Secondary: after acute, or with disease of liver, spleen, kidney,
rheumatism, melanosis, lymphadenoma, epithelioma, carcinoma, or
sarcoma. Gastric ulcer, infected punctures. Symptoms: poor health,
tender abdomen, irregular bowels, slight colic, tense, fluctuating
belly, pallid mucosæ, dropsy of sheath, limbs, etc., slight fever.
Treatment: remove primary disease: saline laxatives, diuretics,
drainage, antiseptic irrigation (boric acid, etc.), abdominal bandage,
tonics, derivatives.
_Causes._ Chronic peritonitis is always a secondary disease, succeeding
the acute, or dependent on some other affection of the abdominal organs,
as chronic congestion of the liver, or spleen, Bright’s disease,
rheumatism, melanosis, lymphadenoma, epithelioma, carcinoma, or sarcoma.
Tuberculosis and actinomycosis, so common in cattle, are rare in
solipeds. Chronic ulcers of stomach or bowels and injuries and
infections from punctures are exceptional causes.
_Symptoms._ The manifestations of the disease are indefinite, the acute
form may have subsided so that the patient is supposed to have
completely recovered, a moderate appetite and a certain capacity for
work may be present, yet he is easily fatigued, there is some tenderness
of the abdomen to pressure, some irregularity of the bowels—constipation
and diarrhœa alternating—and occasional slight colics. Some weeks later
may be noticed abdominal tension and tympany, with perhaps fluctuation
in the lower parts, increasing pallor of the mucosæ, and œdematous
swelling of the sheath, mammæ, abdominal walls or hind limbs. To detect
fluctuation it is sometimes necessary to introduce one hand into the
rectum. When present hyperthermia is slight, but assists in diagnosis
from ascites.
_Treatment_ should be directed to the primary disease. As that is too
often irremediable the peritonitis will resist all other treatment.
In cases that supervene on the acute form, paracentesis, saline
laxatives and diuretics with antiseptics, tonics, and counter-irritants
will sometimes succeed. As in the acute form of the disease the removal
of the effusion is the removal of the culture fluid, and may be followed
by irrigation of the peritoneum with a normal salt solution, or with an
antiseptic solution (boric acid or potassium permanganate), 1:20 warm
water; Aluminum acetate, 1:2000. Sulphate of soda given to keep up a
moderately laxative action, tends to counteract the contraction of the
intestine by false membranes, and operates with diuretics in reducing
the tendency to exudation or in causing its reabsorption. After removal
of the liquid, support by a close (or elastic) abdominal bandage is
often of value in preventing further effusion. As tonics, gentian, nux
vomica and the iron salts may be profitably employed, and as antiseptics
salicylate of soda and iodide of potassium. As counter-irritants mustard
and cantharides may be named.