Causes: infection, chill, blows, wounds, debility, ill health,
Chauveau’s experiment with castration, dystokia, abdominal congestion
and inflammation, bile or urine in absence of sepsis, gastric or
intestinal ulcer or perforation, foreign bodies, abscesses, surgical
wounds. Spoilt marc of beet sugar factories. Symptoms: fever,
stiffness, dragging hind limbs, knuckling, arched back, shifting feet,
moving tail, tense belly, pendent, fluctuating below, friction sounds,
diarrhœa, later constipation, weakness, emaciation, death fourth to
twentieth day. Recovery, often partial. After dystokia putrid vaginal
discharge, and nervous depression, resembling parturition fever.
Infection in ewes through shepherd’s hands, œdematous swellings of
vulva, perineum and abdomen. Lesions: as in solipeds, with abundant
false membranes, fœtid pus metritis, with putrid contents of womb.
Treatment: saline laxatives, diuretics, demulcents, enemata, morphia,
antiseptics, cold to abdomen. After dystokia, antiseptic irrigation of
womb, elevation of head, with ice, strychnia, acetanilid. Tubercular
peritonitis.
_Causes._ As in solipeds infection of the peritoneum and the increase of
susceptibility by exposure to cold, blows, wounds, poor feeding or
stabling, disease and other causes of ill health, operate together in
inducing peritonitis.
The effect of debility or predisposition of the tissues is well shown in
Chauveau’s experiments with _bistournage_ in rams. Healthy rams
subjected to bistournage showed no infection, and rams subjected to
intravenous injection of pus microbes without _bistournage_ showed no
infection, whereas if the rams were first subjected to injection of pus
microbes, and then to _bistournage_, peritonitis set in. In the same way
chills occurring after dystokia, when the womb is charged with microbes
and more or less congested, may determine peritonitis, and congestions,
impactions, tympanies, and other injuries of the gastro-intestinal
viscera coöperate with cold to the same end. Rupture of the gall or
urinary bladder does not usually cause prompt peritonitis, yet it
irritates the serosa and lays it open to infection if the germs should
reach it through the circulation. Otherwise the animal suffers only from
uræmia or biliary poisoning and may survive one or two weeks. Ruptures
of stomach or intestine, or ulceration or the perforation of their walls
by hard, pointed or other metallic bodies are causes of peritonitis. The
rupture of abscesses into the peritoneum and the escape of germs from
the womb in case of rupture of the womb in difficult parturition, or in
metritis, are additional causes. Surgical wounds as in castration of the
male or female, and punctures and incisions of the rumen are occasional
causes, but there is by no means the tendency to extension of such
peritonitis that we see in solipeds. The self-protective power of the
tissues is incomparably greater in the ruminant.
Nocard, Butel and others have recorded a gastro-entero-peritonitis of
septic nature, occurring in cattle and above all in sheep, fed on the
fermented refuse of beet sugar factories, which had been kept in silos
through the winter. On the third and fourth days of this feeding many
were attacked.
_Symptoms._ Beside the general systemic disorder and a very variable
amount of hyperthermia (102° to 107°), there are the special indications
of abdominal inflammation, stiff movement and dragging of the hind
limbs, or if standing the back is arched, the head drooping and the legs
drawn together and slightly bent, with uneasy shifting of the hind feet,
and lateral movements of the tail. The walls of the abdomen are usually
tense, often bulging laterally below, though fallen in beneath the
lumbar transverse processes (pot-bellied); they are tender to pressure,
and may be drum like to percussion above, while flat, dull, and
fluctuating below. The tenderness is slightest below, where liquid
effusion has settled, but is quite marked in the upper and resonant
parts, where pressure will cause wincing and trembling. In this upper
part on the left side may be heard friction sounds after the fourth or
sixth day. This is especially observable in tuberculous peritonitis over
the parts covered by tubercular growths. There may be at first diarrhœa
which usually soon gives place to constipation, and weakness and
emaciation advances rapidly, and death may take place from the fourth to
eighth day, or may be deferred for some weeks.
In favorable cases the acute symptoms subside, the liquid effusion is
absorbed, appetite and rumination are in great part restored, and a
partial recovery is made. It is, however, very liable to merge into the
chronic form, and inevitably so in tuberculous cases.
In cases following on difficult parturition there are redness of the
vaginal mucosa, with mucopurulent or putrid discharges, and swelling of
the lower part of the abdomen, with liquid effusion and fluctuation, and
tenderness of the right flank. The further symptoms are largely nervous,
approximating somewhat to those of parturition fever. Temperature may
rise to 104° or 106°, blindness, stupor, incoördination of muscular
movement, staggering gait, if down she may lie on the side or sternum
unable to rise, has frequent afterpains, tympany, sour eructations, and
grinding of the teeth. The case may culminate in loss of vision, in
stupor and coma, or improvement may set in and go on to a rapid
recovery. This is a more common affection in ewes than in cows and is
very destructive, the infection being carried by the hands of the
shepherd. The most fatal cases are those in which the infection becomes
generalized, and œdematous swellings appear round the vulva, between the
thighs and beneath the abdomen.
In traumatic cases the external wounds can usually be found with active
inflammation and surrounding tumefaction.
_Lesions._ The peritoneum, as in solipeds, shows the symptoms of
congestion, exudation of a fine fibrinous network or shreds, of thicker
and more extended false membranes in patches, of effusions more or less
sanguineous, of formation of pus, usually fœtid, or the presence of
decomposing ingesta which has escaped through a lesion of stomach or
bowels. The peritoneal and subserous tissue are infiltrated with liquid,
and the other gastric and intestinal organs are more or less tympanitic,
and the mucosa of the latter is thickened, ecchymosed, or eroded, with
black, fœtid bloodstained contents. In parturient cases, the uterine
mucosa is congested, reddened and softened, the cotyledons swollen,
perhaps gangrenous, and the membranes, if still present, float in a
dark, putrid offensive liquid.
_Treatment._ As in the horse, morphia has been used to relieve pain and
check peristalsis. The addition of saline laxatives, and diuretics, will
assist in elimination and depletion, and in the removal of intestinal
bacteria which become a source of danger. A laxative dose should be
followed by frequent drinks of pure water or mucilaginous liquids, and
sulphate of soda may also be given freely in enema. As diuretics,
saltpeter or digitalis may be resorted to. Antiferments (salicylate of
soda, bisulphite of soda) should not be forgotten nor cold applications
to the abdomen. When effusion or suppuration has taken place evacuation
by puncture may be followed by antiseptic irrigation.
If with septic metritis, antiseptic injections of the vagina and womb
are the first consideration. With boiled water at a tepid heat the womb
should be thoroughly washed out, followed by a solution of mercuric
chloride (1:2000), or permanganate of potash (1:1000), or boric acid
(1:25) until the liquid returns clear and odorless. This may be repeated
several times a day. The symptoms of brain congestion, may be met by
tying, or packing up the patient with straw so that the head will be
somewhat elevated, and bags of ice or snow, or simple cold water may be
kept applied to the upper part of the head and neck. When there is no
great nervous excitement the nervous functions may be roused by nux
vomica in enema, or strychnia subcutem. If on the other hand the
temperature runs very high acetanilid may be tried with caution, or
resort may be had to wet compresses.
In case of perforation or rupture, if the animal cannot be at once
sacrificed for beef or mutton before inflammation has set in, the only
hope lies in laparotomy, followed by the cleansing, disinfection and
suturing of the wound.
In tubercular peritonitis which constitutes a very large proportion of
bovine cases, treatment is undesirable, and the animal is unfit for
consumption.