OSTEO-MALACIA (MALAXOS SOFT): CACHEXIA OSSIFRAGA; FRAGILITAS OSSIUM: “THE CRIPPLE:” “THE STIFFNESS.”
Definition. Disease of the mature. Decalcifying in cancelli and Canals of Havers. Dairy cows. Heavy milkers. Perverted appetite. Limed soils, sandy or limestone. Low, damp, soils rich in organic matter. Cultivation. Watery food. Plethoric. Debilitated. Cold. Change of locality improves. Microbes. Toxins. Lesions: vary with stage, congestion of marrow, excess of cells and fat, osteoclasts, exudates, friability of bone, distortions and fractures in pelvis and elsewhere. Symptoms: low condition, projecting bones, rough coat, perverted appetite, stiffness, decubitus, swaying limbs, inappetence, drying of milk, fever, bed sores, sloughs, sepsis, pus infection, fractures. Duration, 2 to 3 months and upward. Enzootic. Prognosis, varies with enzootic, and stage; best in recent cases, occurring, sporadically. Treatment: according to cause, rich, generous diet, grain, salt bitters, cod liver oil, apomorphia, wholesome pasturage, intensive culture change water, dry up milk, dry stables, pure air, sunshine. Slaughter. Local derivatives.
Definition. A softening and fragility of the bones of adult animals, in connection with solution and removal of the earthy salts.
This is essentially a disease of mature animals and is thus easily distinguished from rachitis, in which the lesions are due to a faulty development of young, growing bone. In osteo-malacia, too, the decalcifying proceeds most actively in the walls of the Haversian canals and cancelli, while in rachitis it progresses especially under the periosteum and in and around the epiphyseal cartilage.
The disease is found most commonly in dairy cows, but softening of the bones of mature animals has also been seen in horses and other animals. Dieckerhoff, who quotes cases in mature horses, adduces similar instances in colts under a year old, occurring enzootically, and without the specific lesions of rachitis. Seven out of sixteen broke their femurs in October, 1886, all kept on the same place, in good box stalls, and well cared for. Landois found in bones an abnormal amount of fat, ossein, water and lime salts. Grawitz found no material change in the cancellated tissue. In one district in Jutland, Stockfleth found an extraordinary number of broken legs as the result of castration of colts, which had not shown the thickening or distortions of rachitis.
Causes. The disease is particularly common in cows which yield a calf every year, and especially in heavy milkers, in which respect it agrees with the osteo-malacia of woman. The heavy demands upon the system for the nourishment of the fœtus and the supply of milk, undoubtedly lay the system open to attack, if they do not directly cause the disease. An early and usually a persistent feature of the malady is a depraved appetite, the causes of which may be read up in Vol. II. The statements there made, require some qualification, inasmuch as osteo-malacia is at times found on limestone soils with hard, calcareous water, and on rich, alluvial valley soils abounding in both clay and lime (Sarginson, Leclainche), as well as on barren sands and granite soils deficient in both lime and phosphorus. It may even appear on virgin or mucky soils after liming, which had been free from the trouble up to that time (Thorburn). The decomposition of the abundance of organic matter, hastened by the quicklime, has evidently been a contributing cause.
The excess of organic matter in the soil seems to be a considerable factor. Both Thorburn and Sarginson mention the “mossy” soils and waters, and in Lanarkshire, Scotland, and Westmoreland, England, where they practised, black muck and peats abound. This is corroborated by the prevalence of the disorder in the damp lowlands of Belgium and Jutland, in the Swiss valleys, on the damp lands of New Jersey and the Carolina seaboard, and generally on damp pastures with rank, watery herbage.
When land has been better cultivated and enriched by manure, the disease has in many cases disappeared. This has been observed in England (Sarginson), Wurtenberg, Switzerland, etc. (Leclainche).
Succulent, watery food (potatoes, turnips), have been quoted as causes, as also rank, watery grasses, deficient in nutritious solids, but such food has invariably come from habitual osteo-malacia soils. On the rich, cultivated soils of the Lothians, Scotland, cattle are fed in large numbers on turnips alone, and osteo-malacia and pica are alike unknown. It is often noticed that the fodder grown on particular (osteo-malacia) soils will cause the disease when fed elsewhere, so that the inference is that some agent derived from these soils, and which is destroyed or rendered harmless by cultivation, is carried in the food. It cannot be a mere defect of nutritive matter, as this could be counter-balanced by the simple expedient of consuming a larger ration. Leclainche has seen the disease in its worst form in herds which received a rich and varied ration, while it spared adjacent herds that were kept on rather short rations. Even young plethoric animals suffered badly, though having all they would eat of natural fodders (hay) from districts where the disease was unknown, and in addition grain, linseed cake, cooked legumes and bread. In two neighboring stables, where the stock were kept in identical conditions, receiving the same food, in equal quantity, one was decimated by the malady, while the other was spared (Leclainche).
The affection often prevails on the higher lands, which, beside having the poorer soils, are specially exposed to cold storms and frosts, so that chill enters as an accessory condition. In Westmoreland, England, the river Eden divides the affected from the sound lands; the victims are found on the west bank which receives the cold, east winds, and not at all on the east bank where the warm, soft, west winds prevail. Thorburn noticed that the majority of cases start in spring, when the animals, debilitated by the winter’s seclusion, are exposed to severe vicissitudes of temperature and driving storms, to the strain of parturition, a fresh, heavy milk yield, and moulting.
The presence of a contagion has been suggested, but if this exists it must be habitually introduced in the food or water rather than transmitted from victim to victim. The healthy will often stand beside the diseased for an indefinite length of time without injury, and in certain recent cases a change to an uncontaminated farm, or an abundant ration drawn from such sound soil, will secure immediate improvement and recovery in a few weeks. In view of such prompt recoveries it would be quite as reasonable to suspect some ptomaine or toxin taken in with the food. The question of a microbe or a microbian poison is as yet a mere hypothesis.
Cows become more susceptible with advancing age, and Dengler alone claims to have seen the disease in calves. This is unfavorable to the idea of immunity, and rather favors that of debility or cachexia.
Lesions. These are confined to the bones. Decalcification in the Haversian canals and cancelli, reduces the bony tissue to a thin soft plate. Yet the condition is not constant. Grawitz found no special dilatation of the canals or cancelli in colts. Nessler and others found decrease of the lime salts, Bibra and Grouven detected no marked change, and Hoffmann and Begemann found an actual excess of phosphates. Doubtless the specimens selected and the stage of the disease, whether in active progress or during convalescence, may somewhat explain discrepancies. The fat cells increase in the cancelli, with more or less hyperæmia, and even blood staining as the disease advances, the bone cells become less branching, and there may be gelatinoid exudates. The resistance of the bone is diminished, it may be indented with the finger, or scraped off with the nail, or cut with a knife. It breaks under a slight strain, and is easily crushed under the weight of the animal so that fractures and distortions of all kinds are met with. In breeding cows the earliest and most marked lesions are in the pelvic bones, but fractures of the bones of the limbs are common.
Symptoms. Poor condition or even emaciation, with very visible projection of the bones is common. The coat is rough, the skin tense, inelastic and hide bound, appetite variable, sometimes impaired, and nearly always perverted so that the patient will lick the manger continually or pick up and chew all sorts of objects, bones, leather, articles of clothing, pieces of wood or iron, stones, etc. The amount of food consumed may, however, be up to the normal. The most marked feature is the difficulty and stiffness of locomotion. The patient lies most of the time, rises languidly and with difficulty and moves the limbs as if each were a rigid post without joints. The hocks will knock together, and the restricted movements of the joint are often attended by cracking. Yet appetite, temperature and yield of milk may remain normal.
Later appetite and milk secretion fail, temperature rises a degree or two, the animal refuses to rise, remaining down twelve to twenty-four hours at a time, and rising first on the hind parts, and remaining on the knees for a length of time, moaning and indisposed to exert herself further. Many cases at this stage begin to improve and may get well in five or six weeks. Some will remain down for several weeks and finally get up and recover. With constant decubitus however, the animal falls off greatly, becoming emaciated and weak, the appetite may fail altogether, and the patient is worn out by the persistent fever, nervous exhaustion and poisoning from the numerous bad sores. Abscesses, sloughs and fistulæ are common over the bony prominences.
It is in these last conditions above all that fractures and distortions of the pelvic bones and less frequently of the bones of the legs occur. They occur earlier as well in connection with falls, blows, crowding by their fellows and sudden active movements of various kinds.
The disease may advance for two or three months, and in case of pelvic fractures and distortions, there may be permanent lameness, and dangerous obstruction to parturition, even though the bones should acquire their normal hardness through the deposition of lime salts.
It has been noted that the disease is usually confined to well defined areas, and that even in these it has its periods of abatement and recrudescence so that given years are osteo-malacia years. In the department of l’Aube, France, Leclainche, particularly noted the enzootics of 1865–6, 1870, 1875–6, and 1883–4.
Prognosis. The gravity of the affection varies greatly under different conditions. Some outbreaks are mild while others are very severe, and the prognosis must vary with this gravity. Again at the decline of an enzootic the disease is more benign and less ruinous. A case in its very earliest stage is much more hopeful, than one that is far advanced, with bones extensively softened or even broken, digestion and assimilation badly impaired, and infecting sores and sloughs on different parts of the body. Isolated cases are usually much milder than when the affection has gathered strength enough to determine an enzootic.
Treatment. This will vary with the predominance of the causes, essential or accessory. In some cases the suspension of the injurious food and a rich alimentation on well grown fodders from sound lands will meet every need. Green clover, alfalfa, and other leguminous products, ground oats, beans, peas, linseed cake, rape cake, cotton seed and vetches may be especially named. Even animal food may be availed of, and cases are recorded in which cows have themselves hunted for snails and frogs and devoured them greedily. The free access to common salt, and a liberal supply of bone meal are helpful. Iron and bitter tonics, (gentian, quinine, salicine, nux, copperas, tincture of iron) and cod liver oil, in pint doses daily, have been found advantageous. Apomorphia has been found especially valuable in correcting the preverted appetite, and stimulating digestion.
Where it is feasible to move the affected herd from the unwholesome pasturage or locality to one in which the aliment is rich and the disease unknown, success usually follows the change.
On poor, uncultivated lands where the disease appears yearly, or at short intervals, intensive culture with heavy manuring, and the heavy feeding of the herd on grain products, linseed cake, etc., will often banish the trouble.
Care should be taken to change the water as well as the food.
Finally every drain upon the system should be lessened or stopped. The milk may be dried up and the animal should not be bred. Sweet, dry buildings, pure air, sunshine and grooming are important auxiliaries.
In severe outbreaks, in high conditioned animals, the owner often consults his interest, in sending the victims to the butcher as soon as the affection shows itself and before time has been allowed for the inevitable emaciation and loss.
Some, on osteo-malacia lands, have profited by changing the entire herd every two years, as they become rapidly worn out under successive attacks.
As local derivatives, oil of turpentine, hot vinegar, tincture of iodine and biniodide of mercury have been employed. Open sores are treated with antiseptic lotions, creolin, lysol, carbolic acid, iodine lotions, iodoform, etc.