Treatment is essentially the same as in leukæmia, and equally unsatisfactory. Arsenic has in the main given the best results. In the very earliest stages when the granular hyperplasia is confined to one group, excision is advisable. This should be avoided in all cases in which the constitutional symptoms have developed. Phosphorus and phosphide of zinc have seemed beneficial in certain hands. Injections into the glands have so far proved useless.
ACUTE LYMPHANGITIS OF PLETHORA IN HORSE. ANGEIOLEUCITIS.
Definition. Symptoms and causes. Genera affected. Causes of plethora. High feeding. Work followed by rest. Fever, hurried breathing, strong, rapid pulse, anorexia, stiffness and swelling in a hind limb, inguinal glands, connective tissue engorgement, corded lymphatics, suppuration rare. Mild forms. Lesions, in lymphatic vessels and glands. Chronic cases. Nature, plethoric, lymph excess, stasis, excess of cells and fibrine, immunity of the fore limb. Season of prevalence. Climate. Diagnosis, from farcy, erysipelas, etc. Treatment, exercise, friction, resolvents, purgative, bleeding, diuretics, astringents, iodine, pressure, diet. Prevention. Treatment of chronic cases.
Definition. Inflammation of the lymphatic vessels and glands of one limb usually in connection with rest.
Symptoms. This affection is common in heavy draft horses of a lymphatic temperament and kept on high feeding and at hard work. It rarely develops however while the subject is kept at steady work. But if, in the midst of such work, the horse is kept at rest in the stall over one, two, or more days on the same generous diet, he is found shivering violently, with rapid, labored, breathing, high pulse and elevated temperature, symptoms which have been frequently mistaken for those of pneumonia. There is complete anorexia, and often ardent thirst. The patient is indisposed to move and if forced to it shows lameness in one hind limb with an extraordinary abduction of the limb at each step, and sometimes so severe as to prevent his putting his full weight upon it. If an examination is now made high up in the groin close outside the inguinal ring, the lymphatic glands will be found to be swollen, hot and tender, so that under even moderate pressure the leg will be lifted and abducted until the patient threatens to fall on the other side.
A little later the shivering may have given way to the hot stage, with it may be general perspiration, and the swelling may have extended down the course of the saphena vein and lymphatics, as a distinct ridge and the lower part of the limb from the foot to the hock may be filled, dropsical and hot. Unless checked the swelling goes on increasing till the lower part of the limb is two or three times its natural thickness, and the swelling has extended well up on the thigh. The swelling has a soft œdematous feeling, easily receiving and retaining the imprint of the finger and is not only hot, but excessively tender. From the margin of the swelling, firm, tender, rounded cords are found to emerge passing upward along the line of the saphena vein and its branches toward the inguinal glands. These represent the swollen and gorged lymphatic trunks, and may often be traced for some distance into the substance of the general engorgement.
When the inflammation is violent, suppuration may ensue at one or several centers, but more commonly the engorgement goes on increasing and when the febrile attack has subsided the limb is left permanently enlarged and correspondingly liable to a second attack.
Milder cases are met with which are perhaps even more misleading. There may be little or no rise of temperature, loss of appetite or general constitutional disturbance, but under some change of regimen and particularly after one or two days of rest the subject becomes lame in one hind limb, without any of the usual injuries to account for it. Examination of the groin shows swelling and tenderness of the external inguinal glands, with or without, a tender cord-like swelling running down from them.
Between these two types may be found all grades of lymphatic inflammation with a varied degree of attendant constitutional disturbance.
Lesions. The coats of the inflamed lymphatic vessels are thickened by exudate and the outer coat is the seat of ramified redness with minute spots of blood extravasation. The inner coat is dull, opaque, or even thickened. The vessel is dilated and its walls friable. The contained lymph in the intervals between the valves has coagulated into a very thin diffluent jelly-like clot, which in old standing cases may have become granular. The connective tissue from which these vessels lead is infiltrated with liquid and the lacunar spaces distended. Red patches from blood extravasations are numerous. The external inguinal glands and often the internal and sublumbar are swollen, congested, and the seat of active cell hyperplasia. Abscesses are exceptionally seen.