This wound is the seat of one or more sinuses which penetrate the vein, arteries, or urachus. If only one sinus exists, it always passes upward and forward into the umbilical vein. The utmost precaution should be employed in examining the parts. Should it be thought desirable to probe the sinus in order to discover its direction, the probe must be very cautiously introduced, and only for a short distance, because rough handling would tear the tissues and carry infective material to deeper seated points.
Complications. These are numerous and very grave. Long ago Lecoq described a disease suggestive of laminitis, which beyond doubt was only a form of purulent infection. At a later date Loiset studied a disease following omphalitis, in which interstitial abscesses developed in the cord. This also was simply purulent infection.
More recently complications such as pleurisy, pneumonia, infectious endocarditis, diarrhœic enteritis, and especially suppurative polyarthritis of young animals have been referred to omphalo-phlebitis. All these complications result from infection. The microorganisms themselves or the toxins they secrete appear to have a particularly injurious action on the serous membranes, a fact which throws light on the frequency of such complications as pleurisy, peritonitis, endocarditis and arthritis.
Intoxication also plays a certain part, and microbic toxins are responsible, at least at first, for the uncontrollable diarrhœa, arthritis with sterile exudations, etc.
Diagnosis. This presents no difficulty. The alarming general symptoms seen at the outset immediately suggest in the case of young animals the possibility of disease in the umbilical region.
Prognosis. The prognosis is grave, it may be said very grave, because treatment is difficult to apply, and dangerous complications, which almost always prove fatal, may already have been set up.
One must always distinguish, however, and take into account in forming the prognosis, the special characteristics of the phlebitis, and weigh carefully the signs of complication. The fistula should be cautiously explored, and its depth, etc., noted, while the temperature, circulation, respiration, etc., should be carefully studied.
Treatment. A very important item of treatment consists in regularly and scrupulously cleansing the region of the umbilicus after the cord has separated and until the wound has completely cicatrised. The parts are washed with boiled water and dusted with boric acid, iodoform, etc.
A still better plan, and one that almost certainly guards against this disease, is to apply an antiseptic dry dressing as soon as the new-born animal has become dry. This need only consist of a small sheet of antiseptic cotton wool fixed to the umbilicus by four pitch bandages or by two pieces of webbing passed over the back. In this way contamination of the cord and the risk of infection are avoided.
In cases of fully-developed phlebitis the old generation of practitioners used to recommend local dressings with adhesive plasters, astringent and vesicant applications, etc. All such methods are useless, because they only act on a part of the diseased structures and cannot reach the blind ends of the sinuses. The classic treatment of suppurative phlebitis also is out of the question.