OPERATIONS.
I. CONTROL OF ANIMALS 720
Control of oxen 720
Partial control 720
Control of the limbs 720
General control 722
Control by casting 723
Control of sheep and goats 725
Control of pigs 725
Anæsthesia 726
II. CIRCULATORY APPARATUS 727
Bleeding 727
Bleeding in sheep 727
Bleeding in the pig 728
Setons, rowels, plugs, or issues 728
III. APPARATUS OF LOCOMOTION 730
Surgical dressing for a claw 730
Amputation of the claw or of the two last phalanges 730
IV. DIGESTIVE APPARATUS 734
Ringing pigs 734
Œsophagus 734
Passing the probang 735
Crushing foreign bodies in the œsophagus 735
Œsophagotomy 736
Sub-mucous dissection of the foreign body 736
Rumen 737
Puncture of the rumen 737
Gastrotomy 739
Laparotomy 740
Herniæ 741
Inguinal hernia in young pigs 741
Imperforate anus 742
Prolapsus and inversion of the rectum 743
V. RESPIRATORY APPARATUS 745
Trephining the facial sinuses 745
Trephining the horn core 745
Frontal sinus 745
Maxillary sinus 745
Tracheotomy 746
VI. GENITO-URINARY ORGANS 747
Urethrotomy in the ox 747
Ischial urethrotomy 747
Scrotal urethrotomy 748
Passage of the catheter and urethrotomy in the ram 749
Passage of the catheter in the cow 750
Castration 751
Castration of the bull and ram 751
Bistournage 751
Martelage 756
Castration by clams 756
Castration by torsion 757
Castration with the actual cautery 758
Castration by the elastic ligature 758
Castration of the ram 759
Castration of boars and young pigs 759
Castration of cryptorchids 760
Female genital organs 760
Castration of the cow 761
Castration of the sow 765
Suture of the vulva 768
Trusses 769
Section of the sphincter of the teat 770
Dilatation of the orifice of the teat 770
Ablation of the mammæ 771
DISEASES OF CATTLE, SHEEP, GOATS AND SWINE.
SECTION I.
DISEASES OF THE ORGANS OF LOCOMOTION.
METHODS OF EXAMINATION.
Accidental and local diseases of the apparatus of locomotion are matters
of less urgency in the case of cattle than in that of the horse. On the
other hand, general affections, such as rheumatism and osseous cachexia,
demand a larger share of attention, and are of the utmost importance.
As the accurate diagnosis of any disease demands careful and systematic
examination, the practitioner usually observes a certain order in his
investigations, as indicated below:—
(1.) =Inspection=, from the side, from the front and from behind,
reveals the existence of deformities of bones, limbs, muscles and
joints, articular displacements, and irregularities of conformation or
of gait.
By inspection of an animal as it walks various forms of lameness, and
their particular characteristics, are rendered visible.
(2.) =Palpation and pressure= will detect changes in local sensibility,
the softness or hardness of tissues, the existence of superficial or
deep fluctuation, œdematous swelling, and abnormal growths like
ring-bones and exostoses, as well as the exact character of articular
enlargements.
(3.) =Percussion= is of little value in examining the apparatus of
locomotion. Nevertheless, percussion of the claws, and of certain bones
of the limbs, or of flat bones, may afford valuable information in cases
of laminitis, ostitis, and periostitis. Percussion along the
longitudinal axes of the limb bones is also useful in diagnosing
intra-articular fractures, subacute arthritis, osteomyelitis, etc.
(4.) =The gait.= Lame animals should be made to move, in order to assist
both in discovering the cause, and in estimating the gravity of the
condition. Sometimes it is advisable to turn the animal loose, but most
frequently it is moved in hand, either in straight lines or in circles.
Information so obtained should always be supplemented by local
manipulation and by passive movement, such as flexion, extension,
abduction, adduction and rotation of the joints.
A knowledge of the characteristics of normal movement in any given
joint, renders it comparatively easy to detect abnormality, such as
increased sensibility, articular crepitation or friction, and to
diagnose fractures with or without displacement, ruptures of tendons or
ligaments, etc.
CHAPTER I.
DISEASES OF BONES.
The diseases affecting bony tissues may broadly be divided into local
and general. Local diseases like ostitis, periostitis, necrosis,
fracture, etc., are somewhat rare, and are less important in cattle than
such general diseases as rachitis and osseous cachexia.
Rachitis is a disease of young animals, and occurs during the growing
period. Osseous cachexia is a disease of adults. Nevertheless, there is
a relationship between these two morbid conditions, for they frequently
co-exist in one family. Moreover, brood mares and cows suffering from
osseous cachexia give birth to foals and calves, which, if left with
their mothers, almost inevitably become rachitic.
The general characteristic common to both rachitis and osseous cachexia
consisting in diminution in the normal proportion of mineral salts
entering into the constitution of the bone, numerous theories have been
advanced to explain this irregularity in nutrition.
=The theory of insufficiency= is one of the oldest. It presupposes that
the young animals’ food contains insufficient mineral salts necessary
for building up the skeleton, hence rachitis; or again, that the daily
food of the adults does not afford sufficient mineral salts to
compensate for the normal transformation which is continually going on
within the organism, and for the direct losses which occur through the
medium of the urine, milk, etc.
This extremely simple theory appears perfectly logical, but
unfortunately does not fit in with all the observed facts. In reality,
rachitis attacks children whose supply of milk, from a chemical point of
view, leaves nothing to be desired. The same is true of animals,
particularly of young pigs. The so-called “acid theory” has therefore
been advanced to explain the points left obscure by its predecessor.
=The acid theory.= According to this theory, the food may contain more
than sufficient mineral material without, however, preventing the
development of rachitis or of osseous cachexia.
In animals suffering from digestive disturbance the alimentary tract may
become the seat of excessive fermentation or of changes in secretion.
There is thus produced an excess of lactic acid which passes into the
circulation and accumulates in the tissues, checking the processes which
end in ossification or, in the case of adults, even leading to
decalcification.
It seems fairly well established that experimental administration of
lactic acid to animals causes diminution in the quantity of calcium
salts contained in the bones (Siedamgrotsky, Hofmeister). On the other
hand however Arloing and Tripier failed to produce rachitis
experimentally.
Bouchard revived this theory in a somewhat modified form. He considers
that calcium salts are absorbed as carbonates and chlorides and
phosphoric acid as phospho-glyceric acid. The reaction which these
compounds undergo within the organism ends in the formation of the
phosphate of calcium necessary to ossification, but this “phosphate of
ossification” cannot be deposited if the organism contains an excess of
lactic acid.
=Theory of inflammation.= A third theory which until now has received
very little support is that called the theory of inflammation. The
general lesions which characterise rachitis are regarded as resulting
from primary attacks of ostitis and osteo-periostitis. The cause of
these forms of inflammation is not suggested.
To the above views may be added that more recently emitted by Dr.
Chaumier, according to which rachitis is of an infectious nature.
Unfortunately no proof of this has yet been adduced.
GENERAL DISEASES.
RACHITIS.
Rachitis is a disease of youth, and is common both to the human species
and to all domestic animals. It is characterised by irregularities in
development and by imperfect consolidation of the bones. The boundary
between rachitis and osseous cachexia is difficult to define and in fact
at the present moment the two diseases can scarcely be defined with
exactitude. Rachitis again is often complicated with softening of the
bones, disease of the limbs, arrested development, etc., but it must not
be forgotten that although the irregularities in ossification and
development of the skeleton are the symptoms most striking to the eye,
they do not stand alone, and that from the point of view of development
all the tissues, including the muscles, are more or less affected and
that most of the physiological functions such as digestion and the
secretion of urine are deranged.
=Etiology.= One of the principal causes suggested is that of heredity,
and so far as human beings are concerned, one seldom fails to discover
the rachitic taint. Certainly the offspring of individuals marked by any
debilitating disease like alcoholism, tuberculosis, syphilis, etc., are
poorly equipped for their future development. Their tissues lack the
necessary qualities and, _cæteris paribus_, their physiological
functions are performed less perfectly than are those of normal
individuals.
It is difficult to apply such information to domestic animals, because
badly developed subjects are not used for reproduction and the
importance assigned to heredity can therefore scarcely be sustained. The
conditions of life, on the contrary, have an unquestionable influence,
and if rachitis is so frequent in young animals living near towns, for
example, it is undoubtedly due to that want of air, light and liberty,
which first affects the mother’s health and later that of her offspring.
The same may be said of insufficient and improper food; for in this
connection quality is of even greater importance than quantity. Even
free feeding is insufficient if the fodder does not contain the material
necessary for sustaining and building up the developing frame, a point
which readily explains the occurrence of rachitis when young animals
receive a diet deficient in certain chemical constituents.
This occurs in young lambs and pigs where the mothers are given too
little variety or too small a quantity of food.
In calves and foals rachitis is rare but occurs when the mothers are
exhausted or cachectic or are debilitated by chronic wasting diseases
like tuberculosis or osseous cachexia. The milk is then no longer of
normal chemical constitution.
One fact appears to dominate the whole subject of the causation of
rachitis, viz., the failure to assimilate sufficient of the mineral
salts required in building up the skeleton. This failure to assimilate
may be caused by too meagre feeding, but even when the food is
sufficiently rich, some digestive disturbance may reduce the amount
absorbed below normal. This appears the only plausible explanation
unless we admit Dr. Chaumier’s theory that the disease is of an
infectious character.
=Symptoms.= The onset is absolutely insidious and the diagnosis of
rachitis is never made until nutrition has long been abnormal.
This disturbance of nutrition is revealed by irregularity and
abnormality in appetite, by difficulty in rising and moving about, and
by the animals lying down for long periods. The subjects are feeble,
sluggish and badly developed.
Next supervenes the second phase characterised by deformity of bones.
This is of two kinds—deformity in the neighbourhood of joints (deformity
or enlargement of the epiphyses) and deformity of the diaphyses. The
former results from irregularity in ossification of the articular
cartilages. The latter is followed by loss of rigidity in the bones of
the limbs which, under the influence of the body weight and of muscular
contraction, bend in different directions.
The bones appear of increased thickness principally towards the
articulations. The latter are deformed, and on palpation are found to be
surrounded by uneven and irregular growths.
The front limbs are distorted. In young pigs, lambs, and less frequently
in foals, calves and dogs, the jaws become deformed, and mastication is
rendered difficult.
The vertebral column may also be affected, and lordosis (bending
downwards of the back) or skoliosis (lateral bending of the back) is
somewhat frequent.
Cyphosis, or upward bending of the back, seldom occurs, and when seen,
sometimes results from disease other than rachitis.
[Illustration: $1]
General development is always interfered with and the young creatures
are generally dwarfed.
The digestive apparatus is disordered, the appetite is irregular and
sometimes depraved, while indigestion, gastritis, and enteritis are not
exceptional. Physiological and pathological research has shown that the
quantity of phosphoric acid eliminated in twenty-four hours in a
rachitic child is double the quantity passed by a healthy infant. The
amount of urea in the urine (which is a criterion of nutrition, and
usually varies in proportion to the amount of food ingested) is, on the
contrary, diminished even when highly nitrogenous food is given, thus
suggesting diminution in nutrition.
=Lesions.= The lesions are represented by abnormal and irregular
thickening around the interarticular cartilages. The cartilage is
thickened, compressible, very spongy and without regular ossification.
Diffused periostitis exists principally towards the extremities of the
bone. Beneath the periosteum the surface of the bone appears rough and
softened. On section the medullary canals are seen to be enlarged and
filled with marrow of a gelatinous character. The Haversian canals are
dilated, and the entire tissue appears very vascular. Chemical analysis
proves that the mineral constituents of the bone, particularly the
phosphates, have diminished by one-half; the organic constituents on the
other hand are increased in a similar ratio, but the ossein is abnormal.
Ossification has, in a word, been incomplete.
=Diagnosis.= Diagnosis presents no difficulty except in the early stages
before deformity has occurred.
Rachitis can scarcely be mistaken for any other condition except perhaps
infectious rheumatism, but the rapid course of the disease in the latter
case, the persistence of fever and the swelling of the joint cavities
sufficiently differentiate the conditions provided care is exercised.
=Prognosis.= From an economic point of view the prognosis is very grave
for if the lesions are extensive there is nothing to be gained by
keeping the animal.
=Treatment.= Treatment differs very little, whether the animals are
still being suckled or have been weaned. In the former case it is
necessary to improve the quality and chemical constitution of the
mother’s milk by giving food, richer both in mineral salts and in
nitrogenous material.
Cooked grains, milk, and forage of good quality should be given freely.
When the mothers are exhausted and anæmic it is better to feed the
little animals artificially or to change them to a foster-mother. Those
already weaned should be given good rich milk, eggs, boiled gruel, and
drugs, such as the phospho-chlorate of lime, 1 to 1½ drachms per day
(for a calf); lacto-phosphate of lime, 1 to 1½ drachms; bi-phosphate of
lime, 1 drachm, or simply ordinary phosphate of lime. Oil containing 1
per cent. of dissolved phosphorus may be given in doses of 1 to 2½
drachms, according to the size of the calves, but its use calls for much
care, and it should only be given for alternate periods of a fortnight.
The glycerophosphates are not very active. Beef meal in doses of 6
drachms to 1½ ounces and chloride of ammonium in doses of 30 to 60
grains have also been used advantageously. The above drugs, but
particularly the bi-phosphate of lime and chloride of ammonium,
stimulate nutrition and diminish the quantity of phosphoric acid
eliminated.
OSSEOUS CACHEXIA.
“Osseous cachexia” is a general disease which develops slowly and
progressively, producing its most marked effects on the bony tissues. It
has received a great many different names, such as osteoporosis,
osteoclastia, osteomalacia, fragilitas ossium, enzootic ostitis, bone
softening, etc., but none of these appears so appropriate as the term
osseous cachexia, suggested by Cantiget.
All the above-mentioned names are applicable to some phase of the
disease, but none to the disease in its complete development. Thus the
name “osteoporosis,” accepted by German authors, is quite applicable to
the phase of rarefying ostitis seen at the commencement, but this
condition occurs in other diseases. The expressions “osteoclastia” and
“fragilitas ossium” suggest the fragility of the bones and the
commonness of fracture. The term “osteomalacia” is warranted during the
period of bone softening. The term “gout,” though in practice confusing,
has been held to be justified by the frequent appearance of synovitis
and arthritis; while that of “enzootic ostitis” indicates the appearance
of the disease in all the stables in one district, without however
pointing to its nature. It is possible that under certain circumstances
the train of symptoms might be incomplete, and then the terms above
indicated would be quite inappropriate. “Osseous cachexia,” on the other
hand, is very comprehensive, and appears to cover the entire development
of the disease, for which reason it here receives preference.
Law defines the disease as “a softening and fragility of the bones of
adult animals, in connection with solution and removal of the earthy
salts.” He describes it as an enzootic disease of mature animals—mainly
cows—in which the decalcifying process proceeds most actively in the
walls of the Haversian canals and cancelli of the affected bones. In
consequence of the removal of the earthy salts the bones become soft and
more or less fragile.
The disease has been observed in England, Scotland, United States,
France, Belgium, and Jutland, and generally in districts with low-lying
damp pastures. It attacks cows which are heavy milkers. Susceptibility
appears to increase with advancing age.
=History.= Having been described by Vegetius, the disease was again
observed about 1650 in Norway where it was treated by the administration
of crushed bones. It is fairly frequent in some parts of Germany and
Belgium. In France it was studied in 1825 by Roux, and in 1846 by
Dupont, but Zundel in 1870 was the first who gave a good description of
it, founded partly on the authority of German authors and partly on
observations made by himself in the Valley of the Lower Rhine. Since
that time it has successively been reported in the Yonne by Thierry, in
the Nièvre by Vernant, in the Aube by Collard and Henriot (1893), in the
Indre by Cantiget, as well as in La Vendée by Tapon in 1893. In that and
the succeeding year Moussu also saw numerous cases in the districts of
Indre-et-Loire, Loire-et-Cher, Berry, Sologne, and in some parts of
Beauce.
=Symptoms.= The first symptoms are difficult to detect and interpret,
especially at the commencement of an outbreak and in parts where the
disease is rare they may lead to confusion and errors in diagnosis. On
the other hand, in regions where the disease is common the practitioner
will be able to form his diagnosis from the appearance of the first
signs.
To render clear the mode in which the symptoms develop we may divide the
progress of the disease into four phases, though this grouping is
somewhat arbitrary.
=1. The initial phase= is not well marked, and is announced by digestive
disturbance and by wasting. The former of these symptoms may be referred
to some other cause, but consists in irregularity, diminution and
sometimes perversion of the appetite. These earlier signs are soon
followed by loss of spirits, and some interference with movement, but
the symptoms only become of importance or attain their full development
when the animals remain lying for a long period in the stable.
[Illustration: $1]
=2. The second phase= is characterised by more precise signs, which
become almost pathognomonic. Difficulty in rising is added to the
already existing tendency to remain lying, and to the interference with
movement.
When lying down the patient no longer responds to the trifling stimulus,
which a healthy animal needs to cause it to rise. It remains languid and
apparently lazy, though in reality it experiences pain and difficulty on
attempting to get up. The least muscular effort when lying down often
causes it to moan, as do efforts to change its position or to walk. Even
when standing still, it may appear to be in pain, and patients often
assume a position similar to that of a horse suffering from laminitis.
At the end of this second phase, swellings appear, due to synovitis or
arthritis of the extremities, synovitis of the sesamoid or navicular
sheaths or to inter-phalangeal arthritis or arthritis of the fetlock
joint. Weakness becomes marked, and the appetite is very irregular.
Secretion of milk diminishes or ceases and abortion is not uncommon.
=3. The third phase= is characterised by fractures, and it is this
peculiarity of the disease which has procured for it the names of
fragilitas ossium, and osteoclastia. These fractures may affect any
portion of the skeleton. Animals so suffering sometimes break a leg
whilst trotting or the pelvis in simply jumping over a ditch; a
collision with a fixed object like the jamb of the stable door, or a
fall on the ground, may result in the fracture of one or several ribs.
[Illustration: $1]
Such shocks would be of no importance to a healthy animal, but to one
suffering from osseous cachexia, any violence, or even the slightest
muscular effort may be followed by fracture of the gravest character,
involving even the vertebral column. In cows the pelvis, femur, and
tibia are most frequently injured.
In horses, particularly in riding horses, fractures are commonest in the
region of the forearm, cannon bone, and anterior phalanges. So extremely
fragile are the bones at this stage that the horse represented herewith
broke twelve ribs at one time by simply falling on its side. It is
interesting to note that such fractures are never accompanied by any
extensive bleeding. They have little tendency to repair, no real callus
formation occurs, and on post-mortem examination one often finds the
ends unconnected by temporary callus, worn, and rounded by reciprocal
friction.
At this stage but under other circumstances, the animals show great
reluctance to rise, remaining down for twelve to twenty-four hours
without shifting their position. If forced to get up, they stand as
though fixed in one position, the respiration and circulation become
rapid, and they soon grow tired and fall.
=4. The fourth phase=, or period of osteomalacia, _i.e._ softening of
the bones, is also the last. It is rarely seen in large animals like
horses and oxen, because accidents so often accompany the preceding
stages and necessitate slaughter; but it is common in goats and pigs.
In this phase the bones become elastic, soft and depressible, yielding
to the pressure of the operator’s fingers.
[Illustration: $1]
The flat bones are particularly liable to this change, which is common
to domesticated animals. The bones of the head are the first to suffer;
later those of the pelvis. The lower jaw becomes swollen, particularly
about the centre of the branches which may attain three, four, or five
times, their normal thickness.
The depression in the submaxillary space disappears. The upper jaw
undergoes similar changes, becoming deformed and thickened until the
cavities of the sinuses and the hollow appearance of the palate are
lost, while the face is so changed that it cannot be recognised as that
of a horse, goat, etc.
The molar teeth are almost buried, their tables alone being visible at
the bottom of a depression, the edges of which rise above the
neighbouring parts (pig).
Mastication is clearly impossible, the jaws appear paralysed, the
muscles powerless, and only swallowing is possible, a fact which
explains why life is only prolonged to this stage in animals which can
be fed with a spoon or bottle (pigs and goats). The bones of the
cranium, although greatly changed in texture, are always less deformed
than those of the face.
The changes are such that it is often easy with a mere post-mortem knife
to cut the head completely in two. Osseous tissue, properly so-called,
has disappeared.
All the constituent tissues, with the exception of the skin and muscles,
_i.e._, the bone, periosteum and aponeuroses, have the appearance and
consistence on section of the fibro-lardaceous tissue seen in chronic
inflammation.
The following is a condensed description of the disease as given by
Law:—
=Symptoms.= Poor condition or even emaciation, with very visible
projection of the bones. The coat is rough, skin tense, inelastic and
hidebound, appetite variable, sometimes impaired, and nearly always
perverted (or depraved) so that the patient will lick the manger
continually or pick up and chew all sorts of objects: bones, leather,
clothing, wood or iron, stones, etc. The amount of food consumed may,
however, be up to the normal. The most marked feature is the difficulty
and stiffness of locomotion.... Temperature and yield of milk may remain
normal.
“Later, appetite and milk secretion fail, temperature rises a degree or
two, the animal refuses to rise, remaining down twelve to twenty-four
hours at a time, and ... when rising ... remaining on the knees for a
time, moaning and indisposed to exert itself further. At this stage many
cases begin to improve and may get well in five or six weeks. Some will
remain down for several weeks and finally get up and recover. With
constant decubitus, however, the animal falls off greatly, becoming
emaciated and weak, the appetite may fail altogether, and the patient is
worn out by the persistent fever, nervous exhaustion and poisoning from
the numerous bed-sores ... which are common over the bony prominences.
It is in these last conditions, above all, that fractures and
distortions of the pelvic bones, and less frequently of the bones of the
legs occur.”
[Illustration: $1]
“The disease may advance for two or three months, and in case of pelvic
fractures and distortions, there may be permanent lameness, and
dangerous obstruction to parturition, even though the bones should
acquire their normal hardness through the deposition of lime salts.”
In horses, the different phases of the disease develop precisely as in
bovines. The apparent differences between affected horses and cattle
result in reality from differences in their capacity for continuing
work. In the first phase, horses are incapable of work, their movements
being badly co-ordinated. They are inclined to stumble, and appear as
though suffering from strain of the lumbar muscles.
In the second phase pain referable to the bones sets in. Lameness
develops without visible lesions and is rapidly followed by synovitis
and arthritis in the lower portions of the limbs, and by wasting and
anæmia.
The animals seem unable to move rapidly, or if forced to do so may
sustain fractures even at a trot: the limb bones sometimes break or
ligamentous insertions in the neighbourhood of joints are torn away,
resulting in sudden falls on the ground and fracture of ribs or even of
the vertebral column. This corresponds to the third phase, osteoclastia,
in oxen.
[Illustration: $1]
From then onwards, horses become useless and, if not destroyed, may,
after a few weeks or months, develop the condition known as
osteomalacia, in which the flat bones become softened, the head, the
branches of the lower jaw and the face become deformed, while
mastication and other functions are impeded.
Germain gives the above symptoms as characteristic of the mode of
development of the disease in French and Algerian horses imported into
Tonquin, and his description, written several years ago, is fully
confirmed by more recent observations. Since Tonquin was taken over by
the French, however, improved methods of culture have resulted in the
production of better cereals and forage; the fodder plants have been
vastly improved, to the great benefit of imported animals.
In the goat, the disease shows some slight peculiarities. Thus, in the
second phase, during which goats and sheep suffer so markedly from
lameness and pain in the bones, goats often walk on the knees. The
disease, however, is uncommon in these animals. The phase of
osteoclastia is also less marked and fractures are rare, because the
animals weigh less and also because they are less exposed to falls and
violent shocks. The bones, nevertheless, are extremely fragile and
fractures may be produced at will.
Osteomalacia, on the other hand, is always well marked.
Regarding the development of the disease in pigs, we may repeat what has
just been said respecting the goat. Walking on the knees is often one of
the first signs, fractures are somewhat rare, and the period of
softening and deformity is always very noticeable.
=Course.= The development of the disease is slow, lasting from one to
three months as a rule, and is little influenced by hygienic conditions.
Good milking cows, however, seem to be most frequently attacked,
probably because of the great losses of nutritive material which occur
through the milk. The calves borne by such animals are often rachitic.
Oxen are less commonly attacked. Horses rarely suffer from the disease
in France, but frequently in Tonquin. Pigs reared on very poor soil
seldom escape attack.
[Illustration: $1]
If treated from the beginning, or even before the second phase has
become well developed, the disease may be cured, but after this period
little improvement need be expected.
=Causation.= The problem of why osseous cachexia occurs has naturally
given rise to numerous explanations, some plainly inadmissible, others,
however, of greater or less plausibility.
The fact which, from the earliest times, appears to have attracted most
attention is the relation defective nourishment bears to development of
the disease. In Norway, as early as the year 1650, the plant known as
sterregraes (which renders animals dull and heavy) was thought to be the
cause of the disease; two centuries later, in 1846, the _Anthericum
ossifragum_ was similarly regarded. Zundel, in 1870, claimed that the
Germans first referred the development of the disease to chemically
incomplete forms of nourishment. This opinion seems fully confirmed by
the remarkable observations of Germain on European horses imported into
Cochin-China, and it is finally placed beyond question by the work of
Cantiget. Basing his researches on analysis of the soil, he proved that
osseous cachexia only occurs in cattle depastured on land which is too
poor in phosphoric acid and calcium phosphate, and that it can be
banished by enriching the soil with suitable manures up to a point when
the proportion of phosphoric acid becomes normal. In good land, suitable
for raising cattle, the proportion of phosphoric acid, according to the
best exponents of agricultural chemistry, should not fall below 4,000
kilograms to the hectare. Cantiget and Brissonet have shown that where
the soil contains less than 1,500 kilograms to the hectare, osseous
cachexia is almost permanently present. As soon, however, as this
proportion is raised above 2,000 kilograms by suitable culture, the
losses diminish, and the cachexia finally disappears.
This view was greatly strengthened by fodder analyses, which showed that
in all cases where the soil is poor in calcium phosphate, the forage is
poor in phosphoric acid, and _vice versâ_. The food is too poor in
mineral salts, firstly for normal development; and secondly for the
proper nutrition of the skeleton.
Germain is of a similar opinion with regard to the occurrence of osseous
cachexia in horses in Cochin-China, where the soil is very poor in lime.
The fodder and cereals are poor in mineral salts, and even when given in
large quantities do not furnish proper (chemical) nutrition. Clear proof
of the correctness of this view is afforded by the fact that feeding
with forage and cereals obtained from France or Algeria prevents the
disease appearing, or diminishes and finally removes the previously
existing symptoms. Furthermore, Germain shows that Europeans, living
solely on the products of the country, to some extent suffer like the
horses.
This theory though based on sufficiently solid foundations to carry
conviction, has been questioned, and it may be desirable to record
briefly the criticisms advanced against it.
One of the most important is as follows:—
As osseous cachexia of oxen occurs in certain well-defined districts in
France, and seems due to the feeding, why does it not attack horses in
the same regions in an enzootic form? The answer appears to be that
horses receive a greater amount of rich food, particularly of cereals,
which contain much larger amounts of mineral salts, including
phosphates, than does ordinary forage.
The most serious objection was made by Tapon, who states that in 1893 he
saw osseous cachexia in oxen on farms in La Vendée where superphosphate
had been used for years, whilst the disease did not exist on other farms
where such chemical manures were not employed. Before attaching much
weight to this objection, however, it would be necessary to know the
richness in phosphoric acid of the soil on the respective farms, for it
is possible that, in consequence of natural conditions and in spite of
the use of certain mineral manures, the richness of the soil on the
first-mentioned farms, though manured with superphosphates, was still
below that of the others which had received no artificial, manure.
The system of culture is also of importance, for at the present day,
even with the use of artificial manures, cropping would rapidly
impoverish soils which were not suitably and sufficiently enriched.
Abundance or apparent richness of food signifies nothing if quality is
lacking.
It may also be asked: if the question of nourishment is of such prime
importance why are animals of European origin in Cochin-China affected,
whilst the indigenous races prove immune? The answer would appear to be
that, in addition to the defective quality of food, other factors, such
as adaptation to environment and relative digestive power, play a
considerable part in the production of the disease.
=Favouring causes.= Whilst conceding that the disease is due to one
determining cause, viz. the food, it is unquestionable that other causes
may favour its appearance. Abundant milking is one, so that the disease
most frequently appears six to eight weeks after calving. Gestation may
also determine an attack. The disease is rarer in oxen than in milch
cows. Starvation and bad hygienic conditions also have a certain
influence; it is well known that during dry years, particularly when
fodder is scarce, osseous cachexia makes the greatest ravages. Law
states that the disease has been attributed to excess of organic matter
in the soil, to succulent watery foods, as rank watery grasses,
potatoes, turnips and other roots deficient in nutritious solids. Some
agent—microbe or toxin—swallowed with the food has been suspected but
not yet isolated.
Other explanations have been advanced but up to the present time they
scarcely deserve to be regarded even as hypotheses. Thus Anacker in 1865
declared that the disease commenced as muscular rheumatism, was
succeeded by destructive or atrophic ostitis, and ended as osteoporosis.
So far as the order of the osseous lesions is concerned, this view is
quite correct, but the ossific changes are consequences and not causes.
The idea that the disease was due to an infectious agent has been
advocated by Leclainche, without, however, having been proved. Pétrone
is the only person who has hitherto suggested that osteomalacia in man
is due to infection with a nitric ferment (_Micrococcus nitrificans_).
According to him, pure cultures of this organism injected into dogs,
produce osteomalacia. These statements, however, require confirmation.
=Lesions.= The chief lesions are to be found in the bones. They consist
in rarefaction of the compact tissue, increase in size of the medullary
cavity and Haversian canals, and enlargement of the areolæ of the spongy
tissue. The bone marrow loses its fatty constituents, appears red and
gelatinous, and contains a greatly exaggerated number of blood-vessels.
When heated, the bones do not yield oil as in healthy subjects, and when
dry, they seem abnormally porous. In the osteoclastic phase, the bones
become very friable and even the shafts assume a spongy appearance. They
diminish in density. These changes correspond to the stages of eccentric
rarefying ostitis and osteoporosis of German authors.
The flat bones often show well-marked periostitis, but the great
thickening sometimes seen in certain of the bones of the head appears to
be the result of a special osteo-periostitis. It is quite certain that
the disease is due to something more than a mere want of mineral
constituents in the bone, and poverty in this respect certainly does not
explain the hypertrophic changes. The nutrition of the bones as a whole
is disturbed, resulting in alterations both in the ossein and in the
mineral salts, the whole process being accompanied by symptoms of
osteo-periostitis.
[Illustration: $1]
The fractures which occur so frequently during the osteoclastic phase
have well-marked peculiarities. The extravasation of blood is trifling,
and no callus forms, even when the ends of the bones are immobilised by
external aid; if the ends are left free, they soon become worn and
polished by rubbing against one another.
In the neighbourhood of the articulations and ligamentous insertions the
periosteum soon undergoes change, and it is not uncommon to find
sub-periosteal and intra-osseous extravasations of blood.
Germain has also noted in horses the disappearance of the intervertebral
and articular cartilages, and the frequent occurrence of anchylosis,
true or false.
In the final stages, the bones may be cut with a knife, and a time
arrives when bony tissue seems completely to have disappeared; thus, as
shown in Fig. 8 herewith, it was possible to cut the entire head of a
pig into thin slices without the slightest difficulty. All parts of the
head had been affected by the softening change.
From the chemical point of view, the diminution in mineral salts and in
phosphate of calcium has long been recognised, but the degree of this
change varies according to the phase. In human beings the proportions
have been estimated as follows: Normal bone, 50 to 80 per cent. of
phosphate of calcium; bone in persons suffering from osteomalacia, 5 to
20 per cent. of phosphate of calcium. The changes in the ossein have not
been carefully studied. We only know that histologically the ossein
becomes fibrillar, and that chemically it no longer retains its normal
composition.
=The diagnosis= is difficult, particularly on the first occasion of
seeing the disease, and especially if this is of an enzootic character.
The practitioner may also have some hesitation in diagnosing isolated
cases in regions where the disease seldom occurs.
Otherwise, diagnosis is usually easy, as soon as lameness or synovitis,
or arthritis of the lower regions of the limbs appears. Only in isolated
cases are the lesions likely to be mistaken for accidental injuries, and
it is also fairly easy to differentiate them from the localised lesions
of rheumatism. The latter disease seems more frequently to attack the
upper joints of the limbs, and is often accompanied by intense fever and
cardiac disturbance.
=Prognosis.= In a general sense the disease is very grave, because it
appears as an enzootic, and, in dry years and those during which there
is a scarcity of forage, inflicts enormous losses on the breeders of
certain countries. When advice is sought towards the end of the second
phase of the disease the prognosis is therefore very grave. Under such
circumstances it is often better to slaughter rather than to treat,
provided that the affected animals, like cows, pigs, or goats are still
of some value.
=The prognosis= is much more hopeful if treatment is attempted at an
early stage, when improved diet and the use of suitable drugs sometimes
lead to recovery.
=Treatment.= We know that in the Middle Ages this disease was often
treated by the administration of crushed bones, and even at the present
day ground bones are frequently recommended. Treatment must be
subordinated to proper feeding, no system of medication being of any
value whatever unless the food is suitable.
Germain states that imported horses in Cochin-China recover if simply
returned to their former diet, _i.e._ to cereals and forage obtained
from France or Algeria. Cantiget shows that such improvements in
cultivation as the free distribution of superphosphate manures on
impoverished soils modify the chemical composition of the forage, and
render it capable of building up and sustaining the organism and bony
tissues; treatment should therefore be essentially prophylactic in
character.
Animals suffering from osseous cachexia should be fed on cereals and
forage obtained from rich districts where the disease has never
occurred; but, as in times of scarcity questions of expense almost
always receive first consideration, it may be necessary to substitute
bran for such products, or give oats, maize, beans, rice, and oil or
cotton cake, etc., all of which can be obtained commercially, and are of
sufficient nutritive richness. It is often advantageous to give such
food cooked and slightly salted.
Commercial ground bones and calcium phosphate (bi- or tri-basic), in
doses of 1 ounce per day for oxen and 1¼ to 2 drachms for pigs or goats,
have given excellent results in the hands of most practitioners. Some
recommend the addition of iron salts or bitter tonics like gentian or
nux vomica in doses of 2½ drachms per day for a full-grown ox.
Law declares that the treatment should be varied “with the predominance
of the causes, essential or accessory.... Green clover, alfalfa, and
other leguminous products, ground oats, beans, peas, linseed or rape
cake ... and vetches may be especially recommended.... The free access
to common salt and a liberal supply of bone meal are helpful....
Apomorphia is especially valuable in correcting the perverted appetite
and stimulating digestion. A change of pasture is always advisable. In
all cases where possible the water should be changed as well as the
food. Attention to the housing, grooming, and general care of the
animals should not be neglected. Finally, every drain upon the system
should be lessened or stopped. The milk may be dried up, and the animal
should not be bred.”
Meat meal also renders good service, but the use of cod liver oil,
suggested by Zundel, is too expensive, and phosphorised oil is too
dangerous to be adopted in ordinary treatment.
Local treatment for synovitis and arthritis has been recommended. It is
ineffective unless accompanied by good feeding and internal medication.
On the other hand, the lesions often diminish rapidly or totally
disappear under the influence of general medication alone.
LOCAL AFFECTIONS.
FRACTURES.
Although oxen, sheep, goats, and pigs are much less subject to fractures
than the horse and dog, nevertheless, they do suffer from such
accidents. Repair is perfectly possible, but the cases are often not
worth treating, unless the subjects are young or of considerable value.
On the other hand, in fat and heavy subjects, it is difficult to fix the
parts in position. Slinging produces bad results, and generally should
not be encouraged.
Apart from fractures accompanying general chronic diseases, like
rachitis and osseous cachexia, the vertebræ, the pelvis, the ribs, or
any of the limb bones, may be fractured in consequence of accident.
Such fractures may be either complete or incomplete (fissures), simple
or compound.
The general signs which indicate fracture are always the same, viz.,
loss of function, local pain, abnormal mobility, crepitation, due to
rubbing together of the ends of the bones, and deformity of the part.
Diagnosis is generally easy; prognosis on the other hand is very
variable.
The vertebral column may be accidentally fractured in the region of the
neck in consequence of the animal falling on its head; in the
dorsolumbar region, from falling into ditches or ravines, or, in the
case of bulls fighting, from violent muscular efforts. Fractures of the
first kind are immediately fatal; those of the second result in
paraplegia of the hind limbs, and necessitate immediate slaughter.
=Fractures= of the =pelvis= comprise:—
1. Fractures of the angle of the haunch, resulting from external
violence and characterised by sinking of the external angle of the
ilium, deformity of the hip, and lameness without specially marked
characters. This fracture is rarely complicated. The symptoms of
lameness diminish with rest, but deformity continues.
2. Fractures of the floor of the pelvis, usually extending from the
anterior margin of the pubis to the foramen ovale and from the posterior
margin of the foramen ovale to the end of the symphysis. They result
from obstetrical manipulation, as in forcibly removing a fœtus which is
too large, or a monstrosity. As a rule, the animals cannot rise, or if
they succeed in doing so, are incapable of moving. Diagnosis is made by
exploration through the rectum. Such fractures always necessitate
slaughter.
Fractures of the neck of the ilium and of the base of the cotyloid
cavity, even in cases of dislocation, are rare despite what has been
said to the contrary.
In the fore limb, fractures of the scapula and humerus are usually of
traumatic origin, are seldom accompanied by marked displacement, and are
capable of uniting if a long rest at grass is allowed. Pitch bandages
should be applied to the surface, covering all the surrounding regions,
viz. the withers, upper portion of the forearm, girth and chest, to
assist in immobilising the region of fracture, and to promote union.
Fractures of the forearm are more difficult to treat, because the
bandage applied must extend as far as the hoof. In this case
displacement often occurs. It is therefore necessary, firstly, to reduce
the fracture, and bring the ends in perfect contact, for which purpose
it may be requisite to cast the animal, and give an anæsthetic; and,
secondly, to apply a pitch plaster in the form of a shallow gutter,
leaving the inner surface of the limb uncovered along a line about two
inches wide following the course of the veins of the forearm.
Fractures of the metacarpus and metatarsus usually heal well in all
animals of moderate weight, such as heifers, steers, goats or sheep,
provided a simple plaster bandage, covering the entire limb or
preferably with an opening in the position above indicated, is applied
and continued downwards as far as the claws.
In sheep and goats it is sometimes even sufficient to use a splint
formed of straw-boards, and in the case of oxen, of wood, applied over a
cotton-wool padding and retained in position by straps, or in the case
of the heavier animals by dextrine or pitch bandages.
In the hind limb, fractures of the femur are more serious, because the
apparatus that can be used to secure immobility is seldom or never
effective; excepting in young animals, it is therefore usually better to
slaughter.
Fractures of the tibia are treated like those of the forearm when it
appears desirable to keep the animals alive.
Plaster bandages can very easily be prepared by saturating tarlatan in a
mixture of equal parts of thoroughly dry plaster and water. Six to ten
thicknesses of tarlatan, arranged alternately longitudinally and
transversely, are sufficient. When adjusted they can be kept in position
until the plaster has hardened by means of dry bandages applied from
below upwards, which can be removed after a lapse of half an hour to an
hour.
FRACTURES OF THE HORNS.
=Anatomy of the horns.= The horns form organs of defence, and project on
either side of the frontal bone at the poll. Each consists firstly of a
bony basis generally known as the horn core; secondly, of a
horn-secreting membrane; thirdly, of a horny sheath, the horn properly
so called.
(1.) The horn core projecting from the frontal bone does not develop
until after birth. About the third month a little prominence appears
under the skin, which, as it develops, assumes a conical shape, and may
be seen to be covered with a horny substance. In proportion as the horn
core grows, there develops within it a cavity which may either be of a
simple character or divided by a longitudinal partition. This
communicates with the frontal sinus, a fact which explains the
collection of pus in the sinuses as a result of injuries to the horns.
The sinus of the horn core does not exist in young animals, and is not
completely developed before the third or fourth year of life.
[Illustration: $1]
(2.) The horn-secreting membrane is formed by the skin, which undergoes
special development around the base of the horn and comes to resemble
that of the coronary band, from which the hoof or claw is secreted. The
band is about one-fifth of an inch in breadth. The papillæ of the dermis
are specially developed at this point, and the epithelium which they
secrete eventually forms the horn.
The internal surface of the growing horn is adherent to the horn core
through the medium of another tissue formed by a specially
differentiated periosteum which is continuous with the periosteum
covering the frontal bone. It is not a true periosteum, but a vascular
tissue formed of papillary layers analogous to those of the podophyllous
tissue of the ox’s claw or horse’s hoof.
This keratogenous membrane receives a rich vascular supply from the
arterial circle formed at the base of the horn core by a division of the
external carotid, the blood conveyed by which is freely distributed to
the enlarged papillæ. The great vascularity of these parts explains why
lesions of the horns are often followed by such profuse bleeding.
(3.) The horn secreted by the papillæ of the horn band (which is
analogous to that of the coronary band of the horse) forms a cone
varying in its curve in various breeds. Its base is hollow, and contains
little depressions holding the papillæ from which the horn is secreted.
From its base up to the end of the horn core the walls progressively
increase in thickness. From this point it is solid; in a fully-grown
horn the bone does not extend more than one-half or two-thirds of the
entire length.
In the adult, the development of the horns varies with different breeds
and is affected by sex. In the bull the horns are short, but in the cow
and ox long. Short and fine in animals of improved breed like the
Durham, they are long and thick in breeds of working oxen.
Injuries affecting the horns are of three classes, determined by the
part affected.
1. Detachment of the horn or sheath.
2. Laceration:—
(_a_) Of the horny sheath alone.
(_b_) Of the horny sheath and of the horn core.
(_c_) Of the horn core alone, the horny sheath remaining intact.
3. Fractures:—
(_a_) Of the terminal half of the horn.
(_b_) Of the lower half.
(_c_) Of the base.
DETACHMENT OF THE HORNS.
When the yoke is badly fitted or padded, it is liable to cause a
continual strain or a succession of shocks producing chronic
inflammation of the keratogenous membrane. Should the end of the horn
then be struck heavily, it is quite possible that the horn will either
partially or wholly be detached. In this case it falls away without
there necessarily being any important lesion of the horn core.
Such accidents are not infrequently caused by the driver striking the ox
on the horn with the yoke in order to keep it quiet while it is being
harnessed.
=The prognosis= of this condition is not grave, except for the fact that
working animals cannot be used until the horn is completely regrown.
=The treatment= simply consists in thoroughly cleansing and disinfecting
the horn core and then applying a protective dressing. The bony basis is
surrounded with a mass of tow saturated with an antiseptic solution,
like 2 per cent. creolin or carbolic acid solution, which is kept in
position by a spiral bandage passed around the horn, and secured in a
figure of 8 on the opposite horn. Instead of applying such a dressing,
some practitioners content themselves with using an antiseptic ointment
or even a simple dressing of tar.
FISSURING OF THE HORNS.
=Causation.= In a general sense fissures may result from any violence
affecting the centre portion of the horns, such as blows with the yoke
or accidental bruises inflicted by the animals themselves in fighting
with their neighbours.
=Symptoms.= Whether the fissure is confined to the horny covering itself
or whether it extends to both the portions constituting the horn, that
is, the horny covering and the horn core, two very noticeable symptoms
are always present: 1. A straight fissure resembling a sand crack, and
appearing usually on the convexity of the horn, and, 2. A very trifling
hæmorrhage, which does not appear until some hours or even a day after
the accident.
=Diagnosis.= If the lesion only affects the horn core, diagnosis is
always difficult, for one can hardly perceive any sensitiveness of the
horn near the fissure.
=Prognosis.= Provided that the horn core is not injured, the prognosis
is favourable; but in the contrary case, it should be reserved; for
hæmorrhage extending to the interior of the frontal sinus not
infrequently causes suppuration in that cavity.
=Treatment.= Attempts should first be made to check hæmorrhage by
applying masses of tow saturated with cold water and frequently wetted
with slightly antiseptic solutions, such as 2 per cent. creolin or
carbolic acid. If hæmorrhage persists in spite of this simple treatment,
astringents may be employed, which, by causing the formation of a clot,
mechanically arrest further extravasation of blood. These astringents
vary considerably in value, and we should particularly warn
practitioners against perchloride of iron, which causes necrosis of the
tissues, and later, formation of pus. A 5 per cent. solution of gelatine
is hæmostatic and excellent for the purpose named, as also is hydroxyl
solution. When once hæmorrhage is arrested, the keratogenous membrane
rapidly heals in consequence of its vascularity, and soon secretes fresh
horn.
FRACTURES OF THE HORNS.
=Etiology.= Fractures of the horns, like fissures, are produced by
violence, but of a more marked character. They are termed complete or
incomplete, according as the entire thickness of the horn or only a
portion of that thickness is involved.
The fracture may affect either the terminal half or the basilar half;
or, again, it may have its seat in the frontal bone below the origin of
the horn core, in which case a flake of bone will be detached. Such
fractures assume varying forms, and may either be deeply excavated,
oblique, smooth, regular or dentated.
[Illustration: $1]
=Symptoms.= The symptoms are extremely simple. They consist mainly in
the mobility of the fractured end, and such phenomena as sensitiveness,
hæmorrhage, etc. When the fracture extends to the frontal bone,
crepitation may also be noted.
=Prognosis.= The prognosis is not grave unless the fracture extends to
the basilar half of the horn or affects the frontal bone.
=Treatment.= (1.) If the fracture is confined to the horn core, it is
only necessary to bring the fragments into regular apposition, after
having removed the broken end of the horn itself.
(2.) In treating a fracture affecting the middle portion of the horn or
in treating animals destined for the butcher, the best method is to make
a simple wound by dividing the parts with a saw below the fracture. This
is a painful operation, necessitating anæsthesia, and requiring the
animal to be cast or firmly fixed to a post or placed in a trevis. To
diminish the painful stage of the operation, it was formerly recommended
to make a circular incision extending through the entire thickness of
the horn proper, and then to remove with a fine, very sharp saw the
portion of the horn core. This, however, is scarcely practicable, and it
is much better to make a direct section. Hæmorrhage is checked with
compresses, moistened with cold water, after which a dressing known as
the “Maltese cross dressing” (Fig. 10) is applied according to general
principles.
The surface of the section, after washing with an antiseptic solution,
is powdered with iodoform or a mixture of iodoform and boric acid,
covered with a mass of tow or cotton wool, saturated with liquid
antiseptic, and then surrounded with a flat pad of wadding, which
extends completely around the horn as far as its base. A second pad of
larger size, intended to protect the wound against external violence, is
arranged around the free extremity of the horn. This is kept in position
by two small cross bandages. Another bandage, the loop of which is fixed
to the base of the opposite horn, is then applied in spiral turns,
completely enveloping the former pads and extending from the base to the
point. Arriving at the free end, the operator reverses the bandage,
draws it tight, and continues down to the base of the horn, fixing it by
figure of 8 turns passed around the base of both horns.
[Illustration: $1]
(3.) In dealing with fractures of the lower third of the horn in working
oxen, it is necessary to seek consolidation of the horn by callus
formation, so that the animals may again become useful in the yoke. Very
great difficulty accompanies attempts to immobilise the horn in such
cases, since the least shock to the extremity of the horn destroys the
union, on account of the length of the lever represented by the horn
itself.
The first method of treatment consists, after the wound has been
carefully disinfected, in fixing the ends in place by tightly applied
pads, surrounded by splints, curved to fit to the horn. These are
supported by several turns of a spiral bandage.
Were one certain of the cleanliness of the wound and of its perfectly
aseptic condition, it would be better at once to have recourse to a
fixed bandage, strengthened by plaster or silicate of soda.
These bandages are applied longitudinally and should extend a
considerable distance on either side of the fractures. If the horn is
long and thick, it is best to use a fixed dressing of this kind secured
by bandages in the form of a Maltese cross.
All these methods, however, are more or less inconvenient, and the most
practical procedure often consists in removing the horn. Treatment
should only be attempted when the owner specially requests it in order
to render the animal useful for working or show purposes.
Moreover, however strong the dressing, accidents are frequent, for
accidental shocks to the fractured horn interfere with the co-aptation
of parts, and diminish the chance of perfect union. To avoid these
drawbacks, the apparatus shown in Fig. 11 has been invented.
This apparatus consists of a splint, the middle of which fits the back
of the animal’s poll, the sides being gouged out to receive the lower
half of the horn and notched, to enable the fractured horn to be well
supported by bandages.
[Illustration: $1]
(4.) Fractures of the base of the horn are more serious, because a
fragment of the frontal bone is usually torn away with the horn core. As
a rule, the fracture is subcutaneous or without external wound. The horn
is displaced, and swings loosely. On examination, a characteristic
crepitation sound is easily detected. In such fractures hæmorrhage is
subcutaneous and often extends to the frontal sinus, in consequence of
which it is not uncommon for pus to form in the sinus as a complication.
Treatment includes reduction of the fracture, and the application of a
fixed plaster or silicate bandage covering the fronto-occipital and
superior auricular regions.
When a skin wound exists, it is better to remove the horn and bony
fragment, and to apply an antiseptic dressing in order to prevent
infection of the frontal sinus.
EXOSTOSES.
SPAVIN IN THE OX.
Exostoses are somewhat uncommon in the bovine species, and when they
occur are rarely of great clinical interest. Nevertheless, in cows and
old working oxen one sometimes sees metatarsal spavin. Its gravity,
however, appears to be very much less than in the horse, on account of
its position. Very commonly there is only trifling lameness.
Treatment by application of biniodide of mercury ointment or the actual
cautery gives good results. The principal precaution required is to
prevent the animals licking the parts.
RING-BONE.
Ring-bones only occur in working oxen, and particularly in aged animals
used in hilly regions. They result almost exclusively from wounds,
ligamentous and tendinous strains, and articular injuries.
[Illustration: $1]
They are preceded (as can usually be proved by dissection of limbs) by
fibrous or fibro-cartilaginous induration in or about the coronet or one
of the phalanges. These thickenings increase the diameter of the pastern
in all directions. Ring-bones are seldom very large; but as they
partially or entirely surround the insertions of the lateral ligaments,
inter-phalangeal articulations or insertions of the digital extensors,
they are painful, and produce lameness of varying intensity.
=Diagnosis= is easy, partly because the tension of the skin and the
fibrous thickening render palpation painful.
=Prognosis= is grave, because the effect of ring-bone is sometimes to
render working animals useless.
[Illustration: $1]
[Illustration: $1]
=Treatment.= To relieve the diseased claw of pressure due to its bearing
on the ground, the shoe should be removed and the claw freely pared. If
necessary, the healthy claw of the same foot may be raised by placing a
piece of thick leather between the sole and the shoe. It is advisable at
once to apply an energetic plaster, or, better still, to resort to
firing in points.
SUPPURATING OSTITIS.
In addition to the changes in bone resulting from rachitis, osseous
cachexia, tuberculosis, and actinomycosis, one sometimes sees cases of
periostitis or ostitis pure and simple. As a result of external injury
or direct wounds, the bone may be contused and injured, becoming the
seat of diffused periostitis, necrosis, suppurating ostitis or
osteomyelitis. Open fractures may produce the same results.
=Treatment= comprises disinfection of wounds, antiseptic injection of
fistulæ, the application of antiseptic pencils, curettage, the removal
of sequestra, and vesicant or resolvent complications. When such
conditions extend to neighbouring joints and produce suppurative
arthritis, the animals ought to be killed.
BONE TUMOURS.
The only bone tumours of real importance from a practical point of view
are malignant growths represented by rapidly spreading epitheliomata or
sarcomata, originating in the periosteum. Fortunately such tumours are
rare.
They are not difficult to diagnose, as they develop rapidly, are
accompanied by pain and lameness ending in diminution or loss of the
power of movement, and frequently attack neighbouring lymphatic glands.
Even when in good condition, animals lose flesh and appetite, and
finally die of general wasting. The =diagnosis= is sufficiently guided
by the deformity of the parts, the bosselated appearance of the tumours,
the absence of fluctuation, the hæmorrhage which follows exploratory
puncture, the character of the little fragments of tissue removed
through these punctures, and finally the leukocytosis, which accompanies
the development of malignant tumours.
=The prognosis= is grave, for it is usually difficult or out of the
question to have recourse to removal, resection or amputation, when the
tumours have acquired any considerable size. Success is impossible
unless intervention is early, and the growth is in a readily accessible
part. In other circumstances early slaughter is indicated.
CHAPTER II.
DISEASES OF THE FOOT.
CONGESTION OF THE CLAWS.
Congestion of the claws is not infrequently confused with contusion of
the sole. It is, however, essentially different, and presents closer
analogies with laminitis. The condition is characterised by congestion
of the entire vascular system of the claw and principally of the velvety
tissue. Like laminitis, it affects all four limbs; in rare cases the two
front or two hind.
Congestion of the claw results almost exclusively from enforced movement
on hard, dry and hot ground. It is commoner in animals unaccustomed to
walking, and in heavy beasts which have been travelled considerable
distances to attend fairs or markets. It is commonest in the bovine and
porcine species, and less common in sheep.
The =symptoms= appear after animals return from a long journey by road.
They are characterised by unwillingness to bear weight on the feet and
difficulty in movement. Standing is painful, and the animals resist
being moved; as soon as released they lie down.
=Diagnosis= presents no difficulty, though the condition is sometimes
mistaken for slight laminitis.
=Prognosis= is favourable.
Absolute and prolonged rest is always followed by recovery, no internal
medication being necessary, though this result is promoted by enveloping
the claws in wet compresses or by using cold foot baths, etc.
CONTUSIONS OF THE SOLE.
Contusions of the sole are only seen in animals which work without shoes
or in such as are badly shod.
Work on rocky ground, movement over newly metalled roads, and wounds
produced by sharp stones, are the principal causes of contusion of the
sole. Badly applied shoes, flat or slightly convex on their upper
surfaces, may also produce bruising in the region of the sole. The
anterior angle of the claw is rarely affected.
Lameness is the first symptom to attract attention. It is slightly
marked, unless the bruising has been overlooked until suppuration has
set in. It affects only one or two limbs, and is rarely accompanied by
general disturbance, such as loss of appetite, fever, exhaustion during
work, etc.
Locally the claw or claws affected are abnormally sensitive to
percussion of the wall, and particularly to compression of the sole.
The parts are hot to the hand, and thinning the sole with a knife shows
little perforations, irregular points and crevices in the horn. One may
also find softening, infiltration and hæmorrhage within the horn similar
to those of corn in the horse, undermining of the sole over limited
areas, and sometimes suppuration, if the animals have been forced to
work when lame.
Complications like necrosis of the velvety tissue or of the bone, though
comparatively common in the horse, are rare in oxen.
=Diagnosis= is not difficult provided the history of the case is known.
Confusion with laminitis is scarcely possible, for the gait of this
lameness and the local symptoms are all different. Examination of the
sole will usually dispel any remaining doubt.
=Prognosis.= The prognosis is favourable. When the horn is simply
softened and a blackish liquid transudes, the lesion is trifling; if the
discharge is reddish grey the lesion is graver, and implicates all the
velvety tissue; finally, separation of the horn from the secreting
membrane and the discharge of true pus point to death of the
keratogenous tissue or of the bone.
=Treatment= should be commenced by carefully thinning the sole around
the wound and applying moist antiseptic dressings or cold affusions.
Removal of loose portions of horn hastens repair by allowing discharge,
which has accumulated between the living tissues and the horn itself, to
escape freely. The extirpation of necrotic tissue and the application of
surgical dressings are only called for in specially grave cases.
This treatment usually gives good results. The acute complications which
are so common and so dangerous in the horse seldom occur in the ox.
Most of these operations can be performed without casting, provided the
animal is placed in a trevis or is sufficiently secured.
LAMINITIS.
Laminitis is characterised by congestion, followed by inflammation of
the horn-secreting tissues of the foot. It is now rare in oxen and very
seldom assumes an acute form. The slow pace at which animals of the
bovine species move may sufficiently explain this rarity; nevertheless,
prolonged travel on stony roads with heavy vehicles, rapid and repeated
marches to towns or important fairs, are sufficient to produce attacks.
Before the days of railways, and for some time after their introduction,
in Britain cattle were travelled by road, and laminitis was common.
Long journeys in crowded railway trucks may also produce the disease,
although the animal has not been forced to walk. Persons engaged in
exhibiting cattle at shows are well aware of this. Prolonged maintenance
of the standing position will produce the trouble, to which the joltings
of the railway journey may also contribute their share. Prolonged
standing on board ship may induce laminitis.
“Show condition” and the consumption of highly nitrogenous, and
particularly of farinaceous, foods favour the occurrence of laminitis.
Breed is also considered to have some influence, and laminitis is said
to occur more frequently in animals raised in flat districts, because in
their case the space between the digits is larger than in mountain-bred
cattle. In this connection the body weight may perhaps play a certain
part.
=The symptoms= vary somewhat, depending on whether laminitis is general
and affects all four feet, or restricted to the two front or the two
hind feet.
The internal claws always seem more severely affected and more sensitive
than the external. In very rare cases the animal remains standing, but
usually it lies down, and will only rise under strong compulsion.
When standing, the symptoms are similar to those noted in the horse; the
animal appears as though absolutely incapable of moving. If all four
feet are affected the animal assumes a position as though just about to
rise; if the front feet alone are affected the animal kneels in front
whilst it stands on its hind legs, a very unusual position for the ox to
assume; finally, if the hind feet alone are affected, the animal seems
to prefer a position with the feet under the body both in front and
behind. (See _Veterinarian_, 1894, case by Bayley, and note by Nunn.)
It is always difficult to make the animal move. Walking seems painful,
and most weight is thrown on the heels. The body swings from side to
side as the limbs are advanced, and each limb is moved with a kind of
general bodily effort.
The claws are hot, sensitive to the slightest touch, and painful on
percussion.
Throughout the development of laminitis the general symptoms are very
marked. The appetite falls off early, fever soon appears, and in grave
cases the temperature rises to 105° or to 106° Fahr. Thirst is marked,
and the animal seems to prefer cold drinks. The muzzle is dry, the face
anxious and expressive of pain. Wasting is rapid.
The ordinary termination is in resolution, which occurs between the
eighth and fifteenth day, provided the patient has been suitably
treated. The disease rarely becomes chronic. On the other hand, the claw
occasionally separates, as a consequence of hæmorrhage or suppuration,
between the horn proper and its secreting membrane. Should this
complication threaten, the pastern becomes greatly swollen, the
extremities become intensely congested, and separation commences at the
coronet. Loss of the claws, however, like suppuration, is rare.
=Diagnosis.= Congestion of the sole, the early stage of infectious
rheumatism and osseous cachexia may, at certain periods of their
development, be confused with laminitis; but the history and the method
of development of the above-mentioned diseases always allow of easy
differentiation.
It should, however, be added that, in certain exceptional conditions
(suppurating echinococosis, producing chronic intoxication, tumours of
the liver, and tumours of the pericardium and mediastinum), symptoms may
be shown that suggest the existence of laminitis, although it is not
really present. In these cases pain may possibly be felt in the bones of
the extremities.
=The prognosis= is usually favourable, but necessarily depends on the
intensity of the disease. Fat stock always suffer severely.
=The treatment= varies in no important particular from that prescribed
for the horse, and is usually followed by rapid improvement. The chief
indications are free bleeding from the jugular, the application of a
mustard plaster over the chest, and the administration of a smart
purgative (1 to 2 lbs. of sulphate of soda, according to the size of the
animal) at first, followed by laxatives. This treatment may be completed
by giving salicylate of soda _per os_ in doses of 5 to 8 drams, or
arecoline in subcutaneous injection, 1 to 1½ grains. Local treatment
consists in cold affusions or poultices to the feet.
Failing cold baths, clay plasters applied to the feet are useful. To
ensure success all these methods should be utilised simultaneously. In
cases of separation of the claw, antiseptic dressings, with a thick pad
of tow placed under the sole, become necessary.
Chronic laminitis may perhaps occur in the ox as in the horse, but, as a
rule, oxen are slaughtered before the disease can assume this form. In
dealing with fat, or even with fairly well-nourished, oxen it would
clearly be more economical to slaughter early, and so prevent wasting
and the resulting loss from disease.
SAND CRACK.
Sand crack—that is to say, the occurrence of vertical fissures in the
wall of the claw—is not absolutely rare in bovines. It is commonest in
working oxen drawing heavy loads, though in very exceptional cases it
affects animals which have never worked. (Moussu describes one case in a
young ox where four sand cracks existed simultaneously.) It may also
result from injuries to the coronet. In contrast to the case of the
horse, and owing to the different conditions under which the ox performs
its work, the disease is commoner in front than in hind feet. In
drawing, the ox’s front limbs play the principal part, and the animal
pivots, so to speak, on the claws of the front limbs.
The position of the crack may vary. It is commonest on the inner surface
of the claw, rare at the toe, and still rarer at the quarter. It is
often superficial and complete, extending throughout the entire height
of the claw, but not throughout its thickness; sometimes it is complete
and profound, the fissure then extending to the podophyllous tissue.
=The symptoms= are purely local in the case of superficial lesions. When
the injury is deep seated, or when it originates in a wound of the
coronet, lameness is present. Intense lameness, swelling of the coronet,
and blood-stained or purulent discharge point to grave injury and
probable complications.
=Diagnosis= is easy. The =prognosis= naturally varies with the symptoms.
It is favourable when the fissure is merely superficial, but becomes
grave when it is deep seated and the animal is exclusively used for
heavy draught.
=Treatment.= When the lesion is superficial and unaccompanied by
lameness, no surgical interference is necessary. Rest or very light work
is alone required. As soon as lameness appears, rest is obligatory. The
application of antiseptic poultices, containing 2½ to 3 per cent. of
carbolic acid, creolin, etc., usually alleviates pain in a short time,
and facilitates healing in the depth of the fissure.
In exceptional cases, where complications have occurred in consequence
of suppuration beneath the fissure, suppuration in the coronary region,
or necrosis of the podophyllous tissues, an operation becomes necessary,
and is of exactly similar character to that performed under like
circumstances in the horse.
Over a space of 1 to 1½ inches on either side of the fissure the horn is
thinned “to the blood,” and the subjacent dead tissue removed. The claw
is then thoroughly cleansed with some antiseptic solution, the wound
freely dusted with equal parts of iodoform, tannin and boric acid, and
covered with pads of tow or cotton wool, fixed in position by
appropriate bandages. After such operations a long rest is essential for
complete recovery, during which, however, the animal may be fattened.
The object of operation is to prevent complications, like chronic
suppuration and necrosis, which would endanger the animal’s life, rather
than to effect perfect restoration of usefulness for the work previously
done.
PRICKS AND STABS IN SHOEING.
The wall of the ox’s claw is so thin that shoeing is always somewhat
difficult, more especially as nails can only be inserted in the external
wall. Moreover, as very fine nails must be used, they are apt to bend,
penetrate the podophyllous tissue, and cause injuries of varying
importance. The ox is often very restless when being shod, and, even
though firmly fixed, usually contrives to move the foot every time the
nail is struck. The farrier, therefore, may easily overlook the injury
which he has just caused, and by proceeding and ignoring it may
transform a simple stab into a much more dangerous wound.
=Symptoms.= In most cases lameness appears immediately the animal leaves
the trevis, but, although this is more difficult to explain, lameness is
sometimes deferred until the day after, or even two days after, shoeing.
Though little marked at first, lameness may become so severe that the
animal cannot bear the pain caused by the foot touching the ground. When
this stage is reached general disturbance becomes marked, fever sets in,
rumination stops, and appetite is lost.
These symptoms point to the occurrence of suppuration. The pus, confined
within the horny covering of the foot, causes very acute suffering and
sometimes grave general disturbance; later it burrows in various
directions, separating the podophyllous tissue from the horn, and ends
by breaking through “between hair and hoof” in the region of the
coronet. In exceptional cases, complications such as necrosis of the
podophyllous tissue extending to the bone, and suppuration of its spongy
tissue, may be observed.
=Diagnosis.= When the farrier suspects he has pricked an animal the
immediate withdrawal of the nail will remove any doubt, because bleeding
usually follows. If the condition is only detected at a later stage, the
early lameness having been misinterpreted, examination of the claw and
tapping the clenches of the nails will cause the animal to show pain at
a given point, thus indicating the penetration of the nail. Removal of
the offending nail is painful, and is often followed by discharge of pus
or blood-stained fluid, which clearly points to the character of the
injury. In obscure cases the shoe should not be reapplied.
When the horn wall is separated from the sensitive structures, there is
marked general disturbance, and pus is discharging at the coronet, it is
practically impossible to err in diagnosis.
=Prognosis.= In cases of simple nail puncture the prognosis is hopeful,
provided that the condition is at once diagnosed. The longer it remains
unrecognised, particularly if complication like necrosis has occurred,
the graver becomes the outlook.
=Treatment.= In cases of simple puncture the nail should immediately be
withdrawn and the animal placed on a perfectly clean bed to prevent the
wound becoming soiled or infected. If lameness appear and become
aggravated, the shoe should be removed and antiseptic poultices applied.
In the majority of cases the lameness will then diminish, and in a few
days completely disappear.
In cases of discovery within the first few days the same treatment is
applicable, and is often sufficient. If, on the contrary, pus is
discharging at the coronet, if lameness is intense and the general
symptoms marked, it may be needful to operate.
The stages of operation comprise: thorough thinning of the horn in the
shape of an inverted =V= over the affected portion of the wall, removal
of the loose necrosed parts, disinfection of the wound, and the
application of a surgical dressing covering the entire claw.
PICKED-UP NAILS, Etc. (“GATHERED NAIL.”)
Penetrating wounds of the plantar region are, as in the horse, usually
included under the heading of “Picked-up Nails.” They are only seen in
oxen or cows which are not shod. Pointed objects, like nails, harrow
teeth, sharp fragments of wood or glass, etc., may produce injuries of
the character of that now in question.
In considering the position of such wounds we may for convenience divide
the plantar region into two zones, one extending from the toe of the
claw to the point of insertion of the perforans tendon, the other
comprising the region between this insertion and the bulb of the heel.
=Symptoms.= Lameness occurs immediately, and varies with the intensity
of the existing pain. If the offending body has not remained fixed in
the wound, this lameness may in a few moments disappear, either for good
or merely for a time. The recurrence of lameness on the following day or
a couple of days later marks the commencement of inflammatory changes in
the deeper seated tissues. This lameness in many instances is
accompanied by a movement suggestive of stringhalt, the foot being kept
on the ground only for a very short time, or sometimes not being brought
into contact with the ground at all.
The depth to which the offending object has penetrated, and the
direction it has taken, may sometimes be discovered by a mere casual
examination of the sole. In other cases only the orifice by which it has
penetrated can be found. If the injury has existed for several days, the
discharge from the puncture will be thin and blackish, purulent, or
blood-stained, according to the case. Fever and general systemic
disturbance suggest an injury of a grave character.
=Diagnosis.= The diagnosis is easy, inasmuch as the lameness almost
directs examination to the foot.
=Prognosis= is rarely grave. The direction, the situation and mode of
insertion of the flexor tendon, which forms the plantar aponeurosis,
ensure this aponeurosis being rarely injured by objects penetrating from
without. The points of the offending bodies usually pass either forwards
to the phalanx or backwards in the direction of the plantar cushion.
=Treatment.= The first stage in treatment consists in removing the
foreign body and thoroughly thinning the neighbouring horn. An
antiseptic poultice consisting of linseed meal saturated with 3 per
cent. carbolic acid or creolin solution is then applied. Considerable
and progressive improvement usually takes place in a few hours. If
lameness persists, surgical interference becomes necessary; in the
anterior zone it is confined to removing any dead portions of the
velvety tissue and to extirpating the fragment of bone which has
undergone necrosis. In the posterior zone the sinus must be probed and
laid open, so that all the diseased parts can be treated as an open
wound.
If, as happens in exceptional cases, the plantar aponeurosis is found to
be severely injured, the complete operation for picked-up nail, as
practised in the horse, may be performed, or the claw may be amputated.
In the former operation the horn covering the sole is first thinned “to
the blood.”
The stages of operation are as follows:—
(1.) Ablation of the anterior portion of the plantar cushion. Transverse
vertical incision at a distance of 1¼ inches in front of the heel;
excision of the anterior flap.
(2.) Transverse incision and ablation of the plantar aponeurosis by the
same method.
(3.) Curettage of the point of implantation of the aponeurosis into the
bone.
(4.) Antiseptic dressing of the claw.
Finally, if the primary lesion, wherever it may have started, has become
complicated by arthritis of the inter-phalangeal joint, it will be
necessary to remove the claw, or, better still, to remove the two last
phalanges, the latter operation being easier than the former, and
providing flaps of more regular shape and better adapted for the
production of a satisfactory stump.
INFLAMMATION OF THE INTERDIGITAL SPACE.
(CONDYLOMATA.)
Condylomata result from chronic inflammation of the skin covering the
interdigital ligament. Any injury to this region causing even
superficial damage may result in chronic inflammation of the skin and
hypertrophy of the papillæ, the first stage in the production of
condylomata.
Injuries produced by cords slipped into the interdigital space for the
purpose of lifting the feet when shoeing working oxen are also fruitful
causes.
Inflammation of the interdigital space is also a common complication of
aphthous eruptions around the claws and in the space between them.
Continual contact with litter, dung and urine favour infection of
superficial or deep wounds, and by causing exuberant granulation lead to
hypertrophy of the papillary layer of the skin. When the animal stands
on the foot the claws separate under the pressure of the body weight and
the condylomata are relieved of pressure. When, however, the limbs are
rested, the claws mutually approach, compress the abnormal vegetations,
flatten, excoriate, and irritate them, thus favouring their further
development.
[Illustration: $1]
The symptoms are easy to detect. The animals appear in perfect health,
but have difficulty in walking, and show pain. They walk as though on
sharp, rough ground, and lameness is sometimes severe. Locally, the
anterior surface of the claws and the interdigital space are markedly
congested and sensitive, or painful on pressure. The growths are of
varying size, isolated or confluent, bleeding, excoriated, or covered
with horn, and are visible between the claws when the animal stands on
the limb. In many cases they form a perfect cast of the vertical
interspace. When the superficial layers have undergone conversion into a
horn-like material, lameness diminishes or disappears.
=Diagnosis= presents no difficulty.
=Prognosis= is only grave in so far as the condition interferes with
animals working, but it may render working oxen entirely useless.
=Treatment= in the early stages is of a preventive character, and
consists in placing animals which have been accidentally injured or
attacked with foot-and-mouth disease on a perfectly clean bed.
Surgical treatment is the only reliable method in cases where
hypertrophy of the papillary layer is well marked, and is extremely
simple.
The animal should be fixed in the trevis, the foot to be operated on
separately secured, and the growths completely removed with sharp
scissors or with a bistoury and forceps. When bleeding has subsided the
wound is covered with a mixture of equal parts of iodoform, tannin, and
powdered boric acid, and an interdigital dressing is applied. The
dressing is removed after five to ten days, according to circumstances.
If the cicatrix shows signs of exuberant growth it is dusted with
powdered burnt alum, and the parts are treated as an open wound. When
the growths are covered with horn and no longer painful it is not
desirable to interfere with them.
CANKER.
Canker—_i.e._, chronic suppurative inflammation of the podophyllous or
velvety tissue—is accompanied by hypertrophy of the papillæ and
progressive separation of the horn of the sole. It is much rarer in the
ox than in the horse, although it occasionally occurs.
Prolonged retention in dirty stables, where the bedding is mixed with
manure and continually moistened with urine, is the principal cause of
the disease. Individual predisposition and the action of some specific
organism may also have some influence.
Canker in oxen, like the same disease in horses, is recognised by
softening and separation of the horn of the sole, and by progressive
extension of the process towards neighbouring parts. The usual course
consists in invasion of the podophyllous tissue, separation of the wall
and of the heels, and pathological hypertrophy of the horn-forming
tissues, producing condylomata.
The new growths do not attain the same dimensions as in the horse, but,
on the other hand, the disease very frequently takes a progressive
course, involving the whole of the claw. A trifling accidental injury
may be followed by infection of the subungual tissues, and thus become
the point of origin for canker.
Canker may attack only one claw; on the other hand, it may extend to
both claws of one foot, or to the claws of more than one foot in the
same animal.
=Diagnosis.= Diagnosis is easy. The separation of the horn, the presence
of a caseous, greyish-yellow and offensive discharge between the
separated parts and the horn-secreting tissues, the appearance of the
exposed living tissues, etc., leave no room for doubt.
=Prognosis.= The prognosis is grave; for, as in the horse, the disease
is obstinate.
=Treatment= consists in scrupulously removing all separated horn, so as
fully to expose the tissues attacked by the disease. The parts should
then be thoroughly disinfected with a liquid antiseptic, and a
protective pressure dressing applied.
As a rule, cauterisation with nitric acid, followed by applications of
tar or of mixtures of tannin and iodoform, iodoform and powdered burnt
alum, etc., effect healing, without such free use of the knife as has
been recommended in the horse during the last few years.
GREASE.
Grease in the ox seems only to have been described by Morot and Cadéac,
and even in these cases the descriptions appear rather to apply to
elephantiasis or fibrous thickening of the skin than to grease proper.
The descriptions are not sufficiently clear, and the symptoms described
differ too much from the classical type seen in the horse to convince us
without further confirmation of the occurrence of the disease.
PANARITIUM—FELON—WHITLOW.
Any injury in the interdigital space or flexure of the pastern may,
under unfavourable circumstances, be complicated by death of the skin,
necrosis of the interdigital ligament, of the fibro-fatty cushion in the
flexure of the pastern, and of the terminal portions of the tendons.
These lesions are sometimes regarded as panaritium. In reality, they
correspond exactly to what, in the horse, are known as “cracked heels”
and “quittor.” The primary injury becomes infected with organisms which
rapidly cause death of the skin or the formation of a deep-seated
abscess and necrosis of the invaded tissues.
=Causation.= Neglect of sanitary precautions and filthy stables
constitute favouring conditions, the feet being continually soiled and
irritated by the manure and urine. Animals reared on plains, and having
broad, flat, widely-separated claws, are more predisposed than animals
from mountainous regions, in which the interdigital ligament is stronger
and the separation of the claws less marked. Any injury, abrasion, or
cut may serve as a point of origin for such complications.
Panaritium may even occur as an enzootic with all the characters noted
in isolated cases. In Germany it has received the name of “contagious
foot disease.” These enzootic outbreaks of panaritium follow epizootics
of foot-and-mouth disease, with lesions about the claws. Through the
superficial aphthous lesions the parts become inoculated with bacteria,
and the severity of the resulting injury is in some measure an
indication of the virulence of the infecting organism.
=Symptoms.= The first important symptom consists in intense local pain,
rapidly followed by marked lameness. The affected region soon becomes
swollen; the coronary band appears congested; the skin of the
interdigital space projects both in front and behind; the claws are
separated, and all the lower portion of the limb appears congested and
œdematous. The engorgement usually extends as high as the fetlock, and
the parts are hard and extremely sensitive. The patient is feverish,
loses appetite, and commences to waste. After five to ten days sloughing
occurs at some point—if the ligament is affected, in the interdigital
space; if the tendons, or the fibro-fatty cushions, the slough appears
in the flexure of the pastern. The dead tissue may separate and fall
away, or remain in position macerated in pus. Separation is generally
slow, requiring from twelve to fifteen days, and, unless precautions are
taken, complications occur. If only the interdigital ligament or
fibro-fatty cushion be necrotic, recovery may be hoped for; but, on the
other hand, if the tendons, tendon sheaths, ligaments, or bones are
affected, complications like suppurating synovitis, suppurating ostitis,
arthritis, etc., supervene, with fatal results. Death may occur from
purulent infection, unless the animal is slaughtered early.
=The diagnosis= is easy. The intensity of the lameness, separation of
the claws, swelling of the pastern region, sensitiveness of the swollen
parts, and absence of lesions in the ungual region sufficiently indicate
the nature of the condition.
=The prognosis= is grave, for complications may result, in spite of
proper treatment.
=Treatment.= Treatment consists, first of all, in thoroughly cleansing
the affected limb and placing the animal on a very clean bed. The parts
are next subjected to antiseptic baths containing carbolic acid,
creolin, sulphate of zinc, or sulphate of copper. It is often more
convenient, and quite as efficacious, to apply antiseptic poultices to
the foot and pastern, and to allow them to remain for some days, being
moistened several times daily with one of the solutions indicated. The
effects are: rapid diminution of the pain, delimitation of the necrotic
tissues is hastened, and the abscess is more readily opened.
Many practitioners recommend early intervention in the form of deep
scarification in the interdigital space or pastern region. The local
bleeding, and the drainage which takes place through the wounds so made,
is said to hasten recovery or to prevent complications.
When the abscess has opened, and the dead tissue separated, the abscess
cavity or wound should be regularly washed out with a disinfecting
solution, to prevent complications, in case fragments of necrotic tissue
have been retained. If, however, complications have occurred, no
hesitation should be felt in freely incising the parts, and, if
necessary, in removing one or both phalanges. When both joints of one
foot are affected, and arthritis threatens to or has set in, there is no
object in treating the animal, and early slaughter is to be recommended.
In cases where the disease follows foot-and-mouth disease, and threatens
to become enzootic, it can generally be prevented spreading by keeping
the foot-and-mouth subjects on very clean beds, and frequently washing
the feet with antiseptic solutions. Disinfection of the sheds is also
very desirable.
FOOT ROT.
Foot rot is a disease of sheep, and, like canker, is confined to the
claws.
Thanks to the progress of hygiene, it tends to become rarer, but is
still seen in the enzootic form in some portions of England and
Scotland, in the mountains of Vivarais, the Cévennes, and the Pyrenees.
It affects large numbers of animals at once, animals belonging to one
flock or to neighbouring flocks in one locality, and when it invades a
sheep farm, all the animals may successively be attacked at intervals,
according to the local conditions.
=Symptoms.= The disease develops rather insidiously, and the patients
always retain an excellent appetite. It begins with lameness, which is
at first slight, later becomes accentuated, and in the last periods is
very intense. On examination, the coronet and lower part of the limb as
high as the fetlock are found to be swollen. Palpation reveals
exaggerated sensibility, and on direct examination, a fœtid discharge is
discovered in the interdigital space. This discharge, which is peculiar
to the onset of the disease, only continues for a week or two, and is
succeeded by a caseous exudate which is always offensive, which moistens
and macerates the horn, the skin, the tissues in the interdigital space,
and the region of the heels. From the 20th to the 30th day after onset
the claw separates above in the interdigital space. The separation
extends towards the heel, then to the toe, exposing ulceration of the
subjacent podophyllous tissue.
From this time the patients experience very severe pain, and, as in
other diseases of the feet, remain lying for long periods. Movement
becomes extremely painful, and the animals frequently walk on the knees.
The subungual lesions become aggravated, separation of the claw extends,
necrosis of the podophyllous tissue and of subjacent tissue becomes more
extensive, and the inter-phalangeal ligaments and the extensor or flexor
tendons become involved. Finally, the claws are lost, and synovitis and
arthritis are added to the complications already existing.
In an infected locality the development is always the same. The animals
lose flesh, become anæmic, and, unless vigorously treated, soon die. The
ordinary duration of the disease is from five to eight months, sometimes
more. If, however, patients are isolated and well treated they recover.
=Causation.= The specific cause of foot rot still remains to be
discovered, although everything points to the conclusion that it
consists in an organism capable of cultivation in manure, litter, etc.,
for foot rot is transmissible by cohabitation, by mediate contagion
through infected pasture, by direct contact and by inoculation.
The chief favouring influences are bad drainage, filthy condition of the
folds, and herding in marshy localities.
=Diagnosis.= The condition can scarcely be mistaken, for the sheep
suffers from no other disease resembling it, excepting, perhaps,
foot-and-mouth disease.
=Prognosis.= The prognosis is grave, for the disease usually assumes a
chronic course, affects entire flocks, and the patients require
individual attention.
=Treatment.= The primary essential to success in treatment consists in
separating and isolating the diseased animals in a scrupulously clean
place and providing a very dry bed.
In the early stages the disease may be checked by astringent and
antiseptic foot baths. It is then sufficient to construct a foot-bath at
the entrance to the fold, containing either milk of lime, 4 per cent.
sulphate of iron, copper sulphate, creolin, etc. Through this the sheep
are passed two or three times a week. These precautions rarely suffice
when the feet are already extensively diseased; and when the horn is
separated to any considerable extent, surgical treatment is
indispensable. All loose portions of horn should be removed and
antiseptic applications made to the parts.
When a large number of sheep are affected the treatment is very
prolonged, but it is absolutely indispensable, and the numerous
dressings required necessarily complicate the treatment. It would be
valuable to experiment with small leggings, which would retain the
dressings in position, and, at the same time, shelter the claws from the
action of the litter, while favouring the prolonged action of the
antiseptic.
When the lesions are not extensive, a daily dressing is sufficient.
Among the materials most strongly recommended are antiseptic and
astringent ointments containing carbolic acid, iodoform, or camphor.
Vaseline with 5 per cent. of iodine is very serviceable, and much to be
preferred to applications like copper sulphate, iron sulphate, etc. Its
greatest drawback is its expense.
CHAPTER III.
DISEASES OF THE SYNOVIAL MEMBRANES AND OF THE ARTICULATIONS.
I.—SYNOVIAL MEMBRANES AND ARTICULATIONS.
SYNOVITIS.
Inflammation of the synovial membranes, or synovitis, may affect the
synovial sacs either of the joints or of the tendon sheaths. It may be
acute or chronic and occur either idiopathically or follow the
infliction of an injury. Its two chief forms are simple, or “closed,”
synovitis and suppurative, or “open,” synovitis, the essential
distinction between which is that in the latter microorganisms are
present, whilst in simple synovitis they are absent. In all cases the
disease is characterised by distension of the sac affected.
Synovitis produced by a wound communicating with the outer air may be
complicated by suppuration, and if the synovial membrane of a joint be
involved the primary synovitis is almost always followed by traumatic
arthritis.
The commonest forms of chronic simple synovitis are:—
INFLAMMATION OF THE PATELLAR SYNOVIAL CAPSULE.
Inflammation of the synovial membrane of the femoro-patellar joint is
most commonly seen in working oxen as a consequence of strains during
draught. It is also found in young animals which have injured the
synovial capsule through falls, slips, or over-extension of the limb.
=Symptoms.= Development is slow and progressive, and injury may not be
discovered until the lameness which follows has become fairly marked.
This lesion is characterised by swelling in the region of the stifle. On
palpation, fluctuation may readily be noted both on the outer and inner
surfaces of the joint. The exudate is sometimes so abundant and
distension so great that the straight ligaments, the neighbouring bony
prominences, and the ends of the tendons are buried in the liquid
swelling.
Lameness, which is at first marked, often diminishes with exercise. The
length of the step is lessened.
=Diagnosis.= The diagnosis presents no difficulty, but the lesions must
be distinguished from those due to tuberculosis in this region,
rheumatic arthritis, and the specific arthritis seen in milch cows.
=The prognosis= is grave, for the disease renders animals useless for
work.
=Treatment.= Rest, cold moist applications, and massage constitute the
best treatment in the early stages. Should swelling persist, one may
afterwards apply a smart blister or even tap the joint aseptically,
drawing off the fluid and then applying the actual cautery. Irritant
injections must be avoided.
DISTENSION OF THE SYNOVIAL CAPSULE OF THE HOCK JOINT.
_Bog Spavin in the Ox._
Bog spavin is frequent in working oxen and in oxen from three to five
years old. It is due to strain in draught or to strain produced in
rearing up at the moment of covering. Old bulls, heavy of body, and
stiff in their limbs are predisposed to it.
=Symptoms.= The symptoms usually develop gradually and without lameness,
but sometimes declare themselves more rapidly with lameness, accompanied
by marked sensitiveness on palpation. At first the hock shows a
generalised doughy swelling, soon followed by dilatation of the
articular synovial sac. Somewhat later four different swellings
appear—two in front, separated by the tendons of the common extensor and
flexor metatarsi, and two at the back, extending inside and outside to
the flexure of the hock.
=Diagnosis.= The only precaution required in diagnosis is to avoid
confusion with articular rheumatism.
=Prognosis.= The prognosis is rather grave in the case of working oxen,
and even of bulls; often slaughter is preferable to treatment.
=Treatment= differs in no respect from that of distension of the stifle
joint. In young bulls aseptic puncture and drainage of the joint,
followed by the application of the actual cautery, probably give the
best results.
DISTENSION OF TENDON SHEATHS IN THE HOCK REGION.
Like the preceding, this condition is rarely seen except in bulls and
working oxen. It is characterised by dilatation of the upper portion of
the tarsal sheath, one swelling appearing on the outer side, the other
on the inner.
The differential =diagnosis= is based on the position of these synovial
sacs, which are quite close to the insertion of the tendo-Achillis, and
on the absence of any swelling in front of the joint.
=Treatment= is identical with that indicated in the last condition.
Massage and cold water applications should be employed at first, to be
followed by aseptic puncture and withdrawal of fluid, supplemented if
necessary by firing in points.
DISTENSION OF THE SYNOVIAL CAPSULE OF THE KNEE JOINT.
[Illustration: $1]
[Illustration: $1]
This is one of the rarest conditions now under consideration, because
the synovial membranes of the knee joint are everywhere strongly
supported by very powerful ligaments. The synovial capsules of the
carpo-metacarpal and inter-carpal joints are incapable of forming sacs
of any size. On the other hand, the radio-carpal may become moderately
prominent in front, especially towards the outside above the superior
carpal ligament. When weight is placed on the limb, the excess of
synovia is expelled from the joint cavity towards this little sac, which
then becomes greatly distended. If, on the other hand, the knee is bent,
the sac shrinks or disappears.
=Treatment.= Treatment is restricted to the application of a blister or
to firing in points.
DISTENSION OF THE SYNOVIAL CAPSULE OF THE FETLOCK JOINT.
The synovial capsule of the fetlock joint in the ox is strongly
supported in front and at the sides, but may protrude under the anterior
ligament, producing a swelling behind the metacarpus under the five
branches of division of the suspensory ligament and slightly below the
sesamoid bones. These distensions, like bursal swellings, are commoner
in hind limbs and in old working oxen. Their development is always
followed in time by a certain degree of knuckling over. At first the
metacarpus and phalanges come to form a straight line, but later the
fetlock joint itself is thrust forward.
=The diagnosis= necessitates careful manual examination of the region of
the fetlock joint.
=The prognosis= is somewhat grave, for the disease sooner or later
necessitates the destruction of certain animals.
=Treatment= is practically identical with that used in all such
conditions: friction with camphorated alcohol, cold affusions and
massage in the earlier stages, followed if needful by blisters or firing
in points.
DISTENSION OF TENDON SHEATHS.
Distension of the synovial capsule which surrounds the superior
suspensory ligament, like distension of the articular capsule of the
fetlock, occurs in working animals, and most commonly affects the front
limbs. It is indicated by two swellings, one situated on either side of
and behind the branches of division of the suspensory ligament and in
front of the flexor tendons. These two swellings extend higher than the
articular swellings, which, however, they sometimes accompany. The
surface of the fetlock is then swollen, doughy on pressure, and somewhat
painful.
These enlargements may produce more or less marked lameness and cause
knuckling.
=The diagnosis= is clear from local examination.
=The prognosis= is unfavourable, as the animals after a time become
useless for work.
=Treatment.= The beginning of the disease may often be cured by baths of
running water, combined with massage. At a later stage, local
stimulants, blisters, or firing are necessary. The best treatment
probably consists in puncturing the parts with antiseptic precautions,
washing out the synovial cavity with an antiseptic, and immediately
afterwards lightly firing the surface of the region in points.
DISTENSION OF TENDON SHEATHS IN THE REGION OF THE KNEE.
Any of the numerous tendon sheaths which facilitate the gliding of
tendons in the neighbourhood of the knee may become inflamed and give
rise to a chronic synovial swelling. The commonest of such swellings is
due to distension of the sheath of the extensor metacarpi magnus, which
appears as a vertical line in front of the knee, extending from the
lower third of the forearm and slightly to the outer side of the central
line. This synovial enlargement arises in oxen working on broken roads,
in clay or marshy soils, where the animals are liable to stick fast, and
are often obliged to struggle vigorously in order to extricate
themselves.
=The diagnosis= is based on the position and direction of the dilated
synovial sheath.
=Treatment= is identical with that of other cases of chronic synovitis.
DISTENSION OF THE BURSAL SHEATH OF THE FLEXOR TENDONS.
This condition is rare. It is announced, as in the horse, by a
dilatation of semi-conical form, the apex of which is situated opposite
the lower margin of the carpal sheath, the base extending as high as the
infero-posterior third of the radius.
The dilatation is more marked on the inner than on the outer side of the
limb.
Distension of the synovial sheath of the common extensor of the digits
in the fore limb and of the extensor of the external digit is still
rarer than the preceding conditions.
TRAUMATIC SYNOVITIS—“OPEN SYNOVITIS.”
When an injury in the neighbourhood of a joint penetrates deeply, it may
implicate either the synovial sheath of a tendon or the synovial
membrane of a joint. If the body inflicting the wound is aseptic, a
condition which in accidental wounds is rare, the wound may have no
grave consequences. Usually, however, the body producing the injury is
infected, and the infection rapidly extends throughout the tendon sheath
or synovial sac. In the first case, traumatic suppurating synovitis of a
tendon sheath is the result; in the second, a suppurating articular
synovitis arises, which soon becomes complicated with injury of the
articular cartilages, ligaments, etc. (traumatic arthritis).
The primary lesion may only affect the periarticular region, not
directly extending to the synovial membranes, and only after an interval
of some days may symptoms of suppurating synovitis or suppurating
arthritis appear, in consequence of progressive invasion of the parts by
specially virulent microbes.
TRAUMATIC TENDINOUS SYNOVITIS.
Suppurative inflammation of the synovial bursæ of tendons in consequence
of wounds most commonly affects the sesamoid sheaths of the front or
hind limbs; more rarely, the tendon sheaths of the hock or knee; and,
exceptionally, the small synovial sheaths of the extensors of the
metacarpus and phalanges, etc.
Such inflammation follows injuries with forks, harrow teeth, or any
sharp foreign body. It is characterised by the existence of a fistula or
wound, indicating the course taken by the body inflicting the injury,
from which at first normal synovia escapes. Later, however, the
discharge becomes turbid, and after the second day gives place to a
clotted, serous, or purulent fluid.
A diffuse, œdematous, warm, painful swelling very rapidly develops
around the injury. The animal is more or less feverish and lame. The
swelling soon extends throughout the entire length of the infected
synovial sheath. The patient loses appetite, and unless treatment is
promptly undertaken, complications supervene which often necessitate
slaughter. The prognosis is always grave.
=Treatment.= Continuous irrigation has long been recommended. It is
worthy of trial, but in the majority of cases occurring in current
practice it cannot be carried out.
Moussu prefers a form of treatment which he claims has always succeeded
in horses and oxen—viz., irrigation of the parts, followed by injection
of sublimate glycerine solution.
He first washes out the infected synovial cavity with boiled water
cooled to 100° Fahr. A counter-opening may become necessary, and the
washing should be continued until the escaping water appears perfectly
clear. Immediately after each such irrigation he injects from 7 to 14
drams of glycerine containing 1 part in 1,000 of corrosive sublimate. He
repeats this treatment daily.
By reason of its affinity for water and for the liquids in the tissues
or suppurating cavities into which it is injected, the glycerine
penetrates in all directions, reaching the finest ramifications of the
synovial sacs, a fact which explains its superiority over aqueous
antiseptic solutions.
Suppuration is rapidly checked and repair becomes regular. The pain and
lameness progressively diminish, and recovery may be complete.
It is advisable to assist this internal antiseptic treatment by external
stimulants and by the use of a blister. Solutions of greater strength
than 1 part of sublimate to 500 of glycerine are only required during
the first few days of treatment and until suppuration diminishes. Later,
they prove irritant, and interfere with healing.
TRAUMATIC ARTICULAR SYNOVITIS—TRAUMATIC ARTHRITIS—“OPEN ARTHRITIS.”
[Illustration: $1]
It has been described above how primary inflammation of the articular
synovial membrane produced by a wound may rapidly develop into
suppurating arthritis.
=Symptoms.= The pain is very marked at the moment when the accident
occurs, but this pain, due to the mechanical injury inflicted,
diminishes or completely disappears after some hours. Soon, however,
synovial discharge sets in, announcing the onset of traumatic synovitis.
At first limpid, it soon becomes turbid, then curdled, and finally
grumous, purulent and greyish in colour.
Pain then returns, rapidly becomes intense, continuous and lancinating.
It produces lameness, sometimes so severe that no weight whatever can be
borne on the limb. A diffuse, œdematous, warm and extremely sensitive
swelling then rapidly develops around the whole of the injured joint.
General disturbance, with fever and loss of appetite, appears,
indicating a very alarming condition.
It is sometimes a little difficult to differentiate between this
condition and that due to injury of a tendon sheath, but as a rule
diagnosis is easy.
=Prognosis= is very grave. Life is threatened, and wasting occurs very
rapidly. Infection of the synovial membrane is soon followed by necrosis
and erosion of the articular cartilages, as well as by softening and
inflammatory change in the ligaments, etc.
[Illustration: $1]
=Treatment.= Should the patient be in reasonably good condition, but
otherwise of no particular value, it should at once be slaughtered. If,
on the other hand, it possess a special value, and the owner wish to
preserve its life, the same antiseptic treatment should be adopted as
was indicated in dealing with suppurating synovitis of tendon sheaths.
The loss of the articular cartilage of the joint is followed by free
granulation and union of the apposed surfaces of bone resulting in
anchylosis of the joint and qualified recovery. Such results, however,
are only likely to follow in relatively light animals which are capable
of standing for considerable periods.
II.—STRAINS OF JOINTS.