Treatment
. — When proceeding from blows, convulsions, or
inflammation of the nerve itself, bleeding will be serviceable, as also
purging and blistering. If the disease should appear without any
symptom, or other cause, to lead us to believe that there is any local
affection, the antiphlogistic course should be laid aside, and resort be
had to local and constitutional tonic applications, and revulsive
frictions to the nape of the neck and spine. A seton may also be
applied; and electricity has been recommended in such cases, no doubt
arising from want of tone in the general system.
This affection, in spite of every effort, is very unmanageable, and but
seldom yields to any course of treatment. Strychnia has been used
lately, both internally and externally, in the cure of this complaint;
it may be sprinkled over a blistered surface immediately above the eye,
in the proportion of a grain morning and evening; it may also be
administered inwardly at the same time, in doses from the half a grain
to a grain twice a day.
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Extirpation Of The Eye
It sometimes becomes necessary, from the diseased state of this organ,
that it should be taken completely from its socket. This operation,
though frightful, perhaps, to consider, is very simple in its
application, and may be performed without difficulty by any one
accustomed to the use of the knife. The animal is to be held firmly, as
before directed, and an assistant to keep the lids widely extended.
If the lids cannot be drawn well over the eye, owing to enlargement of
the ball caused by disease, they may be separated by an incision at the
external angle. A curved needle armed with a thread is now to be passed
entirely through the eye, being careful to include sufficient of the
sound parts within its grasp to prevent its tearing out. This finished,
the needle may be detached, and the ends of the thread being united, the
movements of the eye can be governed by means of this ligature: then
proceed as follows:
1st.
The assistant keeping the lids well separated, the operator draws
the eye upward and outward, and then inserting the scalpel at the inner
and lower angle of the eye, with a gentle sweep separates the ball from
the lids, extending the incisions through to the external canthus.
2d.
The ball is now to be drawn inwardly and downward, while the
scalpel, continuing the circular movement as far as the internal
canthus, separates the upper lid.
3d.
The muscles and optic nerves still bind this organ to the orbit,
which attachments can easily be destroyed by the scalpel, by pulling the
eye forward sufficiently to reach them. If the eye has been extirpated
on account of any malignant disease, it is necessary to remove every
particle of muscle from the orbit; and when the disease has extended
itself to the lids, it will also be proper to remove that portion of
them included in the affection.
The hemorrhage from the operation is trifling, and may generally be
arrested by the pressure of the fingers, or the insertion of a conical
ball of lint within the socket, which may be allowed to remain two or
three days if necessary. If there is nothing to apprehend from
hemorrhage, it is only necessary to draw the lids together, and unite
that portion which has been separated by a suture, and place a hood over
the whole.
We do not recommend the stuffing of the orbit with lint, except in case
of hemorrhage, as its presence will sometimes produce violent
inflammation, which may extend to the brain. The cavity of the eye will,
in a measure, be filled up by newly formed matter. The dog must be
restricted to a low cooling diet, and have administered two or three
saline purges.
Contents/Detailed Contents, p. 4/Index
Ulcerations of the Eyelids
are often met with in old mangy, ill-fed animals, and are difficult to
overcome, except by curing the the primary affection, which is often no
easy task. The lids become enlarged, puffy, and tender, the lashes fall
out, and the edges present an angry reddish appearance.
Treatment
— Must be directed, in the first place, to the curing
of the old affection, by which, in connection with blisters, purging,
stimulating washes, &c., a cure may be effected. When the swelling of
the lids is considerable, scarifying them with the point of a lancet
will often be of much service. Ointment of nitrate of silver may also be
smeared on the edges.
Contents/Detailed Contents, p. 4/Index
Warts on the Eyelids
sometimes make their appearance; they may be lifted up with the forceps,
and excised with a knife or scissors, and the wound touched with nitrate
of silver. The same treatment will answer for those warts, or little
excrescences, that sometimes come on the inside of the lids.
Contents/Detailed Contents, p. 4/Index
Entropium — Inversion of the Eyelids
This disease we do not find mentioned by any of the writers on canine
pathology: nevertheless, we are led to believe that it is not an
uncommon form of ophthalmia; and we must express our surprise that it
should have escaped the attention of such close observers as Blaine and
Youatt.
The acute form of the disease resulting from, or attending, simple
ophthalmia, we have often witnessed, but the chronic form, of which we
more particularly speak, is more rare. We have seen three cases of the
latter, and, no doubt, might have found many more if our opportunities
of studying canine pathology were equal to those of the English writers.
The inversion of the eyelids upon the globe is accompanied with pain and
irritation, swelling and inflammation, both of the lids and eye, which
ultimately renders the dog almost useless, if not entirely blind.
Causes
. — Neglected chronic ophthalmia was, no doubt, the cause of
the disease in two cases, a setter and a pointer, while the other, in a
hound, was the result of an acute attack of ophthalmia brought on by
scalding with hot pitch thrown upon the animal. Some of this substance
entered the eye, while a large portion adhered to the muzzle and lids.
The eye, as well as the lids, became inflamed; the latter, being puffed
up and contracted on their edges, were necessarily drawn inwards from
the tension of the parts, and double entropium was thus produced. The
inflammation and tumefaction of the parts continued for a considerable
time, and when ultimately reduced by the application of tepid
fomentations, the skin appeared greatly relaxed; and the muscular fibres
having lost their power of support or contractility, owing to their long
quiescence, seemed no longer able to keep their lids in their proper
situation; the edges therefore remained in the abnormous position
previously assumed.
By this strange condition of the parts, the eyeball continued greatly
irritated by the constant friction of the lashes; water was continually
flowing over the lids, and from its irritating character produced
considerable excoriation of the face and muzzle. The conjunctiva
remained inflamed, the cornea in due course became ulcerous, and the eye
was ultimately destroyed by the discharge of its contents. This was the
course and final termination of the disease in the case of the hound
above referred to, all of which disastrous results might have been
prevented by proper management.
Treatment.
— When in England, we sent to the United States a fine
bred pointer dog, designed as a present for one of our sporting friends.
This animal travelled from Leeds to Liverpool, chained on top of the
railroad cars; the journey occupied several hours, daring which the
weather was cold and boisterous, and we noticed on his arrival at the
latter place that his eyes were watering and somewhat inflamed. On
examining them more particularly, we were enabled to extract several
pieces of cinder from under the lids, which seemed to relieve him
somewhat. He went to sea, in the care of the steward, on the following
day; and remained on deck exposed to the inclemency of the weather
during a long voyage. When he arrived in Philadelphia, the inflammation,
we were informed, was very considerable, occasioned by the presence of
some other small particles of cinder that may have escaped our attention
before shipping him. The presence of these foreign substances in the
eye, in connection with the salt spray and irritating atmosphere,
greatly aggravated the ophthalmia, and resolved it into a chronic
affection, which ultimately resulted in entropium.
"Fop" was hunted during the same autumn, which no doubt increased the
malady to a considerable extent; and before the hunting season was over,
the dog was rendered almost useless: the lids becoming so much swollen
and the irritation so considerable, that it was deemed cruel to allow
him to go into the field.
When we saw him some time in the course of the same winter, the lower
lids of both eyes were completely inverted on their globes, and the
conjunctival inflammation and flow of tears considerable.
The eyes seemed contracted within their sockets, and at times were
nearly hidden from view, the corneas were somewhat opaque, the
photophobia intolerable, and the animal showed evident signs of extreme
pain, by his restless anxiety and constant efforts at scratching and
rubbing the eyes.
Under the judicious application of cooling astringent collyria, and
other remediate means, the irritation and pain of the parts were
relieved, and the lids somewhat retracted.
"Fop" remained in this condition till the following autumn, suffering at
times considerably from the increased inflammation and tumefaction of
the lids, which continued obstinately to persist, insomuch that when
turned out by the pressure of the fingers on them, they immediately
contracted, and were forced inwards on the ball when freed from the
fingers.
Finding that no external application was of any permanent benefit, we resolved to have resort to the same operation we saw practised in ihe Parisian hospitals for the cure of a similar malformation in the human subject. To insure quiet we enclosed the body of the dog in a case, made stationary and sufficiently small to prevent struggling, with the head firmly fixed by a sliding door, as represented in the accompanying drawing. The mouth was kept closed by a small strap passed around the muzzle. This method of fixing a strong dog, we consider the best ever adopted for all nice operations on the face. The first step in the operation was to pinch up a portion of the lax skin of the diseased lid and pass three needles, armed with silk ligatures, successively through the base of the upraised integuments. |
| One needle approximating the external canthus, another the internal, and
a third midway between these two points, as represented in the annexed
drawing. The next step was lo raise up the integuments included in the ligature, and, by means of a pair of sharp scissors, cut off the super-abundant skin as near to the ligatures as possible; having care however to leave sufficient substance included in the ligatures, to prevent their sloughing out before adhesion has taken place. The next and last step of the operation was, to draw the edges of the wound together by tying each ligature, which procedure immediately secured the lid and held it firmly in its natural position. The ligatures were now cut short, and a large wire muzzle, covered over with some dark substance on the operated eye, being put on him, and his legs hobbled with a piece of strong twine, more effectually to prevent his scratching the head, "Fop" was then set at liberty, and soon became reconciled to this eye-shade. |
The hemorrhage was trifling, the wound healed up by the first intention
and the ligatures were drawn away in a few days, when a perfect cure was
effected — the conjunctiva having lost its inflammatory appearance, and
the cornea having again become quite transparent.
The other eye was operated on in the same way and with like success. In
the first operation we cut away the loose flaccid integuments only;
whereas, in the second, we snipped small longitudinal fibres from the
cartilage itself, and the operation consequently was more perfect, if
possible, than in the first instance.
The eyes were now perfectly restored, and remained well during the whole
of the shooting season, after which we lost sight of our patient, he
having accompanied one of our friends as a "compagnon de voyage" on a
commercial expedition to Santa Fe, and, when on his return, had the
misfortune to lose "Fop," who was carried off into captivity by some
prowling Camanches, who no doubt have long since sacrificed him to the
Great Spirit in celebrating the buffalo or wolf dance.
Contents/Detailed Contents, p. 5/Index
Protrusion of the Eye
The eye may be forced from its orbit by wounds or the bites of other
animals.
If not materially injured, the ball should be cleaned with a little
tepid water, or by wiping off with a fine silk or cambric handkerchief,
and immediately replaced within its socket; otherwise the inflammation
and swelling of the lids will soon prevent its easy admission. When
handling the protruded eye, the fingers should be dipped in olive oil or
warm water.
When sufficient time has elapsed from the occurrence of the accident to
prevent the ball being replaced, owing to the swelling and contraction
of the lids, an incision may be made at the external angle of the eye,
so as to divide the lids, which will then admit the eye into its natural
position. If not, the lid itself can be raised up and slit far enough to
allow its being drawn over the globe. As considerable inflammation
generally follows this accident, it will be prudent to bleed the animal
and confine him.
We have seen eyes replaced, that have been out of their sockets for
several hours, perfectly recover their strength and brilliancy.
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Weak Eyes
Some dogs, particularly several breeds of spaniels, have naturally weak
eyes, attended by an over-secretion and constant flow of tears, more
particularly when exposed to the sun. When there is no disease of the
lachrymal duct, the secretion may be diminished and the eyes
strengthened by the daily application of some slightly tonic wash, as
No. 1, 2, 3, &c.
Contents/Detailed Contents, p. 5/Index
Fistula Lachrymalis
The lachrymal duct is a small canal, leading from the internal angle of
the eye to the nostrils, and is the passage through which the tears
escape from the eye. This duct may become closed by inflammation of the
lining membrane of the nose, caries of the bone, ulcers, fungous
growths, or by the presence of some extraneous substance impacted in it.
The tears, no longer having a natural outlet, are necessarily forced
over the lids, accompanied, not unfrequently, by a good deal of purulent
matter.
This canal, when thus obstructed from some one of the above causes,
often forms an ulcerous opening at its upper extremity, just below the
internal canthus, for the escape of the pus that usually collects in a
sac at that point. This perforation is called "Fistula Lachrymalis." The
tears, entering the canal at its punctum, are carried along till they
pass out at the fistulous opening.
Treatment
. — This is a very troublesome affection, and has been
pronounced incurable by some writers. However, we would not hesitate
making an attempt at relieving a favourite or valuable dog of this
disagreeable deformity. We should first endeavour to clear out the nasal
canal, either by means of a minute flexible probe, or by directing a
stream of water from a suitable syringe through its course. A small
silver or copper style may then be placed in the canal to keep it open,
as also to direct the tears through the natural route. This being done,
and the dog confined in such a way as not to be able to scratch or rub
the eye, the fistulous opening might close up in a short time. However,
it might be necessary to wear the style for many months. In such a case,
we see no reason why a wire muzzle, such as used by us after the
operation for Entropium, might not be worn for an indefinite period,
without any inconvenience to the animal.
Contents/Detailed Contents, p. 5/Index
Caruncula Lachrymalis and Plica Semilunaris, or Haw
The caruncula lachrymalis is a small glandular body situated at the internal commissure of each eye. This little gland often becomes greatly enlarged from inflammation or fungous growths — old dogs are much more subject to the disease than young ones. Treatment. — The application of cooling collyria and a weak solution of nitrate of silver, will generally suppress the further growth of this gland. If, however, it continues much swollen and runs on to suppuration, it may be punctured with a lancet and poultices applied. If the affection be of a malignant character, the gland may be drawn out by passing a ligature through its base, and then excised. The haw is most frequently concerned in the disease, and may also be removed. Collyria No. 9: Infusions of slippery elm bark, sassafras or elder pith, infusions of green tea, flaxseed, &c., are all excellent emollient applications — L. |
Contents/Detailed Contents, p.5/Index
Chapter IX — The Ear and its Diseases
Canker in the Ear (1)
All water-dogs, and some others, are subject to a disease designated by
this name, and which, in fact, is inflammation of the integumental
lining of the inside of the ear. When the whole of the body, except the
head and ears, is surrounded by cold water, there will be an unusual
determination of blood to those parts, and consequent distension of the
vessels and a predisposition to inflammation. A Newfoundland dog, or
setter, or poodle, that has been subject to canker, is often freed from
a return of the disease by being kept from the water.
The earliest symptom of the approach of canker is frequent shaking of
the head, or holding of the head on one side, or violent scratching of
one or both ears. Redness of the integument may then be observed, and
particularly of that portion of it which lines the annular cartilage.
This is usually accompanied by some enlargement of the folds of the
skin. As soon as any of these symptoms are observed, the ear should be
gently but well washed, two or three times in the day, with lukewarm
water, and after that a weak solution of the extract of lead should be
applied, and a dose or two of physic administered.
If the case is neglected, the pain will rapidly increase; the ear will
become of an intenser red; the folds of the integument will enlarge, and
there will be a deposition of red or black matter in the hollow of the
ear. The case is now more serious, and should be immediately attended
to. This black or bloody deposit should be gently but carefully washed
away with warm water and soap; and the extract of lead, in the
proportion of a scruple to an ounce of water, should be frequently
applied, until the redness and heat are abated. A solution of alum, in
about the same quantity of alum and water as the foregoing lotion,
should then be used.
Some attention should be paid to the method of applying these lotions.
Two persons will be required in order to accomplish the operation. The
surgeon must hold the muzzle of the dog with one hand, and have the root
of the ear in the hollow of the other, and between the first finger and
the thumb. The assistant must then pour the liquid into the ear; half a
tea-spoonful will usually be sufficient. The surgeon, without quitting
the dog, will then close the ear, and mould it gently until the liquid
has insinuated itself as deeply as possible into the passages of the
ear. Should not the inflammation abate in the course of a few days, a
seton should be inserted in the poll, between the integument and the
muscles of the occiput, reaching from ear to ear. The excitement of a
new inflammation, so near to the part previously diseased, will
materially abate the original affection. Physic is now indispensable.
From half a drachm to a drachm of aloes, with from one to two grains of
calomel, should be given every third day.
Should the complaint have been much neglected, or the inflammation so
great as to bid defiance to these means, ulceration will too often
speedily follow. It will be found lodged deep in the passage, and can
only be detected by moulding the ear; the effused pus will occasionally
occupy the inside of the ear to its very tip. However extensive and
annoying the inflammation may be, and occasionally causing so much
thickening of the integument as perfectly to close the ear, it is always
superficial. It will generally yield to proper treatment, and the
cartilage of the ear may not be in the slightest degree affected. Still,
however, the animal may suffer extreme pain; the discharge from the
ulcer may produce extensive excoriation of the cheek; and, in a few
cases, the system may sympathise with the excessive local application,
and the animal may be lost.
The treatment must vary with circumstances. If the ulceration is deep in
the ear, and there is not a very great degree of apparent inflammation,
recourse may be had at once to a stimulating and astringent application,
such as alum or the sulphate of zinc, and in the proportion of six
grains of either to an ounce of water. If, however, the ulceration
occupies the greater part of the hollow of the ear, and is accompanied
by much thickening of the integument, and apparent filling up of the
entrance to the ear, some portion of the inflammation must be first
subdued.
The only chance of getting rid of the disease is to confine the ear. A
piece of strong calico must be procured, six or eight inches in width,
and sufficiently long to reach round the head and meet under the jaw.
Along each side of it must be a running piece of tape, and a shorter
piece sewed at the centre of each of the ends. By means of these the cap
may be drawn tightly over the head, above the eyes, and likewise round
the neck behind the ears, so as perfectly to confine them.
all, no mild ointment will dispose such an ulcer to heal, and
recourse must be had at once to a caustic application. A scruple of the
nitrate of silver must be rubbed down with an ounce of lard, and a
little of it applied twice every day, and rubbed tolerably hard into the
sore until it assumes a healthy appearance; it may then be dressed with
the common calamine ointment.
If the discharge should return, the practitioner must again have
recourse to the caustic ointment.
The cartilage will never close, but the integument will gradually cover
the exposed edges, and the wound will be healed. The ear will, however,
long continue tender, and, if it should be much beaten, by the shaking
of the head, the ulcer will reappear. This must be obviated by
occasionally confining the ears, and not overfeeding the dog.
Some sportsmen are accustomed to
round
the ears, that is to cut
off the diseased part. In very few instances, however, will a permanent
cure be effected, while the dog is often sadly disfigured. A fresh ulcer
frequently appears on the new edge, and is more difficult to heal than
the original one. Nine times out of ten the disease reappears.
The Newfoundland dog is very subject to this disease, to remedy which
recourse must be had to the nitrate of silver.
Spaniels have often a mangy inflammation of the edges of the ear. It
seldom runs on to canker; but the hair comes off round the edges of the
ear, accompanied by much heat and scurfiness of the skin. The common
sulphur ointment, with an eighth part of mercurial ointment, will
usually remove the disease.
From the irritation produced by canker in or on the ear, and the
constant flapping and beating of the ear, there is sometimes a
considerable effusion of fluid between the integument and the cartilage
occupying the whole of the inside of the flap of the ear. The only
remedy is to open the enlarged part from end to end, carefully to take
out the gossamer lining of the cyst, and then to insert some bits of
lint on each side of the incision, in order to prevent its closing too
soon. In a few days, the parietes of the cyst will begin to adhere, and
a perfect cure will be accomplished
If the tumour is simply punctured, the incision will speedily close, and
the cyst will fill again in the space of four-and-twenty hours. A seton
may be used, but it is more painful to the dog, and slower in its
operation.
The ear should be frequently fomented with a decoction of white poppies,
and to this should follow the Goulard lotion; and, after that, if
necessary, a solution of alum should be applied. To the soreness or
scabby eruption, which extends higher up the ear, olive oil or
spermaceti ointment may be applied. In some cases, portions of the
thickened skin, projecting and excoriated, and pressing on each other,
unite, and the opening into the ear is then mechanically filled. I know
not of any remedy for this. It is useless to perforate the adventitious
substance, for the orifice will soon close; and, more than once, when I
have made a crucial incision, and cut out the unnatural mass that closed
the passage, I have found it impossible to keep down the fungous
granulations or to prevent total deafness.
following is a singular case of this disease:
1st July, 1820
: a dog
was sent with a tumour, evidently containing a fluid, in the flap of the
ear. A seton had been introduced, but had been sadly neglected. The hair
had become matted round the seton, and the discharge had thus been
stopped. Inflammation and considerable pain had evidently followed, and
the dog had nearly torn the seton out. I removed it, washed the ear
well, and applied the tincture of myrrh and aloes. The wound soon
healed. On the 14th the ear began again to fill. On the 17th the tumour
was ripe for the seton, which was again introduced, and worn until the
9th of August, when the sides of the abscess appeared again to have
adhered, and it was withdrawn. Canker had continued in the ear during
the whole time; and, in defiance of a cold lotion daily applied, the ear
was perceived again to be disposed to fill. The seton was once more
inserted, and the cyst apparently closed. The seton was continued a
fortnight after the sinus was obliterated, and then removed. Six weeks
afterwards the swelling had disappeared, and the canker was quite
removed. This anecdote is an encouragement to persevere under the most
disheartening circumstances.
All dogs that are foolishly suffered to become gross and fat are subject
to canker. It seems to be a natural outlet for excess of nutriment or
gross humour; and, when a dog has once laboured under the disease, he is
very subject to a return of it. The fatal power of habit is in few cases
more evident than in this disease. When a dog has symptoms of mange, the
redness or eruption of the skin, generally, will not unfrequently
disappear, and bad canker speedily follow. The habit, however, may be
subdued, or at least may be kept at bay, by physic and the use of
Goulard lotion or alum.
Sportsmen are often annoyed by another species of canker Pointers and
hounds are particularly subject to it.
This species of canker commences with a scurfy eruption and thickening
of the edges of the ear, apparently attended by considerable itching or
pain. The dog is continually flapping his ear, and beating it violently
against his head. The inflammation is thus increased, and the tip of the
ear becomes exceedingly sore. This causes him to shake his head still
more violently, and the ulcer spreads and is indisposed to heal, and at
length a fissure or crack appears on the tip of the cartilage, and
extends to a greater or less distance down the ear.
narration of one or two cases may be useful, as showing the
inveteracy of the disease.
8
th Feb.
1832. — A Newfoundland dog, very fat, had dreadful canker
in both ears, and considerable discharge of purulent matter. He was
continually shaking his ears, lying and moaning. Apply the canker
lotion, and give the alterative balls.
13
th.
The discharge considerably lessened from one ear, but that
from the other has increased. Continue the lotion and apply a seton.
22
d.
The dog, probably neglected at home, was sent to me. Both
ears were as bad as ever.
25
th.
The dog is perfectly unmanageable when the lotion is poured
into the ear, but submits when an ointment is applied. Use
ung. sambuci,
[Symbol: ounce] j. cerus, acet. [Symbol: ounce] j
., mix well together. Continue the alteratives.