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Fractures of the Cervical Spine in Animals
I'" ,., JJ
(~ .
II.
I. I \-ESEY ,
\ LR, C. \' , :-J't
!l O VE.
1 WAS ve ry muc h in teres ted in readin g D r. C orn e r's a rt ic le in t he J an ua ry number o f th e J ourn a l on " F rac tur es o f th e Ce rvi cal S pin e in Ani m a ls ," as a fe w s uch cases in dogs have co me un de r my n o tice a t va riou s tim es , a nd I ca n fully endorse his \·ie w th a t Sti c h fra c tures need no t n ecessa rily prove fata l. Th e g rea t diffi c ulty to most of us seems to be th a t o f ma k ing a correc t d iag nosis s uffi c iently early in the case for t rea tm ent to be e ffecti ve . Thi s was impressed upon my mind by a case w hi c h r ece n tly ca m e un de r Illy n ot ice, A fox, te rri er b elo ngin g to one of my c li en ts was ta ken on a d a y's vi sit to ano th e r tow n with her mi s tress, Thi s dog was ve ry fon d of fetch in g and c arr y in g a n ind ia-rubber ball, and b eca lll ~ \ er y exc ited at t he ga m e. D uri ng th e a ft ern oon h er mi s tress b ad bee n throwing th e ball fo r th e dog , a nd a ll we nt well un til o nce , when rus hing dow n t he lin ole um -co\'ered sta irs , th e dog tripped a nd sli pped dow n the wh ole leng t h o f th e fli g ht, la ndin g on th e poin t of he r n ose and turnin g a co mpl e te so mersa ult on to her bac k. S he gave a sha r p c ry of pain, and fo r so me fe w mo me nt s wa s ap pa rently so sha ke n a s to be un a ble o r unw il lin g to do a nythin g b ut li e s till. Late r in th e af te rnoon she br ig ht e ned up, and th e ga me of ba ll was resum ed in the ga rd e n_ Th is was soon b ro ug ht to a s ud de n te rmin a ti o n by th e d og bein g ev ide ntly ull we ll a nd un a bl e to rno\-e her hind-l egs properly. S he wa s b rought indoo rs an d nursed, but began to sha ke a ll ove r, a nd had wha t wa s su p pose d to be a fit. T he hind e r pa rt of h e r body \vas pa rtially paralysed a nd she wou ld no t m ove of he r own will, whil s t s he see med to be g radually beco min g un consciou s_ Ve te rin a ry aid was a t once soug ht , a nd a n asoista nt to o ne of th e loca l prac titi oners ca me. H e is re port ed to h ave sai d th a t he co ul d fi nd nothin g se riou s a mi ss , a nd see med to t hink th e dog ha d had an epil e pti for m fi t. He sent med icine to he g i\-e n at once. Alt holl g h on ly h alf th e presc ri bed dose wa s a dmini stere d th e d og di ed a lmos t imm ediat ely_ Th e body wa s brou g ht to me for POsl -lI/ orloll exa min a ti on, b ut on ly ve ry littl e of th e a bo \-e hi story \\'as then gi ve n to lIl e. 1 was tol d of th e accide nt o n t he s ta irs a nd the su bseq ue nt ga m e, w hi c h led m e a t on ce t o e xa mine th e neck a nd head , H ere 1 a t o nce, w ith o ut a ny diffi c ulty , \\'as a bl e to o bta in a distin c t cre pit us o n rota tin g th e hea d or tiltin g it up wa rds , I boiled do wn the bo nes c;lreflill y and fo und t he atl as cracke d t h ro llgho ut it s entire length inferi or ly, a ncl th e h \-o a nt e ri or articul atin g s urfaces slig htly ch ipped. Th e occ ipta l bone was uninjured, as we re a lso th e bones a t th e ba se of th e s kull. I tlll n k th e pro ha b le imm edi a te ca use o f d eath here was the admin istrat io n o f some medi cin e \\'hich was broug ht to m e som e days later by t he dog 's ow ne r (a c hem is t ). I t undoub tedly cont ain ed ch lora l h yd rate, a nd I sho uld t hink tha t thi s was one of th e \-e ry last drugs all1 on !,( th e l1/lIl el'il1 .Hedira to b e se lec ted as suit a bl e to the ca se. I fee l co nfid e nt th a t , ha d th is dog been k ep t q ui te q uie t, with th e hea d and nec k fixe d , a nd had s timula nt s bee n a dmi nis tered, t here was e\' ery chan ce th a t th e p a ti ent \\-o uld have m ad e a n exce lle nt reco \'ery ,
The Veterillary
134
J Oltrna!.
I do not think it was e,-en absolut ely necessa ry to fix the head and neck, for the dog would scarcely move of its own will, and , provided it had been kept quite still and qu iet, disp lacement of the broken bones would have been very improbable. I have seen four cases of fracture of th e atlas, one of fracture of the axis, and one of the third cervi cal, but th e above case is the only one of which I have any notes. The grea t dan ger in a ll the se cases is displacement of the frac tured bone a nd consequent inte rference with some of th e grea t ner ve trunks. The usual sym ptoms noticed are a condition of profound collapse, a nd great depression of th e heart a nd respiration. The best trea tment th at I can recomm end is absolut e quiet in a da rkened room, warmth (hot-water bottl e) to th e extremiti es , a nd repea ted small doses of strychnine and bromide of potassium, or, if these can not be readily obtained, three drops of brandy in warm milk every half hour. When th e urgent symptoms ha,-e s ubsided it will be tim e enough to set a bout fi xi ng the neck in a s plint. Thi s requires great skill and patien ce to adapt, although if the dog is a sma ll one the nec k and part of th e head may be enveloped in plaster of Paris or several plaster bandages applied. Let me once more warn those who have yet to meet their first case of frac ture of one or more of th e cervica l bones to a void c hloral above all other drugs . The hi s tory of a fall or collision should alone be enoug h to put one on one's g uard against such an error.
OPEN TEMPORO-MAXILLARY JOINT. BY
CAPT .
..-\.
11.
LA:\"E,
ARMY VJ<:TERIN i\R Y DEP..\RTMIU,T , SOU TH AFRICA .
HLOEi\'1F O~ TEI:\,
THE patient, a mule, belong ing to the South African Garrison In stitute, was a dmitted on November IS with a wound in th e region of the right temporo.maxillaryarticulation . There was consid erab le discharge of pus , but no synovia was noticed . The injury had been caused about a week previous- to a ll a ppea rance by a seve re blow. There was a good deal of swelling of surro unding tissues, and no treatm en t had been carried Ollt. The animal was sec ured and the wound carefully syrin ged out with carbolic acid solution, I in 50- ] t was no t thought advi sable to thoroug hly explore the injury, but it was ev id ently more than two inches dee p. Novem ber 17. Th e ani ma l h ad been rubbing his head against the man ger, a nd there was a discharge o f a good deal of synovia from the wound ; the joint of th e Jaw was ev identl y open. The region around th e \" OLIlld lVas se"erely blistered with bin iodide of mercury, I in 7, and the an im a l was g iven as mu c h water as it would drink. A small quantity of oi l of cloves was th en inj ec ted into th e wound and the patient put on pi llar rein s ; pOll-dered perchloride of mercury was blown on th e ou tside of th e wo und three tim es daily. Every precaution was nolV taken to keep the pati ent sec ured so that he could not rub himself, but as he cha mped hi s jaws a strap was put tightly round th e mu zz le and lowe r j aw . N o food and no more water were given th a t day, and in s tructions were given th a t fo r the follo\\- in g days g ruel only was to he g i"en four tim es daily.
(~ .
II.
I. I \-ESEY ,
\ LR, C. \' , :-J't
!l O VE.
1 WAS ve ry muc h in teres ted in readin g D r. C orn e r's a rt ic le in t he J an ua ry number o f th e J ourn a l on " F rac tur es o f th e Ce rvi cal S pin e in Ani m a ls ," as a fe w s uch cases in dogs have co me un de r my n o tice a t va riou s tim es , a nd I ca n fully endorse his \·ie w th a t Sti c h fra c tures need no t n ecessa rily prove fata l. Th e g rea t diffi c ulty to most of us seems to be th a t o f ma k ing a correc t d iag nosis s uffi c iently early in the case for t rea tm ent to be e ffecti ve . Thi s was impressed upon my mind by a case w hi c h r ece n tly ca m e un de r Illy n ot ice, A fox, te rri er b elo ngin g to one of my c li en ts was ta ken on a d a y's vi sit to ano th e r tow n with her mi s tress, Thi s dog was ve ry fon d of fetch in g and c arr y in g a n ind ia-rubber ball, and b eca lll ~ \ er y exc ited at t he ga m e. D uri ng th e a ft ern oon h er mi s tress b ad bee n throwing th e ball fo r th e dog , a nd a ll we nt well un til o nce , when rus hing dow n t he lin ole um -co\'ered sta irs , th e dog tripped a nd sli pped dow n the wh ole leng t h o f th e fli g ht, la ndin g on th e poin t of he r n ose and turnin g a co mpl e te so mersa ult on to her bac k. S he gave a sha r p c ry of pain, and fo r so me fe w mo me nt s wa s ap pa rently so sha ke n a s to be un a ble o r unw il lin g to do a nythin g b ut li e s till. Late r in th e af te rnoon she br ig ht e ned up, and th e ga me of ba ll was resum ed in the ga rd e n_ Th is was soon b ro ug ht to a s ud de n te rmin a ti o n by th e d og bein g ev ide ntly ull we ll a nd un a bl e to rno\-e her hind-l egs properly. S he wa s b rought indoo rs an d nursed, but began to sha ke a ll ove r, a nd had wha t wa s su p pose d to be a fit. T he hind e r pa rt of h e r body \vas pa rtially paralysed a nd she wou ld no t m ove of he r own will, whil s t s he see med to be g radually beco min g un consciou s_ Ve te rin a ry aid was a t once soug ht , a nd a n asoista nt to o ne of th e loca l prac titi oners ca me. H e is re port ed to h ave sai d th a t he co ul d fi nd nothin g se riou s a mi ss , a nd see med to t hink th e dog ha d had an epil e pti for m fi t. He sent med icine to he g i\-e n at once. Alt holl g h on ly h alf th e presc ri bed dose wa s a dmini stere d th e d og di ed a lmos t imm ediat ely_ Th e body wa s brou g ht to me for POsl -lI/ orloll exa min a ti on, b ut on ly ve ry littl e of th e a bo \-e hi story \\'as then gi ve n to lIl e. 1 was tol d of th e accide nt o n t he s ta irs a nd the su bseq ue nt ga m e, w hi c h led m e a t on ce t o e xa mine th e neck a nd head , H ere 1 a t o nce, w ith o ut a ny diffi c ulty , \\'as a bl e to o bta in a distin c t cre pit us o n rota tin g th e hea d or tiltin g it up wa rds , I boiled do wn the bo nes c;lreflill y and fo und t he atl as cracke d t h ro llgho ut it s entire length inferi or ly, a ncl th e h \-o a nt e ri or articul atin g s urfaces slig htly ch ipped. Th e occ ipta l bone was uninjured, as we re a lso th e bones a t th e ba se of th e s kull. I tlll n k th e pro ha b le imm edi a te ca use o f d eath here was the admin istrat io n o f some medi cin e \\'hich was broug ht to m e som e days later by t he dog 's ow ne r (a c hem is t ). I t undoub tedly cont ain ed ch lora l h yd rate, a nd I sho uld t hink tha t thi s was one of th e \-e ry last drugs all1 on !,( th e l1/lIl el'il1 .Hedira to b e se lec ted as suit a bl e to the ca se. I fee l co nfid e nt th a t , ha d th is dog been k ep t q ui te q uie t, with th e hea d and nec k fixe d , a nd had s timula nt s bee n a dmi nis tered, t here was e\' ery chan ce th a t th e p a ti ent \\-o uld have m ad e a n exce lle nt reco \'ery ,
The Veterillary
134
J Oltrna!.
I do not think it was e,-en absolut ely necessa ry to fix the head and neck, for the dog would scarcely move of its own will, and , provided it had been kept quite still and qu iet, disp lacement of the broken bones would have been very improbable. I have seen four cases of fracture of th e atlas, one of fracture of the axis, and one of the third cervi cal, but th e above case is the only one of which I have any notes. The grea t dan ger in a ll the se cases is displacement of the frac tured bone a nd consequent inte rference with some of th e grea t ner ve trunks. The usual sym ptoms noticed are a condition of profound collapse, a nd great depression of th e heart a nd respiration. The best trea tment th at I can recomm end is absolut e quiet in a da rkened room, warmth (hot-water bottl e) to th e extremiti es , a nd repea ted small doses of strychnine and bromide of potassium, or, if these can not be readily obtained, three drops of brandy in warm milk every half hour. When th e urgent symptoms ha,-e s ubsided it will be tim e enough to set a bout fi xi ng the neck in a s plint. Thi s requires great skill and patien ce to adapt, although if the dog is a sma ll one the nec k and part of th e head may be enveloped in plaster of Paris or several plaster bandages applied. Let me once more warn those who have yet to meet their first case of frac ture of one or more of th e cervica l bones to a void c hloral above all other drugs . The hi s tory of a fall or collision should alone be enoug h to put one on one's g uard against such an error.
OPEN TEMPORO-MAXILLARY JOINT. BY
CAPT .
..-\.
11.
LA:\"E,
ARMY VJ<:TERIN i\R Y DEP..\RTMIU,T , SOU TH AFRICA .
HLOEi\'1F O~ TEI:\,
THE patient, a mule, belong ing to the South African Garrison In stitute, was a dmitted on November IS with a wound in th e region of the right temporo.maxillaryarticulation . There was consid erab le discharge of pus , but no synovia was noticed . The injury had been caused about a week previous- to a ll a ppea rance by a seve re blow. There was a good deal of swelling of surro unding tissues, and no treatm en t had been carried Ollt. The animal was sec ured and the wound carefully syrin ged out with carbolic acid solution, I in 50- ] t was no t thought advi sable to thoroug hly explore the injury, but it was ev id ently more than two inches dee p. Novem ber 17. Th e ani ma l h ad been rubbing his head against the man ger, a nd there was a discharge o f a good deal of synovia from the wound ; the joint of th e Jaw was ev identl y open. The region around th e \" OLIlld lVas se"erely blistered with bin iodide of mercury, I in 7, and the an im a l was g iven as mu c h water as it would drink. A small quantity of oi l of cloves was th en inj ec ted into th e wound and the patient put on pi llar rein s ; pOll-dered perchloride of mercury was blown on th e ou tside of th e wo und three tim es daily. Every precaution was nolV taken to keep the pati ent sec ured so that he could not rub himself, but as he cha mped hi s jaws a strap was put tightly round th e mu zz le and lowe r j aw . N o food and no more water were given th a t day, and in s tructions were given th a t fo r the follo\\- in g days g ruel only was to he g i"en four tim es daily.