Treatment. - In very many cases, possibly on account of the decreased circulation and vitality of the parts, these growths occur in aged animals. Here treatment is not economic, and may for that reason be put out of the question. Further, the growths are more common in heavy cart animals of a lymphatic type than in those of a lighter breed. Couple this with the fact that the tumour is often unattended with pain, and we see that the animal is still able to perform his accustomed labour. Here, again, treatment is contra-indicated.

For still another reason surgical treatment, which is the only treatment likely to be of benefit, must not be undertaken rashly. A large and open wound is bound to be left behind. So large is it in many cases that the complete covering of the exposed surface with epidermal growths from the circumference cannot possibly be looked for. There is then left a large and horny-looking scar, which is an even worse eyesore than was the original enlargement.

When the patient is a young and otherwise valuable animal, however, and when the case, judged either by the size of the swelling or its outside appearance, promises a fair measure of success, operative measures may be determined on.

In this case the author's practice has been, after casting the animal, to apply a tourniquet to the limb and proceed to excision. A lozenge-shaped incision, extending to near but not quite the circumference of the swelling, should be made with a large knife right through the skin and deeply into the growth. The whole is then removed, proceeding in an excavating manner under the thickened skin at the margin. Haemorrhage, though proceeding from several apparently large vessels in the structure of the tumour, and oozing generally over the whole of the outer surface, is rarely profuse enough to interfere with the operation, and is easily controlled by cold water douches and the application of the artery forceps to one or more of the larger vessels. The operation completed, the larger bleeding-points should be secured by exerting torsion with the artery forceps, and the surface oozing stayed by frequent dashing with cold water.

When the haemorrhage has sufficiently ceased, an ordinary flat firing-iron should be passed over the whole of the cut surface, and an effectual eschar formed.

Following this, and before removing the tourniquet, the wound should be filled with pledgets of carbolized tow, and the whole tightly secured by a stout and broad linen bandage of not less than 6 yards in length.

Reported Case. - 'The patient, a middle-aged cart mare, had a pair of fore-feet the like of which I never saw. As the result of long-standing and imperfectly-treated quittor all over the seat of side-bone on the outer side of each fore-foot, beginning pretty far forward, and extending to the heel on the inner side, filling up the hollow and reaching nearly to the fetlock, was a big, bulging, hard, calloused enlargement or tumour standing out 3 or 4 inches all round, covered with thick horny skin and stubby hair, and having on its surface the small openings of several sinuses leading deeply down to the ossified and diseased cartilage underneath. And yet with all this diseased undergrowth the mare, strangely enough, walked and trotted sound. I was told that this mare had been troubled with suppurating corns and quittor, that many unsuccessful attempts had been made at cure, but that, getting worse instead of better, these tumours had formed.

'After casting and anaesthetizing, a strong rubber tourniquet was placed above the knee and the operation commenced. With a surgeon's amputating knife all the big fibrous mass which I could safely remove was cut and sliced off, and the coronet and pastern reduced as nearly as possible to its natural dimensions. The diseased cartilage, or side-bone, gave some trouble, a considerable portion having to be cut and scraped, and the sinus in it gouged out; but its complete removal did not appear to be called for.

'There was little if any haemorrhage until release of the tourniquet, when the whole broad surface became deluged with blood, three or four small arteries spurting and veins flowing in all directions, so much so that I was glad to refix the clasp, and with the firing-iron seal up the vessels, searing gently all over the surface.

Fig. 113.   Chronic Coronitis Following 'Tread

Fig. 113. - Chronic Coronitis Following 'Tread.'

'A good dusting with antiseptic powder, a thick pad of carbolized wool, and two long calico bandages wound tightly round, completed the work.

'The other, the near-leg, was then dealt with in the same way.

'The mass removed weighed a little over 9-1/2 pounds - 5 pounds from the off-foot and 4-1/2 pounds from the near. Its structure was fibrous tissue, almost as firm and hard as cartilage, and with no appearance of malignancy.

'The after-treatment consisted simply of fresh dry dressings - copper, sulphate, zinc sulphate, and calamine, equal parts - applied every third or fourth day, after first bathing the feet in a shallow tub of warm antiseptic water.

'At the end of eight or ten weeks a fairly presentable appearance existed. The greater part of what had been raw surface was covered with healthy skin, and the remainder had become dry and horny.'[A]

[Footnote A: Veterinary Record, vol. xiv., p. 201 (C. Cunningham, M.R.C.V.S.).]

A further form of chronic coronitis is that shown in Fig. 113.

This condition is commonly the result of a severe and jagged tread with the calkin, and takes the form of an ulcerous and excessively granulating wound. As time goes on the granulations become hard and horny-looking, and their fibrous tissue as hard and unyielding as tendon or cartilage.

These if treated in the early stages with repeated dressings of caustic, or, if very exuberant, the use of the knife, usually yield to treatment. If neglected until the condition depicted in the figure is arrived at, then treatment, as a rule, is of no avail. Neither is treatment of any use if any great loss of the coronary cushion has occurred.