4-14: Intestinal Invagination. 



Course. After the disappearance of the abdominal pains, 

 which are at first very intense, several lionrs elapse (in cattle 

 usnally six to twelve hours), occasionally several days (partic- 

 ularly in horses), then the animals become quiet, and they die 

 from complications which have developed. In horses several 

 attacks of colic may be observed exceptionally, occurring at 

 brief intervals, while some authors claim that in cattle the dis- 

 ease may run its course without any pain. Pains may, however, 

 be overlooked of course in animals which are not always under 

 observation (at night). 



The disease lasts usually six to nine days in cattle and may 

 rarely be prolonged to two weeks, while a short course of only 

 a few days is rare. In horses invagination of the cecum into 

 itself or into the colon may run a course of six weeks (Panthe) 

 or even of months (Colin) ; during these long periods the ani- 

 mals present the symptoms of intestinal stenosis. 



Recovery is rare, but possible if the invaginated portion 

 becomes cut off at its oral end and is voided with the feces, in 

 cases where adhesions have formed between the serous layers 

 at the entrance of the invagination. Cases of this kind have 

 been reported in horses (Verrier, Eackow, Martin, Ilochstein, 

 Perkuhn) and also in cattle. Stenosis of the intestine usually 

 follows this course. 



Diagnosis. Intestinal invagination may be diagnosticated 

 with certainty by positive findings on rectal examination; in 

 very rare cases a diagnosis may be made later in the course of 

 the disease, on account of the expulsion of pieces of intestines 

 with the feces. Hemorrhagic feces with mucus or even masses 

 of fil)rin, also symptoms of intestinal obstruction and signs of 

 general disease can, in spite of an early disappearance of the 

 restlessness, create only a suspicion of invagination ; they cannot 

 be relied upon for a definite diagnosis. 



On the basis of the results of rectal examination, the affec- 

 tion may be confounded with impaction in the small intestines 

 and also, in cattle, with impaction in the large intestine ; im- 

 pacted intestinal loops feel more doughy or harder, less elastic, 

 nodular, not painful, and often several loops show this condi- 

 tion. One also finds occasionally thick-walled, painful elastic 

 portions of the intestines in membranous enteritis, but the symp- 

 toms of intestinal occlusion are then missing. Invagination in 

 cattle cannot always be differentiated from volvulus or from 

 obstruction of the intestines with coagulated blood ; tliis is, how- 

 ever, inmiaterial as far as further therapeutic procedures are 

 concerned. In dogs the affection might be confounded, after 

 abdominal palpation, with impaction in the large intestine; but 

 in obstipation we find a soft-firm or then a hard, nodular, cylin- 

 drical mass, not movable, not elastic and, as a rule, not painful; 

 defecation does not occur. The affection of invagination in 

 dogs may more easily be confounded with obstruction of the 



