182 DISEASES OF THE BLOOD 



rectum are also paralyzed. The skin posterior to the injury 

 is not sensitive to pin pricks. There is no hemoglobinuria. 



(c) Fractures of the pelvis and posterior limb bones may 

 sometimes simulate azoturia. This is also true of rupture of 

 the Achilles tendon. Only a careful examination of the 

 patient will determine these surgical conditions. The history 

 and absence of hemoglobinuria are indicative. 



(d) Thrombosis of the posterior aorta and its branches may 

 resemble azoturia in that the patient falls upon the roadway, 

 sweats, etc. However, the attack is of short duration (fifteen 

 minutes) when the horse gets up again. By driving it farther 

 an attack can be brought on as before. 



Prognosis. — Mild cases which do not "go down" as a rule 

 recover. In the lighter horses the prognosis seems more 

 favorable than in the heavier breeds. The greater the 

 severity of the attack and the darker the urine, generally 

 speaking, the graver the prognosis. When the patient has 

 not been properly nursed (frequently turned and deeply 

 bedded) decubital sores develop and lead to fatal septicemia. 

 Nephritis may cause death in a few cases. The mortality is 

 about 80 per cent. There are, however, great variations in 

 this regard. Some years the disease seems more severe than 

 others. Not a few cases recover from the azoturia but are 

 left lame in one or both hind limbs', due to a quadriceps 

 paralysis commonly called " azoturia drop." A rapid atrophy 

 of the affected muscles takes place from which the patient 

 usually recovers in three to twelve months. The crural 

 muscles or adductors may be similarly affected. 



Treatment. — There is no specific treatment. The use of 

 drugs is secondary to proper dietetics and hygiene. The 

 patient should be placed in a well-ventilated, clean, light stall 

 and be given plenty of bedding. It is advisable to bolster 

 the horse with straw bundles so that it lies on its sternum. 

 Every three or four hours, if the patient lies on its side, it 

 should be turned over. Where feasible use slings to raise the 

 horse up. Even if it cannot rest in the slings more than a 

 few minutes at a time, relief is afforded in that a better circu- 

 lation of the blood is induced and a change of the bedding 

 made possible. In the early stage when the patient is thrash- 



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