Definition: Infectious, non-febrile affection of solipeds with lesions
of the genito-urinary mucosa and nerve centres, paresis and paralysis.
History. Causes: Microbes varying; bacteria of colon group; infected
urine, genital mucus, brushes, combs, rubbers, mares especially
exposed; infection local or general. Lesions: Congestion, exudation,
swelling, discharge from vulva, vagina, bladder, ureter, kidneys;
lumbar spinal cord, brain. Symptoms: Mare, swollen open vulva,
congestion and petechiæ, bloody mucus; horse, swollen sheath, pendant
penis, congested papilla, discharge; paresis of hind limbs, falls,
inability to get up, incontinence of urine; paresis of fore limbs, of
thoracic muscles, asphyxia, fever in late stages. Recovery. Diagnosis:
From hæmoglobinuria by absence of dietetic cause, the infectious
progress and genital lesions. Prognosis: One-fourth to one-third die
or fail to recover. Treatment: Antiseptic washes and irrigations of
vagina, urethra, bladder, skin; internally oil of turpentine; slings.
Prevention: Isolation, disinfection, separate attendants, litter,
sponges, etc., fly nets, screens, insect powder, removal and
disinfection of manure and garbage.
_Definition._ A contagious, non-febrile affection of solipeds,
characterised by congestive and hæmorrhagic lesions of the
genito-urinary mucosa, the spinal cord and its meninges, and by
paraplegia or paresis of the hind limbs.
_History._ This was described in 1888 by Comeny, as occurring in a
regiment of French cavalry. Other outbreaks have been observed in 1892
(Rancoule); in 1896 (Blin and Lambert). Earlier outbreaks have doubtless
been confounded with cerebro-spinal meningitis, hæmoglobinuria or simple
paraplegia, the genito-urinary symptoms having been overlooked or viewed
as secondary.
_Causes._ The disease, as hitherto observed, has been invariably
associated with microbian infection of the genito-urinary mucosa, but no
one microörganism has been found to be constantly present. In the 1888
cases, Nocard isolated from the kidneys and lumbar cord a small, motile
bacillus which was not stained by Gram’s method and the inoculation of
which proved fruitless. Zschokke, in 1889, found in the kidneys, lungs,
liver and spleen of both horses and cattle, the victims of a progressive
infectious paralysis, a bacterium coli commune 1.5μ long by 0.7μ broad,
which stained in methylin blue and grew in agar and gelatine, and when
inoculated under the skin of a goat provoked paralysis. It had no effect
on a pig. In keeping with this, Thomassen, in 1893, alleged that the
bacillus coli communis in certain conditions, when colonized in the
solid organs, produced a toxin which caused paresis and paraplegia. Blin
and Lambert, in 1896, found in the urine, in pure cultures, a short
ovoid microbe, motile, non-liquefying and bleached by Gram’s solution.
It grew on gelose and peptonized gelatine as a creamy surface layer
which did not extend into the medium, and assumed a brownish color as it
became older. On potato it formed a superficial bright yellow film. In
bouillon the surface film which formed gradually precipitated to the
bottom of the vessel.
This microörganism was not found in the blood, liver, muscles nor spinal
cord.
Inoculation into the pleural cavity of the horse induced
pleuro-pneumonia.
The contagion appears to be transmitted through the urine and morbid
discharges of the urino-genital canal, falling on the litter and floor
and thus contaminating the tail, and indirectly the generative organs.
The brushes, combs and rubbers used on one horse after another are
similarly incriminated. The mares, having a wider exposure to infection,
appear to suffer most. Comeny saw eighty sick mares to twenty-eight
horses, and the mortality was thirty-four mares to three horses. The
smallness and length of the male urethra and its frequent flushing
throughout its whole length with urine seems to give a greater measure
of immunity to the horse.
In the Blin and Lambert cases the indications pointed to a local
infection and to the presence in the spinal cord of the toxins alone. It
may be assumed that in such cases there was a purely local infection. In
the Zschokke cases on the other hand, with microbian infection of
internal parenchymatous organs the presumption is that the paralysis was
due to a totally different infection, as appears to be further indicated
by the morphology of the microbe. They may have been, however, but the
advanced and generalized stages of a primary local infection.
_Lesions._ These appear to vary with the progressive advance of the
malady. In an ass which was killed as soon as paraplegia appeared and
the necropsy made at once, the lesions were confined to the vulva,
vagina and bladder. In advanced cases the ureters and kidneys are
visibly involved together with the spinal cord, especially in the lumbar
region, and in certain instances the brain.
The vulva is swollen, held habitually open so as to expose the erect
clitoris; the mucosa is irregularly swollen and petechiated, and there
is a glairy or bloody discharge. The swelling usually extends to the
inner side of the thighs, the mammary glands and the adjacent wall of
the abdomen. The vaginal mucosa is congested, swollen so as to bulge
irregularly at intervals and covered with a glairy muco-purulent matter
often mingled with clots of blood. The urethra and bladder are red and
congested, with marked thickening and ecchymosis of the mucosa and an
abundant serous exudate which extends into the muscular and peritoneal
coats as well. Minute extravasations are found in the two outer coats
and petechiæ of the serosa is the rule. In fatal cases the ureters and
kidneys are involved, the renal parenchyma is greatly congested and
softened, the cortical part especially being of a dark red, and the
glomeruli distinctly enlarged. An oily sanguineous liquid can be
squeezed from the cut surface. The lumbar portion of the spinal cord
together with its meninges, is congested and arborescent, and in bad
cases this may extend upward to the head and involve the brain and its
coverings.
There is general congestion of the venous system with black blood,
especially noticeable in the arborescent lines on the inner surface of
the skin and in the serosæ, and the liver and spleen are gorged with
black blood, which, however, reddens on exposure to the air. Muscles and
parenchymatous organs may show a parboiled appearance. In the male the
swelling appears about the sheath and penis, the papilla, the urethral
mucosa and that of the bladder are deeply congested and petechiated, and
the kidneys and medulla may be implicated as in the mare.
_Symptoms._ In the _mare_ the early symptoms are the swelling and gaping
of the vulva, with the muco-purulent or sanguineous discharge and the
presence of redness, congestion and petechiæ of the mucous membrane.
In the _horse_ there is swelling of the sheath and a pendant condition
of the penis, which in its turn may be irregularly reddened and swollen,
and the papilla and orifice of the urethra are deep red and angry.
Most commonly these early local symptoms are overlooked until attention
is drawn by some lack of control of the hind quarters. When moved the
animal sways or staggers behind, knuckles forward at the fetlocks and
drags the toe along the ground. This weakness encreases, and although
for a time the animal can stand steadily, he is liable to fall when we
make him take a step, and when down he will require help to get up. In
advanced stages the animal remains recumbent and cannot be made to stand
even with help, the fore limbs have become implicated in the paralysis,
and in the end the respiratory muscles are involved and the patient dies
asphyxiated. This marks the occurrence of severe lesions in the medulla
oblongata. Incontinence of urine is a frequent symptom. Fever usually
sets in, in advanced cases. Recoveries may take place from the first and
second stages, the control of the muscular system improves, the animal
lies down and rises with greater ease, the drooping penis is retracted
within the sheath, incontinence of urine ceases, micturition becoming
less frequent and more abundant at a time, and finally muscular control
becomes once more perfect. Convalescence may be complete in eight days
if it begins early, while it may require two or three months when the
disease has been more advanced.
Some subjects survive without overcoming the paralysis, so that they
simply _eat their heads off_ if preserved.
_Diagnosis._ From hæmoglobinuria this disease is to be distinguished by
the history which fails to show its supervention on a period of hard
work and high feeding, followed by one or more days of rest and then
sudden exercise; by the swelling ecchymosis and discharge from the vulva
or sheath, and by the occurrence of several cases in animals that have
had an opportunity for a common infection. In case of death the
condition of the kidney, bladder and urethra, and the marked congestion
of the lumbar portion of the cord is significant, the congestion,
petechiæ and extravasations are deeper and the glairy discharge is
present.
_Prognosis._ From one-fourth to a third of the animals attacked either
die or are rendered permanently useless.
_Treatment._ Antiseptic washes and irrigations of the genito-urinary
passages, and the adjacent parts, if employed early enough, would tend
to abort the disease. Even if resorted to later, they would be of some
value in limiting the multiplication of the microbe and the absorption
of its toxins. For this purpose boric or salicylic acid, salicylate of
soda, permanganate of potash, or silver nitrate may be taken as
examples. They should be as thoroughly applied as possible, the bladder
being thoroughly evacuated and injected several times a day. As internal
medication, oil of turpentine and other stimulant antiseptics that are
eliminated by the kidneys might be tried in small doses frequently
repeated. Keep in slings. The patient that cannot stand up is lost.
_Prevention._ This consists in isolation of the healthy, thorough
disinfection of the stalls, gutters, combs, brushes, rubbers, blankets,
and the hands of attendants. Litter used for the sick should be burned
and manure piles secluded and disinfected. Even flies are to be dreaded,
so that darkness in the stable, fly nets, fly screens, and insect powder
and other means of insect destruction will be in order. Sponges and
other means of dressing should not be used indiscriminately on different
animals.