SSS \ \\ \ ~ NAG << ~~ AAC SS x \ SF CORNELL UNIVERSITY. aot S25 THE Roswell P. Flower Library THE GIFT OF ROSWELL P. FLOWER FOR THE USE OF THE N. Y. STATE VETERINARY COLLEGE 1897 8394-1 anine medicine and surgery / VETERINARY MEDICINE SERIES No. 5 Edited by D. M. CAMPBELL, D. V. S. CANINE MEDICINE AND SURGERY BY CHAS. G. SAUNDERS, V.5S., B. V. Se. SENIOR PROFESSOR ONTARIO VETERINARY COLLEGE, PROFESSOR : CANINE AND FELINE MEDICINE ONTARIO VETERINARY CoLLecE, EpitoR CANINE DEPARTMENT AMER- ICAN JOURNAL OF VETERINARY MEDI- CINE, O. C. No. 2 SEcT. CANADIAN ARMY VETERINARY Corps, Etc. Chicago AMERICAN JOURNAL OF VETERINARY MEDICINE 1915 ' CopyRicHT, 1915, BY D. M. CAMPBELL PREFACE i offering this little work to the profession the author wishes to point out that it is published mainly for the use of senior students and practi- tioners. It presumes a knowledge of pathology, histology and anatomy, and aims to deal only with the clinical aspect of the various diseases. It does not presume to be an encyclopedia, but deals merely with the conditions «commonly found in everyday practice. If it succeeds in arousing more interest in and deeper study of canine practice, the “xuthor feels that his labor will not have been in vain. Toronto, Ont. Cag, SENATOR VEST'S EULOGY ON THE DOG The best friend a man has in this world may turn against him and become his enemy. His son and daughter that he has reared with loving care may become ungrateful. Those who are nearest and dearest to us, those whom we trust with our happiness and our good name, may become traitors to their faith. The money that a man has he may lose. It flies away from him when “he may need it most. Man’s reputation may be sacrificed in a moment of ill-considered action. The people who are prone to fall on their knees and do us honor when success is with us may be the first to throw the stone of malice when failure settles its cloud upon our heads. The one absolutely unselfish friend a man may have in this selfish world, the one that never deserts him, the one that never proves ungrateful or treacherous, is the dog. A man’s dog stands by him in prosperity and poverty, in health and in sickness. He will sleep on the cold ground, when the wintry winds blow and the snow drives fiercely, if only he may be near his master’s side. He will kiss the hand that has no food to offer, he will lick the wounds and sores that come in encounter with the roughness of the world. He quar the sleep of his pauper master as if he were a prince. ‘When all other friends desert, he remains. When riches take wings and reputation falls to pieces he is as constant in his love ~ as the sun in its journey through the heavens. If fortune drives the master forth an outcast into the world, friendless and homeless, the faithful dog asks no higher privilege than that of accompanying him, to guard him against danger, to fight against his enemies, and when the last scene of all comes and death takes his master in its embrace and his body is laid away in the cold ground, no matter if all other friends pursue their way, there by his graveside. will the noble dog be found, his head between his paws and his eyes sad, but open in alert watchfulness, faithful and true even to death. CONTENTS PART | SECTION I. GENERAL REMARKS 2.0... cc ccc ccc cee cece scree eee neeeees SECTION II. DISEASES OF THE UPPER RESPIRATORY PASSAGES...........+ Simple Nasal Catarrh — Rhinitis — Coryza — Epis- taxis—Laryngitis—Chronic Laryngitis. SECTION III. DISEASES OF THE BRONCHI AND LUNGS........--.000e eee Bronchitis—Acute Bronchitis—Chronic Bronchitis —Pneumonia—Lobar (Croupous) Pneumonia—Lobu- lar (Catarrhal) Pneumonia. SECTION IV. DISEASES OF THE PLEURZ....... cee cece cence eee 9 eitolet an Pleurisy—Inflammation of the Pleura; Pleuritis— Hydrothorax (Dropsy of the Thoracic Cavity)— Pleurodynia. SECTION V. DISEASES OF THE MouTH, PHARYNX AND HSOPHAGUS...... Stomatitis—Stomatitis Ulcerosa or Necrotic Stoma- titis—Glossitis—Ranula—Epulis—Papilloma or Wart —Neoplasms—Harelip and Cleft Palate—The Teeth— Tartar—Caries of the Teeth (Caries Dentum)—Em- pyema of the Superior Maxillary Sinus—Pharyngitis, or Sore Throat—Parotitis; Inflammation of the Parotid Gland (Mumps). SECTION VI. DISEASES OF THE STOMACH AND INTESTINES.............. Impaction of the Stomach—Gastritis-—-Acute Gas- tritis—Chroniec Gastritis—Foreign Bodies in the Stomach—Intestinal Catarrh—Colic—Intussusception —Diarrhea—Constipation—Typhilitis—Enteritis. SECTION VII. DISEASES OF THE RECTUM AND ANUS.......-c.ceeeeeeees Hemorrhoids—Prolapsus Recti—Amputation of the Prolapsed Rectum—Prolapsus Ani—Fistula in Ano— Atresia Ani—Obstruction of the Anal Glands. 3 17 31 37 50 66 4 CONTENTS SECTION VIII. DISEASES OF THE LIVER..... 2.0... eee ee een e reece eeeeees Icterus or Jaundice—Catarrhal Jaundice—Hepto- genous Icterus—Hematogenous Icterus—Malignant Malarial Jaundice—Hepatitis; Inflammation of the Liver—Cirrhosis of the Liver; Interstitial Hepatitis —Ascites or Abdominal Dropsy—Diabetes Mellitus. SECTION IX. DISEASES OF THE KIDNEY....... 0.0. eee ee cence cence ones Acute Inflammation of the Kidney; Acute Ne- phritis—Chronic Nephritis—Suppurative Nephritis— Degenerations and Neoplasms of the Kidney—Para- sites of the’ Kidney—Diabetes Insipidus—Diabetes Mellitus. SECTION X. DISEASES OF THE BLADDER..........-ccccceeccecceeeceens Cystitis—Spasm of the Sphincter Vesice—Paraly- sis of the Sphincter—Lithiasis; Stone in the Bladder —Retroflexion—Tumors—Prolapse—Eversion. SECTION XI. DISEASES OF THE PROSTATE, URETHRA AND PREPUCE........ Urethral Calculi—Urethritis; Catarrhal Inflamma- tion of the Mucosa of the Urethra—Prostatitis—Hy- pertrophy of the Prostate—Neoplasm; Tumor of the Prostate—Phimosis—Paraphimosis—Tumors of the Glans, Prepuce and Vagina. : SECTION XII. : DISEASES OF THE TESTICLES AND SCROTUM............020.5 Orchitis—Abcess of the Testicle—New Growths. SECTION XIII. DISEASES OF THE HEART AND BLOOD VESSELS...........0005 Pericarditis—Acute Endocarditis—Chronic Endo- carditis and Valvular Defects—Hypertrophy and Dila- tation of the Heart—Rupture of the Heart. SECTION XIV. DISEASES OF THE BLOOD AND BLOOD VESSELS............4.. Aneurysms—Hematozoa—Anemia of the Brain—- Cerebral Hemorrhage. SECTION XV. DISEASES OF THE NERVOUS SYSTEM............cccecucces Encephalitis—Cerebrospinal Meningitis—Inflamma- tion of the Spinal Cord and Membrane; Myelitis and Meningitis Spinalis—Apoplexy—Epilepsy—Chorea. 82 90 98 103 105 111 113 CONTENTS SECTION XVI. DISEASES OF THE BYE........ 02 ccc ccc cece csc een eesees wee Conjunctivitis—Keratitis—Abscess of the Cornea— Opacities of the Cornea—Congenital Opacities—Iritis —Cataract—Diseases of the Retina—Glaucoma. SECTION XVII. DISEASES OF THE HAR... .... ccc cece ccc e eee eeeees eees Ulceration of the Ear Flap—Catarrh of the Auditory Canal (Canker)—Deafness. SECTION XVIII. DISEASES OF THE SKIN..........ceeeeeee sis, tee taneaeesua savapenaneon x Sarcoptic Mange—Follicular Mange—Ringworm and Favus—Parasitic Dermatitis—Non-Parasitic Dis- eases of the Skin—Hrythema—Eczema—urticaria— Alopecia—Acne. SECTION XIX. INFECTIOUS CONSTITUTIONAL DISEASES..........2ceceeeees Distemper—Rabies—Furious Rabies—Dumb Rabies —Tetanus—Anthrax—Tuberculosis—Granuloma. SECTION XxX. INTERNAL PARASITES AND PARASITISMS. .+........0e0s0eee Spiroptera Sanguinolenta— Ascaris Marginata— Oxyuris Vermicularis—Ankylostomum Trigonocepha- lum—tTricocephalus Depressiusculus—Tenia; Tape- worms. SECTION XXI. POISONS -AND: POISONING «sissies 9:4 05) vce: 4 aie) 0 8s Ghee, Weve en 8 AUTOS Pathology of Poisoning—Arsenic—Phosphorus— Strychnin—Hydrocyanic Acid and Potassium Cyanid —Carbolic Acid (Phenol)—Iodoform. PART II SURGICAL OPERATIONS. SECTION I. PRELIMINARIES © i jpacsvea.s dice Bes eres Wok aed a4 meee ws eeneel WP Duran Anesthesia — General Anesthesia — Preparatory Treatment of the Operative Area—Preparation of In- struments—Preparation of the Operator’s Hands. SECTION II. SURGERY OF THE HEAD AND NECK.......... cc eee e cece eceee Hematoma of the Ear Flap—Plastic Operation for Split Ears—Harelip and Cleft Palate—Hsophagotomy —Tracheotomy. 122 131 135 148 165 180 188 6 CONTENTS SECTION III. SURGERY OF THE EYE...... cece cece eee eeeeee Kane foes Injuries; Foreign Bodies—Warts and Foreign Bodies — Entropion — Ectropion — Pterygium — Dis- placed Orbital Gland—Enucleation of the Eyeball. SECTION IV. SURGERY OF THE THORAX AND ABDOMEN........-.eeseeeeee Paracentesis Thoracic—Paracentesis Abdominis— Paracentesis Vesice — Laparotomy — Gastrotomy — Enterotomy—Enterectomy and Anastomosis of the Intestine—Ovariotomy and Ovariohysterectomy—Hy- sterotomy—Cesarian Section—Suprapubic Lithotomy. SECTION V. * OPERATIONS FOR HERNIA... . 6. cece cece cece ete eececcnenes Umbilical Hernia — Ventral Hernia — Inguinal Hernia—Scrotal Hernia—Perineal Hernia. SECTION VI. SURGERY OF THE LEGS AND TAIL. ........ 0c cece eee ence nee Sprains — Dislocations — Necrosis — Amputation of the. Tail—Fractures—Amputation of Claws—In- terdigital Cysts—Tumors. SECTION VII. OBSTETRICS: iia cs ers alae sda seg sew RUE Re la ies cas RES, WE Rear eN Dystocia—Maternal Dystocia—Fetal Dystocia— Accidents Liable to Occur During Parturition Ex- haustion—Lacerations of the Vagina—Rupture of the Uterus—Sequele to Parturition—Vaginitis—Pro- lapse of the Vagina and Uterus—Metritis—Simple Metritis—Septic Metritis or Puerperal Fever—Mam- mitis—Eclampsia. 194 203 275 279 225 CANINE MEDICINE AND SURGERY PART I CANINE MEDICINE SECTION I GENERAL REMARKS HE examination of a sick dog must be made carefully, so that a correct diagnosis of its condition may be reached, as on this the treatment and ultimate results largely depend. In this pre- liminary examination the animal must be handled gently but firmly, and so secured that it can do no injury to the veterinarian or to his assistants. In every case, unless the animal is known to be docile, its jaws should be secured either by a muz- zle or by a clove hitch. The non-observance of this precaution has led repeatedly to painful in- juries, and in several instances in the writer’s expe- rience has made necessary a visit to the hospital for the Pasteur treatment. The physical condition of the patient, and its mental attitude, should be noted, and its appetite, diet and the condition of the bowels and urinary apparatus should be inquired into. The tempera- ture, the rate and character of the pulse and the respiration should also be noted. The nose of a well dog is moist and cool; in a sick dog it is usu- ally hot and dry. The skin, normally, is loose and supple, and the hair bright and lustrous; in disease, 7 8 CANINE MEDICINE AND SURGERY on the other hand, the skin becomes dry, often hot to the touch, ‘and it may be the site of erup- tions, and in some places be devoid of hair. In wasting disease, skin ailments and digestive derange- ments the hair feels harsh and dry, is staring in ap- pearance, and is often brittle or easily pulled from the follicles. The condition and color of the visible mucous membranes are often valuable guides to diagnosis, and should always be examined, while the character and amount of any discharge from the eyes and natural openings of the body must on no account be overlooked. Having made this general examination of the patient, a more searching and specialized one is next carried out. The information obtained by the general examination will determine what organ or organs it is necessary to examine more closely. If the lungs, bronchial tubes:or pleurz are sus- pected, the special examination consists of ausculta- tion and percussion to determine what abnormalities, if any, are present. The abdomen should be pal- pated, auscultated to determine the absence or pres- ence of peristalsis, and moderate pressure applied over the abdominal walls to discover any unusual tenderness or tenseness of these walls. The eyes should be carefully scrutinized, and the action of the pupils noted, to learn whether the dilation is equal or unequal. The writer cannot urge too strongly that through- out the examination all gentleness and consideration be shown the patient, both for humane and ethical reasons, and because of the fact that success in dog practice depends in no mean degree upon one’s ability to “get along” with the mistress of the dog and win the confidence of the pet, both of which are impossible if the dog is handled roughly during the examination. ADMINISTRATION OF MEDICINES 9 THE ADMINISTRATION OF MEDICINES Medicine may be administered as to other animals, by the mouth, hypodermically, intravenously or by the rectum. The first two methods, save in excep- tional cases, are those most frequently practiced. The Oral Method Medicine in solution, in emulsion and in pill or tablet form may be given orally, but the two latter are by far the easiest to administer. To administer a pill or tablet the animal is either held by an assist- ant or steadied against the operator’s legs; the left hand is placed over the upper jaw and the cheeks pressed against the teeth, while the under jaw is gently depressed by the first finger of the right hand. As the mouth opens, pressure is maintained by the fingers of the left hand, thereby forcing the cheeks between the molars and effectually preventing the mouth closing. The pill or tablet is then placed well back on the animal’s tongue and the mouth allowed to close. In cases where it is desirable to administer the medicament in liquid form the dose should be regu- lated so as to be of as small a quantity as possible, except, of course, where irritant drugs are used, in which case they must be properly diluted to avoid irritation of the buccal mucous membrane. The medicine being already placed in a teaspoon, syringe or other convenient receptacle, the animal’s mouth is closed, either by an assistant holding the jaws closely together or by tying them together with a tape. The index finger of the left hand is then introduced at the corner of the lips and the cheeks pulled outwards to form a pocket, into which the medicine should be poured slowly until the animal has taken the required dose. 10 CANINE MEDICINE AND SURGERY The Hypodermic Method This is one of the most effectual methods of administration where quick absorption, with con- sequently quick results, is desired. The require- ments are’ non-irritating and easily soluble drugs, small-caliber needles and a twenty-minim syringe, preferably all metal, because such are easily steril- ized. The site of injection is of no importance, provided the skin be loose+ and thin, and for this reason the region of the scapula is generally selected. The site of injection should be painted with tinc- ture of iodin to disinfect it; the needle and syringe should be sterilized by boiling, and the drug com- pletely dissolved in distilled water. Unless all of these precautions are taken, an abscess may result at the site of the puncture. The syringe being filled, the skin is pinched up by the index finger and thumb of the left hand, the needle pushed quickly through the skin into the subcutaneous tis- sues, by the right hand, and the syringe is then attached and its contents evacuated slowly. The Intravenous Method This method is not used extensively in dog prac- tice, but is coming more into vogue than formerly. The skin over the vein selected for the injection, usually the auricular vein, must be most carefully disinfected before the needle is inserted. The needle and the syringe must also have been sterilized, dis- tilled water should be used for the solvent, and the drug must be completely dissolved to avoid em- bolism with its attendant dangers. The temperature of the solution should be raised to the temperature of the animal, and great care exercised in introducing the needle into the vein. All air must be expelled ADMINISTRATION OF MEDICINES 11 from the syringe before injecting, and the injection made slowly. The Rectal Method Medicine is administered by the rectum chiefly in the form of suppositories for the treatment of some local conditions, such as hemorrhoids, although both ether and chloral may be given by this method to induce anesthesia. The rectum is first emptied by an enema of warm, soapy water, then the sup- pository is introduced manually or the liquid injected by means of a syringe. Rectal injections to remove feces, to lower temperature and for other purposes may also be considered as medication by the rectum. SECTION II DISEASES OF THE UPPER RESPIRATORY PASSAGES Simple Nasal Catarrh, Rhinitis, Coryza, Cold in the Head HIS condition, as the name implies, consists of an inflammation of the nasal mucous (schneid- erian) membrane. However, it sometimes extends to the mucous membrane of the sinuses of the head. Cause.—Cold, infection and the inhalation of ir- ritant gases and other substances, for example, chemical fumes, smoke, dust or pollen are frequent causes of this condition. Symptoms.—The first symptom noticed is sneez- ing and pruritus of the nose, the animal trying to alleviate the itching by pawing at the nose or trying to rub it against something. The nose is hot and dry and the nasal mucous membrane hyperemic. In from twelve to twenty-four hours exudatiop from the mucous membrane takes place and a thin and watery discharge is established. This later becomes thicker and more tenacious, taking on a purulent character. This discharge must be differentiated from that of canine distemper, which is more sticky and of a greenish-yellow color, besides being nearly always of an offensive odor and often streaked with blood. The duration of an attack of nasal catarrh is usually about one week. Treatment.—Nasal catarrh should always receive treatment, since it opens the gates, as it were, to other infectious agents; and, furthermore, the 12 EPISTAXIS 13 catarrhal conditions may spread farther down the respiratory tract. A mild laxative, such as olive oil or cascara ex- tract, should be given, and the nose kept clear of discharge. Inhalation of medicated vapor gives great relief and soothes the inflamed mucous mem- brane. A few drops of oil of eucalyptus, creolin or Friar’s balsam (compound tincture of benzoin), in a kettle of boiling water, is: all the apparatus re- quired for steaming a dog. Small doses of quinin bromid, given three or four times daily, are usually all the medicine required. Attention must be paid to the surroundings, the patient being made com- fortable in a warm, dry and properly ventilated kennel. The diet should consist chiefly of milk and easily digested colid foods. Epistaxis Bleeding from the nose is usually the result of violence, such as a kick or blow; it may be slight or very profuse, according to the extent of the in- jury. It is also seen as a symptom in disease of the turbinated bones, in neoplasms of the nasal or other sinuses of the head, and also in some para- sitic affections, such as from the Pentastoma teni- oides and in hookworm disease (Uncinaria trigono- cephala infestation). Treatment.—The animal must be kept quiet, and cold, either in the form of cold water or ice packs, should be applied over the nasal sinuses. Spraying the nostrils and nasal mucous membrane with a 1-1000 solution of adrenalin chlorid will usually control the hemorrhage. However, in case the hemorrhage becomes alarming and fails to respond to the foregoing treatment, a full physiologic dose 14 CANINE MEDICINE AND SURGERY of atropin sulphate should be injected hypo- dermically. Laryngitis The most common cause of laryngitis is cold. The usual way the animal becomes affected is by lying near a hot stove or a fire until he is too warm, and then lying by a door where a cold draught strikes the neck. Constant barking, a habit of dogs when away from home, is another prolific cause. External injuries to the larynx, caused by the dog straining at the leash or the jerk-line being applied too vigorously by the dog trainer while training animals to the gun, are likewise considered among causative factors. Laryngitis may also appear as a complication in distemper or in bronchitis. Symptoms.—A cough is the first symptom of laryngitis. This may be quite violent, and at first is hard, harsh and dry. When exudation takes place the cough becomes moister and softer. Auscultation over the larynx reveals wheezing or rattling sounds; manipulation of the larynx is painful, producing an attack of coughing. The cough is also easily excited and aggravated by running, eating, drinking and by the administration of drugs. In severe cases, where the mucous membrane is much swollen, there is a well-marked difficulty in respiration; the tempera- ture runs high, to 104 or 105 degrees Fahrenheit, and the appetite is impaired. The average duration of an uncomplicated attack of laryngitis is about four days, when, if not relieved, it may run on into the chronic form, or sudden death may occur from edema of the glottis. Treatment—The animal must be immediately placed in warm and comfortable quarters, and an abundance of cold water provided and kept con- LARYNGITIS 15 stantly before him. According to the situation and circumstances, antiphlogistin (cataplasma kaolini U. S. P.), hot applications constantly renewed, a Priessnitz compress,* or the ammoniacal liniment (B. P.), must be applied over the region of the larynx. The throat should be sprayed three or four times daily with an antiseptic solution, such as equal parts of listerine:and water, or one dram tincture of iodin in one pint of normal saline solution. To control the cough administer codein sulphate in doses of from one-fourth grain to two grains, ac- cording to size and weight of dog. Glycoheroin (Smith) in teaspoonful doses is useful, as are also some of the preparations of heroin and codein now on the market. Where edema of the glottis threatens, guaiacol should be given and pushed to effect; tracheotomy should not be delayed. if there are symp- toms of impending suffocation. The following pre- scription has been used with success: Bo “Gua ACO Sie cca s.sin disse. A ceanavery Sraddnace, a deeseodoce Rineueed dr. i GLY COR ia & ctsecans caceand snrmaroarieie wins dagceea-ane dr. ii Sptsy Vint wectc coe wexearguwes eases saee oz. iv M. Sig. Give half a teaspoonful in four teaspoonfuls of water three times daily. Chronic Laryngitis This condition usually results from an acute at- tack or from some other grave respiratory disorder. It may also be caused by new growths, or it may be tuberculous: Except as a sequel to the acute form, the approach of chronic laryngitis is gradual and unaccompanied by constitutional disturbances other than those produced by the conditions of which it is a complication. *For a description of the Priessnitz compress or bandage, see the footnote on page 4 16 CANINE MEDICINE AND SURGERY Symptoms.—The manifestations of chronic laryn- gitis are the same as of the acute form, but are much modified in intensity. The cough is not so easily excited, but is hard and dry, and is usually worse at night, being often of a spasmodic nature. On manipulation, the larynx is not so tender as in the acute form of the disease, though coughing can be produced by pressure upon it. Exercise and excitement likewise produce attacks of coughing, as does also exposure to cold winds or draughts. Treatment.—This, as a rule, is not satisfactory, but should consist of sedatives, to allay the cough, and stimulant inhalations, such as steam medicated with turpentine or oil of eucalyptus. Medicinally, guaiacol in oil may be given, and the patient should be placed on a good tonic course and liberal diet. A sharp counterirritant over the laryngeal region is also of benefit in some cases. SECTION III DISEASES OF THE BRONCHI AND LUNGS Bronchitis HIS affection is quite common; it consists of a catarrhal inflammation of the bronchial mu- cous membrane, and occurs both in the acute and chronic form, which see. Acute Bronchitis Acute bronchitis may be due to any of the fol- lowing causes: Infection; exposure to cold and wet draughts when warm from exercise, or from lying in front of a stove or fire; smoke, chemical fumes (inhalation bronchitis), medicines going “the wrong way,” particles of food inspired when the animal is insensible, parasites, ether anesthesia, and as a complication of distemper. The average duration of an attack of acute bron- chitis is from two to three weeks: Symptoms.—This disease is ushered in with shivering fits or rigors, and a rise of temperature to 103 or 105 degrees Fahrenheit. The animal is depressed and more or less indifferent to its sur- roundings; the bowels are costive; the urine highly colored and scanty. Soon a cough appears, at first dry and dull, but later, as the disease reaches the second stage, moist and loose. The cough can be quite easily excited by pressure on the thoracic walls behind the shoulder or by slight pressure on the trachea. At first only the large bronchi may be 17 18 CANINE MEDICINE AND SURGERY affected, but if the condition extends to the capil- lary air passages the above symptoms are much inten- sified. The respirations are quickened and labored, and the cheeks puff out at each expiration; the fever runs higher and the depression and general constitutional disturbance become more marked. The pulse at first is full and bounding, then becomes quicker and weaker, and in cases approaching a fatal termination is almost imperceptible. Percus- sion gives negative results. In the first stage, auscultation reveals that the respiratory sounds are harsh and dry (bronchus rale); in the second stage the mucous rale is well established, and the vascular murmur intensified. An attack lasts two to three weeks, and ends in recovery, chronic bronchitis, catarrhal pneumonia, stenosis, or asthma. Treatment.—In smooth-haired dogs the thorax should be covered with a coating of cataplasma kaolini U. S. P. (or antiphlogistin, thermofuge, or similar remedy), applied hot, and covered with a thick covering of cotton wool, kept in place either by a bandage or by a pneumonia jacket, which can easily be made from factory cotton quilted with cotton wool or batting. This application should be removed and reapplied every twenty-four hours, for two dressings. In animals covered thickly with hair, oil of Sinapis, one part, and olive oil, forty parts, well rubbed in, should be substituted for the cataplasm, and the jacket applied as before. A purgative is always indicated in acute bron- chitis, and may consist of one half to two grains of calomel, repeated as occasion requires, it being most important to stimulate elimination from the outset of the disease. Unless the disease is of the well- marked sthenic type and the fever extreme, the coal-tar antipyretics, such as phenacetin and anti- BRONCHITIS 19 pyrin, should be sedulously avoided, on account of their depressing ‘action on the heart. The fever may be kept within bounds and elimination obtained far better by febrifuges and diuretics. The following is a satisfactory combination: EH Potassii acetatis............... 0.0 e eee grs. Xv Liquor ammonii acetatis............... dr. i Spiritus etheris nitrosi................. min, xxx Infusion buchu ...... a ch Has alee aur ec ata drs. iv M. Give four drams without water twice daily. The cough may be regulated by one-fourth-grain doses of codein sulphate every hour. In the second stage an expectorant cough mixture should be given, and stimulants as needed, of which there is none better than 1-200 to 1-60 grain of strychnin. Either of the following prescriptions may be used with good results: RB Heroin hydrochloridi.....................- er. i Syr. tolutani, 7 Sy?) SCillB, A4) cccacsscdadawacosacwa Canawe drs. vi Aquz chloroformi............eceee eee e eens ozs. vi M. Give two to four drams in water three times daily. BR Vini ipecacuanhe..................... min. xii Liquor ammonii acetatis, Syr: codeine sca ssews a vew ven ness anced s dr. ss Sym: SCH, Aa... oes oes. 8 sehueaiag acdon ene mee min. xv AGUS: Adis coenity any can vesiag eawaenred drs. iv M. Give four drams three times daily. Should the bronchial tubes become loaded with mucus of which they are not able to rid themselves, ‘and the animal’s breathing becomes greatly dis- tressed because of its interference with the passage of air, an emetic, of which the most effective is one thirtieth to one-tenth of a grain of apomorphin hydrochlorid, will give great relief, often averting suffocation. The after-treatment consists of a liberal diet and J 20 CANINE MEDICINE AND SURGERY tonics, such as Blaud’s pills, one pill three times a day, or a granule composed of Rk Strychnin arsenate................0008- gr. 1-128 Iron arsenate, Quinin arsenate, aa..........-... eee eee gr. 1-64 Nuclein solution. ..........-.csee cee eens min. iv M. Give one half to three, three times daily, or give ferri et quinine arsenas, two to ten grains, three times daily. Chronic Bronchitis This is a sequel to cases of acute bronchitis which, owing to neglect or other reasons, merge into the chronic. It runs a varied course of from a few weeks to several months. Symptoms.—Continual coughing and _ expectora- tion is a symptom of chronic bronchitis. The cough is easily started by exertion or excitement, and the expectorated matter is tenacious and often of an offensive odor. The pulse and temperature as a rule are disturbed but little, although in some cases the latter may be slightly elevated. The animal’s appetite is variable, and it generally loses flesh and becomes more or less emaciated. Treatment.—The treatment consists in controlling the cough and the exhibition of expectorants, steam- ing with stimulating medicated inhalations, and the administration of tonics. In this condition “Guaialyptol,’ a combination of guaiacol, eucalyptus, camphor, and phenic acid in oil has a markedly beneficial effect upon the mu- cous membrane and disinfects the entire respiratory tract. Cod-liver oil is also a most valuable re- constructive and should be given a trial. A liberal diet must be prescribed, and, as in all diseases of the organs of respiration, the importance of proper hygienic conditions must not be overlooked. PNEUMONIA 21 Pneumonia Like bronchitis, inflammation of the substance of the lungs is due to infection (pneumoccoccus, or Diplococcus pneumonie, and various Streptococci and Micrococci). It may also be caused by the spread of inflammation from other parts, as from the bronchial tubes in bronchitis or from the pleura in pleurisy. Again, it may be developed by the direct action of mechanical or other irritation, such as the inhalation of irritant gases or dust, or by vomition; or it may spring from the presence of emboli in the branches of the pulmonary artery or of tubercles or clots in the lung tissue; it may also occur as a complication of heart disease, kid- ney disease, rheumatism, debilitating diseases, dis- temper, tuberculosis, or echinococcosis. Cold and wet, unhealthful surroundings, and a lowered vitality are undoubtedly predisposing causes. Clinically, in the dog we have to deal with two forms of pneumonia, namely, lobar pneumoma, which is of rare occurrence, and lobular pneumonia, which is common. The words “diffuse” and “cir- cumscribed,” however, might be used to better ad- vantage, the type of the former variety being fur- nished by the idiopathic affection; that of the latter by the condition which is secondary to diseases of the air passages. The two varieties, however, merge into one another. Lobar (Croupous) Pneumonia This type begins with hyperemia of the small vessels which are distributed in the walls of the air cells and bronchial passages, a swelling and tend- ency to proliferation of the epithelial cells of these, parts, and an exudation of serum and cellular ele- ments of the blood. The air vesicles and. passages 22 CANINE MEDICINE AND SURGERY communicating with them gradually become filled and finally distended with this exudate, the air in them is expelled or absorbed by degrees, and the affected lung tissue becomes solid and heavy. If the parts be now examined microscopically, the dilated blood vessels will be found crowded with their corpuscular contents, and the alveoli full of cells, all blended ‘together into a common mass either by an amorphous, glutinous cement, or by a delicate, fibrillated network. With the progress of the disease the contents of the air vesicles liquefy and acquire a purulent character. This liquefied exudate is removed partly by expectora- tion and partly by gradual absorption. Occasion- ally, however, this breaking up of the exudate is followed by a breaking down of the lung substance, abscess formation, and gangrene. The progress of a case of pneumonia through its various phases is quite gradual, but there are at least three stages that are more or less well marked. The first of these is the stage of en- gorgement (congestion, hyperemia), the second that of red hepatization, the third that of gray hepatiza- tion. In the first stage the lung still contains air, though in diminished quantity; it is deeply con- gested, exudes more moisture than is natural, is increased in weight, and is more friable than nor- mal lung tissue. This condition of the lung tissue is difficult to distinguish from hypostatic conges- tion, for which it must not be mistaken if found on autopsy. In the second stage the lung is con- solidated; the cells have lost their air and the cavities are filled with adherent masses of cells ; it is distended to its full size, and its constituent lobules are distinctly mapped out upon the sur- face. In this stage the lung will sink in water PNEUMONIA 23 and when sectioned it appears fairly dry and slightly granular, presenting a marbled aspect which is due to the intermixture of nearly colorless inflammatory exudate and areas of congestion. The third stage differs from the second mainly in the assumption by the affected lung tissue of a fairly uniform, opaque, grayish, yellowish, or greenish tinge, in its largely increased friability, and in the ready exudation from the cut surface of a thick, turbid, purulent fluid; in some cases this exudate is comparatively scanty; in others it is so abund- ant that the lung is like a sponge saturated with pus. Since pneumonia tends to spread, it naturally follows that different portions of the affected lung often present well-marked differences of condition, and that we occasionally find all the recognized stages of pneumonia present at the same time in the same case. Inflammation may involve the lung to a varied extent; thus it may be. limited to a section no larger than a walnut or it may include the whole lobe or even a whole lung; and further, it may affect both lungs. The right lung is affected more frequently than the left, and the lower lobe more often than the upper. Symptoms.—Although of somewhat rare occur- rence, the symptoms of lobar pneumonia should be known by the veterinarian. The disease is ushered in with a day or two of lassitude and dullness, anorexia, and restlessness. The invasion of the dis- ease is generally marked by a rigor or a succession of rigors, and the temperature rises to 104 or 106 degrees Fahrenheit; the respirations are increased, in some cases up to sixty a minute. The breath- ing is shallow and labored and accompanied by more or less dyspnea; the cheeks are puffed out 24 CANINE’ MEDICINE AND SURGERY at each expiration. There is a short, dry, painful cough. The pulse is full and bounding, running at the rate of 150 to 190 a minute during the hyperemic stage, but becoming softer and weaker but still fast in the second and third stages. In cases approaching a favorable termination the pulse gradually regains its normal tone and rate, but in those cases that do not recover the pulse becomes’ weaker and ‘weaker, until it is barely perceptible. While pneumonia is in progress the systemic veins are apt to become overloaded and the mucous membranes may assume a cyanotic tint, although usually" they are congested and of a reddish color. Thirst is always increased, but loss of appetite is invariable. The condition of the bowels varies, and though the patient is usually constipated, some- times there is more or less diarrhea. The urine is scanty and dark colored. In the first stage of lobar or croupous pneumonia the most observable auscultatory phenomenon is minute crepitation, which may be audible during the whole of inspiration, sometimes during expira- tion as well, and not infrequently at the end of a deep inspiration, such as that which precedes a cough. In association with this there may be no change or percussion or there may be high-pitched resonance. The second stage is marked by the supervention over the consolidated portion of the lung of cessation of the fine crepitation and the development in its place of well-marked tubular breathing; when, however, the bronchial tubes lead- ing to these consolidated areas are completely ob- structed there is total absence of respiratory sounds. When pleurisy is coexistent with pneumonia, as is often the case, the friction sound indicative of PNEUMONIA 25 that condition will also be heard. At a later stage, when the lung tissue is breaking down or resolu- tion is taking place, tubular breathing gives way to a sort of coarse crepitation to which the name crepitatio redux has been given. This gradually passes into the ordinary bronchitic rales. The sputum expectorated is of little diagnostic value in the dog, as it is almost invariably swal- lowed immediately it is coughed up. It is, however, at first transparent, very viscid, and tinged with blood, later it loses its sanguineous tint and be- comes opaque and greenish, acquiring, in fact, a mucopurulent character, and then gradually dimin- ishes in quantity. In some cases, instead of undergoing these changes, which may be regarded as the normal changes, the sputum acquires a deep purplish or reddish-brown tint, and at the same time a more watery consistency. This form of sputum has been likened to prune juice and is gen- erally the sign not only of increased congestion and escape of blood but of the onset of the third stage. If attended by a disgusting fetor, it indi- cates the onset of pulmonary gangrene. In either case, it cannot but be regarded as an unfavorable symptom. Lobular (Catarrhal) Pneumonia This is the commonest pneumonia of the dog. In typical cases the lung is studded with pneu- monic patches varying in size from that of a pea to that of a walnut, each involving one or more pulmonary lobules, circumscribed by the interlobu- lar connective tissue and separated-from one an- other by a network of still crepitant, and, it may be, of perfectly healthy lung tissue. The pneumonic patches may be in the hyperemic condition only, in which case they may not be recognized or may 26 CANINE MEDICINE AND SURGERY present the features of ordinary red or gray hepa- tization. Further, by an extension of the disease, the neighboring diseased’ areas may coalesce and thus extensive tracts of lung tissue become involved. Full lobular pneumonia is always secondary to the blocking up of air passages, and especially those of capillary size; it may be excited either by the gradual extension of the inflammatory process from the tubes to the air vesicles, or by the entrance into the vesicles during inspiration of the inflamma- tory products of the tubes, which then act as irri- tants and carriers of infection. Closely related to lobular pneumonia is the dis- seminated pneumonia due to obstruction of small branches of the pulmonary artery, either by em- bolism or thrombosis, or in the course of pyemia. In these cases, as in the other, the affected areas are of small size and limited by the margin of the lobules. But there is a greater variety of result, especially in pyemia; in which, while the affected areas sometimes present simple hyperemia, or red or gray hepatization, they not infrequently are the seat of hemorrhage, or undergo rapid suppuration or gangrene, In all forms of pneumonia, even in such as are not of bronchitic origin, there is a tendency to the development sooner or later of bronchitis. But apart from this there is a marked disposition early in the course of pneumonia to the effusion into the tubes from the inflamed air cells of a transparent, very viscid fluid, uniformly stained with blood and containing cells; and in some rare cases this fluid, like that in the air cells whence it is derived, under- goes coagulation in the bronchial tubes, which thus PNEUMONIA 27 become filled to a greater or less extent with’ casts consisting of coagulated fibrin and cells. , Fortunately, abscess formation is the exception rather than the rule in lobular pneumonia, the dis- ease seldom going beyond the third stage. Gangrene seldom occurs in idiopathic pneumonia, it being met with chiefly in those cases in which the pneumonia is secondary to or complicated with some other affection. It is characterized by~ the breaking down of the lung tissue into a fetid, dirty, greenish-yellow pulp, and by more or less greenish discoloration. of the’ surrounding consoli- dated tissue. The gangrenous condition may involve either an extensive tract of lung tissue of several scattered areas or even a single small patch. The complications of pneumonia are pleurisy, bronchitis, icterus, and intestinal congestion. It is common to find on autopsy the right side of the heart filled with a fibrinous coagulum which is prolonged into the pulmonary artery (antemortem clot), while the left side is contracted and almost empty. Symptoms.—The lobular type, the common pneu- monia of the dog, attacks its victims insidiously during the progress of some other disease, such as distemper or bronchitis, Its onset is not usually marked by rigors or the violent circulatory dis- turbances noted in the lobar form. In patients suffering from bronchitis or distemper the super- vention of this form of pneumonia may be sus- pected by an aggravation of the respiratory dis- turbance. The temperature mounts higher, the respirations are more labored, and the puffing out of the cheeks at each expiration more marked. Auscultatory and percussive phenomena are not so distinctive as in the idiopathic form, but apart from its insidious approach, longer course, and greater 28 / CANINE MEDICINE AND SURGERY mortality, lobular pneumonia, with the exception noted, presents the same clinical symptoms as the idiopathic variety. Treatment.—The treatment of pneumonia of either the lobar or lobular type, resolves itself into the treatment of conditions found, and the upkeep of the vital forces of the patient until the disease runs its course. The most modern: method of treating pneumonia is by the pneumobacterin and antipneumococcic serum. The former combats the disease by raising the opsonic index of the patient, thus enabling the leukocytes to more effectually cope with the in- vading organisms (active immunity), and should be employed as soon as the diagnosis of pneumonia is positive. It may be used in doses corresponding ‘to those used in human practice, namely twenty- five to fifty million dead bacteria injected hypoder- mically. It is not necessary to obtain the opsonic index, as variations in the temperature constitute a sufficient clinical guide. In cases responding to bacterin treatment the” temperature will fall after the injection and then gradually rise again, when another injection should be given. The antiserum is used to neutralize the toxins already liberated by the organism and often produces great ameliora- tion of the symptoms (passive immunity). One of the most important factors in treating this, or for that matter, any other infectious dis- ease, is to secure free elimination for both the toxins produced by the infecting agents, and also for those manufactured in the animal’s own ali- mentary canal. In health these toxins are elimi- nated or neutralized, and their producers kept under control by the excretory organs and digestive juices. In disease, on the other hand, the functions PNEUMONIA 29 of the excretory organs and, in fact, the whole mechanism of the body, is more or less interfered with and thrown out of its normal equilibrium. In other words, we have to deal. “not only with toxins produced by the invading” organisms, but with toxins produced by the animal itself, that is, with an autointoxication., Thus free elimination, both by the intestinal. tract and the kidneys, must be maintained as the most essential part of the treatment. This may be accomplished by small doses of calomel, one- fourth grain every two hours to effect, or until one to two grains have been taken, and by the diuretic mixture given for the treatment of bronchitis. Constipation must never be allowed to persist. In sthenic cases, with a full, bounding pulse, the circulation must be equalized either by bleeding or, better still, by small, repeated doses of 1-1600 to 1-800 grain of aconitin every thirty minutes to effect, and then at intervals sufficient to keep the pulse within bounds. The same application to the chest wall as given under bronchitis should be applied, or equal parts of guaiacol and camphorated oil rubbed in and the thorax covered with a padded jacket. Abundance of fresh air should be allowed. The cough may be controlled by the administration of codein, one- fourth grain as required, and expectoration facili- tated by inhalations and expectorant mixtures. Guaiacol is an extremely useful drug in this con- dition, being an antipyretic, stimulant, and respira- tory disinfectant. In the second and third stages an ever-watchful eye must be kept on the heart, and stimulants given as conditions indicate. Strychnin, 1-200 to 1-60 grain, is the drug most useful here, and it may be advantageously combined with 1-50 grain of digi- 30 CANINE MEDICINE AND SURGERY talin. Throughout the illness the diet must be light, nourishing, and easily digested. Milk, beef tea, and small quantities of finely chopped raw beef are appropriate articles of diet. In cases where the animal refuses to eat at all, extract of meat, made into pills, may be administered, or a teaspoonful each of brandy and beef tea may be given every two hours. The after-treatment of pneumonia consists of liberal diet, moderate exercise, and a good, iron tonic. In cases of pneumonia that take on a septic char- acter due to secondary infection (pyogenic bac- teria), all the usual symptoms are accentuated, there is the addition of great prostration, and the case only too often ends fatally. However, anti- streptococcic serum in full and repeated doses has in many cases saved life, and should be resorted to as soon as the secondary infection is diagnosed. Subcutaneous injections of camphor are particu- larly useful in these cases and should be repeated as required. Thirty to sixty minims of spirit of camphor may be given, or it may be given as fol- lows: B Camphor® sev evew eesseeaade tb cc ecto grs. xv Etheris sulphurici...................... dr. ss OCR SOV Bb ses ttiricacsovnrtaceucynan peerdareeaeeat tlesaees drs. ii M. Inject fifteen to thirty minims, according to the cir- cumstances, Gangrene of the lung is often the sequel of the secondary invasion in pneumonia and is nearly always fatal, but the above treatment should be persisted in, in the hope of inducing a favorable termination. SECTION IV DISEASES OF THE PLEURZ Pleurisy (Inflammation of the Pleura; Pleuritis) The disease is found in two forms, primary and secondary pleuritis. The primary form is usually caused by exposure to cold, especially when the coat is wet, as in sporting dogs after swimming, or running through wet underbrush. Secondary pleurisy appears as a complication of other dis- eases, stich as pneumonia, pericarditis, peritonitis (extending from the abdominal cavity through the diaphragm), fractured ribs, punctured wounds of the thorax, perforation of the esophagus by for- eign bodies, tuberculosis, or pyemia. Morbid Anatomy.—The pleura is dull and tume- fied and very hyperemic. Its surface is roughened by accumulations of fibrin and in appearance may be likened to the surfaces of two pieces of bread and butter- that have been placed together and then separated. When there is no accumulation of fluid it is termed dry pleurisy, or pleuritis fibrinosa. Usually, however, exudation takes place and an accumulation of a serous fluid in which fibrinous coagula float, is found between the pleural folds. This pleuritic fluid, closely resembling blood serum, contains cells, and, according to the number of red blood corpuscles it contains, is of a straw color or of a sanguineous color. In secondary pleuritis, infection with pyogenic organisms may take place and then the fluid be- 31 32 CANINE MEDICINE AND SURGERY comes purulent, constituting the condition known as septic pleuritis or empyema. In primary pleur- itis the condition as a rule affects only one side of the chest, while in secondary pleuritis it affects both sides, but this is no hard and fast rule. The prognosis in primary pleuritis is generally favorable, though convalescence may be slow; that of the secondary variety depends entirely on the primary cause, or trauma. Symptoms.—Pleurisy may or may not be ushered in by rigors, but there is always malaise and great stiffness in action, and disinclination to move or bend the body, the condition being very painful. The respiratory movements are painful and almost entirely abdominal, the animal, on account of the pain attending thoracic movement, trying to fix the chest walls as much as possible. The constitu- tional disturbance is great, thirst is’ greatly in- creased,e anorexia generally complete; the bowels are costive; the urine is scanty, highly colored, and contains albumin; the pulse is fast and wiry, the temperature 104 to 105 degrees Fahrenheit; the mucous membranes are congested. Until the effusion has taken place percussion yields negative results. Afterwards a dull sound is heard up to the level of the accumulated fluid. Auscultation reveals the characteristic friction sounds of pleurisy, or later the fluid may be heard splashing during respiration. Since the accumula- tion of fluid in the pleural cavity compresses the lung, sometimes to complete collapse, dyspnea is always well marked when effusion has taken. place, and when the effusion is great symptoms of asphyxia manifest themselves; the compression of the heart and great blood vessels also leads to their disturbed and impaired action. PLEURISY 33° Where the effusion is great in amount the inter- costal spaces may be seen to bulge outward and the whole side of the chest is thus altered in ap- pearance. If empyema supervenes, the pulse be- comes rapid and weak,-and the temperature is inter- mittent but always high. Sometimes, however, the first indication of the empyemic condition is the expectoration of pus or a pointing in an intercostal space; as the evacuation of the pus in empyema must not be delayed, every endeavor should be made to diagnose it early. If the presence of pus is at all suspected, an exploratory puncture should be made. Cough may or may not be present in pleurisy; when present it is always painful, dry and sup- pressed. ' Treatment.—At the onset of the disease there is hardly any drug that will combat the pain and fever and equalize the circulation better than aconite or its alkaloid aconitin. Either may be ad- ministered in small doses every fifteen minutes for two hours, and then hourly, until the effusion takes place. The tincture of aconite in two minim doses, or 1-800 grain of aconitin, or a defervescent compound (aconitin, 1-800 grain; diditalin, 1-64 grain; veratrin, 1-128 grain), is perhaps the most useful. Aconitin, it must be remembered, is a powerful drug, and its frequent administration must be stopped as soon as either the desired effect is pro- duced or the physiological action of the drug brought about, as manifested by the softening of the pulse, champing movements of the jaws, and general relaxation of the patient. When this has been attained the dose is given at longer inter- vals to maintain the effect. Counter-irritants should 34 CANINE MEDICINE AND SURGERY be applied to the thoracic walls, either in the form of cataplasma kaolini, or mustard or oleum sinapis, and a firm supporting bandage placed around the chest to immobilize the ribs. The relief from pain given by thus fixing the ribs is most marked. When effusion has taken place, efforts must be made to hasten its reabsorption and_ elimination. This may be done by purgatives and diuretics. By their alterative and diuretic actions potassium iodid or ammonium iodid is of great service here. Codein in one-fourth grain doses, repeated as re- quired, will control the cough which, if present, is always distressing. Where the effusion is so exces- sive as to cause great difficulty in breathing, with symptoms of asphyxia, paracentesis thoracis should not be delayed, but promptly performed. The main danger lies in delaying the operation after the necessity for it is recognized, the patient’s vitality then not being sufficient for it to recuperate. The after-treatment consists in protecting the animal from exposure to cold and wet, liberal diet, and a line of alterative and tonic treatment. Hydrothorax (Dropsy of the Thoracic Cavity) Hydrothorax, strictly speaking, is true dropsy of the chest, although the term has been loosely used in connection with the effusion found in pleurisy. Hydrothorax is a transudation, non-inflammatory in origin, and is the result of some other pathologic condition, such as cardiac or renal disease. Symptoms.—A gradual filling up of the thoracic cavity with the transuded fluid, with corresponding difficulty in respiration, is the usual symptom of hydrothorax. Percussion reveals a distinct level of the fluid in the cavity, parallel to the horizon. PLEURODYNIA 35 The normal respiratory sounds may be _ heard above the level of the fluid, and indistinctly or not at all below the level. Splashing sounds are also in evidence. The other symptoms will depend upon the primary condition. Treatment.—Treatment for this disease is usually unsatisfactory. It must first of all be directed to the primary disease, and unless this can be diagnosed and corrected the treatment of the hydrothorax can be only palliative. It consists in the exhibition of diuretics and in resorting to paracentesis thoracis. This operation is harmless and may be repeatedly performed to relieve the dyspnea, but as a rule gives no permanent relief unless the primary cause is curable. On the other hand, by its repeated per- formance the life of an old favorite may often be prolonged for a considerable time. Pleurodynia Pleurodynia is essentially rheumatism of the mus- cular walls of the thorax. This exceedingly pain- ful condition might possible be mistaken for pleurisy unless a careful examination is made. It is due undoubtedly to exposure to wet and cold, more especially in rheumatic subjects. - Symptoms.—The animal is dull and listless, and evinces ‘:pain on movement and upon being handled. The breathing is shallow and abdominal, the patient trying to use his respiratory muscles as little as possible. When compelled to move, the animal shows great stiffness and disinclination to bend the body. The pulse may be a little more rapid than normal, but has not the wiry characteristic of the pulse in pleurisy. The temperature, as a rule, is about normal, or a little above it. Auscultation and percussion reveal nothing. 36 CANINE MEDICINE AND SURGERY Treatment.—Counterirritants to the affected mus- cles, capsicum linament or mustard, and the appli- cation of the padded pneumonia jacket should be resorted to. The region on each side of the spine should be palpated, and spots tender to pressure’ should receive smart counterirritation. The patient should receive a saline laxative, such as one to four _drams of magnesium sulphate, Its head being kept elevated for twenty minutes after its admin- istration to prevent it being vomited, and acetyl salicylic acid in doses of five to fifteen grains. Asperin (acetyl salicylic acid) is far superior to the ordinary salicylates, because it is soluble only in an alkaline medium and it does not cause’ the gas- tric disturbances that other salicylates cause. Bryonin, 1-20 to 1-40 grain, every two to six hours, will usually give prompt relief. In addition to the medical treatment, the patient must be kept in a warm, dry kennel and not ex- posed to cold or wet. The diet should be of a light and easily digested nature, such as milk, oatmeal porridge, or dog biscuit, while meat should be with- held until the attack is over. SECTION V DISEASES OF THE MOUTH, PHARYNX, AND ESOPHAGUS Stomatitis TOMATITIS, or inflammation of the buccal mucous membrane, is the result of either chem- ical, thermal or mechanical irritants, and is often a complication or symptom of some other disease or condition. It is also common during teething, and where there are decayed teeth. Symptoms.—The patient is observed to be slow and careful in eating, large pieces of food being discarded and smaller portions bolted without mas- tication. Salivation is a prominent symptom, the saliva hanging out at the corners of the mouth in glairy strings. Upon examination the mucous mem- brane of the mouth will be found to be red, swollen, and inflamed, the amount of inflammation depend- ing on the cause. In the case of corrosive poisons having been taken into the mouth the mucous mem- branes may be greatly eroded and hanging in shreds, the gums and tongue are also inflamed and tender, and ulcers sometimes appear on different parts of the mouth. Treatment.—The dog’s diet must consist of bland and non-irritating liquids or mashes, such as soups, milk, beef tea, bread and milk, and boiled rice; plenty of cold water should be supplied constantly. The mouth should be kept clean by means of antiseptic and mild astringent washes, applied either with a camel’s-hair brush or an atomizer; decayed 37 38 CANINE MEDICINE AND SURGERY and loose teeth .~must be removed and the tartar cleaned from the remaining teeth. In teething, the inflamed gums may be lanced. Any of the following solutions constitutes a useful mouth ‘wash for this condition: 1. Potassium permanganate, one-per-cent solution. 2. Peroxid of hydrogen, one to five parts water. 3. Borax, 130 grains; sodium bicarbonate, 130 grains; carbolic acid, twenty-five grains; glycerin, five one-half drams, and water to make twenty fluid ounces. Ulcers may be touched with tincture of iodin or a strong solution of alum. The tender gums may be painted with a tincture of myrrh, or one part tannic acid to four parts glycerin. Stomatitis Ulcerosa, or Necrotic Stomatitis This condition is a necrotic inflammation of the mucous membrane of the mouth. It attacks the gums more frequently than other parts. Cause.—This serious condition is generally seen in old, debilitated dogs and in weakly, anemic, and pampered animals of all ages. It is usually associ- ated with decayed teeth, and is no doubt due to some microérganism, probably the Bacillus necro- phorus, or possibly to various organisms. It is possible that the “Black Tongue” of the Southern states is a modified (intestinal), type of this same infection. Symptoms.—The gums in the neighborhood of certain teeth become swollen, red, and painful to the touch. In a day or so there is marked increase of the swelling, and the affected gum is of a dark red, brown-red, or of a purplish hue, while the tis- sue affected is spongy, bleeds on the slightest pres- sure, and is seen to have receded from the teeth. Later, beginning with the swollen region next to STOMATITIS 39 the teeth, the affected part takes on a yellowish or greenish-yellow color. This necrotic tissue is of a pulpy, greasy consistency, and if removed, either by the sloughing process or by force, leaves a large ulcer about one sixteenth of an inch deep, with irregular, ragged edges. - The walls of the ulcer are hard and hyperemic and raised above the general surface of the gum. As the gangrenous process proceeds, abscesses form in the alveolar process, and the teeth become loose and fall out; in extreme cases, the jaw itself may become necrotic and portions of the bone exfoliate. The morbid process extends from the gums to the lips and to the cheek, corners of the mouth, ani in rare cases to the tongue. There is always a profuse salivation, the discharge being ropy, glairy, blood-stained, and of an intolerably fetid odor. There is usually a rise of temperature to 103 degrees Fahrenheit, or even higher if septic absorption takes place, in which case the patient usually dies of septicemia. The appetite is generally good, although mastica- tion is both painful and difficult. In cases that run a benign course the necrosis is, usually confined to the mucous membrane, and ‘after the separation of the slough, the ulcers heal rapidly, often being entire- ly well in from eight to ten days. In the case of old, debilitated subjects the disease more often assumes a malignarit type, the gangrenous and necrotic proc- esses extend rapidly, and the animal dies from septic absorption. Treatment.—All loose and decayed teeth must first be extracted and abscesses evacuated. The mouth must be frequently swabbed with a deodorant mouth wash, such as potassium permanganate in one-per-cent solution or hydrogen peroxid, and after- 40 CANINE MEDICINE AND SURGERY wards strong disinfectants applied. Creolin in two- per-cent solution, painted on with a camel’s-hair brush, is most- effectual. Lugol’s solution* of iodin applied in the same manner often gives good re- sults, and touching up the ulcers with catstics is also effective. Internally the patient should receive an occasional laxative and an iron tonic. Nuclein (eight minims hypodermically twice daily) should be given from the beginning of the treatment, and the animal’s strength kept up by a liberal and easily digested diet. Glossitis ; Inflammation of the tongue is usually the result of injury by foreign bodies becoming em- bedded in or lacerating the substances of the tongue. Among the common causes of this condition may be mentioned spicules of bone that become lodged between the molar teeth, elastic bands placed around the tongue either by children in play or by some malicious person, irritant medicines, and caustics, new growths (carcinoma, sarcoma), etc. Symptoms —The animal shows difficulty in mas- tication and in lapping water. Salivation is pres- ent, the tongue is red, swollen, and tender, and the breath is often offensive. Treatment.—A careful examination of the tongue must be made for foreign bodies, which, if present, must be removed. The teeth must also be examined for particles of bone wedged between them, and if any are found they must be removed. Wounds of the tongue heal with remarkable rapidity, and often the removal of the cause and the use of some mild antiseptic mouth wash complete the cure. *Lugol’s solution consists of: Iodin 5 parts; potassium iodid 10 parts; water gq. s. 100 parts. EPULIS 41 Ranula Ranula is a large, fluctuating swelling which ap- pears at the lateral or under surface of the tongue, usually near the frenum. It is painful, produces profuse salivation, and may attain such size as to prevent the complete closure of the mouth. Cause.—This trouble is due to the blocking up or closure of the mucous gland and the consequent enlargement of the gland. An obstruction of Whar- ton’s duct sometimes produces a similar condition. The contents of ranule are of a thick, glairy, mucoid nature. Treatment.—This should be surgical, the instru- ments required are a mouth speculum, a small scalpel, scissors, and tissue forceps. The instrument having been sterilized by boiling for twenty min- utes, the mouth is fixed open with a mouth specu- lum and the tongue drawn into such a position as to place the ranula in the most suitable situation for removal. The sac is then punctured with the scalpel and the whole of the wall dissected out; unless this is thoroughly done, the ranula will recur. After-treatment consists in washing out the wound three or four times a day with. an antiseptic and astringent mouth wash. Boracic acid, ten grains to the ounce, and chinosol, one-half grain to the ounce of water, make useful antiseptic washes. Epulis This name is given to a hard, smooth, periosteal tumor which appears on the gums at the edge of the alveoli. There may be only one tumor, or they may be numerous, and may be benign or malig- nant in character. Unless these tumors cause pain and undue inconvenience in eating it is better not to interfere with them. If an operation is decided upon, they may be removed with a scalpel or scis- 42 CANINE MEDICINE AND SUI sors and the hemorrhage controlled by styptics. Occasionally a bony attachment may be found, in which cases bone forceps will be necessary to com- plete their removal. Papilloma or Wart Papillomas are often multiple, and may cover nearly the entire surface or the mucous membrane of the lips. Cause.—These tumors are of infectious origin. Treatment.—In many instances papillomas disap- pear spontaneously without treatment, and the ani- mal is immune against a second infection. Where they are very numerous, local applications of a satu- rated tannic-acid solution should be applied and Fowler’s solution given internally for at least a month before resorting to surgical means. If, how- ever, there are only a few tumors present, or the above treatment is futile, they may be removed by ligature or with the thermo cautery. It is best not to excise them with the scalpel or scissors, as the blood may infect a new area. Tumors of the Mouth The new growths met with in the mouth and pharynx of the dog are mostly carcinoma, sarcoma, and adenoma. Usually they are found affecting the soft palate, the pharynx, and the vicinity of the tonsils, sometimes even invading the eustachian tubes. The cause of new growths is unknown. Symptoms.—At first the patient shows some diffi- culty in swallowing, and the appetite may be capri- cous. Upon examination the growth may be dis- covered or, if deep seated, an unhealthy looking ulcer with ragged edges may be seen. This may be mistaken for an injury caused by a bone or some other foreign body, but the. involvement of the TEETH 43 neighboring lymphatic glands and the non-response to treatment in time reveal its true character. The diagnosis may be absolutely confirmed if a small portion be excised and submitted to an expert pathologist for microscopic examination. In all cases there is rapid emaciation, and sooner or later death relieves the sufferer. Treatment.—There is no successful treatment for this condition. Surgical interference appears to stimulate the malignant properties of these neoplasms, and the most humane course, once the diagnosis of malignancy is positive, is to end the animal’s suffer- ing by an overdose of chloroform. Harelip and Cleft Palate These congenital malformations may occur con- jointly or singly, and are serious defects. More especially is this true of the latter, as it is impos- sible for the puppy to feed in the natural way and it has to be fed from a feeding bottle with a nipple large enough to reach to the back of the mouth. A harelip may be double or single. A _ cleft palate may be wide or narrow, existing either in the anterior or posterior portion of the mouth, or it may extend the whole length. Treatment.—The treatment is surgical, and con- sists of scarifying the edges of the lips or palate and uniting them by sutures. The details of this operation are given in Part II (see page 191). The Teeth The dog has forty-two teeth, formulated thus: i. 3-3 ec. 1-1 pm. 4-4 m. 2-2—= 42 3-3 1-1 4-4 3-3 INCISORS CANINES PREMOLARS MOLARS JAW. r. 1. Yr. 1. r. 1 r. 1. Upper .....3 3 1 1 4 4 2 2 Lower ....3 3 1 1 4 4: 3 3 44 CANINE MEDICINE AND SURGERY The first incisors and the canines, and the second, third, and fourth molars appear in the dog at the end of five weeks. The permanent teeth begin’ to appear about the third or fourth month; the canine and middle incisors about the fourth month, and the remaining incisors at the end of five months, as well as the second, third, and fourth molars, the fifth molar about five months, the sixth about the sixth month, and the seventh about the end of the seventh month. Then the dog has a “full mouth” at the end of the seventh month. During teething the gums become red and tender and the flow of saliva is increased. In some cases the appetite may be entirely suspended and convul- sions may occur from reflex nervous irritation. In such cases the proper treatment is the administra- tion of simple sedatives, such as potassium bromid (five grains three times daily), and scarification of the gums. Tartar Tartar is a calcareous deposit on the neck of the tooth at the border of the gums. It is deposited chiefly around the canine and molar teeth, and causes great irritation of the gums, sometimes even loosening the teeth and giving the breath an offen- sive odor. Tartar should be removed by scraping the tooth with a specially constructed instrument termed a “scaler,” the mouth either being closed with a tape or kept open by means of mouth specu- lum. In powerful, violent patients a general anes- thetic may be necessary to facilitate the operation of removal. The teeth should ther be cleaned with a toothbrush and camphorated chalk or other suit- able dentifrice. CARIES 45 Caries Dentum (Caries of the Teeth) True caries of the teeth—that is, molecular de- struction—is rare in the dog, but such cases have been observed. It begins on the upper“ surface and mainly in the cavity of the crown, appearing as a black spot. This spot, which is the decaying part of the tooth, gradually penetrates the tooth toward the pulp cavity, and finally exposes the nerve, tooth- ache being the result. In necrosis of the teeth there is usually an alveolar periostitis associated with it, the tooth becoming loose, and yellow in color. In these cases alveolar abscesses may form and pyorrhea alveolaris, or dental fistula, remain. An animal affected with toothache becomes irritable, resents any manipula- tion of the mouth, has difficulty in mastication, and is salivated. The affected tooth is very tender; if struck with a sound or key causes the animal to cry. Treatment.—In true caries, if treated before the nerve is exposed, the tooth may be saved by care- fully drilling out the cavity, removing all diseased tooth substance, and filling the cavity with dental cement or amalgam. If, however, the case has gone too far for filling, extraction is the only remedy. For this purpose the mouth is held open by a specu- lum or gag, the forceps applied as far on the tooth as possible, the tooth loosened by a few lateral twists and finally. extracted by a strong pull in the direction of its roots. Immediately after the ex- traction the gums should be firmly compressed and the mouth washed out with an antiseptic lotion. 46 CANINE MEDICINE AND SURGERY Emp yema of the Superior Maxillary Sinus Necrosis of the fourth upper premolar often leads to empyema of the superior maxillary sinus, into which its roots penetrate, the pus discharging by a fistula just below the eye. This fistula may heal for a time under an antiseptic treatment, but sooner or later the discharge is reéstablished. By the use of a probe and tapping the affected tooth the signifi- cance of the fistula is recognized. Treatment.—The fourth premolar must be ex- tracted, the probe pushed down the fistula into the mouth, the sinus syringed out with an antiseptic, and free drainage maintained. The syringing is continued until healing takes place. Pharyngitis, or Sore Throat Cause.—Pharyngitis, or inflammation of the mu- cous membrane of the pharynx, may be caused by the extension or spread of inflammation from con- tiguous organs, by irritant medicines and chemicals, foreign bodies, or by injuries’ caused by unskillful attempts at removing obstructions lodged in the throat or in passing the probang. Symptoms.—Pharyngitis is manifested by a some- what stiff carriage of the head; difficulty in swal- lowing solids; sometimes by coughing, especially if laryngitis exists also, and by a congested appear- ance of the affected mucous membrane. Treatment.—The throat must be examined for foreign bodies, and if any are found they must be removed; this often presents considerable difficulty in the case of needles or pins, and great care must be exercised to avoid breaking them. The throat should then be sprayed either with iodin solution, PAROTITIS 47 hydrogen peroxid, or Dobell’s solution of the fol- lowing formula: BOPaxs sacs Ga eae san tasers eae ne ones gers. 130 Sodium bicarbonate ...............c..045 gers. 130 Carbolic acid .......... cc cece eee e eens grs. 25 GIYCenit. 2 sacs. saciid nanas soa A Ae Re fl. ozs. 5% Wal ers: 0s (Sins escle sig awe os pada va tues ow aes fl. ozs. 20 The diet must be restricted to liquids and soft foods to avoid irritation of the inflamed mucous membrane. ‘ Parotitis (Inflammation of the Parotid Gland—Mumps) Cause.—There are four varieties of parotitis (or parotiditis), the causes of which differ. They may be classed as follows: Contagious” parotitis, the specific organism of which has not yet been determined; traumatic parotitis, produced by injuries; metastatic parotitis, due to a metastasis of pyogenic organisms during attacks of distemper, pyemia, or septicemia; and parotitis caused by the extension of a neighboring inflammatory focus, as in pharyngitis, mastoiditis, or similar diseases. Symptoms.—In the contagious form the whole gland, or both glands, are swollen and tender, but there is no tendency to suppuration. In the other varieties the swelling is more circumscribed and suppuration usually takes places. The swollen glands are hot and tender and the act of swallowing is difficult and painful. Constitutional symptoms are fever, anorexia, and lassitude, while in sup- purative cases fluctuation is detected and the fever is usually high. Treatment:—The patient should receive a mild laxative—olive oil or cascara—and the’ affected glands, after being freely fomented with hot water, 48 CANINE MEDICINE AND SURGERY should receive an inunction of warm camphorated oil or have calaplasma kaolini applied. Moist heat in the form of Priessnitz compresses* often gives great relief by lessening the tension of the parts, and in cases where abscess formation is taking place it hastens the formation of the pus. Abscesses should be evacuated, drainage established, and the wound treated antiseptically. The diet must be of a liquid nature, such as beef tea, milk, and soft mushes. Foreign Bodies in the Esophagus, and Choking Choking is caused by the lodgment in the throat or esophagus of some foreign body, and is usually the result of greediness in feeding. The most com- mon foreign bodies are bones, gristle, needles, and pieces of wood. ! Symptoms.—The patient is greatly distressed, efforts at deglutition are greatly increased, and there is a return of food and drink through the nostrils. Treatment.—Sometimes the offending article may be forced back into the mouth by manipulation of the exterior parts, and in’ some cases extraction with throat forceps is easy; but in cases where neither of these methods is successful the probang must be *Describing the Priessnitz bandage or compress and its use, Glass says: . “The object of the compress or bandage is to maintain a con- tinual heat, either dry or moist, to certain parts of the animal’s body. We first apply to the part affected a piece of absorbent cotton, thick wool, or dry felt: or if moisture is required, it is soaked in warm water or a medicated solution and wrung out to remove the excess of fluid: this is then held in position by a cov- ering of some light material—a wide bandage of cheese-cloth is the best—next a layer of oiled silk cr rubber cloth (the object of this is to retain the heat and in case of a wet compress, the moisture), and finally over this is placed a compress or bandage of flannel. This last is to prevent loss of heat by radiation. -Some- times the inner layer cf cheese-clcth is omitted, or it may be put cn the outside of all. i “The above procedure may seem to the hurried practitioner a rather long and unnecessary method, but after one has tried it and found the great advantages it has in the retention of heat, especially in diseases of lungs, in hastening the maturing of an abscess, or in the lessening of a tumefaction by the constant and direct application of heat and moisture, he will realize its benefits,”’ PAROTITIS 49 passed and the offending body cautiously pushed on to the stomach. In the case of fish bones or needles the operator may be able to entangle them in the horse-hair portion of the probang and ex- tract them. . Great caution must be exercised not to use undue force or the esophagus may be ruptured, with seri- ous, if not fatal, results. Fuller directions for pass- ing the probang and for esophagotomy are given in Part II, Section II (see page 192). SECTION VI DISEASES OF THE STOMACH AND ° INTESTINES N the dog, impaction of the stomach and gas- tritis constitute about sixty per cent of all dis- eases of digestion. This is due mainly to the want of proper attention to the animal’s diet and to the practice of feeding only once a day, whereby the animal seeks to satisfy its hunger in a voracious manner. Impaction of the Stomach Cause.—Overfeeding and improper food are the principal causes of impaction. Symptoms.—Vomiting is an evidence of this trou- ble, and if it takes place may empty the stomach and so relieve the condition, but in the majority of cases vomiting is not violent enough to give much relief, and the patient will retch, slaver, and eruc- tate gas. Pressure over the epigastric region pro- duces pain, the respirations are accelerated, and the patient is greatly depressed. There are colicky symptoms, with great uneasiness and a frequent desire to change positions. The animal groans or whines, and may be irritable and “snappy.” Treatment.—Empty the stomach by a hypodermic injection of 1-20 'to 1-10 grain of apomorphin. Enormous masses of undigested or partially di- gested food are usually vomited, and relief is almost instantaneous. The stomach may then be washed out by means of the stomach pump, or eight to ten ounces of water may be administered and the 50 GASTRITIS 51 dose of apomorphin repeated to more thoroughly clean the stomach. A_ gastric sedative, such as from five to twenty grains of bismuth subnitrate, may then be administered and the animal’s diet restricted for a week or longer to small quantities of easily digested food. Gastritis This ailment, due to inflammation of the mucous membrane of the stomach, occurs both in the acute and the chronic forms. Acute Gastritis Cause—Acute gastritis is caused by irritating foods or medicines, such as decomposing meat. or arsenic, corrosive sublimate, or phosphorus, as well as by foreign bodies. Acute gastritis also occurs as a symptom of distemper. Symptoms.—There is vomiting, with little or no appetite, and increased thirst, great quantities of water sometimes being taken, only to be immedi- ately vomited. There is more or less constipation. The temperature is raised and the pulse accelerated. Pressure on the stomach causes pain. The patient is greatly depressed, lying down a great deal and assuming an almost diagnostic attitude, by trying to rest its abdomen on the floor. Treatment.—If an irritant-poison, decayed meat, or a foreign body is suspected to be the cause, an emetic should be administered to clean out the stomach. The vomiting may be controlled with from five to twenty grains of bismuth subnitrate, combined with three grains of cerium oxalate or five grains of chloretone. The constipation may be overcome by laxatives and enemas. If the pain ‘ 52 CANINE MEDICINE AND SURGERY indicates it, morphin in one-fourth-grain doses may be given subcutaneously, but chloral hydrate must never be used on account of its irritating effect on mucous membranes. In cases where there is ex- cessive tenderness on pressure, warm fomentations or turpentine stupes, or even the application of mus- tard over the epigastric region, often afford great relief. The animal must be kept on a low diet for some days; equal parts of milk and lime water may be given, and beef tea or finely minced, raw beef m small quantities. The after-treatment consists of a’ stomachic, such as a combination of quassia and strychnin, or tincture of rhei and tincture of nux vomica. Chronic Gastritis This disease is often the sequel to repeated at- tacks of the acute form; it may appear also as a secondary complication in other diseases. Gen- erally, however, it is the result of continued im- proper diet, associated with a debilitated state of the system. Symptoms.—Evidences of chronic gastritis are somewhat similar to those of acute gastritis, with the difference that the appetite is not entirely lost but is extremely capricious. Vomiting comes on only after eating, and there is no fever, and seldom is there evidence of pain on pressure over the epigas- trium.. The patient gradually becomes emaciated. Treatment.—Constipation or diarrhea must be cor- rected at the outset and the diet previously indi- cated for acute gastritis prescribed. Internally a combination of two grains of pepsin, two and one- half grains of bismuth subnitrate, and 1-100 grain of strychnin may be given immediately after meals GASTRITIS 53 three times daily, followed later with an alterative and tonic mixture such as: R Tr. nucis vomice................0000 drs, 4 Liar. acidi arsenosi...............0005 drs. 1 DE BOTAN: 2 sccogsveeahnsrnaarwep arenes ees oz. 1 Syfs aurantli. sses