Special Report on Diseases of the Horse Part 32

This may occur as the result of some previous disease, such as fatty degeneration, dilatation with weakness of the muscular walls, etc. It may be caused by external violence, a crus.h.i.+ng fall, pressure of some great weight, etc. Usually death follows a rupture very quickly, though an animal may live for some time when the rent is not very large.

WEAKNESS OF THE HEART.

This may arise from general debility, the result of exhausting disease, overwork, or heart strain, or loss of blood. It is indicated by a small, feeble, but generally regular pulse, coldness of the body, etc.

Treatment should be directed to support and increase the strength of the animal by tonics, rest, and nutritious feed. Carbonate of ammonia may be given to stimulate the heart's action and to prevent the formation of heart clot.

CONGESTION OF THE HEART

Congestion, or an acc.u.mulation of the blood in the cavities of the heart, may occur in consequence of fibrinous deposits interfering with the free movements of the valves, usually the product of endocarditis or as a result of excessive muscular exertion.

Symptoms are great difficulty of breathing, paleness of the visible mucous membranes, great anxiety, frequently accompanied by a general tremor and cold perspiration, followed by death. It usually results in death very quickly.

CYANOSIS OF NEWBORN FOALS.

This is a condition sometimes found in foals immediately after birth, and is due to nonclosure of the foramen ovale, which allows a mixture of the venous with the arterial blood in the left cavities of the heart. It is characterized by a dark purple or bluish color of the visible mucous membranes, shortness of breath, and a general feebleness. Foals thus affected generally live only a few hours after birth.

DISEASES OF ARTERIES, OR ARTERITIS AND ENDARTERITIS.

Inflammation of arteries is rarely observed in the horse as a primary affection. Direct injuries, such as blows, may produce a contusion and subsequent inflammation of the wall of an artery; severe muscular strain may involve an arterial trunk; hypertrophy of the heart, by increasing arterial tension, may result in the production of a general endarteritis. Septic infection may affect the inner coat and ultimately involve all three, or it may be the result of an inflammation in the vicinity of the vessels, etc. Inflammation of arteries, whatever the cause may be, often leads to very serious results in the development of secondary changes in their walls. Arteritis may be acute, subacute, or chronic; when the inner coat alone is affected it is known as endarteritis.

_Symptoms._--Arteritis is characterized by a painful swelling along the inflamed vessel, throbbing pulse, coldness of the parts supplied by the inflamed vessel, sometimes the formation of gangrenous sloughs, suppuration, abscess, etc. In an inflammation of the iliac arteries we find coldness and excessive lameness or paralysis of one or both hind limbs.

_Pathology._--In acute arteritis we find swelling along the vessel, loss of elasticity, friability, and thickening of the walls; a roughness and loss of gloss of the inner coat, with the formation of coagula or pus in the vessel. Subacute or chronic arteritis may affect only the outer coat (periarteritis), both the outer and middle coat, or the inner coat alone (endarteritis); and by weakening the respective coats leads to rupture, aneurism, or to degenerations, such as bony, calcareous, fatty, atheromatous, etc. It may also lead to sclerosis or increase of fibrous tissue, especially in the kidneys, when it may result in the condition known as arterio-capillary fibrosis. Chronic endarteritis is fruitful in the production of thrombus and atheroma. Arteritis may be limited to single trunks or it may affect, more or less, all the arteries of the body. Arteries which are at the seat of chronic endarteritis are liable to suffer degenerative changes, consisting chiefly of fatty degeneration, calcification, or the breaking down of the degenerated tissue, and the formation of erosions or ulcerlike openings in the inner coat. These erosions are frequently called atheromatous ulcers, and fragments of tissue from these ulcers may be carried into the circulation, forming emboli. Fibrinous thrombi are apt to form upon the roughened surface of the inner coat or upon the surface of the erosions.

Fatty degeneration and calcification of the middle and outer coats may occur, and large, hard, calcareous plates project inward, upon which thrombi may form or may exist in connection with atheroma of the inner coat. When there is much thickening and increase of new tissue in the wall of the affected artery it may encroach upon the capacity of the vessel, and even lead to obliteration. This is often a.s.sociated with interst.i.tial inflammation of glandular organs.

_Treatment._--Carbonate of pota.s.sium in 1-dram doses, to be given in 4 ounces liquor acetate of ammonia every six hours; scalded bran sufficient to produce loosening of the bowels, and complete rest; externally, applications of hot water or hot hop infusion.

ATHEROMA.

Atheroma is a direct result of an existing chronic endarteritis, the lining membrane of the vessels being invariably involved to a greater or less degree. It is most frequently found in the arteries, although the veins may develop an atheromatous condition when exposed to any source of prolonged irritation. Atheroma may affect arteries in any part of the body; in some instances almost every vessel is diseased, in others only a few, or even parts of one vessel. It is a very common result of endocarditis extending into the aorta, which we find perhaps the most frequent seat of atheroma. As a result of this condition the affected vessel becomes impaired in its contractile power, loses its natural strength, and, in consequence of its inability to sustain its accustomed internal pressure, undergoes in many cases dilatation at the seat of disease, const.i.tuting aneurism. In an atheromatous vessel, calcareous deposits soon occur, which render it rigid, brittle, and subject to ulceration or rupture. In such vessels the contractility is destroyed, the middle coat atrophied and beyond repair. Atheroma in the vessels of the brain is a frequent cause of cerebral apoplexy. No symptoms are manifested by which we can recognize this condition during life.

CONSTRICTION OF AN ARTERY.

This is usually the result of arteritis, and may partly or wholly be impervious to the flow of blood. When this occurs in a large vessel it may be followed by gangrene of the parts; usually, however, collateral circulation will be established to nourish the parts previously supplied by the obliterated vessel. In a few instances constriction of the aorta has produced death.

ANEURISM.

Aneurism is usually described as true or false. True aneurism is a dilatation of the coats of an artery over a larger or smaller part of its course. Such dilatations are usually due to chronic endarteritis and atheroma. False aneurism is formed after a puncture of an artery by a dilatation of the adhesive lymph by which the puncture was united.

_Symptoms._--If the aneurism is seated along the neck or a limb it appears as a tumor in the course of an artery and pulsating with it. The tumor is round, soft, and compressible, and yields a peculiar fluctuation upon pressure. By applying the ear over it a peculiar purring or hissing sound may sometimes be heard. Pulsation, synchronous with the action of the heart, is the diagnostic symptom. It is of a slow, expansive, and heavy character, as if the whole tumor were enlarging under the hand. Aneurisms seated internally may occupy the cavity of the cranium, chest, or abdomen. As regards the first, little is known during life, for all the symptoms which they produce may arise from other causes. Aneurism of the anterior aorta may be situated very closely to the heart or in the arch, and it is very seldom that we can distinguish it from disease of the heart. The tumor may encroach upon the windpipe and produce difficulty in breathing, or it may produce pressure upon the vena cava or the thoracic duct, obstructing the flow of blood and lymph. In fact, whatever parts the aneurism may reach or subject to its pressure, may have their functions suspended or disturbed. When the tumor in the chest is large, we generally find much irregularity in the action of the heart; the superficial veins of the neck are distended, and there is usually dropsical swelling under the breast and of the limbs. There may be a very troublesome cough without any evidence of lung affection. Sometimes pulsation of the tumor may be felt at the lower part of the neck where it joins the chest. When the aneurism occurs in the posterior aorta no diagnostic symptoms are appreciable; when it occurs in the internal iliac arteries an examination per r.e.c.t.u.m will reveal it.

There is one form of aneurism which is not infrequently overlooked, affecting the anterior mesenteric artery, primarily induced by a worm--_Strongylus vulgaris_. This worm produces an arteritis, with atheroma, degeneration, and dilatation of the mesenteric arteries, a.s.sociated with thrombus and aneurism. The aneurism gives rise to colic, which appears periodically in a very violent and often persistent type.

Ordinary colic remedies have no effect, and after a time the animal succ.u.mbs to the disease. In all cases of animals which are habitually subject to colicky attacks, parasitic aneurism of the anterior mesenteric artery may be suspected. (See p. 92.)

_Pathology._--Aneurisms may be diffuse or sacculated. The diffuse consists in a uniform dilatation of all the coats of an artery, so that it a.s.sumes the shape of a cylindrical swelling. The wall of the aneurism is atheromatous, or calcified; the middle coat may be atrophied. The sacculated, or circ.u.mscribed, aneurism consists either in a dilatation of the entire circ.u.mference of an artery over a short portion of its length, or in a dilatation of only a small portion of one side of the wall. Aneurism may become very large; as it increases in size it presses upon and causes the destruction of neighboring tissues. The cavity of the aneurismal sac is filled with fluid or clotted blood or with layers of fibrin which adhere closely to its wall. Death is produced usually by the pressure and interference of the aneurism with adjoining organs or by rupture. In worm aneurism we usually find large thrombi within the aneurismal dilatation of the artery, which sometimes plug the whole vessel or extend into the aorta. Portions of this thrombus, or clot, may be washed away and produce embolism of a smaller artery. The effect in either case is to produce anemia of the intestinal ca.n.a.l, serous or b.l.o.o.d.y exudation in its walls, which leads to paralysis of the intestine and resultant colicky symptoms.

_Treatment._--The only treatment advisable is to extirpate or ligate the tumor above and below.

RUPTURE OF AN ARTERY.

Endarteritis, with its subsequent changes in the walls of arteries, is the primary cause of rupture in the majority of instances. The rupture may be partial, involving only one or two coats, and will then form an aneurism. If complete, it may produce death when it involves a large vessel, especially if it is situated in one of the large cavities permitting an excessive escape of blood. Rupture may be produced by mechanical violence or accident.

_Symptoms._--In fatal rupture, a.s.sociated with profuse bleeding, the animal becomes weak, the visible mucous membranes become blanched, the breathing hurried or gasping, pupils dilated, staggering in gait, syncope, death. When the hemorrhage is limited the symptoms may not become noticeable; if it is near the surface of the body a round or diffuse swelling or tumor may form, const.i.tuting a hygroma. If the rupture is a.s.sociated with an external wound, the bleeding artery should be ligated, or where a bandage is applicable, pressure may be applied by tight bandaging. As a secondary result of rupture of an artery we may have formation of abscess, gangrene of a part, etc.

_Treatment._--When rupture of a deep-seated artery is suspected, large doses of fluid extract of ergot may be given to produce contraction of the blood vessels. Tannin and iron are also useful. The animal should be allowed to have as much water as he desires. Afterwards stimulants and nouris.h.i.+ng feed are indicated.

THROMBUS AND EMBOLISM.

By thrombosis is generally understood the partial or complete closure of a vessel by a morbid product developed at the site of the obstruction.

The coagulum, which is usually fibrinous, is known as a thrombus. The term "embolism" designates an obstruction caused by any body detached and transported from the interior of the heart or of some vessel.

Thrombi occur as the result of an injury to the wall of the vessel or may follow its compression or dilatation; they may result from some alteration of the wall of the vessel by disease or by the r.e.t.a.r.dation of the circulation. These formations may occur during life, in the heart, arteries, veins, or in the portal system. When a portion of fibrin coagulates in one of the arteries and is carried along by the circulation, it will be arrested, of course, in the capillaries, if not before; when in the veins, it may not be stopped until it reaches the lungs; and when in the portal system the capillaries of the liver will prevent its further progress. The formation of thrombi may act primarily by causing partial or complete obstruction, and, secondarily, either by larger or smaller fragments becoming detached from their end and by being carried along by the circulation of the blood to remote vessels, embolism; or by the coagulum becoming softened and converted into pus, const.i.tuting suppurative phlebitis. These substances occur most frequently in those affections characterized by great exhaustion or debility, such as pneumonia, purpura hemorrhagica, endocarditis, phlebitis, puerperal fever, hemorrhages, etc. These concretions may form suddenly and produce instantaneous death by r.e.t.a.r.ding the blood current, or they may arise gradually, in which case the thrombi may be organized and attached to the walls of the heart, or they may soften, and fragments of them (emboli) may be carried away. The small, wartlike excrescences occurring sometimes in endocarditis may occasionally form a foundation on which a thrombi may develop.

_Symptoms._--When heart clot, or thrombus, exists in the right side, the return of blood from the body and the aeration in the lungs is impeded, and if death occurs, it is owing to syncope rather than to strangulation in pulmonary respiration. There will be hurried and gasping breathing, paleness and coldness of the surface of the body, a feeble and intermittent or fluttering pulse, and fainting. When a fibrinous coagulum is carried into the pulmonary artery from the right side of the heart, the indications are a swelling and infiltration of the lungs and pulmonary apoplexy. When the clot is situated in the left cavities of the heart or in the aorta, death, if it occurs, takes place either suddenly or at the end of a few hours from coma.

_Pathology._--When a coagulum is observed in the heart it may become a question whether it was formed during life or after death. The loose, dark coagula so often found after death are polypi. If the deposition has taken place during the last moments of life, the fibrin will be isolated and soft, but not adherent to the walls; if it be isolated, dense, and adherent or closely intertwined with the muscles of the papillae and tendinous cords, the deposition has occurred more or less remote from the act of dying. Occasionally the fibrin may be seen lining one of the cavities of the heart, like a false endocardium, or else forming an additional coat to the aorta or other large vessels without producing much obstruction. Thrombi, in some instances, soften in their centers, and are then observed to contain a puslike substance. If this softening has extended considerably, an outer sh.e.l.l, or cyst, only may remain. The sources of danger exist not only in the interruption of the circulation of the blood, but also in a morbid state of the system, produced by the disturbed nutrition of a limb or organ, as well as the mingling of purulent and gangrenous elements with the blood.

_Treatment._--The urgent symptoms should be relieved by rest, stimulants, and the use of agents which will act as solvents to the fibrinous clots. Alkalis are specially useful for this purpose.

Carbonate of ammonia may be administered in all cases of thrombus, and should be continued for a long time in small doses several times a day.

In cases of great debility a.s.sociated with a low grade of fever, stimulants and tonics, and nitro-muriatic acid as an antiseptic, may be beneficial.

DISEASES OF VEINS, OR PHLEBITIS.

Inflammation of veins may be simple or diffuse. In simple phlebitis the disease of the vein is confined to a circ.u.mscribed or limited portion of a vein; in diffuse it involves the vein for a long distance; it may even extend from a limb or foot to the heart.

_Causes._--Phlebitis may be induced by contusions or direct injuries, an extension of inflammation from surrounding tissue, such as in abscess, formation of tumor, or malignant growth. It is often due to embolism of infective material, gangrenous matter, etc. Blood-letting from the jugular vein is occasionally followed by dangerous phlebitis.

_Symptoms._--The symptoms vary according to the extent and severity of the inflammation. In most cases the vein is swollen, thickened, and indurated to such a degree as to resemble an artery. A diffused swelling, with great tenderness, may extend along the affected vessel and the animal manifest all the symptoms connected with acute fever and general functional disturbance.

_Pathology._--The disease is only serious when large veins are affected.

The coats undergo the same changes as in arteritis; clots of blood and lymph plug the inflamed vessel, and, if the inflammatory process continues, these are converted into pus, which ruptures the vessel and produces a deep abscess; or it may be carried away in the circulation and produce metastatic abscess in the lungs or other remote organs. In mild cases the clots may become absorbed and the vessel restored to health. Phlebitis in the course of the veins of the limbs frequently leads to numerous abscesses, which may be mistaken for farcy ulcerations. A very common result of phlebitis is an obliteration of the affected portion of the vein, but as collateral circulation is readily established this is seldom of any material inconvenience.

_Treatment._--Phlebitis should be treated by the application of a smart blister along the course of the inflamed vessel; early opening of any abscesses which may form; the animal should have complete rest, and the bowels be kept loose with bran mashes. When the fever runs high, half-ounce doses of nitrate of pota.s.sium may be given in the drinking water, which may be changed in two or three days for 1-dram doses of the iodid of pota.s.sium. If the animal becomes debilitated, carbonate of ammonia, 1 dram, and powdered gentian, 3 drams, may be given every six hours.

VARICOSE VEINS, VARIX, OR DILATATION OF VEINS.

This may be a result of weakening of the coats from inflammatory disease and degeneration. It may also be due to mechanical obstruction from internal or external sources. It is sometimes found in the vein which lies superficial over the inside of the hock joint, and may be due to the pressure of a spavin. Occasionally it may be observed in stallions, which are more or less subject to varicocele, or dilatation of the veins of the testicular cord. Hemorrhoidal veins, or piles, are occasionally met with, generally in horses which run at pasture. Varicose veins may ulcerate and form an abscess in the surrounding tissues, or they may rupture from internal blood pressure and the blood form large tumors where the tissues are soft.