Probable causation by parasites, calculi, irritants, microbes.
Lesions: mucosa reddened, thickened, ducts dilated, epithelium fatty,
granular, desquamating, pus, connective tissue indurated.
Interdependence of pancreatitis and hepatitis in horse, sheep and
goat. Liver lesions. Symptoms: loss of vigor, endurance, appetite, and
condition. Icterus, costiveness, fœtid, fatty stools, percussion
tenderness—right side. Treatment: antithermics, eliminants,
antiseptics, derivatives, alkalies, salicylates, ether.
_Causes._ We know little of the causes of this affection, but it may be
inferred that parasites, calculi and other irritants, will produce in
this as in other mucosæ a mucopurulent inflammation. Then again the
presence of pus suggests the coöperation of pus microbes as in the
infective catarrhal icterus. The blocking of the common gall and
pancreatic duct, by gall stones or biliary products, will entail arrest
of the discharge of pancreatic juice, and a consequent pancreatitis,
just as blocking with pancreatic products will cause hepatitis and
icterus.
_Lesions._ The mucosa of the pancreatic ducts is reddened, congested and
thickened and their lumen blocked by a white, granular matter,
containing pus globules, fibrine filaments, and granular, ciliated
epithelium. The blocked ducts become dilated, and their walls thickened,
the epithelium is desquamated to a greater or less extent, and the raw
exposed surface may present ulcers or granulations. The pancreatic cells
undergo fatty degeneration and the connective tissue becomes steadily
indurated (sclerosis). These lesions were especially noted by Megnin and
Nocard in a case of pancreatitis in the horse.
In the horse, sheep and goat, which have a common outlet for the bile
and pancreatic juice, the blocking of the latter and the arrest of the
bile almost of necessity causes hepatitis, and infection in the one
gland is directly transferred to the other so that pancreatitis and
hepatitis are mutually causative of each other. In the ox, pig, dog and
cat, in which the bile and pancreatic juice are poured into the duodenum
through separate ducts and orifices, this mutual pathogenic action is
not so certain.
When the liver is implicated, there is catarrh and dilatation of the
bile ducts, fatty degeneration commencing in the centre of the acini,
pigmentation appearing at their periphery, and sclerosis of the organ
follows.
_Symptoms._ In Nocard’s equine case there was progressive loss of
spirit, energy, and endurance; appetite was poor and eating listless;
after two weeks jaundice set in, the visible mucosæ and skin showing a
yellow tinge, and the scanty urine becoming brownish yellow; the bowels
became costive the fæces being formed of small hard discolored balls,
but no excess of fatty matter is recorded. Emaciation advanced rapidly,
the most marked wasting being in the muscles of the back, loins and
croup. Death ensued at the end of two months from the commencement of
the illness. In man sudden, violent colic, with nausea, tympany and
collapse are prominent symptoms.
_Diagnosis_ is more satisfactory when with digestive disorder, tardily
developing icterus, and rapid emaciation, there is an excess of fat in
the ill-smelling fæces. Pain on percussion of the right hypochondrium
would be an additional feature.
_Treatment_ can rarely be adopted because of the uncertainty of the
diagnosis. It would proceed on general principles, antithermics,
eliminants, antiseptics, and counter-irritants being resorted to as the
conditions seem to demand. Alkaline laxatives and diuretics, salicylates
of soda or potash, and guarded doses of sulphuric ether to solicit the
action of the pancreas, might be resorted to. The disorder of the liver
would require attention along the lines indicated under catarrh of that
organ.