Usual seat. Causes: house life, neglect of call to defecate, lack of
exercise, overdistension, atony, watch dogs, over feeding, obesity,
ill health, debility, loss of teeth, paraplegia, spiced and sweet
food, matting of hair over anus, tumors round anus. Symptoms: small,
hard, white, glazed stools, straining, no stools, hot, tender,
swollen, bulging anus, abdominal manipulation, dullness, laziness,
seeking seclusion, colics, tender abdomen, stiffness, arched back,
drooping head and tail, vomiting—sometimes feculent, fever. Lesions:
impacted mass of hard, gritty particles, catarrhal congested or
necrotic mucosa, and outer coats, perforating ulcers. Treatment: air,
exercise, laxative diet, mechanical extraction, purgatives, enemata,
demulcents, laparotomy, enterrectomy.
In the dog, atony and impaction are common especially in the rectum,
where the fæces are unduly retained in connection with house life until
accumulated and dried. The impaction tends to extension forward, the new
material adding continually to the old, and the overdistended rectum
becoming more and more atonic in proportion to the increase of the
distension.
_Causes._ The most prominent factor is denial of nature’s call to
defecate, on the part of house dogs trained to habits of cleanliness.
The accumulated mass distends and weakens the rectum, enabling it to
hold more without suffering, making the call of nature less imperious,
and diminishing the power of expulsion. Lack of exercise usually
operates in the same animals, as it also does in watch dogs, the
movements of which are limited by the length of their chains.
Overfeeding contributes, in various ways, by increasing the amount of
feculent matter passed on into the rectum, by hastening the food through
stomach and small intestine imperfectly digested and therefore in a more
irritating condition, and by contributing to obesity and lack of tone.
In mastiffs, hounds, bull-dogs, etc., which are naturally gluttonous and
swallow animal food in large masses without tearing apart, or
mastication, portions pass into the intestine undigested and tend to
disturb and block the terminal bowel.
Dogs that are out of health, and which lack tone in general have usually
torpid bowels and suffer from delay and impaction of contents. Hence all
chronic and debilitating diseases are liable to become aggravated by
this troublesome complication.
Old dogs with the teeth worn out and the general tone of the stomach and
intestines low are habitual sufferers.
Paralysis of the posterior limbs is usually associated with paresis of
the rectum and accumulation, and various other atonic nervous disorders
act in the same way.
The sympathy between the skin and alimentary tract shows itself in
common disorders, indigestions and catarrh becoming complicated by skin
eruptions acute and chronic, by indigestions and impactions. To both
conditions the nature of the food of house dogs largely contributes, the
habit of eating abundantly at each meal time of the master, the
consumption of highly spiced meats, of sweet cakes, pastry and puddings,
and even the exclusive diet of white bread or farinaceous and starchy
aliment.
In long haired dogs, the matting of these hairs together across the anus
proves a factor by rendering defecation difficult and painful.
The formation of tumors around the anus, or inflammation and swelling of
the anal glands are additional causes.
_Symptoms._ As in other animals this condition may be chronic, lasting
for a long time without leading to complete obstruction. The fæces are
passed in hard fœtid, whitish masses, often partly divided, in pellets,
dry, and polished on the surface and covered with a film of mucus,
sometimes blood. They are passed at considerable intervals, slowly and
with painful effort and straining.
In the more advanced and violent cases defecation becomes absolutely
impossible, though the animal strains violently and frequently. The anus
and rectum bulge as a rounded swelling and the congested and bleeding
mucous membrane may be exposed, but nothing is passed. The anus is hot
and tender to the touch and the anal glands swollen. Manipulation of the
abdomen between the two hands can detect the impacted gut extended
forward for a considerable distance, and even implicating the colon. The
oiled finger in the rectum may detect the impacted matter as a
conglomerate mass of gritty materials. If the appetite continues this
becomes all the more extensive. The affected animal is dull, prostrate
and indisposed to exertion, seeking a dark retired place where he can
rest undisturbed curled up into a ball. Sometimes he starts with a sharp
yelp. Especially does he shrink and complain when the belly is handled.
If made to walk, he does so stiffly, hangs head and tail, arches the
back and tucks up the belly. The face and eyes express severe suffering.
Vomiting is a frequent complication, the rejected matters being often
feculent. Colicy pains are indicated by yelping or moaning, enteritis
and peritonitis by hyperthermia and extreme abdominal tenderness. The
acute disease may last from one to two weeks, and death may be preceded
by auto-infection, by nervous symptoms of various kinds or by enteritis
or peritonitis.
_Lesions._ These may be stated shortly as impaction, catarrh or necrotic
changes of the mucosa, more or less extensive inflammations of the
bowels and peritoneum, perforations, and congestions of the liver and
kidneys.
_Treatment._ In the milder cases plenty of open air exercise and a
laxative diet may succeed. In the more severe cases it is usually
requisite to unload the rectum mechanically. The dog is laid on a table,
and the oiled finger introduced through the anus, lubricates the mucosa
as far as it can be reached. Then little by little the firm mass may be
disintegrated and removed being steadied by the other hand applied on
the abdomen. The handle of a teaspoon or a special spoonshaped curette
may at times replace the finger to advantage, but must be used with due
judgment, in view of the thinness and friability of the walls of the
gut.
When the gut has been emptied in this way, or in the less severe cases
without this preliminary, purgatives and frequent injections can be used
to advantage. Jalap ½ dr. and calomel 5 grains, or castor oil ½ oz., or
syrup of buckthorn have been usually employed. The impaction is usually
too firm for the transient action of eserine or pilocarpin. As
injections, castor oil, soapsuds, decoctions of flaxseed, mallow or elm
bark may be employed being repeated as often as they are expelled and
supplemented by the mechanical removal of all solid matters that come
within reach.
In cases so extensive as to resist the above measures we can resort to
laparotomy. The incision can be made close and parallel to the linea
alba, the rectum, or floating colon drawn out through the wound, the
other intestines being carefully held back by an assistant, the gut is
then incised longitudinally and its solid contents removed. The wound is
thoroughly cleansed, washed with an antiseptic (mercuric chloride
1:2000), and sutured with catgut, the mucosa being carefully turned in
and the muscular and peritoneal coats kept in accurate contact. Finally
the abdominal wound is closed by silk sutures. The patient must be
placed for a week or ten days on well boiled gruels and the rectum
frequently emptied by injections of tepid water.
In case the bowel is found to be necrotic, the gangrenous section may be
excised and the ends brought together by Murphy’s button, or simply
sutured with catgut over a hollow tube of raw potato.