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Peculiar Case of Occult Laminitis, or Laminal Congestion
Pecu!z'ar Case of La'm iu/tis. The system of treatment by neem fomentation in the case of castration wounds, with native practitioners, dates from the earliest times; but its explanation has hardly been before given, or its raison d'itre fully described.
PECULIAR CASE OF OCCULT LAMINITIS, OR LAMINAL CONGESTION. BY
J. HUNTER, V.S., SKENE, ABERDEEN SHIRE, N.n.
THE apology I make for briefly chronicling this case-if, perhaps, a corner of space may be found for it in the VETERINARY JOURNAL-is that, as far as I am aware, with recovery it may be a rara avis. While at tea one evening in the middle of November last, I observed one of James Proctor's, Esq., of Kirkville, carriage horses pass the window, showing a miserably haggard countenance and a spasmodically tottering gait. So much so, that I passed the remark that I would requ ire to see that animal before he reached home again. Accordingly, after having some of his shoes removed and put on again in the forge at the other end of our tiny village, I had a call from the coachman stating that one of their horses had stuck on the way from the" smiddy," and would not move a step. On approaching the animal I observed the unmistakable fiery flash of fever in his eyes; pulse about roo and irregularly intermittent, respiration much accelerated, but temperature nearly normal. The hind legs were drawn forward under the body in such a fashion that the four feet were nearly all in contact. By dint of shoving and pushing, and now and again manually lifting and shifting a foot, he was at last with difficulty got into the stable, where the shoer, with the assistance of a few other men, had much trouble in removing the fore shoes, the one foot being as bad as the other. On manipulation of the limbs and feet, the only tangible symptoms I could find to account for such lameness was the manifestation of pain on gently tapping and squeezing the walls and soles of each fore hoof. Between four and five quarts of blood were immediately abstracted, an aloes ball administered, and I ordered the feet to be placed in a fine linseed poultice,
The Veterinary Journal. and periodic doses of Fl. Tinct. aconite to be given. On calling next day, fully expecting, as usual in apparently similar cases, to find a mitigation of the se\rerity of the symptoms, I was rather astonished, instead of this, to observe their intensification. The animal was in a painfully-looking stretched-out position, with the fore limbs shaky and determinedly posted out forward, seemingly suffering extreme pain, constitutionally as well as locally. A summing-up of the state of symptoms not warranting further phlebotomy, I advised an increase in the dose of aconite, with simple febrifuge medicines and a continuance of poulticing. Third day: Constitutional symptoms slightly easier, bo\vels relaxed, with bad smell. Treatment same, with addition of diuretic powder. Fourth day: Much the same, but bowels constipated; the groom complaining of the terrible business of changing the poultices, the horse not having as yet dared to lie down, and it was scarcely possible to hold up either of his fore feet for a moment. On examining the feet I found a perceptible swelling around both pasterns-slightly more so on the one limb than the other. There was a little abnormal heat of the wall and sole of each hoof, but the animal was utterly unfit for the slightest locomotion. Advised the discontinuance of poulticing, and the feet to be placed in finely-made clay, and cold-water swabs applied round the pasterns, and administered a laxo·derivative ball. Fif~h day: Constitutional improvement. Prescribed some alkaline powders; spare diet, restricting his regimen to a few fresh carrots, a mouthful of bran-mash, and a bite or two of hay, with cold water ad libitum. After a few days he began to lie down and rest himself, and the symptoms were markedly easier; the feet now being kept in leather boots amongst fine · clay, there was a gradually improving state of matters for about three weeks, The following week, however, showing no improvement, I had the boots and clay removed. The pasterns seemed a little enlarged-in fact, the very feet themselves looked somewhat bigger, this being the more noticeable as the one was more so than the other; but there was no appearance of contraction or rings, and no loosening or convexity of soles, or any of the usual results of Laminitis. On visiting next morning, I had him led out-the result being that
Peculiar Case of Lamiuitis.
243
he could scarcely cross the road without tumbling on his nose, but on the greensward he could walk wonderfully well. Prescribed a sharp blister round the coronet, to be repeated in the course of eight days. A fortnight afterwards I had him shod, but his locomotion proved very uncertain and short on the hard road, especially one fore foot, which still remained perceptibly larger -this extending as far up as the pastern joint. So, fancying from what I had seen and also what I had read about such cases in this valuable Journal and elsewhere, the animal might be of no more use for carriage purposes, I proposed having him examined by some of my professional friends. This accordingly was done: firstly by Mr. Sorley, M.R.C.V.S., Hazelhead, Aberdeen, who pronounced the case to be fracture of the coronary bone of the left fore limb, and that he would be of no more use for road purposes; secondly by Mr. Thomson, M.R.C. V.S., Aberdeen, County Inspector, who sent us a certificate that the horse was suffering from Ringbone, and was incurably useless for carriage purposes, D eriving but scant comfort from these different opinions, I fell back upon my own resources, and commenced blistering again, repeating it every ten days for a month. The response to this treatment was so encouraging that he was sent away to the neighbouring farm of West Fornet, t o take a turn at the plough. Mr. D ewar, M.R.C.v.S., Kintore, who had a look at him some time afterwards, gave it as his opinion that he had suffered from a sprain. Latterly, Mr. Able, farmer, purchased the animal, and he is now doing his road work in the dog-cart, and taking a turn at any other work, apparently as sound as a bell. The gradual disappearance of the swelling, and the non-appearance of any other abnormality in the parts g ive reasonable grounds for supposing that recovery is permanent. No/e.- It must be understood, or at least I presume, that these three professional gentlemen whose names are quoted did not know the previous history of the case before giving their opinions; and I communicate these facts simply with the view of illustrating the peculiarity of the case, and how apt we are, at different stages of some of these singular diseases, to form so many erratic diagnoses and prognoses.
PECULIAR CASE OF OCCULT LAMINITIS, OR LAMINAL CONGESTION. BY
J. HUNTER, V.S., SKENE, ABERDEEN SHIRE, N.n.
THE apology I make for briefly chronicling this case-if, perhaps, a corner of space may be found for it in the VETERINARY JOURNAL-is that, as far as I am aware, with recovery it may be a rara avis. While at tea one evening in the middle of November last, I observed one of James Proctor's, Esq., of Kirkville, carriage horses pass the window, showing a miserably haggard countenance and a spasmodically tottering gait. So much so, that I passed the remark that I would requ ire to see that animal before he reached home again. Accordingly, after having some of his shoes removed and put on again in the forge at the other end of our tiny village, I had a call from the coachman stating that one of their horses had stuck on the way from the" smiddy," and would not move a step. On approaching the animal I observed the unmistakable fiery flash of fever in his eyes; pulse about roo and irregularly intermittent, respiration much accelerated, but temperature nearly normal. The hind legs were drawn forward under the body in such a fashion that the four feet were nearly all in contact. By dint of shoving and pushing, and now and again manually lifting and shifting a foot, he was at last with difficulty got into the stable, where the shoer, with the assistance of a few other men, had much trouble in removing the fore shoes, the one foot being as bad as the other. On manipulation of the limbs and feet, the only tangible symptoms I could find to account for such lameness was the manifestation of pain on gently tapping and squeezing the walls and soles of each fore hoof. Between four and five quarts of blood were immediately abstracted, an aloes ball administered, and I ordered the feet to be placed in a fine linseed poultice,
The Veterinary Journal. and periodic doses of Fl. Tinct. aconite to be given. On calling next day, fully expecting, as usual in apparently similar cases, to find a mitigation of the se\rerity of the symptoms, I was rather astonished, instead of this, to observe their intensification. The animal was in a painfully-looking stretched-out position, with the fore limbs shaky and determinedly posted out forward, seemingly suffering extreme pain, constitutionally as well as locally. A summing-up of the state of symptoms not warranting further phlebotomy, I advised an increase in the dose of aconite, with simple febrifuge medicines and a continuance of poulticing. Third day: Constitutional symptoms slightly easier, bo\vels relaxed, with bad smell. Treatment same, with addition of diuretic powder. Fourth day: Much the same, but bowels constipated; the groom complaining of the terrible business of changing the poultices, the horse not having as yet dared to lie down, and it was scarcely possible to hold up either of his fore feet for a moment. On examining the feet I found a perceptible swelling around both pasterns-slightly more so on the one limb than the other. There was a little abnormal heat of the wall and sole of each hoof, but the animal was utterly unfit for the slightest locomotion. Advised the discontinuance of poulticing, and the feet to be placed in finely-made clay, and cold-water swabs applied round the pasterns, and administered a laxo·derivative ball. Fif~h day: Constitutional improvement. Prescribed some alkaline powders; spare diet, restricting his regimen to a few fresh carrots, a mouthful of bran-mash, and a bite or two of hay, with cold water ad libitum. After a few days he began to lie down and rest himself, and the symptoms were markedly easier; the feet now being kept in leather boots amongst fine · clay, there was a gradually improving state of matters for about three weeks, The following week, however, showing no improvement, I had the boots and clay removed. The pasterns seemed a little enlarged-in fact, the very feet themselves looked somewhat bigger, this being the more noticeable as the one was more so than the other; but there was no appearance of contraction or rings, and no loosening or convexity of soles, or any of the usual results of Laminitis. On visiting next morning, I had him led out-the result being that
Peculiar Case of Lamiuitis.
243
he could scarcely cross the road without tumbling on his nose, but on the greensward he could walk wonderfully well. Prescribed a sharp blister round the coronet, to be repeated in the course of eight days. A fortnight afterwards I had him shod, but his locomotion proved very uncertain and short on the hard road, especially one fore foot, which still remained perceptibly larger -this extending as far up as the pastern joint. So, fancying from what I had seen and also what I had read about such cases in this valuable Journal and elsewhere, the animal might be of no more use for carriage purposes, I proposed having him examined by some of my professional friends. This accordingly was done: firstly by Mr. Sorley, M.R.C.V.S., Hazelhead, Aberdeen, who pronounced the case to be fracture of the coronary bone of the left fore limb, and that he would be of no more use for road purposes; secondly by Mr. Thomson, M.R.C. V.S., Aberdeen, County Inspector, who sent us a certificate that the horse was suffering from Ringbone, and was incurably useless for carriage purposes, D eriving but scant comfort from these different opinions, I fell back upon my own resources, and commenced blistering again, repeating it every ten days for a month. The response to this treatment was so encouraging that he was sent away to the neighbouring farm of West Fornet, t o take a turn at the plough. Mr. D ewar, M.R.C.v.S., Kintore, who had a look at him some time afterwards, gave it as his opinion that he had suffered from a sprain. Latterly, Mr. Able, farmer, purchased the animal, and he is now doing his road work in the dog-cart, and taking a turn at any other work, apparently as sound as a bell. The gradual disappearance of the swelling, and the non-appearance of any other abnormality in the parts g ive reasonable grounds for supposing that recovery is permanent. No/e.- It must be understood, or at least I presume, that these three professional gentlemen whose names are quoted did not know the previous history of the case before giving their opinions; and I communicate these facts simply with the view of illustrating the peculiarity of the case, and how apt we are, at different stages of some of these singular diseases, to form so many erratic diagnoses and prognoses.