Definition. Synonyms. Causes, torpid action, defective insalivation,
inactive rumen, fever, inflammation, spinal paresis, dry, fibrous,
innutritious food, fungi, ergot, smut, privation of water, or of
succulent food, microbian ferments and their products, chronic heart
disease, dry farinas, extreme changes of diet, brain disease.
Symptoms: slight or violent; ill health, impaired appetite and
rumination, grunting, tympany, diarrhœa, constipation, baked coated
fæces, percussion signs, separation from herd, red eyes, stiffness,
agalactia, fœtid eructations, paralysis, drowsiness, stupor, delirium,
nervous symptoms mostly in acute cases. Course in chronic and acute
cases. Diagnosis; from pneumonia, and overloaded rumen. Lesions; solid
impacted omasum, baked contents, shedding of epithelium, congestion,
petechiæ, ulceration, empty, and congested abomasum and small
intestine. Treatment: laxative food, purgatives, stimulants,
antiseptics, enemata, stimulants of peristalsis, counter-irritants,
mucilages, laxative diet, tonics.
_Definition._ This may be defined as a form of indigestion of which the
prominent feature is the drying and impaction of the ingesta between the
folds of the third stomach. It may seem to be a primary disease, but in
very many cases it occurs as a result of some acute febrile or
inflammatory affection.
_Synonyms._ As the disease has been long popularly known it has received
a variety of popular names which are more or less characteristic. Dry
murrain, Clewbound, Fardelbound, Stomach staggers, Grass staggers,
Vertigo, Chronic dyspepsia, and Chronic indigestion may serve to
illustrate these.
_Causes._ Torpor of the manifolds and the suppression of secretion of
saliva, together with the absence of a continuous access of waves of
liquid floating the finely divided food from the mouth or rumen to the
third stomach are prime conditions of dessication of the contents. The
third stomach, like the two first, has no provision for liquid
secretion, but is dependent for its supply on constant flushing from in
front. If therefore feeding and rumination are interrupted as the result
of a febrile disease, if the secretion of saliva is in great part
suppressed, if the vermicular movements of the rumen and resulting
overflow into the third stomach are checked, and if in addition the
omasum itself is rendered torpid, the ingesta compressed between its
folds becomes drained of its liquid, and in no great length of time, to
such an extent that it may be rubbed up into a dry powder. All this is a
necessary result of an acute febrile condition, and therefore all
febrile and inflammatory affections tend to drying and impaction of the
contents of the omasum. If therefore the observer were to go no further
than this he would have a very simple pathology, for all or nearly all
fevers and inflammations would be to him simply impacted omasum. In the
great majority of cases this condition is to be looked on as a secondary
and subsidiary affection, while the real primary disease has still to be
sought for.
Some explanation of the special susceptibility of the third stomach in
such constitutional troubles, is found in the source of innervation of
the viscus. Colin and Ellenberger could rouse the movements of the first
two stomachs but not of the third by electric stimulation of the vagus,
while the third stomach was excited to action by excitation of the
spinal cord and of the sympathetic twigs proceeding from this to the
manifolds. Ellenberger indeed avers that the walls of this viscus are
abundantly furnished with ganglionic cells which are called into action
by this sympathetic stimulus. The innervation being derived from an
independent source, derangement of the third stomach may be quite
independent of any primary disorder of the first, and the omasum
deriving its motor supply from sources so closely related to the
vaso-motor ones, may give an additional explanation of the intimate
connection of its disorders with febrile and inflammatory diseases.
But while acknowledging the controlling influence of torpor or paresis
of the omasum, it would be an error to follow Cadeac in denying the
influence of food as a cause of impaction. It has long been notorious
that impaction of the omasum is preëminently a disease of winter, or of
the period of dry feeding. It occurs in cattle fed on dry, fibrous,
innutritious fodder, and especially when there is a scarcity of water,
or when in connection with severe frost the usual water supply has been
frozen up. It prevails in stock turned in spring or autumn on pastures
in which the fresh green grass grows up among the dead, dried and
withered stems of a previous growth and tempts them to eat them. It
appears when the stock consumes corn or cornstalks affected with smut or
certain other fungi, or the cereals or grasses suffering from ergot or
smut, but this is especially the case when there is also a privation of
water, whereas, with an abundant water supply or a partial ration of
roots, potatoes or ensilage the danger is greatly reduced. Sometimes a
change from soft to very hard water appears to act as a cause but
whether from a special astringent action or a disinclination to consume
the usual amount has not been made clear.
It must be allowed that the sheep and goat which habitually drink
little, suffer far less from this affection than the ox which drinks
freely, yet allowance must be made for the constitution and long settled
habits of the genus, and we must not forget that it is usually under
privation of water or a restricted supply that the ox suffers.
Among other causes must be named fermented food, the microbian ferments
and their products, serving to render the organ torpid, but also to
produce fever, lessened secretion and an arrest or retardation of liquid
supplies from the mouth or rumen.
Chronic heart disease, causing blood stasis in the omasum, appears to
induce torpor and favor impaction.
The ingestion of lead has a very direct action in producing paralysis
and consequent impaction.
Finally, finely divided dry food like meal or bran, swallowed hastily,
tends to pass in large amount directly into the omasum, and, before the
animal has become accustomed to the ration, is liable to clog the viscus
and induce impaction.
In nearly all cases, the commencing impaction entails a certain rise of
temperature and suppression of secretions, so that the malady tends to
move in a vicious circle, each new step tending to aggravate the already
existing condition. In chronic cases, which are very common, a careful
record of bodily temperature shows oscillations, above and to the
normal, at irregular intervals, each rise tending to add to the
impaction.
The most acute and fatal forms of the affection occur in connection with
a sudden change from dry to rich, luscious, green food in spring, the
unwonted stimulus giving rise to general irritation of the whole gastric
mucosa, with disordered and impaired function of all four stomachs, but
especially of the third. Such cases are usually congestive and
inflammatory and the suspension of the gastric movements is a grand
cause of impaction. In such cases too the brain or spinal cord, or both,
are seriously involved, and the early death is preceded by torpor,
paralysis, violent delirium or convulsions, following largely the type
of acute lead poisoning.
_Symptoms._ These vary according to the degree of impaction or gastric
torpor, from simple, irregular, or suspended rumination (loss of cud) to
the most severe gastric and nervous disorder.
The slighter or less acute cases are marked by a failure to re-establish
regular rumination on partial convalescence from a fever or
inflammation. The hyperthermia subsides, but the appetite remains poor
and capricious, the muzzle dry, the eyes dull, the spirits low,
breathing quickened and occasionally accompanied by a moan, especially
when moving down hill, slight tympanies of the rumen may appear and the
contents of that organ seem consolidated and may be felt as solid masses
when pressure is made by the hand. The mouth is hot, clammy and fœtid,
and the bowels costive, the fæces being passed in small amount and in
the form of hard, black pellets, covered by a film of mucus, or streaks
of blood, and containing particles of undigested food. This not
unfrequently merges into a transient diarrhœa to be followed in turn by
renewed constipation, and such alternations may repeat themselves again
and again. The omasum is so deeply seated under the ribs on the right
side that exploration is unsatisfactory, especially in the milder cases,
yet pressure of the closed fist upward and forward below the middle of
the chest will give the impression of a specially solid resistance and
the patient may indicate suffering by a moan. Percussion with the closed
fist has the same effect. There may be slight tremors of the body, the
horns, ears and limbs are cold, and the hair erect in patches, dry and
lustreless.
In cases occurring independently of previous disease, diarrhœa may be
the first symptom noted, the malady being preceded by local irritation
and congestion, but this soon gives place to constipation with
alternating diarrhœa and the general train of symptoms above mentioned.
The animal leaves the herd and is found lying apart on its left side
with the nose in the right flank, the pulse and breathing quickened, the
eyes congested, and a moan emitted occasionally in expiration. This is
increased if the patient is raised and driven, especially down hill. He
walks with stiff, arched back, unsteady gait and dragging limbs.
Appetite may not be entirely lost at first, but only impaired and
irregular, and as rumination ceases, grinding of the teeth becomes
common. The secretion of milk is diminished or altogether arrested, and
emaciation advances day by day. Fœtor of the eructations, the result of
prolonged and septic fermentation in the rumen, is often a marked
symptom.
This form may last from ten to fourteen days and merge finally into
paralysis of the hind limbs, drowsiness and stupor, or delirium and
convulsions.
In the more acute cases resulting from a sudden access of green food, a
change of water, or the ingestion of irritant plants, the affection
partakes more or less of the nature of congestion or inflammation of the
viscus, and may run a rapidly fatal course. The animal may be seen apart
from the herd in the characteristic recumbent position, with eyes red
and glassy, eyelids semi-closed, and much drowsiness and stupor, but
when raised he may still feed in a sleepy, listless manner. The bowels
may be loose or confined, the pulse and breathing accelerated, the right
hypochondrium firm and tender, and as in the other forms the crepitating
sound of fermentation is slight or absent over the region of the
manifolds. Soon nervous disorder appears, the eyes glare wildly, the
animal seeks relief in motion, it may be in a straight line, or to one
side, and being blind and unconscious of obstacles he may fall into
pits, or ditches, dash against trees, fences or buildings, and if they
offer sufficient resistance he will continue pushing, breaking teeth or
horns, and subject to violent muscular contractions, causing even the
grubs to start from the back. The nervous disorder is often further
shown in loud and terrified bellowing as if chased by a dog or gored by
one of its fellows.
_Course._ Chronic cases may continue almost indefinitely the victims
showing merely poor health, impaired digestion, and steady loss of
condition. After death the omasum is sometimes found to contain dried
materials, such as the animal has not had access to for from three to
five months.
In those which end in an early recovery there occurs a free and abundant
diarrhœa, the fæces containing solid flattened masses with black baked
or polished surface, the result of the detachment of the impacted layers
from between the folds of the third stomach. The tympany of the rumen
subsides, crepitation is renewed in the rumen and omasum, there is free
rumbling in the bowels, and the appetite gradually improves. The
softening and removal of the dessicated contents are slow and it may be
weeks before there is a complete restoration to normal conditions.
_Diagnosis._ The hurried pulse and breathing and the grunting with
expiration may be mistaken for pneumonia or pleurisy, but the
distinction can be made as in impacted rumen. There is at first no
fever, the tenderness is confined to the right side, the percussion
dullness of the chest is in the posterior part and distinctly referrible
to the loaded abdominal viscera, it is attended by no pulmonary
crepitation, indeed crepitation in rumen and omasum is lessened or
abolished, there is no pleural effusion, but there are the
unquestionable signs of gastric and intestinal disorder.
It may be confounded with overloading of the rumen, but in the latter
case the distension occurs rapidly, there is little or no indication of
movement of the viscus, appetite and rumination are usually early
suspended and the gaseous eructations are not putrid.
_Postmortem Appearances._ These are essentially connected with the
impaction of the omasum. This organ is gorged to twice its normal size
or larger, firm, solid and resistant, not easily taking an impression of
the finger, and having at times an almost stony hardness. When incised
the intervals between the folds are sure to be packed with dessicated
food, often so dry in the upper part that it may be rubbed down into a
grayish powder, and it has been compared to the cakes of linseed as they
come from the press. The surface of such cakes is smooth and dark, and
usually covered by a layer of epithelium which has detached itself from
the surface of the fold. This is usually quoted as a morbid
desquamation, but inasmuch as we frequently see it in perfectly healthy
conditions in animals killed in abattoirs, it must be admitted to occur
also as a normal physiological exfoliation. The exposed mucosa shows
spots and patches of congestion, extravasation, and even at times
ulceration, or slight areas of necrosis.
The rumen shows the result of torpor and inactivity. The ingesta is
largely packed into solid masses, which have advanced from the simple
acid fermentation, to evident putrefaction with offensive emanations.
The abomasum is empty or nearly so of ingesta, but contains abundance of
mucus and shows patches of congestion as in prolonged abstinence.
The small intestine is also empty and collapsed, with considerable
redness and congestion. The larger intestine contains a small quantity
of feculent matter, dry, massed in small pellets and with smooth
glistening surface. Mucus is abundant and dense.
_Treatment._ This must follow the same lines as in impaction of the
rumen with the understanding that the response is less certain and the
result somewhat more tardy in reaching complete convalescence. In mild
and chronic cases a liberal allowance of flaxseed tea, several
bucketfuls per day, will often succeed.
In using purgatives those are usually the best which lead to drinking
abundantly. For the ox a pound each of Epsom and common table salt, with
an antiseptic stimulant like aqua ammonia (3 to 4 drachms) or oil of
turpentine (2 oz.) will often act favorably. The sodium chloride is
antiseptic, and induces ardent thirst and if there is free access to
water, tepid or not too cold, purgation is early secured and the
impacted cakes in the manifolds are slowly softened, detached and
removed. But unless water is given freely the salt will prove irritating
and even injurious.
In obstinate cases, and in the absence of indications of gastric or
cerebral congestion the addition of 20 croton beans or 20 drops of
croton oil will be excellent. Nux vomica (½ drachm) is also of value in
rousing the torpid nervous action. Injections are always in order, and
it is recommended to use these cold so as to rouse the muscular action
of the intestine and stomach.
Some of the newer remedies which rouse the contractility of the
digestive organs and at the same time stimulate secretion serve an
excellent purpose in these cases. Eserine 1½ grain, veratrine 1 grain,
barium chloride 10 to 15 grains, or pilocarpin 3 grains may be given
hypodermically in addition to the usual purgative. The pilocarpin is
theoretically the best as its tendency is to cause free secretion from
all mucous surfaces, and even a slight secretion from the omasal folds
will greatly favor detachment and discharge of the impacted plates.
These as well as the stimulants may be repeated as the effects pass off.
The purgatives on the other hand should be given at first in a large
dose, and not repeated except under the stress of necessity as their
constant repetition in small doses seems to nauseate the animal and even
to retard action. In the case of profuse secretion from the kidneys
however it may be supposed that the saline agents have passed off in
that way and a purgative may be safely repeated. It may be well however
to use one which is less likely to stimulate the kidney, such as castor,
olive, or raw linseed oil or senna.
The patient may be several days or even a week without alvine discharge
and yet do well. If there are fever and other indications of gastric
congestion a blister to the right hypochondrium may be of value. Rub
well with oil of turpentine and then with a pulp of the best ground
mustard and tepid or cold water and cover with sheets of thick paper to
prevent evaporation.
If nervous, symptoms are manifested by dilated pupils, blindness,
congested conjunctiva, hot horns and ears, and drowsiness, or
excitability apply cold water or an icebag to the head and continue as
long as may be needful. If the patient should become violently delirious
he may be fastened to a beam overhead in the centre of the stall so as
to prevent him from injuring himself or others.
In these cases the more violent and irritant purgatives are to be
avoided, and decoctions of slippery elm, linseed or gum may be given to
sheathe and protect the irritated membrane.
Even though a free action of the bowels has been secured it is not to be
assumed that all impacted material has been removed. A specially
laxative diet of roots, ensilage, or succulent green food, with a
liberal supply of salt, and free access to water should be kept up for
some weeks to secure a complete softening and expulsion of the impacted
material. Repeated small doses of laxative medicine may be requisite to
bring this about. As a rule a course of tonics, and above all of nux
vomica is valuable in re-establishing the normal tone of the stomachs
and intestines.