winter are no protection against it. Heat, however, conduces to fever, and
fever means lessened secretion, which means a plethoric state of the
circulation. The heats of summer are, however, often only a coincidence of
the real cause, the mature rich pastures, and especially the clover ones,
being the greater.
Electrical disturbances have an influence of a similar kind, disturbing the
functions of the body and favoring sudden variations in the circulation. A
succession of cases of the malady often accompany or precede a change of
weather from dry to wet, from a low to a high barometric pressure.
Costiveness, which is the usual concomitant of fever, may in a case of this
kind become an accessory cause, the retention in the blood of what should
have passed off by the bowels tending to increase the fullness of the blood
vessels and the density of the blood.
Mature age is a very strong accessory cause. The disease never occurs with
the first parturition, and rarely with the second. It appears with the
third, fourth, fifth, or sixth--after the growth of the cow has ceased and
when all her powers are devoted to the production of milk.
Calving is an essential condition, as the disturbance of the circulation
consequent on the contraction of the womb and the expulsion into the
general circulation of the enormous mass of blood hitherto circulating in
the walls of the womb fills to repletion the vessels of the rest of the
body and very greatly intensifies the already existing plethora. If this is
not speedily counterbalanced by a free secretion from the udder, kidneys,
bowels, and other excretory organs, the most dire results may ensue.
Calving may thus be held to be an exciting cause, and yet the labor and
fatigue of the act are not active factors. It is after the easy calving,
when there has been little expenditure of muscular or nervous energy and no
loss of blood, that the malady is seen. Difficult parturitions may be
followed by metritis, but they are rarely connected with parturition fever.
All these factors coincide in intensifying the one condition of plethora
and point to that as a most essential cause of the affection. It is
needless to enter here into the much-debated question as to the mode in
which the plethora brings about the characteristic symptoms and results. As
the results show disorder or suspension of the nervous functions mainly, it
may suffice to say that this condition of the blood and blood vessels is
incompatible with the normal functional activity of the nerve centers. How
much is due to congestion of the brain and how much to bloodlessness may
well be debated, yet in a closed box like the cranium, in which the
absolute contents can not be appreciably increased or diminished, it is
evident that, apart from dropsical effusion or inflammatory exudation,
there can be only a given amount of blood; therefore, if one portion of the
brain is congested, another must be proportionately bloodless; and as
congestion of the eyes and head generally and great heat of the head are
most prominent features of the disease, congestion of the brain must be
accepted. This, of course, implies a lack of blood in certain other parts
or blood vessels.
The latest developments of treatment indicate very clearly that the main
cause is the production of poisonous, metabolic products (leucomains and
toxins) by secreting cells of the follicles of the udder, acting on the
susceptible nerve centers of the plethoric, calving cow. Less fatal
examples of udder poisons are found in the first milk (colostrum), which is
distinctly irritant and purgative, and in the toxic qualities of the first
milk drawn from an animal which has been subjected to violent overexertion
or excitement. Still more conclusive as to the production of such poisons
is the fact that the full distention of the milk ducts and follicles, and
the consequent driving of the blood out of the udder and arrest of the
formation of depraved products, determines a speedy and complete recovery
from the disease. This does not exclude the other causes above named, nor
the influence of a reflex nervous derangement proceeding from the udder to
the brain.
_Symptoms._--It may be said that there are two extreme types of this
disease, with intervening grades. In both forms there is the characteristic
plethora and more or less sudden loss of voluntary movement and sensation,
indicating a sudden collapse of nervous power; in one, however, there is
such prominent evidence of congestion of head and brain that it may be
called the congestive form par excellence, without thereby intimating that
the torpid form is independent of congestion.
In the congestive form there is sudden dullness, languor, hanging back in
the stall, or drooping the head, uneasy movements of the hind limbs or
tail; if the cow is moved, she steps unsteadily, or even staggers; she no
longer notices her calf or her feed; the eyes appear red and their pupils
dilated; the weakness increases and the cow lies down or falls and after
that is unable to rise. At this time the pulse is usually full, bounding,
and the temperature raised, though not invariably so, the head, horns, and
ears being especially hot and the veins of the head full, while the visible
mucous membranes of nose and eyes are deeply congested.
The cow may lie on her breastbone with her feet beneath the body and her
head turned sleepily round, with the nose resting on the right flank; or,
if worse, she may be stretched full on her side, with even the head
extended, though at times it is suddenly raised and again dashed back on
the ground. At such times the legs, fore and hind, struggle convulsively,
evidently through unconscious nervous spasm. By this time the
unconsciousness is usually complete; the eyes are glazed, their pupils
widely dilated, and their lids are not moved when the ball of the eye is
touched with the finger. Pricking the skin with a pin also fails to bring
any wincing or other response. The pulse, at first from 50 to 70 a minute,
becomes weaker and more accelerated as the disease advances. The breathing
is quickened, becoming more and more so with the violence of the symptoms,
and at first associated with moaning (in exceptional cases, bellowing), it
may, before death, become slow, deep, sighing, or rattling (stertorous).
The temperature, at first usually raised, tends to become lower as stupor
and utter insensibility and coma supervene. The bowels, which may have
moved at the onset of the attack, become torpid or completely paralyzed,
and, unless in case of improvement, they are not likely to operate again.
Yet this is the result of paralysis and not of induration of the feces, as
often shown by the semiliquid, pultaceous condition of the contents after
death. The bladder, too, is paralyzed and fails to expel its contents. A
free action of either bladder or bowels, or of both, is always a favorable
symptom. The urine contains sugar, in quantity proportionate to the
severity of the attack.
In nearly all cases the torpor of the digestive organs results in gastric
disorder; the paunch becomes the seat of fermentation, producing gas, which
causes it to bloat like a drum. There are frequent eructations of gas and
liquid and solid feed, which, reaching the paralyzed throat, pass in part
into the windpipe and cause inflammations of the air passages and lungs.
In the torpid form of the disease there is much less indication of fever or
violence. There may be no special heat about the horns, ears, or forehead,
nor any marked redness or congestion of the eyes or nose, nor engorgement
of the veins of the head. The attack comes on more slowly, with apparent
weakness of the hind limbs, dullness, drowsiness, suspension of rumination
and appetite, and a general indifference to surrounding objects. Soon the
cow lies down, or falls and is unable to rise, but for one or two days she
may rest on the breastbone and hold the head in the flank without showing
any disorderly movements. Meanwhile there is not only loss of muscular
power and inability to stand, but also considerable dullness of sensation,
pricking the skin producing no quick response, and even touching the edge
of the eyelids causing no very prompt winking. Unless she gets relief,
however, the case develops all the advanced symptoms of the more violent
form, and the animal perishes.
In advanced and fatal cases of either form the insensibility becomes
complete; no irritation of skin or eye meets any response; the eye becomes
more dull and glassy; the head rests on the ground or other object; unless
prevented the cow lies stretched fully on her side; the pulse is small,
rapid, and finally imperceptible; the breathing is slow, deep, stertorous,
and the expirations accompanied with puffing is slow, the cheeks, and death
comes quietly or with accompanying struggles.
_Prevention._--For such fatal disease prevention is of far more consequence
than treatment. Among the most efficient preventives may be named a spare
diet (amounting to actual starvation in very plethoric, heavy-milking cows)
for a week before calving and at least four days after. A free access to
salt and water is most important, as the salt favors drinking and the water
serves to dilute the rich and dense blood. Iced water, however, is
undesirable, as a chill may favor the onset of fever. A dose of Epsom salt
(1 to 2 pounds) should be given 12 to 24 hours before calving is due, so
that it may operate at or just before that act. In case calving has
occurred unexpectedly in the heavy milker, no time should be lost in giving
the purgative thereafter. A most important precaution in the fleshy,
plethoric cow, or in one that has been attacked at a previous calving, is
to avoid drawing any milk from the bag for 12 or 24 hours after calving.
Breeders on the island of Jersey have found that this alone has almost
abolished the mortality from milk fever. If Epsom salt is not at hand,
saltpeter (1 ounce) should be used for several days. Daily exercise is also
of importance, and, excepting in midsummer, when the heat of the sun may be
injurious, the value of open air is unquestionable. Even in summer an open
shed or shady grove is incomparably better than a close, stuffy stall. A
rich pasture (clover especially), in May, June, or July, when at its best,
is to be carefully avoided. It is better to keep the cow indoors on dry
straw with plenty of salt and water than to have access to such pastures.
_Treatment._--Treatment of milk fever has been completely revolutionized,
with the result that a former mortality of 50 to 70 per cent has been
practically abolished. Formerly the most vigorous treatment was practiced
by bleeding, purging, the increase of peristalsis by eserin or pilocarpin,
enemas, cold in the head, counterirritants, aconite, tartar emetic,
sponging, wet-sheet packing, etc. The gross mortality, however, was not
materially reduced, and nearly all that were attacked within the first two
days after calving perished.
The first step in the modern treatment was made in 1897, when J. Schmidt
published his successful treatment by the injection of the teats and milk
ducts with a solution of iodid of potassium (1-1/2 drams to 1 quart of
water). This reduced the mortality to 17 per cent. Others followed this
lead by the injection of other antiseptics (lysol, creolin, creosol,
chinosol, common salt, etherized air, oxygen). These succeeded as well as
the iodid solution. With the injection of gases, however, a fuller
distention of the udder was usually secured, and virtually every case
recovered. This suggested the full distention of the udder with common
atmospheric air filtered and sterilized, and this with the most perfect
success. With sterile air Schmidt-Kolding claimed 96.7 per cent recoveries
in 914 cases.
In America the full distention of the udder, whether with oxygen or
filtered air, has proved invariably successful in all kinds of cases,
including the violent ones that set in within a few hours after calving. In
1 or 2 hours after the injection the cow has got up, had free passages from
the bowels and bladder, bright expression of countenance, and some return
of appetite. In my cases which had made no response for 8 hours to the
iodid injection, the injection of the udder to full repletion with the gas
(oxygen or air) has had immediately beneficial results. A similar full
distention of the bag with a common-salt solution (0.5 to 100), or even
with well-boiled water, is equally effective, but in these cases the weight
of the liquid causes dragging upon the udder and a measure of discomfort
which is escaped under the treatment with gas.
The value of each method depends on the fullness of distention of the udder
and the arrest in larger part of the circulation and chemical changes in
its tissues. This distention acts like magic, and seems hardly to admit of
failure in securing a successful outcome.
It can not, however, be recommended as absolutely devoid of dangers and
serious complications. To get the best results it should be applied only by
one who has been trained in the careful antiseptic methods of the
bacteriological laboratory. Some readers will recall the case of the
injection of the udders of show cows at Toronto to impose upon the judges.
The cows treated in this way had the udders infected and ruined, and
several lost their lives. There is no better culture medium for septic and
other germs than the first milk (colostrum) charged with albumin and
retained in the warm udder. Already in the hands of veterinarians even the
Schmidt treatment has produced a small proportion of cases of infective
mammitis. How many more such cases will develop if this treatment becomes a
popular domestic resort, applied by the dairyman himself in all sorts of
surroundings and with little or no antiseptic precautions? Even then,
however, the losses will by no means approach the past mortality of 50 to
70 per cent, so that the economy will be immeasurable under even the worst
conditions. A fair test and judgment of this treatment, however, can be
obtained only when the administrator is trustworthy and painstaking, well
acquainted with bacteriological antisepsis and with the general and special
pathology of the bovine animal.
The necessary precautions may be summarized as follows:
(1) Provide an elastic rubber ball and tubes furnished with valves to
direct the current of air, as in a common Davidson syringe.
(2) Fill the delivery tube for a short distance with cotton sterilized by
prolonged heating in a water bath.
(3) In the free end of the delivery tube fit a milking tube to be inserted
into the teat.
(4) Sterilize the entire apparatus by boiling for 30 minutes, and, without
touching the milking tube, wrap it in a towel that has been sterilized in a
water bath or in live steam and dried.
(5) Avoid drawing any milk from the teats; wash them and the udder
thoroughly with warm soapsuds; rinse off with well-boiled and cooled water,
and apply to the teats, and especially to their tips, a 5 per cent solution
of carbolic acid or lysol, taking care that the teats are not allowed to
touch any other body from the time they are cleansed until the teat tube is
inserted. It is well to rest the cleansed and disinfected udder on a
sterilized pad of cotton or a boiled towel.
(6) The injecting apparatus is unwrapped; the teat tube, seized by its
attached end and kept from contact with any other body, is inserted into
the teat, while an assistant working the rubber pump fills the quarter as
full as it will hold. The tube is now withdrawn and a broad tape is tied
around the free end of the teat to prevent escape of the air.
(7) The teat tube, which has been carefully preserved from possible contact
with other bodies, is dipped in the carbolic acid solution and inserted in
a second teat, and the second quarter is inflated, and so with the third
and fourth.
(8) The recumbent cow is kept resting on her breastbone, with the head
elevated, even if it should be necessary to pack around her with straw
bundles or to suspend the head by a halter. When lying on her side she is
liable to develop fatal bloating and to have belching of gas and liquids,
which, passing down the windpipe, cause fatal broncho-pneumonia.
(9) If in 2 hours the cow is not on her feet, if there is no brighter or
more intelligent expression, if she has passed no manure or urine, and if
the air has become absorbed, leaving the udder less tense, the injection of
the bag may be repeated, under the same scrupulous and rigid precautions as
at first. In all cases, but especially in severe ones, it is well to keep
watch of the patient, and to repeat the distention on the first indication
of relapse. Should there not be a free discharge of feces and urine after
rising, indicating a natural resumption of the nervous functions, the case
should be all the more carefully watched, so that the treatment may be
repeated if necessary.
Accessory treatment may still be used, but is rarely necessary. A dose of
purgative medicine (1-1/2 pounds of Epsom salt) in warm water may be given
in the early stages, while as yet there is no danger of its passing into
the lungs through paralysis of the throat. Eserin or pilocarpin (1-1/2
grains) may be given under the skin to stimulate the movements of the
bowels. Sponging the skin, and especially the udder, with cool water, may
be resorted to in hot weather.
Bloating may demand puncture of the paunch, in the left flank, with a
cannula and trocar, the evacuation of the gas, and the introduction through
the tube of a tablespoonful of strong liquid ammonia in a quart of cold
water or other antiferment.
The economic value of the new treatment of milk fever is enormous. The
United States has more than 22,000,000 milk cows. If we could raise their
quality by preserving and breeding from the largest producers of both milk
and butterfat, in place of losing the best by milk fever, as in the past,
and if we could thus obtain an average increase of 2 quarts a day, the
proceeds at 3 cents a quart would amount to $130,000,000 a year.
PALSY AFTER CALVING (DROPPING AFTER CALVING).
This consists in a more or less complete loss of control of the hind limbs
occurring after calving, and caused by low condition, weakness, and
exposure to cold or to injurious compression of the nerves of the hind
limbs by a large calf passing through the pelvis. Its symptoms do not
differ from those of palsy of the hind limbs, occurring at other times, and
it may be treated in the same way, except so far as bruises of the vagina
may demand special smoothing treatment.
CONGESTION OF THE UDDER (GARGET).
In heavy milkers, before and just after calving, it is the rule that the
mammary gland is enlarged, hot, tense, and tender, and that a slight
exudation or pasty swelling extends forward from the gland on the lower
surface of the abdomen. This physiological congestion is looked upon as a
matter of course, and disappears in two or three days when the secretion of
milk has been fully established. This breaking up of the bag may be greatly
hastened by the sucking of a hungry calf and the kneading it gives the
udder with its nose, by stripping the glands clean thrice daily, and by
active rubbing at each milking with the palm of the hand, with or without
lard or, better, with camphorated ointment.
The congestion may be at times aggravated by standing in a draft of cold
air or by neglect to milk for an entire day or more (overstocking, hefting)
with the view of making a great show of udder for purposes of sale. In such
cases the surface of the bag pits on pressure, and the milk has a reddish
tinge or even streaks of blood, or it is partially or fully clotted and is
drawn with difficulty, mixed, it may be, with a yellowish serum (whey)
which has separated from the casein. This should be treated like the above,
though it may sometimes demand fomentations with warm water to ward off
inflammation, and it may be a week before the natural condition of the
gland is restored.
INFLAMMATION OF THE UDDER (SIMPLE MAMMITIS).
Congestion may merge into active inflammation, or it may arise direct, in
connection with exposure to cold or wet, with standing in a cold draft,
with blows on the udder with clubs, stones, horns, or feet, with injury
from a sharp or cold stone, or the projecting edge of a board or end of a
nail in the floor, with sudden and extreme changes of weather, with
overfeeding on rich albuminous feed like cotton seed, beans, or peas, with
indigestions, with sores on the teats, or with insufficient stripping of
the udder in milking. In the period of full milk the organ is so
susceptible that any serious disturbance of the general health is liable to
fall upon the udder.
_Symptoms._--The symptoms and mode of onset vary in different cases. When
following exposure there is usually a violent shivering fit, with cold
horns, ears, tail, and limbs, and general erection of the hair. This is
succeeded by a flush of heat (reaction) in which the horns, ears, and limbs
become unnaturally warm and the gland swells up and becomes firm and solid
in one, two, three, or all four quarters. There is hot dry muzzle, elevated
temperature, full, accelerated pulse, and excited breathing, impaired or
suspended appetite and rumination, with more or less costiveness,
suppression of urine, and a lessened yield of milk, which may be entirely
suppressed in the affected quarter.
In other cases the shivering escapes notice, the general disorder of the
system is little marked or comes on late, and the first observed sign of
illness is the firm swelling, heat, and tenderness of the bag. As the
inflammation increases and extends, the hot, tender udder causes the animal
to straddle with its hind limbs, and, when walking, to halt on the limb on
that side. If the cow lies down it is on the unaffected side. With the
increase in intensity and the extension of the inflammation the general
fever manifests itself more prominently. In some instances the connective
tissue beneath the skin and between the lobules of the gland is affected,
then the swelling is uniformly rounded and of nearly the same consistency,
pitting everywhere on pressure. In other cases it primarily attacks the
secreting tissue of the gland, then the swelling is more localized and
appears as hard, nodular masses in the interior of the gland. This last is
the usual form of inflammation occurring from infection entering by the
teats.
In all cases, but especially in the last-named form, the milk is suppressed
and replaced by a watery fluid colored with blood (sometimes deeply) and
mingled with masses of clotted casein. Later it becomes white and purulent,
and in many cases of an offensive odor.
The course of the disease is sometimes so rapid and at others so slow that
no definite rule can be laid down. In two or three days, or from that to
the end of the week, the bag may soften, lose its heat and tenderness, and
subside into the healthy condition, even resuming the secretion of milk.
The longer the inflammatory hardness continues the greater the probability
that its complete restoration will not be effected. When a portion of the
gland fails to be restored in this way, and has its secretion arrested, it
usually shrinks to a smaller size. More commonly a greater quantity of the
inflammatory product remains in the gland and develops into a solid,
fibrous mass, causing permanent hardening (induration). In other cases, in
place of the product of inflammation developing into a fibrous mass, it
softens and breaks down into white, creamy, liquid pus (abscess). This
abscess may make its way to the surface and escape externally, or it may
burst into a milk duct and discharge through the teat. It may break into
both and establish a channel for the escape of milk (fistula). In the worst
types of the disease gangrene may ensue, a quarter or half or even the
whole udder, losing its vitality, and sloughing off if the cow can bear up
against the depressing influence. These gangrenous cases are probably
always the result of infection and sometimes run a very rapidly fatal
course. I remember one to which I was called as soon as the owner noticed
it, yet I found one-quarter dark blue, cold, and showing a tendency to the
formation of blebs containing a bloody secretion. The cow, which had waded
through a depth of semiliquid manure to reach her stall, died within 24
hours.