The presence of solid bodies (calculi, gravel) in the stomach or even in the intestines has appeared to cause rupture by blocking the outlet of ingesta and determining indigestion.
Certain conditions predispose to rupture, notably dilatation of the stomach with attenuation of its walls, cribbiting, old standing catarrh of the viscus, pre-existing ulcerations, cicatrices and abscesses.
Symptoms. There is usually the history of a full feed of grain, followed by violent colic, and indications of gastric overdistension, tense abdomen, dullness, then the rejection of the gastric contents by vomiting, the matters escaping by the nose, and then collapse. The violence of the colics may cease, but the pulse becomes rapid, small, and finally imperceptible, the breathing hurried, the head depressed, eyelids, ears and often the lower lips drooping, the face becomes heavy and expressionless, the belly distended and tender, the skin covered with cold sweat, and the temperature exalted above or depressed below the normal. There is never any disposition to eat nor drink. Death follows in a few hours.
In the vomiting which is independent of rupture, the symptoms are usually at once relieved, when the emesis occurs, since not only liquid and solid matters escape but also gaseous material. The pulse retains its fullness, the facial expression is that of intelligence and comfort, rumbling may be resumed in the bowels, fæces and urine may be passed, and colics are less acute. In favorable cases the animal may even desire to eat or drink.
Lesions. The usual seat of rupture is on the great curvature and may extend longitudinally for from six to ten inches. The laceration is usually most extensive in the outer coats, and the mucosa is carried outward with the escaping ingesta, which helps to efface the normal mucous folds at the cardia, and to render vomiting possible. The edges of the wound are more or less shreddy, and of a dark violet color from blood extravasation and clots. The escaping contents are rarely diffused in the cavity of the abdomen, but remain enclosed in the omentum through the thin meshes of which they can be easily seen, and which has sometimes been mistaken for the walls of the stomach reduced to this attenuated condition by disease. When the omentum gives way the contents are at once diffused through the abdominal cavity between the convolutions of the intestines. In exceptional cases the rupture has its seat in the lesser curvature, or even at the cardia. In still others the laceration implicates the muscular and peritoneal coats only, and the looser mucosa, filled with ingesta bulges outward as a hernia. In such a case a recovery seems possible if the viscus could be relieved of its contents.
Treatment is virtually hopeless. Yet a moderate laceration of the two outer coats only might be followed by recovery through the formation of a cicatrix. The first consideration would be the unloading of the stomach spontaneously or by the aid of the stomach pump, and thereafter the adoption of a rigidly restricted diet of easily digestible food (such as gruels) in small quantities at a time.
Prevention is much more available. In violent colics with overloading or tympany of the stomach, employ anodynes to keep the animal from throwing himself down violently, give a soft bed of litter where the shock on lying down will be lessened, employ antiferments to prevent gaseous distension, and whenever possible relieve the plenitude of the viscus by the stomach pump or tube.
TORSION OF THE STOMACH IN THE DOG.
Causes: mobility of dog’s stomach when empty, leaping, running down stairs. Lesions: viscus doubled forward, pylorus in front of cardia, duodenum compresses cardia, liver, spleen and omentum displaced, stomach tympanitic, lungs and heart compressed, latter gorged with dark blood. Symptoms: tympanitic abdomen, and half thorax, no rumbling, murmur in front of thorax, abdomen tender, patient stands, dyspnœa, emesis impossible. Course: violent symptoms in twelve hours, death in thirty-six. Diagnosis: sudden, severe seizure, complete anorexia, tympany, tenderness, dyspnœa, no vomiting, arrest of peristalsis. Obstruction. Peritonitis. Choking. Treatment: tapping, laparotomy, replacing the viscus.
This has been demonstrated by Kitt and Cadeac who believe that it is quite a common occurrence.