Piles.—The dog is very subject to these annoyances in all their various forms; for the posterior intestine of the animal seems to be peculiarly susceptible of disease. When enteritis exists the rectum never escapes, but is very frequently the seat of the most virulent malice of the disorder. There are reasons why such should be the case. The dog has but a small apology for what should be a cÆcum, and the colon I assume to be entirely wanting. The guts, which in the horse are largest, in the canine species are not characterised by any difference of bulk; and however compact may be the food on which the dog subsists, nevertheless a proportionate quantity of its substance must be voided. If the excrement be less than in beasts of herbivorous natures, yet there being but one small receptacle in which it can be retained, the effects upon that receptacle are more concentrated, and the consequences therefore are very much more violent. The dung of the horse and ox is naturally moist, and only during disease is it ever in a contrary condition. Costiveness is nearly always in some degree present in the dog. During health the animal's bowels are never relaxed; but the violent straining it habitually employs to expel its fÆces would alone suggest the injury to which the rectum is exposed, even if the inclination to swallow substances which in their passage are likely to cause excoriation did not exist. The grit, dirt, bone, and filth that dogs will, spite of every precaution, manage to obtain, must be frequent sources of piles, which without such instigation would frequently appear. Bones, which people carelessly conclude the dog should consume, it can in some measure digest; but it can do this only partially when in vigorous health. Should the body be delicate, such substances pass through it hardly affected by the powers of assimilation; they become sharp and hard projections when surrounded by, and fixed in the firm mass, which is characteristic of the excrement of the dog. A pointed piece of bone, projecting from an almost solid body, is nearly certain to lacerate the tender and soft membrane over which it would have to be propelled; and though, as I have said, strong and vigorous dogs can eat almost with impunity, and extract considerable nourishment from bones, nevertheless they do not constitute a proper food for these animals at any time. When the system is debilitated, the digestion is always feeble; and, under some conditions of disease, I have taken from the stomachs of dogs after death, in an unaltered state, meat, which had been swallowed two days prior to death. It had been eaten and had been retained for at least forty-eight hours, but all the functions had been paralyzed, and it continued unchanged. If such a thing be possible under any circumstances, then in the fact there is sufficient reason why people should be more cautious in the mode of feeding these creatures; for I have extracted from the rectums of dogs large quantities of trash, such as hardened masses of comminuted bones and of cocoanut, which, because the animal would eat it, the owners thought it to be incapable of doing harm. Nature has not fitted the dog to thrive upon many substances; certain vegetables afford it wholesome nourishment, but a large share of that which is either wantonly or ignorantly given as food, is neither nutritive nor harmless. Whatever injures the digestion, from the disposition of the rectum to sympathise in all disorders of the great mucous track, is likely to induce piles; and the anus of the animal is often as indicative of the general state of the body as is the tongue of man.

In perfect health the anus should be small, firm, close, and entirely retracted; especially should it be cleanly. Any soil upon the part, or any excrement adhering to the hair about its margin, is indicative of derangement. If the fundament protrudes, so that it can be grasped by the finger and thumb, or if it presents a sensible projection to the touch, the digestion is not sound. The indication is still worse when the orifice is enlarged—the edges not being inflamed, which indeed they seldom are, but swollen, loose, coarse, creased, and unsightly. This state will not continue long before cracks and ulcers may be detected upon the borders of the opening, which ultimately is constantly moistened by an unctuous and peculiarly fetid discharge. If the lips of the orifice be gently pulled aside, the more inward portion of the membrane will frequently be seen of a bright scarlet color, and wet with a watery fluid, but the anus is rarely of so deep a tint, the hue being, even in aggravated cases, only a pale reddish brown.

To correct this state of disease, the first thing to be attended to is the food. The diet must be strictly regulated; it should not be too much reduced either in quantity or quality, for dogs in this state are generally old, and always weakly. Enough of good food should be allowed, but nothing more ought to be given. Meat, lean, and from a healthy animal, as constituting the lightest and most nourishing diet, will here be best, and from two ounces to two pounds may be divided into four meals, and given in the course of the day. Plenty of exercise and a daily cold bath will likewise be beneficial.

Medicine must be employed for two purposes; the first, to alleviate the pain and act locally on the disease; and the second, to amend the general health, checking the constitutional disposition to be affected. As a local application, Mr. Blaine recommends an ointment; which I object to, because I have found it aggravate the suffering without conferring any compensating benefit. Astringents, such as the acetate of lead, are not curative; but the following ointment has done so much good in these cases that I can most confidently submit it to the public:—

The only addition I make to the above is occasionally a drachm of powdered opium. This is smeared over the exterior of, and also inserted up, the rectum, thrice in the day. A piece of wood nicely rounded, or a penholder if the animal be small, answers very well to introduce the salve into the gut; and of course it should be done with every consideration, for the pain it will at first produce. The resistance is often strong, and the cries violent; for in some cases the rectum is so sensitive that the mere lifting of the tail cannot be silently endured. The poor dog seems in constant agony; for I have known the exclamations to be provoked by simply looking at the part, and the animal evidently shrieked from the idea of it being touched. All possible tenderness, therefore, is required; and the dog should be very firmly held, to prevent its contortions from adding to its anguish. When the ointment is regularly and properly employed, the relief is generally speedy; and after the third day the dog, which had been so energetically resistful, often submits to be dressed without a murmur. The cessation of the howling will indicate the progress of the cure, but the application should be used for some days after the animal becomes silent. If much stench is present, the fundament may be at each dressing moistened with very dilute solution of the chloride of zinc, and a small quantity may be administered as an injection, after the grease has been introduced.

The constitutional remedies must be regulated by the symptoms, and nothing absolute can be said on this subject; but in the great majority of instances tonics will be required. Purgatives are not often needed, but a day's feed of liver once or twice a week will do no harm. Should it not have the desired effect, a little olive oil may be given; but nothing stronger ought to be risked, and above all, no preparation of mercury—which, in the dog, specially acts upon the rectum—ought on any account to be permitted.

Piles, if not attended to, become causes of further disease, which may in some cases prove fatal, though in the larger number of instances they are far more distressing than dangerous.

A sero-sanguineous abscess, that is, a tumor consisting of a single sac or numerous small bladders, containing a thin and bloody fluid, is by no means a rare accompaniment of long-continued piles. These mostly appear rather to one side of, and more below than above, the opening, the verge of which they always involve. They occasion little pain, and often grow to a comparatively enormous size; when they may burst and leave a ragged ulcer, which has little disposition to heal, and is not improved by the dog's drawing it along the ground.

When these are observed, the knife should not be too quickly resorted to. The abscess should be allowed to progress until it is fully matured, the dog being in the meantime treated for simple piles. When the tumor perceptibly fluctuates, it should be freely opened, the incision being made along its entire length. This is best done with one of Liston's knives, which should be thrust fairly through the swelling, entering at the top and coming out at the lowest part, when with one movement of the wrist the substance is divided. The operation thus performed is much quicker, less painful, and more safe than it can possibly be rendered if the tumor be punctured and slit up with repeated thrusts of an ordinary lancet. I have frequently opened these sacs without the animal uttering even a moan, and mercy is wisdom where surgery is employed. Dogs will not bear torture, and soon become blindly infuriated if subjected to pain. The animal is naturally so sensitive and excitable that the brutality or suffering a horse can sustain, these animals would perish under. He, therefore, who undertakes to treat the diseases of the canine race, if the amiable qualities of the brute or his own feelings have no influence, will in the success of his practice discover ample reason for the exercise of a little humanity.

After the sac is opened a portion of lint should be used, to render the part perfectly dry, which may then be lightly pencilled over with lunar caustic, or moistened with some caustic solution. Fomentations of warm water to keep the wound free from dirt, and with no other object, are all that subsequently will be required.

Tumors of a solid nature also form about the anus, and are likewise consequent upon neglected piles. These generally appear at the root of the tail superior to the opening. They feel hard; are glistening; not very tender; but highly vascular, and in some cases pulsate strongly. The dog is generally loaded with fat, perhaps slightly mangy; nearly always old, gross and weak. The quantity of blood that at various intervals is lost from this tumor, which at length ulcerates and bleeds at the slightest touch, or without any apparent cause, is often very great; but it does not, save in the very latest stage, induce obvious emaciation. The health is not good, of course, but to the casual observer the disease does not appear to affect the system. The spirits under excitement are, to all appearances, undiminished, and the appetite is in these cases ravenous. If, however, the dog had to do work, the truth would be soon discovered. After a short space the strength would fail, and no correction could keep the poor animal to its duty.

The treatment must commence with constitutional remedies, if the state of the part permits of the requisite delay. The digestion should be amended, and the piles, which are certain to be present, attended to. After a fortnight, more or less, has been devoted to such measures, a strong ligature should be tied as tight up as possible around the base of the growth, and a fresh one should be applied every second day. There must be no forbearance in the application of the ligature, but the degree of tension must be regulated only by the strength of the operator. This is far more severe than the removal would be if the knife were employed, but I have not seen a case which I dared venture to excise. I do not like the ligature; it is long and torturing in its action; but here there will be no chance, for the vessels are too numerous and large to admit of the speedier process being resorted to. Where it is possible, it is well, however, to cut through the skin before applying the cord; for the operation is expedited considerably, and an important deduction made from the animal's agony.

When the tumor drops off, the surface may be sprinkled thrice a day with the following powder:—

Or a little of the ointment recommended for piles may be smeared upon the wound in lieu of the above. An unguent is perhaps to be preferred, as giving better protection to the sore, over which the fÆces must pass, and also as being more grateful to the feelings of the patient. Powder and ointment may be changed and varied according to the judgment of the attendant: thus, to render the last more stimulating, I mix creosote with it occasionally; or to give it an astringent property I add a portion of galls, catechu, or kino; but these I never pass into the rectum. Astringents introduced upon the sore and ulcerated surface of the intestine of course render it harsh, dry, and corrugated; and as during the exercise of its function the part is necessarily dilated, the animal is, by the pain produced from the stretching of the constringed membrane, indisposed for the performance of that act, on the regular discharge of which its health in no little measure depends. Astringents, moreover, heat and irritate the part; and the sensations induced make the dog draw its anus along the ground, thereby adding greatly to the evil it is the intention of the application to remove. Therefore prudence will approve what humanity suggests; and those who in kindly feeling can discover no motive, will in the colder reason find every inducement for the adoption of the gentler measure.

Protrusion of the rectum is also sometimes a consequence of gross feeding, starting up piles in the first instance, and then, from more intense digestive derangement, causing purgation, accompanied with violent straining. The tone of the intestine is destroyed. It becomes lax, and its muscular power is lost. The gut is at first only a little exposed during the act, and when that is over, it is retracted; but after some time, the limit of which is uncertain, it remains constantly protruded. It is not so violently inflamed as might be expected, but it soon gets dry and harsh; cracks appear upon its surface; and the pressure of the muscle which closes the anus preventing the free circulation of the blood, renders it black from congestion.

If taken early, the treatment recommended for piles will generally effect a cure; but if nothing be done in the first instance, the disease when established is apt to prove intractable. The intestine should be sopped with cold water until every particle of dirt is removed. It should then be dried with a soft cloth, and afterwards returned. There is never much difficulty in replacing the gut; but there is always considerable difficulty to get it to be retained. So soon as it is restored to its situation, a human stomach pump should be inserted up the rectum, and a full stream of the coldest spring water should be thrown into the bowel for ten minutes. The fluid will be returned so fast as it enters, and it must be allowed to do so, the fingers of one hand being employed against the anus to prevent the disordered rectum being ejected with the water. Cold injection in less quantity must be administered several times during the day, and with each a little of the tincture of galls, or of nux vomica, in the proportion of a drachm to a pint, may be united. The ointment recommended for piles may also be employed, but without opium, for no application of a sedative nature must be used. The constitutional measures will consist of tonics into which nux vomica enters. The food must be light and nourishing, and purgatives on no account must be administered. Cold will do good by invigorating the system, and should always be recommended. Some persons, unable by sedatives and purgatives, which are injurious, to obtain relief, have gone so far as to cut off the projecting bowel, and they have thereby certainly ended the case; for the dog dies whenever this is done. I remember at the Veterinary College, Professor Simonds killed a fine animal by attempting this operation; for he took a heated spatula to remove the part, and carried the incision so high up that he opened the abdomen, and the bowels protruded from the anus. Amputation of any portion of the rectum is not to be thought of; but an operation of a less heroic description will sometimes accomplish what the previous measures failed to effect. With a knife, having not too sharp but a coarse edge, a circular portion of the exposed lining membrane, of a width proportioned to the size of the animal, may be scraped off, so as to induce a cicatrix; or, if the dog be very tractable, and the operator skilful, a piece of it may partially be dissected off; but the knife, when employed in the last method, is apt to cause alarming hemorrhage. When this is done, as the wound heals the edges come together, and the gut is so far shortened as to be thereby retracted. There is, however, some danger of stricture being afterwards established; wherefore this operation, however satisfactory it may seem to be in the first instance, is not so certain in the benefit of its results that it should be resorted to, save in extreme cases when every other means have failed, and the choice at last hangs between relief and destruction.

Another affection of the part, to which Scotch terriers of great size are particularly subject, begins with an enlargement below the anus, extending either quite or almost to the testicles; for males are more frequently attacked by this form of disease than females. The dog is generally old, and a favorite with an indulgent mistress, having much to eat, and little or no work to do. The swelling is soft and attended with no pain. On pressure and on percussion it is ascertained to hold fluid, and in fact it arises from dropsy of the perinÆum. The health may appear to be good, but on examination debility will be found to be present. The anus also protrudes, and the orifice is thickened; while, possibly, a marked tendency to piles may at the same time be displayed. Should no attention be paid to the case, the swelling will continue without sensibly enlarging; but after a period, hard substances may with the fingers be detected beneath it. These hard bodies are fÆces, which accumulate within the rectum, and often in so great a quantity as to seriously inconvenience the animal, rendering it dull and indisposed to feed.

Before attempting to direct the treatment for these cases, it is necessary the nature of the affection should be fully explained. The enlargement, to which attention is at first solely directed, is always of secondary consideration. The dropsy is merely a symptom indicative of the loss of tone of the adjacent parts, of which the rectum is by far the most important. If this circumstance be not observed, but the swelling be treated as if it was all the practitioner had to contend with, he will in the end learn his mistake. The intestine loses its tonicity; it no longer has power to contract upon or to expel its contents; it becomes paralysed, and the dung consequently accumulates within it, distending it, and adding to its weakness by constant tension. The rectum at length retains no ability to perform its function; but the sphincter of the anus, or the circular muscle that closes the opening, appears to gain the strength of which the intestine is deprived. It contracts, and thus shuts up the fÆces which the rectum cannot make an effort to dislodge; and in this circumstance the physiologist sees evidence of the sources whence the different parts derive their contractility. The rectum, like the other intestines, gains its vital power from the sympathetic nerve, or that nerve of nutrition and secretion which presides over organic life. The muscle of the anus, on the other hand, is influenced by nerves derived from the spinal column; and thus, understanding the two parts obtain their motor power from different sources, the reader will comprehend how one can be incapable of motion while the other is unaffected, or rather excited; for the presence of the retained dung acts as an irritant, and provokes the anus to contract with more than usual vigor.

If nothing be done to restore the balance of power, the rectum speedily is so much distended that its walls become attenuated, and then a cure is hopeless; a sac is formed, and the gut is not only much stretched or enlarged, but it is also, by the excessive bulk of its contents, forced from its natural position, being carried either to one side or the other, but always to where the dropsy is most conspicuous.

In such cases, when the dropsy is first observed, our care must be to invigorate the system. Small doses of nux vomica, with iron, gentian and capsicums, made into a pill, will generally do this, and the following form may be employed:—

Make into twenty pills, and give four in the course of the day. The liver is too often at this time unhealthy, and to correct it the subjoined may be administered:—

Dose, from a tea-spoon to a table-spoonful three times a day. The food should be chiefly vegetables, or at all events only so much meat should be allowed as is required to induce the dog to eat the mess of boiled rice. Exercise is also essential, and a daily cold bath with a brisk run afterwards, will be of service. The dog will likewise be benefited if his skin be well brushed every morning; and perhaps it is hardly necessary to state that any symptoms denoting mange or skin disease, canker, &c., should be specially counteracted.

Hitherto, however, nothing has been said about any treatment of the part which is the immediate seat of the disease. If the fluid poured into the perinÆum be excessive, the part must be laid freely open by two or three incisions being made along the entire length of the swelling. After this has been done, the liquid will not escape as from an abscess; for being held within the cells of the membrane that lies immediately under the skin, comparatively little of it is released from the knife. A fine pair of scissors will be required to snip the separate bags or bladders; but that operation must be performed with caution, else injury may possibly be done. The business being concluded, let the parts be afterwards dressed with the tincture of iodine, or a tincture of the iodide of potassium, of the strength of a drachm to the ounce of proof spirit; this being preferable to water for a solution in these cases. Into the rectum also injections should be thrown at least three times a day, and all of these ought to be of a tonic and stimulating kind, being used perfectly cold. Either of the following may be administered:—

Any of the above may be employed, from a tablespoonful to a common wine-glass full being used for a dose. The pile ointment will likewise be beneficial, by facilitating the passage of the fÆces, allaying local irritability, and correcting that tendency to piles which is generally attendant upon, if not the original cause of the affection.

From what has been described, the reader will have seen that the diseases of the dog's rectum are neither few nor insignificant. Fistula in ano is said to be often beheld; but I have never seen a case in which it assumed in the dog that serious form which characterises it in man. In the canine race I have mostly let it alone, and hitherto I have had no reason to repent my forbearance. Blaine and Youatt both speak of the affection, and give directions for its treatment by operation. The most active remedy I have found it necessary to resort to has been an astringent or mildly caustic injection; the solution of the chloride of zinc I prefer to every other, but the sulphates are also not to be despised. Injections, when not designed to be immediately operative, or meant to distend the gut and to act through being ejected, are best given by means of the India-rubber bladder, which allows the fluid to be more gently and silently thrown up. The less noise or force attending the operation the less likely is the animal to be alarmed or excited, and the probability is the enema will be retained. Small quantities are to be administered when the fluid is wished to remain; and by attracting the attention of the dog at the time, and amusing him after the business is finished, the object in view is considerably favored. The administration of an injection is in the first instance almost certain to alarm the animal, who can neither understand nor passively sanction the strange liberty the operation implies. A little soothing, however, will restore his confidence, and he who has gained the trust of a dog, may subsequently do as he pleases with the body of the generous and confiding beast.