254 DISEASES OP THE HORSE. 



against the chest wall will not produce pain unless roughly applied. 

 The animal is not disposed to eat or drink much ; the surface of the 

 body and legs are cold — rarely excessively hot — and frequently the 

 body of the animal is in a subdued tremor. In nearly all cases there 

 is partial suppression of the urinary secretion. The symptoms may 

 continue with very little modification for three or four days, some- 

 times seven days, without any marked changes. If large fibrinous 

 clots form in the heart the change will be sudden and quickly prove 

 fatal unless they become loosened and are carried away in the cir- 

 culation; then apoplexy may result from the plugging of arteries 

 too small to give further transmission. If the animal manifests 

 symptoms of improvement, the changes usually are slow and steady 

 until he feels apparently as well as ever, eats well, and moves freely 

 in his stall or yard. When he is taken out, however, the seeming 

 strength often proves deceptive, as he may quickly weaken if urged 

 into a fast gait, the breathing becomes quickened with a double flank 

 movement as in heaves, and all the former symptoms reappear in a 

 modified degree. An examination at this stage may reveal valvular 

 insufficiency, cardiac hypertrophy, or pulmonary engorgement. 



In fatal cases of endocarditis death often occurs about the fourth 

 day, from the formation of heart clot or too great embarrassment of 

 the circulation. Endocarditis may be suspected in all cases where 

 plain symptoms of cardiac affection are manifested in animals af- 

 fected with influenza, rheumatism, or any disease in which the blood 

 may convey septic matter. 



Acute endocardial inflammation may be distinguished from pleu- 

 ritis by the absence of any friction murmur, absence of pain when the 

 chest wall is percussed, and the absence of effusion in the cavity of 

 the chest. It may be distinguished from pericarditis by the absence 

 of the friction sounds and want of an enlarged area of dullness on 

 percussion. 



Treatment. — ^The objects to be attained by treatment will be to 

 remove or mitigate as much as possible the cause inducing the dis- 

 ease ; to find a medicine which will lessen the irritability of the heart 

 without weakening it ; and, last, to maintain a free urinary secretion 

 and prevent exudation and hypertrophy. So long as there is an 

 increase of temperature, with some degree of scantiness of the urine, 

 it may be safe to believe that there is some degree of inflammatory 

 action existing in the cardiac structures, and as long as any evidence 

 of inflammatory action remains, however moderate in degree, there 

 is a tendency to increase or hypertrophy of the connective tissue of 

 the heart or valves, thereby rendering it almost certain that the 

 structural changes will become permanent unless counteracted by 

 persistent treatment and complete rest. 



