796 TREATMENT OF CAPPED ELBOW IN THE HORSE. 



seen in horses shod with short shoes, or " tips," and in horses without 

 shoes at grass, so that the shoe cannot always be blamed. The 

 position assumed by the horse when lying or about to rise (elbow 

 and foot position), is of great importance in determining the 

 condition. Metastatic disease of the bursa is sometimes seen during 

 strangles. 



Course. Capped elbow is generally produced in a single night. 

 By immediate treatment the swelling may sometimes disperse, but 

 more frequently it becomes chronic, resorption being incomplete, 

 and induration occurring in the parabursal tissue. When a large 

 swelling disperses after existing for some time, a loose fold of skin 

 remains, which detracts from the animal's appearance. Resorption, 

 however, is not infrequently prevented by further bruising. The 

 animal may continue to lie in the position described, repeating the 

 injury, and chronic thickening may occur in the parabursal con- 

 nective tissue, rendering resorption impossible. 



When the skin is injured suppuration may occur in the bursa, 

 and after some time be followed by fluctuation and perforation. 

 Metastatic bursitis produced during strangles is always of this 

 character. As the disease seldom causes lameness, prognosis in 

 working horses is always favourable as far as continued usefulness 

 is concerned. The older the condition the less the chance of complete 

 recovery, but firm swellings can be removed with the knife. 



Treatment. An excellent preventive consists in causing the 

 horse to wear a stout cushion extending across the chest just behind 

 the elbows. This cushion, if applied regularly every night, sometimes 

 causes small capped elbows to disappear. Another mode of 

 prevention is to apply a well-padded " boot," covering the heels, or 

 to strap a thick straw pad extending above and below the knee to 

 the back of the limb. This checks the animal when it attempts 

 to flex the knee, and prevents it taking up the undesirable position. 

 Shoeing the fore-feet with bar-pads often succeeds when other means 

 have failed. 



Fresh swellings are treated by cold applications, and if further 

 bruising be prevented, complete dispersal often results. Resorption 

 is assisted by repeatedly applying irritants, which favour resolution. 

 At the same time they render the skin sore, and thus prevent the 

 animal lying on the diseased spot and renewing the injury. 

 A 10 per cent, iodide of mercury ointment may be applied every 

 two or three days. 



When the swelling fluctuates it may be opened at the lowest point, 

 the contents pressed out, the cavity flushed with iodine solution and 



