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

by James Law

In some instances there is rupture of the diaphragm with marked increase in the abdominal pain and the difficulty of breathing. In others there is a laceration of the inner and middle coats of the rumen so that the gas diffuses under the peritoneum and may even be betrayed by an emphysematous extravasation under the skin.

Diagnosis. From tympany this is easily distinguished by the general dullness on percussion, the persistence of the indentation caused by pressure, the outward and downward rather than the upward extension of the swelling, and the slower development of the affection.

It is far more likely to be confounded with pneumonia, which it resembles in the hurried, labored breathing, the moans emitted in expiration, in the dullness on percussion over the posterior part of the chest, it may be even forward to the shoulders, and in the cyanotic state of the mucosæ. The distinction is easily made by the absence of hyperthermia, and of crepitation along the margins of the nonresonant areas in the lungs, by the fact that the area of chest dullness covers the whole posterior part of the thorax to a given oblique line, and by the history of the case and the manifest symptoms of overloaded stomach, not with gas but with solids. From gastro-intestinal catarrh it may be distinguished by the more rapid advance of the symptoms and by the absence of the slight fever which characterizes the latter.

Treatment. Slight cases may be treated by hygienic measures only. Walking the animal uphill, injections of cold water, friction on the left side of the abdomen to rouse the rumen to activity, antiseptics as in tympany to check further fermentation, and stimulants to overcome the nervous and muscular torpor, may be employed separately or conjointly. When it can be availed of, a rubber hose may be wound round the abdomen and a current of cold water forced through it.

When further measures are demanded we should evacuate any gas through the probang or a cannula, as in tympany, and thus relieve tension and then resort to stimulants and purgatives. Common salt 1 ℔. is of value in checking fermentation, and may be added to 1 ℔. Glauber salts in four or five quarts of warm water. A drachm of strong aqua ammonia or 2 oz. oil of turpentine and ½ drachm of nux vomica may be added. Bouley advocated tartar emetic (2 to 3 drachms), and Lafosse ipecacuan (1 oz. of the wine) to rouse the walls of the rumen, and more recently pilocarpin (ox 3 grs.), eserine (ox 2 grs.) and barium chloride (ox 15 grs.), have offered themselves for this purpose. The three last have the advantage of adaptability to hypodermic use, and prompt action. The repetition of stimulants and nux vomica may be continued while there appears any prospect of restoring the normal functions of the paunch, and when all other measures fail the only hope lies in rumenotomy.

Rumenotomy. The warrant for this operation is found in the entire lack of movement in the rumen, the absence of eructation, the cessation of rumbling and motion of the bowels, and the deepening of the stupor in which the patient is plunged. The longer the delay and the deeper the stupor and prostration the less the likelihood of a successful issue from the operation. The animal is made to stand with its right side against a wall, and its nose held by the fingers or bulldog forceps. If judged necessary a rope may be passed from a ring in the wall in front of the shoulder around the animal to another ring behind the thigh and held tight. Or a strong bar with a fulcrum in front, may be pressed against the left side of the body, and well down so as to keep the right side fast against the wall. A line may be clipped from the point of election for puncture in tympany down for a distance of six inches. A sharp pointed knife is now plunged through the walls of the abdomen and rumen in the upper part of this line, and is slowly withdrawn, cutting downward and outward until the opening is large enough to admit the hand. The lips of the wound in the overdistended stomach will now bulge out through to the wound in the abdominal walls, and three stitches on each side may be taken through these structures to prevent displacement as the stomach is emptied and rendered more flaccid. A cloth wrung out of a mercuric chloride solution may be laid in the lower part of the wound to guard against any escape of liquid into the peritoneal cavity. The contents may now be removed with the hand, until the organ has been left but moderately full. Two or three stable bucketfuls are usually taken, but it is by no means necessary nor desirable that the rumen be left empty, as a moderate amount of food is requisite to ensure its functional activity. As a rule at least fifty pounds should be left. Before closing the wound and especially in cases due to dry feeding, it is well in a tolerably large animal to introduce the hand through the demicanal to ascertain if impactions exist in the third stomach and to break up these so far as they can be reached. This done, the edges of the wound in the stomach are to be carefully cleansed, washed with the mercuric chloride solution and sewed together with carbolated catgut, care being taken to turn the mucosa inward and to retain the muscular and peritoneal layers in close contact with each other. It will usually be convenient to cut first the two lower stitches through the abdominal walls, and suture from below upward. When finished the peritoneal surface of the gastric wound may be again sponged with the mercuric chloride solution, together with the edges of the wound in the abdominal walls. Finally the abdominal wound is sutured, the stitches including the skin only or the muscular tissues as well. The smooth surface of the paunch acts as an internal pad and support, and with due care as to cleanliness, antisepsis and accuracy of stitching, it is rare to find any drawback to continuous and perfect healing. It is well to restrict the animal for three days to well boiled gruels, and for ten days to soft mashes in very moderate amount lest the wound in the paunch should be fatally burst open before a solid union has been effected.

RUMINITIS. INFLAMMATION OF THE RUMEN.

Prevalence in different genera. Causes, as in tympany and impaction, irritants, specific fevers. Symptoms: impaired rumination, tympanies, impactions, depraved appetite, fever, nervous disorders. Lesions: hyperæmia, petechiæ, exudates, ulcers, desquamation, swollen or shrunken papillæ. Treatment: remove cause, mucilaginous food, or gruels, sodium sulphate, or chloride, bismuth, bitters, mustard cataplasm, electricity.

This is not a prevalent disease but affects animals at all periods of life and is a cause of tardy and difficult digestion and rumination. It usually shows itself as a catarrhal inflammation and by favoring fermentation in the food, and torpor of the muscular walls of the organ contributes to tympany and impaction. It is more common in the ox than in the sheep owing, perhaps, to the more habitual overloading of the stomach and to the hurried, careless manner of feeding. In the goat it is rare.

Causes. Among the causes may be named tympany and overloading, so that all the dietary faults that lead to these may be set down as causes of inflammation. Irritants taken with the food, whether in the form of acrid plants (ranunculaceæ, euphorbiaceæ, etc.), musty fodder, irritant products in spoiled fodder, aliments which are swallowed while very hot or in a frozen state, and foreign bodies of an irritating kind are especially liable to induce it. Congestions of the paunch are not uncommon in specific infectious diseases like Rinderpest, malignant catarrh, anthrax, and Texas fever, and specific eruptions sometimes appear in aphthous fever and sheeppox.