DILATATION OF THE STOMACH.
Adaptability to bulk of food. Dilatation with atony. Eructation. Cribbiting. Vomiting. Age. Rare in cattle. Catarrh, overloading, nervous lesions, intestinal obstructions, tumors, calculi, volvulus, invagination, hepatitis. Symptoms: overfeeding, pot-belly, unthrifty hide, emaciation, eructations, cribbiting, fatigue, perspiration, indigestion, colic after meals, tympanic resonance. Lesions: varying distension, contents, action of calculus or pebbles, cardiac dilatation. Treatment: nutritive, digestible, concentrated food, lavage, strychnia, iron, faradisation, antiseptics.
The stomach has a great power of accommodation to the amount of food habitually taken. In the horse fed mainly on grain with only a little hay, it is habitually small, while in one fed on cut straw with a little grain, on hay alone, or on green food, it is very much more capacious though within the physiological limits of health. The cow wintered on grain alone, has all four stomachs lessened in capacity, and though she maintains good condition she is ill fitted to change at once to the bulky grass diet of spring. The heavily fed swine, and the farina fed dog and cat, have both stomach and intestines increased in capacity over those of the wild boar, or the purely carnivorous wolf or wild cat.
The condition becomes pathological when associated with atony, and this may occur directly from over distension. It is especially common in the horse by reason of the difficulty of relieving the over distension by eructation or vomiting, and also by reason of the habit of swallowing air (cribbiting). The dog, which has great facility in vomiting, should be correspondingly protected from the condition, yet it is very common in old dogs, doubtless from their common vice of gourmandizing and lack of exercise. Cattle are rarely attacked, the fourth stomach being protected by the others which stand guardian over it and prevent the sudden access of excess of food even if that is rapidly swallowed.
Other causes are: chronic catarrh which renders the stomach atonic, lessens its peptic secretion and determines indigestions and over distensions: habitual overfeeding which results in chronic indigestions and fermentations; lesions of the brain, and tumors of the jugular furrow or mediastinum which interfere with the functions of the vagus nerve; obstructions of the intestines which force the contents back into the stomach or hinder their exit. Thus tumors on the duodenum, calculi in stomach or intestines, volvulus and invagination have been charged with producing overdistension. Chronic hepatic disorder has also been quoted as a cause.
Symptoms. The subject may eat naturally or excessively yet is unthrifty, the belly is habitually distended, the hair dry and rough, there is loss of flesh, there may be eructations or (in the horse) swallowing of air, lack of endurance, a disposition to perspire easily, a tendency to indigestion and colics after meals, and hurried breathing sometimes marked by a double lifting of the flank in expiration. In the dog which has the stomach more accessible to examination its outline may be followed by percussion, a tympanitic resonance being produced from the eighth rib back to the umbilicus or further. If there is any difficulty the organ may be emptied of water by a stomach tube and then pumped full of air by means of a Davidson’s syringe, and percussed in each condition. Or a half a teaspoonful of bicarbonate of soda may be given in a little water followed by an equal amount of tartaric acid, and the stomach percussed.
Lesions. The distension of the stomach may reach ten times its normal size in the horse (Leisering). Kitt found a stomach with a capacity of 84 quarts. Fitzroy Philipot took from a dilated equine stomach 140 lbs. of contents. The contents of the viscus are usually largely of solids which the weakened and attenuated walls failed to pass into the duodenum. On the contrary and as if by compensation, the pylorus and duodenum are constricted and the latter has liquid contents which pass from the stomach with very little of the solids.
Special dilatations are sometimes met with, thus an equine stomach has been found largely dilated at the greater curvature where concretions formed in the viscus or pebbles introduced with the food had habitually lodged. In other cases the cardia has been dilated like a funnel, so that the animal could eructate or vomit with great facility. This last dilatation is especially common in cribbiters.
Treatment. This must necessarily be prolonged as time must be allowed for a tonic contraction of the viscus. Food must be given often in small quantity, of easy digestion, and of aqueous composition. For dogs, milk, eggs and soups, or pulped raw meat furnish examples. For horses milk gruels, boiled flax seed, pulped roots may suffice. If the stomach is loaded as is usually the case, it should be washed out with the stomach tube, which when passed into the stomach should be raised at its free end and filled with tepid water; it is then suddenly lowered so as to act as a syphon in evacuating the liquid contents of the stomach. This may be repeated again and again, the stomach in the case of the dog being manipulated so as to mix and float the solids and favor their exit through the tube. Daily washing out of the stomach by the tube is of the greatest possible value.
Meanwhile we should seek to improve the tone of the stomach by strychnia (horse 2 grs., dog ¹⁄₆₀ gr. daily), by salts of iron, and by faradisation.
To counteract fermentation, antiseptics (salol, naphthol, freshly burned charcoal) may be given with each meal, along with pepsin and hydrochloric acid.