Text book of veterinary medicine, Volume 2 (of 5)

by James Law

Symptoms. In the horse in particular there may be premonitory symptoms of fever, dullness, heat of the mouth, ptyalism, slow and imperfect mastication, and the retention of food in the cheeks.

The Stenonian duct becomes swollen and painful. The parotid becomes hard, hot, tender, and is surrounded by a softer pitting infiltration which may extend down around the entire throat, and even along the intermaxillary region to the chin. When the canal is obstructed it may stand out as a thick rope-like resilient swelling extending around the lower border of the jaw and upward toward the cheek as far as the point of obstruction. When one parotid only is involved, the contrast with the other is quite marked. The head is extended and carried stiffly. When the nose is depressed, or when the head is turned to one side or the other, the patient gives evidence of suffering from compression or stretching of the inflamed region. The breath and mouth exhale an offensive odor, determined by the decomposition of mucus and of the retained food products.

Among remote effects may be named dyspnœa and threatened suffocation from pressure on the pharynx and laryngeal nerves, and facial paralysis from pressure on the seventh nerve.

The disease may go on to induration and remain permanently in this condition, or it may suppurate and discharge through the skin, into the pharynx or through the duct of Stenon. It may communicate with both the duct and the skin and determine a fistula. When suppuration occurs there is an access of fever, a chill may be noticed, the swelling becomes more tense, harder, more tender to the touch, and even emphysematous, and finally points internally or externally. This may take place from the fifth to the tenth day or later. When it opens into the duct it may be seen oozing from the orifice in the cheek when the mouth is opened, and in case the jaws are suddenly parted, it may escape in a jet. In such a case and especially if the microbes have come originally from the food the odor is very fœtid. The abscess is not always single and when multiple the pus may escape externally by a variety of orifices. The pus is usually whitish, yellowish or grayish and creamy, but it may be grumous or bloody or serous and of a most offensive odor. In exceptional cases the gland becomes more or less gangrenous and such parts, exposed in the wound are hard, bloodless and insensible, and add very materially to the fœtor. This may lead to general septic infection, or the necrosed masses may slough off and the cavities fill up by granulations.

Diagnosis. Parotitis is distinguished from pharyngitis and abscess of the guttural pouch by the absence of cough and nasal discharge; from abscess of the pharyngeal glands it is differentiated by the limitation of the hard swelling to the parotid gland and by the superficial seat of the resulting abscess. The co-existence of active inflammation serves to distinguish it from ordinary tumors.

Treatment. By way of prevention, the avoidance of injuries by yokes, forks, pokes, and goads is important. Also the disinfection of the mouth by a liberal supply of pure water and even by antiseptic washes:—borax, boric acid, creolin, tannin, chlorate of potash. Also by the removal of foreign bodies or calculi from the canal.

When the inflammation has set in, a saline laxative is often of value. Wash the mouth with a solution of vinegar and salt, or other antiseptic, repeating this at least after every meal. The swollen, painful gland may be covered with a damp compress or anointed with vaseline to which may be added a little creolin, naphthol, carbolic acid or salicylic acid, together with lead acetate and belladonna or other anodyne. The diet must be soft, cool mashes, sliced or pulped roots or any bland agent that will demand little or no mastication. Cool, fresh water should be allowed ad libitum. When the laxative has set, it may be followed by cooling diuretics such as nitrate or acetate of potash.

If suppuration occurs it should be opened as soon as the pus can be definitely recognized, and the cavity treated antiseptically to prevent further local or general infection by the microbes. In deep abscess there is a certain danger of wounding blood vessels and salivary ducts, but this can be to a certain extent obviated by making an incision through the skin only and then boring the way into the abscess with a grooved director or the points of closed scissors. When the cavity is penetrated the pus will ooze out through the groove or between the scissor blades. When the pus has been evacuated the cavity should be washed out two or three times a day with mercuric chloride solution (1 : 1000), or permanganate of potash solution (1 : 100).

When the gland becomes indurated and indolent seeming to merge into the chronic form it may be stimulated to a healthier action by a cantharides blister, or it may be subjected to daily massage, or to a daily current of electricity for ten or fifteen minutes. If the inflammation is slight or unrecognizable, the surface of the gland may be daily painted with tincture of iodine, and iodide of potassium maybe given internally, in daily doses of ½ to 1 drachm.

Gangrene, the result of septic microbes, a weak system or too severe treatment, may be met by astringent and antiseptic agents locally, and by tonics, stimulants and a generous diet internally.