A TEXT-BOOK
OF THE
DISEASES OF THE SMALL
DOMESTIC ANIMALS
BY
OSCAR VICTOR BRUMLEY, V.S.
PROFESSOR OF VETERINARY SURGERY AND DIRECTOR OF CLINICS, COLLEGE
OF VETERINARY MEDICINE, OHIO STATE UNIVERSITY,
COLUMBUS, OHIO
LEA & FEBIGER
PHILADELPHIA AND NEW YORK
14S417
COPYRIGHT
LEA & FEBIGER
1921
PRINTED IN U. S. A.
PREFACE.
THIS book is intended to be a practical text on the Diseases
of the Small Domestic Animals. The author feels that it is
inadvisable to write an exhaustive treatise on this subject,
as it is primarily intended to be a book for student use and for
the busy practitioner. An attempt has been made to include
most of the important diseases (medical and surgical) of
small animals with which the veterinarian comes in contact.
It is hoped that it will serve the purpose for which it is written.
The author does not claim originality for all the material
in the book. The literature and standard books have been
consulted freely.
For scientific reasons the metric system has been used
throughout the text. A table of equivalents in weights and
measures has been inserted so that the dosage can be readily
determined in the other system, if desired. This was thought
to be more desirable than including both under the treatment
of each disease.
The author wishes to express his appreciation for the
valued assistance rendered by his colleagues in the College
of Veterinary Medicine, Ohio State University, in the
preparation of the manuscript. He is especially indebted
to Colonel David S. White, Dean, for his kindness in arrang-
ing and correcting the manuscript, and for his advice relative
to the subject matter, and in many other ways contributing
to the value of the book. Also to Dr. James Howard Snook
iv PREFACE
for suggestions in the chaptep on skin diseases and various
other problems as they presented themselves. The author's
thanks are extended to Dr. John Newton Shoemaker and
others who have been liberal with their assistance during the
preparation of the manuscript.
O. V. B.
Columbus, Ohio, 1921.
CONTENTS.
PART I.
DISEASES OF THE RESPIRATORY SYSTEM.
CHAPTER I.
DISEASES OF THE NASAL PASSAGES.
Examination 17
Acute Nasal Catarrh (Coryza. Rhinitis) 19
Empyema of the Infraorbital Fossae of Birds 20
Infectious Nasal Catarrh of Rabbits (Rabbit Plague. Rabbit
Influenza. Rabbit Distemper) 20
Parasitic Nasal Catarrh of Rabbits (Rhinitis Coccidiosa) ... 22
Chronic Nasal Catarrh (Chronic Coryza. Rhinitis) .... 23
Epistaxis . .... 24
Parasites of the Nasal Passages 25
Neoplasms of the Nasal Passages 28
Papillomata 28
Polypoid Fibromata 28
Malignant Tumors 29
CHAPTER II.
DISEASES OF THE LARYNX.
Acute Laryngitis 30
Chronic Laryngitis 31
CHAPTER III.
DISEASES OF THE TRACHEA AND BRONCHIAL TUBES.
Examination 34
Acute Tracheitis and Bronchitis 34
Bronchial Catarrh of Birds (Bronchitis) 38
Mycotic Pneumonia (Aspergillosis) 40
Animal Parasites in the Trachea and Bronchial Tubes (Syngamosis.
Gapes in Chickens) 42
Chronic Tracheitis and Bronchitis 44
vi CONTENTS
CHAPTER IV.
DISEASES OF THE LUNGS.
Examination 47
Congestion of the Lungs (Hyperemia of the Lungs) .... 49
Active Congestion 49
Passive Congestion 50
Pulmonary Edema (Edema of the Lungs) 52
Bronchopneumonia (Catarrhal Pneumonia) 53
Cirrhosis of the Lungs (Chronic Interstitial Pneumonia) ... 57
Foreign Body Pneumonia (Gangrene of the Lungs) .... 58
CHAPTER V.
DISEASES OF THE PLEURA.
Pleuritis (Pleurisy) '....• 60
Hydrothorax . 65
Pneumothorax 66
Hemothorax . 67
PART II.
DISEASES OF THE CIRCULATORY SYSTEM.
CHAPTER I.
DISEASES OF THE PERICARDIUM.
Examination 69
Pericarditis . 73
Hydropericardium (Dropsy of the Pericardium) 76
Hemopericardium 77
CHAPTER II.
DISEASES OF THE HEART.
Valvular Insufficiency and Stenosis 78
Myocarditis 82
Acute Myocarditis 82
Chronic Myocarditis 84
Acute Endocarditis 85
Hypertrophy and Dilatation of the Heart 89
Rupture of the Heart . 92
CONTENTS vii
i
PART III.
DISEASES OF THE DIGESTIVE TRACT.
CHAPTER I.
DISEASES OF THE MOUTH.
Examination 93
Stomatitis 94
Catarrhal Stomatitis 94
Ulcerative Stomatitis 96
Gangrenous Stomatitis (Canker of the Mouth) .... 97
Phlegmonous Stomatitis 99
Parasitic Sto natitis (Thrush. Soor. Aphtha) .... 100
Benign Neoplasms of the Mouth 102
Papillomata 102
Fibromata 102
Osteoma 103
Retention Cysts (Ranula) 103
Malignant Neoplasms of the Mouth 104
Epitheliomata 104
Sarcomata 105
Foreign Bodies in the Mouth . 106
CHAPTER II.
DISEASES OF THE TEETH.
Examination 107
Malformations of the Teeth 107
Fractures of the Teeth ' 108
Incrustations of Tartar 108
Alveolar Periostitis (Pericementitis. Periodontrtis) .... 108
Caries of the Teeth 109
CHAPTER III.
DISEASES OF THE TONGUE.
Examination Ill
Glossitis Ill
Gangrene of the Tongue (Gangrenous Glossitis) . ... 1 12
viii CONTENTS
CHAPTER IV.
DISEASES OF THE SALIVARY GLANDS.
Examination 115
Parotitis (Mumps) 115
Submaxillary and Sublingual Glands 118
Salivary Fistula 118
CHAPTER V.
DISEASES OF THE TONSILS.
Examination . . . 120
Tonsillitis and Lymphadenitis 120
CHAPTER VI.
DISEASES OF THE PHARYNX.
Examination 123
Pharyngitis .... 123
Acute Pharyngitis 123
Chronic Pharyngitis 125
Foreign Bodies in the Pharynx .' . 126
Paralysis of the Pharynx . 127
Croupous Pharyngitis of Birds 127
Neoplasms of the Pharynx 128
Polypoid Growths 128
Epithelioma . 129
CHAPTER VII.
DISEASES OF THE ESOPHAGUS.
Examination 130
Esophagitis 130
Foreign Bodies (Obstruction in Esophagus) 131
Esophagismus 135
Stricture of the Esophagus : 135
Dilatations and Diverticula of the Esophagus 136
Catarrh of the Crop in Birds (Soft Crop) 137
Obstruction of the Crop in Birds (Hard Crop) 139
Neoplasms of the Esophagus 141
CONTENTS ix
CHAPTER VIII.
DISEASES OF THE STOMACH.
Examination 142
Gastritis 142
Acute Gastritis (Simple Catarrh of the Stomach. Acute
Dyspepsia) 142
Chronic Gastritis (Chronic Catarrh of the Stomach. Chronic
Dyspepsia) 146
Foreign Bodies in the Stomach 148
Acute Dilatation of the Stomach 152
Chronic Dilatation of the Stomach 154
Ulceration of the Stomach (Ulcus Ventriculi) 157
Hematemesis 160
Parasites in the Stomach 163
Neoplasms in the Stomach. . .' 165
CHAPTER IX.
DISEASES OF THE INTESTINES.
Examination 167
Enteritis 167
Acute Enteritis 167
Chronic Enteritis 173
Intestinal Hemorrhage (Enterorrhagia) 175
Diarrhea 178
Constipation (Obstipation. Intestinal Obstruction) .... 182
Volvulus " 185
Intussusception 186
Wounds of the Intestines 188
Croupous Enteritis of Cats (Membranous Enteritis) .... 190
Infectious Asthenia of Birds 191
CHAPTER X.
PARASITES IN THE INTESTINES.
Helminthiasis 193
Tseniasis (Cestoda) 193
Tsenise in Dogs 195
Tseniae in the Intestine of the Cat 197
Ta3nia3 in the Intestine of Rabbits 197
Taeniae in the Intestines of Birds . 198
x CONTENTS
Nematoda 201
Round worms (Ascaridse) . . . ." . 201
Round Worms in the Intestine of the Dog 202
Round Worms in the Intestine of the Cat .... 202
Round Worms in the Intestine of the Rabbit . . . 202
Round Worms in the Intestine of Birds 202
StrongylidsE (Hookworm) . . . 206
Strongylidtc in the Intestine of the Dog 207
Strongylidir in the Intestine of the Cat 207
Strongylidie in the Intestine of the Rabbit .... 207
Trichinellidse (Whipworm) 209
Trichinellidjc in the Intestine of the Dog 210
Trichinellidav in the Intestine of the Rabbit .... 210
Trichinellidse in the Intestine of Birds 210
CHAPTER XI.
DISEASES OF THE RECTUM AND ANUS.
Examination 212
Occlusion of the Rectum and Anus . 212
Proctitis 214
Hemorrhoids (Piles) 216
Prolapse of the Rectum 217
Parasites in the Rectum 221
Neoplasms in the Rectum . 222
Suppuration of the. Anal Glands 223
CHAPTER XII.
DISEASES OF THE LIVER.
Examination 225
Icterus (Jaundice) 225
Congestion of the Liver 231
Active Congestion 231
Passive Congestion 233
Hepatitis 235
Suppurative Hepatitis (Abscess of the Liver) ..... 236
Atrophy of the Liver 240
Fatty Liver 241
Amyloid Liver 242
Cirrhosis of the Liver (Chronic Interstitial Hepatitis) .... 243
Neoplasms of the Liver 244
Cholelithiasis. Gall-stones 245
Rupture of the Liver (Ruptura Hepatis. Apoplexia Hepatis) . 246
CONTENTS xi
CHAPTER XIII.
DISEASES OF THE PERITONEUM
General Remarks 248
Peritonitis 250
Acute Peritonitis 250
Chronic Peritonitis 255
Ascites (Hydrops Abdominis. Hydrops Ascites. Hydrops
Peritonei) . . 257
PART IV.
DISEASES OF THE REPRODUCTIVE ORGANS.
CHAPTER I.
DISEASES OF THE PENIS AND PREPUCE.
Examination 263
Wounds of the Penis and Prepuce 263
Congenital Malformations 265
Preputial Catarrh (Balanitis) . . . . 265
Phimosis 266
Paraphimosis 267
Tumors of the Penis and Prepuce . " 268
Papillomata 269
Sarcomata, Epitheliomata and Carcinomata . . . . . 269
Venereal Granulomata 269
CHAPTER -II.
DISEASES OF THE TESTES AND SCROTUM.
Wounds and Injuries of the Testes and Scrotum 271
Orchitis .... .............. 271
Tumors of the Scrotum and Testes 272
Parasites in the Scrotum and Testes (Cuterebra Emasculator) 273
Castration (Orchectomy) 273
Castration of the Dog . . . . 274
Castration of the Monorchid and Cryptorchid Dog . . 275
Castration of the Cat 275
Castration of Birds (Caponizing) 276
xii CONTENTS
CHAPTER III..
DISEASES OF THE PROSTATE GLAND.
Examination 279
Prostatitis 279
Tumors of the Prostate Gland (Hypertrophy of the Prostate
Gland) 280
CHAPTER IV.
DISEASES OF THE OVARIES.
Examination 283
Inflammation of the Ovaries (Oophoritis) 283
Tumors of the Ovaries 284
Cysts 284
Oophorectomy (Ovariectomy) 285
Oophorectomy in the Dog 286
Oophorectomy in the Cat 289
Poulardizing the Female Chicken 289
CHAPTER V.
DISEASES OF THE UTERINE TUBES.
Examination 291
Salpingitis 291
Pyosalpinx 291
Tumors (Cysts) 291
CHAPTER VI.
DISEASES OF THE UTERUS.
Examination 292
Metritis 293
Acute Metritis 293
Chronic Metritis (Pyometra) 296
Puerperal Septicemia 298
Eversion of the Uterus (Prolapse. Inversion of the Uterus) . . 300
Torsion of the Cornua Uteri 302
Rupture of the Uterus 303
Tumors of the Uterus 303
Fibromata 303
Myomata 304
Hydrometra 304
Dystocia 305
CONTENTS xiii
CHAPTER VII.
DISEASES OF THE VAGINA AND VULVA.
Examination 309
Congenital Malformations 309
Vaginitis and Vulvitis 309
Prolapse of the Vagina , 311
Rupture of the Vagina 313
Tumors of the Vulva and Vagina 313
Fibromata 313
Papillomata 314
Sarcomata 314
Venereal Granulomata 314
CHAPTER VIII.
DISEASES OF THE MAMMARY GLANDS.
Examination 315
Wounds and Injuries of the Mammary Glands 315
Congestion of the Mammary Glands .316
Mammitis (Mastitis) 316
Tumors of the Mammary Glands 317
Benign Tumors 317
Fibromata 317
Lipoma 318
Malignant Tumors 318
Carcinomata 318
Sarcomata 318
PART V.
DISEASES OF THE BLOOD AND BLOOD .
PRODUCING ORGANS.
CHAPTER I.
Anemia 319
Leukemia 322
Infectious Leukemia of Chickens 325
Pseudoleukemia (Hodgkin's Disease) 327
Hemophilia 328
Scurvy (Scorbutus) 328
xiv CONTENTS
Animal Parasites in the Blood. (Filariaj. Metastrongulinse) . 330
Dirofilaria Immitis (Filaria Ininiitis) 330
Hematozoon Lewlsi 332
Hsemostrongylus Vasorum 332
Spiroptera Sanguinolenta 333
CHAPTER II.
DISEASES OF THE THYROID GLANDS.
Examination and General Consideration 334
Congestion of the Thyroid Glands 334
Acute Thyroiditis 335
Goiter (Struma. Bronchocele) 336
Parenchymatous Goiter . 336
Cystic Goiter 339
Fibrous Goiter 340
Vascular Goiter 341
Malignant Goiter 342
Exophthalmic Goiter (Basedow's Disease. Graves's Disease) 343
PART VI.
>
DISEASES OF METABOLISM.
CHAPTER I.
DISEASES OF METABOLISM.
Diabetes 347
Diabetes Insipidus 347
Diabetes Mellitus 350
Obesity 352
Gout (Podagra. Arthritis Urica) 354
Feather Eating (Feather Pulling in Birds) . . ' 357
CHAPTER II.
DISEASES OF METABOLISM AFFECTING PRIMARILY THE BONES.
Rachitis (Rickets) 359
Osteomalacia (Brittleness of Bones) . 362
CONTENTS xv
PART VII.
DISEASES OF THE ORGANS OF LOCOMOTION.
CHAPTER I.
Articular Rheumatism (Polyarthritis Rheumatica) .... 363
Muscular Rheumatism 365
Fracture of Bones •„.... 368
Cranial Bones 368
Fracture of the Inferior Maxilla 369
Fracture of the Vertebrae 370
Fracture of the Ribs 371
Fracture of the Scapula 371
Fracture of the Humerus 372
Fracture of the Radius and Ulna . • 372
Fracture of the Metacarpal and Phalangeal Bones . . . 373
Fracture of the Pelvis 373
Fracture of the Femur 374
Fracture of the Patella 375
Fracture of the Tibia and Fibula 375
CHAPTER II.
DISEASES OF THE ARTICULATIONS.
Wounds of the Articulations 376
Sprains and Injuries to the Articulations 377
Dislocation of the Articulations (Luxation) 378
Temporomaxillary 378
Vertebral .- . . 379
Scapulohumeral 379
Humero-radio-ulnar 379
Radio-ulnar-carpal 380
Phalangeal 381
Coxofemoral 381
Patellar 382
Tibiotarsal • 383
Caudal Vertebra; 383
Inflammation of the Synovial Membrane and Articulations.
(Synovitis. Arthritis) 383
xvi CONTENTS
PART'VIII.
DISEASES OF THE URINARY SYSTEM.
CHAPTER I.
DISEASES OF THE KIDNEYS.
Examination 385
Congestion of the Kidneys (Hyperemia . ) . - 387
Acute Hyperemia 387
Passive Hyperemia 388
Inflammation of the Kidneys (Nephritis) 388
Acute Nephritis 388
Chronic Nephritis 392
Purulent Nephritis (Kidney Abscess) 396
Inflammation of the Renal Pelvis (Pyelitis) . 398
Uremia 400
Calculi in the Kidney (Nephrolithiasis) 402
Dropsy of the Kidney (Hydronephrosis. Cystic Kidney) . . . 405
Amyloid Kidney 407
Tumors in the Kidney 407
Animal Parasites in the Kidney 407
Dioctophyme Renale (Eustrongylus Gigas) 407
Other Parasites in the Kidney . . 409
CHAPTER II.
DISEASES OF THE BLADDER.
Examination 410
Wounds of the Bladder 412
Rupture of the Bladder 412
Retention of Urine in the Bladder (Retcntio Urinse Vcsicalis) . 414
Incontinence of Urine 416
Catarrh of the Bladder (Cystitis. Urocystitis) 416
Torsion of the Bladder 420
Calculi in the Bladder 420
Tumors of the Bladder 423
Parasites in the Bladder . . 423
CONTENTS xvii
CHAPTER III.
DISEASES OF THE URETHRA.
Examination 425
Congenital Malformations (Occlusion of the Urethra) .... 425
Wounds of the Urethra 426
Stricture of the Urethra 426
Calculi in the Urethra 427
Inflammation of the Urethra (Urethritis) 420
PART IX.
DISEASES OF THE NERVOUS SYSTEM.
CHAPTER I.
DISEASES OF THE BRAIN.
General Considerations 431
Examination 432
Psychic Disturbances 433
Sensibility 433
Hyperemia of the Brain (Congestion of the Brain) 435
Anemia of the Brain (Cerebral Anemia) 437
Meningo-eqcephalitis 438
Cerebral Hemorrhage (Apoplexy) 440
Tumors of the Brain 441
CHAPTER II.
DISEASES OF THE SPINAL CORD.
General Considerations 443
Examination 443
Meningomyelitis 443
Concussion of the Spinal Cord (Injuries of the Spinal Cord) . . 445
Compression of the Spinal Cord 448
xviii CONTENTS
CHAPTER III.
DISEASES OF THE PERIPHERAL NERVOUS SYSTEM.
Injuries of the Peripheral Nerves 450
Pressure upon the Peripheral Nerves (Compression) .... 450
Paralysis of the Peripheral Nerves 450
Facial Nerve 450
Trigeminal Nerve 452
Auditory Nerve 453
Radial Nerve 454
Brachial Plexus 455
Sciatic Nerve 456
CHAPTER IV.
FUNCTIONAL NERVOUS DISEASES.
Vertigo (Megrim) 455
Epilepsy 456
Reflex or Secondary Epilepsy 459
Catalepsy 460
Chorea 461
Eclampsia 462
PART X.
DISEASES OF THE SKIN.
CHAPTER I.
NON-PARASITIC SKIN DISEASES.
Examination 463
Dandruff .464
Alopecia 465
Dermatitis 466
Acne 468
Eczema 469
CONTENTS xix
CHAPTER II.
PARASITIC SKIN DISEASES.
Fleas 472
Lice 473
Scabies (Mange. Red Mange. Itch) ... T .... 475
Sarcoptes Mite 476
Demodex Mite 480
Dermatomycosis (Vegetable Parasitic Disease of the Skin) . . 482
Herpes Tonsurans (Ringworm. Red Itch) 482
Favus (Honeycomb Ringworm. Comb Disease. White Comb) 484
PART XL
DISEASES OF THE EAR.
Examination 487
Wounds of the Ear ' 487
Ulceration of the Concha 488
Hematoma 489
Otitis Externa (Otorrhea) 490
Otitis Media and Interna . 493
Tumors (Neoplasms of the Ear) 493
Papillomata 493
Sebaceous Tumors or Cysts 494
Parasites in the Ear 494
Deafness 495
Ear Fistula . 495
PART XII.
DISEASES OF THE EYE.
CHAPTER I.
DISEASES OF THE EYELIDS.
Examination 497
Wounds of the Eyelids 497
Inflammation of the Eyelids (Blepharitis) 498
xx CONTENTS
Malposition of the Eyelids 499
Entropion 499
Ectropion 500
Ptosis (Blepharoptosis) 501
Paralysis of the Orbicularis Nerve 502
Spasm of the Orbicularis Nerve (Blepharospasm) . 503
Trichiasis 503
Districhiasis 504
Adhesions of the Eyelids 504
Ankyloblepharon 505
Symblepharon 505
Lagophthalmos 506
Tumors of the Eyelids 506
Papillomata (Warts) 506
Chalazion (Meibomian Cyst) 507
Pilosebaceous Cysts 507
Lipoina and Sebaceous Tumors in Birds 508
Enlargement of the Glands of Moll 508
Granulomas 508
Malignant Neoplasms 508
CHAPTER II.
DlSKASES OF THE CONJUNCTIVA.
Examination 510
Conjunctivitis 510
Catarrhal Conjunctivitis 511
Purulent Conjunctivitis (Blennorrhea) 512
Parenchymatous Conjunctivitis (Erysipelatious Conjunctivi-
tis) 514
Croupous Conjunctivitis 516
Follicular Conjunctivitis 517
Exanthematous Conjunctivitis 518
Pterygium • 519
Traumatic Lesions of the Conjunctiva 519
Foreign Bodies in the Conjunctiva 519
Wounds of the Conjunctiva 520
Corrosions and Burns of the Conjunctiva 521
Ulceration of the Conjunctiva 521
Tumors and Growths on the Conjunctiva 522
Inflammation of the Membrana Nictitans 522
Wounds of the Membrana Nictitans 523
Tumors of the Membrana Nictitans . 523
CONTENTS
CHAPTER III.
DISEASES OF THE LACRIMAL APPARATUS.
Examination 524
Lamination (Epiphora) 524
Dacryocystitis 525
CHAPTER IV.
DISEASES OF THE CORNEA.
Examination 526
Keratitis '....-. 526
Non-suppurative Keratitis 527
Superficial Keratitis 527
Vascular Keratitis (Pannus) 528
Keratitis Pigmentosa (PigmentaryjKeratitis; . . . . 529
Keratitis Punctata Superficialis (Facetted Keratitis) . 529
Parenchymatous Keratitis 530
Keratitis Punctata Profunda 532
Suppurative Keratitis 532
Ulceration of the Cornea 532
Abscess of the Cornea 534
Keratitis Xeuroparalytica 535
Keratitis from Lagophthalmus 535
Foreign Bodies and Wounds of the Cornea 535
Opacities of the Cornea 536
Ectasia of the Cornea 537
Inflammatory Ectasia 537
Staphyloma 537
Keratectasia 537
Non-inflammatory Ectasia 538
Keratoconus 538
Keratoglobus 538
Tumors of the Cornea 538
CHAPTER V.
DISEASES OF THE IRIS AND CILIARY BODY.
Congenital Defects of the Iris 539
Mydriasis 540
Myosis 540
Iritis and Cyclitis (Iridocyclitis) 540
Cysts and Tumors of the Iris . 541
xxn CONTENTS
CHAPTER VI.
DISEASES OF THE LENS.
Examination 542
Cataract 542
Luxation of the Lens 544
CHAPTER VII.
DISEASES OF THE RETINA AND CHOROID . . . 545
CHAPTER VIII.
DISEASES OF THE OPTIC NERVE.
Papillitis 546
Retrobulbar Neuritis 546
Atrophy of the Optic Nerve 547
Amblyopia 547
Amaurosis 547
CHAPTER IX.
DISEASES OF THE GLOBE AND ORBIT.
Panophthalmitis 548
Glaucoma 549
Hydropthalmus 550
Exophthalmus 550
Luxation of the Eyeball 550
Enophthalmus 551
Strabismus • 552
Nystagmus 552
Parasites of the Eye 553
Fracture of the Orbit 553
Inflammation of the Orbit 553
Tumors of the Orbit . . . 553
CONTENTS xxiii
PART XIII.
HERNIA.
General Remarks 555
Umbilical Hernia 557
Ventral Hernia 558
Inguinal Hernia 560
Inguinal Hernia in the Female 560
Inguinal and Scrotal Hernia in the Male 561
Femoral Hernia 562
Diaphragmatic Hernia 563
Perineal Hernia . 563
PART XIV.
INFECTIOUS DISEASES.
CHAPTER I.
ACUTE GENERAL INFECTIOUS DISEASES.
Distemper of Dogs 565
Distemper of Cats 577
Typhus of Dogs (Canine Typhus. Hemorrhagic Gastro-enteritis.
Dog Plague. Black Tongue) 579
Purpura Hemorrhagica of Dogs 583
Fowl Cholera (Cholera Gallinarum. Pasteurellosis Avium. Fowl
Typhoid) 584
Fowl Pest (Fowl Plague. Pestus Avium) 589
CHAPTER II.
ACUTE INFECTIOUS DISEASES WITH LOCALIZATION IN CERTAIN ORGANS.
Epitheliosis Infectiosa Avium (Contagious Epithelioma. Chicken-
pox. Diphtheria. Roup. Canker) 593
Anthrax 599
Foot-and-mouth Disease (Aphthae Epizootics:) 600
Hemorrhagic Septicemia of Cats (Infectious Gastro-enteritis) . . 600
xxiv CONTENTS
CHAPTER III.
INFECTIOUS DISEASES WITH SPECIAL INVOLVEMENT OF THE NERVOUS
SYSTEM.
Rabies (Hydrophobia. Lyssa) 603
Infectious Bulbar Paralysis (Pseudorabies) 611
Tetanus (Lockjaw) 613
CHAPTER IV.
CHRONIC INFECTIOUS DISEASES.
Tuberculosis of Birds (Tuberculosis Avium. Avian Tuberculosis) 616
Tuberculosis of Dogs and Cats 620
Glanders 622
Pseudo-act inomycosis of Dogs (Streptotrichosis Canum. Actiuo- .
myces Canis) 623
CHAPTER V.
INFECTIOUS DISEASES PRODUCED BY PROTOZOA.
Spirochaetosis of Fowls (Spirochsetosis Avium. Spirillosis of
Chickens) 625
Enterohepatitis (Blackhead) 627
Infectious Diarrhea of Chicks (White Diarrhea) 629
Piroplasmosis of the Dog (Infectious Jaundice. Biliary Fever.
Malignant Jaundice) 633
Table of Equivalents in Weights and Measures 637
DISEASES OF THE SMALL DOMESTIC
ANIMALS.
PART I.
DISEASES OF THE RESPIRATORY SYSTEM.
CHAPTER I.
DISEASES OF THE NASAL PASSAGES.
Examination.— The nasal passages are very small and do
not admit of a free examination. In some breeds of dogs
(English bull) there is an obstruction of the nasal passages
which during inspiration produces a peculiar snoring sound.
This should not be mistaken for an abnormal condition. In
other breeds (Collie) where the nasal passages are longer
and less tortuous respiration produces no sound. Dogs
breathe freely through the mouth. In the cat the nasal
passages are very small and short and can only be examined
at their openings.
The examination of the nasal passages should be made as
follows: Good light such as ordinary daylight or strong
artificial light is necessary. A mirror to reflect light into
the nasal openings is of little value as the passages are so
small that the light will be reflected only a short distance.
A very small nasal dilator will be found useful in some of
the larger breeds. A small flexible probe with a pledget of
cotton securely wrapped around one end, large enough to
occlude the nostril when inserted rather high up, will at once
2
18 DISEASES OF THE NASAL PASSAGES
induce sneezing and the character of the secretions from the
opposite nostril can be more easily determined. The probe
is then removed and inserted in the other nostril for a similar
examination. The nose in health is moist and cool with a
very thin, slight mucous discharge. The mucous membrane
is variable in color; in most breeds dark, in others light with
dark spots, and in a few breeds pink.
Abnormal conditions to be noted are the following:
Turn or*.— Small papillomas on the skin and mucous
membrane at the entrance to the nasal openings are fre-
quently seen. Epitheliomas extending from the lips to form
a diffuse enlargement which may partially or completely
obstruct the nasal openings. Polypoid enlargements on the
mucous membrane of the nasal passages are often noted and
can be accurately determined by using a small, fine wire
snare to pull them toward the nasal opening.
Foreign Bodies. — Frequently in hunting dogs small pieces
of straw, twigs and other foreign material will be found rather
high up in the passages. These injure the mucous membrane
and often become deeply imbedded in it and the underlying
tissues.
Parasites.— The Pentastoma rhinaria (Linguatula rhinaria)
is occasionally found in the nasal passages and when suspected
the nasal discharge should be examined microscopically to
reveal the presence of the eggs of the parasite.
Infectious.— Distemper infection frequently takes place in
the nasal passages and produces both local and general
symptoms. Staphylococcus infection from wounds in the
mucous membrane, or as secondary infection following dis-
temper, is of common occurrence. In these conditions the
nose is usually dry and hot, showing numerous fissures on
the mucous membrane and nose at the borders of the nasal
openings.
Hemorrhage.— This occurs often from injuries, as blows
over the nasal bones, fractures of the nasal bones; from
punctured wounds through the bones and from injury to the
turbinated bones.
Malformations.— Some diseases (rachitis) produce a de-
formity of the nasal bones interfering with the free passage
ACUTE NASAL CATARRH 19
of air through the nostrils and producing marked enlarge-
ment of the nose.
Discharge.— In acute and chronic nasal catarrh (coryza,
rhinitis) the mucous and serous discharge from the nasal
passages is greatly increased. The general condition is but
little disturbed.
ACUTE NASAL CATARRH.
Coryza. Rhinitis.
Definition. —Acute inflammatory condition of the nasal
mucous membrane producing a serous or mucous discharge.
Etiology. — (a) Inhalations of dust or other foreign material.
(6) Inhalations of irritating gases or chemicals.
(c) Exposure to cold (cold draughts of air).
(d) Ordinary infection (staphylococcus, etc.); specific
infections (distemper, etc.).
(e) Linguatula rhinaria (early stages of invasion) .
During the first stages there is hyperemia and dryness of
the nasal mucosa, which is soon followed by a discharge that
is serous, seromucous, or mucopurulent. This discharge
often causes excoriation of the tissues with which it comes in
contact. In non-pigmented membranes the congestion is
more prominent.
The discharge when examined with the microscope shows
epithelial cells, leukocytes, bacteria and sometimes the eggs
of the parasite, Linguatula rhinaria.
Symptoms.— Sneezing and the presence of a thin, serous
discharge in the early stages, which later is mixed with mucus,
becomes dry and adheres around the nasal openings. The
nose is rubbed against objects and wiped with the paws.
Excoriations appear around the margins of nasal openings.
Diagnosis.— The presence of the above symptoms and the
absence of any general disturbance characterize simple
rhinitis.
Prognosis. Eavorable.— Recovery usually takes place in
about one to two weeks.
Treatment.— Hygienic.— The animal should be kept warm
and protected from draughts of cold air.
20 DISEASES OF THE NASAL PASSAGES
Medical.— Spray the nasal passages with a warm boric
acid (2 per cent.) or sodium bicarbonate (2 per cent.) solution.
Remove the dry discharge from the edge of the nasal openings.
Apply vaselin or zinc oxid ointment to those parts as protec-
tive agents.
EMPYEMA OF THE INFRAOEBITAL FOSS/E OF BIRDS.
Definition.— A collection of pus in the infraorbital fossae
which causes a distention of one or both of them.
Etiology.— This condition usually occurs during the course
of infectious nasal catarrh, diphtheria or parasites (monos-
toma). The mucous membrane becomes infected and the
purulent material collects in the fossse greatly distending
them.
Symptoms.— A warm painful swelling is noticed in the infra-
orbital region, which may affect one or both sides. The
enlargement, which is quite firm, protrudes over and closes
the eye.
Prognosis.— Depends upon the primary cause. When the
affection is confined to the fossae the prognosis is favorable.
Treatment.— Surgical.— An incision should be made over
the enlargement and the accumulated material which is
quite hard and firm removed with a curette. The cavity
should be washed with antiseptics.
INFECTIOUS NASAL CATARRH OF RABBITS.
Rabbit Plague. Rabbit Influenza. Rabbit Distemper.
Definition.— An infectious disease involving the mucous
membrane of the nasal passages, which later produces general
infection.
Etiology.— The exciting cause is a small, slender, immobile
bacillus, similar in size to the bacillus of cholera in birds. It
does not form spores and is Gram-negative. This organism
is also pathogenic to guinea-pigs and mice, but rabbits are
most susceptible. Infection takes place by inhalation during
cohabitation with affected animals, or by being taken in with
INFECTIOUS NASAL CATARRH OF RABBITS 21
the food. The organism produces a severe inflammation of
the mucosa of the nasal passages and sinuses, and later enters
the circulation producing general infection, causing elevation
of temperature and in most cases an inflammation of the
serous membranes. The infection is often carried directly to
the trachea, bronchial tubes and lungs, where it produces an
acute inflammatory condition.
Necropsy.— The nasal, oral and pharyngeal mucous mem-
branes .are intensively congested, swollen and covered with a
purulent exudate. In the lungs are often found evidences
of a bronchopneumonia. The thoracic cavity may contain
a serous or purulent exudate with fibrinous deposits on the
pleura. The peritoneum will also show inflammation with
some exudate in the abdominal cavity. The bacilli can be
found in large numbers in the exudate and in affected organs.
Symptoms.— The incubation period is from four to six
days. The first symptoms noticed are depression, a copious
discharge of serous secretion from both nasal openings and
severe sneezing. The temperature is usually from 104°-106°
F. and there is complete loss of appetite. This discharge
soon becomes thick and tenacious, adhering around the nasal
openings and on the hair of the chest and limbs, the animal
frequently rubbing its nose with its paws to relieve the intense
irritation. With the extension of the inflammation to the
larynx and bronchi, dyspnea and coughing result. Exhaus-
tion is soon noticed due to the general infection and anorexia.
Prognosis. — Very unfavorable in acute cases, death occur-
ring in three to five days. In subacute and chronic cases in
older animals the course is fifteen to thirty days. Complete
recovery, however, is rare; chronic nasal catarrh is a common
sequel.
Diagnosis.— The rapid development, high temperature,
absence of coccidia (see rhinitis coccidiosa), the acute inflam-
mation of the serous membranes and the finding of the specific
bacillus in the discharges confirm the diagnosis.
Treatment.— M edicaL— The nasal passages should be
sprayed with antiseptic solutions (boric acid 2 per cent, or
sodium bicarbonate 2 per cent.), the accumulated crusts
removed with warm water and a protective dressing of zinc
22 DISEASES OF THE NASAL PASSAGES
oxid ointment or vaselin applied. The use of internal anti-
septics (salol 0.12-0.2, etc.) is indicated to combat the
general infection. Autogenic vaccines may be used.
Prophylaxis.— All material soiled by the nasal discharges
as well as all animals that die should be burned and well
covered with lime; all parts of the hutch and the runways
thoroughly disinfected, and a quarantine of at least two
weeks imposed upon all newly acquired animals.
PARASITIC NASAL CATARRH OF RABBITS.
Rhinitis Coccidiosa.
Definition.— An inflammation of the mucous membrane
of the nasal passages and sinuses due to an infestation with
coccidia.
Etiology . —This condition is due to the Coccidia perforans
or the Coccidia oviformis, which gains entrance to the nasal
passages and sinuses. The discharges of affected animals
are infectious. Damp hutches with soiled litter and filth
in them favor the spread of the disease. Young animals are
more susceptible than those fully matured, the latter usually
contracting the disease in a mild form.
Symptoms.— The clinical symptoms are similar to those of
infectious nasal catarrh. The nasal discharge is present,
being serous at first, later becoming thick and tenacious.
After two or three days the animals become depressed, fre-
quently gnashing the teeth and rubbing the nose. The tem-
perature, however, is subnormal. In some cases the mucous
membranes of the mouth and the conjunctiva exhibit
catarrhal symptoms. In cases where the coccidia pass into
the middle ear, the semicircular canals become involved
causing the head to be carried to one side, staggering gait,
and( in some cases rolling over and over. Spasms of the
muscles occur followed by paralysis. Paralysis, however,
is a symptom of many irritating conditions in rabbits which
in other animals ordinarily cause excitement. Later a pro-
fuse diarrhea is noticed followed rapidly by exhaustion and
death.
CHRONIC NASAL CATARRH 23
Diagnosis.— Microscopic examination of the nasal dis-
charges reveals the presence of the coccidia. In otodectes
cynotis mange, catarrhal symptoms of the mucous mem-
brane are absent.
Prognosis. —Unfavorable.
Treatment.— The nasal passages, eyes and mouth are
cleansed with antiseptic solutions and astringents (boric acid
2 per cent., zinc sulphate 1 per cent., copper sulphate 1 per
cent., creolin 2 per cent.). Small doses of sulphur (0.1-0.2)
may be given every four to six hours to produce antiseptic
and laxative action.
Prevention.— (See Infectious Nasal Catarrh of Rabbits.)
CHRONIC NASAL CATARRH.
Chronic Coryza. Chronic Rhinitis.
Definition.— A chronic inflammatory condition of the
mucous membrane of the nasal passages with a mucopurulent
discharge.
Etiology.— Usually follows repeated attacks of acute nasal
catarrh; ordinary infection; tumors.
Pathology. — (a) In the productive or hypertrophic form
there is a generalized infiltration of the mucosa, particularly
that covering the lower portion of the turbinated bones,
which leads to a more or less extensive thickening of the
mucous membrane. The mucous glands increase in size,
there is a thick, viscid secretion, and the nasal passages
become obstructed by enlargement of the lower part of the
turbinated bones. The atrophic form follows the course of
the hypertrophic. The hyperplastic tissue atrophies, the
epithelium of the mucosa and the glands is destroyed, and
there is a collection of a yellowish, purulent material on the
surface of the mucous membrane. (6) The discharge from
the nasal passages contains bacteria, leukocytes, red cor-
puscles and epithelial cells.
Symptoms.— A purulent discharge varying in quantity
from both nasal passages. This discharge in severe cases is
streaked with blood and has a very offensive odor; it causes
24 DISEASES OF THE NASAL PASSAGES
excoriations on the mucous membrane and skin at the nasal
openings, where it drys and forms hard crusts. There are
frequent paroxysms of sneezing. In cases where the nasal
passages are occluded the animal breathes through its mouth.
In some cases where infection is severe general symptoms of
loss of appetite, dulness and emaciation will be noted.
Diagnosis. —The presence of the nasal discharge, the chronic
course and the mild general symptoms in severe cases.
Prognosis.— Not so favorable as acute nasal catarrh. It
requires several weeks for a complete disappearance of the
symptoms.
Treatment. — Hygienic. —The animal should be kept in a
warm place free from all irritating materials which might
affect the nasal mucous membrane.
Medical.— The nasal passages should be sprayed daily with
creolin (2 per cent.), boric acid (2 per cent.), or sodium bicar-
bonate (2 per cent.) solution; the dried crusts may be removed
with warm water, and zinc oxid ointment applied to the
membranes and skin at the nasal openings.
Sera-vaccine. — Cultures may be grown from the nasal dis-
charge, and a standardized autogenic vaccine made. Two
c.c. of this vaccine are injected subcutaneously every five to
seven days until the purulent discharge ceases.
EPISTAXIS.
Definition.— Hemorrhages from the nasal passages.
Etiology . — (a) Injuries to the nasal mucous membrane
from foreign bodies (straws, twigs, etc.); probing; injuries
to the turbinated bones due to fractures or trephining the
sinuses.
(6) Carbolic acid poisoning causing necrosis of the mem-
brane extending into the nasal passages which opens the
vessels.
(c) Specific and ordinary infections during the course of
distemper and chronic nasal catarrh.
(d) Parasitic invasion (Linguatula rhinaria). Hemorrhage
occurs during the course of the following disease conditions :
PARASITES OF THE NASAL PASSAGES 25
Hemophilia, plethora, leukemia, parasitic anemia and
catarrhal pneumonia.
Symptoms.— A unilateral or bilateral discharge of blood
from the nasal passages. When primary the blood is of a
bright red color and flows away a few drops at a time or the
flow may be copious, and sometimes sufficient to produce
general symptoms. When secondary to chronic nasal
catarrh or distemper it is mixed with the secretions.
As small animals lick the nose the amount of hemorrhage
is not easily determined.
Prognosis.— The prognosis depends on the character and
amount of the hemorrhage. Most cases terminate favorably.
Treatment.— Medical.— In mild cases when treatment is
necessary use injections of cold water (ice-water) or alum
solution (3 per cent.) into the nasal passages. In severe
cases when hemorrhage is copious and persistent use injec-
tions of adrenalin chlorid (1-1000) solution. Give internally
iron and quinin citrate (0.2-0.35) three times daily; or adre-
nalin chlorid (1-1000) ten to twenty drops, twice daily.
Surgical.— When the hemorrhage is continuous and cannot
be stopped by medical treatment, it will be necessary to use
a tampon made of gauze and saturated in an alum (3 per
cent.) or tannic acid (3 per cent.) solution. They should be
inserted with a small flexible probe firmly and carefully as
far up the nasal passages as possible. In some cases it will
be necessary to use the same kind of a tampon inserted in the
posterior part of the nasal passage. This is best accom-
plished by use of the mouth speculum and a flexible probe
bent in the shape of a hook. When a tampon is inserted a
free end should be exposed to facilitate removal. As small
animals breathe freely through the mouth tampons may be
inserted in both nasal passages.
PARASITES OF THE NASAL PASSAGES.
Definition.— Infestation of the nasal passages and chambers
by the Linguatula rhinaria.
Etiology.— History.— The infestation of the dog with this
parasite is rather rare in the United States. Only a few cases
26 DISEASES OF THE NASAL PASSAGES
have been recorded, but in other countries (France, Germany)
they are frequently found. The Linguatula rhinaria are
white, the body lanceolated, elongated, vermiform and flat-
tened above and below, the ventral surface nearly plane, the
dorsal surface rounded, anterior extremity broad and rounded,
posterior extremity attenuated. The thorax is short and
between it and the abdomen there is no distinct boundary.
The integuments show about ninety rings or segments, widest
in their middle, causing the margins of the parasite to be
distinctly crenated. The hooks are sharp, curved, and bi-
articulated. Each hook is retractile into a small sheath and
is moved by muscular cords arranged in different direc-
tions. The mouth is rounded, digestive tube rectilinear. Size:
Male, 18-20 mm. long, 3 mm. broad in front and 0.5 mm.
behind. Female, 8-10 cm. long, 8-10 mm. broad in front
and 2 mm. behind. The eggs are ovoid, 90 mmm. long and
70 mmm. broad.
The life cycle of the Linguatula rhinaria is as follows:
The female deposits her eggs in the nasal passages of the
dog; the eggs are expelled by sneezing and, being surrounded
by mucus, they adhere to grasses or whatever they happen
to come in contact with. The grasses are eaten by any of
the herbivorous animals. The shells of the eggs are dissolved
by the gastric juice and the embryos are set at liberty in the
intestinal tract. Each embryo is provided with a median
stylet and two curved hooks with which it penetrates
the walls of the intestines and reaches the peritoneum,
mesenteric glands, liver and the lungs where it becomes
encysted. During the period of encystment in the organs
and glands the embryo undergoes successive changes in its
development and becomes a larva (Linguatula denticulatum) .
When mature the larvae migrate by means of their hooks and
the sharp spiculse on their skin. Some of them pass into the
bronchi and trachea reaching the nasal passages where they
develop into the perfect parasite. Dogs become infested
by eating the viscera of animals containing the larval form
which passes from the stomach via the esophagus to the
nasal passages where it develops.
PARASITES OF THE NASAL PASSAGES 27
Necropsy.— In the early stages of the invasion of the Lin-
guatula rhinaria they attach themselves to the mucous
membrane of the nasal cavities producing an acute inflam-
mation. The exudate is increased in quantity and later is
mixed with pus covering the surface of the mucous membrane
which becomes greatly thickened especially around the
turbinated bones and in the nasal chambers. In the later
stages necrosis of the turbinated bones and nasal septum
may take place.
The discharge from the nasal passages often contains the
parasites, pus, epithelial cells and large numbers of the ovoid
eggs.
Symptoms.— In the early stages the symptoms are par-
oxysms of sneezing; obstruction of the nasal passages; a
discharge which is at first serous, later becomes mucopurulent,
mixed with blood, and has a very offensive odor. Accumula-
tions of the dried discharge form crusts at the nasal openings.
In animals of a nervous temperament symptoms of excite-
ment are noted from reflex irritation of the nasal passages.
Severe hemorrhage is seen from the necrosis opening blood-
vessels. '
Diagnosis.— The presence of the parasites or eggs in the
nasal discharge.
Prognosis.— Depends upon the number of parasites and the
probability of becoming reinfested.
Treatment.— Medical.— Inhalations of small amounts of
chloroform, turpentine, or some other volatile oils. Spray
the passages twice daily with creolin (2 per cent.), carbolic
acid (2 per cent.), or boric acid (2 per cent.) solution. Re-
move the crusts from around the nasal openings with warm
creolin solution and apply zinc oxid ointment to the excori-
ated membrane and skin. Give internally tincture mix vomica
(0.3-0.65) daily; iron and quinin citrate (0.2-0.4) daily.
Surgical.— Irrigation of the nasal passages with a warm
solution of creolin (2 per cent.). This can be done by using
a small, soft rubber tube inserted as high up in the nasal
passages as possible. Attach a funnel to the other end and
pour the solution slowly into it using only a small quantity
of the fluid. The nasal passages can also be irrigated through
28 DISEASES OF THE NASAL PASSAGES
the posterior nares by the use of a hard nozzle bent in the
form of a curved hook. Depress the head and allow the
fluid to flow out through the nasal passages.
NEOPLASMS OF THE NASAL PASSAGES.
Papillomata.— These are benign tumors having a frame-
work of fibrous tissue and bloodvessels covered by squamous
epithelium. The surface of the tumor is roughened by many
elevations and proliferations. Papillomata are most com-
monly located around the margins of the nasal openings and
especially at the juncture of the skin and mucous membrane.
Sometimes they extend a short distance up the nasal passages
and may extend to the skin of the lips and the nose. They
are found here in two forms : (a) A hard form which presents
smooth, rounded elevations on the skin. (6) A soft form,
which is pedunculated, has an irregular, broad surface and
cauliflower-like appearance. The soft tumors are found on
the mucous membrane. In size they vary from that of a
millet seed to a walnut. There may be a large number or
only a few present.
Treatment.— Surgical.— They are removed as follows:
The animal should be given an anesthetic (morphin subcu-
taneously, or ether inhalation). Sterilize curved scissors,
forceps and artery forceps; disinfect the surface of the skin,
mucous membrane and tumors with boric acid solution
(2 per cent.). Grasp the tumor with the forceps and cut off
with the scissors, and if the hemorrhage is persistent use the
artery forceps. Alum (2 per cent.) or silver nitrate solution
(0.25-0.5) may afterward be applied. The after-treatment
consists in washing the surface where the tumors are removed
with antiseptic solutions.
Polypoid Fibromata.— These occur as enlargements on the
mucous membrane of the nasal passages and frequently
interfere with breathing, producing complete obstruction of
one or both passages.
Treatment. —These are best removed with a fine wire snare.
Inject astringent solutions (alum 2 per cent.) up the nasal
passages to control the hemorrhage. When this method of
NEOPLASMS OF THE NASAL PASSAGES 29
removal fails it is best to trephine the superior wall of the
nasal passages and extirpate the tumor through the opening.
After-treatment consists of warm antiseptic solutions injected
daily up the passages.
Malignant Tumors.— Occasionally in the nasal passages
are found epitheliomas, osteosarcomas, and sarcomas which
are usually secondary to primary growths having their origin
in the buccal mucosa, maxillary bones or lips (epitheliomas) .
Symptoms.— Malignant growths give rise to distortions of
the nasal bones, lips and often result in necrosis of the parts
involved. The nasal discharge will contain necrotic material
and blood and has a very offensive odor.
Diagnosis. — To make an accurate diagnosis some of the
tumors should be obtained and examined microscopically.
Prognosis.— The prognosis is very unfavorable.
Treatment.— Owing to the location of the tumors, their
malignant character and the tissues involved, treatment is
not to be attempted.
CHAPTER II.
DISEASES OF THE LARYNX.
Examination.— (a) With the mouth speculum, laryngo-
scope and good light, the anterior portion of the larynx and
the surrounding tissues can be readily inspected provided the
tongue is drawn well forward.
(6) By examining some of the nasal discharge collected
with a dressing forceps carrying a pledget of cotton, its
character is decided.
(c) By palpation, enlargements, injuries and the degree
of sensitiveness may be determined.
Laryngitis.— Two forms of laryngitis are frequently
observed in small animals, viz: (a) Acute, and (6) chronic.
Acute Laryngitis.— Definition.— An acute catarrhal inflam-
mation of the mucous membrane of the larynx.
Etiology.— (a) Excessive use of the voice (barking). This
is often seen at dog shows; in hounds after hunting; in some
dogs when penned up or tied ; during the course of rabies and
the nervous form of distemper; excitement.
(6) Inhalations of dust, dirt, etc.; injuries (tight collars,
etc.). Inhalations of gases and smoke; irritating drugs and
chemicals.
(c) Exposure to cold.
(d) Infections (staphylococcus, etc.) and during the course
of infectious diseases (rabies, distemper, etc.).
(e) Extension of inflammation from adjacent parts.
Pathology.— (a) There is an acute inflammation of the
mucous membrane which, in the early stages, is covered by
a thin serous exudate which later becomes turbid from admix-
ture of leukocytes. From the irritation produced by cough-
ing small quantities of blood are often raised. When infection
is present the secretions are mucopurulent in character.
CHRONIC LARYNGITIS 31
(6) The discharge contains bacteria, leukocytes, red cor-
puscles and epithelial cells.
Symptoms.— Hoarseness, change of voice, frequent
attempts at deglutition, a harsh, dry cough which later
becomes softer and moist as the secretions are increased.
The mucous membranes are congested and swollen. Pressure
on the larynx, exercise, excitement or drinking cold water
induces coughing. General symptoms are rare.
Diagnosis.— The presence of the harsh, dry cough which is
aggravated by exercise and excitement and the absence of
general disturbance are characteristic of laryngitis.
Prognosis.— Favorable. Recovery usually follows in eight
to ten days, unless when secondary to rabies, distemper, etc.
Treatment.— Hygienic.— Keep warm; supply plenty of
fresh air.
Dietetic.— Give warm milk and warm liquid foods.
Medical.— Direct application of medicinal preparations to
the mucous membrane is unpracticable and of little value.
The following formula should be used to allay irritation and
stop the coughing :
1$ — Morphini hydrochlorati 0.1
Aquae amygdalae amarse
Misce et fiat solutio.
Sig. — Give teaspoonful three times daily.
Surgical.— Apply Priesnitz compress or hot antiphlogistin
pack over the larynx. Renew twice daily.
Chronic Laryngitis. — Definition. — A chronic catarrhal in-
flammation of the mucosa and submucosa of the larynx.
Etiology.— This is usually the result of frequent acute
attacks, and therefore the causes enumerated under acute
laryngitis are applicable to the chronic form. Chronic laryn-
gitis is often the result of the extension of chronic nasal and
pharyngeal catarrh; the presence of papillomata and poly-
poid fibromata within the larynx; as a sequel to distemper;
may be caused by pressure on the vagus nerve (enlarged
mediastinal lymph glands, sarcomas, carcinomas, etc.);
to direct irritation of the mucosa by malignant growths;
enlarged thyroids.
32 DISEASES OF THE LARYNX
Pathology.— Chronic catarrh leads to hyperemia of the
parts with hypertrophy of the mucosa and the submucosa,
together with fibrous tissue proliferation. Localized thick-
enings, either flat or wart-like, are often noticed. The sub-
mucosa is infiltrated with cells and the mucous glands are
swollen and distinct, producing a granular condition.
Symptoms.— The symptoms are somewhat similar to those
of acute laryngitis but not so severe and continue for a longer
time. The cough is hoarse, dry, seldom moist, and is aggra-
vated by exposure to cold, exercise or excitement. The
larynx is less sensitive than in the acute form when examined
by external manipulation. After severe attacks of coughing
the patients may show nausea and vomiting.
Diagnosis.— The chronic course, absence of general symp-
toms and the cough characterize the condition.
Prognosis.— Owing to the changes in the mucosa and the
submucosa, improvement is slow and complete recovery
seldom takes place.
Treatment.— Hygienic.— Keep warm; supply plenty of
fresh air.
Dietetic.— Give warm liquid foods (milk, soups, etc.).
Medical.— The following formulae may be used to stop the
coughing and allay the irritation :
H — Morphini sulphatis 0.1
Aquae amygdalae amarse 30.0
Misce et fiat solutio.
Sig. — Give teaspoonful three times daily.
1^ — Potassi bromidi 10.0
Morphini sulphatis
Aquse distillata . 150.0
Misce et fiat solutio.
Sig. — Give teaspoonful three times daily.
For expectorant action may use the following:
1$ — Ammonii chloridi
Antimonii et potassi tartras
Extract, glycyrrhizae .
Aquse feniculae
Misce et fiat solutio.
Sig. — Give teaspoonful every eight to ten hours.
CHRONIC LARYNGITIS 33
or
3 — Apomorphin. hydrochloras 0.05
Acidi hydrochloric! 1.0
Aquse distillata 250.0
Misce et fiat solutio.
Sig. — Give teaspoonful twice daily.
Syrup of tar or syrup of wild cherry may be given in
teaspoonful doses twice daily.
Inhalations of medicinal preparations (turpentine, etc.)
and direct applications (silver nitrate 1, glycerin 130) may
be used in some of the more obstinate cases.
CHAPTER III.
DISEASES OF THE TRACHEA AND BRONCHIAL
TUBES.
Examination.— (a) By palpation, the upper part of the
trachea can be examined for enlargements, deformities of
the tracheal rings, constrictions and sensitiveness to pressure.
Often when inflammatory conditions are present, slight
pressure on the trachea will induce coughing, attempts at
swallowing and considerable uneasiness and pain.
(6) By auscultation, the condition of the mucous mem-
brane and the character of the secretions can be determined.
The tracheal and bronchial sounds are most distinct at the
entrance of the trachea to the thorax. A phonendoscope
held directly against the trachea at this point will greatly
assist in the examination.
ACUTE TRACHEITIS AND BRONCHITIS.
Definition.— These are acute inflammatory conditions
involving the mucous membrane of the trachea and the
bronchial tubes.
Etiology.— (a) Small particles of foreign bodies (dust, etc.)
enter the trachea and bronchial tubes producing excoriations
and congestion of the mucous membrane which allow infec-
tion to take place. If these substances are putrescent a fetid
bronchitis will be produced.
(6) Irritating gases (ammonia, etc.) and the fumes of
acids (carbolic, etc.) may excite an attack of bronchitis by
direct irritation to the mucous membrane. When inhaled
in concentrated form and in large quantities they will induce
inflammation extending into the smaller bronchioli producing
an acute capillary bronchitis. The excretion of toxic sub-
ACUTE TRACHEITIS AND BRONCHITIS 35
stances by the bronchial mucosa causes a rapid proliferation
of the surface and granular epithelium of the mucous mem-
brane and an increased secretion of mucus. The epithelium
of the mucous membrane becomes more embryonal in char-
acter and therefore less resistant to the invasion of micro-
organisms. At the same time these organisms, ordinarily
present, multiply more rapidly and increase in virulence, and
unless the process is arrested a bronchitis is soon established.
Some drugs (iodin, bromin, etc.) when administered in large
doses and continued for quite a time may be excreted in
sufficient quantities to produce an acute bronchitis.
(c) Inhalations of smoke containing various gases and
particles of foreign material will irritate the mucous mem-
brane of the entire respiratory tract, frequently resulting in
an active congestion and later in inflammation of the mucous
membrane which favors the growth and development of the
infection which is always present.
(d) Acute bronchitis develops frequently as a secondary
disease following specific infections (distemper, etc.). The
specific infection reduces the normal resistance of the mucous
membrane thus allowing the secondary infection (staphylo-
coccus, streptococcus) to develop rapidly and produce the
disease.
(e} Parasitic. In severe infestations of the Uncinaria
canina, the larval form of this parasite, in its migrations
through the body, often burrows along or through the walls
of the bronchi and trachea producing an inflammation of the
mucous membrane and the underlying tissues. (See Unci-
nariasis.)
(/) Tracheitis and acute bronchitis are often consecutive
to inflammations of the nasal passages, larynx and pharynx.
The infection is carried to the trachea and bronchi by inhala-
tion where it develops, producing the inflammation.
(g) Other diseases (renal affections, endocarditis, diabetes,
carcinomas and sarcoma, valvular insufficiency) produce a
disturbance of the heart action, enfeeblement of the vaso-
motor nerve and reduce the resistance of the mucous mem-
brane.
It is quite evident that acute tracheitis and bronchitis
36 DISEASES OF THE TRACHEA
in most cases develop from bacteria found normally on the
mucous membrane.
Pathology . —The pathological changes that are liable to
be found in acute tracheitis and bronchitis are somewhat
diverse, the details of the process being considerably modified
by the anatomical peculiarities of the parts affected and the
different causes that affect them. The inflammation may
be restricted to the bronchial structure but is frequently
associated with other and more serious disturbances. The
condition is usually bilateral, although certain parts are
affected more than others. Tracheitis and bronchitis are
often associated with laryngitis, peribronchitis and broncho-
pneumonia.
Symptoms.— Coug h.— This is the most important symptom
and is never absent, although it may be slight or very severe
and loud, occurring as isolated coughs succeeding each other
with greater or less frequency, or in paroxysms which often
end in nausea or vomiting. The cough is dry and harsh in
the early stages, later becoming moist as the inflamed mucous
membranes produce an increased secretion. Paroxysms of
coughing are often induced by excitement (visits of the owner,
etc.), exposure to cold, moist air, pressure over the lower part
of the trachea or by percussion over the sides of the chest.
The object of the cough is to expel the accumulated discharge
from the air passages.
Discharge,— This is always present except in the early
stages; it is mucous at first, becoming mucopurulent or puru-
lent as the disease progresses. In small animals the discharge
is expelled from the trachea and bronchi directly into the
mouth and swallowed. Therefore it is impossible to deter-
mine the amount and character, and it becomes necessary
to observe the animal while coughing to ascertain the condi-
tion of the discharge.
Dyspnea.— The degree of dyspnea depends on the obstruc-
tion of the free movement of air through the bronchial tubes.
In mild cases it may not be noticed but in other cases, in
which the calibre of the bronchi is materially decreased by
the swelling of the mucous membrane, it may be quite dis-
tressing.
ACUTE TRACHEITIS AND BRONCHITIS 37
General Symptoms.— Moderate temperature (rise of l°-2°),
pulse quickened, partial loss of appetite and increased thirst.
In severe cases, there is complete loss of appetite, high tem-
perature (104°-105°) and general depression. On percussion
nothing abnormal is noted, except in cases where the bron-
chioli are affected and filled with an exudate where there may
be local areas of dulness.
Auscultation.— In mild cases the vesicular sound is in-
creased. In well marked cases the respiratory sounds are
harsh with some lengthening of expiration. Absence of sound
may be found when obstruction of the bronchi or collapse
of lobules occurs. Sibilant and sonorous sounds are typical
signs which are due to the irregular narrowing of the calibre
of the large and small bronchi respectively. As the secretion
becomes more liquid, moist rales are produced in the tubes
due to the liquid being driven back and forth by the air
currents. The volume of the rale is in proportion to the size
of the tube in which it originates. Large, moist, bubbling
rales are produced in the large bronchi, and the small, moist
rales arise in the smaller tubes.
Diagnosis.— From the character of the cough, auscultation
and general symptoms one may readily detect the presence
of acute tracheitis and bronchitis. Careful examination of
the animal should be made, however, to determine if the
disease is primary or secondary.
Prognosis.— Favorable in most primary cases; when secon-
dary to other diseases the prognosis is not so favorable. In
primary cases, the course is usually eight to fourteen days;
in secondary it is much longer.
Treatment.— Hygienic.— The animal must be kept in a
warm place (70° F.) having good ventilation but direct
currents of cold air must not reach it.
Dietetic.— Light, soft or liquid foods should be used (milk,
extract of beef, soups or small amounts of raw or cooked
beef). In cases where the animal will not eat, it should be
given warm milk to which raw eggs .have been added.
Medical.— Tor the appetite use compound tincture of
gentian (0.8-2.0) or tincture of nux vomica (0.3-0.0 drops).
In the early stages while the cough is dry and harsh,
4 /I t? /I
38 DISEASES OF THE TRACHEA
expectorant formulae should be used to stimulate the secre-
tion of the mucous membrane, as
R — Ammonii chloridi 5.0
Extract, glycyrrhizae . 10.0
Aquae 150.0
Misce et fiat solutio.
Sig. — Give a teaspoonful three times a day.
or
J$— Apomorphini hydrochlorati 0 . 02
Acidi hydrochlorati 1 . 00
Aquae distillata 150.00
Misce et fiat solutio.
Sig. — Give a teaspoonful four times a day.
When severe cough is present, sedatives should be given
to reduce the irritation to the nerve endings in the mucous
membrane, in the following formula:
Ifc — Morphini sulphatis 0.2
Aquae amygdalae amarse 20.0
Aquae 150.0
Misce et fiat solutio.
Sig. — Give teaspoonful every three hours.
Counterirritants (oil of mustard and glycerin 1-20) may be
applied to the walls of the thorax to stimulate the enervation
and circulation in the trachea and bronchi.
Inhalations of antiseptics and stimulants (oil of turpen-
tine, oil of tar, creolin, etc.) may be used. These are best
administered by adding them to hot water and allowing the
animal to inhale the vapor.
In the treatment of this disease the predisposing causes
should be considered more than the infection as antiseptics
cannot be applied to produce thorough antiseptic action on
the mucous membrane.
BRONCHIAL CATARRH OF BIRDS.
Bronchitis.
Definition.— An acute or chronic inflammatory condition
of the mucous membrane of the bronchial tubes.
BRONCHIAL CATARRH OF BIRDS 39
Etiology.— This often occurs from the extension of inflam-
mation of the nasal passages, the larynx and trachea. Expos-
ure to dampness, cold draughts of air and to sudden and
extreme changes of temperature are predisposing causes.
Specific infections (infectious nasal catarrh, tuberculosis);
parasites (Syngamus trachealis) ; fungi (aspergillus) are all
exciting causes and may produce an extensive and severe
bronchitis.
Symptoms. —The birds become somewhat stupid, lose appe-
tite, show accelerated respirations and cough. Later the
symptoms grow more pronounced inducing severe dyspnea,
the mouth frequently held open to facilitate respiration.
Auscultation reveals a blowing or whistling sound in the
bronchi, which, later, as the secretions accumulate, is
bubbling or rattling.
Diagnosis.— This is made by the dyspnea, cough, stupidity
of the patient, and the course of the disease.
Prognosis.— Favorable unless due to specific infection or
parasites.
Treatment.— Hygienic.— Keep the birds in a warm place
which is well ventilated and free from cold draughts.
Dietetic.— Give soft and nutritious food (stale bread and
milk, oatmeal and milk, meat scraps) .
Medical.— Inhalations of vapors from boiling water con-
taining sodium bicarbonate (2 per cent.), creolin (2 per cent.)
or carbolic acid (3 per cent.).
To stimulate the bronchial secretions use the following:
1$ — Ammonii chloridi .........
Mellis ...........
Aquae feniculi .........
Misce et fiat solutio.
Sig. — Give teaspoonful three to four times daily.
As a laxative and antiseptic:
terebinthi nse • • ° 40
Oleiricini ........
Misce et fiat solutio.
Sig. — Give at once and repeat every four to six hours until a laxative
action is produced.
40 DISEASES OF THE TRACHEA
In treating a large number of birds encourage the appetite
with stomachic tonics (iron sulphate) in the food and drink-
ing water.
MYCOTIC PNEUMONIA.
Aspergillosis.
Definition.— A mycotic disease affecting primarily the
respiratory passages, often producing bronchitis and pneu-
monia.
Etiology.— The exciting causes are species of fungi belonging
to the genus Aspergillus. These fungi exist abundantly in
nature upon all kinds of grain especially during the warm,
moist weather. The spores are inhaled with dust or taken
with food and lodge on the mucous membrane where they
rapidly develop into the fungus, which causes the irritation.
The most common species in the domestic birds are the
Aspergillus fumigatus, A. nigrescens, A. glaucus and the
A. candidus.
Other species are rarely found in the respiratory tract of
birds. The predisposing factors are bronchitis, affections
of the lungs, delicate breeds of birds, or delicate and weak
individuals.
Pathology.— (a) On the mucous membrane of the trachea
and bronchi is found a thick membranous mass which bears
upon its surface a growth of the fungus. These masses are
at first soft but become firmer with age and are yellowish or
greenish in color, with some resemblance to a fibrinopurulent
exudate. They adhere firmly to the mucous membrane
which is thickened and congested. These growths may
obstruct the air cells and the smaller bronchi, often being
found as caseous or even calcareous nodules, somewhat
resembling tuberculosis. The nodules vary in size from
that of a pinhead to a pea and may involve the greater part
of the lung tissue. Nodules may also be found in the liver,
intestines, the mesenteric glands or other organs. In very
acute cases the lungs may show simply an acute inflammation
with secondary conditions in other organs. •
MYCOTIC PNEUMONIA 41
(6) Microscopic examination reveals the spores or fila-
ments of the fungus in most of the lesions, either acute or
chronic.
Symptoms. — In the very early stages no symptoms are
noted, and it is only after the disease has progressed suffici-
ently to cause obstruction or irritation to the tissues that
symptoms are manifested. The affected birds become weak
and depressed, do not follow the flock; the plumage is rough.
Respirations are accelerated and during expiration are accom-
panied by a rattling or snoring sound. The mouth is held
open to facilitate breathing. The temperature is elevated,
the appetite diminished and thirst increased. There is often
a greenish-yellow discharge from the nasal passages. The
birds soon become emaciated, a severe diarrhea develops, and
death results from exhaustion.
Diagnosis.— Made by finding the spores or fungi by a
microscopical examination of scrapings taken from the
affected parts.
Prognosis.— Very unfavorable.
Treatment.— Hygienic.— Keep the affected birds in a warm,
well ventilated place.
Dietetic.— Feed concentrated nutritious food.
Medical.— Treatment is unsatisfactory in well established
cases. Inhalations of antiseptics as tar or turpentine are
indicated. These substances may be volatilized with boiling
water or the tar by placing it on a hot surface. The affected
birds are allowed to inhale the fumes for a half hour every
day. Potassium iodid (.05-0.1 per bird daily) is also indi-
cated; sulphate of iron (4.0 to 1000.0) may be used in the
drinking water.
Prevention.— The healthy birds should be separated from
the sick ones and the premises disinfected (lime or carbolic
acid 5 per cent.). The straw and grain should be cleaned
before given to the birds, as dust is the common carrier of
the fungus. Successful disinfection cannot be attained as
the spores occur widely distributed in nature. Cleaning
of the straw and grain as suggested assists in eliminating the
fungus.
42 DISEASES OF THE TRACHEA
ANIMAL PARASITES IN THE TRACHEA AND BRONCHIAL
TUBES.
Syngamosis. Gapes in Chickens.
Definition.— This is a condition due to the Syngarnus
trachealis found most commonly in the trachea and bronchi
of birds.
Etiology.— The only cause is the parasite Syngamus
trachealis, genus Syngamus. This is a small, round worm,
red in color, and the male is about 5 mm. long and the female
5 to 20 mm. A remarkable feature of these worms is per-
manent copulation, which is so intimate that the males
cannot be separated from the females without tearing their
integuments. This arrangement gives the worms a forked
or Y appearance.
They attach themselves to the mucous membrane of the
trachea and larger bronchi and suck the blood. By so doing
they produce considerable irritation. The ova of the syn-
gamus are not laid but pass from the body of the female
which suffers rupture and usually occurs after death.
These ova are hatched in from one to six weeks according to
the temperature on damp ground or in water. The embryo
does not need an intermediate host in order to become trans-
formed into an adult worm. Birds ingest the embryos along
with food or water or the adult worm coughed up by an
affected bird may be swallowed; earth worms in infested
yards frequently have embryos in their intestinal tract and
when these are swallowed the embryos are liberated. They
then burrow out through the walls of the esophagus and
stomach and migrate through the tissues or possibly ma the
blood stream until they reach the lungs and trachea. It has
been shown that fully developed parasites can be found in
the trachea twelve (lays after feeding the ova to healthy
birds.
Symptoms.— This disease is seen most frequently in young
birds of from one to four weeks old, and is especially common
in chicks. They have a whistling cough, and the most
seriously affected open the beak at the same time stretching
ANIMAL PARASITES IN THE TRACHEA 43
the neck by a peculiar movement (gaping) in order to facili-
tate inspiration. The general signs are loss of appetite,
dulness, wings pendant and all evidence of cachexia. Death
results from exhaustion or asphyxiation.
Diagnosis.— The peculiar gaping movement at each inspira-
tion, sneezing, and distressed breathing as from obstruction
in the trachea. Finding the worms in the trachea or eggs in
the discharge from the mouth is conclusive.
Prognosis.— Unfavorable, but depends upon the number
of parasites present in the trachea. A spontaneous recovery
is rare, especially in young birds.
Treatment.— All of the young birds should be treated as
soon as the disease is noticed. As much garlic as they can
be made to eat when chopped fine and mixed with other food,
or powdered asafetida (0.25 per head daily) may be used.
The volatile part of the garlic or the asafetida is eliminated
with the expired air and acts as a toxicant to the parasites
in the trachea. Individuals may be treated by intratracheal
injections of sodium salicylate (5 per cent.) using 1 c.c. per
bird and injected with a medicine dropper directly into the
trachea. This loosens the worms and they can be coughed
out. In cases of imminent asphyxia the worms may be with-
drawn by the aid of a feather, having the barbules all removed
except at the end. Or a horsehair folded and twisted so as to
form a small loop may be used. It is introduced into the
trachea through the open mouth and turned round and
round, the object being to loosen the worms. They may be
then withdrawn with the feather or coughed out. This
method of ridding the chick of the parasite is dangerous and
insufficient, and can remove only those parasites which are
slightly attached and in the upper part of the trachea.
Prevention.— Separate the sick birds from the healthy and
clean up all coops, pens and runways, drinking troughs, etc.
and disinfect with carbolic acid (5 per cent.) . Lime sprinkled
freely throughout the house and in the coops will aid in
keeping them clean. Burn all dead birds and provide clean
water and food.
44 DISEASES OF THE TRACHEA
CHRONIC TRACHEITIS AND BRONCHITIS.
Definition.— This is a chronic inflammation of the mucous
membrane of the trachea and bronchial tubes.
Etiology.— Chronic tracheitis and bronchitis may occur
independently or secondary to some other disease. It may
originate from any of the causes of acute tracheitis and
bronchitis, especially when their action is persistent or fre-
quently repeated. The common causes are:
(a) Continued inhalation of irritating dust, dirt, etc.
(6) Exposure to cold, damp air (as keeping animals in
cold, damp basements having poor ventilation).
(c) Parasitic. In severe infestations with Ankylostoma
canina, when the animal is being constantly reinfested, the
passage of the larvae through the tracheal and bronchial
structure produces a chronic irritation. (See Uncinariasis.)
Chronic tracheitis and bronchitis often result from the
gradual extension of the inflammatory process from the
other parts (laryngitis, pharyngitis, etc.). Many cases are
secondary to special diseases such as distemper, carcinoma,
sarcoma, rachitis and acute valvular insufficiency.
Pathology.— Chronic tracheitis and bronchitis are practi-
cally always purulent, and while in most particulars it
closely resembles the acute form, it differs from it in the
presence of a more deeply penetrating inflammation and in
the production of fibrous tissue. The mucous membrane
is swollen, reddened, infiltrated, and covered with purulent
secretion. The walls of the bronchi are hypertrophic. Not
infrequently the mucosa is thrown into little polypoid excres-
cences, due partly to contraction and partly to fibrous prolif-
eration. The walls of the bronchi become thickened and
there is often a fibrous peribronchitis, which in time may
lead to induration of the lungs.
Symptoms. —This condition is most common in old animals
where it frequently interferes with respiration producing
so-called asthma. . The most prominent symptom of this dis-
ease is the cough. It is usually moist, varying in intensity,
depending upon the amount of secretion and extent of mucous
membrane involved. Excitement frequently produces par-
CHRONIC TRACHEITIS AND BRONCHITIS 45
oxysms of coughing which are often attended by severe
nausea and vomiting. In cases secondary to other diseases
the cough is modified becoming short, isolated and more
spasmodic. This is particularly so in chronic bronchitis due
to the parasite, Uncinaria canina, and to valvular insuf-
ficiency of the heart. The discharge is mucopurulent in
character, and is usually swallowed, but during paroxysms
of coughing some of it mixed with mucus will be expelled
from the mouth. In severe cases when the discharge is
decomposed by putrefaction organisms there is a very offen-
sive odor given off with the exhaled air.
Dyspnea. — This is always present to some extent; in old
animals it is well marked. The dyspnea results from the
emphysema and interstitial pulmonary fibrosis which always
develops, and, when secretion is present in large amounts,
the dyspnea is increased accordingly, producing asthmatic
conditions. On auscultation there are sibilant or there may
be moist rales, depending on the condition of the membranes
and the character and quantity of the secretion. Vesicular
sounds are increased. Percussion usually gives negative
results, and only in the more severe cases are the general
symptoms of emaciation, loss of appetite, etc., noted.
Diagnosis.— The long continued course of the disease, the
age of the animal, the absence of general symptoms in most
cases and the characteristic cough are indicative.
Prognosis. — In most cases of chronic tracheitis and bron-
chitis the prognosis should be considered unfavorable as
complete recovery seldom takes place. During the warm,
dry months the symptoms often subside only to reappear
with the return of the cold, damp weather.
Treatment.— Symptomatic treatment can be used to alle-
viate the cough and to modify the secretions. The following
formula? may be used:
T$ — Apomorphinse hydrochlorati ....
Syrupus pruni virginianse
Syrupus picis liquidaj
Misce et fiat solutio.
Sig. — Give tcaspoonful three times daily.
1$ — Acidi henzoici
Sacchari albse
Misce et fiat pulvis No. XX.
Sig. — Give a powder morning and evening.
46 DISEASES OF THE TRACHEA
In general debilitated conditions tonics and alteratives
should be used as in the following formula:
1$ — Ferri et quinini citratis 10.0
Syrupi 90.0
Misce et fiat solutio.
Sig. — Give teaspoonful once daily.
or
!$ — Tincture nuces vomicse 7.0
Tincture gentianise 10.0
Aquae 60.0
Misce et fiat solutio.
Sig. — Give teaspoonful once daily.
Daily inhalations of medicated vapors (turpentine, creolin,
etc.) are valuable to stimulate the secretions and assist in
their removal.
CHAPTER IV.
DISEASES OF THE LUNGS.
Examination. — The following things are essential for a
complete and thorough examination:
1 . The number and character of the respiratory movements.
2. The size, shape and sensitiveness of the thorax.
3. Auscultation.
4. Percussion.
1. Respiration. — In small animals the number of respira-
tory movements normally varies greatly. The average
number while at rest is 12-24. This is easily and quickly
increased by excitement and exercise until they may reach
60-90 per minute. During warm weather even while at rest
the respirations are greatly accelerated, owing to the skin
glands not being active enough to assist in the respiratory
function. In order to overcome this physiological condi-
tion the animal breathes forcibly through the mouth, and the
frequency of respirations is increased. Respiratory move-
ments are also increased in the following diseased conditions:
Catarrhal pneumonia, foreign body pneumonia, chronic
interstitial pneumonia, usually when the temperature is
elevated, in laryngitis, acute and chronic bronchitis, hydro-
thorax, pleurodynia, ascites, peritonitis, valvular insuffi-
ciencies, eclampsia and during the early stages of some poi-
sonings. A lessening in the number of respirations is found
in narcotic poisoning, diseases of the brain and its membranes
and in the later stages of infectious diseases, septicemia and
pyemia.
2. The Thorax.— In shape both sides of the chest wall
should be symmetrical. Depression on one side indicates
fractured ribs or pleurodynia. Distention of the thorax is
seen in hydrothorax, and in fluid accumulations (ascites),
tumors or when the stomach is distended, causing pressure
against the diaphragm.
3. Auscultation is practised by using the phonendoscope
or by covering the thoracic wall with a piece of cloth against
48 DISEASES OF THE LUNGS
which the ear is placed. With the phonendoscope the sounds
are made more audible and distinct.
The normal sounds of the lungs are: (a) The vesicular;
(6) bronchial, and (c) the expiratory, (a) The vesicular sound
normally is a soft, regular, blowing sound caused by the air
passing into the alveoli and distending them. It is most dis-
tinct in emaciated animals and where the lung tissue is in close
contact with the thoracic walls. It is normally increased by
excitement or exercise and is always more distinct in puppies
than in older dogs. The vesicular sound is modified in the
following pathological conditions: Increased in dyspnea in
the healthy portion of the lung, in tracheitis and in bronchitis;
decreased in stenosis of the upper air passages; in certain
stages of catarrhal pneumonia; emphysema of the lungs;
hydrothorax; swelling and thickening of the skin and muscles
of the thorax and in certain poisonings.
(6) Bronchial respiratory sounds are best recognized by
placing the phonendoscope directly over the trachea at its
entrance to the chest. These sounds are normal in the larynx
and trachea, but their appearance in the thorax is significant
of disease. Bronchial respiratory sounds are increased by
secretions in the smaller bronchi, as in catarrhal pneumonia;
compression of the lungs by pleuritic exudate; laryngitis,
tracheitis and bronchitis.
Irregular bronchial sounds are caused by the secretions
being carried to and fro by the passage of the air. They are
dry (wheezing) where there is a small quantity of mucus
adherent to the mucous membrane. These sounds (wheezing)
occur mostly in the smaller bronchi, while the moist, bubbling
rales (sonorous) emanate from the larger bronchi where they
are produced by the collection of secretions. Cavities in the
lungs also produce them. Bronchial sounds are important
in determining the existence, extent and character of trache-
itis and bronchitis. When sibilant (wheezing) sounds are
prominent it indicates that the infection extends into the
bronchioli.
(c) Expiratory sounds are produced by the rapid expulsion
of air from the lungs, and in normal conditions are hardly
perceptible, except in puppies. This sound is increased by
CONGESTION OF THE LUNGS 49
excitement, exercise, etc. In some diseases it is varied in
tone, becoming louder and more prolonged.
4. Percussion.— This is performed by the use of the per-
cussion hammer and pleximeter or by one hand placed
against the chest wall and tapped with the fingers of the
other hand. The normal sounds of a healthy lung are heard
all over the thorax, the volume of sound depending on the
thickness of the lung at the particular part being examined.
The normal sound is clear, loud and resonant as distinguished
from the tympanitic, dull or solid sound of disease. Tym-
panitic sounds are heard in the following conditions: (a)
Emphysema, (6) pneumothorax, (c) cavities in the lungs,
(d) in collapse of the pulmonary tissue from a retraction of
the lungs in the presence of pleuritic exudates. The col-
lapsed lung floats upon the surface of the fluid above the line
of dulness and on percussion emits a tympanitic sound, (e)
In the first and last stages of pneumonias. Dull or flat
sounds are heard over hepatized areas of the lungs, chronic
interstitial pneumonia; tumors in the lungs, and hydro-
thorax.
CONGESTION OF THE LUNGS.
Hyperemia of the Lungs.
Definition. —An excessive or abnormal accumulation of
blood in the lungs. Hyperemia may be either active or
passive.
Active Congestion.— Etiology.— It is found in the early
stages of all inflammatory conditions of the lungs and pleura.
Occasionally it may be due to inhalations of irritating gases,
smoke, acid fumes, etc., or may result from cold.
Pathology.— The lungs are dark red in color; on cross-
section blood escapes from the cut surface. The tissue will
float in water.
Symptoms.— Active congestion of the lungs is characterized
by its sudden onset, beginning as a rule with a chill and
rapidly developing dyspnea accompanied by a short, dry
cough and a rapid, full pulse. The animal often assumes a
sitting posture with elbows held outwardly, ribs elevated
4
50 DISEASES OF THE LUNGS
and cheeks inflated at each expiration. The temperature
may rise to 103°-104° F., possibly higher, but it does not
persist, falling by crisis in three or four days. Owing to the
aeration of the lungs being diminished the visible mucous
membranes become cyanotic. On auscultation the respira-
tory sounds will be increased, harsh and rough, and rales of
various kinds may be heard. At the base of the lung fine
crepitant or subcrepitant rales may be distinctly audible,
while over other parts sibilant or sonorous rales may be heard.
Percussion reveals only slight dulness.
Diagnosis.— Active congestion of the lungs in the beginning
possesses no distinctive characteristics, but resembles broncho-
pneumonia. As it progresses it will be readily distinguished
from this condition by the absence of hepatization and the
occurrence of the crisis on the fourth or fifth day.
Prognosis.— Usually favorable but in some cases pulmonary
edema with fatal results, or pneumonia may develop. The
affection is always to be looked upon as serious and one
demanding active treatment.
Treatment.— Hygienic.— The animal must be kept in a warm
place and it is important that it be well ventilated.
Dietetic.— Give warm liquid foods (milk, beef tea, soups,
etc.).
Medical.— Magnesium sulphate (8.0-10.0 in cold water)
should be used as a hydragogue purgative. To equalize the
circulation tincture of aconite (0.01-0.1) or veratrum viride
(0.1-0.2) is beneficial and can be given every three to five
hours if necessary. Oil of mustard and glycerin (1-20) can
be applied to the walls of the thorax as a counterirritant.
When the initial intensity of the symptoms yields, then a
stimulating expectorant as ammonium chlorid should be used
as follows:
I^ — Ammonii chloridi 5.0
Extract, glycyrrhizae 10.0
Aquae 150.0
Misce et fiat solutio.
Sig. — Give a teaspoonful three times a day.
Passive Congestion.— Etiology.— This results from obstruc-
tion to the free outflow of the blood from the lungs to the
CONGESTION OF THE LUNGS 51
heart. It is nearly always due to the lack of force or faulty
action of the heart, as stenosis or insufficiency of the mitral
valve, dilation of the right ventricle, or fatty degeneration.
It may also be caused by pressure on the pulmonary veins
by tumors, etc. In the latter stages of long continued dis-
eases or in any febrile condition when the heart action is
slowed, the blood gravitates to the lower part of the lung
producing a hypostatic congestion.
Pathology. —The lung is somewhat enlarged, its consistency
increased, of a dark red color, and on section venous blood
escapes. When the condition has persisted for a long time,
the lung becomes brown, dense and firm, due to a deposit
of blood pigment and a proliferation of fibrous tissue in the
septa of the lung, a condition known as brown induration.
Symptoms.— Dyspnea and a short, hard and usually dry
cough which has a tendency to become worse with exercise
or excitement. The bronchial discharge varies in amount
and in some cases may contain blood. Auscultation reveals
rales. On percussion only slight dulness may be noted.
The membranes are cyanotic.
Diagnosis. —The dyspnea, cyanosis, characteristic cough
and shallow respirations without rise- of temperature are
indicative.
Prognosis.— Unfavorable, depending upon the cause and
extent.
Treatment.— In the treatment of passive congestion of the
lungs, medicinal agents directed against the causative cardiac
affection are the ones which will most favorably influence
the pulmonary condition. As a heart stimulant the following
formula gives good results:
R — Extract! digitalis fluidi 1.0
Syrupus pruni virginianse 60.0
Misce et fiat solutio.
Sig. — Give one teaspoonful once a day.
In addition to this formula strychnin sulphate (0.001
daily) may be used as a general stimulant. To relieve the
cough when severe use:
1$ — Morphini sulphatis .
Aquae amygdalae amarse .
Misce et fiat solutio.
Sig. — Give a teaspoonful twice daily.
52 DISEASES OF THE LUNGS
If the animal's condition will permit the use of a hydra-
gogue purgative, magnesium sulphate (8.0-10.0) is useful to
modify the circulation and remove fluid from it. This dose
may be repeated in twelve hours if sufficient action has not
taken place.
PULMONARY EDEMA.
Edema of the Lungs.
Definition.— An effusion of serous fluid into the alveoli and
interstitial tissue of the lungs.
Etiology.— Diseases of the heart (valvular insufficiency,
etc.) are the most frequent predisposing causes of pulmonary
edema, although it occurs as a secondary condition to chronic
pulmonary congestion, nephritis, cachexia, anemia and infec-
tious diseases (distemper, etc.). In the latter stages of dis-
temper pulmonary edema frequently develops when it is
often the immediate cause of death. Edema of the lungs
occasionally follows the administration of drugs (pilocarpin,
etc.) .
Pathology.— The lung is heavier and firmer than normal,
pale in color and pits on pressure. When incised a thin
serous fluid escapes. This may be clear or if there is conges-
tion present it may be stained with blood. Crepitation is
always lessened and small patches may be entirely airless.
The bronchi contain a frothy fluid.
Symptoms.— The symptoms develop rapidly except in
those cases occurring as the terminal event in exhaustive
diseases in which the course is more gradual and the symp-
toms less pronounced. Severe dyspnea, which becomes
worse as the exudate accumulates is an important symptom.
The pulse is weak and small, the visible mucous membranes
are cyanotic and the extremities cold. A short, feeble cough
often accompanies the condition. The temperature is sub-
normal. There may be a frothy nasal discharge. Upon
auscultation various kinds of rales (fine, course or bubbling)
will be heard. Percussion reveals diminished normal reso-
nance with occasional small areas of tympany, especially over
the posterior part of the lungs.
BRONCHOPNEUMONIA 53
Diagnosis.— The sudden onset, severe dyspnea and the
absence of temperature, accompanied by moist, bubbling
rales on auscultation are indicative.
Prognosis.— Always unfavorable, depending upon the cause.
Recovery may occur in mild acute cases.
Treatment.— Treatment must be directed first to relieve
the edema which threatens the life of the animal, and sec-
ondarily to overcome the cause. For the first purpose use
counterirritation to the walls of the thorax, oil of mustard
and glycerin (1-20) or Priesnitz compress (applied hot) ; also
strychnin sulphate (0.001 subcutaneously) as a heart stimu-
lant. Subcutaneous injections of ether (0.8), or camphor
(0.1) in ether (0.8) are often useful as prompt stimulants.
Atropin (0.002) is of value as a heart stimulant and is espe-
cially useful in cases of edema due to pilocarpin, being a
physiological antidote.
In the treatment for the removal of the cause digitalis
fluidextract (0.1) is most valuable to regulate the heart
action. Hydragogue purgation (magnesium sulphate 8.0-
12.0) will remove fluid from the blood which tends to reduce
the exudation of serum into the lungs; also the use of a diuretic
(oil of juniper 0.3-0.5) for the same purpose in cases of renal
disease.
BRONCHOPNEUMONIA .
Catarrhal Pneumonia.
Definition.— This is an affection of the lungs in which the
usual sequence of events is, that an inflammation of the
smaller bronchioles in scattered areas is succeeded by the
involvement of anatomically related or contiguous vesicles.
Etiology. — (a) The inhalation of foreign material in the
form of small particles of dirt, dust, etc., which irritates the
mucous membrane and modifies the secretions, favors the
development of infection and leads to inflammation of the
bronchioli and alveoli.
(b) Irritating chemicals and gases when inhaled produce
an active congestion and inflammation of the lungs. How-
ever, in most cases when inhaled in large quantities they act
54
as irritants to the mucous membrane and thus favor the
development of infection which leads to hronchopneumonia.
(c) Cold, damp, changeable weather is a very important
predisposing factor inasmuch as chilling the surface of the
animal's body modifies the circulation and the secretions of
the mucous membrane, reducing its resistance, as well as the
general resistance of the body. This favors the growth of
infection which may be already present. The effect of cold,
damp weather is well shown by the greater incidence of the
disease in the winter and spring months. Young puppies,
especially, are quite frequently affected with bronchopneu-
monia when kept in cold, damp and poorly ventilated kennels.
(d) Bronchopneumonia is frequently secondary to specific
infections (distemper, etc.) which reduces the general as well
as the local resistance.
(e) Inflammation of other parts of the respiratory system
may produce bronchopneumonia by an extension of the
inflammation. This is especially true of acute bronchitis
which by extension at first produces a capillary bronchitis
and later a bronchopneumonia.
(/) During the course of some diseases (nephritis, endo-
carditis, diabetes, valvular insufficiencies, sarcomas and
carcinomas), the heart action is disturbed, the vasomotor
nerve is enfeebled, both of which reduce the resistance to
infection. Young puppies infested with parasites, which
interfere with the general nutrition, frequently develop
bronchopneumonia from the reduced resistance to infection.
(gr) Infectious material from the mouth and the nasal
passages which reach the bronchial tubes and alveoli will
produce a bronchopneumonia.
Possibly in no other disease do lessened powers of resist-
ance of the animal, from whatever cause, play such an impor-
tant part in determining the inception.
Pathology.— The process in bronchopneumonia is associated
with bronchitis, and indeed almost always starts with an
inflammation of the smaller bronchioles, which then spreads
to the adjacent alveoli. The exudate is at first serous and
contains a few erythrocytes, but more numerous white cells.
There is also a large number of mononuclear cells with clear
BRONCHOPNEUMONIA 55
protoplasm, which are swollen desquamated epithelial cells
from the alveolar walls. The disease usually affects both
lungs, but may involve only one or even a single lobe or a
portion thereof. The affected organ is heavier than normal,
somewhat congested, and in its substance can be felt areas
of increased consistence. These are friable, of a reddish-
gray, gray or grayish-yellow color, contrasting somewhat
with the rest of the lung.
On pressure a turbid fluid can be expressed, in which can
be seen small particles of a gray, grayish-yellow, or purulent
appearance. From the sporadic distribution of the consoli-
dated areas, the term " splenization" has been given to the
condition. On section of the lung, both red and gray stages
are recognized. The smaller bronchi and bronchioli show
inflammation and are filled with exudate. In the alveolar
spaces the exudate consists mainly of serum, a few red cells,
abundant leukocytes and desquamated cells. The latter fre-
quently contain pigment and bacteria. In the form due to
inhalation of infective material, or foreign bodies, the exudate
is usually purulent. Such a condition leads to a diffuse puru-
lent infiltration of the lungs and abscess formation. Occa-
sionally gangrene of some of the lung tissue will be noted.
This is especially true in weak and debilitated animals with
general circulatory disturbance.
Symptoms.— The symptoms of primary bronchopneumonia
develop rapidly, usually beginning with a chill and the animal
appears depressed and restless. The temperature is high
(104°-105° F.) and falls by crisis. Dyspnea is pronounced,
the respirations being short, shallow and very rapid, inflating
the cheeks at each expiration. A short painful cough is
noticed and the pulse is accelerated (180-200). On auscul-
tation the sounds are mostly those of an acute bronchitis
(impairment of the vesicular murmur, moist sibilant or
sonorous rales). On percussion dulness is noted where there
is a large area of consolidation, while in cases where the con-
solidated areas are scattered compensatory emphysema may
overcome the dulness. In the secondary forms following
other diseases (bronchitis, distemper, etc.) the onset is less
severe and the symptoms less pronounced. The cough and
56 DISEASES OF THE LUNGS
high temperature may be absent, but if temperature be
present it falls by lysis. Dyspnea is usually seen indicating
a lack of aeration of the lungs. In the course of this secon-
dary bronchopneumonia the symptoms are not well marked
and depend largely upon the primary disease.
Diagnosis.— This is made in the primary form by the sudden
onset with severe dyspnea, cough and high temperature,
while in the secondary form the symptoms, not being char-
acteristic, the diagnosis is more difficult, depending mostly
upon the dyspnea with its attending conditions.
Prognosis.— Unfavorable. In the primary form the prog-
nosis is determined by the extent of the inflammatory process
in the lungs, while in the secondary form it depends upon the
causative disease, and as this is usually distemper the mor-
tality is high.
Treatment. — Hygienic.— The animal should be kept in a
warm, well ventilated room free from cold draughts.
Dietetic.— The animal's strength should be sustained by the
use of appetizing foods (milk, beef extract, etc.) given warm
in small quantities every few hours. During convalescence
small amounts of lean meat or other nutritious food may be
given 3 or 4 times a day.
Medical.— At the onset a purgative should be given
(calomel 0.03 and sodium bicarbonate 0.5) to produce free
purgation and stimulate the activity of the kidneys. Expec-
torants are useful to modify and aid in expelling the discharge
from the bronchial tubes.
1$ — Ammonii chloridi 10.0
Extract, glycyrrhizse 20.0
Aquse 150.0
Misce ct fiat solutio.
Sig. — Give teaspoonful four times daily.
Counterirritants to the walls of the thorax in the form
of oil of mustard and glycerin (1-20) or Priesnitz compress
applied hot around the chest. The heart action should be
stimulated in severe cases by the use of digitalis fluid-extract
(0.08-0.1) and for general stimulation use strychnin (0.001).
Inhalations of medicated vapors (turpentine, oil of tar,
creolin in hot water) are useful to stimulate the mucous
membrane and to produce antiseptic action.
CIRRHOSIS OF THE LUNGS 57
CIRRHOSIS OF THE LUNGS.
Chronic Interstitial Pneumonia.
Definition.— A chronic inflammatory condition of the lungs
characterized by an increase in the interstitial tissue and
fibroid collections in the alveoli.
Etiology. — (a) Inhalation of particles of dust when con-
tinued for a long period produces h'brosis of the lungs, due
to the chronic irritation of the foreign material in the tissues.
The degree depends upon the amount and character of the
inhaled material.
(6) Pressure upon the lungs by neighboring structures, as
new growths and diverticula of the esophagus, tumors in
the lung substance, all of which produce a reactive inflamma-
tion resulting in increased connective tissue proliferation.
(c) One of the most frequent causes in small animals is
bronchopneumonia. When it terminates atypically fibroid
changes occur in some of the involved lobules. In these
cases the fibrosis begins as a chronic bronchitis or peri-
bronchitis, invading later the surrounding parenchyma of the
lung, which results in a great increase in the interstitial
tissue. This is a frequent sequel to bronchopneumonia
occurring during the course of infectious diseases (dis-
temper, etc.). For some unexplained reason resolution
does not occur, and the fibrinous exudate collected in the
alveoli during the stage of red hepatization is displaced by
fibrous tissue. The connective tissue formation necessarily
begins in the alveolar walls, as from this source must be
derived the new vessels which appear in the intra-alveolar
new formations. Proliferative changes in the alveolar epi-
thelium may for a time be active during this transformation
of the exudate, but eventually the new tissue within the
alveoli merges with the thickened, enclosing walls, which
take a relatively inactive part in the process, and the area
becomes entirely fibroid. Usually this lesion is only in parts
of the lobules, but in some cases may extend into a consider-
able portion of the lung tissue, involving the interstitial
connective tissue which is greatly increased in amount.
(d) Localized areas of interstitial pneumonia may originate
58 DISEASES OF THE LUNGS
from abscesses in the lungs, sarcomas and carcinomas, or
from inflammatory reactions from the pleura.
Pathology.— Cirrhosis is characterized by the overgrowth
of connective tissue in the lungs so that they become hard,
traversed by fibrous bands, and more or less shrunken. The
condition leads to destruction of the alveolar spaces, some-
times with bronchiectasis, and always to marked impair-
ment of function. When due to lobular pneumonia, which
is the common form of pneumonia in small animals, the
fibrous tissue production follows the course of the bronchi
and bronchioli. The lung is greatly increased in weight, has
lost its spongy condition, and is quite hard. On cut surface
it shows grayish-white color, and sometimes caseous nodules
of necrosis may be seen. In advanced cases the pleura is
thickened and the lungs distorted. The two layers of .the pleura
are often adherent and the mediastinum may be indurated.
Symptoms.— Moderate dyspnea and a chronic cough, with
a discharge which may be slight or profuse, and the exhaled
air has a fetid odor due to the retention of some of the dis-
charge in the bronchiectatic cavities. The temperature is
usually normal and no general symptoms are noticed.
Auscultation reveals increased resonance and bronchial
breathing. Percussion yields dulness except where there are
saccular dilatations of the bronchi.
Diagnosis.— The history of the case and slow development
following bronchopneumonia and the presence of severe
dyspnea will materially aid in making the diagnosis.
Prognosis.— Incurable.
Treatment.— Expectorants and general stimulants may be
used to modify the symptoms.
FOREIGN BODY PNEUMONIA.
Gangrene of the Lungs.
Definition.— An inflammation of the lungs due to the inhala-
tion of coarse material which usually results in necrosis of a
part or of the entire organ.
Etiology . — (a) Inhalation of foreign material (particles
of food from the mouth, especially during anesthesia when
vomition occurs, also when the pharynx and larynx are par-
FOREIGN BODY PNEUMONIA 59
alyzed) ; injury to the lungs from contusions, fractured ribs,
penetrating wounds through the thoracic walls or from the
esophagus and stomach (swallowed needles, sharp pieces of
bone, etc.).
(6) Inhalation of irritant medicinal substances when
improperly administered (by closing the nasal openings,
pulling the tongue forward or holding the mouth open too
wide; holding the head too high or in any position which
interferes with swallowing, manipulating the larynx or
pharynx).
(c) The causes enumerated above are to be considered as
predisposing factors, inasmuch as infection must be present to
complete the process. In addition to the ordinary infection,
which is normally present in the lungs, putrefactive organ-
isms are necessary to produce gangrene.
Pathology.— The involvement may be either diffuse or
circumscribed, usually the latter, and in the form of irregular
areas having a brown, greenish or black color. These are
dry and surrounded by a zone of congestion and around this
a zone of edema. The gangrene is of the moist variety and
gives off a very penetrating odor. Cavities may occur in the
lungs when the necrotic material is coughed out.
Symptoms.— Dyspnea is pronounced and the expired air
has a sweet, fetid odor. The temperature is elevated (104°-
106° F.) and the pulse is small, rapid and very irregular.
In the early stages the symptoms are similar to broncho-
pneumonia, but when cavities appear in the lungs the symp-
toms rapidly increase in severity. It is at this stage when
the odor is a prominent symptom.
Diagnosis.— This rests upon the characteristic odor of the
exhaled air, high temperature and the rapid development. The
history of the case often assists materially in the diagnosis.
Prognosis.— Very unfavorable. Most cases terminate fatally
in a few days.
Treatment.— The animal's strength should be maintained
by the use of highly concentrated foods (raw eggs, extract of
beef, milk, etc.), given at frequent intervals.
Little can be expected of medical treatment. Inhalations
(oil of tar, turpentine, or creolin) may be used to overcome
the odor and produce antiseptic action.
CHAPTER V.
DISEASES OF THE PLEURA.
PLEURITIS. PLEURISY.
Definition.— An inflammation of the pleura accompanied
by a serous, serofibrinous, hemorrhagic, or purulent exuda-
tion into the pleural cavity.
Etiology . — (a) Penetrating wounds through the thoracic
walls, from fractured ribs or sharp foreign bodies in the esoph-
agus or stomach; contusion of the thoracic walls; tumors
in adjacent parts; in rare cases cysts of tapeworms. These
conditions make possible the entrance of organisms directly
into the pleura, or by lowering the resistance of the pleura
wrhich favors the growth of organisms that are carried to it
by the lymph and blood streams. These are quite numerous
and consist most often of the following: Bacillus bipolaris,
Staphylococcus pyogenes, Leptothrix buccalis, and Strepto-
thrix canis.
(6) Occurs in cases of nephritis from an accumulation of
waste products in the blood or by bacterial toxins which are
carried to the pleura by the blood and produce direct irrita-
tion to the serous membrane.
(c) Exposure to cold and cold dampness are common
predisposing factors as they reduce the general resistance to
infection.
(d) Pleuritis frequently follows bronchitis and pneumonia,
the organisms present enter the lymph and blood streams and
are carried to the pleural cavity. In some cases of pneumonia
where abscesses develop and open* into the pleural cavity a
purulent pleuritis is produced.
(e) Extension of inflammation of neighboring tissues, viz:
Mediastinitis during the course of infectious diseases; acute
peritonitis; inflammation of abdominal organs.
PLEURITIS— PLEURISY 61
(/) Pleuritis is very often found during the course of infec-
tious diseases. In the dog it occurs frequently as a secondary
disease following distemper, septicemia and pyemia, the
infection being carried by the blood and lymph. It is also
seen during the course of rheumatic conditions.
(g) Other predisposing causes are extreme exertion (hunt-
ing dogs, greyhounds), or living under adverse conditions
(bench shows, during transportation, etc.) which reduce the
natural resistance.
Pathology.— The involvement in pleuritis may be acute
or chronic, local or general, and according to the variety of
exudate, serous, serofibrinous, hemorrhagic or purulent. A
single case of pleuritis may pass through all of the above
stages. In all cases the pleura becomes hyperemic, rough
and dull. The roughness interferes with the free movement
of the gliding surface producing pain and the characteristic
frictional sounds. Later exudation takes place into the
pleural cavity. In the fibrinous form there is soon an exudate
of fibrin, forming a thin, yellowish layer on the surface, and
as this increases it causes the pleural surfaces to adhere
together slightly. The exudate is composed of flakes and
masses of fibrin containing leukocytes. The exudate may
be absorbed completely, but if there has been much fibrin
formation adhesions of varying density result. These
adhesions later are organized into connective tissue which is
at first delicate but soon becomes very dense, and in some
cases so extensive as to obliterate almost completely the
pleural cavity; or they may be in scattered areas only.
In serofibrinous pleuritis there is a large amount of serous
as well as fibrinous exudate. It may originate as the fibrinous
form, but usually begins with a serous outpouring. This
exudate is denser than the transudate seen in hydrothorax,
and contains the usual inflammatory products. The amount
of fluid will vary with individual cases and in the different
small animals from 100 c.c. to 5000 c.c. When present
in large quantities the lung is pushed backward and the
neighboring organs pressed upon. This pressure on the
lungs of the dog and cat is often sufficient to completely
occlude the passage of air into the right posterior lobes.
62 DISEASES OF THE PLEURA
Hemorrhagic pleuritis is generally the result of infectious
diseases and malignant growths on the pleura. The exudate
is chiefly serous, with red blood cells present, but at times
may be almost pure blood.
Purulent pleuritis (pleuritis purulenta; pyothorax; em-
pyema) is the result of infection by some one of the many
pyogenic organisms (staphylococcus, etc.). It may begin
as a purulent pleuritis or it may follow infection of the sero-
fibrinous form. In the pleural cavity is found a varying
amount of cloudy fluid which contains a great number of pus
cells. It may be greenish in color at times, but is usually
yellowish. The pleurae are generally thickened and con-
gested and covered with flakes of fibrin or degenerated
endothelium. The pus may be completely absorbed and the
two surfaces unite with dense adhesions; or it may become
caseated and undergo calcareous infiltration. The changes
are most marked in the visceral pleura, which becomes
greatly thickened, at first being soft and edematous while
fluid is present, but as .this disappears it becomes indurated.
During the course of purulent pleuritis there is always more
or less involvement of the lungs which in some cases may
result in pleurogenic pneumonia. In some chronic cases of
pleuritis (pleuritis granulosa) there are numerous papilloma-
like enlargements distributed over the surface of the pleura,
and these by becoming confluent may produce extensive
masses which interfere with the function of the neighboring
tissues and organs.
The serous exudate contains endothelial cells, white cor-
puscles and small particles of fibrin. The infected exudate
contains numerous pus cells, endothelial cells, and various
kinds of detritis. A rather high percentage of albumin is
found in the serous exudate.
Symptoms.— In the early stages of pleuritis the symptoms
manifest themselves in various ways, depending largely
whether the disease is primary or secondary, local or general.
In acute, primary pleuritis the disease usually begins abruptly
with pronounced general symptoms, viz: A chill, the animal
seeking a warm place, twitching and trembling of the muscles,
followed in a few hours with an elevation of temperature
PLEUR1TIS— PLEURISY 63
(103°-105° F.) and a small, weak and thready pulse. Cough
appears early, is usually dry, and on account of the pain, is
partially suppressed. The gait is stiff and they show con-
siderable pain when moved. There is little or no appetite,
but as a rule the thirst is intense. The visible mucous mem-
branes are reddened and congested, and in cases where there
is much exudation the membranes are cyanotic. Constipa-
tion is often noted, the feces being quite dry and hard. The
urine, while the exudate is forming, is voided in small quanti-
ties and contains albumin. Later as it is absorbed the urine
is increased in amount and of very light color.
Dyspnea is quite marked in nearly all cases of pleuritis.
In the early stages when the pleura is dry,- the respirations
are superficial, rapid and painful, but after exudation takes
place they are less painful but labored. When bilateral the
animal usually 'assumes a sitting posture, but when only one
side is affected, will lie on the affected side. These positions
are assumed to assist in fixing the intercostal muscles to
relieve the pain which accompanies the elevation and depres-
sion of the ribs. The abdominal type of respiration is used,
the elbows being held outwardly and the abdominal muscles
and the diaphragm brought into action. There is less ex-
pansion on the affected side on account of the pain; when
both sides are affected the ribs are held in a fixed position.
Palpation of affected parts produces acute pain.
Percussion. Dulness which gradually rises as the fluid
accumulates in the cavity. The upper line of dulness is
horizontal and varies with the position of the animal. Above
the level of the accumulated fluid tympany will be noted.
Auscultation. In the early stages when the inflamed mem-
brane is dry, frictional sounds are characteristic and the
vesicular murmur is increased, but as the exudate collects
the sounds become less distinct or blowing in character, and
finally only the bronchial tones will be audible.
In the chronic form all the acute symptoms are modified
with slight, if any general disturbance, although the tempera-
ture may be variable, changing daily from below to above
normal (100°-103° F.).
Auscultation gives negative results. Pleuritic adhesions
cannot be diagnosed during life.
64 DISEASES OF THE PLEURA
Diagnosis. —The diagnosis depends upon the painful
respiration, pain on palpation, abdominal type of respiration,
and the presence of fluid in the thoracic cavity. History of
injury may also aid materially.
Prognosis.— Usually favorable in mild, acute cases or when
local; the generalized purulent forms rarely recover.
Treatment.— Hygienic.— It is necessary that the animal be
kept in a warm and well ventilated place but free from
draughts of cold, moist air.
Dietetic.— Concentrated food should be given 3 or 4 times
daily, using warm milk, eggs or extract of beef.
Medical.— In the very early stages of pleuritis when the
frictional sounds are present, cold applications to the walls
of the thorax are indicated (cold water compresses, ice packs,
etc.). The refrigeration from these cold applications pene-
trates the walls and contracts the vessels, thus relieving the
congestion of the pleura. Later (two or three days) warm,
moist compresses are indicated to increase the circulation
which will modify the inflammatory process and hasten the
absorption of the fluid. In addition to this, counterirritants
(oil of mustard and alcohol 1-20, tincture of cantharides,
etc.) could be used to continue the same process. When the
cough is severe, narcotic agents (morphin sulphate 0.025
daily) can be used to allay the irritation. Quinin sulphate
(0.2 three times daily) may be used to control the tempera-
ture and pulse if they become too high. Encourage diuresis
by using fluidextract of digitalis (0.1-0.2 daily) or diuretin
(0.2-0.5 three times daily). If constipation be present
catharsis may be produced by the use of calomel (0.05-0.5
daily) or magnesium sulphate (5.0-10.0) to produce a hydra-
gogue action. When fluid is present absorption may be
induced by the use of potassium iodid (0.2-0.3 three times
daily) or pilocarpin (0.005-0.1) except in cases of feeble
heart action when they must be used sparingly.
Surgical.— The effusion will require aspiration under the
following conditions: (a) When it excites much dyspnea;
(6) when in large quantities; (c) when purulent; (d) when it
remains unabsorbed after ten to twenty days' treatment.
Thoracentesis is performed by the use of a thoroughly
HYDROTHORAX 65
sterilized trocar and cannula or aspirating needle. It is best
done with the animal in either a sitting or standing position.
Remove the hair from and disinfect a small area on the side
of the thorax so that the instrument may be inserted (in a
forward direction) at the anterior border of the sixth, seventh
and eighth ribs and as low in the cavity as possible. The
cavity is reached as soon as resistance to the passage of the
needle has ceased. The fluid flows out in a continuous stream
at first, then synchronous with respiration. After some of the
fluid is out, the air may rush in during inspiration, and to
prevent this hold the finger over the tube at the end of each
expiration. If the flow ceases suddenly it is due to plugging
with flakes of fibrin which can be forced away by reinsertion
of the trocar. The amount of fluid removed depends upon
the heart action. When it becomes weak and rapid, or when
coughing suddenly develops, the operation should be dis-
continued. This can be done daily at a different site of
puncture until all of the fluid is removed.
HYDROTHORAX.
Definition.— A collection of serous fluid in the thoracic
cavity without inflammation of the pleura.
Etiology.— This condition always occurs as a secondary
process and is a symptom of many affections (insufficiency of
the heart ; nephritis ; chronic diseases of the lungs) . It usually
accompanies ascites, hydropericardium and edema of the
skin; also due to obstruction of vessels (vena azygos) ; follows
a general anemia, hydremia, chronic infectious diseases,
carcinomas and sarcomas. These latter diseases damage
the endothelium of the vessels and allow the transudation
of fluid from them.
Pathology.— The transudate is light or reddish-yellow in
color and contains a few flakes of fibrin. If the condition
develops very rapidly, the transudate contains many rod
corpuscles. The specific gravity and albumin content are
less than that of blood serum. The pleura may be thickened
and pale.
5
66 DISEASES OF THE PLEURA
Symptoms.— Hydrothorax develops rapidly and on both
sides of the thoracic cavity. Dyspnea results from compres-
sion of the lungs. In severe cases this compression may be
sufficient to cause edema of the lungs. The temperature is
normal. The shape of the chest is unchanged except when a
very large quantity of fluid is present causing the lower part
of the thorax to be depressed.
Auscultation reveals hard respiratory sounds due to
increased respiration. Percussion over the lower part of the
chest reveals dulness, the upper level of which changes with
the position of the animal. Above this level tympany is
pronounced.
Diagnosis.— Dyspnea with sudden onset in the absence of
other symptoms; percussion, and exploratory puncture.
Prognosis.— Depends upon the causative disease.
Treatment.— Medical.— Saline purgatives (magnesium sul-
phate, 8.0-12.0) may assist in the removal of the fluid by
eliminating fluid from the circulation.
Surgical.— Thoracentesis (see pleuritis), when respiration
becomes distressed, and cyanosis is evident. Repeat as
often as necessary, using a new site for puncture each time.
Further treatment is to be directed to the primary cause.
PNEUMOTHORAX.
Definition.— Air in the pleural sac.
Etiology.— Mechanical.— Perforating wounds from the
exterior (injuries, exploratory puncture, etc.); perforation
through the diaphragm by abscesses of the liver, stomach
or esophagus; perforation from the lung by abscesses or rup-
ture of air vessels in the normal lung. Gas-producing organ-
isms (B. aerogenes capsulatus) in the pleural exudates are
occasional causes.
Pathology.— Pneumothorax rarely occurs by itself, usually
being associated with serofibrinous (hydropneumothorax)
or infectious pleuritis (pyopneumothorax), due to infection
being carried in with the air. A serous or purulent fluid is
found in the pleural sacs and the membranes are inflamed.
HEMOTHORAX 67
Symptoms.— Dyspnea is usually quite pronounced, the
mucous membrane cyanotic and the pulse rapid and feeble.
The physical signs are very distinctive. The affected side
shows marked enlargement and the heart beat is displaced.
On percussion the resonance is usually tympanitic, and
depending upon the degree of tension there may be flat
tympany, or a full hyperresonant tone like emphysema,
while in others with extreme tension dulness will be noticed.
There is usually dulness at the lower part due to the effused
fluid, wrhich can readily be made to change the level by
changing the position of the animal.
On auscultation the normal lung sounds are suppressed
on the affected side and exaggerated on the other side, which
is very suggestive. The rales have a peculiar metallic
sound.
Diagnosis.— The dyspnea, enlargement of the affected side,
small amount of effusion in the cavity and cyanotic mem-
branes.
Prognosis.— Depends upon the cause but is usually favor-
able.
Treatment.— In pneumothorax with extreme tension imme-
diate aspiration (see thoracentesis) should be performed.
Penetrating wounds through the thoracic walls should be
occluded (adhesive plasters, bandage, etc.) to prevent
further entrance of air and infection into the cavity. A small
amount of it will be readily absorbed and if infection has not
been carried into the cavity recovery will be prompt.
HEMOTHORAX.
Definition.— An effusion of pure blood into the pleural sac.
Etiology.— Traumatism, rupture of the vessels from over-
exertion especially when the walls of the vessels are diseased
(carcinomas, sarcomas, and infections).
Pathology.— Presence of pure blood in the thoracic cavity
and the injury to the vessel wall.
Symptoms.— The symptoms are those of an acute anemia
accompanied by a rapid filling of the thoracic cavity.
68 DISEASES OF THE PLEURA
Diagnosis.— The above symptoms in addition to thoracen-
tesis confirm the diagnosis.
Prognosis.— Depends upon the extent and nature of the
injury.
Treatment.— Medical.— The administration of internal
astringents (ergot fld. ext. 2.0-4.0) or adrenalin chlorid
(0.6-4.0 of 1-1000 sol.). These can be repeated in one or
two hours if necessary. Intravenous injections of normal salt
solution to maintain the blood pressure may also be used.
PART II.
DISEASES OF THE CIRCULATORY SYSTEM.
CHAPTER I.
DISEASES OF THE PERICARDIUM.
Examination.— An examination of the circulatory system
in small animals is of importance in determining diseases
affecting primarily the heart and bloodvessels, and also for
assisting in the diagnosis of a number of acute infectious and
non-infectious diseases.
A systematic examination from a clinical standpoint
includes the following: (1) The pulse, and (2) the heart.
1 . The pulse is best examined in the dog by slightly press-
ing the femoral artery with the index finger, or the radial
artery inside the forearm. In small dogs this is often diffi-
cult, and in such cases the hand should be placed against the
thorax on the left side just behind the elbow, and at the
lower third of the cavity, where the heart beat is readily
distinguished. In cats and rabbits this method is the most
satisfactory. In birds the pulse is difficult to recognize owing
to the vessels being well protected and the heart very small
and surrounded with fat and the other organs. A phonendo-
scope is best used to detect the heart beats. Clinically we
must consider: (a) The frequency, (6) the rhythm or cadence,
and (c) the quality of the pulse.
(a) The frequency of the pulse varies considerably in
different species of small animals and birds, and also in
individual animals of the same species.* The size, age, sex,
breeding, temperature, time of day, etc., all have a decided
70 DISEASES OF THE PERICARDIUM
influence upon it. The average frequency for small animals
is as follows :
Dogs 60-200
Cats . 100-180
Rabbits . 110-140
Birds 120-180
An abnormal increase in the pulse is found in all elevations
of temperature, in severe injuries (fractures of bones, etc.),
in mental excitement, valvular defects, severe hemorrhage,
and in heart weakness from any cause.
A decrease in frequency, or slow pulse, occurs in the later
stages of some poisonings, diseases of the brain (chronic
and subacute hydrocephalus), tumors in the brain, icterus
gravis, collapse, etc.
(6) The rhythm of the pulse should be regular, especially
in cats, rabbits and birds; in the dog an irregular pulse is
found so frequently in apparently healthy animals, that it
should not be looked upon as an abnormal condition ; in fact,
an irregular pulse in the dog is the rule. An irregular or
arhythmic pulse is therefore a physiological condition in some
of the small animals. However, in many pathological con-
ditions a pronounced irregularity occurs as, during convales-
cence from infectious diseases, severe gastro-intestinal dis-
turbances, severe weakness, and in some chronic constitu-
tional diseases. An irregular pulse is observed often after
large doses of digitalis.
(c) The quality of the pulse. The pulse beat should be
of equal volume, and it varies with the different species of
animal. In all small animals the pulse is rapid, strong and
hard. In the dog an unequal pulse is frequently observed.
The pulse is full and distended after exercise, during the early
stages of a number of diseases; empty after severe hemor-
rhage, intense heart weakness and collapse. The pulse is
hard and full in severe pain, peritonitis, and acute brain
diseases.
The venous pulse is often observed in old dogs and is
usually indicative of some chronic heart affection, or general
heart weakness.
EXAMINATION 71
2. The Heart.— This is best examined in small animals, by
(a) palpation, (6) percussion, and (c) auscultation.
(a) Palpation. The heart beat is readily felt in all small
animals by placing the hand over the cardiac region (between
the fourth and seventh ribs, lower third of thorax on either
side). The heart beat can be felt on both sides of the chest.
This method of determining the frequency of the heart beat
is practical especially in very young or small animals, and,
as noted, also gives us the frequency of the pulse.
The force of the heart beat depends largely upon the con-
dition of the animal (emaciated or fat), and whether taken
during exercise, excitement or at rest.
The force of the heart beat is increased in the following
conditions:
In hypertrophy of the heart, acute myocarditis, endo-
carditis, and pericarditis; some poisons, such as aconite and
digitalis; after severe exertion or excitement; after consider-
able loss of blood; where the temperature is elevated. The
heart beat is weakened in the following: Degeneration of the
heart muscle; the later stages of acute infectious diseases;
some poisonings; compression of the heart in hydrothorax,
hydropericardium, pneumopericardium; emphysema of the
lungs, and in the effusion stage of pleuritis. In unilateral
pleuritis the normal force of the beat may be more plainly
noted on the healthy than on the diseased side.
(6) Percussion. This is of little value in diagnosis in
small animals. The zone of cardiac dulness is between the
fourth and seventh ribs. This zone is normally about two
to two and one-half inches in diameter.
The zone of cardiac dulness is increased in hypertrophy
of the heart; hydropericardium; tumors and induration of
the lungs (chronic interstitial pneumonia). The zone is
decreased in emphysema of the lungs and pneumothorax.
Pain is observed on percussion in acute pericarditis and myo-
carditis.
(c) Auscultation. This method of examination is of great
value in determining the condition of the heart. It is best
done in the small animal by placing the patient in a standing
position on a table, covering the cardiac region with a cloth,
72 DISEASES OF THE PERICARDIUM
and placing the right ear directly over it. A phonendoscope
may be used which materially assists in differentiating the
heart sounds, the instrument greatly intensifying them.
Normally, there are two heart tones. One of these occurs
at the moment of contraction of the heart (systolic), and
the other at the dilatation of the organ (diastolic). In most
small animals the rapid pulse makes it difficult to distin-
guish between these sounds. It is therefore best to com-
pare the pulse with the heart beat. The interval between
the systolic and diastolic sounds is shorter than the one
between the diastolic and systolic. In very fat animals it
is difficult to distinguish the heart tones with any degree of
accuracy. In rabbits and cats the heart tones are often so
rapid, the sounds following each other in such rapid succes-
sion, that they are indistinguishable. This condition occurs
in all animals after excitement or exercise. In very young
animals it is normal. In birds the heart sounds are almost
impossible to recognize.
Both of these heart sounds are increased in hypertrophy
of the heart, anemias, and thickening of the lung tissue
around the heart.
The second or diastolic sound is increased in distention
of the arteries, often the result of a congestion of the pulmo-
nary circulation combined with hypertrophy of the heart.
A decrease in the volume of the heart sounds is observed
in heart weakness, such as degeneration of the heart muscle,
in hydropericardium, and in emphysema of the lung. In
many of these cases the heart sounds are imperceptible. In
small animals the various heart bruits (abnormal sounds)
are often difficult to recognize.
It will require careful and persistent effort on the part of
the student to familiarize himself with even the more common
bruits which are the following: (1) Endocardial, and (2)
pericardial.
1. Endocardial Bruits are divided into: (a) Organic
endocardial bruits which are caused either by a narrowing
(stenosis) of the valves of the heart, or changes in the valves
which interfere with their proper closing (insufficiency).
(6) Inorganic endocardial bruits occurring without any
PERICARDITIS 73
particular alteration at the orifices or valves of the heart,
and are found in the different forms of anemia in animals.
2. Pericardia! Bruits.— These bruits consist of friction
sounds due to the pericardium becoming rough and dry.
These sounds can be distinguished, as they do not occur
synchronously with the heart sounds and are often indepen-
ent of them. They are noted in pericarditis where there is
not sufficient fluid to keep the membranes separated. They
must be distinguished from pleural friction sounds, and can
be quite readily, as they occur entirely independent of the
respiratory movements.
From a clinical standpoint, in small animals, further
differentiation of the various heart bruits cannot be made.
PERICARDITIS.
Definition.— An acute or chronic inflammation of the peri-
cardium.
Etiology.— Inflammation of the pericardium may originate
primarily or secondarily.
Primary pericarditis may result from: (a) Trauma, which
may originate from within, such as the passage of foreign
bodies (needles, pins, pieces of bone, etc.) through the esopha-
geal walls. This occurs most commonly in the dog and cat
from swallowing needles, pins, etc., during play. It may also
result from trauma from without, such as puncture wounds
through the thoracic walls, or from falling, being run over
by vehicles, etc. In such cases the pericardium is injured
directly or indirectly by being pressed upon by the displaced
thoracic wall or adjacent organs.
(6) Infective processes which in some cases may be
primary or at least involve principally the pericardium.
Staphylococci, streptococci and the specific virus of dis-
temper are the most common organisms found. Primary
infection, however, is not a common etiological factor.
(c) Cold has frequently been mentioned as one of the
causes of pericarditis. This should be considered simply
as a predisposing factor in lowering general resistance, which
allows the development of infection, etc.
74 DISEASES OF THE PERICARDIUM
Secondary Pericarditis.— This form may result from a
number of conditions: (a) Catarrhal pneumonia, which is
common in the dog and cat; simple pleuritis; endocarditis,
myocarditis, etc. It may also follow diseases of the medi-
astinal lymph glands, the ribs, sternum, and even in some
cases the abdominal viscera. (6) In septic processes, such
as suppurating wounds, puerperal septicemia, etc. (c) In
specific febrile diseases, such as distemper in- the dog and
cat, pneumonia, chicken cholera, etc.
Necropsy.— On postmortem are recognized: (a) Acute
fibrinous pericarditis, (6) pericarditis with effusion, and (c)
chronic adhesive pericarditis.
(a) Acute Fibrinous Pericarditis.— This may be local or
general. In the mild form dull, rough, lusterless masses of
exudate cover the surface of the pericardium with a thin
coating of fibrin which is readily peeled off. In the more
severe form the exudate is more abundant, the masses of
organized fibrinous deposits giving the surface a rough,
shaggy appearance. In this form there is usually found a
small quantity of fluid in the meshes of the fibrin. The heart
muscle is not affected, except in the more severe form where
it will be found pale and turbid.
(6) Pericarditis with Effusion.— This effusion may.be sero-
fibrinous, hemorrhagic or purulent. It is most commonly
serofibrinous. In this case the pericardial surfaces are covered
with a thick fibrin and a collection of serous fluid fills the
pericardial sac. The hemorrhagic form is usually found in
acute cases which have terminated fatally following injuries,
etc. The pericardial sac will contain a varying quantity of
serous fluid mixed with blood. When pus is present the peri-
cardial surfaces will appear rough, occasionally eroded and
of grayish color. This form occurs via metastasis or from
internal trauma introducing infection into the pericardial sac.
(c) Chronic Adhesive Pericarditis.— Chronic adhesive peri-
carditis is found occasionally on postmortem. It is char-
acterized by marked thickening of the membranes, with
adhesions between the membranes themselves, and the
adjacent organs.
PERICARDITIS 75
Symptoms.— Mild cases of pericarditis present, as a rule,
no symptoms by which an accurate diagnosis can be made.
In the more severe forms, fever is usually present, but the
elevation of temperature depends as much upon the primary
disease as upon the pericarditis present. Temperature is
usually 103°-104° F. The respirations are increased, espe-
cially when the animal is moved, the slightest exertion causing
a marked dyspnea. Palpation over the cardiac region often
reveals a distinct fremitus from the pericardial folds rubbing
together.
Auscultation. The friction sound due to the rubbing
together of the pericardial surfaces is distinctly audible, and
is the most important diagnostic symptom. The examiner
is greatly aided by the phonendoscope, which brings out the
friction sounds more prominently compensating for their
indistinctness due to the rapid heart beat.
As the disease advances, the heart action becomes inter-
fered with, and all the symptoms of valvular insufficiency
will present themselves. Dropsical conditions from defective
arterial tension will be in evidence, especially ascites, and
dropsy of the extremities. There are general symptoms of
impaired appetite, emaciation and general weakness. Death
may occur suddenly or the condition become chronic and
last for weeks, depending very largely upon the cause.
Diagnosis.— An accurate diagnosis in small animals presents
some difficulties, and a thorough examination is always
necessary. The frictional tones are characteristic, but they
are determinable only in the acute fibrinous pericarditis.
Prognosis.— In the milder cases of acute fibrinous peri-
carditis and serofibrinous pericarditis the prognosis while
favorable, should always be guarded at least until the
etiological factor can be established. Other forms are always
to be considered unfavorable.
Treatment.— Hygienic.— The animal should be placed
where there is absolute quiet. Prevent excitement, such as
by the visits of the owner, or strangers. Have the room
moderately warm and well ventilated.
Dietetic.— Nutritious food (lean meat, raw or cooked ; milk,
etc.) should be given to maintain the general condition of the
animal.
76 DISEASES OF THE PERICARDIUM
Medical.— Heart tonics and stimulants are indicated to
tone up the action of the heart, and to assist in the elimina-
tion of fluid from the body. Digitalis is of value for this
purpose, given to dogs in doses of 0.1-0.2 of the fluidextract
once or twice daily depending upon the condition of the
patient.
Laxatives (magnesium sulphate 8.0-12.0, or calomel 0.05-
0.1) are indicated occasionally to regulate the bowels and
also to assist in the elimination of fluids.
Surgical.— When the exudate accumulates to the extent
of greatly interfering with the heart action, indicated by
dyspnea, small rapid pulse, cyanosis, etc., paracentesis of the
pericardium should be performed at once. The operation is
not very difficult and is as follows: A rather long, small
exploring trocar or aspirating needle is thoroughly sterilized.
Shave the hair over the left cardiac region, wash thoroughly
with soap and water, and follow with alcohol ; then paint the
surface with tincture of iodin. The needle should be inserted
at the lowest point in the pericardial sac so as to be able to
remove all the exudate and lessen the danger of injury to the
heart. Insert the needle slightly downward and forward,
and not too deep. The fluid will flow out in a steady stream.
Repeated operations on successive days are often necessary.
The skin wound should be protected by covering with flexible
collodion.
HYDROPERIC ARDIUM .
Dropsy of the Pericardium.
Definition. — A collection of serous fluid (transudate) in
the pericardial sac not due to inflammation.
Etiology.— This condition most often accompanies general
hydropsy resulting from valvular defects (insufficiencies),
myocarditis, diseases of the coronary arteries, chronic nephri-
tis, etc. It also occurs from pericarditis (see Pericarditis).
Symptoms.— The symptoms are similar to pericarditis
(see Pericarditis) except it runs a longer and more chronic
course. There is absence of temperature, and frictional bruit
is heard on auscultation.
Treatment.— Same as for serofibrinous pericarditis, which
see.
HEMOPER1CARDIUM 77
HEMOPERICARDIUM.
Definition.— A collection of blood in the pericardial sac.
Etiology.— This condition is found in aneurysm of the
aorta, cardiac wall, or coronary arteries, and in rupture and
wounds of the heart. Dogs and cats are frequently affected
from gunshot wounds, being run over, etc.
Symptoms.— The principal symptoms are those of rapid
heart weakness, paleness of the mucous membranes, rapid
weakness and in most cases death in a very short time from
compression of the heart. In slight hemorrhages the animal
may live for several hours or days with a progressive heart
weakness, dyspnea and all the physical signs of effusion in
the pericardial sac.
Treatment. — Treatment in most cases is impossible, and in
the slow progressive cases usually unsatisfactory.
Other diseases of the pericardium, such as pneumoperi-
cardium, are of no importance clinically.
CHAPTER II.
DISEASES OF THE HEART.
VALVULAR INSUFFICIENCY AND STENOSIS.
Definition.— A pathological or anatomical defect in the
valves and openings of he heart leading to an irregularity
in the circulation of the blood. These conditions are very
common in small animals, especially the dog, where often
quite extensive alterations in the valves are found on autopsy
which failed to produce any marked symptom during life.
However, when severe forms of insufficiency or stenosis
occur, they are characterized by a marked disturbance in the
heart action, circulation of the blood and the general condi-
tion of the animal. It is often very difficult and sometimes
impossible to differentiate clinically between the various
valvular and ostial defects which are found on autopsies.
Insufficiency.— In general, this condition occurs in two
forms: (a) Imperfect closing of the valves which permits
a portion of the blood at the contraction of the heart muscle
to flow back into the chamber from which it came. This
defect may exist in the atrioventricular valves or in the semi-
lunar. Improper closing of the semilunar valve allows a
portion of the blood which has been forced into the artery
to again return to the chamber during diastole; or imperfect
closing of the mitral or tricuspid valves during systole allows
a portion of the blood to flow back into the auricles again
from whence it came. In the early stages of insufficiency,
owing to certain compensatory processes, no marked symp-
toms will be observed. However, as soon as the heart is not
capable of performing the increased labor from lack of nutri-
tion, increased disturbance in the valves, or general weakness
from anemia, cachexia, etc., marked disturbance in the
general circulation will soon become evident. These are
VALVULAR INSUFFICIENCY AND STENOSIS 79
manifested by ascites, dropsical effusions, etc., in different
parts of the body.
(6) Stenosis or contraction of the openings. In this con-
dition the opening is narrowed so that the chambers of the
heart are improperly filled. At the period of diastole, the
blood is held back at the entrance of the affected chamber,
and therefore normal filling of the chamber is interfered
with. This condition may occur at any of the openings of
the heart and will always induce imperfect heart action.
Every interference with an arterial opening causes imperfect
ventricular contraction; likewise defective venous openings
lessen the auricular contraction and power. This abnor-
mality in the action of the heart produces more or less
general disturbance in the circulation of the blood, and as
a consequence the reserve force of the heart is called into
action until compensatory hypertrophy can take place to
keep the circulation as near normal as possible. As soon as
the reserve energy is used, or the compensatory hypertrophy
fails to keep up the circulation, serious general symptoms
of defective circulation appear as is often observed in old dogs.
Etiology.— Valvular defects are produced by a variety of
causes :
(a) Endocarditis is the most common cause (see Etiology
of Endocarditis). Endocarditis produces an inflammatory
thickening of the margins of the valves leading to their
imperfect closure. If the chronic inflammations persist it
leads to cicatricial contractions (stenoses), and often there
are found in long standing cases in old animals, deposits of
calcareous matter on the valves and around the openings.
(6) Dilatation of the heart or weakness of the heart muscle
will sometimes affect the openings, the dilatation preventing
contact of the valve margins and a complete closure.
(c) Certain poisons and toxins are causes \vhich lead to
alterations in the structure and ultimately the action of the
valves.
(d) Atheromatous processes may produce the condition.
However this is not common in small animals.
(e) Occurs during the course of some diseases, such as
anemia, pernicious anemia, etc.
80 DISEASES OF THE HEART
Necropsy.— It has been found that the mitral and aortic
valves are the ones most commonly affected in the dog. In
the early stages the edges of the valves are slightly thickened
and invaded with small nodules. Later are found, as the
sclerotic changes increase, contractions of the fibrinous
tissue, producing thickening and deformity of the segments
of the valves, the edges of which become round, curled and
cannot be closed perfectly. In some severe cases the valves
become very much thickened, with numerous hard nodules
(which may be calcareous), giving them a marked uneven
surface. The chordae tendinese are often found thickened
and contracted. The apices of the papillary muscles fre-
quently show fibrated or calcareous change.
Symptoms.— In small animals the general symptoms of
valvular deficiency are of greatest importance from a clinical
standpoint, as it is very difficult during the life of the animal
to distinguish with any degree of accuracy the separate
valvular insufficiencies. However, some of them present
some symptoms which are rather characteristic, and there-
fore, a brief description of the most common ones will be
given.
As general symptoms, the following are the principal ones
observed which are common to all valvular defects at some
period in their course: Increased heart action; rapid and
irregular pulse; palpitation of the heart; venous pulse
(observed in the jugular at its entrance to the thorax);
dyspnea; cyanosis of mucous membranes; hydrothorax;
ascites; edema along abdomen, pectoral region, extremities;
general emaciation, partial or complete loss of appetite with
marked digestive disturbance. The condition gradually
becomes aggravated until there is a general nutritive dis-
turbance, weakness, and death from exhaustion. Careful
auscultation will reveal the valvular insufficiency. Palpation
over the cardiac region will determine the irregular and
rapid pulse, and often a distinct fremitus. The temperature
in the early stages is usually elevated (103°-104° F.); it
later becomes normal or even subnormal as the disease
progresses.
Symptoms of insufficiency of the mitral valves: This is of
VALVULAR INSUFFICIENCY AND STENOSIS 81
frequent occurrence in the dog. It is often accompanied by
dilatation or hypertrophy of the heart. Pulse rapid and
irregular; systolic bruit and increase of the diastolic sound on
auscultation; dyspnea; cyanosis; general weakness; dropsical
conditions (ascites, etc.). A careful examination is necessary
to make a differential diagnosis.
The direct effect of aortic insufficiency is the'regurgitation
of blood from the artery into the ventricle, causing a disten-
tion of the cavity and a reduction of blood pressure in the
artery. The amount returning varies with the size of the
opening. This regurgitation eventually leads to dilatation
and finally hypertrophy. In this way the valve defect is
compensated for, and as with each ventricular contraction a
larger amount of blood is forced into the arterial system, the
regurgitation of a certain amount for a time during diastole
does not interfere with the nutrition or with the general
circulation.
The condition is characterized clinically by: A full pulse;
strong heart beat; dyspnea; dropsical conditions (ascites,
etc.) ; cough from congestion and edema of the lungs; increased
area of dulness in the cardiac region; diastolic bruit, etc.
Insufficiencies of other valves are impossible to recognize
during life in these animals.
Diagnosis.— The faulty heart action is not difficult to
recognize, but to determine the location of the lesion is very
difficult in small animals. In some cases, however, by care-
fully observing the symptoms and using the phonendoscope
a differentiation is possible.
Prognosis.— Complete recovery cannot be expected even
in mild cases of insufficiency, therefore the prognosis is
unfavorable. However, the condition may exist for a long
time in individual cases without producing any serious
symptoms provided adequate compensation exists.
Treatment. — (a) During the stage of compensation no
medical treatment is indicated. Keep the animal quiet as
possible, avoid all undue excitement and exercise, and give
nutritious food to maintain the general condition.
(b) Stage of broken compensation, when the symptoms
of weakness, edema, palpitation, etc., appear, heart tonics
6
82
are indicated. Digitalis fluidextract (0.05-0.15); tinct.
strophanthus (0.5-1.5 twice daily); or caff em citrate (0.1-0.2
twice daily). By the use of these preparations an effort is
made to reestablish a compensatory action, and should this
take place the symptoms of edema, ascites, palpitation, etc.,
will gradually disappear.' Should this treatment be unsuc-
cessful, a symptomatic treatment may be tried such as the
use of diuretics and cathartics to relieve the effusions, and
in severe palpitation, sedatives (morphin). In cases of
severe weakness, where the pulse is very weak and irregular,
direct heart stimulants (camphor, ether, etc.) must be given
to afford temporary relief.
In disturbances of the digestive tract with loss of appetite,
tincture of nux vomica (0.2-0.8) or tincture of gentian (1.0-
2.0) should be given twice daily to tone the digestive tract.
Other symptoms that develop must be treated according to
their importance.
MYOCARDITIS.
The following forms of myocarditis are observed in small
animals: (a) Acute myocarditis, and (6) chronic myocarditis.
Acute Myocarditis.— Definition.— An acute inflammation
of the heart muscle (myocardium). From a pathological
standpoint two distinct types of this condition are recog-
nized, viz.: The acute parenchymatous and the purulent
myocarditis. From a clinical standpoint such a differentia-
tion cannot usually be made. Therefore, both will be con-
sidered under acute myocarditis.
Etiology.— (a) From severe exertion, such as hunting dogs
on long runs, continuous stud service, hard pulling of draft
dogs, etc.
(6) Exposure to cold, or sudden chilling of the surface of
the body, resulting in an unequal distribution of the blood,
producing a congestion of the bloodvessels of the heart and
occasionally resulting in an inflammatory reaction.
(c) Secondary to infectious diseases, such as distemper,
pyemia, septicemia, tuberculosis, cholera, and entero-
hepatitis in fowls, etc. During the course of the infectious
diseases toxins are formed and carried by the blood to the
MYOCARDITIS 83
heart muscle leading to inflammation and fatty degeneration.
The other organs in the body are often similarly affected
during the course of infectious diseases.
(d) From poisons (arsenic, phosphorous, silver, mercury,
etc.) being absorbed, carried through the circulation to the
heart muscle, producing irritation, congestion, and some of
them (phosphorous, arsenic) later fatty degeneration of the
muscle.
(e) Often results by spread of the inflammation from the
endocardium and pericardium, especially in ulcerous endo-
carditis and suppurative pericarditis, the infection reaching
via blood the heart muscle.
(/) Direct injuries to the heart which occur quite frequently
in small animals from foreign bodies perforating the esoph-
agus or chest wall; also by being run over, the heart muscle
becoming contused.
Necropsy.— Pathologically numerous conditions are found,
the changes in the myocardium are quite varied, and in acute
myocarditis may be classed under two heads as follows:
(a) Acute Parenchymatous Myocarditis.— This as a primary
condition, is not very common, and is usually associated with
acute inflammation in other organs. In this form there is
found interstitial infiltration, inflammation of the muscle
fibers, which are colored reddish-gray, yellowish-white, or
even white. The muscle fibers are indistinct and show a
more or less homogeneous structure.
Microscopically, the fibers show a loss of striation, with
small cellular infiltration in the interstitial connective tissue.
Large numbers of white corpuscles are found between the
fibers.
(6) Purulent Myocarditis.— This form occurs quite com-
monly in the dog, less commonly in cats and birds, and is
found mostly in pyemic conditions. Small abscesses are dis-
tributed through the connective tissue varying in size from a
millet seed to a pea. Sometimes by confluence the abscesses
are much larger.
Symptoms.— In the early stages the symptoms are similar
to those of insufficiency or weakness of the heart. The heart
beat is very rapid, three to four times normal, throbbing, and
84 DISEASES OF THE HEART
in the dog can be seen quite a distance from the animal, the
tumultuous throb of the heart shaking the whole body. The
heart action soon becomes irregular and very weak. The
pulse is very rapid, weak, small, irregular and in later stages
imperceptible. The pulse usually becomes so rapid that it
is impossible to count it. Respirations are rapid, labored,
and the animal soon becomes prostrated.
The temperature in the early stages is elevated, the degree
depending upon the etiological factor; later it becomes
subnormal.
In some cases myocarditis takes a very rapid course, the
animals dying suddenly from rupture or paralysis of the heart.
Diagnosis.— This is difficult as the symptoms are quite
similar to endocarditis, pericarditis, etc. A careful exami-
nation should always be made. When insufficiency of the
heart action exists without frictional sounds or bruits, myo-
carditis may be suspected.
Prognosis.— The prognosis is unfavorable, especially in
secondary myocarditis, due to infection, or during the course
of infectious diseases. Even in primary acute myocarditis
there are always degenerative changes in the heart muscle
which are impossible to entirely overcome. If recovery
occurs it is as a rule only partial (chronic myocarditis).
Treatment.— Hygienic.— The animal should be kept in a
quiet place, avoiding all excitement or handling.
Medical.— The heart weakness should be treated by using
heart stimulants and tonics, such as dilute alcohol (2.0-
4.0); fluidextract digitalis (0.075-0.10); caffein citrate
(0.5-1.0 subcutaneously every six to ten hours); ether (2.0-
4.0 subcutaneously); oil camphor (1.0-4.0 subcutaneously);
or atropin sulphate (0.04-0.075 subcutaneously). The use
of these preparations will depend largely upon the needs of
the case.
In very acute cases there is no treatment that will produce
satisfactory results.
Chronic Myocarditis.— Definition.— A chronic inflamma-
tion of the myocardium. This condition occurs frequently
in small animals but is rarely recognized during life. It is
often confused with other heart affections.
ACUTE ENDOCARDITIS 85
Etiology. — (a) Occurs commonly from mild, acute attacks,
especially in those cases where the interstitial connective
tissue is primarily involved.
(6) During the course of chronic muscular or articular
rheumatism in old dogs; also from chronic nephritis, tuber-
culosis, pericarditis, endocarditis of dogs, cats and birds.
(c) Chronic poisoning by chemicals, toxins, etc., often
will produce the condition by interfering with the circulation
through the coronary arteries.
Necropsy. — Throughout the heart muscle appear circum-
scribed masses of fibrous tissue which are white in color and
of firm to hard consistency. They occur most conspicuously
near the apex of the left ventricle. The fibrous areas may be
quite dense, like a cicatrix, constituting the so-called " heart-
scar." Pigment and calcareous deposits may be present in
them. The affected heart wall becomes very thin in places
and may bulge forming a so-called aneurysm. Fatty degener-
ation may be present. The heart may show hypertrophy
with dilatation.
ACUTE ENDOCARDITIS.
Definition.— An acute inflammation of the endocardium,
especially involving the part covering the valves. This con-
dition occurs very commonly in small animals, especially in
dogs and birds.
Etiology. — 1. The acute endocarditis in the majority of
cases results from infection, the toxins of a number of infec-
tious diseases irritating the endocardium. The organisms
(pus-producing organisms, bipolar bacillus, colon bacillus,
Bacterium tuberculosis, etc.), or their toxins, are the ones
most commonly accused. An acute, primary, infectious
endocarditis is observed occasionally; in the majority of
cases, however, it occurs secondary to other diseases, pyemia
and septicemia usually producing it. It develops often also
after abscesses, wounds on the skin, abscesses in the internal
organs, septic metritis, sapremia, etc. The organisms or
their products (toxins) are carried by the blood to the endo-
cardium where they become lodged, especially along the
86
edge of the valves. They propagate, produce irritation, and
assisted by the mechanical action of the valves, an active
inflammatory reaction is soon established. The inflammation
spreads to the other parts of the endocardium and may cause
a general endocarditis. The rapidity of the process depends
upon the virulency of the infection or the amount of the
toxins present.
2. Spread of the inflammation from adjacent structures
or organs may produce the condition, such as from a myo-
carditis, pericarditis, pleuritis, or a pneumonia.
3. There are several predisposing conditions which should
be considered: (a) ("hilling the surface of the body, such as
exposure to cold, or cold baths, carelessness in thoroughly
drying the skin of animals after baths, etc., make them more
susceptible to infection by reducing resistance.
(6) In old animals degenerative changes of the heart
muscle, valves, etc., make them less resistant.
(c) Young puppies, chicks, kittens, from hereditary influ-
ences, often favor the development of the condition.
(d) During convalescence from long-continued diseases
there is a predisposition to endocarditis.
(e) Traumatic conditions over the region of the heart
(kicks, blows, fractured ribs, etc.).
4. Mineral poisons (mercury, phosphorus, etc.) or some
drugs administered in large doses, or for too long a period,
produce direct irritation to the endocardium, or predispose
to the condition.
In the etiology of endocarditis, infection must always be
regarded as the principal causative factor.
Necropsy.— Macroscopically two forms of acute endocar-
ditis are recognized, viz.:
(a) Endocarditis Vahularis Vernicosa.— This is charac-
terized by small enlargements, about the size of a millet
seed", on the free edges of the valves, on the tendons and
papillary muscles. They are nodular, wart-like in appear-
ance, grayish-white or whitish-yellow in color, and their
surface covered with blood-stained or colorless stratified
epithelium. The-e growths may develop into large polypous
proliferations, which often cause stenosis of the openings
ACUTE ENDOCARDITIS 87
and insufficiency of the valves of the heart. The endocar-
dium in general is swollen, opaque, reddened somewhat, and
covered with a thin coagulum; small hemorrhagic foci are
found often in the subendocardial tissue, as well as between
the fibers of the heart muscle.
(6) Endocarditis Ulcerosa.—T\\is is the more severe form
of the condition, characterized by necrosis and ulceration
of the margins of the valves and other portions of the endo-
cardium. The ulcers are usually well defined, isolated and
vary considerably in size from a pea to several times larger.
They are covered with friable, discolored, necrotic masses.
These masses are often torn loose by the circulating blood
and are carried to the other organs, even to the heart itself,
forming metastatic abscesses. In dogs endocarditis verru-
cosa is very commonly found on postmortem and although
the lesions may be extensive no marked symptoms were
noted during life. The aortic or bicuspid valves are most
often affected.
Symptoms.— The symptoms of acute endocarditis vary
considerably, depending to a great extent upon the cause,
and the nature and extent of the inflammatory process.
The early symptoms are those of a greatly disturbed heart
action, which is at first palpitating and irregular; later the
beat is diffuse. The number of heart beats sometimes exceeds
that of the pulse (Frohner) . The heart beat is often so tumul-
tuous, especially in dogs, that the entire body is shaken and
can be observed some distance from the animal.
The pulse is very rapid, intermittent, irregular, and in the
later stages becomes imperceptible. The frequency in dogs
will be 120-300, and in other animals even more rapid. The
heart muscle is at first normal, but soon becomes abnormal,
the sounds often blended to a single sound. Later, charac-
teristic endocardial bruits are heard, a blowing, stenotic
(systolic) noise occurring with the first heart sound, and at
times a prolonged rustling and vibrating sound occurs at
diastole.
The temperature in the early stages is always high (10.T-
105° F.), but in the dog it becomes normal or subnormal.
Cats have a high temperature, which remains high for a
88 DISEASES OF THE HEART
longer period than in the dog. The respirations are acceler-
ated, the dyspnea similar to that of pneumonia, a disease with
which it is sometimes confused in making a diagnosis.
In the later stages of the condition, circulatory disturbances
are quite prominent. These are manifested by cyanosis,
venous pulse, edema of the lungs, etc. In the septic form a
hemorrhagic diathesis appears with hemorrhages from the
membranes, bloody urine, etc. As general symptoms,
depression, weakness, etc., come on rapidly, the animal often
shows complete prostration.
Diagnosis.— Acute endocarditis is quite difficult to recog-
nize as the symptoms are similar to other diseases of the heart.
It may be confused with any acute febrile disease having a
sudden onset (septicemia, inflammation of the brain, pneu-
monia, etc.). A careful examination of the heart is always
necessary for a diagnosis. It is often very difficult, and in
some cases quite impossible to distinguish between acute
endocarditis and myocarditis, with which it is very closely
associated. Between the two forms of endocarditis it is
almost impossible to differentiate. In the ulcerous form the
onset is more rapid than in the verrucose, and sometimes the
primary seat of infection can be located.
Prognosis.— The prognosis is unfavorable, especially in the
ulcerous form. Complete recovery is rare. The valves are
usually left permanently impaired resulting in valvular
insufficiency.
The course of the disease varies. It is sometimes very
acute, ending in death in a few hours or days (endocarditis
ulcerosa). Or the condition may last for several days or
weeks, eventually developing into the chronic form (endo-
carditis valvularis verrucosa) .
Treatment.— The animals should be kept in an absolutely
quiet place avoiding all excitement or movement.
In the early stages (in dogs especially) cold compresses
should be applied over the region of the heart (ice-bag or
cold water compress). These should be changed as often
as necessary.
Regulate the action of the heart by the u.se of digitalis, or
if the heart is very weak, it should be stimulated by the use
HYPERTROPHY AND DILATATION OF THE HEART 89
of alcohol, caffein citrate or ether subcutaneously. To reduce
the temperature acetanilid (dog 0.2-0.5; cat 0.05-0.1) should
be given twice daily.
In endocarditis from rheumatic conditions, salicylic acid
or sodium salicylate (dog 0.2-0.5; cat 0.05-0.1) should be
administered twice daily.
When general weakness is well marked, stimulants must
be administered according to the needs of the patient.
Camphor, ether, or atropin are best for this purpose.
HYPERTROPHY AND DILATATION OF THE HEART.
Definition.— Hypertrophy is an enlargement of the heart
due to a thickening of its musculature; dilatation is an
increase in the size of the heart from an enlargement of its
cavities. From a clinical standpoint a distinction between
them cannot be made as they nearly always coexist. Hyper-
trophy is an active enlargement of the heart, while dilatation
is a passive one.
Etiology. — Generally speaking the causes of hypertrophy
of the heart are those conditions which interfere with the
circulation of the blood and thus increase the blood pressure.
The following are the most common:
(a) Increased physical exertion. This occurs in dogs used
for hunting (fox hounds, greyhounds) .
(b) Adhesions between the pericardium and heart inter-
fering with the heart action.
(c) Obstruction to the free circulation through the arteries,
such as aneurysms of the aorta, stenosis of the aorta, thrombi,
atheromatous and arteriosclerotic processes, etc.
(d) Defects in the valves of the heart (chronic endocar-
ditis).
(e) Diseases of the lungs, such as chronic interstitial
pneumonia (common in the dog), adhesions, exudations,
abscesses, chronic bronchitis, which increase the blood
pressure through the right heart.
(/) Chronic inflammation of the liver, kidneys, etc., by
impeding the free circulation of blood (common in old dogs).
(0) Dilatation of the heart usually follows hypertrophy,
90 DISEASES OF THE HEART
the hypertrophied heart eventually growing weaker and
becoming distended by the abnormally increased blood
pressure. It may also develop in an acute form after acute
diseases of the lungs, as the circulation through the right
heart is greatly interfered with.
Necropsy.— In both hypertrophy and dilatation the heart
is enlarged, in hypertrophy the increase in the thickness of
the walls, in dilatation in an enlargement of its cavities.
(a) True hypertrophy of the heart appears in several
forms, depending upon whether it is general or local, i. e.,
involving a whole ventricle, or circumscribed affecting only
some of the papillary muscles. The left heart is most fre-
quently affected. In hypertrophy the shape of the heart
will vary. When the left heart is involved it appears elon-
gated, cylindrical; when the right heart, it is flatter and
broader than normal. If the whole heart is hypertrophied
it assumes a round or oval form and is increased in size. The
walls are usually two or three times the normal thickness,
the muscles firmer, tougher, darker red in color, and the inter-
stitial connective tissue occasionally shows marked prolifera-
tion. Sometimes areas of fatty degeneration are noted on the
surface.
(6) In dilatation of the heart the cavities are found much
larger than normal, and the wralls thinner and weaker. In
the active form of dilatation the walls are stronger than in
the passive where they are relaxed and distended. Dilatation
appears oftener in the right heart than in the left. The
structure of the muscles may be normal. Usually, however,
the organ is anemic, friable, the musculature yellowish-
brown in color, often very thin, and due to a complete atrophy
of the muscle, in some areas the wall is almost transparent.
Symptoms. — In true hypertrophy of the heart, especially
compensatory, the development is often so gradual that it
may exist for a long period without producing marked symp-
toms. In severe cases, when accompanying other diseases, it
is characterized by a strong, full pulse, very loud, clear heart
sounds, and an increase in the area of cardiac dulness. Due
to the coexistence of dilatation the symptoms which charac-
terize hypertrophy are rarely noted in practice. The most
HYPERTROPHY AND DILATATION OF THE HEART 91
prominent symptom of hypertrophy with dilatation is the
extension of cardiac dulness, which in dogs may reach as far
back as the last rib, or even to the false ribs.
Dyspnea, palpitation, disturbances in the circulation,
dizziness, etc., are resulting symptoms. A prominent sign
is the throbbing of the heart, which often shakes the whole
body and may be seen quite a distance from the animal.
The heart sounds are usually irregular, the first sound loud,
metallic and sometimes vibrating; the second sound very
weak and often imperceptible. The slightest exertion will
produce a very rapid heart action. The pulse is weak. A
venous pulse is common in old dogs. Ultimately, due to
insufficient heart action, general cyanosis, ascites, hydro-
thorax, etc., develop.
Diagnosis.— Care should be taken not to confuse hyper-
trophy and dilatation with diseases of the lungs, and other
affections of the heart. The increase in the area of cardiac
dulness, the abnormally loud, systolic sound, arhythmic
pulse, and tendency for ascites and edemas are all charac-
teristic of dilatation of the heart. A hard, full pulse with
increased areas of dulness points to hypertrophy of the heart.
These conditions usually can be distinguished from val-
vular defects by the absence of the characteristic bruits.
Prognosis.— Favorable in simple hypertrophy of the heart.
Unfavorable in dilatation of the heart, except in the very
acute cases.
Treatment.— Absolute rest and quiet should always be
insisted upon. It is important to remove the causes of these
conditions if possible.
(a) In hypertrophy of the heart with hyperkinesis, seda-
tives such as potassium iodid (dogs 0.2-0.8; cats 0.05-0.10)
to act as a general sedative may be used for one or two doses.
(6) In hypertrophy complicated by dilatation, with a
weak, feeble heart action, cardiac tonics and stimulants are
indicated. Digitalis fluidextract (dogs 0.1-0.3, cats half
the quantity) is probably the most important drug for this
condition. These doses may be repeated as often as neces-
sary. Good, nutritious food should be allowed at all times.
General stimulants are to be used when necessary.
92 DISEASES OF THE HEART
RUPTURE OF THE HEART.
Etiology. — (a) Traumatic influences (kicks, fractured ribs,
being run over, falling, etc.). (6) Diseases of the muscular
walls of the heart (abscesses, fatty degeneration and infiltra-
tion, endocarditis and myocarditis, atheromatous degenera-
tions of the aortic walls at their origin, etc.). (c) Shock
from operations, and other conditions and diseases.
Symptoms.— In most cases the animal dies apoplectic.
In cases where the rupture is very small, symptoms of internal
hemorrhage are noticeable. Death in these cases, however,
usually occurs in a few hours.
Treatment. — No treatment can be given in this condition.
PART III.
DISEASES OF THE DIGESTIVE TRACT.
CHAPTER I.
DISEASES OF THE MOUTH.
Examination. — The examination of the oral cavity requires
good light (daylight) or in some cases artificial light (electric-
bulb with reflector) is necessary where a careful examination
is to be made. In docile animals the mouth can be opened
by pressing the lips against the teeth above and below causing
the animal to open the jaws. For protracted examination
it is necessary to hold the mouth open by the use of tapes
placed just back of the canines, one tape above and one below,
which are grasped by an assistant ; or a mouth speculum may
be used. In vicious animals an anesthetic should be employed
(morphin for dogs; ether for cats). For examination of the
posterior part of the cavity, the tongue should be depressed
with a spatula, or pulled well forward with the fingers or
blunt forceps. In examining the mouth, the following
should be observed :
(a) Odor.— An offensive odor is noted from retained
or decomposed food; ulcerative or gangrenous stomatitis;
gangrene of the lungs; fetid bronchitis; acute* and chronic-
gastritis; caries of the teeth; roup in birds. The odor is
often characteristic and readily distinguished. In some
poisonings the odor of the drug is evident (carbolic acid,
hydrocyanic acid, etc.).
(b) Secretions.— Secretion is diminished in all acute febrile
conditions; in some poisonings (belladonna, atropin). Secre-
94 DISEASES OF THE MOUTH
tion is increased in parotitis; inflammatory conditions of the
mouth; injuries; foreign bodies; poisons (calomel); eruption
of teeth in puppies; following injections of pilocarpin. An
abnormal quantity of saliva is noted in the mouth in dys-
phagia. The saliva which flows from the mouth is in clear
strands or in the form of foam from masticatory movements.
(c) The Mucous Membranes. — An anemic or pale condition
is found in chronic constitutional diseases; intestinal para-
sites; skin parasites, especially in birds; severe hemorrhage.
A hyperemic or congested condition is noticed in all acute
inflammatory conditions; in acute infectious diseases with
elevation of temperature; occurs during the course of gas-
tritis. Cyanosis occurs from chronic heart diseases; inter-
ference with respiration or the local circulation. A blue line
is seen around the gums in lead poisoning.
(d) Foreign Bodies.— A. careful examination should be
made for foreign bodies which often become imbedded in
the mucous membrane or around the tongue or forced in
between the teeth. In cats' fishbones, needles or pins are
often found in the posterior part of the mouth.
(e) Neoplasms.— Papillomata are frequently seen on the
margins of the lips or on the mucous membrane in various
parts of the mouth. Retention cysts often occur under the
tongue (submaxillary gland), inner surface of the lips and
cheeks (buccal glands). 'Other tumors are occasionally
found. In all cases where the mouth is held open, whether
from complete or partial paralysis or foreign bodies, dumb
rabies should be suspected and the examination made with
care.
STOMATITIS.
Several varieties of stomatitis are met with in practice as
follows: (a> Catarrhal; (6) ulcerative; (<•) gangrenous; (d)
phlegmonous; (e) parasitic.
Catarrhal Stomatitis.— Definition.— An acute or chronic
inflammatory condition of the mucous membrane of the
mouth.
Etiology.— Mechanical.— Injuries from foreign bodies or
sharp material in the food (bones, etc.); from irritation due
STOMATITIS 95
to tartar around the teeth; dentition; weed hairs penetrating
the membrane (seen in hunting dogs after running in fields).
Chemical— Irritating medicinal agents administered in
concentrated form; poisons (carbolic acid, arsenic, mercury,
etc.) ; decomposed food which has been retained in the mouth;
internal administration of calomel or lead compounds in
too large doses or for too long a time.
Thermic. — Hot food or drink.
Infectious. — It occurs in the suckling young of bitches
affected with infectious mammitis; accompanies infectious
diseases (septicemia, distemper in dogs and cats, diphtheria
and roup in birds) ; usually present during the course of gas-
tritis, some of the toxins when absorbed into the circulation
are secreted with the saliva and thus cause irritation to the
oral mucous membrane; produced by extension of inflamma-
tion from other parts (pharynx, larynx and salivary glands) .
Chronic constitutional diseases (rachitis, anemia and
leukemia) are predisposing factors.
Pathology. —There is at first a superficial redness and dry-
ness of the mucous membrane followed by an increased secre-
tion and swelling. This secretion collects around the teeth
and on the tongue in the form of a dirty gray or brown coat-
ing. The lips often become fissured and ulcerated.
Symptoms.— The animal shows pain during mastication
and has an increased thirst. On direct examination the
mucous membranes are seen to be red, swollen, and covered
with mucus. The redness may be in spots or diffuse, depend-
ing on the cause. Saliva often flows from the mouth or hangs
in strings from the lips. The swelling of the mucous mem-
brane may occlude ducts of the buccal glands, forming cysts
which appear as small gray nodules on the inner surface of
the lips. Quite frequently there is an edematous condition
of the mucous membrane. The upper surface of the tongue
shows a brown or greenish-brown discoloration. In cats it
is slightly yellow, and the papillae are enlarged and quite
prominent. In birds the epithelium is thickened, tongue
dry, and a pseudomembrane is often noticed.
Diagnosis.— The diagnosis is made by the absence of general
symptoms, the inflamed and sensitive mucous membrane
and the characteristic conditions noted above.
96 DISEASES OF THE MOUTH
Prognosis.— Favorable in primary cases, healing occurring
in about one week; in secondary cases it depends on the
causative disease.
Treatment.— Dietetic.— The animal should be fed warm
liquid food in small amounts.
Medical.— The use of antiseptic mouth washes is indicated
(boric acid 2 per cent., alum or tannic acid 1 per cent.,
vinegar and water 1-10) ; in the severe chronic form direct
application of silver nitrate (1-2 per cent.) may be found
useful. Tincture of myrrh applied direct to the gums is very
useful as a deodorant and antiseptic.
Surgical.— Remove foreign bodies and tartar from around
the teeth, using a curette.
Ulcerative Stomatitis.— Fetid Stomatitis. Stomacace. Sore
Mouth.— Definition.— An acute inflammation of the mucous
membrane of the mouth resulting in the formation of ulcers,
which appear most commonly on the margins of the gums.
Etiology.— This disease is found in weak, anemic dogs and
cats. It also frequently develops during the course of dis-
temper, rachitis and other constitutional diseases. It is
found commonly in old dogs and cats with diseases of the
teeth (caries) , especially when these animals are insufficiently
nourished. The exact causes producing this necrosis of the
tissues are not definitely known. The character of the dis-
ease process points to infection. In man a similar disease is
contagious. The Bacillus septicus has been isolated from
the diseased area in dogs, and the Bacillus necrosis and
Bacillus coli communis in cats, but have not been proved to
be the specific cause. Lack of cleanliness in the mouth,
diseased teeth and accumulations around them favor the
occurrence of the disease. The internal administration of
mercury in large or long continued doses, may produce a
similar condition of the gums.
Pathology.— The gums at first are swollen and dark red
in color, but soon become pale yellowish and necrotic. The
epithelium is destroyed, deep ulcers form, suppuration ensues
and the teeth may become loose and fall out.
Symptoms.— In the early stages it begins as a severe
stomatitis, the gums bleed freely, are swollen and partly
STOMATITIS 97
envelop the teeth, but as their margins ulcerate and recede
the teeth become more and more exposed. The ulcerative
process may spread to the contiguous parts destroying much
tissue. Salivation is profuse and the odor of the breath very
fetid. Chewing and swallowing are difficult. The tempera-
ture is usually slightly increased. In severe cases the afferent
lymph glands are enlarged and symptoms of septicemia
may be noted.
Diagnosis.— This condition should be distinguished from
scorbutus. The chief differential features are the absence
of general symptoms and the free bleeding of the gums, both
of which are more marked in scorbutus. The anamnesis will
usually differentiate ulcerative stomatitis from poisons; the
characteristic general symptoms of the latter are also evident.
Prognosis.— A favorable termination of the disease is only
to be expected in young, healthy animals with mild affection.
In such cases, the course is from one to three weeks. In
severe cases in weak anemic animals the prognosis is unfavor-
able. Complete healing is, however, rare; death may occur
suddenly from septicemia.
Treatment.— Medical.— Potassium chlorate seems to be
nearly a specific for this condition. It may be administered
internally (0.3-0.6) three times daily, and also applied as a
mouth wash. As potassium chlorate is toxic, its use should
not be prolonged. When there is much fetor, a solution of
potassium permanganate (2 per cent.) can be used as a
mouth wash and silver nitrate (2 per cent.) applied to the
ulcers. In the mercurial stomatitis, a subvariety of the
ulcerative, the treatment consists in the removal of the
cause and the use of antiseptic mouth washes.
Surgical.— Examine the teeth carefully and remove all
incrustation. Loose teeth should be extracted.
Gangrenous Stomatitis.— Can ker of the Mouth.— Defini-
tion.— A disease of the mouth characterized by a rapidly
progressing gangrene, starting on the gums or lips and pro-
ducing extensive sloughing.
Etiology. — This disease is usually seen in young animals
(puppies, kittens, etc.) which have been kept under very
unsanitary conditions; or in older animals convalescent
7
98 DISEASES OF THE MOUTH
from infectious diseases. It is evidently an infectious dis-
ease, probably due to the Bacillus necrophorus. The lack
of resistance especially in young animals favors the develop-
ment of the organisms. Accumulations of filth in the kennels
and injuries to the tissues are predisposing causes.
Pathology.— The gangrenous area has the appearance of a
corroded surface under which the mucous membrane seems
transformed into a dry, finely granular or firm mass. It is
grayish-yellow in color and bordered by a zone of thickened
tissue, slightly reddened and somewhat granulated. The
necrotic tissue is very adherent and can be only partially
peeled off. The condition may extend to the underlying
tissues and even involve the bones.
Symptoms.— Slight salivation and a disinclination to take
food are the first symptoms noticed. An examination of the
mouth at this time may show an area of inflammation or
possibly an erosion. The latter rapidly increases in size and
depth, forming a sharply circumscribed, or at times diffuse
area of necrosis, which continuing to spread, may involve
any of the adjacent tissues. It often perforates the cheeks
forming a fistulous opening, or it may penetrate the hard
palate and produce a greenish-yellow nasal discharge'. With
the involvement of the nasal passages, the larynx or trachea
respiration is disturbed. When life is prolonged for a week
or more, necrotic foci may be established in the lungs, giving
rise to symptoms of bronchopneumonia. As the disease
progresses, salivation becomes profuse, deglutition difficult
and the swollen tongue often protrudes from the open mouth.
A very offensive odor is exhaled. W'hen the infection becomes
general (septicemia), the temperature is elevated (104°-
106° F.) and the animal shows extreme weakness. Diarrhea
is not uncommon and indicates an invasion of the gastro-
intestinal tract.
Diagnosis.— This is made by the rapid spread of the disease
in the tissues of the mouth, fetid odor and the general
symptoms.
Prognosis. — Ordinarily this disease shows no tendency to
a spontaneous recovery, and if untreated death usually
results. If taken early, however, it usually responds to
STOMATITIS 99
treatment. Under such favorable conditions the prognosis
is good, recovery occurring in twelve to fifteen days.
Treatment.— Dietetic.— As the animal refuses food on
account of the pain when swallowing it should be forced to
take some nourishment (warm milk can be given puppies
and kittens; milk and soups to older animals).
Surgical.— In those cases where the lesions are accessible,
the treatment consists in removing all the necrotic tissue with
a curette. This exposes the causative agent, an anaerobe,
to the air which inhibits its growth and development.
Medical.— The skin around the head, eyes and mouth
must be thoroughly cleaned with antiseptic washes (boric
acid 2 per cent., potassium permanganate 1-250). The
direct application of carbolic acid (5 per cent.), or Lugol's
solution to the exposed areas has proved quite beneficial.
In obstinate cases silver nitrate (2 per cent.) may be used.
Prevention. — Prevention of this disease consists in a thor-
ough disinfection once daily for a few days, of the mouth and
nose of those animals that have been exposed and are pre-
disposed by the eruption of the first teeth or the shedding
of the milk teeth; or through association with affected animals.
All filth should be removed from the kennel and disinfectants
freely used.
Phlegmonous Stomatitis. —Definition.— An acute phleg-
monous inflammation of the mucous membranes of the
mouth, lips and tongue.
Etiology.— M echanical.— Foods containing irritating mate-
rials. In hunting dogs sharp projections, such as thorns,
spikes, nettles, hairs, etc., on grasses and weeds are causes.
Chemical.— Carbolic acid, alkalies, ammonia, croton oil,
etc., when concentrated, produce an intense inflammation
and swelling of the membranes.
Infections.— It is produced secondarily during the course
of diseased processes of neighboring organs (infectious
pharyngitis) ; also secondary to infectious diseases (distemper
in dogs and cats and diphtheria in birds).
Pathology.— The mucous membrane is reddened, edematous
and covered with a thick tenacious mucus. The subcu-
taneous tissues are infiltrated with serum. Desquamation
of the epithelium is often noticed from the intense irritation.
100 DISEASES OF THE MOUTH
Symptoms.— The disease begins with swelling, redness and
a very painful condition of the mucous membrane. The
local temperature is accelerated. The lips and cheeks
become swollen, the lower lip hangs down and strands of
saliva hang from the corners of the mouth. Later the mucous
membranes on the inner surface of the lips, cheeks and the
back part of the mouth are bluish-red in color. The gums
are swollen and dark red, the tongue becomes much thickened
which interferes with deglutition and forces the mouth open.
In severe cases following infectious diseases, the submaxillary
and sublingual lymph glands are swollen and very painful
to the touch. The general symptoms depend largely upon
the primary condition.
Diagnosis.— Is made by the acute inflammatory condition
of the mucous membranes with the swelling of the lips,
cheeks and tongue. The anamnesis in some cases will
materially assist in making the diagnosis.
Prognosis.— Usually favorable; in the secondary cases it
depends on primary condition.
Treatment.— Dietetic.— All solid food should be withheld
for a few days and small quantities of liquid foods given
(milk, meat broth, etc.).
Medical.— The mouth should be thoroughly cleansed twice
daily with antiseptic and astringent solutions (alum 1-250;
tannic acid 1-250; potassium permanganate 1-250).
Parasitic Stomatitis.— Thrush. Soor. Aphtha.— Definition.
—An inflammation of the mucous membrane of the mouth
produced by the Oidium albicans.
Etiology.— The Oidium albicans (Monilla Candida, Sac-
charomyces albicans) is the exciting cause of this disease
which is found occasionally in healthy young animals, most fre-
quently in birds. This fungus is widespread in nature, occur-
ring especially on decaying vegetable matter as a saprophyte.
The mycelia are composed of cylindrical cells, 1-4 microns
wide and 10-20 microns long. The filaments show branching
and the outer ends are rounded off or club shaped. The
rounded ends often contain oval, highly refractive bodies,
the gonidia or spores, which are also found free between the
filaments. If the free spores come in contact with the oral
STOMATITIS 101
mucosa, in which there are slight epithelial defects, they may
develop and lead to the formation of thrush spots and pseudo-
membranes. In some cases the filaments and spores may
penetrate deeper into the tissues, or by metastasis involve
the internal organs. Frequently in birds, the spores are
taken into the crop where they develop and produce typical
thrush lesions. Damp, warm rooms poorly ventilated and
filthy, favor the growth of this fungus.
Pathology.— The affection begins with diffuse redness of
the mucosa and the formation of a glistening or shiny
adhesive exudate of grayish appearance. Small white or
yellowish dots next appear, which stand out prominently
against the hyperemic background. These patches may be
quite large and when removed the underlying mucosa is
congested and eroded. The disease usually begins on the
tongue or inner parts of the cheeks, from where it spreads
to other parts of the mouth. In severe cases it may extend
to the pharynx, esophagus, or even in fowls to the crop and
intestines. The microscope reveals filaments, spores, epi-
thelial cells and pus.
Symptoms.— The general symptoms are depression, emacia-
tion and loss of strength. On direct examination of the mouth
an acid odor will be detected and the characteristic lesions or
spots will be seen on the mucosa. These may be in the form
of white or yellowish spots, or they may coalesce forming a
superficial felt-like membrane which can be readily scraped
off. Similar membranes form in the esophagus and crop
interfering with the appetite and nutrition. This condition
leads to cachexia and death, which is often preceded by
convulsions.
Diagnosis.— The disease is readily distinguished from other
forms of stomatitis by the absence of acute inflammation.
The diagnosis is made positive by the finding of the filaments
or spores of the fungus in the deposits on the membranes.
The clinical appearance may be confused with the condition
due to the aspergillus fungi. (See Aspergillosis.)
t Prognosis.— When the disease is localized on the mucous
membrane of the mouth, the prognosis is favorable, but when
it extends to the esophagus and crop, treatment is unsatis-
factory.
102 DISEASES OF THE MOUTH
Treatment.— Dietetic.— Good nutritious food should be
given (small meat scraps, oatmeal and milk, etc.) to sustain
the strength.
Surgical.— Carefully curette all the accessible lesions and
wash with antiseptic solutions (boric acid 2 per cent., mer-
curic chlorid 1-1000, the latter used with care that it may
not be swallowed). When the disease extends to the crop,
give enough boric acid (2 per cent.) solution to distend the
latter, then massage it thoroughly with the head held down
so the contents will be forced out of the mouth. Repeat this
daily until the appetite is improved.
BENIGN NEOPLASMS OF THE MOUTH.
Papillomata. — These tumors occur on the mucous mem-
brane of the mouth and occasionally on the margins of the
lips and sometimes they apparently assume a contagious
character.
Symptoms.— They are noticed as small, isolated or confluent
growths, usually pedunculated, of a whitish color and often
rough (cauliflower-like) on their surface. They are found
most commonly at the juncture of the mucous membrane
and the skin, and on the inner surface of the lips, but may be
generally distributed over the oral mucosa. They rarely inter-
fere with mastication, but when present in large numbers
or masses they may cause some salivation and from the
decomposed food collecting around them a very disagreeable
odor is emitted.
Treatment.— These tumors frequently disappear in a short
time without any treatment. However, it is best to remove
them by clipping off with scissors. The mouth should be
washed for a day or two with antiseptic solutions (alum
1-250; potassium permanganate 1-250). Tannic acid (2
per cent.) applied direct to small papillomata often causes
them to slough off after a few applications.
Fibromata. — These tumors are composed of connective
tissue elements which may be a pure or mixed fibrous growth
BENIGN NEOPLASMS OF THE MOUTH lO.'i
containing cartilage and sometimes spicula of bone. They
have their origin in the submucous tissue or the periosteum
of the bone, and usually occur as a single growth.
Symptoms.— The tumor is found growing at the edge of the
gums in the form of a hard, reddish enlargement varying
in size from a pea to a walnut. Its growth is slow often
requiring months to develop into sufficient size to be notice-
able. The slow growth and firm consistency assist in dis-
tinguishing it from any of the malignant growths.
Treatment.— Complete extirpation and cauterization of the
wound with silver nitrate or thermocautery are curative.
Osteoma. — These tumors are found growing from the peri-
osteum of the maxillae. They are composed of osseous mate-
rial and frequently develop after injuries to the periosteum.
Symptoms.— Osteomas appear as very hard enlargements
firmly attached at their base. As a rule the skin or mucous
membrane is riot adherent over them. Their hardness and
slow growth readily distinguish them from malignant tumors.
Treatment. — Expose the enlargement by an incision through
the soft tissues and dissect down to the base, when it may
be removed if not too diffuse, by the use of bone forceps or a
small bone chisel. Curette the surface until smooth and
suture the skin over it. After-treatment as an ordinary
wound, using antiseptics to cleanse it daily.
Retention Cysts.— Ramda. — These are enlargements ap-
pearing in the buccal cavity from a stoppage of the ducts of
glands which discharge their secretions into the mouth. Co-
hesion of openings occurs from inflammations of the mucous
membrane, swelling, etc., partially or completely closing the
duct. At the same time the glands continue to secrete their
fluids which distend the ducts forming the enlargements.
Closure or obstruction of Wharton's duct produces an exten-
sive enlargement under the tongue. The most common
retention cysts, however, are from the ducts of the buccal
or sublingual glands. When the obstruction is complete
the secretions, as they collect, burrow downward along the
neck producing an enlargement which appears subcutane-
ously in the submaxillary region, or may extend to the supe-
104 DISEASES OF THE MOUTH
rior part of the neck, appearing as a soft fluctuating enlarge-
ment. There is an absence of inflammatory symptoms and
the skin is not adherent over it. These cysts develop slowly
in contrast to a rapidly developing hematoma; the skin is
adherent in the latter. The contents of the cysts can be
obtained by the use of a large aspirating needle or trocar
and examined. The fluid which flows out very slowly is a
thick, viscid, honey-like material which makes the diagnosis
positive.
Treatment.— Surgical.— Complete removal of the cyst is
hardly possible by excision, as the glandular secretion con-
tinues, and when adhesion of the edges of the wound takes
place, another cyst will develop. The most satisfactory
treatment consists in aspirating all of the contents and the
injection of Lugol's solution or tincture of iodin to destroy
the cyst wall and the secreting gland. The injection should
be sufficient to distend the cyst so that some of it will be
forced to gravitate into the gland to destroy it. This should
be done every second or third day. As soon as the gland
, is destroyed, the secretions will stop, the gland will atrophy
and the enlargement disappear. This usually takes place in
three to four weeks.
MALIGNANT NEOPLASMS OF THE MOUTH.
Epitheliomata.— These tumors appear most commonly on
the margin of the lips, involving the mucous membrane,
subcutaneous tissue, muscles and skin. They occur most
often in old animals.
Symptoms.— In the beginning they are observed as small
flat growths, which later have a tendency to show ulceration
on the surface. The surface has a roughened, granulating
appearance often covered with a thin dried mass. It grad-
ually develops in size until it invades the entire lip and occa-
sionally the maxillae. Secondary enlargement of the cervical
and submaxillary lymph glands is of common occurrence.
Epitheliomata are diagnosed clinically by their rapid, pro-
gressive growth, roughened irregular surface and invasion
MALIGNANT NEOPLASMS OF THE MOUTH 105
of the entire lip. In cases where a satisfactory diagnosis can-
not be made clinically a small portion can be removed for
microscopical examination.
Treatment.— Surgical.— Complete excision early as pos-
sible. When the tumor is small and involving the lip, a
"V-shaped incision should be made through the entire lip
removing all of the tissue affected. The wound should be
carefully sutured to bring the edges in direct apposition
when healing will readily take place. In more diffuse and
extensive growths complete excision is difficult but should
be attempted if at all possible. When the lymph glands are
involved treatment is usually unsatisfactory. After-treat-
ment consists in the use of antiseptic washes.
Sarcomata.— This tumor most commonly affects the
maxillse, usually the superior maxilla, as it originates either
in the periosteum, the medulla, or the endosteum of the bone.
They are frequently quite large and often invade the nasal
passages, the orbits and the sinuses. Metastatic processes
are common in the adjacent lymph glands and occasionally
a generalized sarcomatosis is produced.
Symptoms.— The growth first appears as a rather firm,
oval, reddish colored enlargement in close proximity to the
maxilla. Later the surface becomes irregular, lobulated and
covered with thickened mucous membrane. The tumor
usually has a broad base rather firmly attached, but may
in some cases be pedunculated. The growth is quite rapid,
beginning as one enlargement around which eventually
numerous secondary ones develop; later by confluence the
base becomes broad. The teeth are often hidden by the
growth or in some cases elevated from their position.
Treatment.— The removal of the entire growth should be
done as early as possible. Under general anesthesia, dissect
out the tumor, using bone forceps, chisel or curette, being
careful to get out all the affected tissue. When the alveoli
are affected, extract the 'tooth and curette and cauterize the
cavities to destroy, as far as possible, all the sarcomatous
cells. When the lymph glands and the sinuses are involved
treatment is practically impossible.
106 DISEASES OF THE MOUTH
FOREIGN BODIES IN THE MOUTH.
Foreign bodies in the mouth consist principally of such
objects as are taken in the mouth with food or during play.
Fragments of bone are most common. These either penetrate
the soft tissues or are firmly lodged in between the teeth, or,
if larger, may be between the rows of teeth. Splinters of
wood and pieces of wire are usually found imbedded in the
mucous membrane. Needles, pins and fish bones are also
common, especially in cats. Birds often have grains of corn,
sunflower seeds, etc., lodged under the tongue in the floor of
the mouth. Hunting dogs when running through fields often
have pieces of twigs or weeds forced in the mucous mem-
brane of the mouth. Porcupine quills are common in locali-
ties where these animals abound.
Symptoms.— When the foreign body causes much incon-
venience, the animal makes persistent attempts to remove
it by pawing at the mouth with the feet and shaking the head.
Masticatory movements may be continuous or the mouth
may be held open, with some salivation. Smaller objects
as needles, pins, etc., may not produce prominent symptoms
at first and the former may only be noticed by the presence
of a thread attached. Food and drink are either entirely
refused or feeble attempts made at eating. Thorough inspec-
tion of the mouth reveals the foreign body or the wound
in the membrane where it entered.
Treatment.— Ordinarily objects lodged between the teeth
may be readily removed with forceps. Imbedded objects
should be observed closely to determine their direction of
entrance and removed in the opposite direction. Vicious
animals, especially cats, should be etherized to render the
operation safe.
CHAPTER II.
DISEASES OF THE TEETH.
Examination.— Examination of the teeth can be done by
elevating the lips, which readily exposes them, or by the use
of tapes or a mouth speculum to hold the mouth open (see
examination of the mouth). Careful inspection should be
made for malformations, fractures, incrustations of tartar
and disease conditions.
MALFORMATIONS OF THE TEETH.
These are not common in small animals, only occasionally
being seen as distortions of the skull bones so affecting the jaws
that the teeth do not meet in proper relationship. This may
result in excessively long teeth. A few instances of defective
dentition are recorded. They are important only when they
interfere with mastication and subsequent nutrition. Breeding
has been carried to such an extent with some breeds (English
bull, etc.) as to amount almost to a malformation of the max-
illte with unusual relationship of the teeth in some individuals.
Birds occasionally have a deformity of the beak rendering
prehension of food difficult.
Treatment. — Surgical.— Surgical intervention is possible
only in rare cases to improve the appearance or condition.
Prescribe a suitable diet when the animal is unable to masti-
cate solid food (meat, etc., should be given in small pieces).
Long teeth may be removed or the points clipped off with
bone forceps. The long points of malformed beaks should
be so shaped, using a sharp knife, that they will assume a
more normal form.
108 DISEASES OF THE TEETH
FRACTURES OF THE TEETH.
Fractures of the teeth with exposure of the pulp cavity
sometimes occur, especially in dogs, and are usually due to
fighting, falls on hard surfaces, kicks (horses, etc.), being hit
with hard objects; often occur during play in attempting to
catch a ball or stone when thrown; also due to biting iron
bars in their attempts to escape from cages.
Treatment.— If the fractured tooth is painful, extract it.
It is possible to have it filled.
INCRUSTATIONS OF TARTAR.
Tartar occurs quite commonly on the teeth of dogs and it
is due to the precipitation of the carbonates, phosphates and
some organic substances from their solution in the mouth
secretions. It collects around the neck of the tooth close to
the gingival border which is the least exposed part of the
tooth, and therefore the deposits are not worn off by eating.
By constant accretion, these deposits increase, producing an
irritation to the gums and inflammation. As the process
continues, it separates the gums from the teeth and often
causes the teeth to loosen and fall out. In some severe cases,
the tooth may be completely covered with the incrustations.
The gums are reddened, swollen and painful, later showing
ulceration. A foul odor is emitted from the mouth.
Remove all deposits from the teeth with a curette or scaling
instrument, being careful not to injure the gums. Extract all
loose teeth. Tincture of myrrh applied to the gums is useful
as an antiseptic, astringent and deodorant. As this condi-
tion usually persists, these cases should have attention every
few weeks.
ALVEOLAR PERIOSTITIS.
Pericementitis . Periodontitis .
Definition.— This is an inflammation of the alveolar peri-
osteum.
Etiology.— It begins in most cases from the irritation pro-
duced by a collection of tartar around the teeth. As the
CARIES OF THE TEETH 109
incrustation gradually increases, it causes separation of the
gums from the teeth and this leads to suppuration of the peri-
dental membrane at the neck of the tooth, and, as the process
continues, the entire membrane becomes involved.
Pathology.— The affected tooth is loosened, slightly raised
from its alveolus, and, from disturbance to the vessels and
nerves leading to loss of nutrition, it becomes discolored
(dark or yellowish.) Injury to a tooth with exposure of the
peridental membrane may also lead to a similar condition
but in this case only one or a few teeth are affected while in
the former several, or in severe cases the entire set is lost.
Symptoms.— The animal either refuses food or takes only
a small amount and this very carefully. Saliva flows freely
and the mouth emits a foul odor. The gums are dark red
(livid), swollen and bleed easily. Ulcerative stomatitis
often accompanies this condition.
Treatment. — Extract all loose teeth and remove incrusta-
tions from the others. Disinfect the mouth daily with anti-
septic solutions (potassium permanganate 1-250), or by
direct application of tincture of myrrh to the gums. Extrac-
tion may be accomplished by the use of dental forceps, a
mouth speculum being necessary to open the mouth when
molars are to be extracted but not necessary for the incisors.
Grasp the tooth as far up the root as possible and for single
fanged teeth, loosen with half turn twist each way, and molars
with a pressure alternately inward and outward, care being
taken to avoid breaking the roots. General anesthesia
should be used when the animal is vicious.
CARIES OF THE TEETH.
Definition.— Caries is the true decomposition or disinte-
gration of the dental tissues. It is rare in small animals.
Etiology.— The process always commences on the surface
of the tooth where the enamel is inferior or damaged, or at
protected parts of the tooth where food particles lodge and
decompose.
Pathology.— The point where this begins may or may
not be discolored, and as the dentin is disintegrated more
110 DISEASES OF THE TEETH
rapidly than the enamel, a cavity is soon formed within the
tooth but having a small opening through the enamel. As
this process continues it opens the pulp cavity which becomes
infected. As long as the opening through the enamel is free
the pus will be discharged without further complication but
if it becomes closed with food particles, etc., an abscess
develops at the root and the pus burrows out into the adja-
cent parts, usually into the sinuses or may break down the
sinus wall resulting in a maxillary fistula. The disintegra-
tion of the dental tissue is brought about by chemical action
from the lactic acid fermentation in the mouth.
Symptoms.— This condition will be noticed only by careful
inspection until the disintegrating process reaches the pulp
cavity when it gives rise to sharp pain, depression of the head
toward the affected side and careful mastication. When a
fistula results the pain is not pronounced. Empyema of the
sinuses often causes a distortion of the affected side and a
dull sound when percussed. Suspect all fistulse opening in
the maxillary region as having their origin in a carious tooth.
Treatment.— Extract diseased tooth and cleanse the alveo-
lus with antiseptic solution (boric acid 2 per cent.). If a
fistula is present, it is readily irrigated when the tooth is
removed. Thorough irrigation through the entire tract
should be done daily. Healing is usually rapid.
CHAPTER III.
DISEASES OF THE TONGUE.
Examination. — This can be readily done by opening the
mouth (see examination of the mouth) and pulling the tongue
forward as far as possible with a blunt forceps or by a piece
of tape wrapped around the free end of the tongue, using
gentle traction.
In paralysis of the tongue, it will be relaxed and protrude
from one side of the mouth. The examination should be
made for (a) foreign bodies, splinters of bone, needles, pins,
etc., which often penetrate the tongue. (6) Rubber bands,
pieces of bone or cartilage becoming fixed around the free
portion of the tongue, (c) Inflammation of the tongue
(glossitis), (d) Necrosis of the free portion of the tongue.
(e) Ulcerative processes extending from the mucous mem-
brane of the mouth. (/) Edema of the tongue occurring
during the course of infectious diseases (distemper, etc.).
(g) Inflammation of the glands in the posterior part of the
tongue, (h) Deposits on the tongue.
GLOSSITIS.
Definition.— An inflammation of the tongue.
Etiology.— Mechanical.— Injuries by foreign bodies (pieces
of bone, needles, etc.) which penetrate it; biting the tongue
or being bitten by other animals or insects, cats being fre-
quently bitten by rats or mice.
Chemical.— Medicinal substances taken in too concentrated
form (carbolic acid, ammonia, etc.) or given for too long a
period or in too large doses will lead to severe glossitis.
Thermic.— Hot foodstuffs or the tip of the tongue touched
against hot objects.
112 DISEASES OF THE TONGUE
Infectious.— Occurs during the course of infectious dis-
eases (distemper, etc.). Glossitis also usually accompanies
the various forms of stomatitis.
Pathology. —The mucous membrane is reddened, swollen
and covered with a grayish-white membranous deposit.
When foreign bodies are present at the point of entrance,
the tongue is swollen and edematous, later becoming a dark
bluish color. In severe cases foci of gangrene are seen.
Symptoms.— The animal refuses food or eats very carefully;
the mouth is often held open; saliva, sometimes streaked with
blood, runs from the corners of the mouth. The swelling
may be so great that the tongue is protruded. Direct ex-
amination reveals the swollen and reddened condition of the
tongue and quite often foreign bodies are found imbedded in
it or around the free end. As a rule no general symptoms
are noticed except when due to infectious diseases.
Prognosis.— The majority of cases terminate in recovery,
depending somewhat on the cause and extent of the injury.
When due to infectious diseases, the prognosis is less favor-
able.
Treatment.— Dietetic.— \Vhen the swelling interferes with
mastication, soft or liquid foods should be given (milk, beef
broth, etc.).
Medical.— Antiseptic washes (boric acid 2 per cent.,
potassium permanganate 1-250, potassium chlorate 1-100)
may be used several times daily. When there is severe
swelling, astringent solutions are also indicated (alum 1
per cent.).
Surgical. — In very severe cases or where abscesses develop,
make deep incisions in the substance of the tongue followed
by the use of antiseptic solutions.
GANGRENE OF THE TONGUE.
Gangrenous Glossitis.
Definition.— This is a gangrenous condition of the tongue
which may involve the entire free end or appear as small
rapidly spreading ulcers.
GANGRENE OF THE TONGUE 113
Etiology.— M echanical.— Obstruction to the circulation
from foreign bodies is not uncommon. Rubber bands are
occasionally slipped over the tongue by children; rings of
cartilage from the trachea or aorta from cadavers upon
which the dog has been feeding, have been found around the
tongue.
Infectious. — Gangrene of the tongue may be caused by the
Bacillus necrophorus and often is associated with gangrenous
stomatitis.
Chemical.— The action of concentrated drugs may be so
severe as to cause a gangrene.
Pathology.— When the tongue is encircled by foreign
bodies which shut off the blood supply that part of the tongue
anterior to the foreign body becomes swollen and in a few
hours very dark and gangrenous and will slough off in three
or four days. In cases of infection, the process begins as a
small ulcer which rapidly extends and may involve the entire
organ. Chemicals usually cause only small areas of gangrene
which do not show a tendency to spread.
Symptoms.— The animals refuse food and drink, and saliva
flows freely. If the tongue is much swollen it may protrude
from the mouth. The inconvenience causes the animal to
appear depressed. General disturbance is not noticed in the
early stages but later, from the absorption of the gangrenous
toxins, an elevation of temperature and symptoms of sapremia
are seen.
Diagnosis.— The presence of the foreign body around the
tongue partly obscured by the swelling, or in infection the
rapidly spreading ulcer.
Prognosis.— This depends on the degree of compression
by the foreign body, and the length of time it has been on
the tongue. Complete obstruction of the blood supply for a
few hours (4-6) will often result in loss of the tongue. The
infectious form is favorable if treated early.
Treatment. — Remove the cause if a foreign body. When
due to infection or chemicals, remove the necrotic material
with a curette and thoroughly cleanse with antiseptic solu-
tions (see Gangrenous Stomatitis.) After removing the
foreign body from around the tongue a few hours should
8
114 DISEASES OF THE TONGUE
be allowed for the establishment of the circulation and if it
does not occur in that time, the affected part should be
amputated. This must be done under general anesthesia.
Fix the jaws open with a mouth speculum and draw the
tongue forward, using blunt forceps or a tape suture through
the healthy tissue to hold it. A pair of dull, heavy scissors
can be used to remove the diseased part. A small ecraseur
will also do. Control the excessive hemorrhage by twisting
the artery with forceps or by ligation. An animal with part
of the tongue removed will have difficulty in drinking, and
water should be supplied in a vessel of sufficient depth to
allow the mouth to be submerged or from a faucet placed at
the height of the head.
CHAPTER IV.
DISEASES OF THE SALIVARY GLANDS.
Examination.— 1. The glands can be examined by palpa-
tion for: (a) Enlargements (cysts, abscesses, tumors, etc.);
(6) inflammations; (c) wounds; (d) fistulse.
2. The character and the amount of the secretions. The
normal secretion is a mixture of secretions from the parotid,
submaxillary, sublingual and the mucous glands of the mouth.
It is a thin, slightly viscid, opalescent fluid, having a feeble
alkalin reaction and a specific gravity of 1005-1008.
An increase in the salivary secretion is noticed in the follow-
ing conditions: The different forms of stomatitis; dentition;
chorea by reason of the increased masticatory movements;
gastric ulcers; nausea; helminthiasis; severe pain; direct nerve
stimulation either central or peripheral; uremia; mercurial
poisoning; drugs such as pilocarpin which produce direct
stimulation to the secretory nerve.
The secretion of saliva is diminished in the following
conditions : During the course of fevers (pneumonia, septic
fever, etc.); after the use of atropin or belladonna; fright
and excitement ; severe diarrheas ; cirrhosis of the liver when
ascites is developing; atrophy of the salivary glands.
PAROTITIS.
Mumps.
Definition. — An acute or chronic inflammation of the
parotid gland.
Etiology.— Mechanical— Direct injuries to the gland by
being run over by vehicles; struck with stones; kicks, etc.;
pulling back when tied and the collar injuring the gland or
by being caught in a door.
Chemical.— The internal administration of potassium iodid
in too large doses or the absorption of iodin from local appli-
116 DISEASES OF THE SALIVARY GLANDS
cations will often produce it. Lead when given in large doses
will sometimes cause acute parotitis which may result in a
chronic induration of the gland. Inflammations of the
mucous membrane of the mouth from chemicals will reflexly
and by absorption produce an inflammation of the glands.
Obstruction of the ducts from chemical action or from other
causes of stomatitis often leads to a chronic parotitis. From
the retention of the secretions, the glands become enlarged
and hard and may resemble tumor formation.
Infectious.— The disease sometimes appears in the form
of an epizootic which no doubt is caused by a specific organ-
ism. A diplostreptococcus has been isolated from the gland
and from Steno's duct during such epizootics. Other organ-
isms have also been found but as yet none of them has
proved specific. During the course of infectious diseases
(distemper, etc.) the parotid is frequently infected resulting
in an acute inflammation. Parotitis occurs as a secondary
disease in pharyngitis, stomatitis and other local inflamma-
tory conditions. Chronic parotitis results from repeated
acute attacks or from obstruction to the ducts.
Pathology.— The acute parotitis in the early stages begins
with a swelling, congestion and serous infiltration of the
interlobular connective tissue. Later small abscesses develop
which become confluent forming one large abscess. In chronic
parotitis there is a thickening of the connective tissue and
atrophy of the glandular substance which produce a hard,
fibrous condition (indurative parotitis).
Symptoms.— The acute infectious parotitis begins with a
swelling in one or both glands, with a collateral edema in the
surrounding tissues. The swelling usually develops rapidly,
is very painful to the touch and changes the appearance
of the head and neck. The head is held away from the
affected side or if bilateral is extended. The temperature
is elevated (103°-105° F.), the animal shows depression,
partial or complete loss of appetite, and mastication is slow
and careful. The saliva is usually increased in quantity and
runs from the corners of the mouth in strands. In a few
days abscesses develop, producing a fluctuating enlargement
which discharges reddish colored pus when opened. In
PAROTITIS 117
parotitis produced by injuries, lesions are often found on
the skin. In most cases only one gland is affected and general
disturbance will not be noted. When resulting from pharyn-
gitis and stomatitis, the symptoms are modified by the
swelling of the mucous membrane and connective tissues.
There is quite an extensive edema of the lips, tongue and in
the tissue around the gland. Chronic parotitis is charac-
terized by a firm enlargement of the gland, acute symptoms
being absent. Steno's duct may be distended from a closure
of the buccal opening.
Diagnosis. — Acute parotitis may be confused with enlarge-
ment of the lymph glands and therefore must be examined
carefully. The position, shape and nature of the enlarge-
ment are to be considered in making the diagnosis.
Prognosis.— Usually favorable. When abscesses develop
a fistula may result from the opening of some of the ducts.
In chronic indurative parotitis, the prognosis is less favorable.
Treatment.— In the early stages when the glands are
enlarged endeavor to hasten resolution, or abscess formation.
Later a stimulating liniment (soap or white) may be used
with good results. When abscesses develop, they should
be opened early so as to secure good drainage. When the
incision is made, it should be only through the skin, and the
tissues then separated with the fingers in order not to injure
the gland any more than is absolutely necessary. Irrigate
the cavity daily with antiseptic solutions (boric acid 2 per
cent., etc.). In cases where the discharge is persistent and
abundant, tincture of iodin or Lugol's solution injected into
the gland gives good results (see Salivary Fistula).
In chronic parotitis recovery may be hastened by the
application of iodin ointment over the surface of the glands.
Lugol's solution may be injected directly into the gland.
Insert the needle rather deep into the gland substance, being
careful that it does not enter a bloodvessel, which will be
shown by the free flow of blood. Injections may be made at
different parts of the gland and repeated in a few days if
necessary. Small doses of potassium iodid (0.05-0.10) given
once daily will assist in the absorption of the deposits in the
gland.
118 DISEASES OF THE SALIVARY GLANDS
SUBMAXILLARY AND SUBLINGUAL GLANDS.
These glands owing to their position are not as often
injured as the parotid, therefore inflammation due to trau-
matism is rare. Occasionally infection develops in the glands
by gaining entrance through the ducts and producing an
acute inflammation.
Symptoms.— Enlargement of the glands, profuse salivation
with the head held extended. Abscesses often form in the
glands which open and discharge a reddish colored pus.
The opening may be through the skin or into the mouth.
Treatment. — See Parotitis .
SALIVARY FISTULA.
Definition.— A fistula which discharges secretions from the
salivary glands.
Etiology.— Mechanical.— Injuries (cuts, bites, etc.) in
which Steno's duct or any of the smaller ducts are opened
so as to permit the escape of saliva; often follows operations
for the removal of a calculus from Steno's duct.
Infectious.— Abscesses which develop within the gland
may rupture and leave an opening through which the saliva
escapes.
Pathology.— When the injuries or abscesses open a duct,
the overlying tissues heal until there is only a small opening
left through which the saliva continues to be discharged. In
some cases, however, the healing of the skin is complete and
then the accumulated secretions burrow along under the
skin. When there is enough fluid to cause necrosis of the
skin by the pressure, it opens and thus forms a fistula. This
in turn may heal only to reopen in another place. Such
openings have been found in the lumbar region.
Symptoms.— A small opening will be noted partially
covered with matted hair and from which is discharged a
thin serous fluid (saliva) and occasionally a small amount
of pus. When probed, it will be found to be only subcu-
taneous unless in the region of the gland when it will be
deeper and lead to the gland or duct. A history of these
SALIVARY FISTULA 119
fistulse appearing from time to time may extend over several
months. In fistula of the duct, the saliva flows freely and
increases where food is offered or taken.
Diagnosis.— The chronicity and the character of the dis-
charge are usually sufficient to make a diagnosis.
Prognosis. —Unfavorable.
Treatment.— When the fistula is distant from the gland,
probe carefully until the origin is reached. Open the skin
at this point and apply treatment direct to the opening in
the duct or gland. Tincture of iodin applied direct to the
opening leads to swelling which occludes the opening.
In obstinate cases the thermocautery should be used.
When Steno's duct is open, suturing may be attempted.
When all treatment fails complete destruction of the gland
by repeated injections of iodin directly into the gland or
extirpation should be practised.
CHAPTER V.
DISEASES OF THE TONSILS.
Examination.— The tonsils can be readily examined in
docile animals by opening the mouth (see examination of
the mouth) and pulling the tongue well forward. In vicious
animals, partial or complete anesthesia is advisable. The
tonsils should be examined for acute or chronic inflamma-
tions, deposits of mucus on their surface, abscess formation,
tumors and foreign bodies. The adjacent lymphatic tissues
are frequently involved producing a diffuse enlargement of
all the surrounding parts.
TONSILLITIS AND LYMPHADENITIS.
Definition.— An acute or chronic inflammation of the tonsils
and the adjacent lymphatic tissues.
Etiology.— Tonsillitis is not of very frequent occurrence.
Some breeds (Boston terrier), however, are occasionally
affected.
Exposure to wet and cold and bad hygienic surroundings
appear to have a direct influence in producing the disease.
Chemical. — Carbolic acid, arsenic, etc., may produce it
by direct irritation.
Mechanical. — Foreign bodies (sharp pieces of bone, needles
and pins, etc.) often penetrate the glands and lymph tissue
resulting in acute inflammation. Inflammation of contigu-
ous parts will often produce the condition by spread of the
inflammatory process (stomatitis, pharyngitis, etc.).
Infectious.— The tonsils and lymphatic tissues undoubtedly
take up a lot of microorganisms, the most common of which
are the streptococci and the staphylococci. These organisms
by their rapid development in the tonsils produce an acute
TONSILLITIS AND LYMPHADENITIS 121
inflammation, and from there, they or their products may
enter the general circulation and produce symptoms of a
general infection, or toxemia. Further, this condition may
appear during the course of some diseases, as distemper,
rabies, endocarditis, etc.
Pathology.— The tonsils and the lymphatic tissues become
swollen, reddened, and later covered with a thick, tenacious
mucus. Vesicles are frequently formed, and in some instances
even membranous exudation, forming a pseudomembrane.
The lacunae of the tonsils become filled with a cheesy mass
of exudation, often becoming confluent, forming small
abscesses. The contents of the lacunae are composed of
epithelial debris and micrococci. In the chronic form, the
tonsils become hypertrophied due to a multiplication of the
glands mainly involving the lymphoid; or in some instances
the fibrous stroma is increased and the tonsils become hard
and swollen.
Symptoms. — In the early stages the temperature is
elevated 102°-104° F., respirations and pulse accelerated.
When the glands become much enlarged, the patient breathes
with difficulty, holding the mouth open, producing a peculiar
snoring sound. Direct examination reveals the reddened
and enlarged tonsils. The cervical lymph glands are also
frequently enlarged from the infection. In severe cases the
tonsils become very much enlarged forming abscesses.
However, in the majority of cases the inflammation subsides
within a week, the temperature becomes normal, and the
local, condition rapidly disappears. In the chronic form the
symptoms are milder and are usually overlooked.
Prognosis. — In most cases favorable; depends somewhat
upon the cause. The course is rarely longer than one week
or ten days for the acute form, while the chronic form may
continue for several weeks.
Treatment.— Locally the tonsils and the lymph tissues may
be treated with a 5 per cent, sodium bicarbonate solution.
Astringent and styptic preparations (iron, alum, zinc and
silver nitrate) may be found useful. Borax in glycerin
(2 per cent.) or thymol in glycerin (3 per cent.) can be used
as a deodorant when the mouth becomes offensive. Abscesses
122 DISEASES OF THE TONSILS
should be incised freely to allow drainage and antiseptic
solutions used. In chronic hypertrophy of the glands and
lymph tissues, it often becomes necessary to remove the
enlargement surgically. This can readily be done under
anesthesia with the aid of a mouth speculum to fix the jaws
open when with a sharp curette the growths can quickly be
removed. After-treatment with antiseptic solutions (boric
acid 2 per cent.) should be continued for a few days.
CHAPTER VI.
DISEASES OF THE PHARYNX.
Examination.— The pharynx is easily exposed to view by
opening the mouth and pulling the tongue forward. For a
more careful examination the mouth speculum may be used
to immobilize the jaws, while in vicious animals it is always
best to use an anesthetic.
PHARYNGITIS.
Pharyngitis is divided into (a) acute, and (6) chronic.
Acute Pharyngitis.— Definition.— An acute inflammation
of the pharynx.
Etiology.— Mechanical.— Sharp foreign bodies (needles,
pins, sharp pieces of bone, etc.) may penetrate the mucous
membrane and produce an acute local inflammation.
Chemical.— Inhalation of gases (smoke, ammonia, etc.)
will produce inflammation in the pharynx as wrell as in the
larynx. Drugs administered in concentrated form.
Thermic.— Very hot liquids or foodstuffs when swallowed
frequently produce in dogs a severe pharyngitis. Exposure
to cold when the body is heated will produce a congestion
in the pharyngeal mucous membrane and this may result
in an acute pharyngitis.
Infectious.— Many of the above causes predispose to infec-
tion, the most common of which are produced by the strepto-
coccus and the Bacillus necrophorus. A severe form of
infectious pharyngitis is occasionally seen in week -old
puppies and kittens, in some cases amounting almost to an
enzootic, affecting the entire litter. Pharyngitis is secondary
to infectious diseases as rabies, distemper, infectious nasal
catarrh and cholera of birds. It is often produced by an
extension of inflammation from the adjacent organs and
tissues (nasal catarrh, bronchitis, stomatitis, etc.).
124 DISEASES OF THE PHARYNX
Pathology. — (a) Acute pharyngitis is characterized by
redness and swelling of the mucous membrane which has a
glazed appearance due to the collection of mucus on the
surface. Later there is an abundant discharge of a thick
mucus or a mucopurulent exudate. Occasionally it may be
tinged with blood. In severe cases small erosions appear on
the posterior part of the pharynx. The lymph follicles are
enlarged and appear as small, round, elevated, reddish
nodules projecting through the membrane.
(6) The discharge contains bacteria, leukocytes, blood
cells and desquamated and degenerated epithelium.
Symptoms.— One of the first symptoms is difficulty in
swallowing food. Frequent attempts at swallowing with the
head extended are often noticed in the early stages. Later,
in the more severe cases, abundant salivation results from
increased secretion. and inability to swallow, while retching
and sometimes vomiting will be seen in some cases from the
irritation. The head is usually held extended and palpation
of the pharynx produces pain. The submaxillary and retro-
pharyngeal lymph glands often become enlarged and may
produce abscesses. Occasionally in severe cases the salivary
glands become involved. On examination of the pharynx
the mucous membrane will be found reddened, congested,
and covered with mucus or mucopurulent exudate, depending
upon the stage of the development of the disease, and in
severe cases swelling and congestion of the adjacent tissues.
Cough is absent and only occurs when the inflammatory
process extends to the larynx. In all cases where infection
develops, the temperature is elevated (103°-105° F.). In
mild cases when the general symptoms are absent, the appe-
tite remains good although the animal takes food slowly and
with care. In severe cases there is a complete loss of appetite.
Diagnosis.— The symptoms of acute pharyngitis are very
characteristic: The extended head, difficult swallowing and
salivation; while direct examination and the temperature
readily distinguish it from foreign bodies, tumors and par-
alysis of the pharynx.
Prognosis.— In older animals it is favorable, recovery
occurring in one to two weeks. In young animals, when it
occurs as an cnzootic, the mortality is high.
PHARYNGITIS 125
Treatment.— Dietetic.— Soft liquid foods (rice soup, milk,
extract of beef, etc.) should be given in preference to solids
to avoid irritating the mucous membrane.
Medical.— Local treatment in the form of astringent and
antiseptic solutions (2 per cent, silver nitrate solution; 5
per cent, alum solution; iodin and glycerin 1-30) applied
directly to the membrane by using a pledget of cotton held in
dressing forceps. In milder cases a solution of potassium
chlorate (2 per cent.) or iron sulphate in the drinking water
is recommended. A Priesnitz compress applied over the
pharynx and followed with mild stimulating liniments
(soap liniment, etc.) is often beneficial. Internally mild
purgatives such as castor oil or cascara should be used.
Chronic Pharyngitis.— Definition.— A chronic inflammation
of the mucous membrane of the pharynx.
Etiology.— This condition may follow repeated acute at-
tacks, or is frequently associated with chronic nasal catarrh.
It also occurs secondary to inflammation of adjacent tissues.
Dogs constantly barking from a nervous temperament or
during shows are often affected from the spread of the
inflammation from the larynx.
Pathology. — The mucous membrane is relaxed, the lymph
tissue becomes proliferated forming small, round elevations,
red or bluish-red in color which project above the surface
of the membrane, and is known as pharyngitis granulosa.
The secretions are lessened producing a dry, glistening con-
dition of the pharyngeal mucosa.
Symptoms.— The symptoms are similar in many respects
to those of acute pharyngitis, but milder in most cases. The
swelling of the adjacent tissues and lymph glands is hardly
noticeable. The difficulty in swallowing is especially marked
when a large quantity of food is taken or when the food is
very hot or very cold. Direct examination of the pharynx
reveals the bluish-red color and the elevations over its surface.
Prognosis.— Considered favorable in most cases, depending
somewhat on the possibility of removing the causes. In the
milder cases it is very often overlooked.
Treatment.— Direct application of Lugol's solution to the
mucous membrane has been found useful in most cases.
126 DISEASES OF THE PHARYNX
Tannic acid and glycerin (1-30) may also be used. Chlorid
of iron (1-10) in water is of value owing to its astringent and
antiseptic qualities. The application of the preparations
should be made daily until the symptoms subside.
FOREIGN BODIES IN THE PHARYNX.
Foreign bodies may find lodgment in the mouth or in the
pharynx. When dogs are ravenously hungry large particles
of food or food containing foreign bodies are swallowed which
may lodge in the pharynx, producing choking. The condi-
tion often terminates fatally in a short time. Cats when fed
on fish are liable to have fish bones lodge in the pharynx.
These bones frequently penetrate the mucosa, producing an
edema of the pharynx and larynx, resulting in death from
asphyxia. Birds, when eating large seeds (sunflower seeds,
corn, etc.) often have them lodge in the pharynx, producing
serious symptoms. Various kinds of foreign bodies have
been found in the pharynx, the most common being needles,
pins, bones, hard food masses, meat skewers, cartilage, etc.
Symptoms.— The symptoms vary somewhat according to
the size and character of the foreign body. Dribbling of
saliva from the corners of the mouth; frequent attempts at
swallowing; clawing at the mouth with the forefeet, and
sometimes retching and vomiting. When the foreign bodies
are large they often interfere with the respirations.
Diagnosis.— The diagnosis is made by direct examination
of the pharynx (see examination of the pharynx), the sudden
development and the characteristic symptoms.
Prognosis.— Depends upon the size and character of the
foreign body. Where the foreign bodies are small and the
animal can be treated at once, the prognosis is favorable. In
other cases where edema occurs or where the foreign body is
quite large, death may terminate before assistance can be
given.
Treatment.— Surgical.— A mouth speculum is used to keep
the mouth open and the foreign body often can be easily
removed with a long curved throat forceps. Holding the
tongue well forward will materially assist in locating accu-
CROUPOUS PHARYNGITIS OF BIRDS 127
rately the foreign body. When the foreign body is in the form
of a threaded needle, which frequently occurs in cats, the
sharp point is usually toward the mouth. Therefore care
should be used in removing it to prevent laceration of the
tissues. By grasping it with the forceps and pushing it down-
ward until the sharp point is free from the tissues, it can then
be readily removed. Large food masses often can be broken
between the fingers and extracted or pushed down into the
esophagus. Where edema of the tissues results from lacera-
tion and symptoms of suffocation develop, tracheotomy
should be performed at once. (See Tracheotomy.) No
after-treatment is necessary except when severe injury to
the tissues has taken place ; in these conditions the pharynx
should be treated direct with antiseptic solutions (boric acid
2 per cent.), using a dressing forceps with a pledget of cotton
firmly attached. In birds the mouth is held open and a
small pincette used to dislodge the foreign body.
PARALYSIS OF THE PHARYNX.
Pharyngeal paralysis occurs mostly during the course of
specific diseases (rabies, distemper) and will therefore be
described under those diseases which it accompanies.
CROUPOUS PHARYNGITIS OF BIRDS.
Definition.— A croupous inflammation affecting the pharyn-
geal mucous membrane of birds.
Etiology.— This condition is produced by a flagellated
infusoria, the Monocercomonas gallinse. This parasite is
round or discoid in shape, of a pale color and from 14 to 25
mm. in length and 5 to 7 mmm. in breadth. The disease
affects young birds, especially pigeons. Unsanitary condi-
tions and cold, damp quarters are predisposing factors.
Pathology.— Small white elevations are found on the
mucous membrane of the pharynx, often extending into the
esophagus and crop. Occasionally these lesions are noted
at the base of the tongue and on the palate. Surrounding
these small elevations are found zones of acute inflammations
with considerable swelling and congestion of the membrane.
128 DISEASES OF THE PHARYNX
Symptoms.— Loss of appetite, dulness and general weakness
are the first symptoms observed. The plumage becomes
rough, the wings are pendant and the mouth held open.
The odor from the mouth is offensive. Examination of the
posterior part of the mouth and the pharynx reveals the
presence of the small white elevations. A microscopic exami-
nation of scrapings made from these white spots will confirm
the diagnosis by finding the infusoria.
Prognosis.— It should be considered unfavorable especially
in very young birds. Death occurs in many cases from loss
of appetite and exhaustion.
Treatment.— Where only a few cases are observed, they
should be separated at once from the healthy birds and the
runways and roosts thoroughly disinfected with lime, or
carbolic acid (5 per cent.). The mouth and pharynx should
be cleansed with a solution of boric acid (2 per cent.) or
creolin to destroy the infusoria. Remove the small elevations
with a blunt curette and apply to the surface chlorid of iron
(1-10) in water or a solution of tannic acid (5 per cent.) in
water, to arrest the hemorrhage and to produce antiseptic
action.
NEOPLASMS OF THE PHARYNX.
Polypoid Growths.— Polypoid growths (myxomas) are
found occasionally projecting from the pharyngeal mucous
.membrane. They vary greatly in size from half an inch to
four inches in length. From severe or sudden exertion or
swallowing they are often forced into the esophageal opening,
interfering with the prehension of food and drink.
Symptoms.— Sudden interference with deglutition; symp-
toms of suffocation ; often rapid recovery ; periodic recurrence
of the symptoms and direct examination of the pharynx will
reveal the presence of the polypoid growths.
Treatment. — Surgical.— The mouth speculum should be
used, the tongue pulled well forward and a small wire ecraseur
used to remove the enlargement. It should be removed as
close to the base as possible. No after-treatment is necessary.
Recovery takes place promptly.
NEOPLASMS OF THE PHARYNX 129
Epithelioma. — These are found occasionally in old animals,
and occur in the pharynx as a primary condition or may he due
to metastasis. The retropharyngeal and submaxillary lymph
glands are nearly always involved. This condition has been
seen secondary to malignant goiter, having extended to the
lymph glands by metastasis and from there to the pharynx.
Symptoms.— Difficulty in swallowing; fetid odor from the
mouth; often profuse salivation. Direct examination shows
the presence of an ulcerated enlargement on the pharyngeal
mucosa. The general condition is in most cases disturbed.
Emaciation, especially when due to metastasis; loss of appe-
tite. A small portion of the enlargement should be obtained
and examined microscopically to confirm the diagnosis.
Treatment.— No satisfactory treatment can be given.
CHAPTER VII.
DISEASES OF THE ESOPHAGUS.
Examination.— The cervical portion of the esophagus is
readily examined by palpation over its course along the
upper surface of the trachea. The probang affords a means
of examining the interior for foreign bodies, strictures, etc.,
along its entire length.
ESOPHAGITIS.
Definition.— An acute inflammation of the mucous mem-
brane of the esophagus.
Etiology.— (a) Mechanical. — Irritation from foreign bodies
(bones, needles, splinters of wood, etc.), passing of sounds,
etc., lacerating the mucous membrane. External injuries to
walls.
(6) Thermic. — Eating very hot foodstuffs or drinking hot
liquids.
(c) Chemical.— Alkalies and acids, ammonia and corrosive
medicinal agents frequently in their passage through the
esophagus produce an acute inflammation.
(d) Infectious. — Occurs during the course of infectious
diseases (rabies, distemper).
Secondarily it is produced by the spread of the inflamma-
tion from the pharynx or stomach. It occurs sometimes
spontaneously in very young suckling animals.
Pathology.— Redness of the mucosa is rarely seen except
after injuries or severe chemical irritants. The epithelium
is thickened, desquamated and the surface covered with a
fine granular substance. The mucous follicles are swollen
and sometimes erosions may be seen. In phlegmonous
inflammation, the mucous membrane is swollen, with a
FOREIGN BODIES— OBSTRUCTION IN ESOPHAGUS 131
purulent infiltration in the submucosa. This condition is
usually seen around foreign bodies when they penetrate the
membranes, and, as a rule, remains localized. Gangrene of
the membrane is sometimes seen where the injury or infec-
tion has been severe.
Symptoms.— In the milder forms of esophagitis the symp-
toms are unobserved. In more severe forms there is great
difficulty in swallowing which act is often soon followed by
vomiting. The vomitus contains blood, the solid particles
covered or streaked with it. Frequent attempts at swallow-
ing, constantly extending the head or moving it from side
to side. In some cases where corrosives have been swallowed
fragments of the mucous membrane will be ejected with the
vomitus. Profuse salivation, blood is often mixed with the
saliva. Palpation along the cervical portion of the esophagus
produces severe pain. ' When localized in the cervical por-
tion the esophagus should be palpated carefully for foreign
bodies.
Course and Prognosis.— In the majority of cases, recovery
takes place in one to two weeks. In very severe inflammation
complications are liable to occur. Strictures or abscess with
perforation of the walls of the esophagus may result. In the
latter when the thoracic portion is involved the termination
is fatal from infectious pleuritis.
Treatment.— In the early stages cold milk, or tannic acid
(1-2 per cent.) in cold water is indicated to allay the inflam-
mation and to produce astringent action. Cold compresses
to the cervical portion of the esophagus often have a beneficial
action. Inflammations from caustic substances should be
treated as early as possible with the proper antidote. When
severe pain is shown small doses of morphin should be admin-
istered subcutaneously. Tincture of opium in dilute solution
may be given per orem. In very severe cases where foods
cannot be given via the mouth, enemata should be employed.
FOREIGN BODIES. OBSTRUCTION IN ESOPHAGUS.
Etiology.— Obstruction in the esophagus occurs most fre-
quently in dogs. The body 'lodges immediately posterior to
132 DISEASES OF THE ESOPHAGUS
the pharynx; at the lower extremity of the cervical portion
at its entrance to the thorax; or near the cardiac orifice (at
this point the lumen of the esophagus is less than at any
other place along its course). Owing to the habit of these
animals of taking food in large pieces and without mastica-
tion the majority of the obstructions occur just posterior to
the pharynx. However, sharp bodies may be found anywhere
along its course. In the dog a great variety of substances
have been found producing the obstruction, as these animals
during eating or at play swallow many substances that would
not be found in other animals. The most common substances
which are liable to produce the obstruction in dogs are:
Bones, cartilage, hard food masses, pieces of tendon, needles,
rubber balls, meat skewers, stones, etc. In cats fish bones
are frequently found which they get from eating scraps of
fish given them without removing the bones. As a rule fish
bones lodge in the anterior portion of the esophagus just
behind the pharynx. Young kittens while playing occa-
sionally attempt to swallow threaded needles, or pins which
lodge at some point along the esophageal wall. Large bodies
when indefinitely retained often produce a pressure necrosis
with perforation of the walls.
Symptoms.— The early symptoms are those of refusing
food, pain during swallowing, paroxysms of choking with
retching and in some cases vomiting, salivation, and scratch-
ing at the mouth and neck. The head is held extended, the
respirations become labored, and the patient evinces severe
pain. In cats the mouth is held open, there is profuse saliva-
tion, and when the foreign body has penetrated the walls
severe nervous symptoms are produced. The foreign body
when located in the cervical portion of the esophagus will at
once be recognized by the painful swelling which appears
along its course, especially in the case of large objects. There
is frequently edema of the surrounding tissues which may
extend for some distance from the point of injury. Palpation
usually reveals the size and character of the obstruction.
Often when the objects are located just posterior to the
pharynx by opening the mouth and pulling the tongue well
forward they can be seen or felt with the finger. In cats,
FOREIGN BODIES— OBSTRUCTION IN ESOPHAGUS 133
needles and fish bones are often seen by this method. In cases
of small obstructions located in the thoracic portion of the
esophagus, the symptoms are not so pronounced. Loss of
appetite, emaciation and occasional vomiting are the most
prominent manifestations of the condition. However, when
sharp objects penetrate the walls at this point, various com-
plications of a serious nature may be produced. The passage
of a sound (horse catheter) is often a valuable aid in arriving
at a correct diagnosis. In valuable animals, Roentgen rays
may be used to assist in locating hard or metallic substances.
Diagnosis. — This is made positive by a careful examination
together with the above mentioned" symptoms. Care should
be taken to exclude rabies as the symptoms are similar. (See
Rabies.) Always beware of the dog with "bone in the
throat."
Prognosis. — Foreign bodies located in the cervical portion
of the esophagus can usually be removed which is followed
by rapid recovery except in those cases where necrosis is
produced from pressure upon the walls, or extensive phleg-
monous inflammation from perforation. It sometimes
happens that needles and pins will penetrate the walls and
become encapsuled in the adjacent tissues without producing
any further disturbance to the animal. Foreign bodies
located in the thoracic portion of the esophagus should always
be considered unfavorable owing to their location and the
danger of injury to the organs in the thoracic cavity or a
purulent pleuritis resulting from perforation.
Treatment.— Obstructions to the esophagus are removed
by: (a) Use of throat forceps; (b) by propulsion with the
sound into stomach; (c) by emesis; (d) by esophagotomy;
(e) by gastrotomy and sound forcing the foreign body out
via mouth.
(a) The throat forceps can often be used to an advantage
when the object is located in the posterior part of the
pharynx or in the anterior part of the esophagus. The mouth
is held open with the speculum, the tongue pulled well for-
ward, and the object grasped with the forceps and removed.
Care should be taken to prevent laceration of the tissues in
case of a sharp object or one of an irregular shape.
134 DISEASES OF THE ESOPHAGUS
(6) The sound is to be used in those cases where the
obstruction is located farther down the tube and cannot be
reached with the throat forceps. Various kinds of instru-
ments have been devised for this purpose. The horse catheter
will answer in a large number of cases. It is introduced by
using the mouth speculum, depressing the tongue. Having
oiled the instrument, it is passed, holding it firmly against
the roof of the mouth and following the posterior wall of the
pharynx, into the esophagus. When the instrument reaches
the pharynx the animal will invariably swallow, which
greatly assists in its introduction into the esophagus. The
sound is then brought in contact with the object which is
carefully pushed into the stomach. When there is much
resistance and the object is firmly fixed, the catheter should
be removed and other methods used to dislodge it. The
bristle probang is often used to advantage in extracting
foreign bodies which do not entirely close the lumen of the
esophagus. It is introduced closed so that it may pass the
object, and then opened so that the bristles will completely
fill the lumen when it is withdrawn bringing the foreign body
out in front of it.
(c) The act of vomiting, which is easily induced, will often
displace the foreign body. This is best brought about by
the use of apomorphin (dogs 0.0016-0.006; cats 0.001-0.003).
The administration of castor or linseed oil to lubricate the
mucous membrane will often assist in removing the obstruc-
tion.
(d) Esophagotomy is performed in the following man-
ner: Secure the animal in the dorsal position with the
head extended. Clip and shave the hair over the field
of operation and cleanse thoroughly with antiseptic solu-
tions (bichlorid of mercury 1-2000; boric acid 2 per cent.,
etc.). Under general anesthesia, using morphin (0.016-0.21),
ether, etc., make a skin incision over the obstructing body
and between the muscles, being careful to avoid the large
vessels of the neck. When the esophagus is exposed make
a longitudinal incision through it of sufficient length to allow
the foreign body to be removed. Care should be used to pre-
vent laceration of the mucous membrane. W7hen the incision
STRICTURE OF THE ESOPHAGUS 135
is very long, one or more interrupted sutures should be made
in the esophagus and the wound packed with gauze saturated
in a boric acid solution (2 per cent.), retained with sutures
through the skin. Allow this to remain in position for
twenty-four to forty-eight hours, then remove pack, the
sutures in the esophageal wall and treat as an open wound,
cleansing it daily with boric acid solution (2 per cent.) until
healing is complete. Withhold all food and drink for twenty-
four hours and then give only liquid foods for a few days.
Rectal feeding of milk, eggs, etc., may be used when the
swelling of the mucous membrane is sufficient to obstruct
the esophagus.
(e) As a last resort when the firmly fixed object is located
in the thoracic portion of the esophagus and cannot be
removed by the methods mentioned, gastrotomy should be
performed (see Diseases of Stomach), and the catheter
introduced to propel the foreign body out via the mouth.
Should the object be located in the cardiac portion of the
esophagus, a small dressing forceps is often useful to grasp it
and remove it via stomach incision.
ESOPHAGISMUS.
Definition.— A spasmodic contraction of the esophagus. .
Etiology.— This condition occurs occasionally during the
course of some diseases. It has been observed in chorea,
epilepsy and in the early stages of rabies. Sometimes foreign
bodies, by irritating the membranes, produce a spasmodic
contraction of the walls of the esophagus.
Symptoms.— Very similar to foreign bodies in the esophagus;
often foreign bodies are also present.
Prognosis. — In most cases favorable.
Treatment.— The passage of the sound is usually sufficient
to overcome the condition except in the case of foreign bodies
being present. (See Foreign Bodies in the Esophagus.)
STRICTURE OF THE ESOPHAGUS.
Definition.— A constriction of the esophagus due in most
cases to cicatricial contraction of the walls reducing the size
of the lumen.
136 DISEASES OF THE ESOPHAGUS
Etiology.— The most common causes of this condition are
the following: (a) Cicatricial contraction of healed ulcers,
usually due to corrosive poisons; injuries by foreign bodies,
etc. ; esophagotomy . (6) External pressure by enlarged lymph
glands, enlarged thyroids, other tumors and occasionally
pericardial effusion, (c) The growth of tumors in the walls
of the esophagus (metastatic sarcomas and carcinomas).
The stricture may occur in any part of the esophagus, and
in severe cases may involve the entire tube, but usually it is
found either near the pharynx or the stomach.
Symptoms.— Difficulty in swallowing and only small
quantities taken. Severe pain immediately after eating.
Retching and vomiting are often noticed. Gradual emacia-
tion due to the interference with deglutition. Examination
of the esophagus in the cervical region by palpation or the
passage of the sound to the thoracic region will usually reveal
the constricted condition of the esophagus.
Prognosis.— Should be considered unfavorable in all cases
of long standing. Recent cases, depending upon the cause,
may recover sufficiently not to interfere much with the
animal's general condition.
Treatment.— By surgical means the cause of the condition
should be removed if possible. The passage of the sound,
well lubricated, daily for a time will in some cases overcome
the constriction. In severe constrictions where a large por-
tion of the walls is involved no treatment can be applied that
will be of any service.
DILATATIONS AND DIVERTICULA OF THE ESOPHAGUS.
Definition.— Dilatation is a diseased condition whereby
the lumen of the esophagus is enlarged (ectasia oesophagi).
A diverticulum is a saccular distention of the esophageal wall
at a given point along its course (diverticulum oesophagi).
Etiology. — Dilatation may develop secondary to stenosis of
the esophagus, from pressure of food masses retained above
the stenosis resulting in paralysis or atony of .the muscular
wall; from foreign bodies remaining in the esophagus for
sufficient length of time to produce paralysis; injuries;
CATARRH OF THE CROP IN BIRDS— SOFT CROP 137
esophagotomy. Diverticula may result from overdistention
of the esophagus with rupture of the muscles allowing the
mucous membrane to protrude; also due to cicatricial con-
tractions following inflammatory adhesions to lymph glands.
Symptoms.— An enlargement will be noticed along the
region of the esophagus if it be in the cervical portion. Diffi-
culty in swallowing; saliva increased; regurgitation of small
amounts of undigested and decomposed food covered with
mucus; fetid odor from the mouth; the probang may pass
without difficulty although it may be obstructed by the
stenosis or stricture at the distal end. The symptoms of a
diverticulum are very obscure except when large and in the
cervical portion of the esophagus. The retention of food
gives rise to retching and vomiting, or from the ensuing
ulceration may result in the formation of a fistula.
Diagnosis.— Careful observation of the symptoms; the
absence of gastric secretions in the vomitus; palpation
reducing the enlargement which will become refilled after
feeding. The use of the probang may assist in the diagnosis
by determining the presence of the stenosis or spasm .
Prognosis.— Diffuse dilatation, or a diverticulum of the
thoracic portion of the esophagus, should be considered
incurable. The prognosis depends upon the completeness
with which nutrition can be carried on. It is always unfavor-
able as there is a tendency to ulceration and perforation of the
walls with formation of a fistula.
Treatment.— No satisfactory treatment can be given except
in diverticulum in the cervical portion of the esophagus
which may be operated (see Esophagotomy) and the diver-
ticulum reduced by suturing.
CATARRH OF THE CROP IN BIRDS. SOFT CROP.
Definition.— A catarrhal inflammation of the mucous mem-
brane of the crop.
Etiology.— Irregular feeding is a common causative factor.
Birds fed irregularly are quite liable to overload the crop,
resulting in distention and partial paralysis of the muscular
walls. This condition interferes with the secretion of the
138 DISEASES OF THE ESOPHAGUS
glands resulting in fermentation or decomposition of the crop
contents which irritate the mucous membrane often pro-
ducing a severe catarrhal inflammation. Elating indigestible
or decomposed substances (feathers, putrid meat, etc.) often
produces catarrh of the crop.
Poisons (arsenic, phosphorous, salt, etc.), when taken acci-
dentally or given intentionally, often produce a very severe
form of the disease. The presence of parasites (Dispharagus
nasutus, etc.) in the crop will in most cases produce a catarrhal
inflammation, the severity of which depends upon the num-
ber present. In pigeons fermentation of an overabundant
secretion after the loss of the young will produce a serious
catarrhal inflammation of the crop and other parts of the
digestive tract. Crop catarrh also occurs during the course
of some diseases (diphtheria, thrush, cholera).
Symptoms.— Distention of the crop is at first the most
noticeable symptom. On palpation the crop will be found
to be soft and fluctuating, due to an accumulation of liquid,
gaseous and solid food material. Loss of appetite, eructations
of gases, sometimes retching and vomiting are symptoms.
By pressure upon the crop the contents will be expelled via
mouth, emitting a very offensive odor. The birds may die
from exhaustion.
Diagnosis.— This is determined quite accurately by a care-
ful examination of the crop and the character and condition
of the contents.
Prognosis.— When not a symptom or complication of
some other disease (cholera, thrush, etc.), the prognosis is
usually considered favorable and the majority respond readily
to treatment. When a large number of a flock is affected,
indicating a severe catarrhal inflammation, the prognosis is
less favorable owing to the difficulty in applying prompt
remedial measures. Repeated return of the condition often
produces the so-called hanging crop or dilation.
Treatment.— Hygienic.— The birds should be provided with
a clean, dry place free from extremes in temperature.
Dietetic.— In mild cases where the appetite is not entirely
lost, solid food should be withheld for a day or so, only a
small quantity of liquids being allowed.
OBSTRUCTION OF CROP IN BIRDS— HARD CROP 139
Medical.— Before administering medicinal agents it is
necessary to thoroughly empty the crop which -is done in the
following manner: The bird is held with its head pendant,
and the crop carefully manipulated and compressed between
the thumb and fingers, when the contents will flow out via
mouth. The crop should be thoroughly compressed from
behind toward the mouth until it is completely emptied.
Ten to 30 c.c. of a bicarbonate of soda solution (2 per cent.)
is then administered to neutralize the acidity of the retained
contents and to dissolve the accumulated mucus from the
membrane. For a few days small doses of sodium bicar-
bonate (0.15) or bismuth subnitrate (0.10) may be admin-
istered daily. Only small quantities of food should be
allowed for at least four to five days.
OBSTRUCTION OF THE CROP IN BIRDS. HARD CROP.
Definition.— An impaction of the crop.
Etiology.— The obstruction of the crop is often seen from
overfeeding, especially with dry foods (oats, rye, corn, peas,
etc.) or with quantities of straw, leaves, grasses, and other
indigestible substances swallowed by the bird. In water
birds it occurs from eating large quantities of certain grasses
(triticum repens, etc.). Turkeys are most commonly affected
by eating large quantities of insects (grasshoppers, etc.),
straw, grains and grasses. Further, swallowing various kinds
of foreign bodies with the food (metallic substances, large
stones, pieces of glass, bones, egg shells, or large numbers of
very small stones, etc.) often produces impaction of the crop.
In some mild cases of catarrh with irritation of the mucous
membrane the birds often eat large quantities of indigestible
substances leading to an impaction. Animal parasites when
in large numbers will produce the same result.
Symptoms.— The birds are dull, stupid, show rough plu-
mage, pale comb and wattles, with a constant opening and
closing of the beak; or the beak is held open to facilitate
breathing which is often interfered with by pressure of the
enlarged crop upon the trachea. A disagreeable odor ema-
nates from the mouth, and often quantities of fermented or
140 DISEASES OF THE ESOPHAGUS
decomposed liquids and food particles escape from the
mouth and nostrils. The appetite in the early stages is
lessened and later entirely lost. The crop when examined
will be found greatly distended, hard and more or less firm
on palpation. In some cases it is very hard, producing the
so-called " hard crop." When metallic substances are present,
it is possible in some cases to palpate them, or in case of
sharp objects they are sometimes found projecting through
the muscular walls and skin. With the aid of the Roentgen
rays the character and size of the foreign body can often be
revealed.
Prognosis.— This depends upon the character of the
impacted material, its duration and the condition of the bird.
In most cases if allowed to continue it will result fatally. In
some cases, the crop becomes enormously distended, pro-
ducing the so-called "hanging crop."
Treatment.— The early indication in the treatment is to
massage the crop and try to remove the contents via mouth.
This is best done by suspending the bird head downward,
and massaging and kneading the crop carefully which crushes
the crop contents so that they may be gently forced into the
mouth. Often the entire contents can be removed in this
manner. The administration of a small quantity of linseed
oil to lubricate the esophagus will often assist when applying
the above method.
\Vhere this method will not suffice, it will be necessary
to open the crop and remove the contents through the
incision. The feathers should be pulled out over a space
about \\ inches wide and 2-3 inches long at the point of
greatest protrusion. The field of operation should be
thoroughly disinfected. The incision can be enlarged suffi-
ciently to admit of the crop contents being easily removed.
A blunt curette or pincette is useful in assisting removal.
The crop should be thoroughly irrigated with a sodium
bicarbonate solution (2 per cent.), and the edges of the
wound disinfected with a boric acid solution (2 per cent.).
The wound is then stitched with a single row of interrupted
sutures sufficiently close together to prevent the escape of
anv contents. The stitches should not be removed for at
NEOPLASMS OF THE ESOPHAGUS 141
least eight to ten days. All food and liquids should be with-
held for twenty-four hours and for the next four or five days
only a small quantity of liquid food given.
NEOPLASMS OF THE ESOPHAGUS.
Tumors of the esophagus are very rare and those occurring
most commonly are: Epithelioma, sarcoma and carcinoma.
These occur most frequently via metastasis. Retention
cysts are found at the anterior part of the esophagus.
Symptoms.— Tumors produce a narrowing of the esophagus
similar to stenosis (see Stenosis). When this occurs in the
cervical portion the condition may be determined by palpa-
tion. A differentiation from foreign bodies, diverticula and
dilatation is often made possible by careful palpation.
Diagnosis.— The kind of tumor can only be determined
by obtaining some of the enlargement for microscopical
examination.
Prognosis.— When malignant tumors (carcinoma, sarcoma,
epithelioma) are present, the prognosis is very unfavorable;
retention cysts unless they interfere with nutrition are more
favorable. Small ones may be present without being noticed
for a long time.
Treatment. — No treatment should be attempted for
malignant tumors. Retention cysts may be reduced by
pressure from the outside or esophagotomy (see Esophagot-
omy) may be performed and the cyst wall destroyed.
CHAPTER VIII.
DISEASES OF THE STOMACH.
Examination.— The stomach can be examined as follows:
1. By the character, condition and quantity of the contents,
which may be obtained : (a) By the use of an emetic (apo-
morphin 0.0016.-0.003 etc.), (6) by natural vomiting, (c) by
the use of a stomach tube or (d) through gastrotomy (see
Foreign Bodies in the Stomach).
2. Palpation over the region of the stomach will cause
pain in acute inflammatory conditions, although this may
be confused with painful conditions of the liver, peritonitis
and enteritis.
3. By performing laparotomy and making a direct exami-
nation of the stomach. The mucous membrane may also
be examined directly by performing gastrotomy.
GASTRITIS.
Gastritis is an inflammation of the stomach. The following
forms are recognized: (a) Acute, and (6) chronic.
Acute Gastritis. — Simple Catarrh of the Stomach. Acute
Dyspepsia.— Definition.— An acute catarrhal inflammation
of the mucous membrane of the stomach which may involve
the entire wall.
Etiology.— Acute catarrhal gastritis is usually due to errors
in diet. The ingestion of more food than can be digested,
irregular feeding, or eating unsuitable food, which is partially
decomposed containing ptomaines (cadavers, garbage, etc.),
and hard pieces of bone, cartilage and tendon are very com-
mon causes of this condition. Injuries to the epigastrium
(kicks, blows, and being run over by vehicles, etc.).
Chemical. — Various chemical substances (phenol, arsenic,
mercury, phosphorus, etc.) when taken accidentally or
GASTRITIS 143
given intentionally will produce a very serious form of gas-
tritis (toxic). An excess of sodium chlorid given in the food
to birds will often produce a severe gastritis.
Thermic.— Very hot, solid foods and liquids, or very cold,
frozen foods will sometimes produce a gastritis. Rabbits
eating frozen vegetables are thus often affected.
Infectious.— Infectious gastritis occurs during the course
of most infectious diseases (distemper, rabies, etc.) .
Parasites.— See Parasites of the Stomach.
Pathology.— Acute catarrhal gastritis is characterized by a
swelling and hyperemia of the mucous membrane which is
often corrugated, and intensely red with small ecchymoses
appearing over the surface. Small superficial erosions are
occasionally noticed.
Symptoms.— Vomiting occurs early and is the most promi-
nent symptom often being quite frequent and in severe cases
very persistent. The vomitus in the beginning consists of
quantities of undigested and decomposed food material
covered with mucus and sometimes streaked with blood, with
a very disagreeable odor. When due to chemical causes it
often has the characteristic odor of the poison. Later the
vomitus consists almost entirely of small amounts of frothy
mucus, and when the vomiting is severe there is often an
admixture of bile. The appetite in severe cases is completely
lost and in mild cases it is variable and vitiated, the animal
eating unnatural material. Bowel complications (see
Enteritis) invariably follow severe cases of gastritis.
On examination the animals show pain on palpation over
the region of the stomach, which manipulation often induces
vomiting. There is a grayish-white deposit over the dorsal
surface of the tongue (furred tongue); the temperature is
elevated in the early stages of severe cases (103°-105° F.),
later the temperature is subnormal (97°-100° F.). In milder
cases the temperature shows but little variation.
The general symptoms in the early stages of severe gas-
tritis are those of uneasiness and intense pain (howling,
etc.), stiffness and considerable pain which is shown when the
patient is moved about. In milder cases the only symptoms
noticeable are occasional vomiting and variable appetite.
144 DISEASES OF THE STOMACH
Diagnosis.— Acute non-infectious gastritis is not very
difficult to diagnose as the symptoms are very characteristic
and quite often the anamnesis is of value. The primary
infectious form, however, may be confused with that due to
specific infectious diseases (distemper, etc.), but this can be
distinguished by the general symptoms, especially the tem-
perature which in the latter cases rises more abruptly and
shows less variation than in the former.
Prognosis. — In primary acute gastritis, due to errors in
feeding, the prognosis is usually favorable.
When due to poisons, foreign bodies, and injuries, it
depends largely upon the extent of injury to the stomach
and the possibility of removing the cause. In infectious
gastritis, when not due to specific infection, the prognosis is
usually favorable, but if accompanying a specific disease it
depends on the primary disease.
Treatment. — Dietetic. — In strong animals all food should
be withheld twenty-four to forty-eight hours and then only
a small amount of easily digested food given at frequent
intervals until recovery takes place. In weak individuals
easily or predigested food may be allowed unless it induces
persistent vomiting when nourishment should be given via
the rectum.
Medical.— Mild cases usually recover promptly following
the use of a purgative (ol. ricini, dogs 15.0 to 60.0, cats 5.0
to 20.0; calomel, dogs 0.3-0.4, cats 0.01-0.005; cascara fld.
ext. dogs, 5.0-10.0, cats 1.0-5.0).
In severe cases unless vomiting has occurred an emetic,
such as apomorphin hydrochlorate (dogs 0.005-0.01, cats
0.002-0.005) given subcutaneously is indicated to expel
irritating material and foreign bodies which may be present.
Following vomiting, irrigation of the stomach with a sodium
bicarbonate solution (2 per cent.) is advisable to remove irri-
tating material from the surface of the mucous membrane.
This can be accomplished by the use of a rubber tube or
horse catheter inserted into the stomach. The warm sodium
bicarbonate solution (500.0-1000.0) may be introduced into
the stomach by elevating the free end of the tube and using
a funnel. Allow the tube to remain in the stomach for a few
GASTRITIS 145
minutes, then depress it to allow the fluid to flow out again.
Repeat this two or three times. To stimulate the functions
of the stomach, stomachic tonics are indicated :
For Dog.
H — Ferri et quinnse citratis 4.0
Pepsini 1.0
Sacchari albae 2.0
Misce et fiat pulv. No. XX.
Sig. — Give a powder every twelve hours.
For Cats.
One-half the above dose.
or
For Dog.
J$ — Tincturse nucis vomicse • . . . 7.0
Tincturse gentianse 10.0
Aqua communis 60.0
Misce et fiat solutio.
Sig. — Give teaspoonful twice daily.
For Cats.
T$ — Tinctura? nucis vomica3 1.0
Syrupi auranti 60.0
Misce et fiat solutio.
Sig. — Give teaspoonful once daily.
or
I^ — Acidi hydrochlorici 2.5
Tinctura gentianse comp 10.0
Aqua 150.0
Misce et fiat solutio.
Sig. — Give teaspoonful three times a day.
Vomiting is often present in these cases but it is usually
stopped by the removal of the irritating material through
irrigation of the stomach (lavage), but if it persists it may
be controlled by using sedatives.
For Dog.
}\ — Bismuth! subnitratis
Opii pulvorati
Sacchari alb* ' <>
Misce et fiat pulv. No. VI.
Sig. — Give one powder every four to six hours until vomiting is reduced.
10
146 DISEASES OF THE STOMACH
When due to chemicals the proper antidote should be
administered (see Poisons).
Surgical. — When foreign bodies are present and cannot be
expelled by emesis or purgation, gastrotomy must be per-
formed (see Foreign Bodies of the Stomach) .
Chronic Gastritis. — Chronic Catarrh of the Stomach.
Chronic Dyspepsia. — Definition. — A chronic catarrh of the
stomach with a disturbance in digestion, increased mucus
formation, changes in the gastric secretions, partial paralysis
of the muscular walls and alterations in the structure of the
mucosa.
Etiology. — Chronic gastritis is a rather common condition
especially in the dog. It results very frequently from several
repeated attacks of acute gastritis and is therefore produced
by causes similar to those found under acute gastritis (see
Etiology of Acute Gastritis). It often occurs as a secondary
complication to various diseases, such as ulceration of the
stomach, gastric tumors, diseases of the liver, chronic con-
stitutional diseases (anemia, chlorosis, chronic nephritis,
etc.). Parasites, by constant irritation to the membranes
for a long period, will produce chronic gastritis (see Parasites).
Pathology. —The stomach is usually enlarged, the mucous
membrane pale, becomes gray in color and its surface covered
with a thick, tenacious mucus. The veins are found distended
and small hemorrhagic erosions and ecchymoses are seen
distributed over the mucous membrane. In the later stages
the mucous membrane becomes greatly thickened, especially
toward the pyloris, and the mucous glands large and indur-
ated from the constant irritation. Microscopically there is
every evidence of a parenchymatous and an interstitial
inflammation.
Symptoms.— This affection persists for an indefinite period
and like most chronic conditions changes from time to time.
In the dog, the animal most commonly affected, the appetite
is variable, sometimes greatly impaired and at other times
very good. Vomiting and retching are frequent symptoms
and are especially noticeable a short time after eating. The
vomited material consists of undigested food particles covered
with a thick, tenacious mucus and has a very sour, disagree-
GASTRITIS 147
able odor. After severe and prolonged paroxysms of vomit-
ing, the mucus is frequently mixed .with blood from the rup-
turing of small bloodvessels at the seat of the erosions. The
chemical analysis of the vomited material shows the presence
of abnormal acids, such as butyric or sometimes acetic in
addition to lactic acid, while the hydrochloric acid is either
absent or greatly reduced in quantity. Digestion, therefore,
is delayed and decomposition and gas formation favored
which in some cases greatly distends the stomach. Con-
stipation is usually present, but in some cases there is diar-
rhea and the undigested food passes rapidly through the
bowels. The urine is often reduced in quantity, has a high
color and a very disagreeable odor. There are general
symptoms of disturbed nutrition, resulting in emaciation and
general weakness.
Diagnosis.— A diagnosis of chronic gastritis is not always
easy as the symptoms present are also indicative of other
conditions. However, by a careful analysis of the symptoms
and considering the condition of the animal and a careful
examination of the contents of the stomach, the diagnosis
may be made with a certain degree of accuracy.
Prognosis.— A complete recovery in this condition is prac-
tically impossible. However, a great number of cases will
improve with careful diet and treatment. As a rule an
unfavorable prognosis should be made owing to the patho-
logical changes which have taken place in the mucosa and
muscular walls of the stomach.
Treatment.— Dietetic.— The dietetic treatment is of greater
importance in the majority of cases than the use of medicines.
A careful regulation of the diet is always to be insisted upon.
Only small quantities of easily digested food should be given
for the first few days (beef extract, rice soup, white of eggs,
small quantities of milk, oatmeal gruel). In cats very small
amounts of milk or rice soup show the best results.
Medical. — A thorough lavage of the stomach witli warm
water or a sodium bicarbonate solution (2 per cent.) should
always be the first tiling attempted. It can be done readily
in the following manner: The animal is placed on a table
and held by an assistant; a stomach tube is then iiitro-
148 DISEASES OF THE STOMACH
duced into the stomach (see Foreign Bodies in Esophagus)
and the free end depressed to allow some of the stomach
contents to flow out. Should the contents be too thick to
pass out through the tube, some of the 2 per cent, soda
solution (about 500 c.c.) is introduced into the stomach by
elevating the free end of the tube. Attach a funnel to the
tube and gradually pour in the solution. After it has entered
the stomach by gravity, allow it to remain for a few minutes,
depress the tube and allow it to flow out again. This opera-
tion should be repeated until the liquid flows out freely and
is clear of food particles and mucus. It is advisable in severe
cases to repeat this treatment daily for three or four days and
after this at biweekly intervals.
Bitter stomachics (tincture gentian compound 4.0; or
tincture of Colombo 2.0) are indicated before feeding to
stimulate the mucous membrane and the muscular walls of
the stomach. Small doses of pepsin and hydrochloric acid
are indicated in severe cases to assist in digesting the food.
These should be administered shortly after feeding to obtain
the best results. Artificial Carlsbad salts (8.0) given twice
daily is valuable as a stomachic and anticatarrhal agent for
the mucous membrane. Further, in cases where there is
considerable fermentation, salicylic acid (0.2-0.5) or creosote
(0.1) is useful to arrest the fermentation. These drugs should
be repeated at each meal to obtain the desired results.
FOREIGN BODIES IN THE STOMACH.
Etiology.— Dogs often swallow foreign bodies with the
food, or during play, which pass into the stomach and pro-
duce symptoms of a serious nature. Most commonly the
foreign bodies consist of small rubber balls, glass marbles,
peach stones, stones, needles, pins, and meat skewers. Dur-
ing rabies (see Rabies), owing to the vitiated appetite, dogs
eat large quantities of foreign material, such as splinters of
wood, pieces of cloth, stones, straw, etc.
Cats often take with the food, needles, pins, fish bones,
fruit stones, which enter the stomach and remain for some
FOREIGN BODIES IN THE STOMACH 149
time producing alarming symptoms. Birds often pick up
metallic substances with the food (nails, pins, etc.).
These substances after entering the stomach may remain
for a long time without producing any marked disturbance.
However, as a rule they produce an acute or chronic gastritis
and sharp objects may penetrate the walls of the stomach
producing an acute inflammatory condition, or peritonitis.
Hair balls are occasionally found in the stomach of rabbits
and dogs.
Symptoms. — In a large percentage of cases where foreign
bodies are taken there are no symptoms noticeable, espec-
ially where the foreign bodies are small and regular in outline.
These will often pass out via the intestinal tract or be vomited
up without interfering with the function of the stomach or
producing general symptoms. When the foreign bodies are
of large size, irregular in outline, or sharp, they often produce
symptoms of acute or chronic gastritis (see Acute and
Chronic Gastritis). Very commonly the foreign bodies
produce extensive irritation of the mucous membrane,
penetrate the walls of the stomach or obstruct the pylorus
producing severe vomiting (which is persistent), complete
loss of appetite, intense thirst, hematemesis (from the ero-
sions on the mucous membranes or some of the bloodvessels
being injured by the sharp objects). Where extensive injury
is produced in the membranes, the animals often show excit-
able symptoms, howling and other symptoms similar to
rabies (see Rabies), stiffness in gait, and wralk with the back
arched. By palpation over the region of the stomach (espe-
cially in cats, rabbits and in some breeds of dogs), the foreign
bodies can often be detected and their character determined.
WThen perforation of the walls of the stomach is produced by
sharp objects, symptoms of acute peritonitis develop (see
Peritonitis). Lastly, under symptoms of general weakness,
subnormal temperature, and very weak, imperceptible pulse
the animals often die from exhaustion.
Diagnosis.— The characteristic symptoms, the anamnesis
and careful palpation make the diagnosis rather easy when
foreign bodies are present in the stomach. Direct palpa-
tion of the walls of the stomach (explorative laparotomy)
150 DISEASES OF THE STOMACH
is to be recommended in some cases where the diagnosis
is in doubt. In other cases the Roentgen rays will assist
in locating the foreign body. However, this method is
rather difficult owing to the location of the stomach and its
relationship to the adjacent organs.
Prognosis.— The prognosis depends upon the character,
size and condition of the foreign body, the general condition
of the animal and the possibility of its removal. In most
cases the prognosis should be made unfavorable.
Treatment.— Medical.— Emetics are often of value in
removing foreign bodies from the stomach. Subcutaneous
injection of apomorphin hydrochlorate (0.005-0.01) should
be administered and the vomitus carefully inspected to
determine whether or not the foreign body has been ejected.
Should this method fail, surgical means should be employed
as early as possible.
Surgical.— This consists in performing laparotomy and
gastrotomy-as follows:
Laparotomy.— This operation should be performed at the
median line whenever it is possible to do so. When the inci-
sion is made through the linea alba, healing may not be quite
so rapid as if it were made just to one side through the
muscular tissue. The former position is to be preferred,
however, as there is little or no hemorrhage to interfere with
the operation, and, as both sides of the wound are alike, the
edges can be more evenly approximated by suturing.
The animal being secured in the dorsal position, and
under general anesthesia, the skin at the field of opera-
tion is clipped and shaved of all hair and cleansed, first with
soap and warm water and then with antiseptic solution
(boric acid 2 per cent.; creolin 2 per cent.; mercuric bichlorid
1-2000).
When the operation is not extremely urgent, it is best to
apply an antiseptic pack (boric acid powder) over the field
of operation after cleansing for the twenty-four hours preced-
ing in order to ensure better antisepsis of the skin. Sterilize
the following instruments: Scalpel, probe pointed bistoury,
scissors, artery forceps, a full curved needle and suturing
material. The incision is made with a sharp scalpel through
FOREIGN BODIES IN THE STOMACH 151
all the tissues down to the peritoneum. Considerable care
should be taken in going through this in order to avoid
puncturing the abdominal organs. It is best to grasp a
small part with forceps and clip it out with the scissors,
making an opening large enough to insert the probe pointed
bistoury and with this enlarge the incision the desired length
which depends on the operation to be performed and on the
size of the operator's finger. One and one-half inches is
sufficient for most cases, although it may be made large
enough in a large dog to admit the entire hand. Absorbent
cotton or a pledget of gauze moistened with antiseptic solu-
tion is useful to keep the wound free from blood, but none of
the antiseptic fluids should be allowed to enter the peri-
toneal cavity. Sterile water should be used to cleanse any
portion of the viscera or peritoneum exposed . To suture the
laparotomy wound, use medium-sized silk or linen suture
material and make interrupted sutures about one-quarter to
three-eighths of an inch apart depending upon the thickness
of the abdominal wall. Using a long, slender, full curved
needle, start about one-quarter of an inch from the margin
of the wound, and pass it through the muscle and peritoneum,
having the index finger inserted in the wound to prevent
the needle entering the viscera, particularly the intestine or
bladder, and bring it out on the other side at the same dis-
tance from the margin so that when tied, and swelling occurs,
one edge will not be forced above the other. The surgeon's
knot, i. e., wrapping the first half of the knot twice, should
be used, and if omentum is forced out when suturing it may
be pushed back with blunt forceps as the knot is being tied.
To avoid a hernia following this operation, be sure ^that the
sutures pass through all the layers of the abdominal wall,
i. e., skin, muscle, aponeurosis, and peritoneum.
Gastrotomy.— Perform laparotomy, as above, in the median
line and about one-quarter of an inch posterior to the xiphoid
cartilage, making the incision about two and a half inches
long. Grasp the stomach with the thumb and finger and
draw it out as far as possible. Tack it securely with sterile
cotton squeezed out with sterile water, or with dry sterile
gauze to prevent any of the stomach contents from entering
152 DISEASES OF THE STOMACH
the peritoneal cavity when the incision is made. Have an
assistant support the stomach by grasping it at either end
with thumb and finger. Make the incision at the greater
curvature and at right angles to the long axis of the stomach,
and at a point where the bloodvessels are few and small.
The organ is best opened by puncturing with a sharp pointed
bistoury through the muscular and mucous coats and then
enlarging it with the scissors, the length of incision depending
upon the size of the foreign body to be removed. The removal
of large sharp pointed bodies must be done with care and, if
possible, they should be crushed to avoid making too long
an incision. Blunt dressing forceps are useful to grasp small
objects. The division of the muscular coat allows it to con-
tract while the mucous coat projects out through the excess
of mucous membrane so that its edges may be evenly approxi-
mated. Suture the mucous membrane with interrupted
sutures one-eighth of an inch apart, then suture the muscular
coat in the same way, being careful to bring the edges in
close contact. A Lembert suture is then applied over the
wound to invert it. This is made by inserting the needle
through a small portion of the muscular coat on one side of
the wound, carrying it over and inserting the same way on
the other side, and these when tied will invert the wound
and bring the peritoneal surfaces of either side of the wound
in apposition, which favors an early adhesion and prevents
the escape of the stomach contents. These sutures will be
encapsuled and are not to be removed. Cleanse the surface
of the stomach and return to the abdominal cavity. All
food should be withheld for twenty-four hours, after which
time a small amount of liquid food (milk, beef broth) may
be fed for a few days when the regular diet may be given.
ACUTE DILATATION OF THE STOMACH.
Etiology.— This condition is observed more frequently in
dogs and rabbits than in other small animals. It is most
frequently produced by overloading the stomach, especially
when large quantities of indigestible or dry foods are taken.
Such substances as potatoes, bread (dry), dog biscuits, blood,
ACUTE DILATATION OF THE STOMACH 153
some green foods, grains, etc., afe the ones most liable to
produce the condition. Dogs when very hungry, will often
eat an entire bird, rat or mouse, without masticating it.
When the mass reaches the stomach it will cause a sudden
dilatation.
Debilitating Condition.— Both general and local, such as
rachitis, anemia, toxic conditions, infections, diseases of the
heart, etc. These conditions may be the result of various
influences which alter the tone of the muscular wall, either
indirectly by affecting nervous control, or more directly by
toxic action on the muscle.
Previous gastric diseases often predispose to the condition,
usually through fermentation, distending the walls leading to
the gaseous form of acute dilatation. Excessive secretions
at the same time will assist in the dilatation.
Injuries.— Such as blows on the abdomen, being run over
by vehicles, spinal injuries, abdominal operations (ovari-
otomy) have been known to produce dilatation.
Pathology.— The stomach is usually of enormous size,
extending back nearly to the pelvis. The color is bluish,
purple-red, or pale, and the wall is often very thin. The
dilatation not infrequently involves the duodenum and in
some cases may extend to the other small intestines. At
times the stomach will be found distended with hard, undi-
gested food masses, and in rabbits rupture of the stomach at
the greater curvature often takes place from the distention
with food and gases.
Symptoms. — Vomiting is one of the early symptoms and
the vomitus consists in many cases of particles of hard food
masses, fluids, etc. Owing to the act of vomiting taking place
early, some of the material will be ejected, so that in many
cases this will be the principal symptom noticeable. However,
in some cases where the stomach contents are not removed by
vomiting, more serious symptoms develop. There is profuse
ptyalism, accelerated pulse, dyspnea, evidences of severe pain
such as howling, excitement, etc. In severe cases fermentation
often takes place in the intestinal tract, producing severe dysp-
nea and death in a short time. In rabbits and some breeds
of dogs, by palpation, the stomach will often be found greatly
154 DISEASES OF THE STOMACH
distended with food masses, gas, and fluids, which can readily
be distinguished through the abdominal walls. Very often
the symptoms of this condition are similar to acute gastritis
(see Symptoms of Acute Gastritis).
Diagnosis.— A correct diagnosis requires a careful and
accurate anamnesis. This condition is often mistaken for
some acute abdominal disease, such as peritonitis, acute
gastritis or intestinal obstruction. However, by carefully
observing the symptoms, and by palpation, together with
the anamnesis, the diagnosis is usually made without much
difficulty.
Prognosis.— In those cases, due to overloading, the prog-
nosis is considered favorable; when due to other causes it is
unfavorable as complications are liable to ensue which often
terminate fatally.
Treatment.— Medical.— When due to overloading the
stomach or from foreign material, emetics are indicated
early to remove it. Apomorphin (0.005-0.01) should be
administered subcutaneously, and the stomach carefully
kneaded to break up the food masses and to mix the con-
tents with the secretions so that they will be more easily
ejected. After the material has been removed by vomit-
ing it is advisable to administer sodium bicarbonate solu-
tion (2 per cent.) to remove irritating material from the
surface of the mucous membrane. (See Treatment of
Acute Gastritis). In cases where there is a lack of tone in
the muscular walls from pressure by retained food masses,
gas, etc., or defective nervous control of the muscle, the
administration of strychnin sulphate (0.0005-0.001 daily),
or tincture of nux vomica (0.3-0.6 twice daily) has been
found advantageous.
Surgical.— In severe cases where the food particles cannot
be removed by emesis, or where foreign material is present,
it is advisable to remove it by performing gastrotomy. (See
Surgical Treatment of Foreign Bodies in the Stomach).
CHRONIC DILATATION OF THE STOMACH.
Etiology.— While not common in small animals it is occa-
sionally observed, and consists of a dilatation of the
CHRONIC DILATATION OF THE STOMACH 155
stomach, which is very commonly produced by food masses
remaining in the stomach for a long period, producing press-
ure on the walls of the stomach leading to a lack of tone
in the muscular wall. This allows further accumulation of
fluids and gases from the fermentation of the food contained
and consequently the stomach becomes dilated. In some
individual animals the walls of the stomach are relatively
weak, and after eating, the food will remain in the stomach
for too long a period, and gradually produce a chronic dila-
tation. Many of the causes enumerated under acute dilata-
tion, if continued for some time, will result in the chronic
condition.
Stenosis of the pylorus is one of the most frequent causes
of this condition. The etiological factors producing the
stenosis are the following: Spasm, gastric ulcer, erosions
of the mucous membranes resulting in cicatrix formation.
Foreign bodies which may remain in the stomach for a
long period, and produce by their constant irritation hyper-
trophy of the mucosa of the pylorus, resulting in a nar-
rowing or complete closing of the pyloric opening. Tumors,
either malignant or benign, extending into the pylorus.
Tumors, outside of the stomach (carcinomas, sarcomas)
and associated with adjacent organs or tissues. These by
producing pressure upon the duodenum will narrow the
lumen and result in a stenosis. Inflammation in organs
adjacent to the stomach as the liver and pancreas; or omental
adhesions which occur commonly after abdominal opera-
tions, or by being injured, as blows to the abdomen or being
run over by vehicles. The stenosis which is produced by
the above causes will interfere with the passage of the food
from the stomach where it remains too long eventually
leading to chronic dilatation. In old dogs it frequently
results from chronic obstipation. Further, debilitating dis-
eases will often produce it by interfering with the nervous
control of the stomach.
Pathology.— The stomach is much enlarged and in many
cases distorted. When due to stenosis or obstruction to the
pylorus, the stomach walls are greatly thickened. The mus-
culature is hypertrophic and the mucous membrane is often
156 DISEASES OF THE STOMACH
several times its normal thickness, with all the evidences of
a chronic inflammation. When no stenosis exists, the dila-
tation being produced by other causes, the muscular wall is
very thin and atrophic. In some cases the mucous mem-
brane shows areas of atrophy and hypertrophy alternating.
The interstitial tissue is often infiltrated with fibrous tissue.
Symptoms.— In dogs the symptoms are very similar to
chronic gastritis. There is a partial or complete loss of appe-
tite, intense thirst, especially if the pylorus is obstructed,
the patients drinking large amounts of water which is after-
ward vomited.
Constipation is also quite marked in most cases of chronic
dilatation. As no water can pass from the stomach to the
intestines, the contents of the intestinal tract become hard
and dry to be passed with difficulty, or retained as a hard
mass in the posterior part of the bowels. When dilatation
occurs without stenosis of the pylorus large amounts of water
will pass into the intestinal tract producing diarrhea, which
may alternate with constipation. Emaciation is usually
quite marked, especially in advanced cases, because no
nutriment can be absorbed. In some cases where there is
only a partial stenosis the emaciation will be more gradual,
as some food will be passed to the small intestines. Severe
pain, the animal often showing excitable symptoms, howling,
etc., is shown a short period after eating, due to the par-
ticles of food passing through the narrowed lumen of the
pylorus. Where no stenosis exists there is but little pain.
Vomiting is a constant symptom, especially in obstruction
of the pylorus, and usually occurs shortly after feeding. The
patient will sometimes eat the ejected mass again only to
repeat the act of vomiting. This symptom is quite charac-
teristic coming as it does shortly after eating and continuing
in some cases in the same manner for days or even weeks.
Gradually the animals become weak, anemic, the tempera-
ture subnormal, and die from inanition.
Palpation over the region of the stomach will often reveal
the enlarged organ with its contents; percussion gives a
tympanitic sound.
ULCERATION OF THE STOMACH 157
Diagnosis.— Diagnosis is rather difficult in most cases.
The chronic course, the characteristic symptoms, and the
findings of an explorative laparotomy suffice to make the
diagnosis.
Prognosis.— The prognosis should be carefully guarded
until the causes and condition of the stomach are thoroughly
understood. Complete recovery is possible in both forms of
this disease, provided the wall of the stomach is not perma-
nently damaged and the general condition of the animal
capable of improvement. However, in stenosis of the pylorus,
it should always be considered unfavorable when tumors are
present.
Treatment.— Dietetic.— Small amounts of easily digested
food are to be given at short intervals during the day rather
than large quantities at long intervals. In some cases where
vomiting is persistent, rectal feeding should be employed
giving albumen or predigested foods.
Medical.— In dilatation accompanied by lack of tone of
the muscle stomachic tonics, such as tincture of nux vomica
(0.3-0.6 twice daily) or strychnin sulphate (0.0005-0.001),
may be used.
Massaging or kneading the abdominal wall over the
stomach is a valuable adjunct to increase the muscular tone.
When stenosis exists surgical interference is the only thing
that will give relief; it should be resorted to as early as
possible. (See Gastroduodenostomy) .
ULCERATION OF THE STOMACH.
Ulcus Venlriculi.
Definition.— This condition is a more or less progressive
destruction through necrosis beginning in the mucosa and
often extending to and through the deeper layers of the
stomach wall. True ulcers appear only where the gastric
juice flows. They are found in the dog at the extreme lower
end of the esophagus, in the stomach wall itself, and in a
portion of the duodenum above the opening of the bile duct.
The ulcerations may be acute or chronic. Sometimes a ten-
dency to cicatrization and healing is shown. At the point
158 DISEASES OF THE STOMACH
where the stomach tissue is destroyed an oval or round
opening or depression with irregular margins appears. The
more chronic the process the greater the irregularity in
outline.
Etiology.— Simple ulceration of the stomach is due to a
destruction of the gastric epithelium caused chiefly by a dis-
turbance in blood circulation in the stomach and hyperacidity
of the gastric juice. It is often brought about by inflammation
of the mucosa or hemorrhages, resulting from poisonous sub-
stances, caustics, drugs (when administered in too concentrated
form); sharp foreign bodies; during the course of infectious
diseases (distemper, etc.), or from an invasion by the Bacillus
necrophorus (puppies and kittens), or other local infections.
General infection (pyernia) may too be a causative factor.
These infections produce an extensive inflammation of the
mucosa, often leading to a disturbance in the circulation,
interfering with nutrition, and ultimately leading to an ulcera-
tive process. Wounds of the mucous membrane from external
violence, partial rupture of the stomach walls or parasitic
invasion are causes. They are often contributory to the
beginning of the ulcerative process. Embolism is also a cause,
producing infarcts in the mucosa and submucous tissue.
Hemorrhagic erosions and hemorrhages occurring and
associated with chronic diseases of the heart, liver or kidneys
are probable causes. Hyperacidity may produce gastric
ulcer when from any cause the mucous membrane is injured,
the acid acting upon the ends of exposed vessels by contract-
ing them, thus inducing local anemia and eventually necrosis.
Pathology.— The typical ulcer is round or oval, extending
more or less deeply into the mucous membrane or the wall
of the stomach. They have a characteristic funnel shape,
and when acute form a rather regular outline, while in ulcers
of long standing the margins become very irregular. When
chronic ulcers are present, the entire wall is usually thickened.
Sometimes a coalescence of the ulcerations or erosions occurs.
When ulceration becomes severe and the submucosa is
involved, adhesions exist with adjacent organs.
Symptoms.— In quite a large percentage of cases of mild
ulceration or erosions the symptoms are never observed
ULCERATION OF THE STOMACH 159
during the life of the animal. In more advanced ulcerations
the symptoms are often very similar to chronic gastritis
(see Chronic Gastritis). Bloody vomiting is a characteristic
symptom. The amount of blood ejected varies depending
upon the extent of the injury to the vessels done by the ulcera-
tive process. This condition usually persists for a long time
with exacerbations and remissions. When the ulcer perfo-
rates the wall of the stomach symptoms of acute peritonitis
develop rapidly and a fatal termination soon follows.
General symptoms of emaciation, weakness, and disturb-
ances of the intestinal tract are usually observed.
Diagnosis.— An accurate diagnosis is very difficult, and can
only be made by a careful observation of the symptoms.
When ulceration is suspected laparotorny can be performed
(see Foreign Bodies of the Stomach) to determine the condi-
tion of the stomach. However, when the ulcerative process
is slight or only erosions are present, even this examination
may not suffice for diagnosis.
Prognosis.— The prognosis is always unfavorable, as only
the advanced cases are recognized clinically.
Treatment.— Dietetic.— Only small quantities of easily
digested food (beef broth, milk, small amounts of lean meat
finely divided) should be allowed, as there is danger of the
•wall rupturing at the point of ulceration.
Medical.— Astringents and hemostatics are indicated (bis-
muth subnitrate 0.3-0.5, or silver nitrate 0.05-0.1 well
diluted in distilled water) . These preparations can be admin-
istered two or three times daily, depending upon the action
desired. Where severe hemorrhage takes place, adrenalin
chlorid (1.0-2.0 of a 1-1000 sol.) may be given several
times daily until the hemorrhage stops. To neutralize the
acid secretions in the stomach Carlsbad salts (2.0-4.0) can
be used twice daily. In cases where vomiting is persistent
small doses of tincture of opium (0.2-0.5) are administered
every two hours until vomiting ceases.
Surgical.— In some cases where medical treatment does not
afford relief, laparotomy should be performed (see Foreign
Bodies of the Stomach) and the ulcerated area extirpated
(see Gastrotomy, under Foreign Bodies of the Stomach).
160 DISEASES OF THE STOMACH
HEMATEMESIS.
Definition.— Hematemesis is the vomiting of blood. It is
merely a symptom. The hemorrhage does not always come
from the stomach itself, but from structures contiguous to
the stomach. In small animals hematemesis is much more
common than is usually recognized, but unless large quanti-
ties of blood are vomited, it escapes notice. Often scant
hemorrhages go unrecognized, the determination of which
would be valuable for the diagnosis of some diseases.
Etiology. — In hematemesis there may be no anatomical
lesions on the mucous membrane (diapedesis) ; or the lesions
may be very small but numerous and the hemorrhages
copious coming from a large surface of the mucosa. On the
other hand the lesion in the mucosa may be quite marked
(rhexis; ulcer, etc.). In the dog hematemesis is quite common
and has the following causes:
Local causes: Ulcerations on the mucosa; erosions on the
mucosa; acute and chronic gastritis; tumors; trauma which
may be direct (foreign bodies, injury from stomach sound)
or indirect (straining during vomiting, stomach operations) ;
chemicals (poisons, purgatives, emetics).
Indirect local causes are further: Obstruction to the portal
circulation; pressure on the portal vein; thoracic diseases,
disturbing circulation ; organic heart lesions, etc.
Hematemesis may occur also from many general causes
which produce at the same time hemorrhage from several
of the mucous membranes. The following are the most
common conditions: Septicemia; autotoxic conditions,
uremia, etc.; blood dyscrasias and diseases, hemophilia,
scurvy, pernicious anemia, leukemia. The blood may have
its origin outside the stomach and come from contiguous
abscesses rupturing the stomach wall, or from ulcers and
fistula1 which may open a suppurating tract into the stomach.
Hematemesis also occurs during the course of infectious
diseases (distemper, rabies).
Pathology. —The pathological findings depend upon the
amount of the hemorrhage. When the hemorrhages prove
fatal there is a general pallor of all the viscera; where the
HEMATEMESIS 161
hemorrhages have been slow and continuous fatty degenera-
tions of the heart, liver, kidneys, gland cells are observed.
The original cause will in part determine the nature of the
pathological changes. The mucous membrane of the gastro-
intestinal tract is pale, and remains of the hemorrhage will
be noticed along its course, which is of a dark color and more
or less tarry. At the seat of the hemorrhage will be found
eroded vessels, and .sometimes imperfect clot formation.
Other lesions found are those of ulceration, foreign bodies,
depending upon the original cause of the hemorrhage.
Symptoms.— These depend very largely upon the amount
of hemorrhage and rapidity with which it flows. When
the amount of hemorrhage is small the symptoms may be
entirely overlooked. The vomited blood may be only in
small quantities often poorly mixed with the ejected food.
The color of the blood depends upon the amount and length
of time remaining in the stomach. When fresh, the color is
bright and the cells are unchanged; when retained in the
stomach some time before it is ejected, it is dark, the oxy-
hemoglobin being changed to hematin, and resembles coffee
grounds. A microscopic examination of the ejected mass
will at once reveal the presence of large numbers of red cor-
puscles unless the blood has been retained in the stomach
long enough for the red corpuscles to become entirely dis-
integrated.
When severe hemorrhages take place in the stomach, some
of the blood will pass into the intestinal tract to be passed
out with the feces. The feces will be of a dark tarry consist-
ency, with a disagreeable odor. If examined the blood
pigment will be found in large quantities.
General symptoms of internal hemorrhage are noticed in
the more severe cases. The mucous membranes suddenly
become pale and colorless, the pulse very weak and often
imperceptible, dyspnea and general weakness appear. If
repeated hemorrhages do not result fatally the patient
suffers from chronic anemia.
Diagnosis.— This depends upon the presence of the blood
mixed with the vomitus. Tare should be taken in making
the diagnosis in the dog as they often eat large quantities of
11
162 DISEASES OF THE STOMACH
clotted blood, or lick blood from bleeding surfaces which
may produce vomiting. When this is suspected the general
symptoms should be carefully considered and a careful
anamnesis obtained if possible.
A microscopic examination of the contents from the
stomach and bowels will in most cases assist in arriving at
an accurate diagnosis. It may be differentiated from hemor-
rhage of the lungs by the presence of food particles, and
the absence of air mixed with the material, and from the
fact that it usually has an acid reaction from contact with the
gastric juice.
Prognosis.— This depends very largely upon the cause, and
to a less extent upon the severity of the hemorrhage. When
resulting from wounds in the mucosa when not too extensive
it should be considered favorable. However, when due to
ulceration of the mucosa, or resulting from general causes the
prognosis is unfavorable.
Treatment.— The early indication in the treatment is
to keep the animal in a quiet place free from all excite-
ment or noise. The administration of cold water (ice water)
internally or cold applications to the epigastrium in the
form of cold water or ice are beneficial. To control the
hemorrhage when severe, adrenalin chlorid solution (1.5-2.0
of 1-1000 solution), or ergotin (0.2-1.0) subcutaneously
should be given every two or three hours until the hemor-
rhage stops. Gelatin given via the mouth has been highly
recommended for the same purpose. In less severe cases
mild astringents (tannic acid, lead acetate, tannoform, alum)
are to be used. Wrhere general weakness is well marked
subcutaneous injections of strychnin sulphate (0.0005-0.001),
or caffein citrate (0.06-0.19) are to be used to stimulate the
heart action, and as a general stimulant. Saline infusions
given as rectal injections, intravenous injections, or intra-
peritoneally are indicated in severe hemorrhages to replace
the loss of blood in the body. When hematemesis is due to
other diseases, the cause should be determined and treat-
ment applied accordingly.
All food should be withheld for at least two days, and then
allowed only in small quantities. Milk or beef broth is
useful in this regard.
PARASITES IN THE STOMACH 163
PARASITES IN THE STOMACH.
The parasites that develop in the stomach of the dog are
very rare. The Spiroptera sanguinolenta, a small blood red
worm from 5 to 8 cm. long, is the most common. It forms
small, tumor-like masses in the mucosa. Occasionally the
larvae of the Gastrophilis intestinalis are found attached to the
mucous membrane. Ascarides and teenia commonly migrate
from the intestines. Tsenia are often found in the stomach
of the cat, the Taenia tseniseformis being the most common.
The Ollulanus tricuspis, however, is the only parasite proper
to the stomach of the cat.
The adult Ollulanus tricuspis is about 1 mm. long and has
three points at the caudal extremity. The adult worm lives
in the gastric mucous membrane and when present in large
numbers, seriously interferes with the function of the mem-
brane. The embryos are quite large compared with the
adult parasite. Some of these embryos are passed with the
feces while others burrow through the walls of the intestines
and wander to various parts of their host, particularly the
pleura, diaphragm, liver and lung, wrhere they form cysts.
When the free embryos are ingested by rodents they migrate
into the muscles and become encysted. It is probable that
their development is completed in the digestive canal of the
cat that feeds upon the infested rodent.
Rabbits are chiefly infested with the Strongylus strigosus,
often found in large numbers, and give rise to a fatal anemia.
This parasite is 8 to 16 mm. long, body blood red, filiform
and transversely striated.
The parasites most common in the anterior portion of the
digestive canal of birds are the Dispharagus spiralis, Disphar-
agus nasutus and the Trichosomum contortum. The dis-
pharagi are from 7 to 9 mm. long and the trichosome 12 to
17 mm. and are found either entirely embedded in the mucous
membrane or fixed in it by one extremity and the other
floating free in the cavity of the organ. The Trichosomum
contortum is frequently found in adjacent structures, but
is common in the walls of the esophagus.
164 DISEASES OF THE STOMACH
Symptoms.— The parasites which are proper to the stomach
of small animals and to the anterior part of the digestive
canal of birds do not as a rule produce any marked symptoms
unless present in very large numbers. The Spiroptera
sanguinolenta of the dog may give rise to a chronic gastritis
with frequent vomiting, an irregular appetite and resulting
emaciation. The tumor-like masses in which the parasites
live may perforate the peritoneum and occasion a fatal peri-
tonitis. Large numbers of the Ollulanus tricuspis in the cat's
stomach cause a thickening and ecchymosed condition in
the mucous membrane with severe gastric disturbance. As
the larvae of this parasite migrate into the adjacent tissues,
they can produce extensive inflammatory processes and give
rise to pleuritis, peritonitis, bronchitis, etc. The Strongylus
strigosus produces a severe anemia in rabbits by abstracting
blood from the mucous membrane of the stomach, and by
so doing produces a disturbance in the function of the stomach
with inanition as a result. In warren rabbits where they are
continually subjected to reinfection, this anemia often
terminates fatally, at times being epizootic in its extent.
The parasites of birds produce the most serious disturb-
ance by burrowing in the walls of the esophagus and crop.
The food when swallowed becomes impacted through loss
of propelling action of the organ and dilatation results often
with fatal termination.
Diagnosis. — An accurate diagnosis of the stomach parasites
of the dog and cat is difficult. A microscopical examination
of the feces and vomitus for the larva? may reveal their
presence. When the general symptoms are indicative of
parasitism laparotomy and possibly gastrotomy should be
performed, and a direct examination of the tumor-like masses
made. In rabbits and birds, as several are usually affected, a
postmortem examination of one or two of the most typical
cases is recommended.
Prognosis.— Unfavorable in all cases of severe infestation.
Mild cases in dog, cat and rabbit often recover spontaneously
or with ordinary treatment. In birds, however, the injury
to the walls soon leads to dilatation and quite often to a
fatal termination.
NEOPLASMS IN THE STOMACH 165
Treatment.— No satisfactory treatment can be given for
those parasites living within the tumor masses or burrows
in the mucous membrane. When such parasites are diag-
nosed, all the affected individuals should be removed and a
thorough cleaning given all the houses, runways, and grounds
to which they have had access. (For ascarides and taenia see
Parasites of the Intestines.)
NEOPLASMS IN THE STOMACH.
Tumors in the stomach especially primary growths are
very seldom found in small animals. Occasionally secondary
carcinomas or sarcomas occur.
Symptoms.— The symptoms observed are very similar to
chronic gastritis (see Chronic Gastritis). The growth of the
tumor is often sufficient to increase the size of the abdomen
and can usually be palpated through the abdominal walls.
Other symptoms are persistent vomiting, icterus, and loss
of appetite. When a tumor of the stomach is suspected
laparotomy should be performed and a direct examination
made.
Prognosis. — Unfavorable.
Treatment.— No attempt should be made to operate malig-
nant growths. Tumors involving the anterior part of the
stomach are inoperable owing to the location and close attach-
ment of the stomach. Fortunately, however, tumors of the
stomach usually involve the pyloric end, and in such cases
gastroduodenostomy should be performed removing the
entire part involved. Gastroduodenostomy must be per-
formed with considerable care to prevent infection from
the stomach contents and hemorrhage from the large vessels,
and also to so place the ligatures as to avoid cutting off
blood supply from any part of the stomach not removed.
The modus operandi is as follows: Thoroughly anesthetize
the animal and secure in the dorsal position. Cover the
field of operation with sterile cloths and provide plenty of
suture material (linen machine cord No. 40) and medium-
sized, straight sewing needles (Emmet's bowel needles).
Perform laparotomy at the median line from the xiphoid
166 DISEASES OF THE STOMACH
cartilage to the umbilical scar. Grasp the stomach and draw
it up through the opening. Ligate the right and left branches
of the gastric arteries, the splenic and the gastrohepatic
arteries. The location of the ligatures along the arteries
depends on the location of the excision. In all cases the
ligatures must be close to the excision to avoid having an
area of the stomach left without blood supply. Place a gas-
trectomy forceps, the jaws protected with rubber tubing,
across the stomach just back of the point of each excision,
and two others across the part to be removed far enough
from the others to allow cutting between them with shears.
The forceps protect against hemorrhage and escape of con-
tents while the latter prevent escape of material contained
in the part to be removed. Remove by cutting between the
clamp with scissors and suture both ends with continuous
suture over and over the cut edges to control hemorrhage,
and invert the ends by putting in Lembert sutures. Remove
the forceps and take up a part of the anterior wall of the
stomach and apply the forceps, having the part that projects
through the forceps about two inches long by one-half inch
through. Do the same with the duodenum about three
inches from the pylorus. Place the forceps close together
and apply sutures through the muscular coat close to the
lower jaw of each forceps, and do not cut off the suture.
Then make an incision in the stomach close to the line of
sutures and one in the duodenum to correspond with the one
in the stomach. Then with a new suture join the distal
edges of the wound with Council's sutures, the forceps being
loosened but left in place to support the stomach. These
latter sutures invert the cut edges and the first suture can
now be continued over the Connell suture as a Lembert
suture. Return the organs and suture the laparotomy
wound. After forty-eight hours feed liquid food for several
days.
CHAPTER IX.
DISEASES OF THE INTESTINES.
Examination.— The intestines can be easily palpated
through the abdominal wall in most small animals, when
they are not too fat, and this greatly assists in making an
accurate diagnosis, especially of foreign bodies, fecal accumu-
lation (coprolith), etc. This is best done by placing the
animal in the standing position using both hands, one on
either side of the abdomen. When necessary to make a more
careful examination, as for perforating wounds, volvulus,
etc., explorative laparotomy should be employed. The
intestines are best reached by making the incision at the
median line in the middle of the distance from the xiphoid
cartilage to the anterior border of the pelvis, and of sufficient
size to permit of a thorough examination of the entire length
of the intestine. The Roentgen rays can be employed to
detect foreign bodies.
The feces should be carefully examined for the following:
Frequency, color, odor, quantity, consistency, presence of
blood, parasites or their ova, mucus, foreign bodies, undi-
gested food. The peristalsis is important and can be exam-
ined by placing the animal on its side, covering the abdomen
with a towel or cloth and applying the ear. The phonendo-
scope is of great assistance for this purpose. Percussion is
important in differentiating accumulations of fluid or gas
in the abdomen or intestines.
ENTERITIS.
Two forms of enteritis are recognized in small animals,
viz.: (a) Acute, and (6) chronic.
Acute Enteritis.— Definition.— This is a catarrhal inflamma-
tion of the mucous membrane of the small intestine, as well
168 DISEASES OF THE INTESTINES
as the upper portion of the large bowel. In small animals it
is impossible from a clinical standpoint to recognize the
condition as affecting different parts of the bowels as:
Duodenitis, ileitis, jejunitis, etc. P^nteritis very frequently
accompanies acute gastritis, the causes producing acute
gastritis often extending into the intestines.
Etiology.— The etiology is in many respects similar to that
of acute gastritis: (a) Foreign bodies which irritate, such
as sharp pieces of bone, needles, pins, etc. These when swal-
lowed pass through the stomach into the intestines, often
producing extensive irritation to the mucosa, resulting in an
acute inflammation. Enteritis may result also from opera-
tions, such as laparotomy when the bowels are roughly
handled, rectal injections and manipulations, etc. Powdered
glass is sometimes given intentionally to small animals, and
it produces a very severe form of enteritis.
(6) Chemical substances (carbolic acid, arsenic, phos-
phorus, mercury, etc.) produce a very severe form of enteritis
by their corrosive action on the mucous membrane. Chemical
irritants contained in food when eaten by the animals will
produce the same condition. Sometimes excessive quantities
of foods, or digestive disturbance may occasion fermentation
in the intestinal tract and the formation of irritants that
directly excite an inflammatory condition. Also foods (meat,
fish) may contain preformed toxic bodies, such as ptomaines
or other products of bacterial action, which may occasion
violent inflammation of the bowels. Cats are frequently
affected by eating fish partially decomposed. Birds, from
eating substances containing rather large quantities of
sodium chlorid, suffer from a severe form of inflammation
of the bowels as the result.
(c) Exposure to cold, or sudden cooling of the surface of
the body may produce an enteritis by interfering with the
innervation and circulation in the intestinal walls; also
taking large quantities of cold water, frozen or very cold
foods will induce it.
(d) Bacteria probably rarely cause inflammation of the
bowels directly, but their action upon the intestinal contents
causing fermentative changes are causes of enteritis. Ente-
ENTERITIS 1G9
ritis is an essential complication in certain infectious diseases
(distemper, enterohepatitis, etc.). ,
(e) Severe infestations with animal parasites can produce
acute enteritis by the irritant action of the parasites upon
the mucosa producing congestion and in some cases by
attaching themselves to the membrane or burrowing into its
walls. The severity of the inflammation produced depends
very largely upon the number and species of parasites present.
This condition is observed most often in puppies and kittens.
Acute enteritis also occurs secondarily to other diseases,
such as septicemia, septicemic diseases of birds, peritonitis,
coccidiosis of rabbits and birds, etc.
Pathology. — The mucous membrane of the bowel may be
involved in its entire length with almost equal severity, but
usually certain portions are more seriously affected than
others. The mucosa is swollen and reddened, the surface
usually covered with mucus, which may be tinged with blood,
and sometimes the submucosa is edematous with hemor-
rhagic extravasations. The lymphatic follicles are enlarged
and project out from the mucosa prominently as light patches
against the inflamed surface of the mucosa. In severe cases
pseudomembranous or diphtheritic inflammations of the
mucous membrane of the intestines may be seen occurring
usually secondary to infections originating elsewhere or
from the action of corrosive poisons which are very common
in dogs and birds. In all of these cases the mucous mem-
brane is covered with an extensive, dirty yellow or grayish
deposit, appearing as a coating over the surface or as a
firmly attached pseudomembrane. This pseudomembrane
may be found in the entire length of the bowel. Areas of
the necrosis and deep ulceration are often seen where the
pseudomembrane has been dislodged. Hemorrhages are
often found under and from the mucosa, the blood mixing
with the intestinal contents forming a dark red mass. The
feces are very thin even in the large intestine and have a
disagreeable odor. The mesenteric lymph glands are swollen
and edematous.
Symptoms.— The clinical symptoms in enteritis vary with
the intensity of the cause and the part of the intestinal tract
170 DISEASES OF THE INTESTINES
involved. In milder cases the symptoms are those of diar-
rhea due to functional disturbances of the bowels. In severe
cases the symptoms come on suddenly and are of great
severity. In dogs there is usually constipation in the early
stages followed in a few hours by diarrhea. The feces, as a
rule, are liquid, brownish in color and of more or less offen-
sive odor, depending upon the extent of the putrefactive
changes and the intensity of the inflammation. In severe
inflammations due to corrosive poisons, etc., the feces are
mixed with blood, sometimes passed in quite large quanti-
ties, and in the form of clots. When due to poisons, the odor
of the poison is often noticed in the feces.
Colicky pains are noted and in severe cases intense abdom-
inal pain is one of the most prominent symptoms. The
abdominal muscles are tense, contracted, often giving the
animal a "tucked up" appearance. In severe inflammation
of the bowels the dog will often lie stretched out on its
abdomen, showing intense pain by howling, crying, nervous-
ness, etc. Sometimes the nervous symptoms will be promi-
nent enough to simulate rabies.
Vomiting is a common symptom provided the stomach is
involved. The vomitus usually consists of food particles,
mucus, blood, bile, and in rare cases feces from the small
intestines. There is loss of appetite except in the very mild
cases. Fever is more or less high in the early stages, while
later in the dog it becomes subnormal. The temperature, as a
rule, cannot be depended upon to determine the severity of
the condition, as it may be increased in slight cases, and in
severe, be normal or subnormal. The general symptoms are
those of weakness, in proportion to the degree of inflamma-
tion, complete prostration or collapse. The surface of the
body becomes cold, the mucous membranes cyanotic, there
is well marked dyspnea and a weak, rapid pulse. In cats
the diarrhea is a very prominent early symptom. The feces
are liquid and often mixed with blood. Complete prostra-
tion takes place early under symptoms of dyspnea, general
weakness, and a very rapid weak pulse.
In birds enteritis begins with diarrhea. The feces are
of a thin consistency, of a yellowish or greenish color, and
ENTERITIS 171
very offensive odor. The feathers in the region of the cloaca
become soiled, matted together, retaining a quantity of the
feces which often becomes dried and forms a hard mass
around the anal opening. There is usually loss of appetite,
general weakness, the wings are held pendant and the patient
completely prostrated. In the more severe cases due to
ptomaines, toxins, etc., the symptoms develop very rapidly,
and there is but little noticed except subnormal temperature,
narcosis and coma. Death occurs in a large percentage of
those cases due to ptomaines, toxins, etc.
Diagnosis.— The recognition of acute enteritis offers no
great difficulties in most cases. The anamnesis, sudden
onset, abdominal pain, and the severe diarrhea are all quite
characteristic. Only when diarrhea is absent would the
diagnosis be difficult. A careful examination should always
be made to determine if possible the cause of the enteritis,
whether it is a primary condition or secondary to some other
disease. Examination of the feces should be made both
macro- and microscopically to determine their condition,
the presence of blood, foreign material, or of parasites.
Prognosis.— In ordinary cases of enteritis the prognosis is
usually favorable. However, it depends very largely upon
the cause, and all cases should be considered serious until
the cause can be determined. "When due to corrosive poisons,
ptomaines, toxins, etc., the prognosis should be considered
very unfavorable depending upon the amount of the material
ingested. In cats the prognosis should be guarded as these
animals are very sensitive to intestinal disturbances.
Treatment.— Hygienic.— The animals should be placed in
a warm, dry place which is well ventilated and free from all
noise and excitement. Not too many birds or small animals
should be allowed in one room, and the floors, roosts, etc.,
should be thoroughly cleaned (daily) and disinfectants,
such as carbolic acid (5 per cent.) freely used. The drinking
water should be kept fresh, and the food, when allowed, free
from dirt, dust, and not contaminated with bowel discharges.
Collections of feces on the hair and feathers should be
removed daily with warm water or bicarbonate of soda
solution (2 per cent). The mouth may be washed with clean
172 DISEASES OF THE INTESTINES
water to remove all food particles which might remain to
decompose and eventually be swallowed to perpetuate the
intestinal disturbance.
Dietetic.— In most cases of acute enteritis, all food is
withheld for at least twenty-four to forty-eight hours. After
this time, when improvement begins to be noticeable, dogs
may be given small amounts of lean, meat finely divided,
milk, beef tea, rice soup, etc., once or twice daily. Rabbits
should be fed small quantities of roasted oats, corn or barley,
or roasted bread. For birds small amounts of cooked rice,
oatmeal, cornmeal or bread and milk may be given once
daily. Green foods should be withheld at first and only
allowed in small quantities several days after improvement
is noted. They tend to increase the diarrhea by their laxa-
tive action.
Medical.— In mild cases of enteritis, due to errors in feeding
or irritating foodstuffs, etc., small doses of laxatives are
indicated to remove the irritating material from the bowels.
Castor oil (dogs, 15.0-40.0; cats, 3.0-15.0; rabbits, 5.0-10.0;
birds, 1.0-8.0), or calomel (dogs, 0.3-0.4; cats, 0.1-0.15;
rabbits, 0.2 ; birds, 0.05-0.2) can be administered. Magnesium
sulphate (dogs, 10.0-15.0; cats, 1.0-5.0; rabbits, 1.0-3.0;
birds, 1.0-2.0) is frequently used for the same purpose owing
to its increasing the fluids in the bowels and flushing them
out more promptly and thoroughly. It is best administered
in solution with warm water.
In more severe cases where the diarrhea is persistent after
the use of laxatives, it is necessary to administer styptics,
such as opium (dogs, 0.1-0.5; cats, 0.005-0.2; rabbits, 0.05-
0.1; birds, 0.05-0.1). In cases where severe pain is present,
especially in dogs, morphin sulphate is indicated. It may be
given (for dogs, 0.02-0.15) as a subcutaneous injection dis-
solved in water (5.00).
Astringents are sometimes of value in controlling the
persistent diarrhea and tannic acid is often administered
for that purpose in the following dosage: Dogs (0.1-0.5),
cats (0.05-0.2), rabbits (0.05-0.2), birds (0.01-0.05).
Where fermentative processes continue in the bowels
disinfectants may be administered: Lysol (0.5-2.0), creolin
(0.5-2.0), salol (0.2-0.8).
ENTERITIS 173
It is often advisable in dogs to wash out the intestinal
tract with bicarbonate of soda solution (1 to 2 per cent.)
followed by alum, tannic acid or iron sulphate solutions
(1 to 2 per cent.). This can be done quite readily in the
dog by the use of a flexible rubber tube inserted as far up
into the bowels as possible. The free end is elevated and a
funnel attached. The solution is poured into the funnel
and allowed to gravitate slowly into the bowels. When
there is no obstruction the fluid will flow into the stomach
and be ejected through the mouth. In birds it is best intro-
duced with a small syringe, being careful to avoid using too
much force. In very severe cases, where general weakness
is apparent, stimulants are advisable. Subcutaneous injec-
tions of caffein citrate (0.1-0.5) may be used as a heart
stimulant. Normal salt solution, at the body tempera-
ture (100° F.), is of great value in severe weakness from
hemorrhage or narcosis. It may be introduced intravenously,
subcutaneously, intraperitoneally or per rectum.
Chronic Enteritis.— Definition.— This is a chronic inflam-
mation of the small intestines involving the upper part of the
large intestines, but often extending to all parts of the intes-
tinal mucosa. Frequently there is extensive ulceration at
different places along the intestinal tract. In some cases the
stomach mucosa is involved from the same causes that pro-
duce the chronic enteritis.
Etiology.— Chronic enteritis most commonly develops
from repeated acute attacks or from the same causes acting
mildly producing gradually a chronic inflammatory condi-
tion. (See Acute f^nteritis.)
Chronic enteritis also occurs secondary to other diseases,
such as chronic diseases of the heart, lungs, and liver which
cause interference with the circulation in the walls of the
intestines. Chronic infectious diseases, such as chronic
distemper, chronic constitutional diseases, rachitis, etc.,
have at times chronic enteritis associated with them. Para-
sites in the intestinal tract are common causes.
Pathology. —The intestines always present evidences of
long-continued inflammation of the mucosa, the surface
being covered with excessive secretions of mucus or muco-
174 DISEASES OF THE INTESTINES
purulent material. There are extensive areas of thickening
in the mucous membrane; erosions and atrophy may too be
present. Ulcerations and cicatrices are often noted. Ulcera-
tions may lead to perforation of the bowel wall producing
a localized area of adhesive peritonitis, or in some cases a
generalized peritonitis. The mucous membrane is usually
bluish-red and at various points will be noted light and dark
points due to the pathological changes in the structure of
the membrane. The intestinal contents are usually liquid,
of a slate gray color and emit a very offensive odor. Some-
times when constipation is present the feces will be dry and
hard in the large bowels, and of a grayish color.
Symptoms.— The most conspicuous symptom is a continu-
ous or intermittent diarrhea. However, diarrhea may alter-
nate with constipation. The general symptoms are dulness,
gradual emaciation, rough hair coat and inanition which is
marked owing to the lost or variable appetite and the inter-
ference with digestion and food assimilation. From time
to time the bowels are distended with gases from the fer-
mentative processes in the intestinal tract. This is especially
marked when constipation is present and the peristalsis
reduced. At other times large quantities of gases, feces
mixed with mucus and often streaked with blood, are passed
during the period of diarrhea.
In most cases there is little evidence of abdominal pain,
except when ulceration of the bowel wall takes place and an
adhesive or a general peritonitis is produced. Then all the
evidences of inflammation of serous membranes are present.
(See Peritonitis).
Diagnosis.— The long-continued course, the intermittent
diarrhea, the anamnesis and the general condition of the
animal will be sufficient in most cases to make a compara-
tively accurate diagnosis. However, a careful and thorough
examination should always be made to determine if possible
the cause of the enteritis. This is valuable especially for a
proper prognosis and rational therapeutics. The feces
should be carefully examined for parasites and their ova, as
these form a frequent cause.
INTESTINAL HEMORRHAGE— ENTERORRHAGIA 175
Further, as this condition is often secondary to other
diseases, a differential diagnosis should always be attempted.
Look for chronic constitutional diseases, diseases of the liver,
heart and lungs and chronic infectious diseases. In birds
an examination should be made for infectious asthenia and
parasites.
Prognosis.— Chronic enteritis whether of primary or sec-
ondary origin should be considered unfavorable owing to
the pathological changes which have taken place in the
mucous membrane. Complete recovery can hardly be
expected even in mild cases. In mature animals the prog-
nosis is considered more favorable than in young animals.
When it occurs secondary to other diseases the prognosis
depends largely upon the primary disease.
Treatment.— A careful regulation of the diet (see Acute
Enteritis) is of great importance and should be thoroughly
impressed upon the attendant.
Medical.— The action of the bowels should be kept as
regular as possible by the use of castor oil, magnesium
sulphate, etc. (See Acute Enteritis.) When diarrhea
becomes persistent astringents are indicated as in acute
enteritis.
Washing out the bowels (see Acute Enteritis) is especially
valuable in chronic enteritis to remove irritating material,
mucus, fecal matter, etc.
If parasites are present proper anthelmintics should be
employed. (See Parasites in the Intestines.)
To encourage the appetite and to aid in digestion, bitter
stomachics (gentian, nux vomica) are indicated. In the
treatment an attempt should always be made to remove the
cause; when secondary to other diseases treatment should
be given to promote the removal of the fundamental disease.
INTESTINAL HEMORRHAGE. ENTERORRHAGIA.
Definition.— This is a condition where hemorrhage takes
place from the intestinal mucosa. It may be due to a definite
176 DISEASES OF THE INTESTINES
change in the structure of the mucosa or occur during the
course of certain diseases attended by hemorrhagic diatheses.
Etiology. — The causes of intestinal hemorrhage are quite
numerous: (a) Mechanical agents, such as sharp foreign
bodies which penetrate the intestinal mucosa and injure the
bloodvessels, producing a more or less severe hemorrhage.
Parasites, by their irritating action on the mucous membrane,
or by burrowing into the mucosa, will produce the same
result. Injuries, such as being run over by vehicles, kicks,
blows, etc., over the region of the abdomen will often rupture
some of the vessels in the intestinal mucosa, resulting in
hemorrhage. Powdered glass, when administered to destroy
animals, will produce severe hemorrhage by the fragments
of glass penetrating the mucosa and opening the vessels.
(6) During the course of poisonings by chemicals or caustic
substances, severe hemorrhage often takes place due to the
corrosive action on the mucous membrane. Drugs, when
administered in large doses, may produce a congestion of the
bloodvessels of the mucosa, resulting occasionally in over-
distention and rupture.
(c) Hemorrhage takes place sometimes from an engorge-
ment of the intestinal circulation from diseases of the heart
and liver, hemorrhagic infarction of the bowel from embolism
or thrombosis of the mesenteric vessels, intussusception or
strangulation of the bowel, or hernia. In these cases the
hemorrhage may result from an overdistention of the blood-
vessels.
(d) During the course of some diseases severe hemorrhage
in the intestinal tract occurs, as in anemias, severe infections
(distemper) and certain degenerations.
(e) Tumors (carcinomas) and ulcerations on the mucous
membranes may lead to severe hemorrhage by destruction
of some of the bloodvessel walls. Hemorrhoids, collections
of feces, etc., may produce hemorrhage in the large bowels.
Symptoms.— Hemorrhage in the intestinal tract is often
difficult to recognize, unless the quantity of blood is sufficient
to distend the bowels, or be ejected through the rectum. In
mild cases of hemorrhage only general weakness and paleness
INTESTINAL HEMORRHAGE—ENTERORRHAGIA 177
of the mucous membranes may be recognized. When the
hemorrhage has been severe from the small bowels the feces
will be very dark and of a tarry consistency; from the large
bowels and rectum the color is a bright red the blood being
well preserved. In severe hemorrhage the symptoms are
those of extensive hemorrhage from any source. Sudden
paleness of the membranes, rapid weakness, etc., are the
most prominent symptoms observed. Repeated small hemor-
rhages, such as occur during ulceration, action of parasites,
etc., may produce different grades of anemia, depending upon
the extent of the hemorrhage.
Diagnosis.— This can only be made after a careful examina-
tion of the animal and the discharges from the bowels. When
slight hemorrhages take place, a microscopic examination
of the discharges may be necessary to determine the presence
of blood.
Prognosis.— This depends upon the cause, and the extent
of the hemorrhage. In most cases bowel hemorrhage should
be considered serious, as it is often impossible to determine
the cause or extent of the hemorrhage.
Treatment.— The cause should be determined if possible,
as the treatment depends very largely upon this factor.
Opium is often of great value to suppress peristalsis. The
tincture may be used in the following dosage: For dogs
(0.5-1.0), cats (0.2-0.5), rabbits (0.2-0.5), birds (0.1-0.2).
Astringents, such as tannic acid, etc., are also indicated.
They should be administered in rather large doses, and
repeated every hour or so. Adrenalin chlorid is most useful
in severe hemorrhage: The dose for dogs is 2.0 of a 1-1000
solution given every hour; other animals one-half the quantity.
Ergot may also be used. Hemorrhage from the rectum or
large bowels is best treated by injections of gelatin dissolved
in hot water, astringents (alum 2-5 per cent.), or cold water.
The injections should be repeated as often as necessary to
control the hemorrhage.
When there is great loss of blood, normal salt solution
(500.0) should be administered intraperitoneally or per
rectum. Further treatment depends upon the symptoms
that develop.
12
178 DISEASES OF THE INTESTINES
DIARRHEA.
Definition.— This term is applied to a too frequent discharge
of more or less fluid feces. The condition may vary greatly
in small animals from a slight increase in the daily evacua-
tions to repeated evacuations of large quantities of liquid
feces. It is important to note that often repeated evacuations
of small amounts of liquid feces may occur even when an
actual obstruction of the bowels ' (fecal impaction) exists.
Etiology.— The essential condition in diarrhea is an abnor-
mal increase of fluid in the feces. The causes, therefore, will
be found to be those which occasion a rapid evacuation of the
bowel contents, or a reduction in the absorption from the
bowels; or an oversupply of fluid in the bowels either from
the ingestion of large quantities of water or any over-
abundant secretion from the mucous membrane.
Normally the contents of the small bowels are fluid. They
pass from the stomach to the large bowels in a few hours.
The contents of the large bowels become gradually hardened
from the absorption of the water during their passage through
this part of the intestinal tract, which requires in small
animals, from twelve to twenty hours. Any conditions
therefore that hasten the movements of the contents through
the large bowels would tend to make the feces softer or liquid.
The same result may occur from a variety of conditions which
disturb the process of absorption and keep the feces in a liquid
state. Occasionally conditions that influence the absorption
from the mucous membrane, such as irritations of various
kinds, at the same time excite the secretion of considerable
quantities of fluids. These same agents may also increase
peristalsis and thus hurry the contents through the bowels.
The most common causes of diarrhea therefore are: (a)
Drinking excessive quantities of water or eating large quan-
tities of fat meat, lard, or butter will result in diarrhea. The
unabsorbed fat or its decomposition in the intestinal tract
acts as an irritant and greatly increases intestinal activity.
(6) Foods will sometimes produce diarrhea by their irri-
tating action on the mucous membrane. Such substances
as table scraps containing fruit stones, parings, or fish,
DIARRHEA 179
.cheese, milk, etc., may undergo fermentative changes in the
intestinal tract or from their decomposition contain preformed
toxic substances which excite diarrhea. Excessive amounts
of food may set up a diarrhea as a result of derangement of
the gastric digestion and secondary bacterial fermentations.
(c) A large number of purgatives, when administered in
large doses, will produce diarrhea by acting upon the muscle
of the bowel and the nervous mechanism stimulating peri-
stalsis and thus hastening the contents through the bowels
before absorption can take place. Salines (magnesium
sulphate) increase the amount of fluid in the bowels, and also
stimulate peristalsis. Some foods in which bacterial decom-
position has taken place will have an action similar to salines
greatly increasing the amount of fluids in the bowels by excit-
ing secretion from the glands in the mucosa.
(d) In some animals (cat) the nervous mechanism of the
stomach will be greatly influenced by shock, fright, excite-
ment, etc., and severe diarrhea may result.
(e) Diarrhea may result from diseases of other organs. In
diseases of the stomach, when undigested food is passed
into the intestines, the resulting irritation may induce severe
diarrhea. In valvular insufficiencies or other heart lesions a
congestion of the mucous membrane of the bowel results and
an excessive secretion follows. Diseases of the kidney may
also produce diarrhea by vicarious excretion of urea ma
intestinal tract. The urea decomposes producing free
ammonia which irritates the mucosa causing a severe form
of diarrhea.
(/) Various infections in the bowels (distemper, etc.) are
associated with a more or less intense diarrhea. Infections
with lesions at some distance from the bowels may have
diarrhea as a consequence due to the elimination of toxic
substances from the intestinal mucous membrane, which
can result in severe diarrhea. An overproduction of bile
during the course of some diseases of the liver can have the
same effect.
(g) Organic diseases of the bowels (catarrhs, ulcerations)
often lead to diarrhea from the irritation and resultant
products of decomposition.
180 DISEASES OF THE INTESTINES
(K) The normal contents of the bowels contain numerous
varieties of organisms, which under abnormal conditions
may multiply sufficiently or increase in virulence as to
bee me pathogenic, producing diarrhea.
(i) Various specific organisms (coccidia, etc.) produce
diarrhea. They will be considered under the diseases caused
by them.
Symptoms.— The clinical symptoms of diarrhea depend
largely upon the part of the intestine affected and the nature
of the causative agent. When due to errors in feeding and
the upper part of the intestine is involved, diarrhea may not
occur if the posterior bowels remain normal. In diarrhea the
discharges from the bowels consist of portions of undigested
food, mucus, etc., and are yellowish or greenish in color,
due in part to unchanged bile or to pigment derived from
fermentation. Excessive acidity, which has not been suffi-
ciently neutralized in the small intestines, may produce
inflammation in the lower bowel, due to its irritant action
upon the mucous membrane. In cases where both 'the small
and the large bowels are involved the discharges are more
abundant and liquid. The feces will be very thin and of a
yellowish or a dark brown color. When the large bowel is
particularly affected, the animal shows frequent attempts
at defecation, and only a small amount of feces and blood
mixed with quantities of mucus will be passed.
In the more severe forms of diarrhea colicky pains are
often observed and in some cases the pain becomes intense.
There are frequent attempts at defecation, and tenesmus
is not unusual. When severe diarrhea is present it frequently
produces extreme prostration and in cats complete collapse.
The extremities become cold, the mucous membranes at
first pale, later cyanotic and every evidence of extreme
weakness appears.
The temperature as a rule becomes subnormal ; however, in
the very early stages it is often elevated one or two degrees.
The severity of the symptoms and the course depend very
largely upon the causative agents producing the diarrhea.
In mild cases it lasts only a few hours; in the severe forms
several davs.
DIARRHEA 181
Diagnosis. — This is established mainly by determining the
cause. The history of the case is of great service in this
regard. A thorough examination of the animal and feces
is necessary for a differential diagnosis to distinguish this
condition from specific diseases of the bowels.
Prognosis. —The prognosis is favorable in most cases but
depends largely upon the cause. Diarrhea is a symptom and
not a disease. Until the cause is determined an accurate
prognosis cannot be made.
Treatment.— Dietetic.— All food should be withheld for at
least twenty-four to forty-eight hours, especially where but
little weakness or prostration is apparent. Should weakness
develop small amounts of milk, or milk and egg beaten
together, should be given every four to six hours. Later
when the symptoms of diarrhea begin to disappear a little
lean meat may be allowed. Cats may have small quantities
of rice and milk, or salmon. Birds should be allowed only
small quantities of oatmeal or seeds. Avoid the use of laxa-
tive foods, or foods containing irritating material of any kind.
Medical.— The first indication in the treatment of diarrhea
is the evacuation of the irritating material from the intestinal
tract. In a large percentage of cases the spontaneous evacua-
tions are sufficient to rid the bowels of this material. How-
ever, as a general rule, it is advisable to assist nature by the
administration of a laxative to ensure the prompt removal
of all irritating ingesta. Castor oil (dogs, 15.0-40.0; cats,
5.0-10.0; rabbits and birds, 1.0-4.0) is valuable. After thor-
ough evacuation of the bowels opiates are indicated to con-
trol the excessive peristalsis and secretions. Useful is tinct-
ure of opium (dogs, 0.5-1.0; cats, 0.2-0.5; rabbits, 0.2-0.5;
birds, 0.1-0.2). These doses can be repeated every few hours
if necessary.
Small doses of lime water are of value to neutralize exces-
sive acidity which is often a common condition in small
animals.
Where severe pain is present, which is rather common in
the dog, small doses of morphin sulphate (0.05-0.10) may be
given subcutaneously.
Where the diarrhea becomes persistent, it should be treated
as in acute or chronic enteritis.
182 DISEASES OF THE INTESTINES
CONSTIPATION. OBSTIPATION. INTESTINAL
OBSTRUCTION.
Definition. — An infrequent or difficult evacuation of feces
which are abnormally dry or hard; or may be retained.
Etiology. — The common causes of constipation in dogs are
lack of exercise and feeding dry food. Dogs kept in the
house or kennel often withhold the feces until they become
hard and dry. Usually in old dogs the peristalsis becomes
slowed and there is lack of tone in the muscular wall with
some dilatation of the large bowel which causes constipation.
The passage through the intestine may be blocked by fecal
masses (coproliths), foreign bodies, calculi, parasites or hair
balls, the latter being more common in cats as they lick off
and swallow loose hair. The lumen of the intestine may be
narrowed as a result of chronic inflammation, cicatricial
contraction, stenosis, tumors within the wall, or hemorrhoids.
Causative conditions external to the bowel are hernias,
fibrous adhesions or tumors. Other causes are chronic
inflammation of the liver with suppression of bile; chronic
diseases of the spinal cord; enlarged prostates in old dogs;
chronic inflammation of the anal glands; agglutination of the
hair with feces at the anus in long-haired dogs. Rabbits
are commonly affected by eating too much dry food. Hair
balls or masses of hair and feces are often found in these
animals. Birds occasionally swallow feathers which accumu-
late in the intestines interfering with the passage of the con-
tents. The most common causes are dry feed and foreign
bodies.
Pathology.— The feces are dry, hard, usually of a light gray
color and sometimes covered wLh mucus or streaked with
blood. Coproliths or calculi or impactions of large size often
result in necrosis of the intestinal wall with perforation and
peritonitis.
Symptoms.— Mild cases show only difficult defecation at
long intervals (two to four days). The feces are very dry,
hard and may be streaked with blood from injuries produced
in the rectal mucosa.
In severe cases the retained feces decompose producing
CONSTIPATION— OBSTIPATION 183
toxins which are absorbed and intoxicate the patient. The
animal will show depression, loss of appetite, increased tem-
perature (103°-104° F.), and thirst. Frequent efforts at
defecation are made, the attempts inducing cries of pain.
There is a characteristic carriage of the tail which is arched
as when defecating, and a fulness of the abdomen. Vomiting
is not uncommon especially in the more acute cases, the
vomitus containing some bile and feces. Rabbits often show
paralysis of the posterior parts. Birds make frequent
attempts to pass feces and usually sit or stand in an upright
position. By palpation large hard masses in the posterior
bowel can be determined.
Digital examination per rectum or over the abdomen will
often reveal sensitiveness and the impacted fecal masses.
Diagnosis.— The frequent attempts to defecate, the condi-
tion of the evacuated material, and the presence of fecal
masses on digital examination will readily identify the con-
dition.
Prognosis. — Favorable in mild cases when due to errors in
feeding; otherwise depends entirely upon the causes.
Treatment.— Mild cases of constipation may be relieved
by the use of a purgative given in full doses (castor oil I).
15.0-40.0, C. 5.0-10.0; calomel 0.05-0.15), while in chronic-
cases after these purgative^ clear the bowel small doses of
laxatives (extract of cascara sagrada, 2.0-10.0; tincture rhei,
5.0-10.0) must be given for some time to prevent a recur-
rence of the condition. Tincture of mix vomica (0.3-0.6) or
strychnin sulphate (0.001) is useful to stimulate peristalsis,
especially when there is enervation from diseases of the cord,
and to increase the tone of the muscular wall in dilatations.
In obstinate cases large quantities of warm soapy water, or
oil and water, introduced with a soft rubber tube and irri-
gator well up into the rectum, will stimulate peristalsis,
lubricate and soften the fecal masses and facilitate removal.
A blunt irrigating curette can be used to break down the
hard masses. Manipulation of the abdomen while irrigating
is often beneficial.
Rabbits may be relieved by the use of purgatives (castor oil,
2.0-4.0; tincture rhei, 0.3-0.6) and a diet of green foods, vege-
184 DISEASES OF THE INTESTINES
tables, etc., should be supplied. Chickens may be treated with
enemas of glycerin, or warm soapy water, and massaging over
the abdomen. Fecal masses, calculi or foreign bodies that can-
not be evacuated by any of the above methods may be removed
by laparotomy and enterotomy. This operation should be
performed early before necrosis occurs in which case enter-
ectomy must be resorted to and the necrotic portion of the
intestine resected (see Enterectomy) . The modus operandi
is as follows: Perform laparotomy (see Laparotomy) at the
median line just posterior to the umbilicus and withdraw the
intestine containing the obstruction. Ligate the bowel with
a heavy suture or tape on either side of the obstruction
to prevent escape of contents and control hemorrhage by
ligating all vessels supplying the part to be operated. Make
an incision lengthwise of the bowel opposite the blood supply
and of sufficient length to remove the obstruction which
must be done carefully. Cleanse the bowel, and suture the
mucous membrane, and then the muscular coat with con-
tinuous sutures applied very close to the edge and then apply
continuous Lembert sutures over these. By suturing the two
layers separately, there is less tissue in the part to be folded
on by the Lembert sutures. Remove the ligatures from
around the bowel and the vessels, cleanse and return to the
cavity.
Constipation due to cicatricial contraction or stenosis may
be alleviated by entero-enterotomy. Perform laparotomy
as for enterotomy, withdraw the part of the intestine involved
and apply a long bowel clamp lengthwise across a curved
portion of the bowel, clamping off about three inches above
the affected area, and another below, having not less than
eight inches between the two clamps. Bring the clamped-
off portions in apposition, making a circular loop in the bowel,
thus having the peristalsis in the same direction. Apply
continuous sutures through the muscular and serous coat
of the clamped off portion just above the clamps, bringing
the two parts in contact and leave the suture. Make an
incision from one to one and a half inches long of same length
and position in each bowel. Apply continuous suture over
the free edges in contact. Loosen clamps but leave in posi-
VOLVULUS 18,5
tion, and continuing with the latter suture, apply Council's
sutures closing the opening. Then beginning with the first
suture apply Lembert sutures around to the point of begin-
ning. Remove vessel ligatures, cleanse and return to the
abdominal cavity.
Following these operations all food must be withheld
twenty-four to forty-eight hours and then only small amounts
of liquid food for several days. Tumor formations in the
bowel are rare but when causing trouble must be removed
by enterectomy (see Enterectomy) .
VOLVULUS.
Definition.— An intestinal obstruction due to a twisting
or knotting of the bowel.
Etiology. — This condition is rare in dogs owing to the
short mesentery. It may occur following falls or rough
handling by children during play, or by a portion of the
bowel passing through an opening in the mesentery caused
by an injury or following operations (enterectomy).
Pathology.— Volvulus of the bowel is more or less obstructive
owing to twisting or kinking which it produces. In other cases
a loop of intestine is twisted about another like a bow knot
or slipped through an opening in the mesentery which partly
obstructs the passage of the contents. Gas formation soon
dilates the bowel further obstructing it and also the blood-
vessels. When the obstruction is complete the bowel above
is much distended while the part actually involved, having
the circulation arrested, will appear dark red and later
become necrotic leading to peritonitis.
Symptoms.— As the condition is acute the symptoms appear
suddenly and are very pronounced. They are abdominal
pain, accompanied by vomiting, great prostration and a
hard, rapid pulse. Palpation of the abdomen may or may
not produce much pain; sometimes no change in the intestine
can be detected.
Diagnosis.— The acute abdominal pain, the sudden onset,
rapidly increasing severity of the symptoms, vomiting and
186 DISEASES OF THE INTESTINES
rapid pulse, serve to identify volvulus and differentiate it
from other more chronic forms of intestinal obstruction.
Prognosis.— Unfavorable unless recognized early when a
prompt operation affords relief.
Treatment.— Injections of large quantities of warm water
or of air into the rectum may be beneficial in some cases.
However, owing to the rapid changes taking place in the bowel,
laparotomy should be performed early, and an attempt
made to reduce the volvulus. Should the involved part of
the intestine be necrotic, enterectomy must be employed to
remove the entire part affected.
INTUSSUSCEPTION.
Definition. — The invagination of a part of the intestine
into an adjacent portion.
Etiology . —The exact causes are not known, although from
the conditions under which it occurs and by experiments
it is believed to be due to irregular innervation by which
a given spot is contracted while immediately below it there
is a dilatation, thus permitting the latter to invaginate the
former. It may be produced by supercatharsis, increased
production of bile (icterus), or the taking of cold water
immediately following severe exercise, all of which excite
innervation or produce sudden increase in peristalsis. Pre-
disposing causes are constipation; dilatations following
removal of fecal masses by enterotomy; end-to-end enterec-
tomy, the circular cicatrix being incapable of contraction or
dilatation which favors invagination; tumors in the intestinal
wall. Intussusception may involve any part of the small
intestine. The small intestine may pass in the ileocecal
valve. Invagination of the colon or rectum may also occur.
Pathology.— Intussusception is a condition in which one
part of the bowel slips into another forming a sausage-like
enlargement of varied length. The enlargement is slightly
curved from tension of the mesentery. As a result of the
constriction, blood circulation is interfered with and often
entirely arrested. In the early stages there is slight redden-
ing, later the parts are swollen, congested and of bluish color.
INTUSSUSCEPTION 187
Adhesions occur between the adjacent layers in a few hours
and finally the parts become necrotic and may perforate
leading to peritonitis. The rapidity with which these changes
occur depends upon the extent of the intussusception as the
farther the invagination the greater the pressure on the
bloodvessels; if the circulation be completely obstructed,
necrosis will occur in a few hours.
Symptoms. — Intussusception manifests itself early by
abdominal pain, the tension on the mesentery producing
the first symptoms. It has been noticed in a few cases
that the animal will lie on its back in order to ease the
pain from mesenteric tension. Later symptoms of acute
enteritis become prominent, the feces frequently show the
presence of blood, there is tenesmus, colicky pains and
occasionally vomiting, and the vomitus may be mixed with
feces. Palpation of the abdomen will often reveal an elon-
gated enlargement of the bowel and slight pressure will
cause pain. Palpation is difficult in very fat animals or those
having a very thick-walled abdomen.
Diagnosis. —The presence of the painful enlargement of
the bowel, bloody stools, tenesmus and the sudden occur-
rence are the principal diagnostic features.
Prognosis. — Unfavorable in all cases not operated early. If
recognized early and reduced or the portion excised (enter-
ectomy) a good recovery may be expected. Spontaneous
healing may occur by sloughing of the invaginated portion
and adhesion at the anterior part.
Treatment.— Intussusception of the posterior part of the
bowel may be reduced in the early stages by dilating the
bowel with rectal injections of large quantities of warm
water, using as much pressure as can be applied safely. Air
may also be used in the same manner. Purgatives or specific
stimulants to peristalsis should not be used as they only
serve to increase the invagination. Operative measures
should be at once resorted to when other efforts fail. A
laparotomy should be performed at the median line just
posterior to the umbilical scar, the enlarged portion of the
bowel sought and attempts made to reduce it by careful
manipulation. A small blunt probe or scalpel handle may
188 DISEASES OF THE INTESTINES
be inserted between the adhered peritoneal surfaces to break
down the adhesions which hold the two layers together. If
this is impossible enterectomy must be performed. Place
ligatures of heavy suture material around the bowel a short
distance above and below the affected area and cut off the
bowel with scissors making the incision diagonally across the
intestine. Cut off the mesentery supporting the part to be
removed, ligating each vessel as it is reached. Bring the
parts of the bowel in end-to-end contact and suture with
Council's sutures or if preferred a lateral anastomosis may
be used. After-treatment is the same as for enterotomy.
WOUNDS OF THE INTESTINES.
Definition.— Wounds of the intestines frequently occur in
small animals, especially the dog, which is more subject to
injury than the cat, rabbit or bird.
Etiology.— The most common causes are: Falling from a
great height, being run over by vehicles, kicks, or severe
blows over the abdomen. Punctured wounds of the abdomen
often penetrate the intestines, such as gunshot wounds or
those produced by sharp objects (forks, etc.) which penetrate
the abdominal walls. Penetrating wounds should always be
considered serious, as the extent of the injury in the abdom-
inal cavity is difficult to determine. There is also danger of
infection being carried into the abdominal cavity from with-
out, or from within, the bowel contents escaping into the
cavity and causing septic peritonitis.
Symptoms.— Injuries to the intestines are often difficult
to recognize, especially those produced by kicks, blowrs and
other forms of external violence. The most prominent symp-
toms of intestinal wounds are hemorrhage and collapse.
Often the abdomen will become distended with blood when
the bowel is ruptured. The anamnesis, paleness of the
mucous membranes and the sudden enlargement and dis-
tention of the abdomen usually suffice for diagnosis. However,
an accurate diagnosis cannot be made, unless an explorative
WOUNDS OF THE INTESTINES 189
laparotomy is performed, and the cavity most thoroughly
inspected. Other organs in the abdominal cavity may also be
injured by the causes mentioned. The symptoms produced by
punctured wounds depend very largely upon the extent of in-
jury to the intestines or other organs. Gunshot wounds when
of small caliber will not produce any very marked symptoms
other than tenderness over the abdomen. Healing may follow
readily. Small wounds may not penetrate farther than the
mucosa which may pouch outward through the opening and
prevent the escape of the intestinal contents. Later adhesions
take place preventing septic peritonitis. Larger wounds,
however, usually prove fatal under symptoms of collapse
from hemorrhage or septic peritonitis, unless an accurate
diagnosis is made and the proper treatment immediately
applied. When punctured wounds are observed, the animal's
general condition should be noted at once. Avoid the use of
probes owing to the danger of carrying infection into the
cavity.
Treatment.— The first indication in the treatment of intes-
tinal wounds is to perform laparotomy (see Laparotomy)
as early as possible. A generous incision should be made in
the median line to allow a complete and thorough examina-
tion of the entire intestinal tract and other organs. The
intestine should be thoroughly examined the entire length,
and any wounds found closed with Lembert sutures. If the
wound is extensive, as a rupture of the bowel, it should be
closed as in enterotomy. In some cases where the bowel
wall becomes torn or has an uneven surface, a portion should
be removed. (See Enterectomy.)
The organs should also be inspected and any wounds in
them sutured.
The abdominal cavity should be thoroughly irrigated with
a boric acid solution (2 per cent.), or normal salt solution,
especially in those cases where intestinal contents have
escaped or blood is present.
Should the animal be weak from loss of blood, stimulants
should be given, such as strychnin sulphate (0.001) repeated
as often as necessary.
190 DISEASES OF THE INTESTINES
CROUPOUS ENTERITIS OF CATS.
Membranous Enteritis.
Definition.— A croupous or membranous inflammation
involving the mucous membrane of the intestines.
Etiology.— Croupous enteritis is observed most frequently
in kittens occurring as an epizootic in certain districts during
the winter and spring seasons of the year. The exact etio-
logical factor has never been determined. It is possibly due
to a virulent form of the colon bacillus aided by a reduction
in resistance from exposure to cold, irregularities in diet,
parasites, etc. Older animals are also occasionally affected
but not in such large numbers.
Pathology.— The principal pathological changes are noticed
on the mucous membrane of the bowels, the muscular walls,
and the mesenteric lymph glands. The mucous membrane
is highly congested, reddened, swollen, and the surface
covered with a thick membranous exudate. Often the epi-
thelial surface and even the submucosa will become loosened
from the other tissues. The wall of the bowel is edematous,
and the serous covering shows inflammation. The mesen-
teric lymph glands are enlarged, edematous, and show acute
inflammatory changes. The liver, spleen and kidneys show
similar changes. The contents of the bowels are liquid, and
contain considerable blood.
Symptoms.— The early symptoms are: Vomiting and a
severe diarrhea which come on suddenly and usually affect
several animals at the same time. There is a complete loss of
appetite, depression, and in twenty-four to forty-eight hours
the animals will become very weak, comatose and die from
exhaustion.
Diagnosis.— The epizootic character of the disease, the sud-
den onset and the age of the animal affected are indicative.
It can be easily mistaken for various kinds of poisonings; the
anamnesis therefore should be carefully ascertained to assist
in the differential diagnosis.
Prognosis. — Should be considered unfavorable; the largest
percentage of cases terminate fatally.
INFECTIOUS ASTHENIA .OF BIRDS 191
Treatment.— Treatment of croupous enteritis is as a rule
unsatisfactory. Little can be done except the administration
of general stimulants and bowel disinfectants. As prophy-
lactic measures, all feeding pans should be thoroughly cleaned
and sterilized, and the discharges of the bowels carefully
taken care of to prevent further contamination of the food.
INFECTIOUS ASTHENIA OF BIRDS.
Definition.— This is a chronic disease found in birds, which
affects primarily the duodenum in the form of a chronic
catarrhal inflammation.
Etiology.— The cause is a microorganism known as the
Bacterium asthenia?. It develops principally in the duo-
denum, producing an irritation to the mucous membrane,
which gradually leads to chronic inflammation.
Pathology. — The characteristic lesions are: Extreme ema-
ciation of the muscular system with an almost complete
absence of fat. The bowels are empty, containing only a
small quantity of slimy mucus. The walls of the duodenum
are reddened, thickened, and show all the evidences of a
catarrhal inflammation of the mucous membrane. The
duodenal feces will contain large numbers of the Bacterium
asthenia1.
Symptoms.— Infectious asthenia is observed most com-
monly in young birds one to six months old. It is charac-
terized by extreme emaciation, variable appetite, paleness of
the comb, wattles and membranes. The course is chronic
and the termination usually fatal in about three months.
The extreme emaciation which comes on gradually has led
to the term "going light" being given it. During the
course of the disease the birds become weak, anemic, the
plumage rough; there is general depression which causes
them to sit in one position for a long time. Death occurs
from cachexia.
Diagnosis.— The large number of birds affected, the age of
the birds, the long chronic course, and the characteristic
lesions found on postmortem are usually sufficient to estab-
192 DISEASES OF THE INTESTINES
lish the diagnosis. The finding of the Bacterium asthenise
in several of the birds will confirm the diagnosis.
Prognosis.— Owing to the infectious nature of the disease,
the chronic course, and the pathological changes which have
taken place in the duodenal mucosa, the prognosis is unfavor-
able. Where the disease has reached an advanced stage it is
advisable to destroy the bird and thoroughly disinfect the
premises.
Treatment.— Medical.— Small doses of laxative, castor oil
(1.0-4.0) or calomel (0.01-43.05) should be given.
As a stomachic and tonic iron sulphate may be given in
the drinking water (1-1000).
The aromatic seeds (fennel, coriander, anise) may be used
once or twice daily with the food to stimulate the secretions
of the stomach and intestines.
Prevention.— The healthy birds should be separated from
the sick ones at once. All parts of the houses (roosts, floors,
etc.) should be thoroughly cleaned and disinfected with a
carbolic acid solution (5 per cent.).
CHAPTER X.
PARASITES IN THE INTESTINES.
HELMINTHIASIS.
In small animals parasites in the digestive tract are very
numerous. They pass rapidly through the anterior portion
of the digestive tract, which prevents their becoming fixed;
also in this portion of the canal secretions for their proper
development are lacking. In the stomach, owing to its
acidity, they do not remain long, but are either destroyed
or pass into the small intestines. In a few instances, how-
ever, they may burrow underneath the mucosa of the stom-
ach. The intestines are favorable for the development of
parasites, owing to their length, the presence of an abun-
dance of fluid, and the slow peristaltic movement of the
bowels which does not materially interfere with their fixation
and development. The majority of the parasites are found
in the small intestines; fewer are found in the cecum, colon
and rectum. Each species of parasite has its particular
location, and unless in unusual numbers, or under abnormal
conditions, they will be found infesting an exclusive portion
of the bowel. Parasites are frequently found in very large
numbers, and produce serious disturbances in the intestinal
tract, depending upon the species of parasite and the animal
infested. The most common parasites found in the intestinal
tract belong to the animal kingdom, and are: Cestoda;
Nematoda; Acanthocephala; Coccidia.
TJENIASIS.
Cestoda.
The dog is the favorite host of the tirnitv. They occur in
this animal in considerable numbers, sometimes so as to
13
194 PARASITES IN THE INTESTINES
excite wonder at the continued good health of the host.
More than 50 per cent, of the dogs examined harbor worm
parasites.
It is essential for the taenise to have an intermediate host
to complete their life cycle. The following animals serve
as intermediate hosts for most of them: Sheep, ox, pig,
horse, goat, rabbit, and even man.
The head (scolex) of a tsenia is generally expanded and
supplied with suckers ; some species in addition are provided
with hooks. From this head, by proliferation, is formed the
neck, a thin non-annulated constriction, which, continuing
and becoming wider produces the body or strobila. The
body is in the form of a long, narrow band divided into more
or less distinct segments, and as these become mature they
are cast off gradually from the distal end of the parasite as
new segments develop from the head. Each of the segments
contain numerous eggs (ova) which pass out with the feces.
Before becoming detached the segments can also liberate ova
through an opening on the lateral wall or ventral surface,
called the genital pore, forming two ways of disseminating
the ova. When deposited in a suitable medium, preferably
warm, moist soil, or filth, the ova undergo a series of compli-
cated changes which finally result in the first larval form. In
this form they are ingested by the intermediate host, most
commonly with the food or water. They burrow through the
intestinal walls and migrate into the adjacent tissues, or writh
the blood stream are carried to remote parts where they
develop into cysts. During the development of the cyst in
the various organs serious conditions, such as " gid" in sheep,
echinococcus disease of man, etc., may arise in the new host.
As the dog is the harborer of the parent tsenia, treatment
should be given not only to reduce the disorders they occasion
in other hosts but also to lessen the injury they produce in the
dog. The cyst form is the limit of development in the inter-
mediate host. The life cycle can be completed only in case
the cyst is ingested by and reaches the digestive tract of
another host in which it can develop. Dogs harboring the
adult tsenia cannot become reinfested by ingesting the larval
form, but the larval form may migrate from the intestines
TMNIAS1S 195
into adjacent tissues and there develop new cysts. This is
the limit of their growth, however, in the host of the adult
worm.
Taenias in Dogs.— The most common tsenise found in the
dog are as follows: (a) Dipylidium caninum (Tcenia cucum-
erina), a worm 30 to 40 cm. and 3 mm. at its greatest
breadth. Its club-shaped head is provided with four
suckers and four rows of very small hooks. The neck is
long and narrow. The first segments are narrow, the others
are longer than they are wide and like melon seeds in form
(cucumis). Genital pore double and opening toward the
middle of each side of the segments on a slight prominence.
Ova are globular, from 37 to 46 microns in diameter, and
pass from the segments massed in a small group enclosed by
a capsule (cocoon) . The cyst form is the Cryptocystis tricho-
dectis and the intermediate hosts are the dog flea (Cteno-
cephalus canis), dog louse (Trichodectis canis) and the flea
that lives on man (Pulex irritans). These intermediate hosts
become infested by ingesting the ova of the tsenise which are
always present on the skin or hair of the dog by having fecal
discharge mixed with the bedding in the kennel. The cysts
develop usually in the abdominal cavity of the intermediate
hosts which are in turn swallowed by the dog with water and
food, or while licking or biting the skin to relieve the irrita-
tion which they produce. They then attach themselves to
the walls of the intestine where they develop into the adult
worm.
(b) Tcenia pisiformis (Tcenia serrata). — This parasite is
about 1 meter long, head a little broader than the neck, and
armed with 24 to 38 hooks. Segments at first are much
shorter than broad, about square in the middle portion while
the mature segments are 10 to 17 mm. long by 4 to t> mm.
broad. Genital pore on the lateral border, and very promi-
nent, causing the border to appear convex and the segment
to be wider in the middle than at the ends. Posterior borders
straight and the angles uneven which gives the strobila a
saw-like appearance. Eggs are ovoid and 30 to 40 microns
long and 31 to 30 microns broad. The cyst form is the Cys-
ticercus pisiformis and is frequent in the peritoneal cavity
196 PARASITES IN THE INTESTINES
of hares and rabbits. Dogs become infested by eating the
viscera and in twelve days the tsenise are 2 to 3 cm. long, and
matured in two months. The ripe ova given to rabbits
become cysticerci.
(c) Tcenia hydatigena (Tcenia marginata) .— This is the
largest tsenia found in the dog, being 1.5 to 2.0 m. long.
The head is scarcely wider than the neck and has 30 to 44
hooks. The segments are nearly square with the genital pore
on the lateral border which begins to develop in the seg-
ments about one-fourth of the distance from the head. The
posterior border of the segments is slightly wavy, and
received into the succeeding segment. Mature segments
when detached are about 15 mm. long by 7 mm. wide. The
ova are almost spherical and from 30 to 36 microns in
diameter. The cyst form is the Cysticercus tenuicollis and
is commonly found in the peritoneum, pleura and even in the
pericardium of domesticated animals, especially ruminants.
It requires four to five months to fully develop into the mature
worm.
(d) Multiceps multiceps (Tcenia ccenurus).— This worm
rarely exceeds 1 m. in length. Head small, slightly broader
than the neck and armed with 22 to 32 hooks. Segments
narrower than any of the preceding species, becoming square
with the genital pore developed about the 125th segment, 15
to 20 cm. from the head. Mature segments 10 to 12 m.
long, 3 to 4 m. wide. Eggs spherical 31 to 36 microns in
diameter. The cystic form is the Multiceps multiceps
(Coenurus cerebralis) which is developed in the cerebro-
spinal cavity of sheep; more rarely in other domesticated
animals, causing the disease commonly called "gid." The
cyst is polycephalic, the ingestion of one cyst producing
numerous taenise. The tsenia requires about two to three
months to reach maturity.
(e) Multiceps serialis (Tcenia serialis}.— This parasite is
45 to 75 cm. long, head wider than the neck and having
26 to 32 hooks. Segments similar to those of the M. multi-
ceps. The ripe segments are 10 to 16 mm. long and 3 to 4
mm. wide, the posterior border being straight. Eggs ovoid
and 34 microns long and 27 microns wide. The cyst form is
TMNIASIS 197
the Multiceps serialis and its intermediate hosts are some
of the rodents and warren rabbits. This tsenia develops
more rapidly than the others requiring but a few weeks.
(/) Echinococcus granulosiis (Tcenia echinococcus).— This
species is distinguished from all others by its size. It is only
4 to 5 mm. long, and composed of 3 to 4 segments, the last
of which contains the mature ova. The head is armed with
a double row of 28 to 50 hooks. Eggs ovoid, 34 by 25
microns. The cyst form is the Echinococcus granulosus
(E. polymorphus) and is found in most of the organs of the
herbivora and even man, but is more common in the liver
and lungs of ruminants and pigs. It requires one month to
fully develop. This cyst is polycephalic and polysomatic.
Tseniae in the Intestine of the Cat.— Three species of
taenise have been found in the cat.
(a) Tcenia tceniceformis (Tcenia crassicollis^.—This is the
most common tsenia found in the cat. It attains a length
of 15 to 50 cm. and in appearance is similar to those found
in the dog. The head is armed with a double crown of 26
to 52 hooks and is about as wide as the neck. The posterior
segments are 8 to 10 mm. long and 5 to 6 mm. wide. Ova are
globular and 31 to 37 mm. in diameter. This tsenia is repre-
sented in the vesicular or bladder form by the Cysticercus
fasciolaris which inhabits the liver of rats, mice and other
rodents. This cysticercus, which is always coiled up in a
cyst it has itself produced, is elongated in form, the body
composed of segments, and from 3 to 20 cm. long, while the
vesicle is ovoid and frequently no larger than a pea.
(6) Tcenia elliptica and (c) Tcenia pseudo-elliptica have
been described as a variety of the Dipylidium caninum of
dogs; they are unimportant.
(d) The Bothriocephalus felis has also been mentioned.
Little is known about it and no disturbance in the cat has
been ascribed to its presence.
TaeniaB in the Intestine of Rabbits.— Cestodes are rare in
these animals and all belong to one species, the Cittotenia
denticulata (Moniezia denticulata). These may attain the
length of 8 cm., head small and supplied with suckers. Seg-
ments 1 cm. broad and not so long. Two genital pores are
198 PARASITES IN THE INTESTINES
in the posterior part of the segment. The cyst form and
intermediate hosts are unknown.
T sendee in the Intestines of Birds.— In the intestines of the
fowl, nine species of cestodes have been found— eight tsenia
and one bothriocephalus. The tsenise are difficult to distin-
guish from one another, and as they are rare, little work has
been done to establish their complete history. Outbreaks do
occur, however, in which so many fowls are infested as to
amount to an epizootic tseniasis.
(a) Choanotcenia infundibuliformis, length 20 to 130 mm.,
armed and supplied with suckers. Intermediate host said to
be the common house fly.
(6) Dicranotcenia sphenoides, length 2 mm., head armed
and supplied writh suckers. Intermediate host the earth-
worm.
(c) Davainea proglottina, length 1.0-1.5 mm., head armed,
and supplied with suckers. The segments of this taenia are
cast off as soon as mature. They continue to live and develop,
greatly increasing in length. Intermediate hosts are various
species of mollusca.
(d) Davainea cesticillus, length 9 to 45 mm., head unarmed.
Intermediate host unknown.
(e) Davainea echinobothrida, length 50 to 100 mm., head
has suckers and is armed. Intermediate host unknown.
(/) Davainea tetragona, length 25-100 mm., head has
suckers and armed. Intermediate host unknown. Very little
is known of the other species.
(</) Tcenia cantaniani, the only tsenia found in turkeys.
It is 14 mm. long, head unarmed, but provided with suckers,
and has no neck. Life history unknown.
(h) Davainea crassula very rarely infests pigeons. Length
30 to 40 cm., breadth 4 mm., head armed with double crown
of 60 hooks. First segment short, posterior ones long, genital
pores unilateral. Ova very large, ovoid, 28 microns long,
and arranged in groups.
Pathology.— TflenicT are extremely frequent in dogs, but the
various species are not equally distributed, and the variation
seems to pertain to different countries and also to the differ-
ent sections of the country. The frequency of tsenia is also
T&NIASlft 199
directly related to that of the cystic or bladder worms
infesting ruminants, rabbits, and other intermediate hosts.
The number of individuals by which each of these teenia3
may be represented in the same dog is also variable. The
Dipylidium caninum varies up to 360, the T. pisiformis as
high as 64, the T. hydatigena and the M. rnulticeps usually
less than 10, but the Echinococcus granulosus from one to
several thousand. This variation is due in part to the fact
that some cyst forms give rise to but one adult parasite
(monocephalic), while others produce many (polycephalic).
The common location of the tsenia is in the small intestine;
only occasionally does it migrate to other parts of the diges-
tive canal. The head is attached to the mucosa by suckers or
hooks, and as the body may be folded on itself many times
long parasites may only occupy a short distance of the bowel.
Large numbers are often massed together almost completely
occluding the lumen of the bowel. The mucosa is hyperemic,
thickened and covered with mucus. Some of the glands are
hypertrophied. Rare cases of perforation of the walls by
tsenise have been reported, but as a rule the pathological
changes are those of a chronic enteritis.
Symptoms.— Notwithstanding their extreme frequency, the
tsenise often have no apparent influence on the health of the
dog. Sometimes, however, by their accumulation and intes-j
tinal obstruction, they cause abdominal pain or a chronic
enteritis. The appetite is often irregular, but while the
patient may eat well its condition remains bad. Growth is
checked, emaciation often develops, and the hair coat loses
its normal luster. Young dogs are uneasy, change their
position frequently and show a desire to bite the skin over
the abdomen. They may have epileptiform attacks.which
are periodical, with normal intervals between. When fre-
quent, these attacks may be followed by a gradual sinking
and death.
The Tsenia tseniseformis of cats is frequently found in large
numbers in the small intestines and occasions serious dis-
ease. The appetite gradually declines. A slight diarrhea is an
early symptom followed by constipation; salivation is abun-
dant; great prostration; nervous phenomena as loss of sight
200 PARASITES IN THE INTESTINES
and hearing, and epileptiform convulsions which occur at
intervals.
Rabbits exhibit symptoms similar to the cat, except the
former usually have a partial posterior paralysis instead of
convulsions.
Chickens lose their appetite, become emaciated, are dull
and feeble and a few show diarrhea. The presence of seg-
ments on the surface of the feces is often the only symptom
of tseniasis.
Diagnosis.— The poor or emaciated condition of the animal,
diarrhea or constipation, would indicate the presence of
intestinal parasites, but an accurate diagnosis of tseniasis
can only be made by finding the segments or ova mixed with
the feces. The ova can only be detected by the microscope.
A microscopic examination is readily made by shaking some
of the feces in a test-tube, one-half full of water, until the
mass is broken up. Allow it to stand for a few minutes, and
with a pipette withdraw a quantity from the center of the
fluid. Place a few drops on a slide, cover with a cover-glass,
and examine first with low, then with high power. The
ova of the tseniadse all appear about the same size. While
the variations peculiar to each species make differentiation
possible, it is unnecessary to consider them as the prognosis
and treatment are similar for all the species. For an accurate
diagnosis of the species, the entire parasite, especially the
head, must be obtained and examined microscopically.
Should the feces be soft or liquid, smear slides can be made
and examined with as good results. A negative opinion
should not be given without examining several slides.
Usually, however, one finds 20 or 30 ova on a single slide.
Prognosis.— Favorable in mild infestations, but when large
numbers are present chronic catarrh, or death from obstruc-
tion is always probable.
Treatment.— As tsenise, even in mild infestations, incon-
venience the host more or less, it is advisable to treat them.
A further reason is the possible infestation of man and herbiv-
orous animals with the cyst form. Hogs, sheep, cattle, show
and hunting dogs not only improve in condition when the
tsenise are removed, but the further propagation of tseniasis
is correspondingly reduced.
NEMATODA 201
The administration of a tueniafuge should be preceded by a
purgative and a twenty-four hour fast. Many preparations
have been employed with good results, but male fern is
probably one of the most reliable. The oleoresin (small dogs,
0.5-1.0; large dogs, 2.0-5.0; cats, 0.2-0.5) may be used. An
excellent mode of administration is to mix it with a dose of
castor oil. The purgative action of the oil assists in the
evacuation of the parasites. Kamala (dogs, 3.0-10.0; cats,
1.0-4.0) is good; it also produces a purgative action. Areca
nut powder is often used and is given in doses of two grains
per pound weight of the animal. It may be given with
soup, ordinary food or milk, after the bowels have been
emptied by a purgative. Areca nut powder may be repeated
in a few days. Rabbits may be given kamala (0.5-1.0) in
the feed. Birds are best treated for taeniasis by mixing areca
nut powder (chickens, 2.0; geese, 4.0; young chickens, 1.0)
with the feed. Oil of anise is also good, and can be adminis-
tered in 0.9-1.0 doses to adult birds.
NEMATODA.
Round Worms.— A scaridce.— Round worms are quite com-
mon in dogs and cats, especially in puppies and kittens two
or three months old. Fully 50 per cent, are infested. In one
animal ten to thirty parasites are usually present; eighty were
found in one subject.
Round worms do not require an intermediate host to com-
plete their life cycle as do the tsenise. The ova deposited by
the adult worm with the feces are passed out, and in warm,
damp ground or in other suitable places undergo certain
changes, leading to the formation of embryos. Such changes
may occupy a few days to several weeks, depending upon
the conditions of moisture and temperature. The embryos
when ingested by their particular host, rapidly develop into
the adult parasite. Puppies and kittens become infested
as soon as they begin nursing, provided these parasites are
present in the mother or other animals in the kennel. The
adult worms pass continuously a large number of ova, and
embryos are present in infested soil which adhere to the
202 PARASITES IN THE INTESTINES
mammary glands and are swallowed by the young while
nursing. Birds are less commonly affected with round worms,
and as a rule they harbor only a few specimens. Occasionally,
however, round worms are found in birds in large numbers,
especially in certain localities where this form of parasitism
may be enzootic. Pigeons are the common victims; in some
cases whole flocks succumb to the infestation.
Round Worms in the Intestine of the Dog.—Belascaris
marginata.— This species is similar to the B. mystax of the
cat, and is somewhat larger. The body is white or reddish,
head usually curved and provided with two membranous
lateral wings, which cause it to look like an arrow head.
Male 5 to 10 cm. long, tail curved. Female slightly longer,
tail obtuse. Ova almost globular and 75 to 80 microns in
diameter. Capsule thick and showing circular striations;
granular center with small clear space between it and the
capsule
Toxascaris limbata (T. marginata). — This parasite is simi-
lar to the above; found in intestinal tract of dogs; rare in
United States.
Echinorhynchus canis.— Occasionally found in the dog in
certain districts (Texas).
Round Worms in the Intestine of the CaA.—Belascaris
mystax.— This round worm is slightly smaller than the B.
marginata of the dog, the male being 4 to 6 cm., the female
4 to 10 cm. long. Ova slightly smaller than B. marginata,
60 to 75 microns in diameter. Similar to B. marginata only
smaller.
Round Worms in the Intestine of the Rabbit.— Oxyuris
ambigua (Passolurus ambigus).—Th'is is a white fusiform
worm, male 3 to 5 mm. long, female 8 to 11 mm. The body
of both sexes terminates in a suddenly tapering tail, 0.22 mm.
in length. It infests the large intestine and cecum. It is not
so common as the round worm of the dog and cat, nor does
it occur in as large numbers. Ova globular and very small,
with thick capsule similar to B. marginata.
Round Worms in the Intestine of Birds.— Heterakidce.—
(a) Heterakis papittosa (Heterakis vesicularis).—This is a
common species infesting chickens, and occasionally ducks.
NEMATODA 203
Male is 8 to 9 mm., female 11 to 15 mm. long. Mouth sur-
rounded by three distinct lips. The body is gradually attenu-
ated toward the posterior part, and has two unequal spicules.
This parasite is found exclusively in the caeca and occasion-
ally in large numbers. Ova are elongated, capsule with full
granular center.
(6) Heterakis di/erens.—This species is slightly larger than
the Heterakis papillosa attaining a length of 15 to 20 mm.
The mouth has no apparent lips. Has two spicules of equal
length and the posterior extremity of the female terminates
in a sharp point. It is usually found in the posterior part of
the intestine of chickens. Ova similar to H. papillosa.
(c) Heterakisinflexa (Heterakis perspicillutii).—rY\i\'s is not
very common, and when present is found in the small intes-
tines. In length and appearance it is similar to the. H.
differens. The host is the ordinary fowl.
(d) Heterakis compressa is similar to above; occasionally
found in the small intestines of chickens.
(e) Heterakis muculosa. — This is the common parasite of
pigeons and often occurs in such large numbers as to prevent
their being reared, 400 to 500 are sometimes found in an
individual. The body is white and attenuated at both ends.
Male is 20-25 mm.; female 20-25 mm. long.
(/) Heterakis crassa.— This parasite is common in the
duck. The male is 12 to 15 mm. long and the female 40 to
50 mm. Tail is thin, conical, and straight.
(g) Heterakis lineata.— Heterakis lineata is rare; found in
the intestine of the domesticated duck. Its length is from 6
to 10 cm.
(h) Heterakis d is par.— This species found in small intes-
tine of geese is closely related and similar to the H. papillosa.
Mouth has three very small lobes. Two lateral wings on the
neck becoming narrower toward the tail. Male 12 to IS mm.,
female 16 to 23 mm. long. This parasite is not very common.
Pathology.— Young animals which have died from the dis-
order caused by the ascarides, show on autopsy large numbers
of this parasite which almost occlude the lumen of the bowel.
The stomach may also contain many of them. They are
found scattered along the intestines or coiled up in masses.
204 PARASITES IN THE INTESTINES
The mucous membrane shows a severe enteritis with numer-
ous ecchymoses and many small ulcerations. The intestines
contain no food, only a slimy mucus in which are found the
parasites. In older dogs the parasites are fewer in number
and are found scattered along the entire length of the intes-
tine and rarely cause much change in the mucosa.
Symptoms.— Puppies and kittens when infested show
symptoms of inanition at three to five weeks of age. They
are stupid and do not play as such animals usually do at this
age. Vomiting is common and quite often some of the para-
sites are thus expelled. Emaciation increases, the mucous
membranes are anemic, and the abdomen appears enlarged
("pot bellied"). Diarrhea is not uncommon, often alternat-
ing with constipation. Quite frequently the patients, espe-
cially kittens, show epileptiform or rabiform symptoms.
These are probably due to the irritation of the nervous system
produced by toxins excreted by the parasites as well as by
the irritation of the intestines they produce. These symp-
toms gradually become more severe, and finally food is
refused, followed by weakness, coma and death in five to
eight weeks. The temperature is only slightly elevated in
the early stages, later as coma comes on it is subnormal.
In mild cases or in older dogs the symptoms are less
intensive, and often unnoticed. The appetite remains good,
often voracious, but the general condition is not the best;
the hair coat dull and rough and the growth impaired.
Young birds infested with round worms show diarrhea,
emaciation and depression, finally resulting in death. In
older birds the condition becomes chronic with marked ema-
ciation.
Diagnosis.— This can only be positively made by finding
the ova in the feces or the parasites in the feces or vomitus; or
on postmortem examination. (See Diagnosis of Tseniasis.)
The general symptoms are similar to those of tseniasis.
Ascariasis is, however, more common in very young animals
which have had no meat. When several animals or birds are
affected one or more of the typical cases should be killed
and a careful autopsy made.
NEMATODA 205
Prognosis.— Severe infestation in young animals is very
unfavorable. Ascariasis causes greater loss among puppies
and kittens than any other disease. Entire litters often
succumb at four to eight weeks of age, and in some kennels
it is almost impossible to rear young animals due to this
parasite. Chicks and young birds usually succumb; while'
older birds do not die, they grow emaciated and droopy and
become an easy prey for other diseases.
Treatment.— Medical.— It is advisable to administer a
vermicide to all puppies and kittens when three to five
weeks of age, and repeat every two to four weeks until several
months old. Treatment should be given as soon as symp-
toms appear. Santonin (puppies, 0.016; small dogs, 0.05-0.2;
large dogs, 0.2-0.5; kittens, 0.008-0.025; cats, 0.06-0.2) is the
most efficient agent used to remove the ascaridae. It is best
administered in small doses, repeated for three or four days,
than in a single, large dose. This is especially true for all
young animals, as they are very susceptible to the toxic
action of this drug. Older animals are rarely affected even
with enormous doses. Santonin may be administered in
castor oil in sufficient amount to produce catharsis, or the
oil may be given an hour or two later. Tablets of santonin
and calomel of various proportions may be had and are
convenient to use with the food. Other anthelmintics are
employed with good results, such as areca nut powder (dogs,
0.5-4.0; cats, 0.1-2.0) which is easily given with milk; ben-
zine (1.0-7.0 in oil) ; kamala (2.0-8.0). Birds may be treated
with areca nut powder (chickens 3.0, pigeons 1.0 each),
mixed with moist ground feed. Oil of anise (0.4-0.8) or
benzine (0.2-0.6) in castor oil has been used with good
results.
Prevention.— In order to rear young animals free from
these parasites energetic measures must be directed toward
the removal of all ascarida* from the older animals and a
thorough disinfection of all the premises to which they have
access. This is best done in the early winter, the weather
conditions at this time being unfavorable to their develop-
ment. Frequent examinations of the feces should be made
and treatment applied when necessary. All additions to
206 PARASITES IN THE INTESTINES
the kennel or flock should be examined and treated before
being allowed with the other animals or birds.
Pregnant animals should be entirely freed of all parasites,
and thoroughly washed to remove all ova or embryos that
may be on the hair or skin. Afterward remove to a clean
place that has not been used for animals for some time where
the mother and young should be kept for several weeks.
The feed and water, and all receptacles must not be per-
mitted to be soiled by other animals which harbor parasites.
In this way it is possible to rear puppies, kittens or birds
without experiencing the trouble with parasites.
Strongylidse. — Hookworm. — This species of the nematodes
inhabits the small intestines, preferring the anterior half,
and occasionally is found in the stomach. They attach
themselves to the intestinal walls, wound the mucosa, eat
the epithelium, and suck the blood. According to present
evidence they produce a poisonous substance which inhibits
the coagulation of blood and possibly also injures the host.
Inasmuch as these parasites frequently move from place
to place, wounding the mucous membrane in many different
places, from which hemorrhage continues for some time, a
severe anemia is soon produced. These continued injuries
to the mucosa soon result in a severe enteritis with all of
the symptoms of inanition.
The adult parasite in the intestine lays numerous eggs
which are passed out with the fecal material. After a short
time (eight hours to several days), the period varying accord-
ing to conditions of heat and moisture, an embryo develops
in each egg. The embryo soon breaks through the shell. In
the soil it undergoes a change in two or three days, and
another in about a week, during which time it also becomes
larger. This stage is known as the infesting stage. The
parasite may live in this condition for five months or longer.
Infestation may occur via the mouth, the embryo being
taken with the food or drink; also by burrowing through
the skin or mucous membrane and by following the blood
stream finally reaching the intestines. In experimental
cases the worm has been found in the intestines in eight to
fourteen days after skin infestation. t
NEMATODA 207
Strongylidae in the Intestine of the Dog. — (a) Ankylos-
toma canina (Uncinaria trigonacephala; Dochmins trigona-
cephalus] .— This parasite is small, being 10 to 15 mm.
long, the body white, mouth slightly expanded, the ven-
tral border or jaw terminating in four hook-shaped pro-
jections arranged in pairs, and usually called lips, by means
of which the worm attaches itself to the mucous membrane.
Within the mouth on the median line is a conical tooth-like
projection, on the summit of which a gland opens. On the
dorsal border there are in addition, two small straight teeth.
The tail of the male is expanded, while that of the female
terminates in a blunt point. The vulva is at the posterior
third of the body. Ova ovoid, 74 to 84 microns long by 48
to 54 microns broad.
(6) Uncinaria stenocephala (Anhylostomum stenocephalum).
-This species of the strongylidse is smaller than the above
and less common. Body is thinner than that of the Anky-
lostomum canina. Head is narrow, buccal capsule having on
each side of its ventral aspect a sharp bordered "lip," back
of which is a hook-shaped tooth. The dorsal border has
no teeth. The male is 6 to 8 mm. long, female 8 to 10
mm. Ova ovoid, 63 to 67 microns long by 32 to 38 microns
broad.
Strongylidse in the Intestine of the Ca,t.—Ankylostomum
trigonacephalum. — This parasite has been described under
the name of Dochmius balsami. It is almost, if not, identical
with the Ankylostoma canina of dogs as described above.
They often occur in larger numbers in cats, and may
localize at one particular part of the small intestine.
Strongylidae in the Intestine of the Rabbit. — (a) Strmigy-
hrides longus.—1\\is species inhabits the anterior part of the
small intestines. It is a very small worm, and the mouth
has no hooks. Eggs are ovoid, 40 microns long and 20
microns wide.
(b) Strongylus strigosus.— This is a rare species and inhabits
the cecum and colon of the rabbit. In rabbits the parasite
has not been known as yet to produce any serious pathogenic
conditions.
208 PARASITES IN THE INTESTINES
Pathology.— On autopsy dogs which have died from ankylo-
stomiasis show cachexia. In addition the mucous membrane
of the small intestines and cecum is very much thickened.
Small hemorrhagic areas are scattered over it, and often so
extensively as to be visible on the peritoneal surface of the
intestine. The villi are quintuple their normal size, are
highly injected and closely packed together. In the rela-
tively healthy parts are seen a multitude of small hemor-
rhagic points, and in their centers or vicinity are noted one
or more of the parasites, often coupled. More parasites are
found in dogs that have been ill only a short time than in
those in which the malady is chronic. In the latter only a
few parasites may be found in the ileum, a circumstance which
may raise a doubt as to the anemia being due to them.
Only a small amount of very dark or black fecal material
will be found in the intestines.
Symptoms.— The symptoms are those of a severe anemia.
At first there is only debility and wasting, although the
appetite remains good, though at times variable. The
animals affected appear dull and indifferent, the hair coat
is rough and staring, and the skin scaly or reddened with
erythematous patches, especially at the stifles and nose.
The latter is tumefied, cracked, rough and excoriated, with
a mucopurulent discharge from the nostrils. Attacks of
epistaxis occur at intervals of a few to several days with a
loss of two or three ounces of blood. Another important
symptom is edema of the limbs. It is at first intermittent,
but finally becomes quite permanent. In the latter stages
the diarrhea, at first intermittent, becomes continuous, and
the appetite, which was capric'ous, disappears. The animals,
feeble and emaciated, remain in a lying position, grow coma-
tose and die sometimes in convulsions. Death takes place in
from a few months to a year.
Diagnosis — Ankylostomiasis is easily mistaken for non-
parasitic anemia. The diagnosis really depends upon the
finding of the ova or the parasites. When several animals
in a kennel or pack are affected, an autopsy will remove all
doubt as to the nature of the malady.
NEMATODA 209
Prognosis.— If the condition is recognized early and treat-
ment administered, the prognosis is favorable. In those
cases showing extreme emaciation and exhaustion the prog-
nosis is bad.
Treatment.— Treatment in ankylostomiasis must be
directed toward the removal of the parasite. The common
anthelmintics used for intestinal parasites have little or
no effect on the strongylidse. Thymol (0.06-0.6) is prob-
ably the best for this species, and good results follow
its use in daily repeated doses. It is advisable to pre-
cede the treatment with a dose of Epsom salts to free
the intestines of food and the mucus with which the para-
sites are usually covered. The object of the treatment is to
have the finely pulverized thymol pass, only slightly dis-
solved, through the entire length of the intestines, and com-
ing in contact with the parasites, destroy, or so disable them,
that they may be evacuated. As thymol is very soluble in
alcohol, fats or oil, and serious results follow its absorption,
all medicines containing alcohol as well as all fatty foods
(fat meat, milk, butter, etc.) should be avoided during its
use. It must be administered in a capsule thoroughly mixed
with three times the amount of sugar to prevent the thymol
collecting in a mass, as it would otherwise do as soon as
liberated from the capsule and pass through the intestine
with little or no effect on the parasites. Should absorption
occur with the production of toxic symptoms, a subcutaneous
injection of magnesium sulphate (0.3) will often overcome it.
Nutritious and easily digested food (lean meat, rice soup,
cooked vegetables) may be given during the treatment after
which the best of food that the dog will eat should be allowed.
Stomachic tonics as iron, quinine citrate (0.2-0.3), tincture
gentian compound (1.0-4.0) are useful to stimulate the
appetite. These should be continued for some time. In a
few weeks make another examination for parasites or ova,
and, if present, repeat the treatment. Thorough disinfection
of the kennels is important.
Trichinellidae. — Whijnvonu. — This parasite lives in the
cecum and large intestines, and is less common than the
species described. It is also much slower in development,
14
210 PARASITES IN THE INTESTINES
requiring three to four months to produce embryos, which,
when introduced into the digestive tract, attain complete
development in two to three months. The trichuris does
not require an intermediate host; embryonic development
takes place entirely outside the body and the parasite
must pass into the digestive canal while still enveloped in
its shell. This species is often found in animals affected with
severe anemia, but it does not appear to play other than a
secondary part in the development of the disease. When
present in considerable numbers in the cecum, however, it
may cause a chronic inflammatory condition by its repeated
injuries to the mucosa.
The ova differ considerably from those of other intestinal
parasites, being ovoid, 70 to 80 microns long and 30 to 35
microns broad, of a distinct yellow color, and have at each
end a small rounded projection which appears clear under the
microscope.
Birds are occasionally infested but the parasite is rarely
present in large numbers, and the anemia it produces is only
secondary to the chronic enteritis which results.
Trichinellidse in the Intestine of the Dog. — Trichuris
depressiuscuhis. — This species is often spoken of as the
whipworm, owing to the resemblance of the body to a whip.
It is 45 to 75 mm. long. The anterior half of the body is
much smaller than the posterior part and the tail is usually
curved.
Trichinellide in the Intestine of the Rabbit. — Trichuris
unguiculatus.—This species is rare and is only occasionally
found in the large intestine and cecum of the wild rabbit
and the hare. The male is 3 to 4 cm., the female 3 to
5 cm. long.
Trichinellide in the Intestine of Birds. — (a) Trichosumum
retusum.—Msi\e 13 mm., female 19 mm. long. Body white
or yellowish-white, tail blunt.
(6) Trichosomum annulatum.—M.a\e 15 mm., female 80
mm. long. Body white and very attenuated at its anterior
extremity and marked with close annular stripes.
(c) Trichosomum collare.— Male 8 to 10 mm., female 9 to
12 mm. long.
NEMATODA 211
(d) Trichosomum tennissimum. — This species has been
found in pigeons. It is 10 to 18 mm. long.
(e) Trichosomum brevicolle.—M.a\e 10 to 12 mm., female
20 to 24 mm. long. This parasite is found occasionally in
the large intestine of geese.
Pathology. —These parasites are usually found in the cecum
and large intestines but rarely in large numbers. In several
cases of parasitic anemia in which whipworms occur other
parasites are usually also present. The whipworms are found
partly coiled up and attached to the mucous membranes
of the posterior bowel. The mucous membrane is slightly
thickened and shows small areas of inflammation from the
injury produced by the parasites.
Symptoms.— Gradual emaciation and anemia are the prin-
cipal symptoms. The appetite may be variable, and con-
stipation and diarrhea alternate.
General symptoms are rarely noted, unless the infestation
has been severe when general anemia occurs. Birds are
more often seriously affected than other animals.
Diagnosis.— This depends entirely upon finding the para-
sites or ova in the feces. (See Fecal Examination for Para-
sites.)
Prognosis.— Favorable if the condition is recognized, treat-
ment applied early, and before extreme emaciation occurs.
Treatment.— Thymol, same as for the strongylidw.
CHAPTER XL
DISEASES OF THE RECTUM AND ANUS.
Examination.— These parts are quite readily examined in
all small animals. The anus by inspection and palpation
for enlargements and abscess formation in the anal glands,
congenital occlusion in puppies, pseudocoprostasis, inflam-
mation at the anal opening, foreign bodies and parasites.
The rectum is best examined as follows: (a) Direct
palpation. The index finger is inserted as far as possible to
determine the condition of the mucosa, the presence of
foreign bodies, parasites, fecal matter, blood, etc. (6) A
rectal speculum is used to dilate the anus and rectum. By
using reflected light (mirror) the mucosa can be directly
examined for inflammations, tumors, parasites, foreign bodies
etc. (c) Palpation through the abdominal walls will admit
of an examination of the anterior portion of the rectum. It
can easily be distinguished from the other tissues, and quite
readily inspected in this location for fecal accumulations,
foreign bodies, etc. (d) Laparotomy when performed just
anterior to the pubis, in the median line of females, and to
either side of the penis in males, will allow direct inspection
of the rectum for inflammations, tumors, fecal accumula-
tions, etc.
OCCLUSION OF THE RECTUM AND ANUS.
(a) A congenital occlusion of the rectum and anus has been
observed quite frequently in puppies. Imperforate anus is
most common. This condition exists at birth and is the
result of improper development during fetal life. The rectum
is formed from the hypoblastic and mesoblastic embryonic-
layers while the anus is developed by the imagination of the
epiblastic which, as the development progresses, joins the
rectum by absorption of the intervening septum. Anything
OCCLUSION OF THE RECTUM AND ANUS 213
which interferes with the normal development would pro-
duce imperf orate anus. Sometimes the fetal development
will be interfered with sufficiently to produce occlusion of
both the rectum and anus.
(6) An artificial occlusion of the rectum and anus (pseudo-
coprostasis) occurs occasionally in long haired dogs (poodles),
birds and cats (angoras) from the hair or feathers becoming
agglutinated with fecal matter which becomes dry and forms
a firm film or plaster over the anal opening interfering with
defecation. Also occasionally foreign bodies (splinters of
bone, needles, pins, etc.) are found which have successfully
passed other portions of the alimentary tract only to become
lodged at or near the anal opening interfering with the pas-
sage of the feces.
Symptoms.— The congenital occlusion is seldom observed
until there is persistent and ineffectual attempts at defeca-
tion. Puppies when examined carefully will be found to
have the rectum distended with feces and an absence of an
anal opening, the skin being pouched out where the anal
opening should be. However, should the rectum and anus
both be imperf orate the enlargement will be absent. The
abdomen becomes distended, and they refuse to nurse.
A careful examination will at once reveal the condition.
There is more difficulty in recognizing an occlusion of the
rectum, but by passing a small probe or sound the condition
can be definitely determined.
In artificial occlusion (pseudocoprostasis) the principal
symptom is the persistent attempts at defecation without
the passage of fecal matter. A careful inspection of the anal
region will at once reveal a collection of feces and the matted
hair or feathers. This condition if persistent will produce
symptoms similar to constipation or obstipation. (See Con-
stipation.)
Diagnosis.— The diagnosis is quite readily established by
a careful inspection of the parts involved.
Prognosis.— Favorable, except in congenital deformity of
the rectum.
Treatment. — In imperforate anus, an X-shaped incision
should be made over the point distended by the feces. < 'are
214 DISEASES OF THE RECTUM AND ANUS
should be taken to prevent injuring the sphincter muscle.
The flaps of skin should be either trimmed off to form a
circular opening, or stitched back to prevent adhesions taking
place. The passage of a small sound daily, keeping the edges
of the wound well lubricated with vaseline, or the direct
application of silver nitrate ever}' day or two, will prevent
adhesions. In cases where the rectum is also involved,
treatment is not to be attempted.
Artificial occlusion from collections of feces can be removed
by clipping away the hair or feathers from around the anal
opening, softening the hardened mass by the use of warm
water, and administering a purgative or allowing laxative
foods for a few days.
When foreign bodies are present, a careful examination
should be made to determine their size and character. They
should be removed carefully to prevent laceration of the
tissues.
A purgative is advisable, and if the foreign body has led
to atony of the walls of the lower bowels, small doses of
strychnin sulphate (0.0005-0.001) should be administered
daily.
PROCTITIS.
Definition.— An acute inflammation of the mucous mem-
brane of the rectum.
Etiology. — Proctitis is observed quite commonly in the
dog and cat and results usually from the same causes that
produce inflammation of other parts of the alimentary tract.
Also, it occurs frequently from direct injuries, such as inser-
tion of the thermometer, careless manipulation \vith the
finger, frequent passing of catheters or sounds, or the injec-
tions of too strong antiseptic solutions or soapy water, etc.
All of these conditions will produce a more or less severe
proctitis depending upon the amount of injury done to the
mucosa.
Pathology.— The mucous membrane becomes reddened
and congested, especially at the apex of the folds; hemor-
rhages and erosions are often observed. Hemorrhages take
place from the mucous membrane, and occasionally small or
PROCTITIS 215
copious quantities are ejected from the rectum. In severe
forms, due to poisons, infections, etc., the epithelium becomes
desquamated, and quantities of it will become loosened from
the submucosa. Further, when due to injuries, the lesions
are usually confined to the lower part of the rectum, and
depend upon the extent of injury.
Symptoms.— Difficult and painful defecation with frequent
attempts at defecating and only a small quantity of feces
being passed. The feces are streaked or covered with blood.
Edema of the mucosa, which can be seen slightly pouching
out through the anal opening. Direct examination reveals
the painful, inflamed mucous membrane. Digital examina-
tion produces severe pain. Through the rectal speculum the
mucous membrane will be found highly congested, swollen
and the surface covered with dark, bloody fecal matter.
Diagnosis.— This is not difficult as a direct examination
will readily detect the inflammatory condition.
Prognosis.— Usually favorable when localized in the rectum.
However, a careful examination should be made of the other
portions of the digestive tract before a positive prognosis is
made. It depends also somewhat upon the cause and the
extent of injury to the mucosa and the adjacent structures.
Treatment. —The cause should first be found if possible,
and removed, to prevent further injury and irritation to the
mucous membrane.
Rectal injections of mild astringent and antiseptic solutions
(alum 1-2 per cent., boric acid 2 per cent.) are indicated.
These should be introduced with a syringe having a blunt,
well rounded nozzle, and the injection made slowly only a
small quantity at each time. The fluid should be at or near
the body temperature to avoid straining.
Tincture of opium is indicated as an injection when pain
is severe, to allay irritation and to prevent straining. A
solution of one part tincture opium to thirty parts water will
be found useful for this condition. This injection should be
repeated as often as necessary.
In some cases it is advisable, where irritants are sus-
pected of being present, to irrigate the rectum with warm
water or a bicarbonate of soda solution (2 per cent.)-
216 DISEASES OF THE RECTUM AND ANUS
HEMORRHOIDS. PILES.
Definition. — Hemorrhoids are varicose or dilated veins of
the hemorrhoidal plexus. According to their location they
are termed external, internal or mixed. External hemor-
rhoids are located outside the sphincter ani and in the sub-
cutaneous tissue, while internal hemorrhoids are located
inside the sphincter muscle and under the mucous membrane.
The mixed variety consists of both of the above appearing
at the same time.
Etiology.— This condition is commonest in old dogs, and
results most frequently from obstructions to the portal
circulation, through constipation, congestion of the liver,
proctitis, enlarged prostate glands, or chronic cardiac dis-
eases. All of these conditions, from a defective circulation
to the parts involved, lead to a venous stasis with a resultant
distention of the veins of the hemorrhoidal plexus.
Pathology.— The external variety is usually made up
chiefly of hypertrophied perirectal connective tissue, appear-
ing as small cutaneous projections, involving the external
veins, which become distended or rupture, forming a soft
tumor-like mass. The internal variety consists of numerous
distended vessels, increased connective tissue formation,
which often show an ulcerating surface, and are sometimes
found projecting through the anal opening. Hemorrhages
often take place readily from them, through irritation by the
passage of fecal material.
Symptoms.— The act of defecation is usually very painful,
the feces being covered with blood, or a quantity of blood
passed following the feces. Sometimes defecation is stopped
entirely from the severe pain which is induced by it. Pruritus
is also a prominent symptom, the animal biting or licking the
parts, or sliding the anus along the floor. Direct inspection
of the parts reveals the presence of the hemorrhoidal enlarge-
ments, which appear as bluish-red knots encircling the rec-
tum. If external, the enlargements will be noticed on e ther
side of the anal opening. Hectal examination is very painful
(different from rectal polypi, or other neoplasms, which are
occasionally found in this location).
PROLAPSE OF THE RECTUM 217
Diagnosis. —This is usually not difficult, as the parts can
be readily inspected.
Prognosis.— When appearing in old animals a complete
recovery seldom takes place as the causes are difficult to
eliminate. However, in recent cases, or in younger animals,
the prognosis is more favorable, as a number of the cases are
amenable to treatment.
Treatment. — The early indications in the treatment are to
regulate the bowels by the use of saline laxatives (magnesium
sulphate, dog 8.0-12.0), and laxative foods (soups, etc.) to
overcome constipation.
Enemas of cold water are also useful to relieve the con-
gestion and irritation. Zinc oxid ointment will also be found
valuable for its astringent and lubricating properties.
Should the internal hemorrhoids protrude into the canal
or through the anal opening, they should be grasped with
the forceps, drawn out through the anal opening, and
ligated (see Prolapse of the Rectum). In some cases where
ligation is impracticable, the rectum is dilated with a specu-
lum and the actual cautery applied, care being taken to
prevent injuring the adjacent tissues.
In external hemorrhoids, it is advisable to operate by
dissecting around them carefully, ligating them firmly at the
base with sterile silk or linen, removing the ligated portion
and suturing the skin wound. Should blood clots or abscesses
form they should be opened and treated with antiseptic-
solutions.
PROLAPSE OF THE RECTUM.
Definition.— An eversion of the rectal mucosa, or the entire
walls of the rectum through the anal opening.
Etiology.— An eversion of the rectal mucosa is very common
in the dog and cat, and occurs most often from a local hyper-
emia just anterior to the anal opening, the resultant swelling
forcing the mucosa out through the opening. Or it may
come from straining during constipation, diarrhea, or the
presence of parasites, or foreign bodies in the rectum. Rectal
prolapse is observed very often in puppies and kittens, due
in part to straining incident to catarrh of the bowels, presence
218 DISEASES OF THE RECTUM AND ANUS
of parasites, etc., and also in part to a weakness of the
sphincter muscles or the supporting tissues of the rectum.
Prolapsus of a part or the entire rectum is also frequently
observed, due mainly to excessive straining during constipa-
tion, in diarrhea, enteritis, etc. This is common in old dogs
from unduly straining during the course of chronic constipa-
tion, diarrhea, hemorrhoids, urethral stricture, enlarged
prostate glands, rectal tumors, labor pains, or after the use
of irritating or hot rectal injections or infusions. Some-
times these causes not only lead to prolapsus or intussuscep-
tion of the rectum, but other portions of the bowels may be
involved, and protrude out through the anal opening. (See
Intussusception.)
Symptoms.— Mild cases of eversion of the rectal mucosa
are hardly noticeable, except when the animal strains, wrhen
the enlargement becomes visible. In more severe cases, the
rectal mucosa will appear as a rounded, congested enlarge-
ment, protruding out through the anal opening. The condi-
tion of the mucosa will depend greatly upon the length of
time it has been everted. On close inspection, the mucosa
will usually be found to be everted only from one side of the
rectum, or in rare instances may be the entire mucosa. It
will be found congested, of dark color, hemorrhagic, the
external covering desquamated and often hanging in thin
shreds. Often the surface bleeds when the parts are manipu-
lated. Necrosis may result from exposure, or from the blood
supply becoming reduced by the swelling. An eversion of the
rectum will at once be recognized by the curved, cylinder-
like bowel which protrudes. Some feces will be passed, and
will collect around the orifice of the canal. Longer exposure
(twenty-four to forty-eight hours) will often lead to inqlura-
tion, with foci of ulceration, gangrene, beginning as a rule at
the apex of prolapsed portion. The progressive changes
which develop will depend very largely upon the length of
time the bowel remains exposed.
Diagnosis.— This is not difficult as a close inspection of the
parts involved will at once reveal the condition.
Prognosis. — An eversion of the mucosa is always considered
favorable, recovery taking place promptly. However, if the
PROLAPSE OF THE RECTUM 219
causes persist, in some cases the eversion of the mucosa may
be followed by a prolapsus of the rectum.
The prognosis in prolapsus of the rectum is usually favor-
able, unless the bowel becomes necrotic, or complications
higher up in the bowel take place from infection, etc. There-
fore, the prognosis depends very largely upon the length of
time the bowel has been protruded. When treated early and
before pathological changes have developed in the exposed
bowel, the prognosis should be considered favorable.
Treatment.— In the mild cases of everted mucosa, when
taken early, applications of cold water or astringent solutions,
such as alum (2-5 per cent.), are usually efficient in reducing
the size of prolapsed portion so that it can be returned to its
proper position. Further application of astringents will
assist in keeping it in position. Only small quantities of the
solutions should be employed, owing to the danger of induc-
ing undue straining. Should this method fail in keeping the
mucosa in its proper position, it can be grasped with small
dressing forceps, pulled out gently and cauterized with the
thermocautery, making two or three longitudinal lines, being
careful to prevent going through the mucosa. Should the
prolapsed mucosa show necrosis, it is best to remove it in the
following manner: The prolapsed portion should be grasped
firmly with dressing forceps and drawn out until the normal
membrane appears; it is held in this position and a double
suture applied through the base and tied either way around
the enlargement. The ligature should be applied rather
firmly to prevent hemorrhage and retraction of the tissues
which would loosen it. The ligated portion is then removed
with the scissors. The base is returned to the rectum and
treated with antiseptic and astringent solutions.
Prolapsus of the rectum is often quite difficult to reduce.
When taken early, before much swelling has taken place, it
can usually be pushed back into place, by digital kneading,
or by the use of a bougie or a well rounded sound. Placing
the animal in a pendant position with the head downward,
will assist in the replacement. When the parts are in posi-
tion, it is advisable to resort to some method of retaining
them in place for a time, otherwise they are quite liable to be
220 DISEASES OF THE RECTUM AND ANUS
thrown out again by the animal straining. A tobacco-pouch
suture, which is used to constrict the anal opening, is often
used successfully, making the constriction just sufficient to
hold the parts in position, and to allow soft or liquid feces to
be passed. However, as soon as this suture is removed the
prolapsus often recurs.
Should these methods fail to replace the prolapsed rectum,
or hold it in position, laparotomy should be performed (see
Laparotomy), and the prolapsed bowel returned to its proper
position by gentle traction. Thef bowel when returned to
the cavity should be held in place by suturing same to the
abdominal wall (ventrofixation) . The sutures should be
applied carefully so that they only pass through the serous
and muscular coats of the bowel. Several of these sutures
should be applied to firmly fix the bowel in position. Laxa-
tives or laxative foods are indicated to prevent constipation
and pressure on the posterior bowels. Should the prolapsed
portion be much swollen, necrotic, or severely inflamed, this
method is not advisable, as it would act as a foreign body and
induce severe straining, resulting in a repetition of the former
condition. Should the prolapsed portion show evidences of
marked pathological changes, it is advisable to resort to
amputation, which is done in the following manner: The
animal is given a general anesthetic, placed on the table in a
ventral position, and the parts involved thoroughly cleansed
with an antiseptic solution. The prolapsed bowel is then
grasped with a bowel clamp, gentle traction used until
normal tissues appear, and a previously sterilized small,
rubber tube applied close to the anus, to act as a tourniquet.
A circular incision should be made through the external
intestinal wall, a short distance posterior to the tourniquet,
and parallel to the anal margin. Seize the severed external
tube at the anal margin with small hemostatic forceps, to
prevent its retraction and draw it out gently to bring its
serous coat in contact with the serous coat of the internal
tube. These two surfaces should be sutured using sterilized
cat-gut, silk or linen, making interrupted sutures the entire
circumference of the incised portion, ("are should be taken
in inserting these stitches, as they should only pass through
PARASITES IN THE RECTUM 221
the serous and muscular coats. When this is completed, the
outer tube is cut off with the scissors distal but close to the
row of stitches. The mucous surfaces are then approximated
with continuous or interrupted sutures, and the stump thor-
oughly cleansed with antiseptics and returned within the
anus.
Should hemorrhage occur during the operation all vessels
should be ligated, as the persistent hemorrhage interferes
with the application of the sutures. The after-treatment
consists in the daily injection of small quantities of antiseptic
solutions.
Another successful method of procedure is to insert a sound
of proper size, depending upon the size of the animal, into the
lumen of the canal; apply a tourniquet rather firmly around
the prolapsed portion close to the anal margin to control the
hemorrhage, and to prevent the wall from retracting. The
prolapsed portion is then amputated rather close to the
tourniquet. A continuous suture is applied around the
margin of the incised portion, the stitches placed close to-
gether and including enough of the tissues so that the serous
coats will be brought in apposition. The tourniquet and
sound are removed and the stump replaced within the anus.
Antiseptic and astringent solutions should be used for a few
days.
'PARASITES IN THE RECTUM.
Parasites in the rectum are not very numerous, although
one species is found inhabiting the posterior bowels. Other
species are found quite often in their exit from the intestinal
tract, especially tsenise, ascarides, etc.
The parasites inhabiting the rectum belong to the Xeina-
toda family, Oxyuridje. The following are the ones most
often found :
(a) Oxyuris vennicularis , found in the dog. The male is
2 mm. to 3 mm. long, the female 9 mm. to 10 mm., the color
being white and the body expanded anteriorly.
(6) Oxyuri-s compar, found in the cat in the small ami large
bowels, also in the rectum. The female is 8 mm. to l.~> mm.
long. Same characteristics as those found in the dog.
222 DISEASES OF THE RECTUM AND ANUS
(c) Oxyuris ambigua, found in the rabbit. The male is
3 mm. to 5 mm. long, and the female 8 mm. to 11 mm. They
are white fusiform worms the body terminating in a sublated
or suddenly tapering tail.
Sympt Dins. —These parasites, by producing irritation to the
rectal mucosa, induce severe pruritis, causing the animals to
bi^e or lick the anus and often slide along on the floor to
relieve the intense itching. The parasites are often seen
projecting from the anal opening, or observed being passed
with the feces. Aside from the disagreeable symptoms in-
duced they do not effect much change to the mucosa, and no
general symptoms are observed.
Treatment.— Oleaginous or saline infusions injected into
the rectum with a syringe are usually sufficient to destroy
them. These injections may be repeated every few days
until the symptoms disappear.
NEOPLASMS IN THE RECTUM.
Tumors of the rectum and around the anal opening are
occasionally observed, more commonly in dogs than in any of
the other small animals. The most common tumors found in
the rectum are adenocarcinomas or adenomas. Epithe-
liomas also occur located outside the anus and originating
from the skin. Occasionally are found fibromas and sarcomas
originating from the periproctal connective tissue.
Symptoms. — The adenomas or adenocarcinomas found on
the rectal mucosa or margin of the anal opening interfere
with defecation and cause straining. They usually appear as
fungus-like growths with ulcerated, bleeding surfaces. Their
rapid development is characteristic. Epitheliomas occur as
a wart- or cauliflower-like growth with a rough uneven surface
situated in the skin around the1 margin of the anal opening
and often involving the anus, skin and periproctal connective
tissue. These vary in size, may appear singly or multiple
and often show an ulcerated surface, with a fetid discharge.
Fibromas are usually quite large and grow from the peri-
proctal tissue on one side of the anus. They may be two or
three inches in diameter, and are characterized by their
SUPPURATION OF THE ANAL GLANDS 223
slow growth, smooth surface and firm consistency. They
greatly interfere with defecation.
Diagnosis.— While an approximate diagnosis may be made
from the symptoms, the growth and the general appearance
of enlargement, an accurate diagnosis depends upon the
microscopical examination.
Prognosis.— Obviously the prognosis in all malignant
tumors is unfavorable, because of the danger of recurrence
and the difficulty of a complete removal. Benign tumors
when not too extensive take on the other hand a favorable
prognosis.
Treatment.— Tumors should be extirpated early. Under
general anesthesia, and strict antiseptic precautions, they
should be carefully dissected out, including some of the
normal tissue to be sure the entire growth is obtained. A
ligature is applied firmly around the base of them to con-
trol the hemorrhage, when they may be removed with the
scissors or knife. Sometimes it is advisable to cauterize the
base of the tumor with a thermocautery. Other methods of
procedure in the removal of these growths will depend very
largely upon the location, size and character of the tumor.
SUPPURATION OF THE ANAL GLANDS.
This condition has been observed quite frequently in the
dog. The anal glands secrete a grayish or brownish material
of fetid odor and acid reaction, discharged through a circular
Opening on either side of the margin of the anus. In .old
animals the secreting membrane often becomes inflamed or
irritated from constipation, foreign bodies, infection, etc.,
which changes the character of the secreted material. From
infection, the secretion becomes purulent and the orifice
partially or completely closed giving rise to a retention of
the secretion, and swelling. In some cases an increase of the
secretion may result causing discharge which collects on the
margin of the anus or soils the hair around the anal region.
Sometimes when the orifices become closed, and no outlet
is left for the escape of the discharge, the skin perforates
over the enlargement forming an exit for the escape of the
224 DISEASES OF THE RECTUM AND ANUS
discharge. Thus a fistulous tract may form. Painful defe-
cation is noted, or, if the pain is great, severe constipation
results. There are frequent attempts at defecation, and
pruritis. Direct examination reveals the presence of a hot,
sensitive, fluctuating enlargement or there may be a fistula
present. The discharge is noted when it collects on the hair
around the anus and tail which it stains, and an offensive
odor is emitted.
Diagnosis. — Usually not difficult as a direct examination
will reveal the condition.
Treatment. — When the enlargement is present, the contents
of the sac should be expelled by pressure with the thumb and
finger. This should be repeated daily for several days in
case the sac shows a tendency to refill. If necessary to stop
the discharge, Lugol's solution or tincture of iodin should be
injected with a hypodermic syringe, enough of either to
slightly distend the sacs. This treatment can be repeated
in a few days if necessary.
Should a fistulous tract be found, it should first be
thoroughly cleansed with an antiseptic solution (boric acid
2 per cent.) to remove all of the secretions, etc., then injected
with Lugol's solution to destroy the secreting membrane.
This treatment should be repeated every few days until the
discharge ceases.
CHAPTER XII.
DISEASES OF THE LIVER.
Examination.— The liver is examined by:
(a) Palpation.— This method is not very satisfactory
owing to the well protected position of the liver, and the
thickness of the abdominal muscles over it. However, when
the liver is much enlarged from acute inflammation, etc., it is
possible to palpate it through the walls.
(6) Laparotomy.— When a thorough examination of the
liver is desired this method is much more satisfactory than
by palpation. The incision is made just posterior to the
xiphoid cartilage, same as for gastrotomy, and long enough
to admit of a thorough examination. The liver should be
examined for inflammations, atrophy, cirrhosis, foreign
bodies, abscesses, tumors, injuries, etc.
ICTERUS. JAUNDICE.
Definition.— Icterus (jaundice) is a term applied to staining
of the tissues with bile pigments. It is characterized clini-
cally by a yellowish or greenish-yellow discoloration of the
skin, mucous membranes, and the presence of the bile pig-
ments in the urine. This is not a disease in itself, but merely
a symptom of a number of conditions, indicative of a disturb-
ance in the secretion or excretion of bile, which is significant
of a disease of the liver.
Etiology.— Icterus evidently results from two general
conditions: (a) An obstruction at some point in the course
of the biliary ducts in consequence of which the bile becomes
absorbed by the lymphatics or the bloodvessels, producing
icterus by stasis or hepatogenous icterus. This form of
icterus is very common in the dog and has a number of
15
226 DISEASES OF THE LIVER
etiological factors, which are: Catarrhal inflammations of
the mucous membrane of the stomach and duodenum, the
inflammation being sufficient in a number of cases to close
the orifice of the duct by the swelling of the mucosa; foreign
bodies in the duct producing irritation and swelling; parasites;
gall-stones; inflammatory conditions of the duct; neoplastic
formations in the duct; cicatricial stenosis of the duct;
compression of the duct from without by tumors on or in the
stomach, intestine, lymph glands or mesentery. Adhesions
after operations (gastrotomy), fecal accumulations, aneu-
rysms of the arteries, interference with the outflow of bile by
torsion of the ducts which sometimes occurs during preg-
nancy, tumors in the abdomen, etc.; localized inflammatory
processes in the liver (abscesses), and primary and secondary
new growths in the liver are further etiological factors.
Obstruction of the bile ducts causes the bile to be retained
in the liver, the hepatic cells continue to secrete bile and to
convert into bile pigments the free hemoglobin brought
thither. From the resulting accumulation the pressure in the
smaller biliary capillaries increases causing them to rupture
into the lymph spaces to be eventually carried through the
lymph vessels to the general circulation.
(6) Disturbance in the function of the liver cells, diverting
the bile from the biliary capillaries to the lymphatics or blood-
vessels producing icterus by hemolysis or hemohepatogenous
icterus. This form of icterus occurs most commonly from
the following: In many infections, such as the different
types of infectious icterus; distemper (partly obstructive,
by producing a catarrhal inflammation of the duodenum);
pyemia; in the different forms of intoxications, poisonings
by ptomaines, mineral poisons (phosphorus, arsenic, coal-tar
products, etc.); pernicious anemia; hemoglobinemia; disturb-
ance of the circulation, such as passive congestion; some nerv-
ous diseases, whereby the function of the liver is modified.
Pathology.— Yellow discoloration of all the organs and
tissues by the bile pigment with the exception of some of the
nervous and corneal tissue, characterizes the postmortem.
The discoloration varies from a slight tinge of yellow to a
deep greenish yellow, depending upon the amount of bile
ICTERUS— JAUNDICE 227
pigment deposited. Catarrhal inflammation of the stomach
and duodenum is often observed, the mucous membrane
swollen, the bloodvessels congested, and as a rule the mouth
of the hepatic duct will be found closed from the swelling of
the mucosa. The duct itself is often found occluded from a
swelling of its membranes from infection, parasites, foreign
bodies, gall-stones, etc. The duct is usually partially filled
with a thick, syrupy, or semisolid mass of bile and mucus.
The liver is usually found enlarged, and varies in color from
a diffuse light yellow to yellowish-brown, or the color may be
irregularly distributed causing a mottled appearance. The
boWtel contents are light gray or slate gray in color, owing to
the absence of bile, and emit a fetid odor.
Symptoms. —The early manifestations of icterus depend
largely upon the underlying causes of which jaundice is
merely a symptom. All of the tissues and organs, with the
exception of the nervous, are stained with biliary pigments;
in very severe cases where infection is the cause the nervous
system may also be stained. The discoloration is most
noticeable in the skin and mucous membrane.
Mucous Membranes and Skin.— Icterus is first manifested
by a yellowish discoloration of the eye involving the con-
junctiva and sclera. In very mild cases a slight tinge of
yellow noticed on the conjunctiva may be the only symptom
of the condition. As a rule, as the disease progresses the
other visible mucous membranes will also show the yellowish
discoloration. In the dog the entire membranes of the
mouth will be colored yellow. The skin, especially if non-
pigmented, becomes a characteristic light yellow, or greenish-
yellow depending upon the amount of bile pigment distribut-
ed. The discoloration is seen early on the skin of the abdo-
men, thighs, and ultimately over the entire body. In dark
skinned animals the condition can also be observed, the skin
assuming a dark olive green color. The color of the skin may
assist somewhat in arriving at the possible etiological factor,
as the discoloration is usually light in the toxic or hemo-
hepatogenous icterus, while it usually is darkest when the
ducts are completely obstructed— hepatogenous icterus.
The intensity of the external symptoms, therefore, is in pro-
228 DISEASES OF THE LIVER
portion to the completeness of the obstruction to the ducts
and to the extent of the rupturing o*f the biliary capillaries.
The symptoms develop on the external membranes, as a rule,
in a few hours, although in some cases of slow development
three to four days may be required depending upon the degree
of infection or obstruction of the ducts.
The Urine.— This is changed in color to a yellowish-green,
dark green, yellowish-red, or greenish-brown, depending
upon the amounts of bilirubin, biliverdin (oxidation prod-
ucts), or urobilin (reduction product). These bile pigments
are often observed in the urine before any discoloration takes
place in the tissues, therefore the urine furnishes an e&rly
important symptom. The urine when it comes in contact
with organic matter will stain it the color of bile, or upon
shaking or agitating the urine it will form a foamy liquid,
which is quite characteristic. Gmelin's test may also be
used for recognition of icteric urine. In addition to the bile
pigments the urine often contains a number of hyaline casts
(indicating nephritis) and desquamated epithelial cells.
(>astro-intestinal Tract. — The absence of bile from the
intestinal tract results in most cases in the passage of pale,
grayish, clay colored, or slate gray feces, having a fetid odor,
and containing undigested fat, and hydrobilirubin. The
pale color is due partly to the absence of bile, and partly to
the imperfectly digested fat which may be increased from the
normal 20 to 50 per cent. The fetid odor of the feces is
ascribed to the absence of bile which when present limits
fermentation of the intestinal contents. Constipation is
the rule in the majority of cases. However, diarrhea may be
present in some cases due to the imperfect digestion of the
fats and to the laxative action of free fatty acids which are
formed. The constipation is due no doubt, when present, to
defective motility of the muscular walls of the bowels, from
lack of the normal stimulating properties of the bile. In-
creased acidity of the stomach is observed in many cases, the
obstruction to the flow of bile apparently causing an increase
in the activity of the gastric secretion.
Nervous System. — Serious nervous symptoms are often
observed. The bile salts present in the circulation are at
ICTERUS— JAUNDICE 229
once carried to the nervous system, and, when accumulated
in sufficient quantities, will produce by irritation of the nerve
cells marked symptoms of active delirium, convulsions, etc.
This period of excitement and delirium, as a rule, lasts only
a very short time, terminating in depression, muscular de-
bility, somnolence, and eventually deep coma and death from
a general paralysis.
The general symptoms (loss of appetite, increased thirst)
are noticeable from the beginning. Usually a subnormal
temperature (96-100° F.) exists, depending upon the severity
of the condition. Examination of the liver by palpation is
unsatisfactory, as pain or enlargement of the liver is rarely
noted.
Diagnosis —The recognition of this condition offers no
difficulties, as the symptoms are very characteristic. How-
ever, the cause in many cases is hard to determine. In dogs
digestive disturbances, often resulting from errors in diet,
etc., produce the largest percentage of cases. Here the
anamnesis is valuable. From infectious jaundice a differen-
tiation can in most cases be made from the fact that this
condition occurs mostly in young dogs (puppies) and in an
enzootic form, affecting all the puppies of a litter.
Prognosis.— The prognosis in icterus is generally speaking
unfavorable. A large percentage of the cases in the dog
terminate fatally. In mild cases, due to catarrhal inflamma-
tion of the mucous membrane of the duodenum, recovery
usually takes place. The cause, if possible, should be ascer-
tained, and the conditions thoroughly considered before
making a prognosis.
Treatment.— Dietetic.— In the milder cases where the
appetite is retained small quantities of lean meat should be
given, avoiding all fats for a few days. In severe cases to
conserve the animal's strength eggs, given in small quantities
of milk, are useful. During convalescence foods should be
allowed only in small quantities, avoiding fats and irritating
foods as much as possible.
lied ical.— When icterus is the result of catarrhal inflamma-
tion of the duodenum, it is advisable to irrigate the stomach
with bicarbonate of soda solution (2 per cent.), repeating this
230 DISEASES OF THE LIVER
operation until all mucus is dissolved and the liquid flows
out clear. This treatment should be used at least once or
twice daily. Following the stomach lavage Carlsbad salts
(0.5-2.0) are useful to stimulate secretions and to dissolve the
mucus accumulated on the mucous membrane of the stomach
and duodenum. In some cases this will be sufficient to. allow
the escape of the bile into the duodenum.
Injections of warm water or warm bicarbonate of soda
solution (2 per cent.) into the rectum as high up as possible
are often valuable to stimulate peristalsis, encourage defeca-
tion, and to produce alkalinity of the intestinal contents.
Should constipation be present calomel (dog, 0.3-0.4; cat,
0.1-0.15) should be given and repeated in twelve to fifteen
hours if catharsis has not been established. Magnesium
sulphate (dog, 8.0-16.0; cat, 1.0-4.0) or castor oil (dog,
15.0-16.0; cat, 5.0-20.0) may be used for the same pur-
pose.
In severe cases it is advisable to try to overcome the
obstruction to the duct and empty the gall-bladder, either by
mechanically compressing the liver by manipulation or by the
use of emetics. The latter method has proved to be the
most satisfactory. The action of the emetic by contracting
the abdominal muscles will often exert enough pressure upon
the liver and gall-bladder to force the bile out into the bowel.
An obstruction, such as mucus, parasites, foreign bodies, etc.,
can thus also often be removed.
When the bile pigments are deposited in the body in large
quantities, or the blood contains a large amount of unde-
posited bile salts, its elimination should be encouraged by the
use of diuretics. Potassium acetate or nitrate (dog, 0.20-
0.50; cat, 0.05-0.10) is to be given twice daily.
General stimulants, such as camphor or ether, are indicated
when general depression and coma are observed.
In severe cases normal salt solution given as an intravenous
injection is useful to assist in the elimination of bile and to
produce general stimulation.
Faradization of the liver has been tried but its usefulness
is questionable.
CONGESTION OF THE LIVER 231
CONGESTION OF THE LIVER.
Two forms of this disease are distinguished: (a) Active,
and (b) passive.
Active Congestion.— Definition.— An engorgement of the
liver with blood resulting from an increased circulation
through the portal vein or hepatic artery.
Etiology. —There are a number of etiological factors in
active congestion of the liver: (a) During the process of
digestion there is a physiological increase in the amount of
blood carried to the liver by the portal vein. This, however,
usually subsides after digestion is completed. In small
animals, owing to the great variation in the amount and
quality of food taken, and the fact that the food often
contains irritating material, toxins, ptomaines, etc., all of
which increase the functional activity of the liver, a more
or less permanent active congestion results. (6) Various
poisons provoke a severe form of congestion of the liver.
These include many autogenic poisons carried to the liver
from the intestinal tract by the portal vein, or certain
ptomaines preformed in the food before it is ingested. Min-
eral poisons (arsenic, mercury, phosphorus) can produce it.
Some of the toxic products of infections, which develop in
the intestinal tract, will sometimes be carried to the liver in
sufficient quantities to excite an acute congestion, (c) Con-
gestion of the liver may also result from the specific products
of certain infections (virus of distemper, staphylococci and
streptococci) that may reach the liver via the general circula-
tion, (d) Dogs, when kept indoors, fed on highly nutritious
food, and not receiving the proper amount of exercise, will
often develop active congestion of the liver.
Many of the causes mentioned are also the chief etiological
factors in producing inflammation of the liver (hepatitis)
of which congestion is the first stage.
Pathology.— The liver is enlarged, feels firm or hard,
contains an increased amount of blood, and is of a dark red
or reddish-brown color. On cut surface, the blood drips or
flows off freely.
232 DISEASES OF THE LIVER
Symptoms. -Due to the fact that excretion is interfered
with, which leads to a general intoxication of the body,
general symptoms of stupidity, depression, loss of appetite,
etc., appear. Nausea and vomiting are often observed.
Constipation is the rule. The feces are clay colored and have
a fetid odor. Jaundice, which is nearly always present, is
first noticed in the conjunctiva; the urine is stained yellow
with bile pigment. The liver is usually enlarged and by
palpation it may be distinguished through the abdominal
walls; also is often quite painful to the animal when com-
pressed by digital pressure.
The urine is highly colored (often green), of high specific
gravity, and shows precipitates of urates and uric acid. The
body temperature is either normal or subnormal.
Diagnosis.— An accurate diagnosis presents some difficul-
ties. The causes (history), the disturbance of the digestive
tract, the jaundice, and the enlarged and painful liver, should
be considered in arriving at a definite conclusion. In atypical
cases an accurate diagnosis is impossible, although enough
symptoms may develop to suspect the acute congestion.
Prognosis.— The prognosis is usually favorable, except in
those cases produced by poisons and infections. In these
the prognosis will depend largely upon the character of the
infection or the nature and amount of the poison.
Course.— In most cases the course is short, rarely lasting
over two to four days.
Treatment.— Dietetic.— All irritating food should be with-
held. The diet should consist almost entirely of milk given
only in small quantities with long intervals between meals.
Lime water added to the milk, to make it alkaline, will have a
beneficial action on the mucosa of the stomach and intestines.
Medical.— Free purgation is indicated early. Magnesium
sulphate (dog, 10.0-15.0; cat, 1.0-5.0) has proved to be the
most satisfactory. These doses .should be repeated until free
catharsis has been established. Calomel may also be used,
but is not as good as magnesium sulphate, as its action is
more cholagogic which would be contraindicated where con-
gestion of the liver exists. When nausea and vomiting are
present, indicating an irritated condition of the stomach and
CONGESTION OF THE LIVER 23! 5
intestinal muco.su, sodium bicarbonate (dog, 0.5-1.0; cat,
0.2-0.8) given three to four times daily is beneficial. Am-
monium chlorid (dog, 0.5-1.2; cat, 0.2-0.5) given three times
daily will assist in the excretion of the urea, uric acid, etc.,
and relieve the intestinal catarrh. During convalescence
bitter stomachics are indicated to stimulate secretions and to
assist in digestion. Intestinal antiseptics, such as salol, are
also often indicated.
Passive Congestion. Definition.— A congestion of the liver
due to some impediment in the efferent circulation of the
blood in the liver.
Etiology. — This condition may result from the following:
(a) Defective heart action, whether it be acute or chronic,
such as valvular insufficiencies. (6) During the course of
some diseases of the lungs which increase the work of the
right side of the heart, eventually weakening it. Examples
are emphysema, chronic bronchitis (common in old dogs),
compression by pleural exudates, adhesive pleuritis, tumors of
the mediastinum, etc. (c) Local obstructions to the circula-
tion of blood through the hepatic veins and posterior vena
cava. The most common are: Pleural or peritoneal effu-
sions (when in large quantities, displacing the heart or com-
pressing the veins), tumors of the liver (carcinomas and
sarcomas in older animals), adhesions around the liver from
abdominal operations, injuries, etc.
Pathology.— The congested liver in the early stages is
somewhat increased in size, depending upon the amount of
blood contained. The organ is firm, dense and of a bluish
or dark purple color.
Cut section shows a more or less uniformly congested,
dark-blue or purplish color, and presents a mottled appear-
ance with light areas. In the advanced stages there is an
excess of blood, and the liver presents the characteristics
of the "nutmeg" liver; the intralobular and sublobular
venules being distended and filled with blood, appearing as
dark blue, purplish or reddish spots, while the liver cells are
pale yellowish, or whitish, showing fatty infiltration and
biliary pigmentation, which gives the marked contrast in
color ("nutmeg" liver). In the most advanced stages, the
234 DISEASES OF THE LIVER
liver becomes smaller, and may be smaller than normal. It
is firm and dense, but still retains the characteristic nutmeg
appearance. Connective tissue develops around the central
veins; the adjacent hepatic tissue is atrophic and pigmented,
and invading it are fine fibrous connective tissue trabeculse.
The capsule is often thickened and opaque.
Symptoms. —The symptoms vary greatly, depending largely
upon the causes. When due to primary cardiac or pulmonary
disease, the symptoms are complicated with these condi-
tions, those of the primary condition usually predominating.
The local symptoms are principally loss of appetite, dis-.
turbance in digestion, nausea, vomiting, and more or less
obstinate constipation. Jaundice is a common symptom.
It may be moderate. The cyanosis which is present in the
conjunctiva with the jaundice produces a peculiar bluish-
green color of the mucous membranes. In cases where infec-
tion develops rapidly, the jaundice increases, often producing
nervous symptoms such as excitement, convulsions, etc.
Ascites is a common symptom in the later stages resulting
from the extensive interference with the circulation. A large
amount of fluid is often found in the abdominal cavity,
especially in dogs. In the early stages the liver is enlarged,
while in the more advanced cases it may be atrophied.
Examination of the liver, therefore, by palpation may not
reveal any characteristic condition. An accompanying
gastro-intestinal catarrh develops which interferes with
digestion; the chronic course leads to general weakness and
emaciation.
Diagnosis.— The diagnosis depends upon finding the
primary disease of the heart or lungs, the condition of the
liver, and the local symptoms' of icterus, gastro-intestinal
catarrh, etc. An accurate diagnosis is somewhat difficult.
A careful examination of the patient and the prolonged
chronic course of the disease will assist in arriving at an
accurate conclusion.
Prognosis.— As a rule unfavorable, especially in the dog.
It depends upon the primary condition, the stage of the
disease and the condition of the animal.
HEPATITIS 235
Treatment.— Dietetic.— Treatment affords only temporary
relief. Encourage the animal to eat, by giving small amounts
of lean meat, milk, etc., which may be given in conjunction
with alkalies (sodium bicarbonate) to conserve the strength.
Medical.— For defective circulation, due to diminished
heart action (valvular insufficiency), digitalis fluidextract
(dog, 0.1-0.3; cat, 0.025-0.05 once or twice daily) is the
most efficient drug, especially when used in the early stages.
Magnesium sulphate should be given in constipation.
Stomachic tonics (gentian, nux vomica) are also indicated.
HEPATITIS.
Definition.— An acute or chronic inflammation of the liver.
This comprises a series of most diverse conditions varying
from active congestion, acute or chronic inflammation, to
localized foci of necrosis or to the different forms of icterus
gravis.
Etiology.— Hepatitis may result from the many causes
enumerated under active congestion of the liver (see Conges-
tion). The only real difference between the conditions is in
degree. A clinical differentiation, therefore, may be difficult.
Acute hepatitis is most commonly due to the absorption of
toxins during the course of infections or specific infectious
diseases. It may also result from the absorption of toxic
materials, such as poisons, from the intestinal tract (common
in dogs) .
Chronic interstitial hepatitis may develop from the acute
or from valvular disease of the heart.
Pathology. — In acute hepatitis the pathological changes are
varied. The whole phenomena of inflammation (congestion,
cloudy swelling, focal necrosis, etc.) may be present. In
mild cases the liver appears as in active congestion with
cloudy swelling. In severe cases the pathological changes
are intensified. The liver is enlarged, swollen, softened, and
rather pale in color; the cut surface is pale, opaque, and
shows mottling depending upon the degree of inflammation.
Symptoms.— The symptoms are very similar in many res-
pects to those of active congestion of the liver of which acute
236 DISEASES OF THE LIVER
hepatitis is a more advanced stage. As a rule the symptoms
are more intensive than in acute congestion. Nausea and
vomiting are more pronounced and usually more persistent;
the vomited material often contains a quantity of bile color-
ing the material a greenish color. Blood may be vomited
up along with the other material, from the irritation of the
mucous membrane. Constipation is nearly always present.
At certain periods in the course of the disease diarrhea
may appear. The fecal discharges are very fetid, yellowish
or clay colored. Icterus, noticeable on the conjunctiva,
mucous membrane of the mouth, and sometimes in the non-
pigmented skin, will be a prominent symptom. The liver is
found enlarged and sensitive on palpation.
The urine is usually concentrated, highly colored, of
increased specific gravity, and contains a high percentage
of urates and uric acid as well as bile pigment.
The temperature in the early stages of acute hepatitis is
usually quite materially elevated (103-104° F.). The fever
temperature assists in differentiating the condition from
simple congestion. However, in the later stages, the tem-
perature may be found normal, or even subnormal, due to
retained toxins, bile salts, etc. The general symptoms are
dullness, intense thirst, and gastro-intestinal disturbance.
Diagnosis. — The diagnosis depends on the causes, the
elevation of temperature, the enlargement and sensitiveness
of the liver, and the general symptoms. To distinguish
between acute congestion and inflammation of the liver is
difficult and depends upon the severity of the symptoms.
Prognosis. —The prognosis is unfavorable. In some of the
milder cases recovery takes place, but when advanced it
nearly always proves fatal.
Treatment. —The treatment for active congestion of the
liver is applicable. (See Active Congestion of the Liver.)
In chronic hepatitis treatment is valueless.
Suppurative Hepatitis.— Abscess of the Liver. — Definition.
—An inflammation of the liver resulting in abscess formation,
which occurs under a variety of circumstances and in several
forms. Liver abscesses are commonly divided into two kinds :
(a) The large single abscess; (b) the small multiple abscess.
HEPATITIS 237
Fundamentally, however, the two kinds may not differ from
each other, since the large single abscess may become multiple
by infecting adjacent liver tissue giving rise to the develop-
ment of secondary abscesses. By coalescence a number of
small abscesses may by peripheral extension form a large
single abscess.
Etiology.— Liver abscess is always the result of infection
by microorganisms (staphylococci, streptococci) which reach
the liver in one of several ways: (a) Traumatism. In
small animals injuries, direct or indirect, frequently give rise
to abscess of the liver. Direct injuries, such as punctured
wounds, gunshot wounds, etc., permit the entrance of
pyogenic organisms. Indirectly contusions or rupture of
the liver, which reduce the resistance to infecting organisms
which may be circulating in the hepatic or portal blood.
Such usually produces a single, small or medium-sized abscess.
(6) Diseases of contiguous organs often occasion the forma-
tion of abscess in the liver. Examples are: Gastric or
duodenal ulcer with perforation; abdominal organs which
have been operated and infected, and suppurative conditions
of adjacent organs.
(c) Infection via the portal or hepatic circulation. Multi-
ple abscesses result from gangrene or abscess of the lungs,
purulent pleuritis, purulent and fetid bronchitis, etc. These
processes give rise to many infectious einboli which lodge in
the liver forming abscesses.
(<7) Infection via the biliary ducts. Here abscess forma-
tion is due to the infection carried in through the bile ducts,
or by direct extension of ulcerative and suppurative processes
in the biliary tract to the adjacent liver tissue.
(c) In some cases infection may take place through the
lymphatics.
Pathology. Tin- appearance of the liver will vary greatly,
depending upon the mode of infection, the virulence of the
infecting material, and the location and number of abscesses.
Abscesses resulting from traumatism, ulcerative and
suppurative processes in adjacent organs are usually single,
small or of moderate size, and mostly superficial. These
abscesses are in isolated areas, a focus of inflammation sur-
238 DISEASES OF THE LIVER
rounded by a zone of intense hyperemia. In or near the
center liquefaction necrosis of the exudation begins which
spreads by peripheral extension until a smaller or larger
area of softened or fluid purulent material, surrounded by
a more or less well defined zone of limitation, results. The
softened material consists of leukocytes, red cells, necrotic
and degenerated liver tissue, infection, etc. The abscesses
are very commonly situated near or on the surface of the
liver. The surface of the liver is, therefore, involved (peri-
hepatitis), and extensive adhesions may bind to it the
contiguous organs. In some cases (especially after opera-
tions) the abscess is on rather than in the liver (suprahepatic,
infrahepatic) .
When small, multiple, metastatic abscesses are present, the
liver is usually enlarged, swollen, opaque, and shows evidence
of parenchymatous degeneration, or cloudy swelling. On
section the organ reveals numerous grayish or yellowish,
softened spots surrounded by hyperemic zones; the spots
vary considerably in size depending upon the stage of develop-
ment of the condition. In some cases the numerous small
abscesses, by peripheral extension, become confluent and
form a large abscess which may involve a whole lobe or in
some cases the entire liver. The purulent contents are
usually thick, creamy, yellowish, or thinner and seropurulent,
or stained with blood or bile; the surrounding liver tissue is
in most cases stained a greenish-yellow tint. The pus often
has an offensive odor especially when due to gastric or duo-
denal ulcers.
Symptoms.— The early manifestations are not very charac-
teristic. Therefore, unless the condition is well established
involving a large portion of the liver, or interfering severely
with its function, it is apt to be overlooked.
In traumatic abscess, and abscesses due to spread of
infection from adjacent organs, the patient usually shows
pain in the region of the liver, especially when the animal is
handled or moved about. Jaundice, due to compression of
the biliary ducts, and enlargement of the liver can usually
be determined by palpation; fluctuation may also be evident.
In multiple abscess the diagnosis is difficult,, as there are
HEPATITIS 239
no characteristic symptoms. The temperature is variable,
usually slightly elevated; chills may 'be present. Examina-
tion of the blood often reveals leukocytosis, which is not
always present, especially in chronic, well encapsulated
abscesses. The urine is concentrated, highly colored, specific
gravity increased, with an abundant deposit of urates and
uric acid. When there is much destruction of the liver tissue
the amount of urea is diminished, and albumin is often
present.
Spontaneous rupture of the abscesses often takes place,
especially in those cases resulting from traumatism, causing
serious symptoms to suddenly develop. As in most cases
the rupture occurs into the peritoneal cavity, a generalized
peritonitis follows which soon leads to death.
Diagnosis.— An accurate diagnosis is usually quite difficult.
The most suggestive signs are progressive enlargement and
tenderness of the liver, jaundice, chills and fever, leukocytosis,
and the consideration of the etiological factors.
When an abscess is suspected an accurate diagnosis can
be made with safety (especially in the dog) by making an
explorative laparotomy.
Prognosis.— Abscesses of the liver even in the single supra-
hepatic form should always be considered unfavorable.
The small multiple abscesses are almost always fatal, death
occurring in one to two weeks.
Treatment.— The early indications in the treatment are
surgical. Under general anesthesia and strict antiseptic-
precautions, an explorative laparotomy should be per-
formed. The incision in the abdominal wall should be
made large enough to admit of a careful and free examination
of the liver. Should the abscess be suprahepatic, or single
in the liver substance, that portion of the liver is carefully
brought out through the incision. It is very important that
the liver be carefully manipulated to prevent rupturing the
abscess. Should the abscess be of large size, it is often
advisable to aspirate most of the contents before it is manipu-
lated to prevent rupture of the sac and also to facilitate
its withdrawal through the abdominal incision. \Vhen the
affected portion of the liver is withdrawn, it should be sur-
240 DISEASES OF THE LIVER
4
rounded on either side with sterile gauze to prevent any of
the pus entering the cavity while operating. A free incision
is made directly over the abscess its full length, the contents
of the cavity thoroughly washed out with boric acid solution
(2 per cent.) and the abscess wall thoroughly curetted to
remove all of the necrotic tissue and detritus. If necessary
some of the tissue is removed with the scissors or knife to
straighten the edges of the wound, and also to be sure to
remove all of the necrotic tissue. The wound in the liver is
sutured with a deep continuous suture. Should the hemor-
rhage interfere it should be controlled by ligating the larger
vessels.
Should the abscess be suprahepatic or infrahepatic, the
affected parts should be carefully withdrawn, the adhesions
broken down and the entire wall of the abscess completely
extirpated. All exposed portions should be thoroughly
irrigated before returning to the abdominal cavity.
When multiple abscesses are found surgical treatment is
rarely of value. The external wound is sutured as in gastrot-
omy. (See Gastrotomy.)
ATROPHY OF THE LIVER.
Definition.— A term generally applied to a reduction in the
size of the liver. In most conditions where there is a reduc-
tion in the size of the liver it is due to degenerative changes.
Etiology.— Atrophy of the liver occurs most commonly
from the following:
(a) Pressure upon the liver, by tumors, enlargement of
adjacent organs, passive congestion, amyloid disease, etc.
These causes may produce a true atrophic condition of the
liver with subsequent replacement fibrosis, or atrophy and
degeneration (fatty degeneration and necrosis) as in passive
congestion and amyloid disease.
(b) From a stenosis or occlusion of the portal vein, general
hepatitis, advanced passive congestion, etc., a general
atrophy of the liver may develop.
(c) A reduction in the size of the liver, which is not a true
atrophic condition, follows many degenerative processes,
FATTY LIVER 241
such as poisoning by phosphorus, arsenic, mercury, chloro-
form, etc.
(d) Reduction in the size of the liver frequently occurs, to
which the term atrophy is applicable, in inanition, cachexia,
etc. In this case the liver participates in the general
atrophic process.
Pathology.— The liver is smaller than normal, dark in color,
dense, of increased specific gravity, and dry. These changes
are the result of the increase in the connective tissue and the
decrease in the parenchyma. On cut section the surface is
dry, and the liver substance very dense and firm.
Symptoms.— The symptoms are not very characteristic.
There will be noticed inanition, cachexia, etc. The patient
shows digestive disturbances, and the feces are light colored.
The liver is very small ; owing to its location it is difficult to
palpate.
Diagnosis.— An accurate diagnosis is in most cases impos-
sible during the life of the animal. The etiological factors
may assist somewhat in making a diagnosis.
Prognosis.— The prognosis should always be considered
unfavorable, owing to the structural change which has taken
place in the liver, and the difficulty of removing the causative
factors.
Treatment.— Satisfactory treatment is hardly possible,
although treatment for the removal of the cause would be
indicated.
FATTY LIVER.
Definition.— A term applied to the excessive amount of fat'
in the liver. It includes fatty infiltration, in which there is
an excessive deposit of fat without the liver cells becoming
much altered, and also fatty degeneration, in which the liver
cells are converted into fat cells.
Etiology.— The causes are: (a) Feeding of animal for a
long period on fats and carbohydrates, without the proper
amount of exercise. This tends to produce obesity (which
is common in house dogs), of which fatty liver is a common
symptom. The fatty deposit is probably due to the incom-
plete oxidation of the excessive amounts of food. (6) Anemia,
16
242 DISEASES OF THE LIVER
and cachexia, occurring in the later stages of chronic diseases,
carcinomatosis and sarcomatosis, general inanition, etc.
These conditions result in an insufficient supply of blood,
therefore incomplete oxidation, (c) Passive congestion of
the liver due to valvular insufficiency of the heart, (d)
Poisonings, such as phosphorus, arsenic, mercury, etc., which
are very common in small animals. Ptomaines from meats
will produce a similar effect, (e) Infections developing
in the intestinal tract, as distemper, infectious diarrheas,
etc., the toxins of which are carried to the liver through the
portal vein. General infection, such as by pyogenic organ-
isms, will produce the same effect on the liver.
It is quite evident that the majority of cases of fatty liver
develop through a deficient oxidation.
Pathology.— The liver is enlarged, often twice the normal
size, the specific gravity lessened, and the resistance reduced.
It is pale yellow in color, or yellowish areas or streaks are
seen on the surface. The surface is smooth, and the edges
somewhat rounded. On cross-section it is usually pale,
anemic, and fat globules which adhere to the knife are often
noted. In cases of passive congestion the characteristic
appearance of nutmeg liver is observed (dark center and
light periphery of the lobules).
Symptoms.— The symptoms of fatty liver are very obscure,
and not sufficient in most cases to make an accurate diagnosis
intra mtam.
AMYLOID LIVER.
Definition.— A degenerative process of the liver charac-
terized by the conversion of the proteins of the tissues into
a structureless, homogeneous substance called lardacein.
Etiology. — This condition results most commonly in animals
from the absorption of the toxins of pyogenic organisms. It
requires for its production a long time and a persistent and
continuous infection. It is not a very common condition in
animals, and usually accompanies a general amyloid degen-
eration of other organs.
Pathology.— The liver is enlarged, sometimes two or three
times its normal size, and the edges are rounded or blunt.
CIRRHOSIS OF THE LIVER 243
The color is grayish-brown, and on cut section shows white
points. Microscopic examination reveals the amyloid degen-
eration.
Symptoms.— Difficult to recognize during the life of the
animal, and is only of importance to the pathologist. Other
degenerative conditions. which have been observed on post-
mortem in small animals are only of importance to the student
in pathology and will not be described here, as a diagnosis
can only be made on postmortem.
CIRRHOSIS OF THE LIVER.
Chronic Interstitial Hepatitis.
Definition.— A chronic inflammation of the liver with an
increase in the interstitial connective tissue.
Etiology. — The exact causes are not definitely known.
Infection no doubt plays an important role, bacterial toxins
from the intestinal tract being carried direct to the liver.
It may be produced secondarily from other diseases of the
liver, such as acute and chronic hepatitis, congestion, etc.
Parasitic invasion has been known to produce it in certain
districts.
Pathology.— In the early stages the organ is usually en-
larged; in later stages often atrophic. The liver maintains
its shape, the surface is smooth, or in some cases granular.
The color varies somewhat from a light green to a dark olive
green, and the liver nodules are separated by connective
tissue. The consistency of the liver is greatly increased, and
when incised it cuts hard and grates under the knife, due to
the excessive amount of connective tissue. The bile passages
are usually found normal.
Symptoms.— The symptoms are those of a chronic condi-
tion, with which is associated a disturbance in the intestinal
tract. Jaundice, which is usually mild, producing only a
slight tinge of yellow in the mucous membranes; bile in the
urine, giving it a greenish color; nausea and vomiting are
often observed in the dog. An enlargement of the liver can
be readily detected by palpation. In the advanced stages of
244 DISEASES OF THE LIVER
the disease there is often ascites, enlargement of the spleen,
and eventually general cachexia.
Diagnosis.— In animals a diagnosis is very difficult. The
condition is usually first noted on postmortem examination.
An explorative laparotomy in the dog is recommendable.
Prognosis.— The prognosis is unfavorable owing to the
changes which have developed in the structure of the liver.
Treatment.— Dietetic.— Small quantities of easily digested
food (raw, lean meat, milk, etc.) should be given to sustain
the condition of the animal.
Medical.— Salines (magnesium sulphate, dog 8.0-12.0) are
indicated to produce a laxative action.
Should ascites be present diuretics are indicated to assist
in the removal of the fluid from the abdominal cavity.
Surgical. — Thoracentesis abdominis is indicated. (See
Ascites.)
NEOPLASMS OF THE LIVER.
Tumors of the liver are not very common, except second-
ary to malignant growths in other organs. These consist
mainly of carcinomas and sarcomas, which have become
generalized (carcinomatosis and sarcomatosis) . Benign
tumors are occasionally met with, viz.: Adenomas and
angiomas.
Symptoms. — Tumors of the liver are difficult to recognize
during life, and only in those cases where they become very
large, producing distention of the abdomen, will they be
recognizable. Palpation, when done carefully, will often
reveal the tumor which will be freely movable in the cavity.
If the tumor is malignant (sarcoma and carcinoma) it will
lead to symptoms of anemia and cachexia. An accurate
diagnosis can only be made after laparotomy.
Treatment.— When malignant tumors are found, no treat-
ment is of value. Benign tumors may be removed by
carefully ligating all vessels, and preferably removing an
entire lobe of the liver where affected. Hemorrhage is
usually severe when the tissue of the liver is incised. There-
fore operations on the liver are always considered serious.
CHOLELITHIASIS— GALL-STONES 245
CHOLELITHIASIS. GALL-STONES.
Cholelithiasis is quite rare in animals. Only a few cases
have been reported where free concretions were found in
the biliary ducts and these occurred most commonly in the
gall-bladder and ductus choledochus. Gall-stones are the
result of a catarrhal inflammation of the membrane of the
duct or gall-bladder causing a desquamation of the epithe-
lium and a collection of bile salts, gradually forming con-
cretions. Infection or parasites gaining entrance via the
duct and producing irritation are common causes.
Symptoms.— Gall-stones may exist for some time without
producing any marked symptoms, depending upon the
location of the concretion. When in the gall-bladder but
little disturbance will be produced, but when the concretion
passes out into the ductus choledochus, severe colicky symp-
toms are observed, and by completely blocking the exit of
the bile, obstruction or hepatogenous icterus is produced.
(See Icterus or Jaundice.) A diagnosis is difficul: and, when
suspected, an explorative laparotomy should be performed.
Treatment.— Surgical means should be employed early.
Under general anesthesia laparotomy is performed, as for
gastrotomy (see Gastrotomy) making the incision longer, if
necessary. The portion of the liver containing the gall-
bladder and duct is brought out through the incision. A
careful examination should be made to determine the location
of the concretion. When located, an incision is made down
upon the concretion just large enough for its removal. Care
should be taken to prevent the bile from running into the
cavity. After all the concretions are removed the wound
is stitched carefully with a fine suture using a small, straight
needle. A continuous suture is first used to bring the edges
of the wound in apposition, and then a Lembert suture
to completely close the opening and to bring the serous
membranes together for rapid healing. The parts should
be thoroughly cleansed before returning to the abdominal
cavity. The laparotomy wound is sutured in the regular
manner. (See Laparotomy.)
246 DISEASES OF THE LIVER
RUPTURE OF THE LIVER.
i
Ruptura Hepatw. Apoplexia Hepatis.
Etiology. — Owing to the structure of the liver being very
friable and easily torn and its blood supply great, it is not
uncommon that rupture of this organ takes place. The
common causes are injuries, such as being run over by
vehicles, penetrating rib fractures; severe exertion (running,
jumping, falling, etc.), or during the course of infectious dis-
eases when there is a severe congestion or inflammation of
the liver. Predisposing factors are: Degenerative processes
in the liver, such as fatty liver, amyloid liver, etc., or diseases
of the heart and vessels.
Pathology.— The postmortem lesions depend largely upon
the extent of the rupture. Small hemorrhages are often
found showing through the capsule of the liver, greater may
occur in the form of a large hematoma. In most cases, how-
ever, the capsule also becomes torn and the blood is allowed
to flow out into the abdominal cavity. The liver when
examined will reveal the rupture. The other tissues and
organs will be pale and anemic.
Symptoms. — Small hemorrhages in the liver will not pro-
duce any marked symptoms. If severe there will be all the
symptoms of internal hemorrhage, such as paleness of the
mucous membranes, general weakness, anxious expression,
weak rapid pulse, and dyspnea; the extremities and skin
become cold, trembling of muscles, and finally coma. Death
often takes place very suddenly or within ten or twelve hours,
depending upon the extent of the rupture. Small and con-
tinuous hemorrhages will be observed where the rupture is
very small or where a hematoma is forming showing symp-
toms of weakness, paleness of the membranes and often some
icteric symptoms. Such cases often recover in a few days or
death may occur from exhaustion in four to ten days.
Diagnosis. — An accurate diagnosis is very difficult. The
anamnesis may assist in arriving at a definite conclusion.
Prognosis. — Should be considered unfavorable as most
cases, especially where the hemorrhage is severe, terminate
RUPTURE OF THE LIVER 247
fatally. Where slight hemorrhage takes place, the prognosis
is more favorable, although if there is some disease of the
liver present, fatal hemorrhage may recur at any time.
Treatment.— The treatment must be given as early as
possible and is the same as for any internal hemorrhage.
Subcutaneous injections of ergotin (dog, 0.1-0.3) or adrena-
lin chlorid (0.5 to 1.0 of a 1-1000 solution) are useful. These
doses can be repeated in a half to one hour if necessary.
To stimulate the heart action strychnin sulphate (0.001)
or caffein citrate (0.1-0.3) should be given every few hours.
Otherwise the treatment is symptomatic.
CjHAPTER XIII.
DISEASES OF THE PERITONEUM.
General Remarks. — The peritoneum is a serous sac, and,
considering all of its reflections and fossae, it covers a surface
very nearly as great as that of the skin. In the female it
differs from other serous cavities in that it has an indirect
external opening through the uterine tube; in the male there
is no opening.
The peritoneum through the lymphatics and bloodvessels
has great power of absorption as has been demonstrated on
numerous occasions. The dog or rabbit will absorb fluid
equal to 10 per cent, of the body weight in a half hour.
Fluids and soluble substances are readily taken up and car-
ried away by the blood, while insoluble substances, including
microorganisms, are taken up by the lymphatics with the
aid of the phagocytes. In health, the secretion of fluid into
the peritoneal cavity and the absorption therefrom is just
sufficient to keep the surfaces moist and free from infection.
In disease this normal equilibrium becomes disturbed, and
either produces a dry condition of the membrane, from
absorption being greater than secretion (acute inflammation),
or secretion being in excess of absorption (ascites). The
presence of the fluid in the peritoneal sac has a further action
than preventing friction to the surface, and that is by exert-
ing a bactericidal action.
The lymphatic absorption is carried forward by the
lymphatic trunks to the mediastinal glands. Experiments
have shown that microorganisms can be removed from the
peritoneal sac via the lymph stream, and carried into the
mediastinal glands in six minutes after their injection into
the abdominal cavity. The peritoneum covering the dia-
phragm and the omentum is most active in this process of
GENERAL REMARKS 249
absorption, removing inert bodies and also microorganisms
from the peritoneal cavity. The omentum is, further, an
important factor in preventing peritonitis, in that it removes
the microorganisms from the abdominal cavity before they
can produce their pathogenic action. The omentum also
has the great faculty of localizing inflammation and infection
by attaching itself to any inflamed organ or possible source
of infection. It becomes fixed around the margin of the
inflammatory or infected area, where it adheres, preventing
generalization. The omentum is an important protective
mechanism after surgical work on the organs in the abdominal
cavity. Another point worthy of mention is the fact that
abscesses which develop following operations, puncture of
abdominal walls, etc., usually open to the outside rather than
in the abdominal cavity, due no doubt to the great defensive
powers of the peritoneum as compared to the other tissues.
The visceral peritoneum is not very sensitive to pain while
the parietal is very sensitive. Therefore, the reason for
extreme sensitiveness to pressure over the abdomen in acute
peritonitis. The visceral peritoneum even in inflammatory
conditions is not very sensitive. The natural resistance of
the peritoneum varies greatly in the different animals. The
dog seemingly has the greatest resistance, and, therefore,
abdominal surgery can be practised on this animal with a
much greater degree of safety than in other animals. The
cat is slightly less resistant than the dog. However, it must
always be remembered that there is a great variation in the
natural resistance of individuals of the same species depend-
ing to a great extent upon their physical condition, etc.
As a summary, the defensive powers of the peritoneum
are of great importance and are: (a) Its great absorbing
power, removing organisms before they can multiply suffi-
ciently, produce toxins, and excite inflammation, (b) The
phagocytic action exerted by leukocytes, polymorphonuclear
leukocytes and the endothelial cells, (c) The faculty of the
omentum in walling off local infections and inflammations
preventing diffuse peritonitis, (rf) The antitoxic and
bactericidal properties of the peritoneal fluid. Thi- thud
is increased when necessary.
250 DISEASES OF THE PERITONEUM
PERITONITIS.
Definition.— An inflammation of the peritoneum. From
the standpoints of intensity and duration peritonitis may be
classified into: (a) Acute, and (6) chronic.
.Acute Peritonitis.— Definition.— An acute inflammation of
the peritoneum. From a clinical standpoint acute perito-
nitis may be divided into: (a) Circumscribed or localized,
and (6) general or diffuse. Other divisions are hardly recog-
nizable during the life of the animal. Even the most severe
cases of peritoneal infection often show the least evidence
of inflammatory reaction. The inflammatory reaction which
takes place in peritonitis is often a salutary process, by pre-
venting excessive absorption from the peritoneum, leading to
the destruction of microorganisms that have gained entrance,
and by the formation of fibrin and adhesions preventing the
spread of infection to the entire serous membrane.
Etiology.— From the standpoint of cause acute peritonitis
may be divided into : (a) Primary, and (6) secondary.
(a) Primary, acute peritonitis is applied to those cases
where there is no local focus in the abdomen to account for
the infection of the peritoneum; it is assumed that the
infection has reached the abdomen by the blood or lymph
stream, or from some injury to the abdominal wall, such as
blows, kicks, gunshot wounds through the abdominal walls,
bowels, etc., or operations of various kinds on the organs in
the abdominal cavity.
(6) Secondary, acute peritonitis is due to infection at some
localized area in the abdomen, or in the immediate neighbor-
hood, which develops rapidly producing a diffuse or circum-
scribed inflammation. This form of peritonitis is very
common in animals and results from a number of conditions.
It may be due to infection from the abdominal viscera,
following perforation of their walls, or to inflammation and
the infection passing through the walls. The following con-
ditions are frequent causes: Perforation of gastric or
duodenal ulcer; acute toxic gastro-enteritis; mycotic gastro-
enteritis; traumatic rupture of the stomach or bowels;
strangulation of the bowels, volvulus; intussusception;
PERITONITIS 251
foreign bodies in the bowels; iinpaction of the bowels; rupture
of abscesses in the liver, spleen, omentura, lymph glands,
etc.; rupture of the bladder when inflamed; acute phleg-
monous, or gangrenous cholecystitis; metritis and para-
metritis after parturition; injuries to the uterus during
parturition; abscess of the prostate gland, etc. These con-
ditions allow the free entrance of microorganisms, or reduce
the resistance of the peritoneum so that organisms develop
readily. Numerous organisms are found producing peri-
tonitis, such as staphylococci, diplococci, streptococci,
Bacillus bipolaris, Streptothrix canis, Bacillus pyogenes,
Bacillus coli communis. In chickens, peritonitis is often
found as a prominent condition in cholera, and also from
different species of fungi, such as Aspergillus fumigatus,
Aspergillus glaucus, etc. A fungoid peritonitis has also
been observed in the dog produced by the Sporotrichum
beurmani. Parasites (Pleurocercoides bailletis) when severe
invasions take place will often produce peritonitis. Exposure
to cold, and unsanitary conditions are often predisposing
causes, especially in dogs and birds.
Pathogenesis. — As soon as the defensive powers of the
peritoneum (the phagocytic action of the endothelial and
other cells, the bactericidal power of the peritoneal fluid
depending on the presence of antibodies, and absorption
which destroy and remove organisms) are neutralized by
any of the etiological factors mentioned, the membrane
becoming dried and exposed during operations, etc., or the
presence of solid bodies, particles of food, blood clots, etc.,
the resistance of the peritoneum is lowered and its absorbing
and bactericidal power interfered with. This allows the
organisms to develop, produce their toxins and an acute
peritonitis.
Pathology.— According to the character of the exudation,
peritonitis can be classified as fibrinous, serofibrinous, fibrino-
purulent, suppurative and hemorrhagic. The character ot
the inflammation depends greatly on the nature of the infec-
tion. In cases of low virulence, such as are occasionally-
observed, the serous surfaces present little more than a slight
loss of luster, with some slight deposits of delicate fibrin. In
252 DISEASES OF THE PERITONEUM
the ordinary form, in the early stages, there is marked
congestion of the serous membrane, later the serous surface
becomes dull, lusterless, and the contiguous surfaces become
slightly adherent through the depositing of yellowish-white
flakes of fibrin (peritonitis fibrinosa). In some instances
there is but little effusion of fluid, but in most cases there is a
copious effusion of exudation, somewhat turbid containing floc-
culent masses of a yellowish color (peritonitis serofibrinosa) .
The quantity of fluid varies considerably from a few cubic
centimeters to several liters. In other cases the exudation
is more turbid and contains purulent material (peritonitis
purulenta) . The peritonitis following rupture of the bowels
is very virulent, the exudation is purulent and contains
bowel contents. In the abdominal cavity a quantity of dirty,
brown, turbid fluid of offensive odor is found. In all cases
of peritonitis with effusion more or less blood is always
present (peritonitis hemorrhagica) . When the peritonitis
results from rupture of the bladder, urine will be present in
the abdominal cavity, and the odor will be detected in the
abdominal contents.
Symptoms.— Acute, diffuse peritonitis, when due to inju-
ries, rupture of the bowels, abscesses, etc., usually develops
rapidly under symptoms of marked general disturbance.
In the most severe infections the symptoms are principally
those of a septicemia or toxemia. In the beginning there
is abdominal pain, restlessness, stiff unnatural gait, and
" tucked up" abdomen. Palpation over the abdomen reveals
intense contraction of the abdominal muscles, and con-
siderable sensitiveness. When the peritonitis is .diffuse the
sensitiveness is noted over the entire abdomen; when cir-
cumscribed only local areas of tenderness are evinced. The
pain is often severe enough in small patients (dog and cat)
to cause them to groan and cry. Pain is a prominent
symptom, and is usually continuous, except in cases where a
general toxemia exists. The respirations are of the costal
type. In most cases they are diminished, but if fluid is
present there is severe dyspnea.
Vomiting is an early and characteristic symptom of peri-
tonitis in the dog and cat. It is usually one of the first
PERITONITIS 253
symptoms, and is very persistent. The vomitus consists
mainly of mucus, food particles, bile, and, if severe, of fecal
matter.
There is complete loss of appetite noted early in the course
of the disease. The urine is decreased in quantity, highly
colored, and contains a large amount of indican. There is
often severe straining as if to urinate (tenesmus vesicae).
In the early stages there is diarrhea followed later by
constipation with considerable tympany. In the very early
stages the temperature in the dog and cat is elevated (104-
106° F.). The temperature, however, remains high for only
a few hours when it drops rapidly and becomes subnormal
(96-100° F.). In small animals the temperature in perito-
nitis is usually normal or subnormal.
The pulse is rapid, small, hard and often wiry. In the
later stages the pulse becomes very weak, irregular, and
finally imperceptible. 'The extremities grow cold, the
mucous membranes cyanotic, and there is every evidence of
a deficient heart action.
Effusion of fluid (ascites) is usually present except in some
of the more acute cases which are rapidly fatal. The per-
cussion sound is flat, the area of dulness shifting as the
patient's position is changed. A friction sound may be
present in the early stages, but due to the effusion which
forms early, soon disappears.
In some cases of peritonitis, due to severe septic infection
(rupture of abscesses), the course is very rapid and the
general symptoms of toxemia are the only ones noticed.
Peritonitis following rupture of the stomach or bowel, from
severe injury, such as being run over, kicks, etc., runs a very
rapid course. General weakness, coldness of the extremities,
and coma may be the only symptoms noted.
The symptoms of circumscribed peritonitis are similar to
those of diffuse, except that they are so mild at times as
to be overlooked.
Course.— The acute, diffuse peritonitis usually terminates
in death. The most intensive forms usually produce death
in thirty-six to seventy-two hours; however, most commonly
death results in five to eight days. Some of the milder cases
254 DISEASES OF THE PERITONEUM
terminate in recovery, or chronic peritonitis, which runs a
long chronic course.
Diagnosis.— In typical cases the sudden onset, the sensi-
tiveness over the abdominal region, the fever, the wiry pulse,
the development of effusion, the collapse and the vomiting,
present a rather characteristic picture. In some cases of
rapid development the diagnosis is very difficult and is
hard to differentiate from septicemia or toxemia.
In the latter stages of the disease, where deep coma is
present, an accurate diagnosis is impossible. Often circum-
scribed, acute peritonitis is overlooked. A careful examina-
tion, therefore, is necessary to determine the exact condition.
Prognosis.— The prognosis in acute, diffuse peritonitis is
unfavorable, especially if it follow rupture of the stomach,
bowel or abdominal abscesses. Such cases invariably
terminate in death. In circumscribed fibrinous or sero-
fibrinous peritonitis the majority of cases make a complete
recovery. Circumscribed peritonitis, however, due to local
infection should be looked upon as dangerous, as the abscess
may rupture into the abdominal cavity eventually terminat-
ing in death from diffuse peritonitis.
Treatment.— Medical.— In the early stages, diarrhea is
present and fhe peristalsis active. In order to prevent
friction between the peritoneal surfaces, which tends to
spread the inflammation, small doses of opium (dog, 0.1-0.3;
cat, 0.05-0.1), or morphin sulphate (dog, 0.016-0.12) subcu-
taneously are indicated.
Cold applications, if applied early to the walls of the
abdomen, are indicated (cold water compress or ice pack) to
relieve the intense congestion of the serous membrane. Later
counterirritants may be used in the form of oil of mustard
mixed with olive oil (1-10). Apply by rubbing well into the
skin of the abdomen. Hot water applications may also be
used. Should constipation be marked laxatives should be
given, such as castor oil (dog, 15.0-30.0; cat, 5.0-8.0) or mag-
nesium sulphate (dog, 10.0-14.0; cat, 2.0-5.0). Warm water
infusions into the rectum will be useful to remove feces and
also to produce a soothing action on the membranes.
General stimulants (strychnin sulphate, dog 0.001; cat, \
PERITONITIS 255
the quantity subcutaneously) are employed to combat symp-
toms of general weakness and coma. Alcoholic stimulants
or camphor may also be used for the same purpose.
Surgical.— When severe infection is present, and in the
early stages, it is advisable to irrigate the abdominal cavity
in the following manner: Laparotomy should be performed
(see Laparotomy) and a sufficient amount of sterile, normal
salt solution introduced at the body temperature to
thoroughly irrigate all parts of the cavity. This should be
followed by a boric acid (2 per cent.) or a salicylic acid solu-
tion (2 per cent.). The value of this method will depend
largely upon the thoroughness of the application. Before
irrigating a thorough examination of the organs and tissues
in the cavity should be made for ruptures, etc., and if found,
proper treatment should be applied. When an excessive
amount of effusion is present it should be removed. (See
Treatment for Ascites.)
Chronic Peritonitis.— Definition.— A chronic inflammation
of the peritoneum which may be either diffuse or circum-
scribed. As a rule chronic peritonitis is rarely found equally
well marked over the entire abdominal cavity. From a
clinical standpoint it is difficult to separate the two condi-
tions, therefore, they will be described as one.
Etiology. — Chronic peritonitis may be due to a number of
different causes, the most important of which are: Intra-
abdominal lesions, such as diseases of the liver (hepatitis,
abscesses), the kidneys, spleen, etc., which may reduce the
resistance of the peritoneum; or from gastric or duodenal
ulceration providing a focus for peritoneal infection. In
these cases a general chronic peritonitis results instead of a
•local inflammation, owing to the reduced resistance of the
membrane, or the low virulency of the infection. Chronic
venous engorgement from defective heart action would
produce much the same effect. Chronic peritonitis may
result from the acute fibrinous form when complete resolution
does not take place, or the infection is mild.
In some cases it may result from disease of the pleura by
spreading through the diaphragm. Chronic peritonitis may
also result from disturbances of the intestinal tract.
256 DISEASES OF THE PERITONEUM
Ascites, when due to disease of the heart, may produce
chronic peritonitis by lowering general resistance, or through
organisms which gain entrance during paracentesis abdom-
inis. Parasites (Linguatula denticulatum, Plerocercoides
bailleti, Echinococcus granulosus) in the dog and cat may
cause chronic peritonitis by the constant irritation to the
peritoneum they produce.
Pathology. — The postmortem lesions vary somewhat de-
pending upon the causes, and the extent of the process. The
peritoneum is covered by a thick membrane, which is dull
white or glistening, pearl-like in color; pigmentation is some-
times present. In very severe cases of long standing this
membrane becomes very thick, especially over the visceral
peritoneum, and can be peeled off from the organs. Adhe-
sions between the folds of the visceral peritoneum are often
found, which may bind together several organs into one mass.
The formation of this membrane is due mainly to an organ-
ization of the exudation and not to hyperplasia of the peri-
toneum itself.
Symptoms.— The symptoms are somewhat similar to ascites.
The onset is gradual; usually no symptoms are noted until
distention of the abdomen develops. There is no pain or
tenderness on manipulation. On percussion a dull sound is
emitted, and on auscultation, especially if the abdomen be
tapped on the opposite side with a finger, the presence of
fluid can be detected by the splashing sound produced.
There are usually general symptoms of dullness, and lack
of energy, shown by the animal lying down a great deal and
refusing .to move about. The patient has, as a rule, a good
appetite unless constipated. Respirations are increased
owing to the pressure against the diaphragm.
The character of the fluid varies somewhat. It has a
specific gravity of about 1015, is of a yellowish or turbid
color, from the presence of large numbers of cells, and when
allowed to stand it usually becomes thick and forms large
amounts of floccuhv.
The temperature in the dog and cat remains normal or
slightly subnormal. The pulse is^often lapid and irregular.
ASCITES 257
Diagnosis.— The character of the fluid in the abdomen is
one of the chief diagnostic symptoms, and some of it should
be obtained and examined for its specific gravity, cells, etc.
A careful examination of the animal must be made to distin-
guish this from ascites due to other causes. The anamnesis
may also assist in making the diagnosis.
Prognosis.— The prognosis is unfavorable, the course
chronic. Complete recovery is hardly to be expected,
although a number of cases have been reported where appar-
ent recoveries- have taken place. Death is usually the result
of heart failure.
Treatment.— The cause should be ascertained if possible,
and the treatment given accordingly. If the cause cannot
be determined, symptomatic treatment is given. Diuretics,
such as caffein citrate (0.1-0.3) or diuretin (0.15-0.4) are
indicated to assist in removal of the fluid.
Paracentesis abdominis (see Ascites) should be performed
whenever necessary to remove the fluid from the cavity.
The dog, as a rule, responds more readily to treatment than
the cat.
ASCITES.
Hy drops Abdominis. Hydrops Ascites. Hydrops Peritonei.
Definition.— A collection of serous fluid in the abdominal
cavity. This condition is quite common in dogs, and also
occurs in cats and birds. Mild cases of ascites are often
overlooked during life, and are only found on postmortem or
during operations on the abdominal cavity.
Etiology.— 1. Local Causes.— (a) Chronic inflammation of
the peritoneum, either simple, carcinomatous, sarcomatous,
or by cysts of parasites (Plerocercoides bailleti, Linguatula
denticulatum, etc.). (6) Obstruction to the portal vein,
either in its terminal branches in the liver, such as by
cirrhosis, chronic, passive congestion, etc., or by compression
of the vein in the gastrohepatic omentuin, such as by pro-
liferative peritonitis, abscesses, tumors (sarcomas, carci-
nomas, etc.), or by aneurysm. (c) Thrombosis of the portal
vein. (fT) Tumors in the abdominal cavity in general, (e)
17
258 DISEASES OF THE PERITONEUM
Cysts of the ovaries (common in cats). (/) Occurs in the
secondary stage of acute circumscribed or diffuse peritonitis.
2. General Causes.— Ascites often occurs as a symptom of
general dropsy, the result of mechanical effects, as in heart
diseases, chronic indurative or interstitial pneumonia. In
some heart diseases the effusion is confined to the abdominal
cavity, in which case it is no doubt due to secondary changes
in the liver. Ascites also occurs in chronic diseases of the
liver. In young dogs (puppies) ascites is frequently observed,
and often disappears as the animal develops, apparently
without any particular cause being found.
Pathology. —The presence of fluid in the abdominal cavity,
of varying quantity from a few cubic centimeters to 15-20
liters. This fluid has a specific gravity of 1012-1015, a light
or yellowish color, clear, and contains, as -a rule, but a slight
amount of fibrin, or flocculent precipitate. The chemical
reaction of the fluid is alkaline or neutral; the albumin con-
tent is about 2 to 5 per cent. Sometimes the fluid wTill be of a
reddish color, due to slight hemorrhages, or to some of the
red cells passing out with the serum. This is especially
noticeable in obstruction to the portal vein. A greenish"
cast is noticed when the liver is secondarily affected. The
precipitate when examined will be found to contain a small
number of leukocytes, fatty endothelial cells, flakes of fibrin,
and sometimes red cells, and in rare cases numbers of small
cysts of parasites. In dogs and cats the fluid often contains
numerous fat cells and has a milky appearance.
The peritoneum is usually pale, glistening, thickened,
especially in cases of long standing or those due to chronic
peritonitis. The organs in the cavity are usually anemic,
dull on the surface and sometimes atrophic.
Symptoms.— An enlargement of the abdomen is usually
the first indication of the disorder. Until the accumulation
of fluid becomes great enough to cause a distention of the
abdomen, the symptoms will not be positive enough to make
a diagnosis. As the amount of fluid in the abdomen varies
greatly, the symptoms will vary considerably in individual
cases. The fluid distends the abdominal wall, causing the
muscles and skin to become tense, and the abdomen to assume
ASCITES 259
a characteristic pear shape. When the animal assumes a
standing posture, the fluid collects in the lower portion of the
abdomen and the amount can be rather accurately deter-
mined by percussion. Above the line of dulness will be
noticed a tympanitic sound. Changing the position of the
animal causes a shifting of the horizontal line which marks
the upper limits of the area of dulness.
On palpation the resistance is fairly uniform. By placing
one hand on the side of the abdomen, and tapping gently on
the other side with the other hand, a plain undulation will be
felt. As the amount of fluid increases, pressure is produced
on the diaphragm, interfering with the function of the organs
in the thoracic cavity. Severe dyspnea with cyanotic mem-
branes is noted in some cases. The pulse is weak and rapid.
As the cases progress, emaciation appears. The appetite
is impaired, the digestive tract disturbed and occasional
attacks of vomiting occur. The temperature is normal; in
the later stages it may be subnormal. The urine is reduced
in amount, and often highly colored in the dog; otherwise it
is normal. The animal may die from general exhaustion,
or from asphyxia.
Diagnosis.— The diagnosis is not difficult, provided a care-
ful examination is made of the patient, its history obtained,
and all the symptoms carefully noted. However, there are
quite a number of conditions with which ascites might be
confused. It might be mistaken for acute or chronic peri-
tonitis with effusion. By puncturing the abdominal wall with
an explorative trocar and obtaining some of the fluid, a dif-
ferential diagnosis can be made.
Excessive accumulation of fat (obesity) might be confusing.
However, obesity occurs mostly in old animals, and the shape
of the abdomen is more apple (broad back, well rounded
barrel) than pear shaped.
Advanced pregnancy can be . differentiated by careful
palpation which will reveal the presence of the fetuses.
Tumors in the cavity can be differentiated by their consist-
ency and their permanent position. Distention «>t the
bladder produces an enlargement which remains in the same
position at all times, and when palpated can be felt as a
260 DISEASES OF THE PERITONEUM
large body within the cavity. Passing the catheter will
reduce the enlargement by removing the urine.
Rupture of the bladder, when distended, will produce a
sudden distention of the abdomen, and general symptoms of
stupor and coma often with convulsions. Puncturing the
abdomen will reveal the presence of urine.
Prognosis. —The prognosis depends largely upon the cause.
As a rule, it is unfavorable.
Treatment.— Medical.— The cause should first be deter-
mined, if possible, and measures taken to eliminate it.
Should the heart action be deficient, digitalis would be
indicated (dog, 0.05-0.10; cat, ^ quantity) to stimulate the
heart and overcome venous stasis. This drug is further of
great value owing to its diuretic action, which assists in the
elimination of fluid from the body. Caffein citrate (dog,
0.1-0.5; cat, 0.05-0.1) has a similar action. The resorption
of the exudate may also be aided by the use of diuretics:
Potassium acetate (dog, 0.5-0.8; cat, 0.05-0.1) ; bulbous scillee
in powder form (dog, 0.05-0.2; cat, 0.01-0.05) ; diuretin (dog,
0.5-1.0; cat, 0.01-0.05) every two or three hours, or agurin
(dog, 1.0-2.0; cat, 0.02-0.08) daily. Laxatives should be
administered occasionally to keep the bowels open which
also assists in removing the fluid. Magnesium sulphate
(dog, 8.0-14.0; cat, 1.0-4.0) is best for this purpose. Dia-
phoretics may also be administered, although not so impor-
tant in small animals as in large ones, as the skin glands are
less developed. Pilocarpin hydrochlorate (dog, 0.005-0.01)
can be used, but there is some danger of edema of the lungs
or paralysis of the heart from its use.
Surgical.— If the fluid produces severe dyspnea and inter-
feres with the action and function of abdominal and thoracic
organs, it should be removed surgically by performing para-
centesis abdominis. The operation is as follows: The
animal is placed in a standing position, or on its side on the
operating table and the hair shaved from a small area at
the most pendent portion of the abdomen, usually near the
umbilicus. The surface should be thoroughly disinfected by
washing with bichJorid soap, followed by alcohol, and
tincture of iodin painted over the surface where the puncture
ASCITES 201
is to be made. A small exploring trocar is used, which
should be sterilized, and inserted through the abdominal
walls. When the stylet is withdrawn, the fluid will usually
flow out in a stream. Sometimes the end of the cannula
becomes blocked by omentum or bowel. This can be over-
come by moving the cannula slightly or by re-inserting the
stylet. The fluid should be collected in a vessel to note its
character. The amount of fluid to remove depends largely
upon the condition of the animal. Should, however, symp-
toms of dyspnea, cyanosis, and rapid, weak pulse appear,
the cannula should be at once removed. The operation
may be repeated next day. The punctured wound resulting
from the operation should be protected by covering with
collodion and a small pledget of cotton. Death occurs
occasionally from collapse following the operation. There-
fore the patient should be carefully watched and the removal
of the fluid stopped, and general stimulants given, when
signs of collapse appear.
PART IV.
DISEASES OF THE REPRODUCTIVE ORGANS.
CHAPTER I.
DISEASES OF THE PENIS AND PREPUCE.
Examination.— The prepuce should be examined by observ-
ing the discharge at its opening, and the condition of the
mucous membrane. Frequently there will be found a more
or less extensive mucopurulent discharge which indicates a
catarrhal inflammation of the prepuce. The preputial open-
ing should be dilated and the mucosa examined for foreign
bodies, tumors, ulcerations, secretions, etc.
The penis may be examined in the following manner:
The animal should be placed in the dorsal position, and
either held by assistants, or securely fastened to the table
with hopples. With the left hand, the prepuce is gently
pushed downward and backward, exposing the free end of the
penis. The penis is then grasped with the fingers of the
other hand and pulled as far out of the prepuce as possible.
A piece of tape should be placed around the penis just
posterior to the glans, and with gentle traction the penis can
be exposed for a considerable distance. The penis should be
examined for inflammations, tumors, venereal granulomata,
rubber bands, wounds, fractures of the os penis, etc.
WOUNDS OF THE PENIS AND PREPUCE.
There are quite a variety of injuries which are found
involving these structures. Principally, injuries result from
264 DISEASES OF THE PENIS AND PREPUCE
the bites of other animals, and different degrees of the con-
ditions are found, from small cuts of the prepuce to extensive
laceration of the tissues. Rubber bands are occasionally
found on the penis just back of the glans. These, if left on
very long, result in extensive edema and necrosis of a portion
of the penis. Injuries also occur during coition as the penis
is retained in the vagina until the semen is ejaculated, which
requires several minutes in the dog, and during which time
the movement of the female will often cause torsion or
twisting of the penis with subsequent edema. Frequently
dogs are roughly handled at this time and the penis lacerated
or cut. The prepuce is often found split from being cut by
sharp objects, or perforations occur which allow the penis to
prolapse through the opening.
Symptoms.— The symptoms depend to a great extent upon
the kind of injury and the amount of damage done to the
tissues. Attention to wounds of the prepuce will be drawn
by the hemorrhage and swelling. Examination reveals the
extent of the wound. In edemas of the penis, the animal
shows difficulty in urination, the penis often projecting
from the prepuce, swollen, reddened, and if strangulated
will be of a dark color (venous stasis). Thorough examina-
tion should be made to determine the degree of injury, and
to discover any foreign bodies which might be present.
Prognosis.— Favorable in most cases, as wounds in this
location respond to treatment readily. Not so favorable in
cases of strangulation of the penis with subsequent necrosis.
Treatment. —The parts must be thoroughly cleansed,
washed with an antiseptic solution, and the character of the
injury determined. Wounds in the prepuce, such as cuts or
perforations, are sutured after thorough disinfection and all
ragged edges removed with the scissors. Injuries to the
penis should be looked after carefully, as they sometimes
lead to sufficient swelling to interfere with the discharge of
urine. In such cases, the catheter is introduced and the
urine withdrawn. Should this procedure fail, make an
opening in the urethra at the ischial arch to temporarily take
care of the discharge of urine. Applications of antiseptic
solutions for a few days will reduce the inflammation and
PREPUTIAL CATARRH 205
infection. When the penis is strangulated and necrotic, it is
advisable to amputate the affected portion. This is done
in the following manner: The animal is anesthetized,
placed on the table in a dorsal position and securely hoppled.
The parts should be thoroughly cleansed with soap and water
and disinfected. Pull the penis out of the prepuce as far as
possible, and apply a rubber tourniquet at a point above the
seat of operation to control the helnorrhage. Incise the
penis with a scalpel, and if it is necessary to amputate through
the os penis a saw should be used for this portion. The
urethra is protected by a catheter previously inserted, and
left about one-half inch longer than the stump of the penis.
It is split with the scissors on its dorsal surface back to where
the penis was incised. The flaps of the urethra are then
securely stitched to the stump of the penis to prevent a
stricture forming at this point. All vessels should be ligated,
and the parts again washed with an antiseptic solution. The
tourniquet is removed and the penis allowed to retract back
into the prepuce. Cleanse daily with antiseptics.
CONGENITAL MALFORMATIONS.
Malformations of these structures are not common.
Arrested development of the penis or prepuce is seen occa-
sionally. Hermaphrodites are not common among dogs.
Congenital closure of the prepuce is observed sometimes in
puppies, which must be opened with a scalpel and the edges
of the skin stitched back to prevent adhesions.
PREPUTIAL CATARRH.
Balanitis.
Definition.— A catarrhal inflammation of the mucous
membrane of the prepuce.
Etiology.— Preputial catarrh may be produced by several
different factors:
(a) Principally local infection.
(6) Develops in a number of cases secondary to other
diseases; venous stasis; phimosis; paraphimosis; injuries,
or foreign bodies.
266 DISEASES OF THE PENIS AND PREPUCE
(c) Sequel to specific infectious diseases, as distemper.
(d) Follows in some cases of mange and eczema.
In all of the above causes we find that the condition is
brought about by infection either as a primary cause, or due
to reduced resistance of the tissues by other diseases which
allows secondary infection to take place. In some, accumu-
lations of dirt will favor injury to the mucosa with subsequent
infection.
Symptoms. —The mucosa of the prepuce will be injected,
swollen, and there is present at the preputial opening a dis-
charge of pus of a yellowish or greenish color. Some of the
material accumulates around the preputial opening aggluti-
nating the hair, drying and forming crusts. Examination
of the mucosa shows a marked catarrhal inflammation.
Prognosis.— The condition is not serious as in most cases it
remains local. When treatment is applied, recovery takes
place after a few weeks.
Treatment. —The parts are thoroughly cleansed and all
long hairs removed with the scissors. The prepuce should
be washed thoroughly once or twice daily with antiseptic
and astringent solutions (alum, 2 per cent.; silver nitrate,
j per cent.; zinc sulphate, 1 per cent.).
PfflMOSIS.
Definition.— A contraction of the prepuce in front of the
glans penis, preventing the projection of the penis, interfering
with coition, and in some cases the escape of urine.
Etiology.— Phimosis is a congenital defect in puppies. It
may cause in some cases almost complete occlusion. It
results frequently from trauma of various kinds, the subse-
quent cicatricial tissue formed leading to constriction. Acute
infectious inflammation (balanitis) with severe swelling will
produce a temporary closure, and in some cases, owing to
the change in the structure of the tissues, a permanent
contraction.
Symptoms.— In puppies it will be noticed that urine cannot
be discharged; there may be frequent attempts at micturition,
with only a small quantity passed or there may be complete
PARAPH I MOSIS 267
suppression. In mature animals the same symptom of
difficulty in passing urine is often present. There is a
narrowing of the preputial opening; sometimes it is exceed-
ingly small. Animals suffering from phimosis are unable to
copulate.
Treatment.— In phimosis surgical relief should be given
promptly. There are two methods employed:
(a) The patient is placed in a dorsal position on the
table and the parts disinfected. A longitudinal incision of
sufficient length is made on the inferior portion of the prepuce
to allow the penis to protrude. The two portions are
temporarily stitched back to the skin to prevent adhesions
and a recurrence of the condition. The wound should be
treated daily with antiseptics.
(b) The animal is placed in the same position as above and
local or general anesthesia given. A circular incision is
made completely around the prepuce, removing about one-
quarter to one-half inch of its end. The hemorrhage is
usually slight. The mucosa should be stitched to the skin
for the entire distance around the prepuce. This will insure
a preputial opening of sufficient size. Care must be taken
in this operation not to remove too much of the prepuce, as
it would allow prolapsus of the penis. After-treatment
consists in cleaning and disinfecting the parts daily.
PARAPfflMOSIS.
Definition.— A contraction of the* prepuce around the penis,
preventing the penis from assuming its normal position.
Etiology. — Paraphimosis can result from coition. The
prepuce becomes inverted when the penis retracts, but the
resulting swelling prevents complete retraction. As a result
of coition, with subsequent swelling, the penis becomes too
large to pass through the preputial opening. It is further
observed in some cases of paralysis of the penis, organic-
changes having taken place in the tissues from exposure.
Neoplasms, such as granulomata, are sometimes productive
of the same condition.
268 DISEASES OF THE PENIS AND PREPUCE
Symptoms. —The exposed penis becomes swollen, edema-
tous and discolored and when strangulated, gangrenous.
The animal will have difficulty in voiding urine due to the
•swelling and compression of the urethra. There is stiffness
in walking. Examination of the parts will at once reveal the
exact nature of the condition.
Prognosis.— In early cases, resulting from coition, the
prognosis is favorable. In cases of long standing, after
strangulation, or in paralysis, the prognosis is unfavorable.
Treatment.— In early cases of paraphimosis, following
coition and before much swelling has taken place, it is
possible in most cases to correct the inversion of the prepuce
and return the penis to its normal position. This is best
done by cleansing and disinfecting the parts thoroughly,
lubricating the penis and preputial ring with some bland oil
(olive), and by manipulating the parts by pressing on the
glans penis. If at the same time the prepuce is pressed for-
ward, the parts will often be reduced without much difficulty.
Should this procedure fail, it is advisable to reduce the con-
gestion of the glans penis by bathing in cold water, applying
alum solution (2-5 per cent.), or by applying tape tightly
around the glans. After the congestion has been reduced,
manipulation as above will often reduce the condition.
These manipulations will not suffice in cases which have
become greatly swollen or edematous. It is then necessary
to resort to an operation, which consists in simply splitting
the prepuce longitudinally on its lower surface, making a slit
of a sufficient length to relieve the strangulation and allow
the penis to retract. Where gangrenous conditions have
developed, amputation of the penis must be resorted to.
After-treatment in these cases consists in applying antiseptic
solutions freely.
TUMORS OF THE PENIS AND PREPUCE.
Various forms of tumors, both benign and malignant, are
found in this location. The following varieties are most
common :
TUMORS OF THE PENIS AND PREPUCE 209
Papillomata.— These in most cases involve the prepuce.
They are small, benign growths, appearing usually as pedun-
culated warts. Sometimes they are found in large numbers
with irregular or cauliflower-like surfaces and are usually
found at the juncture of the skin and mucous membrane.
Symptoms.— They produce, as a rule, no marked symptoms
of any kind, except in some cases a catarrh al inflammation
of the prepuce (balanitis) .
Treatment.— Tumors should be removed with scissors as
close to the base as possible. Cauterize the base with silver
nitrate. A recurrence is unusual.
Sarcomata, Epitheliomata and Carcinomata.— These are
occasionally found involving the prepuce and penis. These
tumors are malignant and show much the same character-
istics from a clinical standpoint.
Symptoms. — In most cases these tumors involve the pre-
puce. They are characterized by their sudden development,
irregular outline, degenerative changes, and tendency to
spread into the adjacent tissues. They usually present a
raw, ulcerating surface, show a tendency to bleed, etc.
Diagnosis. — The diagnosis depends upon the characteristic
growth, and the microscopic findings.
Treatment.— In case a diagnosis of malignant tumor is
positively made, the results of treatment are only temporary.
Removal of the tumor is advised, and the incised portion
should contain not only all of the malignant growth but also
include a small portion of adjacent normal tissue. Malignant
tumors are liable to recur in a short time.
Venereal Granulomata. — This is a specific, infectious
tumor formation affecting the penis and prepuce of the dog.
It is transmitted in most cases by the act of copulation.
Affected stud dogs transmit it during coition. It may be
transmitted in rare instances by intermediary agents. It is
far more common in Europe than in the United States where
it has been introduced by imported stud dogs. The growth
seems to confine itself to the prepuce, penis, and immediately
adjacent tissues with involvement of the efferent lymphatics.
Symptoms.— Venereal granulomata are usually found only
in the best bred dogs. The early symptoms are redness,
270 DISEASES OF THE PENIS AND PREPUCE
swelling and a reddish colored discharge from the prepuce.
Micturition is frequent, and the penis is protruded from the
prepuce. On palpation the prepuce will be found swollen
and irregular in outline. On exposing the penis, it will be
tumified, purplish or dark red in color, and on its surface
presents a number of vegetative growths. These growths
may be found also on the prepuce. They are characterized
by their soft friable condition, tendency to bleed at the least
touch; they may be sessile or pedunculated. The growths
first appear in the form of small vesicles, which soon develop
into pimples at first of a firm consistency, but as they grow
become softer and more friable. Their growth is slow. In
six months to one year they can involve most of the prepuce
and penis. Examination of the inguinal lymph glands often
reveals enlargement and secondary changes.
Diagnosis.— This must be based mainly on the infectious
character of the growth (its spread by coition), and its char-
acteristic development.
Prognosis.— The tendency to reappear after removal and
the spread to other animals make the prognosis unfavorable.
Often when the growths are removed from one area they
reappear on another.
Treatment. — Complete removal of the growths surgically
is recommended when possible. On account of the tendency
to recur, they should be completely dissected out, even includ-
ing some of the normal mucosa. It is advisable to cauterize
the surface after their removal, and to treat the wounds with
antiseptics. In all cases the patient must be closely observed
and at the first sign of recurrence of the growths, promptly
operated. In advanced cases, with extensive involvement
of both the penis and prepuce, and where general symptoms
of emaciation and weakness are present, the penis should
be amputated even including a portion of the prepuce.
CHAPTER II.
DISEASES OF THE TESTES AND SCROTUM.
WOUNDS AND INJURIES OF THE TESTES AND SCROTUM.
In the dog and cat wounds and injuries of these organs
are of frequent occurrence, partly accidental and partly
intentional. Attempts at castration with the escape of the
animal before completion of the operation is a common con-
dition. There will be incised wounds of the scrotum and in
some cases even exposure of the testes. Bites from other
animals, such as dogs, cats, and rats, produce a variety of
wounds and injuries to the testes. Being run over by vehicles
is a common source of injury to these organs.
Symptoms.— Hemorrhage from the scrotum will be noted
in the case of wounds, which should always be examined
carefully to determine the extent of the injury. Contused
wounds or bruises are always characterized by swelling,
stiffness, straddling gait, and pain on manipulating the testes.
Prognosis.— Wounds in this location are not as a rule
unfavorable, although, if extensive, castration of the animal
may be necessary. Slight wounds heal rapidly.
Treatment.— Small, incised wounds of the scrotum should
be. cleansed thoroughly with antiseptics, at least once daily.
If the wound is recent it should be cleansed, the hemorrhage
controlled, and sutured. Cover the sutures with an imper-
vious dressing like flexible collodion.
In case the testicles are exposed, they should be removed.
(See Castration.) Contusions must be treated as in orchitis.
ORCHITIS.
Definition.— An inflammation of one or both testicles.
Etiology.— Orchitis occurs in the dog and cat from bruises,
or bites of other animals. Being run over by vehicles is a
272 DISEASES OF THE TESTES AND SCROTUM
cause. Orchitis may be a sequel to wound infection, to
distemper in the dog and cat, and the spread of infection
from adjacent organs and tissues.
Symptoms.— The first symptoms noticed are those of
enlargement of one or both testes; pain on manipulation of
the organs; and a stiff, straddling gait. We should not mis-
take thickening of the scrotiun, a common condition in old
dogs, for orchitis. If due to infection there will be more or
less elevation of temperature, and other symptoms of the
primary condition. The local temperature is also increased.
Prognosis. — In orchitis from injuries, most cases terminate
favorably. In the infective form the gland may be destroyed,
or becomes chronic and the patient impotent.
Treatment.— In the early stages cold packs should be
applied, as cold water or a small sack filled with cracked ice.
The ice or water pack can be held in place by a bandage
passed around the abdomen just anterior to the pelvis, and
fastened over the back and between the limbs. It should be
renewed after a few hours to keep up the refrigeration. After
the swelling and pain have subsided, the pack can be gradu-
ally discontinued.
In subacute or chronic cases of orchitis, hot packs are
indicated, best in the form of hot water, applied in the same
manner as above. Massaging with a small amount of anti-
septic ointment is recommended, following the hot packs.
In the infective form hot packs should be used with hot
water to which has been added some antiseptic. Abscesses
must be opened and treated with antiseptics. Should they
involve the testicles it is best to remove them. (See Cas-
tration.)
TUMORS OF THE SCROTUM AND TESTES.
Several forms of tumors are found in these organs:
(a) Fibromata.— In old dogs a marked thickening of the
scrotum is common. It is due either to an eczema, or from
the constant irritation from sitting on the testicles. The
latter is characterized by absence of hair on the scrotum, the
CASTRATION— ORCHECTOMY 273
presence of a dark, thickened pad of tissue, and the increase
in the size of the scrotum.
Fibroid thickening of the stroma of the glands is observed
as a sequel to orchitis of different forms. The glands have lost
their normal resiliency, are hard and non-sensitive. After a
time the animal becomes impotent and the glands atrophic.
(6) Retention cysts are found occasionally in the testicles
of the cat and dog. They are characterized by the increase
in size of the testicles, and by their soft, elastic feel. A small
exploring needle can be used to determine their contents.
(c) Sarcomata and carcinomata occur occasionally in the
testicles, as secondary growths from other parts of the body.
These may develop as unilateral or bilateral tumors. Most
cases observed have been unilateral-. They are characterized
by their rapid growth, their irregular outline, adhesions
between the testicles and the scrotum, and their enormous
size in some cases. They are always accompanied by acute
inflammatory symptoms.
Treatment.— Castration is the best means of relief, even in
the malignant form.
PARASITES IN THE SCROTUM AND TESTES.
Cuter ebra Emasculator.
In some localities a fly (Cuterebra emasculator) has been
observed which makes punctures in the scrotum in which
its eggs are deposited. The larvae develop and induce a
reactive inflammation which leads eventually to swelling
and destruction of the testicles. The infestation has been
observed in several species of animal; it is quite common in
squirrels in certain districts. Castration of the animal, or if
found early the removal of the larva1, is recommended.
CASTRATION. ORCHECTOMY.
In the dog and cat castration is performed in some cases
to relieve pathological conditions of the testicles; in others
as a remedial measure in enlargement of the prostate gland
(chronic prostatitis). It has been proved quite conclusively
18
274 DISEASES OF THE TESTES AND SCROTUM
that enlarged prostates in the dog are materially reduced
by castration. The operation is also quite extensively
practiced in cases where the organs are normal, but to correct
vicious habits (onanism) or a disposition to wander away
from home.
In chickens castration, or caponizing, is becoming quite
general in certain sections. It not only changes the disposi-
tion and habits of the birds, but makes them develop more
rapidly. They become much larger, and the texture of the
flesh much finer. Hence the operation is of considerable
economic importance.
Castration of the Dog.— The operation can be performed
at almost any age, but is less dangerous before the dog reaches
maturity. Between the ages of three to ten months the
operation is safest as it causes less constitutional disturbance
during the early period of the animal's life. The disposition
of the animal is changed less, and there is not the tendency
to obesity when castration is performed at an early age.
However, when pathological conditions, onanism, etc., exist
the operation may be performed at any time.
When the testicles are found in the scrotum, the operation
is as follows: The animal is anesthetized by using morphin
0.06-0.2 subcutaneously, or chloroform inhalation. Place
the patient in a dorsal position, with head lowered, and hind
limbs spread apart on the table. This exposes the testicles
and makes them easy of access. The scrotum should be
thoroughly scrubbed with soap and water, followed by
liberal use of antiseptics. The testicles are grasped between
the thumb and index finger of the left hand and gentle pres-
sure used to make the scrotum tense. With a scalpel or
castrating knife in the right hand, an incision is made parallel
to the long axis of the testicle, cutting through the tunica
propia. The testicle is grasped with the right hand which
exposes to view the epididymis and tunica reflexa. There
are several methods used to remove the testicles. The cord
may be ligated above the epididymis and tunica reflexa by
using a sterile, silk ligature (No. 10). This is a safe method,
as it removes the possibility of hemorrhage, provided the
ligature is securely applied. The other testicle is removed
C ASTRA TION—ORCHECTOM Y 275
in the same manner. The emasculator also gives excellent
results. The instrument should be allowed to remain in
position for a few moments after the cord is severed. Occa-
sionally hemorrhage will follow the emasculator, but is
usually not serious. If severe, the vessels should be ligated.
After the testicles are removed the wound in the scrotum
may be left open, or a retaining suture put in to prevent the
entrance of foreign material. The incisions in the scrotum
should be carried forward sufficiently to afford thorough
drainage. The scrotum should be kept clean for a few days,
and the wound washed with antiseptics. Union takes place
in a week or ten days. It is well to observe the animal, note
the temperature and pulse for a few days, and if the tem-
perature is found elevated, examine the scrotal wound for
retention of pus and secretions.
Castration of the Monorchid and Cryptorchid Dog.— In
monorchids one testicle is removed the same as in ordinary
castration. The retained testicle in the abdominal cavity
must be removed by making an incision through the abdom-
inal walls about two to four inches anterior to the pubis, and
to one side of the penis (note the side of retention!). The
incision is made large enough to admit the index finger freely.
The cord is then searched for in the sublumbar region, and
when found, withdrawn through the opening, the testicle
following. The cord may be ligated or the operation per-
formed with the emasculator. The abdominal wound is
approximated with two or three interrupted sutures. An
antiseptic pack and bandage should be applied to protect the
wound and changed daily until healing takes place. The
bandage is applied so that it does not interfere with micturi-
tion. Cryptorchids are operated in the same manner; both
testicles may be removed through one opening, or two
abdominal incisions made if found necessary. The patient
should be properly prepared by dieting and administering a
laxative twenty-four hours before the operation.
Castration of the Cat.— The same rules in regard to age,
etc., apply as in the dog. Castration of the cat is best per-
formed under complete anesthesia. The animal is placed
on the table in the dorsal position, well hoppled and stretched
276 DISEASES OF THE TESTES AND SCROTUM
out so that it cannot squirm loose. Ether is administered
until complete anesthesia is established. The hair is clipped
off with a scissors, and the scrotum washed with soap and
water and boric acid (2 per cent.) solution.
The testicles are grasped between the thumb and index
finger of the left hand, and with the other hand a scalpel is
used to make the scrotal incision. Two methods of removal
are used :
The first method is to make the incision down to the
testicle exposing it, pulling it out of the scrotal sac, and
removing it with the emasculator or by ligation. Care should
be taken in this method to pull the testicle up far enough to
include the epididymis and tunica reflexa. The other testicle
may be removed in a similar manner.
The second method is to perform the "covered" operation.
This is done in much the same manner as the other operation,
except that the incision is made down to the tunica vaginalis
which is not incised but drawn out with the testicle. The
cord, including the tunica vaginalis, is then ligated above
the epididymis, and the testicle and its enveloping tunic
removed. Hemorrhage and infection are not so liable to
follow this method.
Castration of Birds.— Caponizing.— Castration is com-
monly practiced on male fowls. A castrated rooster is called
a capon. The best results are obtained by operating on the
early hatched birds as it gives them more time for develop-
ment. Two to three months is the best age to operate. When
the bird reaches the age of four or five months the mortality
is much higher and the male characteristics more pronounced.
The fowl is restrained on an operating table, barrel, or box
with a cord looped around the wing and one around the legs,
to each of which a one or two pound weight is attached. The
bird is then laid on its right side; the weights serve to hold
it in position. Other mechanical devices made and used for
this purpose have proved satisfactory. The instruments for
this operation are made up in special sets known as caponizing
sets. A set consists of a scalpel for making the abdominal
incision, spreaders or retractors for keeping the abdominal
CASTRATION— ORCHECTOM Y 277
wound open, and a special, spoon-like hook for removing the
testicles.
The technic of the operation is as follows: The feathers
are plucked from the field of operation, which is between the
last two ribs extending from the cartilage of prolongation of
the ribs to a point about one-half to one and a half inches from
the back. The skin over this region should be disinfected,
best by painting with tincture of iodin. The incision is then
made through the abdominal wall observing the following
points:
The skin should be pulled to one side before the incision is
made, so that following the operation, the skin and deeper
wounds will not cover one another.
The incision should follow closely the border of the last
rib in order to avoid cutting the intercostal artery, ("are
must be taken to avoid injuring the cartilages of prolongation
of the last ribs. Should they be cut, which is easily done, the
healing of the wound will be delayed. Further, the incision
through the walls should be made carefully to avoid punctur-
ing the lungs.
After the retractors are placed in position, and the incision
dilated, the testicles are located just anterior to the kidney.
The upper one will be found without difficulty; the lower one
is brought into view by separating the mesentery with the
handle of the scalpel or other blunt instrument immediately
below the upper testicle. Remove the lower testicle first.
The spoon-hook or scoop is applied around the testicle by
being slipped over the spermatic cord. Care should be taken
to prevent injury to the large bloodvessels. The testicle is
removed by torsion. A few turns of the instrument will sever
the testicle from its attachments when it can be lifted out.
The other testicle is then removed in a similar mariner. The
entire testicle should be removed, for if a portion is left in the
fowl will develop into what is commonly known as a "slip"
and the object of the operation defeated. After the spreaders
or retractors are removed the ribs will assume their normal
position closing the incision. Xo further treatment of the
wound is necessarv; it closes without difficulty in a week or
278 DISEASES OF THE TESTES AND SCROTUM
ten days. The operated birds must be kept quiet for a few
days following the operation, and fed a light diet. The wound
should be observed occasionally until complete union takes
place. In a few cases collections of air under the skin, form-
ing "wind puffs," will develop. If these occur they are
opened and the air forced out. The mortality from caponiz-
ing should not exceed 1 per cent.
CHAPTER III.
DISEASES OF THE PROSTATE GLAND.
Examination.— In the dog this gland is best examined by
digital palpation, and in some cases, when the gland is much
enlarged, by palpation through the abdominal walls. The
finger is inserted in the rectum and if any enlargements are
present they can be distinctly felt by pressing in a downward
direction; if acute inflammation is present the slightest
pressure will produce severe pain.
PROSTATITIS.
Definition. —An acute or chronic inflammation of the pros-
tate gland. In the dog this disease is nearly always found to
be of a subacute or chronic type. Acute prostatitis is very
rare in these animals.
Etiology.— Prostatitis is produced by microbic invasion,
either via the urinary tract, the blood or lymph streams. It
may occur from the spread of the inflammation from other
portions of the urinary tract.
Symptoms.— Prostatitis usually develops gradually. The
early symptoms are painful defecation and micturition.
The animal will make frequent attempts at urinating, the
urine voided in small quantities, or there may be complete
suppression. Defecation is painful; sometimes impossible.
The bladder is found distended. The passage of the catheter
is often difficult due to the pressure of the enlarged glands
upon the urethra. Gentle pressure on the catheter will cause
pain, but in most cases it will gradually pass through the
constricted portion into the bladder. The urine will then
flow out.
Digital examination with the index finger inserted in the
rectum will reveal the enlarged glands. Should pus be present
in the glands they will be somewhat soft and fluctuating.
280 DISEASES OF THE PROSTATE GLAND
The abscesses sometimes rupture, either into the urethra,
the abdominal cavity or through the skin in the perineal
region.
More or less irregularity in the temperature is noted.
Prognosis.— Although complete recovery cannot be hoped
for, owing to the changes which have taken place in the
glands, partial recovery is possible.
Treatment. — M edical.— Purgatives should be administered
at once, such as castor oil (15.0-30.0) or magnesium sulphate
(8.0-15.0). Small doses of morphin may be given in case
pain is severe.
Surgical.— The bladder is examined and if found distended,
the catheter should be passed and the urine withdrawn. If
this is impossible, on account of the compression of the
urethra, immediate puncture of the bladder with a trocar
may be made. The prostate gland must be examined care-
fully, and if found fluctuated, indicating abscess formation,
make an attempt to relieve it by pressure with the finger
inserted into the rectum. This method is often satisfactory.
Should this fail, a long exploring trocar is introduced into
the gland either through the rectal wall or through the peri-
neum. In either case the finger should be retained in the
rectum to guide the insertion of the trocar, and also to exert
some pressure on the gland to force the contents out. Pros-
tatic abscesses are sometimes found with an opening out
through the perineum. The opening should be enlarged
sufficiently to afford good drainage, and syringed out with
an antiseptic solution. Rupture of the abscess into the peri-
toneal cavity results in peritonitis, and death in a short time.
TUMORS OF THE PROSTATE GLAND.
Hypertrophy of the Prostate Gland.
Hypertrophy is common in old dogs, and is occasionally
observed in young animals. In hypertrophy, the normal
glandular tissue is gradually replaced by fibrous connective
tissue, which leads to an atrophy of the tubules and muscle
fibers greatly increasing in the stroma of the gland. The
gland gradually loses its function of secretion, becomes much
TUMORS OF THE PROSTATE (1LAXD 2X1
larger, and firmer than normal. In the dog the prostate
gland lies at the neck of the bladder, almost surrounding the
urethra, and when hypertrophied it causes compression of
the urethra making the passage of urine difficult.
Symptoms.— The most pronounced symptoms of hyper-
trophy of the prostate gland are: Obstruction to the passage
of urine. The animal makes frequent attempts to urinate
but either only a small quantity or none at all is passed. The
straining induced may cause hematuria. The hemorrhage
results from the pressure on the venous plexus of the gland
exerted by the hypertrophic tissue. The bladder will be
found distended and the animal showing considerable dis-
tress. There is always danger of rupture of the bladder from
overdistention. A complication of conditions is often found
' in these cases of long standing, such as hydronephrosis,
cystitis, etc. Constipation is practically a constant symptom
owing to the interference with defecation. Xo febrile symp-
toms are observed in hypertrophy of the. gland. Passing the
catheter will reveal the urethral obstruction. This may be
so pronounced that it will be impossible to get the catheter
beyond the prostate. It is possible to palpate the enlarged
gland by inserting the finger in the rectum, or in very thin
subjects the gland may be felt through the abdominal walls.
Diagnosis. — The diagnosis is made by observing the symp-
toms, passing the catheter, and digital palpation. We must
differentiate hypertrophy from abscess and inflammation of
the gland. The difference in the temperature, the age of the
animal, the size and consistency of the gland, and the ehron-
icity of the process are indicative.
Prognosis. —The prognosis is unfavorable.
Treatment.— The bladder should be examined, and it'
found distended, emptied either by passing the catheter or
by the use of the trocar.
Laxatives should be given (see Inflammation of the Pros-
tate Gland). Internal administration of potassium iodid
(0.1-0.2) daily has been used with success in some cases.
At the same time injections of Lugol's solution directly into
the gland may be employed. The injection is made with a
small calibered, hypodermic needle, which is inserted into the
282 DISEASES OF THE PROSTATE GLAND
gland, either through the rectum or perineal region, the
syringe attached and the injection made. Two to four c.c.
of the solution are sufficient.
Castration is distinctly remedial as it is followed by a
reduction in the size of the gland. Obviously it cannot be
employed in stud dogs. (See Castration.) Experimentally it
has been proved that in a short time following castration
the gland begins to atrophy. The activity and function of
this gland depends to a large extent upon the function of
the testicles. Some few cases have been successfully treated
by castration.
Sarcomata and carcinomata have been found in this
gland, but are not common. When found, no treatment can
be given.
CHAPTER IV.
DISEASES OF THE OVARIES.
Examination.— Several methods of examination are used
to detect abnormal and pathological conditions of the ovaries.
(a) By abdominal palpation. This method has not proved
very satisfactory on account of the small size of the ovaries,
and the amount of tissue necessary to palpate through. In
emaciated subjects or when glands are enlarged, palpation
is useful. In cats with large ovarian cysts, the cysts may be
felt through the abdominal walls. For abdominal palpation
the animal is placed in a standing position. The manipulator
should stand either immediately in front of or in the rear of
the animal with one hand on either side of the abdomen; the
ovaries may be felt in the sublumbar region. This method
is of value in a general way, but for accurate diagnosis it
does not suffice.
(6) By observing the animal to note any symptoms of
excitement, etc. Cats with ovarian cysts will often show
evidences of nervous excitement, epileptiform convulsions,
etc.
(c) Direct inspection of the ovaries can be made with but
very little danger. Therefore in doubtful cases laparotomy
should be performed and the ovaries examined for inflamma-
tion, tumors, cysts, etc.
INFLAMMATION OF THE OVARIES.
Oophoritis.
Definition.— An acute or chronic inflammation of one or
both ovaries. Oophoritis is not observed very often in
animals. It should not be mistaken for the normal hyperemia
of the glands during the estral period. However, acute and
chronic inflammations are found involving these glands.
284 DISEASES OF THE OVARIES
Etiology.— Results from injuries, such as being run over
by vehicles. The compression of the organs may be suffi-
cient to crush them, or it may lead to inflammation.
Extension of the inflammation from adjacent organs and
tissues, as from the uterus and uterine tubes.
Infection of the ovaries may take place in some of the
infectious diseases (distemper in the dog and cat), or it may
be due to some" non-specific infection carried to the ovaries
by the circulatory system.
Symptoms.— In dogs oophoritis may not be noticed. The
patient will show stiffness in walking and pain on palpation
over the glands. In cases where infection has taken place
in the glands, abscesses may develop, and febrile symptoms
be present. In subacute or chronic inflammations no marked
symptoms will be observed beyond an enlargement of the
glands. In cats epileptiform convulsions may result.
Diagnosis.— In the mild forms an accurate diagnosis is
difficult without making an explorative laparotomy. In
cats it should be differentiated from ovarian cysts. A careful
examination must be made in all cases.
Prognosis.— Favorable, except when produced by infection.
In the chronic form sterility is a common sequel.
Treatment.— Not much treatment is needed. In the severe
forms, or when abscesses are present, it is advisable to remove
the ovaries (oophorectomy).
TUMORS OF THE OVARIES.
Cysts.— Cystic formation in the ovaries is of very frequent
occurrence, and perhaps much more common in cats than
in any of the other animals. They consist in most instances
of unruptured Graafian follicles, and are found either single or
multiple. Unless they are of considerable size they do not
produce any marked symptoms. In fact, where they are fre-
quently found as multiple cysts, and when degeneration of
the ovary has taken place, marked nervous symptoms will
be noted. These are excitement, prolonged estrum, and in
some instances epileptiform convulsions.
OOPHORECTOMY—OVARIECTOMY 285
Diagnosis. —The diagnosis is difficult in most cases. Unless
the cysts are of large size, and the nervous symptoms marked,
the condition is usually not suspected. Laparotomy should
be performed and the ovaries inspected to make the diagnosis
positive. The cysts appear as enlargements projecting from
the ovary. Their consistency is fluctuating; their contents
transparent.
Prognosis.— The prognosis is unfavorable so far as relieving
the condition and preserving the ovary are concerned. The
symptoms can be relieved by removal of the glands.
Treatment. — The treatment is surgical and consists of the
removal of the diseased gland. (See Ovariectomy.)
Other tumor formations in the ovaries are uncommon.
Dermoid cysts have been found in a few instances. Adenoma
and adenocarcinoma occur as secondary growths. When
found the entire gland or glands should be extirpated.
OOPHORECTOMY. OVARIECTOMY.
Oophorectomy is extensively practiced to correct certain
pathological conditions which are found in the ovaries to
suppress the sexual desire and prevent the female from becom-
ing pregnant, and to make more desirable house dogs and
pets as they are more contented and peaceful. Cats, when
operated during the first few months of their life, become
much larger, and are much more desirable animals to have
about the house.
All female animals should be operated if possible before
the advent of the first estrual period, as it has been proved by
experience that some females will continue to show sexual
desire following complete removal of the glands. Such cases
are observed in older females, especially those that have given
birth to young, and these that have estruated normally for
some time. However, we must take into consideration that
in a number of cases where estruation follows removal of the
glands, is due to the fact that a small portion of the ovarian
tissue has been left in, which develops and frequently becomes
cystic.
The effect of this operation on females is worthy of note.
286 DISEASES OF THE OVARIES
Young animals operated before the periods of estrum are
present, show no appreciable change in their development.
They are active, develop regularly, and in every way make
very desirable animals. The most marked change occurs
when older animals are operated. They often become fat,
lazy, and inactive. Certain breeds of animals show these
changed characteristics more than others. For this reason
the operation should be performed before the animal reaches
sexual maturity.
Oophorectomy in the Dog.— This is one of the most fre-
quent operations performed on dogs. It is a safe operation
provided the following precautions are taken into considera-
tion : (a) The operation should be performed when the dog
is about three to five months old, and before it has had an
estrual period. (6) The animal should not be operated during
estruation, notwithstanding the prevailing belief of the laity
to the contrary. As the ovaries and other portions of the
generative tract are congested at this time, the danger of
hemorrhage and inflammation is greater. One should wait
two or three weeks after the period of estruation so that the
organs can return to their normal condition, (c) The prep-
aration of the animal before operating is of special impor-
tance. The bowels should be empty. For this purpose castor
oil (15.0-60.0) should be administered twenty-four hours
previous to the operation. All solid food is withheld, but
small amounts of milk and water only may be allowed. The
field of operation should be prepared twenty-four hours pre-
viously; the hair removed, the skin washed with soap and
water, and an antiseptic pack applied. This pack is best
made of cotton of gauze with boric acid; it is applied to the
operating field and held in place by a special bandage made
of a wide piece of muslin so as to extend from in front of the
forelimbs to a point back of the field of operation, and tied
over the back. This pack should be kept in position until
the animal is ready for the operation. This will ensure a
sterile operating field. As a last precautionary measure,
just previous to making the incision, the operating field is
painted with tincture of iodin. An anesthetic or narcotic
should be given. In the dog various methods of anesthetiza-
OOPHORECTOMY—OVARIECTOMY 287
tion and narcotization have been employed with equally
good results. Morphin given as a subcutaneous injection
about twenty to thirty minutes previous to the operation
has been used with most excellent results. The value in this
method of narcotization lies in the fact that it will cause
vomiting in most cases, defecation in some, removing mate-
rial from the stomach and bowels. Further, it will keep the
animal quiet for several hours following the operation. It
may be considered a perfectly safe narcotic, which to dogs
can be administered in large doses. The amount to be
administered will depend to a great extent upon the size of
the animal. Usually from 0.016-0.2 are to be given.
Chloroform and ether may be used as a general anesthetic;
both are safe when administered properly. After anesthe-
tization the animal should be placed in a dorsal position, well
hoppled and the table tilted to lower the head as much as
possible. This assists the operator, as the bowels will descend
toward the diaphragm which lessens the tendency for them
to protrude through the incision. The incision may be made
either at the median line or in the flank region. There are
good reasons for choosing the median incision. There is less
hemorrhage at this location, it is much easier to locate the
cornua and the removal of both ovaries through one opening
can be done with less difficulty. The exact location for the
incision in the median line is at a point about one to one and
a half inches posterior to the umbilicus. The incision should
be made of sufficient length to allow the index finger to be
inserted, or it may be enlarged so that light can be thrown
into the abdominal cavity. The incision is made through
the skin, separating the muscles down to the peritoneum.
In making the incision through the peritoneum it is best to
pick up a small portion of it with a forceps, nick with the
scissors and enlarge with a probe-pointed knife. By this
procedure injury to the bladder or other abdominal organs
is avoided. The index finger of the right hand is then inserted
through the opening; follow the left abdominal wall pushing
the bowels back until the finger reaches the bottom of the
cavity. At this point the finger will come in contact with the
left cornu, which is hooked over the finger and drawn out of
288 DISEASES OF THE OVARIES
the cavity. Be careful to keep the finger in constant contact
with the abdominal wall so that the cornu will not slip off.
When once outside of the cavity the ovary can be located
easily by following the course of the cornu. The ovary is
distinguished by its consistency. In most cases in the dog
it will be found imbedded in a capsule of fat. There are two
methods of removing the ovary, and the choice of them will
depend somewhat upon the condition of the gland. In young
females, before the ovaries have fully matured, and in older
ones between the periods of estrum, it is safe to remove
them with an emasculator, unless considerable congestion is
present. Where there is danger of hemorrhage, the ligation
method is used. When this method is employed, sterile silk
or linen is best which should be put on securely so that it will
not slip off after removing the ovary. Ligation should be
made at two points, around the cornu posterior to the ovary,
and around the vessels and the broad ligament anterior to
the ovary, ("are must be taken that all of the ovarian tissue
is removed. Otherwise the females will again estruate, and
the success of the operation will be incomplete. \Vhen
removing the gland with the emasculator it must be pulled
up sufficiently so that it will include all of the ovarian tissue.
It is best to allow the instrument to remain in position a few
moments. The cornu is then returned to the cavity. The
other ovary is obtained by inserting the index finger of the
left hand and following along the right abdominal wall as
was done on the opposite side.
The location of the ovaries is not difficult when the animal
is properly prepared. Small, fat patients, with a short abdom-
inal cavity, will present the greatest difficulties. The intro-
duction of a probe or catheter through the vagina may be
used by the beginner.
The abdominal incision is cleansed thoroughly and approxi-
mated by using two or more interrupted sutures. Suturing
the abdominal walls may be done by using two rows of sutures
one row including the peritoneum, and the other the skin and
muscles, or may be closed by a single row including all of the
tissues. This method has proved satisfactory. The abdom-
inal walls should be accurately approximated as it facilitates
adhesions and healing.
POULARDIZING THE FEMALE CHICKEN 289
An antiseptic pack is applied and the regular bandage
used to hold it in place. Dress the wound daily and in four
to six days the sutures may be removed.
Sometimes animals are observed to estruate following
this operation, and in such cases they should be reoperated,
as it results in most instances from a small amount of ovarian
tissue being left in. Cysts will form in such cases leading
to a continuance of the estrual period.
Oophorectomy in the Cat.— Cats are operated to correct
pathological conditions, particularly cystic formations in the
ovaries, which are very common in these animals, and also
to prevent them from becoming pregnant. They should be
operated if possible prior to sexual maturity, and the best
time is between the ages of three and seven months.
The same preparation should be made for the cat as in the
dog. The most satisfactory anesthetic is ether. The opera-
tive technic is the same as in the dog. It has been claimed
that this operation is more dangerous in the cat than in other
animals, but when done under proper conditions the mortality
is very low.
POULARDIZING THE FEMALE CHICKEN.
This operation is performed on the female fowl to prevent
egg formation, and to ensure quick growth and a finer quality
of meat. The operation is not practiced as extensively in
this country as in some of the European countries. Undoubt-
edly, however, the operation will become more popular than
at present.
The best age to operate is after two to three months. The
same preparation should be made as in caponizing. (See
Caponizing.)
The operation is performed as follows: Securely fasten
the bird on a table or other suitable place, and remove the
feathers from the field of operation, which is between the
last two ribs. Thoroughly cleanse and disinfect. The
incision is made between the last two ribs, using the same
precautions as in caponi/ing. Retractors are used to spread
the incision. The egg cluster will come into view at once.
ID
290 DISEASES OF THE OVARIES
A section of about one to .one and a half inches of the oviduct
should be removed with the forceps and scissors. Care must
be taken to prevent injury to the large bloodvessels which
lie in close proximity to the egg cluster. The removal of a
portion of the oviduct prevents further egg production.
After-treatment is the same as for caponizing.
CHAPTER V.
DISEASES OF THE UTERINE TUBES.
Examination.— Examination of the uterine tubes is quite
difficult, except by explorative laparotomy. They should
be examined for inflammation, tumors, cysts, and pus accu-
mulations. In some cases, when the animal is much emaci-
ated, and the tubes large, it is possible to palpate them
through the abdominal wall.
SALPINGITIS.
Definition. — Inflammation of the uterine tubes.
Etiology.— Salpingitis occurs as a secondary condition
following inflammation of other portions of the generative
apparatus.
Symptoms. — The diagnosis is difficult unless laparotomy
is resorted to. Other reproductive organs are usually also
involved complicating the symptoms.
Treatment.— Very little can be done except complete extir-
pation of the affected tubes.
PYOSALPINX.
Pyosalpinx is a purulent inflammation of the uterine tubes.
It is secondary to other diseases of the reproductive organs.
Removal of the uterine tubes is recommended.
TUMORS. CYSTS.
These are found occasionally and when present should
be extirpated.
CHAPTER VI.
DISEASES OF THE UTERUS.
Examination.— There are three principal ways in which
an examination of the uterus may be made : (a) By abdom-
inal palpation; (6) by obtaining the discharge from the uterus
and noting the condition of the vulva and vagina; (c) by
laparotomy.
(a) In abdominal palpation it is possible to determine
various conditions involving the uterus. The patient should
be placed in a standing position. With one hand on either
side of it over the postero-inferior abdominal region, the
operator by gentle pressure with the finger can feel the
uterus when distended, as an elongated, suspended body,,
within the abdominal cavity. Palpation may be used to
detect pregnancy, pyometra, hydrometra, tumors and inflam-
mation. Sometimes in order to differentiate between these
conditions it is necessary to make a general examination of
the animal.
(6) In some of the conditions involving the uterus, there
is a discharge from the vulva. The discharge should be
collected and examined carefully, noting whether or not it
consists of blood, mucus, pus, membranes, bacteria, etc.
The microscope may be employed if necessary.
(c) By laparotomy it is possible to make a direct inspec-
tion of the uterus. It is advisable when there is evidence of
serious involvement of the organ, and where the diagnosis
is in doubt. The incision through the abdominal walls is
made in the median line just anterior to the pubis, extend-
ing forward a sufficient distance to allow the uterus to be
drawn out. The uterus may be enlarged. The external or
serous covering should be observed for evidences of inflam-
mation, hemorrhage, and rents or tears in the walls, Note
METRITIS 293
the relative size of the two cornua, as compared to the size
of the body of the uterus, their position and attachments.
Tumors, pregnancy, etc., should be looked for. The con-
sistency of the organ is important as it is modified by the
character of its contents, whether fluid, or solid material.
The entire organ should be carefully palpated for differential
diagnosis between pregnancy, tumors, proliferative or fibroid
endometritis, pyometra, hydrometra, etc. After a careful
examination the uterus may be returned to the cavity or
operated as the condition indicates.
METRITIS.
Definition.— An inflammation of the uterus which may be
(«) acute, or (6) chronic.
Acute Metritis.— Definition.— An acute inflammation of the
uterus. In most instances it is to be regarded as an acute
inflammation of the mucosa (acute endometritis). In some
cases the musculature and serous coverings are involved
(metroperitonitis) .
Etiology.— Metritis is a condition in which infection of
various kinds is found to be the primary etiologies! factor.
There are various conditions which occur in small animals
that favor uterine infection and ultimately lead to an acute
inflammation. These are: (a) The retention of the fetal
envelopes. If not expelled after the normal time has elapsed
they constitute a source of danger to the animal, as they
form a favorable medium for the growth of bacteria. The
retained membranes keep the cervix of the uterus open,
which favors the introduction of bacteria, and interferes with
the normal involution of the organ. Retained placenta is
not so common in small animals as the membranes are
usually passed with the fetus.
(6) Infection is introduced into the uterus at the time of
parturition by the use of infected instruments or ringers
used in cases of dystocia.
(c) Wounds of the mucosa of the vagina and uterus
greatly facilitate the entrance of infection. Depending upon
their depth, wounds may lead to metroperitonitis.
294 DISEASES OF THE UTERUS
(d) The retention of a fetus or fetuses which decompose,
irritate the mucosa, and, if allowed to remain for a long period,
often produce grave symptoms of local inflammation and
sapremia. In some cases the uterine mucosa is greatly
changed by the infection. The uterus may be converted
into a cavity filled with pus (pyometra) .
(e) Slowness in the involution of the uterus from lack of
muscular tone favors the introduction and development of
infection. For the same reason individuals weakened from
delayed parturition, systemic diseases, etc., are predisposed.
(/) In bitches and cats that are kept in cold, damp kennels,
metritis is occasionally observed, and no doubt results from
the general reduction in resistance, and from the weakened
condition of the highly sensitive reproductive organs. This
favors the development of microorganisms.
(g) In small animals injuries of various sorts are common,
such as being kicked, run over by vehicles, or roughly
handled by persons, especially during the latter stages of
pregnancy. The uterus may be injured, sometimes torn or
lacerated, and inflammation with infection is the common
sequel.
Pathology.— In fatal cases of acute metritis, marked patho-
logical changes are observed in the generative tract, and par-
ticularly in the uterus. The uterus is dark colored, in some
cases almost black, the mucosa showing necrotic areas. In
some instances the necrosis extends to the other tissues of
the walls of the uterus causing perforations. The walls of
the uterus are thickened, edematous; the serous covering
is often inflamed as are the adjacent organs and tissues in
contact with it. Occasionally abscesses are found in the
uterine walls, or in the surrounding tissues. In the virulent
cases of metritis there will be found evidences of thrombosis
of the bloodvessels of the uterus, leading to embolisms in the
vessels in distant parts of the body, producing in some cases
pyemic arthritis, etc. The vulva and vagina are swollen and
necrotic, and a greenish colored exudate of offensive odor is
present. The other organs and tissues will show the usual
postmortem lesions of septicemia or pyemia. The blood is
dark colored and fails to coagulate. The kidneys and liver
METRITIS 295
are soft and congested. The musculature in general is pale,
friable and soft.
Symptoms.— The first indication of metritis is a marked
swelling and congestion of the vulva. On(digital examination
the parts will be found sensitive, very hot, and present on the
mucosa a greenish or brown or blood-stained discharge which
has a very fetid odor.
The vagina is swollen, very hot, and in the early stages,
reddened and congested. Later it becomes dark or dark
bluish, and in some cases almost black in color, with a foul
smelling exudate. This discharge is more copious at times,
as it is forced out of the uterus at different intervals.
Frequently the animal shows marked symptoms of strain-
ing, the abdominal muscles become tense, and quantities
of a thick, dark colored exudate are discharged from the
vulva.
The temperature during the early stages is elevated
(106° F.). Later, as the toxins are absorbed, the tempera-
ture drops to normal, often subnormal.
There are general symptoms of suppression of appetite,
vomiting, general stiffness in walking and pain on palpation
over the region of the uterus. The animal in most instances
assumes the recumbent position.
In mild cases the symptoms will gradually disappear and
terminate in complete recovery, or in chronic metritis.
Diagnosis.— The condition appearing as it does following
parturition, with the characteristic discharge from the vulva,
and the painful and sensitive condition of the uterus, makes
the diagnosis rather easy. Careful examination should be
made in all cases to establish a correct diagnosis and espe-
cially to differentiate acute metritis from puerperal septicemia
and pyometra.
Prognosis.— In small animals, owing to the difficulties
encountered in the treatment, and the retention of the
exudate in the cornua, the prognosis is unfavorable. The
milder cases recover but there is always danger, even in the
mild cases, of chronic metritis or pyometra developing.
Treatment.— Medical.— Owing to the small uterus and the
long cornua, irrigation is a more difficult problem than in
296 DISEASES OF THE UTERUS
larger animals. However, it should be attempted as good
results often follow thorough irrigation. Boric acid (2 per
cent.) ; creolin (1 per cent.) ; lysol (1 per cent.) ; or theropogen
(2 per cent.) may be used as follows: A small metallic
catheter or flexible human male catheter is inserted into the
uterus and a rubber tube and funnel attached to the free
end. The antiseptic solution is allowed to flow into the
uterus by gravity. After \ to 1 pint of the solution is intro-
duced the tube should be lowered and the fluid allowed to
flow out. The catheter is introduced into each cornua.
This treatment should be applied every three or four hours
to keep up the antiseptic action, to remove the exudate and
to prevent absorption and the resulting general symptoms.
Small doses of ergot or other ecbolics should be adminis-
tered once daily to stimulate the uterus and to hasten its
involution.
Surgical. — In severe forms of acute metritis, and in cases
where medicinal treatment does not relieve, it is advisable
to remove the uterus and ovaries by performing laparo-
hystero-oophorectomy.
Chronic Metritis. — Pyometra.— Definition.— A chronic in-
flammation of the uterus, characterized by the formation
and collection of pus in the uterine cavity. In case the
cervical canal becomes closed, retaining the pus, the uterus
may be converted into a veritable abscess. Chronic metritis
occurs quite frequently in the bitch; less commonly in cats.
It makes its appearance in most cases following parturition,
at any period in the animal's life, but may be found in females
that have never given birth to young.
Etiology. — (a) Commonly a sequel to acute metritis, the
acute symptoms disappearing, leaving behind bacteria of a
low virulence, which keep up a constant irritation to the
inucosa resulting in chronic inflammation with pus formation.
(6) Infection gaining entrance to some portion of the
reproductive organs which may find its way to the uterus
direct, or by extension of the process from other parts or
adjacent tissues, leading to a primary inflammation of
chronic type.
(c) Following parturition it frequently happens that a
METRITIH 297
small portion of the placenta is retained leading to a slowly
developing inflammation with pus formation.
(r/) Injuries of a mild character during parturition, or at
other periods, reduce the general resistance of the animal
and particularly the local resistance of the uterus allowing
infection to develop. In these cases we will often find that
the female has never been pregnant. Such cases tend to
develop into uterine abscess.
(e) Anything which reduces the resistance of the repro-
ductive organs or the animal's general resistance has a
tendency to favor the formation of this condition. Exposure
is a predisposing factor.
Pathology.— The presence of pus in varying quantity in
the uterus. The pus is thick, viscid, dark or reddish, some-
times reddish-gray in color and of offensive odor. The walls
of the uterus are much thickened, dilated, and in some cases
enormously distended with pus (uterine abscess). The
mucosa is dark in color, soft, spongy, and shows numerous
elevations of various sizes. The process can extend into both
cornua. In general the animal will show emaciation, the
muscles are pale, soft and friable. Secondary abscesses are
often observed in the kidneys, liver and lungs.
Symptoms.— The most prominent symptom is the chronic
discharge from the vulva, which varies in quantity, being
more copious at certain times than at others. This is due
to the fact that it accumulates in the uterus until a certain
distention of the organ is reached, when it will be ejected.
The discharge is grayish-red, or dark red in color, and of fetid
odor. It soils the tail, limbs, and hair around the vulva.
In uterine abscess, with occlusion of the cervical canal, the
discharge will be absent.
Enlargement of the Abdomen.— In all cases, and particu-
larly in uterine abscess, there is a marked increase in the
size of the abdominal cavity which may simulate pregnancy.
Careful palpation should be made especially in distention
of the uterus with no discharge from the vulva (uterine
abscess).
General Symptoms.— In all cases of chronic metritis
systemic disturbances are noted. They are general emacia-
298 DISEASES OF THE UTERUS
tion, weakness, rough hair coat, a variable appetite and
temperature.
Diagnosis.— Diagnosis does not present much difficulty
as the symptoms are quite characteristic. Uterine abscess
should be differentiated from pregnancy, distention of the
bladder, ascites, tumors, etc. In doubtful cases, laparotomy
is advisable.
Prognosis.— Usually favorable, especially so when the
animal's condition is still good, and proper treatment pos-
sible. Such animals cannot be used for breeding as the
condition in the uterus, which cannot be entirely relieved,
prevents conception.
Treatment.— Medical treatment is of little value. Irrigation
of the uterus with an antiseptic solution may be tried. How-
ever, surgical treatment is necessary in order to properly over-
come the general symptoms. An early removal of the uterus
and ovaries will prevent metastatic abscesses developing in the
kidneys, liver, etc. The operation is as follows : The animal
should be given a general anesthetic and placed on the oper-
ating table in the dorsal position with head lowered. The
incision is made in the median line, beginning just anterior to
the pubis and extending forward a sufficient distance to allow
the uterus to be drawn out of the abdominal cavity. Sterile
silk ligatures (No. 10) are applied around the broad ligament
at the distal portion of the ovary, and around the uterus
just anterior to the cervix. The ligature around the uterus
should be placed in sections, and then around the entire part
to prevent it from slipping off and fatal hemorrhage resulting.
The entire portion between the ligatures is then separated
with knife or scissors, and the stumps returned to the abdom-
inal cavity. The abdominal incision is cared for in the regular
way.
In case of collapse or weakness following the operation
small doses of strychnin (0.001) should be given.
PUERPERAL SEPTICEMIA.
Definition.— A common disease in small animals in which
either bacteria or their products are introduced into the
PUERPERAL SEPTICEMIA 299
general system. Puerperal septicemia accompanies to a
greater or less extent most forms of septic infection of the
reproductive organs during the puerperal state.
Etiology.— Puerperal septicemia results invariably from
retention of placenta, a fetus or fetuses, or from wounds
acquired during or following parturition. Putrefaction
changes in the retained placenta occur rapidly, other infection
is introduced, and the products of bacteria or the bacteria
themselves are taken into the circulation producing a general
septicemia or sapremia. This disease may follow normal
birth, dystocia, etc.
Pathology. — The changes in the reproductive organs are
often slight as compared to the severity of the symptoms.
The blood is thin, does not coagulate readily. The muscles
are pale, soft and friable. Ecchymoses are observed on the
serous membranes, particularly in the abdominal cavity.
Parenchymatous degeneration is noted in the liver, kidneys
and spleen.
Symptoms.— The symptoms develop rapidly, usually in
from one to three clays following parturition. There is
great depression, the animal lying down most of the time;
elevated temperature (106°-107° F.), increased respirations
and pulse. Later appear great prostration, subnormal tem-
perature, cold extremities, etc.
Locally the generative organs show marked changes in
some cases, such as swelling of the vulva, the mucosa of the
vagina; in others little change will be found. There is nearly
always a copious discharge from the vulva, consisting of a
greenish colored pus, containing shreds of placenta and
other material. This discharge has a very offensive odor.
The bowels are irregular, in some cases constipation will
be present and in others a severe diarrhea. The symptoms
usually increase in intensity, the animal reaching a stage
of coma or collapse. In the milder forms of infection, and
particularly in sapremic conditions, the symptoms gradually
disappear and the animals make a complete recovery.
Diagnosis.— This is made on the sudden onset, the severe
general symptoms, the high temperature in the early stages,
and the characteristic involvement of the reproductive organs.
300 DISEASES OF THE UTERUS
Puerperal septicemia should be differentiated from acute and
chronic metritis which can be made by a careful examination
of the patient.
Prognosis.— The prognosis is unfavorable, most cases ter-
minating fatally. Mild cases often recover; more severe
ones may recover if treatment can be applied early.
Treatment.— Medical.— In cases of marked collapse, sub-
normal temperature, etc., stimulants, such as aromatic
spirits of ammonia, spirits of camphor, oil of camphor, or
strychnin should be administered early.
Surgical.— As local applications in the form of irrigation
with antiseptics have proved unsatisfactory, an early opera-
tion is advised. Before operating obviously the genital
tract should be flushed with antiseptics. The animal should
be anesthetized and operated as in chronic metritis. (See
Chronic Metritis.) Care must be exercised in preventing
infection of the serous membrane of the abdominal cavity.
The stump of the uterus should be inverted and thoroughly
disinfected before it is returned to the abdominal cavity.
The after-treatment is very important, and prompt
remedial agents (stimulants) should be administered.
Irrigation of the vagina should be done at regular intervals
to control local infection. Normal salt solution should be
used in cases of collapse following the operation. It is best
injected intraperitoneally (250 to 500 c.c.).
EVERSION OF THE UTERUS.
Prolapse. Inversion of the Uterus.
Eversion of the uterus is not common in the small, multip-
arous animals, particularly in the dog and cat. The small
uterus and long cornua present an anatomical arrangement
which tends to prevent eversion except in rare instances.
It is occasionally observed in the bitch following parturi-
tion. The eversion in most cases consists of an invagination
of the anterior extremity of the cornu into the succeeding
portion, and should the process continue, it will appear at
the vulva or even project outside. In most cases the pro-
lapsed portion will consist of one cornu and a portion of the
E VERSION OF THE UTERUS 301
uterus. However, in a few instances there .will be found a
complete eversion of both cornua, the body of the uterus and
a portion of the vagina. The prolapse of one cornu through
the uterus usually prevents the other one following.
Symptoms. — The early indications are the expulsive efforts
of the animal, which are very similar to those noted in par-
turition. The animal becomes uneasy, looking at its sides,
licking the vulva, etc. When such symptoms occur following
parturition, the uterus should be examined. The local symp-
toms after the uterus appears at the vulva, are quite charac-
teristic. There is a rounded enlargement between the lips
of the vulva, at first only slightly congested and swollen,
later considerably swollen and changed in colbr to a dark red
or almost black. When the organ has been prolapsed for
some time, the mucosa becomes darker, covered with a thick
greenish or purulent exudate, and in some cases extensively
gangrenous.
General symptoms of anxiety, restlessness, dyspnea,
increased labor pains, and later septicemia are observed.
Diagnosis. — In small animals care should be taken to
differentiate eversion of the uterus from prolapse of the
vagina or its mucosa, tumors, etc. This can be done by
inserting the finger around the periphery of the enlargement
to determine its point of origin. Further, the characteristics
of the prolapsed portion will assist in the diagnosis. In later
stages, when necrosis has developed with much swelling of
adjacent tissues, the diagnosis is more difficult.
Prognosis.— Several things tend to alter the prognosis.
More favorable are those cases of recent development, and
especially before extensive pathological changes have taken
place in the uterus. The prognosis is unfavorable if amputa-
tion of the uterus is necessary on account of the danger of
septicemia. The prognosis is unfavorable from the stand-
point of breeding.
Treatment. — In case the prolapse is of recent development
reposition should be attempted at once. The parts should
be thoroughly cleansed with antiseptics and astringents.
Reposition should be attempted by gentle pressure on the
prolapsed portion. Patience is often necessary to effect
302 DISEASES OF THE UTERUS
reposition. In case this does not succeed, it is advisable to
perform laparotomy under anesthesia, and pull the uterus
back into position. Care should always be taken to avoid
tearing the tissues, and it is best to have an assistant manipu-
late the parts in the vulva, and at the same time exert some
pressure so that the entire prolapsed portion will at the
same time go back into position. It is advisable to suspend
the uterus to the abdominal wall after it has been withdrawn
in order to prevent further prolapsus. This can be done
easily by simply including the serous and muscular coats of
the uterus in the sutures when closing the abdominal walls.
In case the prolapsed portion is necrotic or gangrenous
it should be amputated at once. The parts are cleansed
thoroughly with antiseptics, and the prolapsed portion
drawn out from the vulva until healthy tissue appears. A
ligature is applied around the entire mass as high up as pos-
sible. It should be placed in position by drawing it tight
to avoid postamputation hemorrhage. The mass is then
removed with a scissors or knife. Hemorrhage should be
controlled, if present. The stump is thoroughly washed with
antiseptics and returned to the vagina. The vagina should
be irrigated with antiseptics for a few days following the
operation. The ligated portion will slough away in a few
days.
TORSION OF THE CORNUA UTERI.
This is a condition occurring occasionally in bitches pre-
vious to or at the time of parturition. A twist occurs at the
junction of the cornua with the body of the uterus, prevent-
ing the birth of the fetuses.
Symptoms.— No special symptom of torsion of the cornua
will be observed. It may be necessary to make a careful
examination to reveal the exact condition; in some cases
an explorative laparotomy must be made.
Treatment.— The torsion can be reduced by performing
laparotomy. In case it is found that the circulation has been
so disturbed as to cause necrosis, it will be best to amputate
the entire organ.
TUMORS OF THE UTERUS 303
RUPTURE OF THE UTERUS.
Rupture of the uterus has been observed in both the bitch
and cat. It may be due to unequal uterine contractions, or
to the rough use of instruments at parturition.
The rupture may be small, simply allowing some of the
fluids from the uterus to escape into the abdominal cavity,
or may be of sufficient size to allow the fetus to pass through.
This is usually a serious condition on account of the infection
getting into the abdominal cavity, producing septic peri-
tonitis.
Symptoms.— The stoppage of the labor pains, and the
sudden prostration of the animal are the most characteristic
symptoms. Examination should be made by inserting the
finger through the vagina into the uterus and at the same
time with the other hand pushing upward and backward on
the fetus. If there is membrane between the fetus and finger,
one should suspect that the fetus is in the abdominal cavity.
Laparotomy should be performed at once to make a positive
diagnosis.
Prognosis.— The prognosis is unfavorable owing to the
danger of peritonitis.
Treatment.— Prompt surgical treatment should be given.
The fetus and membranes should at once be removed, and
the abdominal cavity flushed thoroughly with normal salt
solution. The rent in the uterus is closed with Lembert
sutures. Gauze is placed between two of the sutures in the
abdominal wall to afford drainage. In thirty-six hours this
may be removed.
TUMORS OF THE UTERUS.
Various forms of tumors have been observed involving the
uterus in the bitch and cat. The usual varieties are : Fibro-
mata, myomata, cysts, and hydrometra. Malignant neo-
plasms are very rare.
Fibromata.— These are benign tumors found involving the
muscular wall of the uterus. In the majority of instances
they consist in part of fibrous tissue, and myomatous ele-
304 DISEASES OF THE UTERUS
ments. In older animals there is a preponderance of fibrous
tissue. They develop gradually within the muscular walls,
and project into the lumen of the organ in some cases, while
in others the growth is mainly toward the peritoneal cavity.
When extensive, and when the growth is toward the lumen
of the organ, they may be found projecting through the os
into the vagina. They are characterized by their slow devel-
opment.
Symptoms.— The first indication of the presence of fibro-
mata will be an increase in the size of the abdomen, simulat-
ing pregnancy. However, on examination by palpation, the
difference will be apparent at once. Frequently on inserting
the finger into the vagina the tumor will be recognized, and
it should be observed whether the tumor projects from the os,
or is attached to the vaginal wall. No general disturbances
are noted, except when the tumor becomes of sufficient size
to interfere with the function of the abdominal or thoracic
organs.
Diagnosis.— The enlargement of the abdomen, which comes
on gradually, the lack of general symptoms, and the location
of the enlargement differentiate it from pregnancy. Further,
through laparotomy the uterus may be examined direct.
Prognosis. —Favorable.
Treatment. — Surgical. — Surgical interference by complete
removal of the uterus and ovaries is indicated. When the
tumors are found projecting through the os into the vagina,
they should be withdrawn into the abdominal cavity and
extirpated.
Myomata. —In myomatous tumors of the muscular walls
of the uterus, the symptoms, diagnosis, and treatment are
the same as for fibromatous.
Hydrometra. Definition.— A collection of transudate or
other sterile fluid in the uterus.
Etiology.— Occlusion of the cervix, or any portion of the
uterus which prevents the escape of fluid.
Inflammation of the cervix (endocervicitis) resulting from
wounds and injuries during parturition.
Pressure of inguinal hernia producing occlusion.
It may be produced by ligation of the uterus, as is done
DYSTOCIA 305
occasionally to prevent pregnancy. It may develop as a
simple hydrometra, in which case there will be no serious
effects upon the animal.
Symptoms.— Distention of the abdomen^ which becomes
pronounced and simulates pregnancy. Its persistence and
the absence of lactation differentiate it from pregnancy,
however. There are no general symptoms, no pain on manip-
ulation of the abdomen, and no change in the other parts
of the reproductive organs.
Diagnosis.— Hydrometra should not be confused with
pregnancy, tumors of the uterus, ascites, and pyometra. A
laparotomy may be necessary to make an accurate diagnosis.
Prognosis. —Favorable.
Treatment.— If due to an inguinal hernia, a surgical opera-
tion is necessary for relief. In other cases the entire uterus
together with the ovaries should be removed.
DYSTOCIA.
Definition.— Difficult parturition. Dystocia is of frequent
occurrence in the bitch and cat.
Etiology.— Many etiological factors produce dystocia:
1 . In a mechanical way we find numerous obstacles which
interfere with the expulsion of the fetus.
(a) Lack of expelling power of the uterine muscles. This
is frequently due to general weakness, anemia, etc.
(6) A narrow and undilatable pelvic canal, which is too
small for the fetus to pass.
(c) Constriction of the os uteri, which prevents the pas-
sage of the fetus.
(d) Torsion or displacement of the uterus, closing the
uterine exit.
(e) Abnormal development of one or more of the fetuses
which are too large to pass through the pelvic canal.
(/) Malpresentation or position of the fetus which pre-
vents it entering or passing through the pelvic canal.
(g) Deformity or abnormality in the development of the
fetus. In some instances, as in hydrocephalus, ascites, or
20
306 DISEASES OF THE UTERUS
monstrosities, they are too large to pass through the pelvic
canal.
(h) There is frequently a narrowing of the pelvic canal
from tumors in the vagina, fractures of the pelvic bones with
enlargement, etc.
2. It has been observed frequently that environment has
a great deal to do with producing dystocia in the bitch.
Animals that are kept closely confined, fed highly nutritious
food, and are not exercised, are more predisposed to parturi-
tion difficulties. Some breeds are more often affected than
others, perhaps due in most cases to the manner in which
they are cared for.
3. Mating animals of extremes in size, particularly a small
female bred to large male. The young will be too large in
some cases to be expelled.
4. Young females at the first birth are more commonly
affected with dystocia than at later periods.
5. Females when bred before reaching complete maturity
often will have difficulty at the time of parturition.
Symptoms.— In normal parturition it requires from three
to thirty-six hours for the birth of the young. It depends
somewhat on the number of fetuses, and the condition of the
animal. Therefore it is sometimes difficult to determine
accurately the time at which dystocia begins. The principal
symptoms of dystocia are: Extreme restlessness; severe labor
pains at first, later their cessation; discharge from the
vagina; general weakness.
Examination of the patient will determine the condition.
The following examination should be made in these cases:
Note the general condition in regard to pulse, respiration
and temperature. Note the physical condition.
Palpate the abdominal region to determine whether any
young are present. Differentiate between the presence of
fetuses and other enlargements commonly found in this
location.
Note the condition of the external genitals; the discharge
from the vulva. I )isinfect the fingers and palpate through the
vagina. If the fetus has been presented at the pelvic inlet,
it can be felt. If still in the uterus it mav not be determined
DYSTOCIA 307
by vaginal palpation. In palpating note the condition of the
pelvic canal, whether constricted, tumors present, etc.
Diagnosis. — If the labor pains are normal and no impedi-
ment to the passage of the young through the pelvic canal is
apparent, and the animal is in good physical condition, we
should allow more time to elapse before assuming it to be a
case of dystocia. However, if the animal is weak, the general
condition disturbed, labor pains absent, etc., we are justified
in diagnosing dystocia.
Prognosis.— Favorable in most cases. Will depend upon
(a) the condition of the animal, (6) the length of time in
labor, and (c) the condition of the fetus and membranes.
Treatment.— A thorough examination of the patient should
be made at once to determine the proper treatment to use.
There are three lines of treatment recommended in dystocia.
Medical.— This is indicated in cases when there is no
apparent impediment to the passage of the fetus, and when
the labor pains are weak and insufficient. Extract of ergot
(0.5-2.0) or pituitrin (3.0-10.0) depending on the size of the
animal may be given. These doses may be repeated in a few
hours if necessary. Pituitrin is being used quite successfully
in such cases.
Forced Extraction of the Fetus. — Examination is made of
the condition of the birth canal and the position of the fetus
noted. Various forms of instruments have been recom-
mended for this work. Perhaps the most satisfactory ones
are the smallest forceps, a rather blunt vulsellum forceps,
and a wire snare. These instruments should be thoroughly
disinfected, and the vagina washed with an antiseptic and
lubricant solution (creolin, 2 per cent.; lysol, 1 per cent.).
The method of manipulation will depend upon the position,
presentation, and condition of the fetus. All manipulating
with the instruments should be done carefully to avoid injur-
ing the vaginal mucosa. An assistant who exerts pressure
on the abdominal walls in a backward direction will often
help in keeping the fetus in position until the instrument is
firmly attached. Gentle traction should be used. This
method when done carefully will often overcome the diffi-
cult v.
308 DISEASES OF THE UTERUS
Hysterotomy.—Aher examination of the patient it is found
that it is impossible for the fetus to be born, or after the other
methods of treatment have failed, it is advisable to perform
hysterotomy as early as possible. Delay in performing the
operation is often fatal on account of the infection in the
uterus from resulting sapremia or septicemia.
The animal is anesthetized, placed on the table in a dorsal
position, well hoppled. An incision is made through the
abdominal walls in the median line just anterior to the pubis
and extended forward about three to four inches. The uterus
will at once be seen as a voluminous body. It is withdrawn
carefully from the cavity well surrounded by sterile gauze
to prevent fluids from flowing back into the abdominal
cavity. An incision is made through the walls of the uterus
of sufficient size to allow the fetus or fetuses to be withdrawn.
If there should be any fetus in either of the cornua they can
be removed through the same opening. The membranes
and any other material should be removed from the uterus.
The incision in the uterus is closed with Lembert sutures and
returned to the abdominal cavity. The abdominal incision
closed as usual.
General stimulants should be administered following the
operation.
Hysterectomy is advisable in cases where there is evidence
of puerperal infection. (See Chronic Metritis.)
CHAPTER VII.
DISEASES OF THE VAGINA AND VULVA.
Examination.— It is possible to make a thorough examina-
tion of the vagina and vulva by direct inspection. The animal
should be placed in a dorsal position with the hind limbs
hoppled forward. The vulva can be inspected directly by
separating the labia with the fingers. The condition of the
mucosa should be observed, any wounds or injuries carefully
examined to determine their depth and extent. Note the
color of the mucosa. It should be remembered that in the
bitch there is often a normal pigmentation of the mucosa
which should not be mistaken for some diseased condition.
Papillomata and fibromata are commonly found at the junc-
ture of the skin and mucous membrane. The vagina may be
inspected by using a speculum to dilate the vulva and a
portion of the vagina so that the mucosa can be seen. It is
best to use an artificial light with a reflector to observe the
mucosa farther into the pelvic canal. The mucosa should
be examined for wounds and injuries which are common
sequels to dystocia, inflammation, tumors, prolapsus, con-
strictions, etc.
CONGENITAL MALFORMATIONS.
Various forms of malformations have been observed in the
bitch and cat. Stenosis of the vagina is seen occasionally.
Imperfect development of the vulva, vagina and anus during
fetal life has been noted. These conditions may interfere
with copulation and impregnation. When found an attempt
should be made to correct them surgically.
VAGINITIS AND VULVITIS.
Definition.— An acute or chronic inflammation of the vagina
and vulva. These are very common conditions found in both
the bitch and cat.
310 DISEASES OF THE VAGINA AND VULVA
Etiology.— Mechanically there are a number of conditions
which bring about inflammation of these parts. Anything
causing bruising of the mucosa will result in an inflammatory
condition varying in degree and depending upon the extent
of the injury. Lacerations and abrasions of the mucosa make
possible the entrance of bacteria with resultant inflamma-
tion. During dystocia, wounds, and lacerations of the vulva
and vagina are very common from rough manipulations and
sharp instruments. At this time the animal's general resist-
ance is materially reduced and serious infection and infiltra-
tion of the tissues can take place. Infection is frequently
introduced by infected fingers or instruments. Another
factor of importance in these cases following dystocia is the
fact that in the extraction of the fetus, or the discharge of
the secretions from the uterus, the vagina is further exposed
to infectious material.
Foreign bodies finding their way into the vagina will pro-
duce inflammatory conditions depending upon the kind of
foreign body and the extent of the injury done by the same.
Tumors in the vaginal wall usually produce a chronic inflam-
mation.
Symptoms.— Acute inflammation of the vulva is apparent
from the swelling of the labia and the congestion of the
mucous membrane. The color of the mucosa is at first red,
later of a bluish, or greenish-black, depending upon the stage
of the inflammatory process. At first there is no discharge,
but later a mucous or mucopurulent discharge is observed.
In acute vaginitis the mucosa will be red in color, swollen,
and in most cases the seat of the injury or infection will be
observed. The animal will be restless, often shows symptoms
of straining as if to urinate. General symptoms of elevation
of temperature, disturbances in the circulation and respira-
tion are often observed from the absorption of the toxins,
or the presence of microorganisms in the blood. In chronic
vaginitis the principal symptom is the chronic, whitish,
purulent discharge from the vulva. Examination reveals
the chronic inflammatory changes of the mucosa of the
vagina and vulva. In most of these cases it is difficult to
make a distinction between the two conditions as they are
nearly always associated except in injuries.
PROLAPSE OF THE VAGINA 311
Diagnosis.— This is made by a direct inspection of the
mucosa.
Prognosis. — Favorable in most cases, unless general symp-
toms of septicemia are present, or in some cases of extensive
laceration of the mucous membrane.
Treatment. —The parts should be thoroughly cleansed with
mild antiseptics (lysol, 2 per cent.), followed by weak solu-
tions of astringents (silver nitrate, 0.25 per cent., or silver
citrate 0.5 per cent.). These applications should be made
daily.
In case any foreign bodies are present, they should be
removed and antiseptic treatment applied. When the vulva
or vagina is found lacerated the extent of the wound should
be determined by probing, all loose fragments removed with
the scissors, and antiseptics used as above.
In gangrenous conditions of the vulva or mucosa, all such
portions must be removed promptly, and the surface treated
thoroughly with antiseptic solutions. It is sometimes neces-
sary in recent wounds of the vulva to apply one or more
sutures to properly approximate the torn edges to prevent
improper union.
PROLAPSE OF THE VAGINA.
A true prolapsus of the vagina is uncommon in small
animals. A hypertrophic condition of a portion of the
mucosa which protrudes through the vulvar opening is
frequently mistaken for prolapsus. This, however, is not a
true prolapsus, but inasmuch as it simulates the condition,
it will be described with prolapsus.
Etiology.— Prolapse of the vagina often results from injuries
during copulation, the penis, which is forcibly withdrawn
before ejaculation has taken place, pulling the vaginal
mucosa out with it.
Results also from severe straining, and from inflammation
of the mucosa. Hypertrophy of the mucosa is observed
frequently in some of the larger breeds, Great Danes, St.
Bernards, and becomes a chronic and especially prominent
following the estrual period. It consists of simply a chronic
• inflammation which is most marked during estruation.
312 DISEASES OF THE VAGINA AND VULVA
Symptoms.— The condition is characterized by an enlarge-
ment appearing at the vulvar opening. At first the prolapsus
is a red, congested mass, which later, on exposure, becomes
dark in color and gangrenous. In hypertrophy of the mucosa
it appears as a rounded enlargement of rather firm consist-
ency projecting through the vulvar opening and coming from
one side of the vaginal wall. In some cases it will remain
outside of the vulva, becoming dark in color and gangrenous
on the surface; or it may not protrude beyond the vulvar
opening and appear only at intervals. Usually there are no
general symptoms. There may be some interference with
micturition.
Diagnosis.— This is not difficult in most cases. A thorough
manual examination should be made to determine the exact
conditions present.
Prognosis. —Favorable.
Treatment.— In prolapsus of the vagina an attempt should
be made to replace it. The parts should be cleansed, disin-
fected and if there is much congestion, astringents (alum, 2
per cent.) may be used. In some cases this will be sufficient,
in others when there is a recurrence of the condition without
necrosis or gangrene, it should be returned and if necessary
held in place by temporary sutures through the labia of the
vulva. They should be placed so that the urine can be
voided. Remove them in twenty-four to forty-eight hours.
When gangrene sets in, amputation of the prolapsed portion
becomes necessary. This is done by grasping the mass and
withdrawing it until the normal mucosa appears. If the
prolapsus involves only a portion of the circumference of the
vagina it may be ligated. The ligature should be inserted
through the base of the mass and drawn securely to control
hemorrhage and stop absorption. In case the vagina is
prolapsed, throughout its whole circumference sectional
suturing will be necessary. Care must be taken in all cases
to avoid injuring the urethra. In hypertrophy of the mucosa
amputation of the mass is necessary. This is done by thor-
ough cleansing and disinfecting the parts, withdrawing the
mass from the vulva, and ligating through its base. The
mass should be removed with the knife or scissors and the
TUMORS OF THE VULVA AND VAGINA 313
stump returned to the vagina. The vagina should be cleansed
daily with antiseptics until the discharge has ceased.
RUPTURE OF THE VAGINA.
During dystocia from rough manipulation, or from sharp
instruments the vagina may be torn or ruptured making at
once an opening into the abdominal cavity. This will allow
septic material to gain entrance which usually produces peri-
tonitis. In some cases after rupture of the vagina, and when
straining is induced, or still present from the dystocia, there
may be a prolapsus of the bladder through the rent. When
this occurs the bladder becomes displaced and projects from
the vulva. It will be recognized as a fluctuating enlargement
appearing suddenly between the labia of the vulva. An
exploring trocar may be used to determine its contents if the
diagnosis is in doubt. Laparotomy should be performed at
once (see Laparotomy) and the displaced organs returned to
their normal position. If possible close the opening in the
vagina. If septic infection has developed little can be done.
TUMORS OF THE VULVA AND VAGINA.
The majority of the neoplasms found in the vulva and
vagina are benign growths consisting in most instances of
fibromata, papillomata, or a mixture of fibromata with
myxomatous, myomatous, or lipomatous elements. Malig-
nant tumors are uncommon in the vagina, but do occur
occasionally as secondary growths, or in the form of venereal
granulomata.
Fibromata.— These are found in most instances projecting
from the walls of the vagina, or from the cervix. They
appear as hard, firm enlargements, usually smooth on the
surface, show no tendency to degeneration or necrosis, except
when they project through the vulva and become irritated
from exposure.
Diagnosis.— Made by the character of the enlargement, its
slow growth and finally by a microscopic examination.
Prognosis. — Favorable in most cases.
314 DISEASES OF THE VAGINA AND VULVA
Treatment. —Complete amputation should be done as early
as possible. Ligation, the same as for hypertrophy of the
mucosa, is perhaps the most satisfactory method.
Papillomata. — These occur at the juncture of the skin
and mucous membrane of the vulva. They appear as small,
rounded, pedunculated (usually) tumors. They often have
a roughened surface.
Treatment.— Papillomata should be removed with the
scissors, and the bases cauterized with silver nitrate. They
rarely reappear.
Sarcomata.— These are found occasionally on the vaginal-
mucosa. They are characterized by their rather rapid
growth, uneven surface, and tendency to spread to adjacent
structures. If possible a small section should be obtained
for microscopic examination.
Treatment.— Treatment is unsatisfactory and should not
be attempted.
Venereal Granulomata.— Venereal granulomata have been
described under venereal granulomata in the male animal.
In the female they appear on the mucosa of the vulva and
at the posterior portion of the vagina. They consist of pro-
gressive neoplasms varying in rapidity of growth.
Treatment. — Complete removal should be attempted,
except in very advanced cases.
CHAPTER VIII.
DISEASES OF THE MAMMARY GLANDS.
Examination.— These glands may be examined by observing
their size, condition, and by palpation to note their consist-
ency or the presence of wounds, inflammation, abscesses, etc.
WOUNDS AND INJURIES OF THE MAMMARY
GLANDS.
In the bitch and cat, wounds and bruises of the mammary
glands are quite common. They result in most instances
from being run over by vehicles, by falling, from bites of
other animals, or the glands may be punctured by sharp
objects. The degree of injury will vary greatly. In some
cases it will consist in a simple, slight contusion of the gland-
ular substance; in others bruising with hemorrhage into the
gland producing a hematoma, and in some cases abscesses
result. A careful examination should be made to determine
the degree and extent of the injury.
Treatment.— The treatment will depend to a great extent
on the condition of the glands. In slight contusions but little
treatment is necessary, while in more extensive bruising,
warm applications should be applied in the form of a warm
antiseptic pack containing lysol (2 per cent.). In open
wounds their extent should be determined and treated with
antiseptics. An antiseptic pack may be applied when the
animal interferes with the wound by biting or licking it
excessively.
When abscesses develop in the gland, they should be
opened freely to allow good drainage and the wound treated
as above. In most cases recovery takes place promptly. If
fistula or necrosis of the gland should develop, it may be
amputated.
316 DISEASES OF THE MAMMARY GLANDS
CONGESTION OF THE MAMMARY GLANDS.
A normal condition occurring at the end of the gestation
period, and during lactation. It has been observed in non-
pregnant and virgin animals. The glands become enlarged,
hot, and sensitive. No treatment is necessary.
MAMMITIS. MASTITIS.
Definition.— An inflammation of the mammary glands.
The inflammation may involve one or more of the glands.
Mastitis is a common condition in bitches and cats shortly
after parturition.
Etiology.— In the majority of cases mastitis is due to infec-
tion. Pyogenic organisms enter usually through the teat
canal to the acini of the gland, and from this point spread to
the perilobular lymphatics.
Premature removal of the young seems to be a predisposing
factor as it permits the milk to collect, congesting the gland
as is often noted in cats. Streptococcus infection of the
mammary glands of the cat has been quite often observed.
It frequently has the appearance of a specific disease appear-
ing as an enzootic in catteries. Wounds and contusions of
the gland will produce mammitis and the degree will depend
upon whether or not there is infection. Chronic mammitis is
observed occasionally in the bitch and cat, resulting either
from acute mammitis, or occurring independently.
Symptoms. — One or more of the mammary glands are
swollen, hot, and very sensitive on palpation. As there are
no milk cisterns in the gland, the condition extends immedi-
ately to the glandular tissue producing marked inflammation
and edema of portions of the gland. On palpation the
portion aft'ected can be detected. Later as the infection
develops the milk will be found changed into a grayish,
purulent mass sometimes mixed with blood. Abscesses,
often multiple, frequently develop. They open and dis-
charge a reddish, purulent mass. General symptoms are
quite marked in some cases, especially in cats. The toxins
absorbed produce general intoxication which is often fatal.
TUMORS OF THE MAMMARY GLANDS 317
In the chronic form the glands become indurated and the
milk canals obliterated. The gland tissue becomes fibroid
in character.
Prognosis.— The prognosis is favorable in animals other
than the cat. When general symptoms are present the
prognosis should be guarded.
Treatment.— The milk is removed, and the glands
thoroughly massaged to remove as much of the infective
material as possible. Hot antiseptic packs or fomentations
of hot antiseptic solutions should be applied. These should
be changed every few hours if feasible. Avoid coal-tar
products in cats.
Should abscesses develop in the glands they are incised to
give free drainage. Follow with antiseptics. Small doses of
castor oil, or magnesium sulphate are indicated to assist in
the elimination of toxins. In chronic mammitis with
fibrosis which may also involve the teat, it is best to remove
the gland. An anesthetic should be given, and the animal
placed on the table in the dorsal position. The hair is
shaved from around the gland and the skin thoroughly
disinfected. The gland is then dissected out, which is not
difficult, and the vessels ligated. The skin should be trimmed
so that the edges approximate accurately. A regular bitch
bandage is applied to protect the wound. Recovery is
prompt.
TUMORS OF THE MAMMARY GLANDS.
Neoplasia of the mammary glands is of frequent occur-
rence in bitches. Both benign and malignant types are met
with in practice.
Benign Tumors.— Fibromata.— A very common form of
benign tumor found in the mammary gland of bitches. It
consists of fibrous tissue elements proliferating around and
into the glandular acini, isolating portions of the gland cells.
Their development is slow but progressive, ultimately
involving the entire gland. The tumor may appear as a
pure fibroma or be mixed with other varieties.
318 DISEASES OF THE MAMMARY GLANDS
Symptoms.— Fibromas occur as hard, sharply defined
enlargements which show no inflammatory symptoms nor
tendency to degenerate. The size of the tumors varies from
a pea to several inches in diameter. When mixed with other
tumors, they are softer and take on some of their charac-
teristics.
Progn osis.— Favorable.
Treatment.— Extirpation of the gland.
Lipoma.— Fatty tumor found in old bitches, especially in
those afflicted with obesity.
Symptoms.— They are soft, well-defined tumors of the
gland.
Prognosis. — Favorable.
Treatment. — Removal of the gland is advisable.
Malignant Tumors.— Carcinomata. — A very common form
of malignant growth found in the mammary gland. They
are frequently mixed tumors, appearing as adenocarcinoma,
fibrocarcinoma, etc.
Symptoms.— Carcinomas are characterized by their growth,
slow at first but with sudden, rapid development, lobulated
appearance, and tendency to degeneration and abscess
formation. A small portion of the tumor should be examined
microscopically.
Progn osis. — Unfavorable as they are apt to recur.
Treatment. — Removal of the gland should be done as early
as possible. When metastasis has taken place, no treatment
is successful.
Sarcomata.— Sarcomata occur usually in conjunction with
other varieties of tumor, as fibrosarcoma, adenosarcoma, etc.
Symptoms.— Sarcomas develop rapidly with acute, inflam-
matory symptoms.
Diagnosis. — A diagnosis can be made only by microscopical
examination.
Treatment.— Same as for carcinoma.
Other varieties of tumors which involve the mammary
glands are rare and of minor importance.
PART V.
DISEASES OF THE BLOOD AND BLOOD
PRODUCING ORGANS.
CHAPTER I.
ANEMIA.
Definition.— A reduction in the total volume of blood or
of its corpuscles, oligocythemia, or of certain of its more
important constituents, such as albumin and hemoglobin.
Two forms of anemia are recognized, viz.: (a) Acute, and
(6) chronic.
Occurrence.— Very frequently observed in dogs and cats.
The most common form is the acute. The chronic form
following various diseases is also of common occurrence.
Etiology. — (a) Many cases of acute anemia are the direct
result of loss of blood. The condition develops rapidly
following epistaxis, intestinal hemorrhage, rupture of blood-
vessels in the lungs, hemorrhage of the uterus, parenchy-
matous hemorrhage, or any external, severe hemorrhage.
(6) Chronic anemia develops slowly and gradually.
Several different causes are found producing this type:
Insufficient food, or food of poor quality in which the essential
nutritive elements are deficient; diseases of metabolism in
which the nutritive processes are modified and the food
elements not utilized in the body. In small animals anemia
often follows diseases of the digestive tract (catarrhal inflam-
mation) producing either a loss of appetite or an interference
in the digestion and assimilation of the food. This may
320 ANEMIA
occur following distemper in dogs, presence of parasites in
large numbers, or other diseases affecting the mucous mem-
branes in a similar manner. Large numbers of chickens are
sometimes found with anemia from infectious asthenia, and
other diseases of the digestive tract. Parasites of the blood
are occasionally the cause. Young chicks are frequently
affected with white diarrhea resulting in a severe form of
anemia. Many of the general diseases are accompanied by
anemia.
Pathology. — The most characteristic feature of acute
anemia is the paleness of all the tissues and the absence of
blood. The respiratory passages show evidence of lack of
blood by their pale, pink color. The heart and bloodvessels
are only partially filled with a loose coagulated blood. In
chronic anemia the membranes are found pale and colorless,
the blood present in the vessels and tissues low in coloring
matter, and usually reduced in total volume. Fatty degen-
eration of the heart, liver, kidneys and other organs is often
observed. Owing to the general weakness and emaciation,
transudation of serum takes place and is found present in
the thoracic and abdominal cavities in varying quantities.
Lesions of the primary condition producing anemia are often
apparent.
Symptoms, — (a) Acute Anemia.— The symptoms of acute
anemia, when due to hemorrhage, come on suddenly, and
depend upon the amount of blood lost. The patient becomes
very weak, may be unable to stand, or if standing does so
with difficulty. In attempts at walking the animal will show
muscular incoordination and frequently falls down. Depres-
sion, subnormal temperature and increased respirations are
prominent symptoms. The mucous membranes are pale or
colorless and the heart action may be very weak or imper-
ceptible. In some instances evidence of the hemorrhage will
be present by the discharge of blood either from the nasal
passages, mouth or wound. Many cases terminate fatally
in a few minutes, or hours, when the hemorrhage is severe.
(b) Chronic Anemia. — In chronic anemia the symptoms
come on more slowly and gradually with more or less emacia-
tion and general debility. The hair coat or plumage becomes
ANEMIA 321
rough, and the eyes sunken. The animal is easily fatigued,
and unsteady in its movements. It will lie down much of
the time and refuses to move or get up when called. The
mucous membranes are pale or colorless. The heart action
is irregular, the pulse weak, and the respirations shallow and
accelerated. The appetite becomes variable and entirely
suppressed in some cases ; in others it is retained but weakness
and emaciation continue. The blood when examined will
show a reduction in hemoglobin content and the number of
red corpuscles diminished in proportion to the number of
white. Later as the disease progresses edematous swellings
are found along the abdomen, under the neck, and on the
limbs. Other symptoms may be present depending upon the
complicating conditions present.
Course.— The course of acute anemia is short, lasting in the
majority of cases only a few hours. In the chronic form the
course is much longer lasting for several weeks or months.
In this case the course will depend very largely upon the
cause of the condition.
Diagnosis. —The diagnosis does not present any difficulty.
This is particularly true in the acute form. A differential
diagnosis is necessary in some cases to distinguish it from
diseases of the heart, or leukemia. In the former the
examination of the heart will reveal the difference, while in
the latter case an examination of the blood will at once make
clear the distinction between the two conditions.
Prognosis.— The acute form, providing the animal does
not succumb from the hemorrhage, will disappear promptly.
The elements of the blood will soon be normal from the
drinking of large quantities of water and ingesting nutritious
foods.
In the chronic form the prognosis is not considered very
favorable. It will depend largely upon the primary factor
producing the anemia. A careful examination should be
made in all cases to determine if possible the actual condi-
tions. Many patients will recover completely after the
elimination of the causative factor.
Treatment.— In acute anemia when hemorrhage is taking
place an attempt should be made to arrest it at once. If it is
21
322 ANEMIA
external, the vessels should either be ligated or, if this is
impossible, pack the wound and apply a bandage to compress
the vessels. Internal hemorrhage may be controlled by
administering hemostatics. Adrenalin chlorid solution (1-
1000), using 1-2 c.c. intravenously. This may be repeated
in thirty minutes if necessary. Ergot and fluidextract of
hydrastis may also be used.
Rectal injections of normal salt solution are recommended.
Inject the solution as high up into the rectum as possible.
The solution should be at or near the body temperature.
Intravenous injection of salt solution in small animals is
unsatisfactory. In the chronic form determine the cause of
the condition if possible and apply treatment to correct it.
The diet is an important thing in the treatment of anemia.
Foods should be given that are rich in protein. Meat and
meat scraps, milk and eggs have proved of great value.
These substances should be given frequently and in small
quantities to obtain the maximum benefit. Later the amount
and the time between the feeding periods can be increased.
Numerous medicinal preparations have been used, but
the iron compounds have given the best results. Iron
and quinin citrate in doses of 0.1-0.5 twice daily are of
great value as a general tonic and alterative. Reduced iron,
saccharated carbonate of iron, and sulphate of iron have been
used successfully. Small doses of these preparations can be
given for a few weeks if necessary. Fowler's solution of
arsenic in doses of 0.1-0.8 daily is excellent. Carlsbad salts
should be given in small doses along with the iron prepara-
tions. Good hygienic conditions should always be observed.
LEUKEMIA.
Definition.— A disease characterized by an increase in the
white corpuscles, together with changes in the spleen, lymph
glands, or bone-marrow. Two forms are recognized, viz.:
(«) Myelogenous, and (b) lymphatic. The distinction is
based on whether there is an increase in the leukocytes or
lymphocytes. Combination of the two conditions may be
LEUKEMIA 323
found, or variations and degrees of either of the two forms
may be present.
Occurrence.— This disease occurs most frequently in dogs,
occasionally in cats.
Etiology.— Nothing is definitely proved relative to the
cause of leukemia. The disease is probably of an infectious
origin, but experiments conducted along this line have given
negative results. Toxic agents have been given as the
cause, as have injuries and various other factors.
Pathology.— On necropsy in leukemia it is often difficult
to make a distinction between the two forms as the lesions
of both occur concomitantly in the majority of cases. It is
characterized by enlargement of the spleen, lymph glands,
liver, kidneys and distinct changes in the marrow of the
bones.
The spleen is enlarged (in some instances three to four
times its normal size), dense and often easily torn. Fre-
quently nodules are seen projecting from its surface. The
color is dark red, and on cut surface dry, and shows numer-
ous whitish colored, enlarged follicles each of about the size
of a wheat grain. The stroma of the gland and the capsule
are thickened.
The lymph glands are found enlarged. They are harder
or softer than normal, of a whitish or gray color, sometimes
showing small red points over a cut surface. The surface
when scraped gives off a yellowish, creamy material. The
majority of lymph glands will be found affected. The bone-
marrow is of a dark red or gray color, and soft consistency.
On examination the bone-marrow will be found very rich in
white corpuscles.
The liver is enlarged and shows numerous small nodules
of lymphoid tissue. The kidneys are enlarged in the same
manner. Small nodes will be found throughout the serous
membranes, lungs and other tissues in the body.
Symptoms.— The early development of leukemia is usually
not observed. Very often the disease is not recognized until
the symptoms become prominent and it has reached the
advanced stage. The early symptoms are very similar to
those of anemia, and the differential diagnosis may be very
324 ANEMIA
difficult until decided changes take place either in the blood
or lymphatic system. The mucous membranes are very
pale or white in color, the animal becomes weak and edema-
tous swellings may appear. The enlargement of the lymph
glands comes on gradually and is found involving practically
all of the palpable glands. The enlargements vary in size,
but stand out in some cases very prominently. The glands
are firm, non-painful and well circumscribed or defined.
The glands in the submaxillary space, at the pharynx, chest
and inguinal regions show most enlargement. The move-
ment of the animal may be interfered with on account of the
increase in size of the lymph glands. Respiratory disturb-
ances may be present when the glands become large enough
to compress bloodvessels or nerves. Extensive edemas are
often present from the same cause. Ascites is a common
symptom in dogs from enlargement of the mesenteric glands.
The spleen is enlarged but difficult to palpate on account of
its position; the enlargement of the abdomen may be the
result of the enlargement of the spleen or liver, or both.
Percussion of the abdomen may assist in determining the
character of the enlargement.
Owing to the involvement of the bone-marrow the animal
is lame and shows stiffness and soreness in movement.
Pressure on the long bones frequently shows marked sensi-
tiveness and pain.
Characteristic alterations are found in the blood. It
appears pale red, or even brown, indicating a reduction in
hemoglobin. When allowed to stand and coagulate (which it
does slowly) it separates into two layers, the lower consist-
ing of red corpuscles, while the upper is composed of white
corpuscles and fibrin. The number of white corpuscles is
always increased; in some cases equal in number to the
red ones. A decrease in the number of red corpuscles can
be demonstrated in most cases. A differentiation may be
made between the two forms of leukemia by the blood
examination. In lymphatic leukemia the lymphocytes are
found increased, while in myelogenous leukemia the leuko-
cytes are found in much larger numbers. Clinically the
disease develops gradually, emaciation more prominent, and
INFECTIOUS LEUKEMIA OF CHICKENS 325
more or less extensive hemorrhages occur in the various
organs.
Course.— The disease is usually chronic. The acute form
is very rare in small animals. The course usually extends
over a long period, and complications are common.
Diagnosis.— The characteristic involvement of the lymph
glands, spleen and liver, and the increase in the number of
white corpuscles, will make the diagnosis comparatively
easy. A microscopic examination of the blood is necessary
in order to make the diagnosis accurate. The differentiation
between the forms of leukemia is determined definitely in this
manner.
Prognosis.— Very unfavorable. When the disease -is once
established there is little hope of recovery.
Treatment.— Owing to the pathological changes present
not much can be expected in the way of treatment. In some
cases the patient's general condition may be improved by
allowing plenty of nutritious food and administering altera-
tives and tonics. Iron and quinin citrate (0.2 to 0.4 twice
daily) have given the best results. Transfusion of blood
has proved unsatisfactory in small animals.
INFECTIOUS LEUKEMIA OF CHICKENS.
Definition.— An infectious disease of chickens probably
produced by an ultramicroscopic virus. It is characterized
by an increase in the number of leukocytes, an atrophy of
the marrow of the bones, and an increase in the size of the
spleen and liver. In many cases the number of red blood
corpuscles is reduced and the white ones increased.
Occurrence.— Up to the present time the disease is found
only in chickens. Other fowls are not affected. It often
appears in an enzootic or epizootic form when large numbers
in a flock or community will be affected.
Etiology.— From rather extensive investigations made
with this disease it is evidently due to a virus found in the
affected organs, viz.: The spleen, lymph glands, and bone-
marrow. The disease is easily transmitted by intraperi-
toneal or intravenous injections, while subcutaneous injec-
326 ANEMIA
tions prove negative. Animals other than chickens are not
susceptible to the disease.
Pathogenesis. — The method of development of infectious
leukemia has not been definitely proved. The virus of the
disease by irritation produces an increase in the number of
white blood cells in the capillaries of the spleen, bone-marrow
and liver.
Pathology.— The most pronounced lesions are found in the
spleen, liver and marrow of the bones. The spleen and
liver are much enlarged, and the bone-marrow reddened and
congested. The lymph glands are also enlarged occasionally.
The blood is lighter in color than normal (less hemoglobin)
and contains a larger proportion of leukocytes than normally.
General anemia is apparent by the wasted tissues.
Symptoms.— The period of incubation is approximately
thirty to sixty days. The disease develops very slowly and
insidiously. Some cases may assume an acute form, the
birds succumbing in about two weeks. The early indications
are anemia as indicated by the paleness of the comb and
wattles and a decided loss in weight. Later as the disease
continues there is a tendency for hemorrhages to take place
even from slight wounds, indicating a hemorrhagic diathesis.
Examination of the blood reveals the true condition.
There will be found a great increase in white corpuscles and
a material reduction in the number of red. The latter may
be reduced to one-fourth their normal number. The hemo-
globin content of the blood is also reduced giving it a pale
color and reducing its staining properties.
The condition when chronic develops gradually and the
chicken often dies from exhaustion.
Course. —The course of the disease is quite variable. Many
cases apparently run a very rapid course after the appearance
of the first symptoms, lasting from one to three weeks.
Others may linger longer or from one to four months.
Diagnosis. — The diagnosis can be established only by
necropsy and a microscopic examination of the blood to deter-
mine the ratio of the white to the red corpuscles. Differen-
tial diagnosis may be difficult, but considering the lesions
PSEUDOLEUKEMIA—HODGKIN'S DISEASE 327
and the fact that a number of fowls may be affected at the
same time, assist in arriving at the diagnosis.
Prognosis.— Very unfavorable. Recoveries are very rare.
Treatment. — No treatment has proved of any value. Dis-
infection of the premises and destruction of all affected birds
are advisable.
PSEUDOLEUKEMIA. HODGKIN'S DISEASE.
Definition.— A disease characterized by a progressive
enlargement of the blood-forming organs (spleen, liver,
lymphatic glands) and nodular growths in these and other
organs. It resembles leukemia in many respects. A
notable exception is that the white corpuscles are not
increased as in leukemia.
Occurrence.— The disease appears most commonly in dogs,
cats and chickens. It is more common, however, in dogs and
chickens than leukemia.
Etiology.— The true character of the disease is not known.
The etiological factors are believed by some authorities to be
identical with leukemia. Others are not in accord with this
belief.
Pathology.— The lesions found in pseudoleukemia resemble
very much those found in true leukemia. Enlargement of
the spleen, liver and lymph glands is observed in most cases.
Symptoms.— Progressive anemia and enlargement of the
lymph glands are the prominent early symptoms. Examina-
tion of the blood will show that the ratio between the red
and white corpuscles is nearly normal. Other symptoms are
practically the same as in leukemia.
Diagnosis.— A diagnosis can be made only by a micro-
scopic examination of the blood. It should be differentiated
from leukemia, malignant tumors and tuberculosis.
Prognosis . — I 'nf a vorable .
Treatment. —Treatment is unsatisfactory. Iron and quinin
citrate (0.2 to 0.4 twice daily), or Fowler's solution of arsenic
(0.2 to 0.6 once daily) may be tried. Potassium iodid in
small doses is also recommended.
328 ANEMIA
HEMOPHILIA.
A constitutional defect in which there is a tendency for
uncontrollable hemorrhage from slight wounds. It may
occur after slight injuries, congestions, or apparently spon-
taneously. The coagulation of the blood is retarded or
absent. Hemophilia is very rare in animals. For further
information the reader is referred to other works.
SCURVY. SCORBUTUS.
Definition.— A disease characterized by marked debility
and weakness, spongy and ulcerative condition of the gums
with bleeding and a tendency to hemorrhage in the various
organs.
Occurrence.— Scurvy is not very common in animals. A
few cases have been found in dogs. Ulcerative stomatitis is
often mistaken for true scorbutus.
Etiology.— There are several factors which contribute to
the4 production of this disease, viz.: (a) The diet, when
restricted to certain foods for a comparatively long time,
will produce the disease by disturbing general metabolism,
the body being deprived of food elements necessary for its
normal maintenance. (6) Unsanitary conditions, such as
damp cellars, badly kept kennels, exposure to cold and
dampness are important predisposing causes, (c) One of
the most important causes in dogs is ptomain poisoning,
resulting from eating spoiled meats, fish, etc. (d) There is
some question as to the disease being produced by infection.
Infection is, of course, a possible cause.
Pathology.— Small hemorrhages are found in the tissues
and organs of the body. These are most noticeable under
the skin, in the muscles, on mucous and serous membranes,
in the joints, liver, spleen and kidneys. Along the margin
of the gums will be found distinct ulcerative processes.
The gums are dark, almost black, or reddened, and show
separation from the teeth. Shreds of the membrane may be
removed easily with the forceps. The spleen is enlarged and
of a soft consistency. The lymph glands of the mesentery
SCURVY— SCORBUTUS 329
are enlarged and congested. Changes in the blood may
leave it thin and pale in color.
Symptoms.— Anemia and emaciation are early symptoms
of the disease. The patient becomes very languid, and does
not care to exercise or move about. The appetite is sup-
pressed either partially or completely, and the thirst is
increased. Marked changes are observed on the visible
mucous membranes, those of the mouth showing the most
pronounced lesions. The mucous membrane around the
margin of the gums becomes discolored red, later dark
bluish-red, and even almost black. Hemorrhages are present
in many cases, or the least manipulation of the gums causes
bleeding. The membranes become swollen and very sensitive
to the touch. The patient when eating will often stop
abruptly and show marked pain from the food irritating the
involved membranes. Distinct ulcerative processes are
observed in the later stages, the gingival membrane becoming
separated from the teeth and often the teeth themselves
become loose and fall out. Hemorrhages are also found on
the conjunctiva! membranes, in the nasal passages, and under
the skin.
Vomiting is a common symptom. The vomited stomach
contents are often mixed with blood indicating gastric
hemorrhage. Bowel discharges may also contain blood.
The disease is progressive and the symptoms increase in
intensity until the animal is exhausted or some complication,
such as septicemia, pneumonia, or extensive hemorrhage
develops.
Diagnosis.— A differential diagnosis is necessary in dogs in
order to distinguish scurvy from ulcerative stomatitis. The
main points of difference are: (a) The absence of general
symptoms and hemorrhages in ulcerative stomatitis, (b)
The localization of the condition in ulcerative stomatitis,
while in scurvy other parts of the body are affected. In
long-standing cases of ulcerative stomatitis the differentiation
may be somewhat difficult.
Prognosis.— This will depend a great deal upon the progress
the disease has made. If the cause can be removed in the
very early stages, the prognosis is more favorable than in
330 ANEMIA
cases where the ulcerative processes are well established.
When general symptoms of anemia and cachexia are evident
the prognosis is bad.
Treatment. — This disease can be readily prevented when a
variety of food is allowed and good sanitary conditions
prevail.
The early indications in the treatment are to change and
regulate the diet. Give the patient nourishing food, such
as meat, milk, eggs, etc. Iron preparations (iron and
quinin citrate, pulverized iron, saccharated carbonate of
iron) are the most satisfactory for the anemia which is nearly
always present. Tincture of nux vomica (0.3 to 0.5 daily)
or tincture of gentian (0.5 to 0.8 twice daily) is useful as a
tonic.
Local applications should also be used. Swab the gums
and other affected mucous membranes of the mouth with
tincture of myrrh once or twice daily.
When hemorrhages are present they must be controlled
by appropriate treatment.
ANIMAL PARASITES IN THE BLOOD.
Filaridoe. Mdastrongulincp.
Several species of animal parasites have been found
infesting the blood and circulatory organs in small animals.
The dog is most frequently affected. In several districts of
the United States, Canada and Mexico, the condition has
been reported a number of times. The Dirofilaria immitis,
Hematozoon Lewisi, Hsemostrongylus vasorum and the Spi-
roptera sanguinolenta are the most important ones found.
Dirofilaria immitis (Filaria immitis}.— Occurrence.— This
blood affection has been observed very commonly in the
dog, particularly in Japan, China, and in some sections of
North and South America. The United States is fairly free
from the infestation, but it is quite possible that many cases
have been overlooked.
Etiology.— The Dirofilaria immitis is a long, white worm,
the male being 12 to 18 cm., and the female 20 to 30 cm. long
ANIMAL PARASITES IN THE BLOOD 331
The posterior portion of the male parasite shows a curvature
or spiral bending. The female gives birth to living embryo.
The mature parasites live in heart (right half) in the major-
ity of infestations. The left heart and bloodvessels harbor
them in some cases. The number of parasites vary from a
few to several hundred. They are usually found entangled
in a round ball-like mass. The females give birth to embryos
which are each about j mm. long, and are set free in the blood
in large numbers. The sexually mature parasites may be
found at the same time in other parts of the body. The
manner in which infestation takes place has not been fully
proved. It is probably from the drinking water which
contains the larvae. These embryos reach the heart before
they mature. They may be discharged from the animal
either in the urine, nasal discharge, blood, or with the feces
and contaminate food or water again.
Pathogenesis.— The mature parasites located as they are
in the heart or large vessels produce more or less of a mechan-
ical disturbance in the action of those organs, or direct inter-
ference in the flow of blood through them. Formation of
emboli in the vessels, which often results, brings on various
complications in part due to necrotic foci in the lungs or other
organs. The presence of the embryos in the blood ultimately
leads to anemia with leukocytosis.
Pathology.— On necropsy the right heart is usually found
to be partially or completely filled with the parasites sur-
rounded by a coagulated mass of blood. The endocardium
is found more or less thickened and inflamed. The heart
is often dilated, the walls thin, and some cases ruptured.
Very frequently the lungs show small foci of necrosis, or
nodules in the center of which embryos are found. Similar
lesions occur in the liver, kidneys, skin and muscular tissues.
General anemia is present.
Symptoms.— The symptoms will depend a great deal upon
the number of adult parasites and embryos infesting the
circulatory system. When small numbers are present the
animal may not show any particular manifestations. When
the number is great, anemia and marked emaciation develop.
Hemorrhages are proved to appear in the mucous membranes,
skin, lungs, intestinal tract and other organs.
332 ANEMIA
Various complications will be observed from the emboli
affecting the different functions in the body. The most
pronounced complicating symptoms are in connection with
the heart, lungs and brain. The blood shows evidence of
anemia and leukocytosis. There is absence of fever, and a
gradual progressive anemia which may continue for several
months.
Diagnosis. — A correct diagnosis can be made only by a
microscopic examination of the blood for embryos. These
are easily recognized by their shape and peculiar snake-like
movements.
Treatment.— Very little can be done in the way of treat-
ment. Nutritious food and iron preparations are recom-
mended. Atoxyl in small doses has been used successfully
to reduce the number of embryos in the blood.
Complicating symptoms are treated as they develop.
Hematozoon Lewis!.— This parasite is found infesting the
circulatory system in much the same manner as the Diro-
filaria immitis. Dogs are most commonly affected. A micro-
scopic examination of the blood is necessary in order to
establish the diagnosis. The embryos attach their heads
to the cover-glass and move their bodies very rapidly when
viewed under the microscope. Little is known concerning
the life history of this parasite. It is supposed to be taken
into the body from fleas and lice in which the larvse of this
parasite have been found.
Treatment is the same as for Dirofilaria immitis.
Haemostrongylus vasonun. —This is a fine, thread-like worm
infesting the right ventricle of the heart and the pulmonary
artery and its branches. The male parasite is about 13-16
mm. long, and the female 17-20 mm. It forms small nodules
in the lining membrane of the vessel wall and thrombi in the
smaller vessels. The female parasite lays eggs which lodge
in the finer vessels, which, like the embryos, lead to the
formation of small nodes. The embryos migrate into the
bronchi and are coughed up and taken in by other animals.
Symptoms.— The symptoms are mostly those of a progres-
sive anemia and are not characteristic.
ANIMAL PARASITES IN THE BLOOD 333
Diagnosis.— The diagnosis is only made by finding the
parasites on autopsy or the eggs and embryos in the expecto-
ration or blood.
Treatment. —Unsatisfactory .
Spiroptera sanguinolenta. — This is a small, thread-like
worm found in different parts of the body, but more particu-
larly in the heart and large arterial branches. It is of minor
importance as the infestation is of rare occurrence in small
animals. The symptoms are those of anemia and heart
weakness and are not characteristic. A microscopic exami-
nation or a necropsy is necessary in order to confirm the
diagnosis.
CHAPTER II.
DISEASES OF THE THYROID GLANDS.
Examination and General Consideration.— Diseases involving
these glands are of considerable importance in dogs in which
animals all forms of goiter are found. Other small animals
are very seldom affected. The two thyroid glands, one on
either side of the neck, are situated in the upper third of the
cervical region. They are normally small but easily palpable.
When diseased they usually grow larger and tend to descend
downward toward the thoracic inlet. The position of the
diseased glands will vary, therefore, with their size and the
breed of dog.
An important thing to be considered in connection with
the thyroid glands is the presence of small glandules closely
related to them. These glandules are often found in close
contact with the thyroid glands occurring in the adjacent
tissue or they may be quite a distance removed from them.
They consist of small, nodular glands, composed of true
thyroid or lymphoid tissue, and are considered accessory
glands to the thyroids. Normally they are very small,
but usually become much enlarged when the thyroid glands
are involved. These small glandules seem to be closely
associated with the thyroid glands in function, and will
replace to a certain degree the secretions necessary, when the
true glands are diseased or destroyed.
CONGESTION OF THE THYROID GLANDS.
At or near the time of puberty the glands are often found
enlarged; during the estrual periods the same condition is
commonly observed. This temporary congestion will disap-
pear in a few days in the majority of cases and the glands
ACUTE THYROIDITIS 335
assume their normal size and condition. A temporary con-
gestion may also occur from collars being too tight, or dogs
pulling on the leash, which disturbs the circulation in the
glands. Swelling of one or both glands may result from this
and last for several days simulating goiter. As soon as the
cause is removed the circulation will return to its normal
state and the congestion gradually disappear. Direct
injuries to the glands are not uncommon and congestion and
edema result. Examination will often reveal the presence
of a wound or a contused area. Permanent enlargement of
one or both glands may result from injuries, due to fibrous
formation.
ACUTE THYROIDITIS.
Definition. — An acute inflammation of one or both thyroid
glands. This condition has been observed in dogs.
Etiology.— The majority of cases are secondary to other
diseases, such as distemper, local infection in the adjacent
tissue, or from direct injuries.
Symptoms.— The glands are first noticed to be prominent,
enlarged, sensitive on palpation, and the local temperature
elevated. In severe congestion the gland will often show
pulsation. A differentiation should be made between this
condition and the various forms of goiter. The sudden
development, local heat, and marked reaction in the glands
will assist in making the differentiation. The history of
the condition following distemper or injuries should also be
taken into consideration in making the diagnosis.
Prognosis.— The termination of acute thyroiditis is usually
favorable. The inflammation subsides and the gland resumes
its normal function. Some few cases terminate in a degenera-
tion and suppurative condition which may destroy a part
or the whole gland. It is possible also to have the condition
become chronic and produce a firm fibrous growth simulating
some forms of goiter.
Treatment. — During the acute stage cold applications
should be applied either in the form of cold water or ice packs.
This followed by a hot Priessnitz compress and continued
until resolution takes place or degeneration and abscess
3.36 DISEASES OF THE THYROID GLANDS
formation occur. Should the function of the gland be
disturbed for a prolonged period either potassium iodid in
small doses or thyroid extract has proved to be of consider-
able value. When abscesses occur they should be opened,
drainage effected, and an iodin pack applied.
GOITER. STRUMA. BRONCHOCELE.
Definition.— A hypertrophy or enlargement of the thyroid
glands which occurs sporadically. It is very frequent in
dogs. In some instances goiter is congenital and whole
litters of puppies are affected. The enlargement of the
glands in these cases may be of sufficient size to interfere
seriously with parturition. Very often the glands will be
six to ten times larger than normal, seemingly as large as
the puppy itself. The lobes and isthmus of the glands are
so intermingled that no distinction can be made between
them, the whole forming one large mass in the inferior cervical
region.
The disease is also acquired in a great many cases, coming
on at different periods in the development of individual
animals.
Occurrence.— The occurrence of goiter in the various breeds
of dogs seems to be in about the same ratio, although in
certain districts pointers, bull dogs, and bull terriers, seem
to be affected in larger numbers than other breeds.
Many forms of goiter are recognized in dogs, viz.: (a)
Parenchymatous; (6) cystic; (c) fibrous; (d) vascular; (e)
malignant; (/) exophthalmic.
Parenchymatous Goiter.— Definition.— A diffuse paren-
chymatous enlargement of the gland with an increase in the
stroma and a collection of gelatinous colloid material in the
follicles.
Occurrence.— This form is by far the most common and
occurs more frequently in puppies or young dogs.
Symptoms.— The first symptom noticed is the enlargement
of one or both thyroid glands. The enlargement may not
be equal in both glands. One is frequently much larger
than the other. This form of goiter often develops suddenly
GOI TER—STR UMA—BROXCHOCELE 337
and the glands assume enormous proportions. Puppies are
often born with this particular form or develop it during
the first few weeks of their lives. In many cases no marked
symptoms of any general disturbance are observed, the
animal developing apparently normal except the presence
of the enlarged thyroid glands. In other cases, when the
glandular secretion is materially interfered with, cretinism
and myxedema are prominent symptoms. This is evidenced
by marked nervous disturbances and degeneration of the
various tissues in the body. The animal becomes emaciated,
weak, a mere shadow of its former condition. Young animals
as a result of this glandular disturbance do not develop
normally, the head may be larger than normal, and other
parts of the body undeveloped, or vice versa. Respiratory
disturbances often result from the enlarged glands pressing
upon the trachea, or from compression of the vagus and
sympathetic nerves. The latter condition no doubt accounts
for the larger number of cases in which labored respiration
and spasm of the glottis are prominent symptoms. Hemi-r
plegia laryngis is produced in a similar manner by pressure
on the recurrent nerve. Circulatory irregularities are not so
common in parenchymatous goiter. Direct examination of
the glands will reveal the enlargement, its smooth regular
outline, moderately firm consistency, and absence of local
heat or pain. The isthmus of the glands can be palpated,
except when the glands are greatly enlarged. In many
cases no general symptoms of deranged appetite, elevation
of temperature, or cachexia will be noticed.
Diagnosis.— The diagnosis of goiter in general is quite easy,
but in some cases it is difficult to make a definite distinction
between the various forms. Goiter should be differentiated
from abscess, hematoma, and various cyst formations. This
can be done as a rule very easily after carefully palpating
the enlargement. In order to make a positive diagnosis of
the variety or form of goiter present, it is necessary to
consider the character of the enlargement, its consistency,
the condition and age of the animal. Palpation of the glands
to determine their form, whether regular and smooth, or
irregular and lobulated, and their consistency, is a very
22
338 DISEASES OF THE THYROID GLANDS
important means of making the differentiation between the
various forms of goiter.
Prognosis.— In parenchymatous goiter most cases recover.
The glands grow smaller until of normal size or near it, and
any general symptoms disappear. However, in cases where
the glands are enormously enlarged and symptoms of cretin-
ism and myxedema are present the prognosis is not favorable.
A recurrence of this form of goiter, while rare, is always
probable.
Treatment.— lodin medication both externally and inter-
nally has proved to be of great value. Some remarkable
results have been obtained in the rapidity and degree of
reduction after its use. For internal administration it has
been definitely proved that small doses give the best results.
The dose should be regulated somewhat according to the age
and size of the animal. One-fourth grain, 0.016 of potassium
iodid for puppies, or 0.05-0.08 for older animals, given
once daily, has given the best results. When given in large
doses there is danger of too rapid depletion of the body and
paralysis of the heart. These small doses should be continued
daily for one to three weeks. For external application color-
less tincture of iodin may be applied. Where staining the
hair does not matter the regular tincture should be employed.
An application can be made daily, or every second day.
Thyroid extract (0.15 daily) has been used with excellent
results. Surgical interference has not proved successful
in relieving this form of goiter. Complete unilateral
thyroidectomy might be tried in case one gland is
enormously enlarged and the other nearly normal. The
operation is performed under general anesthesia and strict
antiseptic precautions. The gland is dissected out carefully
and multiple ligation of the pedicle is necessary so that the
tissue will not retract and allow the ligature to slip off. The
gland is then removed about ^ inch from the ligature and the
wound packed with antiseptic gauze for a few days. The
ligature is then removed cautiously and the wound covered
with an antiseptic dusting power. It is very important that
the wound be kept free from infection during the first few
days, and the ligature kept in position to avoid fatal hemor-
rhage.
GOI TER—STR UMA—BRONCHOCELE 339
Cystic Goiter.— Definition.— An enlargement of one or
both thyroid glands, characterized by the formation of cysts
which may be single or multiple. In cases of long standing,
calcification of the cyst wall may take place. The cause of
cystic goiter has never been clearly proved. When hemor-
rhage occurs in the gland follicles they are distended, certain
changes in the contents result, and there is left a more or
less clear serous fluid. Further, through disturbance in the
glandular activity, from injury, nervous influences, or hyper-
emia, the circulation of the glands is abnormal leading to
extravasation of serum into the follicles which may result
in a permanent cystic condition. Cysts commonly compli-
cate parenchymatous goiter.
Symptoms. — An enlargement of one or both of the thyroid
glands is the most prominent symptom. Many cases
develop rather suddenly while others require considerable
time before the glands reach a sufficient size to become
noticeable. As a rule, unless complicated with other forms
of goiter, no general symptoms will be present. Should the
cystic formation involve both glands it is quite possible that
the normal function of the glands will be disturbed, then
general symptoms will result. Pressure on the vagus, sym-
pathetic, and recurrent nerves may lead to complications
as in parenchymatous goiter. In the majority of cases the
course of this goiter is chronic, and aside from the unsightly
enlargement they produce, the animal will not suffer any
inconvenience. Examination of the gland by careful palpa-
tion will reveal the soft, fluctuating swelling, the absence of
inflammation, and a consistency differing from other forms of
goiter.
Diagnosis.— The diagnosis can be made positive by the
examination, and if necessary by the use of an exploring trocar
to obtain some of the yellowish or clear serous fluid.
Prognosis.— Favorable when proper and prompt treatment
is used. Further, as this is in most cases a local condition
confined to the gland, remedial measures can be applied more
satisfactorily.
Treatment.— This is of two kinds, viz.: (a) Medical, and
(b) surgical.
340 DISEASES OF THE THYROID GLANDS
Medical.— Medical treatment in the form of potassium
iodid (0.03-0.06) is of value to assist in replacing the loss
in the normal secretion of the gland, especially when both
glands are extensively involved. Thyroid extract in 0.15
doses daily can also be used.
Surgical. — This consists in either aspirating the serous
fluid from the cystic follicles and injecting a small amount
of Lugol's solution to stop further filling up, or opening the
cysts and packing the cavity temporarily with iodin gauze.
After-treatment consists in the use of antiseptics. The wound
will heal leaving but slight enlargement.
Fibrous Goiter.— Definition.— An enlargement usually of
one of the thyroid glands (rarely both) characterized by a
hypertrophy of the stroma and an atrophy of the glandular
tissue. It is most frequent in old animals. This form of
goiter results in most cases from injuries, acute and chronic
inflammation, and in a few cases no doubt from some of the
other forms of goiter. The interstitial tissue is gradually
increased exerting abnormal pressure on the gland substance,
which leads to pressure atrophy.
Symptoms.— The presence of the enlargement confined in
most cases to one gland. Occasionally both glands will be
found affected. The size of the enlargement varies greatly
from very slight to extreme thickening of the entire intersti-
tial tissue. No general symptoms are observed in the major-
ity of cases as it is confined to one gland and of long standing.
When both glands are extensively involved, interfering with
the function of the glands, emaciation, weakness and general
cachexia may be prominent symptoms. Respiratory and
other disturbances are only observed when the enlargement
presses on the trachea or nerves.
On palpation of the gland it will be found exceedingly
firm, resistant, smooth in outline, non-inflammatory, and
non-sensitive. The isthmus of the gland is easily determined.
Diagnosis.— This should not be difficult as the outline of
the enlargement and the hard, firm consistency, with the
other symptoms, are characteristic of fibrous goiter.
Prognosis.— Favorable. Many cases, when not exceed-
ingly large, are not treated as they cause but little incon-
GO I TER—STR UMA—BRO \CHOC ELK 341
venience to the animal. Reduction in the size of the gland
is possible, or it can be extirpated.
Treatment.— Injections of iodin into the gland substance
have given good results. Inject iodin tincture (2.0 to 5.0)
into the gland being careful to avoid introducing the needle
directly into a bloodvessel. The needle should be inserted
unattached to determine this fact before the injection is
made. The injections may be repeated after the acute
symptoms subside. It is sometimes necessary to make
several applications before reduction is complete. Extirpa-
tion of the enlarged gland is recommended when of consid-
erable size and the fellow gland normal. The operation is
performed in the same manner as in parenchymatous goiter.
When both glands are enlarged and general symptoms of
athyrea are present, potassium iodid, or thyroid extract in
small doses is recommended.
Vascular Goiter.— Definition. — An enlargement of one or
both thyroid glands, characterized by dilatation of the
bloodvessels without the formation of new glandular tissue,
and the absence of any marked general symptoms. This
condition is not to be confused with exophthalmic goiter.
It is the result of a local dilatation of the bloodvessels supply-
ing the glands and may originate from the same causes as
those producing congestion and inflammation of the glands.
The exact etiology is not known, but has been observed as a
sequel to distemper, prolonged estrual periods, and sexual
diseases.
Symptoms. — One or both glands will be found enlarged and
engorged with blood. Distinct pulsation of the arteries
and even the glands can be seen at a distance. In some cases
rupture of some of the vessels results, the blood accumulating
in the adjacent tissues, producing an extensive enlargement
along the course of the neck. The symptoms, as a rule,
subside after a few weeks and may recur at more or less
regular intervals. Many cases recover spontaneously. Very
little general disturbance is present.
Diagnosis.— The dilatation of the arteries and engorgement
of the gland will easily differentiate it from all forms of goiter,
except exophthalmic. In exophthalmic goiter, tachycardia,
342 DISEASES OF THE THYROID GLANDS
and nervous disturbances present should make the clinical
picture complete and different from vascular goiter.
Prognosis.— Complete recovery is possible in most cases.
In the milder forms it often disappears without any treat-
ment.
Treatment.— An examination of the animal should be made
carefully and if any general disturbance is observed it should
be treated. Owing to the increased activity of the gland
locally, iodin preparations are contraindicated. Small doses
of tincture of opium (0.2 to 0.4 daily) can be tried.
Should the glandular activity become too pronounced, as
indicated by hyperthyrea, ligation of a portion of the blood
supply to the gland would be indicated. However, in the
majority of cases this is not necessary as the symptoms will
subside in the course of a few weeks.
Malignant Goiter.— Definition.— An enlargement of one or
both thyroid glands due to a malignant neoplasm. The
malignant growth is either a sarcoma or carcinoma. The
growth tends to invade the adjacent tissues and lymph glands,
or even to the extent of involving secondarily the lymph
glands of the thoracic cavity, the lungs, and other organs
and tissues. The condition may become generalized. It is
found mostly in old animals.
Symptoms.— The malignant growth may be confined to one
gland, but in many cases occurs in both. When the enlarge-
ment once begins, its development is quite rapid, and is
characterized by an uneven, irregular form of the gland, the
presence of acute inflammatory symptoms, very sensitive,
and in some cases areas of degeneration and abscess forma-
tion are found. Within a short time general symptoms
are prominent. Emaciation and general cachexia develop
rapidly. The rapidity of its development and the fact that
it is usually an old animal affected would assist in making the
diagnosis.
Diagnosis.— This is made by careful examination. The
characteristic enlargement and condition of the gland with
secondary involvement of adjacent lymph glands, together
with the general symptoms of emaciation and cachexia, and
GOITER— STRUM A— BRONCHOCELE 343
the age of the animal, should make the differentiation from
other forms of goiter comparatively easy.
Prognosis. —Unfavorable.
Treatment.— But little can be expected of treatment. In
the early stages, before involvement of the adjacent tissues
takes place, extirpation of the gland may relieve the condition
for a time but no permanent results can be hoped for.
Exophthalmic Goiter.— Basedow's Disease. Graves' s Dis-
ease.— Definition.— A disease characterized by exophthalmos,
functional disturbances of the circulatory system, and more
or less enlargement of the thyroid gland. This disease is
not of frequent occurrence in animals, but is found occa-
sionally in the dog.
Etiology. —The exact etiological factor has been in dispute,
but is evidently a pure neurosis as indicated by some of the
more recent investigations made. It has also been claimed
that it is due to a central lesion in the medulla oblongata.
A certain amount of evidence has been produced to partially
substantiate this claim. The fact that the primary result
of the disease is a hyperthyrea would indicate that it
might be a special involvement of the glands. However, this
has not been proved and the best evidence seems to prove
the former etiological factor the most likely.
Pathology.— On examination the thyroid glands show en-
largement, congestion, the production of newly formed
tubular spaces and a collection of mucinous fluid. They
show every evidence of hyperactivity.
Pathogenesis.— It is quite important from every standpoint
to note that this form of goiter is a primary hyperthyrea
while most forms are just the opposite (athyrea). The
development of the disease is the result of the increased
secretion of the thyroid glands leading to a general toxic
condition. The iodothyroidin content of the secretion is
greatly increased which no doubt accounts for the intoxica-
tion.
From an experimental standpoint much the same condition
can be produced in animals by administering large and con-
tinued doses of thyroid extract. Further, when thyroid
extract or iodin is administered in exophthalmic goiter the
condition becomes rapidly aggravated.
344 DISEASES OF THE THYROID GLANDS
Symptoms.— Both the acute and chronic forms have been
observed. In the acute form the disease develops very
rapidly. The following symptoms are most prominent:
(a) Exophthalmos.—A. prominence of the eyes which may
be unilateral or bilateral. This symptom is readily recog-
nized by the protrusion of the eyeballs, and the prominence
of the sclera of the eye. The lids do not cover the eye
completely. It is important to note that in some breeds of
dogs the eyes are very prominent and this should not be
mistaken for exophthalmos. The normal sight is retained
in most cases. In severe cases it is possible to have a pan-
ophthalmitis which wrould destroy the sight temporarily or
permanently. Ulceration of the cornea is common.
(6) Enlargement of the Thyroid Glands. — Some enlarge-
ment of the glands is present in practically all cases. The
common expression ".inward goiter" has been given to this
condition when the glands are not much enlarged and the
other symptoms are prominent. The enlargement may be
general or only one lobe affected.
(c) Tachycardia.— The heart action is rapid and the pulse-
rate is usually so much increased that it cannot be counted
accurately. The action of the heart at first is regular, but
during the later stages of the disease becomes very irregular.
The throbbing of the heart is often so intense as to shake the
animal's body. Acute dilatation of the heart with dyspnea,
cough, etc., is a prominent symptom in the later stages.
Distention of the arteries and pulsation of the entire gland
is easily seen from a distance. On palpation a distinct
throbbing can be felt. The gland may be more or less firm,
or soft and flabby, depending on the degree of involvement.
(d) Tremors. — Tremors or trembling of the muscles is
often observed. General symptoms of restlessness, whining
and crying, and spasms are present in some cases. Emacia-
tion comes on rapidly, and general exhaustion is very
common.
The chronic form is characterized by similar symptoms
but milder in character and lasting for several weeks or
months.
GO I TE R—STR UMA—BRONCHOCELE 345
Diagnosis. — The diagnosis is not difficult when all the
symptoms are taken into consideration. A differential
diagnosis should be made from the other forms of goiter,
but aside from vascular goiter this should be easy. In
vascular goiter the general symptoms are usually absent.
Prognosis.— Not considered favorable. Some cases recover
rapidly under proper treatment.
Treatment.— Owing to the hyperthyrea present, iodin
preparations and thyroid extract are contraindicated. The
treatment indicated is the reduction of the hyperactivity
of the thyroid glands, and regulating the heart action. The
hyperactivity of the glands is best controlled by ligation of a
portion of the blood supply to them which will immediately
stop the function of that particular part and reduce the total
volume of secretion. It is recommended that the anterior
arteries be ligated. -This should be done under strict anti-
septic precautions and morphin anesthesia. Immediate
good results are obtained in many cases. Extirpation of a
portion of the gland is often done in the human subject but
is not so practicable in animals. The heart action should
be controlled by small doses of digitalis fluidextract (0.1 to
0.2 twice daily), or aconite tincture (0.1 to 0.2 two or three
times daily). The animal should be kept in a quiet place.
Other conditions arising must be treated accordingly.
PART VI.
DISEASES OF METABOLISM.
CHAPTER I.
DISEASES OF METABOLISM.
DIABETES.
Definition.— Diabetes is a disease ordinarily characterized
by an excessive secretion of urine. It occurs in two forms:
(a) Diabetes insipidus; (6) diabetes mellitus.
Diabetes Insipidus.— Definition.— A chronic disease charac-
terized by the passage of a large volume of urine of a low
specific gravity and containing no albumin or sugar. There
should be a distinction made between diabetes insipidus and
polyuria. The latter is a symptom of some other disease.
In polyuria, often confused with diabetes insipidus, the
volume of urine passed is not constant. The disease is
evidently a functional disturbance of the kidneys in which
large quantities of water are voided and equal amounts taken
into the system. The solid content of the urine is naturally
reduced.
Occurrence. — Diabetes insipidus is not observed very often,
but perhaps the larger number of cases is folmd in dogs.
Polyuria is frequently seen in rabbits from improper feeding.
Certain foods tend to produce it, which, if continued, may
result in a chronic condition resembling diabetes insipidus.
There is no doubt but that it is often not diagnosed.
Etiology.— Several things have been recorded as having to
do with the cause of diabetes insipidus: (a) Observed dur-
348 DISEASES OF METABOLISM
ing the convalescent stage of acute diseases (distemper). (&)
Accompanying diseases of the nervous system, such as
tumors of the brain, lesions of the medulla, cerebral hemor-
rhage, inflammation of the membranes of the brain or spinal
cord, (c) Subjection to cold; drinking large quantities of
cold water have been thought to cause the disease, (d)
Trauma of the liver; vertebral column, (e) The administra-
tion of diuretics either when given in large doses or con-
tinued over a long period of time in small doses will produce
it. (/) There is a possibility that the disease is of infectious
origin; however, this has never been proved.
The production of diabetes insipidus is no doubt due to
a vasomotor disturbance of the renal vessels resulting in a
great increase in the secretion of urine. The above men-
tioned conditions lead to this disturbance through direct
irritation, or to functional irritation of the center in the
medulla, which brings about a constant state of renal con-
gestion.
Pathology.— The necropsy findings are unimportant in the
majority of cases. Quite often very slight or no changes in
the tissues are found. In some cases the kidneys are enlarged
and hyperemic. Dilation of the ureters and pelvis of the
kidneys is occasionally seen. Certain changes will also
be found in the nervous system, liver and lungs. The
musculature is pale and anemic in advanced cases.
Symptoms.— The disease may come on suddenly resulting
from irritation to the nervous system or kidneys, or it may
be gradual in its development. In rabbits it may develop
suddenly after feeding mouldy food, etc. Many cases are
not observed until the symptoms of anemia and general
cachexia are present. Two very prominent symptoms are:
(a) Copious secretion of urine; (6) intense thirst.
(a) A large quantity of urine is passed each day; in dogs
as much as two to four liters in twenty-four hours, and in
rabbits one-fourth the quantity. The urine has a low
specific gravity (1.001 to 1.003), is colorless, almost odorless,
and voided without any difficulty except when the condition
is accompanied by a catarrhal inflammation of the mucous
membrane of the urethra or bladder. The urine contains
DIABETES 349
neither albumin nor sugar. Normal solids are very much
reduced in quantity.
(6) The animal will show intense thirst; large quantities
of water are consumed each day, in dogs as much as four to
ten liters. Often animals will show a vitiated thirst and
will drink contaminated water or even urine. The appetite
is usually normal during the first stages, but gradually
diminishes and becomes variable. During the later stages
the appetite may be lost entirely, the animal becoming
emaciated, and various complications develop. The tem-
perature remains normal until the very latest stages when
it may be subnormal.
Course.— When polyuria results from the food it may
disappear in a short time following the change in food. This
has been observed particularly in rabbits. In cases of real
diabetes insipidus the course is chronic, the disease lasting
one or two years.
Diagnosis.— A differential diagnosis must be made between
diabetes insipidus, polyuria and diabetes mellitus. Polyuria
is distinguished from diabetes insipidus by the symptoms
disappearing when the food is changed. The symptoms of
polyuria are also more variable. Diabetes mellitus is dis-
tinguished by the increased specific gravity of the urine and
the sugar content.
Prognosis.— ^Yhile in polyuria the prognosis is usually
favorable, in real diabetes insipidus it is bad, the disease
terminating fatally after a prolonged course.
Treatment.— An investigation of the food should be made,
and if found of poor quality, containing moulds or other
objectionable substances, it should be discontinued and other
foods substituted. Regulation of the diet is an important
factor during the early stages of the disease. Limiting the
water supply does not have any appreciable effect on true
diabetes insipidus, but if it is a simple polyuria it would be
well to restrict the patient to a small amount of water.
Medical treatment has not been satisfactory. Small doses
of valerianate of zinc (0.2 to 0.4) daily, may be tried; or
vasoconstrictors used, such as fluidextract of hydrastis, or
fluidextract of ergot. Stomachics and general tonics may be
350 DISEASES OF METABOLISM
of some value, tincture nux vomica (0.3 to 0.6), once or
twice daily.
Diabetes Mellitus.— Definition.— Diabetes mellitus is a
chronic, nutritive disorder in which grape-sugar accumulates
in the blood and is excreted in the urine. The condition may
be permanent or occur periodically. It is generally con-
sidered that in order for a case to be true diabetes mellitus,
the sugar eliminated must be grape-sugar, and it must extend
over a rather long period of time.
Occurrence.— The disease is not very common in animals.
A few cases have been found in dogs. The cat and rabbit
are very seldom affected.
Etiology. — The exact etiology of diabetes mellitus is not
known. It is quite evident that several factors may have to
do with the production of the disease. Nervous diseases,
especially those of the central nervous system, and diseases
of the liver and pancreas probably produce the larger number
of cases. The pathogenesis of diabetes mellitus is not quite
clear, but the condition may be brought about by a disturb-
ance of the liver or pancreas, in which the grape-sugar taken
into the body is not converted into glycogen but taken up as
grape-sugar by the circulation and eliminated in this form.
Pathology.— Many cases present no anatomical changes.
There may be hemorrhages in the nervous system, tumor
formations, etc. Very often fatty degeneration of the liver
is present. The pancreas may be enlarged by connective
tissue proliferation and an atrophy of the glandular substance.
The other structures show emaciation and evidences of
cachexia due no doubt to the chronicity of the disease.
Symptoms.— Until the patient shows emaciation, notwith-
standing good appetite, the disease is usually not recognized.
The general symptoms are: The animal fatigues easily,
becomes dull and listless and does not move about in a normal
way, shows increased thirst and appetite. The mucous
membrane of the mouth becomes dry, and gingivitis is often
present. The most characteristic symptoms are found in
connection with the urinary organs. The urine is increased
in amount, sometimes double the normal quantities voided,
is pale, colorless, of a sweetish odor (aceton) and acid in
DIABETES 351
reaction. The specific gravity is increased (1040 to 1060).
An examination of the urine should be made to determine the
sugar content. From 3 to 5 per cent, of sugar has been
found. The amount of sugar content will depend to quite
an extent on the kind of food given the patient. The
feeding of carbohydrates materially increases the per cent,
while nitrogenous foodstuffs diminish it. (For testing for
sugar in the urine, see Diseases of the Kidneys.)
As the disease progresses certain other symptoms are
uniformly present. Opacity of one or both cornea (keratitis) ,
or of the lens (cataract) is often found, gradually producing
blindness. Other portions of the eye may also be affected,
llceration of the cornea has been observed. Secondary
involvement of the respiratory organs takes place in the form
of a catarrhal inflammation of the larynx, trachea, bronchial
tubes and lungs. Pneumonia and gangrene of the lungs may
develop. Cardiac weakness is noted during the last stages.
Other symptoms, such as vomiting, diarrhea and constipation,
may be seen. Ulceration of the skin, falling out of the hair,
found in some cases, indicate the general disturbance in
metabolism. During the last stages the patient becomes very
weak, emaciated, cachectic, and dies from exhaustion.
Course. — The disease is characterized by its chronicity and
may last from several months to two years. Sugar is some-
times present in the urine for a long time before the disease
is recognized.
Diagnosis.— This disease should be differentiated from
diabetes insipidus. In the former the presence of sugar in
the urine, the gradual emaciation and the retention of the
appetite would be sufficient to make a positive diagnosis.
Prognosis.— Is always unfavorable. The disease is a
progressive one, in which complications follow each other
making the condition hopeless.
Treatment. — Very little can be accomplished except by
regulation of the diet and limiting the carbohydrates fed.
Dogs should be fed on a diet rich in fats and proteids (eggs,
fat meat, or oat meal with fat meat) . Large doses of sodium
bicarbonate should be given (1.5 to 2.5) daily to reduce the
acidosis which is apt to develop. The amount may be
352 DISEASES OF METABOLISM
increased if necessary. Other alkaline agents, such as
Carlsbad salts and ammonium carbonate, may also be
administered. Tincture of opium in large doses (0.6 to 1.0)
once or twice" -daily is highly recommended as it tends to
reduce the amount of sugar. The treatment at best can only
bring about temporary relief, and no permanent results can
be hoped for.
It is important that the patient be kept quiet and its
general strength maintained.
OBESITY.
Definition.— An excessive fat accumulation in the body
which may be general throughout the entire organism, or
confined to certain localized areas, such as under the skin.
The condition is very commonly observed in small animals,
particularly in dogs. Certain breeds, especially the smaller,
are most subject. Castrated animals, especially if castrated
after maturity, tend to become obese.
Etiology.— One of the chief factors in the production of
obesity is the taking in of larger quantities of food elements
than are utilized in the body. Pet animals which are fed
highly nutritious foods (candies, cakes, etc.) and are not
given sufficient exercise become over-fat. It often happens
that an animal will accumulate fat rapidly when only the
normal amount of food is allowed. This occurs in most cases
from insufficient exercise, the elements taken in not being
utilized. The feeding of large quantities of carbohydrates,
or restricting the diet to substances containing a large
proportion of such elements will bring it about. The tem-
perament of animals no doubt has also some influence.
Animals having a phlegmatic temperament tend to become
obese through insufficient activity and exercise. Castration
of animals changes their disposition, tends to make them
phlegmatic and lazy, and therefore fit subjects for the
development of this condition. Should animals be castrated
before maturity this tendency for obesity is not so noticeable.
Anemia by reducing muscular energy may cause obesity,
providing no organic lesion is present and the proper amount
OBESITY 353
of food is allowed. The majority of cases can be ascribed
to hyperalimentation and lack of exercise, rather than any
constitutional disturbance of metabolism. Through the
disturbance of glandular secretions (thyroid) and its regula-
tion by certain organs (adrenals, pancreas, etc.) oxidation
is diminished and constitutional obesity may develop.
Pathology.— No anatomical changes are noted except a
general accumulation of fat under the skin, in the muscles,
liver, around the heart and other organs. The changes in
appearance of the organs and tissue are due to the fatty
deposits.
Symptoms.— The condition is characterized by the rapid
increase in weight, the change in contour of the body, and
in the disposition of the animal. The most common loca-
tions of observable fatty deposits are in the panniculus
adiposus, neck, shoulders and abdomen. Palpation of the
parts will reveal the condition. The animal shows lassitude,
fatigues easily, and often shows dyspnea on exercise. This
is no doubt the result of impeded action of the organs
from the fatty accumulations. Later, during the progress
of the condition, disturbances of other organs and functions
will develop. Digestive disturbances are often quite pro-
nounced and the heart action may be interfered with. The
mucous membranes are pale, showing anemia.
Course. —The course is chronic. Mild degrees of obesity
do not interfere particularly with the animals' health or use-
fulness.
Prognosis.— Depends a great deal upon the extent of the
condition. If the diet can be regulated and restricted, the
prognosis is quite favorable. In pet animals, however, it is
very difficult to restrict the diet as the owner will invariably
break the rules laid down in this regard.
Treatment.— Reduction in the amount of food, system-
atic and forced exercise are important. At first the reduc-
tion in food should be slight but continuous until only a
sufficient amount is allowed to maintain the strength of the
patient. The composition of the foodstuffs given is also
important. Limit the amount of carbohydrates and fats
and allow a greater proportion of nitrogenous foods. A
23
354 DISEASES OF METABOLISM
reduction in the amount of drinking water should be
attempted.
The medical treatment consists in administering small doses
of magnesium sulphate (5.0 to 12.0) daily, or Carlsbad salts
(4.0 to 10.0) once or twice daily. Care should be taken to
avoid a too severe laxative action over a long period of time.
Thyroid extract is of value in increasing the oxidation of
fats. Thyroidinum depuratum (0.2 to 0.75), or iodo-
thyrin (0.1 to 0.2) administered once daily has given
the best results. The proteid food elements should be
increased slightly when these medicinal agents are adminis-
tered. Complications, should they arise, are given appropri-
ate treatment.
GOUT. PODAGRA. ARTHRITIS URICA.
Definition.— A disturbance of nutrition with an excess of
uric acid in the blood. It is characterized clinically by
attacks of acute arthritis, a gradual accumulation of sodium
biurate in and adjacent to the articulations, and with the
development of irregular constitutional symptoms. The con-
dition may involve the internal organs, or both the organs
and the articulations.
Occurrence.— Old dogs are most commonly affected.
Birds, especially chickens, pheasants and pigeons, are also
common sufferers. Experience has shown that it is far more
common in fowls than in any of the other small animals.
Etiology.— The real factors in the production of gout are
not definitely known. The following, probably predisposing
causes, are the most important: (a) The diet evidently
plays an important role in the production of the disease.
Foods rich in albumin, particularly nucleoproteids, seem to
favor the development of the condition. Chickens and other
birds wrhen fed on meat, and meat scraps, are often found with
the disease. Feeding offal from slaughter houses has the
same effect. (6) Certain chemical substances, such as lead,
chromic acid, corrosive sublimate, carbolic acid, acetone,
etc., seem to have some effect in bringing on the disease.
(c) It may be due to the change in the metabolic processes.
GOUT— PODAGRA— ARTHRITIS URICA 355
(d) Fungi on grains and grasses haye been found to be the
cause in fowls, (e) Diseases of the kidneys and ureters, in
which there is an interference in the elimination of the uric
acid compounds, have proved to be important factors in its
production. (/) Lack of exercise, confinement of the animals
or birds, together with the feeding of highly nitrogenous
foods are no doubt the cause of quite a number of cases of
gout. Older dogs, and the larger breeds of chickens are most
commonly affected.
Pathogenesis.— The development of gout is probably due
to an increase in the production of uric acid, and an inhibition
in the elimination of urates, which allows its accumulation
in the blood, and in certain cases to be deposited in connec-
tion with the tissues. Other theories have been advanced
for the development of the disease and have supporters. It
is possible also to have the disease develop in cases when
there is no increase in the formation of uric acid, but other
diseases being present to interfere with the -elimination of the
uric acid compounds.
Pathology.— The characteristic lesions found in articular
gout are enlargement of the joints of the toes, or wings, and
a chalky-like deposit found in the joint proper or in the
adjacent tissue. Examination of the bone-marrow, and the
ligaments and tendons around the joint will often reveal
the same condition. Several joints may be found affected.
In visceral gout, the serous membranes of the cavities, the
pericardium, air sacs, and the liver are covered with small
nodules containing the same white chalky material. The
kidneys contain small white foci, and the ureters are often
found filled with a white, pasty mass. Examination of this
material under the microscope will reveal the crystals of
sodium biurate.
Symptoms.— The first indications of the condition are
usually enlargement of one or more joints, difficulty in
walking about, and lameness. The joints most commonly
enlarged are the wing joints (birds), and the metatarsal and
phalangeal joints in dogs and birds. The animal will stand
quietly and refuse to move, but when forced to do so shows
considerable pain and lameness. Fowls often assume a
356 DISEASES OF METABOLISM
crouching position standing on one limb or shifting from one
leg to the other. Birds will walk or flap their wings with a
minimum use of muscles owing to the pain induced. Exami-
nation of the wings will show enlargement of one or more
joints. At first the swellings are soft and sensitive, but
later become more defined, firmer and not so painful. The
size of the nodules will vary in different birds but is usually
from that of a pea to a hickory nut. Considerable deformity
of the joints of the wings and limbs may be present. The
toes are often spread apart from the enlargement. In some
cases the joints become anchylosed, while in others degenera-
tion takes place with necrosis and a discharge of a whitish-
yellow soft mass. In the latter case there will be an ulcera-
tive process left which often exposes the joint. Small
nodules are found in other locations in the skin, muscles,
and tendons. The general symptoms of rough plumage,
pendent wings, paleness of the comb and wattles, and general
emaciation develop gradually. The bird will frequently die
from exhaustion.
Dogs show enlargement of the joints of the toes, meta-
tarsus ribs, etc. Lameness and stiffness are quite prominent
symptoms. A careful examination should be made in all
cases. Internal or visceral gout will not be recognized except
when accompanied by enlargement of the joints.
Course.— The disease is practically always chronic. A few
cases have been recorded of the acute form. The disease
develops irregularly from one joint to another and therefore
runs a protracted course.
Diagnosis.— The characteristic symptoms of enlargement
of several joints, microscopic examination of the contents of
the nodules, and chemical examination will make the diag-
nosis positive.
Treatment.— Dietetic.— Foods rich in nitrogenous sub-
stances should be withheld. If necessary reduce the total
feed ration for a few days to a week.
Medical.— Alkaline agents, such as sodium bicarbonate
should be used freely in the drinking water of the fowls.
Give dogs 1.5 to 2.0 two or three times daily. The alkaline
preparations will assist in the elimination of the deposited
FEATHER EATING— FEATHER PULLING IN BIRDS 357
urates. Piperazin is highly recommended to prevent the
development of the urates in the tissues (chickens, 0.2 to
1.0; pigeons, 0.1 to 0.4; dogs, 0.5 to 1.0). Small doses are
to be given three times daily and continued for several
days. Internal administration of sodium salicylate has been
tried with fairly good results. Local applications of menthol,
or salicylic acid should be used. I^ffect a solution and apply
to affected joint on absorbent cotton. When the nodules
become large they should be opened, curetted and an anti-
septic pack applied.
FEATHER EATING. FEATHER PULLING IN BIRDS.
A condition observed very commonly in caged birds,
canaries and parrots, but also in chickens, turkeys and
pigeons.
Etiology . — (a) It may be the result of improper food.
Feeding the same materials for a long period, or foods in which
there is a deficiency of certain nutritive elements is a cause.
Confinement of birds in close quarters predispose to it,
partly through lack of exercise, and partly to a narrowing
of the feed ration. (6) It is often considered a vice or habit.
Fighting or picking at each other starts the vice, (c) Results
from skin diseases, especially from parasitic conditions (lice,
fleas, mange mites). The irritation from the parasite leads
to picking at the skin and feathers. Feathers will drop out
as a result of certain diseased conditions.
Symptoms.— Birds are observed to be pulling out their
own feathers or of those confined with them. Bald spots will
be noticed on different parts of the body. Often large areas
are denuded. Careful observation of a flock reveals the
situation. In skin diseases the feathers fall out which can
easily be distinguished from feather pulling. The skin
lesions will assist in making the differentiation.
Treatment. — Birds confined, especially chickens, turkeys
and pigeons, should be given freer range. Complete change
of food will have an important bearing on overcoming the
condition. Feed plenty of oyster shell, bone meal, meat
scrap, dried blood, etc., with green foods to supply the
358 DISEASES OF METABOLISM
elements lacking. Parrots and canaries are difficult to relieve
from the habit. Change in the food, with plenty of green
materials will often help. Examine them carefully to be
sure they are free from lice, or other parasites. Bitter solu-
tions applied to the feathers may stop it. Feather eating
is difficult to control, but change of food as described above,
and the administration of small doses of apomorphin hydro-
chlorid (0.0005-0.001) have proved to be of value in a number
of cases.
CHAPTER II.
DISEASES OF METABOLISM AFFECTING
PRIMARILY THE BONES.
RACHITIS. RICKETS.
Definition.— A disease of young animals, characterized by
impaired nutrition of the entire body and disturbances and
changes in the growth of the bones leading to marked
deformity.
Occurrence.— The disease is rather widespread, appearing
in nearly all countries. Animals in some countries are very
commonly affected, while in others the disease is not so
prevalent. Young animals, as a rule, become affected during
the first few weeks of life, or at about weaning time. The
condition is observed more commonly in dogs than in any
of the other small animals. Cats and rabbits are not very
often affected. Fowls occasionally suffer from the disease,
especially chickens and pigeons. It is commoner in the
larger breeds of dogs and fowls, perhaps due to their more
rapid growth during early life.
Etiology.— Various factors have been given as the cause of
rachitis : (a) Due to a deficiency of lime salts in the organism.
This is no doubt one of the most important causes of the
condition, as it develops most frequently in the breeds that
grow rapidly, and at a time in the animal's life when there is
apt to be a deficiency in the amount of lime salts ingested.
Clinical and experimental evidence tend to prove the accuracy
of this statement. (6) Improper assimilation of lime salts
due to a lack in the acid content of the gastric juice preventing
the lime salts from being dissolved and consequently not
absorbed. Foods rich in potassium salts reduce the hydro-
chloric acid content in the stomach leading to an insufficient
360 DISEASES OF METABOLISM
solution or absorption of the lime salts, (c) Digestive
disturbances (gastric and intestinal catarrh) reduce the
amount of lime salts absorbed by increasing the normal
elimination of calcium compounds from the intestines. In
young animals this condition often occurs at the time of
weaning when the character of the food is suddenly changed.
(d) Inflammatory conditions of the bones in which the blood-
vessels are enlarged and the circulation increased preventing
the depositing of the lime salts in the new bone tissue. This
process keeps the lime salts in solution instead of being
deposited in their normal manner, (e) The possibility of
infection having to do with the production of rachitis has
been considered, but not proved. Various toxic agents
(poisons) wrill bring about a disturbance in the function of
the normal metabolic processes in the body and possibly
bring on the condition or predispose to it. (/) Absence of
sunlight, dark, damp and unsanitary cellars are no doubt
predisposing causes. Heredity has been mentioned also as
having some influence in the development of the disease.
It is quite evident that the exact etiological factor in the
production of rachitis has not yet been determined.
Pathology.— The deformity occurring in rachitis is found
mainly in connection with the long bones. The diaphyses
of the bones are. shortened, softened, become curved. The
epiphyses are thickened, more or less spongy, and much
enlarged. The bones are much softer than normal and have
the consistency of decalcified bone. They can be cut easily
with a knife. The periosteum is thickened, reddened and
when removed from the bones may include some of the bone
substance. In many cases the interior of the bones is soft
and the canal abnormally large. The short bones are found
spongy and easily separated. Marked deformity occurs in
the skull bones which are often separated. The patient in
general will show evidences of malnutrition.
Symptoms.— During the early stages of the disease, before
deformity of the bones is present, there are gastric and
intestinal disturbances (catarrh), and evidences of mal-
nutrition. Weakness, loss of appetite, diarrhea and tendency
RA CHI TI S—RfCKE TX 36 1
for bloating are observed in the early stages. Very often
the disease is not noted until the change in the form of the
bones begins. Deformity appears in various places. The
bones of the head and face show a bulging which gives the
animal a peculiar appearance. The limb bones show curva-
ture and enlargement at the joints. Palpation along the
ribs at the attachment of the bones to the cartilage will reveal
small, rounded enlargements. Twisting and curvature of
the spine are quite commonly observed. The teeth become
loose and displaced, the gums soft and spongy and bleed
easily. Deformity of other bones may be present. General
emaciation, weakness and irregular development of the
bones, writh marked gastric and intestinal disturbances are
prominent symptoms.
Course. — The course of rachitis is nearly always chronic,
lasting for several months. Occasionally the condition runs
an acute course when complications are present.
Prognosis.— When the disease is observed early and treated,
the prognosis is rather favorable. After there is marked
deformity and evidences of emaciation and malnutrition
very little can be hoped for.
Treatment. — The first consideration in the treatment should
be the diet. Dogs should be allowed plenty of meat with
the addition of ground bone. In birds meat scraps and ground
bone seem to produce the best results. Gastric and intestinal
catarrh should be treated, if present, by alkalies and mild
laxatives. The lime deficiency must be relieved by the
administration of lime salts. Syrup of calcium lactophos-
phate has been very satisfactory for this purpose (dogs, 8.0-
12.0; chickens, 1.0-2.0). This should be given twice daily
and continued for a few weeks. Chalk (calcium carbonate),
or calcium phosphate is also to be recommended in doses
of 1.0 to 8.0 daily. In some cases there will also be a
deficiency of phosphorus which can be replaced with calcium
phosphate. Phosphorus in a bland oil (dogs, 0.001-0.002 in
10.0 oil; birds, 0.005-0.001 in 2.0 oil) is also recommended.
Small doses of hydrochloric acid, well diluted, will assist in
the solution and assimilation of lime.
362 DISEASES OF METABOLISM
In dogs, when the limb bones become soft and deformed,
splints and bandages are useful to act as a support which
reduces the deformity to a minimum.
OSTEOMALACIA. BRITTLENESS OF BONES.
Osteomalacia occurs so rarely in small animals that the
reader is referred to other works for the discussion of it.
PART VII.
DISEASES OF THE ORGANS OF LOCOMOTION.
CHAPTER I.
ARTICULAR RHEUMATISM. POLYARTHRITIS
RHEUMATICA.
Definition.— Articular rheumatism is evidently an infectious
febrile disease in which several joints are affected. It is a
serous or serofibrinous inflammation of the joints. It may
suddenly shift from one joint to another.
Etiology.— The actual cause of the disease has never been
definitely proved, but all indications point to infection.
Several factors no doubt have considerable influence in
bringing on the attacks, such as (a) subjection to cold and
chilling the surface of the body; (6) keeping animals in cold,
damp cellars, or forcing them to sleep out in extreme cold
weather; (c) infection following birth of the young. The
close association of the disease with endocarditis and other
diseases of serous membranes further suggest its infectious
nature.
Pathology.— The joint capsule is more or less distended
with a yellowish gelatinous-like fluid mixed with the synovia.
The connective tissue is infiltrated with the same material.
Examination of the synovial membrane itself reveals swelling,
injection and hemorrhages. The cartilage of the joint is
bluish or yellow in color and the surface roughened. Chronic
cases show marked thickening of the periarticular tissue.
Similar changes are often found in the tendon sheaths. The
musculature shows atrophy.
:^64 ARTICULAR RHEUMATISM— POLYARTHRITIS
Symptoms. The condition often begins suddenly involving
one joint or several at the same time. The affected ones are
very painful, the animal refusing to place any weight on the
limb and holding it in a flexed position. The joints will be
hot and swollen. Owing to the pain small animals usually
remain in a recumbent position and refuse to arise. The
acute symptoms often subside after a week, or ten days, and
eventually develop into a chronic inflammation with deform-
ity of the joints. Favorite locations of the inflammation
are in the carpal, stifle, and phalangeal joints. In the early
stages of the attack there is fever, which may reach 103°-105°
F. The respirations are increased, the pulse double the
normal number. The animal refuses to eat in most cases.
The urine is reduced in quantity and dark in color.
In the chronic form the disease assumes the character of
a serosynovitis; the joint capsule is very much thickened
and adhesions take place between the joint surfaces in a
number of cases. Ankylosis, however, is rare. There is
usually but little fever in this form but general emaciation
and cachexia will be prominent. In a few cases complica-
tions develop. Inflammation of the serous membranes is
the most common. This is indicated by a greater rise in
temperature and by the specific symptoms of the complicat-
ing condition.
Course.— In the acute form the disease usually runs for
two or three weeks. Remissions often occur at different
intervals for several months to one year. In many cases the
attack disappears quite suddenly which may be for only a
short time or permanently.
Diagnosis. —This may be difficult. A careful examination
must always be made to differentiate it from other diseases
affecting the joints. It should be borne in mind that articular
rheumatism comes on primarily while that produced by other
diseases shows the primary condition elsewhere before the
joints become affected.
Prognosis.— Should not be considered too favorable. How-
ever, in the dog they may recover completely. Very often
the condition becomes chronic leading to permanent deform-
MUSCULAR RHEUMATISM 365
ity of the joints. Complications may also follow, such as
endocarditis or inflammation of other serous membranes.
Treatment. —Treatment in small animals is often satis-
factory by the use of large doses of sodium salicylate (1.0 to
2.0 daily). After two to three days the temperature falls
almost to normal and the general condition will improve.
Other preparations have been recommended, as salicylic
acid (intravenously), salol, or acetanilid. Local applications
to the joints will assist in giving relief from the pain, and in
the absorption of the deposits. lodin liniments, camphor
oil, or mercuric iodid ointment, any one of which may be
applied alternately with hot water applications. The
animal should be placed in a moderately warm room, where
it is quiet, and provided with a soft bed. In the chronic
form, massage the joints thoroughly daily with Lugol's
ointment.
MUSCULAR RHEUMATISM.
Definition.— A primary affection of the muscles (myositis)
probably of infectious origin. It occurs commonly in dogs.
Owing to the fact that it is very difficult to make a distinction
between muscular rheumatism and so-called "soreness" and
"stiffness" of the muscles, they are usually classed as muscu-
lar rheumatism. The number of cases of muscular rheu-
matism would no doubt be decreased if a careful examination
were made in all cases and a more accurate diagnosis estab-
lished. There has been a tendency no doubt to use the term
muscular rheumatism in a too inclusive sense.
Etiology.— The immediate cause of muscular rheumatism
is probably an infection, the nature of which has not been
determined up to the present time. Several factors have to
do with the development of the disease: (a) Damp, cold
kennels, and exposure to cold have proved decided factors
in bringing on the attacks. Very commonly observed in
hunting dogs following their exposure on hunting trips. This
is especially true in those animals that have been pampered
and kept in warm buildings and quarters, (b) Ptomain
poisoning and intoxication from toxins absorbed from the
intestinal tract will also produce it. (c) Certain infectious
366 ARTICULAR RHEUMATISM— POLYARTHRITIS
diseases of serous membranes will bring on attacks of muscu-
lar rheumatism in a similar manner as articular rheumatism.
(d) Injuries to the muscles, overexertion without previous
exercise, will produce similar symptoms. This, however,
should not be classed as muscular rheumatism.
Pathology.— On examination the muscles will show serous
inflammation with infiltration of the intramuscular con-
nective tissue. Disintegration and fatty degeneration are
found in most cases. The muscular tissue shows evidence
of hyperemia and swelling. In chronic cases the fibrous
connective tissue elements are thickened.
Symptoms.— Pain is always a prominent symptom. This
may be constant in severe attacks or in the milder forms
periodic and recurrent. In dogs the condition very often
comes on suddenly without any prodromal symptoms. The
attack is usually transient lasting from a few hours to several
weeks, and is very apt to recur. The symptoms of muscular
rheumatism will depend somewhat upon the groups of muscles
affected. Sometimes the muscles of the head and neck are
involved ; in this case the head and neck will be more or less
fixed, the animal holding the head in a rigid position. When
manipulated or the animal made to move indications of severe
pain are noted. In other cases the muscles over the scapula
will show the primary seat of the disease. This is often
unilateral, but may be present on both sides. The anterior
limb will be relaxed or the animal show marked lameness
when weight is placed on it. When bilateral the animal
may be found in a recumbent position, with the limbs
straightened out, and refuses to get up. The patient cries
out and whines when the muscles are palpated.
In involvement of the muscles of the back (lumbago
rheumatica) the animal assumes a rigid attitude, very
cautious in all its movements, frequently refusing to move
and when forced to do so great pain is manifest. Occasionally
the patient will be found lying down. Manipulation of the
muscles over the region produces intense pain. When the
muscles of the extremities are primarily affected the animal
lies on its back with the feet upward, whining and crying.
Feces and urine are often retained when the abdominal
MUSCULAR RHEUMATISM 367
muscles are affected. The various functions of the body are
interfered with owing to the pain from the disease. The
sensibility of the skin is either normal or hypersensitive. As
a rule no appreciable rise in temperature is noted. The
respirations are increased and may be shallow when the
respiratory muscles are affected. The pulse may be increased
materially, due to the pain present. The general condition
of the animal is good and the appetite retained. In severe
cases animals become emaciated from the disturbance of the
functions. Complications occur occasionally in the form of
acute inflammation of serous membranes, and disturbances
in the digestive tract.
Course. — The acute attack, as a rule, lasts only a few days
to one week. The symptoms may disappear entirely.
Recurrence of the condition is to be expected.
Prognosis.— Complete recovery without periodical recur-
rences of the disease can hardly be hoped for. Unless
complications develop the patient will apparently recover
from the attack.
Treatment.— The early indications in the treatment are:
Protection of the patient from exposure, relief from the
pain and the administration of antirheumatic agents. The
animal should be placed in a moderately warm, dry place
with a soft bed. All further exposure to cold and dampness
should be avoided. Local applications to the affected
muscles are recommended. Massage the muscles with soap
liniment, camphor liniment, or chloroform liniment. These
should be applied once or twice daily. Hot towels applied
to the affected area often give relief promptly. Internally
administer sodium salicylate or salicylic acid in large doses
(0.9 to 1.5) once daily. When the pain is intense it is
advisable to control it by subcutaneous injections of morphin
sulphate (0.1 to 0.2). This may be repeated in twelve to
eighteen hours if necessary. Complications as they arise
should be treated. In cases that tend to become chronic,
potassium iodid is highly recommended (0.2 to 0.4). Ple-
thoric animals should be depleted by administering saline
laxatives (magnesium sulphate 8.0 to 12.0).
308 ARTICULAR RHEUMATISM— POLYARTHRITIS
FRACTURE OF BONES.
As a result of injuries from various causes small animals
are particularly prone to fractures of different kinds. The
number of fractures and the bones affected are much greater
than in the large animals. All kinds of fractures (partial,
complete, compound, or comminuted) are observed. The
larger number of fractures naturally take place in the extrem-
ities, although fractures of the skull bones, inferior maxilla,
ribs and vertebrte are not uncommon. The causes of frac-
tures are varied, but the greater number of cases result from
traumatism (being run over by vehicles, kicks, falls, jump-
ing, gunshot wounds, bites from other animals). In a few
cases extreme muscular contraction will fracture the bones.
Various diseases of the bones, and senility predispose to
fractures. The following are the more common fractures
met with :
Cranial Bones.— This form of fracture occurs occasionally
in dogs. The writer has observed six cases during the past
ten years.
Etiology.— Practically always results from traumatism.
Being struck by sharp or blunt objects, run over by automo-
biles, kicks, etc., are the most frequent causes.
Symptoms.— Various kinds and degrees of fractures are
recognized, from a simple fissuring of the bones to penetrat-
ing, depressed or compound comminuted fractures. The
symptoms vary with the degree and kind of fracture. Simple
fissuring of the bones may not produce any marked symptoms
unless the concussion has been sufficient to cause hemorrhage
or injury to the membranes of the brain. The presence of the
wound and on pressure slight movement between the bones
may be observed. Penetrating wounds with fracture often
produce complications of hemorrhage into the cranial cavity
or direct injury to the structures within. Examination of the
external wound and carefully probing will at once disclose
the actual conditions. Fractures with depression of a frag-
ment of bone cause more or less brain disturbance depending
upon the location of the fracture. The psychical disturb-
FRACTURE OF BONES 369
ances and the presence of the wound would assist in making
the diagnosis. If there is doubt in regard to the exact con-
ditions the external wound can be opened sufficiently to
examine the parts direct. Compound and comminuted
fractures show the presence of the wound and the opening
through the cranial bones. Fragments of bone may be found
projecting out through the opening or downward into the
cranial cavity. Probing will reveal the conditions. The
concussion from the injury may produce unconsciousness
for a time even though but little damage has been done the
bones themselves. Death occurs suddenly in many instances
when the brain is severely injured or sudden severe hemor-
rhage takes place. Careful examination should be made in
all cases in order to establish a positive diagnosis.
Prognosis.— The prognosis should not be considered too
favorable on account of the danger of brain complications.
Treatment.— The treatment will depend upon the kind of
fracture. In simple fissuring of the bone no treatment is
necessary, except for the contusion of the skin and muscular
tissue covering the bone. Penetrating fractures are best
treated by opening the external wound, examining the
fractured portions and elevating them carefully with a scalpel
or stiff probe. Clean the wound thoroughly and suture the
skin covering it with iodoform collodion.
Depression of the skull bones should have prompt treat-
ment to relieve the pressure from the brain and membranes.
This is best done by making external incision, and if necessary
a small opening through the bones so that an instrument can
be inserted to elevate them to their normal position. Strict
aseptic precautions should be observed in the operation.
Suture the outside wound. In compound comminuted frac-
tures all fragments of bone should be removed, conserving as
much as possible, and a protective dressing applied to the
parts.
Fracture of the Inferior Maxilla.— Fracture of this bone
occurs very often in dogs and cats. The points of fracture
are usually at the symphysis, in front of the premolars, or
posterior to the molars. Frequently the fracture is bilateral,
but in most cases involves one side.
24
370 ARTICULAR RHEUMATISM— POLYARTHRITIS
Etiology.— Traumatism is often the cause of the fracture.
It can result from extraction of teeth. It may follow alveolar
periostitis, or exfoliation of a portion of the bone weakening
the jaw at this point. Extreme pressure from biting on hard
objects (stones of large size) can be a cause. Diseases of the
bones (fragilitas ossium) predisposing them to fracture.
Symptoms.— Difficulty in eating is the first symptom
noticed. Other symptoms are displacement of the maxilla
at the point of fracture, excessive salivation, and enlarge-
ment on the side affected. On examination crepitus and
movement between the portions of bone will be recognized
at once,
Prognosis. — Owing to the complications of infection, and
the difficulty in keeping the parts quiet, the prognosis is
unfavorable.
Treatment.— Various methods of treatment have been
tried. In fissuring without laceration of the mucous mem-
brane it is advisable to try wiring them together with silver
wire using the teeth as fixed points. In compound fractures
when infection takes place treatment is usually unsatis-
factory. Fixing the maxilla by the use of a leather pad or
muzzle in contact with the superior maxilla, disinfecting the
mouth twice daily, and giving liquid foods have proved the
most satisfactory treatment.
In comminuted fractures where fragments of bone must
be removed but little can be expected of any treatment.
Fracture of the Vertebrae.— The points at which fractures
most commonly occur are in the cervical, lumbar, and coccy-
geal segments.
Etiology.— Most cases result from traumatism.
Symptoms.— The symptoms will depend upon the kind of
fracture, whether it is confined to portions of the vertebra?
outside of the canal or involves the canal with the spinal cord.
Crepitus and pain on manipulation of the parts are prominent
symptoms. Should the fracture be confined to the lateral
processes no other symptoms will be observed. In complete
fracture of the cervical vertebrae with involvement of the
cord, death may result in a few minutes, or hours. Complete
paralysis exists posterior to the point of the fracture. Fract-
FRACTURE OF BONES 371
ure in the lurnbar region produces paraplegia and paralysis
of the posterior portion of the body. Differentiation between
hemorrhage in the canal, edema of the cord and fractures is
often difficult and can be determined only by the progress
of the case. Fractures of the coccygeal vertebrae are easily
determined by crepitus and the increased mobility of the
parts.
Prognosis. — Complete fracture of the vertebrae is unfavor-
able. Fracture of the lateral processes or coccygeal vertebra?
is favorable.
Treatment. — No treatment is possible in fracture of the
cervical and lumbar vertebra3. The animal should be placed
in a quiet, comfortable place. Give nourishing food. If
necessary artificial feeding should be carried out. Laxatives
are also necessary. Simple fracture of the coccygeal vertebrae
is best treated by bandaging. If complications arise .or a
compound fracture is present amputation may be necessary
at the point of fracture, or slightly above.
Fracture of the Ribs.— This is found most commonly in
dogs and is of very frequent occurrence.
Etiology.— Produced in many cases by being run over by
vehicles, struck by objects, or kicked.
Symptoms.— One or two ribs may be fractured without
producing marked symptoms. This is especially true in
partial and in simple fractures. Some will show displace-
ment and enlargement at the point of fracture. Crepitus is
hard to distinguish in all patients. Compound fractures may
cause injury to the pleura or lung tissue. Examination should
be made carefully.
Prognosis.— Favorable unless complications involving the
pleura and lungs develop.
Treatment.— Most cases do not require any treatment.
Keep the animal quiet. A bandage applied around the thorax
to assist in keeping the parts fixed might be used. Compli-
cations involving the pleura and lungs should be treated
according to the conditions.
Fracture of the Scapula.— This is not of frequent occur-
rence. In dogs the points of fracture most common are
through the neck and glenoid cavity. In young animals
372 ARTICULAR RHEUM AT ISM— POYL ARTHRITIS
separation takes place frequently between the epiphyses and
diaphyses.
Etiology.— From injuries and diseases of the bones.
Symptoms.— Sudden development of lameness. The limb
usually hangs inert and cannot be moved -upward and for-
ward. Examination will reveal the fracture.
Treatment.— No satisfactory treatment can be applied
owing to the location of the scapula. Dogs, when well cared
for and protected, will recover without special treatment.
Dogs protect the limbs better than any other animal. Stim-
ulating liniments might be applied over the area (soap lini-
ment, iodin liniment).
Fracture of the Humerus.— Owing to the exposed position
of the humerus it is frequently fractured. In young animals
separation of the epiphyseal and diaphyseal portions is not
uncommon. It has been observed that the lower end of the
bone is more often fractured than any other portion. Fract-
ure of the condyles occurs with considerable regularity.
Etiology.— Traumata of various kinds produce the majority
of cases. It occasionally happens that both the humerus
and scapula are fractured at the same time.,
Symptoms.— When unilateral fracture of either the epi-
physeal or diaphyseal portions of the bone takes place the
animal cannot support any weight on the limb. It will hang
free and limp. Should both be fractured the animal rests its
weight on its haunches, or assumes a recumbent position.
Diagnosis. — Examination of the limb will at once make
the diagnosis positive. It is very rare to find a compound
fracture.
Prognosis. —Favorable.
Treatment.— The application of bandages is very difficult.
This is especially true when the fracture occurs in the upper
portion of the bone. Experience has proved that good
results follow without splints or bandages. Occasionally a
false union of cartilage or fibrous connective tissue will result
forming a pseudo-articulation.
Fracture of the Radius and Ulna.— This is the most fre-
quent of all fractures in the anterior limb of the dog. All
small animals are affected in a similar manner. Fracture
FRACTURE OF BOXES 373
usually occurs in both bones simultaneously. When one
bone is fractured it is usually the olecranon portion of the
ulna. The lower third of the bones is the seat of the majority
of fractures.
Etiology.— Practically always result from injuries. Some
few cases are due to diseases of the bones.
Symptoms.— Inability to place weight on the limb and
angularity at the point of fracture. There are swelling and
distortion of the limb. When the olecranon is fractured the
distortion will be marked at the point of the elbow. Crepitus
and free movement between the fractured portions will be
apparent on manipulation.
Treatment.— Wrapping the limb with ordinary linen band-
age is recommended until the swelling subsides. Plaster
bandages are unsatisfactory during the first few days owing
to the change in the size of the parts from swelling. A pad
of cotton should be applied to protect the skin from pressure
necrosis and to allow for swelling to take place, then strips
of cardboard softened by placing in w7arm water for a few
minutes, and over this a linen bandage. The patient should
be observed to determine whether the bandage has been
drawn too tight or has become loose. Should the foot be
found swollen it indicates that the bandage is too tight and
free circulation of blood interfered with. It should be
loosened. After a few days a plaster bandage can be applied
if thought advisable. It should remain in position for a few
weeks to ensure complete union. Uniting the bone at point
of fracture with silver wire has been tried with varying
degrees of success. Radial fractures usually make prompt
and complete recoveries.
Fracture of the Metacarpal and Phalangeal Bones.— These
bones are fractured from the same causes as mentioned under
the others.
Diagnosis. — This is made by careful palpation.
Treatment. — Bandage as in fracture of the radins and ulna.
In compound fractures it is sometimes necessary to amputate
a portion of the limb or toes.
Fracture of the Pelvis. — Fracture of this bone is quite
common in small animals, and presents a variety of condi-
374 ARTICULAR RHEUMATISM—POLYARTHRITIS
tions. The most common points of fracture are through
the symphysis, external angles of the ilium, or through the
acetabulum. Both unilateral and bilateral fractures are
observed. Complications are common following fracture of
the pelvis, owing to the injury of adjacent structures. Injury
to the nerves or bloodvessels is most common.
Etiology.— Pelvic fractures are produced very frequently
by being run over, struck by objects, kicks, or falling.
Symptoms.— The symptoms will vary somewhat depending
on the degree of fracture, its location, and the complications.
Deformity of the pelvis is present in fracture of the external
angle of the ilium. Crepitation and movement of the parts
can be detected. Fracture through the symphysis is evi-
denced by the unnatural gait of the animal, the abduction
of the limbs, and the separation which can be detected on
palpation between the fractured portions. It is sometimes
difficult to make a positive diagnosis in fracture at other
points on account of the smallness of the openings through
which the examination must be made. Complicating symp-
toms should be examined for in all cases.
Prognosis.— Unless complications of hemorrhage and
destruction of some of the nerves occur, the prognosis is
considered favorable. Different degrees of deformity will be
met with which should be considered in the prognosis. The
condition is serious in breeding animals on account of the
deformity narrowing the pelvic canal. Such animals should
be given a careful examination in this regard.
Treatment.— But little can be done in the way of treatment.
Union usually takes place promptly by giving the animal
protection for a few weeks. Various methods have been tried
to approximate fractures of the pelvis but with little success.
Fracture of the Femur.— Fracture of the femur occurs
often in dogs, cats and rabbits. The majority of cases are
found involving the lower third of the bone. Some few cases
are observed in the upper portion, even involving the head
of the femur.
Etiology.— Injuries and accidents account for the larger
number of cases. Diseases of the bone (fragilitas ossium and
osteomalacia) predispose to fracture.
FRACTURE OF BONES 375
Symptoms.— In practically every case the limb is held off
the ground, freely moved in all directions, and appears shorter
than normal. Care should be made to differentiate between
fracture and dislocation of the head of the femur. Examina-
tion of the limb will reveal the point of fracture.
Diagnosis.— Fissuring of the bone may present some diffi-
culty but in other cases the diagnosis is easy.
Prognosis.— Favorable. Union of the bones may result in
some permanent distortion, such as shortening the limb, or a
certain amount of angularity.
Treatment.— An attempt should be made to bandage the
limb to keep the bones in apposition as nearly as possible.
A temporary muslin and splint bandage should be used until
the swelling subsides. Later a better and more permanent
dressing may be applied. As a rule union takes place quite
promptly and without much distortion.
Fracture of the Patella.— This bone is very rarely fractured
in small animals. Careful palpation over the region would
reveal the condition. No treatment other than bandaging
can be applied.
Fracture of the Tibia and Fibula.— These bones are the
seat of all types of fractures. Very common in dogs and
rabbits. The symptoms, prognosis and treatment are similar
to those given for the radius and ulna.-
CHAPTER II.
DISEASES OF THE ARTICULATIONS.
THE various articulations in small animals are subjected
to a variety of conditions.
WOUNDS OF THE ARTICULATIONS.
Punctured wounds and various kinds of incised wounds
are frequently met with. In some cases the adjacent struct-
ures may be severely injured complicating the condition.
Further classification should be made into aseptic and septic
wounds. From a practical standpoint it is important to
examine the wounds carefully to make these distinctions.
Etiology. — It is selfevident that ' these wounds occur
through various accidents and injuries to which the animals
are subjected.
Symptoms.— The animal will favor the joint affected and
refuse to walk on the limb. A thin, serous discharge (synovia)
is noted coming from the wound. The amount of pain and
swelling will not be marked in the early stages. However,
if infection is introduced, these symptoms develop very
rapidly. Pus soon makes its appearance, the joint becomes
very hot and sensitive, and general symptoms of fever, loss
of appetite, are observed.
Diagnosis.— This is made by carefully examining the dis-
charge and by probing the wound with a sterile probe.
Prognosis.— Should not be made very favorable in any case,
owing to the possibility of destruction of the joint, or anky-
losis. Non-infected wounds usually heal without difficulty.
Treatment.— After learning the facts concerning the in-
volvement of the joint, strict antiseptic precautions should
be taken, and all means employed to prevent infection.
SPRAINS AND INJURIES TO THE ARTICULATIONS 377
Shave the hair from the area and disinfect the surface with
bichlorid of mercury and glycerin (1 to 500). Saturate gauze
or cotton with this solution and apply under a bandage, if
possible. When infection is already present it is advisable
to open the wound so that adequate drainage will be brought
about. Use the same solution as above and inject it into the
articulation. Apply a protective dressing. Repeat this
treatment at least twice daily.
SPRAINS AND INJURIES TO THE ARTICULATIONS.
In the larger number of injuries occurring in small animals
it frequently happens that the structures around the joints
are torn or otherwise injured without an external wound.
This condition may occur in any of the articulations. As
soon as the injury occurs the synovial secretion is increased
in amount, and the adjacent tissues are often edematous.
Symptoms.— The condition develops suddenly following
injury, or violent exercise. The articulation soon becomes
enlarged, very hot and painful to the touch. The patient
refuses to bear any weight on the limb. Careful examina-
tion must be made to differentiate sprains from fracture or
dislocation. Distortion, increased movement, and crepitus
found in fractures are absent in this condition. The normal
position of the bones would exclude dislocation. In severe
cases the swelling may be so extensive as to interfere with
making a positive and early diagnosis.
Prognosis. — Most cases of sprains recover.
Course.— The course depends upon the degree of injury.
Treatment.— The animal should be confined in a quiet
place for several days. Cold applications in the form of cold
water, or better, ice packs, should be applied during the
first twenty-four to thirty-six hours. The packs are changed
frequently to keep up the refrigeration. Follow this treat-
ment with hot water, or liniment (iodin liniment, white
liniment) applied once or twice daily. Massage the parts
thoroughly. The latter treatment should be continued for
two to three weeks, if necessary.
378 DISEASES OF THE ARTICULATIONS
DISLOCATION OF THE ARTICULATIONS. LUXATION.
Dislocation of the various articulations in dogs, cats and
rabbits is a common occurrence. Birds often have luxation
of the joints of the wings.
The following are the most common dislocations found in
small animals:
Temporomaxillary.— This occurs more frequently in dogs
than in any other animal. •
Etiology.— Resulting in most cases from extreme opening
of the mouth, either from being forcibly pulled open, or from
large objects being taken into the mouth. The condition
may be either unilateral or bilateral.
Symptoms.— Fixation of the lower maxilla either laterally
(in case of unilateral luxation), or downward and forward
(bilateral luxation). Saliva flows from the mouth freely, the
animal is unable to move the maxilla, or only slightly, and
shows considerable anxiety and pain. Pawing at the mouth
with the forefeet, rubbing the parts against objects, and
carrying the head in abnormal positions, are prominent
symptoms. Patients showing these symptoms should be
handled carefully, as in some respects they are not unlike
dumb rabies. Examination will easily reveal the differential
features.
Prognosis. — Usually .favorable, except when the case is of
too long standing and fracture of the bones is present. There
is always the possibility of a recurrence.
Treatment.— Reduction of the dislocation should be made
early. The animal should be anesthetized (morphin sulphate,
0.1 to 0.2), placed on a suitable table in the dorsal position,
and by using a fulcrum inserted between the teeth, the jaws
are forced apart by bringing the incisors together. By
careful manipulation the bones are replaced in their normal
position. Considerable patience is often necessary to accom-
plish this. If fractures are present but little can be done.
Use artificial feeding of liquid foods for a few days. It is
advisable to tape the mouth shut for a few days until the
articulations are normal again.
DISLOCATION OF THE ARTICULATIONS— LUXATION 379
Vertebral. — Dislocation unattended by fracture is rare.
The articulations are so arranged anatomically that luxation
without fracture is not liable to occur. Partial luxation is
met with occasionally and is diagnosed by the position of
the head and curvature of the vertebrae. Straightening the
head and neck should be attempted.
Scapulohumeral. —Owing to the position of the articulation
and its anatomical structure complete luxation is not com-
mon. The articulation is capable of rather extensive move-
ment without dislocation.
Etiology. — It is brought about by excessive flexion of the
joint from injuries and accidents. The luxation is usually
forward and inward.
Symptoms.— The condition occurs suddenly and distortion
of the joint is apparent at once. The joint is held in a flexed
position and distention is practically impossible. The limb
is much shorter than normal. Examination of the articula-
tion reveals the head of the humerus forward producing an
enlargement anteriorly and a depression posteriorly. Animals
show pain on manipulation of the joint.
Prognosis.— In complete luxation the prognosis is favorable
wThen taken early but later when swelling takes place reduc-
tion is difficult, and the joint capsule will rarely resume its
normal condition. Partial luxations are favorable.
Treatment.— The animal should be anesthetized (morphin
sulphate, 0.1 to 0.2), placed on the table in lateral recumbency
with the affected articulation presented . Extend the humerus
and push backward on the head of the humerus. Usually
replacement will take place without much difficulty. Apply
a bandage for a few days to protect the part. Massage and
a stimulating liniment should be applied around the joint.
Humero-radio-ulnar. —Luxation of this articulation may be
partial or complete. Various conditions can be found owing
to the anatomical structure of the joint. The dislocation
may be between the humerus and radius or between the
radius and ulna. In some cases all of the structures are
involved. The dislocation may take place to the inside or
outside depending upon the cause of the condition. When
dislocation occurs there is nearly always a tearing or stretch-
380 DISEASES OF THE ARTICULATIONS
ing of the ligamentous attachments around the joints. A
congenital dislocation is sometimes observed.
Etiology.— The condition is brought about by injuries, such
as blows from the outside or inside, extreme flexion or exten-
sion of the joint, falling, or jumping. Frequently the limb
is given a sudden twist by the foot being caught when the
animal is in motion, or pulling backward to free itself.
Symptoms.— Distortion of the articulation is noted, and
the lower limb in an abnormal position, either abducted or
adducted. There is an enlargement present on one side and
a corresponding depression on the opposite. The limb
appears short, and the animal refuses to place any weight
on it when in motion or at rest. Examination reveals the
joint to be hot and painful when manipulated. The dis-
placed bone can easily be palpated, and the luxation deter-
mined.
Prognosis.— Not very favorable owing to the injury to the
annular ligaments, and the possibility of a return of the
condition.
Treatment. — Reduction of the dislocation should be made
under general anesthesia. The method of procedure will
depend upon the dislocation. As a rule but little difficulty
will be experienced in bringing the parts back to their normal
position. After reduction of the luxation the parts should
be bandaged to hold them in position. The bandage should
be left in place for two or three weeks, or until the annular
ligaments are united. Congenital luxation is unsatisfactory
from the standpoint of treatment. Wiring of the bones
might be tried in cases that cannot be kept in position by
bandaging.
Radio-ulnar-carpal.— From violent injury luxation of this
articulation may take place. The annular ligaments become
torn allowing the articular surfaces to be displaced.
Symptoms. — Distortion of the articulation either forward
or backward is most common.
Diagnosis.— The diagnosis is not difficult when a careful
examination is made.
Treatment.— Reduction of the luxation is easy, but it
requires several weeks before the animal will be able to use
DISLOCATION OF ARTICULATIONS— LUXATION 381
the limb. Protect the joint by placing a pad of cotton under
a bandage. Keep the bandage on for two or three weeks.
Phalangeal. — Dislocation is very common and results from
traumata. A careful examination should always be made
to differentiate luxations from fractures, and to definitely
determine the joint displaced. They should be reduced as
early as possible and a bandage applied. Keep the bandage
in position for two to three weeks.
Coxofemoral. — This is one of the most common disloca-
tions in dogs, cats and rabbits. It may be partial or com-
plete. When partial the damage is mainly in connection
with the capsular ligament, while in complete luxation the
entire joint structure and the adjacent tissues are involved.
Etiology.— Being struck by objects, run over by vehicles,
and having the foot caught in traps, etc., are the most com-
mon causes. Extreme extension of the limb from any cause
may bring it about.
Symptoms.— The most frequent form of luxation is forward
and upward. The animal is found with the limb fixed in a
backward, adducted position, and refuses to place any weight
on it. An enlargement will be noted just anterior to the
normal position of the joint, and on palpation the head of
the femur can be felt. Manipulation of the limb will at once
reveal the condition. Luxation into the foramen ovale is
not common but occurs in a small percentage of cases. The
limb appears longer than normal, is slightly abducted, and
the stifle joint is turned outward. Adduction of the limb
is difficult and impossible to the normal degree. Palpation
of the parts will easily diagnose the condition.
A backward, upward luxation occurs occasionally and the
position of the limb is forward and inward, with an enlarge-
ment present on the posterior aspect of the joint. ( areful
examination will determine the relationship of the parts. In
partial luxation the animal is able to move the limb and
shows lameness but very little deformity. Chronic conditions
become accommodated to the movements of the anim
through the formation of a pseudo-articulation.
Prognosis.- Rather unfavorable for a complete recovery.
Early cases are much more favorable than those of a few days
or weeks standing.
382 DISEASES OF THE ARTICULATIONS
Treatment.— Treatment should be applied as early as pos-
sible. -Anesthetize the animal and effect replacement by
manipulation of the limb according to the character of the
luxation. The principle involved is to extend the articulation
in whatever direction is necessary so that the head of the
femur can be returned to the acetabulum. Very little can
be done in after-treatment except keeping the animal quiet
for several days. Mechanical appliances to hold the bones
in position have not proved satisfactory. Little can be
expected in the treatment of chronic cases.
Patellar.— This occurs most frequently in the dog. The
ligaments of the patella are not very well developed outside
of the middle one. Therefore, displacement is more liable to
occur laterally. Experience has shown that internal displace-
ment is by far the most common.
Etiology.— The anatomical structure of the patellar liga-
ments and the joint in particular make displacement easy
from excessive exertion or injuries. In some breeds the
internal femoral ridge of the patellar groove is very small;
therefore internal displacement is of common occurrence.
Symptoms.— The limb is held in a flexed position, and the
patient has difficulty in supporting weight. The flexion is
most apparent at the stifle joint. The position of the limb
is somewhat characteristic, the stifle joint adducted, the
hock rotated outwardly, and the lower portion of the limb
carried toward the median line. Examination of the stifle
joint will reveal the misplaced patella. When the condition
is bilateral the animal will show a crouching attitude, and
will have considerable difficulty in maintaining the standing
position. The animal moves with great difficulty in bilateral
dislocation.
Prognosis.— The prognosis should not be considered favor-
able owing to the difficulty in keeping the parts quiet and
the possibility of a recurrence of the condition. Very often
there is a tendency for the condition to become chronic.
Treatment.— Replacement of the patella presents very little
difficulty; therefore the problem of keeping the patella in
position until the ligaments assume 'their normal condition
is to be the principal aim in treatment. Replacement is
INFLAMMATION OF THE SYNOVIAL MEMBRANE 383
affected by extension of the joint which will allow the patella
to be pulled back to its normal position. Apply linen bandage
in order to retain the parts in their normal position. The
animal should be kept quiet for several days. A plaster
bandage might be used to advantage.
Tibiotarsal. — This is not very common in small animals.
When it does occur it is accompanied by rupture of the liga-
ments or fracture of some of the bones. A careful examination
should be made to determine the conditions as accurately as
possible. Linen bandage should be applied for the first few
days, followed by a plaster bandage if necessary.
Caudal Vertebrae.— The larger breeds of dogs with long
tails (Great Dane, greyhound, etc.) are the most frequent
sufferers. Examination of the parts will reveal the condition.
A bandage applied rather firmly and kept in position for
several days will correct the dislocation.
INFLAMMATION OF THE SYNOVIAL MEMBRANE AND
ARTICULATIONS. SYNOVITIS. ARTHRITIS.
Definition.— An inflammation of the synovial membrane
and articular surfaces. The conditions may be acute or
chronic. Very often the entire joint will be inflamed (syno-
vitis and arthritis). It is very difficult to make a distinction
between these two conditions.
Etiology.— Most cases result from sprains and contusions
of the joint. Few result from infection (pyogenic). The
infection usually gains entrance through wounds of the syno-
vial membrane.
Symptoms. -Enlargement of the joint, extreme sensitive-
ness, and increased local temperature are characteristic
symptoms. The animal cannot use the limb to any extent.
Examination should be made carefully to differentiate it
from articular rheumatism.
Prognosis. — Favorable in cases resulting from sprains and
bruises; unfavorable in infected joints.
Treatment. — During the early stages of the condition cold
applications are applied either in the form of cold water or
ice picks which should be carried out conscientiously if the
384 DISEASES OF THE ARTICULATIONS
best results are to be expected. This treatment may be
followed by hot applications and liniments (soap liniment,
white liniment, iodin liniment). During treatment the
animal must be confined to ensure rest to the affected joints.
In case pus is present in the articulation, it should be opened
and antiseptics directly injected. (See Wounds of Joints.)
Chronic cases are not amenable to treatment.
PART VIII.
DISEASES OF THE URINARY SYSTEM.
CHAPTER I.
DISEASES OF THE KIDNEYS.
Examination.— Examination of the kidneys consists of ab-
dominal palpation, direct inspection and exploration, and
examination of the urine.
(a) Abdominal palpation is best done with the animal in a
standing position, using the fingers of both hands. By gentle
digital pressure, abnormalities in the dimension and location
of the kidneys will be noted. This method of examination
will prove satisfactory only in cases where a marked enlarge-
ment occurs, or in emaciated animals.
(6) Direct inspection of the kidneys may be made, espe-
cially in dogs, by performing laparotomy under anesthesia
(see Laparotomy). This method can be done safely and will
be found useful in determining accurately the size, consist-
ency, and location of the kidneys. In cases of cysts or other
enlargements an exploring needle may be used to obtain
some of the contents for examination.
(c) The examination of the urine should be made chemi-
cally and physically. Chemically tests should be made for
albumin and sugar. The tests for albumin are made as
follows: Heller's ring test is a very valuable one as a very
small percentage of albumin can be demonstrated with it.
It is made in the following manner: A small amount of
urine is filtered, poured into a test-tube containing concen-
trated nitric acid. At the point of contact of the two liquids
25
386 DISEASES OF THE KIDNEYS
a well defined white ring forms, the depth of which depends
upon the amount of albumin present.
The boiling point may also be used. Take a few cubic
centimeters of urine in a test-tube and heat to boiling, acidu-
late by adding 5 to 10 drops of concentrated nitric acid. A
precipitate which has been formed by earthy phosphates or
carbonates will then dissolve, but one due to coagulated
albumin remains.
The metaphosphoric acid test is made by adding an aque-
ous solution of metaphosphoric acid to the urine. The urine
becomes cloudy in case albumin is present.
The acetic acid-ferrocyanid of potassium test is made by
adding 2 per cent, of acetic acid to the urine and then a
5 per cent, solution of ferrocyanid of potassium, the latter
drop by drop avoiding an excess. Jf albumin is present a
decided turbidity or flocculent precipitate appears.
The quantitative determination of albumin is made with
Esbach's albuminometer. Acidulated urine is filled into the
sign U, the reagent up to R (1 part of picric acid, 2 parts of
citric acid, and 100 parts distilled water), the tube is closed
with a rubber stopper and slowly turned over several times
without shaking; let stand at room temperature for twenty-
four hours, the precipitate has settled and may be read off.
The figure indicates the proportion of albumin in grams pro
mille. Urine containing a large percentage of albumin must
be first diluted with water and the indicated figure must then
be multiplied with the figure of the dilution to obtain the
exact amount of albumin present.
When it has been demonstrated that albumin is present
in the urine, then it must be determined whether the albumin
originates from the kidneys, from the urinary passages, or
from the nearby genital organs. If the urinary sediment
contains no organic form elements, or form elements derived
from the kidneys, and if the presence of dissolved coloring
matter of the blood may be excluded, then it is positive that
it is renal albuminuria. If there is a large amount of organic
sediment then it is not likely to be renal albuminuria. In
some cases it is possible to have a mixture, coming from the
kidneys and also from other parts of the urinary system.
CONGESTION OF THE KIDNEYS— HYPEREMI A 387
The chemical test for sugar in the urine is best made -by
using Trommer's test, which is as follows:
A few cubic centimeters of urine are put into a test-tube,
after removing any albumin which might be present, dilute
it with an equal volume of water, render it alkaline with a
small quantity of sodium hydrate, then add drop by drop
a 4 per cent, solution of copper sulphate until the liquid is
clear and the sediment dissolved, then heat until it boils. If
sugar is present, a reddish-yellow vapor appears at the sur-
face of the fluid. The bismuth test is often used for the same
determination. The albumin is removed from 10 parts of
urine and added to this is 2 parts of subnitrate of bismuth,
4 parts Rochelle salts, and 100 parts of a 10 per cent, solution
of sodium hydroxid. This mixture is boiled for five minutes.
It becomes black if sugar is present.
To determine the quantity of sugar present the saccharom-
eter is used. The urine is fermented by adding a small
quantity of yeast. Graduated glass tubes or other appa-
ratus are necessary to determine the exact quantity of sugar
present.
Physically the urine varies in color and amount, depending
a great deal upon the kind and amount of food, the condition
of the kidneys, and the species of the animal.
CONGESTION OF THE KIDNEYS. HYPEREMIA.
This condition is- divided into two forms, viz.: (a) Acute
hyperemia (arterial hyperemia), (6) passive hyperemia
(venous hyperemia) .
Acute Hyperemia.— Etiology.— The causes of this condi-
tion are usually the same as those producing acute nephritis.
Irritating foodstuffs, chemicals and various diuretic com-
pounds, are the most common things producing acute hyper-
emia. It may occur during the course of infectious diseases
(distemper, rabies). Plethoric animals frequently have active
hyperemia of the kidneys.
Pathology.— The kidneys are enlarged, swollen, softened
and highly reddened. The arteries and capillaries are found
388 DISEASES OF THE KIDNEYS
distended. Small hemorrhages appear under the capsule.
The capsule is easily removed.
Symptoms.— This condition may not produce very marked
symptoms. The most noticeable is the increased amount
of urine, the specific gravity of which is much lower than
normal. Sensitiveness over the region of the kidneys, and
stiffness in walking are also common symptoms.
Prognosis.— Depends upon the cause. There is always
danger of the condition resulting in an acute inflammation
of the kidneys.
Treatment. — Acute purgation is indicated. Administration
of magnesium sulphate, or calomel to remove the waste
material through the bowels. Avoid irritating foodstuffs.
Give milk for a few days. The cause should be removed if
possible.
Passive Hyperemia.— Etiology.— This condition is brought
about as a secondary disease following valvular defects, dis-
eases of the lungs, pleura, etc. In some cases it is produced
by pressure on the renal vessels by tumors, etc. In all
instances the circulatory disturbances lead to an engorgement
or passive congestion of the kidneys.
Pathology.— In passive hyperemia the kidneys are of a
dark bluish-red color, larger than normal. On cut section
the venous blood oozes out. In old cases there will be found
considerable connective tissue thickening.
Symptoms.— In this condition the quantity of urine is
decreased, and albuminuria is present.
Prognosis.— Depends upon the primary condition.
Treatment. —Medical.— Digitalis administered in small
doses daily. Animals should be given gentle exercise. Give
nourishing food which is non-irritating (milk and eggs).
INFLAMMATION OF THE KIDNEYS. NEPHRITIS.
Acute Nephritis — Definition. — An acute inflammatory condi-
tion of the kidneys, which is characterized either by nutritional
disturbances of the renal epithelium with only a slight change
in the interstitial connective tissue (parenchymatous nephri-
INFLAMMATION OF THE KIDNEYS— NEPHRITIS 389
tis), or an involvement of both the renal epithelium and the
interstitial tissue without the formation of a purulent exudate
(nephritis acuta diffusa).
Etiology.— This disease is quite common in small animals
and birds in which it frequently develops from infectious
diseases and poisons.
Acute nephritis occurs secondary to infectious diseases.
The organisms circulate via the blood stream, become lodged
in the glomeruli and in the intertubular bloodvessels, and
at the point of lodgment injure the tissues. In this way the
disease occurs during the course of distemper, chicken cholera,
septicemia, etc. Bacterial toxins in passing through the
cellular elements of the kidneys, produce in them and the
bloodvessel walls certain degenerative processes, which
eventually lead to an acute inflammation. The bacterial
toxins probably produce the disease in the majority of cases,
as the absorption of toxins takes place in a number of condi-
tions, such as in diseases of the alimentary tract, diseases
of the peritoneum, etc., and in this manner we may account
for the development of acute nephritis during or following
such diseases. In like manner acute nephritis may occur
following any organic disease. In small animals it frequently
follows the ingestion of decayed foods, the preformed toxins
are absorbed and eliminated through the kidneys, producing
a severe form of acute nephritis. The same condition may
result from absorption of products from wounds, from mange,
eczema, etc., especially when extensive.
Acute nephritis also develops from vegetable and mineral
poisons, especially when introduced in rather large quantities.
Such substances, as cantharides, carbolic acid, arsenic, oil
of turpentine, extract of male fern, mercury preparations,
etc., are eliminated via the kidneys and excite an acute inflam-
mation. Birds (turkeys) often eat various insects, such as
grasshoppers, caterpillars, the acrid substances of which are
absorbed from the intestinal tract and induce the inflamma-
tion. This same condition has been observed in cats from
eating large numbers of insects (grasshoppers).
Injuries in small animals are very common, such as blows
across the back in the region of the kidneys, being run over
390 DISEASES OF THE KIDNEYS
by vehicles, falling, etc., which may result in direct injuries
to the kidneys and eventually in acute inflammation. Sub-
jection to extreme cold has been considered one of the etio-
logical factors: It probably reduces the general resistance
of the renal tissue so that infectious substances have a greater
effect upon it. This has been observed, especially in puppies
and kittens that have been kept in damp, cold kennels. The
same thing is found in hunting dogs after being forced to
wade or swim through cold water.
Pathology.— This is usually divided into three classes as
follows :
(a) Parenchymatous nephritis, in which the primary inflam-
matory changes are most pronounced in the parenchyma of
the kidney. This is characterized by only slight swelling,
the capsule more easily removable, and on cut section a
grayish or dull color is noted. Sometimes there will be
observed grayish-red or yellowish-brown spots. The medul-
lary substance is hyperemic, often dark red in color and the
Malpighian bodies are quite prominent, while the balance
of the organ is either normal or of a soft consistency.
Microscopically the veins and capillaries are enlarged,
congested, granular and fibrous deposits between the urinif-
erous tubules, and epithelial casts, cells, fatty degeneration
with swelling and opacity.
(6) Hemorrhagic parenchymatous nephritis, which is char-
acterized by a large number of red points giving the external
appearance of the organ a dark red color, dull gray on
section, blotches of red and in the medullary portion a
deep red.
Microscopically the veins and capillaries are found engorged
with blood, hemorrhages appearing in the adjacent tissues.
(c) Diffuse Acute Nephritis.— Very noticeable is the in-
crease in size and weight of the organ, sometimes two or.
three times larger than normal. The tissues are soft and
friable. The capsule is easily removed, and the external
surface a bright red color with some yellowish or gray patches.
Microscopically there will be found enlargement of all
vessels with extensive extravasation of blood into the tissues,
leukocyte casts in the dilated urinary ducts, and extensive
INFLAMMATION OF THE KIDNEYS— NEPHRITIS 391
cellular infiltration between them. The glomeruli are often
filled with blood and covered with bloody extravasations.
Symptoms.— The general symptoms are loss or suppression
of the appetite, slight elevation of the body temperature,
pulse strong and hard at first, later weak and rapid; frequently
vomiting in the dog and cat. Constipation during the early
stages, followed later by diarrhea, is prominent in most
cases.
Most animals have difficulty in walking (stiff gait) as
the movement of the body tends to compress or move the
kidneys, hence pain is induced. During the early stages of
the disease there are frequently noticed paroxysms of pain,
especially when the animal is first moved, or palpated over
the region of the kidneys. On standing they assume a
stretched attitude in order to relieve the tension on the dis-
eased organ. Frequently in walking the limb on the side
affected will be dragged or the forward step shortened. It
has been observed in male animals that one testicle will be
drawn higher than the other.
The changes in the urine form the most characteristic
symptom. Usually at first there is suppression, with very
scanty flow of urine, highly colored, containing some blood,
albumin and tube casts. The total quantity passed in twenty-
four hours is greatly reduced, specific gravity high, of a
thicker consistency than normal, often slimy and turbid.
Hematuria may develop.
Microscopically the urine is found to contain urinary casts
in large numbers, white and red blood corpuscles and numer-
ous epithelial cells. The urine is voided a few drops at a time,
especially in the dog, with pain (strangury) .
Uremic symptoms are noted in some cases. The stoppage
of the flow of urine from the swelling of the tissue of the
kidneys, compression and filling of the ducts with exuded
casts, causes a retention of waste products and a lack of
secretion, hence an accumulation of urea and uric acid, and
other decomposition products sufficient to produce marked
symptoms. In the dog these symptoms develop rather
rapidly in the form of weakness, staggering gait, convulsions,
irregular temperature and coma.
392 DISEASES OF THE KIDNEYS
Diagnosis. —This condition is very frequently mistaken for
inflammation of some other abdominal organ, especially
peritonitis, enteritis, cystitis, or metritis. It is possible to
make a differential diagnosis by a careful examination of the
animal, by observing the character and amount of urine
voided and a microscopic examination of the urine.
Course.— The course is usually acute; occasionally the dis-
ease terminates in chronic nephritis.
Prognosis.— On the whole. the prognosis is unfavorable, the
patient often dying in six to ten days. When the symptoms
of uremia are present, the prognosis should be considered
very unfavorable.
Treatment.— Dietetic.— For the dog and cat a milk diet is
of the greatest importance. Avoid the giving of irritating
foods and drugs.
Medical.— Establish diaphoresis as early as possible. This
can be done by the use of warm baths, steaming the animal,
and rubbing the skin. Wrap the animal in warm blankets.
Diaphoretics, such as pilocarpin, are not very satisfactory in
small animals.
Purgatives are to be recommended. Magnesium sulphate
(10.0-16.0) every four hours until active catharsis takes place
is useful. Small doses of arecalin (0.003-0.005) may be
given to the dog to hasten early evacuation of the bowels.
Calomel, owing to its prompt action, is excellent for dogs.
In heart weakness, during the secondary stages of the dis-
ease, digitalis fluidextract (0.1-0.15) should be used. Alka-
line diuretics, as potassium acetate, are to be used in
small doses. Diuretin has been found to be valuable as a
diuretic.
In convulsions following uremia, potassium bromid or
morphin for dogs should be administered. Tannic acid (0.1)
is highly recommended.
Chronic Nephritis — Definition.— A chronic inflammation of
kidney, which the may be divided clinically into two groups,
viz.:
(a) Chronic parenchymatous nephritis, characterized by
marked dropsy and during the early stages of the disease, on
postmortem, by the large white kidney. In the later stages
CHRONIC NEPHRITIS 393
of the disease the kidney usually is small— small white
kidney.
(6) Chronic interstitial nephritis, characterized by cardio-
vascular changes which are pronounced, but only in a few
instances will dropsical conditions appear.
Etiology. — It has been observed that chronic nephritis in
some instances follows the acute form of the disease. This is
true no doubt only in the subacute or milder acute cases.
It may develop gradually as an insidious disease without
any apparent cause.
Injurious substances in the form of irritants, which may
be either parasitic or chemical in nature, in being eliminated
via the kidneys, may produce sufficient irritation to induce a
chronic inflammation. Certain drugs when administered
for some time (turpentine) or absorbed from the skin, as in
the treatment of mange (coal-tar compounds), will produce
irritation resulting in chronic nephritis.
It may follow some of the infectious diseases, such as dis-
temper in the dog and cat. The excess of wraste products
together with the various toxins formed are eliminated in
such quantity that they irritate the renal tissue.
Subjection to extremes in temperature (cold or heat) dis-
turbs metabolism, which increases the action of the kidneys,
and the amount of albuminous decomposition may be a
cause. In other cases no apparent cause can be found.
Pathology. — (a) In chronic parenchymatous nephritis sev-
eral varieties have been recognized.
The large white kidney is characterized by enlargement,
the capsule very thin. When cut longitudinally the cortex
is swollen and yellowish-white in color, mottled on surface
with a number of opaque spots. The pyramids of the kidney
are deeply congested.
The small white kidney in which the connective tissue is
found thickened, and a gradual reduction in the enlargement
of the parenchymatous tissue. On cut surface the resistance
is much greater than the other type, the cortex is much
smaller and contains a number of white or whitish-yellow
spots. These whitish-yellow spots represent areas of fatty
degeneration. The interstitial tissue is changed, enlarged,
394 DISEASES OF THE KIDNEYS
many of the glomeruli destroyed, degeneration of the epi-
thelium in the convoluted tubules, and the arteries are much
thickened. Microscopically the epithelium is found granular
and fatty; the tubules of the cortical substances are enlarged
and filled with tube casts. Hyaline changes are found in the
epithelial cells. The glomeruli are found enlarged, the cap-
sules are thicker than normal, and the capillaries show some
hyaline changes. The interstitial tissue is increased to some
extent.
(6) In chronic interstitial nephritis the kidneys are small,
contracted, and may be reduced to nearly one-half their
normal size. The capsule of the kidney is thickened, very
much adherent, and when stripped off carries with it some
of the cortical substance. Small cysts are often found on
the surface. On cut section the kidney is found reddish or
dark red in color. The cortex is very thin. The surface of
the kidney is uneven with numerous small projections.
Sometimes the kidneys are lobulated, the consistency is hard,
and the general texture almost semicartilaginous. The inter-
stitial connective tissue is far in excess of the parenchy-
matous structure.
Microscopically there is noted a great increase in the
connective tissue, a degeneration and atrophy of the secreting
structures, both glomerular and tubal.. The increase in the
fibrous elements is widely distributed throughout the kidney,
although in most cases found more extensively in the cor-
tical portion. The glomerular changes are found marked,
numbers of them being completely degenerated into hyaline
substances. The tubules show changes in the epithelium, in
some instances greatly atrophied, in others the epithelium
has entirely disappeared.
The bloodvessels (arteries) in the advanced cases show
advanced sclerosis. The changes take place in the entire
vessel wall. In chronic nephritis we find in a great many
cases in dogs organic changes in the heart (hypertrophy).
Symptoms.— This condition does not present very definite
symptoms until the disease is quite well advanced. The first
symptoms noted are those of a general nature, such as par-
tial or complete loss of appetite, weakness, fatigue, etc.
CHRONIC NEPHRITIS 395
In parenchymatous nephritis the secondary symptoms
are characterized by dropsical swellings appearing on the
limbs, breast, and particularly ascites. The animal shows
general emaciation, pale membranes, and all the signs of
general cachexia. A careful examination must be made in
such cases to distinguish from circulatory disturbances. The
urine should always be carefully examined. We will find
in these cases the amount of urine decreased and its specific
gravity increased. The urine will also be found to contain
numerous casts, epithelium, fat cells, and in some cases red
blood corpuscles. The pulse will be found accelerated, tense
and hard; the heart beat is strong, palpitating, and in smaller
breeds may shake the entire body. Marked dulness over the
region of the heart is noted indicating hypertrophy. The
temperature is slightly elevated until in the later stages of
the disease when it will be found to be subnormal. In the
very late stages symptoms of uremia appear, with rapid
emaciation and exhaustion, and the animal soon succumbs.
In chronic interstitial nephritis the symptoms are some-
what different. The most noticeable difference is in the
character and composition of the urine. The amount of
urine is increased, the specific gravity very low, and the
albumin content is greatly diminished. There is compensa-
tory hypertrophy of the heart, and if this compensating
action is sufficient, the animal may live for some time. How-
ever, sooner or later there will be insufficient heart action,
the pulse will become weak, feeble, and ascites and edemas
appear. The animal gradually becomes weaker and finally
dies from exhaustion.
Diagnosis. --This is only possible in cases where a careful
examination is made of the urine, together with a pains-
taking general examination. We must differentiate chronic
nephritis from primary circulatory disturbances.
Prognosis. — In both forms of chronic nephritis, the prog-
nosis should be considered unfavorable, because in the
majority of cases the condition is quite well advanced before
a diagnosis is made. Even in apparently mild cases marked
pathological changes in the kidneys are often found.
396 DISEASES OF THE KIDNEYS
Treatment.— Dieted.— Improve the general condition of
the animal by giving plenty of milk and easily digested food.
Avoid highly nitrogenous foods.
Medical.— The first thing to be considered from a medical
standpoint is to sustain and strengthen the heart action by
giving small doses of fluidextract digitalis (0.1 to 0.15) daily.
As a diuretic, administer diuretin (0.2 to 0.4) twice daily.
Calomel is useful in dogs to keep the bowels open and assist
in the elimination of waste products.
In dropsical conditions (ascites) small doses of pilocarpin
(dog and cat 0.003-0.01) may be administered once daily.
Small doses of potassium iodid (0.06-0.2) are to be admin-
istered as a resorbent once daily to dogs.
Surgical.— When ascites threatens the life of the animal
the fluid should be removed with a trocar. (See Abdominal
Puncture.)
Purulent Nephritis.— Kidney Abscess.— Definition.— An in-
flammation of the kidneys resulting from infection and
characterized by the formation of either numerous small
purulent foci, or larger abscesses.
Etiology.— A very common cause of this condition is the
infection reaching the renal tissue from the blood stream
(hematogenous) . This mode of infection in most cases
follows diseases of other organs, or pyemia, such as endo-
metritis puerperalis in the bitch and cat; mammitis, pneu-
monia, phlegmonous pharyngitis in the cat; purulent bron-
chial catarrh, distemper, and, in puppies, infection at birth.
It has been found that purulent nephritis will be produced
in animals without any particular focus of infection. In
cases of general reduced resistance the organisms may find
their way to the renal tissue, develop and form abscesses.
Traumatic causes are quite common in small animals as
injuries over the region of the kidneys are frequent. These
may bring about the condition by reducing the local resist-
ance and the accompanying inflammation makes a favorable
place for the development of organisms which are present
in the blood stream.
Urogenic causes are perhaps the most frequent. The
PURULENT NEPHRITIS 397
infection spreads to the organ via the bladder, ureters, and
pelvis of the kidney.
In small animals subjection to extremes in temperature
has been mentioned as an indirect factor in bringing about
the condition,
Pathology. — We recognize two forms of purulent nephritis
on postmortem:
Diffuse Purulent Nephritis (Nephritis purulenta punctata,
diffusa).~\n this form the kidneys are enlarged; numerous
small white spots or yellowish dots are present which are sur-
rounded by a reddish zone. On close examination the puru-
lent masses may be easily removed. These foci of infection
may be found quite generally distributed in one or both
kidneys.
Microscopically there is found a large number of pus cells
in the foci of infection, cellular infiltration with large numbers
of bacteria present in the tissue surrounding them. The
epithelial cells show fatty degeneration, the glomeruli
surrounded by pus, and the tubules partially filled with
leukocytes, red blood cells, and casts.
Nephritis Apostematosa (Renal abscess).— We find in this
form abscesses of varying size, which may be a single abscess
formed from an embolus, or the kidney tissue break down to
form a very large abscess (pyonephrosis). The connective
tissue increases around the abscess forming a thick wall.
Symptoms.— Clinically it is quite difficult to recognize this
condition. In cases which originate by metastasis we will
observe the symptoms of the primary condition, such as
pyemia, endometritis, etc.
Should the disorder develop rapidly, there will be found
practically the same symptoms as in acute diffuse nephritis.
(See Acute Nephritis.)
In dogs the patient becomes very stiff, refuses to move,
shows pain on palpation over the region of the kidneys; in
some cases a distinct enlargement on one or both sides high
in the lumbar region can be determined. In examining such
cases the animal should be placed in a standing position,
both hands used, one on either side of the animal, and the
398 DISEASES OF THE KIDNEYS
palpation performed with gentle pressure. Micturition is
painful, very often only small quantities of urine being voided.
As the disease progresses more pronounced general symptoms
of weakness, exhaustion, and uremia will be observed.
Animals often die very early from general sepsis.
Diagnosis.— An accurate diagnosis is very difficult. In
many cases the disease is not recognized until a postmortem
examination is made. The symptoms, including careful
palpation coupled with examination of the urine, usually
suffice for the diagnosis.
Prognosis.— The prognosis is bad as the disease is usually
in an advanced stage before being recognized.
Treatment.— In cases of advanced renal abscess there is
little that can be done. The operation of removing one
kidney does little good as both are usually diseased. Uremia
commonly follows the removal of the kidney when both are
involved. Symptomatic treatment is about all that can be
done. Heart stimulants, laxatives, etc., may be tried. (See
Acute Nephritis.)
INFLAMMATION OF THE RENAL PELVIS.
Pyelitis.
Definition.— Inflammation of the pelvis of the kidney.
Etiology.— Pyelitis may result from the spread of inflamma-
tion from adjacent parts or organs, such as from the kidney
(pyelonephritis) or from the bladder (pyelocystitis).
The presence of urinary calculi in the pelvis of the kidney
mechanically irritates the membrane and leads to an inflam-
mation.
In the course of infectious diseases (distemper in the dog
and cat; cholera in birds) this condition develops on account
of the infectious or poisonous matter excreted from the body
via the kidneys irritating the mucous membrane.
Excretion of toxic materials (poisons of different kinds)
would act in a similar manner. On account of the frequency
of poisoning in small animals this is a very common cause.
Parasites often cause pyelitis, especially in dogs
(Dioctophyme renale). The parasites cause an intense inflam-
INFLAMMATION OF THE RENAL PELVIS 399
mation of the pelvis of the kidney which may involve the
entire organ.
Retention of urine from either disease of the ureters or
the bladder. This leads to an inflammation of the pelvis of
the kidney from decomposition of the urine.
Pathology.— Catarrhal inflammation of the pelvis of the
kidney is characterized by swelling and redness, some hem-
orrhage, and later, as the condition becomes chronic, the
membrane becomes thickened, lighter in color and covered
with thick mucus or pus. In severe cases numerous hemor-
rhagic foci will be observed, with sometimes extensive hemor-
rhage, or, if the irritation has been severe, ulcers will be
found (pyeloulcerosa). In cases which have resulted from
obstruction to the flow of urine, we may find dilatation of
the pelvis of the kidneys, with the presence of urine (hydro-
nephrosis).
Symptoms.— This disease does not present a clear clinical
picture; it can easily be confused with inflammation of the
kidneys or adjacent parts. The general symptoms are a
disturbed general condition of the animal, frequent micturi-
tion, which is more or less painful, stiff, painful gait, loss of
appetite and slight elevation of temperature. The urine
shows changes which should be considered. It will be found
to contain much mucus, pus, organic sediment, long-tailed
epithelial cells, having pointed projections on the ends,
which come from the membrane of the renal pelvis. The
urine should be examined for parasite eggs; this will often
assist in locating the seat of the inflammation. Small granules
are found when calculi are present. Careful palpation as in
chronic nephritis may assist in locating the inflammation.
Diagnosis.— The microscopic examination of the urine is
the best means of making an accurate diagnosis. The pres-
ence of the peculiar, molar-shaped epithelial cells may be
considered significant. Pyelitis must be differentiated from
inflammation of the mucous membrane of the bladder or
ureters. The presence of parasite eggs (Dfoctophyme renale)
in the urine will be indicative of involvement of the renal
pelvis.
Prognosis. — The prognosis depends to some extent upon the
causative factor. In most cases it is not very favorable.
400 DISEASES, OF THE KIDNEYS
Treatment.— Dietetic.— Milk should be the principal food.
No irritating materials should be given.
Medical.— Diluents in the form of water or milk should
be administered frequently (2 or 3 times daily) to assist in
increasing the volume of fluids eliminated via kidneys to
remove accumulated products.
Disinfectants in the form of sodium salicylate (dog, 0.1-
2.0; cat, 0.05-0.1) should be given twice daily. Urotropin
(0.5-1.0) three times daily with plenty of water or milk is
useful.
UREMIA.
Definition. — A toxemia developing during the course of
certain diseases, such as nephritis or in conditions associated
with retention of the urine. The nature of the poisons
retained in the body is not definitely known. They may
be normal urine compounds, or the result of abnormal
metabolism.
Etiology. — Uremia is produced by the retention in the body
of waste materials which should be eliminated by the kidneys.
In the development of certain diseases, such as acute and
chronic nephritis, or obstruction to some part of the urinary
passages, the urine is not properly excreted but is retained
in the blood. If due to stoppage of the outflow, the back
pressure produced inhibits further secretion, hence the
products of metabolism accumulate in the body.
A cause is rupture of some of the urinary organs (kidneys,
ureter or bladder) which is of frequent occurrence in the dog
from injuries. The urine will flow out into the adjacent
tissues, or peritoneal cavity, to be absorbed by the circula-
tion, producing in the course of a few hours marked symptoms
of acute poisoning.
Symptoms.— Clinically we recognize two forms: (a) Acute
uremia, and (6) chronic uremia.
Acute Uremia.— In the dog the symptoms usually begin
with chills, trembling of the muscles, staggering gait, followed
in a short time by stupor, the animal finally lapsing into
complete unconsciousness. Frequently there will be noted
UREMIA 401
during the development of uremia certain nervous symptoms,
such as contractions of groups of muscles (clonic spasms,
epileptiform convulsions) followed by unconsciousness.
Yelping or howling is often a prominent symptom during
the nervous attacks.
The respirations are slow, often difficult; edema of the
lungs usually exists.
The temperature is at first elevated, but later becomes
subnormal, sometimes as low as 96° F.
Vomiting in the dog and cat is a frequent symptom as
is diarrhea. The discharges from the stomach and bowels
usually have a uriniferous odor.
Chronic Uremia.— Chronic uremia develops from chronic
diseases of the urinary organs, particularly chronic nephritis,
and from long standing cases of partial urine retention due
to some obstruction in the urinary tract.
The most prominent symptoms of chronic uremia are:
Digestive disturbances, such as gastro-intestinal catarrh,
diarrhea, vomiting, etc., without any apparent cause; dis-
turbances in the nervous system as dulness, and at times epi-
leptiform convulsions, which are usually mild and recurrent.
Diagnosis.— This is made by careful examination of the
patient, observation of the symptoms, and examination of
the urinary organs.
Prognosis.— The prognosis depends upon the primary con-
dition producing the uremia. In acute uremia it is unfavor-
able, most cases terminating fatally.
Chronic uremia is not so immediately fatal. The long
course of the disease, which suffers exacerbations and remis-
sions, eventually, however, terminates in death.
Treatment.— Medical.— Medical treatment consists in the
administration of laxatives to assist the elimination of urea
compounds via the bowels. Diuretics are used except in
those cases where there is some impediment to the outflow
of urine.
In chronic cases, after the uremic symptoms begin to dis-
appear, tonics and alteratives are indicated.
Surgical.— Where an obstruction exists in some portion
of the urinary tract, which interferes with the outflow of
26
402 DISEASES OF THE KIDNEYS
urine an operation may be indicated. Rupture of the bladder
or ureters should receive immediate attention and the torn
or injured part sutured.
CALCULI IN THE KIDNEY.
Nephrolithiasis.
Definition.— The presence of urinary stones in the pelvis
of the kidney.
Etiology.— Calculi in the renal pelvis are not frequent in
small animals. They are far more common in the bladder.
The principal condition for the formation of urolithic deposits
is that the urine contains excess of salts, or that insoluble -or
slightly soluble salts are formed in it. In the elimination
of these salts they become gradually deposited around some
foreign material. The center or nucleus of a calculus is
usually an epithelial cell, bit of mucus, pus, a blood cell, cast,
etc. In some cases the food which is rich in salts of various
kinds will hasten the formation of calculi. In certain dis-
tricts where the water is rich in mineral substances calculi
are more common, no doubt due to the excess salts taken
in and eliminated. Inflammatory diseases of the urinary
passages, or in retention of urine from any cause, will often
lead to the formation of urinary calculi by changing the
character of the urine and the salts contained therein.
Pathology.— Stones in the pelvis of the kidney, if small,
may not produce much change in the mucosa, except slight
abrasion and irritation. When larger they may fill up the
entire calices or the whole renal pelvis, and can lead to marked
pathological changes such as extensive inflammation, hemor-
rhage, and sometimes marked distention of the pelvis. In
small animals the calculi usually consist of ammoniacal
magnesium phosphate, small quantities of calcium phosphate
or carbonate, some uric acid and its salts. Cystic calculi are
also occasionally seen. They are small, soft, and have a
shiny surface.
Symptoms.— The clinical picture of kidney stones is very
similar to that of pyelitis, except the pain is usually more
CALCULI IN THE KIDNEY 403
severe. The condition may be entirely overlooked during
the life of the patient. The most pronounced symptoms are
sudden attacks of colic, which come on after running, jump-
ing, or falling, which dislodge the stone and occlude the
ureter. The colicky symptoms are howling, whining and
crying, which continue until the stone either passes into the
bladder or back into the pelvis of the kidney. A prolonga-
tion of the retention of urine may result in uremic symptoms.
Periodic recurrence of the colicky pains is somewhat charac-
teristic of this condition. The urine when examined micro-
scopically will be found to contain pus cells, epithelial cells,
and often very small fragments of stones. Blood cells are
also common as small hemorrhages frequently take place.
In the dog a direct examination can be made by performing
a laparotomy which permits of the kidney being seen and
felt. If calculi are present, they will be easily recognized by
their hardness and shape.
Diagnosis. — The general symptoms are not sufficient for
an accurate diagnosis. It should be differentiated from other
diseases of the kidney. The urine should be carefully exam-
ined. In doubtful cases a laparotomy may be performed.
Prognosis.— The prognosis depends on the size and number
of stones present and whether or not the condition is uni- or
bilateral. When the stones are small and the condition con-
fined to one kidney, the prognosis is much more favorable.
Owing to the difficulties encountered in removing the stones
the prognosis is usually unfavorable.
Treatment.— Dietetic.— Food should be given that contains
but a small quantity of salts. Plenty of water should be
allowed but the same precaution must be observed in regard
to the salt content.
Medical.— The various compounds used to dissolve calculi
have not proved very satisfactory. Large quantities of
carbonated water may be tried; it has proved of value in
some cases.
Surgical. — Surgical treatment has proved of practical
importance in the dog, and has been successfully accom-
plished in a number of cases. If, after an explorative lapa-
rotomy of the kidney, it is found normal, showing no evidence
404 DISEASES OF THE KIDNEYS
of hydronephrosis, nephrolithotomy should be performed.
There are two methods used in this operation, as follows:
(a) A longitudinal incision is made at the convex border
of the kidney, at which point the vascularity is at a minimum,
into the pelvis. In case hemorrhage is severe, clamping the
renal artery will control it. By compressing the kidney
longitudinally the incision will be held open and with a
blunt curette the stones are removed. Care should be taken
to be sure that the renal pelvis is freed of all the calculi,
and a blunt probe of small caliber inserted into the ureter to
be certain of a free passage into the bladder. Normal salt
solution, which has been previously sterilized, is used to
cleanse the cut surface. The wound is then stitched with
sterile silk, using two or three interrupted sutures. Care
must be taken not to use too much force in drawing the wound
together as the resulting swelling will tear out the sutures.
Return the organ to its proper position. Healing should take
place per primam.
(6) The other method is to open the pelvis of the kidney
direct. Make an incision at one side of the pelvis, in about
its middle portion, of sufficient size to remove the calculi.
After all the stones have been removed and all the fluids
absorbed by sterile gauze, the wound is stitched carefully,
using plenty of sutures so that the edges of the wound will
be thoroughly approximated. This must be done carefully
to avoid fistula following the operation. If, however, the
kidney is found diseased (hydronephrosis) nephrectomy
should be performed, as follows: Laparotomy is performed.
The kidney is then freed of its covering, gently pulled toward
the wound, and doubly ligated at its pedicle, so as to prevent
serious hemorrhage. Care should be taken to get the ligature
securely in place to prevent its slipping off after the abdom-
inal wound is closed. Double ligation is safest, ligating the
vein and artery separately.
After-treatment consists in the administration of general
stimulants, and restricting the diet for four or five days to
milk, or milk and eggs.
DROPSY OF THE KIDNEY 405
DROPSY OF THE KIDNEY.
Hydronephrosis. Cystic Kidney.
Definition.— A chronic condition in which urine collects in
the pelvis of the kidney or the kidney proper, leading to
functional disturbances of the organ.
Etiology.— (a) Mechanically by some impediment to the
flow of urine from one or both kidneys. The urine is dammed
up in the pelvis of the kidney with a gradually increasing
pressure. As the pressure of the urine increases, the loss in
the secreting power of the organ is more manifest, and event-
ually if the pressure is constant or increased, the function
of the organ may be entirely lost. The parts of the urinary
passages affected by the impediment gradually dilate ' and
the renal tissue atrophies, so that the condition anatomically
stops as no more urine is secreted.
(6) A number of conditions which cause partial stoppage of
the flow of urine will cause cystic kidney. The most frequent
are: Catarrhal inflammation of the ureters, bladder, or
prostate glands; the presence of calculi in some portion of the
tract which interferes with the passage of urine.
(c) Sometimes the condition is congenital; there is either
no opening through the ureter, or it is otherwise' anatomi-
cally deficient. This allows the urine first formed to accu-
mulate until the backward pressure is sufficient to stop renal
secretion.
(d) Compression of the urethra and neck of the bladder
by adjacent new growths. The new growths interfere with
the flow of urine and cause it to accumulate in the pelvis of
the kidney.
(e) Paralysis of the urinary bladder which allows the
urine to collect and lead to back pressure.
(/) In chronic inflammation of the kidneys some of the
urinary tubules become constricted at certain points by the
contraction of the interstitial tissue, which undergoes atrophy,
causing the canals which are attached to the Malpighian
bodies to become dilated. If the urine continues to be
secreted it accumulates and forms small retention cysts.
These cysts may be found singly or in large numbers in the
406 DISEASES OF THE KIDNEYS
kidneys. This type of the condition is not found as often as
the other form.
Pathology. — We find varying degrees of cystic kidney. In
the earlier cases will be noted only a dilation of the calices
and pelvis of the kidney with mild pathological changes in
the lining membrane. In the more advanced cases will be
noted distention of the pelvis of the kidney with compression
of the renal tissue so that the atrophy is well marked. In
some cases the renal tissue will be practically destroyed, and
the kidney will be represented by a soft undulating mass. In
dogs the kidneys may be so enlarged that distention of the
abdominal wall appears.
Symptoms.— Frequently on autopsy cystic kidney involv-
ing one of the kidneys, will be found which has not been
noticed during the life of the animal, the other kidney having
performed the function of both. When both kidneys are
involved, howe\er, a change in the quantity of urine will be
noticeable. On careful examination of the patient (dog)
very frequently one of the kidneys, or in rare cases both of
them, will be found much enlarged and can be easily palpated
through the abdominal wall; cases appearing where the
abdominal enlargement is noticeable by observing the stand-
ing patient from the rear and carefully comparing both sides.
General symptoms of weakness, stiffness, etc., are shown in
the more advanced cases. Generally, however, cystic kidney
does not produce characteristic symptoms during life.
Diagnosis.— This is made by careful examination of the
patient, observing the flow of urine, and finally where neces-
sary an explorative laparotomy.
Prognosis.— Favorable when unilateral as it may not affect
the general health of the patient; unfavorable when bilateral.
Treatment.— The early indication in the treatment is to
relieve the impediment to the flow of urine. The ureters,
bladder, and urethra should be examined and if diseased
proper treatment should be given. If the outflow of urine
can be reestablished, the disorder will be relieved. If this
is impossible, nephrectomy should be performed if the con-
dition is unilateral. (For Nephrectomy, see Renal Calculi.)
No other treatment has been found of value.
ANIMAL PARASITES IN THE KIDNEY 407
AMYLOID KIDNEY.
This condition is of no practical importance except to the
student in pathology. It is not common in the small animals
and the symptoms are very obscure.
TUMORS IN THE KIDNEY.
In small animals the kidneys are not commonly affected
by primary tumor formations. There will be found: Sar-
comata, carcinomata, and adenomata, occasionally resulting
as secondary growths from some other organ or tissues.
Tuberculosis of the kidney has been noted in a few cases in
the dog. It may be either metastatic or urogenic in origin.
It is not usually possible to recognize tumors during life.
They sometimes produce disturbance in kidney function
and may become metastatic.
Treatment. — Treatment must be symptomatic.
ANIMAL PARASITES IN THE KIDNEY.
Dioctophyme renale (Eustrongylus GV</as).— This is the
most common parasite found in the kidney of small animals
where it is confined almost exclusively to the dog. Its loca-
tion is usually in the pelvis of the kidney where in some cases
it produces marked clinical symptoms; in others but little
disturbance results considering the degree of pathological
change induced.
Dioctophyme renale is a blood-red worm with a number
of fine transverse stripes, tapering slightly at the extremities.
The mouth is triangular in shape, and surrounded by six
small papilla'. The male is 13 cm. to 40 cm. long, and 4 mm.
to 0 mm. in diameter; tail is obtuse, terminated by a patelli-
form, membranous, entire pouch without radia% and traversed
by a very slender, single spicule. Female, 20 cm. to 1 m.
long, and 5 mm. to 12 mm. in diameter; tail is obtuse and
slightly curved; a single ovary; vulva very near the mouth.
Ova ovoid and brownish, OS to 80 microns long, and 40 to 43
microns broad. (Neuman.)
408 DISEASES OF THE KIDNEYS
The life cycle of the Dioctophyme renale is not entirely
known. The ovum is expelled from the body of the host,
and undergoes further development in water or damp soil.
It requires some time for these changes to take place (from
three to six months). The embryo may live and be active
after one year to eighteen months. The embryo is 240
microns long and 14 microns broad, cylindrical, and gradually
tapering posteriorly; the head is pointed, mouth terminal
and not provided with papillae, but with a small projection
which no doubt serves the embryo as an organ of penetration.
The intermediate host has not been fully determined. The
dog takes the embryo into the intestinal tract, where it
undergoes further development, and the embryo migrates to
the organs and tissues. It may also be introduced into the
urinary passages direct. The favorite seat is the kidney,
although it may be found in the abdominal cavity, liver, etc.
There still exists some doubt as to the exact method of migra-
tion of the embryo.
The parasite after reaching its destination, develops and
produces marked changes in the pelvis of the kidney, and in
a number of instances completely destroys the organ. In
cases of early invasion there will be found inflammation with
hemorrhages, and purulent material. More advanced cases
will reveal a secondary inflammation with destruction of the
renal tissue, often transforming the kidney into a sac with
thick walls. The worm or worms will be found coiled up in
this sac. The number of parasites found will vary. In
most cases only one; in others two or more, even as high as
four have been found.
Symptoms.— There may be no symptoms during life. In
a case of the author's in which four parasites were found, and
the renal tissue completely destroyed, the dog showed no
symptoms. The worms were found on autopsy. The animal
was in excellent condition and apparently in the best of
health. However, in some cases, symptoms are observed.
Severe pain, restlessness, nervousness and even rabiform
phenomena have been observed. The dog may show spinal
curvature due to pain on the affected side. The general
condition is often interfered with, the animal becoming
ANIMAL PARASITES IN THE KIDNEY 409
emaciated and exhausted. The urine is voided with difficulty,
containing blood and pus. Examined microscopically it
will reveal a pyelitis, and the eggs of the parasite. In some
instances after the renal tissue is completely destroyed, the
parasite will pass into the urethra where it becomes lodged.
It may burrow through the urethral wall and ultimately
lodge in either the pelvic fascia or work forward into the
abdominal cavity. Eventually it will produce inflammation
in the new location, resulting in abscess, perforation and
external fistula. Peritonitis may result following its entrance
into the abdominal cavity.
Diagnosis.— An accurate diagnosis can be made only by
finding the eggs in the urine by microscopic examination.
The symptoms would be much the same as those in pyelitis,
etc.
Prognosis. — \\hen the parasite has produced sufficient
pathological changes to bring about emaciation and exhaus-
tion, the prognosis is unfavorable.
Treatment.— Medical.— Anihelmmtics are advisable, and
especially those which will be eliminated via the kidneys.
Turpentine (5.0 to 10.0) repeated in forty-eight hours, may
be given, if necessary.
Surgical.— Laparotomy may be performed, and direct
examination made. If the renal tissue is destroyed, nephrec-
tomy would be indicated. (See Renal Calculi.)
Other Parasites in the Kidney.— A few other species of
parasites are seen occasionally, but as they produce no effect
upon the host they are of no clinical importance.
Cysticercus cellulosae and several forms of coccidia have
been found on autopsy.
Birds are not uncommonly affected by coccidia. The
Eirneria avium (Coccidium tenellum) is the one most com-
monly found in poultry. Some general disturbances, such
as depression and loss of appetite, have been noted. The
birds die of uremic poisoning or exhaustion.
CHAPTER II.
DISEASES OF THE BLADDER.
Examination.— A thorough and complete examination of
this organ may be made, especially in the dog, by palpation
through the rectum, vagina, and abdominal walls; by lapa-
rotomy (direct examination) and by examination of the urine.
Palpation can be done satisfactorily only in the larger
breeds when not too fat. When palpating through the
abdominal wall place the animal in a standing position, and,
with one hand on either side of the lower abdominal wall,
just anterior to the brim of the pubis, exert enough pressure
to feel the bladder through the walls. In case inflammation
is present pain will be evinced. The bladder will be felt as
a pear-shaped enlargement just anterior to the brim of the
pubis, which is movable and extends forward a varying
distance depending upon its distentiqn. Care must be taken
to differentiate between a distended bladder and other
abnormalities which are commonly present in the abdominal
cavity, such as ascites, fecal stasis, neoplasms, etc.
Rectal palpation is done by first thoroughly cleansing the
hand and the anal region with soap and water, followed by
an application of boric acid solution (2 per cent.). The
index finger is inserted through the anal opening as high up
in the rectum as possible. The bladder can be felt as a
distended body, projecting back into the pelvic inlet. Dif-
ferentiation must be made between a distended bladder and
chronic or acute prostatitis which is quite common in old
dogs. This can be done by considering the difference in
position and density of the two bodies. Inflammatory
conditions of the bladder, which are painful on pressure, and
other enlargements such as tumors may be found in this
location.
EXAMINATION 411
Vaginal palpation is possible in the larger breeds, and is
performed in much the same manner as the rectal. The
index finger should be inserted as far as possible, and if
the bladder is distended it can be felt at the pelvic inlet, or
if it is inflamed slight pressure will be very painful. Vaginitis,
fecal accumulations in the rectum, and tumors should be
differentiated.
Laparotomy.— \\\ both the male and female dog it is quite
possible, safe, and practical, to perform this operation under
strict antiseptic precautions, so that a direct inspection of
the bladder may be made. In the female the incision should
be made just anterior to the pubis in the median line, and in
the male to one side of the penis but close to the pubis. The
incision should be made large enough (2 or 3 inches) so that
the bladder may be exposed to view. Care should be
observed in cutting through the peritoneum so as not to incise
the bladder, as this organ when distended will extend forward
in some cases beyond the umbilicus. The bladder is exam-
ined for distention with urine, inflammation (acute and
chronic), calculi, ulcerations, paralysis, etc. The laparotomy
wound should be closed as usual. (See Laparotomy.)
Examination of the Urine.— A sample of urine is best
obtained by passing a catheter, provided there is any urine
present, or by catching the urine in some receptacle as it is
passed by the animal, Catheterization has been found to
be the most practical method in these animals. This is done
in the male animal by placing it in a dorsal position; restrain
with hobbles. Choose a small sized human catheter, soften
and disinfect by placing it for ten to fifteen minutes in warm
lysol solution (2 per cent.). Expose the penis by pushing
back the prepuce with the left hand, and with the right hand
insert the catheter into the urethral opening. Two normal
obstructions will be noted as the catheter is inserted: The
first one as the catheter reaches the bone of the penis; the
other as the catheter reaches the ischial arch. The former
obstruction may be overcome by gentle pressure; to pass
the ischial arch it will sometimes be necessary to partially
remove the stilet, and with the finger direct the catheter
over this point. The stilet should be gradually removed
412 DISEASES OF THE BLADDER
as the catheter is inserted. When it reaches the bladder, if
urine is present, it will begin to flow out at once. In the
female animal the catheter is passed without much difficulty.
It is best to place the animal in a ventral position, securely
fastened with hobbles; the same catheter as for the male
animal can be used, but best to use a special metallic catheter,
as it can be sterilized. To insert the catheter a vaginal
speculum is used to dilate the vagina, which facilitates inser-
tion into the urethral opening.
The urine should be examined particularly for epithelial
cells, pus, bacteria, red blood cells, etc. A differential
examination should be made to determine whether the
abnormal constituents of the urine come from the bladder or
some other urinary organ. Note the reaction of the urine,
its specific gravity, color, odor, consistency, etc.
WOUNDS OF THE BLADDER.
The bladder is the seat of several conditions produced by
trauma in the small animals: Traumatic or spontaneous
rupture, penetrating wounds from bullets or other objects,
accidental cutting of the bladder during surgical operations.
RUPTURE OF THE BLADDER.
Rupture of the bladder is most often brought about by the
animal being run over by vehicles, being kicked, falling, or
may be due to overdistention when there is some impediment
to the flow of urine. It can also occur as the result of the
walls being weakened by ulceration and other destructive
processes. It has been observed in well broken house dogs
when confined for too long a period, the bladder becoming
distended and finally paralyzed, the continuance of the
secretion eventually leading to rupture.
Symptoms.— In rupture the symptoms develop in the
course of a few hours. They are complete suppression of
micturition, general symptoms of collapse, uriniferous^odor
of the exhaled air, subnormal temperature. The history is
quite important, as often the history of an injury will assist
RUPTURE OF THE BLADDER 413
in the diagnosis of rupture. Passing the catheter will reveal
the empty bladder. Examination by performing laparotomy
should be done as early as possible in all cases where rupture
is suspected.
Prognosis. — After the development of general symptoms
of collapse, subnormal temperature, etc., the condition is
considered unfavorable. In cases of rupture where the
diagnosis is established early, or, in accidental cutting
through the walls of the bladder during surgical operations,
the prognosis is quite favorable, provided prompt treatment
is given.
Treatment.— Medical.— It is always advisable to administer
stimulants at once. Strychnin in small doses (0.001).
Surgical.— Prompt surgical treatment is absolutely essen-
tial for a successful termination.
The animal should be properly prepared for laparotomy
(see Laparotomy), and the operation begun as soon as
possible. The abdominal cavity should be emptied of all
the retained urine, by flushing thoroughly with normal salt
solution, which should be repeated two or three times to be
sure that all the urine is removed. Locate the wound in the
bladder and suture with interrupted and Lembert stitches.
A milliner's needle will be found to be the best suturing needle.
Place the stitches quite close together. Suture the abdominal
wound in the usual manner. The after-treatment consists
in placing the animal in a warm place and using stimulants
for the first ten to twelve hours. Thoroughness in treating
these cases will often bring excellent results.
Wounds of the bladder, such as gunshot wounds, injury
by compression without complete rupture, puncture by
fragments of bone, etc., are found in the dog, and their
seriousness depends upon the degree of injury. In very
small punctured wounds and small bullet wounds, aside from
the symptoms of cystitis, and stiffness, no serious com-
plications set in and the animals make prompt recoveries.
In the other forms when urine escapes into the peritoneal
cavity and some hemorrhage takes place, the case will soon
assume serious complications. (See Rupture of the Bladder.)
414 DISEASES OF THE BLADDER
RETENTION OF URINE IN THE BLADDER.
Retentio Urince Vesicalis.
Definition.— A collection of urine in the bladder, with
subsequent distention of the bladder, ureters and pelvis of
the kidney. Retention of urine is a symptom of a number of
independent conditions or diseases which are found in the
dog and cat, often leading to inflammation of the bladder,
rupture, peritonitis, and uremia.
Etiology.— Commonly caused by foreign bodies in the
urethra or neck of the bladder interfering with the voiding
of urine. These foreign bodies consist mainly of calculi of
different kinds, sediment, fibrin, blood coagula, etc.
In paralysis of the bladder, the walls of the bladder lose
their tone. It may be due to affections of the spinal cord,
trauma, various forms of cystitis, or to emaciation and general
weakness, which allows the bladder to distend enormously.
The urine in some cases will flow out in a small continuous
stream after the distention has reached a certain degree.
Compression of some portion of the urethra or neck of the
bladder from without, such as neoplasms, acute and chronic
prostatitis which is common in old dogs. Stricture of the
urethra from injury or surgical operations; compression by
distention of the uterus in pregnancy and diseases of this
organ; diseases of the penis in the male animal are further
causes.
Spasmodic contraction of the sphincter vesicse, which may
be due to sudden change in temperature especially cold
(chills); to some medicinal agent as strychnin; to some
diseases, cystitis, tetanus (rare).
Symptoms.— The early indication of retention of urine is
ischuria (suppression of urine), or painful micturition with
only a small amount of urine passed. In the dog micturition
is accompanied by severe straining.
In sensitive small animals there is usually considerable
abdominal pain, resembling acute indigestion or colic. The
back is arched and the gait is stiff and straddling.
In a short time, in case the condition is not relieved, the
symptoms will increase in intensity until the bladder ruptures,
RETENTION OF URINE IN THE BLADDER 415
in which case the symptoms of pain will disappear for a time
until peritonitis and uremia develop. If the bladder ruptures
symptoms of uremia will develop in a few hours. (See
Uremia.)
In the dog the distention of the bladder will produce a
noticeable increase in size of the abdominal cavity. Careful
palpation will reveal the distended movable bladder. When
rupture occurs the fluid will be detected free in the abdominal
cavity. In such case puncturing the a"bdominal wall writh an
exploring trocar will reveal the presence of urine. Care
should be observed, however, to determine whether the
fluid is in the cavity or still in the bladder, as the distended
bladder can extend well forward in the abdominal cavity.
Diagnosis. — The symptoms should be noted carefully. If
the patient shows colic, frequent micturition, with small quan-
tities of urine passed, a careful and thorough examination
of the urinary organs should be made. As retention of urine
in most cases is secondary to some disease of the urinary,
organs, a careful examination should be made to determine
the' primary condition. The examination may include
puncturing the abdominal walls, laparotomy, rectal or vaginal
exploration.
Prognosis.— The prognosis depends principally upon the
possibility of relieving the primary condition, and whether
or not the bladder is still intact. In case of rupture it is
unfavorable, especially when symptoms of uremia are present.
Treatment.— The treatment must be directed toward
removing the causes. In cases of paralysis of the walls of
the bladder, it is advisable to remove the urine as early as
possible. This can be done in most cases by catheterization.
Small doses of strychnin (0.001, dog) are recommended to
give tone to the walls of the bladder.
In spasms of the sphincter vesica1, catheterization may be
tried; if unsuccessful,, puncture the bladder and remove a
portion of the urine. A small dose of morphin will overcome •
the spasmodic contraction, allowing the urine to flow out.
In case an obstruction to the outflow of urine exists, treat-
ment must be applied to remove it.
House-broken dogs should be allowed to run out of doors
at regular intervals to avoid extreme distention.
416 DISEASES OF THE BLADDER
INCONTINENCE OF URINE.
Definition.— A constant discharge of the urine from the
bladder; inability to retain urine.
Etiology.— Incontinence may result from several different
causes:
(a) Affections of the spinal cord, as degeneration, edema,
compression from hemorrhage, etc.
(6) Paralysis of the sphincter vesicae.
(c) Long standing cases of retention.
(d) Lack of tone of the muscles due to senility.
(e) Some cases of cystitis.
(/) Injury to the sphincter muscles from surgical opera-
tions, tumors, calculi, etc.
Symptoms.— Constant dribbling of urine. Examination
reveals the bladder empty, and the sphincter vesicse relaxed.
Prognosis.— Depends upon the primary cause. Usually
not considered very favorable as recovery is rarely complete.
Treatment.— Symptomatic. Determine the cause and apply
treatment to relieve it.
CATARRH OF THE BLADDER.
Cystitis. Urocystitis.
Definition. — A catarrhal inflammation of the bladder which
may be either acute or chronic.
Etiology.— The principal causes are: 1. Bacteria (infec-
tion), or irritants in the form of toxins, drugs, chemicals,
etc. Bacteria gain entrance to the bladder in various ways:
(a) Through the genito-urinary tract. Catheterization
of animals is a common source of infection, the organisms
being introduced directly by an infected catheter. In the
female germs are easily introduced into the bladder through
the urethra, which is short, and its opening near the vulva.
A spread of inflammation from other infected parts of the
urinary tract, e. g., pyelitis, nephritis, urethritis may also
induce cystitis. Retention of urine from any cause leads to
decomposition of the urine, and lowering of the normal
CATARRH OF THE BLADDER 417
resistance of the mucous membrane of the bladder, allowing
infection to take place.
(6) Infection may gain entrance to the bladder from the
blood. In some of the infectious diseases, as distemper in
the dog and cat, the bacteria are carried to the mucosa of
the bladder by the blood stream. In digestive disturbances
(constipation, etc.) the organisms which accumulate in the
bowels enter the blood stream and are eliminated through
the urinary passages, often leading to an acute cystitis.
The colon bacteria and others more or less closely related
are the chief offenders.
(c) The infection may spread from the peritoneum, either
from acute or chronic peritonitis, producing in some cases
simply a pericystitis, and in others an involvement of the
entire bladder wall.
2. Irritating agents in the form of chemicals, or drugs,
when eliminated in large quantities, frequently will produce
cystitis. Cantharides, turpentine, balsams, and coal tar
compounds given internally will produce it; external applica-
tions of easily diffusible substances will, by absorption have
the same effect, especially when applied over extensive areas.
3. Sudden change in temperature, cold (chills) , disturbs the
general circulation, and may lead to congestion of the bladder.
Extreme cold affecting the body temperature might induce
extensive inflammation of the organ.
4. Calculi and other foreign material often produce chronic
cystitis by the constant irritation they keep up.
Pathology.— In the early stages of acute cystitis, the mucous
membrane will be found reddened, congested, much swollen,
and here and there small hemorrhages will be noted. There
is usually considerable thick, viscid mucus covering the
membrane, or there may be an admixture of pus. The
purulent exudate often covers the entire membrane. In the
later stages of the disease the mucosa is covered by a croupous
or diphtheritic, yellowish membrane. Abscesses of various
size may exist between the mucosa and the muscular walls.
Erosions and ulcerations on the membrane are often the
result of irritating materials.
In the chronic form the pathological changes are principally
27
418 DISEASES OF THE BLADDER
a thickening of the mucosa, which is corrugated, often
presenting projecting growths. The muscular walls become
contracted, thickened and incapable of distention. The
apices of the corrugations are darkened, eroded and ulcerated.
The bladder is usually empty and contracted. Inflammation
of other portions of the urinary tract will be more or less
apparent.
Symptoms.— In acute cystitis, the animal will show marked
symptoms of difficult micturition, severe straining as if to
urinate, with only small quantities of urine passed. Some-
times small quantities of blood follow the attempts to urinate.
The animal stands with the back arched, shows pain when
forced to move, and stiffness in walking. When moved the
patient will cry out; it often assumes the attitude of urinating.
An erection of the penis is a frequent symptom. Pressure
over the region of the bladder induces pain. A dog being
examined in the standing position will often cry out with
pain, and try to bite and get away. Digital pressure either
through the rectum or vagina produces the same symptoms.
In most cases the bladder is found empty. Unless the
condition is mild, general symptoms are usually observed.
The temperature is elevated in the early stages, depending
upon the cause and kind of infection. Later it may be
normal or subnormal. Suppression of appetite, thirst, and
general depression are often observed. Uremic symptoms
will be found in some cases due to reabsorption of urine, or
lack of elimination in cases where the other urinary organs
are involved. The urine, passed in small quantities, will be
dark in color, contains varying amounts of albumin, some-
times pus, and stringy mucus. Shreds of fibrin and necrotic
membrane are passed in the croupous and diphtheritic forms
of cystitis. The urine is usually alkaline in reaction but
may be acid. It will contain fibrin, pus cells (both the large
cells and the long slender variety), crystals of ammonium
urate, and numerous bacteria. The urine content assists
in confirming the diagnosis. Chronic cystitis produces much
the same symptoms but less severe than in the acute form.
The most noticeable indications of chronic cystitis are painful
micturition, the urine passed containing pus, red corpuscles,
CATARRH OF THE BLADDER 419
etc. The catheter should be inserted to differentiate from
calculi.
Diagnosis.— In acute cystitis a diagnosis can be made by
observing the symptoms, making a careful local examination,
and by analysis of the urine. Diseases of other portions of
the urinary tract should be considered. In chronic cystitis
the diagnosis is made by the examination of the urine, and
the local examination of the patient. Calculi in the bladder
and urethra should be excluded.
Prognosis.— In mild cases of acute cystitis the prognosis
is usually favorable. In severe cases, owing to the changes
which are produced in the walls of the bladder, the prognosis
is unfavorable. Chronic cystitis may run a long course
without producing any marked symptoms. Complete re-
covery is rare. By careful treatment considerable improve-
ment can be attained.
Treatment.— Dietetic.— Non-stimulating food should be
given. Milk is perhaps the best as it contains a large per-
centage of water, which is desirable. Avoid giving meats
until the acute symptoms entirely disappear.
Medical.— Much can be done in acute cystitis by the
internal administration of antiseptics and disinfectants.
Urotropin (0.25-0.5) two or three times daily for dogs; cats
should receive about one-fourth the quantity. This prep-
aration produces a disinfectant action owing to the libera-
tion of formaldehyd gas.
Helmitol (dog, 1.0-2.0; cat, 0.1-0.5) can also be used for the
same purpose, administered either in the form of a powder,
or may be given as a subcutaneous injection in 10 per cent,
solution.
Salol, salicylic acid, and resorcin may be given for a
similar action. In chronic catarrh much the same treatment
is recommended as in the acute form of the disease.
Balsam copaiba, and turpentine in small doses are recom-
mended.
Irrigation of the Bladder.— Irrigation of the bladder, which
is easy in the dog, in order to remove infections and irritating
matter, is of great importance in cystitis. In the male animal
a catheter is passed into the bladder, and the urine is allowed
420 DISEASES OF THE BLADDER
to flow out. A rubber tube about 2 or 3 feet in length,
provided with a funnel, is attached to the catheter. The
tube is elevated and a warm, normal salt solution (40.0-70.0)
allowed to flow into the bladder. The tube is then depressed
to siphon out the fluid. Following the injection, it is
advisable to use some of the mild disinfectants as boric acid
(2 per cent.), or ichthyol solution (1-2 per cent.). These
should be allowed to remain in the bladder five to ten min-
utes and then removed. The injection should be repeated in
eight to twelve hours. In females the injections are made
much in the same way. Sometimes in the male, when
injections are to be made often, the urethra becomes irritated
from the frequent passing of the catheter. In such cases a
temporary urethrotomy may be performed at the ischial
arch, and the injections made from this point. Thorough
application of these solutions will often produce most
excellent results.
TORSION OF THE BLADDER.
This condition has been found to occur occasionally in the
dog. It leads to retention of urine and eventually to rupture
of the bladder. Death occurs from peritonitis and uremia.
Surgical relief should be attempted.
CALCULI IN THE BLADDER.
Calculi are more common in the dog than in any other small
animal. They appear in various sizes and forms. In some
cases they are very small and multiple; in others a single,
rounded concretion, conforming to the shape of the bladder,
is found.
Etiology.— The factors producing concretions in the bladder
may be classed under three headings:
(a) Local disturbance in the urinary organs. In this case
there will be found degenerative changes from the products
of the urine (uric acid), leading to necrosis of the cells, such
products forming the nucleus around which the salts deposit.
CALCULI IN THE BLADDER 421
(6) Disturbances of metabolism in which there will be a
larger quantity of material eliminated in the form of phos-
phates, carbonates, oxalates (calcium and ammonium
oxalate), uric acid, urates (ammonium urate), etc. The
excess of these salts becomes deposited around the organic
nucleus, leading to bladder calculus.
(c) The administration of foods rich in salts of various
kinds will increase the quantity in the body, and .consequently
more salts will be eliminated.
Forms and Varieties. — 1 . Acid Urine Calculi, (a) Uric
Acid Calculi (Ammonium Urate). — These are small, hard,
smooth calculi, of a reddish or yellowish-brown color. They
are perhaps the most common kind found in the dog.
(b) Oxalate Calculi (Calcium and Ammonium Oxalate).—
In form these calculi are rough on the surface, irregular in
shape, and usually when removed are of a dirty white or
yellowish color.
(c) Cystin Calculi.— Soft waxy bodies, which no doubt
result from disturbed metabolism of nitrogenous substances.
Their color is brown or brownish-yellow. They are soft
enough in most cases to be crushed between the fingers.
2. Alkaline Urine Calculi.— There will be found various
forms of these concretions, such as phosphates and carbonates
predominating, and in combination with other salts, etc.
These calculi occur either multiple, as particles of sand or
grit, or in single, large concretions. They are hard, irregular,
rough or smooth stones, of a white, yellowish or dirty color,
which are usually flattened, oval or oblong.
The recognition of the different varieties of calculi is
important from the standpoint of recurrence and treatment
following their removal.
Symptoms.— The acid concretions do not, as a rule, produce
any marked symptoms, except as they impede the flow of
urine.
The large, alkaline stones are most productive of clinical
symptoms, and the ones which require the most radical
treatment. There will be symptoms of a catarrhal inflam-
mation of the bladder, and pus is discharged with the urine.
Micturition is painful, and only small quantities of urine are
422 DISEASES OF THE BLADDER
passed. Attention is usually called to the case by the con-
stant dribbling of urine.
Examination of the bladder is necessary to determine the
presence of the calculus. This may be made either by digital
examination through the rectum, by abdominal palpation,
or by laparotomy. (See Examination of Bladder.)
Prognosis.— Cases when taken early before systemic dis-
turbances make their appearance from absorption of urine,
etc., are favorable. However, the local disturbances in the
bladder produced by the calculi should be taken into con-
sideration, for sometimes serious alterations difficult to heal
will be found in the mucosa.
Treatment.— Surgical treatment is the only satisfactory
method of removing calculi from the bladder. In the male
animal the following procedure has been found to be the most
efficient.
The animal is prepared for operation by being given an
anesthetic, placed on the table in the dorsal position, and
the field of operation just anterior to the pubis and lateral
to the penis shaved and disinfected. The incision should
be 2 to 3 inches in length, so that the bladder can be exposed.
After exposing the bladder it should be well protected with
gauze to prevent urine from flowing into the cavity when
incised. The incision is made through the walls of the
bladder where bloodvessels show the fewest anastomoses.
It should be of sufficient size to remove the calculus. After
the removal of the calculus the mucosa of the bladder should
be examined for smaller stones or deposits, and if any are
found they should also be removed with a blunt curette.
The mucosa is then swabbed with gauze saturated in an anti-
septic solution. The wound in the bladder is sutured with
a double row of sutures bringing the serous coats in direct
approximation. The sutures should be placed close together
to prevent the urine escaping until adhesion takes place.
The laparotomy wound is closed and protected in the usual
manner. In the female two methods are employed:
(a) The animal, well hoppled, is placed in the ventral
position on the table. A vaginal speculum is used to dilate
the vagina. A grooved director is inserted into the urethra
PARASITES IN THE BLADDER 423
and with a probe-pointed knife the urethra is incised back to
the neck of the bladder. The stone, if not too large, is grasp-
ed with a suitable forceps and removed. After removal the
bladder should be flushed out with a warm boric acid solution
(2 per cent.). The vagina should be flushed out daily for a
few days.
(6) In case the stone is too large to be removed through
the neck of the bladder without injuring the sphincter vesicse,
the operation for cystotomy should be performed as in the
male.
The after-treatment consists in irrigation of the bladder
(see Cystitis), and feeding plenty of milk and no meat for a
week or ten days. In some cases when hemorrhage takes
place following the operation, the catheter should be passed
daily to remove the urine and any clots which might form.
TUMORS OF THE BLADDER.
There are a few varieties of tumors found involving this
organ. The most common ones are: Sarcomata, carci-
nomata, and fibromata. They will be recognized by the
symptoms of chronic cystitis they produce, by the examina-
tion of the urine and of the bladder. If necessary laparotomy
may be performed and the bladder examined direct. (See
Examination of the Bladder.)
Prognosis.— This is not very favorable, especially if the
tumor is malignant.
Treatment.— Resection of a portion of the bladder wall
is to be recommended when the tumor formation is localized,
otherwise no treatment can be given. Irrigate the bladder
in the same manner as in cystitis. (See Cystitis.)
PARASITES IN THE BLADDER.
The Dioctophyme renale parasite is found occasionally in
the bladder. A few cases have been recorded in which
species of parasites found in the blood became located in
424 DISEASES OF THE BLADDER
the wall of the bladder. Symptoms of catarrhal inflam-
mation of the bladder, with the presence of eggs in the
urine, will assist in making the diagnosis. Should eggs be
found in the urine, it then becomes necessary to definitely
locate the parasite.
Treatment. — Treatment consists in removal of the para-
sites by cystotomy, and the subsequent irrigation of the
bladder with antiseptics.
CHAPTER III.
DISEASES OF THE URETHRA.
Examination. — The urethra may be examined in two
ways :
(a) In the male it is possible to palpate from without
along its course until it passes over the ischial arch; the part
within the pelvis may be palpated through the rectum.
Palpation will reveal sensitiveness in cases of urethritis and
calculi lodged at some point along its course. There arc
three parts of the urethra in which calculi are most apt
to lodge: At the neck of the bladder; where the prostate
glands practically surround it, and at the posterior end of
the bone of the penis. At these points, owing to the struc-
ture of the urethra and adjacent parts, any foreign material
passed from the bladder is most apt to become lodged. In
the female the urethra can be palpated through the vagina.
In the female, the urethra, as a rule, is free from foreign
material, because any substance of this kind small enough
to pass from the bladder into the urethra, will be forced out
with the urine.
(6) The passage of the catheter or sound is a valuable
means of determining the sensitiveness of the mucous mem-
brane, the presence of calculi or other foreign material, or
strictures at different points along the course of the urethra.
Care should be taken in inserting the catheter not to injure
the urethral mucosa; also one should not mistake the normal
narrowing of the lumen of the urethra for strictures, etc.
CONGENITAL MALFORMATIONS.
Occlusion of the Urethra.
Occlusion of the urethra is occasionally found in both the
male and female. Sometimes an opening exists in some other
portion of the urethra through which the urine is discharged.
426 DISEASES OF THE URETHRA
Various kinds of abnormalities have been observed, such as
epispadia and hypospadia.
Symptoms.— Occlusion of the urethra at its outlet is
characterized in young animals by a retention of urine,
enlargement of the abdomen, and no signs of micturition.
The distended bladder will be found on examination.
Treatment.— Surgical treatment should be given at once.
If the occlusion is at the extreme end of the urethra it should
be incised at this point and the flaps stitched back to the
skin to prevent adhesions taking place. The urine will
usually keep the wound open. Should the occlusion be at
a point higher up, in a male dog, an artificial opening should
be made at the ischial arch through which the urine is
allowed to pass. It may be necessary for this opening to
be used permanently, in which case the edges of the mem-
brane on either side should be stitched back to the skin, and
kept clean for several days until union takes place. In
the female the urethra should be opened with a pair of
scissors, and kept dilated with a metallic catheter used
daily.
WOUNDS OF THE URETHRA.
It happens occasionally when animals are injured that
the urethra will be opened at some point along its exposed
portion. It will be made manifest by the presence of a
wound through which urine escapes. Internal wounds of
the mucosa occur from the careless use of a catheter or
sound, or by foreign bodies passing from the bladder, or
by weeds or straws entering the urethral outlet.
Treatment.— In extensive and severe lacerations of the
urethra they should be sutured, and the wound well pro-
tected. In a short time union will take place and the
urine passed normally. Injuries to the mucosa are treated
by injecting mild antiseptic solutions (boric acid 2 per cent).
STRICTURE OF THE URETHRA.
Definition.— A constriction of the wall of the urethra
which narrows the lumen and interferes with the passage
of urine.
CALCULI IN THE URETHRA 427
Etiology.— This is brought .about by a number of condi-
tions which lead to injury of the mucous membrane, and in
the healing process to the formation of cicatricial tissue
with narrowing of the lumen, and loss of elasticity in the
urethral wall. The most common causes of stricture are:
Calculi, tumors, urethritis and torsion of the urethra occur-
ring during copulation.
Symptoms.— Impeded or complete suppression of micturi-
tion, with straining and pain. Bladder distended. In some
cases small quantities of urine will be passed after much
straining.
Diagnosis.— The diagnosis is made by noting the symp-
toms, and the passage of a sound or catheter. Stricture
of the urethra should not be confused with calculi and
prostatic enlargement.
Prognosis.— Not very favorable, as complete recovery is
rare.
Treatment. — The passage of a sound or catheter daily for
a time will tend to dilate the urethra. The catheter or
sound should be well disinfected each time to avoid infec-
tion in the urethra or bladder. No other treatment has
proved of any value.
CALCULI IN THE URETHRA.
Frequently in the male dog calculi are found at some
point along the course of the urethra. These stones are
passed from the bladder and are of sufficient size to become
lodged in the urethra at the prostate gland and at the os
penis. While they usually consist of one or more concre-
tions, in some cases an impacted mass of small stones ^with
blood or fibrin clot forms the stoppage. Occasionally there
will be found injury to the mucous membrane, the stones
passing out in part into the adjacent tissues.
Symptoms.— When the calculi become lodged in the urethra
marked symptoms develop in a short time. If there is
complete stoppage of urine, the animal will soon show dis-
tress, frequent attempts at micturition, straddling, stiff
gait, evidences of urinary pain or colic. Examination of
428 DISEASES OF THE URETHRA
the bladder will reveal its distended condition. Should the
condition continue for several hours the urine will be dammed
back to produce distention of all the urinary passages. Pas-
sage of the sound or catheter will reveal the obstruction in
the urethra. In the female, by inserting the fingers in the
vagina, the enlargement can be felt.
Prognosis. — Favorable in case treatment can be given
promptly. The complications, paralysis or rupture of the
bladder, should be taken into consideration, as they are
apt to occur if treatment is delayed too long.
Treatment.— Surgical treatment is resorted to promptly
to prevent rupture of the bladder. In case rupture threat-
ens, use a long, disinfected, exploring trocar, disinfect the
skin in the prepubic region, place the animal in a dorsal
position and insert the trocar through the abdominal wall
into the bladder. Allow the urine to flow out, remove the
trocar and cover the wound with flexible collodion. There
is usually but little danger of injuring the bowels, as the
distended bladder pushes them to one side. Urethrotomy
should then be performed. In the male an anesthetic
(morphin or chloroform) should be administered, and the
patient placed on the table in a dorsal position with the
hind legs brought forward. The sound or catheter is
inserted as a guide to locate the calculus, and also to assist
in making the incision. The seat of operation will depend
upon the location of the calculus. When located just
posterior to the os penis, the incision is made at the distal
portion of the enlargement. Should the calculus be at the
prostatic portion of the urethra the operation should be
performed at the ischial arch. The seat of operation should
be thoroughly cleaned and disinfected. The incision is
made immediately over the sound which can be distinctly
felt. This should be made of sufficient size to allow the
calculus to be removed without injuring the adjacent tissues.
In some cases, when the tissues are lacerated, they become
infiltrated with urine and cause considerable trouble fol-
lowing the operation. After the removal of the calculus,
if any urine is present, it will flow out; should this fail to
occur examine further for other calculi by passing the sound
INFLAMMATION OF THE URETHRA 429
beyond the point of operation. When the calculus is in
the prostatic portion of the urethra, the sound should be
passed as before and the incision made at the ischial arch,
cutting down to the catheter or sound. The urethra then
is dilated by either passing a larger sound, or by inserting
a grooved director and enlarging it with a probe-pointed
knife. The calculus is then extracted by using a strong
dressing forceps. In some cases it may be crushed with
lithotomy forceps and taken out in pieces.
In the female the operation is much more simple. In
some cases the calculus can be removed by manipulating it
with the finger inserted in the vagina. Should this fail the
urethra must be dilated or enlarged sufficiently to admit
forceps for its extraction. It is best to use a grooved director
and with a probe-pointed knife the urethra is divided up
to the stone, where it can be extracted with forceps.
After-treatment consists in flushing out the bladder with
some mild antiseptic solution, such as sodium bicarbonate
(2 per cent.) or boric acid (2 per cent.). The wound should
be left open and kept clean with antiseptics. The urine
will at first pass out through the incision, but as the wound
fills in by granulation, eventually it will be voided normally.
In the female the vagina should be cleansed daily with
antiseptics.
INFLAMMATION OF THE URETHRA.
Urethritis.
Urethritis is not a common primary condition in small
animals, but it sometimes accompanies other diseases of
the urinary organs. A primary urethritis results from
infection due to the introduction of a sound or catheter or
from injuries during copulation, etc.
Symptoms. — Painful micturition. Pus and blood can be
pressed out of the urethra.
Treatment.— Antiseptic solutions, such as boric acid (2
per cent.) or sulphate of zinc (1 per cent.) are to be used
as injections into the urethra and prepuce.
PART IX.
DISEASES OF THE NERVOUS SYSTEM.
CHAPTER I.
DISEASES OF THE BRAIN.
General Considerations.— Diseases of the central nervous
system are usually, for the purpose of convenience and
pedagogy, classified into those affecting the encephalon or
brain, those affecting the spinal cord, and those affecting
the peripheral nerves.
This seems to be a logical classification, and this method
will be followed in presenting the diseases of the nervous
system. In order to correctly diagnose diseases of this
system, a knowledge of its functions as well as the seat of
each function is required. These will, therefore, be con-
sidered briefly.
Preliminary remarks on the functions and seat of each:
Cortex.— The cortex of the cerebral hemispheres is the
seat of all psychic function, such as thought, the will and
sensation, and all efferent nerve fibers originate here. The
voluntary motor fibers also originate in the cortex, pass
through the pons to the medulla oblongata where they
cross to the opposite side and communicate with the motor
nerves of the extremities. All sensory nerve fibers and
fibers of special sense which conduct perceptible impulses
to the brain terminate in the cortex. The cortex of the
cerebrum, then, being the seat of the mind and of voluntary
movement, it follows that any destructive process affecting
this portion of the brain will produce psychic or mental
432 DISEASES OF THE BRAIN
disturbances as well as impaired mobility and sensation on
the opposite side of the body, the degree of impairment
depending upon the extent of the lesion.
The Midbrain (Crura Cerebri, Corpora Quadrigemini and
Optic Thalami).—This portion of the brain is the seat of
harmony of motion and equilibrium. ' As some of the cranial
nerves arise here, the fifth pair being the most important
of these, any disease, destructive process or undue pressure
operating on this part of the brain will produce sensory
and motor disturbances in the region of the face, lips, eyes,
ears and part of the tongue, and, if extensive, the entire
organism may be affected. Involuntary movements of the
limbs, head, neck and eyes are the most common symptoms
resulting.
The Cerebellum.— The functions of the cerebellum or hind-
brain are not fully known but it is regarded as being closely
connected with locomotion and equilibrium. It is also
thought to be the seat of the muscle sense and assists in the
coordination of the muscle movements. Each hemisphere
of the cerebellum presides over the muscles of the same side
of the body and if either half be injured or diseased the
animal will exhibit muscular and motor disturbances of
the same side, varying in degree from slight muscular
incoordination to spasmodic movements, or it may walk
in a circle or crowd or roll toward the injured hemisphere.
Examination.— The brain, because of its position, pro-
tected by the bones of the cranium, cannot be examined
directly. Diseases of this organ can be recognized only
by observing the disturbed functions produced after patho-
logical changes have occurred. It is necessary, therefore,
to examine carefully the functions of the brain before one
can arrive at definite conclusions.
As the brain is the seat of the mind (thought), feeling,
consciousness, sensibility and voluntary movement, any dis-
turbances or impairment of these functions must be
attributed to some pathological change in that organ.
Taking up the examination of the brain by examining its
functions in the order named above, the psychic function or
mental condition will be first considered.
EXAMINATION 433
1. PSYCHIC DISTURBANCES. — Any variation from the nor-
mal mental condition is manifested by abnormal excitability,
or abnormal depression.
(a) Mental Excitement.— Abnormal mental excitement is
caused by cerebral irritation involving particularly the
cortex. This may be due to hyperemia, inflammatory
changes, excessive heat or toxic influence. The degree of
excitement may vary from restlessness to mania. In these
attacks docile animals may become vicious, bite animate
or inanimate objects, or even their own flesh; may stand
up on their hind legs, froth at the mouth, and the eyes show
a vacant, staring expression, conjunctiva injected. These
symptoms may gradually subside or they may terminate
in spasms and convulsions.
(6) Mental Depression.— This may be defined as a dulling
of the psychic functions and may vary in degree from dul-
ness to coma. Mental depression is shown by the animal
taking less interest in its surroundings than usual, drooping
of the head and tail, refusing to obey commands or obeys
slowly or clumsily; it assumes somnolent or lethargic atti-
tudes or may wander aimlessly about running into objects,
etc. These are the milder manifestations of depression and
are seen in subacute and chronic diseases affecting the brain
chiefly the cortex. They may occur in acute infectious
diseases, as the early stages of distemper, rabies, in severe
febrile diseases, and in icterus and uremia. Other degrees
of mental depression are shown by somnolency, a condition
in which the animal appears to be asleep, but from which
it may be roused; or sopor, deep sleep from which it is
difficult to rouse the animal, and coma, or complete uncon-
sciousness. These conditions are produced by more severe
or extensive lesions. They are seen in compression of the
brain, cerebral hemorrhage and tumors of the brain. They
may be accompanied by motor disturbances in addition to
the mental symptoms, since these conditions may involve
the deeper structures of the brain as well as the cortex.
2. SENSIBILITY.— Disturbances of sensation may be con-
sidered as of two types, viz.: (a) Pathological excitation or
hyperesthesia and (b) pathological depression or anesthesia.
28
434 DISEASES OF THE BRAIN
•
Hyperesthesia when observed in small animals is usually
due to some of the infectious diseases, and is seen in the
early stages of rabies, in tetanus, and in some of the milder
diseases of the cerebrum as hyperemia and acute cerebritis.
Hyperesthesia is manifested by abnormal movements of the
animal which are entirely out of proportion to the stimulus
applied. For example, slamming the door or clapping the
hands may so excite the animal that it will fall to the floor
or ground in spasms. Local or peripheral hyperesthesia is of
little or no importance in small animal practice.
Anesthesia.— This is a condition in which there is a com-
plete loss of sensation. Hyperesthesia indicates a condition
in which tactile sensibility is merely decreased. Dimin-
ished sensibility may be general or complete, affecting the
entire animal, as in subacute or chronic inflammatory
conditions of the cortex of the brain and its coverings. It
may be partial or incomplete, affecting one entire side,
having its origin in one hemisphere, that of the opposite side.
Or it may be local, circumscribed, when more or less exten-
sive areas of the cerebrum are involved. Depression of
sensibility is determined by applying some stimulus, which
when applied to the normal animal will cause pain. To
test sensibility the skin is pricked with a needle or pin,
pinched or burned with a heated instrument. If the animal
fails to react, that is, does not show pain by crying out,
whining, or trying to get away from the irritant, the area
or part tested is anesthetic.
Motility.— Disturbances of motility arising from the
brain vary in degree from slight incoordination to complete
paralysis. They will vary in extent and character, depend-
ing upon the location and size of the lesion. Disturbed
motility may be classified into (a) hyperkinesis or exag-
gerated action as seen in spasms and involuntary movements,
and (6) akinesis or decreased action such as occurs in loss
of the muscular sense and in paralysis. Disordered motility
may arise from pathological changes in the brain or in the
spinal cord. In examining disturbances of motility, itiis
sometimes impossible to locate definitely the seat of the
lesion. However, if the impaired_ function is accompanied
HYPEREMIA OF THE BRAIN 435
by mental disturbances, the brain may be regarded as
being the seat of the lesion. If, on the other hand, no
mental disturbances are noted, it is assumed that the lesion
is in the cord. Further, the portion of the animal affected
will often point to the origin of the disturbance. Hemi-
plegia, or paralysis of one-half of the body, and monoplegia,
paralysis of a single organ or part, indicate that the disturb-
ance is of cerebral origin, while paraplegia, a paralysis of a
portion of both sides, indicates spinal paralysis.
HYPEREMIA OF THE BRAIN.
Congestion of the Brain.
Definition.— Hyperemia is a condition in which there is
an engorgement of the vessels of the brain. The engorge-
ment may be active or passive.
Etiology.— Active hyperemia, or congestion of the brain,
may be caused by anything which affects the cerebral
arterial circulation. Violent exercise, excitement, espe-
cially in young animals, blows and concussion on the head,
are causes. It may accompany eruption of the permanent
teeth, or abnormal heart action as in hypertrophy of the left
ventricle. Excessive heat, as direct sunlight upon the head'
in hot weather, will also produce active hyperemia.
Infective hyperemia of the brain appears secondarily to
some of the infectious diseases, the most common being
rabies and distemper.
Pass-ire Hyperemia. — The causes of passive hyperemia of
the brain are chiefly mechanical, and may be anything
which impedes the outflow of the blood from the brain.
Tight collars will compress the jugular veins and produce
it. Tumors and enlarged thyroid glands (goiter), valvular
insufficiency of the left heart, chronic diseases of the lungs
as interstitial pneumonia, may produce a passive hyperemia.
Pathology.— In severe hyperemia of the brain, the dura
mater or outer covering will be found injected and in cases
of long standing may be adherent to the bones of the cranial
cavity. The pia mater or inner membrane is hyperemic
and the blood vessels engorged. The gray matter varies
436 DISEASES OF THE BRAIN
from a gray to a pinkish color, and the white matter a
yellowish-red. Between the brain and its covering mem-
brane, and between the membranes themselves there is an
abnormal amount of fluid; the brain substance itself is
abnormally infiltrated with serum. In very severe hyper-
emia there may be ecchymoses or petechise present either in
the substance of the brain or its membranes.
Symptoms.— The symptoms of active hyperemia of the
brain vary, depending upon the severity of the engorge-
ment and the degree of intracranial tension. In mild cases
there may be only symptoms of restlessness shown, the
animal frequently changing its position or wandering about
in an aimless manner. Excitement and irritability may
be seen with a tendency to bite, although the animal is not
aggressive. In more severe hyperemia, there may be
spasms and convulsions. The conjunctiva is congested,
the pupil contracted and the expression vacant or staring.
On palpation the head feels warmer than normal. The
pulse and respirations are accelerated, appetite lost or vari-
able and the animal may vomit. These symptoms appear
quite suddenly but do not persist for long periods. They
may disappear in a few hours or may last as long as three
or four days.
The symptoms of passive hyperemia are chiefly those of
depression, although these may alternate with periods of
excitement.
Diagnosis.— Except for its shorter course and less severe
symptoms, hyperemia of the brain cannot be differentiated
from encephalitis, the symptoms being identical.
Prognosis. —The prognosis should be guarded, as even
apparently mild cases terminate fatally through inflamma-
tion of the brain, a common sequel.
Treatment.— Dietetic.— As the animal will not usually
take fowl during the acute stage and forcible feeding aggra-
vates the symptoms, only fresh milk and plenty of fresh
water should be offered at frequent intervals. Keep the
patient in a cool, quiet, dark place, away from noise and
exciting influences.
ANEMIA OF THE BRAIN 437
Medical.— In the early stages mild revulsives may be
administered, the object being to divert the blood from the
head to the intestinal tract. Magnesium sulphate (8.0-10.0)
may be given for this purpose or pilocarpin (0.00324-0.0081),
the latter subcutaneously. If the excitement is intense and
there are convulsions, morphin sulphate (0.0324-0.1944) may
be administered subcutaneously. If the animal is depressed,
narcotics should not be given, but cerebral stimulants admin-
istered: Caffein citrate (0.0324-0.1944) dissolved, in normal
salt solution or distilled water; camphor in the form of the
spirit (0.5-1.0) given subcutaneously, or, diluted via the
mouth. Atropin sulphate (0.0005-0.001) is also useful as a
cerebral and heart stimulant, subcutaneously. If the hyper-
cmia is due to pressure from enlarged glands or tumors, these
must be removed according to the rules of surgery.
Surgical.— It the animal is strong and plethoric, vene-
section may be performed on the saphena veins withdrawing
from 3 to 0 oz. of blood. Cold applications to the head in
the form of cold packs or ice-bags are useful but only in the
earliest stages) and should not be employed if the animal is
depressed. After convalescence is established, feed lightly
giving laxative foods, as mush and liver or oatmeal and
milk.
ANEMIA OF THE BRAIN. CEREBRAL ANEMIA.
Definition.— Anemia of the brain is a condition in which
there is a marked decrease from the normal in the amount
of blood in the brain and its membranes. It may be acute
or chronic.
Etiology.— Acute anemia of the brain may follow severe
hemorrhage, or the too rapid withdrawal of fluid from the
abdominal or thoracic cavities as in paracentesis. It may
occur in thrombosis of the carotid arteries or in cardiac
diseases, as stenosis or valvular insufficiency.
Chronic anemia of the brain is seen in chronic constitu-
tional diseases, and in diseases affecting the blood, as general
anemia and leukemia. Helminthiasis is a common cause.
438 DISEASES OF THE BRAIN
Pathology.— The brain and its coverings are pale and the
vessels quite bloodless. The cortex which is normally
pinkish-gray in color is almost white and on section of the
brain mass appears to be fused with the underlying white
mass, the line of demarcation being indistinct.
Symptoms.— In acute anemia of the brain, the symptoms
appear quite suddenly and vary from a slight dizziness to
complete insensibility. The pulse is small and weak, the
respirations may be slow and labored or accelerated. The
mucous membranes of the head are very pale. The pupil
of the eye is dilated. There may be convulsions from which
the animal gradually recovers or these may be followed by
death. The symptoms of chronic anemia are milder and
in cases which progress slowly, no symptoms of either
motor or psychic disturbances occur.
Prognosis.— Depends on the direct cause and the possi-
bility of its removal.
Treatment.— Medical.— In acute anemia of the brain, the
treatment is stimulative. Any of the cerebral stimulants,
as caffein citrate (0.0324-0.1944) subcutaneously, alcohol
(2.0-4.0) diluted, if the animal can swallow, or aromatic spirit
of ammonia (2.0-4.0) well diluted.
Surgical.— Artificial respiration and massage should be
practiced if the patient requires it. Clysters of normal salt
solution are also beneficial, or the solution may be given
i ntraperitoneally .
Chronic anemia of the brain must be treated by removing
the primary cause and treating the general anemia by the
administration of tonics, particularly the hematinics (iron
and arsenic preparations). Also prescribe a full, rich diet.
MENINGO-ENCEPHALITIS.
Definition.— This is an inflammatory process affecting the
brain and its covering membranes. It may be suppurative
or non-suppurative. The writer's reason for combining
meningitis and encephalitis is, that in practice these diseases
cannot be differentiated during the life of the animal, and
MENINGO-ENCEPHALITIS 439
when one exists the other is present at least to some extent.
Furthermore, the treatment is essentially the same.
Etiology.— Meningo-encephalitis is caused by practically
the same factors that produce hyperemia of the brain.
These are: Violent exercise, excitement, blows or concus-
sions on the head. Excessive heat, direct sunlight, etc., are
thermic causes.
Infectious diseases, as rabies and distemper, are at times
accompanied by meningo-encephalitis as are suppurative dis-
eases of the auditory canal (otitis) frequently seen in the rab-
bit and occasionally in the dog. Other causes are metastatic
emboli from infected internal organs as the uterus, lungs,
heart (endocarditis) and mammary glands (tumors).
Pathology.— In meningo-encephalitis lesions of various
size and character may be seen, depending upon the cause,
and may be formed anywhere in the brain or on the mem-
branes. There may be numerous inflammatory areas or
perhaps only one. Usually hemorrhagic, circumscribed or
diffuse areas are noted either on or within the hemisphere,
or on the cerebral membranes. The color of the areas varies
from a dark brown to a greenish-yellow, depending on the
age of the lesion. In those cases caused by metastatic
emboli, suppurative areas may be found in any part of
the brain and are usually multiple.
Symptoms.— As in hyperemia of the brain, there are symp-
toms of psychic or motor disturbance, or both. Early there
is restlessness and timidity, and the dog may howl or bark
continuously. If unrestrained the animal will run or wander
about in an aimless manner and frequently run against
objects. The head is hot, visible mucous membranes con-
gested, and the eyes have a vacant, staring expression. The
pupils may show unilateral contraction or dilatation. While
most text-books state that the pupils are contracted, the
writer has observed that in most cases they are either dilated
or unequal.
In severe cases of meningo-encephalitis, spasms and
convulsions, followed by unconsciousness, are observed.
The animal may gradually recover consciousness, or may
die in one of these attacks. When the inflammatory areas
440 DISEASES OF THE BRAIN
are caused by metastatic emboli, the temperature is ele-
vated about two degrees and there are symptoms of paralysis
shown, the parts involved depending upon what portion of
the brain is affected. Deafness and blindness are not
uncommon, showing involvement of the cranial nerves.
Diagnosis.— Meningo-encephalitis, except for its longer
course, cannot be differentiated from acute hyperemia or
congestion of the brain. None but the layman would con-
fuse it with rabies (see Rabies).
Prognosis.— The prognosis is unfavorable as less than 20
per cent, of cases fully recover. The others usually die
within a few days or become chronic "dummies."
Treatment.— The treatment of meningo-encephalitis varies
in no way from that of hyperemia of the brain.
CEREBRAL HEMORRHAGE. APOPLEXY.
Definition.— This is a hemorrhage involving usually the
cortex of the cerebrum, though it may occur in any portion
of the brain.
Etiology.— Cerebral hemorrhage is most frequently seen
in old dogs in which there is some degenerative process in
the walls of the afferent bloodvessels of the brain. It is
also seen in distemper and in the arteriosclerosis which may
follow rheumatism. These are predisposing causes. The
direct causes are anything which raises the blood pressitte,
as excitement, violent muscular exercises, etc.
Pathology. — The hemorrhage occurs usually ,on the cere-
brum from rupture of a capillary. If the hemorrhage is
near the surface the membrane covering the brain at that
point will be distended and the convolutions will be depressed
or flattened.
The site of the lesion may contain blood, hemoglobin or
a serous fluid, depending upon the age of the lesion.
Symptoms.— These appear suddenly, usually after play or
excitement and are those of paresis or paralysis. The animal
drops to the floor or ground and is convulsed with muscular
spasms. These may pass off and the animal will rise and
walk about in an unsteady manner, or may lose conscious-
TUMORS OF THE BRAIN 441
ness. The conjunctiva is reddened, and the heart beat
rapid. The respirations are slow and regular or they may
be stuporous and irregular, of the Cheyne-Stokes' variety.
The temperature is about normal.
If the animal does not die at once, it is usually left with
a partial or complete paralysis, monoplegic or hemiplegic in
character, depending upon the size and location of the
hemorrhage. If the hemorrhage is small and away from
the cortex, there will be only slight convulsions shown
followed by muscular incoordination, the animal stumbling
or staggering from side to side and falling.
Diagnosis.— The sudden occurrence, the history, the char-
acter of the respiration and the paralysis make the diagnosis
not difficult.
Prognosis.— The prognosis should be unfavorable, only the
milder cases terminating favorably.
Treatment.— Place the animal in moderately cool, well-
ventilated quarters away from exciting influences. Cold
applications should be applied early to the head, and if there
be convulsions, antispasmodics (morphin, 0.0162-0.1944) may
be administered. Give potassium iodid (0.1-0.8) to resorb
the hemorrhagic exudate, and keep the bowels open with
mild purgatives, such as castor oil (15.0-40.0). Later the
paralysis may be treated by the administration of strychnin
to almost the toxic point (0.00054-0.00216). The faradic
battery is also useful in treating the paralysis.
As this condition is brought about by a high blood pres-
sure and is most commonly seen in plethoric animals, it is
well to reduce the blood pressure by depletion methods, such
as a restricted diet and occasional bleeding from the saphena
vein, to prevent another attack.
TUMORS OF THE BRAIN.
Tumors of the brain are rare in small animals but are
occasionally observed. They may involve any part of the
brain and its covering membrane, and histologically may be
of any type.
442 DISEASES OF THE BRAIN
The symptoms produced depend upon the location of the
tumor and the degree of intracranial tension. They may
be those of paralysis, muscular incoordination, rolling or
turning movements, deafness or blindness. Unless the
symptoms indicate that the tumor is located near the cortex
or involves the membranes covering the brain, treatment,
which is purely surgical, should not be attempted.
CHAPTER II.
DISEASES OF THE SPINAL CORD.
General Considerations. — Functions of the Core?.— Briefly
stated, the functions of the spinal cord are: (a) A con-
ductor of nerve impulses from the intracranial nerve centers
to the periphery (skin and muscles), and from the periphery
to the center; (6) it is the great reflex center for muscular
coordination, and also contains in the anterior part special
reflex centers, which control respiration, the circulation and
deglutition, and in the lumbar portion are the centers for
defecation, micturition, etc.
Examination.— The cord, like the brain, cannot be exam-
ined directly on account of its sheltered position within
the vertebral canal, but diseases of the cord can, in a general
way, be recognized by examining its functions. This is
done by essentially the same methods as are employed in
making an examination of the brain.
It is difficult in some cases to differentiate between diseases
affecting the cord and those affecting the brain, but since
the cord is the seat of the reflex action, diseases affecting
it will, in many cases, destroy one or more of the reflex
arcs depending upon what particular part of the cord the
lesion occurs in. Therefore, all reflex action will be absent
or modified posterior to the lesion. This, together with
the fact that in diseases or lesions involving the cord alone
no psychic disturbances, as a rule, are present, will serve
to differentiate between them.
MENINGOMYELITIS.
Definition.— This is an inflammation of the spinal cord and
its covering membranes. It is quite common in the dog and
rabbit but rare in the other small animals.
444 DISEASES OF THE SPINAL CORD
Etiology. — Mechanical. — Common causes of meningo-
myelitis are traumatic injuries, such as blows in the region
of the back or loins, being run over by vehicles, etc.
Infectious.— It is also seen during or following the infec-
tious diseases as distemper, rabies, pyemia, etc., and abscesses
in the region of the spine, the pus burrowing between the
vertebrae and attacking the meninges and cord occasion it.
Pathology . —The membranes covering the cord are some-
what thickened and show either diffuse or circumscribed
areas of inflammation, and may be adherent to the cord itself.
In other cases, depending on the cause, abscesses may be
found involving both the membranes and the cord. If the
condition is due to traumatic causes, the vertebrae may be
broken or splintered with some portion pressing on the
cord. The spinal fluid is increased in quantity and may be
purulent in character.
Symptoms. —The symptoms of meningomyelitis, unless of
traumatic origin, appear gradually and become more severe
as the disease progresses. They may vary from slight motor
and sensory disturbances to complete paralysis. There is
slight twitching of the extremities which is usually the first
symptom noted.
Disturbances of sensation are frequently observed as
hyperesthesia, the animal showing pain when handled or
even when stroked with the hand. Symptoms of paralysis
are seen later, except when due to severe traumatic causes,
when the}' may be the first and only symptoms shown.
The patient has a staggering gait, sways from side to side
when walking and finally drags its hind limbs. When
placed on its feet, it will drop sideways on its hind quarters.
If the lesion in the cord is far forward, the anterior limbs
may also be involved. If in the cervical region, however,
death usually follows suddenly from respiratory arrest.
The sphincters of the anus and urinary bladder are
usually involved causing the feces and urine to pass involun-
tarily, though there is usually constipation. Progressive
paralysis indicates tumors pressing on the cord. If only
the membranes covering the cord are involved, the spinal
reflex is present and may be exaggerated. If a portion of
CONCUSSION OF THE SPINAL CORD 445
the cord itself is destroyed, reflex movement is absent
posterior to the lesion. Consciousness is not disturbed.
Diagnosis.— It is usually not difficult to differentiate
between diseases of the spinal cord and those of the brain,
but to state definitely the character of the lesion and its
exact location should not be attempted. In diseases of the
nervous system it is generally sufficient to state whether
the brain or cord is affected.
Prognosis. — In meningomyelitis, as in other diseases of
the brain and cord, the prognosis is generally unfavorable,
only a small percentage recovering.
Treatment.— In the early stages give laxatives, as mag-
nesium sulphate (8.0-12.0) or castor oil (15.0-40.0) and
apply counterirritants to the spine.
The faradic battery is useful in treating the paralysis, or
strychnin almost to the point of intoxication. lodid of
potassium may be given to resorb the exudate.
The animal should be placed under good hygienic sur-
roundings and kept clean and dry.
CONCUSSION OF THE SPINAL CORD.
Injuries of the Spinal Cord.
Etiology.— This condition occurs quite frequently in the
dog and cat from a variety of causes. These animals are
subjected to extreme violence often by being run over by
fast moving vehicles, by penetration of the spinal canal
by sharp or blunt objects, or from the animal falling. Many
cases such as described result in fracture of the vertebra1
with direct injury to the cord. Extreme muscular exertion
combined with diseases of the bones (fragilitas ossium) will
result in fracture and injury to the cord. The injuries
to the cord with fracture of the vertebra* often lead to
hemorrhage between the membranes or in the spinal cord
proper. Puncture into the spinal canal as has been practiced
in certain cases, frequently terminates in edema of the cord
and membranes from the irritation, or hemorrhage into the
spinal canal.
446 DISEASES OF THE SPINAL CORD
Pathogenesis. — As soon as the injury occurs, and the cord
either crushed or compressed by extravasated blood or
serum, it loses its conductivity in proportion to the degree
of the injury and compression. The conductivity of the
cord may thus be either partially or entirely lost and the
function of the nerves will be partially or completely
destroyed in the area involved. In minor injuries with
simply edema of the membranes or cord the development
is gradual and the degree of involvement very slight.
Symptoms.— The symptoms of compression or injury to
the spinal cord will depend upon: (a) The location of the
injury or portion of the cord affected; (6) the degree of
compression or destruction of the cord. When the spinal
cord is compressed or crushed in the cervical region the
animal, as a rule, does not live over a few minutes or hours.
Complete paralysis is observed posterior to the point of
injury. The patient may be able to bring the muscles of
the head into action for a short period preceding death.
In cases of lesser injury or compression the symptoms are
not so pronounced and the patient may be able to move
certain groups of muscles. If the compression is due to
edema of the membranes or hemorrhage into the cord or
canal the symptoms are milder and gradually disappear
in the course of a few days or weeks.
Complete destruction of the cord posterior to the cervical
enlargement will produce paralysis and complete loss in
sensation in the limbs, tail and body. This is noticeable
in the respiration as the ribs remain fixed and the respiratory
movements are confined to the diaphragm.
There may be retention of urine and feces, or they may
be voided involuntarily.
When the dorsal portion of the spinal cord is affected
there will be paralysis of the posterior part of the body.
In slight injury or compression there may be only inco-
ordination of movement from the point of injury.
Compression or destruction of the anterior part of the
lumbar segment results in paralysis and anesthesia of the
hind limbs, tail and muscles of the croup. When the
injury is in the middle or posterior portion of the lumbar
CONCUSSION OF THE SPINAL CORD 447
segment the symptoms will be modified somewhat owing
to the injury of the sacral segment which results in paralysis
of the area supplied by the sciatic nerve. The sphincters
of the bladder and anus respectively will be paralyzed and
urine and feces discharged involuntarily.
When the injury occurs in small animals spasms of adja-
cent muscles will be observed. This is due no doubt to the
injury producing stimulation to the nerve roots. On
examination of the patient the temperature is often elevated,
or it may be subnormal if the sphincters are relaxed and the
thermometer inserted in the rectum. Palpation over the
region of injury will cause the animal intense pain and fre-
quently convulsions or spasms. Swelling is often present
and crepitation may be detected. Abnormal movement of
the vertebrae involved can be determined in the cervical and
lumbar segments.
Diagnosis.— This is accomplished only after careful exam-
ination and consideration of the -parts paralyzed. The
determination of the degree of injury is often very difficult.
There might be a complete paralysis resulting from edema
and hemorrhage greatly resembling cases of destruction
of the cord. However, the history of the case will assist in
the differential diagnosis.
Course.— In complete destruction of the cord in the
cervical segment death may occur in a few moments or
may be delayed for several hours. Should there be hemor-
rhage only and partial paralysis the patient may live for
several days and some will make a complete recovery. In
involvement of the dorsal and lumbar segments the course
will depend upon the degree of injury. In small animals they
may live for several weeks or months.
Prognosis.— A definite prognosis is often difficult to arrive
at on account of the impossibility to determine the degree
of injury in all cases. When there is evidence of complete
destruction of the cord the case is hopeless. In cases of
hemorrhage or edema most patients will make a complete
recovery. At best the prognosis should be held in reserve
until the exact condition can be determined.
448 DISEASES OF THE SPINAL CORD
Treatment.— No treatment will be of any value where the
spinal cord is destroyed. If crepitation is present and
distinct separation and movement between the involved
vertebrae are detected it is advisable to destroy the animal.
If in doubt in regard to the actual condition the patient
should be given a soft bed and quiet place. Good nourish-
ing food (meat, milk) and gentle massage over the region
injured will assist in the resorption. In the secondary
stages small doses of strychnin sulphate (0.001) daily and
electricity have proved to be beneficial.
COMPRESSION OF THE SPINAL CORD.
Definition.— A condition in which there is more or less
disturbance in the function of the spinal cord from pressure
by exostosis, tumors, abscesses, parasites, etc.
Etiology.— Various diseased conditions will produce com-
pression of the cord. The following are most common and
important: (a) In the dog degeneration of the interverte-
bral disks in which there is distortion and enlargement
projecting into the spinal canal, narrowing its lumen and
causing compression of the cord. This condition has been
observed in certain breeds of dogs and in Belgian hares.
The cause is no doubt injury to the disks by extreme mobil-
ity or concussion. (/;) Ossification of the intervertebral
disks. This is found in older animals, mainly in old dogs.
It may exist in an individual disk or what is more common
a number of them will be affected producing rigidity of the
vertebral column. The enlargements resulting from the
ossification project into the spinal canal directly compres-
sing the cord. The condition usually begins in the most
mobile portion of the vertebral column. Fracture of the
vertebra? without destruction of the cord may bring about
a similar condition upon union of the fractured portions.
The new bone formation projects into the spinal canal.
(c) Tumors. In the dog sarcomas may cause compression
of the cord by the tumor developing in close proximity to
the vertebral column and the growth extending through the
intervertebral foramina. Other growths rarely produce this
COMPRESSION OF THE SPINAL CORD 449
condition, (d) A few cases have been observed in dogs and in
rabbits in which Echinococcus granulosus cysts produced
local pressure on the spinal cord, (e) Abscesses developing
in the spinal canal are rare, but when found near the verte-
bral column, the pus may burrow in between the inter-
vertebral disks producing infection resulting in edema and
inflammation.
Pathogenesis.— Any of the conditions enumerated may
lead to a reduction in the lumen of the spinal canal. The
degree of injury or compression of the cord will depend
upon the character of the course and the point of involve-
ment of the vertebral column.
Symptoms.— The rigidity of the spine and the careful way
in which the animal lies down and gets up are somewhat
characteristic. Dogs exhibit considerable pain on moving
the spinal column by whining, crying, etc. In movement
the animal is very cautious and often if recumbent refuses
to arise when called. Examination of the patient reveals
the rigid condition of the spine and the fixation of the
muscles of the back. Forced movement of the vertebra?
induces severe pain. Paralysis gradually develops posterior
to the point of compression; sensation is partially or com-
pletely destroyed, and involuntary passage of urine and
feces follows from paralysis of the sphincter muscles con-
cerned.
Diagnosis.— An early diagnosis is often difficult owing to
the gradual development of the primary condition. A
careful examination of the vertebral column, its rigidity,
evidence of pain on movement, will assist in the diagnosis.
It may be confused with muscular rheumatism.
Prognosis.— This must be considered unfavorable in all
cases. Recovery is very rare.
Treatment.— Treatment is practically impossible. Oper-
able tumors, when its cause, may be removed surgically.
Abscesses may be opened and drained, but owing to the
complicating infection little can be expected in the way of
recovery or even improvement. No internal treatment has
proved of any value. Small doses of potassium iodid may
be tried in the milder cases.
29
CHAPTER III.
DISEASES OF THE PERIPHERAL NERVOUS
SYSTEM.
INJURIES OF THE PERIPHERAL NERVES.
Small animals are subjected to a variety of injuries which
may involve the individual nerves or nerve endings, such
as bruises of the muscles, in which the nerve is crushed
against the bones, or between muscles, or stretched or torn
or the nerve is cut by sharp objects which is more frequent.
PRESSURE UPON THE PERIPHERAL NERVES.
COMPRESSION.
Most frequently compression results from neoplastic
formations (sarcomas, neuromas), from hemorrhagic extrav-
asations, serous effusions into the tissues, enlargement of
lymph glands, fractures of bones or abscess formation.
Neuritis undoubtedly occurs in small animals, particu-
larly in dogs, and may result from a variety of causes.
Chilling or subjection to extremes of temperature is
perhaps most productive of the condition. The inflam-
mation resulting is subsequently followed by paralysis in
a number of cases.
PARALYSIS OF THE PERIPHERAL NERVES.
The following paralyses of peripheral nerves have been
noted :
Facial Nerve.— Dogs and rabbits are most often affected.
Etiology.— (a) Traumatic influences play an important role
in the unilateral form of facial paralysis (monoplegia facialis)
by injuring the nerve at the point where it goes around the
maxillary bone'. (6) Neoplasms in the parotid region involve
PARALYSIS OF THE PERIPHERAL NERVES 451
the nerve and destroy its function either by compression
or direct growth into it. (c) Inflammation of the middle
ear, caries of the petrous portion of the temporal bone, and
tumors in the base of the brain often produce it. (d) Dis-
temper (nervous form) producing an encephalitis will often
result in paralysis of the facial nerve, (e) Exposure to cold,
such as hunting dogs, or retrievers in which the surface of
the body is suddenly subjected to the extreme temperature.
A bilateral facial paralysis (diplegia facialis) is usually
of central origin.
Symptoms.— In case the entire nerve with all its branches
is paralyzed there will be paralysis of the ear, eyelids and
lips on the side affected. The ear will droop, and the animal
is unable to elevate it when called or excited. The eyelids
hang downward and are immovable. The lip will be found
soft, flabby and will not react to normal stimuli. When
these symptoms are present the lesion is central. On the
other hand, should there be a paralysis of the lips only,
it would indicate a peripheral form of facial paralysis.
Paralysis of the facial nerve arising from the central nervous
system may have associated with it paralysis of other cranial
nerves. This would complicate the symptoms.
Diagnosis.— The symptoms are characteristic. A differ-
ential diagnosis should be made between central facial
paralysis and the peripheral form. This can be easily
determined in most cases by noting the extent of the paralysis.
Prognosis.— When there is complete paralysis of central
origin it is considered unfavorable. However, if the con-
dition has only temporarily affected the nerve the animal
will recover. The exact condition of the nerve is impossible
to determine. In the peripheral form the condition of the
nerve at the point of injury is important. When not
destroyed the prognosis is favorable.
Treatment. — In the peripheral form due to injury or chill-
ing, the symptoms usually disappear quite promptly. The
parts should be massaged thoroughly and the electric
current applied daily over the region. Stimulating lini-
ments massaged into the tissues are recommended (soap
liniment, camphor liniment, white liniment). If tumors
452 DISEASES OF THE PERIPHERAL NERVES
or abscesses are present they should be operated at once,
care being taken to avoid injuring the nerve. In the central
form nerve stimulants (strychnin sulphate 0.001 daily), or
electricity should be employed. Usually in the course of
ten days to two weeks improvement will be noticed. If
after one month to six weeks no improvement is noted the
chances are that the nerve trunk has been completely
destroyed and further treatment is useless. Spasm of the
muscles supplied by the facial nerve occurs occasionally,
especially in dogs, no doubt due to the infection from dis-
temper producing irritation to the nerve. It may also occur in
meningitis and encephalitis. When present the condition is
characterized by clonic convulsions of the muscles supplied
by the nerve. Sedatives would be indicated to reduce the
irritation.
Trigeminal Nerve.— Paralysis of this nerve is observed
most often in dogs.
Etiology. — (a) Rabies produces the greatest number of
cases. Therefore, all cases of trigeminal paralysis should
be handled with caution until the exact cause is known. (6)
Occurs in some cases from distemper, (c) Inflammation of
the brain and concussion of the brain also cause it. (rf)
Injuries in which the motor branch is pressed or crushed.
This happens not uncommonly in dogs from extreme open-
ing of mouth, or carrying large heavy objects in the mouth.
(e) Tumor formations, such as sarcomata in close proximity
to the nerve, or abscesses. These conditions may either
injure the nerve directly or by external pressure. (/) Rheu-
matic conditions involving the muscles supplied by the nerve.
(g) Neoplasms at the base of the cranium (angioma) .
Symptoms. — The most pronounced symptom is dropping
of the lower jaw, the mouth remaining open constantly. In
such cases rabies should be suspected. In unilateral paralysis
the animal may be able to close the mouth and masticate on
one side. If all three branches of the nerve are paralyzed
mastication and sensibility are lost. In case any individual
branch of the nerve is paralyzed that part supplied by that
branch only will be affected. When the mouth remains
open the tongue will protrude, become dry and discolored.
PAltALYSIS OF THE PERIPHERAL NERVES 453
Saliva is usually profuse and flows from the open mouth.
Attempts at eating and drinking fail. Food is swallowed
when placed hack in the mouth.
Diagnosis. — The only difficulty in diagnosis is to determine
the cause of the paralysis. The symptoms are so charac-
teristic that the actual condition is easily recognized. A
differential diagnosis should be made to determine whether
or not the animal is affected with rabies. The general con-
dition of the animal, disturbance in swallowing, change of
voice and paralysis in the posterior part of the body in
rabies are indicative.
Prognosis.— Should the condition result from trauma then
the prognosis is considered favorable, otherwise unfavorable.
Treatment. — If the paralysis is the result of rabies no
treatment should be attempted. In cases due to other
causes, give nourishing food (milk, chopped meat). This
is best done either by placing the food well back into the
mouth, or by the use of a stomach-tube. Massage the
muscles thoroughly, using at the same time a stimulating
liniment (soap liniment). Electricity may also be tried,
(live internally tincture nux vomica (0.3-0.7) or strych-
nin sulphate (0.001) daily. Spasms of the muscles supplied
by the trigeminal nerve are observed in tetanus and in some
cases of the nervous form of distemper. The muscles
are either rigid as in tetanus, or contracting and relaxing
rapidly as in some cases of distemper. Nerve sedatives
should be used to control the spasms. Tetanus antitoxin
and distemper serum respectively may be employed, depend-
ing on the condition present.
Auditory Nerve. Etiology.— The true nerve of hearing
(cochlear nerve) is not frequently paralyzed. However, it
may be paralyzed from a congenital defect or inflammatory
changes within the internal ear, or from diseases affecting
the medulla oblongata. Paralysis of the vestibular nerve is
very commonly observed in dogs, rabbits, fowls and pigeons.
In practically all cases, however, it is the result of inflam-
matory changes within the middle and inner ear. These
changes may result from chicken pest, cholera, epitheliosis,
contagious rhinitis (rabbit), or distemper. Causes of
454 DISEASES OF THE PERIPHERAL NERVES
minor importance are: Concussion of the brain, hemor-
rhages in the middle ear, or caries of the petrous portion
of the temporal bone.
Symptoms.— Deafness is the pronounced symptom of
paralysis of the cochlear nerve. If bilateral and complete
the animal will be totally deaf. In vestibular paralysis,
when unilateral, the patient will assume a peculiar attitude
holding the head downward and toward the normal side.
In chickens the head is rotated to the degree that the comb
will rest on the ground. In dogs and rabbits rolling move-
ments are very prominent symptoms. This is so marked
in some cases that it is impossible to hold the animal. The
least irritation or disturbance will cause them to show it.
Rolling movements always take place toward the normal
side. Attempts at walking are difficult but if they 'succeed
will travel in circles, often falling down and rolling over
and over. The eyelids are often closed and the eyeball
assumes an abnormal position. In case of bilateral vestib-
ular paralysis, the head drops down and the muscles of
the neck are limp.
Diagnosis.— This should not be difficult, as the symptoms
of deafness are easily manifest and the peculiar movements
of the animal in vestibular paralysis are characteristic.
Prognosis.— Should be considered unfavorable except when
due to injuries.
Treatment.— If due to injuries the animal should be kept
quiet and if necessary fed artificially in order to maintain
its general condition. The ears should always be exam-
ined to determine their condition (disease or parasites).
Pigeons, when affected, are isolated and the premises dis-
infected to guard against contagious meningitis. Internal
administration of magnesium sulphate or castor oil as a
laxative is advised. No treatment can be applied direct
to the seat of the condition.
Radial Nerve.— Paralysis of this nerve occurs occasionally
in the dog and cat.
Etiology. — (a) On account of the position of the radial
nerve it is easily injured by traumatism. Animals struck
by objects, falling, jumping, etc., very commonly injure
PARALYSIS OF THE PERIPHERAL NERVES 455
the nerve with resulting partial or complete paralysis which
may be temporary or permanent. (6) May follow muscular
rheumatism or subjection to cold, (c) Follows infectious
diseases, such as distemper in dogs and cats, (d) Has been
observed from injury to the spinal cord, (e) Tumors and
abscesses in the muscles may bring about at least a tempo-
rary radial paralysis.
Symptoms.— The radial nerve controls the muscles that
extend the forelimb; therefore the most prominent symp-
tom is inability to carry the limb forward. The joints are
extended below the elbow and flexed above that point. The
animal in moving forward drags the toe on the ground and
weight cannot be supported owing to the difficulty of prop-
erly placing the limb in the normal position. Some weight
will be supported on the limb when it is placed in position.
The degree of disturbance will depend upon whether the
paralysis is complete or partial. Local examination reveals
absence of inflammatory changes. There is usually a
normal degree of sensitiveness in the skin.
Diagnosis.— A careful examination should be made in
the dog for they are inclined to favor the limb in the least
disturbance. However, in many cases of injuries, the limb
will be carried from the ground while in this case it will be
just the opposite, dragged on the ground. Examine for
thrombosis of the axillary arteries.
Prognosis.— The larger number of cases recover. This is
explained in that most cases result from injuries which do
not seriously disturb the structure of the nerve. Few cases
will be permanent.
Treatment.— Massage the muscles and stimulate them by
the use of the electric current. Nerve tonics may also be
given. If no improvement is apparent in ten days to two
weeks the case should be considered unfavorable.
Brachial Plexus.— Paralysis of the brachial plexus occurs
most commonly in the dog and cat.
Etiology.— The majority of cases result from injury, from
falling or jumping from great heights. Fracture of bones
adjacent to the plexus resulting in injury will produce it.
Tumor formations and abscesses in the axillary region are
also causes.
450 DISEASES OF THE PERIPHERAL NERVES
Symptoms.— The most prominent symptom is a limp,
lifeless condition of the limb unable to support any weight.
Sensation, as a rule, is lost in the entire limb. If the paralysis
is partial only, the symptoms will be less prominent.
Prognosis.— Most cases, inasmuch as they are due to
injuries, recover completely in the course of a few weeks.
Treatment.— Massage and nerve stimulants are useful.
Keep the animal well nourished.
Sciatic Nerve.— Etiology. — (a) Falling from heights and
jumping. (6) Wounds and direct injuries to the nerve, (c)
Infectious disease^ (distemper), (d) Tumors and abscesses
in contact with the nerve.
Symptoms.— There will be paralysis of the biceps femoris,
the semitendinosus and the muscles below the stifle joint.
In the dog the limb will hang relaxed and during forward
movement the toe is dragged on the ground. Cases will be
seen where the hair and skin are abraded from the anterior
surface of the foot. There may be loss of sensation below
the stifle joint. In bilateral sciatic paralysis it resembles
lumbar paralysis to a certain degree. A differentiation
should be made. Atrophy of the affected muscles will soon
be noticeable.
Prognosis. — If due to injuries it is favorable, provided the
nerve is not completely destroyed.
Treatment.— Massage and employ nerve stimulants. Pro-
tect the feet from injury, give nourishing food and use
the electric current.
Paralysis of other nerves is occasionally seen but is of
minor importance.
CHAPTER IV.
FUNCTIONAL NERVOUS DISEASES.
VERTIGO. MEGRIM.
Definition. —A condition characterized by dizziness and
general disturbance of equilibrium (swooning). In small
animals it is not very commonly observed, except in dogs,
rabbits and pigeons.
Etiology. — In these animals the condition is very seldom
found as a primary disease. It is usually secondary to other
diseases which it may follow.
(a) Diseases of the brain, such as hyperemia, acute and
chronic, or encephalitis, often produce the symptoms of
vertigo. (6) Tumors, hemorrhage into the brain or mem-
branes, concussion of the brain, or emboli of some of the
cerebral bloodvessels may also produce it. (c) Defects of
vision, or irregular lighting in which too sudden change
takes place in the accommodation of the eye, have been
cited as causes, (d) Diseases of the middle or inner ear.
(e) Sudden change in the circulation of the blood in which
there is cerebral anemia. Tight collars may produce the con-
dition, or the dog pulling steadily on the leash may bring
it about. (/) Reflex conditions from the intestinal tract
(parasites or intestinal catarrh), (</) From poisoning, such
as ptomains, certain poisonous plants, or overdoses of alcohol
and other narcotics. (/?) Pigeons are sometimes affected by
a contagious or infectious disease having as its most promi-
nent symptom vertigo. Large numbers may be affected at
the same time.
Symptoms.— The early indication of vertigo is charac-
terized by a sudden staggering gait. The animal falls
down, becomes unconscious. It remains in this position
quietly for a few moments, arises and soon assumes its
normal condition. The individual attack is usually of
458 FUNCTIONAL NERVOUS DISEASES
short duration, from two to ten minutes. The time elaps-
ing between the attacks is variable. The prodromal symp-
toms are anxiety, staring expression, increased respiratory
movements, and sometimes slight twitching of the muscles.
When occurring in pigeons the number affected should be
noted to determine whether or not an infectious disease is
causing it.
Diagnosis.— A differential diagnosis should be made be-
tween vertigo and epilepsy. The main differential feature
is the absence of convulsions in vertigo. The symptom
vertigo is not so difficult to determine, but its causes may
remain quite obscure.
Prognosis.— Should not be considered very favorable as the
cause is hard to determine. Individual attacks of the dis-
ease usually do not cause any serious disturbance barring
accidents and injuries.
Treatment.— During an attack of vertigo the animal should
be placed in a comfortable, quiet place and protected from
injury. Following the attack the examination should be
directed to find out the underlying cause and treatment
applied accordingly. When the condition occurs in pigeons
as a contagious disease, the entire premises should be dis-
infected after the removal of all affected birds. Individual
treatment in these cases is unsatisfactory.
EPILEPSY.
Definition.— Epilepsy is a disease of the central nervous
system which is characterized by convulsions occurring at
irregular intervals, the subject usually being unconscious
during the attack.
Etiology.— The cause of primary true epilepsy is unknown
although it is regarded as being hereditary; at least the
offspring of epileptic parents are markedly predisposed to
the disease. This has been observed in man as well as in the
domesticated animals.
Pathology.— No postmortem lesions of any kind have
been observed either in animals or man which would account
for the disease.
Symptoms.— In epilepsy the attacks come on suddenly,
the. animal performing uncontrollable movements. This is
EPILEPSY 459
followed by the subject falling to the ground or floor and
in convulsions of a clonic type. Generally every muscle is
involved, including the facial muscles. There is champing
of the jaws with salivation, the saliva being churned into
foam and often blood-stained due to injuries of the tongue
by the teeth. The visible mucous membranes are cyanotic;
the heart beat is full and strong, and the respirations sus-
pended. The convulsions last but a few seconds and
gradually become weaker and finally cease. The animal
lies quietly for a few minutes, then rises to its feet, staggers
and finally recovers. The attacks do not occur at regular
periods. The animal may have two or more in a day, or
there may be weeks or months between attacks.
Diagnosis.— It is difficult to differentiate between true
epilepsy and secondary or reflex epilepsy which is merely a
symptom of some other disease. A history of chronicity
and the rather long periods between the attacks point to
true epilepsy. Further, true epilepsy may be seen in both
old and young animals while secondary or reflex is usually
confined to the young.
Prognosis. — The prognosis is unfavorable, as true epilepsy
is considered incurable.
Treatment.— If treatment is undertaken, the bowels
should be kept open by feeding laxative food and, if neces-
sary, the administration of laxative drugs as cascara sagrada,
fluidextract (2.0-8.0), or sulphur (2.0-6.0) in the food as
required.
The periods between the attacks may be lengthened by
the administration of bromides in full doses, the bromid of
sodium being preferable (0.5-4.0).
Castration is said to have a beneficial action in some cases.
Reflex or Secondary Epilepsy.— This is seen as a symptom
of several diseases occurring in small animals and somewhat
resembles true epilepsy.
Reflex or secondary epilepsy is sometimes seen in rickets,
inflammatory diseases of the digestive tract, some infesta-
tion with internal parasites, during the eruption of the
permanent teeth, in constipation, and frequently distemper,
especially the nervous form.
It is seen chiefly in young animals, being quite rare in
400 FUNCTIONAL NERVOUS DISEASES
older, while true epilepsy affects the old as well as the
young. This will assist in the differentiation between reflex
and true epilepsy.
Treatment.— Treatment must be directed toward the
primary disease or condition producing the symptoms.
CATALEPSY.
Definition. — This is a peculiar functional disease of the
central nervous system, probably of the cortex of the brain.
It is characterized by a suspension of voluntary motion on
the part of the subject, but when the position of the animal
is passively changed, it will be maintained by the patient
for a long time.
Etiology. —The cause of catalepsy is not known, though
it is probably of reflex origin.
Pathology.— No pathological lesions of the central nervous
system have been demonstrated. Degenerative changes in
the muscles have been observed, also small hemorrhages
in the stomach and intestines, but these are not constant.
Symptoms.— The attacks come on rather suddenly, the
animal becoming rigid, muscles hard and tense. The
eyes are fixed and dull in appearance, the pupils may be
dilated or contracted to the utmost. Sensation seems to
be inhibited during the attack. The circulatory and respir-
atory functions are undisturbed; temperature normal. If
the position of the animal's limbs be passively changed it
will remain in that position for a long time.
Diagnosis. —This is made chiefly by passively changing
the position of the body of the animal or its limbs. If it
remains in this position without change for a considerable
length of time, the attack is undoubtedly catalepsy.
Course. —The course of the attacks is from four to twenty-
four hours from which the animal usually recovers.
Prognosis.— The prognosis is not unfavorable, though the
attacks may recur.
Treatment. —The administration of antispasmodics is indi-
cated. Give morphin (0.032-0.2) subcutaneously, or chloral
hydrate (2.0-4.0) in emulsion per rectum. This will relieve
the attack, but there is a tendency to recurrence.
ECLAMPSIA 461
CHOREA.
Definition.— This is a persistent clonic spasm, or twitching
of certain muscles, or group of muscles. It is oftenest seen
in the dog; rare in other animals.
Etiology.— Chorea results most frequently from acute
infectious diseases as distemper to which it is a common
sequel. It also occurs in myelitis, and in the early stages
of rachitis.
Pathology.— There is no demonstrable lesion observed
even in the most careful examination which might account
for the symptoms shown. Anemia is the most constant.
Symptoms.— The twitching of the muscles is quite constant
and usually involves those of the head and anterior limbs,
though often one or both of the pelvic limbs may be involved.
There is a peculiar dipping movement of the head and
shoulders. Often the masseter muscles are the only ones
involved producing a spasmodic movement of the jaws.
Consciousness is not disturbed.
These rhythmic spasms are less marked when the animal
is alone and during sleep. The pulse and temperature are
normal; the appetite unaffected. The disease is chronic and
may persist for months or years. Young animals frequently
recover without treatment.
Diagnosis.— Diagnosis is not difficult. The history, the
peculiar rhythmic spasms of certain muscles, and the absence
of general symptoms point clearly to chorea.
Prognosis.— Prognosis is good so far as the life of the animal
is concerned, but bad from the standpoint of recovery or cure.
Treatment.— Many kinds of treatment have been tried
but none have given decided results. Arsenic in the form
of Fowler's solution (0.1-0.75) once daily has proved helpful.
Recently leukocytic extract has been administered experi-
mentally with excellent results. The animal should be
given nourishing food, and if anemic, iron preparations as
iron and quinin citrate (0.2-0.7) are useful.
ECLAMPSIA.
Definition.— Eclampsia is a tonoclonic spasm observed in
bitches. It is associated, though in some cases quite remotely,
462 FUNCTIONAL NERVOUS DISEASES
with parturition. As a rule the animal is conscious during
the attack.
Etiology.— The cause of eclampsia is not definitely known.
It occurs in pregnant bitches and as late as fifty days after
whelping. It has been observed to follow exposure to cold
in pregnant bitches, and following grief or anxiety owing
to the loss of one or more of the puppies in suckling bitches.
Symptoms.— The disease appears suddenly, usually about
the second week after parturition, though it may occur
before. Generally small delicate house dogs are affected.
Early in the attack the animal becomes restless and has
an anxious facial expression. Later motor disturbances
are seen, the animal falls to the ground or floor in spasms
of a tonoclonic, or mixed type, the legs sticking out stiffly
as in tetanus. The muscles of the body and limbs are hard
and tense, occasionally the limbs will relax and immediately
become stiff again. The respiration is rapid, and the pulse
accelerated, small and hard. Visible mucous membranes
are congested. There is some salivation, the saliva being
swallowed or dripping from the mouth. The eyes are open,
pupil normal, and the corneal reflex present. The animal
is conscious but unable to obey commands. The tempera-
ture is normal or subnormal.
Diagnosis.— The diagnosis of eclampsia is sometimes
difficult. It might be confused with strychnin poisoning,
a condition it closely resembles, but in eclampsia there is
less hyperesthesia. It might also be confused with tetanus
but tetanus comes on gradually, this being about the only
differential feature.
Prognosis.— If the animal is presented for treatment
early, the prognosis is favorable. Otherwise it is unfavorable,
especially when the temperature is more than 1|° below
normal.
Treatment.— Give narcotics as morphin subcutaneously in
full doses and keep the animal in a warm, quiet place.
Chloroform syrup (1 c.c. of chloroform to 90 c.c. of simple
syrup) in doses of 4.0-8.0 every fifteen minutes until the mus-
cles relax, then at longer intervals as required, may be given.
Puppies must not be allowed to nurse during the acute
stage and should be kept away from the dam.
PART X.
DISEASES OF THE SKIN.
CHAPTER I.
NON-PARASITIC SKIN DISEASES.
Examination.— Careful methods are required for an accu-
rate diagnosis of skin diseases. Small diseased areas and
the larger parasites, if not very numerous, may easily be
overlooked in long-haired individuals, or in birds.
In the majority of cases a microscopic examination is
necessary to determine if a skin disease is parasitic or non-
parasitic. If the former, it is necessary to identify the
parasite in order to give the proper prognosis and treatment.
Some few cases present certain rather characteristic
features which indicate the real nature of the disease but
the only accurate diagnostic method is by the use of the
microscope. The larger parasites may be identified with a
reading glass; the mange mites can be seen with a micro-
scope, using low power, while high power is necessary to
identify some of the vegetable forms.
Microscopic Examinations. — With a small, sharp curette
scrape deeply into the skin at a point where the disease
process is active until a mass of moist scrapings the size
of a grain of wheat is obtained. Transfer this mass directly
to a slide and moisten it with a drop of water. Put on a
cover-glass and press down with a rotary motion to evenly
distribute the material to the proper density. By this
method animal parasites remain active, and their movements
readily indicate their presence. For vegetable parasites
30
464 NON-PARASITIC SKIN DISEASES
in addition to the scrapings pluck a tuft of hair at the edge
of the diseased area and mount as above. Examine with
high power for the fungus along the hair near the roots. If
the scrapings are to be examined later, secure a larger
amount and put in a clean vial or ointment box. Smear
slides cannot be made with this very well after it has dried.
Usually it is best to boil it slightly in a 10 per cent, solution
of KOH. Centrifuge it and withdraw some material from
near the bottom with a pipette and mount with cover-glass.
DANDRUFF.
Definition.— The presence of fine, grayish-white scales on
the skin or in the hair, which may affect the entire skin
surface or small circumscribed areas.
Etiology.— A mild superficial inflammation of the skin
resulting in excessive exfoliation of the epidermis. Dandruff
may be due to several causes, viz.: Bath soaps that are
too irritating or used too often; irritating medicinal prepa-
rations used on the skin, especially parasiticide preparations;
direct sunshine on short-haired animals, especially when
unaccustomed to it or those recently sheared. Parasites
are a frequent cause; a mild attack of the demodectic para-
sites will occasionally produce no other symptoms. Internal
disorders, especially digestive diseases favor the condition.
Very often no assignable cause can be discovered.
Symptoms.— The disease occurs chiefly on the upper
surface of the body, especially on the neck, under the collar
and along the back. The hair coat is dull and dry and the
skin is covered with small grayish-white scales or dust.
Itching is sometimes present.
Diagnosis.— The presence of the scales indicates the condi-
tion, and only the absence of parasites distinguishes it from
parasitic diseases.
Prognosis. — The disease runs a rather prolonged course
but continued treatment usually effects a cure.
Treatment. — Good nourishment is necessary if digestive
disturbances are suspected as the indirect cause. Internal
treatment with digestive tonics, especially preparations
ALOPECIA 465
containing arsenic for its action on the skin. The external
treatment consists in cleaning applications with alkaline
solution (sodium carbonate, 2 per cent.) and applications
of salicylic ointment (10 per cent.). A solution of resorcin
(5 per cent.) is very satisfactory as it does not soil the
hair coat, nor cause dirt to adhere to it. It is best to clip
the hair and brush the skin well before medicinal treatment
is begun, and thereafter at frequent intervals.
ALOPECIA.
Definition.— A loss of hair, feathers or fur from large
or small areas due to causes other than organic diseases or
parasites.
Etiology.— Mechanical.— Fowls, especially the males when
penned, may pluck the feathers from the breast, denuding
a large area. Female rabbits pull out their fur for use in
preparing a nest for their young.
Chemical. — Acids or strong caustics by deep action on the
skin will destroy the hair follicles and when healing occurs
the area is free of hair.
Thermic.— Hot water, often intentionally applied, may
act deeply enough to destroy the follicles and denude an
area. Burns appear similar but more diffuse.
The most common cause is deranged nutrition to such
an extent that the hair falls out usually in patches over the
body. A single area, so affected, and when the usual
etiological factors are wanting, must be ascribed to a dis-
turbance of the trophic skin nerves of that part. In one
case the hair was lost each succeeding summer from pig-
mented parts of the skin. No cause could be given.
Pathology. --The hair appears to loosen in patches and fall
out. The skin appears almost normal in some cases but
usually somewhat dry and hard. In those cases following
severe wounds, scalds, or burns, the skin shows scar forma-
tion. The microscopic examination for parasites is negative.
Symptoms.— There appear on the skin small areas de-
nuded of hair, which gradually become larger. The hair
466 NON-PARASITIC SKIN DISEASES
at other parts can be readily pulled out. The skin of fowls,
when feathers have been plucked, appears apparently
healthy, as does that of rabbits which have pulled out the
fur. When due to wounds, scalds and burns the skin is
thickened, often scaly and the hair around the affected
area often distorted from its usual direction of growth,
appearing longer at the margins.
Diagnosis.— This is made by negative microscopic exami-
nation of skin scrapings, and inspection of skin for scars.
Observing or inquiring into the habits of the animal affected, and
a careful examination into its general condition are helpful.
Differential Diagnosis.— Alopecia must not be confused
with demodectic mange, which frequently causes loss of
hair in small but gradually enlarging areas, nor with the
depluming mite which acts similarly on fowls.
Prognosis.— Good if due to general nutrition disturbance.
If from scar formation the loss is permanent, as is also true
of trophic nerve disturbance.
Treatment.— Treatment consists in giving good food in
proper amounts, and stimulating metabolism by tonics,
especially those containing arsenic for its alterative action
on the skin. Scarified areas, if small, may be overcome by
complete removal of the areas and the healthy skin approxi-
mated by suturing. Feather pulling may be prevented by
allowing free range, or by using a device attached around
the upper half of the beak which prevents complete closing
but does not inconvenience the bird in eating or drinking.
Fur pulling of rabbits is not objectionable when their habits
are known. It may be overcome in part by supplying
proper material for bedding just before parturition.
DERMATITIS.
Definition.— An acute or subacute, septic or aseptic
inflammation of the skin. It may be local or general.
Etiology.— Parasites. — Probably more inflammatory con-
ditions of the skin in small animals are due to small parasites
DERMATITIS 467
than to all other causes combined, therefore, such are consid-
ered under parasitic skin diseases.
Mechanical, — Traumatic causes may be pressure, as lying
on hard floor, whipping, bites (flies), running through brush as
hunting dogs do, excessive wagging of the tail, friction when
bathing by use of stiff brush, and shaking the ears.
Chemical. — Chemical agents as strong caustic soaps or the
too frequent use of ordinary soap; irritating medicinal prepar-
ations, as parasiticides improperly applied, or vesicatory
agents as mustard. Acids intentionally applied, caustics
as use of lime in dusting pens for poultry, and bee or wasp
stings are also causes.
Thermic. — Thermic causes are : Scalding, burning, freezing
or exposure to direct sun rays of animals unaccustomed to
it after having been sheared.
Infectious. — Infections of Bacillus necrophorus, especially
in suckling young, produce serious necrotic sloughs of the
skin. Secondary dermatitis is frequently seen during the
course of distemper in dogs.
Pathology.— The mild, acute form reddens the skin, which
becomes sensitive, but is otherwise little changed. The
subacute form is shown by a thickening and hardening of
the skin. The skin feels rough and fissured. Any serous
or hemorrhagic discharge soils the hair and forms crusts.
The microscopic examination for parasites is negative and the
skin itself shows an increase of connective tissue and general
infiltration often to the extent of separation of the layers.
Symptoms. — Pruritus is usually the first noticeable symp-
tom which causes repeated scratching, rubbing on the
ground or floor and licking the part. In hunting dogs,
especially at the beginning of the season, the skin over the
chest and anterior part of limbs, between the toes, and
on the end of the tail, will be reddened and moist, often
bleeding, while the dog is being used in the field. In dogs
and cats following the use of strong or the too frequent use
of bath soaps, and in poultry from dusting them in lime, a
mild, acute, diffuse dermatitis ensues. Its persistence
depends on the continuance of the causes. Sleeping on
hard surfaces without bedding causes a chronic local der-
468 NON-PARASITIC SKIN DISEASES
matitis, especially in large dogs, which appears in the form
of a thickened, roughened, hairless area over the elbow
(scleroderma) . A persistent form of dermatitis occurs as
a result of injuries to the edge of pendulous ears and the
irritation induces frequent shaking of the head which
serves to aggravate the condition. Fly bites on the ears to
the extent of producing severe inflammation are common.
Diagnosis.— Negative microscopic examination with con-
sideration of the several causes assists in making a diagnosis.
Prognosis.— Good, especially in acute conditions when the
causes can be removed.
Treatment.— Mild acute forms may be treated success-
fully with the application of lead water or drying powders.
When crusts have formed, soiling the hair, a cleansing wash
of a sodium carbonate solution (5 per cent.) repeated daily
is very good and will relieve the itching usually present in
this form. Chronic forms necessarily require longer treat-
ment with preparations to soften the skin as lanolin or
ichthyol ointment. The chronic form which occurs on the
edge of pendulous ears can be successfully treated only by
bandaging which prevents the animal shaking the ears.
The bandage should be so applied that the affected tips are
exposed for treatment with creolin ointment. This aids
healing and prevents further injury from fly bites, the most
usual source of this trouble. If the ears are very much
thickened it may be advisable to remove the edges evenly
and immobilize until complete healing occurs. Gangrenous
dermatitis requires prompt treatment by removing the
affected parts of skin and applying strong antiseptics.
ACNE.
Definition.— An inflammation of the glands of the skin
with enlargement, appearing as small nodules in the skin.
Quite frequently they pass on into pustules.
Etiology.— Irritation of the glands by rubbing, or by the
collar, or when there is an obstruction to the glandular
openings by accumulations of dirt or medicinal substances
which have been applied. Preparations, as creolin, con-
ECZEMA 469
tinued for a time may produce inflammation of the glands.
The bacteria always present in the skin find favorable con-
ditions in an obstructed gland and soon convert it into a
pustule. Acne is secondary to an invasion of the hair
follicles and glands with parasites. (See Demodex Mange.)
Pathology.— Small elevations appear on the skin. They
may be scattered or appear in groups. As the condition
advances a few show a change to pustular form.
Symptoms.— Small, round elevations varying in size up
to that of a pea appear on above-mentioned parts of the
skin. Inflammatory symptoms are present and the skin
is quite sensitive. Small, clear vesicles appear and soon
become turbid, rupture and their contents dry to form a
scab. These scabs fall off and leave a small area denuded
of hair for some time. Some nodules may gradually dis-
appear in one to two weeks without disturbance of the skin
or hair over them. All stages of the disease may be present
at the same time.
Prognosis. —The prognosis is good. Recovery occurs in
one to two weeks, either by pustular formation, rupture
and escape of the contents, or by gradual reduction of the
inflammatory process.
Treatment. —Thoroughly cleanse the affected parts of the
skin with a warm alkaline solution; in the nodular stage
salicylic ointment (5 per cent.) may be used. As the
nodules become softened the contents should be squeezed,
after opening if necessary, and washed out with antiseptic
solutions. Internally the administration of Fowler's solu-
tion is usually beneficial. The use of tar, phenol, sulphur
or salicylic acid preparations is contra indicated in cases of
acne due to chemical irritations of the skin as they usually
aggravate the condition.
ECZEMA.
Definition.— A chronic inflammation of the skin in the
course of which papules, vesicles and pustules develop.
Rupture of these complicate the condition by causing the
skin to be moist and covered with crusts matted in the
470 NON-PARASITIC SKIN DISEASES
hair. Under these crusts infection flourishes and decora-
position occurs, further irritating the skin.
Etiology. —Various irritants which produce dermatitis
may be the remote causes of eczema. The most frequent
external cause is the accumulation of dirt on the skin,
especially when the hair is long. Consequently the regions
most commonly affected are the root of the tail, along the
back, shoulders, neck and back of the ears. It is more
common in long-haired dogs. Digestive disturbance has
an indirect relation to eczema. Decomposing food is a
common cause, as is overfeeding. Probably the most
persisting forms of eczema occur in overfed, fat animals.
Pathology . —The skin may show all the stages of inflam-
mation from acute to chronic. As it is a chronic condition,
the acute symptoms are usually induced by scratching or
biting the parts.
Symptoms.— The early stages appear as an ordinary
dermatitis progressing through the various stages of inflam-
mation until the pustular eruptions occur. Recovery may
occur spontaneously at this time, or with proper treatment,
but if not it passes on to the eczematous stage. Pustules
continue to form and discharge their contents often unno-
ticed, under the long hair and crusts. If sufficient to keep
the skin moist it is commonly classed as weeping eczema.
The itching is intense, and the frequent scratching, biting
or rubbing removes the matted hair and crusts leaving a
raw bleeding surface. The skin lesions may occur in one or
more small areas or over a gradually increasing large surface.
In consequence of continued efforts to relieve the itching by
licking and scratching, the inflammation extends into the
deeper layers of the skin. Healing occurs in three or four
weeks with recurrence of the condition. The skin becomes
thickened and fissured, and bleeds easily. Scales continue
to form on these partly healed areas. Some of the hair bulbs
atrophy or are destroyed and only a partial growth of hair
reappears on the surface. A recurrence of the condition each
succeeding summer is quite common in well fed house pets
especially among well bred dogs with fine skins, as the
poodle.
ECZEMA 471
Diagnosis.— A diagnosis can only be made by the exclusion
of parasitic conditions and the more acute forms of dermatitis
and acne.
Prognosis.— Favorable in the earlier stages, but when the
skin becomes thickened, hard and fissured, healing is as a
rule only temporary, as acute relapses occur. When occurring
as result of a chronic internal disease the prognosis is espe-
cially unfavorable.
Treatment.— Carefully cleanse the affected parts, remove
all the crusts and scabs possible, and clip any hair that may
be over the part and for some distance around the margin.
Mild soap may be used for washing, also alkaline solution
(sodium carbonate 5 per cent.). Upon the condition of the
skin further treatment depends. If the surface is moist,
drying powders can be used, such as talcum, zinc oxid, or
boric acid. Liquid preparations of lead and zinc (Burrow's
solution) are also very good. Proper internal treatment is
important in all cases of eczema as has been shown by marked
improvement from this form of treatment alone. Mild pur-
gatives, especially calomel (0.06-0.12) or magnesium sulphate
(8.0-12.0), for their antiseptic and laxative action repeated
at two- or three-day intervals. Fowler's solution (0.19-0.58)
daily for dogs gives the best general results and should be
continued for a long time. Calcium chlorate (15.0-30.0)
in solution daily acts to relieve the itching. A good diet
of easily digested, non-irritating foods is essential.
CHAPTER II.
PARASITIC SKIN DISEASES.
FLEAS.
Description.— Fleas are large enough to be seen with the
naked eye, but magnification is necessary to distinguish the
species. They are a jumping insect without wings, brown in
color and about 2 to 4 mm. long. The female is the larger.
They obtain nourishment by sucking blood. They readily
pass from one animal to another and may reside in dust,
filth, etc. The eggs are dropped or deposited on the ground
or floor and hatch in six to twelve days. The final transforma-
tion into perfect insects requires three to five weeks depending
upon the temperature.
Occurrence.— The dog is the most commonly affected of
the small animals, with the Ctenocephalus canis, the
common dog flea. The Pulex irritans of man will also live
on dogs. The cat (Ctenocephalus felis) is rarely affected
except when closely associated with infested dogs. They
suffer considerable annoyance but the fleas soon leave of
their own accord. Hares and rabbits harbor the rabbit flea
(Pulex gonivcephalus), but may also be the hosts of the dog
and human flea. On fowls, pigeons and other birds the bird
flea (Pulex avium) is parasitic.
Symptoms.— Fleas are most common on dogs and pigeons.
Sedentery, feeble or young animals, or those nursing young,
or birds incubating eggs, are particularly susceptible; also
animals kept in close quarters. Fleas are tormenting and
harm the animal chiefly by disturbing rest and quiet. Large
numbers may produce chronic skin eruptions, but the most
damage to the skin results from frequent and persistent
scratching which produces irritated areas on the skin of the
neck, back of the ears, and back of the forearm. The skin
LICE 473
is soiled with the excrement of the parasite which appears
as brown specks scattered through the hair. Birds pick and
scratch the skin to relieve the irritation and pluck at their
feathers. Severe infestations in young or feeble animals
may finally cause death from exhaustion.
Diagnosis.— The diagnosis is easy by identifying the flea.
It is well to be careful not to attribute a severe condition to
fleas alone as smaller parasites may also be present.
Treatment.— The destruction of fleas on dogs and cats is
best effected by the use of creolin (1 to 2 per cent.) solution.
It is cheap, only slightly toxic and may be applied to the
entire skin surface at one time, and will destroy all fleas with
which it comes in contact. The odor which persists for two
or three days will prevent further infestation only for that
period, consequently a thorough cleansing of the premises
and the repeated use of the creolin solution in the kennel
are necessary for permanent relief. Creolin is somewl at
irritating to the animal's eyes which may be avoided by
careful bathing. Owing to the odor it is not advisable to
use it on house pets. Instead pyrethrum or insecticide pow-
ders containing same should be used by dusting it well in the
hair or feathers and then brushing it out in fifteen to thirty
minutes. Serious results have followed the too liberal and
careless use of it. Frequent cleansing of both animals and
quarters is discouraging to these pests. The use of powdered
tobacco in the bedding or sprinkling the floor with creolin
solution usually serves to prevent further infestation. Dogs
permitted free range will soon become reinfested from asso-
ciation with others. The nests of birds may be kept free
from lice by mixing powdered tobacco with the straw. Gum
camphor may be used in the same way.
LICE.
Description.— The louse as ordinarily classed covers all
the wingless parasites which do not jump. Lice do not leave
their hosts except the fowl louse which drops off after engorge-
ment with blood to return again when the birds return to
roost. They are dull white in color except when engorged
474 PARASITIC SKIN DISEASES
with blood. The eggs, commonly called nits, are firmly
glued to the hairs or feathers. The young are similar in
shape to the adults but only attain full size after several
changes. The females are larger and more numerous than
males. Phthiriasis or lousiness is a term applied to the con-
dition of an animal or bird infested with lice. Two kinds of
lice affect small animals: The Linognathus piliferus which
obtains nourishment by sucking blood, and the Trichodectes
latus which lives by eating the epidermal scales and hair.
The former may be recognized by its elongated head; the
head of the latter is short and broad. The common louse of
the dog is the Linognathus piliferus (Hematopinus piliferus),
whic,h may also live on ferrets, and the Trichodectes latus.
The cat louse is Trichodectes subrostratus, and a rare species
of Linognathus piliferus is sometimes found on rabbits.
Several species of blood sucking lice infest fowls and birds,
chiefly the Menopum trigonocephalum, while a larger one,
the Menopum biseriatum, is most commonly found on the
heads of young chicks. By cohabitation of the different
species of fowls parasites peculiar to one of the species may
be found on others. Other animals or man coming in contact
with articles where lousy fowls roost will become infested,
but the lice soon leave their illegitimate host and the irritated
condition soon ends unless conditions favor further infesta-
tion as when straw is used from barns where fowls roost.
Symptoms.— The blood-sucking louse causes the most
annoyance. Consequently dogs and fowls are the greatest
sufferers. The dog is not so frequently infested nor does
he suffer as much as fowls in which phthiriasis is a serious
condition, causing, the birds to lose their rest and become
emaciated. It also interferes with the rearing of young.
While incubating, when conditions are ideal for a rapid
increase in these parasites, fowls suffer to such an extent as
to be compelled to leave the nest, or remaining, often die
from exhaustion from loss of blood and irritation. Newly
hatched chicks are frequent sufferers from large numbers of
lice especially the large ones on the head. The dog does not
seem to resent the presence of lice as much as fleas, hence
scratching and rubbing is less pronounced. A mild derma-
SCABIES— MANGE— RED MANGE— ITCH 475
titis may result from both parasitic wounds and scratching
especially along under the surface of the neck. Fowls and
birds scratch and pick themselves and pluck feathers, and,
as the parasites increase gradually, exhibit all the symptoms
of cachexia. With increasing numbers of lice emaciation
increases, the birds appear droopy and a few may finally
die from exhaustion. Canaries and parrots are frequent
sufferers with the same symptoms.
Diagnosis. — The diagnosis of lice is easy when the size of
the species is known. Numbers sufficient to cause noticeable
symptoms are readily seen. Mange in dogs has been occa-
sionally overlooked because the pruritus was ascribed to
lice.
Prognosis.— Phthiriasis is serious and obstinate when young
or feeble animals are affected, or when the number of animals
is large and they have extensive range. Ordinarily it is not
serious if treated, as many remedies are efficacious. Exten-
sive obstinate cases reported have often proved to have a
coincident infestation with mange mites.
Treatment. — Cleanliness discourages lice. In short-haired
animals it is most easily attained. Long-haired animals should
be closely clipped and thoroughly brushed. The use of a
creolin solution (2 per cent.) is very effective. It may be
used as a bath and applied to kennel and runways. For
poultry frequent applications of creolin (2 per cent.) or other
parasiticides to the roosts and nesting places are sufficient
for most of the birds. A small amount of oil of anise applied
under the wing has proved of value in the treatment of
canary birds. Sulphur and lard (5.0-20.0) has also been used.
Those showing severe symptoms should have special treat-
ment. Tobacco or gum camphor placed in the nests is usually
necessary to protect incubating fowls and little chicks.
SCABIES. MANGE. RED MANGE. ITCH.
Definition.— Mange is a contagious disease of the skin due
to so-called mites.
Etiology.— Two kinds of mites, the Sarcoptes and the
Demodex, are the chief ones found on small animals. They
476 PARASITIC SKIN DISEASES
are quite small and can only be recognized when highly
magnified.
Sarcoptes Mite.— This is the most common mange mite
and is distinguished by its tortoise-like appearance, an
elongated horseshoe-shaped head, and four pairs of short,
thick legs. In the male, which is the smaller, the first and
fourth pairs of legs are provided with a distinct cup-shaped
disk, but only the first and second pairs are so provided in
the female. The other legs are each supplied with a long
bristle. These parasites make burrows in the skin where they
live and obtain nourishment and in which the female deposits
eggs. The eggs hatch in five to eight days and the parasite
is fully developed in two to three weeks. They increase
rapidly. It is estimated that a million and a half are pro-
duced in three months, under favorable conditions, from a
single female. The sarcoptes mite varies slightly in size and
minor details according to the species of animal upon which
it lives. This makes several varieties which are sometimes
described as so many species. Most of the sarcoptes mites
live exclusively on their particular host, but, due to intimate
association, may be found occasionally on others.
Pathology.— The skin shows symptoms of chronic inflam-
mation varied according to the severity of the attack. In
mild cases dry crusts and scales cover the surface while the
severe ones show a much wrinkled and sometimes moist
surface. Fresh, bleeding areas may be associated with the
condition as the result of scratching or rubbing the part.
Sarcoptes Mite of the Dog (Sarcoptes scabiei, variety canis).
-This is the common mite found on the dog. Sarcoptic
scabies may appear on any part of the body but usually
around the head. If unchecked it gradually spreads, becom-
ing generalized in four to eight weeks. Scratching and rub-
bing induced by the intense pruritus are the first noticeable
symptoms. Small red spots appear followed by papules and
pustules and these, ruptured by scratching, lead to formation
of moist areas which continue to spread. The areas first
invaded soon become dry. Yellowish-gray crusts form and
gradually scale off. The hair falls out during the process.
The skin becomes thickened and shows wrinkles and thick
SCABIES— MANGE— RED MANGE— ITCH 477
folds. The dog gives off an offensive but characteristic odor,
and is repulsive in appearance. Emaciation increases, and,
if not treated, death occurs from cachexia and exhaustion.
In some cases the skin remains dry with profuse desquama-
tion of bran-like scales; it may be and often is mistaken for
a non-parasitic condition.
Sarcoptes Mite of the Cat (Notcedres cati, var. cati; Sarcoptes
minor, var. cati).— Scabies of the cat usually affects the head
and neck, only occasionally invading the legs. The acute stages
are less marked than in the dog, probably due in part to less
violent scratching. The process continues with slight pustular
eruption and the formation of crusts. Sometimes, especially
when irregularly treated, it continues for months as a very
mild condition with only slight thickening of the skin and
scanty crust formation. The crusts are most noticeable on
the edges of the ears and there is often a slight loss of hair
on top of the head. In more severe cases the skin becomes
thickened, hard and wrinkled. The eyelids become involved
resulting in an intense conjunctivitis. The thickening of the
skin around the nostril openings may be sufficient to interfere
with respiration. The animal gradually becomes emaciated,
exhausted and death occurs usually in four to six months.
Young animals die earlier.
Sarcoptes Mite of the Rabbit (Xotoedres cati, vir. cuniculi;
Sarcoptes minor, var. cuniculi). — In rabbits scabies attacks
chiefly the skin of the head, particularly around the eyes,
nose and at the base of the ears. It frequently extends to the
hind and sometimes to the forepaws. The lesion resembles
that seen in cats. Itching is intense inducing continual
scratching and rubbing; the fur falls out and thick, gray
scabs appear. As the process continues the eyes become
surrounded by masses of dry exudate. Conjunctivitis is also
present. By affecting the lips prehension of food is difficult.
Emaciation appears early, and, if untreated, the animals
invariably die in three to five months. The disease is highly
communicable and serious in young animals.
Sarcoptes Mite of the Ferret (Sarcoptes scabiei, var. hydro-
chaeri).— This disease in ferrets is usually confined to the
head and feet. The affected skin is usually found covered
478 PARASITIC SKIN DISEASES
with dirty yellow crusts. Crusts also form on the plantar
surface of the feet and at the root of the claws which become
swollen and distorted. To relieve the intense itching the
animal frequently scratches and bites itself, at times gnawing
the feet so viciously that they become severely wounded.
Walking is difficult, the weight being thrown on posterior
parts of the foot. A disagreeable odor is exhaled from the
animal.
Sarcoptes Mite of the Fowl (Cnemidocoptes mutans, Sarcoptes
mutans, var. gallince) . — These parasites burrow under the scales
on the featherless parts of the skin of the feet and legs. The
resulting exudate elevates the scales and there is a formation of
a white granular matter agglutinated by the exuded serum.
Irregular masses of crusts separated by fissures continue to
form and usually involving all of the skin on both legs. They
are firmly adherent and when detached leave the skin raw
and bleeding. The crusts become of a soft, spongy consist-
ency due to the numerous furrows excavated by the parasite.
Movements of the joints aggravate the condition; walking
and even standing are difficult and painful. Occasionally
an entire toe may drop off. The course of the disease is
slow, the fowls become emaciated and finally die from
exhaustion.
Diagnosis.— An accurate diagnosis is possible only by a
careful microscopic examination. Otherwise sarcoptic mange
may be mistaken for many other diseases of the skin. It is
essential to detect and identify the parasite before a correct
diagnosis can be made.
Prognosis.— Mild cases with local lesions only may be
treated with very good results. This is especially true in
cats. Severe cases, where the process affects the entire skin
surface, are almost incurable especially if symptoms of
emaciation and exhaustion are present.
Treatment.— It is necessary to remove all the hair coat, if
long. A possible exception may be made when the disease
is strictly localized as in cats. Cleanse the skin and remove
all scales and crusts by using an alkaline wash (sodium
carbonate 2 per cent., or soapy water) applied with a fairly
stiff brush. However, indiscriminate brushing should be
SCABIES— MANGE— RED MANGE-ITCH 479
avoided in localized cases as it may tend to spread the dis-
ease to healthy parts of the skin. Care must be observed in
washing the cat, rabbit and ferret as they do not endure
bathing very well. In some cases softening of the crusts is
advisable which may be accomplished by using carbolated
oil or' glycerin. For dogs, even in the early stages with only
small areas affected, vigorous treatment is advisable and
careful repeated inspection is necessary to detect new areas.
This is especially true in long-haired individuals. Most any
of the parasiticides are more or less effective and failures are
due as much to improper application as to the preparation
used. Alcohol or aqueous preparations are convenient to
apply but they are less energetic than those prepared with
an oleaginous base. These will adhere to the skin longer
and at the same time penetrate to the deeper layers. They
should be applied generously and well rubbed in. Care should
be taken to avoid irritating the conjunctiva when applying
in the region of the eyes. Application may be made imme-
diately after cleaning the skin, and repeated daily for four to
six days, followed by another thorough cleansing. This
course of treatment must be continued with three or four-
day intermissions until itching disappears. Prevent the
animal from licking the applications by muzzling or the
addition of a bitter substance such as aloes. Many remedies
have been used to destroy the mites. The following give
good results and are least objectionable.
Sulphur ointment is one of the most common preparations
used for the sarcoptes mite. It gives better results when
used against the Notoedres cati of the cat and Cnemido-
coptes mutans of the chicken. A more active preparation
must be used on the dog. The following mixture is recom-
mended :
I* — Creolini 30.0
Phenol 15.0
Sulphur flor 60.0
Ol. terebinth 120.0
Aq. ammonii 90.0
Ol. lini 600.0
Kerosene 1200.0
Misce et fiat emulsio.
480 PARASITIC SKIN DISEASES
Daily application may be made over small areas but in
generalized cases only a part of the body should be treated
at a time. The mixture is irritating, hence when the animal
shows signs of exhaustion its use should be discontinued for
a few days. Other preparations used are balsam of Peru in
alcohol (5 to 10 per cent.), creolin ointment, styrax ointment
(5 per cent.).
Demodex Mite.— Etiology.— Demodectic scabies is pro-
duced by the parasite, Demodex follicutorum. This parasite
lives in the hair follicles and sebaceous glands, locations
favoring much irritation and making treatment most difficult.
The demodex mite is decidedly different in appearance from
the sarcoptes. Its body is elongated, and provided with
eight short legs emanating from its anterior third. The
posterior part tapers to a blunt point. The head is short
and thick. The total length is about six times the body
width. Some one of the many varieties may be found on all
kinds of small animals. The dog, however, is the principal
sufferer. Cats are rarely attacked.
Pathology.— The skin in mild cases shows only slight inflam-
matory symptoms. In severe cases the skin is greatly
thickened, and shows intact or ruptured pustules. In micro-
scopic cross-sections the parasite is found within the glands
and follicles.
Symptoms.— The early indications of demodex mange are
the presence of isolated inflammatory areas from one-half to
two inches in diameter. The hair covering them appears as
though clipped off closely. The condition gradually spreads
and may cover the entire body. Occasionally demodex
mange occurs in the well named squamous form. In this
there is only slight irritation and no» marked inflammatory
symptoms. The hair becomes thin, and gray-white scales
cover the skin. This condition may continue without change
for months especially when the dog is brushed and bathed
frequently as may be done with house pets. The disease
makes progress by a gradual peripheral spread over the skin,
or less often by the occurrence of new isolated areas over the
body. The skin thickens, pustules develop and erupt form-
ing crusts; the hair falls out. Emaciation follows and the
SCABIES—MANGE—RED MANGE— ITCH 481
animal becomes cachectic and exhausted. Pruritus is present
from the beginning and frequent scratching and rubbing are
the most noticeable symptoms.
Diagnosis.— A positive diagnosis can be made only by
identifying the parasite under the microscope. As these
parasites live deep in the skin it is necessary to make the
.scraping accordingly.
Prognosis.— Favorable if local and treated in the early
stages; unfavorable if generalized. Recovery may be
obtained by proper treatment which may require eight to
ten weeks. In severe cases with symptoms of cachexia and
exhaustion present the treatment usually hastens the fatal
termination.
Treatment. —Mild localized cases may be treated without
washing or brushing. Generalized cases with crust forma-
tions require thorough cleansing with soap or alkaline solu-
tions and all hair removed. As the demodex live deep in the
skin glands it is evident that severe and vigorous treatment
is required to effect recovery. Every parasiticide known has
been used either alone, or in combination but without
success. One mixture deserves mention as many cases have
recovered after its prolonged use. It is not toxic, and will
not be licked off.
I}— C'reolini 30.0
Phenol 15.0
Sulphur flor 60.0
Ol. terebinth 120.0
Aq. ammonii 90.0
Ol. lini 600.0
Kerosene 1200.0
Mi see et fiat emulsio.
This may be applied daily over diseased areas. If the
entire body is affected, only one-third of it should be treated
at a time. A thorough skin washing should be given once a
week. If the animal shows ill effects of the treatment after
a time, it may be discontinued for a few days and a dressing
of oil substituted. Avoid the eyes in applying it; keep the
patient in a warm place. Feed well and stimulate the appe-
tite with tonics. A saturated solution of balsam of Peru in
31
482 PARASITIC SKIN DISEASES
alcohol (1.0-5.0) has given good results but the odor is objec-
tionable in house pets. Animals being treated with oily or
fatty preparations must be kept in a warm place as the heat
radiation from the body is increased by such application.
DERMATOMYCOSIS.
Vegetable Parasitic Disease of the Skin.
Definition.— A communicable disease of the skin produced
by fungi, somewhat similar to ordinary molds. Several
species of fungi have been found to produce skin diseases.
From the standpoint of clinical diagnosis they may be divided
into two classes. Identification is possible only by their
cultural characteristics. These parasites occur on the skin
in the form of mycelia or filaments which may or may not
be segmented. From these segments spores are formed which
in turn, germinate to form new mycelia. The spores are
round or oblong and under the microscope strongly refract
the light.
Examination.— The mycelia and spores are extremely
small and require high power magnification. A smear slide
made with scrapings from the crusts or scabs, examined under
high power, will show them as small, rounded spores either
scattered or in chains. The segmented mycelia may also be
recognized. It is advisable to pull a few hairs from the dis-
eased area and examine near the roots for masses of fungi.
HERPES TONSURANS.
Ringworm. Red Itch.
Etiology.— This disease is produced by the Trichophyton
tonsurans or other similar forms of fungi which are usually
classed as the trichophyta.
Pathology.— The fungi develop around the shaft of the
hair and extend down into the follicle but not to the root.
The hair becomes brittle, splits and breaks off close to the
skin. The enormous number of spores that grow in the
follicles and beneath the epidermis set up inflammation,
especially in the parts of the skin thickly covered with hair.
HERPES TONSURANS 483
Symptoms.— Ringworm occurs in all small animals but
is most common in the dog. The lesions may be found on
any part of the skin but usually appear on the head and
legs, parts frequently in contact with objects harboring the
parasite.
Ringworm is characterized by small, well defined, circular
areas. By increasing in size and number they merge to
form irregular, large patches. At first slightly reddened,
these areas soon are covered with dirty, gray crusts or
scabs. Irritation is variable, at times very intense inducing
scratching and rubbing which remove the crusts and leave
the surface raw and bleeding. Small nodules are some-
times seen, due to swollen hair follicles. Most of the hair
is broken off. On those areas where pruritus is absent the
crusts remain, become thicker and agglutinate the hairs.
Suppuration proceeds beneath the crusts and an offensive
odor is emitted. In general the condition is less severe and
more superficial than sarcoptic scabies, but the spread is
more rapid. When the condition involves a greater part of
the body general disturbance follows. Suppuration beneath
the scabs permits of the absorption of toxins which poison,
and the constant irritation exhausts the animal.
Diagnosis.— Accurate diagnosis is possible only with the
microscope. The well defined, circular areas covered with
short hairs in most cases and the rapid progress may be indic-
ative.
Prognosis.— Very good if treated before the animal becomes
emaciated and exhausted. Spontaneous recovery is exceed-
ingly rare.
Treatment.— In a generalized case, except in short haired
animals, remove all of the hair. Where only isolated spots
occur clip the hair well back from the margin. Remove the
crusts, softening them if necessary with lard, oil or ointments.
Cleanse the skin by washing with a soapy or alkaline (sodium
carbonate) solution.
This parasite is not very resistant, hence most of the anti-
parasitic preparations give good results. Inasmuch as the
fungus is somewhat susceptible to fats the medicinal agents
should be applied in oils or ointments. These prevent fur-
484 PARASITIC SKIN DISEASES
ther spread of the fungus and in addition are soothing and
protective to the irritated skin.
Creolin or iodin ointment is recommended and gives
good results. These may be applied once daily for a week
followed by a thorough cleansing. Continued treatment
depends upon the appearance. Small areas may be treated
with pure tincture of iodin, two or three applications a week.
A strong solution of bichlorid of mercury (1-500) is also
quite efficient. Careful inspection must be made frequently
for new disease areas. Powdered aloes will prevent the
patient licking off the ointment.
If other animals are kept near care must be taken to
prevent the spread of the disease. All removed hair, crusts,
also the bedding used by the patient, should be destroyed.
Cleanse the sleeping quarters with a strong solution of
bichlorid of mercury. Restrict their range to prevent con-
tamination of runways and yards. Cleanse and disinfect
all utensils and other articles used about them.
FAVUS.
Honeycomb Ringworm. Comb Disease. White Comb.
Etiology.— This disease is due to a fungus, the Achorion
schonleinii. It occurs chiefly in cats, mice and rats, but also
in dogs and rabbits. The type affecting birds is caused by a
special fungus similar to the trichophyton and designated
as the Lophophyton gallinarum, commonly called "white
comb" or "comb disease."
Pathology.— The fungus localizes itself in a hair follicle. As
it develops it gradually extends over the surrounding skin
forming a yellowish crust. Immediately beneath it the skin
atrophies, becomes moist and around the edge of the lesion
appears an inflammatory swelling producing a cup-shaped
depression at the bottom of which the crust is attached.
This crust is composed mostly of the fungus material, mixed
with hair or epithelial masses.
Symptoms.— Fa vus usually appears about the head espe-
cially in cats but the feet are also commonly affected. This
FAVUS 485
is clue to the infection being acquired from mice and rats
affected with the disease. In dogs and cats the lesions appear
as a sulphur-yellow, circular mass depressed in the center
and free at the edges, the size of a ten-cent piece. A number
of areas in contact do not merge but encroach upon one
another producing irregular shaped figures. In birds the
crusts are thinner than in mammals and the areas tend to
coalesce until a large surface is formed covered by a creviced
crust. When feathered parts of the skin are invaded the
feathers fall out. The disease may extend all over the body.
Pruritus is rare and it is seldom that the crusts are rubbed
or scratched off.
Diagnosis. — The presence of the sulphur-yellow, fa vie cup
and slow growth make it easily recognized. In birds the
mouldy appearance and progressive growth indicate the
character of the disease.
Prognosis.— The prognosis is favorable; the disease may
heal spontaneously. If far advanced and generalized in
birds it is usually fatal.
Treatment.— Remove the crusts with a blunt instrument
damaging the skin as little as possible. Wash or otherwise
cleanse the skin and apply tincture of iodin diluted well with
alcohol. Bichlorid of mercury (1-500) is equally good.
Dilute silver nitrate solution (2 per cent.) may also be used.
I'suallv 5 to 0 dailv treatments are sufficient.
PART XI.
DISEASE OF THE EAR,
Examination.— The external ear (concha) in dogs varies
greatly in size depending upon the breed and size of the
animal. It is easily examined by direct inspection. Careful
examination should be made for wounds, bruises, hematomas
and scars. Long hairs in certain breeds (cocker spaniels)
will interfere to a certain degree with the examination. In
cats and rabbits an inspection of the external ear can be
made without difficulty. Note sensitiveness to manipulation.
The external ear canal can be inspected in ordinary day-
light but the examination is facilitated by the use of an ear
speculum and mirror to reflect the light to the bottom of the
canal. The operator should exercise care in the examina-
tion by either muzzling or taping the animal. Examine
the external canal for inflammation, tumors, foreign bodies,
cerumen accumulations and parasites.
WOUNDS OF THE EAR.
Various degrees of wounds are observed involving the
concha. Bites from other animals are the most common
causes. The lesion may be a simple scratch or cut in the skin
or the entire structure may be split in various degrees. Exten-
sive wounds are often found in all the animals. Constant
shaking the head especially in long eared dogs often leads to
extensive injury to the outer margin of the concha. This
mode of injury is often brought about by the parts being
irritated by insects (flies) and parasites (Otodectes cynotis).
488 DISEASES OF THE EAR
In some animals the thick, heavy, cartilaginous conchal base
may be fractured by external violence.
Symptoms.— In dogs careful shaking of the head and hold-
ing it to one side, crying and evincing pain when the ear
comes in contact with objects are often noted. Careful
inspection will reveal the nature and extent of the wound.
Prognosis.— Favorable in most cases. In dogs with long
ears, and when the wounds are extensive, it is difficult to
prevent their shaking the head and aggravating the wound,
which will materially influence the healing process.
Treatment.— In recent wounds the edges should be care-
fully cleaned, straightened with the scissors if necessary, and
approximated with sutures. To facilitate union in some cases
it is necessary to bandage the ears over the top of the head
using a cap to cover the entire head to hold them in place.
Frequent dressing (twice daily) is advisable. Apply boric
acid powder as an antiseptic and to prevent adhesions of the
parts by the secretions. When extensive tearing of the entire
structure is found, it is necessary in some cases to remove
a portion of the ear-flap. In this case it is best to remove a
similar portion of the normal ear so that the ears will be
symmetrical after healing takes place.
ULCERATION OF THE CONCHA.
This condition occurs most frequently in dogs and espe-
cially in the breeds possessing long pendent ears. The ulcer-
ous process is found in nearly all cases on the edge of the
concha.
Etiology.— Occurs in most cases from injuries with more
or less constant shaking of the head. The irritation thus
produced keeps up the injury and interferes with union of the
parts. Ulceration is most frequent during the fly season.
The irritation produced by the flies causes the animal to
shake its head violently, injuring still further the wounded
parts. This is observed especially in older animals. Other
diseases such as otitis and eczema produce it in a similar
manner. Hunting dogs are frequently affected from the ears
becoming injured while going, through brush, briers, etc.
HEM ATOM A 489
Symptoms. — The condition is easily diagnosed as the ulcera-
tion is observed on or near the edge of the ear-flap. The
constant shaking and holding the head to one side are the
most pronounced symptoms. On examination the part is
usually found edematous, hot, painful and more or less hemor-
rhage present. Dried blood will be found on the margins of
the ear-flap. Should the fissuring be deep it may be infected
with pus.
Prognosis.— Should not be made very favorable as there is
usually some loss in the ear-flap, which in some animals
would be serious by disfiguring. Further, the condition is
often resistant to treatment. The prognosis is less favorable
in old animals.
Treatment. — The part should be first washed with an alka-
line soap, to remove all dried crusts and other accumula-
tions. Apply silver nitrate solution (2 per cent.) to stimulate
granulation. Follow by an antiseptic dusting powder (iodo-
form; xeroform). One of the essential factors is to protect
the ears from further injury and irritation. This is best done
by bandaging the ears over the top of the head and using a
head cap. Frequent dressing with the above materials is
advisable. If the condition is due to insect bites the animal
should be protected. In hunting dogs the ears should also be
protected from further injury by light head cap or bandage.
HEMATOMA.
Hematomas are frequently found in dogs with long pendent
ears. Other animals are seldom affected.
Etiology.— This condition is brought about through trau-
matism. Very often it occurs secondary to otitis or ulcera-
tion of the concha. The hematoma results from a rupture
of the capillaries and an extravasation of blood or serum
between the skin and conchal cartilage.
Symptoms.— As a rule hematoma develops suddenly. The
animal holds the head sideways, the affected ear down and
frequently shakes its head. The ear-flap is sensitive to the
touch, and a distinct bulging of the skin on the upper or
lower surface is noted; both surfaces may be involved. The
490 DISEASES OF THE EAR
enlargement will be found sensitive, hot and fluctuating.
When of older standing the acute symptoms will be absent
and some organization of tissue will be found around the
margins of the enlargement.
Diagnosis.— This is made on the location of the enlarge-
ment, the fluctuation and the absence of marked inflamma-
tory symptoms.
Prognosis.— Favorable in most cases.
Treatment.— Several modes of remedial procedure have
been used. The principles involved in the treatment in
order to be successful consist in the evacuation of the con-
tents, maintaining the separated tissues in contact so that
union can take place, and keeping the ear-flap quiet. This
is best accomplished perhaps by the following: Shave the
hair over the area and thoroughly disinfect the surface by
painting with iodin. Make the incision at the most pendent
portion of the enlargement and of sufficient length to permit
all the serum, blood clots and organized tissue to be removed
completely. Press out all the fluid and bring the separated
tissues in contact with the cartilage. Retain in contact by
suturing with interrupted sutures which pass through the
concha. The sutures should be placed so that the skin is
held in intimate contact with the cartilage at all points. A
dressing of iodoform should be applied and the ears band-
aged over the top of the head to ensure a quiet position and
sufficient external pressure to prevent any further collection
of serum. The dressing should be changed daily. In a week
or ten days the sutures may be removed and the bandage
discontinued. This method must be rather rigidly adhered
to if good results are expected. Other methods such as
removing the collection of material and injecting Lugol's
solution or tincture of iodin have been used.
OTITIS EXTERNA. OTORRHEA.
Involvement of the internal portion of the external ear
with various degrees of inflammation is very common in
dogs with long pendulous ears and in rabbits from parasitic
invasion. It is frequently unilateral, but in a number of
OTITIS EXTERNA—OTORRHEA 491
cases both ears are involved. Middle aged or older animals
are affected most commonly.
Etiology.— There are a variety of things having to do with
the cause of this condition: (a) Accumulations of cerumen
and dirt are common causative factors. These substances
cause irritation to the skin resulting in inflammation and
pyogenic infection. Animals with long pendent ears tend to
retain these materials and decomposition and infection are
thus formed, (b) Retention of debris from acute attacks
leads to further irritation and often produces a chronic form
of the disease with considerable thickening of the tissues.
(c) In young animals the condition is frequently associated
with distemper. Secondary infection during the progress
of the disease involves the auditory canal, (d) Occasionally
in dogs, but more commonly in rabbits, invasion with the
parasite Otodectes cynotis occurs. In this case the entire
canal is involved, even the internal ear. The parasites pro-
duce extensive irritation and an aggravated form of the dis-
ease, (e) May result from ulceration of the concha and
hematoma by extension of the process from continued
irritation.
Symptoms.— In the early stages and when the condition
is acute the animal shows restlessness, shakes and scratches
its head and ears with its paws almost continuously, and
rubs them against objects. Along the margins of the ear is
often noticed a blood-mixed discharge. Direct examination
reveals the ear to be hot, sensitive and the surface covered
with a thick waxy secretion. Owing to the swelling of the
skin and contiguous tissues an ear speculum is often neces-
sary in order to examine thoroughly the lower portion of the
canal. During the later stages ulceration takes place and
more or less extensive pus formation is found. Palpating
the base of the concha and exerting some pressure a thick,
dark colored discharge will be forced out. The head is
usually held in a fixed position, and if one side only is affected
it will be held to that side. The condition may produce tem-
porary or permanent deafness. In rabbits, when due to
parasites, nervous symptoms are very common. This has
been observed in dogs.
492 DISEASES OF THE EAR
In the chronic form there will be extensive proliferation
of connective tissue projecting out into the auditory canal.
The mass is irregular in form, often pedunculated, and will
in some cases close the entire opening.
Diagnosis.— The characteristic discharge and other symp-
toms as described make the diagnosis simple. Examination
of the discharge should be made carefully to determine
whether parasites are present or not.
Prognosis.— In the acute form, favorable. After extensive
proliferation of tissue has taken place the prognosis is less
favorable and recovery is difficult.
Treatment. — Both ears should be examined carefully to
determine the degree of involvement. It is essential in the
h'rst place to remove all dirt and cerumen which has accumu-
lated. This is best accomplished by taking pledgets of
cotton or gauze on a dressing forceps, saturate them in ether,
thoroughly swabbing out the whole canal until all the debris
is removed. In this cleansing process all of the small inter-
stices between the swollen masses should be opened and
swabbed. The ether solution is necessary in order to dis-
solve the cerumen. With the scissors cut away all super-
fluous hair in the canal. Dry cotton or gauze should then
be used in making the surface perfectly dry and also to remove
any excess of ether which might be retained. An antiseptic
powder (boric acid; xeriform; tannoform) is worked down
carefully into the canal to produce antiseptic action and to
prevent the secretions adhering to the skin surface. This
treatment should be applied daily until the inflammation
and swelling subside.
In the chronic form with proliferation of tissue and ulcera-
tion the canal should be cleaned as described and the surface
thoroughly cauterized with stick silver nitrate. To prevent
undue cauterization follow by salt solution. After the ulcera-
tive process is reduced antiseptic treatment can be substi-
tuted. Several weeks' treatment is often required in this
form. Should the animal continue to shake the head and
aggravate the condition a head cap may be employed for a
few days. In long-eared dogs the ears should be examined
every few weeks as there is danger of recurrence. Should
parasites be present treat with antiparasitics.
TUMORS—NEOPLASMS OF THE EAR 493
OTITIS MEDIA AND INTERNA.
This condition is not very common in small animals. It
occurs most frequently in rabbits from parasitic invasion.
The diagnosis is difficult as the condition is usually compli-
cated with involvement of the auditory nerve, or pachy-
meningitis. Xo treatment is of any value. Sedatives would
be indicated to control the nervous symptoms.
TUMORS. NEOPLASMS OF THE EAR.
Xeoplastic formations are not so common in this location.
Papillomata occur commonly on the inner surface of the
outer ear, but malignant tumors are rarely seen. Distentions
of the sebaceous ducts are occasionally seen.
Papillomata.— These are found on the margins of the skin
or in some portion of the vestibule of the ear and appear
as single or multiple excrescences. They are fiat, oval or
cauliflower-like in their growth. The surface is smooth or
roughened and frequently covered by a thick, greasy material.
Symptoms. — The presence of tumors often leads to irrita-
tion and may produce otitis. (See Otitis.) On examination
they are observed either as isolated single tumors or multiple
tumors and with smooth or irregular surface. They are
often pedunculated and stand out prominently. AVhen in
the lower portion of the canal they may completely occlude
the opening. The diagnosis can be made positive by micro-
scopic examination.
Prognosis. — Favorable.
Treatment. —Operation is advisable. When large numbers
are present the animal should be anesthetized and the entire
surface cleaned and disinfected. The tumors are removed
as close to the base as possible, best by the scissors. The
base should be cauterized by the actual cautery. The after-
treatment consists in keeping the part clean and using an
antiseptic astringent powder (tannoform). If necessary a
head bandage or cap may be used to keep the ear quiet.
494 DISEASES OF THE EAR
Sebaceous Tumors or Cysts.— These are recognized by
their rounded, well-defined appearance, absence of inflam-
matory symptoms, and the character of the contents.
Treatment.— The cyst should be opened well, all of the
secretions pressed out, and tincture of iodin applied to
destroy the gland. It may be necessary in some cases to
open into the gland and destroy it by silver nitrate or the
actual cautery.
PARASITES IN THE EAR.
In the rabbit and dog the Otodectes c^notis and the
Dermatophagus canis are frequently found producing a more
or less intensive form of otitis.
Symptoms.— During the early stage of invasion the symp-
toms are n6t very pronounced. Later as the parasites
increase in numbers and they extend farther down into the
canal, the patient carries its head at an angle, whines, and
rubs its ears against objects. Rabbits often show marked
nervous symptoms from the irritation of the internal ear and
auditory nerve direct. On examination there will be found a
similar condition as in otitis. Tiny white or reddish specks
will be visible in the discharge and when examined under a
low power microscope or reading glass, the parasites are seen
and recognized without difficulty.
Diagnosis.— This is made positive by the presence of the
parasites in the discharge.
Prognosis.— Favorable. Most cases will recover unless
nervous symptoms are present indicating the involvement
of the internal ear. Such cases should be considered hopeless,
especially in rabbits.
Treatment. — Local applications have proved quite satis-
factory in these cases. Remove all crusts, secretions and
debris with a solution of alcohol or ether. Dry the surface
by using a swab of cotton or gauze. Apply paraffin oil to
the entire surface, or a solution of carbolic acid (5 per cent.)
in paraffin oil. Other oleaginous compounds may be used.
Thoroughness in the application is important in order to
destroy all parasites present. Daily applications are advis-
able.
EAR FISTULA 495
DEAFNESS.
Etiology.— This condition is observed from diseases affecting
the internal ear, from closure of the external canal or it may
be congenital. Paralysis of the auditory nerve may be the
result of general infection (distemper) or ptomain poisoning.
Deafness is noted very commonly in puppies, sometimes
several in a litter will be affected. This no doubt is due to
improper development of the auditory nerve or other struct-
ures of the internal ear. The condition is acquired in some
cases from disease processes and infection extending to the
internal ear. Complete closure of the external canal will
produce at least a temporary deafness.
Symptoms.— The most pronounced symptom is failure to
obey commands. Puppies deaf from birth do not bark or
make any definite sounds. In congenital deafness the
examination will reveal nothing abnormal with the external
ear. In acquired deafness in some cases the cause may be
found, such as closure of the external canal.
Prognosis.— Unfavorable in all cases of congenital origin
or in cases due to external infection or parasites entering and
destroying the internal ear. It is favorable in some cases
of closure of the external canal with cerumen or tumor
formation.
Treatment.— In congenital deafness no treatment seems to
be of any value. If the deafness is due to paralysis of the
auditory nerve small doses of strychnin would be recom-
mended (0.001 once daily). Examination of the external
meatus should be made and, if closed, it should be dilated
and the cause removed.
EAR FISTULA.
Etiology. — Dentigerous cysts are occasionally found in the
temporal region and have their opening in the auditory canal.
Wounds of the cartilage of the ear, either from sharp objects
penetrating this region or from other causes may lead to a
fistulous opening.
496 DISEASES OF THE EAR
Symptoms.— The presence of a thick, white, glutinous dis-
charge either into the auditory meatus or to the outside
should be regarded with suspicion and the parts thoroughly
examined. Often the hair will be removed at the point of
discharge and the material collect, become dried and form
crusts. Pressure over the region will often reveal the point
of discharge. The introduction of a small flexible probe will
make the diagnosis positive. There is in nearly all cases
some enlargement in the tissues adjacent to the fistula.
Prognosis. — All fistulse involving the cartilage of the ear
should not be considered in favorable light. As the process
is a progressively destructive one, healing is difficult.
Treatment.— The part should be shaved and cleansed
thoroughly. Introduce a flexible probe to determine the
extent of the fistula and the tissue invaded. A free opening
is made and all necrotic tissue removed. Pack the wound
with iodin gauze. A head bandage should be employed to
keep the pack in position. Dress the wound daily. After
a few days it may be treated as an open wound. Some cases
will require amputation of the concha. This, however,
should be avoided if possible.
PART XII.
DISEASES OF THE EYE.
CHAPTER I.
DISEASES OF THE EYELIDS.
Examination. — This is easily accomplished in ordinary
daylight, or artificial light. The following points are worthy
of consideration: (a) Note the position of the lids, whether
they are normal or the degree of abnormality if present.
(6) Note the reaction of the lids to ordinary stimuli. This
is important to determine different degrees of sensitiveness.
(c) Inspect the margin of the lids to determine whether or
not the outline is regular, the presence or absence of the
eyelashes, (d) Palpate the external surface for irregularities,
tumors, etc. (e) The condition of the hair and surface of the
eyelid should be inspected for wounds, denuded areas,
eczema, mange, etc. (/) Evert the lids noting the resistance
of the supporting structure and the condition of the conjunc-
t-ival surface.
Various positions and reactions of the lids bear an impor-
tant relation to different forms of paralysis and other diseases.
WOUNDS OF THE EYELIDS.
Various degrees of wounds are found involving the eyelids.
Lacerations of different degrees are quite common from
injuries or having the lids caught on sharp objects and torn.
These wounds may involve only the margin of the lids, the
skin covering the cartilage, or the entire structure. Even
498 DISEASES OF THE EYELIDS
slight wounds on the lids should be considered important on
account of the deformity, entropion or ectropion which might
result.
All wounds should be examined thoroughly in order to
determine the actual condition present. The wound should
be cleaned and washed with boric acid solution (2 per cent.).
Approximate with sutures and cover the surface with flexible
collodion or airol paste. After adhesions have taken place
the sutures may be removed and a dusting powder applied.
Irritating substances should be avoided to prevent irritation
to the eye proper.
When edema is present as a result of the injury, warm
water applications are useful. If abscesses develop they
are opened, drainage effected, and boric acid powder applied.
All wounds should be given careful attention to prevent
complications in the eye itself.
INFLAMMATION OF THE EYELIDS.
Blepharitis.
Definition.— An inflammation of the eyelids often leading
to edema and suppuration or abscess formation.
Etiology.— Several factors have to do with producing this
condition: (a) AVounds and bruises often develop into
abscess formation, (b) Mange, particularly follicular, is a
frequent cause in dogs; and sarcoptic mange in cats, (c)
Eczema, (d) Exposure to cold winds, water, etc., seen in
hunting dogs, (e) Spread of inflammation from the conjunc-
tiva. (/) Foreign bodies penetrating the lids, such as brier
barbs, etc.
Symptoms.— The condition is self-evident. An examina-
tion should be made to determine the cause of the inflamma-
tion, whether it is due to parasites, trauma, eczema, or other
things.
Prognosis.— The prognosis is favorable in most cases unless
complications involving the eye are present.
Treatment.— Treatment must be applied to remove the
cause of the condition. When due to mange mites non-
irritating antiparasitic agents are recommended. Balsam
MALPOSITION OF THE EYELIDS 499
of Peru has been very satisfactory for this purpose. In
eczema the surface of the lid should be freed of all scales,
and other accumulating material by washing, and astringent
antiseptics applied either in the form of solution or dusting
powder. Abscesses when present should be opened and
proper drainage afforded. All foreign bodies present must
be removed and the wound treated with boric acid solution
(2 per cent.).
MALPOSITION OF THE EYELIDS.
Several malpositions of the eyelids are met with, especially
in dogs. Certain breeds of dogs are predisposed thereto from
their breeding. The abnormalities most often found are:
(a) Entropion, (b) ectropion, (c) ptosis, (d) paralysis of the
orbicularis, and (e) spasm of the orbicularis.
Entropion. — Definition. — An inversion of the eyelids either
in part or the entire lid. Entropion is usually complicated
with trichiasis in which the eyelashes cause more or less
direct irritation and injury to the conjunctiva and cornea.
The condition is present in the upper lid in most cases on
account of the difference in form.
Etiology. —It often results from the cicatrization of wounds,
chronic inflammation of the lids, and mange.
Symptoms.— The eyelid is turned inwardly against the
cornea. The eyelashes coming in contact with the cornea
produce inflammation, suppuration and in some cases ulcera-
tion. There is copious discharge of tears, and pus. The
conjunctiva will be found reddened and congested.
Prognosis. — Favorable. The condition can be corrected
in the majority of cases.
Treatment.— The injury to the cornea or conjunctiva may
be treated with boric acid solution (2 per cent.). Surgical
treatment is necessary in order to afford permanent relief.
An elliptical piece of skin is removed from the eyelid, parallel
to the margin and about one-eighth to one-quarter inch
from the edge of the lid.
Entropion forceps are used to grasp a sufficient fold of the
skin so that when it is removed and sutured the edge of the
500 DISEASES OF THE EYELIDS
lid will be drawn outward or everted. Care should be used
to avoid injury to the deeper structures or the margin of the
lid. A certain amount of judgment is necessary to determine
the amount of skin to remove in each case. After operation
the wound is covered with an impervious dressing (flexible
collodion, airol paste). In two or three days the sutures
may be removed. Kecovery is prompt and complete in
most cases. Eye complications should be treated according
to their condition.
Ectropion.— Definition.— An eversion of the eyelid in part
or the whole lid. It is rare in animals. Some breeds are more
predisposed than others (bloodhounds, pointers) . The lower
lid is most frequently involved due to the lesser curvature as
compared to the upper.
Etiology.— The common causes of this condition are:
Wounds with cicatrix formation, lacerations of the margin
of the lid, ulceration and abscess formation of the lid, and
inflammation of the conjunctiva. All of these conditions
tend to force the margin of the lid outward. Paralysis of the
facial nerve allows the lower lid to fall outward.
Symptoms.— The prominence of the conjunctiva of the
lower lid and the formation of a more or less deep gutter
from the separation of the palpebral edge from the cornea
are present in all cases. The conjunctiva is reddened,
thickened, and there is a more or less constant flow of tears
down over the face.
Prognosis.— The majority of cases can be relieved by
surgical means. It might be possible that the operation will
need to be repeated to properly approximate the parts.
Treatment.— In mild cases, resulting from congestion of
the conjunctiva, relief is afforded by removing the cause and
treating with mild astringents and antiseptics (0.5 to 1 per
cent, zinc sulphate solution).
When the conjunctiva is chronically thickened forcing
the palpebral edge outward, it is advisable to remove a
portion of the conjunctiva. The resulting contracture of
the wound in healing will bring the lid back in position.
Codrenin solution should be instilled into the tissues before
operating to reduce the pain and control the hemorrhage.
MALPOSITION OF THE EYELIDS 501
Several operations have been used successfully in relieving
this condition. The removal of a V-shaped portion of the
lower lid, leaving the margin of the lid free, and bringing the
edges of the wound together with sutures has been successful.
This forces the margin of the lid upward and inward. The
amount of tissue removed will depend upon the degree of
correction to be made.
Another method frequently employed is to remove a tri-
angular piece of skin just outside of the external canthus
and on a direct line with the lower lid, the base of the triangle
being upward. Sutures are applied and the traction of the
sutures and the cicatricial tissue formed keeps the lower lid
pulled upward. In this case the size of the triangle will
depend on the degree of ectropion present.
These operations should be made under strict antiseptic
precautions and the parts protected. If necessary a head
bandage with eye protector can be used.
Ptosis. — Blepharoptosis.— Definition.— A dropping or fall-
ing of the upper lid so that it continuously covers the eye.
It may occur as a symptomatic condition in conjunction
with other local affections, such as atrophy of the eyeball,
enophthalmos, etc.
Etiology.— The causes are various:
(a) It may be sympathetic, resulting from paralysis of the
cervical sympathetic nerves. Wounds and injuries to the
nerve, or growths, or enlarged glands, in its cervical or intra-
thoracic course will produce ptosis.
(6) Ptosis is often paralytic produced by a paralysis of the
muscles of the upper eyelid, either due to a lesion of the
muscle or its nerve supply.
(c) It may result from fracture of the orbital rim or process
of the frontal bone.
(d) Tumors pressing on the cerebrum or cerebellum have
been known to cause it.
(e) Ptosis often follows distemper, and other general dis-
eases.
(/) Very often tumor formation on the upper eyelid will
gradually overcome the muscular action and drag the eyelid
downward.
502 DISEASES OF THE EYELIDS
Symptoms.— The position of the upper eyelid, which hangs
downward and partially covers the eyeball, is characteristic.
All movements of the animal indicate its inability to move
the eyelid to any degree. The most important thing to be
considered is the causative factor, and the examination should
be made to determine it, if possible.
Treatment.— The treatment should be applied to remove
the cause. If sympathetic and the lesion apparent an attempt
should be made to correct it. Very often the cause is central
and cannot be removed. Potassium iodid in small doses
is indicated. If of paralytic origin nerve stimulants, such
as strychnin sulphate (0.001 daily) may be tried. Tumor
formations on the eyelid should be removed conserving as
much of the lid as possible.
Paralysis of the Orbicularis Nerve. —Definition.— Paralysis
of the facial nerve, probably of central origin, may be periph-
eral in which the eye is held open, the lower lid relaxed
falling away from the eyeball.
Etiology.— The cause of paralysis of the orbicularis may
be wounds or contusions of the nerve leading to temporary
or permanent paralysis. When of central origin it often
results from hemorrhages in contact with the nerve at the
point where it leaves the brain; or thrombus formation in the
left posterior cerebellar artery interfering with the nutrition
of the nucleus of the facial nerve. Tumors of the brain, and
chronic lesions resulting from distemper have also been
found to produce it.
Symptoms.— The lack of symmetry of the two sides of the
face is the most apparent symptom of facial paralysis. The
side paralyzed has a relaxed and drooped appearance. The
eyelid will be drooped to a degree and cover a portion of the
eyeball but cannot be closed producing a condition of lag-
ophthalmus. There is a very noticeable absence of winking
of the lids. Palpation of the lids will at once reveal their
condition.
Prognosis.— If of peripheral origin and resulting from simple
contusing a favorable termination may be looked for. How-
ever, if indications point to central origin the condition is
often permanent. The degree of injury to the nerve will
TR1CHIASIS 503
determine the prognosis. Unfortunately in many cases this
cannot be accurately determined.
Treatment.— As the eye cannot be completely closed, the
cornea is exposed and may become dry and injured. An
attempt should be made to correct this if possible. Oily
collyria should be instilled in the eye two or three times daily.
Massage over the course of the nerve trunk with a stimulat-
ing liniment (white liniment, soap liniment) often produces
good results. Internal administration of strychnin sulphate
(0.001-0.0025 once daily) should be continued for a few
days. If no results are obtained from the treatment after a
course of two to three weeks further medication should be
discontinued.
Spasm of the Orbicularis Nerve. — Blepharospasm.—
Definition.— A tonic or clonic spasm of the eyelids. It may
occur periodically or be continuous. In the tonic form the
eye is more or less permanently closed and -constitutes
usually a reflex symptom of a local eye disease, such as kera-
titis, panophthalmitis, conjunctivitis, or the presence of
foreign bodies in the eye. Naturally the vision is interfered
with by the original affection as well as by the spasm of the
orbicularis nerve.
Clonic blepharospasm is observed in dogs following dis-
temper when chorea-like movements are a sequel. Rapid
contractions and relaxations of the lid (winking) take place.
Twitching of the muscles of the face and ear often are asso-
ciated with the eye symptoms.
Treatment.— An examination of the eye should always be
made to determine the cause of the condition. If the symp-
toms result from local affections, treatment must be applied
to relieve the special condition. If no local involvement can
lie found, treatment is out of the question. Twitching of
the eyelid as a sequel to distemper may disappear in a few
weeks, or may remain permanently. Treatment has been
unsatisfactory.
TRICHIASIS.
Definition.— An abnormal position or direction of the eye-
lashes. The condition, as a rule, is not observed in animals
504 DISEASES OF THE EYELIDS
unless the lashes are directed toward the cornea and more or
less injury to this membrane occurs. Trichiasis is often con-
genital in dogs, although it may be acquired. The smaller
breeds of dogs are most often affected (Pekinese and Japanese
spaniels). It also occurs in the cat and bird. In the latter
fine, small feathers, which take the place of the eyelashes,
are misdirected.
Symptoms.— The principal symptoms are lacrimation, kera-
titis, blepharo spasm, and ulceration of the cornea. The eye
must be examined by elevating the lids, and after cleansing
with tepid water the lashes will be seen taking an abnormal
direction. Extensive irritation and injury have been observed
in such cases when they have been neglected.
Prognosis.— Favorable, except when the complications lead
to corneal ulcer, or panophthalmitis.
Treatment.— Removal of the offending lashes is the first
consideration. Their removal is effected by pulling them
out with small tweezers or forceps. Temporary relief can
also be obtained by cutting the lashes close to the margin
of the lids. More permanent results will be obtained by
performing the entropion operation. Any injury to the
structures of the eye should be treated with antiseptics
(boric acid 2 per cent, solution in distilled water).
DISTRICfflASIS.
Definition.— A condition in which there are two rows of
eyelashes present on the margin of the lids. One row is
usually normally directed while the other is misdirected
against the eyeball. The smaller breeds of dogs are most
often affected. The abnormal lashes grow out from the
puncta or outlets of the Meibomian glands.
The symptoms and treatment are the same as in trichiasis.
ADHESIONS OF THE EYELIDS.
A normal adhesion of the eyelids is found at birth, and
continues for a period of twelve to fifteen days. At this
period the eyelids open and assume their normal function
ADHESIONS OF THE EYELIDS 505
unless some abnormality is present. Adhesions form between
the margins of the lids which may be partial or complete
(ankyloblepharon), or betwreen the eyelids and the eyeball,
the margins of the lids being free (symblepharon).
Ankyloblepharon.— In complete ankyloblepharon the pal-
pebral fissure has entirely disappeared. An incomplete
closure of the palpebral fissure is known as blepharophimosis.
This condition> as a rule, is congenital, and is found in the
dog and cat. It is diagnosed readily. A sufficient time should
be allowed (ten to eighteen days) for the normal adhesions
to disappear. Very often there will be found a small line or
groove at the point where the opening should be.
Treatment.— A small opening is made through the lid at
the outer canthus, a grooved director inserted and the incision
carried clear across to the inner canthus. The after-treatment
consists in washing the eyes with a boric acid solution (2 per
cent), and applying vaseline to the lid margins to prevent
further adhesions.
In blepharophimosis there is a narrowing of the palpebral
fissure which makes the eye appear much smaller than normal.
It is often associated with trichiasis or entropion. To correct
it the palpebral opening should be enlarged at the external
canthus, and the skin sutured back both on the upper and
lower lids to prevent adhesions. This operation will also
correct trichiasis or entropion if either should be present.
Keep the wound clean and apply a mild ointment to the
recently incised margins.
Symblepharon.— This is an adhesion of the eyelids to the
eyeball, and has been observed in dogs and cats. The
majority of cases are congenital. Occasionally an acquired
symblepharon is found due to adhesions following destruction
of the conjunctiva! membrane during the course of distemper.
An examination of the eye will at once reveal the condition.
The lids cannot be everted and are found adherent to the
eyeball.
Treatment.— Separation of the lid from the eyeball is pos-
sible. The animal should be anesthetized. The lids are
carefully separated so that the eyeball is left intact. The
operation can be done satisfactorily with a fine pair of
506 DISEASES OF THE EYELIDS
scissors or a very small scalpel. After the operation is com-
pleted all hemorrhage must be controlled and an antiseptic
ointment applied under the lids. Yellow oxid of mercury
ointment has proved satisfactory for this purpose. It should
be applied daily.
LAGOPHTHALMUS.
Definition. — An incomplete closure of the eyelids in which
a portion of the cornea is left exposed. When the cornea or
conjunctiva is left continuously exposed to the air without
the normal secretions covering them, they become irritated,
inflamed and serious alterations take place. The membranes
are thickened, the cornea opaque and dry, and may even
become perforated. The tears follow the angle of the eyelids
and flow down over the face. The condition is brought about
in most cases by ectropion, exophthalmos, enlargement of the
eyeball, and some few cases by paralysis of the orbicularis
nerve. Wounds of the lids with extensive loss of substance
may also produce it.
Treatment.— The first indication is to remove the cause,
if possible. If this cannot be done the only thing left is- to
protect the conjunctiva and cornea from dessication and
eventual destruction. Oily solutions are best for this purpose.
Instill them into the eye once or twice daily.
TUMORS OF THE EYELIDS.
Several varieties of tumors are found on the eyelids of
small animals.
Papillomata. — Warts.— These are not uncommon in dogs
and birds. The wart-like excrescences found in birds, par-
ticularly parrots, are usually tubercular, and are often asso-
ciated with degenerations and abscess formation. In old
dogs and cats, horn-like growths are found as outgrowths
from the walls of Meibomian cysts. Small warts are also
seen developing along the margin of the lid, or on the skin
over the eyelid. During the course of epitheliosis of birds
small horn-like growths appear on the lids.
Treatment.— Small warts appearing on the margin of the
lids, or skin, are removed with the scissors. Cauterize the
TUMORS OF THE EYELIDS 507
base of them with silver nitrate, and follow at once with salt
solution to prevent undue caustic action and injury to the
eye. Tubercular nodules and warts in parrots should be
incised and removed as completely as possible. Conserve
as much of the eyelid as possible. In epitheliosis the warts
should be removed with the knife or curette and iodin applied.
Warts projecting out from the Meibomian glands are opened
and curetted with a small instrument. The base of the warts
should be carefully cauterized.
Chalazion. — Meibomian Cyst.— These are small cystic
growths, appearing on the free margin of the lid, or on the
skin, standing out prominently. They are sebaceous cysts
having no inflammatory reaction and filled, as a rule, with a
thick honey-like material. A true chalazion is a retention
of the secretions of the Meibomian glands. They are fre-
quently observed in dogs, more commonly in mature animals.
They form a firm, circumscribed swelling, gradually enlarg-
ing until they reach the size of a pea or walnut. A differentia-
tion is difficult to make as they resemble sebaceous cysts.
Their development often leads to a horny-like excrescence
on the surface, and often take on the character of a malignant
growth. They may involve the free margin of the lid, or
extend to the entire structure of the upper eyelid.
Treatment.— Small sebaceous cysts are opened and the
contents squeezed out. The opening is made large enough
in order that the gland can be destroyed with iodin or silver
nitrate.
In true chalazion it is advisable to remove a small trian-
gular portion of the lid, including the cyst, with the base of
the triangle on the margin of the lid. This is best done, under
morphin anesthesia, with the scissors. Approximate the
wound thus made with fine silk or linen. Union is usually
complete in ten days to two weeks. Curetting the enlarge-
ment may be tried in cases where the operation is not possible.
Pilosebaceous Cysts. — These are found on the upper eye-
lid in dogs, especially bulldogs and pugs with wrinkled skin.
The contents of the cysts are hair, sebum, and pus, which
is usually discharged through a fistulous opening.
508 DISEASES OF THE EYELIDS
Treatment.— The cyst should be opened, curetted, and the
cyst wall destroyed with tincture of iodin.
Lipoma and Sebaceous Tumors in Birds.— These are fre-
quently observed in the different species of birds. The
tumors are well defined, of a firm consistency, and vary in
size from a pea to a walnut. On opening the tumor fatty
tissue may be seen, or which is more common, a yellowish,
cheesy, tough material enclosed in a distinct capsule is present.
They are situated immediately under the skin. From their
nature they are either lipomas or sebaceous cysts. Various
conditions are found. Sometimes the cysts will rupture,
discharging the material, while in other cases horny growths
will partially replace the cyst. Very often a number of birds
in a flock will be affected.
Treatment.— Incise the tumor, remove all the contents and
apply tincture of iodin to its base. Free hemorrhage may
occur after incision, which can be controlled by cauterizing
with silver nitrate.
Enlargement of the Glands of Moll.— These small glands
are situated along the free margin of the eyelid, their ducts
emptying into the glands of the hair follicles. They are
enlarged commonly in older animals. The cysts are clear,
transparent, and varying in size from a wheat grain and
smaller.
Treatment.— The contents of the cysts are discharged.
This is best done by crushing the small cyst with an artery
forceps. Iodin is then applied to destroy the gland and cyst
wall.
Granulomas. — Resulting from wounds, granulomatous
tissue is often found developing on the free margin of the
lids, or on the surface. This is easily determined by its
general appearance. If there should be doubt a definite
diagnosis may be made with the microscope.
Treatment.— Complete extirpation is indicated. Cauterize
the base of the tumefaction with silver nitrate, or actual
cautery.
Malignant Neoplasms.— Several varieties of malignant
tumors have been found involving the eyelids of small animals.
TUMORS OF THE EYELIDS 509
Epitheliomata, sarcomata, carcinomata, and tuberculomata
are the ones most often observed.
Diagnosis.— A diagnosis is made partly on the character
of the growth and finally by microscopic examination.
Treatment.— Complete excision of the tumor should be
attempted as early as possible. When the entire eyelid is
involved treatment is of very little value. A recurrence of
the tumors is liable to occur after operation. In removing
the tumor as much as possible of the eyelid should be saved.
CHAPTER II.
DISEASES OF THE CONJUNCTIVA.
Examination.— Examination is simple in the dog, cat and
bird. The animal should be held either by an assistant or
restrained so as to facilitate the examination. Ordinary
daylight or artificial light may be used. The lower lid can
be pulled downward by placing the thumb on or near the
palpebral margin, and the upper lid pushed upward with
the index finger of the same hand in a similar position. This
manipulation will expose nearly all of the membrane. The
examination is made for inflammations, foreign bodies, cysts,
tumors, and wounds of various kinds. Vicious animals
should be restrained by taping the mouth or by general
anesthesia.
CONJUNCTIVITIS.
Definition.— Inflammation of the conjunctiva. In small
animals various types of inflammation are of frequent occur-
rence. These animals are subjected to injuries which often
involve the conjunctival membrane, and infectious diseases
(distemper in dog and cat, epitheliosis in bird) which
produce various . forms of inflammation. The xerosis
bacillus, Staphylococcus albus and S. aureus, strepto-
coccus, diphtheria bacillus and others are more or less present
in the eye leading in many cases to local infection and
inflammation.
It is noted further that the conjunctival membrane is
very vascular, rich in lymph cells, and sensitive to outside
influences, all of which tend to favor the development of
inflammatory conditions.
The following forms of conjunctivitis are recognized:
(a) Catarrhal, (b) purulent, (c) parenchymatous, (d)
croupous, (e) follicular, and (/) exanthematous.
CONJUNCTIVITIS 511
Catarrhal Conjunctivitis.— A form of inflammation of very
frequent occurrence in all small animals. It is characterized
by congestion, swelling, and a discharge which may be serous,
mucous, or mucopurulent.
Etiology.— Catarrhal conjunctivitis is often associated with
or secondary to other diseases, such as eczema, distemper,
epitheliosis, nasal catarrh, bronchitis and some constitutional
diseases.
Mechanical conjunctivitis often occurs in small animals
from injuries of various kinds, foreign bodies, dirt or dust
getting into contact with the membranes. Cold winds some-
times produce it in hunting dogs.
Irritating collyria instilled too often may produce it. Seri-
ous disturbances are frequently observed from too strong
solutions.
Infection no doubt plays an important role in producing
catarrhal conjunctivitis. The ordinary infection is con-
stantly present and develops when the local resistance is
reduced.
Symptoms. — There is a distinct change in the color of the
membrane and a mucous or mucopurulent discharge. The
congestion of the membrane produces a pink or reddish
coloration which may be accompanied by a slight yellow tinge
due to interstitial infiltration.
The secretion, at first serous, soon, changes to mucous or
mucopurulent and collects around the palpebral margin.
The edges of the lids are found edematous.
Some photophobia is present. The animal will show more
or less constant movement of the lids, and holds the lids par-
tially or completely closed. A careful examination reveals
the true nature of the condition.
Prognosis.-— As a rule favorable except when secondary to
infectious diseases. The inflammation usually subsides in a
week or ten days.
Treatment.— A careful examination should be made to
determine whether any foreign substances are present which
must be carefully removed.
Wash the membranes thoroughly with boric acid (2 per
cent.). This can be repeated two or three times daily during
512 DISEASES OF THE CONJUNCTIVA
the first few days. Follow each application of boric acid
with an instillation of one of the following solutions: Zinc
sulphate (1-1| per cent.) ; tannic acid (1-2 per cent.) ; chinosol
(1-500); protargol (2-4 per cent.); or if the condition is
persistent solution of silver nitrate (0.5 per cent.).
The animal should be isolated and the premises disinfected
to avoid spreading the disease.
Purulent Conjunctivitis . — Blennorrhea. —Acute Form. —
Definition. — A purulent secretion present in one or both eyes.
In this condition the discharge is more copious and the
inflammation more intense than in catarrhal conjunctivitis.
Purulent conjunctivitis results very frequently from or
accompanies distemper of dogs and cats, and epitheliosis in
fowls. It often occurs as an epizootic or enzootic in kittens
and puppies. Both the acute and chronic forms of the
disease are frequently met with in practice.
Etiology.— The majority of cases can be determined quite
definite!}- to be due to infection accompanying or following
infectious diseases. It is very common in dog distemper,
cat distemper, and epitheliosis in birds. Various kinds of
organisms have been isolated from the discharge but none
of them has been proved to be the specific cause. The
fact that large numbers of puppies, kittens or fowls are
affected, when closely associated, indicates the communicable
character of the disease. It is possible to have this form of
conjunctivitis follow the catarrhal, owing to the reduced
resistance of the membrane which allows secondary infection
to develop. It is, however, possible that many cases are
produced in fowls and in some of the other animals by a
parasite. Several species of parasites have been isolated
from the conjunctival sac of birds.
Newly born animals contract the disease from the vaginal
infection of the mother at the time of parturition.
Symptoms.— The conjunctival membrane is of an intense
red color and more or less uniform over its entire surface.
The degree of redness depends upon the severity of the
infection and the stage of development. In many cases the
mucous membrane is prominent from the edematous swelling
resulting from the irritation, thus giving it a "pouching out"
CONJUNCTIVITIS 513
appearance. The amount of pus present is more or less
characteristic. The eye is often entirely filled with a thick,
whitish, glutinous pus, which becomes dried around the
palpebral borders and forms crusts frequently agglutinating
the eyelids. On account of the spread of the infection to the
cornea, this organ becomes cloudy or even ulcerated. Owing
to the irritant action of the pus the animal will show con-
siderable pain, scratch and rub the eyes either with the paws
or against objects. The membrana nictitans is red and
protrudes over a portion of the eyeball. Most cases show
considerable photophobia.
General.— General symptoms are noted in many cases in
the form of dulness, loss of appetite and general weakness.
There may be sufficient infection to produce general intoxica-
tion and death in birds. In these cases, however, it is quite
likely that the infection is found in other parts of the body.
Prognosis.— The prognosis is not always favorable. Due
to complications, which may involve the eyeball, partial or
total blindness can result. While many cases terminate in
complete resolution, others produce ulcerations and perfora-
tions of the cornea. When the latter occurs panophthalmitis
is the result. In some animals, particularly birds, this would
seriously interfere with the obtaining of food. When para-
sites are the cause of the condition other complications
follow, such as infestation of the nasal passages and sinuses,
and in some cases invasion of the air sacs.
Treatment. — Thorough disinfection of the premises, houses,
etc., should be practised in order to prevent the spread of the
infection. This can be accomplished either by the use of
liquor cresolis compositus (3 per cent.) with which all places
and articles in contact with the animals are thoroughly
saturated, or the animals are removed from the house or
kennel which is then disinfected with formaldehyd fumes.
The general condition of the patient must be considered
and its strength maintained by good, nourishing food and
such tonics as tincture of gentian, or tincture of mix vomica
(0.2-0.4 twice daily). A solution of iron sulphate (2 per
cent.) in the drinking water has proved of value as a tonic
for birds.
33
514 DISEASES OF THE CONJUNCTIVA
Local treatment is applied at least twice daily in order to
remove the irritating material from the conjunctival sac,
and also to destroy infection. Many preparations have been
recommended and used for this purpose: Boric acid (2 per
cent.); creolin (2 per cent.); chinosol (1-500); protargol
(2-3 per cent.) ; or in severe cases silver nitrate (0.5 per cent.).
This treatment must be continued for one to two weeks to
obtain the best results.
Chronic Form.— This form of the disease has been observed
very frequently in dogs and cats following infectious and
contagious diseases. To recognize it as being separate from
the acute form is necessary on account of its persistent and
long course. It is very common in old animals and those
kept under bad hygienic conditions. Many cases of eczema
and mange are associated with chronic purulent conjuncti-
vitis. It may follow the acute form.
Symptoms.— The condition of the conjunctiva and the
presence of pus with agglutination of the palpebral margins
present the appearance in general of the acute form. On
examination the conjunctiva is found to be dull red in color,
slightly edematous and the cornea frequently has numerous
small bloodvessels over its surface. The general condition
of the patient is usually bad.
Prognosis.— Owing to the chronic nature of the disease and
its persistency the prognosis is not favorable. The disease
may last for months or even the entire life of the animal.
Treatment.— One of the first essentials in the treatment
of this disease is to secure good sanitary conditions, giv-
ing plenty of nourishing food and do everything possible
to increase the strength of the patient. The various anti-
septic solutions recommended for the acute form may also
be tried.
Good results have followed in some chronic cases by pre-
paring an autogenic vaccine and administering 1 to 2 c.c.
subcutaneously every three to five days. This in con-
junction with the above treatment has proved to be of
considerable value.
Parenchymatous Conjunctivitis. — Erysipelatons Conjuncti-
vitis.— Definition.— An inflammation of the deeper layers of
CONJUNCTIVITIS 515
the conjunctiva and its submucous tissue. It occurs in all
small animals, most frequently in birds.
Etiology.— There are many factors producing parenchy-
matous conjunctivitis. Many of them are the same as those
causing the catarrhal form. Injuries to the mucous mem-
branes and underlying structures can produce it. Chronic
agents in the form of irritants, such as irritating collyria,
when used too often or in too large quantities; thermic agents
in the form of hot water or hot antiseptic solutions. The
disease is observed in hunting dogs from exposure, or to
foreign bodies getting into the eyes while going through
briers and brush. Infection plays an important role in the
production of this form of conjunctivitis. The infection is
often introduced directly into the conjunctiva! sac where it
enters small wounds and produces intense inflammation of
the parenchyma. Numerous organisms have been isolated
in these cases. It is evident that no one specific organism
produces it. The disease may also develop secondarily
(hematogenously) to some of the infectious diseases. It is a
common sequel to dog distemper or epitheliosis of fowls.
Symptoms. -The early indications of the disease are
swelling and puffiness of the mucous membrane. This is so
marked in many cases that the swollen conjunctiva pouches
outward over the palpebral borders or the cornea. During
this stage the conjunctiva is intensely congested and
reddened. There is considerable lacrimation and photo-
phobia during the entire period of the disease. In the second
stage there is a purulent discharge from the eye, which may
be very copious. The general condition of the patient is
usually not disturbed unless complications develop, or from
the attending infectious diseases.
Prognosis. The prognosis in most primary cases is favor-
able. In the acute form it subsides in a week or ten days.
When secondary to infectious diseases, the prognosis is not
so favorable. In such instances it may develop into a chronic
purulent conjunctivitis.
Treatment. - -Prompt treatment is important in preventing
the spread of the inflammation. Antiseptic and astringent
solutions should be employed: Boric acid (2 per cent.);
516 DISEASES OF THE CONJUNCTIVA
lead water (2 per cent.); potassium permanganate (£ per
cent.); tincture opium (1 per cent.). If the patient shows
considerable pain and irritation with marked congestion of
the membrane, codrenin solution (2 per cent.), or a few drops
of stovain solution (2 per cent.) are recommended. When
intense pain is present and the conjunctiva is a dull, red color
indicating a subacute inflammation, silver nitrate (0.5 per
cent.) is of value.
Croupous Conjunctivitis.— Definition.— An inflammation of
the conjunctiva characterized by the formation of a pseudo-
membrane which covers its surface. Croupous conjunctivitis
is observed more commonly in the dog and cat. In birds it
accompanies epitheliosis, when the eyes are involved.
Etiology.— The majority of cases occurring in the dog and
cat are produced either by chemical irritation or as a result
of specific infection following or accompanying infectious
diseases. In birds, owing to the prevalency of epitheliosis,
large numbers in an individual flock may be affected at the
same time.
Symptoms.— The conjunctiva is covered with a fibrinous
exudate which frequently extends over the cornea. The
corneal surface may be entirely covered. In birds a very
heavy, thick, fibrinous membrane completely covers the
entire anterior surface of the eye. Due to exudate and
secretions collecting under the pseudomembrane, it is forced
outwardly protruding between the lids. If the membrane
is removed, the eye will be found normal in position and color.
There are no general symptoms except as produced by some
infectious diseases which the conjunctivitis attends.
Prognosis.— Favorable in primary cases. When secondary
the prognosis depends upon the primary disease it accom-
panies.
Treatment.— The animal's general condition should be
observed and any necessary treatment applied. The eye
may be flushed out with a warm boric acid solution and the
croupous membrane removed with a pledget of cotton or a
pincette. After the membrane is removed, apply antiseptic
or astringent collyria. It will probably be necessary to re-
move fragments of membrane as they later develop.
CONJUNCTIVITIS 517
Follicular Conjunctivitis.— Definition.— An inflammation of
the conjunctiva characterized by the formation of small,
granular elevations over its surface. These granulations are
due to swelling of the lymph follicles and to connective
tissue proliferation, the result of inflammation. The granu-
lations often attain the size of a grain of millet or larger.
Follicular conjunctivitis occurs usually on the inner surfa'«
of the membrana nictitans. In a large number of dog^
examined, nearly one-half were found to be affected with ,
this disease. House dogs seem more susceptible than others.
Etiology.— The cause is unknown. Many etiological
factors have been accused, such as dirt, dust and other
irritants which enter the eye. Undoubtedly many cases
result from distemper.
Symptoms.— As such a large number of dogs are affected
with enlarged lymph follicles on the membrana nictitans one
is led to conclude that their presence may not be abnormal.
However, in many cases the granules appear also over the
entire conjunctiva leading often to ectropion, an outward
rolling of the eyelids. On examination the mucous mem-
brane will be found to be of a dull red color and irregular on
the surface. Small, white granules at their apices stand out
quite prominently over the membrane. The membrana
nictitans, when elevated with the forceps, will disclose small
elevations on its under surface. In case of long standing the
palpebral margins become red and the small glands prominent.
There is some lacrimation and frequently a discharge of pus
from the inner canthus. During the later stage small ulcers
appear on the apices of the granulations, which, by confluence,
form large, ulcerated surfaces. The eyes, kept partly closed
and rubbed with the pawrs, show evidence of irritation and
pain.
Prognosis.— The prognosis is not very favorable because
the disease is usually well developed before the animal shows
any marked symptoms. Owing to the chronic character of
the disease the course is protracted requiring long continued
treatment.
Treatment.— A thorough examination should be made of
the entire conjunctiva in order to determine the extent of
518 DISEASES OF THE CONJUNCTIVA
the disease. The ordinary collyria, such as zinc sulphate
(1 per cent.) ; silver nitrate (0.5 per cent.), or chinosol (1-500),
should be used for a few days to remove all of the surface
infection and astringe the membrane. Following this treat-
ment the affected parts of the conjunctiva are cauterized
with silver nitrate. Apply immediately a solution of sodium
cl^orid to prevent injury to the cornea. This operation
c'£ ly be repeated in a few days, if necessary. In the mean-
\e the astringent and antiseptic solutions are to be con-
aed.
It is advisable to remove the membrana nictitans when it
nows the pronounced follicular granulations. This is best
,ione in the following manner: The animal may be given
a general anesthetic, or anesthetize the membrane locally
by instilling 0.8-1.5 of codrenin solution in the affected
eye. If the latter is used the operation should be delayed for
ten or fifteen minutes for complete anesthesia. The animal
is placed on the operating table, held by an assistant, the
membrana nictitans grasped with a small forceps and pulled
outwardly toward the inner canthus of the eye. It is then
cut off carefully with a curved scissors. Care must be taken
to prevent removal of any of the other conjunctival mem-
brane, as this would lead to scar formation and result in
entropion. Serious hemorrhage may occur in individual
cases. If the hemorrhage is copious a gauze pack should be
placed over the eye and held in place by a head bandage.
This may be removed in twenty-four hours and the ordinary
antiseptic solutions used. Recovery from the operation
requires ten days to two weeks.
Exanthematous Conjunctivitis.— Definition.— An exanthe-
inatous eruption occurring during the course of certain
diseases. In small animals this form of conjunctivitis is not
very common, but has been observed accompanying or
following distemper in the dog and cat. Parasitic skin
diseases and eczemas often extend to the conjunctiva from
the skin around the palpebral margins. This frequently
results in suppurative inflammation of the glands along the
margin of the lids, and in the membrana nictitans. Many
cases of favus in fowls extend to the conjunctiva.
TRAUMATIC LESIONS OF THE CONJUNCTIVA 519
Treatment. —The treatment of exanthematous conjuncti-
vitis is very similar to that of the catarrhal form and its
varieties. The original disease must be treated, and anti-
septic and astringent solutions applied to the affected con-
junctiva. When there is severe lacrimation, calomel has
proved to be of considerable value.
PTERYGIUM.
Definition.— A triangular fold of the conjunctiva and sub-
conjunctival tissue extending over a part of the cornea. It
is derived from the bulbar conjunctiva and narrows to a
point as it extends over the corneal membrane.
Symptoms.— Pterygium develops gradually and does not
produce any marked irritation except a slight catarrhal
inflammation. When it extends over on the cornea it may
affect vision.
Diagnosis. —The diagnosis is not difficult. The triangular
growth, attached more or less firmly to the cornea, rich in
bloodvessels, which gives it a pink or reddish cast, charac-
terizes it.
Prognosis.— Pterygium is not very serious and can usually
be operated successfully.
Treatment.— It is advisable to treat the mucous membrane
for a few days previous to the operation with antiseptic and
astringent solutions. A local anesthetic should be adminis-
tered, or if the animal is nervous, general anesthesia would
be preferable. Dissect off the triangular fold of membrane
from the cornea and remove it as near the base as possible
with the scissors. It is further recommended that the base
of the growth be dissected out completely and the wound
sutured. The after-treatment consists in the use of antiseptic
arid astringent solutions. Recovery is usually prompt, and,
if the operation has been thorough, the growth does not
return.
TRAUMATIC LESIONS OF THE CONJUNCTIVA.
Foreign Bodies in the Conjunctiva.— Various kinds of sub-
stances are found in the conjunctival sac of small animals.
520 DISEASES OF THE CONJUNCTIVA
Dirt, straws, briars, wheat seeds, splinters of wood, etc., have
been observed quite commonly. This is particularly true
in hunting dogs, and animals that are kept in dusty and
unsanitary kennels. In birds, parasites have been found in
a number of cases (spiroptera) . These substances are fre-
quently found underneath the membrana nictitans.
Symptoms.— All foreign bodies cause more or less intense
reactive symptoms, such as lacrimation, photophobia, serous
or mucopurulent discharge, swelling of the eyelids, opaque-
ness of the cornea, etc. The severity of the symptoms will
depend somewhat upon the character of the foreign body and
the degree of irritation. The patient usually shows con-
siderable pain, rubs the eyes against objects or with the paws,
and thus intensifies the symptoms.
A sudden development of the symptoms cited should lead
one to suspect a- foreign body in the eye.
Treatment.— Flush out the conjunctival sac with warm
water or boric acid solution (2 per cent.). Raise the mem-
brana nictitans and evert the lids so that a close inspection
of the entire conjunctival sac can be made. In the majority
of cases the foreign body is visible. A reading glass will
facilitate finding small foreign bodies.
After the foreign body is located it is advisable to remove
it either by flushing the surface with a boric acid solution
(2 per cent.) or by grasping it with a small forceps, or wiping
it out with a pledget of cotton. Considerable care should be
exercised to see that all of the foreign material is removed.
After removal flush the mucous membrane two or three times
daily with boric acid solution (2 per cent.).
Wounds on the Conjunctiva.— Very often the conjunctiva
is injured by sticks, pieces of straw, briers, etc. In the
majority of cases the injury is slight and of little significance.
In a few cases, where the lesion is extensive, there will be
symptoms similar to those caused by foreign bodies in the
conjunctival sac. A differentiation is made only by a careful
examination.
Treatment.— The lids should be everted and the part
thoroughly examined to determine the extent of the injury.
ULCE RATION OF THE CONJUNCTIVA f>21
If any shreds of membrane are present, they should be
removed with the scissors. Antiseptic and astringent collyria
are used until the symptoms subside.
CORROSIONS AND BURNS OF THE CONJUNCTIVA.
These occur rather commonly in dogs and cats the result
of accident or intent. They may also be due to the use of
strong collyria. A common practice, when dogs are fighting,
is to separate them by throwing ammonia, pepper, or other
irritant substances into their eyes. This often results in a
serious inflammation of the conjunctiva and cornea. Thermic
agents, such as hot water, also produce extensive injury.
Treatment.— A careful history of the case should be
obtained if possible in order to determine the cause of the
injury. It would be best to first flush out the eyes with a
warm boric acid solution (2 per cent.), and if the injury is
produced by strong alkalies, follow with some soothing,
lubricating agent, such as warm milk, or a dilute glycerin
solution. Oleaginous preparations are also to be recom-
mended. Ophthalmic ointments are useful. If the cauter-
ization has produced an opacity of the cornea, of great value
is a solution of succus cineraria maritima compositus (50
per cent.) used daily.
ULCERATION OF THE CONJUNCTIVA.
A more or less extensive ulceration of the conjunctiva!
membrane occurs following diseases or injuries. It has been
observed following burns and corrosions; in birds, tuberculosis
produces it.
Treatment.- When ulceration of the conjunctiva occurs,
the part should be thoroughly cleaned, curetted, and the
base of the ulcer cauterized with silver nitrate followed by
salt solution. This treatment may be repeated in a few days,
if necessary. The conjunctiva! sac should be washed daily
with boric acid (2 per cent.) to prevent infection and injury
to other parts of the eye.
522 DISEASES OF THE CONJUNCTIVA
TUMORS AND GROWTHS ON THE CONJUNCTIVA.
In small animals, tumors involving the conjunctiva and
the membrana nictitans are of frequent occurrence. Several
varieties of tumors have been observed. The principal ones
are : Epitheliomas, sarcomas, tubercular nodules, dermoids,
adenomas of the glands of Harder, papillomas, fibromas and
lipomas. It is very essential that a differential diagnosis
be made in order to distinguish the malignant from the non-
malignant varieties. Malignant growths will not only invade
the conjunctiva but spread rapidly to the adjacent tissue, and
eventually cause the destruction of the entire eyeball.
Treatment.— All enlargements along the margin of the lids,
on the conjunctiva or on the membrana nictitans should be
removed completely as early as possible. This operation is
best accomplished under general anesthesia. The after-
treatment would consist in cauterizing the wound and the
application of the ordinary antiseptics.
INFLAMMATION OF THE MEMBRANA NICTITANS.
Examination. — An examination of the membrana nictitans
is very easily accomplished in small animals by ordinary
daylight. Proper restraint of the animal is necessary for a
careful and thorough inspection. If the animal is of a nerv-
ous temperament, or inclined to be vicious, a general anes-
thetic should be administered, or the patient hoppled and a
tape applied around the mouth. The lids are then everted
or held open with the thumb and finger while with the other
hand the membrana nictitans can be grasped writh a forceps
and elevated so that all parts of it can be examined. Exami-
nation should be made for inflammation, granular enlarge-
ments, tumors, and injuries.
As the mucous membrane of the membrana nictitans is
exposed to the same causes of disease as the rest of the
conjunctiva, it frequently shows lesions.
Symptoms.— Inflammation of the membrana nictitans is
characterized by a red, more or less flat enlargement appear-
ing at the inner palpebral fissure. In severe cases the
TUMORS OF THE MEMBRANA NICTITANS 523
membrane stands out prominently and extends over a portion
of the cornea. A protrusion of the membrana nictitans is
observed in tetanus, which should not be mistaken for an
inflammatory condition. This can easily be distinguished
by other symptoms of tetanus appearing in other parts of the
body.
Prognosis.— Favorable in most cases. It may terminate
in a chronic inflammation in which case the membrana
nictitans will remain permanently thickened.
Treatment.— The entire membrane should be inspected
closely for foreign bodies. Flush out the membrane daily
with boric acid solution (2 per cent.).
If in the course of two or three weeks the swelling has not
subsided, it would indicate a chronic inflammation. In this
case the removal of the entire membrane is recommended.
WOUNDS OF THE MEMBRANA NICTITANS.
In small animals wounds of the membrana nictitans are
produced by the same causes as those producing traumatic
conjunctivitis elsewhere. As a rule they are of little impor-
tance unless very extensive or followed by marked granula-
tion . Antiseptic and astringent solutions usually suffice to heal
them. If extensive granulation occur, it may be necessary
to extirpate the entire membrane.
TUMORS ON THE MEMBRANA NICTITANS.
Various tumors have been found on the membrana nicti-
tans. It is advisable in all cases to remove the membrane
surgically.
CHAPTER III.
DISEASES OF THE LACRIMAL APPARATUS.
Examination.— This apparatus consists of the lacrimal
gland and the lacrimal passages. In small animals it is
somewhat difficult to make an examination of the entire
apparatus. The lacrimal gland in the dog is flat, light pink
in color, of a mixed type and is situated in the periorbit
directly under the orbital ligament. In the cat the position
is very similar. In birds the gland is a small, round, reddish
body against the eyeball near the outer canthus and opens
upon the wall of the eyelid through a small slit.
The lacrimal openings (puncta lacrimalia) are elliptical
fissures and are two in number in the dog and one in the bird.
The lacrimal canal extends from the lacrimal gland to an
opening in the lower border of the nasal canal. This is a
whitish, membranous tube to conduct the excessive secretion
into the nasal passages. The entire lacrimal apparatus is of
lesser importance in small animals than in horses.
LACRIMATION.
Epiphora.
Definition.— A term applied to designate a flow of tears
over the lid margins. It is not of common occurrence in
small animals, except in certain breeds of dogs.
Etiology.— (a) Very often due to ectropion or entropion,
which may produce a deviation of the puncta lacrimalia,
allowing the secretion to flow out over the margin of the lids.
(b) Obstruction of the lacrimal duct by foreign substances,
mucus, etc. (c) Constriction and obliteration of the duct
due to injuries, etc. (d) Lacrimation is often seen as a result
of irritation or diseases affecting the conjunctiva! membranes.
In this case the secretion forms so rapidly that the lacrimal
duct cannot carry it away, the excess flowing over the lid
margins, (e) Ordinary lacrimation may be produced by
exposure to irritating gases, smoke, dust or cold air.
DACRYOCYSTITIS 525
Symptoms.— A copious tear flow over the lid margin. An
examination of the surroundings of the patient should be
made, and also a close inspection of the conjunctiva and
lacrimal apparatus, to determine if possible the cause of the
condition. In certain breeds of dogs (spaniels, poodles,
Boston terriers) it should not be looked upon as anything
serious.
Prognosis.— As soon as the causes are removed most cases
recover promptly. In case the lacrimal passages are
obstructed, the prognosis would be unfavorable.
Treatment. — If possible remove the cause of the condition.
If in the lacrimal passages, the}- should be opened by injecting
a warm solution of boric acid (2 per cent.) or sodium bicar-
bonate (1 per cent.) with a fine nozzled syringe. As the duct
is often very small the operation is not always successful.
DACRYOCYSTITIS.
Definition. — An inflammation of the lacrimal sac. It is
quite common in dogs and cats.
Symptoms.— The first symptom is a swelling or bulging in
the neighborhood of the inner canthus of the eye. When
pressed with the finger the contents are forced out through
the puncta lacrimalia. The discharge may be serous, mucoid,
or purulent, depending upon the age of the condition. The
case often develops suddenly, the skin over the swelling
becoming shiny and red. It often perforates and through
the opening blood-tinged pus is discharged. Later the
discharge becomes mucoid or serous. A lacrimal fistula
frequently results from the continuous tear flow through the
abscess opening. Dacryocystitis usually becomes chronic.
Prognosis.— On account of its chronicity and the develop-
ment of fistula the prognosis is not very favorable. As a
rule several weeks are required to bring about complete
recovery.
Treatment. — In dacryocystitis, lacrimal catarrh and fistula
thorough irrigation with warm antiseptic solutions is
indicated. Apply with a syringe with a fine long nozzle.
If the fistula persists, open the canaliculus and lacrimal sac
by slitting and treat as an open wound.
CHAPTER IV.
DISEASES OF THE CORNEA.
Examination.— The cornea is normally transparent forming
the anterior covering of the eyeball. It is shaped somewhat
like a watch-crystal and in the dog, cat and bird spherical in
form. The surface is smooth and shiny. In examining the
cornea employ either daylight or artificial light. The animal
may be restrained writh an anesthetic or hoppled and tape
applied around the mouth. By everting the eyelids with
the thumb and index finger the entire cornea is exposed. Its
form should be noted, its curvature and its transparency.
The curvature of the cornea of one eye should be compared
with that of the other. Of assistance in this regard is a
lighted candle. By noting the size of the flame as reflected
by the cornea of each eye, comparisons may be made. If
the curvature is weak, the flame appears larger; if strong,
smaller. In dogs and cats physiological variations will be
noted in the curvature of each cornea due to the difference
in the shape and size of the eyes. The surface of the cornea
should be smooth and even. To determine these observe it
from the side, best using reflected light. The cornea should
be tested for sensitiveness by gently touching it. It is
normally very sensitive. In ulceration and when inflamed
sensitiveness is increased; it is reduced in glaucoma. Further
examination is made for cuts, scratches, foreign bodies, etc. '
KERATITIS.
Definition. — An inflammation of the cornea. Two types
are recognized: 1. Non-suppurative, and 2, suppurative
keratitis. Under the former are included the following
forms: (a) Superficial, (b) vascular (pannus), (c) keratitis
pigmentosa, (d) keratitis punctata superficial, (e) parenchy-
KE RAT IT IS 527
matous, (/) keratitis punctata profunda. Under the latter
are included: (a) Ulceration of the cornea, (6) abscess of the
cornea, (c) keratitis neuroparalytica, and (d) keratitis from
lagophthalmus.
Non-suppurative Keratitis.
Superficial Keratitis.— Definition.— An inflammation of the
cornea which involves the epithelial layer and the superficial
layers of the parenchyma. It is very commonly due to acci-
dents, injuries, and infections.
Etiology.— Superficial keratitis may result from (a) a spread
of infection from the palpebral or scleral conjunctiva. (6)
Wounds on the cornea, (c) Foreign bodies, (d) Chemical
irritants, such as too strong silver preparations, antisep-
tics, etc. The common practice among the laity of using
alum, ammonia, powdered glass in turbidity of the cornea
obviously often injures it. (e) Spreading of inflammation
from adjacent structures, such as the iris and ciliary bodies.
(/) Superficial keratitis is often observed to accompany dog
distempter and epitheliosis of fowls.
Symptoms.— Lacrimation and photophobia are early and
prominent symptoms. Clouding of the cornea in the form of
a bluish-white film is seen which may be localized or general.
An epithelial desquamation is often produced on the surface
of the corneal infiltration. This is so slight in many cases
that it is not recognized. The symptoms usually disappear
completely in a week or ten days.
Course.— The course is usually about two weeks.
Prognosis. — Favorable unless complications develop.
Treatment.— A careful examination should be made of all
parts of the eyelids and cornea to determine the conditions
accurately. Flush the cornea and conjunctiva with boric-
acid solution (2 per cent.), or chinosol (1-2000 in distilled
water). If considerable pain and photophobia are present
a cocain and atropin solution (1-150) is recommended. A
solution of succus cineraria maritima compositus (50 per
cent.) has given most excellent results. Should the condition
indicate chronicity, and no ulceration be present, a mild
528 DISEASES OF THE CORNEA
solution of silver nitrate will be found useful to change the
type of inflammation and to act as an antiseptic and astrin-
gent. Daily examination and treatment must be carried out
until the opacity disappears.
Vascular Keratitis. — Pannus.— Definition.— The formation
of new vascular tissue extending over the cornea just under-
neath the epithelial covering. Pannus is not frequent in
small animals; it is seen occasionally in dogs.
Etiology.— Pannus occurs in most instances from irritation
of a severe form extending over a long period of time. In
dogs it commonly results from chemical irritation, when
strong chemical agents, such as alum, mercury, etc., are used
in treating opacities and chronic conjunctivitis. It may be
due to trichiasis or districhiasis, and is also a sequel to chronic
conjunctivitis, or may occur during the course of dog dis-
temper.
Symptoms.— Pannus usually begins with photophobia and
lacrimation. This is soon followed by a gray or white
opacity, traversed by numerous bloodvessels which can be
easily seen extending over the cornea in the form of reddish,
radiating lines. Later, when the cause is removed, the new
tissue becomes organized and appears as a white opacity of
varying density.
Prognosis.— Complete recovery is difficult to attain in all
cases. The prognosis should be guarded as complications
may follow.
Treatment.— A careful history of the case should be
obtained in order to determine the cause, which should be
removed, if possible. If opacity is present a solution of
succus cineraria maritima compositus (50 per cent.) is recom-
mended, using a few drops once or twice daily. Some of the
various ophthalmic ointments might also be tried . Operative
procedure is recommended in case the ordinary treatment
fails. The pannus may be removed by first giving the
patient a general or local anesthetic, dilating the lids with an
eye speculum, and carefully curetting the surface with a
rather dull curette, ("are must be taken to prevent curetting
too deep. After operating apply antiseptics, and in severe
cases cover the eye with sterile gauze held in place by a head
bandage. Daily dressing is recommended.
KERATITIS 529
Keratitis Pigmentosa. — Pigmentary Keratitis. —Definition.
-A chronic disease of the cornea, either inflammatory or
degenerative, with which is associated pigment deposit.
It has been observed quite often in certain breeds of dogs
and cats. The poodle, small house spaniel, and other house
dogs are the most common sufferers.
Etiology.— In most cases pigmentary keratitis is secondary
to ulceration of the cornea, other forms of keratitis and
cornea! opacities. It may occur as a primary condition in
dogs having marked pigment deposits along the corneal
limbus. In these cases it affects usually only a portion of the
cornea, but may extend gradually to other portions. Occa-
sionally the pigmentation may be deposited around the
scleral corneal zone, extending toward the center of the
cornea. The causes of the primary form are unknown.
Symptoms. — Pigmentary keratitis is characterized by
deposits of melanin or pigment in the cornea. It usually
begins as a fine, triangular network of small, dark lines
radiating from the limbus, the base of the formation being
at the limbus and the apex directed toward the center of the
cornea. The triangular pigment formation is often so dense
that the part of the cornea traversed by it is almost black.
Sometimes the pigmentation disappears to reappear later.
Continued recurrences eventually leave the cornea dull and
uneven on its surface. Lacrimation and photophobia are
little marked.
Prognosis.— The prognosis is unfavorable. As a rule
following frequent recurrences permanent opacity of the
cornea results.
Treatment.— Boric acid (2 per cent.), or ichthyol (2 per
cent.) is recommended. Pain may be arrested by stovain
(2 per cent.), or alypin (2 per cent.), combined with the
antiseptics. Internally potassium iodid (0.012-0.12) once
daily, or atoxyl in small doses has been used with apparent
success. The patient should be fed liberally and given good
Keratitis Punctata Superficialis. — Facetted Keratitis.—
Definition.— A chronic inflammation of the superficial layer
of the cornea causing opacity and the appearance of small
34
530 DISEASES OF THE CORNEA
facets occurring singly or multiple. This disease has been
observed quite often in certain breeds of dogs but is very
rare in cats and birds.
Etiology.— Nothing definite is known in regard to its
etiology. Dogs with prominent eyes are often affected.
It has been observed to accompany or follow rheumatic
affections. It may be due to injuries, infections, specific or
general, or exposure.
Symptoms.— Cloudiness of the cornea is the earliest symp-
tom. This is followed soon by small, opaque, white, gray
or yellow spots which penetrate into the parenchyma of the
cornea. Ulceration of one or more turbid areas may take
place causing small facets to appear. Injection of the
conjunctiva and scleral membranes is a prominent symptom
which may gradually disappear as the case becomes chronic.
Lacrimation and photophobia are frequently seen. Owing
to the disturbance of the cornea it will have a shagreened
appearance.
Prognosis and Course.— The course of the disease is chronic.
The symptoms may almost completely disappear only to
recur. Some cases show a tendency to become periodic.
The prognosis, therefore, should not be made too favorable.
Treatment.— Flush the cornea with boric acid (2 per cent.),
chinosol (1-500), or silver nitrate solution (j per cent.).
This should be followed immediately with a few drops of a
solution of succus cineraria maritima compositus (50 per
cent.). This treatment should be continued for several days
or weeks to obtain the best results. Some of the ophthalmic
ointments may be tried in obstinate cases.
Parenchymatous Keratitis.— Definition.— An inflammation
of the parenchyma of the cornea, characterized by a diffuse
infiltration of the interstitial tissue with a vascularization
of the sclera. It is accompanied in most cases by irido-
cyclitis. Parenchymatous keratitis is a very common
affection in dogs but rare in cats and birds.
Etiology.— Infection is an important factor. In dogs it
follows or accompanies distemper. It may be due to a
spread of inflammation from the iris (iritis), choroid (choroid-
itis), etc. Chronic eczema, mange, etc., when they affect the
KERATITIS 531
eyelids, ear, or adjacent parts, may be attended by it. Direct
injury to the cornea may be a cause.
Symptoms.— The cornea becomes turbid, gray or yellow.
The normal transparency is lost. The turbidity may not
extend over the entire cornea. Very' often a dulness of the
cornea is all that is noticed during the early stages of the
disease.
When the cornea is closely examined there will be found
small elevations over the epithelial layer, and a network of
fine bloodvessels radiating more or less evenly from the
periphery to the center. The bloodvessels are often so small
that a reading glass is necessary in order to see them. They
run parallel to each other and usually do not anastomose
but terminate in a small loop forming a zone entirely around
the corneal limbus. These new formed vessels become quite
extensive and involve the entire cornea- Lacrimation,
photophobia, pain, and congestion of the sclera are present.
When examined with an ophthalmoscope there will be evi-
dence of iritis and choroiditis.
Course.— The course is usually several days to a few weeks.
Abscess or ulceration of the cornea is a rare sequel.
Prognosis. — Owing to the changes that have taken place
in the cornea, it requires quite a long time to bring about
healing. The tendency to recur makes the prognosis rather
unfavorable. Permanent turbidity of the cornea may result
with partial or complete loss of sight.
Treatment.— During the early stages of the disease the
patient should be protected from strong light and everything
possible done to prevent irritation of the cornea.
( 'onstriction of the vessels and reduction of the irritation
are best brought about by applying to the cornea three or
four times daily codrenin solution (4 per cent.). This is
continued for two or three days. When there is evidence
of iritis or choroiditis atropin solution (^ per cent.) is of value
to prevent adhesions (posterior synechia).
If pus is present a mild, non-irritating antiseptic should be
used. Recommended are boric acid (2 per cent.), biniodid
of mercury (1-10,000). Codrenin solution may be added to
the above to constrict the bloodvessels and control the pain.
532 DISEASES OF THE CORNEA
When the condition becomes chronic silver preparations are
useful. An autogenic vaccine has been used with good
results and may be given every four or five days.
Give the patient plenty of good, nourishing food, occasional
laxatives, and small daily doses of potassium iodid (0.016-
0.032).
Keratitis Punctata Profunda. —Definition. —An inflamma-
tion of the deeper layer of the cornea appearing in the form
of multiple, small spots. It is more common in the horse and
dog than in other animals.
Etiology.— The cause has not been determined. It may be
produced by specific infection and inflammation spreading
from adjacent parts.
Symptoms.— Numerous small opacities or spots are noted
in the depths of the cornea. They are visible to the naked
eye, or are seen better with a reading glass, with oblique or
direct illumination. The spots are mostly circular, well
defined, evenly distributed, or more or less grouped. In
color they are usually white, occasionally darker. The rest
of the eye appears normal.
Prognosis. — Unfavorable.
Treatment. —No treatment is of avail.
Suppurative Keratitis.
Ulceration of the Cornea.— Definition.— A destruction of
the substance of the cornea, the result of infection with pus.
The ulcers vary in size, some are not larger than a pin point;
others involve a large part of the cornea.
Etiology.— The causes of ulceration are varied. Wounds
of the cornea, even though slight, form ports of entry for
infection. In small animals the cornea is frequently injured
by foreign Kodies which enter the lid sac, by being bitten or
scratched by other animals, or from an inversion of the
eyelashes.
The undue exposure of the cornea which accompanies
lagophthalmus, exophthalmus, and paralysis of the fifth
nerve is a predisposing cause. Ulceration of the cornea
accompanying or following infectious diseases, especially
KERATITIS 533
distemper of the dog and oat, is not infrequent. Purulent
infection of the conjunctiva (palpebral, scleral, corneal) may
lead to ulceration. The microorganisms most frequently
found are streptococci, staphylococci, pneumococci, and other
pyogenic germs.
The infection producing ulceration is no doubt in many
cases carried by the blood to the cornea, and by the lymph
into the cornea. Many diseases which reduce corneal
resistance predispose to ulceration, such as chronic constitu-
tional diseases, and some infectious diseases. In birds
suppuration of the lacrimal passages and conjunctiva leads
to ulceration as is frequently noted in epitheliosis. This
form commonly leads to perforation of the cornea.
Symptoms. — Corneal ulcers vary considerably in size, form
and depth. Any portion of the cornea may be the seat of
one or more of them. Jn most cases, however, ulcers are
found at or near the center of the cornea. In form they are
mostly round with well defined, sharp borders as if cut out
with a sharp instrument. In other cases their form is
irregular. The base of the ulcer may be flat, concave, or
convex; rough, vascular, or infiltrated. The cornea sur-
rounding the ulcer is usually turbid, and secondary ulcers
not uncommonly develop. Uleeration of the cornea accom-
panying dog distemper often occurs suddenly, tends to spread
rapidly and not infrequently leads to perforation in a few
days. Photophobia, lamination, and congestion of the
adjacent structures are nearly always present. Frequently
a copious discharge of pus occurs from the affected eye.
Pain may or may not be a prominent symptom, depending
upon the cause of the ulcer and to what extent other struc-
tures of the eye are involved.
Course.— The usual course is chronic. Some cases require
several weeks for complete disappearance. The ulcer may
disappear without trace, or it may lead to perforation, or
cicatrization and permanent opacity.
Prognosis.— Ulceration of the cornea is always serious.
Perforation, panophthalmitis, or opacity often follow it. Its
chronicity and tendency to recurrence make the prognosis
always guarded.
534 DISEASES OF THE CORNEA
Treatment.— Flush the corneal surface with a mild anti-
septic solution (boric acid, 2 per cent.; ichthyol, 2 per cent.).
If pain is present, drop into the eye a small amount of cocain,
stovain or alypin solution, to reduce the irritation and
prevent further injury by the patient rubbing or scratching
the affected eye. This treatment will control the general
infection preventing further spread of the ulcer. Where pus
formation is copious (blennorrhea) an autogenic vaccine
may be prepared and used in conjunction with the other
treatment.
Direct treatment of the ulcer requires judgment and care.
Careful curetting followed by applying protargol solution
(5 per cent.) is recommended. Good results have followed
the use of succus cineraria maritima compositus (50 per cent.).
When the ulcer shows a tendency to perforate an anti-
septic pack should be applied to the eye (eyelids closed),
and a head bandage to hold it in place. This will exert
outside pressure and may prevent perforation, permitting in
the meantime new formed granulation tissue to strengthen
the defect. Lead and silver solutions should not be used
too strong on account of the danger of permanent deposits
resulting. Treatment should be applied daily.
Abscess of the Cornea.— Definition.— A collection of pus in
the cornea. Corneal abscesses are very common in dogs.
Etiology.— Infection with pus organisms usually through
wounds or abrasions. Foreign bodies, bites and scratches
pave the way for an infection which results in abscess.
Corneal abscesses commonly result from distemper of the
dog and cat, and epitheliosis in birds.
Symptoms.— The first symptoms noted are discharge of
pus from the affected eye, photophobia, and a tendency to
rub the eye with the paws. On examination a yellow,
sharply defined abscess from the size of a pin-point to a wheat
grain or larger is noted near the center of the cornea. The
cornea surrounding the abscess may be transparent but is
often turbid. As the abscess ages new formed bloodvessels
are projected from the corneal bloodvessels across the cornea
to the abscess. Surrounding the abscess a bloodvessel
appears. If the abscess is large, or a number of small
FOREIGN BODIES AND WOUNDS OF THE CORNEA 535
abscesses are present, the curvature of the cornea becomes
stronger, sometimes cone-shaped. Conjunctivitis, conges-
tion of the episcleral bloodvessels, and profuse lacrimation
accompany the abscess.
Course.— Most cases require several weeks for complete
recovery. As a rule the abscess ruptures outwardly; occa-
sionally inwardly, discharging the pus into the anterior
chamber causing hypopyon and in some cases suppurative
panophthalmitis. Corneal ulcer may result from the abscess.
Prognosis.— On account of the danger of serious complica-
tions, the prognosis should be guarded. It is possible for
the corneal abscess to heal without trace.
Treatment.— To remove surface infection warm, antiseptic
solutions (boric acid, 2 per cent.; ichthyol, 3 per cent.) may
be used. Pain is controlled by cocain, stovain, alypin or
codrenin. The abscess may be opened under strict antiseptic
precautions and the cavity treated with protargol solution
(5 per cent.). Treatment should be made daily.
Keratitis Neuroparalytica.— Definition.— A rare affection in
animals due to a paralysis of nerves (trigeminal, ciliary) lead-
ing to undue exposure of the cornea. (See larger works.)
Keratitis from Lagophthalmus.— Definition.— An inflam-
mation of the cornea resulting from incomplete closing of the
eyelids. The portions of the cornea not protected by the
lid become dry, opaque, and ulcerated. Hypopyon, iritis
and panophthalmitis frequently result.
Treatment.— Besides keeping the parts lubricated with
glycerized antiseptics nothing can be done.
FOREIGN BODIES AND WOUNDS OF THE CORNEA.
Foreign bodies frequently enter the eyes of animals. Occa-
sionally they become imbedded producing usually infected
wounds of the cornea. Wounds also result from bites or
scratches of other animals.
Symptoms.— The symptoms of lacrimation, photophobia
and pain develop suddenly following the injury. The
examination of the eye should be made thorough, everting
the lids and nictating membrane, in order that foreign
bodies will not be overlooked.
53G DISEASES OF THE CORNEA
Prognosis.— Providing too much injury has not been
wrought by the offending foreign body, the prognosis is
favorable. In making the prognosis one should bear in mind
complications resulting from probable infection.
Treatment.— Flush the eye with mild antiseptic solutions
(boric acid, 2 per cent. ; ichthyol, 2 per cent. ; chinosol, 1-2000).
Foreign bodies must be removed. Further treatment will
depend upon the progress of the case. The affected eye
should be watched carefully and threatened complications
promptly treated. Some wounds require careful handling
in order to prevent perforation.
OPACITIES OF THE CORNEA.
Most opacities of the cornea result from inflammation.
Those resulting from other causes are very rare in animals.
The majority follow wounds, ulcers, irritant chemicals
instilled into the eye, or burns.
Depending upon their density, various terms have been
applied to opacities: (a) Nebula, a slight turbidity. The
cornea appears blue or slightly foggy. (6) Macula, a denser
opacity easily seen in ordinary light. It may be milk white.
(c) Albugo, a translucent opacity, (d) Leukoma, the entire
cornea becoming turbid, milk white. It may be either con-
genital or acquired.
Prognosis.— The prognosis depends upon the age of the
patient, duration, location, extent and character of the
opacity. The more recent the opacity, the more favorable
the prognosis. Superficial opacities are more readily removed
than deeper ones. However, the prognosis should be
guarded.
Treatment.— As most opacities of the cornea are composed
of cicatricial tissue complete removal of them is very difficult.
However, some of them will entirely disappear and the cornea
reassume its former transparency. The following agents are
recommended: Dionin solution (o to 10 per cent.), or in the
form of powder, has given excellent results. Begin with a
few drops of a 5 per cent, solutjon instilled two or three
times daily. The strength of the preparation may be
ECTASIA OF THE CORNEA 537
increased later if necessary. A severe reaction usually follows
the first treatments. This disappears later when the strength
of the solution can be increased. Red or yellow oxid of
mercury ointment has also been used with good results.
A small quantity is applied once daily. Silver nitrate
solution (4 per cent.), or protargol (10 per cent.) is used to
stimulate greater cellular activity in the region of the opacity.
Succus cineraria maritima compositus is also of value. To
obtain results treatment must be continued for a long time.
As a last resort, when medical treatment does not suffice,
iridectomy may be tried. The operation consists in making
an artificial pupil so situated that light may reach the
retina.
ECTASIA OF THE CORNEA.
Two types of ectasia are recognized: (a) Inflammatory
ectasia, and (b) non-inflammatory ectasia.
Inflammatory Ectasia. — Two forms occur in animals, viz.:
Staphyloma, and keratectasia.
Staphyloma.— Definition.— A protrusion of the cornea, the
result of inflammation (ulceration, perforation, prolapsus of
iris). Staphyloma may be partial or complete; in form
spherical or conical. In animals it is usually complete the
entire cornea protruding from the scleral margin. In color
it is blue or black due to cellular infiltration and pigment
deposit. The protrusion may interfere with the closing of
the lids. Lacrimation, photophobia and pain are prominent
symptoms. In the incomplete form (conical) only a portion
of the cornea protrudes.
7 'reatment.— Treatment is usually unsatisfactory. The
cause should be removed if possible. Apply gentle pressure
to the eye through antiseptic packs retained with a head
bandage. When the intra-ocular pressure is too great, some
of the fluid from the anterior chamber may be aspirated
before applying the pack. Permanent satisfactory results
can hardly be hoped for. When other treatment fails the
afl'ected eye should be enucleated.
Keratectasia. — Definition. — Keratectasia involves only the
cornea which has become weakened at some point either from
538 DISEASE* OF THE CORNEA
infiltration or from an ulcer which has not perforated its
entire thickness. In keratectasia the iris is not involved as
in staphyloma.
Treatment— Relieve the intra-ocular tension and apply a
compress. Iridectomy may be useful in some cases.
Non-inflammatory Ectasia.— Two forms are recognized:
Keratoconus, and keratoglobus.
Keratoconus.— A cone-shaped protrusion of the cornea
which does not become opaque. It results from a weakening
of the cornea at its center and an increase in intra-ocular
tension. The condition is incurable.
Keratoglobus.— The entire cornea is enlarged as the result
of a general increase in size of the entire eyeball. It is seen
in hydrophthalmus. The cornea retains its transparency.
The condition is usually congenital and most often observed
in young dogs and young cats.
Treatment.— No treatment is of any value.
TUMORS OF THE CORNEA.
Tumors of the cornea are rare in animals. Dermoids are
occasionally met with in dogs and cats. Sarcomas and
carcinomas have been noted. They usually originate either
in some other part of the eye or in adjacent tissues.
Treatment.— Surgical treatment should be attempted as
early as possible. No treatment should be attempted in
malignant tumors.
CHAPTER V.
DISEASES OF THE IRIS AND CILIARY BODY.
General.— In practice it is very difficult to separate the
diseases of the iris and ciliary body of which the iris is
practically an extension. The structure of the iris is much
the same in all animals. The arrangement of its muscular
fibers in different animals accounts for the variation in the
shape of the pupil. In the cat the pupil is an elongated
slit; in dogs it is spherical or oval.
The color of the iris is due to the quantity of pigme nt
present in the posterior layers and in the membrane proper.
Frequently the pigment is entirely absent producing the
albino or pink eye. This is common in rabbits and is
occasionally observed in other animals. The other colors,
such as blue, black or gray eyes, are determined by the
amount and distribution of the pigment. A more com-
plete examination of the iris can be made if a few drops of
eserin are instilled into the eye to contract the pupil. The
examination should be made for congenital defects, inflam-
mations, tumors, etc.
CONGENITAL DEFECTS OF THE IBIS.
A number of defects in the formation and development
of the iris has been observed: (a) Occlusion of the pupil,
occurring in the dog, cat and rabbit, causing congenital
blindness. (6) Ectopia pupillse, a displacement of the
pupil often found accompanying luxation of the lens, (c)
Toloboma, a portion of the iris failing causing a large,
irregular-shaped opening, (d) Aniridia, absence of the iris,
very unusual in animals. Treatment for these conditions
is unsatisfactory. The size and form of the pupil are
influenced by light, disease and medication.
540 DISEASES OF THE IRIS AND CILIARY BODY
MYDRIASIS.
Definition.— A dilatation of the pupil. It may be due to:
(a) Paralysis of the third nerve, (6) disease of the central
nervous system, (c) constitutional diseases, (rf) poisons, (e)
mydriatics.
Mydriasis is produced artificially in order to examine
the interior of the eye.
MYOSIS.
Definition.— A contraction of the pupil. It is caused by
paralysis of the cervical sympathetic nerves, tabes dorsalis,
inflammation of the iris, foreign bodies in the cornea and by
myotic drugs (morphin, codrenin, eserin). It is frequently
noted in rabkr"animals.
IRITIS AND CYCLITIS. IRIDOCYCLITIS.
Definition. — An inflammation of the iris and of the ciliary
body. They usually co-exist and will be therefore con-
sidered together (iridocyclitis).
Etiology.— Traumatism. A primary iridocyclitis is not
common. Most cases are secondary to other diseases,
such as distemper of the dog and cat.
Symptoms. — Iridocyclitis is characterized by congestion,
discoloration, loss of the normal striations and inability
of the iris to react to light or other stimulae. The pupil is
usually found contracted. While it is possible for the
iridian exudate to be very limited, the inflammation stopping
in the congestive stage, as a rule, it is profuse, falls off
the iris and accumulates in the anterior chamber (hypopyon
if purulent). The exudate, which is usually fibrinous, may
be seen through the cornea as a movable, yellow, sometimes
blood-streaked accumulation floating in the anterior cham-
ber. If an adhesion between the iris and the cornea results,
anterior synechia is spoken of; if between the iris and lens,
posterior synechia. Symptoms of lacrimation, photophobia
and congestion of the conjunctiva are usually present. The
cornea is nearly always involved, appearing as if lightly
greased over its surface. When the ciliary bodies are
CYSTS AND TUMORS OF THE IRIS 541
prominently involved a turbidity of the corneal margins is
noted. Exudate, which has passed through the pupil,
reaches the anterior chamber producing the same symptoms
as iridian exudate. The iris may be only slightly involved
as is determined by its color, striations and reaction to
light.
Course. —The course in iridocyclitis is usually short. The
inflammation rapidly subsides and the exudate is quickly
resorbed. A few cases become chronic and lead to posterior
synechia.
Prognosis.— In uncomplicated cases the prognosis is favor-
able. When the choroid or retina is involved the prognosis
is guarded.
Treatment. —When secondary to constitutional diseases,
distemper, etc., these should receive attention. Local
treatment consists in instilling atropin solution (0.5 to 1
per cent.) once or twice daily, which paralyzes the accom-
modation, relieves pain and congestion and prevents adhe-
sions. Dionin solution (4 per cent.) is also useful to stimulate
the lymph circulation. Hot applications in the form of a
hot-water compress are of great service. They should be
applied for an hour at a time during the first twenty-four
to thirty-six hours. Antiseptic and astringent solutions,
such as succus cineraria maritima compositus (50 per cent.),
or ichthyol (4 per cent.) may also be used. Complications
should be treated as they arise.
CYSTS AND TUMORS OF THE IRIS.
Cysts involving the iris are quite rare. They most often
result from injury and appear as enlargements on the iris.
It is difficult to distinguish between cysts and tumors.
They are treated by puncturing, under antiseptic precau-
tions, with a knife needle inserted through the corneal
margin.
Both benign and malignant tumors may involve the iris.
Melanoma is the most frequent primary tumor. Sarcomas
and carcinomas also occur. They usually extend from
adjacent structures which are their primary seats. Treat-
ment consists in enucleating the eyeball.
CHAPTER VI.
DISEASES OF THE LENS.
Examination. —The lens is best examined after dilating
the pupil with atropin. The patient should be placed in
a good light or light may be reflected with an ophthalmo-
scope against the lens. Normally the lens is transparent.
It should be examined for turbidity, position and form.
In old dogs the lens is usually less transparent than in
younger animals.
CATARACT.
Definition.— An opacity of the lens, its capsule or both.
Cataract is common in the dog and cat, especially in old
animals. The following kinds occur: (a) Symptomatic,
(6) traumatic, (c) senile, (d) diabetic, (e) congenital.
Symptomatic Cataract.— This form results from an inflam-
mation of some of the adjacent structures which interferes
with the nutrition of the lens. In the dog and cat it often
develops from distemper.
Traumatic Cataract.— Traumatic cataract is caused by
injury to the lens by sharp objects which penetrate the
cornea. Or it may be due to indirect injury, the animal
receiving a blow which jars the lens from its fastenings. It
may, therefore, result from fracture of the orbit or some of
the other bones of the head.
Senile Cataract.— Common in old dogs. It is due to an
atrophy of the lens and is usually bilateral. In the early
stages senile cataract usually appears as radiating, gray
lines which extend from the periphery to the center of the
lens. In other cases it may occur as an opaque spot or
spots in the lens. The opacity spreads until eventually the
entire lens is involved.
CATARACT 543
Diabetic Cataract.— Very rare in animals. A few cases have
been noted in dogs.
Congenital Cataract.— Quite common in young dogs. As
a rule, the lens only is involved. It is often bilateral. • It
may be partial or complete.
Symptoms.— General.— In animals cataract is usually over-
looked until it becomes so well marked as to be visible to the
ordinary observer. Partial cases are sometimes discovered
during an examination of the eye for some other disease. In
using the ophthalmoscope in cataract the light should not be
too strong. Under subdued light the opacity appears as a dark
spot, its color differentiating it from the tapetum lucidum or
the red papilla. Cataract should be distinguished from foreign
bodies on the cornea, corneal opacities and turbidity of the
vitreous humor. In most cases a careful examination with
an ophthalmoscope will suffice to differentiate between lens
opacities and those in other parts of the eye. When the
diagnosis cataract has been made, the form and cause
should be determined whenever possible. The history of
the case, the age and condition of the patient, and the
appearance of the opacity are indicative.
Course.— The course in cataract is chronic, usually lead-
ing to complete loss of vision. Occasionally a traumatic
cataract develops rapidly and undergoes a spontaneous
recovery within a short time. Such cases are rare.
Prognosis.— The prognosis is unfavorable.
Treatment.— The only treatment of value is an opera-
tion to remove the lens. In veterinary practice the diffi-
culty in keeping the parts aseptic, the dressings in place
and the patient- quiet, is so great that cataract operations
are seldom employed. There are two operations for cata-
ract: (a) A discission of the lens, and (6) extraction of the
lens.
Discission. — Discission is practised only in congenital
cataract, or when cataract appears early in life, is soft and
capable of absorption. The operation is performed under
complete anesthesia and strict asepsis. The eye to be
operated is flushed out with an antiseptic solution (boric
acid, 2 per cent.; bichlorid of mercury, l-5000)s followed
544 DISEASES OF THE LENS
by a solution of atropin (1 per cent.) to dilate the pupil.
The lids are held open with an eye speculum. With a
special instrument, a small knife-needle, which is passed
through the cornea at its margin and pushed diagonally
through the lens capsule into the lens proper, the lens is
cut and separated. The instrument is then withdrawn
carefully so as to avoid injury to the cornea. An absorp-
tion of the lens should follow. If not, the operation may be
repeated in a few weeks.
Complications, such as swelling of the lens and increased
intra-ocular tension with severe pain, may follow the opera-
tion. Cold packs are recommended to reduce the swelling.
If they afford no relief within a short time the cornea may
be punctured at its margin which relieves the tension.
Through the same opening the lens substance may be
removed. If iritis result from particles of the lens coming
in contact with the iris, instil atropin solution and apply
hot packs.
Extraction. — The lens is extracted in all cases when the
discission operation is contra-indicated. The technic of
the operation is rather difficult and requires much practice.
It consists briefly in incising the cornea in the sclerocorneal
limbus, fixing the eyeball with a special fixation forceps,
incising the capsule of the lens, and expressing the lens.
The eye should be cleansed and a dressing applied. Many
complications may follow the operation in animals:
Panophthalmitis, prolapse of the iris; iritis and cyclitis in
a small percentage of cases. Proper and careful dressing of
the wound after the operation is especially important.
LUXATION OF THE LENS.
Luxation is not very frequent in small animals. In most
instances it results from traumatism. It may be due to
extreme intra-ocular tension in either chamber of the eye,
or from rupture of the suspensory ligaments of the lens.
The luxation may be partial or complete; into the anterior
or posterior chamber.
Treatment.— Treatment is of no value. A removal of the
lens is occasionally employed.
CHAPTER VII.
DISEASES OF THE RETINA AND CHOROID.
THESE membranes can be seen only with the ophthalmo-
scope. It is best to dilate the pupil in order to increase
the size of the field of the eye's background.
The following pathological changes may be noted on the
retina: (a) Hyperemia, (6) edema, (c) inflammation (retin-
itis), (d) detachment of the retina, (e) anemia, (/) atrophy.
Hyperemia. — A congestion of the retina. The blood-
vessels will be found dilated and engorged with blood.
Edema.— Rare in animals. It may result from direct
injury, or inflammatory exudate which collects in the retina.
The retina appears cloudy.
Inflammation (Retinitis).—A.n inflammation of the retina.
It usually develops during or as a sequel to infectious or
chronic constitutional diseases. It is characterized by hyper-
emia, edema, partial or complete obliteration of the papilla
and hemorrhage.
Detachment of the Retina.-— Rare in animals. It may result
from an accumulation of exudate or transudate between
the retina and choroid, which causes the retina to become
detached and float loose in the vitreous humor. It causes
partial or complete blindness.
Anemia.— Retinal anemia usually results from general
hemorrhage; obviously it accompanies general anemia. It
may have a local origin, the bloodvessels supplying the
retina becoming blocked and pressed upon by tumors or
inflammatory growths. The retina appears pale and the
bloodvessels reduced in size.
Atrophy,— Usually follows extensive and severe retinitis;
or when the nutrition of the retina has become reduced.
The bloodvessels appear unusually small; in some cases
hardly visible.
The diseases of the choroid are so intimately interwoven
with those of the other membranes that a separate descrip-
tion is unnecessary.
35
CHAPTER VIII.
DISEASES OF THE OPTIC NERVE.
USUALLY when the optic nerve is affected diseases of
other structures, particularly of the retina, co-exist.
The principal pathological changes affecting the optic
nerve are: (a) Wounds, (6) hemorrhages, (c) inflammation,
(d) tumors.
The optic nerve is also affected by inflammation of adja-
cent structures, and diseases of the central nervous system.
The diseases of the optic nerve usually noted are: (a)
Papillitis, (6) retrobulbar neuritis, (c) atrophy. Clinically
amblyopia and amaurosis are recognized.
PAPILLITIS.
Definition.— An inflammation of the papilla. It may be
unilateral or bilateral. It is usually caused by poisons,
traumatism and diseases of the central nervous system.
Viewed with the ophthalmoscope the papilla appears either
enlarged and engorged with blood or, on the other hand, too
pale— even white in color. Its outline is usually indistinct
and striations are seen radiating from its center. When
due to tumors and marked congestion is present, the papilla
appears intensely red ("choked disk").
Prognosis.— The prognosis is unfavorable. Partial or com-
plete blindness will usually result.
RETROBULBAR NEURITIS.
Definition. —An inflammation of the optic nerve just
posterior to its entrance into the eyeball. It may result
from injuries, infection through wounds involving the
orbit; or attend nasal catarrh, or dog distemper which has
AMAUROSIS 547
attacked the sinuses of the head. The patient is partially
or totally blind. The papilla will appear congested. Many
cases will recover when the cause is removed.
ATROPHY OF THE OPTIC NERVE.
Definition. — It may result from inflammation or be a simple
atrophy. Blindness is a prominent symptom.
Prognosis.— The prognosis is unfavorable.
AMBLYOPIA.
Definition. — Partial blindness. No lesion can be deter-
mined. In animals it usually results from poisoning. As a
rule when the cause is removed sight is restored.
AMAUROSIS.
Definition. — Blindness without visible lesion of the eye.
Amaurosis is a symptom and not a disease. The term is
falling into disuse as ophthahnoscopy becomes better
developed. It may be congenital or acquired. Diseases
of the optic nerve, retina, brain and certain poisons are its
principal causes. The symptoms are blindness, abnormal
dilatation of the pupil which does not react to light. In
the early stages the eye appears normal but in time the
globe becomes atrophic. Ophthalmoscopic examination may
be negative, although usually changes can be noted on the
retina or papilla. There is no treatment of value. Cases
due to poisons may recover.
CHAPTER IX.
DISEASES OF THE GLOBE AND ORBIT.
INJURIES to the eyeball are very common. They occur
as wounds, lacerations and contusions. Sometimes the
eyeball is ruptured. Diseases involving the globe and
orbit are also frequent. The following are the most impor-
tant: (a) Panophthalmitis, (b) glaucoma, (c) hydrophthal-
mus, (d) exophthalmus, (e) luxation of the eyeball, (/)
enophthalmus, (g) strabismus, (h) nystagmus, (i) parasites,
0) fracture of the orbit, (k) inflammation of the orbit, (I)
tumors of the orbit.
PANOPHTHALMITIS .
Definition.— An inflammation of the entire eyeball. It is
usually due to injury with infection, or may develop during
the course of infectious diseases, the infection being carried
to the eye by the blood or lymph.
Symptoms.— The initial symptoms will vary, depending
upon whether the infection enters through wounds (exo-
genetic) or is carried by the blood or lymph (endogenic).
When panophthalmitis begins in the posterior part of the
eye it may escape attention until the anterior portion is
involved. In cases of exogenetic origin usually a wound
through the cornea or sclera is found out of which pus
discharges. In endogenic infection a general congestion of
the eyeball is an early symptom. As the disease progresses
perforation usually through the cornea with prolapsus of the
iris and sometimes the lens follows. As a rule, the eyeball
is destroyed.
Diagnosis.- Panophthalmitis should be differentiated from
phleginonous conjunctivitis and inflammation of other
GLAUCOMA 549
parts of the eye. These sometimes present symptoms con-
fusingly like it. The eye should be carefully examined to
avoid error in this regard. Should a perforating wound be
found the diagnosis is simplified.
Prognosis. — Unfavorable. Almost every case leads to
destruction of the eyeball.
Treatment.— An effort should be made to arrest the spread
of the infection. Obviously as the deeper structures are
involved this is difficult to accomplish. The eye should
be flushed with warm antiseptic solutions (boric acid, 2 per
cent.; ichthyol, 3 per cent). Subconjunctival injections of
1-2 c.c. of a solution of cyanide of mercury (0.5 per cent.)
are recommended. Suppurating wounds should be drained
and flushed out. Usually enucleation of the eyeball becomes
necessary.
GLAUCOMA.
Definition.— A term applied to a number of diseases of
the eye marked by intense intra-ocular tension, atrophy
of the papilla and blindness. It is rare in animals. It
is supposed to be due to some disturbance in the lymph
or blood circulation of the eyeball which may be congenital
or acquired.
Symptoms. — Glaucoma develops gradually without signs
of inflammation and with little evidence of pain. The early
stages are often overlooked. As the disease progresses the
pupil dilates and a marked hardness of the eyeball develops
due to increased intra-ocular pressure. The cornea may be
clear or cloudy. With the ophthalmoscope the optic nerve
appears cupped. The vision is gradually destroyed. In
some cases (inflammatory glaucoma) acute inflammatory
symptoms suddenly develop.
Prognosis. — Bad.
Treatment.— Eserin or pilocarpin should be tried; if
unsuccessful relieve the intra-ocular pressure by paracentesis
of the anterior chamber of the eye. The results are usually
unsatisfactorv.
550 DISEASES OF THE GLOBE AND ORBIT
HYDROPHTH ALMUS .
Definition.— An enlargement of the eyeball in all its dimen-
sions. It is common in pups and kittens. Hydrophthalmus
develops slowly, the eyeball enlarging, the curvature of
the cornea becoming weaker, the pupil dilated, intraocular
pressure increased, and the papilla cupped. The condition
is usually congenital.
Treatment.— Eserin and pilocarpin are recommended, but
they do little good. Paracentesis of the anterior chamber will
relieve intraocular pressure as in glaucoma. Iridectomy may
be tried.
EXOPHTH ALMUS.
Definition.— An abnormal protrusion of the eyeball. It
should not be confused with normally prominent eyeballs of
some breeds of dogs.
Etiology. — Fracture of the orbital arch, the displaced bones
forcing the eyeball outward; edema, abscess or hematoma
in the postbulbar tissue; retrobulbary cellulitis; intra-orbital
tumors; tuberculous growths in the orbit. Exophthalmus is
a prominent symptom of exophthalmic goiter in dogs.
Symptoms. — One or both eyes appear unduly prominent.
As the eyelids do not entirely cover the eye the surface of
the cornea becomes dry and ulcerated.
Prognosis.— The prognosis should be guarded.
Treatment.— Treatment is only successful when the cause
can be removed. Tumors should be operated, enlarged
thyroids removed and the affected eyeball protected.
LUXATION OF THE EYEBALL.
Common in the dog and cat. Dogs with prominent
eyes are predisposed. It results from injury, fighting,
becoming caught in doors, etc.
Prognosis. — The prognosis will depend upon how long
the eye has been prolapsed, the degree of injury to the optic
nerve and to the eyeball.
Treatment.— The patient should be anesthetized and the
prolapsed eye flushed with a warm antiseptic solution
ENOPHTHALMUS 551
(boric acid, 2 per cent.). Try replacement by picking
up the eyelids, retracting them as much as possible, at
the same time gently but firmly pressing the eyeball back
into its socket. It may be necessary to enlarge the palpe-
bral slit by cutting the outer canthus. After replacement
two or three stitches will retain the eyeball in position.
The after-treatment consists in fomenting the eye with
warm water and keeping it lubricated with dilute glycerin
or liquid vaselin. Should panophthalmitis or hydrophthal-
mitis develop, or the luxation reappear, enucleation of the
eyeball should be practised. The operation is as follows:
The patient should be given a general anesthetic and the
eyeball thoroughly washed with an antiseptic. The lids
are held apart by a retractor, or with dressing forceps
held by an assistant. Make an incision through the con-
junctiva at the corneal margin, dissect back to the muscles,
cutting them off close to their attachment to the eyeball.
Keep as close to the eyeball as possible. When all of the
muscles have been cut away pull the eyeball downward and
excise the optic nerve. Control hemorrhage, pack the
socket with sterile gauze, or iodoform gauze, put retaining
sutures in the lids, and cover the whole with an antiseptic
pack held in place with a head bandage. In twenty-four
hours remove the pack and treat with antiseptic dusting
powder. Healing is usually prompt.
ENOPHTHALMUS.
Definition.— An abnormal sinking of the eyeball into the
orbit. It is rare in animals.
Etiology.— It may be congenital. Most cases, however,
are acquired and due to an atrophy of the retrobulbar fat
cushion, general emaciation, spasms of the muscles of the
eye.
Symptoms.— The eyeball appears retracted intp its socket.
It should be distinguished from normal eyes which are
unusually small. The general condition of the patient
suffices for differentiation.
552 DISEASES OF THE GLOBE AND ORBIT
Prognosis. —Depends upon the cause.
Treatment.— Determine the cause and eliminate it by
proper treatment.
STRABISMUS.
Definition.— A deviation of one of the eyes from its normal
direction so that the visual axes cannot be focussed simul-
taneously on the same objective point.
Etiology.— It may be due to a mechanical interference
with the movement and position of the eyeball, paralysis of
the muscles of the eye, intracranial paralysis, spasms of the
eye muscles, cerebral hemorrhage, and poisoning.
Diagnosis.— The diagnosis is not difficult. One eye will
be turned inward or outward while the fellow one is directed
straight ahead.
Treatment.— A palliative treatment consists in applying
a counterirritant to the region of the orbit and administering
internally small doses of iodid of potash. A radical treat-
ment is to perform a tenotomy, severing one of the tendons
of the eye muscle at its insertion into the sclera. The
particular tendon to be divided is determined by the indi-
vidual case. If the strabismus is convergent the internal
rectus is cut; if divergent, the external. The operation is
briefly as follows: Give a general anesthetic. Flush the
eye with antiseptics and follow by a solution of codrenin to
control the hemorrhage. Cut through the conjunctiva and
carefully dissect down to the tendon which grasp with a
blunt hook, pull forward and cut oft' with a scissors. Unless
the tendon is entirely severed the results will not be satis-
factory. The wound in the conjunctiva may be left open.
Flush out daily with antiseptic solution.
NYSTAGMUS.
Definition.— A continuous rolling movement of the eye-
ball. It occurs occasionally in dogs. It very often accom-
panies epilepsy, convulsions, parasitic invasion of the ear,
catarrh of the ear and sometimes accompanies chloroform
narcosis.
TUMORS OF THE OK BIT 553
Treatment.— No treatment beyond rectifying the primary
condition of which it is a symptom is recommended.
PARASITES OF THE EYE.
Lice (pediculi) are often found on the margins of the
lids and on the skin over the orbital region. Mange mites
also invade the lids. The demodex mite may enter the
Meibomian glands, conjunctiva and lacrimal apparatus.
The Filaria oculi canini is occasionally found, and spiroptera
have been noted in the eyes of birds.
FRACTURE OF THE ORBIT.
Common in animals. Careful palpation will reveal
crepitation.
Treatment.— Treatment should follow the general principles
of surgery. Possible injury to the eyeball demands first
consideration.
INFLAMMATION OF THE ORBIT.
Usually results from traumatism. Due to the abundance
of fat, inflammation of the orbit spreads rapidly and always
endangers the optic nerve and eyeball. It is usually diffi-
cult to obtain proper drainage or to apply antiseptics to
stop the progress of the inflammation. An attempt should
be made, however, to secure drainage and keep the parts
clean.
TUMORS OF THE ORBIT.
Infrequent. Sarcomas, carcinomas, epitheliomas and oste-
omas have been noted in this region. It is usually necessary
to enucleate the eyeball in order to remove them. Malig-
nant tumors are apt to recur.
PART XIII.
HERNIA.
Definition.— The term hernia is applied to a protrusion of a
portion of the abdominal contents through a normal or an
abnormal opening in the abdominal wall. The larger number
of hernias is found under the skin, the smaller through the
diaphragm.
Occurrence.— Hernia is very frequent in the dog but rather
rare in other small animals.
General Remarks.— Hernia may consist of a portion of the
bowel (enterocele), a section of the omentum (epiplocele), or
a combination of both (entero-epiplocele) ; further, a portion
of the uterus may be protruded (metrocele), or the uterus and
its ligamentous attachments (metro-mesometrocele) . Some
of the other organs are occasionally found in the hernial sac,
such as the liver (hepatocele), etc. In the dog it is possible
to find almost any one of the organs of the abdominal cavity
present in the hernial sac. The number and forms of hernia
are quite varied.
The following parts are distinguished in a hernia: (a)
Hernial sac, (b) hernial ring, (c) hernial contents.
(a) The hernial sac consists of the skin, subcutaneous
cellular tissues, and in most cases the peritoneum. Some-
times the peritoneum is ruptured and when this occurs the
skin and subcutaneous tissues constitute the hernial sac.
(6) The hernial ring is the opening through which the
contents pass from the abdominal cavity. In recent hernias
the ring is made up of the margins of the muscular tissue, and
its size is determined by the rent in the abdominal wall. In
556 HERNIA
old cases connective tissue elements form around the margins
which results in a distinct, firm ring. Palpation of a hernia
will often reveal a well defined, firm enlargement which will
serve to differentiate recent from long standing cases.
(c) The contents of a hernia are quite varied and will
depend somewhat on its location. In most cases they consist
of a portion of bowel, or omentum, or both. In a smaller
number a portion of one of the other abdominal organs is
present, such as the liver, stomach, spleen, uterus or bladder.
When the contents fluctuate on palpation it may be due to the
fluid content in the loop of bowel, or to serum which accumu-
lates from a venous stagnation of the imprisoned contents.
From a practical standpoint it is important to classify
hernias into: (a) Reducible, and (6) irreducible.
(a) Reducible hernias are those in which the contents can
be readily replaced in the abdominal cavity. This may be
done by manipulation, or is often accomplished by changing
the position of the patient. Such hernias present certain
characteristic symptoms: They are enlargements, usually
appearing on some portion of the abdominal wall, non-inflam-
matory (usually), easily replaced in the cavity, and the ring
readily distinguished. It is possible in many cases to
determine the character of the hernial contents by palpation.
Adhesions will take place in some cases between the hernial
sac and its contents which will interfere with complete reduc-
tion of the enlargement. In this case, as soon as pressure is
removed from the outside, the hernial contents will again
reappear in the sac. Practically all reducible hernias return
unless outside pressure is maintained.
(6) Irreducible hernias are those which cannot be returned
by manipulation to the abdominal cavity. This condition
may be brought about by adhesions between the different
parts of the hernia, by swelling around the hernial ring, or by
strangulation with subsequent swelling of the hernial con-
tents. When a loop of bowel is present in the hernial sac-
strangulation frequently occurs from fecal matter accumu-
lating and distending the prolapsed bowel. It is very impor-
tant to distinguish between strangulated and non-strangu-
lated hernias. The differentiation is made very definitely
UMBILICAL HERNIA 557
by the symptoms shown by the patient and the local examina-
tion of the hernia. Marked symptoms of pain, vomiting,
and local inflammation indicate strangulation. During the
secondary stages of its development the hernial sac becomes
cold, doughy, and non-sensitive to the touch. Fecal fistulse
(intestinal fistulse) occur in some cases from a sloughing of
a portion of the intestine.
Forms.— The following are the most common hernias found
in small animals: (a) Umbilical, (6) ventral, (c) inguinal,
(>/) femoral, (e) diaphragmatic, and (/) perineal.
Umbilical Hernia.— Etiology.— This form occurs either
congenitally (usual) or a short time after birth. The hernial
ring is formed by an improper closure of the umbilicus, or the
fibrous organization being of insufficient strength allowing
the abdominal contents to pass through. Occasionally
umbilical hernia occurs accidentally in which case the peri-
toneum forms the inner portion of the hernial sac.
The hernial contents may consist of omentum, small or
large intestines, or both. In most cases in puppies the sac
contains only omentum.
Symptoms.— The presence of an enlargement at the umbili-
cus which may be soft or firm, depending on the contents and
local conditions. In most cases the contents can be readily
returned to the abdominal cavity. Occasionally adhesions
are present which prevent this. Strangulation is very rare
in this hernia.
Treatment. — In puppies many cases disappear sponta-
neously. Several methods of procedure in treatment have
been recommended:
(a) Pressure bandage, or adhesive tape, applied over the
part for a few days has proved satisfactory in many cases.
This method keeps the contents in the cavity, allowing time
for fibrous -tissue organization to close the ring.
(6) Operation. — When adhesions are present or the ring is
of considerable size, it is advisable to perform herniotomy.
The animal is anesthetized, placed in a dorsal position on the
table, the hair removed from the area and painted with
tincture of iodin. An incision is made through the skin of
sufficient length, dissecting the hernial contents from the
558 HERNIA
adjacent tissues, if necessary, carefully so as to avoid injuring
the bowel. Return the contents to the abdominal cavity.
Remove a small portion of the hernial ring on either side
making a fresh wound surface to facilitate union of the
parts. Suture the wound and apply after-treatment as in
laparotomy (see Laparotomy).
Ventral Hernia.— Definition.— Ventral hernia is a term
applied to a subcutaneous rupture of the abdominal muscles
which permits the abdominal contents to pass through.
This may occur at any point in the abdominal walls. The
hernial sac consists of the peritoneum, subcutaneous tissue
and the skin in the majority of cases. Sometimes the peri-
toneum is also ruptured allowing the contents to lie immedi-
ately under the skin.
Etiology.— The cause of ventral hernia is usually traumatic,
or intra-abdominal pressure. In some instances when
incomplete union of the abdominal muscles takes place
following surgical operations, a hernia will develop.
Symptoms.— The sudden development of an enlargement
appearing at some point in the abdominal wall. The size of
the hernia will depend upon the extent of the rent in the
abdominal muscles. Palpation of the enlargement will
reveal a soft, fluctuating or elastic mass which can be reduced
in most cases except when strangulated. When reduction is
brought about the opening through the abdominal muscles
can be easily determined and the margins of the hernial ring
felt. Changing the position of the patient will bring about
reduction except when adhesions are present or the parts
strangulated. Unless the hernia is very recent or strangu-
lated, there will be no inflammation nor pain present on
manipulation. It is necessary to differentiate recent hernia
from abscess. This can be done by careful palpation or by
explorative operation. Some difficulty will be experienced
in distinguishing between incarcerated hernia and tumors.
However, the consistency, location and an explorative opera-
tion if necessary, will serve to make the distinction. A
strangulated ventral hernia will be characterized by symp-
toms of inflammation, doughy consistency, pain on palpation
and the general reaction of the patient.
VENTRAL HERNIA 559
Treatment.— After the examination has been made carefully
to determine the exact conditions, then it is possible to decide
on the method of procedure. Treatment in ventral hernia
should be operative. There is very little danger providing
the usual precautions are observed in opening the abdominal
cavity.
In ventral hernia without strangulation or incarceration
the operation is performed as follows: The animal is given a
laxative and fasted for twenty-four hours. The field of
operation is shaved and an antiseptic pack applied for the
same period. The animal is then given an anesthetic,
preferably morphin, placed on the operating table in an
advantageous position, the pack removed and the surface
painted with tincture of iodin. A longitudinal incision is
made immediately over the hernia through the skin and
parallel to the rent in the abdominal wall. The hernial
contents are returned to the abdominal cavity. It is
advisable to open the hernial sac in order to determine the
condition of the hernial contents. When they are found
normal and no evidence of injury to the structures the hernial
sac can be trimmed off with the scissors and the rent in the
abdominal wall sutured. If the hernial ring indicates fibrous
tissue formation, it is advisable to trim off the margins with
a scissors or knife to produce a fresh wound surface for
approximation. The abdominal wound is then closed as in
laparotomy (see Laparotomy).
In strangulated ventral hernia treatment should be
attempted as early as possible. The same precautions should
be observed as above and the contents examined to deter-
mine the cause of the strangulation and the condition of the
contents of the hernial sac. If the strangulation is produced
by a constricted ring it should be enlarged with a probe-
pointed knife sufficiently to allow the contents to be returned
to the abdominal cavity. The wound in the wall is closed
in the usual manner. If the hernial contents have been
strangulated and retained until gangrenous then proper
treatment should be employed. A section of bowel or omen-
turn may be removed without difficulty and successfully
when properly done. Adhesions when present should be
560 HERNIA
carefully broken down to allow the contents to be returned.
Some of these cases may present special problems, and there-
fore a careful examination of the contents should always be
made. The after-treatment would consist of keeping an
antiseptic pack in contact with the wound for a few days
until union takes place. There is a possibility of a recurrence
of the condition if union of the abdominal wall is incomplete.
Reoperation is recommended when this occurs.
Inguinal Hernia.— It is necessary to divide this form of
hernia into two classes on account of the anatomical differ-
ences in the female and male animal: 1. Inguinal hernia in
the female, and 2. inguinal and scrotal hernia in the male.
1. Inguinal Hernia in the "Female.— Etiology.— A. very
common form of hernia. The inguinal canal in the female
is very short and the diameter usually greater than in the
male animal. During pregnancy considerable strain is
thrown upon these structures resulting in a hernia. It may
result also from increased intra-abdominal pressure, from
ascites, distention of the organs, or hypertrophy. Congenital
inguinal hernia in the female has been observed. •
The hernial contents consist of the round ligament with
peritoneum, or one or both cornua of the uterus. In a
smaller number of cases other abdominal organs may be
present.
Symptoms. —An enlargement appearing just posterior to the
inguinal mammae* It varies in size from a small, rounded
mass to one of sufficient proportions to reach the ground.
The consistency of the hernia will depend on its contents,
sometimes fluctuating, at other times firm. When the
animal is pregnant the fetuses may be palpated in the hernial
sac. The contents, if no adhesions are present, may be
easily pushed back into the abdominal cavity and the hernial
ring distinctly felt. Placing the dog in a dorsal position
with the hind limbs elevated often will effect replacement.
Further, there is no symptom of inflammation and the parts
are non-sensitive on palpation. All enlargements appearing
in this location should be examined from the standpoint of
hernia as it is not always possible to reduce them and palpate
the ring.
INGUINAL AND SCROTAL HERNIA IN THE MALE 56,1
Treatment. —Operation is advised in all cases. Herniotomy
is performed in the following manner: The animal should be
properly prepared by fasting and administration of a laxative
twenty-four hours in advance. The operative field should be
shaved and disinfected. Make an incision longitudinally
over the enlargement through the skin and hernial sac. If
no adhesions are present and the contents capable of being
replaced this should be done at once. If adhesions are
present preventing reduction they must be carefully broken
down when the contents will return easily. Sometimes the
bladder is encountered considerably distended with urine.
If this is the case, introduce a trocar and draw off the urine
which facilitates replacement. When the gravid uterus is
found in the sac it will be necessary to remove the fetuses
in the usual manner and return the cornua to the abdominal
cavity. After reduction has been brought about the hernial
sac should be ligated as close to the cavity as possible and
removed, pushing the stump into the cavity. Suture the
ring by inserting the sutures close together, keeping away
from the pudic veins. The extra skin which will be present
should be properly trimmed off with the scissors and sutured.
An antiseptic pack is applied, renewed daily, and kept in
position until union is complete. The external sutures
should be removed when the wound is healed.
2. Inguinal and Scrotal Hernia in the Male.— Etiology.—
Inguinal hernia is not as common in the male animal although
it is met with occasionally. Dilatation of the inguinal canal
from any cause will allow the intestines or omentum to pass
through carrying a portion of the peritoneum with it forming
an inguinal hernia.
Scrotal hernia is far more common in the male animal.
The hernial sac is formed by the processus vaginalis, and the
•contents consist of omentum or a loop of bowel protruding
out into the scrotum in contact with the testicle. The
hernia may be unilateral or bilateral.
Symptoms.— Inguma.1 hernia is characterized by an en-
largement appearing to one side of the penis. It is usually
soft, fluctuating, and reducible. The ring can be palpated
in most cases, Occasionally some difficulty in diagnosis
36
562 HERNIA
might be met with when adhesions are present. Explorative
operation would be recommended. Scrotal hernia is recog-
nized as an elongated enlargement in the scrotum. Palpa-
tion will usually reveal the dilated canal and the contents
can be easily returned to the abdominal cavity. Holding
the animal up by the hind limbs often effects replacement.
Differentiation should be made from other scrotal enlarge-
ments. As a rule no particular difficulty will be encountered.
Treatment. — In inguinal hernia the operation would be
practically the same as in the female. The same care should
be exercised to avoid complications.
Scrotal hernia may be operated in two wray s : (a) Inguinal
operation, and (6) scrotal operation.
(a) Inguinal Operation. — Prepare the dog the same as in
the female. Make an incision through the skin over the
inguinal canal down upon the internal ring. Open the
processus vaginalis and pull the bowel or omentum back into
the abdominal cavity. Suture the internal ring but allow
sufficient room for the spermatic cord and vessels. A certain
amount of swelling will take place after the operation which
should be considered when applying the sutures. This
operation is especially advised when the male is to be kept in
the stud.
(6) Scrotal Operation.— This operation is performed by
opening the scrotum, removing the testicle, returning the
omentum or bowel to the abdominal cavity, and suturing
the external ring. Retaining sutures should be placed in the
scrotum for a few days to avoid prolapsus of the bowel in
case the other sutures tear out.
Femoral Hernia. —This form of hernia is not common in
small animals. It has been observed in a few instances. It
consists in a portion of the viscera, in most cases intestine
with peritoneum, which passes through the femoral canal in
close proximity to the femoral vessels.
Symptoms.— A soft enlargement is found on the inner part
of the thigh which interferes with bringing the limb forward
producing lameness. Unless strangulated there are no
inflammatory symptoms. Any enlargement in this location
should be suspected of being a femoral hernia.
PEIUNEAL HERNIA 503
Treatment. — It is possible to reduce femoral hernia by the
usual hernia operation but care should be taken to avoid
the large vessels in the immediate vicinity.
Diaphragmatic Hernia.— Definition.— A hernia taking place
through the diaphragm. It may be either congenital or
acquired. This hernia is characterized by the passage of a
portion of the abdominal viscera into the thoracic cavity
either with or without the peritoneum.
Etiology.— Most cases of acquired diaphragmatic hernia
occur as a result of violence in which the diaphragm ruptures
allowing abdominal viscera to pass through the rent. Stran-
gulation is rare.
Symptoms.— No symptoms are observed in most cases of
congenital diaphragmatic hernia. In the acquired form the
symptoms come on suddenly and consist of severe dyspnea,
restlessness, pain, etc. The patient as a rule does not live
but a short time. A few cases have been observed where the
patients lived for several months showing dyspnea and
marked circulatory disturbance. A diagnosis is in most cases
difficult.
Treatment. — Xo treatment can be given.
Perineal Hernia.— Definition.— A hernia appearing in both
males and females and characterized by an enlargement on
one or both sides of the anus.
Etiology.— The perineal tissue is easily ruptured or torn
allowing some of the abdominal organs or omentum to pro-
trude at the sides of the rectum. Perineal hernia is often
observed in trick dogs which are required to walk a great
deal on their hind legs. The unnatural position and the
pressure of the abdominal organs no doubt lead to rupture
of the perineal tissue. It may also result from strain from
coprostasis, prostatic enlargement, -etc. Strangulation is
rare in this form of hernia. In some cases torsion of the
bladder accompanies it.
Symptoms.— This hernia is recognized as an enlargement
appearing at one or both sides of the rectum. The majority
of cases are unilateral. The anus is pushed to one side and
often there is difficulty in defecation. In the female the
enlargement is usually slightly lower than in the male.
564 HERNIA
The consistency of the hernia will depend upon the con-
tents. Perineal hernias are usually soft, easily reduced and
the hernial ring readily palpated. Holding the patient up by
the hind limbs often effects reduction. Should the bladder
be in the hernial sac the patient will show dysuria and the
enlargement feel cystic. A positive diagnosis can be made by
puncturing the swelling writh a trocar and obtaining some of
the contents. A differential diagnosis is necessary between
the hernia and enlargement of the anal pouches. A careful
examination will reveal the difference between them.
Treatment.— A careful consideration of the symptoms
should be taken into account in order to determine definitely
the conditions so that proper treatment can be applied. If
the bladder is in the hernial sac replacement should be
brought about as soon as possible. This may be done by
carefully manipulating the parts, or if this fails open the
hernial sac, empty the bladder with a fine trocar and push it
back into the abdominal cavity. Insert the sutures rather
deep in the tissues in order to effect deep adhesions.
In the female, if the uterus is in the hernial sac, ventro-
fixation is recommended. Many cases, when of ordinary
size and no particular disturbance present, should not be
treated. Castration is recommended when enlarged pros-
tates are present. In some cases it may be necessary to
remove the glands.
Other hernias have been observed but they are so rare that
no attempt will be made to describe them.
PART XIV.
INFECTIOUS DISEASES.
CHAPTER I.
ACUTE GENERAL INFECTIOUS DISEASES.
DISTEMPER OF DOGS.
Definition.— An acute, infectious, communicable disease
which in most cases affects young dogs.
Occurrence.— This is one of the most common diseases
affecting dogs, and is known in every country where dogs
are found. It is particularly a disease of young animals,
the majority of dogs contracting it at some time during
the first year of their lives. Whole litters of puppies, or
all the animals in a kennel may become affected at one
time. It occurs in districts as an enzootic. In cities it is
more prevalent than in the open country. The season of
the year has some influence on its prevalency and distribu-
tion, the fall and winter months being most productive of
the disease. Highly bred animals are more commonly
affected than those bred by natural selection.
Etiology. — There seems to be considerable difference of
opinion in regard to the exact etiology of dog distemper.
Some claim it to be produced by a specific microorganism
(Bronchosepticus canis, Torrey, Ferry, McGowan), while
others think it is due to a filtrable virus. In each case evi-
dence has been produced which seems to substantiate
the claim made. Two distinctive factors are recognized from
a clinical standpoint: (a) A primary infectious agent which
.")<)(> ACUTE GENERAL INFECTIOUS DISEASES
produces the marked initial symptoms of the disease. (6)
Secondary organisms which produce many varied and serious
complicating conditions. A large number of organisms have
been isolated from animals affected with distemper, but so
far they have proved to be simply secondary invaders.
Natural Infection.— Natural infection takes place in
several ways. It may be either direct or indirect, the
animals coming into immediate contact with each other,
or through intermediary agents, the virus being taken into
the digestive tract with the food or drink. There are a
number of factors which tend to favor the development of
the virus, such as influence of any kind which reduces the
general resistance of the animal, in the way of poor food,
insufficient food, colds, etc., or various diseased conditions
interfering with the assimilation of food. Puppies with
weak constitutions are especially susceptible. The develop-
ment of the disease is ordinarily in animals from three
months to one year of age. Older animals are very seldom
att'ected and if so take the disease in a mild form. This
may be explained by the immunity the dog possesses or by
its having had the disease in a mild form. House dogs
which have been pampered and petted, or those of the finer
breeds are more susceptible, and usually take distemper in
a more severe form.
It has been determined quite conclusively that the specific
virus produces an acute or peracute condition with a high
temperature followed in a few days by secondary changes
due to other bacteria resulting in various complications,
such as occur in the skin (pustules), respiratory passages,
digestive tract, nervous system, etc.
Necropsy.— Owing to the variety of forms of distemper
in dogs the lesions found on examination are of many kinds,
varying with the complications due to secondary infection.
In peracute and acute cases there will be effusions of fluid
from the serous membranes particularly in the pericardial
sac, the thoracic and abdominal cavities. Small hemor-
rhages are observed in some of the organs (heart, liver
and kidneys). In most cases of distemper the lungs will be
affected, either as a capillary bronchitis, congestion or
DISTEMPER OF DOGS 567
bronchopneumonia. The pleura is usually congested and
sometimes covered with fibrinous deposits.
The intestinal tract shows marked changes, in most cases
a catarrhal inflammation, which may be primarily in the
stomach, or involving the entire tract. The glands in the
mucosa are swollen. Erosions and ulcerations are fre-
quently noted in the subacute or chronic forms. The
lymph glands of the mesentery are enlarged and edematous.
The liver is usually congested, or inflamed, frequently show-
ing degenerative changes. The kidneys are enlarged, the
capsule easily removed and the cortex markedly changed.
The central nervous system is often involved and there
will be found congestion of the membranes and the cortex
of the brain. Small hemorrhages will be observed in some
cases. Other pathological changes of a minor character
are noted, such as conjunctivitis, keratitis and more rarely
panophthalmitis. Pustules in the skin are common.
Symptoms. — There is quite a variation in the symptoma-
tology depending upon the form which the disease takes.
The most prominent manifestations are those of an infectious
catarrh, involving the membranes of the eye, the respiratory
and digestive systems. The catarrhal symptoms are often
complicated with those of severe disturbance of the brain
and cord, pustular eruptions on the skin, and very frequently
bronchopneumonia. For clearness in the description of
the symptoms it is best to consider them under the following
headings, depending upon the part affected:
1. Initial Symptoms. — The period of incubation is usually
from three to five days. This period will vary consider-
ably, depending upon various factors. Some few cases have
been known to develop the disease in two to three days,
while in others it required two to three weeks. The peracute
type of distemper is ushered in by marked constitutional
disturbances, such as great depression, fatigue, total loss of
appetite, a very high temperature (106°-107° F.) which in
the course of several hours drops to normal, and later to sub-
normal. This form of the disease takes a very rapid course,
the animal soon passing into a comatose state.
568 ACUTE GENERAL INFECTIOUS DISEASES
The acute form usually begins with a rather high tem-
perature (103°-106° F.) and remains elevated for several
days or weeks. Some cases show a marked variation in
temperature, beginning with a high temperature which in
a few days drops to normal or in some cases subnormal
where it remains until either recovery or death takes place.
In some cases due to complications the fever is remittent.
The owner wrill notice in the inception of the disease a
change in the disposition of the animal. Instead of being
lively it will be stupid, does not answer the call or obey
commands given it. The hair coat becomes rough, quickly
loses its gloss and the animal in general shows a dejected
appearance. On examination of the nose, it will be found
hot and dry; the mucosa becoming irritated induces rather
violent sneezing. After one or two days more pronounced
symptoms make their appearance.
2. Symptoms Shown by the Eyes.— In a -large number of
cases conjunctivitis is a prominent symptom. In the
early stages it begins as a serous conjunctivitis, which soon
becomes purulent from secondary infection. The discharge
from the eyes consists of a thick mucus, or whitish or yellow-
ish pus. This discharge is usually found collecting chiefly
at the inner canthus of the eye, soiling the edges of the
eyelids, or from the exudate drying, crusts form causing the
eyelids to adhere. Usually in a few days lesions and ulcers
appear on the cornea as a result of the irritant exudate, the
patient rubbing its eyes or pawing them with the forefeet,
or by the swelling which interferes with local nutrition.
These ulcers are usually small, pin-point, funnel-shaped and
extend downward in a straight direction; their base usually
covered with a pus-like material. They heal by a prolifera-
tion of vessels from the edges of the cornea. In some cases
the ulceration leads to partial perforation of the cornea,
with a protrusion of the Descemet's membrane, prolapsus
of the iris (staphyloma). The resulting cicatrization causes
permanent white spots on the cornea (leukoma). In other
cases the entire cornea becomes opaque (parenchymatous
keratitis) which gives the eyes the appearance of ground
glass. Rarely does the entire eyeball become inflamed
DISTEMPER OF DOGS 569
(panophthalmitis). Opacity of the cornea in a number of
cases remains for weeks and even months.
3. Symptoms Shoicn by the Digestive Tract. — Vomiting is
an early symptom in a large number of cases. The vomitus
often consists of particles of food, frothy mucus stained
with bile in cases where the vomiting is persistent. The
mucous membrane of the mouth is hot,, dry and congested.
The animal drinks freely indicating the involvement of
the mucosa of the stomach and bowels. Constipation is
invariably the rule during the early stages of the disease,
followed by diarrhea in the course of a day or so. The
f eces in the latter case are very fetid, often shiny, frothy
and even bloody indicating hemorrhagic intestinal catarrh.
The intensity of the gastro-intestinal symptoms varies from
mild catarrh to a severe hemorrhagic gastro-enteritis.
Symptoms of icterus are present in some cases due to the
catarrhal duodenitis (catarrhal icterus).
4. Symptoms in the Respiratory Tract. — During the early
stages of the disease the nose becomes dry and hot. There
is nasal discharge which is at first serous but later thicker
and mucopurulent in character. During the early stages
there is much sneezing and sniffling due to the attending
rhinitis. The dog shows much distress and makes frequent
attempts to clear the nasal passages by sudden expiratory
efforts, rubbing the nose against objects and clawing at the
nasal openings with the forepawrs. The discharge accu-
mulates around the nasal openings in the form of crusts;
when these are removed the skin and mucosa often show
excoriations. In severe cases the discharge is often so
copious that the nostrils will be found partially or completely
occluded.
Catarrh of the larynx is nearly always associated with
this condition and is manifested by a cough, which usually
occurs in paroxysms; it is at first dry and harsh, and later
becomes moist and considerable mucus is coughed up, which
is immediately swallowed by the animal. These paroxysms
of coughing frequently end in gagging and vomiting. The
catarrhal inflammation spreads quite rapidly to the trachea
and bronchi. The resulting bronchitis causes a cough, which
570 ACUTE GENERAL INFECTIOUS DISEASES
is deep and explosive. The respirations are accelerated.
Auscultation reveals coarse, sharp vesicular murmurs, and
rhonchi. As the inflammation proceeds it involves the
bronchioli (capillary bronchitis) which produces increased,
labored respirations. At this stage there is usually a feeble
harassing cough, most noticeable when the dog is made to
move, or if the thorax is manipulated. The auscultatory
sounds become increased, and there will be noted dry or
moist, crackling, or fine rales. In very weak, or young
dogs, in which the exudation accumulates in the bronchioli,
it is very sure to produce a bronchopneumonia on account
of the secretions being drawn into the alveoli. The result-
ing pneumonia will be recognized by: (a) The great increase
in the temperature; (6) the excessive dyspnea (inflation of
cheeks at each expiration) ; (c) the sitting posture of animals
with elbows spread apart to facilitate respiration; (d) irregu-
lar vesicular murmur; (e) irregular dulness and tympany on
percussion; (/) the bronchial breathing which wrill be audible.
The cough at this stage becomes very dull and weak. The
nasal discharge becomes very fetid, and often has a greenish
cast. During the last stages as the heart becomes wreak,
symptoms of edema of the lungs appear in the form of
severe dyspnea, and bubbling rhonchi.
o. Symptoms Shown by the Nervous System. —This disease
in practically all cases is accompanied by some nervous
phenomena. It often begins, especially in weak individuals,
with marked dulness and depression. These symptoms
may be all that the animal will show. However, in a great
many cases, the nervous symptoms develop early in the
course of the disease, and are manifested by excitement,
restlessness, yelping, cries, even simulating some of the
symptoms of furious rabies. In many instances tremors
of muscles, tonic and clonic spasms, which mpy involve
certain groups of muscles or the entire muscular system
are observed. Local spasms and twitchings of the muscles
are frequently observed involving the muscles of the face,
over the region of the head and neck. The masseter muscles
are frequently affected, resulting in chattering teeth and
foaming at the mouth. Spasms of the muscles of the neck
DISTEMPER OF DOGS 571
and limbs cause regular or irregular movement of the head
or limbs. These movements may be present constantly or
periodically. Convulsive contractions of certain groups of
muscles are frequently observed, in which the animal at
first becomes restless, excited, runs aimlessly about, is sud-
denly seized by tonic and clonic spasms, the head and
neck usually drawn backward, falls down as if from epilepsy,
barks, cries and becomes unconscious with relaxation of
the sphincter muscles. In some cases the animal will die
during these convulsions; in others there is a gradual return
to consciousness and in one or two minutes the animal
is able to rise. Some cases pass into a long-continued state
of coma. These convulsive seizures may become less fre-
quent, and entirely disappear; or they may terminate in
partial or complete paralysis. Paralysis is a very common
sequel to this disease. It very rarely begins at the onset of
the disease, but appears in most cases during the latter
period. The paralysis may be confined to certain groups
of muscles, in fact the posterior limbs are most often aft'ected.
The paralysis of the sphincter muscles is a very frequent
sequel. Some cases begin with a paralysis of the posterior
limbs, and result subsequently in complete recovery, while
others show a progressive ascending paralysis, resulting in
death from general paralysis. Various paralytic compli-
cations are often observed following the nervous form of
distemper, such as deafness, amaurosis, hemiplegia laryngis,
aphasia, loss of sense of smell, hydrocephalus, etc.
o'. Symptoms Shown by the Skin. — In a large number of
cases there will be noted a characteristic pustular exanthema.
Small, red spots appear along on the abdomen, on the inner
surface of the thighs, occasionally on the skin of the face,
around the eyes and on the internal surface of the external
ear. In twenty-four to thirty-six hours these red spots are
transformed into miliary nodules, each surrounded by a
red ring. These nodules change very rapidly into vesicles
which become infected to form pustules. The pustules vary
but are usually the size of a pea. They dry up either into
a yellow, brown crust, or rupture and leave reddened, moist
places to become covered later by a scab. When the
572 ACUTE GENERAL INFECTIOUS DISEASES
pustular eruption becomes extensive the body gives off a
peculiar, offensive, sweetish odor. Healing of the pustules
takes place usually in about six to eight days, leaving bright
pigmented, reddish spots, which remain for several weeks.
In some cases the pustular form of distemper may spread,
the pustules become confluent, forming a scabby eczema,
which may be localized around the eyes, over the abdomen,
or thighs, or it may be general over the entire body. Com-
plications, such as septicemia and septicopyemia develop
occasionally from this form of the disease. When the
pustular eruption forms around the margin of the lips, it
often spreads rapidly to the mucosa producing a severe
gangrenous stomatitis. Involvement of the external ear
in the form of an otitis is observed in a large number of
cases. This is characterized by a thin fluid secretion, which
accumulates on the surface of the ear, dries and forms a
yellowish-brown crust or scales.
7. General -Symptoms.— The initial high temperature is
usually followed by a remittent or subnormal temperature.
Some cases do not show much abnormality in temperature.
Normal temperature in this disease, when other marked
symptoms are present, does not always indicate a favorable
termination. As the disease progresses the animal becomes
emaciated, weak, and the action of the heart is more or less
disturbed, depending upon the severity of the case. The
mucous membranes are pale, the patient becomes very
weak, staggers or retains a recumbent position.
Diagnosis.— During the early stages of distemper it pre-
sents some difficulty. It becomes necessary to decide
whether we have distemper to deal with, or the beginning
of some other condition, such as catarrhal inflammation of
the eyes, nose, lungs, stomach or bowels. An accurate
diagnosis cannot always be made during the early stages of
the disease. Just as soon, however, as there appear symp-
toms of general depression, high temperature, the implica-
tion of several organs, especially in a young dog, distemper
should be suspected. Should skin pustules be present they
will assist materially in making the diagnosis.
In catarrhal inflammation of the bowels there is usually
DISTEMPER OF DOGS 573
very little rise in temperature, and catarrhal symptoms of
the eyes, nose, etc., fail. The symptoms of cerebral irri-
tation sometimes found in distemper make it necessary to
differentiate it from rabies. The characteristic aggressive
tendency of animals with rabies, the change in the 'voice,
the facial expression, and the absence of catarrhal symptoms
usually make the differentiation easy. The eruption on the
skin might be confused with mange, but negative results on
microscopic examination would at once show the difference.
There should be but little difficulty experienced in differ-
entiating it from eczema as the lesions and their location
differ and the other symptoms of distemper usually present.
The convulsions occurring in the nervous form of distemper
are distinguished from those of epilepsy by the acute char-
acter, occurring at frequent intervals, and the local muscular
twitchings, which occur even between the convulsive attacks.
Prognosis.— The prognosis is not favorable, even in the
milder forms of the disease. Owing to the variety of forms
the disease assumes, and the frequent complications, the
mortality is high, amounting to approximately 50 per cent.
The prognosis depends to a certain extent upon the type of
the disease, and whether or not the animal is strong and
vigorous. The purely exanthematous form is most favor-
able. If the disease confines itself to this form the majority
of the cases will completely recover in two to three weeks.
The catarrhal forms, involving the respiratory or digestive
systems, are less favorable owing to serious complications
which attend them.
The highest mortality occurs when the nervous system
is involved. When severe nervous phenomena are present
the prognosis is bad, only 5 to 10 per cent, recovering.
Where there is a continuous, high temperature the prog-
nosis is not favorable as there is danger of heart compli-
cations. A rapid fall in temperature to below normal is
also a grave sign; in most cases it indicates the approach
of death.
Treatment.— Dietetic. — It is very essential in distemper to
supply the patient with easily digested, nourishing food.
Perhaps the best food is raw meat chopped fine, or scraped
574 ACUTE GENERAL INFECTIOUS DISEASES
into a pulp. Patients will be tempted by this food when
they will not eat anything else. In cases where the appe-
tite is lost, and in order to maintain the animal's strength,
beef broth is most excellent. This may be given with
warm • milk, or milk with an egg beaten up in it. Other
foodstuffs may be given, depending upon the progress of the
case, and the needs of the patient. In the digestive form
of the disease only small amounts of liquid foods should be
given via the mouth. Rectal feeding with warm milk and
meat broth is recommended in these cases.
Hygienic.— The animal must be well protected from expos-
ure to extremes in temperature, or cold draughts of air.
They should be placed in a clean, moderately warm well-
ventilated room. The bedding should be kept clean at all
times. Supply plenty of fresh water.
Medical.— Owing to the various complications the medical
treatment must be essentially symptomatic. During the
early stages of the disease calomal (0.075-0.10) is recom-
mended as a purgative and bowel disinfectant. This dose
may be repeated in twenty-four hours if necessary. To
overcome the general depression, which is an early symptom,
nerve stimulants, alcohol, aromatic spirits ammonia, mix
vomica tincture (0.4-0.7), anyone of which should be given
well diluted, and repeated as the case demands. As an
abortive treatment subcutaneous injections of^trichlorid of
iodin (3 or 4 times daily, 2-4 c.c. of a solution of 1-1000)
have been used with very good results. This treatment
when given early in the course of the disease has a very
beneficial effect in regulating the temperature. The patients
seem brighter, and the catarrhal symptoms diminished.
The injections should be made at different points owing to
the danger of skin necrosis. Further medical treatment
will vary depending upon the part affected.
(a) When the disease involves the eyes, they should be
washed with an antiseptic once or twice daily, boric acid
(2 per cent.), creolin (1.5 per cent.), to prevent undue
injury to the cornea and other structures from the infection.
In obstinate cases with excessive pus formation and dis-
charge, silver nitrate solution (0.5 to 1 per cent.) has been
found very efficacious. When there is extensive parenchy-
DISTEMPER OF DOGS 575
mat ous keratitis solution of stovain (1 to 2 per cent.) is
useful to prevent irritation and subsequent injury to the
eyes from rubbing them against objects, or with the paws.
Opacities of the cornea when of some standing may be
treated with a silver nitrate solution (2 per cent.), followed
by a normal salt solution as a wash, or succus cineraria
maratima compositus (0.4-0.7) dropped into the eye
daily. This latter preparation has proved to be of great
value in the eye complications of distemper.
(6) The respiratory system should be treated by remov-
ing the secretions from the nasal openings, spraying the
nasal passages with creolin (2 per cent.), or silver nitrate
solution (0.25 per cent.). Warm vapors, such as steam, or
solutions containing alkalies (bicarbonate of sodium) given
as inhalations are highly recommended. When there is a
painful, dry, harsh cough the following formula is very
beneficial :
If — Morphinii sulphatis 0.15
Aqua amygdalae amarte 12.00
Aqua dest 150.00
Misce et fiat solutio.
Sig. — Give teaspoonful once or twice daily.
Iii the presence of profuse secretions, sedatives are contra-
indicated. Instead ammonium chlorid (0.1-0.5) is given as
an expectorant twice daily to dissolve the mucus and other
secretions. If symptoms of pneumonia are present, counter-
irritation to the thoracic walls with oil of mustard and
glycerin (1-20). Heart stimulants are also advised. (See
Treatment of Bronchopneumonia.)
(c) The digestive complications are treated according to
the conditions found. If the animal is constipated it should
be relieved by the administration of a purgative; if severe
diarrhea is present the irritating bowel contents are first
removed by a laxative followed by astringents and sedatives.
The following formula will be found beneficial in the latter
condition:
If — Tinctune opii 10.0
Gummii acacia? 8.0
Aqua? fceniculi 250.0
Misce et fiat solutio.
Sig. — Give teaspoonful two or three times daily.
57<> ACUTE GENERAL INFECTIOUS DISEASES
As a bowel disinfectant use small doses of salol (0.2-0.5)
twice daily. If vomiting is persistent it must be controlled
with cold \vater containing soda (2 per cent.), salicylate of
bismuth (0.3), or in extreme cases by small doses of opium
(0.05-0.15).
(d) For the stimulation of the digestion small doses of
hydrochloric acid (0.1-0.5) diluted in water and pepsin
(0.075-0.5) is the best treatment. It is advisable to stimu-
late the mucosa further with tincture of gentian (0.05-0.9),
or tincture of nux vomica (0.4-0.7) given once daily. Fluid
extract of echinacese (0.5-1.0) is also used.
(e) When nervous symptoms are present, it is important
that they be controlled by anodynes and sedatives (mor-
phin 0.03-0.09, or sodium or potassium bromid 1-150 in
water) given in teaspoonful doses four to six times daily.
Some cases, when spasms and convulsions are severe, will
require maximum doses to control them. When paralysis is
present, electricity is highly recommended, also strychnin
(0.001) once or twice daily. Subcutaneous injections of
veratrin (0.01-0.05) are sometimes used. •
(/) The temperature in this disease is rarely treated, and
only in exceptional cases where a very high temperature
remains for several days and threatens to become dangerous
to the heart, would it be advisable to use antipyretics.
Phenacetin, acetanilid (0.25-0.50) may be used for this purpose.
(g) In the skin form, when pustules are present, they
should be opened, and washed with creolin (2 per cent.).
For the exanthema the skin should be washed with an anti-
septic soap (germicidal, or far soap), dried, and a drying
powder or zinc oxid ointment applied. The latter is prefer-
able.
Sera and Vaccines.— This disease has been treated quite
extensively during the past two or three years with vaccines
and sera. Good results have been obtained by their use
by some, others have reported less favorably. The great
advantage no doubt in the use of these preparations is to
control the secondary infection which produces the com-
plicating conditions. Varying degrees of immunity have
been claimed by the use of vaccines.
DISTEMPER OF CATS 577
Prevention.— Animals with distemper should be isolated
and kept from healthy young dogs. Thorough disinfection
of all utensils, bedding, rooms, etc., should be attended to
promptly.
Preventive inoculation has proved of value in a large
number of cases and is highly recommended.
DISTEMPER OF CATS.
Definition.— An acute contagio-infectious disease found
more commonly in young cats. Older animals are less often
affected, probably due to either an acquired immunity (hav-
ing had the disease in a mild form) or to a greater natural
resistance against the infection. The disease in cats is not
nearly so common as in dogs.
Etiology.— According to the best information obtainable
it is produced by the same causes as canine distemper.
Pathology.— The pathological lesions are principally those
found in canine distemper, except that the disease seems
to be confined mainly to the respiratory and digestive
tracts. -In the respiratory form there is an inflammation
involving the nasal passages (rhinitis), larynx (laryngitis),
the bronchi and bronchioli (capillary bronchitis), and the
lungs (bronchopneumonia) . The digestive tract shows
catarrhal inflammation. The mucosa is covered with a
heavy mucous exudate which in some cases is mixed with
blood (hernorrhagic catarrhal gastro-enteritis) . Some of the
other organs (kidneys, liver and heart) show degenerative
changes.
Symptoms.— The initial symptoms are those of inappe-
tence, depression, vomiting in some cases and moderately
high temperature (103°-104° F.). When the respiratory
passages are primarily affected the animal will sneeze fre-
quently, there is a discharge from the nose which is at
first thin, but later becomes thicker and glutinous. This
will collect around the nasal openings and in some cases
occlude them completely.
Conjunctivitis is a very prominent symptom. At first
the discharge is serous, but later it becomes mucopurulent.
37
578 ACUTE GENERAL INFECTIOUS DISEASES
The cornea often presents the characteristic changes noted
in dog distemper. The bowel form is observed frequently,
and is characterized by vomiting, abdominal pain and later
severe diarrhea. The animal becomes emaciated, there is
marked weakness and' a fall i,n temperature, which often
becomes subnormal. Convulsions and other nervous phe-
nomena are not commonly observed.
Diagnosis.— The diagnosis depends upon the existence of
catarrhal symptoms involving the eyes and nose, the tem-
perature and the rapid emaciation and weakness. A
differential diagnosis should be made from hemorrhagic
septicemia. In this disease no catarrhal symptoms are
present, as a rule, but there is marked gastro-enteritis, and
the course is peracute. The mortality in hemorrhagic
septicemia is much higher.
Prognosis.— The prognosis is bad. The mortality, how-
ever, is lower in cats than in dogs. The catarrhal form
involving the eyes, nasal passages and lungs is more favorable
than the bowel form.
Treatment.— Hygienic.— The animal should be kept in a
moderately warm place, free from draughts of air. The
room should be well ventilated, and every precaution taken
to prevent unnecessary exposure.
Dietetic.— The appetite can be tempted by offering small
amounts of fresh lean meat, or liver at frequent intervals.
Milk should be allowed in small quantities.- In case the
animal refuses food, it is advisable to give small quantities
of beef broth, or warm milk to maintain strength.
Medical.— A laxative is given at the onset of the disease
(castor oil 4.0-12.0, or sulphur in milk 1.0-2.0). The eyes
should be cleansed daily with boric acid solution (2 per
cent.) to control the blennorrhea. The nasal passages can be
cleansed with a similar antiseptic solution. Small doses of
opium (tincture of opium 0.10-0.15) are often beneficial in
preventing the spread of the inflammation in the stomach
and bowels and to control the diarrhea. Sulphocarbolate
tablets are to be recommended as a bowel disinfectant
(0.1-0.2). When pneumonia threatens inhalations of warm
medicated solutions are valuable. Atropin sulphate (0.003)
TYPHUS OF DOGS 579
is useful to sustain the heart action. Good care and nour-
ishing food plays a very important role in the treatment of
cat distemper.
TYPHUS OF DOGS.
Canine Typhus. Hemorrhagic Castro-enteritis.
Dog Plague. Black Tongue.
Definition.— An acute, infectious disease occurring in an
epizootic form, characterized by a severe gastro-enteritis,
stomatitis, and in some cases severe nervous symptoms.
Occurrence.— During the past few years this disease has
appeared as an epizootic in various sections of the United
States, producing extensive losses, particularly in old dogs.
In some districts it has made the breeding and handling of
dogs prohibitive. The disease has been disseminated by dog
shows, and follows in the wake of such exhibitions.
Etiology. — The nature of the disease indicates that it is
produced by some specific infection. I p to the present
time the infectious agent has not been isolated. Experi-
mental inoculations with various organisms, which have
been isolated, have not proved that any of them are con-
stant in reproducing the disease in healthy animals. In a
number of outbreaks in this country, old dogs were as com-
monly affected as young. Further, dogs which have had
distemper severely come down with this disease in a severe
form. The breed, or sex of the animal seems to have noth-
ing to do with its susceptibility. The infectious agent is
probably taken in with the food or drink. The disease is
spread by cohabitation, or by the infection being carried
by intermediate agents. The period of incubation is from
three to five days.
Pathology.— The autopsy in this disease presents a rather
constant picture. The digestive tract is mainly involved.
The mucosa of the mouth is often inflamed; ulcers are
found in a number of cases, particularly noticeable along the
margin of gums. In some cases extensive necrosis of the
buccal mucosa is found. The tongue is frequently thick-
580 ACUTE GENERAL INFECTIOUS DISEASES
ened, swollen and dark red or bluish in color. In the
stomach the lesions are very prominent, and consist of an
intense inflammatory condition. The mucosa is dark red,
or almost black, corrugated and at the apex of the corru-
gations the membrane is eroded.
Hemorrhages take place in the membrane and give it a
more or less mottled appearance. Some cases present
extensive hemorrhages over the entire membrane. The
surface of the mucosa is covered by a mucus of a dark
brown, or chocolate color, which can be readily scraped
off. The contents of the stomach have a peculiar offensive
odor. The intestines show similar changes, but in most
cases not_ so extensive. The cecum and small intestines
show the most prominent lesions. The peritoneum covering
the bowels is congested and the mesenteric lymph glands are
enlarged. The spleen is often much enlarged and shows
evidence of acute inflammation. The liver and some of
the other organs are hyperemic. The lungs in most cases
do not show much on examination. They are usually
slightly congested, and edematous. The heart is pale in
color and very friable. The brain and its membranes may
be markedly hyperemic, or show but slight change. The
lesions found on autopsy are indicative of a more or less
intense gastro-enteritis.
Symptoms.— The initial symptom, which is quite constant,
is a very persistent vomiting. The vomitus at first con-
sists of food particles; later mostly mucus mixed with blood
and bile. The attacks of vomiting often begin without
any previous indication of illness, and suddenly become very
severe, producing in a short time marked weakness and
prostration. The appetite is lost; there is rapid exhaustion
and staggering gait. The progress of the disease is quite
rapid. Frequently in one to three days it has reached its
characteristic form. Examination of the mouth reveals more
or less extensive lesions of the mucous membrane. Along
the margin of the gums will be noticed degenerative or
necrotic changes, ulcers and at the margins of the lips there
will be present the characteristic chocolate-colored discharge.
The tongue will be affected; it is sometimes partially or
TYPHUS OF DOGS 581
completely paraly/ed, swollen and of darkbluish color. A
very unpleasant, peculiar odor is emitted from the mouth.
As the disease progresses, the degenerative and necrotic
processes continue until in many cases the ulcers become
confluent, forming extensive ulcerative surfaces. The tongue
usually in the later stages is dry, chapped, loses its sensitive-
ness, and becomes necrotic or gangrenous. Necrosis of the
lip is observed in some cases, usually most prominent at
the commissures of the mouth. Palpation over the region
of the stomach, which often induces vomiting, produces
marked pain. Manipulation of the bowels is also painful in
most cases. Constipation is present during the early period
of the disease to be followed later by diarrhea. The dis-
charges from the bowels are mixed or streaked with blood,
and emit a very offensive odor. The mucous membrane of
the rectum is inflamed and shows degenerative changes.
The conjunctiva shows similar discoloration to that of the
mouth (brownish-red), strongly injected, but the absence of
a purulent discharge. The temperature does not rise, as
a rule, at any stage of the disease. With the appearance
of depression and coma the temperature falls rapidly to
subnormal, the rule in this disease. There is no cough
and in most cases no indication of lung involvement until
the later stages of the disease, when in some cases acute
edema, or a foreign body pneumonia producing dyspnea
develops. The urinary secretion is nearly always dimin-
ished or suppressed. Nervous symptoms of excitement and
convulsions are occasionally observed, but in most cases
somnolence, lassitude and coma are characteristic. Modi-
fication of these symptoms may be found, depending upon
the severity of the condition.
Diagnosis. —There are some very characteristic symp-
toms which materially assist in establishing a diagnosis—
the sudden and persistent vomiting, the inappetence, the
presence of ulcerations on the mucous membranes of the
mouth, the great depression, the character of the vomitus,
the characteristic injection of the conjunctiva, and the
normal or subnormal temperature. A differential diagnosis
must be made from canine distemper. In canine distemper
5X2 ACUTE GENERAL INFECTIOUS DISEASES
there are invariably present the characteristic catarrhal
symptoms involving the eyes and nasal passages. The
period of incubation is usually longer in distemper, five to
nine days. Further, distemper is more common in young
animals, and the course of the disease is acute. This disease
must also be differentiated from ptomain and other poison-
ings. In some cases this is quite difficult, owing to the
close similarity of the symptoms, gastro-enteritis appearing
in both conditions. The necrosis of the membranes and
ulcers are absent in ptomain poisoning, and in the majority
of mineral poisonings. The development of the disease is
different from ptomain, or other poisonings. Canine typhus
usually appears as an epizootic which would assist in estab-
lishing a diagnosis. Differentiation between this disease and
ulcerative stomatitis should present no great difficulties. The
absence of the general depression, vomiting and gastro-
enteritis in ulcerative stomatitis is indicative. Scorbutus
develops slowly, and is attended by neither vomiting nor
general symptoms.
Course.— The average duration of the disease is four to
six days; in milder cases often twelve to fourteen days. A
few cases run a much more rapid course followed by death in
one to three days. At the beginning of an outbreak it
seems to run a more rapid course than later.
Prognosis.— The prognosis is unfavorable; the mortality
from 50 to 75 per cent. Young animals suffer less severely
than older ones. When the disease develops gradually,
indicating low virulence of the infection, or high resistance
on the part of the animal, the prognosis is more favorable;
on the other hand when the development of the disease
is rapid and the symptoms prominent, the outlook is grave.
In some cases recovery takes place quite rapidly, and when
this does occur there is usually no complication, and even
the ulcerative processes disappear completely.
Treatment.— Dietetic.— During the early stages of the dis-
ease, no food should be given. After the acute symptoms
have begun to subside and the animal reaches the con-
valescent stage, nutritious food can be allowed. Meat
broth would be most applicable as the sensitive mucous
1' I 'KITH A HEMORRHAGICA OF DOGS 583
membrane of the stomach would not retain solid food.
Later small amounts of meat chopped fine could be given.
Should it be impossible for the animal to retain food in
the stomach, rectal feeding is advisable, using concentrated
meat broth warmed to the body temperature. This should
be injected high up in the rectum, small amounts given every
three or four hours.
Medical. — At the onset of the disease, when vomiting is
severe and persistent, it would be best to wash the stomach
with sodium bicarbonate solution (2 per cent.). This may
be repeated in ten to twelve hours. To allay vomiting,
sedatives (morphin subcutaneously, 0.016-0.12), or small
amounts of cold water at frequent intervals are useful.
Hot packs applied to the epigastrium are beneficial. Rectal
injections of warm water, or even washing the entire ali-
mentary tract with sodium bicarbonate solution (2 per cent.)
when diarrhea is present, will remove irritating material
and infection. In obstipation, warm rectal infusions may
be used in preference to laxatives or purgatives. Ichthargan
has been highly recommended for typhus in the following
formula:
F$ — lohthargan,
Gummi arabicae aa 20.0
AqucD chloroformi 60.0
Misce et fiat mist.
Sig. — Give teaspoonful every three or four hours.
Stimulants (atropin sulphate, 0.075-0.15 subcutaneously)
to sustain the heart action and to overcome the general
depression would be advised. The mucous membrane of
the mouth should be washed at least twice daily with boric
acid solution (2 per cent.); potassium permanganate (0.25
per cent.), or therapogen (2 per cent.). The animal should
be well protected in a quiet place. In a great many cases
the treatment has proved unsatisfactory owing to the per-
acute course it often assumes.
PURPURA HEMORRHAGICA OF DOGS.
This disease has been observed in dogs, but as it is very
rare it will not be described here. (See other works.)
584 ACUTE GENERAL INFECTIOUS DISEASES
FOWL CHOLERA.
Cholera Gallinarum. Pasteur ellosis Avium. Fowl
Typhoid.
Definition.— This is an acute contagious disease of fowls,
usually occurring in an epizootic form, and affecting par-
ticularly chickens, geese, pigeons, ducks, quail, sparrows and
pheasants. It is characterized by a general infection, and
the prominent symptom of diarrhea.
Occurrence.— Fowl cholera is found in most sections of
the United States, causing extensive losses to poultrymen.
The finer breeds of fowls seem to be more susceptible to
infection, probably because of exposure to the disease at
poultry shows and other public exhibitions. It occurs as
an epizootic, sometimes destroying entire flocks. The losses
are serious from an economic standpoint. The monetary
loss, which is great when a large number of birds die; the
loss in egg production, and the interference with breeding
operations make fowl cholera a formidable disease. The
disease often spreads over a large area, producing enormous
losses.
Etiology.— It is produced by the Bacillus avisepticus (bipo-
laris). This bacillus is one of the smallest bipolar organisms.
Pathogenesis. — The transmission of the disease from one
bird to another is very easy. Directly inoculating the
blood from a sick fowl to a healthy one by scarifying the
skin or membranes, produces the disease in practically
every attempt. Subcutaneous and intramuscular inocu-
lations bring similar results. Inoculations with the infected
blood of any of the birds into other species will produce
the disease. Instillation of the infection into the con-
junctival sac of fowls produces the disease. Feeding
infected meat to other fowls, or cultures of the organism
will in the majority of cases result in the bird coming down
with the disease. Other animals— guinea pigs, mice and
rats— are susceptible to the disease by inoculation with
FOWL 'CHOLERA 585
the infected blood or with cultures of the organism. Some
of the domesticated animals are susceptible to intravenous
injections of highly virulent cultures of the organism. The
disease is not produced in dogs, cats or hogs from eating the
infected meat of fowls. The virulence of the organism may
be increased by repeatedly passing it through chickens,
guinea pigs, pigeons or sparrows. The organism may be
attenuated by subjecting it to sunlight, drying and exposure
to the air. The attenuation may be sufficient to prevent
further spread of the disease.
Natural Infection.— Natural infection may take place in
numerous ways: (a) The droppings of fowls contaminate
the feed and water given other fowls and the infection is
thus introduced immediately into the digestive tract.
(6) In most cases the flock is infected through newly
acquired cholera-sick birds, or birds returned from shows
or exhibitions where they have been in contact with the
infection.
(c) Pigeons and sparrows play an important part in the
dissemination of cholera, by carrying the infection from
flock to flock. This accounts for isolated outbreaks of the
disease where no exchange of birds has taken place.
(d) The infection is frequently carried on clothing, shoes
and other objects.
(e) It may • be spread by carelessness in disinfecting cars
in which cases have been transported. This has proved to
be the source of infection in a number of instances.
(/) Eggs have been the carriers of the infection in some
few cases reported.
The infection in most cases is taken directly in the
digestive tract with the food or drink. The bacilli pene-
trate the mucous membrane and enter the lymph spaces of
the walls of the intestines. They are soon taken into the
circulation where they multiply very rapidly. In some
cases when the infection is introduced into wounds it is
taken into the circulation more promptly, and consequently
the course of the disease is more rapid. Death results in
these cases no doubt from the large amount of toxins formed.
.~>X() ACUTE GENERAL INFECTIOUS DISEASES
Pathology. — The most pronounced pathological changes
»are found in the intestines, heart and lungs. In the acute
form the following lesions are found:
(a) The intestines show marked pathological changes.
The mucous membrane throughout the entire tract is
highly congested and covered in numerous places with
darker areas. The intestines contain a thin, watery,
frothy, mucopurulent and yellow exudate often mixed with
blood and bile giving them a dark greenish tinge. Defects
in the mucosa are often present, the apex of the intestinal
villi are often eroded, and in some cases croupous exudate
is present, in others ulceration. All of these changes in
the mucosa may be observed in the same case. The mucous
membranes of the pharynx, crop, colon and rectum show the
most pronounced lesions. The mesenteric lymph glands
are nearly always enlarged, edematous and show numerous
petechiae.
(b) The heart shows, as a rule, distinctive changes. It
is covered with small, dark red, pin-point dots, and the
bloodvessels congested. The epicardium is often covered
by a fine fibrinous membrane. The pericardial fluid is
nearly always cloudy, containing some fibrinous flakes.
In the peracute form of the disease these changes are not
so prominent.
(c) The lungs are found congested, thickened, dark red
in color, very heavy (hepatized); the milder type will show
congestion and edema. In the subacute form fibrinous
pleuritis is frequently noted. The larynx, trachea and
bronchi show congestion and reddening (catarrh). Some
of the other organs (spleen, liver, kidneys) show parenchy-
matous degeneration. In the subacute and chronic cases
the lesions are caseous foci in the lungs, liver, on the mucosa
of the intestine and occasionally on the epi- and endo-
cardium. Fibrinous pleuritis is frequent in the chronic
form. The joints of the limbs are often involved, showing
exudation and more or less marked arthritis. The mus-
culature in the chronic form will be grayish in color and
flabby.
FOWL CHOLERA 587
Symptoms.— The period of incubation varies somewhat,
no doubt due to the mode and virulency of the infection.
It is usually one to four days; occasionally longer, four to
seven days. Fowl cholera is characterized by its sudden
onset and the rapidity of its course. When it first appears
in a flock, birds will drop dead apoplectically without show-
ing symptoms. They may be found dead beneath the roost,
or on the nest. Some of them when attempting to walk or
fly will drop suddenly and die after a brief struggle. After
the disease has been in a flock for a few days, the less sus-
ceptible will show some marked symptoms. The birds
lose their appetite, become weak and greatly depressed.
The wings are usually pendent, the neck curved and the
head pulled downward. The entire plumage becomes ruffled
and the birds walk with a weak, staggering gait. The
temperature is elevated 2 to 4° F. above normal. Diarrhea,
accompanied by intense thirst, becomes a prominent symp-
tom. The droppings are at first of a yellowish-gray color,
later becoming very thin, watery, fetid, of a greenish cast
or dark green. The feathers around the cloaca become
soiled and matted with the bowel discharge. Marked
dyspnea sets in, the bird opening and closing its mouth
during respirations; wheezing and rhonchi are frequently
heard. The comb and wattles are dark bluish (cyanotic).
The bird finally becomes very weak, staggers about, falls
down, and dies in coma or convulsions. In the chronic
form of the disease the course is much longer. The bird
grows anemic, emaciated and cachectic. Frequently the
joints are enlarged; the joint capsule may rupture and dis-
charge a seropurulent material. Death results from exhaus-
tion. The course in this form may extend over a period of
several weeks.
Diagnosis.— There are a few conditions in birds that
might be confused with cholera, as the symptoms are similar.
An accurate diagnosis is only possible on finding the typical
bacilli. However, the symptoms and pathological findings
should assist in making a diagnosis. A differential diagnosis
must be made from ptomain poisoning which is very com-
mon in birds, and which frequently kills a large number in
">SS ACUTE GENERAL INFECTIOUS DISEASES
a flock. The postmortem examination and the micro-
scopic findings will be sufficient to make the distinction
between them. Parasites in the bowels sometimes pro-
duce similar symptoms, particularly Trichosoma collare,
but an examination of one or more of the affected birds
would make a clear differentiation. Chronic cases are some-
times mistaken for tuberculosis and arthritis urica, but the
autopsy and microscopic examination would at once make
clear the difference. Inoculations with the blood into healthy
birds may be made to assist in making the diagnosis.
Prognosis. — The mortality is 80 to 95 per cent. Fre-
quently the entire flock will die. In some outbreaks the
disease runs a milder course, the virulence of the infection
not being high.
Treatment. — Medical. — Treatment consists in the adminis-
tration of bowel antiseptics and disinfectants. The course
of the disease is usually too rapid for any medical treatment
to be of value. It is advisable to administer to the entire
flock a solution of iron sulphate (1 per cent.), which they
should be allowed to drink of freely; or a solution of tannic
acid (0.5 to 2 per cent.), which may be administered with
a medicine dropper (1.0-2.0) to each bird twice daily. Some
have claimed excellent results with sulphocarbolates (0.2-0.6)
once daily. Various other medicines have been recommended
but none has proved to be specific.
Vaccines and Sera.— The treatment of sick fowls with
vaccines and sera has not been successful to date.
An immune serum has been made which produces a
passive immunity lasting for a period of one to two weeks.
This is recommended as a preventive when the disease
makes its appearance in a flock, or when a flock of birds is
exposed to infection.
Vaccines (autogenic and polyvalent) have been used.
The results have been unsatisfactory where the birds were
already infected. On the other hand, very good results
have been reported from the use of autogenic and polyva-
lent vaccines to prevent the disease in the healthy birds of
an infected flock. Vaccines seem to establish immunity in
healthy flocks, preventing the disease or reducing the
FOWL PEST 589
mortality. More experimentation, however, is necessary
before definite statements can be made regarding the value
of vaccines and sera in the treatment of fowl cholera.
Prevention.— Preventive treatment is by far the most
important. In applying it the following should be consid-
ered :
(a) All newly acquired birds should be isolated for at
least ten days before being allowed to come in contact
with the regular flock.
(b) When the disease makes its appearance in the neigh-
borhood, precautions should be taken in regard to the car-
riers of the infection. Administer antiseptics. (See Medical
Treatment.)
(c) When the disease appears in the flock, radical meas-
ures must be taken promptly. All healthy birds must be
removed to new, uninfected quarters. The sick birds
should be destroyed at once, and either burned or buried
in lime. All litter and droppings should be treated in a
similar manner. Disinfect the houses, coops, ground and yards
with liquor cresolis compositus, using one gallon to thirty
gallons of water. Use a spray pump so that the disinfectant
will be forced to the ceiling, walls and all parts of the build-
ing. The buildings and coops should then be allowed to
stand open for a few days to allow the air to come in contact
with all parts of it. It would be advisable to start with
a new flock in the new quarters after a few weeks. A
second disinfection would be recommended before allowing
birds to be placed in the buildings.
FOWL PEST.
Fowl Plague. Pestus Aviurn.
Definition. —An acute, contagious, infectious disease of
fowls. Very similar in many respects to chicken cholera.
Occurrence.— This disease has been reported from different
sections of the United States, occurring in the form of an
epizootic. It has been very prevalent during the past
ten years in some of the European countries (Germany,
590
Belgium, Italy and France). There is no doubt but that
it has frequently been mistaken for fowl cholera.
Etiology.— This disease is produced by an ultramicroscopic
virus. The exact nature of this virus has never been deter-
mined. It is contained in the blood, the droppings, the
exudate found in the serous cavities, the bile and in the
nasal discharges. The filtrate, when passed through porce-
lain filters and injected into healthy chickens will produce
the characteristic symptoms rather constantly.
Pathogenicity.— Practically all fowls are susceptible to the
virus which is most commonly found in chickens, turkeys,
sparrows and pheasants. Water fowls and pigeons are less
susceptible to infection. Mammalia are not susceptible to
the virus.
Natural Infection.- Cohabitation of birds so that they
come in contact with the nasal discharges and droppings
from the sick is the most likely way in which infection is
spread through a flock. Ingestion of food contaminated
with the virus, or the eating of infected viscera, or blood,
introduces the virus immediately into the digestive tract
where it develops and produces the disease. Infection takes
place no doubt in some cases from the infection entering
the tissues through lesions in the skin or mucous membranes.
The transmission of the disease may be brought about by
the virus being carried through intermediate objects.
Pathology.— The lesions found on autopsy are similar in
some respects to those found in fowl cholera. In the per-
acute cases the lesions may be very slight. The principal
lesions are those found in ordinary septicemia, especially
hemorrhages in the serous membranes (pleura, peritoneum,
epi- and endocardium), and in the mucous membranes of
the digestive tract. The finding of a fibrinous exudate on
the peritoneum and pleura has been frequently reported.
Hyperemia of the spleen, liver and kidneys is usually present.
The comb and wattles are dark bluish in color (cyanotic).
Catarrhal inflammation of the conjunctiva and buccal mem-
brane, with collections of frothy mucus, is often noted. In
the digestive tract changes occur on the mucous membrane
such as hemorrhages, collections of grayish-white, or yel-
FOWL PEST 591
lowish-green fecal material. Catarrhal inflammation of the
intestinal mucosa, in varying degrees of intensity, is found
throughout its course. The lungs are but slightly involved
in the majority of cases.
Symptoms.— These develop suddenly after a period of
incubation of three to five days. They consist chiefly of
depression, marked dulness, plumage becomes rough, comb
and wattles bluish-red; drowsiness, coma, paralysis. The
fowl will seek dark places, sit with head down in a crouching
attitude, and refuse to move except when forced to do so.
They will show a staggering gait, and as the disease pro-
gresses will not be able to walk. There is nearly always a
profuse discharge from the eyes, the conjunctiva inflamed
and swollen. Collections of a similar secretion are found
in the nasal passages, mouth and throat. On opening the
mouth the membrane will show injection; in some cases
hemorrhages and a thick glutinous collection over its surface.
The bird often shakes its head and sneezes frequently to
discharge the exudate which has collected. The bowel dis-
charges may be normal in appearance, or thin, watery and
have a greenish tinge. Sometimes hemorrhages occur in the
bowels which give the feces a red or brown color.
As the disease progresses the bird becomes much weaker,
shows marked dyspnea and dies from paralysis. Some
cases show spasms and convulsions shortly before death.
The course of the disease is usually three to five days.
Subacute cases last five to eight days.
Diagnosis.— There is always some difficulty in differen-
tiating between fowl pest and fowl cholera. The symptoms
and autopsy are so similar that it is necessary to make a
microscopic examination to determine whether or not the
bacilli of fowl cholera are present. In fowl pest no organisms
are found on microscopic examination, nor on cultures.
Differential Diagnosis.— The differential diagnosis will
depend upon: (a) Microscopic findings; (6) the infectio-
contagious character of the disease (to distinguish from
ptomain poisoning); (c) the well-known infectiousness of
cholera virus to pigeons which are not susceptible to fowl
pest.
592 ACUTE GENERAL INFECTIOUS DISEASES
Prognosis.— As most cases terminate fatally, the prognosis
is bad.
Treatment.— No medical treatment is known that has any
material effect in controlling this disease after the fowl is
once infected. Preventive treatment is by far the most
important, and should consist of radical measures of iso-
lation and disinfection. (See Fowl Cholera.)
CHAPTER II.
ACUTE INFECTIOUS DISEASES WITH LOCALIZA-
TION IN CERTAIN ORGANS.
EPITHELIOSIS INFECTIOSA AVIUM.
Contagious Epithelioma. Chicken-pox. Diphtheria.
Ronp. Canker.
Pre valency and Distribution of the Disease.— The disease
affects nearly all birds, especially chickens, turkeys, pea-
fowls, pheasants, guineas, pigeons, sparrows, quail, etc.,
but is not so frequently observed in ducks, geese and swans.
The malady is widely distributed, appearing in practically
all countries where birds are found in any considerable
numbers. In the United States infectious epitheliosis is
quite prevalent, especially in the northern states during the
colder months. In the fall when the cold, damp weather
begins outbreaks occur quite commonly, and poultrymen
often refer to the early inception of the disease as a "cold."
The intensity of the disease usually increases until the
warm weather makes its appearance, when it diminishes and
lies dormant, to reappear at the first cool, damp weather in
the fall when the birds are more closely confined.
Etiology. -Evidence obtained by experiments indicates
that a filtrable virus is the primary causative agent, and
that the more or less severe complicating conditions are
induced by secondary infection, of which a bacillus, probably
the Bacillus diphtheria1 columbarum of Loeffler, seems to be
the most constant.
Pathogenesis. — Transmission of this disease is not very
difficult. Usually about 70 per cent, of healthy birds will
show symptoms of the disease after associating with an
affected one for a short time. Actual contact is not neces-
38
594 ACUTE INFECTIOUS DISEASES
sary, as is shown by the spread of the disease at poultry
shows. A bird with mucous membrane lesions may trans-
mit the disease to a susceptible bird in the cutaneous form,
and vice versa.
Emulsions of scrapings from either cutaneous or mucous
membrane lesions injected subcutaneously, submucously or
applied to scarified areas on the skin, would in some cases
produce the generalized form of the disease. Similar results
were produced by using an emulsion of a twenty-four-hour
agar growth of cultures taken from , lesions and injected
subcutaneously.
It is possible at times by scarifying the mucous mem-
brane of apparently healthy birds to produce at the point
of injury local lesions not unlike those of this disease, but
they disappear in a few days without manifestation of
general symptoms. Incomplete experiments by using the
blood of sick birds in an attempt to produce the disease
gave negative results, which is contrary to that claimed by
a few other investigators.
Natural Infection.— There are a variety of ways by which
natural infection takes place. Cohabitation is one of the
most common, an infected bird introducing the disease
into an entire flock. The exfoliated membranes, or the
exudate given off while sneezing or coughing, act as inter-
mediary carriers to the healthy birds. The infection in this
way will find lodgment on the skin where there are slight
abrasions, or on the mucosa of the eyes or mouth, where
it develops either to form the pox lesions or the various
other forms found on the mucous membranes.
It is quite possible to have the disease develop in the
eyes by the infection gaining entrance, and the bird irri-
tating the skin and conjunctiva by rubbing them against
objects or by scratching them with their feet. The disease
is frequently spread by food or drink which is contaminated
with infective material.
A very common source of the disease is the poultry show
where infected birds are exhibited, and conditions exist
favorable to reduce the bird's resistance. It very fre-
quently happens that on the return of birds from the show
EPITHELIOSIS INFECTIOSA AVJUM 595
the disease develops in the course of a week or ten days.
Sparrows and pigeons are common carriers, often trans-
porting the infection great distances. This is a very impor-
tant method of transmission often overlooked. The disease
has been observed in sparrows in a number of cases and
exhibiting in them the same characteristics as in other
birds. Sparrows and pigeons come in direct contact with
poultry at feeding time and thus infect them. It is some-
times spread by such intermediary agents as infected coops,
clothing, etc. Young birds are more susceptible to the
infection than older ones. Pigeons and chickens seem to
be far more susceptible than other birds.
It has been observed that one attack of the disease will
produce immunity for a certain period. Either the skin
form or involvement of the mucous membranes confers
equal immunity against the opposite form.
Pathology.— The postmortem findings vary with the
immediate cause of death. In rare cases when death is
due to suffocation early in the disease only the acute con-
ditions are noted. The body appears fairly well nourished,
the mucous membranes are covered with a thick slimy
mucus which may occlude the upper air passages. In the
larynx, or somewhere along the trachea, possibly in the
larger bronchi, will be found the mass of dense, tough,
yellowish material obstructing the lumen.
In some cases when both eyes are involved death results
from starvation early in the disease. The body is emaciated.
The mucous membranes of the eyes, and often of the mouth
and respiratory passages show inflammation, and usually
there is a mass of this same yellow material in the con-
junctival sac distorting or obscuring the eyes. The skin
around the eyelids may also be involved.
The majority of the fatal cases die in two to five weeks.
In these the body shows all the symptoms of a toxemia,
emaciation is pronounced, and the serous membranes
studded with petechise. In the cutaneous form the skin
presents all the symptoms of a severe inflammation, each
nodule being a distinct process. Some of them show a
similarity to tumor formation, especially on the comb where
596 ACUTE INFECTIOUS DISEASES
the skin is thickest, but on the wattles and feathered skin
around the head this feature is less pronounced. Masses
of tough yellow material often distend the suborbital fossae,
accumulate in the external ear, in the lung substance and
along the digestive tract.
Symptoms.— The disease assumes various forms, depend-
ing upon whether it involves the mucous membranes of
the mouth, the nasal passages, the eyes, the intestinal tract,
or the skin. It is necessary from a clinical standpoint to
consider these various types of the disease. It is this fact
which has led to so much confusion among the poultrymen,
as they have been inclined to consider these forms separate
diseases.
Na^al Passages.— The early symptoms are similar to those
of an acute nasal catarrh, but the bird shows more dulness
and prostration and there is present a peculiar offensive
odor. The odor is very characteristic. The discharge
from the nasal passages is at first thin, serous and later
becomes thicker and glutinous, causing the affected birds
to sneeze and shake their heads in an effort to clear the
nasal passages. The nasal secretions collect around the
openings, forming dirty, yellowish crusts. The infra-orbital
fossae become inflamed and distended with pus, forming
an enlargement on one or both sides of the head below the
eyes. Owing to the occlusion of the nasal passages the bird
breathes with open mouth.
Eycs.—Kt first a thin serous secretion is observed flowing
from one or both eyes; later it becomes turbid, thicker,
adheres to the edges of the eyelids and dries to form crusts
completely closing the eye. The retained yellow material
becomes thicker and often accumulates to such an extent
that it causes a pronounced bulging of the eyelids. Masses
of this material as large as a walnut are often removed from
beneath the lids. Sometimes infection develops posteriorly
to the eyes in the form of abscesses which force the eyes
partly out of position. The cornea is turbid and often
ulcerated. Complete destruction of one or both eyes is
often observed in severe cases.
EPITHELIOSIS INFECTIOSA AVIUM 597
Mouth.— Involvement of the mucous membrane of the
mouth begins as a local disturbance. The disease is ushered
in by a slight redness or congestion of isolated areas, or
may involve the entire surface. In the center of the con-
gested areas there will appear in a day or so small round
or oval yellowish-white spots, which rapidly spread and
eventually form extensive collections of glutinous pus,
having somewhat the appearance of diphtheritic mem-
brane. The nature of the collected material on these areas
led to the name "diphtheria" for this form. As the disease
progresses this process often extends over the entire mucosa
of the mouth, tongue and throat. When the larynx is
involved, or even the trachea, as is occasionally noted, there
will be marked symptoms of dyspnea. Asphyxia is fre-
quent when the lesions extend to the larynx and trachea.
On removal of the deposits the mucosa presents a red,
granulating surface, which bleeds easily, showing in some
cases extensive submucous swelling and edema. The com-
missures of the mouth are frequently involved as is the
skin and contiguous tissues, a characteristic pox lesion
developing in the skin. Other complications are frequently
found spreading from the oral cavity, i. e., to the pharynx,
esophagus and crop, producing severe diarrhea and other
bowel disturbances.
Skin. — Lesions on the skin are found in quite a few cases,
more commonly on the comb, wattles and other portions
of the skin not covered with feathers. It is first noticed
as a very fine gray vesicle, which soon develops into small
elevations of a reddish-gray color, which later become more
grayish. Microscopically the nodules are composed of
degenerated epithelial cells. These nodules in some cases
become quite large, warty in appearance, dry and hard.
In severe cases large numbers of these nodules are found
distributed over the skin on exposed surfaces. On removing
the surface of the nodules a raw granulating area is noted.
Some cases show distinct degeneration of contiguous tissues.
A mixed variety of the disease is of frequent occurrence,
the mucosa showing the characteristic deposits and the
skin pox lesions. It is quite evident in these cases that
598 ACUTE INFECTIOUS DISEASES
the disease spreads from one location to the other, and the
difference in the lesions is due to the difference in the struct-
ure of the tissue involved.
General Symptoms.— In the early stages before much
secondary infection takes place, there are no marked general
symptoms. Later marked general symptoms appear. The
birds show dulness, assume a sitting posture, wings are
held pendent, plumage becomes rough and the patients
show much depression. The comb and wattles grow
bluish-red in color, later pale and cold. In the colder
climates the disease often assumes a subacute or chronic
form, while in warmer climates the acute form is more often
observed. Frequently, however, the disease assumes the
character of a chronic catarrh.
Diagnosis.— The disease usually makes its first appearance
in the fall and often occurs as the cutaneous form. It may
be overlooked, especially if the birds are on the range.
The mucous membrane form usually makes its appearance
soon after housing for the winter. The sneezing, mouth-
breathing, occluded nostrils and an occasionally inflamed
eye are significant, especially when rapidly spreading
through the flock. Soon after a few will refuse food and
appear depressed.
It must also be suspected when similar symptoms appear
after adding new birds to a healthy flock or birds returned
from shows.
A peculiar characteristic and offensive odor is associated
with this disease and poultrymen familiar with it often
recognize the disease from the odor alone. The same odor
is given off by cultures.
Differential Diagnosis.— Wounds on the skin around the
head, usually pick-inflicted, appear suspicious, but these
heal rapidly without extensive thickening. An injury to
the eye, even though serious, will not cause the formation
of the characteristic yellow deposit. Difficult respiration,
rarely seen in more than one bird in a flock, may be due to
several causes, and those observed persisted for some time
without affecting the general health of the bird.
ANTHRAX 599
Prognosis.— The cutaneous form usually runs a more
favorable course, apparently recovering in one to three
weeks, when the nodules become dry and scale off. The
mucous membrane form is less favorable, the mortality
varying from 10 to 50 per cent., depending on the care and
sanitary surroundings.
Aside from the actual number that die we find there is
considerable loss resulting from the chronic effects. After
the disappearance of all visible lesions the birds do not
seem to regain their former good condition for months.
Egg production is far below normal, and young birds have
their growth checked.
Treatment. — There have been a great many drugs recom-
mended in the treatment of this disease, and so far none
of them have proved very satisfactory. Daily treatment
of individual birds is a tedious and laborious task, especially
where large flocks are affected.
The lesions, whether on the skin or in the mouth, should
be washed with antiseptics, boric acid solution (2 per cent.),
potassium permanganate (0.25-1 per cent.), or any other
equally efficient antiseptic. The deposits should be removed
with a curette or dull knife before applying the antiseptic.
Vaccine.— Vaccination has proved very satisfactory in this
disease. One c.c. is administered subcutaneously, and in
severe cases it should be repeated in four to six days.
Prevention.— All newly acquired birds should be examined
and isolated for at least ten days before allowing them to
come in contact with the regular flock.
As soon as the disease is recognized, it is recommended
that all birds be vaccinated immediately to check it.
Healthy flocks and those intended for exhibition purposes
may be vaccinated to establish immunity. This has proved
very satisfactory. The immunity established will last for
at least six months to one year.
ANTHRAX.
This disease is essentially found in large animals. (See
other works.)
000 ACUTE INFECTIOUS DISEASES
FOOT-AND-MOUTH DISEASE.
Aphthce Epizooticce.
Foot-and-mouth disease rarely occurs in carnivora, but
has been observed in a few cases in dogs. Dogs kept on
infected premises in contact with infected cattle, especially
those that are used for herding animals are the ones most
liable to be affected. Dogs are not very susceptible to the
infection, and take it in a mild form. The principal symp-
toms are vesicles on the mucous membranes of the lips,
sometimes forming ulcers, which penetrate more or less
deeply into the tissues. Sometimes the feet become involved,
when there will appear a vesicular exanthema on the balls
of the feet and between the toes. The feet will be swollen,
hot and sensitive, and the patient very lame. General
symptoms, such as elevation of temperature, diarrhea, loss
of appetite and vomiting have been observed. The disease
has made its appearance in fowls, but only in a few instances
has it been recorded.
HEMORRHAGIC SEPTICEMIA OF CATS.
Infectious G astro-enteritis.
History.— This disease has been reported as occurring in
various sections of the United States and Europe. So far
but little is known about it as the disease is a comparatively
new one.
Occurrence. — Cat septicemia occurs enzootically, espec-
ially among cats congregated as in catteries and shows.
Etiology.— The disease seems to be produced by a specific
organism (Bacterium felisepticus bipolaris of Huse and
Coleman). It is described as a short, rod-shaped organism,
taking the bipolar stain readily with the common stains, but
is Gram-negative.
Pathogenicity . — The work up to the present time indicates
the pathogenicity of this organism is confined to cats, rabbits
and guinea pigs. Dogs and birds show no tendency toward
natural infection.
HEMOKRHAGIC SEPTICEMIA OF CATS (>01
Pathogenesis.— The organisms are evidently taken into
the digestive tract with the food and drink. The organisms
multiply very rapidly and induce in a very short period of
time a severe hemorrhagic gastro-enteritis. The severity
of the disease depends upon the natural resistance of the
animal and the virulency of the infection.
Symptoms.— The period of incubation is from two to five
days. The development of the symptoms is very rapid.
The disease is ushered in by a sudden suppression of the
appetite, vomiting, retching, marked depression and general
weakness. The animal shows a tendency to seek dark cool
places and lies stretched out on its abdomen. The tem-
perature rises rapidly after the onset reaching 103-106° F.
in twelve to twenty-four hours. The temperature remains
high during the early part of the disease, but later becomes
normal or subnormal. Emaciation comes on rapidly, a
profuse diarrhea is present, the feces having a characteristic-
fetid odor. As the disease progresses the animal becomes
weak, eyes retracted and staring. In three to four days
coma develops, and death follows in the course of a few
hours. The course is very rapid in acute cases, ^ome
few cases assume a subacute form, and the symptoms are
milder but progressive.
Pathology.— A more or less severe gastro-enteritis hemor-
rhagica is typical of this disease. The entire mucosa of the
digestive tract is highly congested and dotted over the
surface with petechia> and numerous patches of ecchymoses.
The membrane is covered with a catarrhal exudate which
in the majority of cases contains some blood. The serous
covering of the intestines shows marked congestion, but no
petechirt'. The presence of gas in the stomach and bowels is
quite constant. The stomach particularly is nearly always
found distended. The heart muscle, liver and kidneys show-
signs of rapid degeneration. The gall-bladder is greatly
distended, and the bile is dark colored, thick and tenaceous.
The lungs may show congestion, and in subacute attacks
pneumonic areas. Other cases may not show changes in
the lungs.
602 ACUTE INFECTIOUS DISEASES
Diagnosis.— The disease is recognized by its contagious
character, its rapid, severe course and the profuse diarrhea.
The absence of catarrhal symptoms of the air passages and
eyes would assist in differentiating it from distemper.
Ptomains or mineral poisons will produce similar symptoms,
but the microscopic examination, the contagious character
and the investigation of the food supply, history of poison-
ing, etc., will serve to make clear the differentiation. It
is very important to be able to make an accurate diagnosis
for the protection of other animals.
Prognosis.— The prognosis is bad. Even in the early
period of the disease, and in the apparently mild cases, it
should be looked upon as a very serious condition. The
mortality is very high, from 80 to 90 per cent, of the cases
terminating fatally.
Treatment.— There is no treatment known that has
much, if any, effect on the course of the disease. Sympto-
matic treatment is the only thing that can be done. A
vaccine is being used as a prophylactic treatment, but at
present it is difficult to say what the results will prove to
be. An antisera is also being used at present and gives
considerable promise of success as a curative and preventive
agent. The progress of the disease, after it once breaks out
in a hospital or cattery can be curtailed only by removing
all sick and exposed animals, and thoroughly disinfecting
the rooms with formaldehyd gas. All utensils, litter, etc.,
should be rendered innoxious. Prevention is far more
important than treatment.
CHAPTER III.
INFECTIOUS DISEASES WITH SPECIAL INVOLVE-
MENT OF THE NERVOUS SYSTEM.
RABIES.
Hydrophobia . Lyssa .
Definition.- An acute infectious disease, fatal in the
majority of cases, and characterized clinically by disturb-
ance of consciousness, marked irritability and later by
.symptoms of paralysis.
Occurrence. — Rabies is one of the oldest known diseases
and has been observed in all countries. It is most com-
monly noted in dogs, cats, wolves and foxes. Other animals
are less commonly affected. It is estimated that about
90 per cent, of the cases of rabies occur in dogs. The
disease often occurs enzootically, which may be at any
season of the year. The larger number of outbreaks in the
I nited States has been in the colder months of the year.
Outbreaks are naturally more frequent where dogs congre-
gate, and in communities or cities where there are no pro-
tective regulations. In some countries and districts rabies
is decreasing, due to proper police regulations which restrict
the number of dogs running at large.
Etiology.— Kabies is produced by an ultramicroscopic
virus. This virus is found to be the most virulent when
taken from the central nervous system (brain and cord),
less so from the peripheral nerves, salivary and other glands
and their secretions. The infection does not seem to be
present in the blood of affected animals. The infectious
agent is fixed, non-volatile and is an obligatory or fixed
parasite.
Pathogenicity.— The disease is readily transmitted to
dogs, rabbits, guinea pigs and other animals by inoculating
004 INFECTIOUS DISEASES
them with the virulent saliva, or an emulsion of the cornu
ammonis, medulla ohlongata, and some other portions of
central nerve tissue. The most satisfactory results are
obtained by injecting some of the virus under the dura
mater of the brain or cord. The same inoculation may be
made into the anterior chamber of the eye, or into the
muscles, but the results are not so certain. Injection of
the virus into or around the peripheral nerves has produced
the disease quite constantly. Scarification of the skin and
rubbing the virus on the area has produced positive results
only in about 40 per cent, of the cases. Other methods of
inoculation have been less successful. Birds may be infected
by inoculation.
Natural Infection. — Rabies is produced in practically all
cases by the victim being bitten by a rabid animal, intro-
ducing the virulent saliva into the wound, to come in con-
tact with the nerves, muscles, or subcutaneous tissues.
Rarely are cases produced by the infectious agent being
licked from wounds, or from contact with lesions on the skin.
Pathogenesis. — When the virus is introduced into some
part of the body through a bite by another animal, or by
inoculation artificially, it is supposed that it follows the
course of peripheral nerve fibers along which it is carried
to the central nervous system. The explanation of the
development of the two types of the disease is explained
by the path of travel to the central system, whether it
reaches the brain, medulla oblongata, or the spinal cord.
Alter the virus reaches the central nervous system to pro-
duce irritation on certain groups of cells, it is then centrifu-
gally distributed to different parts of the body. It reaches
the salivary glands, which favors the development of the
virus, increasing the secretion of the glands, and then is
further disseminated through the saliva. The period of
incubation of rabies is quite variable. The virus after
being introduced into a wound may remain in a dormant
state for some time before reaching the central nervous
system. The variation in susceptibility of animals in the
virulency of the infection, and the method of the dissemina-
tion of the virus in the body naturally make the period of
RABIES 605
incubation rather long. Three to seven weeks is the usual
time for development in dogs. However, some cases
develop only after several months. The period of incu-
bation in cats and fowls is usually shorter than in dogs.
The period of incubation is usually shorter in young animals.
The toxicity of rabies virus and the pathogenic action on
the tissues are no doubt due to some chemical product which
up' to the present has not been determined.
Pathology.— The disease is really characterized by the
absence of any marked gross pathological findings. The
lesions vary somewhat in individual cases. The digestive
tract shows congestion and hyperemia. The stomach may
be contracted and empty, or is frequently partially filled
with foreign material such as stones, straw, sticks, splinters
of wood, hair, feathers, etc. The folds of the mucous mem-
brane are markedly congested on their summits. Hemor-
rhage sometimes occurs from the foreign material cutting
or tearing the mucosa. The mucosa of the pharynx and
larynx shows congestion and is covered with mucus. An
acute catarrhal inflammation of the respiratory passages
is frequently found. The brain and its coverings are often
injected with small hemorrhages. No other lesions of any
importance are observed.
Symptoms.— From a clinical standpoint it is necessary
to divide rabies into two types, viz: (1) Furious rabies,
and (2) dumb rabies. The different train of symptoms
depends entirely upon whether the brain or spinal cord is
primarily involved. However, cases are observed occa-
sionally where an animal affected with dumb rabies suddenly
develops the furious type. The dumb or mute rabies seems
to be the most common form in the United States.
1. FURIOUS RABIES.— In this form three stages of devel-
opment are rather sharply defined : (a) Melancholic or pro-
dromic stage; (b) maniacal or irritative stage; (c) paralytic
stage.
(a) Stage of Melancholy.— In the stage of melancholy or in
the beginning of the disease, the first thing usually noted by
the owner is the altered behavior of the animal. It becomes
sullen, afraid, seeks dark places, is easily irritated, restless and
(JOG INFECTIOUS DISEASES
obstinate (often does not obey its master). The patient
is also inclined to hide itself, alternately gets up and lies
down frequently, makes sudden, unusual movements, such
as snapping or biting at imaginary objects, or barks sud-
denly without any cause. During the early stage of the
disease the appetite is not much changed, but later the
manner of eating and the kind of food chosen are greatly
modified. Dogs are inclined to eat indigestible objects,
such as pieces of wood ; eat their own feces and lap up their
own urine, etc. A very noticeable symptom is the tendency
to grasp objects as if to eat them, then suddenly let them
fall from the mouth. Constipation is usually present in
this stage. During the latter part of this stage the patient
is excitable. The patient shows a marked change in dis-
position, snaps at objects, its master, other persons or
other animals. This excitability is more noticeable toward
strange persons or animals. Sometimes the patient mani-
fests no change in disposition toward its master, familiar
persons or animals. The excitability gradually, or very
rapidly, increases. The nervous reflexes become sensitive
and the patient is easily startled by sudden noises, touch-
ing objects or by strong light. The pupil of the eye dilates
and the facial expression is changed. Dyspnea is prominent
at times. The patient will often scratch or bite the place of
infection, sometimes doing extensive injury to the area.
The appetite is entirely suppressed but the animal seeks
water and attempts to drink, but, on account of the begin-
ning paralysis of the larynx and pharynx, does not succeed.
The salivary secretion is increased, and saliva hangs from
the mouth in long strands. This stage usually lasts from
one to three days.
(b) Sbigr. of Irritation . — In this stage the symptoms reach
a higher degree of development. The excitement increases;
hallucinations, which bring about violent fury or rage, are
soon apparent. The voice of the animal changes decidedly
from the normal. This is a very characteristic symptom
of rabies, and no doubt results from the congestion and
paralysis of the vocal cords. The owner's attention is
always attracted by the unusual amount of barking and
RABIES 607
the change in the voice. At this stage they become vicious,
and if confined show a tendency to chew objects and tear
them to pieces. Rugs, carpets, or other objects with which
they come in contact are torn and destroyed. At this
time if they are not confined they will usually wander
away from home, biting other animals or persons that hap-
pen to come in their path. Often during a short period of
time they will travel long distances before returning, which
they invariably do. Upon their return they show emacia-
tion, exhaustion, often wounds from being bitten by other
animals, and in general have a dejected appearance. The
desire to bite aimlessly objects and animals is quite char-
acteristic of this stage. A rabid dog in this stage may
inoculate a large number of animals unless confined. ,When
confined in a cage or room they show at times intense fury
and viciousness. If irritated, by placing a stick between
the bars of the cage, the dog will attack it viciously, but
shows the peculiar symptom of simply biting instead of
holding on to the stick as non-rabid dogs ordinarily do.
As this stage progresses the periods of fury become shorter,
and soon marked depression is noted. Paralysis of some of
the special nerves develops, shown by the increase in the
change of the voice, which becomes a peculiar wail or howl,
and the difficulty in swallowing. The eyes are congested,
and also the mucous membranes of the mouth. This stage
of fury lasts usually two to four days.
(c) Paralytic Stage.— The symptoms of paralysis become
more pronounced, and the patient is less vicious. Complete
loss of voice and the inability to swallow, with paralysis
of the tongue and masseter muscles, are early symptoms of
this stage. The mouth is held open, the dry tongue is pro-
truded and completely paralyzed. The eyes are retracted,
lose their expression and luster; the pupils become dilated,
in some cases unequally. The animal shows marked gen-
eral emaciation, the hair coat rough and there is much
exhaustion. The general paralysis asserts itself, beginning
in most cases at the tail and posterior limbs. The animal
has difficulty in walking or standing; later there is complete
paralysis of the posterior part of the body. The paralysis
rapidly ascends to the fore parts and central nervous sys-
008 INFECTIOUS DISEASES
tern, causing death in most cases on the fifth to eighth day
of the attack. The temperature in rabies has not been
recorded in many cases. During the early stages it is
elevated to 104°-io6° F. ; later becomes subnormal. Varia-
tions in the symptoms of furious rabies are observed, but
most cases present a rather constant clinical picture.
The symptoms of furious rabies in cats are very similar
to those of dogs. They often become very vicious, and
bite and scratch everything that they come in contact
with. The change of voice is also quite noticeable. The
course of the disease is usually shorter, lasting from three
to six days.
2. DUMB RABIES.— This form is characterized by a
paralysis of the lower jaw, tongue, larynx and pharynx.
This symptom develops early in the disease and is the most
prominent one until general paralysis manifests itself.
The owner is often led to suspect that the animal has a
bone or some other object lodged between its teeth, or
in its throat. All such cases should be looked upon with
suspicion, and all precautions taken in making the exami-
nation. In the majority of cases no nervous or excitable
symptoms are shown; the paralytic symptoms gradually
becoming more pronounced until the animal succumbs to
general paralysis. Cases are observed occasionally where
symptoms of excitement develop during the course of the
disease. One such case was observed in which the early
symptoms indicated dumb rabies but in twenty-four hours
all the symptoms of the furious form had developed. Ani-
mals with this form of the disease usually seek dark, cool
places and lie almost constantly.
There is the same peculiar expression from the eyes as
in the other form. The patient often attempts drinking
or eating which the paralysis prevents. There is usually
no tendency to bite nor viciousness manifested.
Rabies in rabbits nearly always assumes the paralytic
form. Fowls show the characteristic symptoms of furious
rabies in some cases, such as excitement, change of voice,
ruffled plumage, attacking other fowls, people, etc. In other
instances the paralytic form is observed.
Diagnosis.— In furious rabies the diagnosis does not
RABIES 609
present any great difficulty where the symptoms are pro-
nounced and the animal observed through the different
stages. The positive proof of a bite inflicted previously
by another animal is of considerable importance in mak-
ing the diagnosis. An accurate diagnosis is of great impor-
tance for two reasons, viz.: (a) In case human subjects are
bitten, or in any way inoculated, it will give them an oppor-
tunity to receive the antirabic treatment early; and (6)
to protect other animals and persons from becoming inocu-
lated by quarantining and confining the animal. Under no
circumstances should an animal showing symptoms of rabies,
or suspected of having the disease, be killed. It should
be put in quarantine and observed. It has been demon-
strated that animals destroyed early in the disease often
do not show positive findings on microscopic examination.
The characteristic symptoms of irritation, tendency for
biting, change of voice, paralysis, etc., generally show evi-
dence enough to the experienced clinician to establish the
diagnosis. The detection of Negri bodies on microscopic
examination will make the diagnosis positive. In dumb
rabies the diagnosis is made on the characteristic symptoms
of paralysis of the lower jaw, the somnolence in most cases,
the expression and the paralysis of other parts of the body
in the course of two to four days. All cases showing the
symptoms of the lower jaw hanging down should be diag-
nosed dumb rabies until ample proof is shown that it is some
other condition. Microscopic examination of the brain
should be made to establish the diagnosis as in furious
rabies. Intracranial inoculations of rabbits have been used
extensively in making a positive diagnosis. This method
requires from fourteen to seventeen days, and is falling
into disuse. Inoculations of the virus in guinea pigs have
also been used extensively as a diagnostic measure.
Prognosis and Course.— The disease is fatal in practically
all cases. The possibility of recovery in very mild cases
cannot be denied. However, no authentic case of recovery
has been recorded. It has been estimated that only about
17 to 20 per cent, of the animals bitten by known rabid
animals develop rabies. This percentage is higher in dogs
than in any other small animal. The course of the disease
39
filf) INFECTIOUS DISEASES
is quite constant in the different animals, although variations
occur occasionally. Five to seven days is the usual course;
it may be in exceptional cases as short as two days or as
long as ten or eleven daj's. There is but little difference
in the course of the two forms; usually dumb rabies runs a
longer course than the furious type.
Differential Diagnosis.— There are quite a number of
diseases in small animals which might be confused with
rabies: (a) Diseases of the brain, particularly inflammations
involving the meninges and the cerebral substance itself.
In these cases irritability and nervousness are present, but
the tendency to bite, the aggressiveness, change in voice
and development of the paralysis in the same way are
absent. If there should be any doubt the animal must be
confined and observed for a few days when the differentia-
tion will not be difficult. (6) Canine distemper (nervous
form) sometimes simulates rabies, but the history of the
case, the other symptoms of distemper and the length of
the course of the disease will reveal the difference, (c)
Parasites in the intestinal tract often produce certain
nervous phenomena, but of different development and type
than rabies. Many of the characteristic symptoms of
rabies are absent, (d) Other parasites (Linguatula
rhinaria, Dioctophyme renale, Spiroptera sanguinolenta,
Otodectes cynotis) may produce certain nervous symp-
toms, but careful examination and observation of the
animal will readily distinguish the difference, (e) Foreign
bodies lodged between the teeth, around the tongue or in
the pharynx all induce salivation, hoarseness from the
accompanying edema and cause the mouth to remain open.
These cases should be examined very carefully to differ-
entiate them from rabies. In most of these cases it is
impossible to close the mouth, which is not true in rabies,
and there are no general symptoms. (/) Trigeminal or
facial paralysis is observed occasionally in the course of
distem])cr, or as an independent condition. In these cases
there are no other symptoms of paralysis, nor any general
symptoms. The course is longer and the animal remains
otherwise normal, (g) Epilepsy might be confused with
RABIES 611
rabies. But this condition comes on suddenly and lasts
only a few minutes to disappear completely until the next
attack, (h) Eclampsia is differentiated by its occurrence
in bitches at or near the time of whelping, clonic spasms
which affect the entire body and none of the other char-
acteristic symptoms of rabies, (i) Infectious bulbar paral-
ysis in which the symptoms are quite similar to rabies.
It is distinguished from rabies by the absence of the furious
attacks, viciousness and paralysis of the lower jaw. The
blood and brain tissue are infectious and the saliva not.
This disease develops suddenly and runs a more rapid
course than rabies. Finally, there are a few conditions in
which the animal will show more or less nervousness, but
none of the other symptoms of rabies. Animal inoculation
and the microscopic examination of the brain should be
made in all cases of doubt.
Treatment.— After rabies has once developed in an animal
no treatment will have any effect on the disease. Bitten
wounds that have been caused by a rabid animal should
be treated promptly. They should be opened freely, and
if hemorrhage takes place it is all the better, as it will tend
to remove the virus from the wound. The wound should
be washed freely and thoroughly with potassium perman-
ganate solution (1 per cent.), or bichlorid solution (1 to
1000). Cauterization of the wound with silver nitrate is
also recommended. The success of this treatment in pre-
venting the development of the disease will depend upon
the length of time which has elapsed after the bite, and the
thoroughness in which the antiseptic or caustic is applied.
Disinfection of the wound alone should not be depended
upon for the prevention of rabies.
Preventive Inoculation.— Preventive inoculation is being
used with great success in animals, and is highly recommended
in all cases where there is any doubt about the animal
being infected.
INFECTIOUS BULBAR PARALYSIS.
Pseudorabies.
Definition.— An infectious disease affecting dogs, cats, rats,
horses and cattle resembling rabies in many respects.
612 INFECTIOUS DISEASES
Etiology.— This disease is produced by a specific virus,
the nature of which has not been determined. All animals
except fowls are susceptible to inoculations with the virus
which is found in the blood, central nervous system, and
in some of the other tissues. The saliva, bile and urine are
free from the virus.
Pathogenicity.— Most animals are very susceptible to
infection by inoculating them with only minute quantities
of the blood, or central nerve tissues, from those affected
with the disease. At the point of inoculation, the tissues
become red and inflamed; later, necrotic. The inoculated
wound shows intense irritation, and the animal bites and
scratches the part almost continuously. Dogs and cats
contract the disease readily after being fed on organs or
tissues containing the virus.
Natural Infection.— This has not been definitely established,
but probably in most cases is due to eating infected meats,
or being inoculated by infected mice or rats.
Pathology.— No marked lesions are found in this disease,
except at the point of inoculation. The meninges of the
brain, and the brain substance, usually show hyperemia,
and blood extravasations. When infection takes place in
cats and dogs from eating infected meat, the stomach and
small intestines are congested, and in some cases markedly
inflamed. Hemorrhages under the mucosa, and frequently
petechise on the serous membranes of the stomach and intes-
tines are noted. No other lesions are found.
Symptoms.— The period of incubation varies from two to
nine days. The onset of the disease is characterized in the
dog and cat by a sudden change in disposition, tendency to
seek dark, cool places, where the patient lies quietly or
maintains a crouching attitude. They often cry or mew
as if in severe pain. Vomiting is more or less persistent,
there is complete loss of appetite, and marked salivation.
Severe itching is manifested in most cases by the animal
scratching and biting itself, sometimes so severely that the
skin is entirely removed over the involved area, usually
around the lips or face. In some few cases this symptom may
TETANUS.— LOCKJAW 613
be absent. As the disease progresses the animal shows more
pain by howling, crying, or groaning. The muscles around
the head and face often show marked twitching, which may
be periodical or constant. The nervous system is affected as
is shown by increased reflex excitability, paralysis of the
pharynx and larynx, and increased muscular sensitiveness.
There is marked dyspnea. The temperature is usually normal
or subnormal ; toward the end the subnormal temperature is
very marked. The animal usually dies in about thirty-six
to forty hours.
Diagnosis.— There might be some difficulty in establishing
an accurate diagnosis. However, the symptoms, which are
quite constant, and the rapid, fatal course, would assist.
Differential Diagnosis.— In the dog and cat it is necessary
to distinguish this disease from rabies. The chief points of
difference are the following: (a) Rabies (furious) is charac-
terized by symptoms of rage or fury, aggressiveness; in dumb
rabies by paralysis of the lower jaw. Both are absent in
bulbar paralysis, (b) The saliva in rabies is highly infectious
while in this disease it is non-infectious, (c) The period of
incubation is usually from two to nine days, while in rabies,
although variable, it is much longer. On account of its rapid
course, it might easily be mistaken for some acute poisoning.
Should the symptom of itching and irritation be absent a
differentiation would be quite difficult. In such cases experi-
mental inoculation with the blood of the affected animal into
healthy ones will assist. Frequently, a number of animals
in a neighborhood will become infected at the same time, the
disease appearing in the form of an enzootic.
Prognosis.— Very unfavorable. The majority of cases die.
Treatment.— Treatment is unsatisfactory. Antiseptics for
the digestive tract may be tried. Thorough disinfection is
necessary in order to check the disease. All dead animals
should be burned or buried in lime to destroy the virus.
TETANUS. LOCKJAW.
Definition.— An acute, infectious disease, characterized by
involvement of the nervous system, resulting in spasmodic
614 INFECTIOUS DISEASES
contractions of certain groups of muscles, or the entire mus-
culature of the animal's body, without that consciousness
is disturbed.
Occurrence.— Tetanus is of rare occurrence in small animals.
It is observed occasionally in dogs and birds. It is far more
common in the large domesticated animals.
Etiology.— It is produced by a specific bacillus (Bacillus
tetani of Nicolaier).
Natural Infection.— Infection takes place by the bacilli or
spores gaining entrance to wounds in the skin or mucous
membranes. The most common intermediate carrier of the
infection is the soil or earth which comes in contact with
the wounds. Rarely is the disease spread from one animal
to another.
Pathology.— The postmortem is usually negative. The
affected muscles are usually pale, or may show occasional
hemorrhages. The condition of the blood indicates in most
cases that death is due to suffocation. Other lesions are
inconstant and of minor importance.
Symptoms. — General tetanus is of rare occurrence, although
observed occasionally. It is characterized by a stiff, stilty
gait, extended head, ears stiffly erected, protrusion of the
membrana nictitans, skin wrinkled over the forehead,
trismus. The muscles of the back and posterior limbs are
stiff and hard; tail erected and stiff. The reflexes are greatly
accelerated as shown when the animal is touched or hears
sudden noises. There i,s frequently opisthotonus, or ortho-
tonus. Very characteristic is the facial expression of dogs
suffering from tetanus. Perhaps in the greater number of
cases in dogs and birds tetanus is local and involves only
certain groups of muscles, usually the masseters, the muscles
of the ears, skin and muscles over the forehead, membrana
nictitans, and the muscles of the neck, all of which are con-
tracted and the head held fixed. In birds the symptoms of
stiffness of the neck, wings held in a fixed position, ruffled
feathers, stilty gait are the most prominent.
Diagnosis.- This is made mainly on the characteristic
symptom of tonic spasms of groups of muscles, with normal
consciousness and temperature, and the subacute course.
Differential Diagnosis.— (a) Differentiation must be made
TETANUS— LOCKJAW 615
between tetanus and strychnin poisoning which show very
similar symptoms. In strychnin poisoning the spasms develop
more rapidly, and are of much greater severity and the mem-
hrana nictitans is not usually affected. .The extremely in-
creased reflex excitability in strychnin poisoning as compared
to tetanus will also serve to differentiate them.
(6) Tetanus may also be mistaken for cerebrospinal menin-
gitis, but in the latter disease other symptoms, such as dulness
and paralysis of certain cerebral nerves, are present which
will assist in the diagnosis.
(c) Muscular rheumatism is differentiated by the absence
of reflex excitability; the muscles are painful and swollen
rather than contracted as in tetanus.
(d) There are quite a number of conditions (rabies, eclamp-
sia, epilepsy, articular rheumatism, etc.) which show some
symptoms of tetanus, but there are always other symptoms
present which are sufficient for differentiation.
Prognosis.— The prognosis in dogs, providing the symp-
toms are localized, is quite favorable. Should the disease,
however, become general it is unfavorable. The course in
the dog is usually subacute or chronic.
Treatment.— Dietetic.— When trismus is present, prevent-
ing the animal from taking food, rectal feeding is recom-
mended. Concentrated beef broth at body temperature is
perhaps best. Two to four ounces should be given 3 to 4
times daily. During the later stages milk can be allowed as
they will lap it in small quantities.
Medical.— Small and repeated doses of morphin sulphate
(0.05-0.2) once or twice daily to control spasms of the muscles;
or chloral hydrate administered per rectum (1 to 4 with acacia
and glycerin), using 6.0-12.0 of the mixture once or twice
daily. Subcutaneous injections of a diluted carbolic acid
solution have been recommended, but are of doubtful value.
Serum. — Tetanus antitoxin has proved to be of greater
value as a prophylactic than a curative treatment. Large
doses might be used, 1500 units daily for three to four days.
Surgical.— In case a wound is found indicating the focus
of infection, it should be thoroughly curetted and strong
antiseptic solutions applied (mercuric chlorid 1 to 1000;
carbolic acid solution 5 per cent.).
CHAPTER IV.
CHRONIC INFECTIOUS DISEASES.
TUBERCULOSIS OF BIRDS.
Tuberculosis Avinm. Avian Tuberculosis.
Definition.— A chronic infectious disease of chickens, ducks,
pigeons, parrots and .canaries. It is characterized by a slow,
progressive emaciation, which ends in death from exhaustion.
Occurrence.— Avian tuberculosis is a very common disease
of chickens and parrots. Occurring enzootically among the
former, enormous losses to the poultrymen result. During
the past few years it has made its appearance in practically
all sections of the United States. In a number of instances
entire flocks of birds have succumbed to the disease, or
become so infected and emaciated that their destruction
was necessary. The economic importance of the disease is
not entirely confined to those that die from the disease
directly, but it has an important bearing on the egg produc-
tion.
Etiology.— Tins disease is produced by the Bacillus tuber-
culosis avium. Its biological characteristics are similar in
many respects to the Bacillus tuberculosis of other animals
(mammalian tuberculosis) .
Pathogenesis.— The bacilli, picked up with the food, are
passed directly to the intestinal tract, where they pass
through the lymph follicles into the intestinal wall, either
to become localized at this point, or to pass into the portal
vein and liver. Or they may gain access to the general circu-
lation and through it become distributed to various parts
of the body. It is possible that the intestines may not
become affected by the bacilli passing through the walls, but
in a great many cases tubercular nodules are found in this
TUBERCULOSIS OF BIRDS 617
location. When the bacilli are taken into the general circula-
tion specific lesions will be found in the spleen, lungs, joints,
etc. The large number of nodules found in the intestinal
wall develop in most cases from the infection following along
the course of the lymph nodes, or from the bacilli becoming
lodged between the serous and muscular coats of the bowel,
producing a reactive inflammation and the formation of
tubercles. The toxic action of -the chemical products of
the bacilli produces a gradual emaciation, cachexia, and
ultimately death.
Natural Infection. — Most cases of tuberculosis in fowls no
doubt result from eating foods contaminated with bowel
discharges from affected birds. Bacilli are found in the
feces of affected birds in large numbers, particularly in those
cases where ulcerations are present on the intestinal mucosa.
Another very common source of infection is when healthy
birds eat the organs of those that have succumbed to the
disease. Carelessness in disposing of dead birds makes this
a very common source of infection. There is a possibility
of birds contracting the disease from the fecal discharges of
cattle affected with tuberculosis. This is a disputed point
at the present time. There is considerable doubt also about
their contracting the disease from the sputum of the human
subject. Parrots seem to contract the disease from this
source. Numerous cases have been recorded where fowls
contracted tuberculosis, and at the same time the attendants
had the disease. Whether transmission of the disease is
brought about in this way is in dispute. Flocks are usually
infected from newly acquired tubercular birds. Pigeons may
carry the disease from flock to flock.
Pathology.— The chief anatomical changes are found in the
liver, spleen, intestines, joints, and in parrots in the joints,
and skin about the head and neck. The surface of the liver
is covered with numerous small nodules and on cross-section
they are found to extend into or through the entire structure.
Sometimes the tubercles become confluent and form large
masses, white, gray, or grayish-white in color, the centers of
which are caseous. The liver is frequently much enlarged,
very friable indicating fatty degeneration. The spleen is
()18 CHRONIC INFECTIOUS DISEASES
similarly affected. The intestinal lesions are very common,
and consist of a large number of small nodules found on the
mucosa. By confluence large areas appear as do ulcers. On
the serous coat of the intestines are found nodules varying
in size from a millet seed to a hazel nut. The mesentery may
show similar lesions. The abdominal lymph glands are
usually enlarged and caseated. In some cases on opening
the abdominal cavity a striking picture is presented as the
entire visceral peritoneum is covered by hundreds of very
small white or grayish nodules. The lesions in the lungs are
similar, although not usually so marked as in the liver and
intestines. The affected joints are enlarged, contain a cheesy,
yellowish mass and the articular cartilages are eroded. The
other organs and tissues are not often involved, although
nodules are found occasionally in the kidneys, ovaries, tes-
ticles, pericardium, heart and gizzard. In parrots the disease
is usually localized around the head and in the mouth.
Xodules varying in size and condition are found containing
the same cheesy, yellowish material.
Symptoms.— In the early stages of avian tuberculosis the
symptoms are very indefinite. The disease is chronic and
characterized by a gradual emaciation without any specific
clinical symptoms. The emaciation continues in spite of good
appetite. The appetite persists as a rule until the beginning
of a general toxemia, when it diminishes to disappear entirely
during the latter stages of the disease. Symptoms of anemia
develop as evidenced by paleness of the mucous membranes,
comb and wattles, dulness, and rough plumage. During the
latter stage the fowls are listless, much emaciated, and show
all the symptoms of asthenia. Diarrhea sets in, and complete
exhaustion is followed in a few days by death. There is con-
siderable variation in the period of time required for the
development of the general symptoms. When the bones and
joints are affected, there is usually an involvement of the
joints of the wings, and the tarsal joints. At first the joint
shows swelling which develops gradually. The swelling is
firm at first, but in nearly all cases becomes soft and fluctuat-
ing, and when opened discharges a yellow, caseous material.
The bird is lame and the wings are held pendent.
TUBERCULOSIS OF BIRDS 619
In some cases small nodules are found beneath the skin on
various parts of the body. Parrots are affected in the major-
ity of cases locally around the eyes, face, or on the neck, or
the articulations may be involved. The lesions are small,
round, or oval nodules developing on some part of the skin
or mucous membrane. Later they become caseous. Their
characteristics vary somewhat, depending upon whether they
are located in the skin, or in the mucous membrane of the
mouth. The nodules when irritated often become quite
large, rupture, and leave an extensive ulcerous surface. When
the joints are involved the same symptoms are observed as in
fowls. General symptoms occur occasionally in parrots.
Diagnosis.— The diagnosis from the symptoms presents
considerable difficulty. However, when we consider that a
number of fowls in a flock are affected with a disease causing
emaciation, exhaustion and death, we should suspect tuber-
culosis. Several methods of diagnosis have been recom-
mended of which the following have given the best results:
(a) An affected bird is killed and an autopsy made. The
tubercular lesions are quite characteristic and the tubercle
bacilli may be found under the microscope. (6) By use of
avian tuberculin. This method has been employed quite
extensively of late. It has been found quite reliable in most
cases. The tuberculin is injected, using about 0.003 per
bird, into the deeper layers of the skin of the comb or wattles,
using a small dental syringe. Care should be observed that
the needle is not inserted too deeply, or the tuberculin will
enter the subcutaneous tissues. On the other hand, it must
not be too superficial or the epithelial layer will rupture and
allow the tuberculin to escape. The reaction consists in a
rounded swelling which develops in twenty-four to seventy-
two hours at the point of injection. The degree of reaction
varies with individual cases.
Differential Diagnosis. — There are several conditions which
might be confused with avian tuberculosis, viz: (a) Asthenia
(" going light") which is characterized by gradual emaciation,
and exhaustion, but negative findings on autopsy. Micro-
scopic examination will aid in revealing the difference. (6)
External parasites when affecting a number of birds in a
020 CHRONIC INFECTIOUS DISEASES
Hock will produce emaciation and a general unthrifty condi-
tion. Finding the parasites in large numbers, and negative
autopsy will suffice for differentiation. (c) Rheumatic
arthritis, or arthritis urica may resemble joint tuberculosis.
In doubtful cases a microscopic examination (tubercle bacilli)
may be resorted to.
Prognosis. — Unfavorable.
Treatment.— Xo treatment is of any value after the disease
has once become established.
Surgical.— Localized abscesses as they occur in parrots
should be incised freely, and the contents thoroughly removed
with a curette. Tincture of iodin is applied to abscess
cavities.
Prevention.— On account of the disease being difficult to
diagnose until well established, separation of the sick from
the healthy birds is not feasible. In valuable birds the
tuberculin test with segregation should be tried. Removing
the reactors will assist in controlling the disease. If this
cannot be done, it is recommended that the entire flock be
killed, all diseased fowls burned, and the healthy ones sold
for food. The premises should be thoroughly disinfected,
buildings, coops, etc., washed with bichlorid solution (1 to
2000). The soil in the runs should be saturated with liquor
cresolis compositus (3 per cent.).
A new flock of birds should not be obtained before at
least six months have elapsed. Thoroughness in the cleaning
and disinfection is very important if good results are to be
expected.
TUBERCULOSIS OF DOGS AND CATS.
Occurrence and Form.— Tuberculosis is not very often
observed in dogs and cats. As the pulmonary form is most
common, the infection is probably transmitted to the lungs
on inhaled particles of dust. In some cases, primary involve-
ment of the digestive tract is found, indicating that the germs
were probably taken in with the food. Rarely do we find
infection has taken place through any other channel.
TUBERCULOSIS OF DOGS AND CATS 621
Pathogenesis.— Most of the cases no doubt result from
association with tubercular human beings, or contact with
infected rooms, etc. It may also result from ingesting meat
containing the bacilli.
Pathology.— Two distinct types are found on necropsy:
(a) Pulmonary form, and (6) digestive form.
(a) In the pulmonary form the lungs show caseous foci,
or small miliary nodules. A chronic, indurative broncho-
pneumonia or a chronic interstitial pneumonia is frequently
found. Adhesions are common between the lungs and
parietal pleura. Aside from these lesions there are very often
present edema and emphysema of the lungs, bronchitis and
bronchiectasis. The pleura often shows evidence of a serous
or serofibrinous pleuritis with considerable fluid present in the
thoracic cavity; or in other cases a dry, granular adhesive
pleuritis in which the parietal and visceral pleura are adherent.
Numerous small nodules are often found on the pleura. The
bronchial lymph glands are more or less enlarged.
(6) The intestinal lesions are mainly in the mesenteric
lymph glands, which are enlarged; the walls of the intestines
show miliary tuberculosis, particularly on the serous covering;
the liver usually presents similar lesions. The spleen and
kidneys often show miliary tuberculosis. The cadaver in
general shows evidence of cachexia and emaciation.
Symptoms.— The disease usually runs a chronic course the
symptoms developing gradually. General emaciation is
apparent in spite of a fairly good appetite, the animals become
easily exhausted, are dyspneic (lung form), and weak. After
emaciation begins to be a prominent symptom, the form of the
disease, whether pulmonary or intestinal, will assert itself.
The pulmonary form is characterized by a short, dry cough,
which later becomes moister and is accompanied by a dis-
charge of a mucopurulent secretion which in most cases is
swallowed. The respirations grow labored; dry or moist
rales are heard on ausculation. Percussion reveals areas of
flatness, and usually hydrothorax. An atypical fever is
present during the course of the disease. In the intestinal
form the symptoms of chronic intestinal catarrh are most
622 CHRONIC INFECTIOUS DISEASES
prominent with diarrhea during the latter stages. Rapid
emaciation is generally followed by death in a short time.
Diagnosis.— As tuberculosis is not very common in dogs
and cats, and the symptoms not particularly characteristic,
a diagnosis is not often made during life. The history of the
case and its chronicity might lead one to suspect it. Tuber-
culin (0.15 to 0.20) might be used subcutaneously. The
reaction is more prompt but the test is not so reliable as in
large animals.
Prognosis. —Unfavorable.
Treatment.— In advanced cases no treatment should be
attempted. During the early stages good nutritious food,
and tonics are best. Inhalations 'of creolin vapor are recom-
mendablc.
GLANDERS.
In dogs and cats glanders is not very common. It is occa-
sionally observed among carnivora fed meat or organs from
horses affected with glanders. In zoological gardens glanders
may be enzootic among meat eating animals, especially
when horse meat is fed. Glanders usually assumes an acute
form in these animals. The early symptoms are those of an
intense inflammation of the mucous membrane of the nasal
passages, larynx, trachea, and the conjunctiva. In a short
time (two to five days) appears a greenish-gray or blood-
stained secretion from the eyes and nose. The respirations
are labored on account of the intense congestion and swell-
ing of the respiratory mucous membrane. The symptoms
rapidly become aggravated, the tissues about the head
become swollen, nodules appear at different points in the
skin, which open and form irregular shaped ulcers. Diarrhea
is a prominent symptom. The animal becomes emaciated,
and succumbs in the course of eight to fourteen days. When
such symptoms occur, the animal should be isolated so that
further spread of the disease is controlled. Thorough dis-
infection of the premises, and proper disposition of the
cadavers are very important.
PSEUDO-ACTINOMYCOSIS OF DOGS 623
PSEUDO-ACTINOMYCOSIS OF DOGS.
Streptotrichosu Canum. Actinomyces Canis.
Definition.— A specific disease, caused by the Actinomyces
canis, cliaracterized by an inflammation of serous mem-
branes, and abscess formation of the subcutaneous tissues.
Occurrence.— This disease is not of frequent occurrence in
dogs. A few cases have also been noted in cats.
Etiology.— The specific virus, Actinomyces canis, produces
long divided filaments, which are easily stained by the Gram-
Weigert method. Sometimes they form club-shaped bodies.
On artificial media the fungus grows at the body temperature.
Pathogenicity. — When pure cultures are injected intra-
peritoneally into mice, they produce at the point of inoculation
nodules of varying size (pea to bean) containing pus. Sub-
cutaneous injections into rabbits cause at the point of injec-
tion nodules which form abscesses. The same condition may
be produced in dogs by subcutaneous injections.
Pathology.— The lesions usually found are in the pleura or
peritoneum. They consist of an exudate of reddish color
collected in the body cavity, containing numerous small,
white, pin-point nodes. On the serous membrane will be a
number of small nodules, and on the pleura fibrinous exudate.
The lungs often contain a number of pea-sized nodes with
caseous centers.
Abscess formation occurs in different parts of the body,
particularly in the subparotid region, the vagina, or in the
subperitoneal connective tissue of the pelvis. The abscesses
contain a grayish turbid mass in which are many of the
characteristic granules. The abscesses usually heal after
discharging their contents. The spleen, kidneys and heart
muscles often show nodular lesions. Arthritis with pus
formation is seen in some cases.
Symptoms.— The disease during the early stages does not
present any characteristic symptoms. Later, however,
there will be evidence of chronic inflammation of the serous
membranes with collections of fluid in the thoracic and
abdominal cavities. As the disease progresses, the animal
shows general emaciation, weakness, and the presence of
024 CHRONIC INFECTIOUS DISEASES
abscesses in various parts of the body. The inflammation
of the lungs develops gradually and is not attended by any
marked change in temperature. Dyspnea is a prominent
symptom. The animal gradually grows weaker and dies from
exhaustion.
Diagnosis. -The diagnosis is established only after rinding
the characteristic granules or filaments in the discharge from
the abscesses. The symptoms alone would not be sufficient
for an accurate diagnosis.
Prognosis. — When the disease shows evidence of general
involvement of the body, the prognosis is unfavorable. More
favorable are those cases of localized infection.
Treatment.— Abscesses should be opened, drained, and the
cavity painted with tincture of iodin. Potassium iodid (dog
0.05 0.15; cat 0.00.5-0.05) given once daily is recommended.
Xo further treatment would be of any value.
CHAPTER V.
INFECTIOUS DISEASES PRODUCED BY
PROTOZOA.
SPIROCKffiTOSIS OF FOWLS.
Spirochcetosis Avium. Spirillosis of Chickens.
Definition.— A fatal septicemia of chickens, ducks, geese,
and pigeons.
Occurrence.— This disease has made its appearance in
several countries in enzootic form. A few outbreaks have
been observed in the southern part of the United States.
Up to the present time the disease has not attained economic
importance in this country. It occurs most commonly in
chickens where it seriously interferes with breeding.
Etiology.— The Spirochaete gallinarum (Spirillum anserum)
is now recognized as the causative agent. This is a blood
parasite, probably a flagellated protozoon. It appears as
fine threads, 10 to 20 microns long, spirally formed, and
provided with one or more cilia which show active move-
ments. These parasites leave the blood rapidly after the
fowl's death.
Pathogenesis.— The disease is easily produced by injections
of virulent blood from one fowl to another of the same
species. Older fowls are less susceptible than younger ones.
The disease develops rapidly following inoculation. After
the second day larger numbers of the spirilla are found in the
blood.
Natural Infection.— The disease is transmitted by ticks;
mainly by the Argas miniatus, in some cases by the Argas
persicus and Argas reflexus, and in others by the Ornitho-
dorus moubata. The ticks exist in waste places or in wooded
districts. Fowls become infested by roosting where the ticks
occur. The ticks attach themselves to the body, and suck
40
626 INFECTIOUS DISEASES PRODUCED BY PROTOZOA
its blood, thus directly inoculating the fowl. The spirillee
are soon found in the blood.
Pathology.— The most characteristic lesions on necropsy
are enlarged spleen and liver, both organs showing numerous
areas of degeneration and necrosis. The heart muscle shows
evidence of inflammation. No other lesions of importance are
found.
Symptoms.— The period of incubation is from eight to ten
days. Some cases develop in four to six days after the ticks
have been placed on the fowl. The early symptoms are those
of suppression of appetite, high temperature (108°-111° F.),
somnolence, weakness. Later diarrhea sets in; the comb and
wattles become bluish-red; marked weakness and paralysis.
During the later stages of the disease the temperature
becomes normal or subnormal. Death follows in a short
time in most cases under symptoms of convulsions and para-
lysis. The majority of cases are acute; a few have been
observed to assume a chronic type. The course of the disease
is usually from four to six days in the acute form and ten to
eighteen days in the chronic.
Diagnosis.— This is made by noting the enzootic character
of the disease; the characteristic lesions on autopsy, and the
finding of the Spirochaetes in the blood of sick birds.
Prognosis.— The prognosis is unfavorable when the disease
is well established. Some cases recover.
Treatment. — Atoxyl (0.1 peroremfortwo consecutive doses)
has been recommended, and has proved to be highly efficient
in producing immunity from infection in normal fowls.
Atoxyl (0.05) as an intramuscular injection is recommended
for infected birds. In two to three days the parasites dis-
appear from the blood. Atoxylate of mercury has also been
used in a similar manner. This treatment when properly
administered will produce excellent results.
Immunization of fowls with the blood of sick chickens,
which has been allowed to stand for forty-eight hours, has
proved of great value. After this period the blood is no
longer infectious and may be injected subcutaneously into
healthy fowls. This establishes an immunity against infec-
tion.
ENTEROHEPATITIS G27
A horse serum has been produced (by hyperimmunization
of the horse with repeated injections of live spirillse). In
doses of 3 to 5 c.c. per bird it has given good results. Immun-
ization of the flock by this method would be recommended as
early as possible.
ENTEROHEPATITIS.
Blackhead.
Definition.— A disease peculiar to turkeys. It is occa-
sionally observed in other birds, particularly chickens.
Occurrence.— Blackhead is very prevalent in various sec-
tions of the United States, occurring often in an enzootic
form destroying whole flocks, and seriously interfering with
the raising of turkeys in many districts. It is especially
fatal in young birds.
Etiology.— It is produced by a protozoon, Amoeba melea-
gridis. This parasite is microscopic in size and is found in large
numbers in the liver, ceca and other portions of the intes-
tinal tract. Some authorities claim that a coccidium is the
cause of the disease. When coccidia are present, however,
the above parasite also coexists which makes it probable
that the amoeba rather than the coccidia cause the disease.
Pathogenesis.— Blackhead is spread by the bowel discharges
of the affected birds which contain the parasites in large
numbers. Food and water polluted with infested fecal
matter are taken into the digestive tract of well birds. When
the amoeba reach the intestinal tract they develop rapidly,
producing irritation to the mucosa and ultimately lead to a
marked inflammation. The liver as a rule is invaded during
the progress of the disease showing intense hepatitis. The
parasites may enter the liver via the lymphatic system or
directly through the bile duct. Intermediate agents (other
birds, sparrows, pigeons, etc.) are often responsible for the
transmission of the disease to other flocks.
Necropsy.— The autopsy findings are confined mostly to
the liver and intestines. The liver is found much enlarged
(often three to four times normal), the surface studded with
whitish or yellowish spots, which when opened show degener-
028 INFECTIOUS DISEASES PRODUCED BY PROTOZOA
ated areas filled with a soft caseated material. On cross-
section the liver will show darkened spots often surrounded
by degenerated areas, giving it a peculiar spotted or marbled
appearance. The organ is soft, friable, easily crushed between
the fingers. The infection produces a more or less rapid
necrosis of the entire liver substance. The ceca are much
enlarged and the mucosa swollen; later cases show ulceration
and degeneration of the membrane. Chronic cases exhibit
extensive ulcerations on various portions of the mucosa.
The fecal matter in the lower bowels is mixed with blood,
giving it a dark tarry appearance. The serous membranes
(pericardium, pleura, peritoneum, etc.) show evidence of
inflammation and effusion of fluid. The cavities (thoracic
and abdominal) may be partially filled with exudate. In
chronic cases dropsical swellings are often found in the
cavities and extremities.
Symptoms.— The disease is most often observed in young
turkeys, although in some outbreaks older birds are affected.
The early indications of the disease are purplish discoloration
of the comb and wattles, dulness, rough plumage, drooping
of the tail and wings, complete loss of appetite in most cases,
and a tendency for the bird to remain in a sitting posture for
long periods. During this period there is nearly always a
severe diarrhea. The discharges, being greenish-yellow in
color, have a very offensive odor. The birds gradually grow
weaker and become exhausted in a few days. Death occurs
in most cases in three to five days. In less severe, or chronic
cases, the birds lose their appetite or it becomes irregular,
and they gradually grow emaciated and weak. Some cases
will partially recover, and the bird will droop around for
several weeks. Other cases recover completely from the
disease.
Diagnosis.— This is made by considering the enzootic
character of the disease, its symptoms, and autopsy findings.
There is no other disease common to turkeys producing such
serious losses. Whenever the disease is suspected a micro-
scopic examination should be made of the discharges and
cecal contents.
INFECTIOUS DIARRHEA OF CHICKS 629
Prognosis.— Owing to the high mortality of the disease the
prognosis is unfavorable. Its rapid spread from one bird
to another, and to other flocks, makes the disease difficult
to control. The mortality may reach from 50 to 90 per cent.
Treatment.— Intestinal antiseptics are indicated. Sodium
sulphocarbolate (0.2-0.4) two or three times daily has
given good results. Also salol in the same doses. Admin-
ister sulphate of iron in the drinking water, using one ounce
of the sulphate of iron to one gallon of water. This has
proved to be of value as a bowel disinfectant. As soon as
an outbreak appears, radical means should be adopted at
once to prevent the spread of the disease. Disinfect the
coops and houses thoroughly with lysol solution (3 per cent.),
or lime solution. Clean up. all droppings two or three times
daily and either burn them or bury in lime. Disinfect all
drinking fountains and feed pans daily. Extreme care must
be used by attendants to prevent carrying the infection to
other birds or flocks. Good results often follow when these
details are carried out conscientiously.
INFECTIOUS DIARRHEA OF CHICKS.
White Diarrhea.
Definition.— An infectious disease affecting young chicks,
characterized by a severe diarrhea, prostration and high
mortality. Owing to the fact that it affects chicks shortly
after being hatched, and such large numbers die, it is
one of the most important diseases with which the poultry-
man has to contend. The losses to the poultry industry
through its ravages are enormous. In some districts it is
becoming very difficult to rear young chicks.
Etiology.— It is necessary to recognize two distinct etiolog-
ical factors, viz: (a) A form produced by the Bacterium
pullorum, and (6) a protozoal form caused by the Coccidium
tenellum. Both of these forms are frequently met with in
practice. The reason the conditions should be classified
together is because they appear in the same aged birds,
produce much the same symptoms, and it has been found
630 INFECTIOUS DISEASES PRODUCED BY PROTOZOA
that the two diseases often coexist in the same chick. It is
necessary to differentiate the two conditions by examination
of the cecal contents for the coccidia, or the liver, spleen and
kidneys for the bacterium.
Necropsy.— In the form produced by the Bacterium pul-
lorum the principal lesions are found in the liver, kidneys,
spleen and intestinal tract. The liver shows areas of conges-
tion and fatty degeneration. The kidneys are usually normal
in size but show some evidence of congestion and cloudy
swelling. The involvement of the intestinal tract is as a rule
of minor importance. Therefore, but slight changes are
found in the majority of cases. The other tissues in the body
are pale, anemic and show evidence of emaciation. In the
form produced by the Coccidium tenellum, the most promi-
nent lesions will be present in the intestinal tract. The mucosa
is congested and distinct ulcerations are usually present in
the ceca. The liver, kidneys and musculature show similar
changes as found in the other form. The intestinal contents
indicate partial or complete loss in function.
Pathogenesis. — In the bacillary form it is quite evident
that the eggs are frequently contaminated in their formative
stage. \Vhen hatched the infection is already present in the
chick. This no doubt accounts for the large number of chicks
that succumb to the disease so soon after they are hatched.
This mode of infection is explained by the fact that the laying
hens carry the infection in some of the organs, probably the
ovaries, which permit the organisms to pass to the eggs
during the early stage of their development. The bacilli
have been found in the yolks of eggs. It is quite possible
to have other modes of transmission of the infection, such
as the infection being carried on the outside of the egg shell
and when the bird is liberated it becomes infected. Many
cases are infected from the water, feed, or discharges from
the diseased chicks. The infection, when introduced into
the delicate digestive tract of the chick, develops rapidly
and interferes with the early digestion of the food. Natu-
rally assimilation is practically stopped and the bird rapidly
becomes weak and emaciated. It has been proved that
during the first few days of the chick's life its principal
INFECTIOUS DIARRHEA OF CHICKS 631
source of food supply is from the yolk of the egg from which
it is hatched. The infection is carried to the other organs by
the blood or lymph systems.
The coccidial form develops in a similar manner. Numer-
ous examinations have proved that laying hens are often
chronic carriers of the coccidia which are passed out either
with the eggs, or with the discharges. The food, water, litter,
etc., are contaminated and therefore easily picked up by the
chick during the first week or ten days of its life. The
coccidia, when introduced into the digestive tract, develop
in a few hours and penetrate into the mucosa which accounts
for the digestive disturbances. Both forms of the disease
result in intestinal irritation, congestion, and disturbed
function.
Symptoms.— The early indication of the disease is the
presence of a whitish, or whitish-brown, frothy discharge
from the bowels. Examination of the chick reveals the soft,
pasty mass adhering around the cloaca and on the feathers.
They are dull, wings held pendent, head held down and more
or less constantly emitting a peculiar "peeping" sound.
The appetite is suppressed or entirely lost. The chicks
rapidly become weak, often fall down when urged to move,
and show every evidence of general cachexia. Death follows
often in a few days following hatching. Other cases when
infected later often are normal during the first few days or
week only to take the disease in two to four weeks, showing
practically the same symptoms. The mortality is 50 to 90
per cent, of the hatch. In order to determine the presence
of the bacilli or coccidia, a microscopic examination should
be made of the discharges, cecal contents, or cultures taken
from the organs.
Diagnosis. — This is not considered difficult as the disease
makes its appearance soon after the chicks are hatched, and
the fact that a number of them are affected at the same time.
The symptoms are also quite characteristic. There is no
similar disease aft'ecting young chicks at this age, except
possibly ptomain poisoning. A microscopic examination will
assist in making the diagnosis.
632 INFECTIOUS DISEASES PRODUCED BY PROTOZOA
Prognosis.— Due to the character of the disease and the
high mortality the prognosis is unfavorable. It will depend
to some extent on the age of the chicks and the virulency
of the infection.
Treatment.— Dietetic.— Withhold all food from the chicks
during the first two or three days. They have sufficient food
from the yolk of the egg to sustain them for this period.
Afterward feed small amounts of egg yolk, or bread and milk.
Buttermilk or sour milk is highly recommended on account
of the acid it contains producing antiseptic action on the
bowel contents. A small amount of lactic acid added to
sweet milk will have a similar action. Buttermilk tablets are
recommended so that a uniform quantity of sour milk may
be kept for their use daily. These when added to sweet milk
bring about sufficient fermentation in twelve to twenty-four
hours. It is quite important that they do not receive too
much food during the first week to bring on digestive dis-
turbances, thereby lowering the natural resistance of the
chick.
Medical.— Zinc sulphocarbolate or sodium sulphocarbo-
late has given excellent results. It is best given by dissolving
the preparation in water and allowing the chicks to drink
of the solution freely. Each chick should receive from three
to five grains of the compound one or twice daily. When the
diarrhea is severe iron sulphate in the drinking water (30.0
to 4000.0) is beneficial as an antiseptic and astringent.
In the coccidial form the following formula is highly
recommended :
3 — Potassi dichromate 12.0
Water . 250.0
Misco et fiat solutio.
N'K- — Use one teaspoonful to 1 quart of water for chicks one week old.
YounRcr chicks half the quantity. Allow them to drink of this solution
freely.
Prevention.— Much can be done to prevent the disease
developing in young chicks: (a) All incubators should be
thoroughly disinfected by washing all parts of them with a
liquor cresolis compositus solution (3 per cent.). Allow them
to dry out thoroughly before using. Another very effective
PIROPLASMOSIS OF THE DOG 633
method is to close them up tight and introduce formaldehyd
gas. Incubators have proved to be common carriers of the
infection, therefore attention to this matter is especially
important. (6) All eggs selected for hatching should be
cleaned and disinfected in the following manner: Saturate
a cloth in 50 per cent, alcohol and wipe each egg carefully
before placing it in the incubator. Do not use an excess of
alcohol as it will penetrate the egg shell. This treatment
will effectively remove all surface infection, (c) All coops,
houses, nests, etc., should be disinfected at regular intervals.
(d) When possible it would be advisable to select hens as
layers that are free from the disease. This can be done quite
efficiently by examining samples of eggs, discharges, aggluti-
nation test, etc. (e) All litter from infected houses, coops,
etc., should either be burned or treated with lime to pre-
vent the perpetuation of the disease.
PIROPLASMOSIS OF THE DOG.
Infectious Jaundice. Biliary Fever. Malignant Jaundice.
Definition.— A malignant or infectious disease of the dog
produced by the Piroplasma canis or Piroplasma commune.
Etiology.— Piroplasmosis of the dog has been reported in
several different countries. It is produced by two species of
piroplasma or Babesia: Piroplasma canis and Piroplasma
commune. Morphologically these parasites are identical
with Piroplasma bigeminum. The Piroplasma canis is 2-4
microns in diameter, the free organisms spherical, and those
contained within the corpuscles are pear-shaped or contain
many angles. Multiplication is by direct division. The
Piroplasma commune is similar, round or pear-shaped. The
round type is 1.0-1.5 microns, and the pear-shaped 1.5-2.5
microns in diameter. The former is not transmissible to any
other animal while the latter has been transmitted to the
guinea pig and cat.
Dogs become infected from ticks and fleas (Ixodes ricinus,
Rhipicephalus sanguineus, Dermacentor variabilis, Haema-
physalis Leachi, Ctenocephalus canis), which have been found
to be common carriers of the disease. Young animals
034 INFECTIOUS DISEASES PRODUCED BY PROTOZOA
(puppies) are most susceptible and often an entire litter will
develop the disease. Older animals are partially or com-
pletely immune. The disease may be readily transmitted
by injecting young animals with virulent blood. The initial
symptoms develop in two to three days. Natural infection
takes place from animals coming in contact with fleas or
ticks infested with the piroplasm. The period of incubation
from natural infection is from seven to ten days.
Pathology.— In the acute form the disease process is often
so rapid that but little will be found on postmortem examina-
tion. The liver is found congested, the bile of dark color and
thick. The spleen is enlarged often two or three times its
normal size; the color is dark, the borders rounded. The
kidneys are congested, and small hemorrhages are noted on
the surface. The heart muscle is pale, and small petechise
and ecchymoses are observed on the endo- and epicardium.
The lungs are usually edematous, and ecchymoses occur on
the membranes. The bladder contains a reddish-brown
colored urine, especially in the very acute form of the disease.
The skin and mucous membranes are greenish in color, which
in some cases may be absent, the membranes very pale and
anemic. In the chronic form the postmortem lesions are
those of an anemia, with a paleness of all the tissues and
organs. The liver is found intensely congested, the bile of a
syrupy consistency and very dark in color. The blood
from the spleen will contain large numbers of the parasites.
The kidneys, heart and lungs are congested and show num-
erous small hemorrhages on their surfaces. The marrow
of the bones is intensely congested, and of a dark reddish
color. In the chronic form icteric symptoms are also
observed. The blood has a thin, watery appearance, the
serum practically colorless.
Symptoms.— The initial symptoms of the acute form are
those of a severe infectious disease: Depression, loss of
appetite, often severe vomiting. Paralysis of the posterior
extremities often takes place early (in eighteen to twenty-
four hours) and ascends rapidly producing a general
paralysis in three to four days. In the more subacute form
the symptoms are less pronounced, presenting all the evi-
PIROPLASMOSIS OF THE DOG 635
deuces of an acute anemia, the mucous membranes becoming
pale, colorless, or bluish. The most common change -in the
mucous membranes, however, is icteric discoloration. A
characteristic symptom is the blood coloring matter in the
urine, which turns it pale red or reddish-brown. The hemo-
globin found in the urine is rather high (5 per cent.). The
temperature in the early stages is elevated (103°-105° F.).
It remains elevated usually for twenty-four to forty-eight
hours, when it drops suddenly and becomes subnormal. In
young dogs the temperature drops very rapidly, as low as
95°-96° F. The pulse is increased, weak and wiry; the
respirations 36 to 60 and often labored.
The blood is thin and paler than normal. The number of
the red corpuscles is greatly reduced (from 5-7 million to
2 million per c.), the white corpuscles greatly increased
(from 6-7000 to 40,000 per c.).
In the chronic form the symptoms are less pronounced.
There are evidences of anemia, the animals become weak
and indifferent to their surroundings. The mucous mem-
branes are usually pale or yellowish, and sometimes of a
bluish color. The urine contains blood-coloring matter,
which seems to be a constant symptom. The blood when
examined will be found to have a great reduction in the
number of red corpuscles, but less than in the acute form,
and the white corpuscles are about in the same ratio as in
the acute form. Most of the white corpuscles are found to
be polynuclear, and are often almost completely filled with
the parasites. The course in this form may be long, lasting
for days or weeks, the animals gradually recovering or dying
of marasmus.
Diagnosis.— The diagnosis is made ^by carefully observing
the symptoms, the fact that the disease occurs in several
animals at the same time, and the microscopic examination
of the blood to determine the ratio between the red and white
corpuscles, and the presence of the specific parasite. Some-
times it is difficult to find the parasite from a clinical case
under the microscope. In such cases it is of advantage to
confirm the diagnosis by inoculating a young puppy with
some of the blood of the affected animal. The virulent
f>3() INFECTIOUS DISEASES PRODUCED BY PROTOZOA
blood should he injected into the circulation to obtain the
most accurate and rapid results.
Prognosis.— In the acute form, the prognosis is very unfavor-
able, the animals grow weak rapidly, and die from exhaustion
in from three to six days. In the chronic form recovery often
takes place after several weeks.
Treatment.— In the acute form, treatment has but little
effect on the course of the disease. Symptomatic treatment
must be used. When there is extreme weakness and sub-
normal temperature stimulants, such as strychnin sulphate
(0.001 subcutaneously) , or diffusible stimulants should be
given as often as necessary to keep up the circulation and
general condition of the animal. Quinin (0.3-1.0) two or
three times daily has been highly recommended.
The treatment in the chronic form is very similar. Plenty
of good nutritious food should be given to conserve the
strength of the patient.
EQUIVALENT OF METRIC WEIGHTS
637
EQUIVALENTS OF APOTHECARIES IN METRIC MEASURES.
Cubic
Cubic
Minims.
Centimeters. Fluidrams.
Centimeters.
1
0.061 1 . .
. . . . 3.7
2
0.123 2 . .
. . . . 7.39
3
0.185 3 . .
. . . . 11.09
4
0.246 4 . .
. . . . 15.00
5
0.308 5 . .
. . . . 18.50
6
0.370 6 . .
. . . . 22.50
7
0.431 7 . .
. . . . 26.00
8
0.493
9
0.554
Cubic
10
0.616 Fluidounces
Centimeters.
11
0.678 1 . .
. . . . 29.57
12
0.739 2 . .
. . . . 59.14
13
0.801 3 . .
. . . . 89.00
14
0.863 4 . .
. . . . 118.29
15
0.924 5 . .
. . . . 148.00
16
1.00 6 . .
. . . . 177.42
17
1.06 7 . .
. . ." . 207.00
18 ......
1.12 8 . .
. . . . 236.59
20
1.23 9 . .
. . . . 266.16
30
1.84 10 ..
. . . . 295.73
40
2.46 12 . .
. . . . 355.00
50
3.08 16 . .
. . . . 473.17
20 . .
. . . . 591.50
24 . .
. . . . 710.00
32 . .
. . . . 946.35
128 . .
. . . . 3785.43
EQUIVALENTS
OF APOTHECARIES IN
METRIC WEIGHTS.
Grain.
Grams. Grain.
Grams.
1-1000 . . .
.000065 1-2
0324
1-500 . . .
.000129 1 . .
. . . . .0648
1-250 . . .
.000258 2 . .
1296
1-200 . . .
.000324 3 . .
1944
1-150 . . .
.00043 4 . .
2592
1-120 . .
.00054 5 . .
3240
1-100 . .
.00064 6 . .
3888
1-75 . .
.00086 7 . .
. . . . .4536
1-60 . .
.00108 8 . .
. . . . .5184
1-50 . . .
.00129 9 . .
5832
1-40 ....
.00162 10 . .
6480
1-30 . . .
.00216 11 . .
7128
1-25 . . .
.00259 12 . .
7776
1-20 . . .
.00324 13 . .
8424
1-12 . .
.00540 14 . .
9072
1-10 ....
.00649 15 . .
. . . . .9720
1-8 . .
.0081 20 . .
. . . . 1.2960
1-6 ...
.0108 25 . .
. . . . 1.6200
1-5 ...
.0129 30 . .
. . . . 1.9440
1-4 . .
.0162 35 . .
. . . . 2.2680
1-3 . .
.0216 40 . .
. . . . 2.2920
638
EQUIVALENTS OF METRIC WEIGHTS
Grain.
Grams.
Ounces.
Grams.
45 . . . .
2.9160
3 . . . .
. . 93.310
50 . . . .
3.2400
4 ...
. . 124.414
55 ....
3.5640
5 . . . .
. . 155.517
59 ....
. . 3.8232
6 . . . .
. . 186.631
7 . . . .
. . 217.724
Drams.
Grams.
8 . . . .
9 . . . .
. . 248.828
. . 279.930
1 ....
2 ....
. . 3 . 88
7.776
10 . . . .
. . 311.035
3 ....
4 ....
5 ....
6 .
7 ....
11.664
. . 15.552
. . 19.440
. . 23.328
. . 27.216
11 . .
12 . . . .
14 . . . .
16 . . . .
20 . . . .
24 . . . .
342.138
. . 373.242
. . 435.449
. . 497.656
. . 622.070
. . 746.484
32 . . . .
. . 995.312
Ounces.
Grams.
48 . . . .
. . 1492.968
1 .
. . 31.103
64 . . . .
. . 1990.624
2 .
62.207
100 . .
. . 3110.350
INDEX.
A
ABSCESS of cornea, 534
of kidney, 396
of liver, 236
renal, 397
Acne, 468
definition, 468
etiology, 468, 469
pathology, 469
prognosis, 469
symptoms, 469
treatment, 469
Actinomyces canis, 623
Adhesions of eyelids, 504, 505
ankyloblepharon, 505
treatment, 505
symblepharon, 505
treatment, 505, 506
Alopecia, 465
definition, 465
diagnosis, 466
differential, 466
etiology, 465
pathology, 465
prognosis, 466
symptoms, 465, 466
treatment, 466
Alveolar periostitis, 108
Amaurosis, 547
Amblyppia, 547
Amyloid kidney, 407
liver, 242
definition, 242
etiology, 242
pathology, 242, 243
symptoms, 243
Anal glands, suppuration of,
224
Anemia, 319
of brain, 437
223 ,
Anemia of brain, definition, 437
etiology, 437
pathology, 438
prognosis, 438
symptoms, 438
treatment, 438
cerebral, 437
course, 321
definition, 319
diagnosis, 321
etiology, 319, 320
occurrence, 319
pathology, 320
prognosis, 321
symptoms, 320, 321
treatment, 321, 322
Animal parasites in blood, 330
in kidney, 407
in trachea and bronchial tubes,
42
Ankyloblepharon, 505
Ankylostoma canina, 207
Ankylostomum stenocephalum, 207
trigonacephalum, 207
Anthrax, 599
Aphtha, 100
Aphthae epizooticse, 600
Apoplexia hepatis, 246
Apoplexy, 440
definition, 440
diagnosis, 441
etiology, 440
pathology, 440
prognosis, 441
symptoms, 440, 441
treatment, 441
Arthritis, 383
urica, 354
Articular rheumatism, 363
Articulations, dislocation of, 378
caudal vertebra, 383
040
INDEX
Articulations, dislocations of, cau-
dal coxofemoral, 381
etiology, 381
prognosis, 381
symptoms, 381
treatment, 382
humero-radio-ulnar, 379, 380
etiology, 380
prognosis, 380
symptoms, 380
treatment, 380
patellar, 382
etiology, 382
prognosis, 382
symptoms, 382
treatment, 382, 383
phalangeal, 381
radio-ulnar-carpal, 380
diagnosis, 380
symptoms, 380
treatment, 380, 381
scapulohumeral, 379
etiology, 379
prognosis, 379
symptoms, 379
treatment, 379
temporomaxillary, 378
etiology, 378
prognosis, 378
symptoms, 378
treatment, 378
tibiotarsal, 383
vertebral, 379
inflammation of, 383
sprains and injuries to, 377
course, 377
prognosis, 377
symptoms, 377
treatment, 377
wounds of, 376
diagnosis, 376
etiology, 376
prognosis, 376
symptoms, 376
treatment, 376, 377
Ascaridir, 201
Ascites, 257 .
definition, 257
diagnosis, 259, 260
etiology, 257, 258
pathology, 258
prognosis, 260
symptoms, 258, 259
Ascites, treatment, 260, 261
Aspergillosis, 40
Asthenia, infectious, of birds, 191
definition, 191
diagnosis, 191, 192
etiology, 191
pathology, 191
prevention, 192
prognosis, 192
symptoms, 191
. treatment, 192
Atrophy of liver, 240
definition, 240
diagnosis, 241
etiology, 240, 241
pathology, 241
prognosis, 241
symptoms, 241
treatment, 241
of optic nerve, 547
definition, 547
prognosis, 547
Auditory nerve, paralysis of, 453
Avian tuberculosis, 616
B
BALANITIS, 265
Basedow's disease, 343
Belascaris marginata, 202
myxtax, 202
Benign neoplasms of mouth, 102
tumors of mammary glands, 317
fibromata, 317, 318
lipoma, 318
Biliary fever, 633
Black tongue, 579
Blackhead, 627
Bladder, calculi in, 420
catarrh of, 416
diseases of, 410
examination, 410, 411, 412
by laparotomy, 411
by palpation, 410, 411
of urine, 411, 412
incontinence of urine in, 416 ,
parasites in, 423, 424
retention of urine in, 414
rupture of, 412
torsion of, 420
tumors in, 423
INDEX
041
Bladder, wounds of, 412
Blennorrhea, 512
Blepharitis, 498
definition, 498
etiology, 498
prognosis, 498
symptoms, 498
treatment, 498, 499
Blepharoptosis, 501
Blepharospasm, 503
Bothriocephalus felis, 197
Brachial plexus, paralysis of, 455
Brain, anemia of, 437
congestion of, 435
diseases of, 431
examination, 432, 433, 434,435
psychic disturbances, 433
sensibility, 433, 434, 435
general considerations, 431,432
cerebellum, 432
cortex, 431, 432
midbrain, 432
hyperemia of, 435
tumors of, 441, 442
Bi ittleness of bones, 362
Bronchial catarrh of birds, 38
tubes and trachea, animal para-
sites in, 42
Bronchitis, 38
and tracheitis, 34
acute, 34
chronic, 44
Bronchocele, 336
Bronchopneumonia, 53
definition, 53
diagnosis, 56
etiology, 53, 54
pathology, 54, 55
prognosis, 56
symptoms, 55, 56
treatment, 56
Bulbar paralysis, infectious, 611
CALCULI in bladder, 420
etiology, 420, 421
forms and varieties, 421
acid urine calculi, 421
alkaline urine calculi, 421
prognosis, 422
symptoms, 421, 422
41
Calculi in bladder, treatment, 422,
423
in kidney, 402
definition, 402
diagnosis, 403
etiology, 402
pathology, 402
prognosis, 403
symptoms, 402, 403
treatment, 403, 404
in urethra, 427
prognosis, 428
symptoms, 427, 428
treatment, 428, 429
Canine typhus, 579
Canker, 593
of mouth, 97
Caponizing, 276, 277, 278
Carcinomata of bladder, 423
of eyelids, 509
of mammary glands, 318
of penis and prepuce, 269
of scrotum and testes, 273
Caries of teeth, 109
definition, 109
etiology, 109
pathology, 109, 110
symptoms, 110
treatment, 110
Castration, 273
of birds, 276, 277, 278
of cat, 275, 276
of dog, 274, 275
cryptorchid, 275
monorchid, 275
Catalepsy, 460
course, 460
definition, 46Q
diagnosis, 460
etiology, 460
pathology, 460
prognosis, 460
symptoms, 460
treatment, 460
Cataract, 542
course, 543
definition, 542
forms, 542
congenital, 543
diabetic, 543
senile, 542
symptomatic, 542
traumatic, 542
642
INDEX
Cataract, prognosis, 543
symptoms, 543
treatment, 543, 544
discission, 543, 544
extraction, 544
Catarrh of bladder, 416
definition, 416
diagnosis, 419
etiology, 416, 417
pathology, 417, 418
prognosis, 419
symptoms, 418, 419
treatment, 419, 420
bronchial, of birds, 38
definition, 38
diagnosis, 39
etiology, 39
prognosis, 39
symptoms, 39
treatment, 39, 40
chronic, of stomach, 146
of crop in birds, 137
definition, 137
diagnosis, 138
etiology, 137, 138
prognosis, 138
symptoms, 138
treatment, 138, 139
nasal, acute, 19
definition, 19
diagnosis, 19
etiology, 19
prognosis, 19
symptoms, 19
treatment, 19, 20
chronic, 23.
definition, 23
diagnosis, 24
etiology, 23
pathology, 23
prognosis, 24
symptoms, 23, 24
treatment, 24
of rabbits, 20
infectious, 20
definition, 20
diagnosis, 21
etiology, 20, 21
necropsy, 21
prognosis, 21
prophylaxis, 22
symptoms, 21
treatment, 21
Catarrh, nasal, of rabbits, para-
sitic, 22
definition, 22
diagnosis, 23
etiology, 22
prevention. 23
prognosis, 23
symptoms, 22
treatment, 23
preputial, 265
definition, 265
etiology, 265, 266
prognosis, 266
symptoms, 266
treatment, 266
simple, of stomach, 142
Catarrhal conjunctivitis, 511
pneumonia, 53
stomatitis, 94
Caudal vertebrae, dislocation of,383
Cerebral anemia, 437
hemorrhage, 440
Cestoda, 193, 194, 195
species, 195
tseniae, 195
in intestine of birds, 198
of cats, 197
of dogs, 195, 196, 197
of rabbits, 197, 198
Chalazion of eyelids, 507
Chicken-pox, 593
Choanptsnia infundibuliformis,198
Cholelithiasis, 245
symptoms, 245
treatment, 245
Cholera, fowl, 584
gallinarum, 584
Chorea, 461
definition, 461
diagnosis, 461
etiology, 461
pathology, 461
prognosis, 461
symptoms, 461
treatment, 461
Chronic catarrh of stomach, 146
coryza, 23
dilatation of stomach, 154
dyspepsia, 146
enteritis, 173
gastritis, 146
interstitial hepatitis, 243
pneumonia, 57
INDEX
643
Chronic inetritis, 29G
nasal catarrh, 23
peritonitis, 255
pharyngitis, 125
rhinitis, 23
tracheitis and bronchitis, 44
Cirrhosis of liver, 243
definition, 243
diagnosis, 244
etiology, 243
pathology, 243
prognosis, 244
symptoms, 243, 244
treatment, 244
of lungs, 57
definition, 57
diagnosis, 58
etiology, 57, 58
pathology, 58
prognosis, 58
symptoms, 58
treatment, 58
Cittotsenia denticulata, 197
Coccidia in kidney, 409
Coccidium tenellum in kidney, 409
Comb disease, 484
white, 484
Compression of peripheral nerves,
450
of spinal cord, 448
definition, 448
diagnosis, 449
etiology, 448, 449
pathogenesis, 449
prognosis, 449
symptoms, 449
treatment, 449
Concha, ulceration of, 488
Concussion of spinal cord, 445
course, 447
diagnosis, 447
etiology, 445
pathogenesis, 446
prognosis, 447
symptoms, 446, 447
treatment, 448
Congenital defects of iris, 539
malformations of penis and pre-
puce, 265
of urethra, 425
of vagina and vulva, 309
Congestion of brain, 435
of kidney, 387
Congestion of liver, 231
active, 231
course, 232
definition, 231
diagnosis, 232
etiology, 231
pathology, 231
prognosis, 232
symptoms, 232
treatment, 232, 233
passive, 233
definition, 233
diagnosis, 234
etiology, 233
pathology, 233, 234
prognosis; 234
symptoms, 234
treatment, 235
of lungs, 49
active, 49
diagnosis, 50
etiology, 49
pathology, 49
prognosis, 50
symptoms, 49, 50
treatment, 50
passive, 50
diagnosis, 51
etiology, 50, 51
pathology, 51
prognosis, 51
symptoms, 51
treatment, 51, 52
of mammary glands, 316
of thyroid glands, 334, 335
Conjunctiva, corrosions and burns
of, 521
diseases of, 510
examination, 510
foreign bodies in, 519, 520
growths on, 522
traumatic lesions of, 519
tumors on, 522
ulceration of, 521
wounds on, 520
Conjunctivitis, 510
definition, 510
forms, 510
catarrhal, 511
etiology, 511
prognosis, 511
symptoms, 511
treatment, 511, 512
644
INDEX
Conjunctivitis, forms, crotipous,
516
definition, 516
etiology, 516
prognosis, 516
symptoms, 516
treatment, 516
erysij)elatous, 514
exanthematous, 518
definition, 518
treatment, 519
follicular, 517
definition, 517
etiology, 517
prognosis, 517
symptoms, 517
treatment, 517, 518
parenrhymatous, 514
definition, 514, 515
etiology, 515
prognosis, 515
symptoms, 515
treatment, 515, 516
purulent, 512
acute, 512
definition, 512
etiology, 512
prognosis, 513
symptoms, 512, 513
treatment, 513, 514
chronic, 514
prognosis, 514
symptoms, 514
treatment, 514
Constipation, 182
definition, 182
diagnosis, 183
etiology, 182
pathology, 182
prognosis, 183
symptoms, 182, 183
treatment, 183, 184, 185
Contagious epithelioma, 593
Cornea, abscess of, 534
diseases of, 526
examination, 526
ectasia of, 537
foreign bodies of-, 535
opacities of, 536
tumors of, 538
ulceration of, 532
wounds of, 535
Cornua uteri, torsion of, 302
Corrosions and burns of conjunc-
tiva, 521
treatment, 521
Coryza, 19
chronic, 19
Coxofemoral dislocation, 381
Cranial bones, fracture of, 368
Crop, catarrh of, in birds, 137
hard, 139
obstruction of, in birds, 139
soft, 137
Croupous conjunctivitis, 516
enteritis of cats, 190
pharyngitis of birds, 127
Ctenocephalus canis of dog, 472,
633
felis of cat, 472
Cuterebra emasculator, 273
Cyclitis, 540
Cystic goiter, 339
kidney, 405
Cysticercus cellulosa; in kidney, 409
Cystitis, 416
Cysts of ear, 494
of eyelids, 507
Meibomian, 507
pilosebaceous, 507
of iris, 541
of ovaries, 284
retention, in mouth, 103
of uterine tubes, 291
DACRYOCYSTITIS, 525
definition, 525
prognosis, 525
symptoms, 525
treatment, 525
Dandruff, 464
definition, 464
diagnosis, 464
etiology, 464
prognosis, 464
symptoms, 464
treatment, 464, 465
Davainea cesticillus, 198
crassula, 198
echinobothrida, 198
proglottina, 198
tetragona, 198
u Deafness, 495
INDEX
645
Deafness, etiology, 495
prognosis, 495
symptoms, 495
treatment, 495
Defects, congenital, of iris, 539
aniridia, 539
coloboma, 539
ectopic pupillie, 539
occlusion of pupil, 539
Demodex folliculorum, 480
mite, 480 .
Dermacentor variabilis, 633
Dermatitis, 466
definition, 466
diagnosis, 468
etiology, 466, 467
pathology, 467
prognosis, 468
symptoms, 467, 468
treatment, 468
Dermatomycosis, 482
definition, 482
examination, 482
Diabetes, 347
definition, 347
insipidus, 347
course, 349
definition, 347
diagnosis, 349
etiology, 347, 348
occurrence, 347
pathology, 348
prognosis, 349
symptoms, 348, 349
treatment, 349, 350
mellitus, 350
course, 351
definition, 350
diagnosis, 351
etiology, 350
occurrence, 350
pathology, 350
prognosis, 351
symptoms, 350, 351
treatment, 351, 352
Diaphragmatic hernia, 563
Diarrhea, 178
definition, 178
diagnosis, 181
etiology, 178, 179, 180
infectious, of chicks, 629
definition, 629
diagnosis, 631
Diarrhea, infectious, of chicks,
etiology, 629, 630
necropsy, 630
pathogenesis, 630, 631
prevention, 632, 633
prognosis, 632
symptoms, 631
treatment, 632
prognosis, 181
symptoms, 180 .
treatment, 181
white, 629
Dicranotaenia sphenoides, 198
Dilatation and diverticula of esoph-
agus, 136
definition, 136
diagnosis, 137
etiology, 136, 137
prognosis, 137
symptoms, 137
treatment, 137
of stomach, 152
acute, 152
diagnosis, 154
etiology, 152, 153
pathology, 153
prognosis, 154
symptoms, 153, 154
treatment, 154
chronic, 154
diagnosis, 157
etiology, 154, 155
pathology, 155, 156
prognosis, 157
symptoms, 156
treatment, 157
Dioctophyme renale, in bladder,423
in kidney, 407
Diphtheria, 593
Dipylidium caninum, 195
Dirofilaria immitis in blood, 330
Dislocation of articulations, 378
Dispharagus nosutus in stomach of
birds, 163
spiralis in stomach of birds, 163
Distemper of cats, 577
definition, 577
diagnosis, 578
etiology, 577
pathology, 577
prognosis, 578
symptoms, 577, 578
treatment, 578, 579
646
INDEX
Distemper of dogs, 565
definition, 565
diagnosis, 572, 573
etiology, 565, 566
natural infection, 566
necropsy, 566, 567
occurrence, 565
prevention, 577
prognosis. 573
symptoms, 567, 568, 569, 570,
571, 572
treatment, 573, 574, 575, 576
rabbit, 20
Districhiasis, 504
Diverticula of esophagus, 136
Dochmius trigonacephulus, 207
Dog plague, 579
Dropsy of kidney, 405
definition, 405
diagnosis, 406
etiology, 405, 406
pathology, 406
prognosis, 406
symptoms, 406
treatment, 406
of pericardium, 76
Dyspepsia, acute, 142
chronic, 146
Dystocia, 305
definition, 305
diagnosis, 307
etiology, 305, 306
prognosis, 307
symptoms, 306, 307
treatment, 307, 308
EAR, diseases of, 487
examination, 487
fistula, 495
etiology, 495
prognosis, 496
symptoms, 4%
treatment, 496
neoplasms of, 493
parasites in, 494
wounds of, 487, 488
Echinococcus granulosus, 197
Kchinorhynchus canis, 202
Eclampsia, 461
definition, 461
Eclampsia, diagnosis, 462
etiology, 462
prognosis, 462
symptoms, 462
treatment, 462
Ectasia of cornea, 537
inflammatory, 537
forms, 537
keratectasia, 537
definition, 537, 538
treatment, 538
staphyloma, 537
definition, 537
treatment, 537
non-inflammatory, 538
forms, 538
keratoconus, 538
keratoglobus, 538
treatment, 538
Ectropion, 500
Eczema, 469
definition, 469
diagnosis, 471
etiology, 470
pathology, 470
prognosis, 471
symptoms, 470
treatment, 471
Edema of lungs, 52
pulmonary, 52
Eimeria avium in kidney, 409
Empyema of infraorbital fossae of
birds, 20
definition, 20
etiology, 20
prognosis, 20
symptoms, 20
treatment, 20
Endocarditis, acute, 85
definition, 85
diagnosis, 88
etiology, 85, 86
necropsy, 86, 87
prognosis, 88
symptoms, 87, 88
treatment, 88, 89
Enophthalmus, 551
definition, 551
etiology, 551
prognosis, 552
symptoms, 551
treatment, 552
Enteritis, 167
INDEX
647
Enteritis, acute, 167
definition, 1G7, 168
diagnosis, 171
etiology, 168, 169
pathology, 169
prognosis, 171
symptoms, 169, 170, 171
treatment, 171, 172, 173
chronic, 173
definition, 173
diagnosis, 174, 175
etiology, 173
pathology, 173, 174
prognosis, 175
symptoms, 174
treatment, 175
croupous, of cats, 190
definition, 190
diagnosis, 190
etiology, 190
pathology, 190
prognosis, 190
symptoms, 190
treatment, 191
membranous, 190
Enterohepatitis, 627
definition, 627
diagnosis, 628
etiology, 627
necropsy. 627, 628
occurrence, 627
pathogenesis, 627
prognosis, 629
symptoms, 628
treatment, 629
Enterorrhagia, 175
Entropion, 499
Epilepsy, 458
definition, 458
diagnosis, 459
etiology, 458
pathology, 458
prognosis, 459
reflex, 459, 460
treatment, 460
secondary, 459, 460
symptoms, 459
treatment, 459
Epiphora, 524
Epistaxis, 24
definition, 24
etiology, 24, 25
prognosis, 25
Epistaxis, symptoms, 25
treatment, 25
| Epithelioma, contagious, 593
Epitheliomata of eyelids, 509
of mouth, 104
of penis and prepuce, 269
of pharynx, 129
Epitheliosis infectiosa avium, 593
diagnosis, 598
etiology, 593
natural infection, 594, 595
pathogenesis, 593, 594
pathology, 595, 598
pre valency and distribution,
593
prevention, 599
prognosis, 599
symptoms, 593, 597, 598
treatment, 599
Esophagismus, 135
definition, 135
etiology, 135
prognosis, 135
symptoms, 135
treatment, 135
Esophagitis, 130
course, 131
definition, 130
etiology, 130
pathology, 130, 131
prognosis, 131
symptoms, 131
treatment, 131
Esophagus, dilatations of, 136
diseases of, 130
examination, 130
diverticula of, 136
foreign bodies in, 131
neoplasms of, 141
obstruction in, 131
stricture of, 135
Eustrongylus gigas, 407
Eversion of uterus, 300
diagnosis, 301
prognosis, 301
symptoms, 301
treatment, 301, 302
Exanthematpus conjunctivitis, 518
Exophthalmic goiter, 343
Exophthalmus, 550
definition, 550
etiology, 550
prognosis, 550
048
INDEX
Exophthahnus, symptoms, 550
treat men I, 550
Eye, parasites of, 553
Eyeball, luxation of, 550
Eyelidd, adhesions of, 504, 50(5
diseases of, 497
examination, 497
inflammation of, 498
malposition of, 499
tumors of, 506
wounds of, 497, 498
F
FACETTED keratitis, 529
Facial nerve, paralysis of, 450
Fatty liver, 241
definition, 241
etiology, 241, 242
pathology, 242
symptoms, 242
Favus, 484
diagnosis, 485
etiology, 484
pathology, 484
prognosis, 485
symptoms, 484, 485
treatment, 485
Feather eating in birds, 357
etiology, 357
symptoms, 357
treatment, 357, 358
pulling in birds, 357
Femoral hernia, 562
Femur, fracture of, 374
Fetid stomatitis, 96
Fibromata of bladder, 423
of mammary glands, 317, 318
of mouth, 102
of scrotum and testes, 272, 273
of "uterus, 303, 304
of vulva and vagina, 313
Fibrous goiter, 340
Filaria immitis in blood, 330
Filarida-, 330
Fistula, ear, 495
salivary, 118
definition, 1 18
diagnosis, 119
etiology, 118
pathology, 118
prognosis, 119
Fistula, salivary, symptoms, 118,
119
treatment, 119
Fleas, 472
description, 472
diagnosis, 473
occurrence, 472
Ctenocephalus canis of dog,
472
felis of cat, 472
Pulex avium of bird, 472
gonivcephalus of rab-
bit, 472
irritans of man, 472
symptoms, 472, 473
treatment, 473
Follicular conjunctivitis, 517
Foot-and-mouth disease, -600
Foreign-body pneumonia,. 58
Foreign bodies and wounds of
cornea, 535
prognosis, 536
symptoms, 535
treatment, 536
in conjunctiva, 519, 520
in esophagus, 131
diagnosis, 133
etiology, 131, 132
prognosis, 133
symptoms, 132, 133
treatment, 133, 134, 135
in mouth, 106
symptoms, 106
treatment, 106
in pharynx, 126
diagnosis, 126
prognosis, 126
symptoms, 126
treatment, 126, 127
in stomach, 148
diagnosis, 149, 150
etiology, 148, 149
prognosis, 150
symptoms, 149
treatment, 150, 151, 152
Fowl cholera; 584
definition, 584
diagnosis, 587, 588
etiology, 584
natural infection, 585
occurrence, 584
pathogenesis, 584, 585
pathology, 586
INDEX
649
Fowl cholera, prevention, 589
prognosis, 588
symptoms, 587
treatment, 588, 589
pest, 589
definition, 589
diagnosis, 591
etiology, 590
natural infection, 590
occurrence, 589, 590
pathogenicity, 590
pathology, 590, 591
prognosis, 592
symptoms, 591
treatment, 592
plague, 589
typhoid, 584
Fracture of bones, 368
cranial, 368
etiology, 368
prognosis, 369
symptoms, 368, 369
treatment, 369
femur, 374
diagnosis, 375
etiology, 374
prognosis, 375
symptoms, 375
treatment, 375
humerus, 372
diagnosis, 372
etiology, 372
prognosis, 372
symptoms, 372
treatment, 372
inferior maxilla, 369
etiology, 370
prognosis, 370
symptoms, 370
treatment, 370
metacarpal and phalangoal,
373
diagnosis, 373
treatment, 373
patella, 375
I>elvis, 373, 374
etiology, 374
prognosis, 374
symptoms, 374
treatment, 374
radius and ulna, 372, 373
etiology, 373
symptoms, 373
Fracture of bones, radius and ulna,
treatment, 373
ribs, 371
etiology, 371
prognosis, 371
symptoms, 371
treatment, 371
scapula, 371
etiology, 372
symptoms, 372
treatment, 372
tibia and fibula, 375
vertebra?, 370
etiology, 370
prognosis, 371
symptoms, 370, 371
treatment, 371
of orbit, 553
treatment, 553
of teeth, 108
treatment, 108
G
GALL-STONES, 245
Gangrene of lungs, 58
of tongue, 112
definition, 112
diagnosis, 113
etiology, 113
pathology, 113
prognosis, 113
symptoms, 113
treatment, 113, 114
Gangrenous glossitis, 112
stomatitis, 97
Gapes in chickens, 42
Gastritis, 142
acute, 142
definition. 142
diagnosis, 144
etiology, 142, 143
pathology; 143
prognosis, 144
symptoms, 143
treatment, 144, 145, 146
chronic, 146
definition, 146
diagnosis, 147
etiology, 146
pathology, 146
prognosis, 147
INDEX
Gastritis, chronic, symptoms, 146
treatment, 147, 148
Gastro-enteritis, hemorrhagic, 579
infectious, 000
Gastrophilus intestinalis in stom-
ach of dog, 163
Glanders, 622
Glands of Moll, enlargement of, 508
submaxillary and sublingual, dis-
eases of, 118
symptoms, 118
treatment, 118
Glaucoma, 549
definition, 549
prognosis, 549
symptoms, 549
treatment, 549
Globe and orbit, diseases of, 548
Glossitis, 111
definition, 111
etiology, 111, 112
gangrenous, 112
pathology, 112
prognosis, 112
symptoms, 112
treatment, 112
Goiter, 336
cystic, 339
definition, 339
diagnosis, 339
prognosis, 339
symptoms, 339
treatment, 339, 340
definition, 336
exophthalmic, 343
definition, 343
diagnosis, 345
etiology, 343
pathogenesis, 343
pathology, 343
prognosis, 345
symptoms, 344
treatment, 345
fibrous, 340
definition, 340
diagnosis, 340
prognosis, 340, 341
symptoms, 340
treatment, 341
malignant, 342
definition, 342
diagnosis, 342, 343
prognosis, 343
Goiter, malignant, symptoms, 342
treatment, 343
occurrence, 336
parenchymatous, 336
definition, 336
diagnosis, 337, 338
occurrence, 336
prognosis, 338
symptoms, 336, 337
treatment, 338
vascular, 341
definition, 341
diagnosis, 341, 342
prognosis, 342
symptoms, 341
treatment, 342
Gout, 354
course, 356
definition, 354
diagnosis, 356
etiology, 354, 355
occurrence, 354
pathogenesis, 355
pathology, 355
symptoms, 355, 356
treatment, 356, 357
Granulomas of eyelids, 510
Graves's disease, 343
H^EMAPHYSALIS L.EACHI, 633
Hsemostrongylus vasorum in blood,
332
Hard crop, 139
Heart, diseases of, 78
hypertrophy and dilatation of, 89
rupture of, 92
Helminthiasis, 193
Hematemesis, 160
definition, 160
diagnosis, 161, 162
etiology, 160
pathology, 160, 161
prognosis, 162
symptoms, 161
treatment, 162
Hematoma, 489
diagnosis, 490
etiology, 489
prognosis, 490
symptoms, 489, 490
INDEX
651
Hematoma, treatment, 490
Hematozoon Lewis! in blood, 332
Hemopericardium, 77
definition, 77
etiology, 77
symptoms, 77
treatment, 77
Hemophilia, 328
Hemorrhage, cerebral, 440
intestinal, 175
definition, 175, 176
diagnosis, 177
etiology, 176
prognosis, 177
symptoms, 176, 177
treatment, 177
Hemorrhagic gastro-enteritis, 579
septicemia of cats, 600
diagnosis, 602
etiology, 600
occurrence, 600
pathogenesis, 601
pathogenicity, 600
pathology, 601
prognosis, 602
symptoms, 601
treatment, 602
Hemorrhoids, 216
definition, 216
diagnosis, 217
etiology, 216
pathology, 216
prognosis, 217
symptoms, 216
treatment, 217
Hemothorax, 67
definition, 67
diagnosis, 68
etiology, 67
pathology, 67
prognosis, 68
symptoms, 67
treatment, 68
Hepatitis, 235
chronic interstitial, 243
definition, 235
diagnosis, 236
etiology, 235
pathology, 235
prognosis, 236
suppurative, 236
definition, 236, 237
diagnosis, 239
Hepatitis, suppurative, etiology,
237
pathology, 237, 238
prognosis, 239
symptoms, 238, 239
treatment, 239, 240
symptoms, 235, 236
treatment, 236
Hernia, 555
definition, 555
diaphragmatic, 563
definition, 563
etiology, 563
symptoms, 563
treatment, 563
femoral, 562
symptoms, 562
treatment, 563
general remarks, 555, 556, 557
hernial contents, 556
ring, 555, 556
sac, 555
irreducible hernias, 556, 557
reducible hernias, 556
inguinal, 560
in female, 560
etiology, 560
symptoms, 560
treatment, 561
in male, 561
etiology, 561
symptoms, 561, 562
treatment, 562
occurrence, 555
perinea!, 563
definition, 563
etiology, 563
symptoms, 563, 564
treatment, 564
scrotal, 561
treatment, 562
umbilical, 557
etiology, 557
symptoms, 557
treatment, 557, 558
ventral, 558
definition, 558
etiology, 558
symptoms, 558
treatment, 559, 560
Herpes tonsurans, 482
diagnosis, 483
etiology, 482
652
INDEX
Herpes tonsurans, pathology, 482
prognosis, 483
symptoms, 483
treatment, 483, 484
Heterakidir, 202
Heterakis compressa, 203
crassa, 203
* differens, 203
. . dispar, 203
inflexa, 203
lineata, 203
muculosa, 203
papillosa, 202. 203
jxjrspicillum, 203
vesicularis, 202, 203
Hodgkin's disease, 327
Honeycomb ringworm, 484
Hookworm, 206
Humero-radio-ulnar dislocation,
379, 380
Humerus, fracture of, 372
Hydrometra of uterus, 304
Hydronephrosis, 405
Hydropericardium, 76
definition. 76
etiology, 76
symptoms, 76
treatment, 76
Hydrophobia, 603
Hydrophthalmus, 550
definition, 550
treatment, 550
Hydrops abdominis, 257
ascites, 257
jxTitonei, 257
Hydrothorax, 65
definition, 65
diagnosis, 66
etiology, 65
pathology, 65
prognosis, 66
symptoms, 66
treatment, 66
Hy|M-remia. 3S7
acute, 387
etiology, 387
pathology, 387. 388
prognosis, 388
symptoms, 388
treatment. 388
of brain, 435
definition, 435
diagnosis, 436
Hyperemia of brain, etiology, 435
pathology, 435. 436
prognosis, 436
symptoms, 436
treatment, 436. 437
of lungs, 49
passive, 388
etiology, 388
pathology, 388
prognosis, 388
symptoms, 388
treatment, 388
Hypertrophy and dilatation of
heart, 89
definition, 89
diagnosis, 91
etiology, 89, 90
necropsy, 90
prognosis, 91
symptoms, 90, 91
treatment, 91
of prostate gland, 280
ICTERUS, 225
definition, 225
diagnosis, 229
etiology, 225, 226
pathology, 226, 227
prognosis, 229
symptoms, 227, 228, 229
treatment, 229, 230
Incontinence of urine in bladder,
416
definition, 416
etiology, 416
prognosis, 416
symptoms, 416
treatment, 416
Incrustations of tartar, 108
Infectious asthenia of birds, 191
bulbar paralysis, 611
diarrhea of chicks, 629
gastro-enteritis, 600
jaundice, 633
leukemia of chickens, 325
nasal catarrh of rabbits, 20
Inferior maxilla, fracture of, 369
Inflammation of eyelids, 498
of kidneys, 388
of rnembrana nictitans, 522
INDEX
653
Inflammation of membrana nicti-
tans, examination, 522
prognosis, 523
symptoms, 522, 523
treatment, 523
of orbit, 553
of ovaries, 283
definition, 283
diagnosis, 284
etiology, 284
prognosis, 284
symptoms, 284
treatment, 284
of renal pelvis, 398
of synovial membrane and artic-
ulations, 383
definition, 383
etiology, 383
prognosis, 383
symptoms, 383
treatment, 383, 384
of urethra, 429
Inflammatory ectasia of cornea, 537
forms, 537
keratectasia, 537
staphyloma, 537
Influenza, rabbit, 20
Infraorbital fossae of birds, empy-
ema of, '20
Inguinal hernia, 560
in female, 560
in male, 561
Injuries of peripheral nerves, 450
of spinal cord, 445
Insufficiency, valvular, 78
Interstitial hepatitis, 243
chronic, 243
pneumonia, 57
chronic, 57
Intestinal hemorrhage, 175
obstruction, 182
Intestines, diseases of, 167
examination, 167
parasites in, 193
round worms in, 202
of birds, 202, 203
of cat, 202
of dog, 202
of rabbit, 202
strongylidse in, 207
of cat, 207
of dog, 207
of rabbit, 207
Intestines, tacnia in, 195
of birds, 198
of cats., 197
of dogs, 195, 196, 197
of rabbits, 197, 198
trichinellidae in, 209, 210, 211
of birds, 210, 211
of dog, 210
of rabbit, 210
wounds of, 188
Intussusception, 186
definition, 186
diagnosis, 187
etiology, 186
pathology, 186, 187
prognosis, 187
symptoms, 187
treatment, 187, 188
Inversion of uterus, 300
Iridocyclitis, 540
course, 541
definition, 540
etiology, 540
prognosis, 541
symptoms, 540, 541
treatment, 541
Iris and ciliary body, diseases of,
539
congenital defects of, 539
cysts of, 541
tumors of, 541
Iritis, 540
Itch, 475
red, 482
Ixodes ricinus, 633
JAUNDICE, 225
infectious, 633
malignant, 633
KERATECTASIA, 537
Keratitis, 526
definition, 526, 527
non-suppurative, 527
keratitis pigmentosa, 529
definition, 529
etiology, 529
654
INDEX
Keratitis, npn-suppurative, kera-
titis pigmentosa, prog-
nosis, 529
symptoms, 529
treatment, 529
punctata profunda, 532
definition, 532
etiology, 532
prognosis, 532
symptoms, 532
treatment, 532
superficialis, 529
course, 530
definition, 529, 530
etiology, 530
prognosis, 530
symptoms, 530
treatment, 530
parenchymatous, 530
course, 531
definition, 530
etiology, 530, 531
prognosis, 531
symptoms, 531
treatment, 531, 532
superficial, 527
course, 527
definition, 527
etiology, 527
prognosis, 527
symptoms, 527
treatment, 527, 528
vascular, 528
definition, 528
etiology, 528
prognosis, 528
symptoms, 528
treatment, 528
suppurative, 527
abscess of cornea, 534
course, 535
definition, 534
etiology, 534
prognosis, 535
symptoms, 534, 535
treatment, 535
keratitis from lagophthalmos,
535
definition, 535
treatment, 535
neuroparalytica, 535
definition, 535
ulceration of cornea, 532
Keratitis, suppurative, ulceration
of cornea, course, 533
definition, 532
etiology, 532, 533
prognosis, 533
symptoms, 533
treatment, 534
Keratoconus, 538
Keratoglobus, 538
Kidney abscess, 396
amyloid, 407
animal parasites in, 407
coccidia, 409
Coccidium tenellum, 409
Cysticercus cellulosse, 409
Dioctophyme renale, 407
Eimeria avium, 409
Eustrongylus gigas, 407
calculi in, 402
congestion of, 387
cystic, 405
diseases of, 385
examination, 385, 386, 387
dropsy of, 405
inflammation of, 388
tumors in, 407
LACRIMAL apparatus, diseases of,
524
examination, 524
Lacrimation, 524
definition, 524
etiology, 524
prognosis, 525
symptoms, 525
treatment, 525
Lagophthalmos, 506
definition, 506
treatment, 506
Laryngitis, 30
acute, 30
definition, 30
diagnosis, 31
etiology, 30
pathology, 30, 31
prognosis, 31
symptoms, 31
treatment, 31
chronic, 31
INDEX
655
Laryngitis, chronic, definition, 31
diagnosis, 32
etiology, 31
pathology, 32
prognosis, 32
symptoms, 32
treatment, 32, 33
Larynx, diseases of, 30
examination, 30
Lens, diseases of, 542
examination, 542
luxation of, 544
Leukemia, 322
course, 325
definition, 322, 323
diagnosis, 325
etiology, 323
infectious, of chickens, 325
course, 326
definition, 325
diagnosis, 326, 327
etiology, 325, 326
occurrence, 325
pathogenesis, 326
pathology, 326
prognosis, 327
symptoms, 326
treatment, 327
lymphatic, 322
myelogenous, 322
occurrence, 323
pathology, 323
prognosis, 325
symptoms, 323, 324, 325
treatment, 325
Lice, 473
description, 473, 474
diagnosis, 475
kinds, 474
Linognathus piliferus, 474
Menopum biseriatum, 474
trigonocephalum, 474
Trichodectes latus, 474
subrostratus, 474
prognosis, 475
symptoms, 474, 475
treatment, 475
Linognathus piliferus, 474
Lipoma of eyelids, in birds, 508
of mammary glands, 318
Liver, abscess of, 236
amyloid, 242
atrophy of, 240
Liver, cirrhosis of, 243
congestion of, 231
diseases of, 225
. examination, 225
fatty, 241
neoplasms of, 244
rupture of, 246
Lockjaw, 613
Lungs, cirrhosis of, 57
congestion of, 49
active, 49
passive, 50
diseases of, 47
examination, 47, 48, 49
auscultation, 47, 48
percussion, 49
respiration, 47
thorax, 47
edema of, 52
gangrene of, 58
hyperemia of, 49
Luxation, 378
of eyeball, 550
prognosis, 550
treatment, 550, 551
of lens, 544
treatment, 544
Lymphadenitis, 120
Lyssa, 603
M
MALFORMATIONS, congenital, of
penis and prepuce, 265
of urethra, 425
symptoms, 426
treatment, 426
of vagina and vulva, 309
of teeth, 107
treatment, 107
Malignant goiter, 342
jaundice, 633
neoplasms of eyelids, 508, 509
of mouth, 104
tumors of mammary glands, 318
carcinoma ta, 318
sarcomata, 318
in nasal passages, 29
Malposition of eyelids, 499
blepharoptosis, 501
blepharospasm, 503
ectropion, 500
050
INDEX
Malposition of eyelids, ectropion,
definition, 500
etiology, 500
prognosis, 500
symptoms, 500
treatment, 500, 501
entropion, 499
definition, 499
etiology, 499
prognosis, 499
symptoms, 499
treatment, 499, 500
paralysis of orbicularis nerve,
502
definition, 502
etiology, 502
prognosis, 502, 503
symptoms, 502
treatment, 503
ptosis, 501
definition, 501
etiology, 501
symptoms, 502
treatment, 502
spasm of orbicularis nerve, 503
definition, 503
treatment, 503
Mammary glands, congestion of,
316
diseases of, 315
examination, 315
tumors of, 317
wounds and injuries of, 315
Mammitis, 316
definition, 310
etiology, 310
prognosis, 317
symptoms, 310, 317
treatment, 317
Mange, 475
definition, 475
demodectic, 480
diagnosis, 481
etiology, 480
pathology, 480
prognosis, 481
symptoms, 480, 481
treatment, 481, 482
etiology, 475, 476
mites, 476
demodex, 480
folliculorum, 480
sarcoptes, 476
Mange, mites, sarcoptes of cat,
477
Sareoptes minor, var. cati,
477
Notoedres cati, var. cat,
477
of dog, 476, 477
Sarcoptes scabiei, var.
canis, 476, 477
of ferret, 477, 478
Sarcoptes scabiei, var.
hydrochsri, 477, 478
of fowl, 478
Cnemidocoptes mutans,
var. gallinae, 478
Sarcoptes mutans, 478
of rabbit, 477
Notaodres cati, var. cuni-
culi, 477
Sarcoptes minor, var.
cuniculi, 477
red, 475
sarcoptic, 475
diagnosis, 478
pathology, 476
prognosis, 478
treatment, 478, 479, 480
Mastitis, 316
Megrim, 457
Meibomian cyst of eyelids, 507
Membrana nictitans, inflammation
of, 522
tumors on, 523
wounds of, 523
Membranous enteritis, 190
Meningo-encephalitis, 438
definition, 43P, 439
diagnosis, 440
etiology, 439
pathology, 439
prognosis, 440
symptoms, 439, 440
treatment, 440
Meningomyelitis, 443
definition, 443
diagnosis, 445
etiology, 444
pathology, 444
prognosis, 445
symptoms, 444, 445
treatment, 445
Menopum biseriatum, 476
trigonocephalum, 476
INDEX
657
Metacarpal and phalangeal bones,
fracture of, 373
Metastrongulinse, 330
Metritis, 293
acute, 293
definition, 293
diagnosis, 295
etiology, 293, 294
pathology, 294, 295
prognosis, 295
symptoms, 295
treatment, 295, 296
chronic, 296
definition, 296
diagnosis, 298
etiology, 296,- 297
pathology, 297
prognosis, 298
symptoms, 297, 298
treatment, 298
definition, 293
Moniezia denticulata, 197
Mouth, benign neoplasms of, 102
canker of, 97
diseases of, 93
examination, 93, 94
abnormal conditions noted,
93, 94
foreign bodies, 94
mucous membranes, 94
neoplasms, 94
odor, 93
secretions, 93, 94
foreign bodies in, 106
malignant neoplasms of, 104
sore, 96
Multiceps multicer-s, 196
serialis, 196, 197
Mumps, 115
Muscular rheumatism, 365
Mycotic pneumonia, 40
Mydriasis, 539, 540
definition, 539
Myocarditis, 82
acute, 82
definition, 82
diagnosis, 84
etiology, 82, 83
necropsy, 83
prognosis, 84
symptoms, 83, 84
treatment, 84
chronic, 84
42
Myocarditis, chronic, definition, 84
etiology, 85
necropsy, 85
Myomata of uterus, 304
Myosis, 540
definition, 540
N
NASAL catarrh, acute, 19
chronic, 23
of rabbits, 20, 21
infectious, 20, 21
parasitic,- 22
passages, diseases of, 17
examination, 17, 18
abnormal conditions noted.
18, 19
discharge, 19
foreign bodies, 18
hemorrhage, 18
infectious, 18
malformations, 18, 19
parasites, 18
tumors, 18
neoplasms of, 28
benign tumors, 28
papillomata, 28
treatment, 28
polypoid fibromata, 28
treatment, 28, 29
malignant tumors, 29
diagnosis, 29
prognosis, 29
symptoms, 29
treatment, 29
parasites of, 25
definition, 25
diagnosis, 27
etiology, 25
life cycle, 26
necropsy, 27
prognosis, 27
symptoms, 27
treatment, 27
Nematoda, 201
species, 201
ascaridae, 201
hookworm, 206
round worms, 201
in intestine of birds, 202,
203
058
INDEX
Ncmatoda, species, round worms,
in intestine of cat,
202
of dog, 202
of rabbit, 202
strongylidse, 206
in intestine of cat, 207
of dog, 207
of rabbit, 207
trichinellidse, 209, 210
in intestine of birds, 210
of dog, 210
of rabbit, 210
whipworm, 209, 210
Neoplasms of ear, 493
cysts, 494
papillomata, 493
prognosis, 493
symptoms, 493
treatment, 493
sebaceous tumors, 494
treatment, 494
of esophagus, 141
diagnosis, 141
prognosis, 141
symptoms, 141
treatment, 141
of eyelids, 508, 509
of liver, 244
symptoms, 244
treatment, 244
of mouth, 102
benign, 102
fibromata, 102
symptoms, 103
treatment, 103
osteoma, 103
symptoms, 103
treatment, 103
papillomata, 102
symptoms, 102
treatment, 102
retention cysts, 103
treatment, 104
malignant, 104
epitheliomata, 104
symptoms, 104, 105
-treatment, 105
sarcomata, 105
symptoms, 105
treatment, 105
of nasal passages, 28
of pharynx, 128
Neoplasms of pharynx, epithelio-
mata, 129
symptoms, 129
treatment, 129
polypoid growths, 128
symptoms, 128
treatment, 128
in rectum, 222
diagnosis, 223
prognosis, 223
symptoms, 222, 223
treatment, 223
in stomach, 165
prognosis, 165
symptoms, 165
treatment, 165, 166
Nephritis, 388
acute, 388
course, 392
definition, 388, 389
diagnosis, 391, 392
etiology, 389, 390
pathology, 390
prognosis, 392
symptoms, 391
treatment, 392
chronic, 392
definition, 392, 393
diagnosis, 395
etiology, 393
pathology, 393, 394
prognosis, 395
symptoms, 394, 395
treatment, 396
purulent, 396
definition, 396
diagnosis, 398
etiology, 396, 397
pathology, 397
prognosis, 398
symptoms, 397, 398
treatment, 398
Nephrolithiasis, 402
Neuritis, retrobulbar, 546, 547
Non-inflammatory ectasia of cor-
nea, 538
forms, 538
keratoconus, 538
keratoglobus, 538
Non-suppurative keratitis, 527
forms, 526, 527
keratitis pigmentosa, 529
punctata profunda, 532
INDEX
659
Non-suppurative keratitis, forms,
keratitis pig mentosa,
punctata superficialis, 529
parenchymatous, 530
superficial, 527
vascular, 528
Nystagmus, 552
definition, 552
treatment, 553
OBESITY, 352
course, 353
definition, 352
etiology, 352, 353
pathology, 353
prognosis, 353
symptoms, 353
treatment, 353, 354
Obstipation, 182
Obstruction of crop in birds, 139
definition, 139
etiology, 139
prognosis, 140
symptoms, 139, 140
treatment, 140, 141
in esophagus, 131
intestinal, 182
Occlusion of rectum and anus, 212,
213
artificial, 213
congenital, 212, 213
diagnosis, 213
prognosis, 213
symptoms, 213
treatment, 213; 214
of urethra, 425
Ollulanus tricuspis in stomach of
cat, 163
Oophorectomy, 285, 286
in cat, 289
in dog, 286, 287, 288, 289
Oophoritis, 283
Opacities of cornea, 536
prognosis, 536
treatment, 536, 537
Optic nerve, atrophy of, 547
diseases of, 546
hemorrhages of, 546
inflammation of, 546
tumors of, 546
Optic nerve, wounds of, 546
Orbicularis nerve, paralysis of, 502
spasm of, 503
Orbit, fracture of, 553
inflammation of, 553
tumors of, 553
Orchectomy, 273
Orchitis, 271
definition, 271
etiology, 271, 272
prognosis, 272
symptoms, 272
treatment, 272
Osteoma of mouth, 103
Osteomalacia, 362
Otitis externa, 490, 491
diagnosis, 492
etiology, 491
prognosis, 492
symptoms, 491, 492
treatment, 492
interna, 493
media, 493
Otorrhea, 490, 491
Ovariectomy, 285, 286
Ovaries, diseases of, 283
examination, 283
inflammation of, 283
tumors of, 284 *
Oxyuridae, 221
Oxyuris ambigua, 202, 222
compar, 221
vermicularis, 221
PANNUS, 528
Panophthalmitis, 548
definition, 548
diagnosis, 548, 549
prognosis, 549
symptoms, 548
treatment, 549
Papillitis, 546
definition, 546
prognosis, 546
Papillomata of ear, 493
of eyelids, 506
of mouth, 102
of nasal passages, 28
of penis and prepuce, 269
of vulva and vagina, 314
660
INDEX
Paralysis, infectious bulbar, 611
definition, 611
diagnosis, 612
etiology, 612
natural infection, 612
pathogenicity, 612
pathology, 612
prognosis, 613
symptoms, 612, 613
treatment, 613
of orbicularis nerve, 502
of peripheral nerves, 450
auditory, 453
diagnosis, 454
etiology, 453, 454
prognosis, 454
symptoms, 454
treatment, 454
brachial plexus, 455
etiology, 455
prognosis, 456
symptoms, 456
treatment, 456
facial, 450
diagnosis, 451
etiology, 450, 451
prognosis, 451
symptoms, 451
treatment, 451, 452
radial, 454
diagnosis, 455
etiology, 454, 455
prognosis, 455
symptoms, 455
treatment, 455
sciatic, 456
etiology, 456
prognosis, 456
symptoms, 456
treatment, 456
trigeminal, 452
diagnosis, 453
etiology, 452
prognosis, 453
symptoms, 452, 453
treatment, 453
of pharynx, 127
Paraphimosis, 267
definition, 267
etiology, 267
prognosis, 268
symptoms, 268
treatment, 268
Parasites, animal, in blood, 330
Dirofilaria immitis, 330
diagnosis, 332
etiology, 330, 331
occurrence, 330
pathogenesis, 331
pathology, 331
symptoms, 331, 332
treatment, 332
Filaria immitis, 330
Haemostrongylus vasorum,
332
diagnosis, 333
symptoms, 332
treatment, 333
Hema'tozoon Lewisi, 332
Spiroptera sanguinolenta,
333
in kidney, 407
coccidia, 409
Coccidium tenellum, 409
Cysticercus cellulosae, 409
Dioctophyme renale, 407
diagnosis, 409
life cycle, 408
prognosis, 409
symptoms, 408, 409
treatment, 409
Eimeria avium, 409
Eustrongylus gigas, 407
in bladder, 423, 424
Dioctophyme renale, 423
treatment, 424
in ear, 494
diagnosis, 494
prognosis, 494
symptoms, 494
treatment, 494
of eye, 553
in intestines, 193
of nasal passages, 25
in rectum, 221
Oxyuridse, 221
Oxyuris ambigua, 222
compar, 221
vermicularis, 221
symptoms, 222
treatment, 222
in scrotum and testes, 273
in stomach, 163
of birds, 163
Dispharagus n a s u t u s,
163
INDEX
661
Parasites in stomach of birds, Dis-
pharagus spiralis, 163
Trichosomum contortum,163
of cat, 163
Ollulanus tricuspis, 163
Taenia tseniaeformis, 163
diagnosis, 164
of dog, 163
Gastrophilus intestinalis, 163
Spiroptera sanguinolenta,
163
prognosis, 164
of rabbits, 163
Strongylus strigosus, 163
symptoms, 164
treatment, 165
in trachea and bronchial tubes,
42
Parasitic nasal catarrh of birds, 22
of rabbits, 22
stomatitis, 100
Parenchymatous conjunctivitis,514
goiter, 336
keratitis, 530
Parotitis, 115
definition, 115
diagnosis, 117
etiology, 115, 116
pathology, 116
prognosis, 117
symptoms, 116, 117
treatment, 117
Passolurus ambigus, 202
Pasteurellosis avium, 584
Patella, fracture of, 375
Patellar dislocation, 382
Pelvis, fracture of, 373, 374
Penis and prepuce, congenital mal-
formations of, 265
diseases of, 263
examination, 263
tumors of, 268
wounds of, 263, 264
Pericarditis, 73
definition, 73
diagnosis, 75
etiology, 73, 74
necropsy, 74
prognosis, 75
symptoms, 75
treatment, 75, 76
Pericardium, diseases of, 69
examination, 69, 70, 71, 72, 73
Pericardium, diseases of, exami-
nation, heart, 71
auscultation, 71, 72, 73
endocardial bruits, 72,
73
pericardial bruits, 73
palpation, 71
percussion, 71
pulse, 69, 70
frequency, 69, 70
quality, 70
rhythm, 70
dropsy of, 76
Pericementitis, 108
Perineal hernia, 563
Periodontitis, 108
Periostitis, alveolar, 108
definition, 108
etiology, 108, 109
pathology, 109
symptoms, 109
treatment, 109
Peripheral nerves, compression of,
450
injuries of, 450
paralysis of, 450
pressure on, 450
Peritoneum, diseases of, 248
general remarks, 248, 249
Peritonitis, 250
acute, 250
course, 253, 254
definition, 250
diagnosis, 254
etiology, 250, 251
pathogenesis, 251
pathology, 251, 252
prognosis, 254 .
symptoms, 252, 253
treatment, 254, 255
chronic, 255
definition, 255
diagnosis, 257
etiology, 255, 256
pathology, 256
prognosis, 257
symptoms, 256
treatment, 257
Pestus avium, 489
Phalangeal dislocation, 381
Pharyngitis, 123
acute, 123
definition, 123
662
INDEX
Pharyngitis, acute, diagnosis, 124
etiology, 123
pathology, 124
prognosis, 124
symptoms, 124
treatment, 125
chronic, 125
definition, 125
etiology, 125
pathology, 125
prognosis, 125
symptoms, 125
treatment, 125, 126
croupous, of birds, 127
definition, 127
etiology, 127
pathology, 127
prognosis, 128
symptoms, 128
treatment, 128
Pharynx, diseases of, 123
examination, 123
foreign bodies in, 126
neoplasms of, 128
paralysis of, 127'
Phimosis, 266
definition, 266
etiology, 266
symptoms, 266, 267
treatment, 267
Phlegmonous stomatitis, 99
Phthiriasis, 474
Pigmentary keratitis, 529
Piles, 216
Pilosebaceous cysts, 507
Piropla-sma bigeminum, 633
canis, 633
commune, 633
Piroplasmosis of dog, 633
definition, 633
diagnosis, 635, 636
etiology, 633, 634
pathology, 634
prognosis, 636
symptoms, 634, 635
treatment, 636
Plague, dog, 579
fowl, 589
rabbit, 20
Pleura, diseases of, 60
Pleurisy, 60
Pleuritis, 60
definition, 60
Pleuritis, diagnosis, 64
etiology, 60, 61
pathology, 61, 62
prognosis, 64
symptoms, 62, 63
treatment, 64, 65
Pneumonia, catarrhal, 53
chronic interstitial, 57
foreign body, 58
definition, 58
diagnosis, 59
etiology, 58, 59
pathology, 59
prognosis, 59
symptoms, 59
treatment, 59
mycotic, 40
definition, 40
diagnosis, 41
etiology, 40
pathology, 40, 41
prevention, 41
prognosis, 41
symptoms, 41
treatment, 41
Pneumothorax, 66
definition, 66
diagnosis, 67
etiology, 66
pathology, 66
prognosis, 67
symptoms, 67
treatment, 67
Podagra, 354
Polyarthritis rheumatica, 363
Polypoid fibromata of nasal pas-
sages, 28
growths of pharynx, 128
Poulardizing the female chicken,
289, 290
Preputial catarrh, 265
Pressure on peripheral nerves, 450
Proctitis, 214
definition, 214
diagnosis, 215
etiology, 214
pathology, 214, 215
prognosis, 215
symptoms, 215
treatment, 215
Prolapse of rectum, 217
definition, 217
diagnosis, 218
INDEX
663
Prolapse of rectum, etiology, 217,
218
prognosis, 218, 219
symptoms, 218
treatment, 219, 220, 221
of uterus, 300
of vagina, 311
diagnosis, 312
etiology, 311
prognosis, 312
symptoms, 312
treatment, 312, 313
Prostate gland, diseases of, 279
examination, 279
hypertrophy of, 280
tumors of, 280
Prostatitis, 279
definition, 279
etiology, 279
prognosis, 280
symptoms, 279, 280
treatment, 280
Pseudo-actinomycosis of dogs, 623
definition, 623
diagnosis, 624
etiology, 623
occurrence, 623
pathogenicity, 623
pathology, 623
prognosis, 624
symptoms, 623, 624
treatment, 624
Pseudoleukemia, 327
definition, 327
diagnosis, 327
etiology, 327
occurrence, 327
pathology, 327
prognosis, 327
symptoms, 327
treatment, 327
Pseudorabies, 611
Pterygium, 519
definition, 519
diagnosis, 519
prognosis, 519
symptoms, 519
treatment, 519
Ptosis, 501
Puerperal septicemia, 298
definition, 298, 299
diagnosis, 299, 300
etiology, 299
Puerperal septicemia, pathology,
299
prognosis, 300
symptoms, 299
treatment, 300
Pulex avium of birds, 472
gonivcephalus of rabbits, 472
irritans of man, 472
Pulmonary edema, 52
definition, 52
diagnosis, 53
etiology, 52
pathology, 52
prognosis, 53
symptoms, 52
treatment, 53
Purpura hemprrhagica of dogs, 583
Purulent conjunctivitis, 512
Pyelitis, 398
definition, 398
diagnosis, 399
etiology, 398, 399
pathology, 399
prognosis, 399
symptoms, 399
treatment, 400
Pyometra, 296
Pyosalpinx, 291
R
RABBIT distemper, 20
influenza, 20
plague, 20
Rabies, 603
course, 609, 610
definition, 603
diagnosis, 608
differential, 610, 611
confused with canine dis-
temper (nervous form),
610
diseases of brain, 610
eclampsia, 611
epilepsy, 611
foreign bodies, 610
infectiousbulbar paralysis,
611
parasites in intestinal
tract, 610
trigeminal or facial par-
alysis, 610, 611
664
INDEX
Rabies, etiology, 603
natural infection, 604
occurrence, 603
pathogenesis, 604, 605
pathogenicity, 603, 604
pathology, 605
preventive inoculation, 611
prognosis, 609, 610
symptoms, 605, 606, 607
treatment, 611
Rachitis, 359
course, 361
definition, 359
etiology, 359, 360
occurrence, 359
pathology, 360
prognosis, 361
svmptoms, 360, 361
treatment, 361, 362
Radial nerve, paralysis of, 454
Radio-ulnar-carpal dislocation, 380
Radius and ulna, fracture of, 372,
373
Ranula, 103
Rectum and anus, diseases of, 212
examination, 212
neoplasms in, 222
occlusion of, 212, 213
parasites in, 221
prolapse of, 217
Red itch, 482
mange, 475
Reflex epilepsy, 459
Renal abscess, 397
pelvis, inflammation of, 398
Reproductive organs, diseases of,
263
Retentio urinae vesicalis, 414
Retention cysts in mouth, 103
of scrotum and testes, 273
of urine in bladder, 414
definition, 414
diagnosis, 415
etiology, 414
prognosis, 415
symptoms, 414, 415
treatment, 415
Retina and choroid, diseases of, 545
pathological changes, 545
anemia, 545
atrophy, 545
detachment of retina, 545
edema, 545
Retina and choroid, pathological
changes, hyperemia, 545
inflammation (retinitis),
545
Retrobulbar neuritis, 546, 547
Rheumatism, 363
articular, 363
course, 364
definition, 363
diagnosis, 364
etiology, 363
pathology, 363
prognosis, 364, 365
symptoms, 364
treatment, 365
muscular, 365
course, 367
definition, 365
etiology, 365, 366
pathology, 366
prognosis, 367
symptoms, 366, 367
treatment, 367
Rhinitis, 19
chronic, 23
coccidiosa, 22
Rhipicephalus sanguineus, 633
Ribs, fracture of, 371
Rickets, 359
Ringworm, 482
honeycomb, 484
Roundworms, 201
diagnosis, 204
in intestine of birds, 202, 203
Heterakis compressa, 203
crassa, 203
differens, 203
P dispar, 203
inflexa, 203
lineata, 203
muculosa, 203
papillosa, 202, 203
perspicillum, 203
vesicularis, 202, 203
of cat, 202
Belascaris mystax, 202
of dog, 202
Belascaris marginata, 202
Echinorhynchus canis,
202
Toxascaris limbata, 202
marginata, 202
of rabbit, 202
INDEX
665
Roundworms in intestine of rabbit,
Oxyuris anibigua, 202
Passolurus ambigus, 202
pathology, 293, 204
prevention, 205, 206
prognosis, 205
symptoms, 204
treatment, 205
Roup, 593
Ruptura hepatis, 246
Rupture of bladder, 412
prognosis, 413
symptoms, 412, 413
treatment, 413
of heart, 92
etiology, 92
symptoms, 92
treatment, 92
of liver, 246
diagnosis, 246
etiology, 246
pathology, 246
prognosis, 246, 247
symptoms, 246
treatment, 247
of uterus, 303
prognosis, 303
symptoms, 303
treatment, 303
of vagina, 313
SALIVARY fistula, 118
glands, diseases of, 115
examination, 115
Salpingitis, 291
definition, 291
etiology, 291
symptoms, 291
treatment, 291
Sarcomata of bladder, 423
of eyelids, 509
of mammary glands, 318
of mouth, 105
of penis and prepuce, 269
of scrotum and testes, 273
of vulva and vagina, 314
Sarcoptes mite, 476
of cat, 477
Notcedres cati, var. cati, 477
Sarcoptes minor, var. cati,
477
Sarcoptes mite of dog, 476, 477
Sarcoptes scabiei, var. canis,
478, 479
of ferret, 479, 480
Sarcoptes scabiei, var. hy-
drochaeri, 477, 478
of fowl, 478
Cnemidocoptes mutans, var.
gallinse, 478
Sarcoptes mutans, 478
of rabbit, 477
• Notoedres cati, var. cuniculi,
477
Sarcoptes minor, var. cuni-
culi, 477
Scabies, 475
Scapula, fracture of, 371
Scapulohumeral dislocation, 379
Sciatic nerve, paralysis of, 456
Scorbutus, 328
Scrotal hernia, 561
Scrotum, diseases of, 271
parasites in, 273
tumors of, 272
wounds and injuries of, 271
Scurvy, 328
definition, 328
diagnosis, 329
etiology, 328
occurrence, 328
pathology, 328, 329
prognosis, 329, 330
symptoms, 329
treatment, 330
Sebaceous tumors in birds, 508
of ear, 494
Secondary epilepsy, 457
Septicemia, hemorrhagic, of cats,
600
puerperal, 298
Simple catarrh of stomach, 142
Skin diseases, non-parasitic, 463
examination, 463, 464
microscopic, 463, 464
parasitic, 472
vegetable 482
Soft crop, 137
Soor, 100
Sore mouth, 96
Spasm of orbicularis nerve, 503
Spinal cord, compression of, 448
concussion of, 445
diseases of, 443
666
INDEX
Spinal cord, diseases of, examina-
tion, 443
general considerations, 443
functions of cord, 443
injuries of, 445
Spirillosis of chickens, 625
Spirochsetosis avium, 625
of fowls, 625
definition, 625
diagnosis, 626
etiology, 625
natural infection, 625, 626
occurrence, 625
pathogenesis, 625
pathology, 626
prognosis, 626
symptoms, 626
treatment, 626, 627
Spiroptera sanguinolenta, 333
in stomach of dog, 163
Sprains and injuries to articula-
tions, 377
Staphyloma, 537
Stenosis, 78
Stomacace, 96
Stomach, chronic catarrh of, 146
dilatation of, 152
acute, 152
chronic, 154
diseases of, 142
examination, 142
foreign bodies in, 148
neoplasms in, 165
parasites in, 163
simple catarrh of, 142
ulceration of, 157
Stomatitis, 94
catarrhal, 94
definition, 94
diagnosis, 95
etiology, 94, 95
pathology, 95
prognosis, 96
symptoms, 95
treatment, 96
fetid, 96
gangrenous, 97
definition, 97
diagnosis, 98
etiology, 97, 98
pathology, 98
prevention, 99
prognosis, 98, 99
Stomatitis, gangrenous, symptoms,
98
treatment, 99
parasitic, 100
definition, 100
diagnosis, 101
etiology, 100, 101
pathology, 101
prognosis, 101
symptoms, 101
treatment, 102
phlegmonous, 99
definition, 99
diagnosis, 100
etiology, 99
pathology, 99
prognosis, 100
symptoms, 100
treatment, 100
ulcerative, 96
definition, 96
diagnosis, 97
etiology, 96
pathology, 96
prognosis, 97
symptoms, 96, 97
treatment. 97
Strabismus, 552
definition, 552
diagnosis, 552
etiology, 552
treatment, 552
Streptotrichosis canum, 623
Stricture of esophagus, 135
definition, 135
etiology, 136
prognosis, 136
symptoms, 136
treatment, 136
of urethra, 426
definition, 426
diagnosis, 427
etiology, 427
prognosis, 427
symptoms, 427
treatment, 427
Strongylidse, 206
diagnosis, 208
in intestine of cat, 207
Ankylostomum trigono-
cephalum, 207
of dog, 207
Ankylostomum canina, 207
INDEX
667
Strongylidae in intestine of dog,
Ankylostomum stenoce-
phalum, 207
Dochmius trigonocephalus,
207
Uncinaria stenocephala, 207
trigonocephala, 207
of rabbit, 207
Strongyloides longus, 207
Strongylus strigosus, 207
pathology, 208
prognosis, 209
symptoms, 208
treatment, 209
Strongyloides longus, 207
Strongylus strigosus, 207
in stomach of rabbits, 163
Struma, 336
Submaxillary andsublingual glands,
118
Superficial keratitis, 529
Suppuration of anal glands,223, 224
diagnosis, 224
treatment, 224
Suppuratiye hepatitis, 236
keratitis, 532
forms, 532
abscess of cornea, 534
keratitis from lagophthal-
mos, 535
neuroparalytica, 535
ulceration of cornea, 532
Symblepharon, 505
Syngamosis, 42
Synovial membrane, inflammation
of, 383
Synovitis, 383
TABLE of equivalents in weights
and measures, 637
Taenia, camirus. 196
crassicollis, 197
cucumerina, 195
echinococcus, 197
elliptica, 197
hydatigena, 196
marginata, 196
pisiformis, 195
pseudo-elliptica, 197
serialis, 190
Tamia serrata, 195, 196
taeniaeformis in stomach of cat,
193
Taeniae, 193
in intestine of birds, 198
Choanotaenia infundibulifor-
mis, 198
Davainea cesticillus, 198
craswula, 198
echinobothrida, 198
proglottina, 198
tetragona, 198
Dicranotaenia sphenoides,
198
Taenia cantaniani, 198
of cats, 197
Bothriocephalus felis, 197
Taenia crassicollis, 197
elliptica, 197
pseudo-elliptica, 197
taeniaeformis, 197
of dogs, 195
Dipylidium caninum, 195
Echinococcus granulosus,
197
Multiceps multiceps, 196
serialis, 196, 197
Taenia ccenurus, 196
cucumerina, 195
echinococcus, 197
hydatigena, 196
marginata, 196
pisiformis, 195, 196
serialis, 196, 197
serrata, 195, 196
of rabbits, 197, 198
Cittotaenia denticulata, 197
Moniezia denticulata, 197
life history, 194, 195
Taeniasis, 193, 194, 195
in birds, 198
in cats, 197
diagnosis, 200
in dogs, 195
pathology, 198, 199
prognosis, 200
in rabbits, 197, 198
symptoms, 199, 200
treatment, 200, 201
Tartar, incrustations of, 108
Teeth, caries of, 109
diseases of, 107
examination, 107
668
INDEX
Teeth, fractures of, 108
malformations of, 107
Teini>oroinaxillary dislocation, 378
Testes, diseases of, 271
parasites in, 273
tumors of, 272
wounds and injuries of, 271
Tetanus, 613
definition, 613, 614
diagnosis, 614
etiology, 614
natural infection, 614
occurrence, 614
pathology, 614
prognosis, 615
symptoms, 614, 615
treatment, 615,
Thrush, 100
Thyroid glands, congestion of, 334,
335
diseases of, 334
examination, 334
general considerations, 334
Thyroiditis, acute, 335
definition, 335
etiology, 335
prognosis, 335
symptoms, 335
treatment, 335, 336
Tibia and fibula, fracture of, 375
Tibiotarsal dislocation, 383
Tongue, diseases of, 111
examination, 111
gangrene of, 1 12
Tonsillitis and lymphadenitis, 120
definition, 120
etiology, 120, 121
pathology, 121
prognosis, 121
symptoms, 121
treatment, 121, 122
Tonsils, diseases of, 120
examination, 120
Torsion of bladder, 420
of cornua uteri, 302
symptoms, 302
treatment, 302
Toxascaris limbata, 202
marginata, 202
Trachea and bronchial tubes, ani-
mal parasites in, 42
definition, 42
diagnosis, 43
Trachea and bronchial tubes, ani-
mal parasites in,
etiology, 42
prevention, 43
prognosis, 43
symptoms, 42, 43
treatment, 43
diseases of, 34
examination, 34
Tracheitis and bronchitis, 34
acute, 34
definition, 34
diagnosis, 37
etiology, 34, 35, 36
pathology, 36
prognosis, 37
symptoms, 36, 37
treatment, 37, 38
chronic, 44
definition, 44
diagnosis, 45
etiology, 44
pathology, 44
prognosis, 45
symptoms, 44, 45
treatment, 45, 46
Traumatic lesions of conjunctiva,
519
foreign bodies, 519, 520
symptoms, 520
treatment, 520
wounds, 520
treatment, 520, 521
Trichiasis, 503
definition, 503, 504
prognosis, 504
symptoms, 504
treatment, 504
Trichinellidse, 209, 210
diagnosis, 211
in intestine of birds, 210, 211
Trichosomum annulatum,
210
brevicolle, 211
collare, 210
retusum, 210
tennissimum, 211
of dog, 210
Trichuris depressiusculus,
210
of rabbit, 210
Trichurus unguiculatus, 210
pathology, 211
INDEX
669
Trichinellidse, prognosis, 211
symptoms, 211
treatment, 211
Trichodectes latus, 474
subrostratus, 474
Trichosomum annulatum, 210
brevicolle, 211
collare, 210
contortum, 163
in stomach of birds, 163
retusum, 210
tennissimum, 211
Trichurus depressiusculus, 210
unguiculatus, 210
Trigeminal nerve, paralysis of, 451
Tuberculomata of eyelids, 511
Tuberculosis, avian, 616
avium, 616
of birds, 616
definition, 616
diagnosis, 619
etiology, 616
natural infection, 617
occurrence, 616
pathogenesis, 616, 617
pathology, 617, 618
prevention, 620
prognosis, 620
symptoms, 618, 619
treatment, 620
of dogs and cats, 620
diagnosis, 622
form, 620
occurrence, 620
pathogenesis, 621
pathology, 621
prognosis, 622
symptoms, 621, 622
treatment, 622
Tumors of bladder, 423
prognosis, 423
treatment, 423
varieties, 423
carcinomata, 423
fibromata, 423
sarcomata, 423
of brain, 441, 442
symptoms, 442
on conjunctiva, 522
treatment, 522
of cornea, 538
treatment, 538
of ear, 493
Tumors of eyelids, 506
varieties, 506
chalazion, 507
treatment, 507
cysts, meibomian, 507
pilosebaceous, 507
enlargement of glands of
Moll, 508
treatment, 508
granulomas, 508
treatment, 508
lipoma in birds, 508
treatment, 508
malignant neoplasms, 508,
509
diagnosis, 509
treatment, 509
varieties, 509
carcinomata, 509
epitheliomata, 509
sarcomata, 509
tuberculomata, 509
Meibomian cysts, 507
papillomata, 506
treatment, 506, 507
pilosebaceous cysts, 507
treatment, 508
sebaceous, in birds, 508
warts, 506
of iris, 541
in kidney, 407
treatment, 407
in nasal passages, 29
benign, 28
malignant, 29
of mammary glands, 317
benign, 317
fibromata, 317
prognosis, 318
symptoms, 318
treatment, 318
lipoma, 318
prognosis, 318
symptoms, 318
treatment, 318
malignant, 318
carcinomata, 318
prognosis, 318
symptoms, 318
treatment, 318
sarcomata, 318
diagnosis, 318
symptoms, 318
070
INDEX
Tumors of mammary glands, ma-
lignant, sarcomata, treatment,
318
on membrana nictitans, 523
of orbit, 553
of ovaries, 284
varieties, 284
cysts, 284
diagnosis, 285
prognosis, 285
treatment, 285
other tumor formations, 285
of penis and prepuce, 268
varieties, 269, 270
carcinomata, 269
epitheliomata, 269
papillomata, 269
symptoms, 269
treatment, 269
sarcomata, 269
diagnosis, 269
symptoms, 269
treatment, 269
venereal granulomata, 269
diagnosis, 270
prognosis, 270
symptoms, 269, 270
treatment, 270
of prostate gland, 280
diagnosis, 281
prognosis, 281
symptoms, 281
treatment, 281, 282
of scrotum and testes, 272
carcinomata, 273
fibromata, 272, 273
retention cysts, 273
sarcomata, 273
treatment, 273
of uterine tubes, 291
of uterus, 303
fibromata, 303, 304
diagnosis, 304
prognosis, 304
symptoms, 304
treatment, 304
hydrometra, 304
definition, 304
diagnosis, 305
etiology, 304, 305
prognosis, 305
symptoms, 305
treatment, 305
Tumors of uterus, myomata, 304
of vulva and vagina, 313
fibromata, 313
diagnosis, 313
prognosis, 313
treatment, 314
papillomata, 314
treatment, 314
sarcomata, 314
treatment, 314
venereal granulomata, 314
treatment, 314
Typhoid, fowl, 584
Typhus, canine, 579
of dogs, 579
course, 582
definition, 579
diagnosis, 581, 582
etiology, 579
occurrence, 579
pathology, 579, 580
prognosis, 582
symptoms, 580, 581
treatment, 582, 583
ULCERATION of concha, 488
etiology, 488
prognosis, 489
symptoms, 489
treatment, 489
of conjunctiva, 521
treatment, 521
of cornea, 532
of stomach, 157
definition, 157, 158
diagnosis, 159
etiology, 158
pathology, 158
prognosis, 159
symptoms, 158, 159
treatment, 159
Ulcerative stomatitis, 96
Ulcus yentriculi, 157
Umbilical hernia, 557
Uncinaria stenocephala, 207
trigonocephala, 207
Uremia, 400
definition, 400
diagnosis, 401
etiology, 400
INDEX
671
Uremia, prognosis, 401
symptoms, 400
treatment, 401, 402
Urethra, calculi in, 427
congenital malformations of, 425
diseases of, 425
examination, 425
inflammation of, 429
occlusion of, 425
stricture of, 426
wounds of, .426
Urethritis, 429
symptoms, 429
treatment, 429
Urine, incontinence of, in bladder,
416
retention of, in bladder, 414
Urocystitis, 416
Uterine tubes, cysts of, 291
diseases of, 291
examination, 291
tumors of, 291
Uterus, diseases of, 292
examination, 292, 293
eversion of, 300
inversion of, 300
prolapse of, 300
rupture of, 303
tumors of, 303
VAGINA, diseases of, 309
examination, 309
malformations, congenital, 309
prolapse of, 311
rupture of, 313
tumors of, 313
and vulva, 309
congenital malformations of,
309
Vaginitis and vulvitis, 309
definition, 309
diagnosis, 311
etiology, 310
prognosis, 311
symptoms, 310
treatment, 311
Valvular insufficiency and stenosis,
78
definition, 78, 79
insufficiency, 78, 79
Valvular insufficiency and stenosis,
definition, insufficiency,
imperfect closing of
valves, 78, 79
stenosis or contraction of
openings, 79
diagnosis, 81
etiology, 79
necropsy, 80
prognosis, 81
symptoms, 80, 81
treatment, 81, 82
Vascular goiter, 341
keratitis, 528
Vegetable parasitic disease of skin,
482
Venereal granulomata of penis and
prepuce, 269
of vulva and vagina, 314
Ventral hernia, 558
Vertebrae, fracture of, 370
Vertebral dislocation, 379
Vertigo, 455
definition, 455
diagnosis, 456
etiology, 455
prognosis, 456
symptoms, 455, 456
treatment, 456
Volvulus, 185 .
definition, 185
diagnosis, 185, 186
etiology, 185
pathology, 185
prognosis, 186
symptoms, 185
treatment, 186
Vulva, diseases of, 309
examination, 309
tumors of, 313
Vulvitis, 309
W
WARTS on eyelids, 506
Whipworm, 209, 210
White comb, 484
diarrhea, 629
Wounds of articulations, 376
of bladder, 412
on conjunctiva, 520
of cornea, 535
072 INDEX
Wounds of ear, 487, 488 ; Wounds of intestines, 188
prognosis, 488 definition, 188
symptoms, 488 etiology, 188
treatment, 488 symptoms, 188, 189
of eyelids, 497, 498 treatment, 189
and injuries of mammary gland of membrana m'ctitans, 523
315 of penis and prepuce, 263, 264
treatment, 315 prognosis, 264
of testes and scrotum, 271 symptoms, 264
prognosis, 271 treatment, 264, 265
symptoms, 271 of urethra, 426
treatment, 271 treatmert, 426
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