Treatment. - In a simple case - and by 'simple' here we mean the case in which the injury is discovered early, and pus has not yet commenced to form - our first duties are to give the wound free drainage, and to maintain it in an aseptic condition. The first of these objects is to be arrived at by paring down the horn in a funnel-shaped fashion over the seat of the prick. It is, perhaps, even better to thin the horn down to the sensitive structures for some little distance round the injury. By this latter method pressure from inflammatory exudate is lessened, and the after-formation of pus, if unfortunate enough to occur, the more readily detected, and the less likely to spread upwards. The matter of asepsis may then be attended to.
When the puncture is sufficiently large to admit of it, the antiseptic dressing is best applied by means of the probe. This instrument is thinly wrapped with tow, or other absorbent material, so as to form a small swab. Dipped in a suitable solution (as, for example, Zinc Chloride, Spts. Hydrarg. Perchlor., Carbolic Acid, or any other that suggests itself), the swab is inserted into the prick, and the wound conveniently mopped clean. A further portion of the medicated tow is then pushed partially into the wound, and allowed to remain in position. The foot is subsequently wrapped in a clean bag, and kept free from dirt. This dressing should be repeated twice daily.
If the prick is in a dangerous position, and deep enough to occasion alarm, our precautions to prevent the formation of septic matters within it may be more elaborate. The thinning of the horn and the swabbing of the wound may, as before, be proceeded with. In addition, the whole foot may then be immersed for some hours daily in a cold bath, which bath should be strongly impregnated with one or other of the following salts: Iron Sulphate, Zinc Sulphate, Copper Sulphate, Aluminium Sulphate, Lead Acetate, or Sodium Chloride - better still, a mixture of the various sulphates here mentioned. If preferred, one of the more commonly accepted antiseptics - such as Carbolic Acid, Lysol, Boracic Acid, or Perchloride of Mercury - may be substituted.
By the cold of the bath inflammatory phenomena are held in check, while its added antiseptic prevents the formation of septic discharges. The lameness gradually diminishes, and resolution is rapid. In this way deep and serious, wounds are sometimes easily and successfully treated.
When suppuration has occurred - and this, by-the-by, is by far the most frequent condition in which we find punctured foot - treatment must be prompt and decided. Careful search must at once be made by thinning down the sole, and carefully trimming the frog. On no account should the veterinary attendant rest content with 'digging' in one place, and upon that basing a negative opinion as to the existence of pus. The paring should be carried on, until either pus or haemorrhage shows itself, in at least three positions - namely, at the most anterior portion of the sole, and in the sole at each side of the frog. In addition to this, the frog itself should be minutely examined for evidence of puncture, or for leaking of pus at the spot where the horn of the heels joins the skin.
In many of our cases, however, this careful search is not so necessary. The accompanying symptoms are so decided as to leave no doubt as to the condition of the case. In such instances paring may often be commenced over the exact position of suppuration as previously ascertained by percussion.
When met with, the track formed by the suppurative process should be followed up in whichever direction it has spread. This will often necessitate the removal of the greater part, if not the whole, of the horny sole.
Having given vent to the pus, and opened up the cavity made by its formation, the foot should be placed in a hot poultice or, preferably, in a hot antiseptic bath.[A]
[Footnote A: At the time of writing this, a certain amount of discussion is going on in our veterinary journals as to whether a hot or a cold bath is the one indicated. It is urged against the application of heat that it favours organismal growth and reproduction, and tends rather to induce the spread of the suppurative process than to overcome it. Those who hold this opinion urge in support of it that cold applications are inimical to the life of the pus organism. At the same time, it must be remembered that in just so far as cold inhibits the growth of the invading germ, so in just the same degree does it adversely influence the functions of the tissues that are to fight against it. To our minds the question thus set up must always remain more or less a moot-point, and while we fully agree that cold undoubtedly checks the growth of septic material, we just as fully believe that warmth serves to place the healthy surrounding structures in a far better condition to maintain a vigorous phagocytosis against it. We thus continue to advise a hot antiseptic poultice, or, better still, a bath. - The Author.]
At the end of the third or fourth day the poultice or the bath may be discontinued, and the opening in the sole dressed with any suitable astringent and antiseptic.
The most serious complication arising from this method of treatment is one of excessive granulation of the sensitive sole. This we find to be successfully held in check by a daily application of undiluted Spts. Hydrarg. Perchlor. (Tuson). Should the granulations become very exuberant, then the knife must be called to our aid, and the wound so made afterwards dressed with an astringent.
When the suppuration has under-run the horny frog there should be no hesitation in at once removing all the horn that is visibly separated from the sensitive structures beneath.
When the os pedis is splintered and carious, a portion of the sole round the wound is removed, and the bone exposed. The diseased portion is scraped away either with a curette or with the point of the drawing-knife. In this case the only after-treatment called for is the application of suitable antiseptic dressings.