Chapter 12

TUMORS WITHIN THE NOSTRILS.

A small, globular tumor is sometimes found within the false nostril, under that part of the skin that is seen to puff or rise and fall when a horse is exerted and breathing hard. These tumors contain matter of a cheesy consistency.

_Treatment._--If the tumor is well opened and the matter squeezed out, nature will perform a cure. If the opening is made from the outside through the skin, it should be at the most dependent part, but much the best way to open the tumor is from the inside. Quiet the animal, gently insert your finger up in the direction of the tumor, and you will soon discover that it is much larger inside than it appears to be on the outside. If necessary put a twitch on the ear of the horse to quiet him; run the index finger of your left hand against the tumor; now, with the right hand, carefully insert the knife by running the back of the blade along the index finger of the left hand until the tumor is reached; with the left index finger guide the point of the blade quickly and surely into the tumor; make the opening large. A little blood may flow for a while, but it is of no consequence. Squeeze out the matter and keep the part clean.

COLD IN THE HEAD, OR NASAL CATARRH.

Catarrh is an inflammation of a mucous membrane. It is accompanied with excessive secretion. In nasal catarrh the inflammation may extend from the membrane lining the nose to the throat, the inside of the sinuses, and to the eyes. The causes are the general causes of respiratory disease enumerated above. It is especially common in young horses and in horses not acclimated.

_Symptoms._--The membrane at the beginning of the attack is dry, congested, and irritable; it is of a deeper hue than natural, pinkish red or red. Soon a watery discharge from the nostrils makes its appearance; the eyes may also be more or less affected and tears flow over the cheeks. The animal has some fever, which may be easily detected by means of a clinical thermometer inserted in the rectum or, roughly, by placing the finger in the mouth, as the feeling of heat conveyed to the finger will be greater than natural.

To become somewhat expert in ascertaining the changes of temperature in the horse it is only necessary to place the finger often in the mouths of horses known to be healthy. After you have become accustomed to the warmth of the mouth of the healthy animal you will have no difficulty in detecting a marked increase of the temperature. The animal may be dull; he sneezes or snorts, but does not cough unless the throat is affected; he expels the air forcibly through his nostrils, very often in a manner that may be aptly called "blowing his nose." A few days after the attack begins the discharge from the nostrils changes from a watery to that of a thick, mucilaginous state, of a yellowish-white color, and may be more or less profuse. Often the appetite is lost and the animal becomes debilitated.

_Treatment._--This disease is not serious, but inasmuch as neglect or bad treatment may cause it to lead to something worse or become chronic it should receive proper attention. The animal should not be worked for a time. A few days of rest, with pure air and good feed, will be of greater benefit than most medication. The value of pure air can not be overestimated, but drafts must be avoided. The benefit derived from the inhalation of steam is considerable. This is effected by holding the horse's head over a bucketful of boiling water, so that the animal will be compelled to inhale steam with every inhalation of air. Stirring the hot water with a wisp of hay causes the steam to arise in greater abundance. One may cause the horse to put his nose in a bag containing cut hay upon which hot water has been poured, the bottom of the bag being stood in a bucket, but the bag must be of loose texture, as gunny sack, or, if of canvas, holes must be cut in the side to admit fresh air.

The horse may be made to inhale steam four or five times a day, about 15 or 20 minutes each time.

Particular attention should be paid to the diet. Give bran mashes, scalded oats, linseed gruel, and grass, if in season. If the horse evinces no desire for this soft diet, it is better to allow any kind of feed he will eat, such as hay, oats, corn, etc., than to keep him on short rations.

If the animal is constipated, relieve this symptom by injections (enemas) of warm water into the rectum three or four times a day, but do not administer purgative medicines, except of a mild character.

For simple cases the foregoing is all that is required, but if the appetite is lost and the animal appears debilitated and dull, give 3 ounces of the solution of acetate of ammonia and 2 drams of powdered chlorate of potassium diluted with a pint of water three times a day as a drench. Be careful when giving the drench; do not pound the horse on the gullet to make him swallow; be patient, and take time, and do it right.

If the weather is cold, blanket the animal and keep him in a comfortable stall. If the throat is sore, treat as advised for that ailment, to be described hereafter.

If, after 10 days or 2 weeks, the discharge from the nostrils continues, give one-half dram of reduced iron three times a day. This may be mixed with damp feed. Common cold should be thoroughly understood and intelligently treated in order to prevent more dangerous diseases.

CHRONIC CATARRH (OR NASAL GLEET, OR COLLECTION IN THE SINUSES).

This is a subacute or chronic inflammation of some part of the membrane affected in common cold, the disease just described. It is manifested by a persistent discharge of a thick white or yellowish-white matter from one or both nostrils. The commonest cause is a neglected or badly treated cold, and it usually follows those cases where the horse has suffered exposure, been overworked, or has not received proper feed, and, as a consequence, has become debilitated. It may occur as a sequel to influenza.

Other but less frequent causes for this affection are: Fractures of the bones that involve the membrane of the sinuses, and even blows on the head over the sinuses. Diseased teeth often involve a sinus and cause a fetid discharge from the nostril. Violent coughing is said to have forced particles of feed into the sinus, which acted as a cause of the disease. Tumors growing in the sinuses are known to have caused it. It is also attributed to disease of the turbinated bones. Absorption of the bones forming the walls of the sinuses has been caused by the pressure of pus collecting in them and by tumors filling up the cavity.

_Symptoms._--Great caution must be exercised when examining these cases, for the horse may have glanders, while, on the other hand, horses have been condemned as glandered when really there was nothing ailing them but nasal gleet. This is not contagious, but may stubbornly resist treatment and last for a long time. In most cases the discharge is from one nostril only, which may signify that the sinuses on that side of the head are affected. The discharge may be intermittent; that is, quantities may be discharged at times and again little or none for a day or so. Such an intermittent discharge usually signifies disease of the sinuses. The glands under and between the bones of the lower jaw may be enlarged. The peculiar ragged-edged ulcer of glanders is not to be found on the membrane within the nostrils, but occasionally sores are to be seen there. If there is any doubt about it, the symptoms of glanders should be well studied in order that one may be competent to form a safe opinion.

The eye on the side of the discharging nostril may have a peculiar appearance and look smaller than its fellow. There may be an enlargement, having the appearance of a bulging out of the bone over the part affected, between or below the eyes. The breath may be offensive, which indicates decomposition of the matter or bones or disease of the teeth. A diseased tooth is further indicated by the horse holding his head to one side when eating, or by dropping the feed from the mouth after partly chewing it. When the bones between the eyes, below the eyes, and above the back teeth of the upper jaw are tapped on, a hollow, drumlike sound is emitted, but if the sinus is filled with pus or contains a large tumor the sound emitted will be the same as if a solid substance were struck; by this means the sinus affected may be located in some instances. The hair may be rough over the affected part, or even the bone may be soft to the touch and the part give somewhat to pressure or leave an impression where it is pressed upon with the finger.

_Treatment._--The cause of the trouble must be ascertained before treatment is commenced. In the many cases in which the animal is in poor condition (in fact, in all cases) he should have the most nutritive feed and regular exercise. The feed, or box containing it, should be placed on the ground, as the dependent position of the head favors the discharge.

The cases that do not require a surgical operation must, as a rule, have persistent medical treatment. Mineral tonics and local medication are of the most value. For eight days give the following mixture: Reduced iron, 3 ounces; powdered nux vomica, 1 ounce. Mix and make into 16 powders; one powder should be mixed with the feed twice a day. Arsenious acid (white arsenic) in doses of from 3 to 6 grains three times daily is a good tonic for such cases. Sulphur burnt in the stable while the animal is there to inhale its fumes is also a valuable adjunct. Care should be taken that the fumes of the burning sulphur are sufficiently diluted with air so as not to suffocate the horse. Chlorid of lime sprinkled around the stall is good. Also keep a quantity of it under the hay in the manger so that the gases will be inhaled as the horse holds his head over the hay while eating. Keep the nostrils washed and the discharge cleaned away from the manger and stall. The horse may be caused to inhale the vapor of compound tincture of benzoin by pouring 2 ounces of this drug into hot water and fumigating in the usual way.

If the nasal gleet is the result of a diseased tooth, the latter must be removed. Trephining is the best possible way to remove it in such cases, as the operation immediately opens the cavity, which can be attended to direct. In all those cases of nasal gleet in which sinuses contain either tumors or collections of pus the only relief is by the trephine; and, no matter how thoroughly described, this is an operation that will be seldom attempted by the nonprofessional. It would therefore be a waste of time to give the modus operandi.

An abscess involving the turbinated bones is similar to the collection of pus in the sinuses and must be relieved by trephining.

THICKENING OF THE NASAL MEMBRANE.

This is sometimes denoted by a chronic discharge, a snuffling in the breathing, and a contraction of the nostril. It is a result of common cold and requires the same treatment as prescribed for nasal gleet, namely, the sulphate of iron, sulphate of copper, iodid of potassium, etc. The membranes of both sides may be affected, but one side only is the rule; the affected side may be easily detected by holding the hand tightly over one nostril at a time. When the healthy side is closed in this manner the breathing through the affected side will demonstrate a decreased caliber or an obstruction.

NASAL POLYPUS.

Tumors with narrow bases (somewhat pear-shaped) are occasionally found attached to the membrane of the nasal chambers, and are obstructions to breathing through the side in which they are located. They vary much in size; some are so small that their presence is not manifested, while others almost completely fill the chamber, thereby causing a serious obstruction to the passage of air. The stem, or base, of the tumor is generally attached high in the chamber, and usually the tumor can not be seen, but occasionally it increases in size until it can be observed within the nostril. Sometimes, instead of hanging down toward the nasal opening, it falls back into the pharynx. It causes a discharge from the nostril, a more or less noisy snuffling sound in breathing, according to its size, a discharge of blood (if it is injured), and sneezing. The side that it occupies can be detected in the same way as described for the detection of the affected side when the breathing is obstructed by a thickened membrane.

The only relief is removal of the polypus, which, like all other operations, should be done by an expert when it is possible to obtain one. The operation is performed by grasping the base of the tumor with suitable forceps and twisting it round and round until it is torn from its attachment, or by cutting it off with a noose of wire. The resulting hemorrhage is checked by the use of an astringent lotion, such as a solution of the tincture of iron, or by packing the nostrils with surgeon's gauze.

PHARYNGEAL POLYPUS.

This is exactly the same kind of tumor described as nasal polypus, the only difference being in the situation. Indeed, the stem of the tumor may be attached to the membrane of the nasal chamber, as before explained, or it may be attached in the fauces (opening of the back part of the mouth), and the body of the tumor then falls into the pharynx. In this situation it may seriously interfere with breathing. Sometimes it drops into the larynx, causing the most alarming symptoms. The animal coughs, or tries to cough, saliva flows from the mouth, the breathing is performed with the greatest difficulty and accompanied with a loud noise; the animal appears as if strangled and often falls exhausted. When the tumor is coughed out of the larynx the animal regains quickly and soon appears as if nothing were ailing. These sudden attacks and quick recoveries point to the nature of the trouble. The examination must be made by holding the animal's mouth open with a balling iron or speculum and running the hand back into the mouth. If the tumor is within reach, it must be removed in the same manner as though it were in the nose.

BLEEDING FROM THE NOSE.

This often occurs during the course of certain diseases, namely, influenza, bronchitis, purpura hemorrhagica, glanders, etc. But it also occurs independently of other affections and, as before mentioned, is a symptom of polypus, or tumor, in the nose.

Injuries to the head, exertion, violent sneezing--causing a rupture of a small blood vessel--also induce it. The bleeding is almost invariably from one nostril only, and is never very serious. The blood escapes in drops (seldom in a stream) and is not frothy, as when the hemorrhage is from the lungs. (See Bleeding from the lungs, p. 127.) In most cases bathing the head and washing out the nostril with cold water are all that is necessary. If the cause is known, you will be guided according to circumstances. If the bleeding continues, pour ice-cold water over the face, between the eyes and down over the nasal chambers. A bag containing ice in small pieces applied to the head is often efficient. If in spite of these measures the hemorrhage continues, plugging the nostrils with cotton, tow, or oakum, should be tried. A string should be tied around the plug before it is pushed up into the nostril, so that it can be safely withdrawn after 4 or 5 hours. If both nostrils are bleeding, only one nostril at a time should be plugged. If the hemorrhage is profuse and persistent, a drench composed of 1 dram of acetate of lead dissolved in 1 pint of water, or ergot, 1 ounce, should be given.

INFLAMMATION OF THE PHARYNX.

As already stated, the pharynx is common to the functions of both respiration and alimentation. From this organ the air passes into the larynx and thence onward to the lungs. In the posterior part of the pharynx is the superior extremity of the gullet, the canal through which the feed and water pass to the stomach. Inflammation of the pharynx is a complication of other diseases--namely, influenza, strangles, etc.--and is probably always more or less complicated with inflammation of the larynx. That it may exist as an independent affection there is no reason to doubt, and it is discussed as such with the diseases of the digestive tract.

SORE THROAT, OR LARYNGITIS.

The larynx is situated in the space between the lower jawbones just back of the root of the tongue. It may be considered as a box (somewhat depressed on each side), composed principally of cartilages and small muscles, and lined on the inside with a continuation of the respiratory mucous membrane. Posteriorly it opens into and is continuous with the windpipe. It is the organ of the voice, the vocal cords being situated within it; but in the horse this function is of little consequence. It dilates and contracts to a certain extent, thus regulating the volume of air passing through it. The mucous membrane lining it internally is so highly sensitive that if the smallest particle of feed happens to drop into it from the pharynx violent coughing ensues instantly and is continued until the source of irritation is ejected. This is a provision of nature to prevent foreign substances gaining access to the lungs. That projection called Adam's apple in the neck of man is the prominent part of one of the cartilages forming the larynx.

Inflammation of the larynx is a serious and sometimes fatal disease, and, as before stated, is usually complicated with inflammation of the pharynx, constituting what is popularly known as "sore throat." The chief causes are chilling and exposure.

_Symptoms._--About the first symptom noticed is cough, followed by difficulty in swallowing, which may be due to soreness of the membrane of the pharynx, over which the feed or water must pass, or from the pain caused by the contraction of the muscles necessary to impel the feed or water onward to the gullet; or this same contraction of the muscles may cause a pressure on the larynx and produce pain. In many instances the difficulty in swallowing is so great that water, and in some cases feed, is returned through the nose. This, however, does not occur in laryngitis alone, but only when the pharynx is involved in the inflammation. The glands between the lower jawbones and below the ears may be swollen. Pressure on the larynx induces coughing. The head is more or less "poked out," and has the appearance of being stiffly carried. The membrane in the nose becomes red. A discharge from the nostrils soon appears. As the disease advances, the breathing may assume a more or less noisy character; sometimes a harsh, rasping snore is emitted with every respiration, the breathing becomes hurried, and occasionally the animal seems threatened with suffocation.

_Treatment._--In all cases steam the nostrils, as has been advised for cold in the head. In bad cases cause the steam to be inhaled continuously for hours--until relief is afforded. Have a bucketful of fresh boiling water every fifteen or twenty minutes. In each bucketful of water put a tablespoonful of oil of turpentine, or compound tincture of benzoin, the vapor of which will be carried along with the steam to the affected parts and have a beneficial effect. In mild cases steaming the nostrils five, six, or seven times a day will suffice.

The animal should be placed in a comfortable, dry stall (a box stall preferred), and should have pure air to breathe. The body should be blanketed, and bandages applied to the legs. The diet should consist of soft feed--bran mashes, scalded oats, linseed gruel, and, best of all, fresh grass, if in season. The manger, or trough, should neither be too high nor too low, but a temporary one should be constructed at about the height he carries his head. Having to reach too high or too low may cause so much pain that the animal would rather forego satisfying what little appetite he may have than inflict pain by craning his head for feed or water. A supply of fresh water should be before him all the time; he will not drink too much, nor will the cold water hurt him. Constipation (if present) must be relieved by enemas of warm water, administered three or four times during the twenty-four hours.

A liniment composed of 2 ounces of olive oil and 1 each of solution of ammonia and tincture of cantharides, well shaken together, may be thoroughly rubbed in about the throat from ear to ear, and about 6 inches down over the windpipe, and in the space between the lower jaws. This liniment should be applied once a day for two or three days.

If the animal is breathing with great difficulty, persevere in steaming the nostrils, and dissolve 2 drams of chlorate of potassium in every gallon of water he will drink; even if he can not swallow much of it, and even if it is returned through the nostrils, it will be of some benefit to the pharynx as a gargle.

An electuary of acetate of potash, 2 drams, honey, and licorice powder may be spread on the teeth with a paddle every few hours. If the pain of coughing is great, 2 or 3 grains of morphin may be added to the electuary.

When the breathing begins to be loud, relief is afforded in some cases by giving a drench composed of 2 drams of fluid extract of jaborandi in half a pint of water. If benefit is derived, this drench may be repeated four or five hours after the first dose is given. It will cause a free flow of saliva from the mouth.

In urgent cases, when suffocation seems inevitable, the operation of tracheotomy must be performed. To describe this operation in words that would make it comprehensible to the general reader is a more difficult task than performing the operation, which, in the hands of the expert, is simple and attended with little danger.

The operator should be provided with a tracheotomy tube (to be purchased from any veterinary instrument maker) and a sharp knife, a sponge, and a bucket of clean cold water. The place to be selected for opening the windpipe is that part which is found, upon examination, to be least covered with muscles, about 5 or 6 inches below the throat. Right here, then, is the place to cut through. Have an assistant hold the animal's head still. Grasp your knife firmly in the right hand, select the spot and make the cut from above to below directly on the median line on the anterior surface of the windpipe. Make the cut about 2 inches long in the windpipe; this necessitates cutting three or four rings. One bold stroke is usually sufficient, but if it is necessary to make several other cuts to finish the operation, do not hesitate. Your purpose is to make a hole in the windpipe sufficiently large to admit the tracheotomy tube. It is quickly manifested when the windpipe is severed; the hot air rushes out, and when air is taken in it is sucked in with a noise. A slight hemorrhage may result (it never amounts to much), which is easily controlled by washing the wound with a sponge and cold water, but use care not to get any water in the windpipe. Do not neglect to instruct your assistant to hold the head down immediately after the operation, so that the neck will be in a horizontal line. This will prevent the blood from getting into the windpipe and will allow it to drop directly on the ground. If you have the self-adjustable tube, it retains its place in the wound without further trouble after it is inserted. The other kind requires to be secured in position by means of two tapes or strings tied around the neck. After the hemorrhage is somewhat abated, sponge the blood away and see that the tube is thoroughly clean, then insert it, directing the tube downward toward the lungs.

The immediate relief this operation affords is gratifying to behold. The animal, a few minutes before on the verge of death from suffocation, emitting a loud wheezing sound with every breath, with haggard countenance, body swaying, pawing, gasping, fighting for breath, now breathes tranquilly, and may be in search of something to eat.