NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
BOVINE NASAL GRANULOMA.
BY
MAJOR G. E. OXSPRING, R.A.V.C.,
Jubbulpore, India.
(Reprinted from the Journal of the Royal Army Veterinary Corps, Volume 2, No. 4, August, 1931.)
This condition will bo to many of academical interest only, but to officers
serving in India, whose duties may include the Veterinary charge of a Government
Military Dairy Farm, it may, at any time, become of practical importance. This
experience was encountered in Jubbulpore last year, and the greater part of the
hot weather was devoted to dealing with it.
The disease does not appear to be mentioned in English or Continental liter-
ature, apart from two articles published by the Imperial Institute of Agricultural
Research, Pusa, by V. Krishnamurti Ayyar, I.V.S., and the late Rai Sahib P. N. Das,
I.V.S., respectively.
The scene of the outbreak in question was the Government Military Dairy
Farm, Jubbulpore, C. P., India. At the time, the herd consisted of roughly 95
cows of various breeds, 5 bulls, 51 young stock, 135 buffaloes and 41 bullocks.
The first cases of Bovine Nasal Granuloma were observed by the writer in
January, 1930, when seven cases of nasal growths were reported. Two of these
animals were admitted to hospital, with a view to attempting to discover the
nature of the disease, and also some form of treatment. At this time it appeared
to be confined to a very few animals, but in April the disease had attained con-
siderable proportions, no less than 45 cows being affected. The transport bullocks
contracted the disease later.
There is no doubt that these animals were all affected sometime previous to
this, but the lesions were minute and no clinical symptoms had developed. Had
we then possessed the experience afterwards gained, I am confident, it would have
been recognizable in most of the cattle in January. However, in April, the symp-
toms had become alarming, the animals were losing condition, the milk supply was
rapidly diminishing, all were having difficulty in breathing, and some almost
to the stage of asphyxiation. The snoring noise of affected animals could be
heard some distance from the sheds.
The disease has been reported in various parts of India by the authors pre-
viously mentioned, but as far as the present outbreak is concerned, inquiries over
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BOVINE NASAL GRANULOMA
333
several months failed to discover any cases in the district which were not either
directly connected with this farm, or had originated from it.
Lesions.— In the early stages, the lesions appear as small, hard nodules about
the size of a pin's head. They are localized on the nasal mucous membrane, and
limited to the anterior nares. Although the lesions are found on any part of this
region, the septum nasi is probably the most common site. As the disease pro-
gresses, the growths give the appearance of masses of granulation tissue, which
is a collection of small nodules, each with a pus centre. These granulations, in
some cases, attain the size of a small hen's egg, and when several of them are
present, the nasal fossæ become almost entirely obliterated.
The growths are a yellowish red colour, very soft, and break down with the
slightest manipulation, which is accompanied by considerable hæmorrhage.
A muco-purulent nasal discharge is always present in the later stages of the
disease. This doubtless arises from the pus centres of the innumerable nodules,
of which the granulations are made up.
It is very probable, although not yet experimentally proved, that this nasal
discharge is the vehicle of infection.
The experience here was that two months is about the time taken for the small,
but macroscopically recognizable, nodules to develop into granulations which
might be described as mature, for at this stage they begin to break down, leaving
a raw bleeding surface, on which further granulations accumulate.
In a few post-mortem examinations which we had the opportunity of making,
the lesions did not spread beyond the middle third of the nasal fossa. The mucosa
in recovered cases was considerably thickened.
Etiology. —Lack of facilities, and also pressure of work in other directions,
made it difficult to make a satisfactory investigation into the cause of this disease.
The collaboration of Mr. Hugh Cooper, M.R.C.V.S., Veterinary Research Officer,
Imperial Institute of Veterinary Research, Muktesar, was obtained, who visited
Jubbulpore during the outbreak, with a view to studying this aspect of the subject.
He prepared statistics, and made helpful suggestions, many of which are in-
corporated in this article.
It is hoped that work on the causation will be continued, as material becomes
available, but lack of it for the time being has brought investigations to a stand-
still.
As far as it is possible to say at present, an organism of the streptothrix group,
very similar to streptothrix actinomyces, can always be found in the lesions, and
is probably responsible for the disease.
334 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ I, IV
That it is not identical with the Ray Fungus of actinomycosis bovis is quite
definite from the symptoms, for lesions of the tongue, jaw or lips are never seen.
Moreover, the effect of iodine in the European condition is quite negative in
nasal granuloma.
The mode of infection of this condition is obscure. Attempts to pass the
disease from one animal to another, by direct transmission of material from the
lesions, always failed. A similar result was obtained by Rai Sahib P. N. Das,
I.V.S., in an interesting series of experiments, published by the Agricultural
Research Institute, Pusa, in 1929.
It is a fact, however, that in the outbreak under review, the cattle in one
shed rapidly becoming infected, and not until three months later did the disease
break out amongst the bullocks, which are housed some distance away. These
animals all became affected about the same time. The food supplied to them was
from the same source as that fed to the cattle.
It has been suggested that the nose strings used in bullocks in India might
be the cause, but the experience here where most of the cases were in dairy cattle,
which do not have nose strings, rules that out entirely.
It appears to be probable that the casual agent is passed on by infected
fodder, on which it may lead a saprophytic existence.
Animals affected.-A point of interest noted during this outbreak was the fact
that no case occurred amongst the buffaloes, although these animals constituted
about 50 per cent. of the total herd, and were fed and watered under the same
condition, whilst over 60 per cent. of the mature cattle suffered.
It appears to be a disease of mature animals, as no cases were seen in calves.
The youngest animal affected was nearly two years of age, from this age onwards
the infection was heavy.
One country-bred bull contracted the disease, but two Frisian bulls on the
farm escaped ; the latter were possibly kept under more pampered conditions, and
were more isolated from the remainder of the herd.
Period of Incubation.—Although at present no definite period of incubation
can be given, it does appear to be fairly certain that it is at least one year before
recognizable lesions can be detected. This assumption is based on the fact that
all affected animals had been on the farm over one year, and no cases were seen
in cattle which had arrived within that time.
When once small nodules are present, it appears to take about two months
for them to become mature granulations.
BOVINE NASAL GRANULOMA
335
Treatment.—At the commencement of the outbreak, local treatment, including
oxcision, was tried but the lesions rapidly recurred. It was soon realised that no
benefit was to be obtained in this direction.
Potassium iodide had been administered to the cattle for some time, in spite of
which the disease progressed. It was also found that massive doses did not alter
the course. It was decided to try the treatment recommended by Rai Sahib
P. N. Das, viz., intravenous injections of tartar emetic. This method, although
very successful in a number of cases, appeared to have also had a good many
failures up to date, and some workers went so far as to say it was useless.
The results obtained, however, in the outbreak under consideration, where the
treatment was persevered with, leaves little doubt in the mind of the writer as to
its specific nature, provided the drug is given in the doses and manner mentioned
below.
It appears probable that failure in the past has been due to the impossibility
of continued treatment.
Six cases were admitted to hospital, and experiments started with tartar emetic
intravenously, various doses, number of injections, and periods between them being
tried.
In March, 1930, it was decided to give a course of ten injections at three days'
intervals, consisting of 10 grains of tartar emetic in 20 c.c. of distilled water.
A very carefully planned technique for injecting the drug was adopted, owing
to its irritating effects, but in spite of this the first series of injections produced
some swellings, which delayed further treatment. Review of the technique, and
possibly more practice by the operator resulted in almost complete disappearance
of this complication. Over 1,000 injections were given, and only two animals
developed obliteration of the vein, and less than a dozen had swellings of any
consequence.
After the third injection, in many cases a definite improvement was observed,
and in few of the milder ones the lesions had entirely disappeared after the fourth
injection. However, when treatment was stopped at this stage, relapses were the
rule, and so the system of giving all cases, as a routine, a course of ten injections
was started. About 70 per cent. of the cases were definitely cured after this
course. leaving 30 per cent. which were either not cured, although improved, or
were apparently cured and relapsed afterwards.
These cases were given a short rest of one to four weeks without treatment,
and then another complete course of injections. In one or two cases even a third
course was given but this was rarely necessary.
336 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ I, IV
It is a fact that all cases on the farm were eventually cured by this treatment,
and have remained so now for a period of over six months.
Although the experience gained during this outbreak leads us to assume that
in tartar emetic we have a specific for Bovine Nasal Granuloma, yet there is no
doubt that the method might be improved with advantage. The large number
of injections make the process long and laborious when many animals are concerned.
Also the fact that the drug must be injected intravenously necessitates the
employment of a skilled person for giving each dose.
An increased dose, with shorter intervals, might curtail the period of treatment,
but experiments would be necessary to ascertain what the patients could tolerate
with a reasonable margin of safety.
Unfortunately, lack of material has prevented this point being settled.
My grateful thanks are due to Major G. F. Watkins, R.A.V.C., who has
collaborated with me throughout this outbreak, and to Jemadar Noor Mohd. Khan,
I.A.V.C, who has skilfully given very many injections.
ARTIFICIALLY INDUCED HYPOGLYCEMIA AND HYPOCAL-
CEMIA IN THE COW AND THE RELATIONSHIP
TO PARTURIENT PARESIS OR
MILK FEVER .*
BY
WILLIAM E. PETERSEN, E. A. HEWITT, W. L. BOYD AND
W. R. BROWN.
Divisions of Dairy Husbandry, Veterinary Medicine and Biochemistry, University
Farm, Saint Paul, Minnesota, and the Department of Veterinary Physiology,
Iowa Stale College, Ames, Iowa.
(Reprinted from the Journal of the American Veterinary Medical Association,
N. S. Vol. 32, 2.)
Probably no problem has baffled the investigator more than the etiology of
parturient paresis. Considerable interest as to the cause of this condition has been
revived during the past decade, which has resulted in the evolution of numerous
theories with the stimulation of a vast amount of research. As a result of conti-
nued investigations, many of the proposed theories have been discarded and addi-
tional support added to others.
It seems an established fact that the prevalence of milk fever is correlated
with the improved methods of agriculture and the development of superior milking
qualities which have resulted from the employment of scientific methods of breed-
ing and feeding cattle.
Milk fever is a disease almost exclusively confined to cattle although it has
been reported as occurring in goats, sheep and swine.
Fish reviewed the history and incorporated an extensive bibliography in an
article in which he discussed the sugar theories as explaining the cause of milk fever
and concluded that a variation in the sugar content of the blood, either above or
below normal, has not been patisfactorily demonstrated as the causative factor, and
considers it more likely a secondary factor resulting from an interference with the
processes of oxidation in the tissues.
Hayden and Sholl reported that the normal standard of sugar in the blood is
definitely lower in the cow, goat and sheep than in the blood of man or the dog.
*Published with the approval of the Director as Paper No. 953 Journal Series, Minnesota Experi-
ment Station.
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338 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ I, IV
They found in a herd consisting mostly of milk cows (an average of 75 tests on 44
cows) the blood-sugar to be 51.75 mg. per 100 cc of blood.
Hayden states that his figures from the use of the Benedict method in the
determination of sugar in the blood of the milk cow gave a low average of 41 .15
mg. per 100 cc of blood.
Schlotthauer reports that the average blood-sugar content in a group of ten
non-lactating cows was 65.45 mg. for each 100 cc of blood, the highest was 70.90
mg. and the lowest 59.85 mg.
In a group of lactating cows, yielding from 8 to 30 pounds of milk daily, the
blood-sugar averaged 63.59 mg. per 100 cc of blood, with a range from 68.45 mg. to
59.98 mg. In another group of lactating cows, yielding from 45 to 58 pounds of
milk daily, the blood-sugar averaged 61.19 mg. per 100 cc of blood with a range
from 68.72 to 52.9 mg.
Amadon reports that the normal average sugar content of blood samples
secured from thirty-five lactating and non-lactating cows and one bull was 68.5 mg.
per 100 cc of blood, with a range of from 40 to 86.9 mg.
Hewitt found the blood-sugar average of 94 determinations on four heifers,
one bull and one steer under two years of age, was 95.9 mg. per 100 cc, and that
the blood-sugar average of eight determinations on three non-lactating cows was
89.1 mg. per 100 cc of blood, whereas the blood-sugar average of eight determina-
tions on three lactating cows was 54.1 mg. per 100 cc of blood.
Widmark and Carlens state that the blood-sugar for the dry cow and heifer is
around 80 mg. per 100 cc, and for the milking cow as low as 40 mg. per 100 cc,
with an average of 60 mg. Auger confirmed the findings of Widmark and Carlens.
Maguire states that the sugar content of the blood of the cow normally ranges
from 80 to 120 mg. per 100 cc of blood.
From the above investigations it is apparent that the sugar concentration in
the blood of cows is subject to quite wide variations but the general conclusion can
be drawn that the sugar level is lower in lactating cows than it is in heifers and
non-lactating animals.
Widmark and Carlens report the successful treatment of cases of milk fever
by the use of glucose injections. They found an increase in the blood-sugar after
udder inflation of cows suffering from this disease and they conclude that hypogly-
cemia is an etiological factor in milk fever.
Hayden and Sholl report the blood-sugar findings for fourteen cases of milk
fever which showed 35.7 mg. to 190.4 mg. per 100 cc, with an average of 99.42 mg.
HYPOGLYCEMIA AND HYPOCALCEMIA IN COW
339
From seven of these a second sample was taken at intervals sufficient that the
animals had shown recovery from the attack. These seven samples showed from
35.2 to 98 mg. per 100 cc, with an average of 64.98 mg. Based on these findings,
the authors stated there was a hyperglycemia at the onset of the disease.
Several other investigators, among them Schlotthauer and Amadon, report
an increase in the total blood-sugar to cows suffering from milk fever.
Amadon produced an artificial hypoglycemia in a cow by the injection of
iletin (Eli Lilly and Co.), being able to reduce the blood-sugar from 55.5 mg. to 41 .6
mg. per 100 cc in two hours by the injection of 480 units of this product. A
further administration of 800 units of iletin, on the same day, brought the blood-
sugar down to 23.5 mg. per 100 cc. After the injection of this amount of iletin, the
animal became comatose in the recumbent position.
Numerous other theories have been advanced as to the cause of milk fever.
Moussu advanced a theory of a hypocholesteremia as a hypothesis for the cause
of milk fever. Hayden reports that the cholesterol content of the blood is not
increased by udder inflation, and concludes that hypocholesteremia does not contri-
bute to the cause of milk fever.
Dryerre and Greig suggest that certain symptoms observed in milk fever are
analogous to those seen in animals deprived of their parathyroids, or those in which
a parathyroid deficiency exists, particularly with reference to the guanidine func-
tion.
Fish reports the effects of injecting 200 cc of a solution containing 60.75
grams of guanidine carbonate into a heifer weighing 980 pounds, which resulted in
increasing the sugar in the blood 18.7 per cent. The urea in the blood was in-
creased 9.7 per cent. and the non-protein nitrogen was increased 17.2 per cent.
Hayden reports that the guanidine average is higher after udder inflation
than before. A guanidine toxemia due to parathyroid deficiency or other causes
should show a greater guanidine content in the samples before inflation. He con-
cludes that the evidence is against the contribution of guanidine to the cause of
milk fever.
The work of Little and Wright, of Dryerre and Greig and of Fish has
shown that there is a marked diminution in the amount of blood calcium in cows
down with milk fever.
Fish found in 18 cases of milk fever the blood phosphates were uniformly and
consistently lower than normal. The calcium was likewise found to be sub-normal,
confirming the earlier work of Little and Wright and agreeing with the observa-
tions of Dryerre and Greig.
G
340 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ I, IV
Fish reports that the examination of 27 cases of milk fever gave a range from
1.75 to 6 mg. of calcium per 100 cc, with an average of 3.31 mg. Little and
Wright found a range of 3.35 mg. of calcium per 100 cc to 7.16 mg. with an
average of 5.18 mg. per 100 cc.
Meigs et al found the plasma calcium content in cows to be between 8.6 and
11.4 mg. per 100 cc of blood, practically unaffected by pregnancy, lactation, or
considerable changes of diet. In calves, however, it is higher, up to 111 mg. per
100 cc of blood.
Sjollema reports upon studies of the blood which have shown that a mineral
metabolism is disturbed in milk fever. He maintains that the disease is a disturb-
ance of the vegetative nervous system and a "labile" condition of the parathy-
roids, in which they are unable to respond to increased demands put upon them.
The calcium of the blood serum in most cases is about 5 mg. per 100 cc. That
calcium deficiency plays an important role in the onset of milk fever may be con-
cluded from the rapid recovery of more than 20 cows by the intravenous injection
of 300 to 400 cc of a 10 per cent. solution of crystallized calcium chlorid. In a
few other cases there was a transient recovery, a relapse occurring in 24 hours or
later. After mammary inflation there was an increase in the percentage of cal-
cium, which also points to the significance of the calcium deficiency.
EXPERIMENTAL PROCEDURE.
The Effect of Hypoglycemia in the Cow.
To produce hypoglycemia, insulin was injected intravenously into two cows
in three experiments. The cows used (141 and 143) were pure-bred Jerseys. Cow
143 was lactating, while cow 141 was dry.
In all cases blood samples for sugar determination were taken from the jugular
vein before the injection of insulin and then at intervals thereafter. The blood-
sugar was determined by the Folin-Wu method. Temperatures of the animals
were taken before and at intervals following the administration of insulin. The
animals were constantly watched for any abnormal symptoms that might appear.
In trial I (cow 143) 800 units of insulin were injected in four equal portions
at 8-40 A.M., 11-10 A.M., 11-50 A.M. and 1-55 P.M.
In trial II cow 143 was used again but was not given any feed for 48 hours
before the experiment and while on trial 1,000 units of insulin were administered
in five portions of 200 units each, at 9-45 A.M., 11-50 A.M., 4-00 P.M., and 9-00 P.M.,
and at 4-00 A.M., the following morning.
HYPOGLYCEMIA AND HYPOCALCEMIA IN COW
341
In trial III cow 141 was used after a 48-hour fast. Between 9-15 and 9-40
A.M., 800 units of insulin were injected.
Chart 1. The effect of insulin on the blood sugar of cows (expressed in per cent).
Results.—The effects of insulin on blood-sugar are given in chart 1. It will
be noted that insulin rapidly reduces the blood-sugar, going down, in trial II, to as
low as 17 mg. per 100 cc of blood. It should be further noted that the adminis-
tration of additional insulin at the low point did not lower the blood-sugar further.
Clinical Observations. —In no case was the body temperature affected. In trial
I, slight muscular tremors were noted fifty minutes after the injection of the first
200 units of insulin. No unusual symptoms were apparent following the three
other injections.
In trial II, mild muscular tremors were noted one minute after the first injec-
tion. Fifteen minutes later there was a marked dilation of the pupils and the ani-
mal appeared depressed. Five minutes later, complete recovery was noted, with no
further appearance of the above-mentioned symptoms following subsequent injec-
tions.