Phlebitis has then set in, and according as one or other complication predominates, it is described as suppurative or hæmorrhagic.
Diagnosis and prognosis. The diagnosis presents no difficulty. In phlebitis of the jugular the neck is held stiffly, and the jugular furrow is partly obliterated.
The prognosis is somewhat serious, particularly in phlebitis of the mammary vein, for obliteration of the vein interferes with the function of the venous plexus from which it springs, and, although there may be a limited vicarious circulation, the secretion of milk is indirectly and secondarily checked owing to difficulty of irrigation.
The extension of phlebitis of the jugular towards the head and the venous sinuses of the cranial cavity, is quite exceptional.
When the mammary vein is inflamed it appears collapsed in the direction of the heart and swollen, indurated, and painful in that of its origin in the mammary gland.
Treatment. The first point requiring attention is so to fix the animal as to prevent the clot from being pressed upon or crushed, though, unfortunately, this cannot always be properly done. The difficulty is obviated by applying vesicants, which cause swelling and pain, and so reduce natural movement of the parts to a minimum.
At first, when the parts surrounding the operative wound are simply swollen and phlebitis is threatened, repeated application of tincture of iodine or a liquid vesicant is useful, and may prevent the disease developing.
In existing cases a blister applied over and around the whole of the hardened tract may prevent the mischief from proceeding beyond the adhesive stage. In such case the clot becomes organised, the vein remains obliterated, and recovery follows.
Similar treatment may also be employed in suppurative phlebitis, but as the clot gradually breaks down in consequence of the action of bacteria it is useful and almost indispensable to disinfect the vessel. For this purpose the opening of the sinus must be enlarged, and, by means of a sterilised or very clean syringe with a curved nozzle, the parts washed out daily with warm boiled water, followed by an antiseptic injection containing 2 per thousand of iodine, 3 per cent. of carbolic acid, or, better still, glycerine containing 1 per thousand of sublimate.
If in spite of this treatment the phlebitis extends towards the origin of the jugular or mammary vein, a counter-opening may be made at the point where the clot still remains adherent, and a strip of iodoform gauze saturated with tincture of iodine or with blistering ointment diluted to one-eighth with oil may be passed. Needle firing is also of value. Finally, as a last resource, a ligature may be applied to the vein above or beyond the clot.