FOREIGN BODIES IN THE STOMACH. HAIR, WOOL, BRISTLE, CLOVER AND COTTON BALLS.
Hair balls, wool balls, bristle balls, cotton balls, clover-hair balls, oat-hair balls, paper balls, phosphatic calculi, sand and gravel, nails, wires, needles, pins, etc., cloth, leather, whalebone, playthings, etc. Symptoms: of catarrh or colic, dullness, restlessness, arched back, in dog vomiting of blood, fistula. Diagnosis. Treatment: emetic, feed potatoes, laparotomy.
Hair Balls. These are common in the rumen of cattle and have been found in the fourth stomach. They are especially injurious to young animals by reason of their irritating the gastric mucosa, but they also occasionally block the pylorus, producing indigestion, gastric dilatation, gradually advancing emaciation and even a fatal result.
Wool Balls. These are found in sheep and are especially injurious in young lambs.
Bristle Balls. These are found in swine as round, or ovoid balls or long ellipses bent upon themselves. The sharp projecting ends of the bristles render them very irritating, especially to young pigs.
All of these are caused by licking themselves or their fellows, and particularly during the period of moulting or as the result of some skin affection. Lambs which are nursed by ewes with an excess of wool on and around the mammæ, and old sheep with a disposition to eat wool are frequent victims.
Cotton Balls. These have been found in lambs fed on cotton seed cake. A certain amount of the cotton fiber is incorporated in the cake, and this is rolled together and felted by the movements of the stomach and agglutinated by mucus.
Clover-hair Balls. The fine hairs from the clover leaf have been found rolled into balls in the abomasum of lambs producing all the evil effects of the other pilous masses.
Oat-hair Balls. The fine hairs which cover the seed of the oat are found matted together and cemented by mucus in the stomach of horses fed on the dust of oatmeal mills. They are especially common in Scotland, where oatmeal has been so extensively used.
Paper-ball. In the museum of the N. Y. State Veterinary College is a conglomerate ball of paper taken from the stomach of a hog by Dr. Johnson, Sioux City.
Phosphatic Calculi have been described as found in the stomach, but this is evidently an error, as the acid secretion would have speedily dissolved them. The error doubtless came from mistaking the transverse colon for the stomach.
Sand and Gravel arrive in the stomach of the horse from pasturing on loose sandy land, the plants being pulled up by the roots and swallowed together with the sand adherent. Also from drinking water from shallow streams with sandy bottoms. Feeding of grain from the ground is a cause of swallowing sand, earth and pebbles. Licking the soil in acidity of the stomach is another cause. Fodder that has been packed down and mixed with earth, and that which has been blown full of sand or dust, and roots eaten from the ground in wet weather lead to the ingestion of much sand or earth. Shetland ponies taken from the islands pass sand for some weeks. Dogs taught to fetch and carry, swallow stones, pebbles, marbles, etc., accidentally.
Nails, Wires, Needles, Pins, etc. More or less pointed metallic objects are often taken in with the food by gluttonous horses and though usually arrested in the intestines they sometimes irritate or wound the stomach.
Fragments of cloth, leather, or whalebone are similarly taken with the food, or in case of depraved appetite are deliberately chewed and swallowed.
Playthings and small household articles are especially taken by puppies through mere wantonness. Rubber balls, pieces of metal, thread, cord, cloth, bits of leather, sponge, horse hair, human hair, corks, bits of wood and everything obtainable of small size may be swallowed and found in the stomach.
Pigs swallow pieces of wood and other objects.
Birds habitually swallow pebbles and ordinary objects are ground down in the gizzard. They also readily vomit feathers, bones and other offensive matters that have proven indigestible.
Symptoms. In horses there are no especial symptoms, though the foreign bodies sometimes cause gastric catarrh, and in other cases produce wounds and ulcers or block the pylorus causing violent colic. Most commonly the foreign bodies pass on into the intestines, where they may directly wound the walls, form nuclei for the deposition of earthy salts in the form of calculi, or in case of fibrous materials (cords) roll into firm balls.
In dogs the foreign bodies may cause gastric catarrh, or puncture or abrasion of the mucosa, and they may be rejected by vomiting. The more rounded, smooth bodies may lie for a length of time in the stomach without doing any manifest injury, as in the case mentioned by Nichoux in which a dog carried in its stomach for twelve years a four franc piece and a large sou. Sometimes the objects block the pylorus. Then the subject is dull, depressed, inclined to lie on the right side but continually changing his position, gives a stifled yelp when he lies down or occasionally when he stops walking. He carries the back arched, and the abdomen tucked up, and drags his hind limbs. Vomiting, is frequent and accompanied by violent and painful retching. The vomited matters may be mixed with blood. The epigastrium is tender to pressure. Death may ensue in twenty-four hours or not until after weeks or even months.
In other cases there is gastro-enteritis with vomiting, colic, anorexia, trembling, hyperthermia, constipation or diarrhœa, and finally the passage of the offending agent per anum, when recovery ensues.
In other cases sharp pointed bodies perforate the walls of the stomach, and determine the formation of abscess or fistula opening at any point around the abdominal cavity. This may be followed by recovery, by gastric or intestinal fistula, or by chronic disease of some important organ like the liver.
In dogs, diagnosis is often possible by manipulation of the stomach through the walls of the abdomen. If the belly is very lax it may be compressed between finger and thumb, or between the two hands; if more tense, pressure with both hands just behind the sternum may detect the resistance of a solid body.
Treatment. In the horse this is hopeless.
In the dog much may be expected from the use of emetics, (ipecacuan, tartar emetic, apomorphine, tepid water, tickling the fauces). In some cases of sharp pointed bodies an exclusive and abundant diet of well boiled potatoes proves successful. The object is to pass much of the starchy matter through the small intestines undigested, so that it may envelop the sharp body and protect the mucosa. When it reaches the colon, the ingesta as a whole becomes more solid and invested by this, the body is often passed without danger. Other methods failing laparotomy remains. The dog is stretched on his back on a table with the forelimbs held well apart. The skin of the epigastrium is denuded of hair and washed with antiseptics (mercuric chloride solution 1:500). Hands and instruments are also made aseptic. Then an incision is made in the epigastrium or in the situation where the offending body has been felt, and the finger is introduced to locate the body. At this point a thread is passed through the walls of the stomach, and these are drawn well out through the abdominal wound and incised to the extent of an inch or more. Through this orifice the foreign body can be easily felt and extracted. Then in case the stomach is over-filled it may be emptied, and the edges washed with the antiseptic and carefully sutured with sterilized catgut. The usual care must be taken to turn the mucosa inward and bring the muscular and serous coats in accurate opposition. Finally the abdominal wound is closed by a continued suture of silk or catgut.
The greatest care must be taken to prevent the escape of any of the gastric contents into the abdominal cavity, to render both wounds aseptic and to protect the external wound especially against infection. A wash of carbolic acid (1:100) with a little of some intense bitter (quassia) will often succeed in preventing licking or gnawing.
Even greater care must be given in the matter of diet. At first a few teaspoonfuls of cold water only need be given. After twenty-four hours a little well strained beef tea; later milk or gruel may be added, and by degrees more solid food. In three weeks the ordinary food may usually be resumed.
In case the foreign body has escaped into the peritoneal cavity, the same method may be pursued, the edges of the gastric or intestinal wound being made raw, treated antiseptically and carefully sutured, and the abdomen washed out with an antiseptic solution (aluminum acetate solution) and closed.