Excluding glanders, in the majority of instances, lymphangitis in the horse, such as frequently affects the hind legs, is due to the local introduction of infectious material into the tissues as a result of wounds. However, one may observe in some instances an acute lymphangitis which affects the pelvic limbs of horses and no evidence of infection exists. Consequently, lymphangitis may be considered as infectious and non-infectious.
INFECTIOUS LYMPHANGITIS.
Etiology and Occurrence.—Traumatisms of the legs frequently result in infection and when such injuries are near lymph glands, even though the degree of infection be slight, more or less disturbance of function of the muscles in the vicinity of such glands occurs and lameness follows.
The prescapular, axillary and cubital lymph glands when in a state of inflammation, cause lameness of the front leg, and the superficial inguinal and deep inguinal lymph glands not infrequently become involved also. Because of the location of these lymph glands, they are subject to comparatively frequent injury and inflammation, causing lameness more often than other lymph-gland-affections.
Small puncture wounds in the region of the elbow are often met with. These may be inflicted when horses lie down upon sharp stumps of vegetation or shoe-calk injuries may be the means of introducing contagium, and an infectious inflammation results. Abscess formation, the result of strangles or other infection in the prescapular glands, may be observed at times. Following castration, the inguinal lymph glands may become involved in an infectious inflammation and locomotion is impeded to a marked degree. Horses running at pasture sometimes become injured by trampling upon pieces of wood, causing one end of these or of various implements to become embedded in the soft earth and the other end to enter at the inguinal region and even penetrate the tissues to and through the skin and fascia just below the perineal region.
Nail punctures resulting in infection frequently cause an infectious lymphangitis and a marked and painful swelling of the legs supervenes.
Fig. 61—Chronic lymphangitis. Showing hypertrophy of the left hind leg, due to repeated inflammation.
Fig. 61—Chronic lymphangitis. Showing hypertrophy of the
left hind leg, due to repeated inflammation.
Symptomatology.—Lameness, mixed or swinging-leg, signalizes the presence of acute lymphangitis. There is always more or less swelling present and manipulation of the affected parts gives pain to the subject. Depending upon the character of the infection and its extent, there is presented a varying degree of constitutional disturbance. There may be a rise in temperature of from two to five degrees, and in such instances there is an accelerated pulse. Where much intoxication is present, anorexia and dipsosis are to be noticed.
Swelling may increase gradually and in time discharge of pus may take place spontaneously without drainage being provided for, if the character of the infection does not cause early death. In these cases lameness is pronounced and the cause of the disturbance is to be sought, particularly if the condition be due to a nail puncture.
Fig. 62—Elephantiasis.
Fig. 62—Elephantiasis.
Treatment.—Location of the site of injury is advisable in all cases and in some instances provision for drainage, as in puncture wounds, is helpful. Locally, curettage and the application of suitable antiseptics are indicated. Hot fomentations are beneficial and should be continued for several days if necessary, to stimulate resolution. A brisk purge should be admintered at the onset and strychnin, because of its indirect stimulative effect upon the circulation together with its tonic effect upon the musculature, is beneficial.
In all such cases rational treatment, good hygiene and careful nursing are the principal factors which stimulate recovery. Individual resistance or lowered vitality has a marked influence on the course of this affection.
NON-INFECTIOUS LYMPHANGITIS.
This type of lymphangitis is associated with, or the result of, a derangement of digestion. It affects heavy draft horses, rarely other types of animals, and involves one or both hind legs.
Occurrence.—In healthy and well nourished horses irregularly used, this affection may suddenly manifest itself. It occurs in singular instances in mares that are in advanced pregnancy even when such animals are at pasture. Usually, however, this malady is found in heavy draft horses that have been kept stabled from one to three days.
Symptomatology.—At the outset in severe cases, there is elevation of temperature, labored breathing, accelerated pulse, anorexia and more or less swelling of the affected members. Swelling is very painful and when the affected legs are palpated, pain is manifested by flinching. The inguinal lymph glands are often swollen but in some cases they are not affected in any perceptible degree. In the average case suppuration does not occur and when conditions are favorable, resolution is complete within ten days. The extent of the involvement and the intensity of the affection vary materially in different cases and a chronic lymphangitis may succeed the acute attacks and finally in some instances, elephantiasis results.
Treatment.—An active purgative should be given at once and in the ordinary case, stimulants are indicated. If marked distress is present, morphin is given and where there is much rise of temperature, cold drinking water is offered in abundance and catharsis is enhanced by enemata. Locally, hot applications are of benefit. Hot towels or cotton held in position by bandages and kept soaked with warm water will relieve pain and stimulate resolution. Diuretics may be of benefit and anodyne applications are to be employed with profit in some cases. Walking exercise, if not indulged in to excess, is helpful as soon as acute inflammation has subsided. By giving careful attention to the regimen and providing regular exercise for susceptible subjects, this type of lymphangitis is often forestalled.
[34] Manual of Veterinary Physiology. Page 610.
[35] Manual of Veterinary Physiology, page 601.
[36] Case report at meeting of the Iowa State Veterinary Medical Association, Jan., 1904, by Dr. S.H. Bauman, Birmingham, Ia.
[37] Regional Veterinary Surgery and Operative Technique, by John A.W. Dollar, M.R.C.V.S., F.R.S.E., M.R.I., page 733.
[38] As quoted by A. Liautard, M.D., V.M., American Veterinary Review, Vol. 37, page 667.
[39] Quoted by Prof. Liautard, American Veterinary Review, Vol. 33, page 190.
[40] Traite de Thérapeutique Chirurgical des Animaux Domestique par P.J. Cadiot et J. Almy, Tome second, page 460.
[41] Traite de Thérapeutique Chirurgical, Tome second, page 465.
[42] Luxation of the Femur, by Wm. V. Lusk, Veterinary Surgeon, U.S. Cavalry, American Veterinary Review, Vol. 21, page 254.
[43] Because of the intimacy of the psoas major (p. magnus) and the iliacus they are sometimes called iliopsoas.
[44] Dr. John Scott, Peoria, Ill., in The American Veterinary Review, Vol. 16, page 16.
[45] Annotation on Surgical Items, by Drs. L.A. and Edward Merillat, American Veterinary Review, Vol. 31, page 358.
[46] W.L. Williams in American Veterinary Review, Vol. 21, page 452.
[47] Geo. H. Berns, D.V.S., report, American Veterinary Medical Association, 1912, page 238.
[48] Joseph Hughes, M.R.C.V.S., in the Chicago Veterinary College Quarterly Bulletin, Vol. 10, page 15.
[49] Traite de Therap. Chir. Cadiot et Almy, Tome second, page 480.
[50] E. Wallis Hoare, F.R.C.V.S., American Veterinary Review, Vol. 27, page 1189.
[51] Discussions on paper entitled "The Spavin Group of Lamenesses," by W.L. Williams, Carl W. Fisher and D.H. Udall, Proceedings of American Veterinary Medical Association, 1905.
[52] "Hock-Joint Lameness," by Dr. James McDonough, Proceedings of the A.V.M.A., 1913, page 545.