Treatment. The indications are to first combat the causes. Irregularities in the heart’s action may be met by digitalis or strophanthus; gastro-intestinal catarrh by a carefully regulated diet, with mineral acids and bitters; portal congestion by a free use of water and other diluents and by saline laxatives; intestinal fermentations by antiferments (salol, naphthol) and toxic matters in the blood by alkaline diuretics. For the liver hyperplasia, potassium iodide may be freely used. Blisters to the right side will occasionally prove useful. The ascitic fluid must be drawn off when it accumulates. A diet of milk, bread and milk, buttermilk and mush, or one in which albuminoid elements are in minimum amount and the action of which is laxative is to be preferred. Out door exercise is desirable.
CHRONIC ATROPHY OF THE LIVER.
Chronic Atrophy: In old horses: in right and spigelian lobes; others show hypertrophy. In ruminants, omnivora and carnivora: in areas compressed by tumors or parasites. Perihepatitis. Sclerosis. Remedy causes if possible. Fatty Degeneration: Oil globules in liver cells, pathological when they destroy the protoplasm. In ducks and geese on forced feeding. Causes: poisoning by phosphorus, arsenic, antimony, lead, phenol, iodoform, alcohol; excess of fat in food, spoiled fodders, colchicum autumnale, yellow lupins, bacteria, hemorrhages, inflammations, tumors, parasites; improved meat producing breeds, old animals, hot stables. Lesions: liver enlarged, pale, yellow, bloodless, knife in cutting is smeared with fat, oily stain on paper, liver cells enlarged, protoplasm replaced by fat or oil; may be circumscribed. Symptoms: obesity, over-fed in fats and starches, of fattening breed, kept in confinement, in hot moist environment, if fed certain poisons, with costiveness and indigestion, no endurance, short winded, slight icterus, scanty urine, little urea, later, emaciation, palpation of enlarged liver. Treatment: send to butcher, pampered horses, cows from swill stable, a run at grass, with shade trees, a poor pasture, salines, cholagogues, mineral acids, bitters, iron with alkalies, currying, massage, douches.
Acute yellow atrophy has been referred to under parenchymatous hepatitis but a chronic atrophy is also met with in all domestic animals.
In old horses it affects, by preference the right and spigelian lobes, the portal circulation of which is less direct because of the veins of supply leaving the parent trunk at right angles (Leblanc), and because these lobes are more exposed to compression by solid accumulations in the double colon (Kitt). In such cases a compensatory hypertrophy of the left and middle lobes is often observed.
In ruminants the lesion is often circumscribed to the areas that have undergone compression by tumors or parasites (echinococcus, actinomycosis), and there may be compensatory increase elsewhere in the organ.
In swine, dogs and cats the same conditions are operative. In all alike perihepatitis may be a causative factor, and sclerosis (cirrhosis), with contraction of the fibrous hyperplasia may also operate.
Symptoms are very obscure and treatment unsatisfactory unless the active causes can be recognized and arrested.
HEPATIC STEATOSIS. FATTY LIVER. FATTY DEGENERATION.
The presence of oil globules in the liver cells is normal and physiological, the liver acting to a certain extent as a store-house for fat. This is always a marked feature, in healthy animals on high rations, and taking little or no work, but so long as the protoplasm and nuclei of the cells retain the normal characters and functions the condition is not a morbid one. It may, however, become excessive, with great enlargement of the liver, and with the substitution of fatty granules for the protoplasm of the cells as in ducks and geese subjected to forced feeding, and the condition becomes a distinctly pathological one.