Causes: round ulcer, foreign bodies, parasites. Symptoms: those of
ulcer, followed by infective peritonitis, fistula, pleuritis,
pericarditis. Treatment: of fistula.
This may be the result of the gradual deepening of the round ulcer, yet
in the domestic animals it mostly comes from the presence of sharp
pointed bodies. These may be enumerated as needles, pins, nails, wires,
sharp bones (dog), whalebone (horse), forks, knives (cattle), and even
gravel. The burrowing of the spiroptera has seemed to cause perforation
in the horse. All causes of ulceration may, however, lead to
perforation.
The _symptoms_ are those of gastric ulcer, already given, followed by
the more specific ones of perforation. These in their turn differ
according to the parts involved. In the horse and dog the perforating
ulcer usually opens into the peritoneum, inducing a fatal infective
peritonitis. In cattle the foreign body sometimes passes toward the
heart, enveloped in a protecting mass of new formed tissue and proves
fatal by heart disease. In other cases it has been found to proceed
downward toward the sternum and to escape by a fistula formed beside the
ensiform cartilage. In other cases it has taken a direction toward the
right wall of the abdomen where it formed a fistula, discharging
alimentary matters. In still other cases it has opened into the
peritoneal cavity with fatal effects.
_Treatment_ in the case of external fistula, without implication of the
peritoneum, consists in the removal of the foreign body, and the
stimulation of granulations along the tract of the fistula by the
application of an ointment of tartar emetic to the interior. Should this
fail the fistulous tract may be scraped to make it raw, and the edges
may then be drawn together with sutures taking a deep hold of the skin.