Definition. Concomitant of other affections. Causes: Congestion,
effusion from small and large intestine, irritants in bowels, or
blood, chill or other shock acting as reflex, cold drink and violent
exercise, aqueous food, cooked, pulped; irritants, feculent
concretions, parasites, fermentation products, diseased teeth, jaws or
salivary glands, drink after grain, gastric hepatic or pancreatic
disease, spoiled food, purgative agents in food, fever products,
purgative waters, rains, dews, damp stalls, etc., fear, “washy”
horses, nervous animals, root diet, œstrum, hepatic torpor, equine
susceptibility. Symptoms: with root diet, with much or little bile,
slight cases do not affect system, in severe cases, tympany, pawing,
straining, fœtor, in infective diseases; complications, laminitis,
enteritis, pneumonia. Treatment: remove or expel cause, demulcents,
laxatives, anodynes, antiseptics; chronic cases, iron, bitters,
antiseptics, astringents, dietetics, rest.
_Definition._ A frequent discharge of fluid or semi-fluid evacuations
from the bowels without excessive griping or painful straining.
This is a common condition attending many diseases, rather than a
specific disease of itself yet it is such a prominent feature of these
various affections, and one so very characteristic that it seems well to
give it a special place, even at the risk of repeating much of what must
necessarily appear elsewhere.
The immediate cause of diarrhœa is a congestion of the intestinal mucous
membrane and a profuse secretion into the intestinal canal. When such
congestion occurs in the small intestine alone, it may be
counterbalanced by increased absorption in the large, so that the
secretion must be excessive to produce liquid alvine discharges. When on
the other hand it occurs in the large intestine or in both large and
small, the product is likely to escape in the liquid form.
In its turn the congestion of the intestinal mucosa may result from
irritants in the bowels, from the presence in the blood of irritant
agents which being secreted stimulate the intestinal glands to excessive
secretion, and from reflex nervous action, starting from a distant point
as in chilling or irritation of the skin or other organ.
Among direct irritants of the intestinal mucosa may be named a full
drink of cold water especially if the horse is trotted or galloped for
twenty minutes immediately after;—soft, juicy, rapidly grown green food,
to which the animal is unaccustomed, as the first grasses of
spring;—cooked or pulped food or ensilage in hard worked animals;—many
irritant and acid plants;—accumulations of hard feculent masses in the
intestines;—irritation caused by intestinal worms especially the
blood-suckers;—the presence in the intestines of undigested matters, and
resulting fermentations, the result of diseased teeth and jaws and
imperfect mastication, of disease of the salivary glands or ducts and
imperfect insalivation, of a drink of water after a grain feed, washing
a part out of the stomach in an undigested condition, of disease of the
stomach, liver or pancreas interfering with their proper functions;
unwholesome and fermenting food like spoiled grain, or fodder, or
decomposed potatoes, apples, turnips, pumpkins, carrots, cabbages,
etc.;—stagnant and putrid water;—tumors, ulcers, volvulus,
invaginations, adhesions and other serious lesions of the bowels may act
in the same way.
As examples of the secretion of irritant matters from the blood may be
mentioned almost all the different agents used as purgatives, and
purgative agents accidentally taken in, these being as a rule absorbed
and later secreted again on the intestinal surface, increasing the
secretions in their passage:—also the morbid products of fevers which
irritate the intestinal mucosa and glands as they are thrown out by them
(rinderpest, lung plague, Southern cattle fever):—the purgative waters
on certain “scouring lands” act in a similar way. Under the head of
reflex action may be named the chills from exposure to cold rains, night
dews, damp stalls or beds, and damp, hot buildings, seasons and
localities. Under the head of nervous causes must be included strong
emotions as excitement, fear, etc., which lead to increase of both
secretion and peristalsis. Some horses are very subject to this and are
known as “washy”. These have usually a slim abdomen and long loin, and
scour whenever they are put to hard work. Other nervous animals with
good conformation, but which fret under saddle or in harness will scour
under specially severe work or under excitement. This is especially
common in young colts while being “broken”, and will occasionally show
in mares which are in _heat_. Cattle that have been on a specially
succulent diet (turnips, beets, ensilage, grass) are liable to scour
profusely if driven far or fast, and stock men seek to obviate this by
feeding some dry bran, meal, and above all fresh dry brewer’s grains
just before starting. Cows running at large when in heat are very liable
to scour. An exclusive diet of turnips or beets will keep cattle in a
chronic condition of mild diarrhœa, though not enough to interfere with
rapid improvement in flesh. Chronic diseases of the liver by obstructing
the flow of blood through the portal vein, cause intestinal congestion
and predispose to diarrhœa.
Of the various domestic animals horses are the most liable to
superpurgation, from an undue dose of aloes acting on the very large
colon and cæcum. Hence the importance of using such an agent carefully
in the young, fat or debilitated especially, of the avoidance of cold
drinks or exercise to excess after the aloes has been given, and of
keeping from work during its operation or immediately after.
_Symptoms._ These are of all degrees of severity from the frequent pulpy
evacuations of animals fed exclusively on roots, (beets, turnips,
potatoes), to the excessive and almost constant discharge of a dark
colored liquid mingled with more or less mucus. The discharge may be of
a light color and fœtid, indicating deficiency of bile, or of a dark
yellowish brown and odorless.
Slight diarrhœa does not affect the appetite nor general health, nor
check improvement in condition. In the more severe and continued forms
there is loud rumbling in the abdomen, loss of appetite and condition, a
rapid small pulse, accelerated breathing, pallid mucous membranes,
sunken glassy eye, and increasing debility even to an unsteady gait.
Distension of the abdomen with pawing and other indications of abdominal
pain may appear in bad cases. In the milder cases due to simple
irritation and congestion there is no tenesmus, no excess of mucus, no
formation of bubbles or froth in the stools, as occurs in active
intestinal fermentation and dysentery. In symptomatic cases on the other
hand there are superadded the marked symptoms of intestinal
inflammation, or fermentation, and the fæces become putrid and
offensive, which they do also in the different infectious diseases
(influenza, contagious pneumonia, rinderpest, lung plague, hog cholera,
swine plague, canine distemper, fowl cholera), when the toxins and waste
matters of the food and decomposing tissues are being thrown off by the
bowels.
Diarrhœa may be complicated with other diseases and especially in the
horse with laminitis.
In mild cases it tends to a spontaneous recovery, and is followed by
some slight costiveness, and if this should prove extreme there may be
some danger of complicating sequelæ such as indigestion, enteritis,
pneumonia or laminitis.
_Treatment._ The first consideration for the practitioner is to discover
if possible the immediate cause of the diarrhœa. If this is found to
reside in some infectious or other disease aside from the bowel, the
attention must be directed to that even more than to the diarrhœa. If it
depends on an overdose of some purgative agent or of acrid purgative
plants taken with the food, any further laxative is to be avoided, and
yet astringents and other agents which tend to lock up the offending
material in the alimentary canal must be equally guarded against. An
abundance of mucilaginous and demulcent liquids (mallow, flaxseed gruel,
boiled starch, etc.) may be given both by the mouth and anus, to sheathe
and protect the irritable mucous membrane and to dilute and carry off
the irritant contents. Moderate doses of opium may be required to allay
the violence of the spasms and peristalsis, but this should not be
pushed to the extent of locking up the irritants. Sometimes antiseptics
(naphthalin, salol) are useful to check fermentation, and pepsin may be
given to assist digestion.
In ordinary cases due to the presence of an irritant the first object
must be to relieve the bowels of this, and the second to soothe the
irritated mucous membrane. A laxative is usually all that is required,
but it must be a mild one so as not to add to already existing
irritation. Olive or castor oil are to be preferred as a rule (horse and
ox 1 pint; sheep and swine 4 ounces; dog ½ ounce), alone or with a
moderate dose of laudanum. Or rhubarb or aloes may be substituted if
desired. A dose of whisky or brandy, or oil of turpentine will often do
much to allay the secretion and peristalsis. These should be followed by
moderate doses of flaxseed gruel, or solution of slippery elm or mallow,
or simple well boiled gruels.
If the discharge persists after the laxative has had time to operate,
these mucilaginous agents may be replaced by solutions of boiled starch,
or of gum arabic, and small doses of calmatives such as laudanum (horse
or ox 1 ounce, sheep or pig 2 drachms, dog 20 drops), or prussic acid or
cyanide of potassium (30 drops of the acid or grains of the salt for
horse or cow). Sub-carbonate of bismuth, chalk, and carminatives and
antiseptics may also be given. According to the indications the
practitioner must combat persistent intestinal fermentation, or a
relaxed adynamic condition of the intestinal mucosa, or general weakness
and exhaustion, with such agents as seem best adapted to the individual
case.
_Chronic_ cases will demand the exercise of much judgment. After a
gentle laxative, salts of iron (sulphate, chloride) and pure bitters may
be given with antiseptics. Or vegetable astringents (catechu, kino) with
freshly burned charcoal and essential oils (peppermint, cloves, cajeput)
may be employed. In some instances calomel and chalk (1:12) will serve a
good end. In others silver nitrate, or arsenite of copper succeeds.
Quinine, nux vomica, pepsin, may be used to improve tone. The diet is
usually all important. Well boiled gruels, boiled milk, arrowroot,
pulped or scraped raw flesh may be demanded in different cases. The
patient should be kept at perfect rest, and all excitement avoided.