Chapter 10

_Treatment._--This is most unsatisfactory, and I am inclined to place more dependence upon the care and feed than any medication that may be adopted. First of all the horse must be placed in a dry, warm, yet well-ventilated stable; the skin is to receive attention by frequent rubbings of the surface of the body, with blankets, and bandages to the legs. The water must be pure and given in small quantities; the feed, that which is light and easily digested. Medicinally, give at first a light dose of castor oil, about one-half pint, to which has been added 2 ounces of laudanum. The vegetable or mineral astringents are also to be given. Starch injections containing laudanum often afford great relief. The strength must be kept up by milk punches, eggs, beef tea, oatmeal gruel, etc. In spite of the best care and treatment, however, dysentery is likely to prove fatal. In the case of nurslings, the dam should be placed in a healthy condition or, failing in this, milk should be had from another mare or from a cow.

GASTROENTERITIS.

This condition consists in an inflammation of the stomach and intestines. Instead of being confined to the mucous, or lining, membrane, as in gastrointestinal catarrh, the inflammatory process extends deeper and may even involve the entire thickness of the wall of the organ.

This disease may be caused by irritant feed, hot drinks, sudden chilling, moldy or decayed feeds, foul water, parasites, or by chemical poisons. It may also complicate some general diseases, especially infectious diseases, as anthrax, influenza, rabies, or petechial fever. Long-continued obstruction of the bowels or displacement resulting in death are preceded by enteritis.

_Symptoms._--The symptoms differ somewhat with the cause and depend also, to some extent, upon the chief location of the inflammation. In general the animal stops eating or eats but little; it shows colicky pain; fever develops; the pulse and respiration become rapid; the mucous membrane becomes red; the mouth is hot and dry. Pressure upon the abdomen may cause pain. Intestinal sounds can not be heard at the flank. There is constipation in the earlier stages that is, followed later by diarrhea. The extremities become cold. Sometimes the feces are coated with or contain shreds of fibrin, looking like scraps of dead membrane, and they have an evil, putrid odor. If the disease is caused by moldy or damaged feed there may be great muscular weakness, with partial paralysis of the throat, as shown by inability to swallow. If chemical poisons are the cause, this fact may be shown by the sudden onset of the disease, the history of the administration of a poison or the entire absence of known cause, the rapid development of threatening symptoms, the involvement of a series of animals in the absence of a contagious disease, and the special symptoms and alterations known to be produced by certain poisons. To make this chain of evidence complete, the poison may be discovered in the organs of the horse by chemical analysis. In nearly all cases of gastro-enteritis there is nervous depression.

The poisons that are most irritant to the digestive tract are arsenic, corrosive sublimate, sugar of lead, sulphate of copper, sulphate or chlorid of zinc, lye, or other strong alkalies, mineral acids, and, among the vegetable poisons, tobacco, lobelia, and water hemlock.

_Treatment._--The treatment will depend upon the cause, but if this can not be detected, certain general indications may be observed. In all cases feed should be given in small amounts and should be of the most soothing description, as oatmeal gruel, flaxseed tea, hay tea, fresh grass, or rice water. The skin should be well rubbed with alcohol and wisps of straw, to equalize the distribution of the blood; the legs, after being rubbed until warm, should be bandaged in raw cotton or with woolen bandages. The horse should be warmly blanketed. It is well to apply to the abdomen blankets wrung out of hot water and frequently changed; or mustard paste may be rubbed on the skin of the belly. Internally, opium is of service to allay pain, check secretion, and soothe the inflamed membrane. The dose is from 1 to 2 drams, given every three of four hours. If there is constipation, the opium should be mixed with 30 grains of calomel. Subnitrate of bismuth may be given with the opium or separately in 2-dram doses. Stimulants, such as alcohol, aromatic spirits of ammonia, or camphor may be given in 2-ounce doses, mixed with warm water to make a drench.

If putrid feed has been consumed, creolin may be administered in doses of 2 drams, mixed with 1 pint of warm water or milk. If there is obstinate constipation and if a laxative must be employed, it should be sweet or castor oil, from 1 pint to 1 quart.

_Antidotes for poisons._--For the various poisons the remedies are as follows:

Arsenic: Oxyhydrate of iron solution, 1 pint to 1 quart; or calcined magnesia, one-half ounce in 1 pint of water.

Corrosive sublimate (bichlorid of mercury): The whites of a dozen eggs, or 2 ounces of flowers of sulphur.

Sugar of lead: Glauber's salt, 1 pound in 1 quart of warm water; to be followed with iodid of potash, 3 drams at a dose, in water, three times daily for five days.

Sulphate of copper: Milk, the whites of eggs, or reduced iron.

Sulphate or chlorid of zinc: Milk, the whites of eggs, or calcined magnesia.

Lye or alkalies, as caustic potash or soda: Vinegar, dilute sulphuric acid, and linseed tea, with opium, 3 drams.

Mineral acids: Chalk, or calcined magnesia, or baking soda; later give linseed tea and opium.

HEMORRHOIDS, OR PILES.

These are rare, comparatively, in horses. They are diagnosed by the appearance of bright-red irregular tumors after defecation, which may remain visible at all times or be seen only when the horse is down or after passing his manure. They are mostly due to constipation, irritation, or injuries, or follow from the severe straining during dysentery. I have observed them to follow from severe labor pains in the mare.

_Treatment._--Attention must be paid to the condition of the bowels; they should be soft, but purging is to be avoided. The tumors should be washed in warm water and thoroughly cleansed, after which scarify them and gently but firmly squeeze out the liquid that will be seen to follow the shallow incisions. After thus squeezing these tumors and before replacing through the anus, bathe the parts with some anodyn wash. For this purpose the glycerite of tannin and laudanum in equal parts is good. Mucilaginous injections into the rectum may be of service for a few days.

HERNIA, OR RUPTURE.

There are several kinds or hernias that require notice, not all of which, however, produce serious symptoms or results. Abdominal hernias, or ruptures, are divided into reducible, irreducible, and strangulated, according to condition; and into inguinal, scrotal, ventral, umbilical, and diaphragmatic, according to their situation. A hernia is reducible when the displaced organ can be returned to its natural location. It consists of a soft swelling, without heat, pain, or any uneasiness, generally larger on full feed, and decreases in size as the bowels become empty. An irreducible hernia is one that can not be returned into the abdomen, and yet does not cause any pain or uneasiness. Strangulated hernia is one in which the contents of the sac are greatly distended, or when from pressure upon the blood vessels of the imprisoned portion the venous circulation is checked or stopped, thereby causing congestion, swelling, inflammation, and, if not relieved, gangrene of the part and death of the animal. According to the time or mode of origin, hernias may be congenital or acquired.

CONGENITAL SCROTAL HERNIA.--Not a few foals are noticed from birth to have an enlarged scrotum, which gradually increases in size until about the sixth month, sometimes longer. Sometimes the scrotum of a six-months-old colt is as large as that of an adult stallion, and operative treatment is considered. This is unnecessary in the great majority of cases, as the enlargement often disappears by the time the colt has reached his second year. Any interference, medicinal or surgical, is worse than useless. If the intestine contained within the scrotum should at any time become strangulated, it must then be treated the same as in an adult horse.

SCROTAL HERNIA is caused by dilatation of the sheath of the testicle, combined with relaxation of the fibrous tissues surrounding the inguinal ring, thus allowing the intestine to descend to the scrotum. At first this is intermittent, appearing during work and returning when the horse is at rest. For a long time this form of hernia may not cause the least uneasiness or distress. In course of time, however, the imprisoned gut becomes filled with feces, its return into the abdominal cavity is prevented, and it becomes strangulated. While the gut is thus filling the horse often appears dull, is disinclined to move, appetite is impaired, and there is rumbling and obstruction of the bowels. Colicky symptoms now supervene. Strangulation and its consequent train of symptoms do not always follow in scrotal hernia, for often horses have this condition for years without suffering inconvenience.

INGUINAL HERNIA is but an incomplete scrotal hernia, and, like the latter, may exist and cause no signs of distress, or, again, it may become strangulated and cause death. Inguinal hernia is seen mostly in stallions, next in geldings, and very rarely in the mare. Bearing in mind that scrotal hernia is seen only in entire horses, we may proceed to detail the symptoms of strangulated, inguinal, and scrotal hernia at the same time. When, during the existence of colicky symptoms, we find a horse kicking with his hind feet while standing or lying upon his back, we should look to the inguinal region and scrotum. If scrotal hernia exists, the scrotum will be enlarged and lobulated; by pressure we may force a portion of the contents of the gut back into the abdomen, eliciting a gurgling sound. If we take a gentle but firm hold upon the enlarged scrotum and then have an assistant cause the horse to cough, the swelling will be felt to expand and as quickly contract again.

The history of these cases will materially aid us, as the owner can often assure us of preceding attacks of "colic," more or less severe, that have been instantaneously relieved in some (to him) unaccountable manner. The colicky symptoms of these hernias are not diagnostic, but, probably, more closely resemble those of enteritis than any other bowel diseases. In many cases the diagnosis can be made only by a veterinarian, when he has recourse to a rectal examination; the bowels can here be felt entering the internal abdominal ring.

_Treatment of inguinal hernia._--If the reader is sure of the existence of hernia, he should secure the horse upon its back, and, with a hand in the rectum, endeavor to catch hold of the wandering bowel and pull it gently back into the cavity of the abdomen. Pressure should be made upon the scrotum during this time. If this fails, a veterinarian must be called to reduce the hernia by means of incising the inguinal ring, replacing the intestines, and to castrate, using clamps and performing the "covered operation."

VENTRAL HERNIA.--In this form of hernia the protrusion is through some accidental opening or rupture of the abdominal wall. It may occur at any part of the belly except at the umbilicus, and is caused by kicks, blows, hooks, severe jumping or pulling, etc. Ventral hernia is most common in pregnant mares, and is here due to the weight of the fetus or to some degenerative changes taking place in the abdominal coats. It is recognized by the appearance of a swelling, at the base of which can be felt the opening or rent in the abdominal tunics, and from the fact that the swelling containing the intestines can be made to disappear when the animal is placed in a favorable position.

_Treatment of ventral hernia._--In many instances there is no occasion for treatment, and again, where the hernial sac is extensive, treatment is of no avail. If the hernia is small, a cure may be attempted by the methods to be described in treating of umbilical hernia. If one is fortunate enough to be present when the hernia occurs, and particularly if it is not too large, he may, by the proper application of a pad and broad bandage, effect a perfect cure.

UMBILICAL HERNIA is the passing of any portion of the bowel or omentum ("caul") through the navel, forming a "tumor" at this point. This is often congenital in our animals, and is due to the imperfect closure of the umbilicus and to the position of the body. Many cases of umbilical hernia, like inguinal and scrotal of the congenital kind, disappear entirely by the time the animal reaches its second or third year. Advancing age favors cure in these cases from the fact that the omentum (swinging support of the bowels) is proportionally shorter in adults than in foals, thus lifting the intestines out of the hernial sac and allowing the opening in the walls to close. Probably one of the most frequent causes of umbilical hernia in foals is the practice of keeping them too long from their dams, causing them to fret and worry, and to neigh, or cry, by the hour. The contraction of the abdominal muscles and pressure of the intestines during neighing seem to open the umbilicus and induce hernia. Accidents may cause umbilical hernia in adults in the same manner as ventral hernia is produced, though this is very rare.

_Treatment of umbilical hernia._--In the treatment of umbilical hernia it should be remembered that congenital hernias are often removed with age, but probably congenital _umbilical hernias_ less frequently than others. Among the many plans of treatment are to be mentioned the application of a pad over the tumor, the pad being held in place by a broad, tight bandage placed around the animal's body. The chief objection to this is the difficulty in keeping the pad in its place. Blisters are often applied over the swelling, and, as the skin hardens and contracts by the formation of scabs, an artificial bandage or pressure is produced that at times is successful. Another treatment that has gained considerable repute of late years consists in first clipping off the hair over the swelling. Nitric acid is then applied with a small brush, using only enough to moisten the skin. This sets up a deep-seated, adhesive inflammation, which, in very many cases, closes the opening in the navel. Still another plan is to inject a solution of common salt by means of the hypodermic syringe at three or four points about the base of the swelling. This acts in the same manner as the preceding, but may cause serious injury if the syringe or solution is not sterile.

Others, again, after keeping the animal fasting for a few hours, cast and secure it upon its back; the bowel is then carefully returned into the abdomen. The skin over the opening is pinched up and one or two skewers are run through the skin from side to side as close as possible to the umbilical opening. These skewers are kept in place by passing a cord around the skin between them and the abdomen and securely tying it. Great care must be taken not to draw these cords too tight, as this would cause a speedy slough of the skin, the intestines would extrude, and death result. If properly applied, an adhesion is established between the skin and the umbilicus, which effectually closes the orifice. Special clamps are provided for taking up the fold of the skin covering the hernial sac and holding it until the adhesion is formed.

DIAPHRAGMATIC HERNIA.--This consists of the passage of any of the abdominal viscera through a rent in the diaphragm (midriff) into the cavity of the thorax. It is a rather rare accident, and one often impossible to diagnose during life. Colicky symptoms, accompanied with great difficulty in breathing, and the peculiar position so often assumed (that of sitting upon the haunches), are somewhat characteristic of this trouble, though these symptoms, as we have already seen, may be present during diseases of the stomach or anterior portion of the bowels. Even could we diagnose with certainty this form of hernia, there is little or nothing that can be done. Leading the horse up a very steep gangway or causing him to rear up may possibly cause the hernial portion to return to its natural position. This is not enough, however; it must be kept there.

PERITONITIS.

Peritonitis is an inflammation of the serous membrane lining the cavity of and covering the viscera contained within the abdomen. It is very rare to see a case of primary peritonitis. It is, however, somewhat common as a secondary disease from extension of the inflammatory action involving organs covered by the peritoneum. Peritonitis is often caused by injuries, as punctured wounds of the abdomen, severe blows or kicks, or, as is still more common, following the operation of castration. It follows strangulated hernia, invagination, or rupture of the stomach, intestines, liver, or womb.

_Symptoms._--Peritonitis is mostly preceded by a chill; the horse is not disposed to move, and, if compelled to do so, moves with a stiff or sore gait; he paws with the front feet and may strike at his belly with the hind ones; lies down very carefully; as the pain is increased while down, he maintains the standing position during most of the time; he walks uneasily about the stall. Constipation is usually present. Pressure on the belly causes acute pain, and the horse will bite, strike, or kick if so disturbed; the abdomen is tucked up; the extremities are fine and cold. The temperature is higher than normal, reaching from 102° to 104° F. The pulse in peritonitis is rather characteristic; it is quickened, beating from 70 to 90 beats a minute, and is hard and wiry. This peculiarity of the pulse occurs in inflammation of the serous membrane, and if accompanied with colicky symptoms, and, in particular, if following any injuries, accidental or surgical, of the peritoneum, there is reason to think that peritonitis is present. Peritonitis in the horse is mostly fatal when it is at all extensive. If death does not occur in a short time, the inflammation assumes a chronic form, in which there is an extensive effusion of water in the cavity of the belly, constituting what is known as ascites, and which, as a rule, results in death.

_Treatment._--The treatment of peritonitis is somewhat like that of enteritis. Opium in powder, 1 to 2 drams, with calomel, one-half dram, is to be given every two, three, or four hours, and constitutes the main dependence in this disease. Extensive counterirritants over the belly, consisting of mustard plasters, applications of mercurial ointment, turpentine stupes, or even mild blisters, are recommended. Purgatives must never be given during this complaint. Should we desire to move the bowels, it can be done by gentle enemas, though it is seldom necessary to resort even to this.

ASCITES, OR DROPSY OF THE ABDOMEN.

This is seen as a result of subacute or chronic peritonitis, but may be due to diseases of the liver, kidneys, heart, or lungs. There will be found, on opening the cavity of the belly, a large collection of yellowish or reddish liquid; from a few quarts to several gallons may be present. It may be clear in color, though generally it is yellowish or of a red tint, and contains numerous loose flakes of coagulable lymph.

_Symptoms._--There is slight tenderness on pressure; awkward gait of the hind legs; the horse is dull, and may have occasional very slight colicky pains, shown by looking back and striking at the belly with the hind feet. Oftener, however, these colicky symptoms are absent. Diarrhea often precedes death, but during the progress of the disease the bowels are alternately constipated and loose. On percussing the abdominal walls we find that dullness exists to the same height on both sides of the belly; by suddenly pushing or striking the abdomen we can hear the rushing or flooding of water. If the case is an advanced one, the horse is potbellied in the extreme, and dropsical swellings are seen under the belly and upon the legs.

Treatment is, as a rule, unsatisfactory. Saline cathartics, as Epsom or Glauber's salt, and diuretics, ounce doses of saltpeter, may be given. If a veterinarian is at hand he will withdraw the accumulation of water by tapping and then endeavor to prevent its recurrence (though this is almost sure to follow) by giving three times a day saltpeter 1 ounce and iodid of potash 1 dram, and by the application of mustard or blisters over the abdominal walls. Tonics, mineral and vegetable, are also indicated. Probably the best tonic is one consisting of powdered sulphate of iron, gentian, and ginger in equal parts; a heaping tablespoonful of the mixture is given as a drench or mixed with the feed, twice a day. Good nutritious feeds and gentle exercise complete the treatment.

DISEASES OF THE LIVER.

In the United States the liver of the horse is but rarely the seat of disease, and when we consider how frequently the liver of man is affected this can not but appear strange. The absence of the gall bladder may account to a certain extent for his freedom from liver diseases, as overdistention of this and the presence in it of calculi (stones) in man is a frequent source of trouble. In domestic animals, as in man, hot climates tend to produce diseases of the liver, just as in cold climates lung diseases prevail. Not only are diseases of the liver rare in horses in temperate climates, but they are also very obscure, and in many cases pass totally unobserved until after death. There are some symptoms, however, which, when present, should make us examine the liver as carefully as possible. These are jaundice (yellowness of the mucous membranes of the mouth, nose, and eyes) and the condition of the dung, it being light in color and pasty in appearance.

HEPATITIS, OR INFLAMMATION OF THE LIVER.

This disease may be general or local, and may assume an acute or chronic form.

_Symptoms._--The symptoms of acute hepatitis are: Dullness; the horse is suffering from some internal pain, but not of a severe type; constipated and clay-colored dung balls; scanty and high-colored urine; and general febrile symptoms. If lying down, he is mostly found on the left side; looks occasionally toward the right side, which, upon close inspection, may be found to be slightly enlarged over the posterior ribs, where pain upon pressure is also evinced. Obscure lameness in front, of the right leg mostly, may be a symptom of hepatitis. The horse, toward the last, reels or staggers in his gait and falls backward in a fainting fit, during one of which he finally succumbs. Death is sometimes due to rupture of the enveloping coat of the liver or of some of its blood vessels.

_Causes._--Among the causes that lead to this disease we must mention first the stimulating effect of overfeeding, particularly during hot weather. Horses that are well fed and receive but little exercise are the best subjects for diseases of this organ. We must add to these causes the more mechanical ones, as injuries on the right side over the liver, worms in the liver, gallstones in the biliary ducts, foreign bodies--as needles or nails that have been swallowed and in their wanderings have entered the liver--and, lastly, in some instances, the extension of inflammation from neighboring parts, thus involving this organ. Acute hepatitis may terminate in chronic inflammation, abscesses, rupture of the liver, or may disappear, leaving behind no trace of disease whatever.