SUPPURATIVE HEPATITIS. HEPATIC ABSCESS.
Causes in horse: pyæmia, omphalitis, thrombosis, infection, biliary calculi, concretions or parasites, foreign bodies, hot, damp climates, strangles, brustseuche, glanders, endocarditis. Lesions in horse: from parasites and mechanical irritants, pea-like or hazelnut; embolic abscess, pin head to hen’s egg; infection from strangles, foreign bodies, etc., may be of large size, and burst into adjacent organs, the peritoneum or externally. Symptoms in horse: of pre-existent malady, remitting fever, successive chills, intermittent icterus, hypochondriac tenderness. Spontaneous recovery, aspiration, opening, antiseptics locally and generally. Lesions in ruminants; secondary multiple abscesses, bean-like or (with foreign body) very large, may extend into adjacent parts. Symptoms in cattle: fever, chills, jaundice, tympany, diarrhœa, dysentery, wasting, tender right hypochondrium. Treatment: as in horse. Causes in dog: foreign bodies, tumors, infections, blows, traumas. Lesions: traumatic abscesses, single, large, infectious abscesses multiple, small. Former fœtid. Symptoms in dog: hepatic congestion or colic, then chills, prostration, irritability, tenderness of right hypochondrium, nausea, vomiting. Treatment in dog: antiseptic aspiration, laparotomy.
Causes in the Horse. Hepatic abscess arises from a great many primary morbid conditions. As a secondary abscess it is seen in the different forms of pyæmia and especially in suppurative omphalitis in young animals. It may start in thrombosis determined by clots or septic matters carried from a distance through the portal vein or hepatic artery, in biliary calculi or concretions, in parasites introduced from the duodenum, in barbs or husks of the cereals that have penetrated through the biliary ducts, or in bacteria or their toxins which have been carried from the bowels, spleen or pancreas. The government veterinarians have found it a comparatively common lesion in the hot damp climate of Hindoostan, and a similar frequency has been noticed in west Africa. Among general affections it is liable to occur in strangles, contagious pneumonia, glanders, endocarditis of the left heart and phlebitis with the formation of thrombi in the lungs. In the two last named disorders, the affection takes place by the simple transference of detached clots to the liver to block its arteries or capillaries. Or it may be that micro-organisms are transferred in the same way. With modern views of suppuration the presence of the pyogenic organisms must be conceded.
Lesions in the horse. Cadeac distinguishes the different types of hepatic abscess as: 1st biliary abscess in which suppuration commences in the interior of the biliary ducts and usually from parasites or mechanical irritants introduced or from calculi or concretions formed within them: these rare abscesses contain biliary salts, pigments, and epithelium and acquire the size of a pea or hazelnut: 2d Metastatic abscesses which start in the arterial, portal, or capillary vessels, by the arrest of infecting clots, which determine a further clotting, the obstruction of the vessel, the accumulation of leucocytes and the formation of abscess of the size of a pin head or larger up to a hen’s egg, surrounded by a hæmorrhagic infarct softening in the centre: these are numerously disseminated through the liver: 3d Mechanical Abscess due to the penetration of foreign bodies or parasites: 4th Infection as in strangles. These may attain a large size, cause adhesion to adjacent organs, and rupture into the chest, the colon, stomach or peritoneum. The pus may even escape externally through the right hypochondrium.
Symptoms in the horse. These are always obscure and vary much with the source of the malady. If there has been a pre-existing hepatic malady the symptoms of that will be in evidence; if an omphalitis its existence may still be recognizable; if pulmonary or cardiac disease, that may be detected; if parasites, evidence of their existence may perchance be found; if gall stone, a previous violent hepatic colic with icterus may have occurred; and if intestinal septic disorder, there may be the testimony of intestinal troubles. The more diagnostic symptoms are a fever of a remittent type, one or several violent shivering fits, a marked jaundice which like the fever shows exacerbations, and a similar irregularity of the condition of the urine which may be successively of a dark brown, a deep yellow, and a transparent amber color. Tenderness and grunting on percussion of the right hypochondrium would be an additional aid in diagnosis.
Treatment. Death has been hitherto considered as the inevitable result, yet recoveries may ensue after rupture into the colon or through the abdominal walls. If the seat of the abscess can be ascertained its evacuation through an aspirator and the subsequent injection of an antiseptic would be appropriate. The concurrent use of antisuppurants like hyposulphite of soda, or sulphide of calcium would also be in order.
Causes in Cattle. Hepatic abscess is much more frequent in cattle, and is commonly a result of perforation by sharp pointed bodies (needles, pins, nails, wires, etc.) from the reticulum and rumen, or of parasites, or biliary calculi. Other cases are occasioned by the presence of tubercles, actinomycosis, or omphalitis.
Lesions in Cattle and Sheep. Secondary abscesses are usually multiple and disseminated through the organ, though Cadeac says they are more common in the left half. They vary in size from a bean to a pigeon’s egg, project often from the surface, and contain a viscid, creamy, yellowish or greenish pus. Abscesses dependent on foreign bodies often attain a great size, so as to contain a pint or quart of pus (Landel). They may make their way through the diaphragm, rumen, or abdominal wall leaving a thick cicatrix in the liver, or they may become slowly absorbed and dry up into a putty-like or cretaceous mass. Brusaferro found hepatic abscesses in lambs twenty to thirty days old—probably of omphalic origin.
Symptoms in Cattle are usually very obscure. Fever, shivering fits, jaundice, indigestion, diarrhœa or dysentery, emaciation, colics, tender right hypochondrium, and peritonitis may all be in evidence but the diagnosis is little better than a guess.
Treatment when possible at all would be on the same lines as for the horse.
Causes in the dog. According to Cadeac these are mostly foreign bodies (needles, pins, etc.) which have been swallowed, tumors of the liver or adjacent organs, phlebitis and thrombosis of the portal vein, pyæmia, septicæmia, and external injuries (kicks, blows, contusions, falls, etc.)
Lesions in the dog. As in the other animals traumatic abscess is usually solitary and large, secondary abscess multiple and small. The pus developed around a foreign body is reddish, greenish and fœtid, that of the metastatic abscess is usually whitish or yellowish and with a sweet odor.
Symptoms in the dog are those of hepatic congestion, or violent gall stone colic, followed by severe rigor, great depression, or irritability, and tenderness over the right hypochondrium. Nausea and vomiting is a marked symptom though not a diagnostic one.
Treatment. If the flaccid abdominal walls will allow of the locating of the abscess it should be treated by aspiration and antiseptic injections. It would even be admissible to perform laparotomy, stitch the wall of the abscess to the external wound, and empty it under due antiseptic precautions.