Definition. Synonyms. Animals susceptible: dog, fox, jackal, hyena,
wolf. Historic notes. Causes: contagion, inoculation, immunity,
contact with sick, clothing, bedding, kennel: infection fixed—little
diffusible, dogs at large, chill, domestication, high breeding,
special breeds, shows, public conveyances, vegetable diet,
debilitating conditions, catarrhs, change of climate, recurrent
attacks, youth, native susceptibility, teething. Microbiology:
micrococci, bacilli, mixed cultures, Shantyr’s observations,
Lignieres’. Virulent products—all secretions and exudates. Vitality:
virus survives drying, freezing, dilution in water. Destroyed by
disinfectants. Forms of distemper: catarrhal, ophthalmic, cutaneous,
gastro-hepatic, bronchitic, pulmonary, nervous. Duration 20 to 30
days. Mortality 20 to 70 per cent. Prognosis: unpromising conditions.
Incubation 4 to 7 days. Symptoms: hyperthermia (103° to 104°),
dulness, debility, anorexia, staring coat, tremors, seeking warmth,
early fatigue, dry burning nose and footpads, irregular temperature,
simultaneous congestion of all visible mucosæ; Respiratory phenomena;
sneezing, congestion of nose, discharge, blocking, snuffling, rubbing,
cough, retching, vomiting; percussion flatness in lungs, in islets or
along the lower part; auscultation râles, wheezing, crepitus,
creaking, etc.; epiphora, swollen eyelids, weeping, photophobia,
muco-purulent discharge, sticking of lids together, opacities,
vesicles, ulcers; red, hot, buccal mucosa, costiveness, fetid
diarrhœa, tenesmus, weakness, emaciation; skin eruption, on delicate
areas, papules, vesicles with colored contents, pustules, sticky,
greasy exudate; irritability, restlessness, taciturnity, depraved
appetite, spasms, delirium, paresis, epilepsy, chorea. Lesions:
inflammation, degeneration, ulceration on air-passages, alimentary
tract, lymph glands, kidneys, liver, cerebral and spinal meninges,
leucocytic infiltration: offensive odor. Lignieres’ views of microbes.
Prevention: quarantine new dogs for 14 days, wash, disinfect all
collars, etc., avoid shows and meetings, exclude street dogs, protect
against mice, rats, birds, shut up all dogs during an epizoötic;
separate a pack into small lots; seclude the sick and all belonging to
them. Immunization: by lung exudate, by weakened cultures. Treatment:
hygienic, dietetic, warm baths, antipyretics, antiferments, calomel,
phenic acid, eliminants, expectorants, collyria, emetic, demulcents,
bismuth, etc., pepsin, quinine, nerve sedatives, tonics.
_Definition._ A contagious, febrile affection attacking dogs (and by
inoculation cats), and tending to local inflammatory and degenerative
lesions in the mucosæ, lungs, bowels, liver, skin, kidneys, and nervous
system,—a first attack usually immunizing against a second.
_Synonyms._ Contagious catarrhal fever; Dog ill; Bronchial Catarrh;
Intestinal Catarrh; _Fr._ Maladie des Chiens, Maladie du jeune age,
Typhoïde, Typhus des chenils, Variole du chien; _Ger._ Staupe; _It._
Cimurro.
_Animals susceptible._ Dogs, especially puppies and young dogs, and
other members of the canine race, fox, jackal, hyena, wolf. Cats suffer
from inoculation (Laosson), also apes (Cadeac). Old cats and dogs are
often immune, also all animals that have passed through one attack of
the disease.
_History._ The older English veterinarians quote the epizoötics in dogs
described by Virgil, Aristotle and even Homer as probably distemper.
Laosson attributes to it a canine epizoötic which prevailed in Bohemia
in 1028. It appears to have been unknown in Europe in the earlier third
of the 18th century though prevailing in Peru. According to Ulloa, it
was introduced from Peru into Spain in 1735, whence, it spread into
France (1740), Germany (1748), Ionian Isles, Greece (1759), England
(1760), Italy (1764) and Russia (1770), Sweden and Norway (1815),
Siberia (1821). Since that time it has prevailed in Europe and many
dependencies of European nations.
_Causes._ Its advent in Europe as a new disease in the second third of
the 18th century, its steady spread, its continued prevalence, and
extension, concur with the infection of kennels and districts by the
introduction of a sick dog, in demonstrating its purely contagious
nature, and this implies a living microbe transferred from animal to
animal. If any doubt remained it must be dispelled by the inoculations
which have been constantly successful when made on young puppies, or
dogs that have not previously suffered, and on cats. A first attack
confers immunity.
Among _accessory causes_ may be especially named _contact with the sick
dog_, its _clothing_ or _bedding_, and above all its _kennel_. A kennel
may retain infection indefinitely, especially if there is a constant
accession of puppies or susceptible dogs. On the contrary it is not
readily carried on the clothes of attendants, and the inmates of a
kennel often remain sound, though only separated by a yard from the
infected one, and though cared for by the same attendant. Yet so
universally diffused is the contagion that few dogs escape it until they
are a year old.
The habit of letting dogs run at large, to meet in roads and fields is a
most prolific cause, which might easily be done away with where
distemper is prevalent.
A _chill_ is a common condition, hence injudicious washing, swimming in
cold water, exposure of house dogs to cold storms, or outdoors at night,
sleeping in cold, damp cellars, on cold stones or metal plates, or in
passages in a current of cold air are frequent factors. Yet it often
spreads rapidly in the summer, the heat favoring the preservation and
diffusion of the germ.
_House dogs_ as a rule suffer more severely, as their systems are more
sensitive to the cold, and the resisting power to invading microbes is
lessened. Country dogs and those living in the open air are hardier and
more resistant and often have the disease in a mild form.
_High bred dogs_ suffer more severely probably largely from the greater
protection and care lavished on them and their consequent diminished
power of resistance. Newfoundlands, great Danes, pointers, pugs,
poodles, spaniels and greyhounds may be named as especially liable.
The exposure to infection at _shows_, and in traveling by _rail_,
_steamboat_ or _other infected conveyance_ must be considered as among
the prominent causes.
An exclusively _bread diet_ has been recognized as a predisposing cause,
by reason of its lowering the stamina of the carnivorous animal.
Any condition which induces _debility_ whether severe or continued
disease, parasitisms, impure air, under feeding, improper food,
rachitis, or scurvy, etc., must be admitted to operate in the same way.
Any _catarrhal disease_ of the nose or bronchia is especially conducive
to the affection by weakening the mucosa and making an easy entrance
channel for the germs.
_Change of climate_ is a strongly predisposing condition, which not only
hastens an attack, but even, at times, arouses anew the susceptibility
in dogs that have passed through a first attack. Dogs that suffered in
England have had a second attack in India, and some have even had a
third attack when brought back to Europe. Four attacks within a year, in
the same dog, and without change of climate, are recorded by Friedberger
and Fröhner.
_Youth_ is much more susceptible than age, even apart from the immunity
which comes to the mature dog from a first attack. Yet some puppies are
insusceptible from birth.
_Microbiology._ No one pathogenic organism has been proved to be the
constant infecting agent, yet two classes of investigators have
contended in favor of micrococci and bacilli respectively.
_Micrococci_, 1 to 3μ in diameter, singly or in chains of 6 or 8 have
been found in the blood, lungs, liver, kidneys and spleen (Semmer,
Friedberger, Krajewski, Rabe, Mathis, Marcone, Meloni, Kitt).
_Bacilli_ were found associated with micrococci by Semmer, Legrain and
Jacquot, Laosson, Millais, Schantyr, and Galli-Valerio. As observed by
the latter they were 1.25, to 2.5μ long, by 0.31μ broad and took the
Gram stain. Cultivated on gelatine the colonies were waxy, lustrous
points, which indented the gelatine without liquefying it.
Cultures of the mixed bacteria (cocci and bacilli) and their inoculation
on young dogs produced the symptoms of distemper with subsequent
immunity (Laosson, Millais). Legrain and Jacquot claimed immunity, as
resulting from inoculations with the cocci in pure cultures.
Galli-Valerio, using the mixed cultures produced all the symptoms
(pulmonary and cerebro-spinal) of distemper.
Schantyr, ignoring the cocci, describes three bacilli which cause three
different diseases (distemper, abdominal typhus, and typhoid), but the
distinctions are not clear nor generally accepted.
Lignieres and Even, in Argentina, and dealing with the more susceptible
high bred dogs (fox terriers, great Danes and carlins), found constantly
in the blood of the dog, in the early stages of the disease, a long,
delicate bacillus, nonmotile and easily stained in aniline, but not by
Gram’s method. Inoculated on the Guinea pig it shortens, approximating
rapidly in successive passages to a cocco-bacillus, and assumes the
general characters of Lignieres’s _pasteurella_. Different bacteria may
be found in the lungs, bronchial and nasal mucus, tears and vesicles.
Lignieres’s _pasteurella_ is inoculable on the Guinea pig, mouse,
rabbit, and dog, producing the symptoms of local or general infection.
Two centigrammes, subcutem, in the _Guinea pig_, produced a local œdema,
disappearing in four or five days and securing immunity. Five cc.
subcutem proved fatal in 48 hours; intraperitoneal in 24 hours. In the
_rabbit_ 1cc., subcutem, caused local œdema for 2 days and hyperthermia
(104°) for 3 days; 1cc. intravenously, caused fever for 3 weeks,
diffluent blood and hæmorrhagic lesions in lungs, liver, kidneys,
bowels, spleen, and serosæ. In the mouse, 4 to 8 drops, subcutem, caused
œdema, and recovery or death in 2 to 4 days. In such cases the microbe
was found in pure cultures in the blood or inoculated tissues.
Inoculations of the pure cultures on dogs produced in different cases,
gastro-enteritis, pneumonia, pleuro-pericarditis, and arthritis, in
various combinations. If the animal survives it is immune.
Grown on _peptonized bouillon_, _neutral_ or _slightly alkaline_, the
bacillus forms, in 24 hours, small granular colonies which fall to the
bottom, leaving the liquid clear. The addition of serum renders this
more abundant without causing opacity.
On _pancreatic_ bouillon the growth is very free without indol.
On _gelatine plates_ there are fine punctiform colonies, transparent,
but becoming white and opaque in 8 or 10 days. Similar colonies form in
stab and streak cultures. The gelatine is not liquefied. Cultures in
_milk_ cause neither coagulation nor acidity. There is little or no
growth in hay tea, on potato, nor in vacuum. The cultures have the
peculiar odor of the pasteurella.
_Virulent Products._ Infection is present sooner or later in all the
morbid animal products. The nasal mucus, bronchial exudate, saliva,
tears, contents of the cutaneous vesicle, milk, contents of the bowels,
and the blood have been successfully inoculated on susceptible subjects.
Inoculations with blood failed with Bryce, but proved successful with
Konnhauser, Krajewski, Even, Lignieres and Physalix, so that the first
named cases may be explained by a prior immunity, or by a too advanced
stage of the case which furnished the matter. The virulence is not lost
nor even diminished by drying at ordinary temperatures, freezing (10°
F.), nor by moderate dilution in water. Prolonged exposure at ordinary
temperature, however, reduces the virulence, which is greatly impaired
in 15 to 25 days (Laosson), or, if dried, in three months and upward
(Krajewski). Virulence is easily destroyed by disinfectants,—thorough
washing (Menard) hypochlorous acid (Trasbot), chloride of lime, mercuric
chloride, etc.
_Forms of Distemper._ This disease is extremely protean in its
manifestations. Many cases, in country districts especially, are
manifested by a slight fever, with a _catarrhal condition of the mucosæ_
of the nose, eyes, and throat. In other cases there may be simply a
slight _conjunctivitis or keratitis_, and in still others a _cutaneous
eruption_, papular, vesicular or pastular. In some instances there is
slight _gastric_ or _hepatic disorder_ with inappetence nausea, and
vomiting or some irregularity of the bowels. In such cases recovery may
take place in eight or ten days.
In the more severe forms, especially seen in house and city dogs, and in
high bred and confined dogs generally, the fever is high and persistent
and the disorders often predominate in particular organs, hence we see a
_catarrhal form_, a _conjunctival_, a _bronchitic_, a _pulmonary_, a
_gastro-intestinal and hepatic_, a _cutaneous_ and a _nervous_. The
severe cases may last for twenty or thirty days or even in their sequelæ
for several months. Exposure to cold contributes greatly to a pulmonary
attack even in inoculated cases (Lignieres).
The _mortality_ varies greatly. In country dogs it may be below 20 per
cent., whereas in city dogs and those kept confined in close quarters
and in large numbers it may rise to 50, 60 or even 70 per cent.
_Prognosis_ is especially unfavorable in severe cases; in those
profoundly affecting the brain, lungs or liver; in high bred or pampered
dogs; in the very young; in the debilitated, anæmic or rhachitic; in
those that have been recently imported from another climate and are as
yet unacclimated. Puppies from debilitated dams, or those raised in a
large litter with insufficient nourishment, or older dogs confined to a
purely vegetable diet show less power of recuperation. Profound
prostration and offensive odor, from excess of toxins are always to be
dreaded.
_Incubation_ in inoculated cases varies from four to seven days
(Krajewski). When contracted by simple exposure it may seem to have been
extended to fourteen or even eighteen days.
_Symptoms._ The _earliest symptom_ is hyperthermia (103° to 104° F.)
This is accompanied and followed by prostration, dulness, impaired
appetite, erection of the hairs along the spine, shivering, trembling,
seeking a warm place, fatigue on slight exertion, hot dry nose, burning
pads of the feet, sometimes taciturnity. Later the temperature may
descend even to the normal or there may be alternations of rise and
fall. One of the most characteristic symptoms of distemper is the
implication of more than one set of organs, so that morbid
manifestations referable to the nose, eyes, throat, stomach, skin and
nervous system occurring in the same subject are to be especially noted.
In enumerating the prominent symptoms caused by disease of one set of
organs therefore, it is not to be implied that the absence of others
referring to a different class of organs is to be understood. On the
contrary a complication of several is especially significant of this
disease, though the predominance in one class of organ will signify a
special form of the disease.
_Respiratory Symptoms._ One of the earliest symptoms is usually sneezing
with redness of the nasal mucosa, followed by a muco-purulent blocking
of the nose, and rubbing of it with the paws. With the implication of
the throat there is usually local tenderness and a hard, painful cough,
which may be accompanied by retching or vomiting. The breathing becomes
snuffling, especially in pugs and bull dogs, and rapid and even
oppressed in case of implication of the smaller bronchia and lungs. The
nostrils may become glued together, the discharge red or dark in color,
vesicles and sores may appear on the mucosa, and the cough gets
paroxysmal, small, weak and husky or gurgling.
Percussion of the lungs may reveal small areas of flatness from exudate
or collapse, and in case of pleurisy and hydrothorax there is a lack of
resonance up to a given horizontal line, varying in position according
to the position of the animal and always keeping to that part of the
thorax which may at the time be lowest. Auscultation will reveal various
sounds according to existing lesions. There may be a loud blowing murmur
over the large bronchia, or at points to which this sound is conveyed
through consolidated lung. Or a coarse or fine mucous râle may be
present indicating the second stage of bronchitis, or a line of
crepitation, around a non-resonant area indicating pneumonia, or there
may be friction sounds or, later, creaking murmurs from false membranes.
Wheezing and sibilant sounds are not uncommon, also sounds of the heart,
bronchia or bowels, heard in unwonted situations to which they are
conveyed through consolidated lung tissue. Dyspnœa may become extreme,
with puffing out of the cheeks, labial soufle, and violent inspiratory
action. Fœtor of the breath is common. Emaciation, marasmus, sunken,
pale or dark red eyes, putrid diarrhœa and nervous disorders usually
precede death.
_Eye Symptoms._ Conjunctival congestion is one of the earliest and most
constant symptoms. Weeping, swollen eyelids and red turgid mucosa.
Photophobia may bespeak keratitis. Soon the watery tears become
muco-purulent, matting together the lashes and even the lids, during the
night especially, so that they must be sponged to get them apart in the
morning. The exudate may accumulate under the lower lid, or may become
flocculent, and usually flows down the cheeks causing matting and even
shedding of the hair. Vesicles exceptionally appear on the conjunctiva;
more frequently it becomes cloudy and opaque, and at points near the
centre, degeneration of the epithelium leads to the formation of ulcers
no larger than pinheads, but extending into the cornea and sometimes
perforating it so as to allow protrusion of the membrane of Descemet or
the escape of the aqueous humor. The formation and extension of the
ulcers are favored by the general debility, the rubbing of the eye with
the paws, and the infection of abrasions, by pus microbes. This
infection may extend to the lining member of the anterior chamber and
even of the posterior with panophthalmia, but, in the absence of
perforation, internal ophthalmia is rare. When the ulcers heal, white
cicatricial spots, or black points caused by the adhesion of the uveal
pigment remain.
_Digestive and Hepatic Symptoms._ Anorexia and vomiting may usher in the
disease. Buccal congestion, dryness, clamminess and fœtor are marked
symptoms and there may be some yellowness of the mouth and eye. The
patient is at first costive, but diarrhœa often sets in early, with
tenesmus, much fœtor, mucus, froth and even blood, also abdominal pain
and tenderness. The abdomen is habitually tense and contracted. The
alvine flux may rapidly exhaust the animal, or it may continue for a
month in dysenteric form with intense fœtor, weakness, emaciation and
exhaustion. Ulceration of the mouth, gums and rectum, invagination,
prolapsus ani, jaundice, septic pneumonia, paralysis, chorea,
convulsions, or cutaneous eruptions are occasional complications. The
abdominal type of distemper is especially fatal. Even in its early
stages debility, prostration and even drowsiness are marked features.
_Cutaneous Symptoms._ Skin eruptions are observed in the great majority
of cases, at some stage of the disease, and may remain as a sequel for a
time after apparent recovery. Friedberger and Fröhner note cases in
which the high fever and skin eruption are the only prominent symptoms,
and recovery may be looked for with some confidence. The lesions are
most patent on white skinned dogs with short hair, and on the more
delicate parts of the skin (abdomen, scrotum, perineum, inside of the
thighs and elbows) but they may extend over the whole body and even
extend on the mucosæ. They vary much in different cases and stages.
There may be punctiform reddish spots, changing to hard elevated
papules, and, in the case of a certain number, to vesicles and even
pustules. Some vesicles may be small and pointed, but more commonly they
are rounded and flat, and as large as a lentil or small pea. When first
formed, the contained liquid exudate may be clear and transparent, but
often it is reddish or even violet. The individual vesicles tend to
speedily burst, and dry up, but others appear, and thus the eruption
will continue for weeks, the skin meanwhile exuding a sticky, greasy,
offensively smelling exudate which mats the hairs together. Itching is
usually slight, yet in given cases excoriations and sores are produced
with considerable moist discharge. It tends to spontaneous recovery when
the general health improves and appears to be little affected by local
treatment.
_Nervous symptoms._ These are shown more or less from the beginning. The
great dulness, depression, apathy and weakness, which usually usher in
the disease, are indications of this. Drowsiness may be early shown.
Even the early nausea and vomiting may be largely central in its origin.
In some cases, however, the brain symptoms are more active and violent.
The dog is restless and irritable, getting up and moving from place to
place, starting from sleep, yelping, snapping, with twitching of the
muscles of the face or limbs, rolling of the eyes, and excessive heat of
the head. Krajewski even describes rabiform paroxysms, depraved
appetite, spasms, furious delirium, fawning, or threatening, and finally
paraplegia and maxillary paralysis Occurring in a country where rabies
is familiar it would have been more satisfactory if inoculations had
been made from such cases with results negativing rabies. Epileptic
attacks may appear at any stage of the disease. Chorea, tonic spasms,
paresis and paralysis are on the contrary habitually late manifestations
and often seem to be sequelæ determined by toxin poisoning of the nerve
centers, or degenerations of their structure. Choreic movements may be
confined to the head, or a limb, or they may affect the whole body.
Tonic spasms often affect the neck, turning the head rigidly to one
side. Among other nervous disorders may be named, amaurosis with dilated
pupil and atrophy of the optic nerve, deafness, anosmia, and dementia.
_Lesions._ These vary as do the symptoms. The nasal pharyngeal, and
laryngeal mucosæ show congestion, swelling, infiltration, ecchymosis
with vesicles, pustules and ulcerations. They are covered by a foul
muco-purulent exudate. The same condition may often be traced to the
final ramifications of the bronchial system. In pulmonary cases, the
lungs show inflammation, inflammatory exudation and consolidation,
collapse, splenization, œdema, and even suppuration in points or large
areas. The bronchial lymph glands and often the pharyngeal are enlarged,
congested and may be suppurating. The pleura over the congested lung may
be the seat of exudation and false membrane, and a bloody serum may
occupy the pleural cavity. The heart may show parenchymatous
degeneration.
In the digestive organs there may be buccal congestion, with
degeneration and the desquamation of the epithelium and formation of
more or less extended ulceration. The stomach shows similar congestions
and degenerations, the ulcer appearing particularly on the summit of the
folds. Together with the intestines this often presents numerous
petechiæ and ulcerations, and is covered by a foul but often tenacious
mucus. The agminated and solitary glands are usually swollen and
infiltrated, and the mesenteric glands are swollen, congested and
infiltrated.
The kidneys are often congested, and show points of blood extravasation
and tissue degeneration.
The meninges of the brain and cord are often inflamed with
infiltrations, false membranes, and especially exudation into the
subarachnoid and ventricles. Centres of congestion and softening have
been noted in the brain and cord with embolism of capillaries and
softening and degeneration of their endothelium. Nocard and others have
noted a leucocytic infiltration of the perivascular lymph spaces. In old
standing cases sclerosis is an occasional feature.
In nearly all cases there is marked emaciation and a very heavy
offensive odor comes from the skin, the tissues, the contents of the
bowels and the exudates on the respiratory passages.
Lignieres alleges that in the early stages, the specific bacillus is
found in the blood and viscera, but that later it is only exceptionally
found and that other bacteria (streptococcus, etc.,) usually take its
place. In the nasal discharge it may be found at times, but in the more
tardily appearing cutaneous vesicles its absence is the rule, and in the
brain matter and meningeal and ventricular fluids, in cases of paralysis
or chorea, it is not to be detected by culture. Hence the case cannot
always be diagnosed by a successful search for, or culture of the germ,
and hence also the frequently unsuccessful inoculations with the blood,
tears, liquid of vesicles, and even the lung tissues or nasal
discharges.
_Prevention._ Distemper, like any other contagious malady may be
excluded from a city or district by the simple expedient of shutting out
animals that bear the infection. From a kennel or pack of hounds, new
arrivals should be quarantined for a fortnight, until danger is past,
and should only be admitted after a good soapy wash. All clothing,
collars, brushes and other material that came with them should be
thoroughly disinfected. Dog shows and other meetings are to be avoided
as far as possible, and any animal that has returned from one should be
quarantined and all his belongings purified. Dogs that run at large
should be carefully excluded from kennels where valuable dogs are kept,
and from all possible contact with them. Even mice, rats, and birds have
to be considered if the disease exists in the near vicinity. When the
disease exists in a district a sound sanitation would demand the
shutting up of all dogs on their owner’s premises, unless carefully led
on chain and prevented from coming in contact with other dogs.
When the disease has broken out in a pack of hounds, or a populous
kennel, the dogs should be separated into small lots of 3 or 4; the
temperatures of all should be taken twice a day; any lot in which one
shows a high temperature should be instantly removed to a safe distance
and placed in quarantine; and the enclosure where they have been and all
their belongings should be thoroughly disinfected. The enclosures where
the sick are kept must be carefully quarantined so that no infection may
escape on food, water, brushes, utensils, clothing, attendants, cats,
vermin, or even birds.
The dogs that are still healthy should have spacious, well-aired
dwellings, open air exercise (as much as possible in the fine season),
good but not too stimulating food (in part at least fresh animal food),
pure water, and protection against undue fatigue, cold, icy baths,
especially when exhausted, rain or snow storms and cold stone or
metallic beds. In the cold season artificial heat in the kennel is
desirable.
_Immunization_ may be sought in various ways based on the use of the
toxins and antitoxins on the one hand, and of a weakened type of virus
on the other. Bryce (1882) and others inoculated with the blood and
pulmonary exudate, and produced in three-months-puppies, local swellings
mainly, with subsequent immunity. The mortality from the inoculation did
not exceed 10 to 15 per cent. These losses imply that in certain cases
the material inoculated conveyed the microbe of the disease, and the
survivors acquired all that immunity which comes from a first attack. In
the cases that show local lesions only, it may be presumed that few
microbes or none were inserted, while the results came mainly from the
toxins or antitoxins. This would be entirely in keeping with Lignieres’
observation that the blood and pulmonary lesions often failed to furnish
the pathogenic microbe, as tested even by attempts at artificial
cultures. The protection secured from the antitoxins alone is
shortlived, terminating with the elimination of these elements, while
that coming from the action of the toxins on the leucocytes, and the
stimulation by these to the production of defensive products, is much
more lasting and in ratio with the quantity of the stimulus introduced
and the profundity and duration of its influence on the leucocytes. This
may partly explain the occasional early exhaustion of the immunity and
the reinfection of the animal within a year after inoculation.
Physalix working in Chauveau’s laboratory has found the best results
from the use of weakened artificial cultures. He cultivated the microbe
of Lignieres in peptonised bouillon having 6 per cent. of glycerine, and
allowed successive cultures to rest (without reseeding a new culture
fluid), after they have attained to their full growth. The strength of
the culture is in inverse ratio to the period that elapsed between
successive cultures, leading up to this one, and the first inoculation
is made with the weakest product that will produce a very limited local
swelling which is fully developed in 48 hours, and disappears in a few
days. Three or four inoculations are made successively with cultures of
gradually encreasing potency, after which immunity persists for years.
It is to be understood, that an overdose will overcome the immunity at
any time; also that the passage of a culture of lessened potency through
a dog or Guinea pig will raise it to its original virulence. Physalix
operated only on young dogs, that had not shed their milk teeth, and
injected 2 to 3 c.c. of the culture as a dose with only 2.5% mortality.
Others had less success.
_Treatment._ To secure good results in the treatment of distemper every
attention must be paid to good hygiene. An open air life in summer, and
a roomy, clean, well-aired, warmed building in winter are most
important. Chills, foul air, and filth generally are to be carefully
guarded against. Food should be moderate in amount, easily digested and
nutritious. Milk is especially good (sweet, skim or buttermilk); then
biscuit and milk, or in patients accustomed to animal food, lean meat,
minced, scraped or pulped. Warm baths are often advantageous, but they
must be given with great caution to avoid chill.
Medicinal treatment is largely symptomatic. An excessively high
temperature (104° and upward) may be met by warm baths, or
antipyretics—quinine, acetanilid, salicylate of soda, antipyrine,
phenacetin, or even damp compresses to the sides. As a rule, however, it
is not well to continue such agents as acetanilid, antipyrine or
phenacetin longer than is absolutely needful to reduce excessive
temperature.
Attempts have been made to check microbian proliferation by
antiferments, such as quinine, calomel, creolin, phenol, and phenacetin.
The tonic action of quinine specially recommends it but like all bitters
it is obnoxious to a dog with a delicate stomach. Calomel is especially
recommended by Fröhner as a gastric and intestinal antiseptic and its
indirect action on the liver renders it valuable in many cases. Creolin
and carbolic acid exhaled from saturated cloths tend to disinfect the
air passages and give tone to the mucosa. My colleague Dr. P. A. Fish
gave carbolic acid, 2 per cent., and afterward 4 per cent. in normal
salt solution, and in doses of ½ to 1 drachm, subcutem once and twice a
day. In the initial stages, it seemed often to be of great value,
quieting the nervous excitement, improving the general symptoms, and in
some instances apparently cutting short the affection. Trasbot
recommended strong infusion of coffee, and Zippelius sodium chloride,
while others gave ergotin, or better hydrogen peroxide in spray or as a
draught.
_Eliminative treatment._ As in all depressing contagious diseases, we
must favor elimination of the toxins, and in this case without risking
any material encrease of debility. Calomel (7 grs.), sodium salicylate
or benzoate (4 grs.), sodium bicarbonate (7 grs.), potassium iodide (4
grs.), chlorate (7 grs.), or nitrate (7 grs.) may be cited. Digitalis (1
gr.), strophanthus, or caffeine are especially recommended by their
power of encreasing the tone of the heart when that has become weak or
exhausted.
For the _respiratory_ symptoms we may employ the antiseptic inhalations
already named, or, in place of these, iodine or sulphurous acid. The
nervous cough may be met by syrup of poppies, or anise, by morphia, or
codeia. (Recipe: morphinæ hydrochloras 0.1 grams: aquæ amygdal. amar. 10
grams, aquæ distill. 150 grams. M. A teaspoonful three or more times a
day. _Fröhner_). As expectorants, ammonium chloride (5 grs), or acetate,
senega, or apomorphia (⅒ gr.), may be used. In vigorous subjects
ipecacuan (½ to ¾ gr.), or antimonial wine (1 drop). Hydrogen peroxide
in doses of a teaspoonful is often useful. Among counterirritants and
derivatives the warm bath and cold compresses are especially valuable,
or tincture of iodine, or camphorated spirit, or equal parts of aqua
ammonia and olive oil serve a double purpose as furnishing at the same
time an expectorant inhalant.
Special pulmonary complications must be dealt with on general principles
as advised for the special diseases, bearing in mind always the profound
prostration and the need to avoid depressing agents.
For _conjunctival symptoms_ bathing with tepid water to soothe
irritation and remove adhesions and crusts, may be followed by a drop of
aqueous solution of pyoktanin (1:1000) under each lid, twice a day, or
cocaine (3:100), or silver nitrate (½:100); may be used. Fröhner advises
creolin (½:100); Cadeac, cresyl (½:100); Müller, mercuric chloride
(1:2000) or boric acid (1:40). Other Collyria may be substituted (see
diseases of the eye). In violent inflammations atropia will find a place
and in ulcerations boric acid, silver, pyoktanin, calomel, or hydrogen
peroxide. When irritation and rubbing are persistent a cocaine solution
may be dropped into the eye every few hours. When the ocular troubles
persist during general convalescence tonics with good nourishment and
hygiene are demanded.
With _digestive symptoms_ the attendant vomiting will usually have
cleared the stomach of irritant contents. In the exceptional cases it
may be unloaded by apomorphia (¹⁄₁₀₀ gr. subcutem), or ipecacuan wine a
teaspoonful by the mouth. More commonly a check must be placed on
persistent vomiting by bismuth nitrate (3 grs.), laudanum (5 to 10
drops), creosote (5 drops), or chloroform (5 to 10 drops), and small
pieces of ice. A derivative to the epigastrium is sometimes useful. The
food should be of the simplest and most easily digested kind, milk,
meat-soup skimmed of fat, meat juice, scraped or pulped raw meat.
Demulcents like gum water, slippery elm bark, or decoction of marsh
mallow may be resorted to, and in case of extreme irritability
nourishment may be given by rectal injection. As vomiting may be kept up
by irritants in the intestines a tablespoonful of tincture of rhubarb
may be required to be repeated twice a day until relief is secured.
Calomel and chalk (1:12) in grain doses will sometimes serve a good
purpose. Also dilute hydrochloric acid in water (1:60) in doses of a
teaspoonful with pepsin, gentian, quinine or nux vomica will often
contribute much to restore tone and function. Septic intestinal
fermentations may be met with beta-naphthol, naphthalin, (7 grs.),
chloral hydrate (10 grs.) lactic acid (buttermilk), or salol (5 grs.).
The attendant fœtid diarrhœa may demand in addition opium or silver
nitrate (½ to 1 gr.). The gastric secretion is usually suspended so that
it largely passes into the intestines unchanged. Of course it should not
be used along with muriatic acid.
The _skin eruption_ is usually considered of little consequence, or, by
some, beneficial (Cadeac). If treatment is desired it may consist in
dusting powders, demulcent soothing dressings and perhaps stimulating
liniments as found under _skin diseases_. It usually disappears with the
elimination of the toxins and the restoration of vigorous health.
For the _nervous symptoms_ treatment must correspond to the morbid
phenomena. Extreme prostration may demand diffusible stimulants. Spasms
and other indications of congestion may be met by cold to the head, and
inhalations of ether, followed by potassium or sodium bromide (8 grs.),
sulphonal (20 grs.), trional (15 grs.) chloral hydrate in mucilage, or
hypnal (15 grs.). Paralysis must be met by tonics, stomachics, easily
digestible, rich food, and good hygiene. Pepsin, muriatic acid, nux
vomica (½ gr.), arsenite of soda solution (5 drops), arsenite of
strychnia (¹⁄₂₀ gr); orexin(3 grs.), strong coffee infusion, wine, and
electricity may be tried, in addition to stimulant liniments. Chorea
must be treated on the same corroborant plan. Cold douches after which
the patient is carefully rubbed dry are sometimes successful, (see
Chorea).
During _convalescence_ and in all cases of debility and anæmia a similar
corroborant treatment is demanded. Pulped raw meat, rich soups,
stomachics, tonics including the preparation of iron, and in extreme
cases transfusion of blood or a normal salt solution may be resorted to.
In _cats_ a parallel course of treatment may be pursued, allowance being
made for the smaller size of the animal and the great susceptibility of
the feline patient to phenol.