Heiss records two cases of this disease in heavy Belgian horses ten and
eleven years old, the urine of which showed a percentage of 3.75 of
grape sugar, and which died in two months in a state of marasmus. The
liver was enlarged and of a clay yellow color. Dieckerhoff reports one
fatal case in which there were also yellow discoloration, congestion and
hypertrophy of the liver. No lesion could be found in the pancreas nor
nervous system. Perosino records a case in a horse suffering from
contagious adenitis, which may be supposed to have been connected with
the action of the toxins or the imperfectly oxidized albuminoids on the
nerve centres or liver. Delprato relates six cases in the same stable in
overworked, half starved and emaciated horses. Rueff and Mouquet each
contributes a case occurring in paraplegia attendant on hæmoglobinuria
and in which the amounts of sugar were respectively 5.85 and 1.01 per
cent. These latter cases are manifestly complicated ones in which the
reflex irritation (or inhibition of glycogenesis) is transmitted from
the diseased or poisoned brain to the already disordered liver.
_Symptoms._ There is a profound interference with nutrition, a rapid
loss of flesh and weight, of spirit and energy and an extreme muscular
weakness in spite of an excessive appetite. The subject is fatigued and
breathless under the slightest exertion, the flanks are retracted and
hollow, and the hair dry, rigid and lifeless. Appetite is poor and
fastidious, but an intense and consuming thirst is usually present, the
animal drinking deeply at every opportunity, and passing urine with
corresponding frequency and abundance. The urine is clear, yellow,
neutral, and saccharine, the sugar varying from 1 to 12 per cent. (3.6
on an average). Notwithstanding the amount passed (55 litres per day,
Cadeac) the density usually exceeds the normal (1052 and upward), normal
being 1040 to 1050. There may or may not be hyperthermia, and in
exceptional cases appetite has been retained to the last. Cataract and
corneal ulceration are sometimes observed as in man.
_Diagnosis._ Presumption may arise from the above mentioned symptoms,
and especially the bulimia, the polydipsia, the polyuria, the rapidly
advancing emaciation, weakness, and prostration and the ocular troubles,
but conclusive evidence is only found in the presence of glucose
permanently in the urine.
_Tests for Sugar in the Urine._ For one who can go through it the
touching of the tip of the tongue with a drop of the suspected urine
will give a prompt and reliable test.
_Fehling’s_ cupric test is the next best for simplicity and
availability. Dissolve 34.639 grammes (1⅕ oz.) pure cupric sulphate in
200 cubic centimeters of distilled water: 173 grammes (6 ozs.) of pure
neutral sodio-potassic tartrate and 80 grammes of potassium hydrate in
500 cubic centimetres of distilled water. Add the copper solution slowly
to the potassium one and dilute the clear mixture to one litre. One
cubic centimeter of this fluid will be discolorized by 0.005 gramme of
sugar; or 200 grains will be discolorized by 1 grain of sugar.
_Trommer’s_ test is even simpler for a mere qualitative test. Pour the
suspected urine, freed from albumen, into a test tube and add a solution
of caustic potassa or soda until distinctly alkaline. Should this throw
down earthy phosphates or carbonates filter these out. Then add drop by
drop a solution of pure cupric sulphate in distilled water (3.5:100) so
long as it throws down a yellowish red precipitate of oxide of copper.
When the supernatent liquid remains clear and assumes a distinctly
bluish tint, the sugar has all been precipitated. The amount of
precipitate is a criterion of the quantity of sugar, which may be
otherwise estimated by the amount of copper salt used.
_The fermentation test_ is made by adding a teaspoonful of liquid yeast
to four ounces of the suspected urine, stopping the flask lightly and
placing it in a temperature of 60° to 80° F. for 12 to 24 hours when the
sugar will have been converted into alcohol and dioxide of carbon. The
loss of weight will indicate the amount of sugar, as also will the
lowering of the specific gravity. If before testing the urine was 1060,
and after 1035, it contained 15 grains of sugar to the fluid ounce.
_Prognosis._ This is always rendered more grave in the horse than in
man, because of the impossibility of putting him on a purely albuminous
diet. The great tendency is to a rapidly fatal issue, especially in
cases of irremediable structural lesions in the brain and liver. Where
the disorder is largely functional, as in connection with hæmoglobinuria
or as the result of poisons ingested the prospect of recovery is often
good.
_Treatment._ In cases due to poisoning the use of antidotes and
eliminating agents will be effectual, and in transient and curable
diseases like pulmonary disorder, hæmoglobinuria and paralysis the
appropriate treatment will restore. In the more inveterate or
constitutional cases all treatment is liable to prove ineffectual. At
the outset some apparent amelioration may be obtained from salicylic
acid, salicylate of soda, bicarbonate, acetate, citrate, sulphate or
chloride of soda, nitro-muriatic acid and other cholagogues. Blisters to
the perichondrium may also be employed. Later, when degeneration of the
liver has reached an extreme point, these will be of no avail. Cadeac
recommends acetanilid, antipyrine, and benzo-naphthol largely on their
antiseptic merits, and Jong claims a recovery in a horse under daily
doses of 12 grains of codeine. Opium has long been employed in man with
partially good results, and croton chloral, strychnia, phosphoric acid,
iodoform and ergot are recommended in different cases.
One of the most beneficial agents is skim milk or buttermilk as an
exclusive diet, and this may be to a large extent adopted for the horse.
Under its use the sugar may entirely disappear, and though rheumatoid
pains in the joints may be brought on, these usually subside on
withdrawing the source of lactic acid. They may further be met by the
use of salicylates. The greatest care should be taken of the general
health, an open air life, with protection against colds and storms, and
a healthy condition of bowels, kidneys and skin being particularly
important.
The impaired digestion and assimilation usually demand carminatives,
stomachics, bitters, and mineral acids, particularly the nitro-muriatic.
With the same intent a fair amount of exercise short of absolute fatigue
should be secured. But each case will require a special study and
treatment consonant to its special attendant lesions, its causative
functional disorders, and its stage. One case may demand attention to
bacteridian poisoning, one to a better regimen and diet, one to liver
disease, and one to disease of the brain, etc. After this treatment
specially directed to the abnormal function or structure, would come the
more specific treatment for mellituria which would be more or less
applicable to the general glycolytic disorder.