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Impaction of the Intestines, Followed by the Passage of an Intestinal Cast Eighteen Inches Long
The Veterinary
:1 oU1'1za/.
were congested, especially the right one-presumably hypostasis. There was a considerable amount of pleurisy. The right heart was filled with dark, tarry blood; left heart empty. This and the condition of the lungs points to asphyxia being the direct cause of death. The notable feature in this case is the enormous length of displaced intestine.
IMPACTION OF THE INTESTINES, FOLLOWED BY THE PASSAGE OF AN INTESTINAL CAST EIGHTEEN INCHES LONG. By
CAPTAIN
A. J. WILLIAMS, F.R.C.V.S., A.V. C. Longllloor, H ants.
SUbjeet.-A Mounted Infantry cob, aged 13 years. Hist01'Y, & c.-October 3, 191O.-Admitted for treatment, being off feed, dull, blowing, temperature 101 0 F . Placed in . loose box, rugged and bandaged, mash diet, stimulant given. During the afternoon symptoms of subacute colic appeared. Chloral hydrate t oz. given. October 4, 191O.-Subacute pain continues, tympany, rectum empty, case diagnosed as impaction of intestines . Aloes Bbd. 4 drachms, and chloral hydrate 4 drachms, given; enema s, abdominal massage. October 5, 19IO.-Much worse, conjunctiVa! injected; constantly lying down and rolling; passes small quantities of urine at short inlervals; catheter passed but no urine found at 3 p.m. Ammon. carb o t oz. and pulv. nucis vom . 2 drachms in bolus three times a day. October 6, I91O.-Condition serious, pulse very fast and weak, refuses all food , a very small quantity of fceces passed, hard pellets, complete absence of borborygmi on the left side. 10 a.m.: Eserine I gr. and pilocarpine t gr. hypodermically ; no result. Ammon. carbo I oz. and pulv. nuci s vom. t oz., three times a day. Temperature , 6 p.m., 102.80 F. o eto ber 7, 1910.-Still in pain, temperature 101.6; pulse 48 and weak; continually up and down, but never violent; pa in continues and subacute. 12.30 p.m.: Eserine 2 gr. and pilocarpine I gr. hypodermically with no re sult, continue ammon. carbo and pulv . nucis vom.
Impaction of the Intestines.
477
October 8, 191O.-Looks brighter, a little freces passed, marked borborygmi on the right side, very sli ght on left, in less pain; continue ammon. carbo and pulv . nucls vom. , enemas, abdominal massage. October 9. 191O·-Standing quiet , head down, a little freces passe d containing a large proportion of undigested oats. October 10, 191O.-Temperature 100, pulse weak, feeding a little, 01. lini . I pint, spts. ~theris nit. ~ oz. g iven; animal taken out for a short walk, stands quite quiet in the box. October II, 1910.-Relapse this morning, off feed, dull pain again, urine passed in small quantitie s and often . Aloes 5 drachms, in solution with tr. zingib. ~ oz., water I pint, given, enemas . 12.30 p.m.: Small quantity of soft freces passed, animal quiet during the afternoon . ' O ctob er 12, 191O.-In much pain, temperature 102, pulse 52 and very weak, conjunctivce deeply congested . At 11.30 a.m. : barium chloride 10 gr. g iven intravenously in ~ drachm water; after twenty minutes animal in great pain, powerful tenesmus at frequent intervals causing partial eversion of the rectum, but no freces passed. 2 p.m.: 1 oz. chloral hydrate given, which controlled the tenesmus . Animal in dull pain all the afternoon. 6 p.m.: Morphia injection given, 4 gr. morphia . 7 p.m.: Animal lyin g down a nd easy . October 13. 1910.-Much brighter, passed a little watery ing esta, warm soapy enemas given, abdominal massage , linseed tea as a drench. October 14, 1910.-Very dull again, a small quantity of pultaceous freces passed, linseed tea, carrots, and a small quantity of green grass given. October IS, 1910.-Still dull, but more borborygmi audible on left side, no freces passed, urine passed in larger quantities and not so frequent. October 16, 19IO.-About the same; small quantity of freces passed, tr. nucis vom., tr. gentian . co. , spts. retheris nit. I oz . eac h, and aqua I pint given. October 17, 191O·-Eating a little mash, turned into paddock for a short time , grazes a little . Passed a shovelful of freces, half of it blood-stained, the remainder normal in appearance, tinged green from the grass, animal very weak and dull; con tinue the medicine given on 16th, three times a day .
The Veterina1J' '.1ournal. October 18, I9IO.-At 8 a.m . the animal was standing in the box with head drooping, hanging from the rectum was seen a dark stringy mass about 2 ft. in length, a shovelful of greenishcoloured soft fceces was passed and the mass came away with it; upon examination it was found to be a cast of the intestines in a gangrenous condition. About half an hour later another quantity of fceces was passed, patient improved, pulse stronger and fuller, temperature 99.5, warm mashes with linseed, and steamed hay g iven , sent to graz e for a short time in the morning, stimulants and tonics continued.
Photograph of patient showing lamen ess of near fore-limb on November
I I,
1910.
October 19, I9IO.-A quantity ~f fceces passed, eating mash well, animal very 'weak and tucked up; continue stimulant s and tonics. October 20, I9IO.-Improvement maintained, lar ge quantities of fceces passed. October 25, I9IO.-Fceces passed normal in quantity and appearance, animal still very weak. October 30, I9IO .-Animal bright and feeling well, noticed to be continually resting the near fore in a position similar to
Impactz'on of the Intestines.
479
:that seen in a case of radial paralysis, and occasionally paws with .the leg. November 14, 19IO.-Still rests near fore, pawing more persistent, carries limb. November 23, 1910.-Marked atrophy of the anterior and posterior spinalis, spine of scapula and point of shoulder stands out prominently : evidently this condition is the result of an injury sustained when knocking about in the box during the periods of acute pain. Treatment: Massage and stimulating liniment, ·exercise. Bad bed-sores re sulted from lying down and bruising when rolling; they are healin g well. November 30, 19IO.-M uch improved, trotting fairly well, atrophy still ma rked , general condition good considering the severity and len gth of the illness . December 20, 19IO.-Animal ha s suddenly gone lame on the off fore , symptoms same as seen in near fore; same t reatment. Does not impr ov e in condition, hide-bound and harsh coat; special diet: bo iled fo od, &c ., an d tonic s. january II , 19I1.- Trottin g nea rly lev el , no sign of at rophy ha s appeared during the period of lame ne ss on the off fore . Massage and ex ercise. FebruaY'jl 12, 19I I.- Animal sou nd, cond ition much improved, discharged for a period of light work, then grad ually brou g ht into ordinary work. REMARKS.
Intestinal cases often pull through in an extraordina ry manner, this case appeared so hopeless at variou s stages that reco ve ry seemed a lmost out of the qu estion. There wa s practica lly no action of the bowels for fourteen days, and during that period it was often difficult to know what line of treatment to ::tdopt. I relied on the stimulatin g treatment and only gave barium chloride as a last re source, its action was so violent and ineffective that I should n ot use it a ga in under similar circumstances. The sudden lameness in the off fore was peculiar and un accountable . Rec overy wa s perfect; the animal ha s been in regul a r work since Mar ch, carries gooa condition, and shows no signs of the sev ere illness. The photograph shows the condition of the animal on November II, 1910.
:1 oU1'1za/.
were congested, especially the right one-presumably hypostasis. There was a considerable amount of pleurisy. The right heart was filled with dark, tarry blood; left heart empty. This and the condition of the lungs points to asphyxia being the direct cause of death. The notable feature in this case is the enormous length of displaced intestine.
IMPACTION OF THE INTESTINES, FOLLOWED BY THE PASSAGE OF AN INTESTINAL CAST EIGHTEEN INCHES LONG. By
CAPTAIN
A. J. WILLIAMS, F.R.C.V.S., A.V. C. Longllloor, H ants.
SUbjeet.-A Mounted Infantry cob, aged 13 years. Hist01'Y, & c.-October 3, 191O.-Admitted for treatment, being off feed, dull, blowing, temperature 101 0 F . Placed in . loose box, rugged and bandaged, mash diet, stimulant given. During the afternoon symptoms of subacute colic appeared. Chloral hydrate t oz. given. October 4, 191O.-Subacute pain continues, tympany, rectum empty, case diagnosed as impaction of intestines . Aloes Bbd. 4 drachms, and chloral hydrate 4 drachms, given; enema s, abdominal massage. October 5, 19IO.-Much worse, conjunctiVa! injected; constantly lying down and rolling; passes small quantities of urine at short inlervals; catheter passed but no urine found at 3 p.m. Ammon. carb o t oz. and pulv. nucis vom . 2 drachms in bolus three times a day. October 6, I91O.-Condition serious, pulse very fast and weak, refuses all food , a very small quantity of fceces passed, hard pellets, complete absence of borborygmi on the left side. 10 a.m.: Eserine I gr. and pilocarpine t gr. hypodermically ; no result. Ammon. carbo I oz. and pulv. nuci s vom. t oz., three times a day. Temperature , 6 p.m., 102.80 F. o eto ber 7, 1910.-Still in pain, temperature 101.6; pulse 48 and weak; continually up and down, but never violent; pa in continues and subacute. 12.30 p.m.: Eserine 2 gr. and pilocarpine I gr. hypodermically with no re sult, continue ammon. carbo and pulv . nucis vom.
Impaction of the Intestines.
477
October 8, 191O.-Looks brighter, a little freces passed, marked borborygmi on the right side, very sli ght on left, in less pain; continue ammon. carbo and pulv . nucls vom. , enemas, abdominal massage. October 9. 191O·-Standing quiet , head down, a little freces passe d containing a large proportion of undigested oats. October 10, 191O.-Temperature 100, pulse weak, feeding a little, 01. lini . I pint, spts. ~theris nit. ~ oz. g iven; animal taken out for a short walk, stands quite quiet in the box. October II, 1910.-Relapse this morning, off feed, dull pain again, urine passed in small quantitie s and often . Aloes 5 drachms, in solution with tr. zingib. ~ oz., water I pint, given, enemas . 12.30 p.m.: Small quantity of soft freces passed, animal quiet during the afternoon . ' O ctob er 12, 191O.-In much pain, temperature 102, pulse 52 and very weak, conjunctivce deeply congested . At 11.30 a.m. : barium chloride 10 gr. g iven intravenously in ~ drachm water; after twenty minutes animal in great pain, powerful tenesmus at frequent intervals causing partial eversion of the rectum, but no freces passed. 2 p.m.: 1 oz. chloral hydrate given, which controlled the tenesmus . Animal in dull pain all the afternoon. 6 p.m.: Morphia injection given, 4 gr. morphia . 7 p.m.: Animal lyin g down a nd easy . October 13. 1910.-Much brighter, passed a little watery ing esta, warm soapy enemas given, abdominal massage , linseed tea as a drench. October 14, 1910.-Very dull again, a small quantity of pultaceous freces passed, linseed tea, carrots, and a small quantity of green grass given. October IS, 1910.-Still dull, but more borborygmi audible on left side, no freces passed, urine passed in larger quantities and not so frequent. October 16, 19IO.-About the same; small quantity of freces passed, tr. nucis vom., tr. gentian . co. , spts. retheris nit. I oz . eac h, and aqua I pint given. October 17, 191O·-Eating a little mash, turned into paddock for a short time , grazes a little . Passed a shovelful of freces, half of it blood-stained, the remainder normal in appearance, tinged green from the grass, animal very weak and dull; con tinue the medicine given on 16th, three times a day .
The Veterina1J' '.1ournal. October 18, I9IO.-At 8 a.m . the animal was standing in the box with head drooping, hanging from the rectum was seen a dark stringy mass about 2 ft. in length, a shovelful of greenishcoloured soft fceces was passed and the mass came away with it; upon examination it was found to be a cast of the intestines in a gangrenous condition. About half an hour later another quantity of fceces was passed, patient improved, pulse stronger and fuller, temperature 99.5, warm mashes with linseed, and steamed hay g iven , sent to graz e for a short time in the morning, stimulants and tonics continued.
Photograph of patient showing lamen ess of near fore-limb on November
I I,
1910.
October 19, I9IO.-A quantity ~f fceces passed, eating mash well, animal very 'weak and tucked up; continue stimulant s and tonics. October 20, I9IO.-Improvement maintained, lar ge quantities of fceces passed. October 25, I9IO.-Fceces passed normal in quantity and appearance, animal still very weak. October 30, I9IO .-Animal bright and feeling well, noticed to be continually resting the near fore in a position similar to
Impactz'on of the Intestines.
479
:that seen in a case of radial paralysis, and occasionally paws with .the leg. November 14, 19IO.-Still rests near fore, pawing more persistent, carries limb. November 23, 1910.-Marked atrophy of the anterior and posterior spinalis, spine of scapula and point of shoulder stands out prominently : evidently this condition is the result of an injury sustained when knocking about in the box during the periods of acute pain. Treatment: Massage and stimulating liniment, ·exercise. Bad bed-sores re sulted from lying down and bruising when rolling; they are healin g well. November 30, 19IO.-M uch improved, trotting fairly well, atrophy still ma rked , general condition good considering the severity and len gth of the illness . December 20, 19IO.-Animal ha s suddenly gone lame on the off fore , symptoms same as seen in near fore; same t reatment. Does not impr ov e in condition, hide-bound and harsh coat; special diet: bo iled fo od, &c ., an d tonic s. january II , 19I1.- Trottin g nea rly lev el , no sign of at rophy ha s appeared during the period of lame ne ss on the off fore . Massage and ex ercise. FebruaY'jl 12, 19I I.- Animal sou nd, cond ition much improved, discharged for a period of light work, then grad ually brou g ht into ordinary work. REMARKS.
Intestinal cases often pull through in an extraordina ry manner, this case appeared so hopeless at variou s stages that reco ve ry seemed a lmost out of the qu estion. There wa s practica lly no action of the bowels for fourteen days, and during that period it was often difficult to know what line of treatment to ::tdopt. I relied on the stimulatin g treatment and only gave barium chloride as a last re source, its action was so violent and ineffective that I should n ot use it a ga in under similar circumstances. The sudden lameness in the off fore was peculiar and un accountable . Rec overy wa s perfect; the animal ha s been in regul a r work since Mar ch, carries gooa condition, and shows no signs of the sev ere illness. The photograph shows the condition of the animal on November II, 1910.