ICTERUS JAUNDICE 229 



once carried to the nervous system, and, when accumulated 

 in sufficient quantities, will produce by irritation of the nerve 

 cells marked symptoms of active delirium, convulsions, etc. 

 This period of excitement and delirium, as a rule, lasts only 

 a very short time, terminating in depression, muscular de- 

 bility, somnolence, and eventually deep coma and death from 

 a general paralysis. 



The general symptoms (loss of appetite, increased thirst) 

 are noticeable from the beginning. Usually a subnormal 

 temperature (96-100 F.) exists, depending upon the severity 

 of the condition. Examination of the liver by palpation is 

 unsatisfactory, as pain or enlargement of the liver is rarely 

 noted. 



Diagnosis The recognition of this condition offers no 

 difficulties, as the symptoms are very characteristic. How- 

 ever, the cause in many cases is hard to determine. In dogs 

 digestive disturbances, often resulting from errors in diet, 

 etc., produce the largest percentage of cases. Here the 

 anamnesis is valuable. From infectious jaundice a differen- 

 tiation can in most cases be made from the fact that this 

 condition occurs mostly in young dogs (puppies) and in an 

 enzootic form, affecting all the puppies of a litter. 



Prognosis. The prognosis in icterus is generally speaking 

 unfavorable. A large percentage of the cases in the dog 

 terminate fatally. In mild cases, due to catarrhal inflamma- 

 tion of the mucous membrane of the duodenum, recovery 

 usually takes place. The cause, if possible, should be ascer- 

 tained, and the conditions thoroughly considered before 

 making a prognosis. 



Treatment. Dietetic. In the milder cases where the 

 appetite is retained small quantities of lean meat should be 

 given, avoiding all fats for a few days. In severe cases to 

 conserve the animal's strength eggs, given in small quantities 

 of milk, are useful. During convalescence foods should be 

 allowed only in small quantities, avoiding fats and irritating 

 foods as much as possible. 



lied ical. When icterus is the result of catarrhal inflamma- 

 tion of the duodenum, it is advisable to irrigate the stomach 

 with bicarbonate of soda solution (2 per cent.), repeating this 



