Treatment. In an acute case, at the outset, elimination of any extraneous poison should be sought as the first step toward a restoration of the normal spinal functions. Purgatives may be employed to this end, and if the case is urgent and without spasms immediate action may be sought by a hypodermic injection of 1½ gr. eserine and 2 grs. of pilocarpin. Meanwhile the horse may receive a dose of aloes or the cow one of Epsom salts. Abundance of watery or demulcent liquids given by the mouth, or as enemas, should not be omitted.
When plethora has been a prominent factor and symptoms are urgent, a free bleeding (4 to 5 quarts for horse or cow) from the jugular vein may serve to relieve the vascular tension, dilute the vital fluid, and moderate the inflammation. Hot fomentations or sinapisms to the limbs, and even cupping on the neck and chest, may contribute to relieve the tension on the spine. When the temperature is already high, bags of ice may be applied to the tender parts of the spine or those indicated to be the inflamed parts by the groups of rigid or paretic muscles. Wet compresses or evaporating lotions may be substituted. In the absence of mustard, tartar emetic, biniodide of mercury, or euphorbium may be used, or even croton oil in a carefully guarded manner, but cantharides, oil of turpentine, and other agents calculated to irritate the kidneys are to be avoided.
Bromides, hydrobromic acid, potassium iodide, chloral, or belladonna may be availed of. Some prefer ergot, but this, like strychnia, is of doubtful effect or positively injurious in most cases in the early stages. Even in the early stages electricity may be used in the form of a constant current, which tends to vaso-motor contraction and a better tone of the capillaries. The electrodes may be applied along the affected side of the spine so that the current may traverse the affected part. It may be kept up for ten to twenty minutes at a time and repeated daily. Any undue suffering under the current may be accepted as a demand for the reduction of its force or its suspension for the time being.
When the hyperthermia has subsided and the occurrence of paresis or paralysis demands nervous stimuli, these may be sought in counter-irritants, strychnia, and interrupted currents of electricity. The blisters already mentioned may be used. Strychnia may be used internally (horse or ox 2 grs., sheep ¼ gr., dog ¹⁄₅₀ to ¹⁄₁₆ gr.) or hypodermically (horse 1½ gr., sheep ⅛ gr., dog ¹⁄₁₀₀ to ¹⁄₃₀ gr.). Should this excite the animal or aggravate the symptoms it must be stopped and deferred until the inflammation shall have more completely subsided. The same remark applies to electricity which may be tried in the interrupted current, and graduated to the endurance of the patient or entirely abandoned for the time.
If the patient is able to support itself on its limbs, it is best kept in a sling to avoid the formation of sloughs and sores. If it cannot so support itself a very thick soft bed of litter is essential to avoid the sloughing and septic poisoning. Food must be laxative and easily digestible such as mashes, hay tea, and boiled or pulped roots. Fresh green grass may be employed when obtainable.
During convalescence a course of bitters with calcium phosphate and carefully regulated exercise are important. In tardy cases Trasbot especially recommends cauterization.
SPINAL MENINGITIS.
Complex cases. Microbian invasion. Lowered vital tone. Traumas. Poisons, parasites, tubercle, rheumatism, neoplasms, poisonous food. Symptoms: Stiffness, tonic contraction, spasms, hyperæsthesia with warmth, enuresis, paralysis later. Treatment: parallel to myelitis; cold, anodynes, nerve sedatives, and antispasmodics, saline purgatives, diuretics. Iodine, electricity, cauterization.
It is often difficult to distinguish between spinal myelitis and meningitis in the lower animals, and the danger of confusion is greater because the two affections are often conjoined. Attacks appear to be often associated with microbian invasion of the membranes, but in its turn this is often favored by the lowered tone of the membranes through mechanical injury, circulatory disorder, trophic changes, or the action of poisons in the blood. Thus the condition may supervene on fractures, partial dislocations or sprains of the neck, back or loins, abscesses pressing on the spine, extension of septic inflammation from poll evil, fistulous withers, or arthritis of the vertebræ, penetration of the membranes by sharp pointed bodies (Reindl found a darning needle in a cow’s spinal canal), invasion by microbes in influenza, brust-seuche, dourine, rabies, milk sickness, distemper, pyæmia, septicæmia, strangles, louping ill, or Texas fever. The toxins of tetanus may start similar trouble. The larva of cysticercus cellulosa may cause meningitis in dogs or pigs, the sclerostoma in the soliped, the filaria in dogs and strongle in a variety of animals. Tubercle of the meninges is not unknown, and rheumatism is alleged as a cause. Neoplasms commencing in the cord act in a similar way, and the poisons of rye grass, millet, loco, lupins, tares and vetches may act on the membranes as well as on the myel.
Symptoms. In the main these resemble those of myelitis and are often present at the same time, and it is only necessary to note those which are especially pathognomonic. The early rigors are followed by stiffness of the back shown in rising or walking and aggravated by motion. There may be tonic contraction of the dorsal and lumbar muscles amounting at times to oposthotonos. The muscles of the limbs, chest or abdomen or some part of them may be the seat of tonic or clonic spasm. The skin is usually hypersensitive and this is aggravated by heat. The urine is liable to be retained because of the pain of stretching to micturate. Paralysis usually follows and implies extension to the myel, compression of the cord by reason of exudation, or implication of the spinal nerves at the points of exit. In myelitis on the other hand the spasms may be entirely absent, and paralysis sets in early and extends rapidly according to the seat and extent of the lesion.