Special Report on Diseases of the Horse Part 62

STRANGLES.

_Synonyms._--Distemper; colt-ill; catarrhal fever; one form of shipping fever; febris pyogenica.

_Definition._--Strangles is an infectious disease of the horse, mule, and a.s.s, seen most frequently in young animals, and usually leaving them immune from future trouble of the same kind.

It appears as a fever lasting for a few days, and is usually a.s.sociated with an abscess formation of lymph glands, especially those under the jaw, which have a tendency to break on the outside. It usually leaves the animal after convalescence perfectly healthy and as good as it was before, but sometimes leaves it a roarer or is followed by the development of deep-seated abscesses which may prove fatal.

_Causes._--The cause of strangles is infection by direct contact with an animal suffering from the disease, or indirectly through contact with the discharges from an infected animal, or by means of the atmosphere in which an infected animal has been. There are many predisposing causes which render some animals much more subject to contract the disease than others. Early age, which has given it the popular name of colt-ill, offers many more subjects than the later periods of life do, for the animal can contract the disease but once, and the large majority of adult and old animals have derived an immunity from previous attacks. At 3, 4, or 5 years of age the colt, which has been at home, safe on a meadow or in a cozy barnyard, far from all intercourse with other animals or sources of contagion, is first put to work and driven to the market town or county fairs to be exposed to an atmosphere or to stables contaminated by other horses suffering from disease and serving as infecting agents. If it fails to contract it there, it is sold and shipped in foul, undisinfected railway cars to dealers' stables, equally unclean, where it meets many opportunities of infection. If it escapes so far, it reaches the time for heavier work and daily contact on the streets of towns or large cities, with numerous other horses and mules, some of which are sure to be the bearers of the germs of this or some other infectious disease, and at last it succ.u.mbs.

The period of the eruption of the last permanent teeth, or the end of the period of development from the colt to an adult horse, at which time the animals usually have a tendency to fatten and be excessively full-blooded, also seems to be a predisposing period for the contraction of this as well as of the other infectious diseases. Thoroughbred colts are very susceptible, and frequently contract strangles at a somewhat earlier age than those of more humble origin. Mules and a.s.ses are much less susceptible and are but rarely affected. Other animals are not subject to this disease, but there is a certain a.n.a.logy between it and distemper in dogs. After exposure to infection there is a period of incubation of the disease, lasting from two to four days, during which the animal enjoys its ordinary health.

_Symptoms._--The horse at first is a little sluggish if used, or when placed in its stable is somewhat dejected, paying but moderate attention to the various disturbing surroundings. Its appet.i.te is somewhat diminished in many cases, while in some cases the animal eats well throughout. Thirst is increased, but not a great deal of water is taken at one time. If a bucket of water is placed in the manger the patient will dip its nose into it and swallow a few mouthfuls, allowing some of it to drip back and then stop, to return to it in a short time. The coat becomes dry and the hairs stand on end. At times the horse will have chills of one or the other leg, the fore quarters, or hind quarters, or in severe cases of the whole body, with trembling of the muscles and dryness of the skin.

If the eyes and mouth are examined the membranes are found reddened to a bright rosy color. The pulse is quickened and the breathing may be slightly accelerated. At the end of two days a cough is heard and a discharge begins to come from the nostrils. This discharge is at first watery; it then becomes thicker, somewhat bluish in color, and sticky, and finally it a.s.sumes the yellowish color of matter and increases greatly in quant.i.ty.

At the outset the colt may sneeze occasionally and a cough is heard. The cough is at first repeated and harsh, but soon becomes softer and moist as the discharge increases. Again, the cough varies according to the source of the discharge, for in light cases this may be only a catarrh of the nasal ca.n.a.ls, or it may be from the throat, the windpipe, or the air tubes of the lungs, or even from the lungs themselves. According to the organ affected the symptoms and character of cough are similar to those of a laryngitis, bronchitis, or lung fever caused by ordinary cold.

Shortly after the discharge is seen a swelling takes place under the jaw, or in the intermaxillary s.p.a.ce. This is at first puffy, somewhat hot and tender, and finally becomes distinctly so, and an abscess is felt, or having broken itself the discharge is seen dripping from a small opening. When the discharge from the nostrils has fully developed the fever usually disappears and the animal regains its appet.i.te, unless the swelling is sufficient to interfere with the function of the throat, causing pain on any attempt to swallow. At the end of four or six days the discharge lessens, the soreness around the throat diminishes, the horse regains its appet.i.te, and in two weeks has regained its usual condition. Old and strong horses may have the disease in so light a form that the fever is not noticeable; they may continue to eat and perform their ordinary work as usual and no symptom may be seen beyond a slight discharge from the nose and a rare cough, which is not sufficient to worry any but the most particular owner. But, on the other hand, the disease may a.s.sume a malignant form or become complicated so as to become a most serious disease, and even prove fatal in many cases.

Inflammation of the larynx and bronchi, if excessive, produce violent, harsh coughing, which may almost asphyxiate the animal. The large amount of discharge may be mixed with air by the difficult breathing, and the nostrils, the front of the animal, manger, and surrounding objects become covered with a white foam. The inflammation may be in the lung itself (lobular pneumonia) and cause the animal to breathe heavily, heave at the flanks, and show great distress. In this condition marked symptoms of fever are seen, the appet.i.te is lost, the coat is dry, the horse stands back in its stall at the end of the halter strap with its neck extended and its legs propped apart to favor breathing. This condition may end by resolution, leaving the horse for some time with a severe cough, or the animal may die from choking up of the lungs (asphyxia).

The swelling under the jaw may be excessive, and if the abscess is not opened it burrows toward the throat or to the side and causes inflammation of the parotid glands and breaks in annoying fistulas at the sides of the throat and even up as high as the ears. Roaring may occur either during a moderately severe attack from inflammation of the throat (larynx), or at a later period as the result of continued lung trouble. Abscesses may develop in other parts of the body, in the poll, in the withers, or in the s.p.a.ces of loose tissue under the arms, in the fold of the thigh, and, in entire horses, in the t.e.s.t.i.c.l.es.

During the course of the disease, or later, when the animal seems to be on the road to perfect recovery, abscesses may form in the internal organs and produce symptoms characteristic of disease of those parts.

Roaring, plunging, wandering in a circle, or standing with the head wedged in a corner of the stall indicate the collection of matter in the brain. Sudden and severe lung symptoms, without previous discharge, point to an abscess between the lungs, in the mediastinum; colic, which is often continuous for days, is the result of the formation of an abscess in some part of the abdominal cavity, usually in the mesentery.

_Pathology._--The lesions of strangles are found on the surface of the mucous membranes, essentially of the respiratory system, and in the loose connective tissue fibers of the internal organs and glands, and consist of acute inflammatory changes, tending to the formation of matter. The blood is unaltered, though it is rich in fibrin, and if the animal has died of asphyxia it is found dark colored and uncoagulated when the body is first opened. If the animal has died while suffering from high fever the ordinary alterations throughout the body, which are produced by any fever not attended by alteration of blood, are found.

_Prevention._--Healthy horses should be separated from the infected animals, and the stables in which the disease has occurred should be thoroughly disinfected. Since the disease frequently occurs annually on infected premises, systematic disinfection should be practiced after an outbreak. The stables, as well as all utensils which might have come in contact with the infection, should be thoroughly disinfected. By such practices recurrences of the disease may be prevented.

_Treatment._--Ordinary light cases require but little treatment beyond diet, warm washes, moistened hay, warm coverings, and protection from exposure to cold. The latter is urgently called for, as lung complications, severe bronchitis, and laryngitis are often the results of neglect of this precaution. If the fever is excessive, the horse may receive small quant.i.ties of Glauber's salt (handful three times a day) as a laxative, bicarbonate of soda or niter in one-dram doses every few hours, and small doses of antimony, iodid of potash, aconite, or quinin.

Steaming the head with the vapor of warm water poured over a bucket of bran and hay, in which belladonna leaves or tar have been placed, will allay the inflammation of the mucous membranes and greatly ease the cough.

The swelling of the glands should be promptly treated by flaxseed poultices and bathing with warm water, and as soon as there is any evidence of the formation of matter it should be opened. Prompt action in this will often save serious complications. Blisters and irritating liniments should _not_ be applied to the throat. When lung complications show themselves the horse should have mustard applied to the belly and to the sides of the chest. When convalescence begins great care must be taken not to expose the animal to cold, which may bring on relapses, and while exercise is of great advantage it must not be turned into work until the animal has entirely regained its strength.

Bacterial vaccines are now being extensively used for the prevention and treatment of this disease. They are prepared from the specific germ of the disease and frequently exert a very beneficial influence. A serum is also being prepared from horses, which is injected with gradually increasing doses of this germ. This serum possesses considerable curative value and may prove especially valuable in cases in which the animals have failed to respond to other forms of treatment, or when valuable animals are affected with the disease.

PURPURA HEMORRHAGICA.

_Synonyms._--Anasarca; petechial fever; morbus maculosus.

_Definition._--This disease is a septic bacterial intoxication, acute and infectious in character, and is manifested by edematous swellings of the subcutaneous connective tissue, and hemorrhages on the mucous membrane and in the internal organs.

A previous attack of influenza is a common predisposing cause of this disease, which appears most frequently a few weeks after convalescence is established. It occurs more frequently in those animals which have made a rapid convalescence and are apparently perfectly well than it does in those which have made a slower recovery.

Anasarca commences by symptoms which are excessively variable. The local lesions may be confined to a small portion of the animal's body and the const.i.tutional phenomena be nil. The appearance and gravity of the local lesions may be so unlike, from difference of location, that they seem to belong to a separate disease, and complications may completely mask the original trouble.

In the simplest form the first symptom noticed is a swelling, or several swellings, occurring on the surface of the body--on the forearm, the leg, the under surface of the belly, or the side of the head. The tumefaction is at first the size of a hen's egg; not hot, little sensitive, and distinctly circ.u.mscribed by a marked line from the surrounding healthy tissue. These tumors gradually extend until they coalesce, and in a few hours we have swelling of the legs, legs and belly, or the head, to an enormous size; they have always the characteristic constricted border, which looks as if it had been tied with a cord. In the nostrils are found small reddish spots, or petechiae, which gradually a.s.sume a brownish and frequently a black color.

Examination of the mouth will frequently reveal similar lesions on the surface of the tongue, along the lingual gutter, and on the fraenum. If the external swelling has been on the head, the petechiae of the mucous membranes are liable to be more numerous and to coalesce into patches of larger size than when the dropsy is confined to the legs. The animal may be rendered stiff by the swelling of the legs, or be annoyed by an awkward swollen head, which at times may be so enormous as to resemble that of a hippopotamus rather than that of a horse. During this period the temperature remains normal; the pulse, if altered at all, is only a little weaker; the respiration is only hurried if the swelling of the head infringes on the caliber of the nostrils. The appet.i.te remains normal. The animal is attentive to all that is going on, and, except for the swelling, apparently in perfect health.

In from two to four days, in severe cases, the tissues can no longer resist the pressure of the exuded fluid. Over the surface of the skin which covers the dropsy we find a slight serous sweating, which loosens the epidermis and dries so as to simulate the eruption of some cutaneous disease. If this is excessive we may see irritated spots which are suppurating. In the nasal fossae the hemorrhagic spots have acted as irritants, and, inviting an increased amount of blood to the Schneiderian membrane, produce a coryza or even a catarrh. We may now find some enlargement and peripheral edema of the lymphatic glands, which are fed from the affected part. The thermometer indicates a slight rise in the body temperature, while the pulse and respiration are somewhat accelerated. The appet.i.te usually remains good. In the course of a few days the temperature may have reached 102, 103, or 104 F.

Fever is established, not an essential or specific fever in any way, but a simple secondary fever produced by the dead material from the surface or superficial suppuration, and by the oxidization and absorption of the colloid ma.s.s contained in the tissues. The skin may suppurate or slough more or less over the areas of greatest tension or where it is irritated by blows or pressure. The great swelling about the head may by closure of the nostrils interfere seriously with breathing. Internal edema may occur in the throat, lungs, or intestines. Septicemia, or blood poisoning, may result from anasarca.

_Terminations._--The simple form of the disease most frequently terminates favorably on the eighth or tenth day by resolution or absorption of the effusion, with usually a profuse diuresis, and with or without diarrhea. The appet.i.te remains good or is at times capricious.

Death may occur from mechanical asphyxia, produced by closure of the nostrils or closure of the glottis. Metastasis to the lungs is almost invariably fatal, causing death by asphyxia, Metastasis to the intestines may cause death from pain, enteritis, or hemorrhage.

Excessive suppuration, lymphangitis, and gangrene are causes of a fatal termination by exhaustion. Mortal exhaustion is again produced by inability to swallow in cases of excessive swelling of the head.

Peritonitis may arise secondary to the enteric edema, or by perforation of the stomach or intestines by a gangrenous spot. Septicemia terminates fatally with its usual train of symptoms.

_Alterations._--The essential alterations of anasarca are exceedingly simple; the capillaries are dilated, the lymphatic s.p.a.ces between the fibers of the connective tissue are filled with serum, and the coagulable portion of the blood presents a yellowish or citrine ma.s.s, jellylike in consistency, which has stretched out the tissue like the meshes of a sponge. Where the effusion has occurred between the muscles, as in the head, these are found dissected and separated from each other like those of a hog's head by the ma.s.ses of fat. The surface of the skin is desquamated and frequently denuded of the hair. Frequently there are traces of suppuration and of ulceration. The mucous membrane of the nose is found studded with small, hemorrhagic spots, sometimes red, more frequently brown or black, often coalesced with each other in irregular-sized patches and surrounded by a reddish zone, the product of irritation. If edema of the intestines has occurred, the membrane is found four or five times its normal thickness, reddish in color, with hemorrhages on the free surface. Edema of the lungs leaves these organs distended. The secondary alterations vary according to the complications. There are frequently the lesions of asphyxia; externally we find ulcers, abscesses, and gangrenous spots and the deep ulcers resulting from the latter. The lymphatic cords and glands are found with all the lesions of lymphangitis. Again are found the traces of excessive emaciation, or the lesions of septicemia. Except from the complications the blood is not altered in anasarca.

_Diagnosis._--The diagnosis of anasarca must princ.i.p.ally be made from farcy or glanders. In anasarca the swelling is nonsensitive, while sensitive in the acute swelling of farcy. The nodes of farcy are distinct and hard and never circ.u.mscribed, as in the other disease. The eruption of glanders on the mucous membranes is nodular, hard, and pelletlike. The redness disappears on pressure. In case of excessive swelling of the head in anasarca, there may occur an extensive sero-fibrinous exudation from the mucous membranes of the nose, poured out as a semifluid ma.s.s or as a cast of the nasal fossae, never having the appearance or typical oily character which it has in glanders. The inflammation of the lymphatic cords and glands in anasarca does not produce the indurated character which is found in farcy.

_Prognosis._--While anasarca is not an excessively fatal disease, the prognosis must always be guarded. The majority of cases run a simple course and terminate favorably at the end of 8 or 10 days, or possibly, after one to two relapses, requiring several weeks for complete recovery. Effusion into the head renders the prognosis much more grave from the possible danger of mechanical asphyxia. Threatened mechanical asphyxia is especially dangerous on account of the risk of blood poisoning after an operation of tracheotomy. Edema of the viscera is a most serious complication. The prognosis is based on the complications, their extent, and their individual gravity, existing, as they do here, in an already debilitated subject.

_Treatment._--The treatment of anasarca may be as variable as are the lesions. The indications are at once shown by the alterations and mechanism of the disease, which we have just studied.

Hygiene comes into play as the most important factor. Oats, oat-and-hay tea, milk, eggs--anything which the stomach or r.e.c.t.u.m can be coaxed to take care of--must be employed to give the nutriment, which is the only thing that will permanently strengthen the tissues; they must be strengthened in order to keep the capillaries at their proper caliber.

Laxatives, diaph.o.r.etics, and diuretics must be used to stimulate the emunctories so that they may carry off the large amount of the products of decomposition which result from the stagnated effusions of anasarca.

Of these the sulphate of soda in small, repeated doses, the nitrate of potash and bicarbonate of soda in small quant.i.ty, or the chlorate of potash in single large doses will be found useful. Williams cites the chlorate of potash as an antiputrid. Stimulants and astringents are directly indicated. Spirits of turpentine serves the double purpose of a cardiac stimulant and a powerful, warm diuretic, for the kidneys in this disease will stand a wonderful amount of work. Camphor can be used with advantage. Coffee and tea are two of the diffusible stimulants which are too much neglected in veterinary medicine; both are valuable adjuncts in treatment of anasarca, as they are during convalescence at the end of any grave disease which has tended to render the patient anemic. Dilute sulphuric and hydrochloric acids are, perhaps, the best examples of a combination of stimulant, astringent, and tonic which can be employed.

The simple astringents of mineral origin, sulphates of iron, copper, etc., are useful as digestive tonics; I doubt whether they have any const.i.tutional effect. The vegetable astringents, tannic acid, etc., have not proved efficacious in my hands. Iodid of potash in small doses serves the triple purpose of digestive tonic, denutritive for inflammation, and diuretic. Among the newer forms of treatment are diluted Lugol's solution injected into the trachea, anti-streptococcus serum and colloidal silver solution injected into the circulation. No one but a qualified veterinarian would be competent to apply these remedies.

_Externally._--Sponging the swollen parts, especially the head, when the swelling occurs there, is most useful. The bath should be at an extreme of temperature--either ice cold to constrict the tissues or hot water to act as an emollient and to favor circulation. Vinegar may be added as an astringent. When we have excessively denuded surfaces, suppuration, or open wounds, disinfectants should be added to the wash.

In cases of excessive swelling, especially of the head, mechanical relief may be required. Even in country practice, punctures of the part should be made with the hot iron, as no other disease so predisposes to septic contamination. When mechanical asphyxia is threatened tracheotomy may be demanded. With the first evidence of dyspnea, not due to closing of the nostrils or glottis, or with the first pawing which gives rise to a suspicion of colic, a mustard plaster should be applied over the whole belly and chest. The sinapism will draw the current of the circulation to the exterior, the metastasis to the lungs or intestines is prevented, and the enfeebled nervous system is stimulated to renewed vigor by the peripheral irritation. The organs are encouraged by it to renewed functional activity; the local inflammation produced by it favors absorption of the exudation. The objection to the use of blisters is their more severe action and the danger of mortification. Septicemia, when occurring as a complication, requires the ordinary treatment for the putrid diseases, with little hope of a good result.

After recovery the animal regains its ordinary health, and there is no predisposition to a return of the disease.

HORSEPOX, OR EQUINE VARIOLA.

_Synonyms._--Variola equina; pustular grease; phlyctenold herpes.

_Definition._--Horsepox is a specific, infectious fever of the horse, attended by an eruption of pustules, or pocks, over any part of the skin or on the mucous membranes lining the various cavities in the body, but chiefly, and often exclusively, upon the pasterns and fetlocks. The eruption may commence upon the lips, or about the nostrils or eyes.

This disease was described by the early Roman agricultural writers and by the veterinarians of the eighteenth century. It received its first important notice from the great Jenner, who confounded it with grease in horses, since animals with this disease are very liable to have the eruption of variola appear on the fetlocks. He saw these cases transmit the disease to cattle in the byres and to the stablemen and milkmaids who attended them, and furnish the latter with immunity from smallpox, which led to the discovery of vaccination. Horsepox is also frequently mistaken for the exanthemata attending some forms of venereal disease in horses.

Variola in the horse, while it is identical in principle, general course, complications, and lesions with variola in other animals, is a disease of the horse itself, and is not transmissible in the form of variola to any other animal; nor is the variola of any other animal transmissible to the horse. Cattle and men, if inoculated from a case of horsepox, develop vaccinia, but vaccinia from the latter animals is not so readily reinoculated into the horse with success. If it does develop, it produces the original disease.

_Causes._--The direct cause of horsepox is infection. A large number of predisposing causes favor the development of the disease, as in the case of strangles, and this trouble, like almost all contagious diseases, renders the animal which has had one attack immune. The chief predisposing cause is youthfulness. Old horses which have not been affected are less liable to become infected when exposed than younger ones. The exposure incident to shipment, through public stables, cars, etc., acts as a predisposing cause, as in the other infectious diseases.

The period of final dent.i.tion is a time which renders it peculiarly susceptible.

Dupaul states that the infection is transmissible through the atmosphere for several hundred yards. The more common means of contagion is by direct contact or by means of fomites. Feed boxes and bridles previously used by horses affected with variola are probably the most frequent carriers of the virus, and we find the lesions in the majority of cases developed in the neighborhood of the lips and nostrils. Coition is a frequent cause. A stallion suffering from this disease may be the cause of a considerable epizootic, as he transmits it to a number of brood mares and they in turn return to the farms where they are surrounded by young animals to which they convey the contagion. The saddle and croup straps are frequent agents of infection. The presence of a wound greatly favors the inoculation of the disease, which is also sometimes carried by surgical instruments or sponges. Trasbot recites a case in which a set of hobbles, which had been used on an animal suffering from variola, were used on a horse for a quittor operation and transmitted the disease, which developed on the edges of the wound.