» ♦' ■*^-»i^ ^ \ ■ - CP ■ (T "♦'JTW ^^**<^. > SF 9 1 1 . W72T^" ""'"*'*'•>' '-"'"'^ 'n*eresting cases from the surgical and 3 1924 000 297 907 [Reprinted from the American Veterin^rv Review^ June, 1898.] INTERESTING CASES FROM THE SURGICAIv AND -OBSTETRIC CLINIC, NEW YORK-^TATE VETERINARY COLLEGE. By "W. Iv. Williams, Prof, of Surgery, etc. TREATMENT OF FRACTURES IN BIRDS BY RUBBER ADHESIVE PIASTER. (963) Patient, a white Leghorn hen, set. i year, had in some unknown manner received a complete simple fracture of the metatarsus at the commencement of the lower third. Displace- ment and mobility were well marked and prohibited the bearing of any weight upon the affected member. The materials generally applied for the fixation of fractures being too bulky and heavy for so small a patient, recourse was had to the commercial rubber adhesive plaster. A strip of plaster >^ inch wide was gently warmed and applied directly to the foot for a sufficient distance on either side of the fracture, in the form of a spiral bandage, each turn overlapping the pre- ceding. The plaster secured complete and permanent fixation, was easily and quickly applied, highly presentable in appearance, and gave the greatest possible comfort and ease of movement to the patient. The hen began using the leg naturally after a few hours, and although permitted the freedom of the poultry yard regardless of moisture, the bandage remained securely in situ until after the fracture had reunited. AMPUTATION OF THE POSTERIOR EEG OF A SOW. (583) Patient, a sow of common breed, had four weeks previ- ously given birth to eight pigs, which she was still suckling. A few hours before being presented at the clinic she had been attacked by a bulldog and the right tarsus severely mangled, the bones of the tarsus being separated from each other and K W. L. WILLIAMS. from the tibia, fibula and metatarsals, the foot being held to the leg chiefly by the posterior tendons and ligaments, the wounds being thoroughly befouled with dirt. Other treatment than amputation was evidently useless, and accordingly the patient was chloroformed, the limb disinfected, and owing to serious mangling in the inferior tibial region am- putation was made by student K. just beneath the head of the tibia. Two lateral flaps were prepared, the chief arteries ligated-, the tibia and fibula were sawed through, the flaps sutured care- fully, the patient was reloaded into a wagon and returned at once to the owner's premises and placed with her pigs. On the following day the patient appeared dull, but the wound looked clean, was free from swelling and no injury had occurred to cause hsemorrhage. On the fourth day the owner reported slight swelling of the stump and the tearing out of one or two sutures, but the patient was brighter, feeding and caring for her pigs, and was moving about some. On the eighth day the patient was running about on three legs without apparent great inconvenience, and in 15 days the wound was practically healed, the sow in good health and flesh and caring for her brood of pigs apparently none the worse for the injury and loss of a leg. CASTRATION OF CRYPTORCHIAI, BOARS. (420) Patient, a boar pig, set. 4 weeks, both testes retained within the peritoneal cavity. Securing the pig on the right side with anterior part of body depressed, an opening was made by student F. in the left flank as if for spaying, the index finger introduced and the left testis grasped, withdrawn from the abdomen and excised, the finger again introduced, passing between the abdomnial floor and intestinal mass until the right testis was encountered and removed in the sartie man- , ner as the left. (421) A boar pig of same age as 430, monorchid, the normal testis having been removed by the owner. The abdominal : testis ;OTas removed by student M. in. same manner as 420. INTERESTING CASES. (432) A four weeks boar pig with right testis retained in abdomen, operated upon by student H. in same manner as pre- ceding. (171) A Chester white boar, aet. about 8 months and weigh- ing about 200 pounds, both testes entirely retained within ab- domen. Operation through left flank, the size of patient requiring the introduction of the entire hand into the abdomen in order to reach the right testis. Both testes were normal in size but soft and flabby. All four were castrated without anesthesia, the abdominal incision was closed by skin sutures only, usual antiseptic precautions were observed and all re- covered promptly without incident. HYDROPS AMNII IN A COW. (556) Occurring almost solely in the cow hydrops amnii presents an interesting problem in etiology, being so far with- out explanation. The patient in question was a Holstein cow of medium size, 7 months pregnant, and had apparently gone well until 14 days prior to examination the owner noted unusual distension of the abdomen and was led to suspect twin pregnancy. She had not been grained but had plenty of grass and fodder and was in fair condition, and believing twin pregnancy to exist and parturition nearing, the owner began feeding a moderate amount of grain. The abdomen continuing to enlarge the owner became sus- picious and gave one pound mag. sulph. without producing any change in the constantly increasing abdominal tension, the patient finally becoming unable to rise without assistance, though when up looked bright and ate and drank normally. Her inability to rise seemed more due to the excessive intra- abdominal weight than to any weakness of the patient. Being called to examine the patient it lequired the aid of six men to get her on her feet, when she stood and walked well, though as if overloaded. Percussion and rectal exploration re- vealed hydrops amnii, and a trocar passed into the amnion through the right flank showed the fluid to be perfectly color- less and odorless, as usually observed in these cases. Twenty W. L. WILLIAMS. gallons of it were allowed to run out through the canula. The OS uteri was dilated, the membranes ruptured and the fluid left free to escape, the patient being now left for 24 hours, hoping there would be sufficient gradual dilatation of os to permit of easy' extraction of the foetus, which was at the date of examina- tion still alive and vigorous in its movements. On the following day the patient could rise with less assis- tance and had shown some slight labor pains ; the os was moderately dilated, the foetus dead and emphysematous and required considerable force for its extraction, after which the cow seemed much exhausted. A stimulant was administered, and the patient placed in comfortable quarters. Although much of the amniotic fluid had escaped through the os, a great deal remained, the long continued over distension having apparently produced uterine paralysis. Three hours after removal of the foetus the cow died from exhaustion. The autopsy showed a very thin chorion and uterus, the body of which was practically obliterated, the hydrops having been confined to the two cornua. This change in relation between uterus and cornua consti- tuted an interesting feature in the case. When dilating the os at the time of the first examination, directly in front of the os, cpntrally located and perpendicular, was a thin band, the nature of which we failed to determine. The autopsy showed this to be the point of juncture between the two cornua which instead of being located several inches in front of the os intern, as in the non gravid or normal gravid uterus, was in direct contact with the os. The uterus was intact in every part except slight lacerations at the cornual juncture, which, however, were of no significance. There were no notable deviations from the normal observed in any organs, except the large flaccid uterus. In a herd of 10 dairy cows the owner had lost one previous to the case here recorded, undoubtedly of the same affection and but two days prior to our visit. The results in this case indicate that the proper method to INTERESTING CASES. pursue, is to complete at once the dilatation of the os and evac- uation of the uterine contents by physical force, and not leave this to be accomplished by labor pains after rupturing the mem- branes. Such a plan involves much time, labor, and patience, as the cow's os is so firm that it can not be rapidly nor easily dilated, but the uterine walls having been so over distended lose their power and fail to accomplish the purpose sought, while the flaccidity and fluidity tend to rapid and intense infection, with death of the foetus and absorption of toxic sub- stances. Siphoning out the fluid after rupturing the membranes would doubtless aid in relieving the uterus and possibly aid it in contracting upon the foetus. After the foetus is properly se- cured by cords it would seem that the recumbent posture would be best for delivery, facilitating the exit of fluids and also the foetus from the paralyzed uterus. ASCITES IN A PREGNANT EWE. (858.) An aged Shropshire ewe at full term of pregnancy had for some weeks shown a progressive distention of the abdomen and for a few days prior to presentation at the clinic had shown inappetence, debility, and difficulty in progression, owing largely to the immoderate distension of the abdomen. Hydrops amnii was at first diagnosed and an effort made to relieve the difficulty by rupturing the supposedly affected membrane through the os uteri, but the effort proving fruitless the pa- tient was destroyed, and the auto'psy showed that the fluid had been intra-peritoneal. The peritoneal fluid was pale, slightly turbid, and contained numerous shred-like masses of dirty grayish lymph floccules. The intestines, mesentery, omentiim, lungs, and liver were thickly infested with the degenerate capsules of the CEsopha^os- tdma Columbianum. It would appear that the unusual number of these caseated nodules in the liver were the probable cause of the ascites, as a result of their interference with the hepatic functions. The differential diagnosis between ascites and hydrops W. L. WILLIAMS. amnii in the pregnant ewe offers peculiar diiEculties. The heavy abdominal tunic excludes abdominal taxis, the rectum is too small for safe exploration per anum, and the vagina fails to offer special facilities. The exploratary trocar might give iden- tical results in either affection, the foetus in each case would tend to float upward, would generally be alive and vigorous, while percussion would reveal the same dullness in one case as in the other. We find no record of hydrops amnii in the ewe, yet it is not impossible, as it has been recorded in the goat, though chiefly affecting cows. The ewe will, in all probability, withstand laparotomy as well as the cow, in which case this one means for positive diag- nosis is readily available, when if it proves to be ascites, the fluid can be drained away through the incision, while if hydrops amnii the incision can be closed, the os uteri dilated and artifi- cial delivery brought about. AMPUTATION OF OVARIES AND GRAVID UTERUS IN A BITCH. (227) Patient, well-developed Collie bitch, set. 8 months, pro- cured by the present owner three weeks prior to presentation at the college clinic, was presumably non-pregnant. She had been fasted for 12 hours preparatory to spaying, which was under- taken by student H. by the flank method without ansesthesia. Difficulty was experienced in bringing up the uterus or other parts of the internal genitals and it was soon discovered that the uterus was gravid, requiring strong tension to lift the cornua up and out through the incision, when it was found that each cornu contained four foetuses, which with their envelopes measured 2% x 4. inches each, the eight foetuses in the now exposed cornua representing a mass of near }4 gallon. The round ligaments of the ovaries were ligated with catgut, another ligature being placed about the cervix uteri, the entire mass, ovaries, cornua, uterus, and broad ligament were removed and the flank incision closed by deep sutures. On the following day the patient looked bright, but lay quietly and refused food ; on the second day the general appearance was better and appetite INTERESTING CASES. fair, the animal taking some milk, and on the third she seemed quite well, moving about freely, had a good appetite and was apparently convalescent. The wound showed slight but unim- portant infection and the patient was permitted to be removed, after which recovery progressed without incident. COMPOUND FRACTURE OF METATARSUS IN A DOG. (133) The patient, an adult Collie, had engaged in a fight with another dog about three weeks prior to presentation, dur- ing which compound fractures of the right metatarsals were produced at the lower third, probably by a bite. The owner fail- ing to secure recovery the patient was submitted for exami- nation, and it was found that the fractured ends of the bones moved freely on each other, while they communicated with the exterior by two fistulse opening on the median side of metatarsus, from which considerable pus was discharging. The injured member was fixed by means of plaster of Paris bandages, the fistulous openings being marked by a cork, which was later cut out and the fistulae dressed with solution of car- bolic acid, followed by powdered iodoform, the dressing being retained by means of a bandage with equitable pressure. The dressing was repeated once daily for six days, at which date the suppuration had virtually ceased and the patient was discharged, with directions for the continuation of the dressing, and re- covery progressed rapidly without further incident. -yj^j^ Cornell University Library The original of tiiis book is in tine Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924000297907 >mf' ^^V-