Part 17

Pleurisy may affect only a small area of one side or it may affect both sides. It is oftener confined to the right side.

Treatment.—The instructions in regard to the general management of bronchitis and pneumonia must be adhered to in the treatment of pleurisy. Comfortable quarters, pure air, warm clothing to the body and bandages to the legs, a plentiful supply of pure cold water, the laxative feed, etc., in this case are equally necessary and efficacious. The hot applications applied to the chest, as directed in the treatment of pneumonia, are very beneficial in pleurisy, and should be kept up while the symptoms show the animal to be in pain.

During the first few days, when pain is manifested by restlessness, apply hot packs to the sides diligently. After four or five days, when the symptoms show that the acute stage has somewhat subsided, mustard may be applied as recommended for pneumonia. From the beginning the following drench may be given every six hours, if the horse takes it kindly: Solution of the acetate of ammonia, 3 ounces; spirits of nitrous ether, 1 ounce; bicarbonate of potassium, 3 drams; water, 1 pint.

If the patient becomes debilitated, the stimulants as prescribed for pneumonia should be used according to the same directions. The same attention should be given to the diet. If the animal will partake of the bran mashes, scalded oats, and grass, it is the best; but if he refuses the laxative diet, then he should be tried with different kinds of feed and allowed whichever kind he desires.

In the beginning of the attack, if the pain is severe, causing the animal to lie down or paw, morphin may be given by the mouth in 5-grain doses, or the fluid extract of Cannabis indica may be used in doses of 2 to 4 drams.

If the case is not progressing favorable in ten or twelve days after the beginning of the attack, convalescence is delayed by the fluid in the chest failing to be absorbed. The animal becomes dull and weak and evinces little or no desire for feed. The breathing becomes still more rapid and difficult. An effort must now be made to excite the absorption of the effusion. An application of liniment or mild blister should be rubbed over the lower part of both sides and the bottom of the chest. The following drench may be given three times a day, for seven or eight days, if it is necessary and appears to benefit: Tincture of the perchlorid of iron, 1 ounce; tincture of gentian, 2 ounces; water, 1 pint. Also give 1 dram of iodid of potassium, dissolved in the drinking water, an hour before feeding every night and morning for a week or two.

Hydrothorax is sometimes difficult to overcome by means of the use of medicines alone, when the operation of tapping the chest is performed to allow an escape for the accumulated fluid. The operation is performed with a combined instrument called the trocar and cannula. The puncture is made in the lower part of the chest, in the space between the eighth and ninth ribs. Wounding of the intercostal artery is avoided by inserting the instrument as near as possible to the anterior edge of the rib. If the operation is of benefit, it is only so when performed before the strength is lowered beyond recovery. The operation merely receives a passing notice here, as it is not presumed that the nonprofessional will attempt it, although in the hands of the expert it is attended with little danger or difficulty.

We have described here bronchitis, pneumonia, and pleurisy mainly as they occur as independent diseases, but it should be remembered that they merge into each other and may occur together at one time. While it is true that much more might have been said in regard to the different stages and types of the affections, and also in regard to the treatment of each stage and each particular type, the plan adopted of advising plain, conservative treatment is considered the wisest on account of simplifying as much as possible a subject of which the reader is supposed to know very little.

PLEUROPNEUMONIA.

This is the state in which an animal is affected with pleurisy and pneumonia combined, which is not infrequently the case. At the beginning of the attack only one of the affections may be present, but the other soon follows. It has already been stated that the pleura is closely adherent to the lung. The pleura on this account is frequently more or less affected by the spreading of the inflammation from the lung tissue. There is a combination of the symptoms of both diseases, but to the ordinary observer the symptoms of pleurisy are the most obvious. The course of treatment to be pursued differs in no manner from that given for the affections when they occur independently. The symptoms will be the guide as to the advisability of giving oil and laudanum for the pain if the pleurisy is very severe. It should not be resorted to unless it is necessary to allay the pain.

BRONCHO-PLEUROPNEUMONIA.

This is the term or terms applied when bronchitis, pleurisy, and pneumonia all exist at once. It is impossible for one who is not an expert to diagnose the state with certainty. The apparent symptoms are the same as when the animal is affected with pleuropneumonia.

SUPPURATION AND ABSCESS IN THE LUNG.

There are instances, and especially when the surroundings of the patient have been bad or the disease is of an especially severe type, when pneumonia terminates in an abscess in the lung. Sometimes, when the inflammation has been extreme, suppuration in a large portion of the lung takes place. Impure air, the result of improper ventilation, is among the most frequent causes of this termination. The symptoms of suppuration in the lung are chronic pneumonia, a solidified area of lung tissue, continued low fever, and, in some cases, offensive smell of the breath, and the discharge of the matter from the nostrils.

MORTIFICATION.

Gangrene, or mortification, means the death of the part affected. Occasionally, owing to the intensity of the inflammation or bad treatment, pneumonia and pleuropneumonia terminate in mortification, which is soon followed by the death of the animal. Perhaps the most common cause of this complication is the presence of a foreign body in the lung, as food particles or medicine. Rough drenching or drenching through the nostrils may cause this serious condition.

HEMOPTYSIS, OR BLEEDING FROM THE LUNGS.

Bleeding from the lungs may occur during the course of congestion of the lungs, bronchitis, pneumonia, influenza, purpura hemorrhagica, or glanders. An accident or exertion may cause a rupture of a vessel. Plethora and hypertrophy of the heart predispose to it. Following the rupture of a vessel the blood may escape into the lung tissue and cause a serious attack of pneumonia, or it may fill up the bronchial tubes and prove fatal by suffocating the animal. When the hemorrhage is from the lung it is accompanied with coughing; the blood is frothy, of a bright red color, and comes from both nostrils; whereas when the bleeding is merely from a rupture of a vessel in some part of the head (heretofore described as bleeding from the nose) the blood is most likely to issue from one nostril only, and the discharge is not accompanied with coughing. The ear may be placed against the windpipe along its course, and if the blood is from the lungs a gurgling or rattling sound will be heard. When it occurs in connection with another disease it seldom requires special treatment. When caused by accident or overexertion the animal should be kept quiet. If the hemorrhage is profuse and continues for several hours, 1 dram of the acetate of lead dissolved in a pint of water may be given as a drench, or 1 ounce of the tincture of the perchlorid of iron, diluted with a pint of water, may be given instead of the lead. It is rare that the hemorrhage is so profuse as to require internal remedies. But hemorrhage into the lung may occur and cause death by suffocation without the least manifestation of it by the discharge of blood from the nose.

TUBERCULOSIS OF THE LUNGS.

Pulmonary consumption or tuberculosis has been recognized in the horse in a number of instances. The symptoms are as of chronic pneumonia or pleurisy. There is no treatment for the disease.

HEAVES, BROKEN WIND, OR ASTHMA.

Much confusion exists in the popular mind in regard to the nature of heaves. Many horsemen loosely apply the term to all ailments where the breathing is difficult or noisy. Scientific veterinarians are well acquainted with the phenomena and locality of the affection, but there is a great diversity of opinion as regards the exact cause. Asthma is generally thought to be caused by spasm of the small circular muscles that surround the bronchial tubes. The continued existence of this affection of the muscles leads to a paralysis of them, and the forced breathing to emphysema, which always accompanies heaves.

Heaves is usually associated with disorder of the function of digestion or to an error in the choice of feed. Feeding on clover hay or damaged hay or straw, too bulky and innutritious feed, and keeping the horse in a dusty atmosphere or a badly ventilated stable produce or predispose to heaves. Horses brought from a high to a low level are predisposed.

In itself broken wind is not a fatal disease, but death is generally caused by an affection closely connected with it. After death, if the organs are examined, the lesions found depend much upon the length of time broken wind has affected the animal. In recent cases very few changes are noticeable, but in animals that have been broken-winded for a long time the changes are well-marked. The lungs are paler than natural, and of much less weight in proportion to the volume, as evidenced by floating them in water. The walls of the small bronchial tubes and the membrane of the larger tubes are thickened. The right side of the heart is enlarged and its cavities dilated. The stomach is enlarged and its walls stretched. The important change found in the lungs is a condition technically called pulmonary emphysema. This is of two varieties: First, what is termed "vesicular emphysema," which consists of an enlargement of the capacity of the air cells (air vesicles) by dilation of their walls. The second form is called interlobular, or interstitial, emphysema, and follows the first. In this variety the air finds its way into the lung tissue between the air cells or the tissue between the small lobules.

Symptoms.—Almost every experienced horseman is able to detect heaves. The peculiar movement of the flanks and abdomen point out the ailment at once. In recent cases, however, the affected animal does not always exhibit the characteristic breathing unless exerted to a certain extent. The cough which accompanies this disease is peculiar to it. It is difficult to describe, but the sound is short and something like a grunt. When air is inspired—that is, taken in—it appears to be done in the same manner as in health; it may possibly be done a little quicker than natural, but not enough to attract any notice. It is when the act of expiration (or expelling the air from the lungs) is performed that the great change in the breathing is perceptible. It must be remembered that the lungs have lost much of their elasticity, and in consequence of their power of contracting on account of the degeneration of the walls of the air cells, and also on account of the paralysis of muscular tissue before mentioned. The air passes into them freely, but the power to expel it is lost to a great extent by the lungs; therefore the abdominal muscles are brought into play. These muscles, especially in the region of the flank, are seen to contract, then pause for a moment, then complete the act of contracting, thus making a double bellowslike movement at each expiration, a sort of jerky motion with every breath. The double expiratory movement may also be detected by allowing the that the expiratory current is not continuous, but is broken into two jets. When the animal is exerted a wheezing noise accompanies the breathing. This noise may be heard to a less extent when the animal is at rest if the ear is applied to the chest.

As before remarked, indigestion is often present in these cases. The animal may have a depraved appetite, as shown by a desire to eat dirt and soiled bedding, which he often devours in preference to the clean feed in the trough or manger. The stomach is liable to be overloaded with indigestible feed. The abdomen may assume that form called "potbellied." The animal frequently passes wind of a very offensive odor. When first put to work dung is passed frequently; the bowels are often loose. The animal can not stand much work, as the muscular system is soft. Round-chested horses are said to be predisposed to the disease, and it is certain that in cases of long standing the chest usually becomes rounder than natural.

Certain individuals become very expert in managing a horse affected with heaves in suppressing the symptoms for a short time. They take advantage of the fact that the breathing is much easier when the stomach and intestines are empty. They also resort to the use of medicines that have a depressing effect. When the veterinarian is examining a horse for soundness, and he suspects that the animal has been "fixed," he usually gives the horse as much water as he will drink and then has him ridden or driven rapidly up a hill or on a heavy road. This will bring out the characteristic breathing of heaves if the horse is so afflicted, but will not cause the symptoms of heaves in a healthy horse. All broken-winded horses have the cough peculiar to the affection, but it is not regular. A considerable time may elapse before it is heard and then it may come on in paroxysms, especially when first brought out of the stable into the cold air, or when excited by work, or after a drink of cold water. The cough is usually the first symptom of the disease.

Treatment.—When the disease is established there is no cure for it. Proper attention paid to the diet will relieve the distressing symptoms to a certain extent, but they will undoubtedly reappear in their intensity the first time the animal overloads the stomach or is allowed food of bad quality. Clover hay or bulky feed which contains but little nutriment have much to do with the cause of the disease, and therefore should be entirely omitted when the animal is affected, as well as before. It has been asserted that the disease is unknown where clover hay is never used. The diet should be confined to feed of the best quality and in the smallest quantity. The bad effect of moldy or dusty hay, fodder, or feed of any kind can not be overestimated. A small quantity of the best hay once a day is sufficient. This should be cut and dampened. The animal should invariably be watered before feeding; never directly after a meal. The animal should not be worked immediately after a meal. Exertion, when the stomach is full, invariably aggravates the symptoms. Turning on pasture gives relief. Carrots, potatoes, or turnips chopped and mixed with oats or corn are a good diet. Half a pint to a pint of thick, dark molasses with each feed is useful.

Arsenic is efficacious in palliating the symptoms. It is best administered in the form of a solution of arsenic, as Fowler's solution or as the white powdered arsenious acid. Of the former the dose is 1 ounce to the drinking water three times daily; of the latter one may give 3 grains in each feed. These quantities may be cautiously increased as the animal becomes accustomed to the drug. If the bowels do not act regularly, a pint of raw linseed oil may be given once or twice a month, or a handful of Glauber's salt may be given in the feed twice daily, so long as necessary. It must, however, be borne in mind that all medicinal treatment is of secondary consideration; careful attention paid to the diet is of greatest importance. Broken-winded animals should not be used for breeding purposes. A predisposition to the disease may be inherited.

CHRONIC COUGH.

A chronic cough may succeed the acute disease of the respiratory organs, such as pneumonia, bronchitis, laryngitis, etc. It accompanies chronic roaring, chronic bronchitis, broken wind; it may succeed influenza. As previously stated, cough is but a symptom and not a disease in itself. Chronic cough is occasionally associated with diseases other than those of the organs of respiration. It may be a symptom of chronic indigestion or of worms. In such cases it is caused by a reflex nervous irritation. The proper treatment in all cases of chronic cough is to ascertain the nature of the disease of which it is a symptom, and then cure the disease if possible and the cough will cease.

The treatment of the affections will be found under their appropriate heads, to which the reader is referred.

PLEURODYNIA.

This is a form of rheumatism that affects the intercostal muscles; that is, the muscles between the ribs. The apparent symptoms are very similar to those of pleurisy. The animal is stiff and not inclined to turn round; the ribs are kept in a fixed state as much as possible. If the head is pulled round suddenly, or the affected side struck with the hand, or if the spaces between the ribs are pressed with the fingers, the animal will flinch and perhaps emit a grunt or groan expressive of much pain. It is distinguished from pleurisy by the absence of fever, cough, the friction sound, the effusion into the chest, and by the existence of rheumatism in other parts. The treatment for this affection is the same as for rheumatism affecting other parts.

WOUNDS PENETRATING THE WALLS OF THE CHEST.

A wound penetrating the wall of the chest admits air into the thoracic cavity outside the lung. This condition is known as pneumothorax and may result in collapse of the lung. The wound may be so made that when the walls of the chest are dilating a little air is sucked in, but during the contraction of the wall the contained air presses against the torn part in such manner as entirely to close the wound; thus a small quantity of air gains access with each inspiration, while none is allowed to escape until the lung is pressed into a very small compass and forced into the anterior part of the chest. The same thing may occur from a broken rib inflicting a wound in the lung. In this form the air gains access from the lung, and there may not be even an opening in the walls of the chest. In such cases the air may be absorbed, when a spontaneous cure is the result, but when the symptoms are urgent it is recommended that the air be removed by a trocar and cannula or by an aspirator.

It is evident that the treatment of wounds that penetrate the thoracic cavity should be prompt. It should be quickly ascertained whether or not a foreign body remains in the wound; then it should be thoroughly cleaned with a solution of carbolic acid, 1 part in 40 parts of water. The wound should then be closed immediately. If it is an incised wound, it should be closed with sutures or with adhesive plasters; if torn or lacerated, adhesive plaster may be used or a bandage around the chest over the dressing. At all events, air must be prevented from getting into the chest as soon and as effectually as possible. The after treatment of the wound should consist principally in keeping the parts clean with a solution of carbolic acid, and applying fresh dressing as often as required to keep the wound in a healthy condition. Care should be taken that the discharges from the wound have an outlet in the most dependent part. (See Wounds and their treatment, p. 484.) If pleurisy supervenes, it should be treated as advised under that head.

THUMPS, OR SPASM OF THE DIAPHRAGM.

"Thumps" is generally thought by the inexperienced to be a palpitation of the heart. While it is true that palpitation of the heart is sometimes called "thumps," it must not be confounded with the affection under consideration.

In the beginning of this article on the diseases of the organs of respiration, the diaphragm was briefly referred to as the principal and essential muscle of respiration. Spasmodic or irregular contractions of it in man are manifested by what is familiarly known as hiccoughs. Thumps in the horse is similar to hiccoughs in man although in all cases the peculiar noise is not made in the throat of the horse.