Definition. Causes: Irritants swallowed, debility, improper,
insufficient food, congestions, parasitisms, impaired innervation or
circulation, iced water, chills, perspirations, fatigue, hot, damp
weather, overfeeding, cryptogams, bacteria, newly harvested fodder,
septic, or fermented food, leafy fodder, toxins, stagnant, septic
water, lack of pepsin, muriatic acid and bile, diseased teeth or jaws
or salivary glands. Lesions: Gastritis, congestion of small intestine
and colon, in striæ, thickening, ecchymosis, ulceration, necrosis,
excess of mucus with pus, villi, follicles and glands swollen.
Symptoms: Fever, high colored urine, costiveness, coated tongue, red
eyes, inappetence, sluggishness, emaciation, weakness, unthriftiness,
colics, rumbling, diarrhœa; or more fever, suffering, anorexia,
icterus, hurried breathing, pleuritic ridge, arched back, tender
abdomen, rumbling, flatus, diarrhœa, critical or bloody, anxiety,
debility, prostration, collapse. Prognosis. Treatment: In mild cases,
careful diet, and laxatives with antiferments, in severe cases,
laxatives, anodynes, antiseptics, demulcents, stimulants of
peristalsis, enemata, counter-irritants, fomentations, compresses,
mustard, in profuse diarrhœa antiseptics, anodynes, demulcents,
calomel and chalk, bismuth, astringents, boiled flour or starch, gums.
Dieting during convalescence.
_Definition._ Inflammation of the intestinal mucosa.
_Causes._ Irritants of all kinds taken in with food, or as medicine or
otherwise and acting on the mucosa. Debilitating conditions (chronic
disease, starvation, overwork, close indoor life) which lower the tone
of the system at large, and local debilitating conditions like coarse,
dry, fibrous, innutritious food, congestions, parasitisms, impaired
innervation and troubles of the circulation are strongly predisposing.
Drinking iced water may operate by lowering the tone of the intestines
but seems to habitually act rather by inducing reaction and congestion.
Chills of the surface, especially when perspiring and fatigued, act in
the same way. The relaxation and atony attending on long continued hot
weather, predisposes to enteritis, but is doubtless even more injurious
by the abundance of ferments which it propagates in food and water.
Overfeeding and stimulating aliments thrown on an alimentary canal in
such an atonic condition become especially hurtful. The injury, however,
comes most commonly from food that contains an excess of cryptogams or
bacterial ferments or from water similarly charged. Newly harvested
fodders in which the microbes are still in a state of vigorous life,
when added to the poisonous principles in certain immature seeds
(leguminosæ, gramineæ, etc.); fodders that have undergone fermentative
changes (rotten potatoes, turnips, musty hay or oats); fodders that are
leafy and harbor an excess of microbes (alfalfa, sainfoin, cowpea,
clover) are especially dangerous at times. If musty or otherwise altered
they often contain besides, dangerous toxins.
In taking into account the fungi and microbes in spoiled foods, we need
not give exclusive attention to the particular species of microbe
present. An extended observation shows that the same ferments may be
present in the dry, well cured, wholesome fodder, and in the musty or
spoiled specimen, the main difference being in the excess found in the
latter case as compared with the former. With the excess too, there is
always present a large amount of toxins, ptomaines and other more or
less poisonous products, which, acting on the intestinal mucosa or even
on the system at large, tend to reduce its vitality and to lay it open
to the attacks of bacteria which had otherwise remained perfectly
harmless. Porcher and Desoubry, Achard and Phulpin and Wurz have shown
experimentally that intestinal microbes can enter the chyle and blood
from even a healthy bowel. The streptococcus of pneumoenteritis equi of
Galtier and Violet appears to be a common fodder and intestinal microbe,
which has become pathogenic, because of its excess or on account of a
lack of resistance on the part of the animal. In the same way the
various intestinal cocci and the common colon bacillus may become
pathogenic when the normal antagonism of the bowels and their contents
is lessened.
In the same way stagnant and septic water may be harmless to one animal
of great vigor and good tone and pathogenic to another which lacks these
qualities; or the excess of the ferment and its toxins may overcome the
natural resistance of the animal. The lack of the natural antiferments
of the intestine, pepsin and hydrochloric acid, on the one hand and bile
on the other, will also conduce to multiplication of the microbes and
their products, so that they can successfully attack the mucous
membrane.
Other accessory causes operate more or less, thus any impairment of the
process of mastication, through diseased teeth or jaws tends to the
escape of undigested food through the stomach, as a specially favorable
culture media for the microbes, and irritants of the mucosa.
_Lesions._ As the disease very often implicates the stomach
(gastro-enteritis), the usual lesions of gastritis will be seen. Most
commonly the lesions are best marked in the small intestine, and again
in other cases in the colon, but usually there is more or less change in
all parts of the intestinal canal. The small intestine is almost devoid
of aliments and the mucosa deeply congested in patches or striæ, with at
points thickening, softening so that it crushes under the finger,
hemorrhagic discoloration, and even ulceration, and necrotic changes. It
is covered with a layer of mucus, thin and mucilaginous or thick and
glutinous, containing many granular and pus cells. The villi are
swollen, the follicles of Lieberkuhn puffed up, and the agminated and
solitary glands widely dilated, filled with exudate, and surrounded by
an area of congestion. Proliferation of small, round cells has produced
embryonic tissue in the mucosa and especially between the glands.
_Symptoms._ In the _mildest form_ there is hyperthermia, thirst,
insensible loins, scanty, high colored urine, costive bowels, a few
small pellets only being passed at a time, hard, dry and covered with a
mucous film, hot, clammy mouth, coated tongue, with redness along the
edges and tip, yellowish red eyes, impaired appetite, dull, sluggish
habit, a tendency to hang back on the halter, and a steady loss of flesh
and increased dryness and unthriftiness of the coat. Slight,
intermittent colics occurring especially after meals and attended by
loud rumbling of the bowels are marked features. This may be followed by
slight relaxation of the bowels and recovery in about a week, unless it
should become complicated by intestinal indigestion or impaction, or
should merge into the acute form.
In the _more intense forms_ all symptoms are aggravated. There is
anorexia and even refusal of water, dullness and prostration are well
marked, the head carried low, and the gait is unsteady. The mouth is hot
with tenacious mucus, and a fœtid odor; the tongue is furred and red at
the tip and margins, the eye is sunken, the conjunctiva icteric, the
face pinched, and the pulse accelerated. Hyperthermia may reach 104° F.
Breathing may be almost normal, or with fever, may become rapid and
accompanied by a pleuritic ridge on the flank. The back is slightly
arched and rigid, the belly drawn up and tender, after meals it may be
tympanitic, and colics set in or are aggravated, pawing, uneasy
movements of the hind limbs, and lying down to rise again shortly, with
frequent looking at the flanks being noticeable.
Defecations are at first abundant and coated with mucus, later the balls
are small and scanty and expelled with much effort. From the first the
everted rectum is of a very deep red. Toward the end of the first day or
later the intestinal rumbling increases, flatus passes freely, and
diarrhœa may set in and prove critical. This usually indicates disease
in the colon and tends to recovery; it may be entirely absent if the
inflammation is confined to the duodenum, the effused liquid being
re-absorbed from the cæcum and colon. If the diarrhœa should prove
critical there is a return of appetite and spirit, the fæcal discharges
become firmer and recovery takes place in a week. If, however, the
diarrhœa becomes more profuse and bloody, the colics more intense, the
eyes more sunken and hopeless, the face more pinched and anxious, and
the temperature reduced to or below the normal, with great weakness and
debility, the near approach of death may be feared. This state of
collapse may be further marked by extreme coldness, or dropsy of the
limbs, increased icterus, hurried breathing and rapid loss of flesh.
A prominent icterus indicates implication of the liver from the ascent
of the infecting germs through the bile ducts, or the passage of
microbes or their products or both through the portal vein. In either
case it is a serious complication.
_Prognosis._ In its uncomplicated form the disease is not very fatal to
vigorous, mature horses, though more trying to the young. If infective
germs or their products implicate the liver producing marked jaundice,
or if the general system is poisoned by the microbes or their toxins,
producing marked depression and prostration the danger is enormously
enhanced.
_Treatment._ In the _mildest cases_ a limitation of the food to moderate
bran mashes, and a dose of ½ lb. of sodic sulphate, with salicylate of
soda (3–4 drs.) or bismuth will usually suffice.
In _severe cases_, at the outset, while constipation exists give 3 or 4
drs. of cape aloes, or ½ lb. Glauber salts or ½ pint olive oil, combined
with 2 drs. of extract of hyoscyamus or belladonna and 3 drs. salicylate
of soda. This serves to deplete from the inflamed vessels and the whole
portal system, to soothe suffering, to expel much of the offensive and
infective matters from the bowels, and to check fermentation in that
which remains. They should be given with, or followed by mucilaginous
liquids like solutions of slippery elm or gum arabic, flaxseed tea, or
well boiled farinaceous gruels.
Pilocarpin, 3 grs., or eserine, 2 grs., or both have been recommended
and may be resorted to when action of the bowels is urgently demanded.
They need not supersede the other laxatives. In manifest impaction of
the large intestines, salts, aloes, pilocarpin and eserine may form an
effective combination.
Copious enemata with mucilaginous liquids or warm soap suds should be
given at frequent intervals.
Counter-irritants and derivatives to the abdomen are most important. Hot
fomentations may be persisted in for an hour at a time, or a damp
compress around the abdomen covered closely by dry blankets and held in
place by elastic circingles. Mustard pulp made with cold water rubbed in
against the hair and at once covered by paper and a thick blanket is
often of great value as drawing blood and nervous action to the skin and
relieving the suffering intestine.
In all cases the diet and drink must be carefully supervised. A little
thoroughly scalded wheat bran, or farina, and decoctions of flaxseed,
farinas, slippery elm or mallow, or a solution of gum arabic will
refresh the animal without overloading the digestive organs or favoring
further fermentation.
In case of the onset of diarrhœa which threatens to prove excessive and
persistent, the giving by mouth and anus of antiseptics and anodynes
with mucilaginous agents may be resorted to. Calomel may be given in 10
grain doses twice daily mixed with five times the amount of chalk. Or 2
drs. each of nitrate of bismuth and salicylate of soda and ½ oz. of
laudanum may be given three times a day. Or quinine, 2 drs. and nux
vomica 10 grs. may be added to the above. A choice may be made of other
anodynes, (hyoscyamus, belladonna), antiseptics, (salol, chloral,
naphthol, naphthalin, creolin), and bitters, (gentian, calumba,
cascarilla).
Antiseptic and even astringent injections must be given, and well boiled
farinas and mucilaginous agents may be given by the mouth. Wheat flour
boiled for several hours; starch prepared with boiling water as for the
laundry, (1 pint); gum arabic, or slippery elm may suffice as examples.
The patient should have a dry comfortable box and warm clothing
according to the season of the year. He must be kept for a week on
linseed gruel or other equally simple demulcent agent and brought back
to his customary food by slow degrees.