Course. Diagnosis. Treatment. 385 



Course. The disease is usually of short duration in larger 

 animals and in complete obturation; it then ordinarily extends 

 over two to three days, rarely over a longer period ; it may, how- 

 ever, occasionally last longer, one to two weeks (authors' obser- 

 vation) or even more. (In a case reported by Felder, the horse 

 died after a sickness of 30 days). In dogs, on the contrary, 

 intestinal obturation often lasts from one to three weeks. Com- 

 plete obturation is often preceded by the symptoms of intestinal 

 stenosis with occasional, more or less severe, disturbances of 

 defecation or colic. 



Recovery occurs rarely spontaneously or only upon internal 

 treatment. It may, however, occur if the obturating body is 

 not too large and can therefore be pressed tow^ards the anus 

 and finally expelled by convulsive contractions of the intestinal 

 wall. Very exceptionally a calculus may return from the be- 

 ginning of the small colon into the stomach-like dilatation. ^ 



In the majority of cases complications lead to a fatal issue, 

 the end being ushered in by febrile temperature, frequent and 

 small pulse, collapse; the intense abdominal pains frequently 

 cease suddenly (rupture) or gradually before death occurs. 



Diagnosis. Obturation of the intestines can be diagnosti- 

 cated positively only after the obstructing body has been felt, 

 either by rectal exploration or, in smaller animals, through the 

 abdominal wall. By means of X-rays one may often detect the 

 foreign body in dogs. The history may furnish valuable data in 

 dogs, and in horses a history of continued feeding with bran 

 and crushed grain or of a long stay on sandy, marshy pastures, 

 creates the suspicion of obturation by calculi or concrements 



The disease is distinguished from primary fecal impaction 

 by the fact that a part oi the cases (of obturation) is compli- 

 cated by severe abdominal pains ; that a distension of the rectum 

 by fecal masses is absent in the beginning and eventually even 

 later, and that there is obstinate constipation from the start. 

 Fecal accumulation in the rectum is not seen in intestinal dis- 

 placements or in thrombosis of mesenteric vessels, but severe 

 bloating of some portions of the intestines and a weak acceler- 

 ated pulse are observed early. 



Treatment. In the horse the expulsion of small calculi may 

 be brought about by laxatives, such as castor oil (500-600 gm. 

 with olive oil, with ether 50-70 gm., or with mucilaginous sub- 

 stances, some radix liquiritia? as an electuary), also pilocarpine 

 (0.20-0.30 g-m.). Eserine or chloride of barium should not be 

 used, because they may bring about intestinal rupture. If the 

 calculus is in the "neighborhood of the anus, it can be grasped 

 with the fingers of the introduced hand and it may be removed 

 by a twisting motion. Some intestinal concrements can easily 

 be crushed with the hand and can then be removed piece-meal. 

 One may also cautiously attempt the breaking up of a concre- 

 ment lodged in the first portion of the small colon. If the cal- 



Vol. 2-25 



