Definition. Symptomatic. Causes: habit of retention in horse, dog and
cat, indigestible matters in colon, calculi, dry food, lack of water,
fever, diuresis, diaphoresis, milking, bleeding, hepatic torpor,
verminous thrombi, old age, debility, nervous disease, matting of
hairs, hæmorrhoids, abdominal suffering. Lesions: dilatation and
catarrh of bowel, disease of rectum. Symptoms: solipeds—small, dry,
coated, infrequent stools, straining, inappetence, tympany, colic,
stretching as if to urinate; dog, fruitless straining, or dry, earthy
looking fæces, coated, bloody, fœtid, anus swollen, tender, moist,
palpitation, colic, vomiting, diarrhœa may fruitlessly occur, male
urinates like bitch, foul, fœtid mouth; may last days or months;
complications, sequelæ. Treatment: solipeds—exercise, pasturage, cold
water before morning feed, regular regimen, bran, flaxseed, carrots,
turnips, ensilage, common salt, Glauber salts, nux, cold injection,
glycerine, barium chloride, purgative, enemata; dog:—mechanical
unloading of the rectum and colon, injections, exercise, water,
regular habits, laxative food, eserine, oil, calomel, jalap,
podophyllin, colocynth, belladonna, nux vomica, abdominal massage,
electricity.
_Definition._ Constipation consists in dryness, hardness, and undue
retention of the fæces. It has of course many grades and may lay claim
to many different causes, so that it might, like its antithesis
diarrhœa, be held as merely a symptom of another disease. It has however
such a definite character, that it is convenient to retain the name to
designate those cases in which the torpor or atony is the most prominent
and dominating feature, while other forms of obstruction will be treated
under different heads.
_Causes._ Defecation is immediately due to the active peristaltic
movements of the rectum overcoming the resistance of the sphincter.
There is also the concurrent closure of the glottis and contraction of
the diaphragm and abdominal walls, and it is usually the voluntary
operation of these forces that rouses the rectum to effective
peristalsis. The excitability of the rectum depends greatly on habit,
hence the habitual retention of fæces, gradually dulls that organ and
renders it less and less disposed to respond. In _horses_ this is seen
largely in connection with abundant dry feeding and lack of exercise. In
house _dogs_ and _cats_ on the other hand, inculcated habits of
cleanliness, compels the suppression of the natural instinct, and the
habitually overloaded bowel becomes less and less responsive. The
retained excrements meanwhile give up more and more of their liquids
until they become so dry, and incompressible as well as massive that
they can be expelled only by violent efforts. Inflammation of the mucosa
naturally follows the retention and this in its turn adds to the
weakness and torpor.
Acting in a similar way the partial obstruction, by accumulations of
bones and other undigested matters in the colon, and by calculi, tends
to continued accessions of new material and to gradually increasing
intestinal paresis. So with the other forms of obstruction which will
not be further referred to here.
In all animals dry feeding and a lack of water are potent causes of
inspissation of the ingesta and torpor of the bowels.
All or nearly all febrile affections, leading as they do to suppression
of secretions, cause drying and tardy movement of the contents of the
bowels.
The excessive loss of liquid through other channels,—by diuresis, by
profuse perspirations, by excessive secretion of milk, or by
bleeding—has a similar tendency.
The suppression of the biliary secretion through liver disease, or
obstruction of the biliary duct, withholds from the intestine, the most
important of the stimuli to peristalsis, and tends to constipation,
unless the resulting irritation should cause excessive secretion.
The derangement in the circulation in the intestinal walls caused by
verminous thrombi in the horse, acts in the same way, the imperfectly
nourished walls not only losing the normal power of peristalsis, but
sometimes contracting so as to cause a stricture. Parasites encysted in
the walls of the bowels, like catarrhal and other inflammations of these
parts tend to atony and tardy peristalsis.
A weakness of the nervous system attendant on old age, or debility, or
chronic lead poisoning often tells with force on the alimentary canal,
and the loss of nervous power through disease of the great nerve centers
(ganglionic system, brain, spinal cord) impairs the vermicular motion.
This is notoriously the case in paraplegia, chronic hydrocephalus, and
vertigo.
Finally among the causes of constipation must be noted the matting of
the hairs around the anus (in dogs), and painful affections of the anus,
or the abdominal walls, which render efforts at defecation painful and
deter the animal from attempting them.
_Lesions._ These are as varied as the diseases which give rise to
constipation, or result from it. Permanent dilatation or sacculation of
the intestine, and the structural changes attendant on intestinal
catarrh are the most common local lesions. But proctitis, hemorrhoids
and ulcers of the anal follicles are met with in canine patients and
ulcers of the colon in the seat of impaction are common.
_Symptoms._ In =Solipeds= the fæces are passed, at long intervals, in
small quantity, usually only a very few balls at a time, firm, dry,
moulded smooth and black on the surface, often covered with mucus, or
with streaks of blood. They are passed with unusual effort and
straining, and even with groaning, and one or more balls that may be
exposed in the act are often drawn back and retained by the inversion of
the rectum and closure of the sphincter. It is liable to be complicated
by impaired appetite, tympanies, slight recurrent colics, and dryness,
scurfiness and unthriftiness of the skin. Not unfrequently the pressure
of the impacted colon (pelvic flexure) irritates the bladder causing
stretching as if to urinate, and the passage of urine often in small
quantity. There may be the symptoms of any one of the different nervous
affections that lead to impaired peristaltic action, or of the local
diseases which tend to obstruction of the bowels.
In =dogs= there are violent and painful efforts to defecate, which may
be fruitless, or may lead to the expulsion of small masses of dry,
earthy looking fæces, smoothly moulded on the surface, coated with
mucus, streaked it may be with blood and highly offensive in odor. The
anus may be puffy and swollen with mucopurulent secretion from the anal
glands, which soils the hair of the hips and tail. If the abdomen is
flaccid, manipulation with both hands on opposite sides usually detects
a solid mass representing the impacted rectum and colon, and extending
from the pelvis forward, often to the sternum. The same mass will be
reached by the oiled finger introduced into the rectum. Both methods of
exploration are painful and may call forth cries from the patient. The
abdomen is usually distended, largely from the impacted fæces, in which
case it gives a flat sound on percussion, or from gaseous emanation, in
which case it is tense, resilient and resonant. Colicy pains are liable
to appear, and vomiting at first of food only, then more or less yellow
and bilious, and finally of distinctly feculent matters. For a time
appetite may be retained, but this is gradually lost. There may
supervene diarrhœa, which in favorable cases may lead to expulsion of
the impacted mass, but in others it fails to completely dislodge it. The
patient is dull and spiritless, inclined to lie curled up in dark
corners, and when raised walks slowly and stiffly, with the tail carried
straight or slightly to one side. The male urinates like a bitch without
lifting the leg. The nose is dry, the tongue furred, the teeth usually
covered with tartar, and the breath fœtid. There is at first no
hyperthermia, but some rise of temperature attends on the advance of the
disease, and the auto-poisoning by absorbed products of the putrefaction
of retained fæces.
The disease may last a few days only or it may continue for weeks or
months. In the last case intestinal catarrh, ulceration, and
circumscribed necrosis are likely to supervene and the animal may die of
auto intoxication, acute peritonitis or enteritis. Yet the majority of
cases in the dog reach a favorable termination, or recover with
remaining cicatrices, strictures or dilatations.
_Treatment._ In =solipeds= accustomed to an idle or pampered life,
plenty of daily exercise will often correct the torpor. A run at pasture
will often effectually counteract the tendency. If the patient must be
kept in the stable a full drink of cold water every morning before
feeding will often succeed. Regularity in feeding and watering is of the
utmost importance, and the addition of a little wheat bran or flaxseed
to the grain is often of material advantage. Next may be added a
moderate allowance of carrots, turnips, or ensilage to furnish the
needed succulence and organic acids. If in addition medicinal measures
are wanted, a small handful of common salt, or of Glauber salts, in the
morning drink to be taken ten or fifteen minutes before the first feed,
will usually operate well. This may be continued for a length of time if
necessary, without the ill effects of purgatives given at other times.
It may be rendered slightly more effectual by the addition of 10 grains
nux vomica on each occasion. A morning injection of a quart or two of
cold water with one or two ounces of glycerine may be tried. Another
resort is 2 or 3 grains of barium chloride in the morning drink or
hypodermically repeated daily for some time.
In the more severe cases with already existing impaction of the colon,
purgatives and copious injections will be demanded as advised under that
disease.
In =dogs= the first object is the unloading of the rectum and colon and
this usually demands direct mechanical intervention. (See Intestinal
Indigestion with Constipation.) In case of hypertrophied prostate this
may be rendered somewhat difficult, yet with a free use of oily, soapy
or mucilaginous injections it can usually be accomplished.
The further treatment is on the same line as for the soliped. An
abundance of exercise in the open air is a prime essential, together
with a free access to fresh water. House dogs must be taken out for
urination and defecation at regular times that are not too far apart.
The food must be of a laxative nature. At first fresh whey or buttermilk
only may be allowed, but as some action of the bowels is obtained well
salted beef tea, pulped or scraped red muscle seasoned with salt, or
milk treated in the same way is permissible. If the bowels fail to
respond when the dog is taken out at the regular times an injection of
cold water may be given. Sulphate of eserine (⅕ gr.) may be given daily
by the mouth or hypodermically, or castor oil (½ to 1 oz.) may be
administered at one dose to be followed by careful dietary and hygienic
measures. Or sweet oil, calomel and jalap, podophyllin, or colocynth may
be substituted. When the bowels have been freely opened a daily morning
dose of a drop of the fluid extract of belladonna and ½ gr. of nux
vomica will often materially improve the peristalsis. Active
manipulation of the abdomen may be employed, or, if available, a current
of electricity through the torpid bowels for 10 or 15 minutes daily.