Symptoms. These are of all degrees of severity from the frequent pulpy evacuations of animals fed exclusively on roots, (beets, turnips, potatoes), to the excessive and almost constant discharge of a dark colored liquid mingled with more or less mucus. The discharge may be of a light color and fœtid, indicating deficiency of bile, or of a dark yellowish brown and odorless.
Slight diarrhœa does not affect the appetite nor general health, nor check improvement in condition. In the more severe and continued forms there is loud rumbling in the abdomen, loss of appetite and condition, a rapid small pulse, accelerated breathing, pallid mucous membranes, sunken glassy eye, and increasing debility even to an unsteady gait. Distension of the abdomen with pawing and other indications of abdominal pain may appear in bad cases. In the milder cases due to simple irritation and congestion there is no tenesmus, no excess of mucus, no formation of bubbles or froth in the stools, as occurs in active intestinal fermentation and dysentery. In symptomatic cases on the other hand there are superadded the marked symptoms of intestinal inflammation, or fermentation, and the fæces become putrid and offensive, which they do also in the different infectious diseases (influenza, contagious pneumonia, rinderpest, lung plague, hog cholera, swine plague, canine distemper, fowl cholera), when the toxins and waste matters of the food and decomposing tissues are being thrown off by the bowels.
Diarrhœa may be complicated with other diseases and especially in the horse with laminitis.
In mild cases it tends to a spontaneous recovery, and is followed by some slight costiveness, and if this should prove extreme there may be some danger of complicating sequelæ such as indigestion, enteritis, pneumonia or laminitis.
Treatment. The first consideration for the practitioner is to discover if possible the immediate cause of the diarrhœa. If this is found to reside in some infectious or other disease aside from the bowel, the attention must be directed to that even more than to the diarrhœa. If it depends on an overdose of some purgative agent or of acrid purgative plants taken with the food, any further laxative is to be avoided, and yet astringents and other agents which tend to lock up the offending material in the alimentary canal must be equally guarded against. An abundance of mucilaginous and demulcent liquids (mallow, flaxseed gruel, boiled starch, etc.) may be given both by the mouth and anus, to sheathe and protect the irritable mucous membrane and to dilute and carry off the irritant contents. Moderate doses of opium may be required to allay the violence of the spasms and peristalsis, but this should not be pushed to the extent of locking up the irritants. Sometimes antiseptics (naphthalin, salol) are useful to check fermentation, and pepsin may be given to assist digestion.
In ordinary cases due to the presence of an irritant the first object must be to relieve the bowels of this, and the second to soothe the irritated mucous membrane. A laxative is usually all that is required, but it must be a mild one so as not to add to already existing irritation. Olive or castor oil are to be preferred as a rule (horse and ox 1 pint; sheep and swine 4 ounces; dog ½ ounce), alone or with a moderate dose of laudanum. Or rhubarb or aloes may be substituted if desired. A dose of whisky or brandy, or oil of turpentine will often do much to allay the secretion and peristalsis. These should be followed by moderate doses of flaxseed gruel, or solution of slippery elm or mallow, or simple well boiled gruels.
If the discharge persists after the laxative has had time to operate, these mucilaginous agents may be replaced by solutions of boiled starch, or of gum arabic, and small doses of calmatives such as laudanum (horse or ox 1 ounce, sheep or pig 2 drachms, dog 20 drops), or prussic acid or cyanide of potassium (30 drops of the acid or grains of the salt for horse or cow). Sub-carbonate of bismuth, chalk, and carminatives and antiseptics may also be given. According to the indications the practitioner must combat persistent intestinal fermentation, or a relaxed adynamic condition of the intestinal mucosa, or general weakness and exhaustion, with such agents as seem best adapted to the individual case.
Chronic cases will demand the exercise of much judgment. After a gentle laxative, salts of iron (sulphate, chloride) and pure bitters may be given with antiseptics. Or vegetable astringents (catechu, kino) with freshly burned charcoal and essential oils (peppermint, cloves, cajeput) may be employed. In some instances calomel and chalk (1:12) will serve a good end. In others silver nitrate, or arsenite of copper succeeds. Quinine, nux vomica, pepsin, may be used to improve tone. The diet is usually all important. Well boiled gruels, boiled milk, arrowroot, pulped or scraped raw flesh may be demanded in different cases. The patient should be kept at perfect rest, and all excitement avoided.
COLIC, ENTERALGIA, INTESTINAL SPASM.
Definition. Colicy pains from spasm, enteralgia, tympanitic indigestion, overloading of bowels, impaction, calculi, concretions, sand, foreign bodies, intestinal and arterial parasites, irritants, enteritis, catarrhal, bacteridian, protozoan, chemicals, strangulation, adhesion, volvulus, invagination, hernia, trauma of stomach or intestine, peritonitis, pleuritis, metritis, ovaritis, hepatitis, biliary calculus, nephritis, urinary calculus, neoplasms, lead poisoning. Causes of enteralgia or spasm, idiosyncrasy, nervousness, cold, wet, high condition, debility, cold, rain, dew, perspiration, fatigue, indigestion, rheumatism. Symptoms: horse—sudden attack, paws, kicks, anxious look at flank, crouches, goes down, rolls, sits, rises, shakes himself, feeds, repeats at intervals, rumbling, defecations. Complications. Diagnosis, symptoms violent, transient, completely intermittent, no fever, no tenderness; from acute indigestion by absence of faulty feed, loaded or tympanitic abdomen, crepitation, continuous pain, and of careful decubitus; from constipation by complete intermissions and freer passages; from intestinal worms by absence of fur on anus, of rubbed rump, and of parasites in stools; from verminous thrombosis by complete intermissions and absence of prostration, cold sweats and of bloody stools; from enteritis and other inflammations by absence of fever; from intestinal anthrax by the intermissions, the absence of brownish mucosa, and perhaps of anthrax from the district; from hepatitis by absence of icterus, tender hypochondrium, and fever; from kidney affections by lack of stiff, straddling gait, tender loins, stretching; from pleurisy by absence of catching breathing, tender intercostals, and friction sound; ruminants—similar symptoms except sitting up or rolling; swine—sudden starting with grunt or scream, vomiting, etc.; Carnivora—frequent moving, yelps, snapping, straining, looking at flank. Treatment: solipeds, morphia subcutem, anodynes, laxative, friction, walking, enemata, chloral hydrate: ruminants, walking, enemata, morphia, laxative; swine, morphia, laxative, antispasmodics, injections, derivatives; dog,—purgative, injections, chloral hydrate, ether, olive oil.