Fracture of the knee (carpus) and hock (tarsus).—This seldom occurs unless it is the result of a very violent injury, and is generally associated with other injury and serious complications. Displacement does not generally occur to any considerable extent. The treatment, of course, consists in holding the limb perfectly quiet in a natural position, which may be done by the application of long, wooden splints retained by bandages, or a plaster-of-Paris bandage.
Fractures below the knee.—Fracture of the long bone below the knee (metacarpus) and hock (metatarsus) is more common. In young animals of quiet temperament the treatment of simple fractures here is likely to be attended with good results. On the other hand, a compound fracture in this region becomes a serious matter. The structures which surround the bones are so thin that a very small degree of sloughing will expose parts of the bones and be liable to lead to serious complications and probably fatal results.
Fractures of bones below the fetlock.—These fractures are comparatively unimportant unless associated with other serious injury. The parts can generally be held in position without much difficulty, and union generally takes place quite rapidly.
Appliances.—Of the appliances used in the treatment of the fracture of limbs above the knee, splints made of wood or iron strips and bandages are likely to serve best. Below the knee plaster-of-Paris bandages are preferable. The writer is well aware that many of the standard authors deprecate the use of the latter, but an extensive experience leads me to believe that they have many advantages over any of the other appliances when used alone, and in many ways they may be used with advantage in combination with others.
Luxation, or displacement without fracture of the bones forming a joint, is comparatively rare among cattle. It most frequently occurs in the stifle joint, where dislocation of the kneepan (patella) takes place. A glance at the skeleton (Pl. XXV) will show the relations better than they can be described. It will be observed that the small, irregularly shaped bone (patella) plays on the anterior rounded part of the lower edge of the thigh bone (femur) and between it and the upper end of the shank bone (tibia). The outer ridge on the lower end of the thigh bone is less prominent than the inner one, so that displacement, when it does take place, is by slipping outward. Such an accident may occur from direct injury or external force, as a blow, or from slipping. When it does occur the symptoms produced are somewhat alarming. The animal is unable to draw the leg forward, and either stands with it thrown back with the toe pointing downward, or, if it should succeed in getting its weight upon it, holds it firmly on the ground, fearing to move it. Examination of the outside of the joint will disclose the situation of the patella outside its proper place. If the operator is not familiar with the normal appearance of the joint, it is well to make a comparison between the injured and the sound one. If compelled to move, the animal does so with great difficulty, jerking the leg which it is unable to bring forward, hopping with the other, and partially dragging the injured one.
PLATE XXV.PLATE XXV.SKELETON OF THE COW.(Click to enlarge)
Treatment.—The treatment is simple. A rope 20 feet long should be applied around the fetlock of the affected leg, passed forward between the front legs and up over the opposite side of the neck, back over the withers, and wrapped once behind the elbow around that portion of the rope which passes between the front legs. The leg is then drawn away from the body and forcibly pushed forward by an assistant, while another person tightens up the slack in the rope until the affected leg is off the ground in front of the supporting leg. The rope is then drawn taut and the assistant grasps the tail and pulls the cow toward the affected side. The animal makes a lurch to keep from falling, contracts the muscles, and the patella slips into place with a sharp click, and the animal walks off as if nothing had happened. If the animal resists this method of handling, it may suffice to manipulate the dislocated kneepan by shoving it inward and forward with the heel of the hand while the affected leg is drawn well forward. Unless some precaution is taken the accident is liable to recur, as the ligaments have been stretched by the dislocation till they no longer hold the bone with that firmness necessary to retain it. The animal should be tied and the foot fastened forward, so that the patient can just stand on it comfortably, by means of a rope or strap around the fetlock carried forward between the front legs, around the neck, and tied on the breast.
Should this accident occur more than once it is a good practice to apply a blister around the joint, as in the formula recommended for sprain of shoulder, and observe the precautions as to restraint and subsequent treatment there recommended. With this one exception dislocations in the ox occurring independently of other complications are rare.
Dislocation with fracture may occur in any of the joints, and if one is suspected or discovered, examination should always be made for the other before treatment is applied. When a fracture occurs near a joint the force sufficient to rend the bone is liable to be partly exerted on the immediate tissues, and when the bone gives way the structures of the joints may be seriously injured. It occasionally happens that the injury to the joint becomes the most important complication in the treatment of a fracture. In order clearly to understand the reason for this a few words are necessary in relation to the structure of joints.
The different pieces constituting the skeleton of the animal body are united in such manner as to admit of more or less motion oneupon another. In some of the more simple joints the bones fitting one into another are held together by the dense structures around them, admitting of very little or no movement at all, as the bones of the head. In other joints the bones are bound together by dense, cartilaginous structures, admitting of only limited motion, such as the union of the small bones at the back part of the knee and hock (metacarpal and metatarsal). In the more nearly perfect form of joint the power of motion becomes complete and the structures are more complex. The substance of the bone on its articular surface is not covered with periosteum, but is sheathed in a dense, thin layer of cartilage, shaped to fit the other surfaces with which it comes in contact (articular). This layer is thickest toward its center when covering bony eminences, and is elastic, of a pearly whiteness, and resisting, though soft enough to be easily cut. The bones forming an articulation are bound together by numerous ligaments attached to bony prominences. The whole joint is sealed in by a band or ribbonlike ligament (capsular ligament) extending around the joint and attached at the outer edge of the articular surface, uniting the bones and hermetically sealing the cavities of the articulation. This structure and the articular surface of the bone is covered by a thin, delicate membrane, known as the "synovial membrane," which secretes the joint oil (synovia). This fluid is viscid and colorless, or slightly yellow, and although it does not possess a large quantity of fat, its character somewhat resembles oil, and it serves the same purpose in lubricating the joints that oil does to the friction surface of an engine. Although the tissues of the joint when used in a natural way are able to withstand the effect of great exertion, when unnaturally used, as they are very delicate and complex, they are liable to inflammatory and other changes of a very serious nature. The synovial membrane, and in fact the whole structure of the joint, is susceptible to injury and serious inflammatory derangement, and the capsular ligament is liable to be distended from excessive secretion of synovia. The latter process may be almost noninflammatory, and attended with little inconvenience or importance other than a blemish to the animal, which in cattle is not serious. It may occur on the back part of the leg above the fetlock or on the inner and fore part of the hock, corresponding in its location to windgalls and bog spavin of the horse. Continuous support by bandages will generally force reabsorption, and as the limb is not subjected to violent action, as in the case of the horse, the affection is not so liable to recur.
Occasionally working oxen that are used in the lumber woods and made to pull heavily, with bad footing, are afflicted with this condition. When it occurs lameness is the first symptom. During theearly stages of the disease the lameness is most severe in the morning, and disappears after the animal is exercised; it gradually becomes more severe as the disease advances, so that when the disease is well established the animal is lame continuously. Shortly after the lameness appears a bunch (exostosis) will be noticed on the inner and fore part of the affected joint. This bunch differs from bog spavin in that it is hard, while bog spavin is soft. It increases in size as the disease advances till the animal is too lame to be used for labor. As the disease is always attended with considerable pain there is more or less loss of flesh. In the most advanced stage the animal will step with difficulty, frequently holding the foot from the ground, or, if forced to take a few steps, stands with it elevated, twitching with pain. In the earlier stages of the disease only a small portion of the fore part of the lower, or second, articulation is involved, but the inflammatory process gradually extends over the whole surface of the lower joints of the hock. The structures of the joint are broken down and the bones are united (anchylosis). This process may include any or all of the three lower joints of the hock. The joint of motion which is situated on the lower end of the leg bone is seldom involved.
Treatment.—Treatment of spavin in the ox, as in the horse, is likely to be tedious, and not always resulting in perfect cure. Usually it is best to fatten the animal for slaughter. If, however, treatment is decided upon, it should consist of complete rest and counterirritation of the part either by sharp blisters or the firing iron. It is advisable to try the effect of blistering first, and for this purpose the following mixture is recommended:
Clip the hair off and apply over the inner and fore part of the joint, covering the surface an inch and a half in every direction from the enlargement, or over an area 3 to 4 inches across. Fasten the animal's head so that it can not reach the part to lick it; after the third day grease with lard every other day until the scabs come off. This blister may be repeated three or four times at intervals of three weeks. The lameness will generally begin to disappear about the third or fourth month if the above-described treatment proves beneficial. Should lameness persist, firing in points by a qualified veterinarian may effect the desired result and should be tried as a last resort.
In a case of spavin the cure is not effected by restoring the diseased parts to their natural condition, but by uniting the bones and obliterating the joints. If this union extends over the whole articular surface of the joints affected and is sufficiently strong to prevent any motion of the bones, the animal will again go sound. The jointsthat are obliterated, not being those of motion, are not important, so that the animal suffers no inconvenience in their loss.
Rheumatism is a constitutional disease from a specific condition of the blood and characterized by inflammation of the fibrous structures of the body. It is usually accompanied with stiffness, lameness, and fever. The parts affected are usually swollen, but swelling may be lacking. The inflammation may be transitory; that is, it changes from place to place. The parts usually affected are the fibrous structures of the joints, tendons, ligaments, and muscles. The serous membranes and heart may also be affected. According to its location, rheumatism is specified as articular or muscular. According to its course, it is designated as acute or chronic.
Cause.—Among the factors which are actively causative of rheumatism may be mentioned exposure to dampness and cold, especially while the animal is perspiring or fatigued after severe physical exertion. Among other causes often mentioned are acidity of the blood, nervous derangement, microbes, and injuries. It occasionally follows another disease, such as pleurisy. The influence of age and heredity may be considered as secondary or predisposing causes. Sometimes the disease appears without any apparent cause. On the whole, it may be said that any of the above-mentioned factors may have more or less influence on the production of rheumatism, but the specific cause is as yet unknown.
Symptoms of articular rheumatism.—The symptoms appear suddenly and with varying degrees of severity. The animal presents a downcast appearance, with staring coat, horns and ears cold, and the mouth and muzzle hot and dry. Appetite and rumination may be impaired and followed later or be accompanied at the same time by constipation. Constipation may be followed by impaction of the stomach or bowels. Thirst is increased, but the amount of urine voided is scanty. Respiration and pulse are accelerated, and there is usually a fever, rising sometimes as high as 108° F. The animal prefers to lie down, and when forced to rise stands with its back arched. The movements are stiff and lame and cause great pain. The disease may attack one or more joints at the same time; in fact, it is often symmetrical. One joint may improve while another becomes affected, thus showing the shifting tendency of the inflammation. The affected joints, including their tendons, ligaments, and synovial membranes, may be swollen, hot, and distended with liquid. They are very tender, and, if treated carelessly or injured, may become infected, thus leading to suppuration. While rheumatism attacks perhaps more frequently the knees and fetlocks, it has no special affinityfor any joint and may attack the stifle, hip, shoulder, or elbow joint. In mild cases of articular rheumatism, the animal may fully recover in a few days.
In chronic articular rheumatism there is less tendency of the disease to shift about, but there is a greater liability of structural change in the affected joints. This change may consist of induration, exostosis, or even anchylosis. These structural changes about the joints may lead to permanent deformity, such as the bending of the neck. Fever is not so constant in the chronic form as in the acute, and the latter may lapse into the former.
Symptoms of muscular rheumatism.—This form of rheumatism may appear under the same general conditions as the articular form. The general appearance of the animal is the same in both forms. The cow usually assumes a recumbent position, and all the movements made are stiff and lame. The method of rising or of locomotion indicates pain in certain muscles or groups of muscles, as of the croup, shoulder, or neck. As in the case of articular rheumatism, the tendons, ligaments, and synovial membranes may become involved. The constitutional symptoms in both articular and muscular rheumatism are similar, so that it is often perplexing to differentiate between the two forms.
Prevention.—It is somewhat difficult to procure preventive treatment for cattle, especially when there are large numbers with little or no shelter. In general, it is advisable to protect the animals so far as possible from inclement weather conditions, such as cold rains, heavy dews, and frosts. This is more particularly necessary for animals in poor condition, or those which are perspiring or fatigued after long physical exertion. Careful feeding is also essential.
Treatment.—In attempting to treat cattle for rheumatism the first step is to procure proper shelter and environment. The animal should be quartered in a large, clean, dry stall, with plenty of light and fresh air, but protected from strong drafts. There should be an abundance of clean, dry bedding. The feed should be soft, easily digestible, and slightly laxative, and the animal should have access to clean, pure, cool water.
For general or constitutional treatment of acute rheumatism, sodium salicylate is indicated. In order to gain the best results from this drug, it should be administered with the idea of rapidly saturating the system. To cattle it may be given in doses of one-half ounce every two hours for ten hours or until immediate relief is obtained. This drug should not be continued indefinitely, but may be given once a day after immediate relief has been obtained, and this single dose continued daily until permanent relief ensues, when it should be stopped. The use of sodium salicylate in chronic rheumatism is not advisable on account of the danger of depressing the heart, whoseaction is already somewhat impaired by the lesions which have attacked it. In this case one-half ounce doses of potassium nitrate or bicarbonate may be given three times a day. Besides the constitutional treatment, it may be necessary to give special attention to the bowels in order to relieve constipation. Cattle may be given saline laxatives at the outset, such as 1 pound of Epsom salt for an ordinary-sized cow, and the bowels kept regular by an occasional smaller dose.
In chronic rheumatism the best course of treatment is to give tonics and local treatment. Local treatment may also be advisable in acute rheumatism in addition to the constitutional treatment already prescribed.
External treatment depends solely on the local conditions and should be applied judiciously. Among the various remedies may be mentioned hot or cold moist packs, hot air and vapor baths, friction, etc. Anodynes are often applied locally with good results. Blisters are occasionally indicated. As anodynes may be mentioned liniments and ointments containing salicylic acid or sodium salicylate in combination with laudanum, aconite, or chloral hydrate. Camphorated spirit, soap liniment, and essential oils also afford some relief when applied locally. Of blisters, those containing cantharides are most effective.
FOOTNOTES:[2]A Priessnitz bandage is a dressing which combines the three properties of keeping a part warm, moist, and subjecting it to uniform pressure. It consists of three layers of material. The inner layer is composed of absorbent cotton or some other material which is capable of holding moisture. This is soaked in water and wrapped around the part. The second layer consists of a substance which is impervious to moisture, as oiled silk or oiled paper, and is applied about the inner layer to prevent evaporation. The third or outside layer is composed of a flannel or woolen bandage to prevent the radiation of heat and thus keep the moist inner layer at the temperature of the body.
[2]A Priessnitz bandage is a dressing which combines the three properties of keeping a part warm, moist, and subjecting it to uniform pressure. It consists of three layers of material. The inner layer is composed of absorbent cotton or some other material which is capable of holding moisture. This is soaked in water and wrapped around the part. The second layer consists of a substance which is impervious to moisture, as oiled silk or oiled paper, and is applied about the inner layer to prevent evaporation. The third or outside layer is composed of a flannel or woolen bandage to prevent the radiation of heat and thus keep the moist inner layer at the temperature of the body.
Surgery is both a science and an art. The success of surgical operations depends on the judgment, skill, and dexterity, as well as upon the knowledge of the operator. The same fundamental principles underlie and govern animal and human surgery, although their applications have a wide range and are very different in many essential particulars. We must not lose sight of the fact that hygiene and sanitation are essential to the best results in veterinary as well as in human surgery.
Asepsis is an ideal condition which, although not always possible in animal surgery, is highly important in connection with the mechanical details of all surgical operations in proportion to the nature and seriousness of the same.
Aseptic surgery is considered to be the performance of operations with sterile instruments with the hands of the operator and the site of operation being rendered as nearly sterile as possible, and the wound treated during operation with sterile solutions and protected following the operation with sterile bandage material. In other words, it is the preservation of the highest degree of cleanliness in connection with operations.
Local or general anesthesia should be resorted to in painful and serious surgical operations, as operations upon all living creatures should be humanely performed and all unnecessary pain and suffering avoided. Anesthesia is necessary where absolute immobility of the patient is essential and where entire muscular relaxation is indispensable. The anesthetic condition is also favorable for the adjustment of displaced organs.
Large animals have to be cast and secured before an anesthetic is administered. For complete anesthesia inhalations of chloroform are generally employed; sometimes of both ether and chloroform. The quantity of chloroform required to produce insensibility to external impressions varies much in different cases and must be regulated, as well as the admixture of air, by a competent assistant.
If the probability of the success of an operation is remote and the animal is in healthy physical condition, so that its flesh is good for human food, it is more advisable to butcher the animal than toattempt a surgical operation that offers little encouragement to the owner. The best judgment has to be exercised in determining a matter of this kind, for no animal suffering from inflammation or that is in a feverish condition is fit for human food.
All cases of major operative surgery require the skill and dexterity of the experienced veterinary surgeon, and no one else should attempt such an operation, for unnecessary suffering must be prevented. Nevertheless, the more knowledge and understanding an owner of animals has of the principles of surgical operations and manipulations, the better for all concerned. In the first place, such an owner will appreciate more fully the skill of the qualified veterinarian, and, in the second place, he will be the better prepared and equipped to render assistance to his suffering dumb dependents where no practitioner is accessible and in cases of emergency. There are, moreover, some minor operations upon cattle, some of which can hardly be classed as surgical, that the stockman and farmer should be able to perform himself.
In the performance of any operation upon an animal of the size and strength of the bull or cow, the first consideration is to secure the animal in such a manner as to preclude the possibility of its injuring either itself or those taking any part in the operation. The nature and time likely to be occupied by an operation must, of course, largely determine the method to be adopted.
The majority of operations with which the present chapter is concerned are usually performed on the animal in a standing position. A bull should always be held by a staff attached to the ring in his nose. To secure the cow in a standing position, grasp the nose, the finger and thumb being introduced into the nostrils, and press against the cartilage which makes a division between them. If she has horns, grasp one of them with the disengaged hand. If this is insufficient the animal should be secured to a post, along the side of a fence, or put into a stanchion. An excellent method of restraint is to tie a long rope in a slip noose over the horns, pass it around the chest just behind the forelegs, taking a half hitch on itself, taking another half hitch in front of the hind limbs, passing the free end under the tail, bringing it forward and making it fast either to the head or one of the hitches. The head should be raised to the level of the back before the final knot is tied, so as to render it too serious and painful a matter for her to repeat the first attempt she makes to lower it. Should the nature or extent of the operation be likely to take up considerable time, it is invariably the best plan to throw the animal. In the case of the ox this is very easily done, either by use of horse hobbles, should they be at hand, or by the application of a simple rope. If the horse hobbles are used, they should be fastened on theleg just above the fetlocks (ankle joints), as in that position they are less liable to come off than if placed around the pastern.
Of the many ways of applying the rope for this purpose we will describe only two, which we consider the best and simplest:
First. Take a long, strong rope (one which has been used a few times is more flexible), double it, and at 2 or 3 feet from the doubled end, according to the size of the animal, make a knot and pass the collar thus formed over the animal's head, allowing it to rest on what would be the collar place in a horse. Now, pass the ends of the rope between the forelegs, carry one around each hind leg just above the fetlock joint, from outside in, under itself once, and bring the free ends forward, passing each through the collar loop on its own side and bringing the slack back toward and beyond the hind quarters. (Pl. XXVI, fig. 2.) Two or three men should then take hold of each rope and at a given signal pull. The animal's hind legs being drawn forward, the balance is lost, and if the animal does not fall or lie down he can be readily pushed over on his side and secured in the desired position.
Second. The three half hitches. Take a rope 30 or more feet long, make a slip noose at the end and pass it over the animal's horns, leaving the knot in the loop between the horns; then pass the rope backward along the neck to the withers, just in front of which take a half hitch on it, passing it along the back, take one half hitch just behind the forelegs and a second in front of the hind limbs round the flank. (Pl. XXVI, fig. 1.) The free end of the rope is taken hold of by one or two assistants while another holds the animal's head. By pulling firmly on the rope, or inducing the animal to make a step or two forward while steady traction is made on the rope, the beast will lie down, when his feet can be secured in the way most convenient for the operator.
There are numerous other methods, involving more or less complete restraint, which may be equally efficacious, but one or other of the ways indicated will doubtless be found to meet fully all ordinary cases.
This is usually and ought always to be done before the calf has attained sufficient weight or strength to make his restraint a matter of serious difficulty. An ordinary halter is usually all that is required, the strap being secured to a tree or post. A jointed steel or copper ring is ordinarily used. Those made of the latter metal are preferable.
The common method of punching a round piece out of the nasal septum for the introduction of the ring is, I think, open to objection, as portions of the fine nervous filaments are destroyed. The sensibility of the parts is thus lessened and the object of ringing to some extent defeated. The insertion of the ring by means of a trocar and cannula is preferable, as the method is not open to this objection.
For some years we have used a little instrument, which can be made by any worker in metal, consisting of a steel point riveted into a short cannula made to fit on one end of the ring while open. (Pl. XXVII, fig. 11.) When attached to the ring it is easily and quickly passed through the septum, the half of the ring following as a matter of course. It can then be removed and the ends of the ring brought together and fastened by means of the screw for that purpose.
In the wild state the utility of the horns of cattle as weapons of offense and defense is apparent, but with domestication of cattle and their confinement the presence of horns constitutes a menace to the safety of their companions. Horned cattle frequently inflict with their horns painful and serious injuries to others. Deaths as a result of such injuries are not unusual. The operation of dehorning would therefore be indicated as a matter of general safety.
On farms where breeding is conducted, the most desirable method is to prevent the horns from growing on the young calves. This action results in a more symmetrical appearance of the poll and eliminates the dangers which would result from the presence of horns on the young cattle prior to their operative removal at a later age. A calf should be treated not later than one week after it is born—preferably when it is from 3 to 5 days old. The agent to be used may be either caustic soda or potash in the form of sticks about the thickness of an ordinary lead pencil. These caustics must be handled with care, as they dissolve the cuticle and may make the hands or fingers sore. The preparation of the calf first consists in clipping the hair from the parts, washing clean with soap or warm water, and thoroughly drying with a cloth or towel. The stick of caustic should be wrapped in a piece of paper to protect the hands and fingers, leaving one end of the stick uncovered. Moisten the uncovered end slightly and rub it on the horn buttons or little points which may be felt on the calf's head—first on one, then on the other—two or three times, allowing the caustic to dry after each application. Be careful to apply the caustic to the horn button only, for if it is brought in contact with the surrounding skin it will cause pain. Too much moisture on the stick of caustic will allow the application to spread to the surrounding skin. After treatment keep the calf protected from rain, as water on the head after application of the caustic will cause it to run down over the face.
Dehorning of adult animals is usually performed after the age of 2 years, as after that age there is less probability of the horns again growing. The horns should be severed from the head from a quarter to a half-inch below where the skin joins the base of the horn, cutting from the back toward the front if a saw is used. If the horn is not cut close enough to the head, an irregular, gnarly growth of horn is liable to follow.
Before attempting to dehorn the animal, it should be securely controlled by ropes in a stanchion or by casting. Upon the range the cattle are usually controlled by casting or by placing them in a "squeezer" connected with a corral. A clean, sharp meat saw or a miter saw with a rigid back may be used. Various types of dehorning shears or clippers are in general use. One type of dehorner has a stationary knife edge with its cutting edge shaped like a very wide V, and opposing this, another knife of similar shape moving in a slide, so that the cutting edges act upon the horn from all four sides at once, all the edges passing the center at the same time. Another type has a movable knife, with one oblique or one curved edge, and the cutting is done in one direction only. The power for cutting with these instruments is supplied by pulling together two long handles which, in order to transmit a greater force, are generally so constructed that they act through the medium of a series of cogs. In dehorning with these instruments the cutting edges should be slipped down over the horn and the knives closed, so that their edges set firmly against the horn in such position that the cut will be made in the right place and in the right direction. The handles should then be drawn together with a quick, firm, strong pull so that the horn will be completely severed by the first act and without twisting.
Dehorning should, when possible, be performed in cool weather when the flies are not plentiful. The loss of blood from the operation is not sufficient, as a rule, to be of consequence, and after care being taken to prevent substances from getting into the openings left after the removal of the horns it is not usual to apply any dressing. Pine tar or a mixture of pine tar and tannic acid may be applied, particularly if the weather is warm.
The ordinary use of a seton is to keep up constant drainage from a cavity containing matter or to act as a stimulant or counterirritant. To insert a seton, the place of entrance and exit having been decided on, with the finger and thumb make a small fold of the skin transversely to the direction the seton is to be inserted, and cut it through, either with a sharp knife or a pair of scissors (this should be done at both the entrance and exit); then with a steady pressure and slightlateral movement insert the seton by means of a seton needle. (Pl. XXVII, figs. 1 and 2.) The seton should consist of a piece of strong tape, varying in breadth according to circumstances, and should be kept in place either by a knot on each end or by tying the ends together.
Setons should be gently moved once a day after suppuration is set up, and they should not be allowed to remain in over three weeks, or a month at the outside.
This operation consists in making an opening in the trachea, or windpipe. It is indicated whenever there is an obstruction from any cause in the upper part of the respiratory tract which threatens the death of the animal by asphyxia (suffocation). The mode of procedure is as follows: Have an assistant extend the animal's head as far as possible to make the trachea tense and prominent; make a longitudinal incision about 2 to 2½ inches long through the skin and deeper tissues and trachea at the most prominent part of the trachea, which is about the middle or upper third, and then insert the tracheotomy tube. The latter should be removed once or twice daily and cleansed, and the wound dressed antiseptically. To ascertain when it is time to discontinue the use of the tube and to allow the wound to close, the hand should be held over the opening, which will require the animal to use its natural passages in breathing. Observe whether it is performed in a natural manner, and if so, remove the tube and allow the wound to close. Often the operation has to be performed in great haste without the proper instruments and under great disadvantages, the operator having to cut down quickly, open the trachea and spread the parts, using some instrument improvised by him at the time. This operation only gives the animal relief in breathing, and therefore the proper remedial treatment should be adopted at the onset of the attack and continued until the cause (the disease) has been overcome.
The opening of the paunch, or rumen, in cattle and the removal of a part or the whole of the ingesta through said opening is termed rumenotomy. The operation should be performed in severe cases only, where the rumen is excessively overloaded and distended. The animal is placed with its right side against a wall and firmly held in position by strong assistants. The incision is made in the same place that the trocar is inserted for puncturing that organ in cases of hoven. The opening is increased in size until the operator's hand can be inserted into the rumen. Before any of the contents are removedfrom that organ a linen cloth should be placed from the outer wound into the rumen in order to prevent any of the ingesta from getting into the abdominal cavity. Some practitioners, after removing a portion of the contents of the rumen, introduce such medicine as may be indicated before closing the wound. Clean the wound and close the opening in the rumen with uninterrupted (Pl. XXVII, fig. 8) carbolized catgut sutures. Next close the external wound, consisting of the integument, muscle, and peritoneum, with stout, interrupted (Pl. XXVII, fig. 6) metallic sutures. No feed should be given for several hours after the operation, and then gruels only. (See "Distention of rumen or paunch with feed,"p. 26.)
An abscess may be detected, if situated externally, by heat, pain, redness, and swelling in the early stages, and, if further developed, by the fluctuation which is present. When any of these symptoms are absent, the suppuration should be encouraged by the means of hot fomentations and poultices. Care must be taken that the abscess is not opened too soon, or to some extent it may cause it to scatter, and the escape of pus will be lessened. The time to open an abscess is just before it is ready to break, and should be done with a sharp lance, a crucial incision sometimes being necessary. The cavity should be syringed out with an antiseptic solution. Care should be taken not to allow the wound to close too rapidly, to prevent which a tent of lint or oakum should be introduced.
For the purposes of the present work wounds may be divided into three classes: (1) Incised; (2) punctured; (3) lacerated or contused. In any wound all that the most suitable applications can accomplish is, in the first place, to prevent the access of those poisonous germs which exist in the animal's surroundings, such as the soil and the manure, and, in the second place, when the process of repair is for some reason temporarily inactive or altogether arrested, to incite that curative inflammation that is the invariable method by which the cure is effected.
Incised wound.—This is one with clean-cut edges, and may be either superficial or deep. In wounds of all descriptions there is necessarily more or less bleeding, and this is especially liable to be the case in incised wounds, particularly when they penetrate to a considerable depth, or when inflicted on a part where blood vessels of any considerable size approach the surface. To arrest the hemorrhage must therefore be the first consideration. If slight, a generous use of cold water is all that is necessary, but if one or more vesselsof any size have been wounded or entirely severed, they should be taken up and ligated. If the blood flows continuously and is dark in color, it proceeds from a vein, but if bright-colored and jerky in its flow, it is arterial.
The taking up of an artery simply means the tying up of the bleeding vessel, which should be accomplished as follows: To discover the bleeding artery take a piece of clean absorbent cotton, dip it in cold water, and by gentle pressure on the wound clear it of the accumulated blood. The jet of fresh blood reveals the end of the vessel, which is readily recognized by its whitish-yellow or buff color. It should be seized with a forceps or pincers and slightly drawn clear of the surrounding tissues. Now take the thread and place the middle of it under the artery, take up the ends, tie one simple knot tightly, pressing the thread down with the forefinger so as not to include the forceps, then a second one over it and cut off the ends. The bleeding being arrested, the operator can now carefully clean and inspect the wound, taking care to remove all blood and foreign matters and clip the hair around the edges before proceeding to stitch it up. If the wound is superficial, the lips may be brought together by a series of independent stitches (Pl. XXVII, fig. 6) about one-half of an inch to three-fourths of an inch apart. The stitches should not be drawn tightly; it is sufficient to bring the edges of the wound in apposition.
If the wound is deep, the needle should be introduced perpendicularly at as great a distance from the lip of the wound as the depth it is to be inserted, so as to give the thread sufficient hold. All the stitches should be as nearly as possible at equal distances from the border of the wound, to prevent unequal strain, and the knots should be made at the side, not over the wound. (Pl. XXVII, fig. 6.) When the wound is large and deep, care should be taken to have an opening in the lowest part to allow for the escape of the discharges.
In deep wounds which run crosswise of a limb or muscle it is often advisable to use what is technically known as the "quilled suture," which is most readily understood by reference toPlate XXVII, figure 7. To accomplish this method a curved needle with an eye in the point and a strong double thread should be used. The needle thus threaded is introduced perpendicularly at least an inch from the wound on one side, carried across below and brought out the same distance from the border of the cut on the opposite side, the thread being seized and held in position while the needle is withdrawn, leaving a loop of thread protruding on one side and two loose ends on the other side of each stitch. When enough stitches have been made, take a light piece of wood about the size of a lead pencil, corresponding in length to the size of the wound or slightly longer, and insert it through each of the loops, drawing up the free ends of the threads,which should in turn be tied securely on a similar piece of wood on that side.
Punctured wounds.—Owing to the uncertainty of their depth and the structures they may involve, punctured wounds are by far the most dangerous and difficult to treat. Not only is the extent of the damage hidden from view, but the very character of the injury, as can be readily understood, implies at least the possibility of deep-seated inflammation and consequent discharge of pus (matter), which, when formed, is kept pent up until it has accumulated to such an extent that it burrows by simple gravity, as no other exit is possible. In this way foreign matters, such as a broken piece of the stake or snag, or whatever caused the wound, may be carried to an indefinite depth, or the cavity of a joint may be invaded and very serious, if not fatal, consequences occur.
The danger is especially marked when the injury is inflicted on parts liable to frequent and extensive motion, but all cases of punctured wounds should receive unusual care, as no judgment can be accurately formed from the external appearance of the wound. While a probe can ascertain the depth, it throws but little light on the extent or exact nature of the internal injury. For this reason all punctured wounds should invariably be carefully searched by means of a probe or some substitute devised for the occasion, such as a piece of wire with a smooth blunt end, or a piece of hard wood shaped for the purpose. Stitching is not admissible in the case of punctured wounds. After thoroughly cleansing the opening of the wound and its surroundings, tincture of iodin should be injected directly into the wound.
If a punctured wound is not very deep, and when the bruising and laceration are slight, it is possible for healing to take place by adhesion, and this should always be encouraged, as the process of repair by this method is far superior to that by granulation, which will be referred to later. With this object in view, the animal should be kept as quiet as possible. A dose of physic, such as a pound of Glauber's or Epsom salt, should be administered, and warm antiseptic fomentations or poultices, when this is practicable, applied frequently to the surface of the wound.
In wounds of this description the process of repair may be complicated by the appearance of exuberant granulations, popularly known as "proud flesh," which is really an overgrowth of new tissue—granulation tissue; but these should not be interfered with unless they continue after the acute stage of inflammation has been subdued. If, after this, they persist, they may be treated with a 10 per cent solution of sulphate of copper (bluestone) or nitrate of silver (lunar caustic) in water.
Contused or lacerated wounds.—These are usually caused by a blow with some blunt instrument or by falls. The seriousness depends largely on the depth of the injury, and treatment should be directed to allaying the inflammation and preventing the consequent tendency to sloughing. To this end soothing applications, such as antiseptic fomentations and poultices, are plainly indicated.
Methods of healing.—Technically these may be divided into a number of distinct processes, but practically we may speak of them as two only, namely, by primary union, or adhesion, and by granulation. As suppuration is not so liable to occur in cattle as in horses, healing by the former and more speedy process is much more common in the first-named species, more particularly in clean-cut or incised wounds, provided they have been stitched within 12 hours from the time the injury which caused them was inflicted, that they have been kept antiseptically clean, and that the patient by some means has been kept fairly still. This latter stipulation is probably hardest to comply with. Quiet is an important factor in the process of repair among the lower animals.
The second method of healing, namely, by granulation, which is, however, the manner in which most wounds in animals heal, takes much longer. In punctured wounds of any depth healing necessarily takes place in this way only, and the treatment should be directed largely to alleviating pain and moderating inflammation.
After-treatment and dressing of wounds.—The dressing of wounds is one of the most important branches of veterinary surgery, and one of the most constant difficulties that the practicing veterinarian has to contend with lies in the lack of cooperation on the part of owners in the care and attention in the after-treatment of wounds.
In summarizing the treatment of wounds, the following recommendations should be observed: wounds must be cleansed and kept clean, using antiseptic solutions which do not produce irritation, and applying the solutions with a syringe or with clean pieces of absorbent cotton. Bleeding should be stopped before the closing of the wound by sutures or bandages. An opening at the bottom of all wounds except small superficial wounds should be provided as a drainage outlet for the escape of wound secretions or pus if it should form. The edges of wounds and the muscles involved in the wound should be kept as quiet as possible during the process of healing. Every wound should be protected by a sterile or antiseptic dressing whenever it is possible to retain a dressing in place. Dressings should be changed when it is apparent that they have become drenched with wound secretions or pus, or have become disarranged or too loose, permitting dirt to enter between them and the skin. If swelling appears beyond the edges of a bandage, it is an indication that it is too tight and it should then be removed and again applied.
The hands of the operator and all instruments and dressings coming in contact with a wound at any time should be made as clean as possible by the use of antiseptics.
Barbed-wire cuts.—We have specified these simply because in some sections of the country there is a fixed idea that there is a specific poison in barbed wire, causing injuries which require treatment differing from that which is applicable to ordinary wounds. Barbed-wire cuts differ from ordinary wounds only in the parts being often lacerated and torn, and the treatment already indicated for wounds of that description is applicable to them.
Castration consists in the removal of the essential organs of generation, and is performed upon both the male and the female. In the male the organs removed are the testicles and in the female the ovaries.
Castration in the male is performed for several different purposes. It may be necessary, as is the case in certain diseased conditions of the testicles and in strangulated hernia, but the usual object of the operation is to enhance the general value of the animal. For example, if the animal is intended for burden, the operation will better fit him for his work by so modifying his temperament and physical condition that he may easily be controlled by his master. Again, if he is merely to be used for beef purposes, the operation will improve the quality of the flesh and cause an added development of the most valuable portions of the dressed carcass.
The operation upon the female may be performed on account of diseased conditions, but we may say that the chief object of the operation is to make the animal one of more profit to its owner by lessening the lacteal secretion and also improving the physical condition from the point of view of beef production. When the cow is spayed, it does away with all trouble attending estrum, or heat, gestation, and parturition with its accidents and ailments. The flesh of the spayed cow is more tender and juicy than that of the natural animal.
The operation upon the male may be either the uncovered or the covered. In the former the incision is made down to the testicle proper, and in the latter the cut is made through the scrotum or the outside covering and through the dartos, or the next coat, care being taken to cut no deeper tissues or coats. The age at which the operation is performed varies, but usually it is performed between the second and third month. If done in early life, there is less danger of complications, the organs being in a latent condition and not fully developed. There are many different methods of operating, the principal ones of which we shall mention. In the uncovered operation agood free incision should be made, exposing the testicle completely. Now it may be removed by simply cutting it off. The only danger of doing this is that hemorrhage is liable to follow. To obviate this, before the division of the spermatic cord it should be twisted several times in the following manner: Take hold of the cord with the left hand, having it between the thumb and the index finger. Now twist the free portion several times with the right hand, all the time being careful to push with the left hand toward the body of the animal. In this way the danger of injury to the cord during the animal's struggles will be overcome. There will be no hemorrhage, or very little, if it has been done properly. This is the most simple manner of torsion. There are forceps and other instruments made to perform the operation in this manner. The actual cautery is an old method, but we shall not describe it, as we consider that we have better methods now. The next method with the clamps, although extensively used upon the horse, is not practiced to so great an extent upon the bovine at the present time. It is a very old method, and is considered very safe. Clamps are used in the covered and uncovered operations.
More modern methods are by the use of special instruments known as the emasculator and the écraseur.
The operation of "mulling" or crushing the spermatic cord is an unscientific and barbarous procedure, causing unnecessary pain and suffering.
The methods described above apply only to the animal in a normal condition. Before operating everything should be examined to see that it is as it should be. If otherwise, a special operative procedure will be necessary. Whichever mode of operation is adopted from a practical standpoint, the principal precautions to be taken in order to attain success are as follows: First, thorough cleanliness under strict aseptic and antiseptic precautions; second, a free and boldly made incision; third, the avoidance of undue pulling or tension upon the spermatic cord; fourth, free drainage, which can be maintained, provided the original incision has been properly made.
The operation of castration of the male is by no means a serious one, and when properly performed there is little danger from complications. Although the danger is trifling, the complications which may arise are sometimes of a serious nature. Hemorrhage, either primary or secondary, tetanus (or lockjaw), abscesses, hernia (or rupture), gangrene, and peritonitis are the most serious complications that follow castration. Whichever complication arises will require its own special treatment, which we will not go into here, as it will be fully dealt with under another heading. We would add, however, that, generally speaking, the animal, after being castrated, should either be regularly exercised or be allowed freedom so that it canexercise itself. Sudden changes of the temperature are dangerous. The animal should be fed moderately, but of a diet easily digestible.
The operation of ovariotomy (spaying) should be performed when the heifer is in her prime and in moderate condition not too plethoric and not in heat or pregnant. This operation may be performed in one of two ways—namely, by the flank or by the vagina—each operation having its special advantages. In the flank operation the animal may be operated upon either while standing or while in the recumbent position. If standing, she should be placed against a wall or a partition and her head held by a strong assistant. The legs also must be secured to prevent the animal from kicking. A vertical incision should be made in the left flank, about the middle of the upper portion, care being taken not to make the opening too far down, in order to avoid the division of the circumflex artery which traverses that region. The operator should now make an opening through the peritoneum, which is best done with the fingers. Next the hand and arm should be introduced into the abdominal cavity and the hand directed backward toward the pelvis, searching for the horns of the uterus; if followed up the ovaries will easily be found. They should then be drawn outward and may be removed either by the écraseur or by torsion. Closing and suturing the wound will complete the operation. An adhesive plaster bandage can be beneficially applied.
The operation by the vagina is more complicated and requires special and expensive instruments. The mode of procedure in brief is as follows: A speculum is introduced into the vagina, and an incision is made into the superior wall of that passage about 2 inches from the neck of the uterus, cutting from below upward and from before backward. An incision which should not exceed 3½ inches in length should be made. The next step is to get possession of the ovaries. They are situated in a fold of the broad ligament and should be drawn carefully through the incision into the vagina. Now take the long-handled scissors, specially made for this purpose, with which the thick border of the broad ligament is divided. The torsion forceps are introduced and applied to the broad ligament above the ovary. The left hand is then introduced, and the thumb and the index finger grasp hold of the broad ligament above the forceps. With the right hand torsion is applied and the ovary removed. The other ovary may be removed in the same manner.
What has been said with regard to complications and aftertreatment in the case of the male also applies to the female.
Descriptions of other surgical operations not given in this chapter may be found in other parts of this work by reference to the index.