Complex cases. Microbian invasion. Lowered vital tone. Traumas.
Poisons, parasites, tubercle, rheumatism, neoplasms, poisonous food.
Symptoms: Stiffness, tonic contraction, spasms, hyperæsthesia with
warmth, enuresis, paralysis later. Treatment: parallel to myelitis;
cold, anodynes, nerve sedatives, and antispasmodics, saline
purgatives, diuretics. Iodine, electricity, cauterization.
It is often difficult to distinguish between spinal myelitis and
meningitis in the lower animals, and the danger of confusion is greater
because the two affections are often conjoined. Attacks appear to be
often associated with microbian invasion of the membranes, but in its
turn this is often favored by the lowered tone of the membranes through
mechanical injury, circulatory disorder, trophic changes, or the action
of poisons in the blood. Thus the condition may supervene on fractures,
partial dislocations or sprains of the neck, back or loins, abscesses
pressing on the spine, extension of septic inflammation from poll evil,
fistulous withers, or arthritis of the vertebræ, penetration of the
membranes by sharp pointed bodies (Reindl found a darning needle in a
cow’s spinal canal), invasion by microbes in influenza, brust-seuche,
dourine, rabies, milk sickness, distemper, pyæmia, septicæmia,
strangles, louping ill, or Texas fever. The toxins of tetanus may start
similar trouble. The larva of cysticercus cellulosa may cause meningitis
in dogs or pigs, the sclerostoma in the soliped, the filaria in dogs and
strongle in a variety of animals. Tubercle of the meninges is not
unknown, and rheumatism is alleged as a cause. Neoplasms commencing in
the cord act in a similar way, and the poisons of rye grass, millet,
loco, lupins, tares and vetches may act on the membranes as well as on
the myel.
_Symptoms._ In the main these resemble those of myelitis and are often
present at the same time, and it is only necessary to note those which
are especially pathognomonic. The early rigors are followed by stiffness
of the back shown in rising or walking and aggravated by motion. There
may be tonic contraction of the dorsal and lumbar muscles amounting at
times to oposthotonos. The muscles of the limbs, chest or abdomen or
some part of them may be the seat of tonic or clonic spasm. The skin is
usually hypersensitive and this is aggravated by heat. The urine is
liable to be retained because of the pain of stretching to micturate.
Paralysis usually follows and implies extension to the myel, compression
of the cord by reason of exudation, or implication of the spinal nerves
at the points of exit. In myelitis on the other hand the spasms may be
entirely absent, and paralysis sets in early and extends rapidly
according to the seat and extent of the lesion.
_Treatment._ This will be along the same lines as in myelitis, being
aimed at elimination of toxic matters, and the counteracting of the
existing inflammation. Anodynes such as bromides and chloral and cold
water or ice are especially called for to alleviate pain and
hyperæsthesia, and antispasmodics like ether, chloroform, chloral,
belladonna, etc., to allay the spasm. Saline purgatives too, and
diuretics may be availed of to limit effusion and favor reabsorption. In
the advanced stages iodine may be freely applied to the spine, and an
occasional electric current, or cauterization may be availed of.