Definition. Colicy pains from spasm, enteralgia, tympanitic
indigestion, overloading of bowels, impaction, calculi, concretions,
sand, foreign bodies, intestinal and arterial parasites, irritants,
enteritis, catarrhal, bacteridian, protozoan, chemicals,
strangulation, adhesion, volvulus, invagination, hernia, trauma of
stomach or intestine, peritonitis, pleuritis, metritis, ovaritis,
hepatitis, biliary calculus, nephritis, urinary calculus, neoplasms,
lead poisoning. Causes of enteralgia or spasm, idiosyncrasy,
nervousness, cold, wet, high condition, debility, cold, rain, dew,
perspiration, fatigue, indigestion, rheumatism. Symptoms: horse—sudden
attack, paws, kicks, anxious look at flank, crouches, goes down,
rolls, sits, rises, shakes himself, feeds, repeats at intervals,
rumbling, defecations. Complications. Diagnosis, symptoms violent,
transient, completely intermittent, no fever, no tenderness; from
acute indigestion by absence of faulty feed, loaded or tympanitic
abdomen, crepitation, continuous pain, and of careful decubitus; from
constipation by complete intermissions and freer passages; from
intestinal worms by absence of fur on anus, of rubbed rump, and of
parasites in stools; from verminous thrombosis by complete
intermissions and absence of prostration, cold sweats and of bloody
stools; from enteritis and other inflammations by absence of fever;
from intestinal anthrax by the intermissions, the absence of brownish
mucosa, and perhaps of anthrax from the district; from hepatitis by
absence of icterus, tender hypochondrium, and fever; from kidney
affections by lack of stiff, straddling gait, tender loins,
stretching; from pleurisy by absence of catching breathing, tender
intercostals, and friction sound; ruminants—similar symptoms except
sitting up or rolling; swine—sudden starting with grunt or scream,
vomiting, etc.; Carnivora—frequent moving, yelps, snapping, straining,
looking at flank. Treatment: solipeds, morphia subcutem, anodynes,
laxative, friction, walking, enemata, chloral hydrate: ruminants,
walking, enemata, morphia, laxative; swine, morphia, laxative,
antispasmodics, injections, derivatives; dog,—purgative, injections,
chloral hydrate, ether, olive oil.
The term colic is loosely applied to all abdominal pains from whatever
cause they may arise. It is thus allowed to embrace all diseases of the
abdomen. In its more restricted sense in which it will here be
considered it may be held to indicate =abdominal pain without
inflammation or any structural lesion=.
It may however be well to note the most common causes of abdominal pain
so that the distinction may be more definitely reached by a process of
exclusion.
1st. =Simple spasmodic colic.= 2d. =Enteralgia or neuralgia of the
intestines.= 3d. =Colics from indigestion=, _a_ =tympanitic=, _b_ =from
overloading with ingesta=, _c_ =from impaction or constipation=, _d_
=from calculi or concretions= or from =sand=, or =gravel= taken with the
food or from =foreign bodies= swallowed, _e_ from =worms in the
intestines=, _f_ from =worms in the mesenteric vessels=
(thrombo-embolic), _g_ from =irritants taken with the food or
otherwise=. 4th. Colics from =structural lesions of the intestines=; _a_
from =inflammation of intestine=, _b_ from =bacteridian inflammation of
the bowels=, _c_ from =protozoan inflammation=, _d_ from =chemical or
other irritants=, _e_ from =intestinal strangulations=, _f_ from
=adhesions=, _g_ from =volvulus=, _h_ from =invagination=, _i_ from
=mesenteric omental or phrenic hernia=, _j_ from =strangulated inguinal,
femoral ventral or umbilical hernia=, _k_ from =wounds=, =ruptures or
perforations of stomach or intestines=, _l_ from =peritonitis or
pleuritis=, _m_ from =metritis or ovaritis=, _n_ from =hepatitis or
biliary calculus=, _o_ from =pancreatitis or pancreatic calculus=, _p_
from =nephritis=, =nephritic=, =uretral=, =cystic or urethral calculus=,
_q_ from =neoplasms affecting any of the abdominal organs=. 5th. Colic
due to =lead poisoning=.
_Causes of enteralgia and spasmodic colic._ Enteralgia may be defined as
a neuralgic pain of the bowel which may therefore be free from spasm or
any other appreciable structural or functional change. Its existence in
the lower animal is necessarily somewhat problematical, as it can only
be inferred from the analogy of the animal with man, and of the enteron
with the superficial parts that are more frequently attacked with
neuralgia, and also from the absence of visible spasmodic contractions
in the bowel which has been the seat of intense pain, yet shows no
inflammatory lesion. But whether this is accepted or not, the occurrence
of spasm is undeniable and as both are functional nervous disorders the
same causative factors will apply to both.
In some nervous animals, especially high bred horses and dogs, there is
undoubtedly an idiosyncrasy which shows itself in a special
susceptibility of the nervous system. In such animals an exposure to
cold or wet, or the presence of a local irritant which would have been
without effect under other circumstances, lights up the nervous disorder
and produces an explosion, it may be as spasm or it may be as nervous
pain. Animals that are kept under the best care, that are least
accustomed to exposure and neglect, that are highly fed, and maintained
in high spirits and are impatient of control are more susceptible than
those that become inured to change and exposure, yet are kept in
moderately good condition. On the other hand the subject which has
become debilitated by overwork, underfeeding, exhausting disease, or the
generation in the system of some depressing poison is likely to show a
similar nervous susceptibility, so that at the two extremes of plethora
and nervous susceptibility, on the one hand, and anæmia and neurasthenia
on the other, we find a corresponding tendency to nervous disorder under
comparatively slight causes. Thus it happens that a drink of ice cold
water, an exposure to a cold blast or a drenching rain or a heavy night
dew may seem to be the one appreciable cause of the trouble. If the
animal has been perspiring and fatigued the attack is more likely to
occur. In other cases a slight indigestion unattended by impaction or
tympany, or the ingestion of an irritant which on another occasion, or
in another animal would have been perfectly harmless, will induce a
violent nervous colic. In some instances the attack is supposed to be of
a rheumatic nature the causative action of the cold giving color to the
theory.
_Symptoms._ The attack usually comes on suddenly especially if it has
followed on a drink of cold water or a cold exposure.
=Solipeds.= The _horse_ leaves off feeding or whatever he may have been
engaged in, paws with his fore feet, moves uneasily with his hind ones
or kicks with them, one at a time against the abdomen or out backward,
he looks back at the abdomen with pinched, drawn, anxious countenance,
bright anxious eye, and dilated nostrils, he moves uneasily from side to
side of the stall or box, crouches for a few seconds with semi-bent
knees and hocks and then throws himself down violently with a prolonged
groan. When down he may roll from side to side over the back, and
struggle in various ways, he may start to rise, sit for a moment on his
haunches, then go down and roll as before. Or he may get up, shake
himself and resume feeding as if entirely well. Soon the spasms
reappear, suddenly as at first, and after a time subside as before. Thus
the disease proceeds, each succeeding paroxysm diminishing in violence
until they permanently subside, or increasing until the animal dies worn
out with shock, suffering and exhaustion. If the paroxysms are severe
the skin is usually bathed more or less in perspiration. Usually the
peristalsis continues more or less, a rumbling is heard in the bowels
and more or less fæces are passed in small solid balls or semi-liquid.
The _course_ of the disease is usually rapid and followed by recovery.
When prolonged it may become complicated by volvulus, invagination,
indigestion or even enteritis.
_Diagnosis._ The characteristic symptoms are the suddenness of the
onset, the extreme suffering during the paroxysm, the reckless manner in
which the animal throws himself down, the intermissions with complete
absence of pain, the natural condition of the pulse and temperature in
the intermissions, the comfort with which the patient shakes himself,
and the absence of all abdominal tenderness, manipulation and friction
seeming to give relief rather than discomfort.
In the colic of =acute indigestion= there is the previous excessive or
unwholesome meal, or the full drink after feeding; there is tympany, or
a loaded state of the abdomen proving flat on percussion, there may be
crepitation on auscultation, there is continuous pain with exacerbations
(not complete intermissions), and there is rather a careful mode of
lying down.
In =intestinal constipation= or other =obstruction=, fæces may be passed
at first in small pellets coated with mucus or they may be at first
passed freely but in steadily lessening quantities until they stop
altogether. The pain is constant but worse at one time than another and
in case of external hernia the swelling will be visible.
In =helminthiasis= there is the general unthriftiness, irregular
appetite, frizzled broken hair on the base of the tail, a fur of dried
mucus around the anus and the presence of parasites in the droppings.
In =verminous thrombosis=, to the symptoms just named there are added
the reckless method of throwing himself down, hyperthermia, constancy of
the pain, rapidly running down pulse, cold sweats, and profound
prostration. When blood is passed per anum it is all the more
significant.
In =enteritis= or =peritonitis= the hyperthermia and the constancy of
the pains are sufficiently pathognomonic.
In =intestinal anthrax= there are the dusky brownish yellow mucosæ, the
marked prostration, the hyperthermia and the constancy of the suffering.
There is also the fact that the region is subject to anthrax and bacilli
may be present in the blood.
In =acute hepatic disease= there is hyperthermia, dusky or icteric
mucous membranes, great tenderness when percussion is made over the
short ribs, and sometimes lameness of one shoulder (usually the right).
In =disease of the urinary or generative organs= the stiff or straddling
gait, tender loins, and the frequent stretching as if to urinate, are
nearly pathognomonic.
In =pleurisy= the hyperthermia, the transient duration of the colic, and
the tenderness on manipulating the intercostal spaces will usually
differentiate.
=Ruminants.= In cattle, as in the horse, the symptoms of spasmodic colic
are restlessness, constant movement, looking round at the flanks,
wriggling of the tail, uneasy lifting of the hind feet, kicking at the
abdomen, and abruptly lying down and rising again. The animal does not
roll on the back nor sit on the haunches. Fæces may be passed in small
quantity or entirely suppressed, and there may be a slight tympany of
the paunch.
=Swine.= The animal is attacked abruptly, starts with a grunt or scream,
moves around uneasily, lies down, rolls, gets up, and repeats the
motions. Vomiting is not uncommon, and the belly may be tense,
tympanitic and even tender. The bowels may be confined or relaxed.
=Carnivora.= The colicy dog is very restless, changing from place to
place, sitting on his haunches, lying down curled up, starting up
suddenly with a yelp, and repeating the restless movements. He looks
anxiously at his flank, sometimes bites at it, and cries plaintively.
The bowels are usually torpid, and defecation effected with straining.
There are distinct intermissions but these are cut short by a new
accession of pain.
The attack is usually transient and ends in recovery.
_Treatment._ =Solipeds.= For nervous colic the hypodermic injection of
sulphate of morphia (2 grs.) is very effective. This will commonly bring
relief in less than five minutes. Should there be no effect at the end
of this time it may be repeated with advantage, but should a second dose
fail, it is well to resort to other measures. Eserine and barium
chloride are contraindicated as being liable to increase the spasm, and
if there is no irritant to expel there is no object in their exhibition.
The old prescriptions of laudanum and turpentine; laudanum and ether;
sweet spirits of nitre with belladonna, or hyoscyamus, and other
stimulants and narcotics are of little avail as they are not absorbed
from the horse’s stomach and cannot operate until they have reached the
duodenum. If given at all, their action may often be hastened by
injecting them into the rectum.
When the morphia fails it is the safest treatment to give a moderate
dose of aloes or other laxative, in combination with extract of
hyoscyamus or chloral hydrate. This takes time to pass into the
duodenum, and be absorbed and secreted anew in order to have its full
effect, and therefore it may be necessary to keep up a moderate action
of the morphia as a palliative. In four hours, however, at the latest,
the aloes can be counted on to bring permanent relief. This appears to
come as soon as the active principles have been absorbed, the nauseating
effect operating at once on the overexcited nerve centres. The action is
more perfect still when a free secretion has been started from the
intestinal mucosa, and the circulation and innervation in the intestinal
walls are essentially changed. This measure which was long successfully
practiced and advocated by the late Joseph Gamgee, is even more
perfectly adapted to the colics of indigestion and irritation, of
impaction and fermentation. There are of course cases of complete
obstruction in which it must fail, but it is probably the most
successful method for colicy affections in general.
In addition to the above, other methods of correcting the disordered
innervation are available. Active friction of the abdomen with straw
wisps is often effective, also fomenting the abdomen with hot water.
Simply leading the animal around acts as a nervous derivative, and may
be employed to prevent his dashing himself down so suddenly as to injure
himself. Then copious injections of warm water soothe the rectum,
solicit its peristalsis and by sympathy affect the other intestines in
the same way. They may often be made more effective by the addition of
antispasmodics (extracts of belladonna or hyoscyamus or chloral
hydrate).
In all cases a soft bed should be provided to secure the animal against
injury in his sudden reckless movements.
=Ruminants.= Simple spasmodic colic is usually transient and may be
successfully treated by driving around, giving copious warm water
injections, and using morphia subcutem. Frictions to the abdomen with
straw wisps, or with oil of turpentine should be tried. Should these
fail there is a presumption of further trouble and no time should be
lost in giving a laxative (Glauber salts) 1 to 2 pounds, or castor oil 1
quart, with antispasmodics and stimulants as for the horse.
=Swine.= The antispasmodic treatment may be tried on the pig, but
usually it is well to give a purgative at once in combination with the
narcotic. Castor oil 4 ounces, laudanum ½ drachm, or jalap 2 drachms,
and extract of hyoscyamus 20 grains in electuary. Warm injections and
embrocations to the abdomen are desirable.
=Dog.= It is usually well to give a purgative at once (jalap ½ drachm)
with 10 to 20 drops laudanum according to size. Copious injections of
warm water and a warm bath may follow. Chloral hydrate 20 to 60 grains,
may be exhibited by the rectum; also ether 1 drachm, in olive oil.