A tendency to transudations and dropsical effusions is common in severe cases, showing especially in the filling of the legs, but in certain epizoötics, these become strikingly prevalent and have secured for such a special name (epizoötic cellulitis). Apart from the limbs these affect particularly the inferior surface of the chest and abdomen. The swellings are not necessarily hot nor painful nor petechiated as in petechial fever, yet they may merge into that affection or they may become phlegmonous and develop abscess.
Complications of many kinds are to be looked for, pregnant mares may abort; laminitis may set in; the microbes of strangles, contagious pneumonia, cerebro-spinal meningitis, septicæmia, pyæmia, etc., may take occasion to attack the debilitated system, and thus complex diseases and manifestations are developed.
Morbid Anatomy. The lesions may predominate in different organs in different subjects and successive epizoötics. It is a protean disease and may expend its main energy on any one of a number of different organs or systems of organs.
In the slighter cases the lesions are often largely confined to the anterior part of the respiratory organs. The fauces, pharynx, larynx, guttural pouches and nasal mucosa are tumified, congested, red and covered with mucous, and this condition may extend down to the bronchia. In such cases the blood is normal or may coagulate with undue readiness and firmness. The pharyngeal and intermaxillary lymph glands are red and congested in their outer zone.
In the more severe cases the alterations in the blood are perhaps the most constant of the morbid features. The blood is fluid and incoagulable, or the clot is soft, diffluent and black, the red globules are crenated or broken up, and show little tendency to adhere in rouleaux. The escaped hæmatoidin accumulates in masses in the serum in crystalline forms, giving it a high staining power when a line is drawn with it on white paper. Fatty globules also float in the mass. The leucocytes are relatively very much encreased and the red globules diminished. Dieckerhoff found 30,000 and Trasbot 40,000 leucocytes in a cubic millimetre.
The diffluence is not constant. Blood drawn in the earlier stages of the disease, coagulates with extraordinary firmness, influenced, doubtless, by the encrease of the leucocytes, the disintegration of the blood globules, and the liberation of globulins. This serves also to partially explain the early and sudden deaths from coagula in the heart and large vessels, which are occasionally met with. Such clots in the heart are often found adherent to the valvular or ventricular endocardium which at such points shows cloudy swelling, thickening, cell proliferation and even encreased vascularity and granular elevations.
In advanced cases, however, the prominent features are usually acidity, blackness, and incoagulability of the blood, its resistance to oxygen, altered and broken down red globules, free coloring matter, relative encrease of white cells, and, if necropsy has been delayed, the abundance of septic microbes (cocci and bacilli). Petechiæ are abundant on the serosæ especially on the pericardium.
Lesions of the alimentary mucosa are very constant. There may be stomatitis, with tumid follicles and even ulcers (Kowalavsky). In the stomach the right sac has its mucosa thickened, softened, red, congested, petechiated and discolored. The summits of the folds may be ulcerated (Labat). Similar lesions are presented in the small intestines. The agminated glands may show many rounded elevations, with or without open discharging follicles. The mucosa is covered with a muco-purulent material. Otherwise, the small intestines, like the stomach, are usually empty. The large intestines present similar lesions, the nodular elevations often representing the solitary glands, and the masses of ingesta are likely to be dry and indurated, in the earlier stages or semiliquid in old standing cases. The peritoneum may be congested, petechiated and at points infiltrated and usually contains a reddish serum in variable quantity. The mesenteric glands are more or less enlarged and congested.
The liver shows more or less congestion as in other infectious diseases localized in the bowels. It usually has a parboiled appearance, and yellowish gray areas of necrosis may be manifest, or again, fatty degeneration may be present. Petechiæ, and even small blood clots may be found on or beneath the capsule. The pancreas, and, still more, the spleen may be the seat of congestion or engorgement but this is far from constant.
The capsule of the kidney may be petechiated or elevated at points by serous exudate or extravasation. The surface of the organ and of sections show a mottling with darker and lighter areas, and petechiæ and patches of congestion may be found on the bladder and urethra.