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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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.
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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.
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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.
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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.
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.
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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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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.
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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.
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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.
After
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.
The
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.
The
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.