QUITTOE. 387 



tendons until the navicular joint is involved, and extensive sloughing 

 of the deeper parts follows. 



Treatment. — The treatment of tendinous quittor is to be directed 

 toward the saving of the foot. First of all an effort must be made to 

 prevent suppuration ; and if the patient is seen at the beginning, cold 

 irrigation, recommended in the treatment for cutaneous quittor, is to 

 be resorted to. Later on, when the tumor is forming on the coronet, 

 , the knife must be used, and a free and deep incision made into the 

 swelling. Whenever openings appear from which pus escapes, they 

 should be carefully probed; in all instances these fistulous tracts lead 

 down to dead tissue which nattire is trying to remove by the process , 

 of sloughing. If a counter opening can be made, which will enable a 

 more ready escape of the pus, it should be done at once ; for instance, 

 if the probe shows that the discharge originates from the bottom of 

 the foot, the sole must be pared through over the seat of trouble. 

 Whenever suppuration has commenced the process is to be stimulated 

 by the use of warm baths and poultices. The pus which accumulates 

 in the deeper parts, especially along the tendons, around the joints, 

 and in the hoof, is to be removed by pressure and injections made 

 with a small syringe, repeated two or three times a day. As soon as 

 the discharge assimies a healthy character and diminishes in quantity, 

 stimulating solutions are to be injected into the open wounds. Where 

 the tendons, ligaments, and other deeper parts are affected, a strong 

 solution of carbolic acid — 1 to 4 — ^ghould be used at first. Or strong 

 solutions of tincture of iodine, sulphate of iron, sulphate of copper, 

 bichloride of mercury, etc., may be used in place of the carbolic ; after 

 which the remedies and dressings directed for use in simple quittor 

 are to be used. In those cases where the fistulous tracts refuse to 

 heal it is often necessary to burn them out with a saturated solution 

 of caustic soda, equal parts of muriatic acid and water; or, better 

 still, with a long, thin iron, heated white hot. 



But no matter what treatment is adopted, a large percentage of 

 the cases of tendinous quittor faU to make good recoveries. Where 

 the entij-e hoof sloughs away, the growth of a new, but soft and imper- 

 fect, hoof may be secured by carefully protecting the exposed tissues 

 with proper bandages. When the joints are opened by deep slough- 

 ing, recovery may eventually take place, but the joint remains immov- 

 able ever after. If caries of a small part of the coffin bone takes place, 

 it may be removed by an operation ; but if much of the bone is affected, 

 or if the navicular and coronet bones are involved in the carious proc- 

 ess, the only hope for a cure is in the amputation of the foot. This 

 operation is advisable only where the animal is valuable for breeding 

 purposes. In all other cases where there is no hope for recovery the 

 patient's suffering should be relieved by death. In tendinous quittor 

 much thickening of the coronary region, and sometimes of the ankle 



