INTESTINAL INDIGESTION IN THE DOG WITH CONSTIPATION.
Usual seat. Causes: house life, neglect of call to defecate, lack of exercise, overdistension, atony, watch dogs, over feeding, obesity, ill health, debility, loss of teeth, paraplegia, spiced and sweet food, matting of hair over anus, tumors round anus. Symptoms: small, hard, white, glazed stools, straining, no stools, hot, tender, swollen, bulging anus, abdominal manipulation, dullness, laziness, seeking seclusion, colics, tender abdomen, stiffness, arched back, drooping head and tail, vomiting—sometimes feculent, fever. Lesions: impacted mass of hard, gritty particles, catarrhal congested or necrotic mucosa, and outer coats, perforating ulcers. Treatment: air, exercise, laxative diet, mechanical extraction, purgatives, enemata, demulcents, laparotomy, enterrectomy.
In the dog, atony and impaction are common especially in the rectum, where the fæces are unduly retained in connection with house life until accumulated and dried. The impaction tends to extension forward, the new material adding continually to the old, and the overdistended rectum becoming more and more atonic in proportion to the increase of the distension.
Causes. The most prominent factor is denial of nature’s call to defecate, on the part of house dogs trained to habits of cleanliness. The accumulated mass distends and weakens the rectum, enabling it to hold more without suffering, making the call of nature less imperious, and diminishing the power of expulsion. Lack of exercise usually operates in the same animals, as it also does in watch dogs, the movements of which are limited by the length of their chains.
Overfeeding contributes, in various ways, by increasing the amount of feculent matter passed on into the rectum, by hastening the food through stomach and small intestine imperfectly digested and therefore in a more irritating condition, and by contributing to obesity and lack of tone.
In mastiffs, hounds, bull-dogs, etc., which are naturally gluttonous and swallow animal food in large masses without tearing apart, or mastication, portions pass into the intestine undigested and tend to disturb and block the terminal bowel.
Dogs that are out of health, and which lack tone in general have usually torpid bowels and suffer from delay and impaction of contents. Hence all chronic and debilitating diseases are liable to become aggravated by this troublesome complication.
Old dogs with the teeth worn out and the general tone of the stomach and intestines low are habitual sufferers.
Paralysis of the posterior limbs is usually associated with paresis of the rectum and accumulation, and various other atonic nervous disorders act in the same way.
The sympathy between the skin and alimentary tract shows itself in common disorders, indigestions and catarrh becoming complicated by skin eruptions acute and chronic, by indigestions and impactions. To both conditions the nature of the food of house dogs largely contributes, the habit of eating abundantly at each meal time of the master, the consumption of highly spiced meats, of sweet cakes, pastry and puddings, and even the exclusive diet of white bread or farinaceous and starchy aliment.
In long haired dogs, the matting of these hairs together across the anus proves a factor by rendering defecation difficult and painful.
The formation of tumors around the anus, or inflammation and swelling of the anal glands are additional causes.
Symptoms. As in other animals this condition may be chronic, lasting for a long time without leading to complete obstruction. The fæces are passed in hard fœtid, whitish masses, often partly divided, in pellets, dry, and polished on the surface and covered with a film of mucus, sometimes blood. They are passed at considerable intervals, slowly and with painful effort and straining.
In the more advanced and violent cases defecation becomes absolutely impossible, though the animal strains violently and frequently. The anus and rectum bulge as a rounded swelling and the congested and bleeding mucous membrane may be exposed, but nothing is passed. The anus is hot and tender to the touch and the anal glands swollen. Manipulation of the abdomen between the two hands can detect the impacted gut extended forward for a considerable distance, and even implicating the colon. The oiled finger in the rectum may detect the impacted matter as a conglomerate mass of gritty materials. If the appetite continues this becomes all the more extensive. The affected animal is dull, prostrate and indisposed to exertion, seeking a dark retired place where he can rest undisturbed curled up into a ball. Sometimes he starts with a sharp yelp. Especially does he shrink and complain when the belly is handled. If made to walk, he does so stiffly, hangs head and tail, arches the back and tucks up the belly. The face and eyes express severe suffering. Vomiting is a frequent complication, the rejected matters being often feculent. Colicy pains are indicated by yelping or moaning, enteritis and peritonitis by hyperthermia and extreme abdominal tenderness. The acute disease may last from one to two weeks, and death may be preceded by auto-infection, by nervous symptoms of various kinds or by enteritis or peritonitis.
Lesions. These may be stated shortly as impaction, catarrh or necrotic changes of the mucosa, more or less extensive inflammations of the bowels and peritoneum, perforations, and congestions of the liver and kidneys.
Treatment. In the milder cases plenty of open air exercise and a laxative diet may succeed. In the more severe cases it is usually requisite to unload the rectum mechanically. The dog is laid on a table, and the oiled finger introduced through the anus, lubricates the mucosa as far as it can be reached. Then little by little the firm mass may be disintegrated and removed being steadied by the other hand applied on the abdomen. The handle of a teaspoon or a special spoonshaped curette may at times replace the finger to advantage, but must be used with due judgment, in view of the thinness and friability of the walls of the gut.
When the gut has been emptied in this way, or in the less severe cases without this preliminary, purgatives and frequent injections can be used to advantage. Jalap ½ dr. and calomel 5 grains, or castor oil ½ oz., or syrup of buckthorn have been usually employed. The impaction is usually too firm for the transient action of eserine or pilocarpin. As injections, castor oil, soapsuds, decoctions of flaxseed, mallow or elm bark may be employed being repeated as often as they are expelled and supplemented by the mechanical removal of all solid matters that come within reach.
In cases so extensive as to resist the above measures we can resort to laparotomy. The incision can be made close and parallel to the linea alba, the rectum, or floating colon drawn out through the wound, the other intestines being carefully held back by an assistant, the gut is then incised longitudinally and its solid contents removed. The wound is thoroughly cleansed, washed with an antiseptic (mercuric chloride 1:2000), and sutured with catgut, the mucosa being carefully turned in and the muscular and peritoneal coats kept in accurate contact. Finally the abdominal wound is closed by silk sutures. The patient must be placed for a week or ten days on well boiled gruels and the rectum frequently emptied by injections of tepid water.
In case the bowel is found to be necrotic, the gangrenous section may be excised and the ends brought together by Murphy’s button, or simply sutured with catgut over a hollow tube of raw potato.