Blood, decrease of red Less altered than in Blood at first clots
globules; encrease of either of the other firmly, later
white, hæmatoblasts, forms. Shows becomes, thick,
fibrine formers and cocco-bacilli in the black, sizy,
soda salts earlier stages: hæmatosis tardy.
streptococci later Reaction acid.
Coagulation firm, buffy Coagulum loose, buffy
coat coat slight
Hepatic congestion, not Hepatic congestion Hepatic congestion
hepatitis excessive, hepatitis, excessive,
necrotic changes hæmorrhagic; fatty
degeneration
_Prognosis._ _Mortality._ As usually met with and under favorable
conditions, equine influenza is a mild disease. In 1872 when the
disease, sweeping the continent and hardly sparing an equine animal,
might be assumed to have reached its maximum, the actual deaths varied
from 2 per cent. in country districts to 7 per cent. in large cities.
The same holds for Europe where Friedberger and Fröhner gives 4 to 5 per
cent. Früs (Denmark) 1 per cent., Aureggio (Italy) 3 per cent.,
Siedamgrotzky 10 per cent. Much depends on conditions: In horses
infected in transit on a long railroad journey it may be 100 per cent.
and in fat dealer’s horses, out of condition for active work it usually
reaches a high figure. If the patients are kept at work the
complications and mortality run very high. The same applies to
debilitated animals kept in close, foul, ill-aired stables, or reduced
by exhausting or long standing diseases. The very young and the senile
suffer more than animals in middle life and vigorous condition. Finally
the parts invaded have a controlling effect. The milder cases affecting
the upper air passages only, nearly all recover, in those showing
abdominal lesions the indications are still favorable; while with double
pulmonary and pleural lesions the patient is too often in a hopeless
condition. Brain lesions are almost equally redoubtable.
The actual money losses, in an epizoötic of influenza, are more in the
way of the loss of work and the complete stagnation of trade in all
departments, than in the number of deaths. Yet even in this sense it may
prove more ruinous than would a disease having a less universal sway,
though far more fatal to the animals attacked.
_Treatment._ A disease like this, which tends to spontaneous and perfect
recovery, needs mainly dietetic and hygienic care in the vast majority
of cases. Rest is a prime consideration in a pure genial atmosphere. In
the summer season, in the absence of rainstorms, an open air life, at
pasture is the best. Shelter must be had in case of storms, and in the
cold season a clean, sweet, roomy well-aired loose box, with a sunny
exposure, is important. Clothing, bandages, blankets and even hoods may
be required if there is any tendency to chill. Food should be laxative,
cooling and of easy digestion. Bran mashes, scalded oats or barley,
ensilage, roots, potatoes, apples, fresh grass or scalded hay may be
suggested. Milk has been strongly advocated, from twelve to fifteen
quarts a day, and linseed tea as being especially adapted to the
irritable stomach and bowels. Food should be given often, in small
quantities so as not to destroy the appetite.
Costiveness is best met by injections of water, blood warm, or if there
is much hyperthermia, of cold water. This latter stimulates the
peristalsis more actively and at the same time lowers the temperature.
By unloading the large intestines it removes irritants, without danger
of encrease of congestion or diarrhœa.
If anything more is wanted for these mild cases, small doses of
stimulating diuretics or diaphoretics may be given. Sweet spirits of
nitre ½ oz. or liquor of acetate of ammonia 2 oz. may be given twice a
day, the latter in the drinking water or gruel. In the absence of these
saltpeter ½ oz, or potassium acetate ½ oz. may be given.
In the more _severe cases_ more active treatment is resorted to, but in
all cases one should avoid measures that tend to greatly depress the
vital powers and especially the circulation. Heroic treatment has been
all but universally condemned and yet Trasbot claims to have had
excellent results from a moderate venesection (2–5 qts.) in strong,
muscular, well conditioned animals. The blood became more fibrinous, the
general symptoms improved and complications were far less marked. During
twenty years, in a large number of cases, it had constantly the same
results, restoring appetite, opening the closed eye, imparting new life,
lowering temperature, and checking congestions. The results were best in
all cases when it was employed early, but they were almost equally good
when later congestions set in, or when the ordinary inflammatory
localizations were advancing, and he found the measure hurtful only
when, in the advanced stages, the animal was worn out, and destitute of
all power of recuperation.
_Antipyretics_ have been lauded and decried, and it is doubtless best to
use them with due discrimination and caution. Acetanilid, the agent in
most common use, is a powerful cardiac depressant, and in this disease
the heart is often already dangerously weak. Yet in cases with very high
temperature, seriously threatening life, acetanilid in doses of 2 drams,
repeated every second or third hour until the temperature falls, and
thereafter twice or thrice daily, for a day or two, may save the
patient. Similarly, where there are indications of violent headache
(drooping head, eyelids and ears, congested and watery conjunctiva,
stupor or irresponsiveness) a dose or two of acetanilid with the same
amount of sodium bromide will often give material relief. The general
suffering and disorder attendant on the cephalalgia, if allowed to
continue, prove a direct bar to improvement, and endanger complications
that might otherwise be escaped. On the other hand, there is constant
danger from too large doses, or a too long continued use of acetanilid
in influenza. Phenacetin may be substituted in 2 dram doses, the action
being somewhat more prompt and transient. As less dangerous than the
coal tar antipyretics, we may fall back on such agents as sodium
salicylate, ½ to 1 oz., or sulphate of quinia, 20 grs.
Elimination of toxins and waste products is to be secured and this is
more safely conducted by the kidneys or skin than by the irritable
alimentary canal. Plenty of pure cold water is one of the best and
simplest resorts. Aside from this, where there is much hyperthermia,
bicarbonate of potash or soda will serve the various purposes of an
antidote to the acid blood, an eliminant and an antithermic. Under the
same circumstances saltpeter may be resorted to in ½ oz. doses twice
daily. When, however, the heart is weak it is better to employ
ammoniacal or etherial diuretics:—spirits of nitrous ether, 1 oz. or
liquor of acetate of ammonia, 2 to 4 ozs. By combining these with
extract of belladonna and camphor a fairly standard prescription may be
prepared.
Inhalations of warm water vapor, rising from hot water or a hot mash in
a bucket, over one end of which a bottomless bag is drawn, while the
other end receives the nose of the horse, will greatly relieve the
irritation and the cough. It can be made even more soothing by
introducing a little alcohol, eucalyptol, menthol, camphor, poppy-heads,
or other anodyne. Or the water vapor may be set free in a close stall
from a boiling tea-kettle or a steam pipe, and an admixture of
sulphurous acid made by burning a few pinches of sulphur, more or less
according to the size and closeness of the stall. If the stall is tight
enough a steam bath may be given with much profit in the early stages.
Counter irritants applied to the throat, or, if need be, to the breast
and sides of the chest will often give material relief, acting as
derivatives and probably also by modifying the globulins in the exudate
and thus influencing the course of the disease. In case of sore throat
of a very high type it may be best to apply a compress or poultice, or
even a piece of sheepskin for a day or two, until, by antithermics,
cooling diuretics and soothing inhalations, the severity of the
inflammation has abated. The common mustard pulp made with tepid water,
rubbed in, and covered by paper, may be applied for an hour; or the
_soap liniment_ (soap 6 ozs., camphor 3 ozs., and proof spirit, liquor
ammonia and linseed oil aa 1 pint) may be rubbed on repeatedly; or a
blister of cantharides may be used.
The _ophthalmia_ may be treated by a moist atmosphere, a few drops twice
daily of a solution of atropine beneath the lids, a similar treatment
with pyoktanin, (1:1000), or a solution of mercuric chloride (1:2000).
In case of _gastro-intestinal inflammation_ elimination is to be sought
by ⅓d the usual laxative dose, supplemented if need be, by injections.
Half a pint of olive oil with 20 grs. calomel will usually be well
borne. Counter irritants may be applied to the abdomen, and the bowels
must be carefully watched and any inactivity or derangement corrected. A
slight diarrhœa is not to be too hastily checked as it may serve at once
to eliminate offensive matters and subdue mucous inflammation. Solutions
of flax seed, gum, or slippery elm in the drinking water may serve a
good end.
In case of _cardiac weakness_ with intermittent or irregular pulse,
hurried breathing, and an undue contrast between the violence of the
heart action and the weakness of the pulse, circulatory stimulants are
called for. Digitalis 10 grains twice daily, strophanthus tincture 1½
dr., strophanthin subcutem ¼ grain, caffeine 5 grains, veratrine ⅒th
grain, or strychnia 2 grains.
_Nervous symptoms_ will exceptionally demand the application of cold
water or even ice or snow to the head, with counterirritants to the
sides of the neck or chest, and the internal use of bromides, iodides,
chloral or other nerve sedative.
Other complications must be treated according to their indications.
As the skin becomes cooler and more moist, and the pulse slower and
fuller, a tonic and stimulating treatment may be desirable. Gentian 4
drs., saltpeter 4 drs., sal-ammoniac 2 drs. may be given night and
morning, or in case of great debility ammonia carbonate may replace the
sal-ammoniac. Or the gentian may be replaced by nux vomica, and the
ammoniacal preparations by alcoholic ones.
When prostration becomes extreme and stimulants and bitters appear
inadequate, transfusion of blood from a healthy horse may save the
patient’s life, or a normal salt solution sterilized may be introduced
into the vein.
The first method is accomplished through a caouchouc tube with a short
tube of silver inserted in each end; the jugular groove of each horse is
washed and disinfected, and the vein opened; the tube disinfected with a
salicylic acid solution, and cleared out with boiled water is inserted
upward into the vein of the sound horse, and when the blood begins to
flow the other end is inserted downward into the vein of the sick one.
In this way the blood is allowed to flow from the one to the other, the
finger being kept on the pulse of the patient to detect any faltering,
which like heaving up of the head or rolling of the eyes, may be taken
to indicate undue arterial tension, or disturbed brain circulation, and
should be the signal for an arrest of the flow. To effect this, pinch
the tube in the centre, and wait a minute or so; if the symptoms subside
the current may be reopened and a little more carefully admitted, but if
not the tube may be withdrawn and the wounds pinned up.
The normal salt solution, .6 per cent., is sterilized by boiling, and
placed in a sterilized vessel where it is allowed to cool to the body
temperature; then a caouchouc tube furnished with a silver tube at one
end and sterilized as for transfusion of blood, is filled with the
solution and the vessel containing the latter having been placed at a
level higher than the patient, the tube is used as a syphon. When the
liquid flows in full stream the silver tube is inserted downward into
the jugular of the patient and the liquid is allowed to flow in, subject
to the same precautions as regards sudden blood tension as in the case
of the transfusion of blood.
_Prevention._ No country appears to have attempted the absolute
exclusion of the disease or the extinction of the germ by a compulsory
quarantine and disinfection. The nearest approach to this is in Prussia
where in the event of an outbreak of equine influenza, the official
veterinarians and police authorities must send in reports to be
published in the official papers and communicated to the directors of
government breeding studs and to the army authorities. We have here the
germ of an effective system of extinction, for if those in charge of
government horses in an infected country can protect them against
infection, much more could such protection be secured by putting an end
to the infection which is now allowed to remain generalized. Moreover in
our great outbreak of 1872–3, when germ-potency and all but universal
susceptibility were so remarkable, effective quarantine showed the most
signal successes, in the resulting immunity of Vancouver’s Island,
Prince Edward Island, the whole of the West Indies except Cuba, Central
and South America, and isolated districts in Mexico.
Sanitary police in this disease has been abandoned mainly because the
virus is so diffusive on the air that quarantine must be more than
usually comprehensive to prevent extension of infection, and because the
disease is fatal only in a small percentage of cases, so that the loss
is apparently minimized. But a panzoötic like that of 1872–3,
prostrating 1,000,000 horses, asses and mules in the United States for
one to two weeks, and paralyzing the agriculture and commerce of the
continent for that length of time, may well make one hesitate to
supinely accept for all time an evil, which, experience has shown, can
be circumscribed and stamped out. When horse owners, legislatures and
veterinarians can be educated up to the needs of the case our yearly
local losses from equine influenza, and the occasional all pervading
epizoötics of this disease can probably be abolished by the extinction
of the germ on the Continent. To achieve this result an immediate large
outlay would be well spent. In a new generation, or a new century
perhaps, this desirable object may be achieved.
Meanwhile the individual owner can do something to secure a partial
protection. On farms and in barracks the animals may be secluded from
all other equine animals during the local prevalence of the disease.
Men, dogs, and wild animals can be similarly excluded. Litter, fodder,
bags, clothing, manure, vehicles, etc., from infected stables and places
must be carefully guarded against. Newly purchased animals, carried in
any public conveyance, or kept or fed in any public yard or stable must
be quarantined at a considerable distance from others, and treated by
disinfectant sponging and fumigation before they are allowed to mingle
with other equine animals. Stables where the disease has occurred must
be thoroughly disinfected, together with all manure made during the
epizoötic and for some time thereafter.