PHLEGMONOUS (PURULENT) GASTRITIS IN THE HORSE.
Definition: deep inflammation tending to abscess. Causes: invasion by pus microbes, infectious diseases, parasitism, traumas. Symptoms: hyperthermia, colic, tenderness, icterus, coincident disease, hæmatemesis. Lesions: submucous or subperitoneal abscess, parasites, peritonitis, exudation, thickening, neoplasm of mucosa, catarrhal complications. Treatment: careful diet, antiseptics, bitters, laxatives.
Definition. This is a gastric inflammation affecting the membranous layers, and tending to submucous or subperitoneal abscess. It is much less frequent than the catarrhal form.
Causes. It may be attributed to invasion of the gastric walls by pus microbes, and appears as secondary abscess in pyæmia and above all in strangles. The microbes are introduced more directly through the wounds inflicted by the larvæ of œstrus, or by the burrowing of these (Argus, Schlieppe, Schortmann), or of spiroptera (Argus). Wounds by sharp pointed bodies taken in with the food, furnish other infection—atria, and in their turn ulcers connected with catarrhal or toxic inflammation may furnish a means of entrance.
Symptoms. These resemble those of catarrhal inflammation, but are usually attended by greater hyperthermia, and the colicy symptoms are more marked. There is also greater tenderness in the epigastrium and left hypochondrium, and icterus is more marked. When it occurs as an extension of strangles or pyæmia the symptoms of these affections elsewhere are pathognomonic. When the abscess bursts into the stomach there may be vomiting of bloody mucus (hæmatemesis) which is not necessarily followed by a fatal result.
Lesions. As these are seen only in fatal cases, the presence of an abscess is the characteristic feature. This is usually submucous, or less frequently subperitoneal, and may vary in size from a hazelnut upward. The tendency appears to be to open into the stomach, though it may burst into the peritoneum and cause general infection of that membrane. In case of parasites, the spiroptera or œstrus larva may be found in the abcess cavity having a narrow opening into the stomach. In certain cases the abscess on the pyloric sac has been found opening into the duodenum. Congestion, thickening, puckering into rugæ and laceration of the adjacent mucosæ may be a marked feature, a circumscribed catarrhal gastritis complicating the local phlegmon.
Treatment. This is less hopeful than in catarrhal gastritis, but should be conducted along the same lines. The same careful diet, with daily antiseptics and bitters may prove valuable in limiting the inevitable suppuration, and, if the pus should escape into the stomach, in healing the lesion. Sulphites of soda, sulphide of calcium, chamomile, and quinia, are to be commended and pepsin may be added to secure at once proteid digestion and antisepsis. Laxatives may be required to counteract constipation or expel irritants, and these may be combined with the antiseptics already named or with salol, eucalyptol, sodium salicylate or other non-poisonous agent of this class.