removed. Trephining is the best possible way to remove it in such cases,
as the operation immediately opens the cavity, which can be attended to
direct. In all those cases of nasal gleet in which sinuses contain
either tumors or collections of pus the only relief is by the trephine;
and, no matter how thoroughly described, this is an operation that will
be seldom attempted by the nonprofessional. It would therefore be a
waste of time to give the modus operandi.
An abscess involving the turbinated bones is similar to the collection
of pus in the sinuses and must be relieved by trephining.
THICKENING OF THE NASAL MEMBRANE.
This is sometimes denoted by a chronic discharge, a snuffling in the
breathing, and a contraction of the nostril. It is a result of common
cold and requires the same treatment as prescribed for nasal gleet,
namely, the sulphate of iron, sulphate of copper, iodid of potassium,
etc. The membranes of both sides may be affected, but one side only is
the rule; the affected side may be easily detected by holding the hand
tightly over one nostril at a time. When the healthy side is closed in
this manner the breathing through the affected side will demonstrate a
decreased caliber or an obstruction.
NASAL POLYPUS.
Tumors with narrow bases (somewhat pear-shaped) are occasionally found
attached to the membrane of the nasal chambers, and are obstructions to
breathing through the side in which they are located. They vary much in
size; some are so small that their presence is not manifested, while
others almost completely fill the chamber, thereby causing a serious
obstruction to the passage of air. The stem, or base, of the tumor is
generally attached high in the chamber, and usually the tumor can not be
seen, but occasionally it increases in size until it can be observed
within the nostril. Sometimes, instead of hanging down toward the nasal
opening, it falls back into the pharynx. It causes a discharge from the
nostril, a more or less noisy snuffling sound in breathing, according to
its size, a discharge of blood (if it is injured), and sneezing. The
side that it occupies can be detected in the same way as described for
the detection of the affected side when the breathing is obstructed by a
thickened membrane.
The only relief is removal of the polypus, which, like all other
operations, should be done by an expert when it is possible to obtain
one. The operation is performed by grasping the base of the tumor with
suitable forceps and twisting it round and round until it is torn from
its attachment, or by cutting it off with a noose of wire. The resulting
hemorrhage is checked by the use of an astringent lotion, such as a
solution of the tincture of iron, or by packing the nostrils with
surgeon's gauze.
PHARYNGEAL POLYPUS.
This is exactly the same kind of tumor described as nasal polypus, the
only difference being in the situation. Indeed, the stem of the tumor
may be attached to the membrane of the nasal chamber, as before
explained, or it may be attached in the fauces (opening of the back part
of the mouth), and the body of the tumor then falls into the pharynx. In
this situation it may seriously interfere with breathing. Sometimes it
drops into the larynx, causing the most alarming symptoms. The animal
coughs, or tries to cough, saliva flows from the mouth, the breathing is
performed with the greatest difficulty and accompanied with a loud
noise; the animal appears as if strangled and often falls exhausted.
When the tumor is coughed out of the larynx the animal regains quickly
and soon appears as if nothing were ailing. These sudden attacks and
quick recoveries point to the nature of the trouble. The examination
must be made by holding the animal's mouth open with a balling iron or
speculum and running the hand back into the mouth. If the tumor is
within reach, it must be removed in the same manner as though it were in
the nose.
BLEEDING FROM THE NOSE.
This often occurs during the course of certain diseases, namely,
influenza, bronchitis, purpura hemorrhagica, glanders, etc. But it also
occurs independently of other affections and, as before mentioned, is a
symptom of polypus, or tumor, in the nose.
Injuries to the head, exertion, violent sneezing--causing a rupture of a
small blood vessel--also induce it. The bleeding is almost invariably
from one nostril only, and is never very serious. The blood escapes in
drops (seldom in a stream) and is not frothy, as when the hemorrhage is
from the lungs. (See Bleeding from the lungs, p. 127.) In most cases
bathing the head and washing out the nostril with cold water are all
that is necessary. If the cause is known, you will be guided according
to circumstances. If the bleeding continues, pour ice-cold water over
the face, between the eyes and down over the nasal chambers. A bag
containing ice in small pieces applied to the head is often efficient.
If in spite of these measures the hemorrhage continues, plugging the
nostrils with cotton, tow, or oakum, should be tried. A string should be
tied around the plug before it is pushed up into the nostril, so that it
can be safely withdrawn after 4 or 5 hours. If both nostrils are
bleeding, only one nostril at a time should be plugged. If the
hemorrhage is profuse and persistent, a drench composed of 1 dram of
acetate of lead dissolved in 1 pint of water, or ergot, 1 ounce, should
be given.
INFLAMMATION OF THE PHARYNX.
As already stated, the pharynx is common to the functions of both
respiration and alimentation. From this organ the air passes into the
larynx and thence onward to the lungs. In the posterior part of the
pharynx is the superior extremity of the gullet, the canal through which
the feed and water pass to the stomach. Inflammation of the pharynx is a
complication of other diseases--namely, influenza, strangles, etc.--and
is probably always more or less complicated with inflammation of the
larynx. That it may exist as an independent affection there is no reason
to doubt, and it is discussed as such with the diseases of the digestive
tract.
SORE THROAT, OR LARYNGITIS.
The larynx is situated in the space between the lower jawbones just back
of the root of the tongue. It may be considered as a box (somewhat
depressed on each side), composed principally of cartilages and small
muscles, and lined on the inside with a continuation of the respiratory
mucous membrane. Posteriorly it opens into and is continuous with the
windpipe. It is the organ of the voice, the vocal cords being situated
within it; but in the horse this function is of little consequence. It
dilates and contracts to a certain extent, thus regulating the volume of
air passing through it. The mucous membrane lining it internally is so
highly sensitive that if the smallest particle of feed happens to drop
into it from the pharynx violent coughing ensues instantly and is
continued until the source of irritation is ejected. This is a provision
of nature to prevent foreign substances gaining access to the lungs.
That projection called Adam's apple in the neck of man is the prominent
part of one of the cartilages forming the larynx.
Inflammation of the larynx is a serious and sometimes fatal disease,
and, as before stated, is usually complicated with inflammation of the
pharynx, constituting what is popularly known as "sore throat." The
chief causes are chilling and exposure.
_Symptoms._--About the first symptom noticed is cough, followed by
difficulty in swallowing, which may be due to soreness of the membrane
of the pharynx, over which the feed or water must pass, or from the pain
caused by the contraction of the muscles necessary to impel the feed or
water onward to the gullet; or this same contraction of the muscles may
cause a pressure on the larynx and produce pain. In many instances the
difficulty in swallowing is so great that water, and in some cases feed,
is returned through the nose. This, however, does not occur in
laryngitis alone, but only when the pharynx is involved in the
inflammation. The glands between the lower jawbones and below the ears
may be swollen. Pressure on the larynx induces coughing. The head is
more or less "poked out," and has the appearance of being stiffly
carried. The membrane in the nose becomes red. A discharge from the
nostrils soon appears. As the disease advances, the breathing may assume
a more or less noisy character; sometimes a harsh, rasping snore is
emitted with every respiration, the breathing becomes hurried, and
occasionally the animal seems threatened with suffocation.
_Treatment._--In all cases steam the nostrils, as has been advised for
cold in the head. In bad cases cause the steam to be inhaled
continuously for hours--until relief is afforded. Have a bucketful of
fresh boiling water every fifteen or twenty minutes. In each bucketful
of water put a tablespoonful of oil of turpentine, or compound tincture
of benzoin, the vapor of which will be carried along with the steam to
the affected parts and have a beneficial effect. In mild cases steaming
the nostrils five, six, or seven times a day will suffice.
The animal should be placed in a comfortable, dry stall (a box stall
preferred), and should have pure air to breathe. The body should be
blanketed, and bandages applied to the legs. The diet should consist of
soft feed--bran mashes, scalded oats, linseed gruel, and, best of all,
fresh grass, if in season. The manger, or trough, should neither be too
high nor too low, but a temporary one should be constructed at about
the height he carries his head. Having to reach too high or too low may
cause so much pain that the animal would rather forego satisfying what
little appetite he may have than inflict pain by craning his head for
feed or water. A supply of fresh water should be before him all the
time; he will not drink too much, nor will the cold water hurt him.
Constipation (if present) must be relieved by enemas of warm water,
administered three or four times during the twenty-four hours.
A liniment composed of 2 ounces of olive oil and 1 each of solution of
ammonia and tincture of cantharides, well shaken together, may be
thoroughly rubbed in about the throat from ear to ear, and about 6
inches down over the windpipe, and in the space between the lower jaws.
This liniment should be applied once a day for two or three days.
If the animal is breathing with great difficulty, persevere in steaming
the nostrils, and dissolve 2 drams of chlorate of potassium in every
gallon of water he will drink; even if he can not swallow much of it,
and even if it is returned through the nostrils, it will be of some
benefit to the pharynx as a gargle.
An electuary of acetate of potash, 2 drams, honey, and licorice powder
may be spread on the teeth with a paddle every few hours. If the pain of
coughing is great, 2 or 3 grains of morphin may be added to the
electuary.
When the breathing begins to be loud, relief is afforded in some cases
by giving a drench composed of 2 drams of fluid extract of jaborandi in
half a pint of water. If benefit is derived, this drench may be repeated
four or five hours after the first dose is given. It will cause a free
flow of saliva from the mouth.
In urgent cases, when suffocation seems inevitable, the operation of
tracheotomy must be performed. To describe this operation in words that
would make it comprehensible to the general reader is a more difficult
task than performing the operation, which, in the hands of the expert,
is simple and attended with little danger.
The operator should be provided with a tracheotomy tube (to be purchased
from any veterinary instrument maker) and a sharp knife, a sponge, and a
bucket of clean cold water. The place to be selected for opening the
windpipe is that part which is found, upon examination, to be least
covered with muscles, about 5 or 6 inches below the throat. Right here,
then, is the place to cut through. Have an assistant hold the animal's
head still. Grasp your knife firmly in the right hand, select the spot
and make the cut from above to below directly on the median line on the
anterior surface of the windpipe. Make the cut about 2 inches long in
the windpipe; this necessitates cutting three or four rings. One bold
stroke is usually sufficient, but if it is necessary to make several
other cuts to finish the operation, do not hesitate. Your purpose is to
make a hole in the windpipe sufficiently large to admit the tracheotomy
tube. It is quickly manifested when the windpipe is severed; the hot air
rushes out, and when air is taken in it is sucked in with a noise. A
slight hemorrhage may result (it never amounts to much), which is easily
controlled by washing the wound with a sponge and cold water, but use
care not to get any water in the windpipe. Do not neglect to instruct
your assistant to hold the head down immediately after the operation, so
that the neck will be in a horizontal line. This will prevent the blood
from getting into the windpipe and will allow it to drop directly on the
ground. If you have the self-adjustable tube, it retains its place in
the wound without further trouble after it is inserted. The other kind
requires to be secured in position by means of two tapes or strings tied
around the neck. After the hemorrhage is somewhat abated, sponge the
blood away and see that the tube is thoroughly clean, then insert it,
directing the tube downward toward the lungs.
The immediate relief this operation affords is gratifying to behold. The
animal, a few minutes before on the verge of death from suffocation,
emitting a loud wheezing sound with every breath, with haggard
countenance, body swaying, pawing, gasping, fighting for breath, now
breathes tranquilly, and may be in search of something to eat.
The tube should be removed once a day and cleaned with carbolic-acid
solution (1 to 20), and the discharge washed away from the wound with a
solution of carbolic acid, 1 part to 40 parts water. Several times a day
the hand should be held over the opening in the tube to test the
animal's ability to breathe through the nostrils, and as soon as it is
demonstrated that breathing can be performed in the natural way the tube
should be removed, the wound thoroughly cleansed with carbolic-acid
solution (1 to 40), and closed by inserting four or five stitches
through the skin and muscle. Do not include the cartilages of the
windpipe in the stitches. Apply the solution to the wound three or four
times a day until healed. When the tube is removed to clean it the lips
of the wound may be pressed together to ascertain whether or not the
horse can breathe through the larynx. The use of the tube should be
discontinued as soon as possible.
It is true that tracheotomy tubes are seldom to be found on farms, and
especially when most urgently required. In such instances there is
nothing left to be done but, with a strong needle, pass a waxed end or
other strong string through each side of the wound, including the
cartilage of the windpipe, and keep the wound open by tying the strings
over the neck.
During the time the tube is used the other treatment advised must not be
neglected. After a few days the discharge from the nostrils becomes
thicker and more profuse. This is a good symptom and signifies that the
acute stage has passed. At any time during the attack, if the horse
becomes weak, give whisky or aromatic spirits of ammonia, 2 ounces in
water. Do not be in a hurry to put the animal back to work, but give
plenty of time for a complete recovery. Gentle and gradually increasing
exercise may be given as soon as the horse is able to stand it. The feed
should be carefully selected and of good quality. Tonics, as iron or
arsenic, may be employed.
If abscesses form in connection with the disease they must be opened to
allow the escape of pus, but do not rashly plunge a knife into swollen
glands; wait until you are certain the swelling contains pus. The
formation of pus may be encouraged by the constant application of
poultices for hours at a time. The best poultice for the purpose is made
of linseed meal, with sufficient hot water to make a thick paste. If the
glands remain swollen for some time after the attack, rub well over them
an application of the following: Biniodid of mercury, 1 dram; lard, 1
ounce; mix well. This may be applied once every day until the part is
blistered.
Sore throat is also a symptom of other diseases, such as influenza,
strangles, purpura hemorrhagica, etc., which diseases may be consulted
under their proper headings.
After a severe attack of inflammation of the larynx the mucous membrane
may be left in a thickened condition, or an ulceration of the part may
ensue, either of which is liable to produce a chronic cough. For the
ulceration it is useless to prescribe, because it can neither be
diagnosed nor topically treated by the nonprofessional.
If a chronic cough remains after all the other symptoms have
disappeared, it is advisable to give 1 dram of iodid of potassium
dissolved in a bucketful of drinking water, one hour before feeding,
three times a day for a month if necessary. Also rub in well the
preparation of iodid of mercury (as advised for the swollen glands)
about the throat, from ear to ear, and in the space between the lower
jawbones. The application may be repeated every third day until the part
is blistered.
SPASM OF THE LARYNX.
The symptoms are as follows: Sudden seizure by a violent fit of
coughing; the horse may reel and fall, and after a few minutes recover
and be as well as ever. The treatment recommended is this: Three drams
of bromid of potassium three times a day, dissolved in the drinking
water, or give as a drench in about a half pint of water for a week.
Then give 1 dram of powdered nux vomica (either on the food or shaken
with water as a drench) once a day for a few weeks.
CROUP AND DIPHTHERIA.
Neither of these diseases affects the horse, but these names are
sometimes wrongly applied to severe laryngitis or pharyngitis, or to
forage poisoning, in which the throat is paralyzed and becomes
excessively inflamed and gangrenous.
THICK WIND AND ROARING.
Horses that are affected with chronic disease that causes a loud,
unnatural noise in breathing are said to have thick wind, or to be
roarers. This class does not include those affected with severe sore
throat, as in these cases the breathing is noisy only during the attack
of the acute disease.
Thick wind is caused by an obstruction to the free passage of the air in
some part of the respiratory tract. Nasal polypi, thickening of the
membrane, pharyngeal polypi, deformed bones, paralysis of the wing of
the nostril, etc., are occasional causes. The noisy breathing of horses
after having been idle and put to sudden exertion is not due to any
disease and is only temporary. Very often a nervous, excitable horse
will make a noise for a short time when started off, generally caused by
the cramped position in which the head and neck are forced in order to
hold him back.
Many other causes may occasion temporary, intermittent, or permanent
noisy respiration, but chronic roaring is caused by paralysis of the
muscles of the larynx; and almost invariably it is the muscles of the
left side of the larynx that are affected.
In chronic roaring the noise is made when the air is drawn into the
lungs; only when the disease is far advanced is a sound produced when
the air is expelled, and even then it is not nearly so loud as during
inspiration.
In a normal condition the muscles dilate the aperture of the larynx by
moving the cartilage and vocal cord outward, allowing a sufficient
volume of air to rush through. But when the muscles are paralyzed the
cartilage and vocal cord that are normally controlled by the affected
muscles lean into the tube of the larynx, so that when the air rushes in
it meets this obstruction and the noise is produced. When the air is
expelled from the lungs its very force pushes the cartilage and vocal
cords out, and consequently noise is not produced in the expiratory act.
The paralysis of the muscles is due to derangement of the nerve that
supplies them with energy. The muscles of both sides are not supplied by
the same nerve; there is a right and a left nerve, each supplying its
respective side. The reason why the muscles on the left side are the
ones usually paralyzed is owing to the difference in the anatomical
arrangement of the nerves. The left nerve is much longer and more
exposed to interference than the right nerve.
In chronic roaring there is no evidence of any disease of the larynx
other than the wasted condition of the muscles in question. The disease
of the nerve is generally far from the larynx. Disease of parts
contiguous to the nerve along any part of its course may interfere with
its proper function. Enlargement of lymphatic glands within the chest
through which the nerve passes on its way back to the larynx is the most
frequent interruption of nervous supply, and consequently roaring. When
roaring becomes confirmed, medical treatment is entirely useless, as it
is impossible to restore the wasted muscle and at the same time remove
the cause of the interruption of the nervous supply. Before roaring
becomes permanent the condition may be benefited by a course of iodid of
potassium, if caused by disease of the lymphatic glands. Electricity has
been used with indifferent success. Blistering or firing over the larynx
is, of course, not worthy of trial if the disease is due to interference
of the nerve supply. The administration of strychnia (nux vomica) on the
ground that it is a nerve tonic with the view of stimulating the
affected muscles is treating only the result of the disease without
considering the cause, and is therefore useless. The operation of
extirpating the collapsed cartilage and vocal cord is believed to be the
only relief, and, as this operation is critical and can be performed
only by the skillful veterinarian, it will not be described here.
From the foregoing description of the disease it will be seen that the
name "roaring," by which the disease is generally known, is only a
symptom and not the disease. Chronic roaring is also in many cases
accompanied with a cough. The best way to test whether a horse is a
"roarer" is either to make him pull a load rapidly up a hill or over a
sandy road or soft ground; or, if he is a saddle horse, gallop him up a
hill or over soft ground. The object is to make him exert himself. Some
horses require a great deal more exertion than others before the
characteristic sound is emitted. The greater the distance he is forced,
the more he will appear exhausted if he is a roarer; in bad cases the
animal becomes utterly exhausted, the breathing is rapid and difficult,
the nostrils dilate to the fullest extent, and the animal appears as if
suffocation was imminent.
An animal that is a roarer should not be used for breeding purposes. The
taint is transmissible in many instances.
_Grunting._--A common test used by veterinarians when examining "the
wind" of a horse is to see if he is a "grunter." This is a sound emitted
during expiration when the animal is suddenly moved, or startled, or
struck at. If he grunts he is further tested for roaring. Grunters are
not always roarers, but, as it is a common thing for a roarer to grunt,
such an animal must be looked upon with suspicion until he is thoroughly
tried by pulling a load or galloped up a hill. The test should be a
severe one. Horses suffering with pleurisy, pleurodynia, or rheumatism,
and other affections accompanied with much pain, will grunt when moved,
or when the pain is aggravated, but grunting under these circumstances
does not justify the term of "grunter" being applied to the horse, as
the grunting ceases when the animal recovers from the disease that
causes the pain.
_High blowing._--This term is applied to a noisy breathing made by some
horses. It is distinctly a nasal sound, and must not be confounded with
"roaring." The sound is produced by the action of the nostrils. It is a
habit and not an unsoundness. Contrary to roaring, when the animal is
put to severe exertion the sound ceases. An animal that emits this sound
is called a "high blower." Some horses have naturally very narrow nasal
openings, and they may emit sounds louder than usual in their breathing
when exercised.