218 PKACTICE OF EQUINE MEDICINE. 



How is the diagnosis made ? 



This affection, as well as many others of the heart, requires 

 a good deal of study and attention in the equine to make a diagnosis. 



It may be diagnosed by an increased dulness of area on per- 

 cussion, the friction sound heard at the same time as the pulse beats, 

 by the rapidity of the heart's action being greater than in any other 

 disease, and by the area of dulness being less than that of pleurisy. 



What disease might especially be taken for pericarditis ? 



Pleurisy. 



How can you make a differential diagnosis ? 



In pericarditis the area of dulness is limited, whereas in 

 pleurisy it is greater. 



On auscultation, the friction sound in pericarditis is limited 

 to the area of the heart, and is heard at the same time as the pulse- 

 beats, whereas in pleurisy it is usually over a larger area and has 

 no connection with the pulse. Pericarditis often follows pleurisy. 



Give the prognosis. 



If the disease is very intense, the animal generally dies in a 

 few days from shock; other cases get well, the exudation becoming 

 absorbed, but the heart may remain weak for some time; still other 

 cases linger along and die from oedema of the lungs, while still 

 others die from cardiac paralysis. 



Give the treatment. 



Perfect rest is essential. The early use of sedatives, as aconite 

 or veratrum, to reduce the heart's action and relieve the symptoms. 

 Opium is one of the best to keep the heart quiet and free from pain; 

 if this does not act well it may be assisted by small doses of chloral. 



Mustard and other irritants are contra-indicated in the early 

 stages; warm applications are the best, as blankets rung out of 

 fairly hot water placed over the parts, with a dry blanket over that; 

 in some cases cold over the heart region is recommended. In the 

 human subject, hot poultices are used, or an oil-silk jacket, which 

 is excellent in horses. 



Quinine is indicated in most all cases; after the acute symp- 

 toms have subsided, and to obviate heart failure, digitalis may be 

 indicated, which also has a diuretic effect. Alkalies, as ammonium 

 carbonate, potassium nitrate, often are used along with digitalis. 



