Indigestion presents itself in one of two forms - either it is acute and attended with severe pain and suffering of short duration, or it assumes a less noticeable but lingering and chronic character.

To the horse-owner and stableman this form of the disease is better known by the terms "stomach staggers", "sleepy staggers", and "mad staggers" - expressions which, if not classical, serve at least to convey a good idea of the leading phenomena of the affection. They specially indicate the two forms of disturbance which the brain suffers as a consequence of acute stomach derangement, in the one case denoted by severe brain disturbance resulting in actual frenzy or madness, in the other by brain torpor or paralysis, with loss of consciousness and volition, and imperfect control over voluntary movement.

Causes

Acute indigestion is recognized by veterinarians as a result of the stomach being gorged or over-crammed with food. In this affection the organ becomes unduly enlarged or distended; its walls are consequently paralysed and incapable of contracting on their contents. The food, therefore, becomes stagnant, and instead of being digested and passed on in the ordinary way, remains to decompose and further distend the organ with gas. Such a condition is in the highest degree dangerous, and frequently ends in rupture and speedy death.

Stomach engorgement or paralysis almost invariably follows upon long fasting, and especially when, in addition, the victim is worn down by fatigue. In this state the stomach shares in the general depression and exhaustion, and suffers at the same time by any unreasonable demand that may be made on its powers. Horses are provoked by long fasting to eat to excess, and the mischief is considerably augmented by the imperfect chewing which the food at these times often undergoes.

Sleepy Staggers.

Fig. 98. - Sleepy Staggers.

The practice of allowing hungry horses an unmeasured quantity of cooked food is one not to be encouraged. Given in a small amount preliminary to the usual feed it is incapable of harm, but when supplied in large rations it not infrequently becomes a means of fatal engorgement of the stomach. This disease is also observed to follow when horses by accident gain access to certain kinds of grain, as wheat, barley, and maize.

Symptoms

It is impossible to say at the outset of an attack of stomach engorgement what particular group of symptoms will arise in the course of the disease. This will most likely depend on the degree of distension and the more or less complete state of paralysis to which the stomach is reduced. It may, however, be safely predicted that they will begin and end in manifestation of abdominal pain, or, from the first, disorder of the brain will appear, or the one may precede and ultimately give way to the other.

In instances of the first kind the patient ceases to feed and presents a dull heavy appearance. He is restless, moves from place to place, looks languidly round to the flank, essays to lie down, and resumes an upstanding posture without going to the ground. He paws with the fore-feet, and as the pain increases in severity exhibits an anxious expression of countenance. The body gradually enlarges as the result of fermentation going on in the stomach, and in the fits of pain he throws himself to the ground and rises again to repeat the same after varying intervals of temporary repose.

Should the disease continue, patchy sweats bedew the body, the movements become unsteady, the muscles of the limbs tremble, gas is belched up from the stomach, and in rare instances attempts at vomiting are observed, but the act is seldom accomplished save as to a little fluid matter.

Should the stomach recover its action, as it sometimes will after a free discharge of gas, these symptoms gradually subside, and nothing remains beyond the weakness resulting from the attack, which, with due care, soon passes away.

In the absence of relief rupture of the stomach and death may be apprehended.

In those cases where the brain becomes affected a different order of symptoms is developed, in some instances assuming the form of what is known as "sleepy staggers" (fig. 98), in others of "mad staggers". In the former the patient, after exhibiting signs of abdominal pain, becomes dull, heavy, and stupid. The head is carried low, the eyelids droop, the lips hang pendulous, and in this drowsy half-insensible condition the horse walks round and round the box with a slow, staggering gait in which the toes are trailed or barely lifted from the ground. After one or two turns the head is forcibly pressed against the wall or rested on the manger, and in this position he sinks into a profound sleep from which he is with difficulty awoke. On being roused the same rotary movements are repeated, and these again are followed by a deep sleep or coma as before.

Vision is much impaired and soon fails altogether, and consciousness gradually disappears. The breathing at this time is slow and attended with a stertor or snorting sound, and the pulse also is less frequent than normal. The bowels are invariably torpid, and little or no faeces are passed. Such as may be expelled are hard and usually covered with a glairy coating of mucus. The liver in these cases frequently gives evidence of disturbance in the high-coloured urine and yellowish discoloration of the membranes of the eyes, mouth, and nostrils.

Sooner or later in the course of the attack dulness or stupor may give place to uncontrollable excitement and delirium (mad staggers). In this condition the animal paws the ground violently and plunges madly about the box. Perspiration bedews the body, and the muscles are thrown into a tremulous agitation over the entire body. Efforts at vomiting may now appear, and a small amount of offensive, sour-smelling fluid escapes from the stomach. In the absence of relief, which is seldom capable of being afforded at this stage of the disease, repeated paroxysms or violent fits of frenzy end in exhaustion, which is frequently followed by rupture of the stomach and speedy death.

Treatment

The prospect of success in the treatment of stomach engorgement will depend in a great measure on the prompt recognition of the disease and speedy adoption of suitable curative measures.

The first and most important object is to unload the bowels and relieve the distended stomach. For this purpose a bold dose of physic is the most suitable means and should be administered at once. Food of every description must be withheld and water allowed in any amount.

Where the symptoms indicate abdominal pain a little aromatic spirit of ammonia, combined with tincture of opium and peppermint-water, may be given and repeated at intervals of two hours for two or three times. This may be supplemented by friction and fomentations to the belly. A few minutes' walking exercise at short intervals will prove beneficial, but the animal must not be hurried. The rectum should be emptied of excrement by means of the hand, after which enemas of salt and water may be thrown into the bowel every three or four hours. On the appearance of brain disturbance a little blood taken from the jugular vein will afford relief to the cerebral vessels, and arrest the progress of the disease as it affects the head.

Ice-bags to the poll, or a cold-water douche kept up for fifteen minutes at a time, will further assist. If the latter course be adopted, cold wet swabs should be applied to the head in the intervals between the douching.