In cases that supervene on the acute form, paracentesis, saline laxatives and diuretics with antiseptics, tonics, and counter-irritants will sometimes succeed. As in the acute form of the disease the removal of the effusion is the removal of the culture fluid, and may be followed by irrigation of the peritoneum with a normal salt solution, or with an antiseptic solution (boric acid or potassium permanganate), 1:20 warm water; Aluminum acetate, 1:2000. Sulphate of soda given to keep up a moderately laxative action, tends to counteract the contraction of the intestine by false membranes, and operates with diuretics in reducing the tendency to exudation or in causing its reabsorption. After removal of the liquid, support by a close (or elastic) abdominal bandage is often of value in preventing further effusion. As tonics, gentian, nux vomica and the iron salts may be profitably employed, and as antiseptics salicylate of soda and iodide of potassium. As counter-irritants mustard and cantharides may be named.
PERITONITIS IN RUMINANTS.
Causes: infection, chill, blows, wounds, debility, ill health, Chauveau’s experiment with castration, dystokia, abdominal congestion and inflammation, bile or urine in absence of sepsis, gastric or intestinal ulcer or perforation, foreign bodies, abscesses, surgical wounds. Spoilt marc of beet sugar factories. Symptoms: fever, stiffness, dragging hind limbs, knuckling, arched back, shifting feet, moving tail, tense belly, pendent, fluctuating below, friction sounds, diarrhœa, later constipation, weakness, emaciation, death fourth to twentieth day. Recovery, often partial. After dystokia putrid vaginal discharge, and nervous depression, resembling parturition fever. Infection in ewes through shepherd’s hands, œdematous swellings of vulva, perineum and abdomen. Lesions: as in solipeds, with abundant false membranes, fœtid pus metritis, with putrid contents of womb. Treatment: saline laxatives, diuretics, demulcents, enemata, morphia, antiseptics, cold to abdomen. After dystokia, antiseptic irrigation of womb, elevation of head, with ice, strychnia, acetanilid. Tubercular peritonitis.
Causes. As in solipeds infection of the peritoneum and the increase of susceptibility by exposure to cold, blows, wounds, poor feeding or stabling, disease and other causes of ill health, operate together in inducing peritonitis.
The effect of debility or predisposition of the tissues is well shown in Chauveau’s experiments with bistournage in rams. Healthy rams subjected to bistournage showed no infection, and rams subjected to intravenous injection of pus microbes without bistournage showed no infection, whereas if the rams were first subjected to injection of pus microbes, and then to bistournage, peritonitis set in. In the same way chills occurring after dystokia, when the womb is charged with microbes and more or less congested, may determine peritonitis, and congestions, impactions, tympanies, and other injuries of the gastro-intestinal viscera coöperate with cold to the same end. Rupture of the gall or urinary bladder does not usually cause prompt peritonitis, yet it irritates the serosa and lays it open to infection if the germs should reach it through the circulation. Otherwise the animal suffers only from uræmia or biliary poisoning and may survive one or two weeks. Ruptures of stomach or intestine, or ulceration or the perforation of their walls by hard, pointed or other metallic bodies are causes of peritonitis. The rupture of abscesses into the peritoneum and the escape of germs from the womb in case of rupture of the womb in difficult parturition, or in metritis, are additional causes. Surgical wounds as in castration of the male or female, and punctures and incisions of the rumen are occasional causes, but there is by no means the tendency to extension of such peritonitis that we see in solipeds. The self-protective power of the tissues is incomparably greater in the ruminant.
Nocard, Butel and others have recorded a gastro-entero-peritonitis of septic nature, occurring in cattle and above all in sheep, fed on the fermented refuse of beet sugar factories, which had been kept in silos through the winter. On the third and fourth days of this feeding many were attacked.
Symptoms. Beside the general systemic disorder and a very variable amount of hyperthermia (102° to 107°), there are the special indications of abdominal inflammation, stiff movement and dragging of the hind limbs, or if standing the back is arched, the head drooping and the legs drawn together and slightly bent, with uneasy shifting of the hind feet, and lateral movements of the tail. The walls of the abdomen are usually tense, often bulging laterally below, though fallen in beneath the lumbar transverse processes (pot-bellied); they are tender to pressure, and may be drum like to percussion above, while flat, dull, and fluctuating below. The tenderness is slightest below, where liquid effusion has settled, but is quite marked in the upper and resonant parts, where pressure will cause wincing and trembling. In this upper part on the left side may be heard friction sounds after the fourth or sixth day. This is especially observable in tuberculous peritonitis over the parts covered by tubercular growths. There may be at first diarrhœa which usually soon gives place to constipation, and weakness and emaciation advances rapidly, and death may take place from the fourth to eighth day, or may be deferred for some weeks.
In favorable cases the acute symptoms subside, the liquid effusion is absorbed, appetite and rumination are in great part restored, and a partial recovery is made. It is, however, very liable to merge into the chronic form, and inevitably so in tuberculous cases.
In cases following on difficult parturition there are redness of the vaginal mucosa, with mucopurulent or putrid discharges, and swelling of the lower part of the abdomen, with liquid effusion and fluctuation, and tenderness of the right flank. The further symptoms are largely nervous, approximating somewhat to those of parturition fever. Temperature may rise to 104° or 106°, blindness, stupor, incoördination of muscular movement, staggering gait, if down she may lie on the side or sternum unable to rise, has frequent afterpains, tympany, sour eructations, and grinding of the teeth. The case may culminate in loss of vision, in stupor and coma, or improvement may set in and go on to a rapid recovery. This is a more common affection in ewes than in cows and is very destructive, the infection being carried by the hands of the shepherd. The most fatal cases are those in which the infection becomes generalized, and œdematous swellings appear round the vulva, between the thighs and beneath the abdomen.
In traumatic cases the external wounds can usually be found with active inflammation and surrounding tumefaction.