Dropsy
Another disease, which is not confined to the abdominal cavity, is dropsy: but, as in the dog it most commonly assumes that form which is termed
ascites
, or
dropsy of the abdomen
, it may be noticed in this place. It is seldom an idiopathic or primary affection, but is generally the consequence of some other disease, most commonly of an inflammatory kind.
Dropsy is a collection of fluid in some part of the frame, either from increased exhalation, or from diminished absorption, the consequence of inflammation. The divisions of dropsy are into active and passive, or acute and chronic. The causes are also very properly arranged as predisposing and exciting. The diseases on which dropsy most frequently supervenes are fevers and visceral inflammations and obstructions. The dog is peculiarly subject to
ascites
or
dropsy of the belly
, and the quantity of fluid contained in the abdomen is sometimes almost incredible. It is usually accompanied or characterised by a weak, unequal, small, and frequent pulse — paleness of the lips, tongue, and gums — flaccidity of the muscles, hurried breathing on the least exertion, feebleness of the joints, swellings of the lower limbs, effusion of fluid into the integuments or among the muscles, before there is any considerable effusion into the thorax or the abdomen, and an unhealthy appearance of the cutaneous surface. The urine seldom coagulates. This form of dropsy is usually seated in the abdomen or cellular tissue.
The treatment of ascites is seldom perfectly successful. The great extent of the peritoneum, the number and importance of the viscera with which it is connected, and of the absorbent glands which it encloses, the number and weakness of the veins which transmit their blood to the portal vessels, and the absence of valves, in some measure account for the frequent accumulation of fluid in this cavity. It appears in both sexes from the usual causes of inflammatory disease. Unwholesome diet, the drastic operation of purgatives, external injuries, the suppression of accustomed secretions and discharges, all are exciting causes of dropsy.
The animal has suffered materially from mange, which has been apparently cured: the itchiness and eruption altogether disappear, but many weeks do not elapse ere ascites begins to be seen, and the abdomen is gradually distended with fluid. When this appears in young and healthy animals, it may be conquered; but when there has been previous disease of almost any kind, comparatively few patients permanently recover. Irritability of the stomach, and a small and accelerated pulse, are unfavourable.
the operation of tapping has taken place, at all times there is danger; but, if there is a thick, brown, albuminous or fetid discharge, it is very unlikely that any permanent advantage will result from the operation.
will introduce a few cases as they occur in our clinical records.
November 7th, 1821
. — A spaniel, nine years old, had been, during four months, alternately asthmatic or mangy, or both. Within the last few days she had apparently increased in size. I was sent for. The first touch of the abdomen betrayed considerable fluctuation. She likewise had piles, sore and swelled. I ordered an alterative ball to be given morning and night.
8th.
One of the balls has been given, and two doses of castor oil; but no effect has been produced. An injection was administered.
9th
. A small evacuation of water has been produced, and the bowels have been slightly opened. Give a dose of the castor-oil mixture.
10th.
The obstruction has been removed; the enlargement is somewhat diminished; much water has passed. Give an alterative ball every morning.
14th.
The alteratives have been continued, and there is a slow but evident decrease of the abdomen.
18th.
I cannot detect any effusion in the abdomen. Give a pill every alternate day for a fortnight. At the expiration of this period the dog was apparently well.
April 23d, 1822.
— A terrier, ten years old, had cough and mange, which ceased. The belly for the first time began to enlarge, and on feeling the dog considerable fluctuation was evident. He would not eat, but he drank immoderately. Give daily a ball consisting of tonic and physic mist., with powdered digitalis and tartrate of iron.
May 6th.
— He is in better spirits, feeds tolerably well, but is rather increased in size. Give daily a ball of tartrate of iron, digitalis, ginger, and a grain of calomel.
22d.
Much thinner, the belly very considerably diminished: a slight fluctuation is still to be perceived. Continue medicine, with a half-grain only of calomel.
July 17th.
— The medicine has been regularly given, and the water of the abdomen has rapidly disappeared, until a fortnight ago: since that time it has been once more filling. The medicine was ordered to be repeated.
August 6th
. — The medicine has once more produced its proper effect, and the fluid has disappeared.
On the
16th,
however, the fluctuation was again too plainly felt, and the owner determined to have nothing more to do with the case. The animal was never brought again, nor could I trace it. The dog might have been saved if the owner had done it justice.
soon as dropsy appears to be established, proper medicines must be resorted to. Foxglove, nitre, and ginger should be first tried in the proportional doses of one, ten, and eight grains, given morning and night. If this does not succeed, iodine from half-a-grain to a grain may be given morning and night, and a weak solution of iodine rubbed on the belly.
This being ineffectual, recourse may be had to tapping, taking care that the trocar is not plunged sufficiently deep to wound the intestines. The place for the operation is directly on the
linea alba
, or middle line of the belly, and about midway between the pubis and the navel. The whole of the intestinal fluid may be suffered to escape. A bandage should then be applied round the belly, and retained there a week or more.
Mr.
[a]Blaine]
very properly states, that the difference between fatness and dropsy is, that the belly hangs pendulous in dropsy, while the back bone stands up, and the hips are protruded through the skin; while the hair is rough, and the feeling of the coat is peculiarly harsh. It may be distinguished from pregnancy by the teats enlarging, in the latter case, as gestation advances, and the young ones may occasionally be felt to move. In addition to this it may be stated, that the presence of water is readily and unerringly detected. If the right hand is laid on one side of the belly, and the other side is gently struck with the left hand, an undulating motion will be readily perceived.
old dogs, dropsy, under the title of
anasarca
, is an unfrequent but occasional accompaniment of ascites. If pressure is made on any particular parts, they yield and continue depressed for a longer or shorter period of time, and slowly and by degrees regain their natural form. The skin is dry and distended, and with no natural action; the circulation is languid and small, the muscular powers are diminished, the animal is unquiet, the thirst is great, the tongue is pale, the appetite diminished, and the limbs are swelled. The best mode, of treatment is the infliction of some very small punctures in the distended skin, and the application of gentle friction. The majority of cases of this kind are usually fatal, and so is almost every case of encysted dropsy.
A dog had cough in
February, 1825
. Various medicines were administered, and at length the cough almost suddenly ceased, and evident ascites appeared. The thirst was insatiable, the dog would not touch food, and he was unable to lie down more than two minutes at a time.
Digitalis, cream of tartar, and
hydrarg. submur
. were given on the
9th April.
On the
13th
he was much worse, and apparently dying. He had been unable to rise for the last twelve hours, and lay panting. I punctured the abdomen, and four quarts of fluid were evacuated.
14th.
The panting continues. The dog will not eat, but he can lie down in any posture.
15th.
The panting is diminished, the appetite is returning, and water continues to ooze from the wound,
17th.
The wound healed on the night of the
15th
, and already the fluid begins to collect. The medicine still continued.
20th.
The spirits good, and strength improving; but the belly is evidently filling, and matter is discharged from both the nose and eyes.
26th.
The swelling a little diminished, respiration easy, and the dog walking comfortably about, and feeding well.
May 13th.
— The swelling, which for some days past diminished, is now again increasing; but the dog is strong and breathes easily. Medicine as before.
24th.
The dog is thinner, weaker, filling fast, and the thirst excessive. [Symbol: Rx]:
Crem. tart., ferri tart
. [Symbol: ounce]
ij., pulv. flor. anthemid.
[Symbol: ounce]
iiij., conser. ros. q. s.: divide in bol. xii.: cap. in dies.
27th.
During two days he has been unable to lie down more than a minute at a time. Again tapped: fully as much fluid was evacuated as before; but there is now blood mingling with it.
30th.
Much relieved by the tapping, and breathes with perfect ease; but, now that the enormous belly is reduced, the dog is very thin.
Bol
. continued.
June 8th. Within the last three days the animal has filled again with extraordinary rapidity. [Symbol: Rx;]:
Ferr. tart.
[Symbol: scruple] j.,
opii. gr. 1/4, pulv. gentianæ
[Symbol: scruple] j.,
cons. ros. q. s.: f. bol. capiend. in dies.
13th.
Is again strangely distended; I advised, or rather solicited, that it might be destroyed; but this not being granted, I once more tapped him. At least a gallon of dark-coloured fluid was evacuated.
22d.
Again rapidly filling, but not losing either flesh or strength.
July 4th.
— Once more punctured, and a gallon of dark-coloured fluid evacuated.
12th.
Again filling and rapidly losing flesh and strength.
26th.
Once more tapped: immediately after which he appeared to be revived, but almost immediately began again to fill.
Aug. 2d.
— He had eaten tolerably; appeared to have nothing more than usual the matter with him, when, being missed for an hour, he was found dead. No examination was permitted.
In 1824 a spaniel, six years old, was brought to the infirmary. It had had an asthmatic cough, which had left it. It was now hollow in the flanks, the belly pendulous, and an evident fluctuation of water. The owner would not consent to any operation. An aloetic physic-ball, however, was given every fifth day, and a ball, composed of tartrate of iron, digitalis, nitre, and antimonial powder, on every intermediate morning and night. The water evidently accumulated; the dog was sent for, and died in the course of a week.
There are a few medicines that may be useful in arresting the effusion of the fluid; but they too often fail in producing any considerable benefit. The fox-glove is, perhaps, possessed of the greatest power, combined with nitre, squills, and bitartrate of potash. At other times chamomile, squills, and spirit of nitrous ether, may be tried.
The following case, treated by the administration of iodine, by Professor Dick, is important:
A black and tan coloured retriever was sent to me labouring under ascites. He was tapped, and two quarts of fluid abstracted. Tonics, combined with diuretics were given, but the fluid continued to accumulate, and in three weeks he was again tapped, and another two quarts drawn away. The disease still went on, and a fortnight afterwards a similar quantity was withdrawn. Various remedies were tried in order to check the power of the disease, but without effect, and the abdomen again became as much distended with the effused serum as before.
He was then put under a course of iodine, which soon began to show its beneficial influence by speedily allaying his excessive thirst; and in about a month the whole of the effused fluid was absorbed, although from the size of the abdomen it must have amounted to a similar quantity to that drawn off on the previous occasions. The dog's appetite soon returned; he gained flesh rapidly, and has continued quite well, and, from being a perfect skeleton, soon became overloaded with fat.
Induced by the great benefit derived in this case from the iodine, I took the opportunity of trying it on a Newfoundland dog similarly affected. He was put on a course of iodine, and the quantity of the drug was gradually increased. As absorption rapidly commenced, the fluid was completely taken up; but, partly in consequence of pushing the medicine too far, and partly from extensive disease in the liver, unfavourable symptoms took place, and he sunk rather unexpectedly. Still, however, from the obvious and decided advantage derived from the medicine, I have no doubt that iodine will be found one of the most efficient remedies in dropsy in dogs.
Iodine is a truly valuable drug. When first introduced into veterinary practice it was observed that it readily accomplished the reduction of the enlarged glands that frequently remain after catarrh; but it was presently evident that it reduced almost every kind of tumour, even the growth of tubercles in the lungs. Professor Morton, in his
Manual of Pharmacy
, has admirably described the different combinations of iodine.
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