are taken, recovery may
oceur at once, and we havea more or less prolonged desqua-
mation of the epidermis. In the majority of cases, however, the
irritation increases and we may have the formation of numerous
pale red, tough, itching nodules, accompanied by serous swellings
and slight cellular infiltration of the papille, but generally it is con-
nected with the cutaneous follicles. This condition may become
retrogressive; the nodules become depressed, forming scabs. In
other cases the serous exudation increases constantly inside the
papule, and, as a consequence, we have a rising of the horny layer
in these locations ; or, in other words, numerous vesicles are formed
(eczema vesiculosum). If the horny covering is strong enough
388 DISEASES OF THE SKIN.
to resist the accumulated exudation for some time, the contents of
the vesicles gradually become milky and pus-like, on account
of the entrance of colorless blood-cells into the tissues (eczema
pustulosum).
In other cases the vesicles burst or are scratched open; the skin
is dark red in large blotches, and is marked by fine furrows
which correspond with the location of the ruptured vesicles; the
eczematous exudation oozes freely out of the upper surface (eczema
rubrum). It is a common occurrence to see the detachment of
small portions of tissue which are located between the numerous
furrows in the epidermis. Thus the whole surface of the eczema
is stripped of its horny layer and may become filled with pus.
The oozing liquid dries rapidly and becomes a scab or crust (eczema
impetiginosum), which is pushed away gradually by the consecu-
tive exudation, and finally becomes hard, dry, and firm. Inflam-
mation and swelling become gradually lessened under the crust,
and we have the formation of a firm epidermic cover, from which
the crusts gradually become detached. The diseased membrane,
which is now exposed, is not swollen to any great extent, but very
red (sometimes marked with dark, livid pigmentations), and covered
with numerous loose scabs, which constantly fall off and are re-
newed from time to time (eczema squamosum).
Errotocgy. The etiology of eczema is of great importance for
establishing the correct prognosis, as no cure can be obtained until
after the cause of the trouble is removed. The first thing we must
do is to lessen the mechanical irritations, such as appear under the
collar and on the testicles. But the lesions which the patient
inflicts upon himself are of very much more importance, for we
see it in all forms of itching eruptions of the skin, in erythema,
in cases of parasites of the cutaneous membrane—flies, lice, acari—
in great accumulations of dirt, scabs, and falling out of the hair.
We also have the appearance of eczema which extends very fast,
and in some cases may go all over the body.
As regards the second group of agents which cause eczema, they
are chemical irritants, especially those which have an influence
upon the tissues, such as acids, alkalies, mixtures of mercury, also
tar and carbolic salves, combinations of ether and oil of turpen-
tine, of mustard, and also tar-soap.
The third group is formed by a number of thermic irritations,
ECZEMA. 389
namely, excessively high temperature, but not high enough to
produce vesicles.
Eczema appears more frequently in summer than in winter, and
we have a great deal more difficulty in healing it during the sum-
mer weather. We also have a number of eczematous formations
for which we can find no cause. In such cases the disease has
been ascribed to acids in the blood or diseases of the nervous
apparatus, and also to vegetable parasites.
CiiInicAL SyMproMs AND CoursE. Eczema may appear in
any breed of dogs, and in any region of the body without regard
to age, sex, etc., but, as a rule, it affects old, well-fed dogs, such
as terriers, Great Danes, and setters. It is usually seen on certain
regions of the body (back, head, neck, and external surface of the
extremities).
There are three general forms of eczema without taking into
consideration the changes which may be produced by irritation,
seratching, or rubbing.
The first type is restricted to small, irregularly circumscribed
regions, but has a tendency to extend to the neighboring tissues.
The eruption begins as eczema papulosum with close nodules. It
is rapidly altered into the vesicular layer by change of the nodule,
and finally we see the appearance of the median stage. This has
a more or less extended surface without skin or hair, and shows
a bright red, serous, sero-fibrinous, or purulent exudate, very
painful to the touch, and having a great tendency to extend
to the adjacent tissues. The stage of crustion follows very
slowly.
The second type shows from the beginning an inclination to
extend. In the early stages we see it as eczema erythematosum
with formation of scattered papules. These are scratched open
on account of the great itching they cause, or they become altered
into pustules. Later we see the appearance of small scabs under
which regeneration of the epidermis occurs. In the other regions
desquamation of the epidermis follows.
The great tendency to scratching in dogs, notwithstanding the
very slight alterations of the cutaneous tissue, may lead to what is
classified under another form of skin affection called ‘ prurigo.”
We must admit, however, with Friedberger and Frohner, that
true prurigo does not exist in the dog, and that all the cases
390 DISEASES OF THE SKIN.
mentioned in canine literature were simply modifications of papu-
lar eczema.
The third stage has a great tendency to become chronic. The
skin is quite hot, a symptom which is not generally observed
during the first stage of the disease; it is also much thickened and
thickly covered with whitish-gray epidermic scabs. If these are
removed, the affected region seems very red and shiny; the skin
becomes tougher and more inflamed; the hair becomes erect,
breaks off, or falls out to some extent. We see the formation of
cracks and fissures, also certain dark pigmentations. A charac-
teristic state of this chronic eczema in the dog which may also be
developed from the other two forms is that of acute vesicular—
that is to say, the moistened scab which forms later may be caused
by the slightest irritation, rubbing, tar or carbolic soap, and this
disease may reappear each summer, finally becoming chronic,
reappearing each spring to dry up the following winter.
THERAPEUTIC TREATMENT. In the treatment of eczema we
must consider the following facts :
1. That we have no specific drug that cures this disease; conse-
quently it is very erroneous to treat all its forms with one agent only.
2. That in many cases the tar preparations which have been
used almost exclusively are very harmful, as is also the method of
systematically washing the animal with strong alkaline or carbolic
soaps. The first thing to do is to give attention to the causes and
find out from what cause the itching really occurs, as many cases
of eczema disappear as soon as the irritation has been suppressed.
The following treatment has given good results :
(a) We must first remove any cause of itching or irritation in the
early stages of eczema erythematosum or eczema madidans. We dust
the affected parts with a powder of oxide of zinc, cerussa, sulphur,
or thiol mixed with cornstarch. If the affected parts are very moist,
they may be dusted with lycopodium or smeared with vaseline.
R.—Zine. oxydat. : : ; é : ; .. 20:0
Lycopodium . 3 : : 4 ; : . 80.0
S.—Dust on the parts several times daily.
R.—Plumbi carbonas_ . ; : : : : . 10:9
Amylum puly. : ; : : - : « 200
Talc. venet. pulv. . : : é ‘ : . 40.0
S.—Dust on the parts once daily.
ECZEMA. 391
In cases of extensive redness of the skin we must apply com-
presses of lead-water or thymol (1 per cent.), creolin (1 to 2 per
cent.), carbolic-acid water, thiol water (20 per cent. thiol, liquid,
50 per cent. glycerin, and 50 per cent. water); but powdering is
preferable, as every skin is not- benefited by liquid applications.
As soon as the marked symptoms of the disease have decreased
we may replace the use of powder by ointments of zinc or lead,
white precipitate ointment, or by mild ichthyol soaps.
(6) In very moist eczema with a prolonged course the use of
powder is not always successful. In those cases we must apply
drying fluids, such as corrosive sublimate solution (1 to 1000),
nitrate of silver solution (2 per cent.), twice daily by means of a
brush or a cotton tampon. Sublimate ointments (1 per cent.) or
subiodide of mercury (2 per cent.) are beneficial, but strong solu-
tions of blue-stone or crude sulphate of iron and tormentilla root
are not to be recommended.
R.—Hydrarg. bichlorid. P : ; : 3 Pag ae
Glycerinum . ‘ ‘ ; : : : - 100
Alcohol . F : : ; - : - . 90.0
To apply upon eczematous surfaces.
R.—Hydrarg. bichlorid. ; : : : : an CO
Alcohol \ aa 5.0
Glycerinum
Adeps . : ; - : é : : 90.0
Ointment for chronic moist eczema,
(c) In cases of pustula we may use the same treatment as is
indicated in 6, after having pressed out and emptied the pustules.
The author has also obtained good results with ichthyol liniment
and salicylic ointment (see Acne).
(d) In eczema when it has reached the scaly stage we must first
clean the skin thoroughly with some mild, non-irritating soap, but
not carbolic or tar soap. The best kind to use is Castile, ivory,
or a pure potash soap of the Pharmacopeeia. The author has had
good results from ‘‘ Hebra’s’’ alcoholic potash soap :
R.—Saponis kalin. venal. . : : : : . 200.0
Alcohol : : . ; : : : . 100.0
Hebra’s soap is poured or rubbed upon the surface which is
thickly covered with crusts, and on the following day they are
removed easily without subjecting the animal to much pain. After
392 DISEASES OF THE SKIN.
careful cleansing we use the same agents as are used in the moist
forms of eczema—zinc powder, corrosive sublimate, or nitrate of
silver.
(e) We use tar and ichthyol preparations with good results in
the chronic forms of eczema where there is considerable cutaneous
thickening with cracks, fissures, ete. Ichthyol is especially use-
ful, and when used in concentrated form in ointments or lini-
ments it is much more valuable than tar preparations, because
it relieves the itching or irritation in a very short time.
Oil of tar in the treatment of eczema (Leistikow) :
R.—Oleum picis . i A lee ae : , ee
Spts. yini rect. : : ‘ : : : in 20
Ether sulphuric. . : : =, eo
F. M. S.—Rub into the parts every third anes
R.—Picis liquide
Saponis kalin. venal. aa 100.0
Spirit. dilut.
Apply once daily.
Rk.—Ammon. sulfo-ichthyolic. . : : ; « 15.0
ane cole e 5 4 ; ‘ . && 75.0
Oleum olivarum
Apply upon the thickened membrane once daily.
(f) If there is considerable thickening of the skin, and if the
latter is covered at the same time with scabs, we can obtain good
results by rubbing salicylic oil (1 part salicylic acid in 35 parts
of warm olive oil) over it daily for a week. If this does not
succeed, which, however, is very rare, we must first use tar or
ichthyol preparations and follow it up by the other. Some authors
advise friction with soft soap, chrysarobin ointment, iodoform,
or naphthalin, and washing with potash.
Internal treatment, as a rule, has been abandoned. Formerly
all used purgatives or laxatives, and administered arsenic, but this
has lately fallen into disuse, and it is only in very obstinate or
chronic cases that anyone uses them. [The translator can not
entirely agree to this, as it is very evident that this disease is
frequently caused by some disorder of the stomach or liver, and
would advise slight laxatives, especially the salines, and small
doses of arsenic in chronic cases, and also certain restrictions in
the diet. |
BURNING AND FREEZING. . 393
Burning and Freezing.
In cases where a high degree of temperature acts upon the skin
it causes hyperemia, accompanied by a slight exudation, or an
erythematous inflammation. This is called the first degree, or
mild form of burning, and generally follows the same course as
that described on page 384. When the skin is subjected to the
action of a very high temperature we see violent serous exuda-
tion in the stratum mucosum. This lifts up the epidermis, form-
ing large vesicles. The covering of the vesicles bursts, and heal-
ing proceeds very rapidly, also complete regeneration of the epi-
dermis, provided there is no septic influence acting on the wound
surface. If the burn is still more severe, the tissue of the skin
becomes charred or burnt entirely, the whole skin being softened
and healing by the formation of a cicatricial tissue underneath.
In cases of burning in the first and second degrees the hair is only
lost temporarily; in the third and fourth degrees of burn it is
permanently lost.
THERAPEUTIC TREATMENT. The treatment of burns consists
in mild cases of cooling agents, sugar of lead, lead ointments (1
part of lead plaster to 9 parts of olive oil); in burns accompanied
by vesicles we use a powder of oxide of zine and apply potash
liniments (equal parts of linseed oil and lime-water), or boric-acid
solution (20 per cent.). In cases where the burn is sufficiently
deep to char and make the skin black we must wait for softening
and detachment of the burnt portion and then proceed according
to the ordinary antiseptic treatment of wounds.
Freezing has exactly the same effect as heat. In the first
degree we find bluish-red, but not distinct, flat swellings. In
more serious freezing we find serous vesicles somewhat bloody.
This, however, is very rare in the dog. Complete loss of the skin
after the freezing of a member has never been observed by the
author in the dog. In such cases it is advisable to use the same
treatment as is followed in human medicine—that is, friction with
petroleum, spirit of camphor, injections of tincture of iodine, and
in the severe forms strict antiseptic methods.
394 DISEASES OF THE SKIN.
Gangrene of the Skin.
We may see necrotic withering of the skin from the effects of
extremely high or low temperature, or it may be caused by trau-
matic influences, by disease-alterations of the mucous membrane
or subcutaneous tissue—for instance, in phlegmone, acne, and in
some cases from internal causes. Spontaneous gangrene belongs
to this latter class. It is developed in some cases, according to
Moller, on the cheeks, and corresponds with noma in the human
species. The disease is recognized by salivation, poor appetite,
fever, and necrosis of the corners of the mouth, which may extend
gradually over the entire cheek.
The treatment is to follow strict antiseptic methods; to apply
dressings of iodoform, sulphonal, or boric creolin (1 part of creo-
lin to 50 of boric acid), and improve the general condition by
means of tonics.
Acne.
Under the name of ‘‘acne’’ we mean an inflammation of the
hair-follicles and sebaceous glands resulting in suppuration. This
is not produced, however, by follicular acari. The anatomical
processes which we recognize in this serious eruptive form have
been already mentioned on page 385.
This condition generally appears on the nose, cheek, side of the
face, and external fascize of the extremities, between the toes, and
in some cases over the entire body.
Ertotocy. Very little is known of the actual cause of this
disease. Local irritations have been thought to be the cause, such
as constant pressure of the muzzle, rubbing the affected parts, and
in certain cases to some hereditary predisposition in the character
of the sebaceous glands. Vegetable irritants have also been said
to cause this disease when the skin was in a certain irritable con-
dition. It is not infectious.
CLINICAL SyMpToMS AND Prognosis. This disease develops
very slowly, beginning with redness and loss of the skin and
hair. These red spots are painful, irregular, swollen, and extend
over the surface the size of a large dollar. They are caused by the
formation of a large number of pea-like nodules which are hard
and firm. In some cases we find the whole surface of the skin
AONE. 395
red, hard, and very painful to the touch. After a short time the
nodules become soft, discharge spontaneously a more or Jess amount
of bloody pus, and contain in some cases cores of necrotic tissue.
Occasionally we see the union of a number of these acne nod-
ules, so that the skin presents a bluish-red discoloration and dies
or becomes purulent, as if the skin was undermined by purulent
collections ; this may appear all over the body.
This ‘‘ non-acarian’’ acne very often produces bad results. It
has a great tendency to extend in almost all directions, and the
cicatrices which appear after healing of the disease leave bare
spots all over the body, pink in color, streaked with lines of black
pigment deposits.
THERAPEUTIC TREATMENT. The treatment consists in the ener-
getic local application of various preparations externally. If the
acneous nodules are in the early part of their development, we
must puncture them, or open the follicles by some strong antiseptic,
such as salicylic or naphthalin ointment. In cases where puru-
lent disintegration has gone on it is advisable to open the pustules.
This is best performed by means of a small bistoury, and then
fill in the opening with boric creolin, or paint it with disinfecting
solutions, such as pyoktanin solution (1 to 10 of alcohol), or a 1
to 1000 solution of corrosive sublimate. This should be used
once a day when the acne is developing. .
R.—Acid. salicylic. . ‘ ; ? : : a 20.0,
Oleum olive . : ; : ’ : . 40.0
Lanolin 3 : f Li P 8010
8.—Put a small portion on the parts once daily.
The following should be used when the pustules have been
emptied :
R.—Creolin . : : : : : : ‘ eyl.O
Acid. boraci. . : : : : : : . 40.0
Fréhner advises curetting the cavities and the use of the creolin
ointment just mentioned, and in some cases cauterization with
nitrate of silver, or powdering with iodoform and tannic acid.
Tn cases of circumscribed acne it is advisable sometimes to cut out
the diseased portion of the skin.
396 DISEASES OF THE SKIN.
CUTANEOUS AFFECTIONS WHICH ARE CAUSED
BY ANIMAL -PARASITES.
The changes produced on the skin from disease caused by animal
parasites are divided into two conditions—primary and secondary.
The primary appears as a superficial inflammatory process, pro-
duced directly by irritations of the parasites upon the skin, and
this condition depends to a large extent upon the amount of irri-
tation and the depth that the parasites have penetrated in the skin.
The secondary symptoms are the results of this penetration into
the cutis, causing more or less itching and irritation, and, as a rule,
scratching and rubbing on the part of the animal, producing heat,
redness, papules, vesicles, pustules, hemorrhages, or excoriations.
These irritated spots may not be restricted entirely to the affected
region in which the parasites are located, but may spread to other
localities. This form, which is nothing more or less than eczema,
possesses two peculiarities which may distinguish it at once from
the common form of eczema which is not produced by a parasite: .
1. It invariably appears in single, isolated eruptive spots, and
it is only after the disease has been present for some time, or where
there is extensive irritation, that we may find the surface connected
together; and,
2. We see the appearance of these eczematous eruptions in cer-
tain locations which are especially preferred by the parasites, and
showing their greatest development of the eruption in those regions,
even when the whole body is affected.
A microscopical examination of the scales of the skin will furnish
definite information as to the character of the cause of the erup-
tion. We distinguish two groups of cutaneous parasites: First,
those which live upon the external surface of the skin, and, second,
those which enter the tissues of the membranes, puncturing deeply
into the tissues. In the first group we have the following:
Ceratopsyllus (Pulex) Canis, the Dog Flea.
The true dog flea as well as the human flea (pulex irritans) is
found in the dog. The former is distinguished from the latter by
its size, by the different length of its tentacles, and by the presence
of a number of sharp hairs arranged in a comb-like layer along
HAMATOPINUS PILIFERUS. 397
the side of the head (Fig. 86). Coarse breeds of dogs are not par-
ticularly affected by the bites of fleas, but pet dogs and delicately
bred animals scratch and rub to
such an extent as to cause irri- Fig. 86.
tated splotches and redness over
the entire body, and lead the
owner to believe that the animal
is affected with mange. If the
fleas are removed from the skin by
a bath or in some other manner,
we may relieve the itching and
irritation by the application of
z : Head of the ceratopsyllus canis.
some soothing solution. (MEGNIN.)
THERAPEUTIC ‘TREATMENT.
Fleas are best removed by means of Persian insect powder (Flores
pyrethri). This must be moistened with alcohol and rubbed into
the hair. Zurn recommends the placing of pine shavings in dogs’
kennels.
Hzmatopinus Piliferus (Dog Lice) and Trichodectes
; Latus Canis (Dog Parasites).
Description of Hematopinus Piliferus. This parasite is distin-
guished by an egg-shaped head fitted with fine, short hairs and
fleshy sheath-trunk with hooks at the edge. This when lifted
shows a sucking tube and two movable knife-shaped stilettos.
The thorax is wrinkled and possesses three pairs of scissor-like
claws. The posterior portion of the body is large and possesses
nine rudimentary legs. The length of the body is about 2 mm.
(see Fig. 87).
Description of the Trichodectes. In this parasite the head is
broad, quarter-shaped, with three manacle feelers and a tooth-
shaped mouth. The thorax is contracted, the posterior part of
the body has nine distinct members, and the length of the body is
from 1 to 2 mm. (see Fig. 88).
The former parasites are the most disagreeable, as they suck the
blood from the body, live particularly on those parts of the skin
where the hair is thick and which are not exposed to the cold, such
as the neck, flanks, and at the tail. The trichodectes feed, as a
398 DISEASES OF THE SKIN.
rule, upon the hair and epidermis, and are particularly found on
the head and neck. Both skin parasites produce intense irritation
Fic. 88.
Hematopinus piliferus. Trichodectes latus.
The accompanying small lines give the natural size of the parasite.
and rubbing, causing inflammatory efflorescences which look very
much like squamous eczema, with partial loss of hair and forma-
tion of scabs. The diagnosis is usually easy, as we can see the
parasites and their eggs by separating the hair.
THERAPEUTIC TREATMENT. This consists of destroying the
parasites and their eggs. For that purpose it is often requisite
to clip the animals. The safest and least harmful agents are
decoctions of tobacco (5 to 10 per cent.), solutions of creolin
(3 to 6 per cent.), petroleum (pure, or mixed with olive oil), and
in small dogs anise-seed oil (1 to 10 per cent. of olive oil). Mer-
curial ointment may be rubbed in the neck around the collar, but
we must not apply more than a piece the
size of a bean. Washing with corrosive sub-
limate solution has been tried, but it must
be very carefully done, and the animal not
allowed to lick the body, as it is very apt to
produce mercurial symptoms and salivation.
Ixodes Ricinus.
This parasite, which is about 2 mm. in
Ixodes ricinus. The ac. length, and sometimes when full grown al-
companying line isthena- most 3 mm., looks very much like an acari
tural size of the parasite. ‘ c .
(Kucuermmsrer-Zuen.) (Fig. 89). It penetrates into the skin
SARCOPTES SCABIEI COMMUNIS. 399
and sucks the blood, and is generally seen in setters or pointers,
and dogs when working through the woods and underbrush be-
come filled with them. Turpentine and petroleum will destroy
them instantly.
Leptus Autumnalis.
This is what is known asa ‘‘ harvest bug,’’ or acari. It is about
4 mm. in length, and is the red larva of thrombidium holoseri-
ceum. While human beings are quite frequently affected with
this parasite, it is only rarely found in the dog. Defrance and
Friedberger have seen pustular inflammations of the skin of the
dog produced by this parasite. The rash was very prominent on the
abdomen and the inner fascia of the legs, and was healed quickly
by an application of carbolic acid and glycerin, or carbolated
cosmoline.
Dermatophagus Canis. This is very rarely found in the dog,
and is a parasite which affects the ear, producing otitis externa.
For further details refer to Parasitic Otitis (page 381).
The following parasites belong to the second group :
Sarcoptes Scabiei Communis.
(Sarcoptic Mange ; Scabies Sarcoptica. )
Description of the Sarcoptes. This para-
site is about 0.25 to 0.830 mm. broad and
from 0.20 to 0.50 mm. long. It has a
rounded, turtle-like shape and a horseshoe-
shaped head, with well-developed club-
shaped scissor-like jaws. It has short
rudimentary feet, and tulip-shaped suction
cups which are attached to the first, second,
and fourth pairs of feet in the male, while
in the female they are found in the first Peas arctan ee
and second pairs only. In the back we magnified75 times, giving the
abdominal view. (SIEDAM-
see a number of acorn-shaped scales or gporzxy.)
thorns, and four rows of lance-shaped
scales on the upper surface of the back. The skin shows trans-
verse folds and we find four elongated hairs on the posterior end
of the body. (Fig. 90.)
400 DISEASES OF THE SKIN.
The male acari and the young parasites generally inhabit cavi-
ties in the skin which they have made for themselves. These
cavities are connected externally by short ducts, the entrances
of which may be marked by small vesicles or pustules, while the
females may move to different parts of the body when sexually
ripe, burrowing ducts through the upper layers of the epidermis
down as far as the membrana Malpighii, which contains a great
deal of fluid. At the end of the duct—that is, the place of entrance
of the acari—we see the development of a small, somewhat moist
nodule—or a vesicle, which dries up ultimately, leaving a scar.
This digging of the parasite may produce more or less detachment
of the epidermis. We generally find that the parasite has a prefer-
ence for certain parts of the body, such as the head, neck, abdomen,
and chest, at the root of the tail, and the paws. It is very hard to
detect it with the microscope. The best way is to remove some of
the membrane with the scissors or scrape the upper portion of the
skin to the corium. If parasites have been present for some time
a secondary eczema is soon developed, which is produced by
scratching and rubbing, also by itching of the scabs and scales.
This ‘“‘ mange eczema’’ appears in various forms, according to the
sensitiveness of the skin, and is either papular, vesicular, or pus-
tular, and sooner or later produces decided thickness of the skin
and leads to the formation of a number of folds, wrinkles, and
ulcerated points between the clefts of the wrinkles. There is
always a certain characteristic appearance about these affected
localities which makes it easy to distinguish between the para-
sitic and simple eczema. The surfaces finally become confluent,
forming large eczematous areas. It is very improbable that a
mistake will be made in diagnosis, except in the early stages,
when there is only a very small spot affected, because the para-
sitic eczema produces rapid characteristic changes, accompanied
by scratching, twitching, rubbing, and licking, which are very
much aggravated as soon as the animal is placed near any warm
object—for instance, in the neighborhood of a stove or if covered
up with a blanket, and also the evident pleasure which the
animal gets if the affected part is rubbed or scratched; and
finally, if the animal is kept with other dogs, the disease is carried
to them and developed very quickly. The disease can also be
produced in man by taking a mangy scab and applying it to the
SARCOPTES SCABIEI COMMUNIS. 401
arm, holding it there by a bandage. As a rule, however, the
parasite does not propagate rapidly in man.
THERAPEUTIC TREATMENT. In order to produce good results
in mange we must kill or remove the parasites, as the itching and
scratching cease as soon as they are destroyed, and on that account
the artificial eczema disappears rapidly. A large number of anti-
parasitic agents are used—creosote, wood-tar, creolin, lysol, sali-
eylic acid, and Peruvian balsam. They are all useful, and may
be applied according to the following directions :
It is always necessary to make a general application of the agent,
even in such cases where the disease seems to be restricted to one
region of the body. The dog must be covered all over with a
layer of soft soap or with Hebra’s alcoholic potash soap (see page
391), which is to be shampooed into the skin with the hands or a
stiff brush, and cleansed thoroughly in clear tepid water. The
agent which is to be used is then applied with the hand or with a
brush, covering only one-third of the body at a time [the trans-
lator thinks that the body can be covered entirely with the medi-
cinal agent at each application, except in the creosote and ecarbolic
acid combination], repeating this operation in two or three days.
At the end of that period the application may be removed by soft
soap and water. The best ointments for mange are:
1. Picis liquid., sapo potassii viridis, spiritus vini rect., 4 q.s.
Ft. linimentum.
2. Creolini, sapo potassii viridis, 44 1 part; spiritus vini rect.,
10 parts.
3. Creosoti, 1 part; picis liquid., sapo viridis, spirit. vini rect.,
aqua, 4a 7 parts.
4, Creolini (lysol), 1; petrolatum, 12.
5. Two to 5 per cent. oily solution of creosote or carbolic acid.
6. Peruvian balsam, pure or with a little aleohol, ether, glycerin,
or oil.
The four agents which are mentioned first are very energetic,
but more or less dangerous, so it is advisable to use them in healthy
or not too young or delicate animals, and at the same time to
administer small quantities of sulphate of sodium in their drink-
ing-water in order to prevent carbolic poisoning. Peruvian balsam
is harmless and very useful, but, unfortunately, it is expensive,
and is only adapted to very fine pet dogs.
26
402 DISEASES OF THE SKIN.
Prevention Methods. The owner of the dog must have his
attention called to the fact that the sarcoptes are highly conta-
gious, and may produce similar complications in other dogs and in
man, and while this may be of a very mild character, it has been
observed in the acute form in several cases (Siedamegrotzky, Fried-
berger, and others). The contact of mangy dogs with healthy
animals must be prevented, and covers, blankets, bedding, etc.,
which have been used by the affected animals must be sub-
jected to a thorough cleansing by washing with hot solutions of
soda and a high degree of heat. The straw, of course, must be
burned.
ACARUS DEMODEX FOLLICULORUM.
(Follicular Mange.)
Description of the Acarus ‘This parasite is about 0.3 mm, in
length and about 0.045 mm. in breadth. It has a broad, scissor-
like masticatory apparatus, a mobile anterior trunk, and three
jointed maxillary feet. It has a worm-shaped, wrinkled abdo-
men, with three jointed, clawy, thick, short feet
attached to the thorax. The elongated oval larve
have only six legs. (Fig. 91.)
These parasites are found in the hair-follicles
and sebaceous glands, and by their presence show
a purulent disintegration of the peri-glandular and
peri-follicular tissues. The sebaceous glands are also
destroyed, causing acneous pustules (see pages 835
and 394). The demodex acne shows itself in cer-
tain preferred parts of the body, especially the head,
throat, neck, and paws, but it may extend over the
entire body. It is not very easily transmitted, as
has been proven by the attempt made by Weiss,
Martemucci, and others, who were unsuccessful.
CLINICAL SymMpToMs AND Course. ‘These are
Acarus follicu- distinguished by a pustular and squamous form of
Saal Aiptek eruption. The pustular form is the most common
(Friepercer.) and may be recognized by the hair falling out,
by hyperemic and swollen skin, which becomes
thickened and folded, forming nodules often the size of a millet-
seed, which change from bluish-red to yellow pustules, and finally
ACARUS DEMODEX FOLLICULORUM. 403
the purulent bloody contents escape, and in it and under the
membrane we find hundreds of acari.
The itching, asa rule, is never very great, as in sarcoptes mange,
and in some cases not even present. When the affected cutaneous
regions are scratched or rubbed, the patients, as a rule, resent it
and do not derive the pleasure that scratching gives in sarcoptes
mange. The disease spreads very slowly, and only in very rare
instances does it cover the whole body. The parts that are affected
finally heal, but the skin remains thick, denuded of hair, marked
in some places by scars or cicatrices, and also by cracks and
wrinkles. In some cases we may have a dark pigmentation
marked with warty projections. When there is any itching pres-
ent the appearance of the cutis may be changed materially by
secondary eczema. The appetite is very rarely affected, the animal
eating well, although some cases, in spite of good food, have shown
the animal to have an impoverished, unhealthy look.
The squamous form is seen in the neighborhood of the eyes, but
it may show itself in other places of the body. It is a normal
cutaneous inflammation accompanied by falling out of the hair and
great accumulation of scabs. The hair drops from the affected
places; the skin is only slightly reddened, but covered with thick
seabs. If these places are squeezed, the parasites can be pushed
out of the skin very rapidly. The easiest way to obtain the para-
site is to rub the blunt end of a knife over the affected parts, and
the microscope will aid you in distinguishing this disease from
simple scaly eczema.
The prognosis is generally unfavorable, and it is almost impos-
sible to reach the parasites. This is especially the case with the
squamous form, which is always considered the worst form of
parasitic mange.
THERAPEUTICS. (a) Treatment of the Pustular Form. When
pustules are present they must be squeezed and emptied every day,
and at the same time apply the antiparasitic agents already men-
tioned with a brush. The animals, as a rule, show great pain and
object to it, but to obtain any good results this must be followed
up patiently. Any of the solutions may be used, as one is as good
as another, but we must remember that where we have an opening
directly into the deep portions of the skin that reabsorption of
poisons through the membrane is much easier, consequently it is
404 DISEASES OF THE SKIN.
better to select a non-poisonous remedy, such as Peruvian balsam
or warm preparations of salicylic acid (1 part of salicylic acid to
40 parts of olive oil). Both agents may be replaced by styrax (in
oil solution).
Another form of treatment which is advised by Friedberger is
also recommended by Bruasco. In following this treatment we
clip the dog carefully and put him in a bath of sulphate of potas-
sium on the first day (100 grammes to 70 litres of water), and on
the second, third, and fourth days rub the body with a thin oint-
ment of cantharides (1 to 6 of lard). Then on the fifth or sixth
day wash the animal thoroughly with soft potash soap. Allow a
few days to intervene, then renew the treatment, going through
the same course again. Megnin has obtained very good results
froma sulphur bath. For this purpose he uses the bath-tub shown
in Fig. 92.
Mm 3 iene
=
Co =o
=
Bath-tub.
(6) Treatment of the Squamous Form. In this we must first try
to reach the parasites, and this we do by systematic rubbing with
acid ointments or strong concentrated salicylic ointments (1 to 5),
and also with soft soap or lye. When we have removed the scabs
and scales with this form of treatment we must apply the same
treatment as prescribed in the pustular form.
The prophylactic measures must be the same as in sarcoptic
mange. No transmission of this disease has ever been observed
in man.
CUTANEOUS AFFECTIONS OF PARASITIC ORIGIN. 405
Filaria. Siedamegrotzky, Rivolta, and Griffith have seen pus-
tular eruptions of the skin which were caused by thread-worms.
The former saw upon the external surface of the legs red-bordered
pustules which contained one or two round worms, which were
0.04 to 0.7 mm. long, and had awl-shaped tails. The parasites
had probably entered the skin through the hair-follicles, and some
were found measuring 1 mm. in length in the straw of the dog’s
kennel.
The treatment is simply cleanliness.
Cutaneous Affections which are Caused by Vegetable
Parasites.
We know at present of but two skin diseases in the dog which
are ascribed to the presence of vegetable parasites; these are favus
and herpes, which belong to the fungi class, and may be simple or
ramified, membranous or non-membranous, double contourated,
cellular threads (hyphen), which become mixed in their growth
and form a real fungous bed or fungous turf (mycelium). These
fungous growths produce at their ends and at the point of their short
side branches bead- or string-like spores, uniting and ligating each
other, which are considered as sexual or multiplying organs (Fig.
Fayus spores, magnified 450 times. (VON DUBEN.)
93). We cannot make a strong distinction between the fungi of
favus and those of herpes, but there is a difference, as is seen in
the disease in its local form, and we have given a description of both.
1. Favus. This fungus is called achorion Schonleinii, and is
developed upon the skin, between the epidermic layers in the
hair-follicles, and also in the hair itself. It may be transmitted
to the cat, horse, rabbit, mouse, and human beings, causing a
characteristic skin affection.
AVG DISEASES OF THE SKIN.
CiinicAL Symptoms. Favus is found in special regions of
the body, namely, upon the forehead, back of the nose, abdomen,
and external surface of the hindlegs, as gray, gray-yellow or even
saffron-yellow, dry, brittle crusts or eschars. These are about the
size of the head of a needle in the beginning, but gradually by their
growth cover the entire surface, and may finally become from 2 to
5 mm. in thickness. They appear in the shape of round or ellip-
tical scutula, depressed in a saucer-like manner, generally per-
forated with a dull, lustreless hair, which drops out later on. If
the escharious mass is removed we find a corresponding depression
with exposed, very red epidermis. As a rule, this is followed by
bleeding,
This last, however, has not been the author’s experience.
THERAPEUTIC TREATMENT. The treatment of this disease is
easy, consisting of removal of the scutula and a daily application
of antiparasitic agents, especially tincture of iodine, carbolic acid
and creosote solution, sublimate solutions of red, white, or gray
mercurial ointment, solution of salicylic acid (10 per cent. solution
with alcohol), and tar soap. Chloride of sodium (common salt)
has recently been advocated in the treatment of ringworm. It is
either to be applied in saturated solution or else made into an oint-
ment with vaseline.
Concerning the prophylaxis, we refer you to the indications
which are given later in herpes.
2. Herpes Tonsurans. JDepilating herpes, herpetic ring,
herpetic eshear, bare herpes. This fungus which is said to be the
cause of herpes, is called trichophyton tonsurans, and is found in
large masses lying on the upper portion of the epidermis, and espe-
cially in the hair and its covering.
and, according to St. Cyr, there is always great itching.
Trichophyton has a much more rapid growth than achorion.
It not only grows from one centre, as in the other form, but it may
make its appearance in a number of new centres scattered all over
the body, until finally the whole is strewn with numerous, isolated,
round-shaped bare spots. The parasite may be transmitted to dogs,
man, cattle, goats, cats, pigs, and rabbits.
CiinicAL Symptoms. The eruption is marked by small, round,
or elongated herpes, which vary in shape and size between a lentil
and a large bean. The spots are hairless and distinctly cireum-
scribed ; the blotches are arranged at intervals, and are generally
ALOPECIA. 407
very regular. They become confluent in some cases, and extend
over the entire body. Affected regions show a peculiar grayish-
white or dirty gray scab, and in old cases yellowish-brown crusts
about 2 mm. in thickness. These crusts may have some hair
adhering to them. The skin under the crust is copper-red in color
and covered with numerous millet-like nodules (swollen hair-folli-
cles). After a certain time, if the disease ceases to spread, the scab
drops off gradually, and we see a bare, scaly herpes upon which
the hair slowly returns. The animals are often affected with sec-
ondary eczema. This, however, is produced by constant scratch-
ing, due to the irritation of the disease.
THERAPEUTIC TREATMENT. The treatment of herpes depends
on the removal of the favus. We must, therefore, clean the
affected part, lift and remove all scabs and eschars by means of a
thin knife, or shampoo with soft soap, following it up by a dress-
ing of some of the agents mentioned under the head of mange.
Prophylaxis. The animals must be separated, as the danger of
infection to both dog and man is very great. The kennels are
to be cleaned and all straw, ete., burned, and the animals kept
away from children.
ATROPHIC CONDITIONS OF THE CUTANEOUS
MEMBRANE.
Alopecia.
(Falling out of the Hair.)
By this term we mean a falling out of the hair which is not
caused by actual disease. We make a distinction, however, between
general alopecia and alopecia areata. The former is an extensive
falling out of the hair, often recognized after serious disease and
during the period of convalescence. The latter is a symptom of
bad nutritive condition (alopecia symptomatica), and is character-
ized in some cases by a circumscribed or rounded herpes; this may
become confluent ard is especially developed on the back, tail,
and external fascize of the thighs. In both forms it is not rare to
find the skin pigmented. Siedamegrotzky has proved that alopecia
of the dog, if circumscribed or diffuse, depends on the atrophic
condition of the hair and infiltration of the upper cutaneous layers,
and it is especially seen in dogs with silky, white or grayish hair.
408 DISEASES OF THE SKIN.
In some cases where the dog has black-tipped hair it is also notice-
able.
THERAPEUTIC TREATMENT. The treatment consists of wash-
ing with alcoholic soap, and a diluted tincture of cantharides is
also useful. It is advisable in alopecia areata to use antiparasitic
agents, such as diluted tincture of iodine (Friedberger and Froh-
ner), or an alcoholic salicylic acid (10 per cent.). The principal
therapeutic agents, however, are rubbing with a strong brush,
increasing the nutrition of the skin, plenty of exercise, and, above
all—patience.
INDEX.
ee OMEN; fatty deposits in, 88
puncture of, 90
Abdominal cavity, tumors of, 89
dropsy, 86
Abscess of the kidneys, 167
of the liver, 96
of the sclerotic membrane, 360
Abscesses, perinephritic, 168
Acarus demodex folliculorum, 402
mystax, 74
Acids, bile, 93
Acne, 394
Acute and chronic peritonitis, 88
catarrh of the bowels, 59
of the bronchia, 121
of the stomach, 55
diffuse peritonitis, 84
inflammation of the kidneys,
162
intestinal catarrh, 59
laryngeal catarrh, 116
laryngitis, 116
nephritis, 162
parenchymatous hepatitis, 95
peritonitis, 8
synovial inflammation of the
joints, 272
Adenoma, 336
Affection of the eyelids, 350
Air-passages, diseases of, 120
Albumin, digestion of, 36
in urine, 160
Alopecia, 407
Amaurosis, 371
Amblyopia, 371
Amount of urine, 156
Amputation, 298
of the tail, 300
Amyloid kidney, 166
liver, 97
Anemia, 256
of the brain, 204
Anesthesia, 346
Anal glands, tumors of, 337
Anchylostomum, 81
Angina catarrhalis, 51
Angioma, 335
Animal parasites, affections caused
by, 396
Anterior chamber, dropsy of, 371
limbs, paralysis of, 200
Anthracosis pulmonum, 129
Anus, imperforate, 74
prolapsus of, 71
stitching of, 73
Aphthe, 43
Apoplexia, 204
Areca nut, 80
Arsenical poisoning, 98
Arthritis deformans, 275
rheumatic, 274
Articulations, diseases of, 268
Ascites, 86
Aseptic wound fever, 309
Asthma, 122
Ataxia, 201
Atresia ani, 74
Atrophic conditions of cutaneous
membrane, 407
Auscultation of the thorax, 110
Factee in the urine, 159, 172
Bench-show distemper, 235
Bile acids, 98
color in urine, 161
Bitch, castration of, 191,193
inguinal hernia in, 329
menstruation of, 154
passing the catheter in, 153
Black cataract, 371
Blackening of the lungs, 129
Bladder, catarrh of, 170
cramp of, 175
debility of, 173
diseases of, 170
examination of, 155
stone in, 176
urine in, 88
worms, 76
Bleeding at the nose, 114
Blennorrheea of the eyelids, 355
( 409 )
410
Blood-boils, 317
-corpuscles in urine, 158
filaria in, 149
Bloodvessels, inflammation of, 308
Boils, 385
Bones, diseases of, 268
fractures of, 291
tumors of, 334
union of fractured, 295
Bothriocephalus, 82
bubius, 82
cordatus, 82
fuscus, 82
latus, 82
reticulatus, 82
Bowels and peritoneum, physical ex-
amination of, 37
acute catarrh of, 59
chronic catarrh of, 62
distention of, with gas, 88
Brain, anemia of, 204
diseases of, 202
hyperemia of, 202
inflammation of, 206
Brom-ether, 348
Bronchia, acute catarrh of, 121
eatarrh of, 120
chronic catarrh of, 121, 122
Bronchial breathing, 111
catarrh, infectious, 235
tubes, diseases of, 120
Bronchitis, 120
Broncho-pneumonia, 124
Bruises, 317
Buccal fungi, 43
Burning, 393
Bursa mucosa, diseases of, 287
(bea operation, 192
Calculi, uric, 177
Cancerous tumor, 342
Cancer of glandular tissue, 342
of the prostate, 182
squamous, 342
Canker, external, 377
internal, 378
of the ear, parasitic, 381
Carbolic-acid poisoning, 98
Carcinoma, 342
Cartilaginous tumor, 333
Castration, 182, 191, 327
in the bitch, 191
Catarrh, acute, of bronchia, 121
laryngeal, 116
chronic, of bowels, 62
of bronchia, 122
of larynx, 118
INDEX.
Catarrh, infectious bronchial, 235
nasal, 113
of the bladder, 170
of the duodenum, 91
of the nose, 113
of the windpipe and bronchia,
120
Catarrhal fever, contagious, 223
inflammation of the lungs, 124
jaundice, 90
metritis, 188
ophthalmia, 354
pheumonia, 124
Catalepsy, 219
Cataract, 365
black, 371
Catheter, passing of, 152
Cauterization of tumors, 345
Cavity of the mouth, malformations
of, 47
Ceratopsyllus canis, 396
Cerebral hemorrhage, 204
Cerebro-spinalis, 209
-spinal meningitis, 209
Cerebrum, inflammation of, 207
Cestodes, 75
Chest, dimensions of, 106
Chloroform, 348
Chlorosis, 256
Chorea, 217
Crystalline lens, diseases of, 365
extraction of, 368
Chronic catarrh of the bowels, 62
of the bronchia, 121, 122
of the larynx, 118
of the stomach, 57
dyspepsia, 57
induration of the lungs, 126
inflammation of the kidneys, 165
interstitial hepatitis, 95
nephritis, 165
irritable cough, 118
laryngitis, 118
nephritis, 165
parenchymatous nephritis, 165
peritonitis, 84, 85, 88
prostatitis, 182
serous inflammation of the joints,
273
Circumscribed peritonitis, 85
phlegmone, 307
Cirrhosis of the liver, 95
of the lungs, 126
Closure of the eyelids, 350
Coccidium, 82
perforans, 82
Ceenurus cerebralis, 78
Cold in the head, 113
INDEX.
411
Collections of urine in the bladder, 88 | Cysts of the kidneys, 169
Color of urine, 156
Compression, 313
Condyloma, 336
Congestive hyperzmia of the liver, 94
Conjunctivitis, 284, 353, 354
in distemper, 234
purulent, 355
Conjunctiva, diseases of, 353
inflammation of, 353
Connective tissue, tumors of, 333
Consciousness, disturbance of, 196
Constipation, 39
Constitutional diseases, 256
Contagious catarrhal fever, 223
Contraction of the intestines, 66
Controlling hemorrhage, 302, 313
Contusions, 317
of the joints, 280
Convulsions, 200
Convulsive cough, 118
Cornea, dermoid of, 364
injuries of, 364
Coryza, 113
Costiveness, 39
Cough, 102
chronic irritable, 118
convulsive, 118
Coverings of the brain, diseases of,”
202
Cramp, cystic, 175
of the bladder, 175
Croupal membranes, 52
pneumonia, 129
Cruralis, hernia, 331
paralysis of, 200
Cutaneous affections caused by ani-
mal parasites, 396
caused by vegetable para-
sites, 405
membrane, inflammatory condi-
tions of, 384
membranes, atrophic conditions
of, 407
tumors, 541
Cuterebro emasculator, 185
Cylindrical cell-tumor, 342
Cystic cramp, 175
Cysticercus pisiformis, 77
tenuicollis, 78
Cystitis, 170
Cystotomy, 179
Cysts, 341
dermoid, 341
extravasation, 341
glandular, 341
honey, 51
‘‘ honey-pouch,” 341
retention, 341
serous, of the ear, 375
EBILITY of the bladder, 173
Deformans, arthritis, 275
Dentition, 47
Deposits in the abdomen, fatty, 88
Dermatitis, 886
Dermoid cysts, 341
of the cornea, 364
Detrusor, paralysis of, 174
Diabetes insipidus, 260
mellitus, 259
Diagnosis of the larynx and wind-
pipe, 102
Diffuse peritonitis, 84
phlegmone, 307
Digestive apparatus, diseases of, 27
examination of, 27
Digestion of albumin, 36
of hydrocarbonaceous food, 35
of meat, 34
of milk, 35
Dimensions of the thorax, 106
Discission, 867
Diseased malformations of the joints,
275
Diseases, constitutional, 256
of the air-passages and bronchial
tubes, 120
of the articulations
bones, 268
of the bladder, 170
of the brain and its coverings, 202
of the bursa mucosa, 287
of the conjunctiva, 3538
of the crystalline lens, 365
of the digestive apparatus, 27
of the ear, 375
of the eyes, 350
of the intestines, 59
of the joints, 270
of the kidneys, 162
of the larynx, 116
of the lens, 365
of the liver, 90
of the lungs, 124
of the mouth, tongue, and sali-
vary glands, 42
of the nasal cavities, 113
of the nervous portion of the eye,
370
of the nervous system, 196
of the esophagus, 53
of the optic nerve, 371
of the penis and prepuce, 183
and the
412
Diseases of the peritoneum, 83
of the pleura, 130
of the prostate, 181
of the respiratory organs, 101
of the retina, 371
of the salivary glands, 49
of the sclerotic coat of the eye, 358
of the sclerotic membrane, 370
of the sexual apparatus, 152
of the skin, 384
of the spinal cord and its cover-
ings, 209
of the stomach, 55
of the teeth, 45
of the testicle and its covering,
184
of the urinary apparatus, 152
of the vagina and the uterus, 185
of the vitreous humor, 370
of true infection, 223
Disinfection of wounds, 311
Dislocation of the elbow, 284
of the lower jaw, 283
of the patella, 285
Dislocations, 281
Distemper, 223
bench-show, 235
conjunctivitis in, 236
false, 235
Distention of bowels with gas, 88
Distortions of the joints, 281
Disturbance of consciousness, 196
of digestion, effect of, on gastric
secretion, 35
of motility, 197
of sensitiveness, 196
Diuretics in dropsy, 89
Dochmius, 81
duodenalis, 82
stenocephalus, 82
trigonocephalus, 82
Dog flea, 396
lice, 897
passing the catheter in the, 152
parasites, 397
Dropsy, abdominal, 86
of the anterior chamber, 371
Duodenum, ecatarrh of, 91
Dura mater, inflammation of, 206
Dyspepsia, 55
chronic, 57
Dyspnea, 107
BAR, diseases of, 375
inflammation of external, 378
parasitic canker, 381
Echinococcus polymorphus, 79
INDEX,
Eclampsia, 220
Kctropion, 352
Eczema, 387
moist, 391
parasitic, 396, 400, 402
Elbow, dislocation of, 284
Emasculating bot-fly, 185
Emphysema, 22
of the lungs, 121, 129
Enchondroma, 338
Enteritis catarrhalis, 59
Enterotomy, 70
Entropion, 350
operation for, 351
Enucleation, 370
Epilepsy, 214
Epistaxis, 214
Epithelial tumors, 335
Epithelium in the urine, 158
Erythema, 386
Ether, 348
Examination of the bladder, 155
of the digestive apparatus, 27
of the mouth and throat, 27
of the nervous system, 196
of the nose, 101
of the cesophagus, 30
of the prepuce and urethra, 152
of the prostate, 154
of the stomach, 31
of the urinary apparatus, 152
of the urine, 155
physical, of the lungs, 103
Exarticulation, 300
Exophthalmus, 372
External canker, 377
Extravasation cysts, 341
Eyeball, prolapse of, 372
Eyes, diseases of the, 350
Hyelids, 350
affections of, 350
blennorrheea of, 355
closure of, 350
inversion of, 350
turning in of, 350
turning out of, 352
Eye, dropsy of the anterior chamber,
371
enucleation of, 369
inflammatory processes of, 366
opening the capsule of, 367
purulent inflammation of, 870
ALLING out of the hair, 407
False distemper, 235
Fat in urine, 158
Fatty deposits in the abdomen, 88 ~
INDEX.
Fatty liver, 97
tumors, 333
Favus, 405
Feces, 38
Femoral hernia, 331
Fever, 308
aseptic wound, 309
puerperal, 189
purulent, 310
septic wound, 309
Fibroma, hard, 333
soft, 333
Filaria, 405
immittis, 149
in the blood, 149
Filix mas, 80
First intention, healing by, 304
Fistula, intestinal, 3238
Flat condyloma, 336
Flea, dog, 396
Follicular mange, 402
ophthalmia, 354
Forceps, 46
Foreign bodies in the esophagus, 53
substances in the urine, 158
Fractures, general classification of,
292
of the bones, 291
union of, 295
Freezing, 393
ALLSTONES, 97
Gangrene of the skin, 394
Gas in bowels, 88
Gastricismus, 55
Gastric secretion, disturbance of, 35
Gastritis catarrhalis, 55
Gastro-hysterotomy, 192
General classification of fractures,
292
examination, 17
Gestation, 88
Glandular cysts, 341
Glands, cancer of, 342
Lieberktihn’s, 79
Glaucoma, 371
Goitre, 338
Gonorrhea, 185
of the prepuce, 183
specific, 184
ee t0200N subulatum, 151
Hair-follicles, inflammation of,
394
Hair, falling out of, 407
Hard fibroma, 333
413
Harvest bug, 399
Head, cold in, 118
Healing by first intention, 304
by suppuration, 305
process of a wound, 304
under a moist scab, 305
Hebra’s potash-soap, 891
Hematoma, 375
Heematopinus piliferus, 397
Hemoglobinemia, 264
Hemoglobinuria, 264
Helminthiasis, 74
Hemorrhage, 302
cerebral, 204
controlling of, 315
Hemorrhoids, 63
Hepar adiposum, 97
Hepatitis, 95
acute parenchymatous, 95
interstitial, 95
Hepatogenous icterus, 91
Hernia, 320
cruralis, 331
femoral, 331
inguinal, 327
in the bitch, 329
irreducible, 322
perineal, 331
reducible, 321
scrotal, 327
umbilical, 330
Herniotomy, 325
Herpes tonsurans, 406
Hobday apparatus, 348
Honey cysts, 51
‘¢ Honey-pouch”’ cyst, 341
Hydrobilirubin, 93
Hydrocarbonaceous food, digestion
of, 35
Hydrocele, 329
Hydrocyanic-acid poisoning, 98
Hydronephrosis, 169
Hydrophobia, 237
Hydrops abdominalis, 86
ascites, 86
peritonii, 86
Hyperemia of the brain, 202
of the liver, 94
Hypereesthesia, 197
[CTERUS catarrhalis, 90
gastro-duodenalis, 90
hepatogenous, 91
of reabsorption, 91
stagnating, 91
Imperforate anus, 74
Induration, chronic, of the lungs, 126
414
Infectious bronchial catarrh, 235
Inflammatory conditions of the cuta-
neous membrane, 3884
Inguinal hernia, 327
in the bitch, 329
Inflammation, mycotic, of the stom-
ach and intestines, 64
of the brain, 206, 207
of the brain-mass, 207
of the cerebral matter, 206
of the cerebral membranes, 206
of the conjunctiva, 353
of the dura mater, 206
of the external ear, 378
of the hair-follicles, 394
of the iris, 370
of the joints, 270
purulent, 273
rheumatic, 274
of the kidneys, 162
of the liver, 95
of the lungs, 124
of the lymphatics, 308
of the mammary gland, 348
of the mucous membranes of the
mouth, 42
of the mucous membranes of the
throat, 51
of the pelvis of the kidney, 169
of the peritoneum, 83
of the pleura, 130
of the prostate, 181
of the salivary glands, 49
of the sclerotic coat, 358
of the spinal cord, 210
of the testicle, 184
of the uterus, 188
of the vagina, 185
of the walls of the bloodvessels,
308
purulent, of the liver, 96
toxic, of the stomach and intes-.
tines, 64
Inflammatory processes of the eye,
366
Injuries of the cornea, 364
of the joints, 278
to the testicles and scrotum, 184
Inoculation, Pasteur’s method, 240
Internal canker, 378
parasites, 74
Interstitial hepatitis, 95
nephritis, chronic, 165
Intestinal fistula, 323
catarrh, 59
Intestines, contraction of, 66
diseases of, 59
mycotic inflammation of, 64
INDEX.
Intestines, obstruction of, 68
stenosis of, 66
toxic inflammation of, 64
Inversion of the eyelid, 350
Iodoform-poisoning, 99
Iris, inflammation of, 370
Tritis, 370
Irreducible hernia, 322
Irritable cough, chronic, 118
Ixodes ricinus, 398
AUNDICE, catarrhal, 90
Jaw, dislocation of, 288
Joints, acute synovial inflammation
of, 272
chronic serous inflammation, 273
contusions of, 280
distortions of, 281
diseases of, 270
inflammation of, 270
injuries of, 278
luxations of, 281
malformation of, 275
puncturing of, 277
purulent inflammation of, 273
rheumatic inflammation of, 274
suppuration of, 273
wounds of, 278
| AMALA, 80
Kennel distemper, 235
Keratitis, 358
parenchymatosa, 359
profunda, 359
superficialis, 359
Kidneys, abscess of, 167
acute inflammation of, 162
amyloid, 166
chronic inflammation of, 165
cysts of, 169
diseases of, 162
inflammation of, 162
of the pelvis, 169
Kusso, 80
ARDACEOUS liver, 97
Laryngeal catarrh, acute, 116
Laryngitis, acute, 116
chronic, 118
Laryngoscope, 28
Larynx, chronic catarrh of, 118
diseases of, 116
physical examination of, 102
Leptomeningitis, 216
Leptus autumnalis, 399
INDEX.
Leukemia, 257
Lice, dog, 397
Lieberkiihn’s glands, 79
Ligation of tumors, 345
Linear extraction of the crystalline
lens, 368
Linguatula tenoides, 114
Lipoma, 333
Lithiasis, 176
Liver, abscess of, 96
amyloid, 97
cirrhosis of, 95
congestive hyperemia of, 94
diseases of, 90
fatty, 97
hyperemia of, 94
inflammation of, 95
lardaceous, 97
neoformations of, 97
physical examination of, 41
purulent inflammation of, 96
stagnating hyperemia of, 94
Lobular extraction of the crystalline
lens, 369
pneumonia, 124
Local temperature, 26
Lockjaw, 219
Lower jaw, dislocation of, 283
paralysis of, 200
Lungs, blackening of the, 129
eatarrhal inflammation of, 125
chronic induration of, 126
cirrhosis of, 126
diseases of, 124
emphysema of, 121, 129
cedema of, 110, 127
physical examination of, 103
Lunguatula denticulata, 115
Luxations of the joints, 281
Lymphangitis, 308
Lymphatics, inflammation of, 308
1 ee fern, 80
Malformation of the joints, 275
Malformations of the cavity of the
mouth, 47
Mammary gland, inflammation of,
343
Mamunitis, 343
Mange, follicular, 402
red, 387
sarcoptic, 399
Meat-diet, 34
-digestion, 34
Melanotic sarcoma, 835
Membrana nictitans, removal of, 856
Meningitis, 209
415
Menstruation of bitch, 154
Mercury-poisoning, 100
Metritis, 188
catarrhal, 188
septic, 189
Milk-digestion, 39
Moist eczema, 391
scab, healing under, 305
Motor symptoms of irritation, 211
of paralysis, 211
Mouth and throat, examination of, 27
diseases of, 42
diseases of the mucous mem-
brane of, 42
malformations of, 47
uleerous inflammation of, 44
Mouth-gag, 28
Mucous membrane of the mouth, dis-
eases of, 42
membranes of the throat, in-
flammation of, 51
Mucus in urine, 158
Mumps, 50
Muscular rheumatism, 288
Mycotic inflammation of the stom-
ach and intestines, 64
Myelitis, 210
NASAL catarrh, 118
cavities, diseases of, 113
Neoformations of the glans penis and
prepuce, 184
of tne liver, 97
Nephritic stones, 170
Nephritis, 162
acute, 162
chronic, 165
interstitial, 165
parenchymatous, 165
suppurative, 167
Nephrolithiasis, 170
Nervous portion of the eye, diseases
of, 370
system, diseases of, 196
examination of, 196
Nettlerash, 387
Nose, catarrh of, 113
examination of, 101
Number and character of the respi-
ratory movements, 106
Nux-vomica poisoning, 100
BESITY, 262
Obstetrics, 191
Obstruction of the intestines, 68
Odor of urine, 157
416
(Edema, 22
of the lungs, 110, 127
(Esophagotomy, 54
(Esophagus, diseases of, 53
examination of, 30
foreign bodies in, 53
Opening of the capsule of the eye,
367
Operation for entropion, 351
Ophthalmia, catarrhal, 354
follicular, 354
purulent, 355
Optic nerve, diseases of, 371
Orchitis, 184
Osteoma, 334
Othzematoma, 375
Otitis externa, 378
parasitic, 381
Ovariotomy, 193
Oxyuris vermicularis, 81
ACHYMENINGITIS, 206
Panophthalmnitis, 370
Papilloma, 335
Paralysis, 197, 211
of the anterior limbs, 200
of the cruralis, 200
of the detrusor, 174
of the lower jaw, 200
of the posterior limbs, 200
of the sphincters, 212
of the sphincter vesice, 174
Paraphimosis, 183
Parasites, 74
Parasitic canker of the ear, 381
eczema, 396, 400, 402
otitis, 381
Parasite, dog, 397
Parasites, internal, 74
tapeworm, 75
Parenchymatous hepatitis, 95
inflammation of the tongue, 48
nephritis, chronic, 165
Parotitis, 50
Passing the catheter, 152
Pasteur’s methods of inoculation, 240
Patella, dislocation of, 285
Pelvis of the kidney, inflammation
of, 169
Penis, diseases of, 183
Pentastoma denticulatum, 115
teenioides, 114
Percussion of the thorax, 109
Perineal hernia, 331
Perinephritic abscesses, 168
Peritoneum, physical examination
of, 37
INDEX.
Peritonitis, 83, 88
acute diffuse, 84
chronic, 84
circumscribed, 85
Peritoneum, diseases of, 83
inflammation of, 83
Pharyngitis, 51
Phimosis, 183
Phlebitis, 308
Phlegmone, 807
Phosphorus-poisoning 99
Phthisis, 126
Physical diagnosis of the larynx and
windpipe, 102
examination, 17
of the bowel and _ perito-
neum, 87
of the liver, 41
of the lungs, 103
of the respiratory apparatus,
101
Pilocarpine in dropsy, 89
Pleura, diseases of, 180
inflammation of, 130
Pleurisy, 130
Pleuritis, 130
Pneumonia, 124
broncho-, 124
catarrhal, 124
croupal, 129
lobular, 124
traumatic, 127
Poisoning by arsenic, 98
by carbolic acid, 98
by hydrocyanie acid, 98
by iodoform, 99
by mercury, 100
by nux vomica, 100
by phosphorus, 99
by strychnine, 100
Poisons, 98
Pomegranate, 80
Posterior chamber of the eye, diseases
of, 370
limbs, paralysis of, 200
Potash-soap, Hebra’s, 391
Prepuce, diseases of, 183
examination of, 152
gonorrheea of, 183
neoformations of, 184
Preventive inoculation, 240
Priessnitz’s compress, 267
Probang, 30
Proglottides, 76
Prolapse of the eyeball, 372
of the rectum, 71
of the uterus, 186
of the vagina, 186
INDEX.
Prolapsus bulbi, 372
of rectum, reduction of, 73
uteri, 186
vagine, 186
Prostate, cancer of, 182
diseases of, 181
examination of, 154
inflammation of, 181
Prostatitis, 181
chronic, 182
Prurigo, 389
Prussic-acid poisoning, 98
Pseudo-leukzemia, 259
Puerperal fever, 189
Pulex, 396
Puncturing the abdomen, 90
the joints, 277
Purgatives in dropsy, 89
Purulent conjunctivitis, 355
fever, 310
inflammation of the eye, 370
of the joints, 273
of the liver, 96
ophthalmia, 355
Pyemia, 310
Pyarthrosis, 273
Pyelitis, 169
Pyelonephritis, 167
PRABies, 237
Rabific symptoms, 82
Ranula, 48
Reabsorption, icterus of, 91
Reaction of urine, 157
Rectum, preternatural, 323
prolapsus of, 71
stitching of, 73
Red mange, 387
Reducible hernia, 321
Removal of the membrana nictitans,
306
of tumors, 346
Respiratory apparatus, physical ex- |
amination of, 101
organs, diseases of, 101
movements, number and charac-
ter of, 106
Retention cysts, 341
Retina, diseases of, 371
Rhachitis, 268
Rheumatic arthritis, 274
inflammation of the joints, 274
Rheumatism, 288
Rhinitis, 113
Round worms, 74
Rupture, 320
of the bladder, 88
417
QGALIVARY glands, inflammation
of, 49
Sarcocele, 328
Sarcoma, 334
melanotic, 335
Sarcoptes scabiei communis, 399
Sarcoptic mange, 399
Sclerotic coat, diseases of, 358
inflammation of, 358
membrane, abscess of, 360
diseases of, 370
ulceration of, 361
Scrotum, injuries of, 184
Scurvy, 266
Sensitiveness, 211
disturbance of, 196, 211
Septiceemia, 309
Septic infection of wounds, 305
metritis, 189
-wound fever, 309
Serous cyst, 375
inflammation of
chronic, 273
Sexual apparatus, diseases of, 152
Skin affections caused by animal par-
asites, 396
caused by vegetable para-
sites, 405
atrophic conditions of, 407
diseases of, 384
gangrene of, 394
inflammatory conditions of, 384
Soft fibroma, 333
Sore-throat, 51
Specific gravity of urine, 157
gonorrhea, 184
Speculum, 38
the joints,
| Sphincter vesice, paralysis of, 174
| Sphincters, paralysis of, 212
Spinal cord, inflammation of, 209
membranes, inflammation of, 209
myelitis, 210
Spine, nutritive disorders of, 212
Spiritual blindness, 372
Spiroptera sanguinolenta, 151
Spleen, 42
Sprains, 281
Squamous cancer, 342
Stagnating hyperemia of the liver, 94
icterus, 91
Staphyloma, 362
Stenosis of the intestines, 66
| Stitches, 314
Stomacace, 44
Stomach, acute catarrh of, 55
chronic catarrh of the, 57
diseases of, 55
examination of, 31
418
INDEX.
Stomach, mycotic inflammation of, 64 | Transparency of urine, 157
-pump, 39
toxic inflammation of, 64
ulceration of, 58
Stomatitis, 42
Stone in the bladder, 176
Stones, nephritic, 170
Strongylus vasorum, 151
Struma, 338
Strychnine-poisoning, 100
St. Vitus’s dance, 217
Sugar in urine, 161
Suppuration, healing by, 3805
of the joints, 273
Suppurative nephritis, 167
Syndesmitis, 353
Synovitis acuta serosa, 272
chronica serosa, 273
Synovial inflammation of the joints,
272
ZENIA, 74
ceenurus, 78
cucumerina, 78, 79
echinococcus, 79, 80, 81
marginata, 77
serrata, 77, 80
Teniafuge, preparation for, 81
Teniafuges, 80
Tail, amputation of, 300
Tapeworms, 75
natural history, 75
Tapping the abdomen, 90
Taxis, 325
Teeth, diseases of, 45
Temperature, 23
-chart, 24
increased, 23
subnormal, 25
Testicles, diseases of, 184
inflammation of, 184
injuries of, 184
Tetanus, 219
Therapeutics of tumors, 344
Thermometer, 23
Thorax, auscultation of, 110
dimensions of, 106
percussion of, 109
Throat, inflammation of the mucous
membranes, 51
Tobacco-bag stitch, 73
Tongue, diseases of, 43
parenchymatous
of, 48
Tooth-forceps, 46
Toxic inflammation of the stomach
and intestines, 64
Trachea, physical examination of, 102
inflammation
Traumatic pneumonia, 127
Treatment of wounds, 301, 311
Trichocephalus, 82
Trichodectes latus canis, 397
True infection, diseases of, 2238
Tumors, 333
cancerous, 342
cartilaginous, 333
cauterization of, 345
cutaneous, 341
cylindrical cell, 342
epithelial, 835
fatty, 333
ligation of, 345
of the abdominal cavity, 89
of the anal glands, 337
of the bones, 384
of the connective tissue, 333
removal of, 346
therapeutics of, 344
Turning in of the eyelid, 350
out of the eyelid, 352
MBILICAL hernia, 330
Ulceration, 316
of the sclerotic membrane,
361
of the stomach, 58
Ulcers and ulceration, 316
Ulcerous inflammation of the mouth,
44
Uleus ventriculi, 58
Union of fractured bones, 295
of fractures, 293
Uremia, 265
Urethra, examination of, 152
Uric calculi, 177
Urinary apparatus, examination of,
152
diseases of, 152
Urine, albumin in, 160
amount of, 156
bacteria in, 159
bile-coloring in, 161
blood-corpuscles in, 158
color of, 156
epithelium in, 158
examination of, 155
fat in, 158
foreign substances in, 158
in the abdominal cavity, 88
in the bladder, 88
mucus in, 158
odor of, 157
reaction of, 157
specific gravity of, 157
Urine, sugar in, 161
transparency of, 157
Urethrotomy, 179
Urticaria, 387
Uterus, diseases of, 185
inflammation of, 188
prolapse of, 186
V
AGINA, diseases of, 185
inflammation of, 185
INDEX. 419
Vagina, prolapse of, 186
Vaginitis, 185
Vegetable parasites, cutaneous affec-
tions caused by, 405
Vermicularis, oxyuris, 81
Vitreous humor, diseases of, 370
Vomiting, 34, 36, 85
YELLOW mucous membranes, 92
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