HEPATITIS.

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CHRONIC HEPATITIS. CHRONIC HEPATITIS.

Liver complaints were once fashionable. A few years ago the mind of Great Britain was in distress about its bile, and blue pill with black draught literally became a part of the national diet. At present nervous and urinary diseases appear to be in vogue; but, with dogs, hepatic disorders are as prevalent as ever. The canine liver is peculiarly susceptible to disease. Very seldom have I dipped into the mysteries of their bodies but I have found the biliary gland of these animals deranged; sometimes inflamed—sometimes in an opposite condition—often enlarged—seldom diminished—rarely of uniform color—occasionally tuberculated—and not unfrequently as fat with disease as those are which have obtained for Strasburg geese a morbid celebrity.

It is, however, somewhat strange that, notwithstanding the almost universality of liver disease among petted dogs, the symptoms which denote its existence are in these creatures so obscure and undefined as rarely to be recognised. Very few dogs have healthy livers, and yet seldom is the disordered condition of this important gland suspected. Various are the causes which different authors, English and foreign, have asserted produced this effect. I shall only allude to such as I can on my own experience corroborate, and here I shall have but little to refer to. Over-feeding and excessive indulgence are the sources to which I have always traced it. In the half-starved or well-worked dog I have seen the liver involved; but have never beheld it in such a state as led me to conclude it was the principal or original seat of the affection which ended in death. On the other hand, in fatted and petted animals, I have seen the gland in a condition that warranted no doubt as to what part the fatal attack had commenced in.

When death has been the consequence of hepatic disorder, the symptoms have in every instance been chronic. I am not aware that I have been called upon to treat a case of an acute description, excepting as a phase of distemper. It would be too much to say such a form of disease does not exist in a carnivorous animal; but I have hitherto not met with it. Neither have I seen it as the effect of inveterate mange; though I have beheld obstinate skin disease the common, but far from invariable, result of chronic hepatitis. I have also known cerebral symptoms to be produced by the derangement of this gland, which, in the dog, may be the cause of almost any possible symptom, and still give so little indication of its actual condition as almost to set our reason at defiance.

When the animal is fat, the visible mucous membranes may be pallid; the tongue white; the pulse full and quick; the spirits slothful: the appetite good; the foeces natural: the bowels irregular; the breath offensive; the anus enlarged, and the rump denuded of hair, the naked skin being covered with a scaly cuticle, thickened and partially insensible.

When the animal is thin, almost all of the foregoing signs may be wanting. The dog may be only emaciated—a living skeleton, with an enlarged belly. It is dull, and has a sleepy look when undisturbed; but when its attention is attracted, the expression of its countenance is half vacant and half wild. The pupil of the eye is dilated, and the visual organs stare as though the power of recognition were enfeebled. The appetite is good and the manner gentle. The tongue is white, and occasionally reddish towards the circumference. The membranes of the eye are very pale, but not yellow. The lining of the mouth is of a faint dull tint, and often it feels cold to the touch. The coat looks not positively bad; but rather like a skin which had been well dressed by a furrier, than one which was still upon a living body.

The history in these cases invariably informs us that the animal has been fat—very fat—about six or twelve months ago. It fell away all at once, though no change was made in the diet; and yet we learn it has been physicked. No restraint has been put upon buckthorn, castor oil, aloes, sulphur, and antimony, but yet the belly will not go down—it keeps getting bigger; and now we are told the animal has a dropsy which "wants to be cured." It is natural the figure and condition should suggest the idea of ascites; but the hair does not pull out—none of the legs are swollen—the shape of the abdomen wants the appearance of gravitation, and if the patient be placed upon its back the form of the rotundity is not altered by the position of the body. Moreover, the breathing is tolerably easy: and, though if one hand be placed against the side of the belly, and the part opposite be struck with the other, there will be a marked sense of fluctuation; still we cannot accept so dubious a test against the mass of evidence that declares dropsy is not the name of the disease. To make sure, we feel the abdomen near to the line of the false ribs. This gives no pain, so we press a little hard, and in two or three places on either side, on the right, or may be the left, high up or low down; for in abnormal growths there can be no rule—in two or three places we can detect hard, solid, but smooth lumps within the cavity. This last discovery leaves no room for further doubt, so we pronounce the liver to be the organ that is principally affected. In chronic cases, especially after the dog has begun to waste, enlargement nearly always may be felt, not invariably hard, yet often so, but never soft or so soft as the other parts; and this proof should, therefore, in every instance of the kind be sought for.

With regard to treatment, the food must not be suddenly reduced to the starvation point. Whether the dog be fat or lean, let the quality be nutritious, and the quantity sufficient; from a quarter of a pound to a pound and a half of paunch, divided into four meals, will be enough for a single day; but nothing more than this must be given. Tonics, to strengthen the system generally, should be employed; and an occasional dose of the cathartic pills administered, providing the condition is such as justifies the use of purgatives. Frequent small blisters, applied over the region of the liver, may do good; but they should not be larger than two or four inches across, and they should be repeated one every three or four days. Leeches put upon the places where hardness can be felt, also are beneficial; but depletion must be regulated by the ability of the animal to sustain it. A long course of iodide of potassium in solution, combined with the liquor potassÆ, will, however, constitute the principal dependence.

Iodide of potassium Two drachms two scruples.
Liquor potassÆ One ounce and a half.
Simple syrup Six ounces.
Water Twelve ounces and a half.

Give from half a teaspoonful to a teaspoonful three times a day.

The above must be persevered in for a couple of months before any effect can be anticipated. Mercury I have not found of any service, though Blaine speaks highly of it, and Youatt quotes his opinion. Perhaps I have not employed it rightly, or ventured to push it far enough.

Under the treatment recommended, the dog may be preserved from speedy death; but the structures have been so much changed that medicine cannot be expected to restore them. The pet may be saved to its indulgent mistress, and again perhaps exhibit all the charms for which it was ever prized; but the sporting-dog will never be made capable of doing work, and certainly it is not to be selected to breed from after it has sustained an attack of hepatitis.

Sometimes, during the existence of hepatitis, the animal will be seized with fits of pain, which appear to render it frantic. These I always attribute to the passage of gall stones, which I have taken in comparative large quantities from the gall-bladders of dogs. The cries and struggles create alarm, but the attack is seldom fatal. A brisk purgative, a warm bath, and free use of laudanum and ether, afford relief; for when the animal dies of chronic hepatitis, it perishes gradually from utter exhaustion.

The post-mortem examination generally presents that which much surprises the proprietor; one lobe of the gland is very greatly enlarged; it evidently contains fluid. It has under disease become a vast cyst, from which, in a setter, I have actually extracted more than two gallons of serum: from a small spaniel I have taken this organ so increased in size that it positively weighed one half the amount of the body from which it was removed. The wonder is that the apparently weak covering to the liver could bear so great a pressure without bursting.


                                                                                                                                                                                                                                                                                                           

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