Mechanical applications are often valuable. If the obstruction is lodged in the rectum or floating colon it can usually be reached by the oiled hand and carefully extracted. If this is not successful, impactions in the floating colon or pelvic flexure may still be to a large extent broken up and loosened by the knuckles of the oiled hand in the rectum. I have often resorted to this with excellent effect. Impactions in the cæcum or elsewhere in the double colon are however inaccessible for such treatment. For these, external measures are available. Wilhelm wraps the abdomen in cold compresses. Causse and Lafosse recommend the electric current. Friction to the skin of the abdomen is a common resort. Rudofsky turns the animal on his side or his back, to remove the weight of the small intestines from the impacted cæcum or colon, and favor the exit by gravitation of the contents from the cæcum into the colon. Kneading of the abdomen with the fists or knee when in this recumbent position may also be resorted to.
As a dernier resort, Gaullet performed laparotomy but with no success as the animal died the following day. The horse was, however, in extremis at the time of the operation and a portion of the intestinal wall was blackish and gangrenous. To be successful such an operation should be practiced before there is any probability of gangrene, and while the patient is still in good condition for recuperation. But these are just the cases in which success is to be hoped for from less dangerous measures. Again the conditions for its success are best in case of obstruction of the pelvic flexure, as that could easily be drawn out through a spacious abdominal wound, incised, emptied and sutured with careful antiseptic precautions, and with little risk of infection of the peritoneum. But this is just the point where an obstruction can be efficiently dealt with in a less dangerous way, by kneading through the rectum for example. The operation, however, is not one to be utterly condemned, but in any case in which it is certain that the obstruction is otherwise irremediable, it should be adopted at as early a stage as possible, under anæsthesia, and with antiseptic precautions. The after treatment would consist in a restricted diet of milk or gruel with antiseptics to prevent fermentation and bloating.
IMPACTION OF THE COLON IN RUMINANTS.
Causes: Debility, hard, fibrous food, dry winter feeding, privation of water, astringents, smut, ergot. Symptoms: Hard, moulded, coated dung, blood-streaked, and in small quantity, tympany, dullness, debility, splashing sound when right flank is pressed, rectal exploration. Treatment: Laxative food, water, salt, strychnia, eserine, barium chloride, enemata, oils.
This is not a common affection in cattle, yet it does occur in weak and debilitated conditions, and in animals fed on fibrous and innutritious aliments. The ingesta are delayed in the gut, their liquid portion absorbed and the remainder accumulates in a hard mass, which distends and weakens the bowel. Dry winter feeding, with a scarcity of water strongly contributes to its production. Astringent plants in the hay, or smut or ergot may add to the tendency.
Symptoms. The fæces are hard and firm, glazed on the surface, coated with mucus and sometimes stained with blood. They are passed in small quantity and with much effort and straining, and finally the bowels become completely blocked, nothing whatever being passed. Tympany of the rumen now appears, especially after feeding, appetite and rumination fail, there is much dullness, debility, and loss of flesh and unless relieved, the animal dies in marasmus. Pressure on the right side of the abdomen made suddenly and forcibly produces a sound of liquid splashing in an air space, derived apparently from the accumulation above the obstruction. The oiled hand introduced into the rectum may feel the solid impaction, but in any case causes pain and moaning when the seat of the impaction is pressed upon.
Treatment. In the milder cases and earlier stages a change to sloppy food, green food, or boiled flaxseed, with plenty of salt, free access to water, and scruple doses of nux vomica may prove successful.
In the more advanced conditions with complete obstruction, give ½ lb. to 1 lb. each of sodium chloride, and sodic sulphate, and ½ dr. nux vomica, inject hypodermically 3 grs. eserine or 7 grains barium chloride, give water ad libitum, and frequent and large injections of soapsuds. If these latter are given cold they will still further stimulate the missing peristalsis. In obstinate cases a second dose of the salts, or 1 quart of castor oil may be given with the addition of 20 drops of croton oil.
When relief has been obtained, a laxative and nutritive diet and a course of bitters should follow.