NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
OSTEOPOROSIS IN NORTH INDIA
351
cooling lotion. After 3 or 4 days, as the lameness was much less, the shoe was
replaced and a little walking exercise ordered.
On the 1st July 1933 Mr. Sharma was again asked to see the pony, which was
then reported to be lying down in its loose box and to be very uneasy, and
states that when first seen by him at this time the pony was sweating a little and
frequently looked round with an anxious expression as if in abdominal pain.
Shortly afterwards, Mr. Sharma having left the box to speak to the owner, the syce
reported that, in trying to rise, the pony had broken one of its fetlocks and was
standing with the back of the off fore fetlock joint on the ground. The
writer was then asked to see the pony and found it standing in its pox perspiring
freely and evidently in great pain with the back of the off fore fetlock resting on
the ground, as abovementioned, and the toe of that foot pointing upwards almost
perpendicularly. It was clear that the limb bad completely given way in the
region of the pastern and Osteoporosis at once suggested itself as the probable
cause of such a lesion. In any event it was obvious that immediate destruction
was the only possible course to adopt. While arrangements were being made
for this to be caried out, the writer, on again entering the loose box, found
that during his short absence of only a few minutes the other fetlock had
descended to the ground in precisely the same manner as the off fore. The pony
was thus standing on the backs of both fore fetlocks with the toes of both fore feet
pointing upwards and was evidently in considerable pain but not apparently to the
same extent as before.
Destruction was carried out as quickly as possible and the head and the fore
limbs below the knees were removed for examination as it was anticipated that
pathognomonic lesions of Osteoporosis would be found in these regions.
Post-mortem Findings. On dissection of the back of the fetlock and pastern it
was found that the flexor pedis perforatus tendons were completely torn away
from their distal attachments at the backs of the pasterns; otherwise the bones,
ligaments and tendons appeared healthy to the naked eye. When boiled out the.
superior and inferior maxillary and the nasal bones showed well marked lesions of
Osteoporosis, particularly in the much thickened and softened rami of the lower
jaw. There was also a definite thickening and softening of the nasal bones at the
point where the pony was supposed to have injured its head when first seen by
Mr. Sharma. These lesions can be seen in the photograph of the skull which
accompanies this article, while the area from which the tendons had been torn
away from the short pastern bones are distinguishable as dark roughened areas
sharply demarcated from the smooth, glistening, posterior surface of the shafts
(Plate XXXIII) of these bones.
352 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [III, IV.
An interesting feature in this case is the fact that the pony had always been
very carefully fed on the best of oats and bran, obtained from a contractor and
not grown in Simla, and that its hay, also, had always been imported from the
plains.
The pony had been given a little grazing at irregular intervals and a little
green lucerne, grown at Simla, but lucerne was only obtainable for a short period
each year and then in very small quantities while the amount of grazing was
always small. The bulk of the diet was thus oats, bran and grass hay, all grown
on the plains, and any mineral deficiency which may have existed can hardly be
attributed to foodstuffs grown in Simla. In fact it seems probable that lack of
an adequate supply of locally grown green-stuff and consequent imbalance or mal¬
assimilation of the minerals present in the ration may have been an important
factor in the causation of the condition which led to the premature destruction of
this apparently well cared for animal.
Causation. As to the causation of Osteoporosis a great deal of difference of
opinion has existed in the past. Some have held it to be of entirely dietetic origin
while other eminent workers, with ample opportunities of studying the disease,
have held it to be of an infectious nature. The available information regarding it
is discussed in the annual reports of the Government "Veterinary Surgeon, Ceylon,
referred to above and the following tentative conclusions, published in the 1926
report, are of particular interest, viz.:—
(1) Osteitis fibrosa can develop when infection, either by direct or indirect
contact, has been prevented as far as was humanly possible under the
conditions of the experiment. Four ponies, so far, have developed the
disease.
(2) The vitamin requirements of horses are apparently extremely low. Their
presence or absence does not show any correlation with the incidence
of the disease ; for instance, pony No. 4- on a diet of bran plus 2 oz.
of sterilized bone meal per day has remained healthy and improved
in condition, while a pony, receiving bran and 10 lb. of fresh green
grass per day, has developed the disease. Bran is deficient in Vitamins
A and B, while Vitamin C is absent. The bone meal was steamed
bone meal, and before feeding was sterilized in the autoclave at 125° C.
for four hours on two successive days, and apparently did not contain
any vitamin.
Guinea pigs fed on a diet of bran and this bone meal succumbed in less
than thirty days with symptoms of wasting and scurvy
OSTEOPOROSIS IN NORTH INDIA
353
(3) The calcium requirement of these ponies is apparently in the region of
20 grams of calcium oxide per day. If there is an excess of phosphoric
acid in the diet, this amount is inadequate.
(4) The causal factor of osteitis fibrosa appears to be a deficiency of calcium
in the foodstuffs, the evil effects being intensified when there is a co-
existing excess of phosphorus.
Further conclusions, derived by Crawford from experimental work carried out
in Ceylon upon animals imported from a locality where Osteoporosis did not exist
and carefully guarded against all risk of infection, are given in the report for the
following year, as follows:—
(1) Osteoporosis occurs when any possibility of infection by contact has been
prevented.
(2) Horses fed on diets containing minimum quantities of calcium and heavy
excess of phosphoric acid develop Osteoporosis.
(3) The disease increases in severity in direct relationship with the excess of
phosphoric acid.
(4) Horses fed on a diet in which phosphoric acid does not greatly exceed
calcium do not develop the disease, although in intimate contact with
affected horses.
From Crawford's report it appears that the ratio of total calcium to phos-
phorus in the diet was the determining factor and it is stated that there was an
exact correspondence between the ratio of CaO to P 2 O 5 and the incidence of
the disease. His experiments appeared to indicate that a ratio of CaO to
P 2 O 5 was on the danger line but more recently however Kintner and Holt, in
an article on Osteomalacia published in the Philippine Journal of Science for Sep-
tember 1932, make the interesting statement that the calcium intake is of secondary
importance to the calcium-phosphorus ratio. Their observations seem to show that
in the Philippine Islands Osteomalacia may develop even when the ratio of
calcium to phosphorus is as high as 1: 2.9. In any case it seems to be now
well established that imbalance of lime and phosphorus in the ration is the main
factor concerned in its causation, and it is important to note that Osteoporosis is
particularly liable to occur amongst horses which are, according to popular
estimation, exceptionally well-fed. It seems probable in fact that. in India as in
Ceylon, the predisposing cause in the majority of the cases reported was a diet com-
posed mainly of cereals with an inadequate proportion of fodder with a high lime
content such as leguminous hay or green food. Moreover when the danger of such
a diet is appreciated it is not difficult to understand the peculiar incidence of Osteo-¬
354 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [ III, IV.
porosis in certain countries which was previously so puzzling. In South Africa,
for example, it was long held by workers who had carefully studied the matter that
the disease must be of a contagious nature because it was first brought prominently
to notice in racing stables in the Cape Peninsula—much more in some than in
others—and to have spread by contagion from these to similar stables in other parts
of the sub-continent. On the other hand it was common experience that, if turned
out to graze in certain districts, cases of the disease tended to cure themselves.
In the light of the information now available the explanation of this peculiar
incidence is no longer difficult, since race horses were in those days fed almost
entirely on the traditional diet of oats, bran and hay, made from natural grasses
or oat hay grown in South Africa, with an almost complete absence of the green
fodder and leguminous hay which might have corrected the dis-proportion of calcium
to phosphorus.
In Ceylon, and in India where cases of Osteoporosis have occurred, the position
appears to have been much the same. Cases of the disease have been most com-
monly met with among animals to which a high grain ration had been fed and it is
clear that, unless the content of lime was high in the other components, such a diet
would be of a high phosphorus low calcium content. In the Simla case the amount
of green stuff consumed was not sufficient to materially affect the mineral composi-
tion of the ration while any effect of a lack of vitamins on the causation of this
condition is discounted by the experimental work described by Sturgess, in his 1926
report before mentioned. It seems in fact that there is danger in adhering too
closely in foreign countries to the traditional British system of feeding equines
on a diet composed mainly of dry cereals, bran and hard hay, unless and until the
mineral content of locally grown food-stuff has been investigated. Moreover the
occurrence of this case of typical Osteoporosis points to the existence of a deficiency
of lime in the hay grown in certain parts of the plains of Northern India since cases
of Osteoporosis do not usually occur in countries where the lime content of locally
grown bulky fodder is even moderately high and the pony in question, though ade-
quately fed for the work performed, had not been given such a heavy grain ration
as would usually be fed to a race-horse, hunter or polo-pony.
ACKNOWLEDGMENTS.
The author's thanks are due to the Director and staff of the Imperial
Institute of Veterinary Research, Muktesar, for furnishing references to the
relevant literature.
OSTEOPOROSIS IN NORTH INDIA
355
REFERENCES
Hayes, M. H. (1879). Veterinary Journal 8, 402-433.
Smith (1887). Quarterly Journal of Veterinary Science in India, 5, 167-168.
Symonds (1887). Quarterly Journal of Veterinary Science in India, 5, 167-168.
Spooner Hart (1895). Veterinarian, 68, 713-717.
Swaminath Ayyar (1931). Indian Veterinery Journal, 7, 263-265.
Sturgess. Annual Reports of the Government Veterinary Surgeon, Ceylon, 1926, 1927.
Crawford. Annual Report of the Government Veterinary Surgeon, Ceylon, 1927.
Kinther and Holt (1932). Philippine Journal of Science.
THE VECTOR OF CANINE PIROPLASMOSIS DUE TO
PIROPLASMA GIBSONI
BY
S. K. SEN, M.Sc., F.R.E.S.,
Imperial Institute of Veterinary Research, Muktesar.
(Received for publication on the 23rd October 1933.)
(With Plate XXXIV and one chart.)
A perusal of the available literature shows that the earliest attempts to
determine the vector of this protozoan infection of dogs were made by Patton
shortly after his discovery of the parasite in the blood of hounds of the Madras
Hunt in 1910. Concerning these attempts, Symons and Patton, in an article which
appeared in 1912, wrote as follows :—" Knowing that this piroplasm is almost
certainly transmitted from the jackal to the hounds by the bite of a tick, one of
us (W. S. P.) has made repeated attempts to try to transmit it by placing ticks
from jackals on clean dogs. So far, Haemaphysalis bispinosa has been used, and
although a large number have been placed on young dogs, we have so far failed to
infect them. We have long known that there is a species of Rhipicephalus, which
is fairly common on the jackal, but unfortunately we have so far failed to obtain
suitable specimens for our transmission experiments." No further work in this
connection appears to have been undertaken during the following 14 years, but in
1926, Rao, in Madras, reported the results of a short series of experiments carried
out by him to test the possibility of the infection being conveyed through the
agency of H. bispinosa (the species of tick originally experimented with by Patton)
and the common dog tick Rhipicephalus sanguineus, the former, according to Rao,
being the most common ecto-parasite on hounds and jackals in Madras. In experi-
menting with H. bispinosa, laboratory-bred larvae were fed upon an infected dog
and the infectivity of the nymphs obtained from these larvae was tested upon
three " clean " dogs, with the following results :—two did not develop the infection
at all, but the third " showed fever and on the 17th day enlargement of the spleen
and other clinical symptoms simulating those of a true case of P. gibsoni, but the
typical parasite was not seen in its blood during the whole period of observation ".
The infectivity of adults bred from infected larvae was tested in one instance and
the dog showed a rise in temperature from the 5th day, with " a few bodies that
appeared like P. gibsoni" on the 9th day, but these bodies were not seen again on
any of the following days. R. sanguineus would appear to have been given only a
( 356 )
VECTOR OF CANINE PIROPLASMOSIS DUE TO P. GIBSONI
357
brief trial, with negative results. This species of tick was not given an extended
trial by Rao, " for lack of time and because it did not seem to be the possible
vector, for it is the commonest tick on ordinary house dogs among whom P. gibsoni
is very rare; further, it carries, as shown by Christophers [1907], P. canis which is
the common parasite among the ordinary house dogs and if it were a carrier of
P. gibsoni as well this parasite should have been seen along with P. canis, but this
is not usually the case ".
Whilst the facts advanced by Rao, as quotad above, doubtless justify tne
conclusion that R. sanguineus is not the likely vector of P. gibsoni in South India,
nevertheless, experience at this Institute during the past few years has shown that,
in so far as Northern India is concerned, P. gibsoni infection is by no means of
rare occurrence in house dogs, whilst it is common knowledge that street dogs
in these localities are not infrequently carriers of this protozoan parasite. As to
H. bispinosa, Sharif [1928], in a publication based upon the collection of ticks in
the possession of the Indian Museum, mentions this tick having been only infre-
quently taken off the canine species. These facts seemed to the present writer
to be suggestive of the possibility that the transmitting agent of P. gibsoni
infection, at any rate in the northern parts of India, was P. sanguineus, which,
in these localities, is parasitic not only on dogs but also on hounds, as judged by
the fact that every single specimen in several consignments of ticks received from
time to time from the Jhind State Kennels at Bhim Tal (situated at a distance
of about 16 miles from this Institute) was fourd on examination to belong to
this species. It is of interest that the possibility of R. sanguineus being involved
in the transmission of P. gibsoni infection has also been mentioned by Wakely
[1931], in a pamphlet issued by the Masters of Foxhounds Association of India.
An opportunity of putting this hypothesis to test occurred in July 1930,
when information was received of the occurrence of a case of P. gibsoni infection
in the Jhind State Kennels at Bhim Tal. A quantity of blood from the affected
hound was obtained by a special messenger and was injected into two dogs which
developed the infection after an incubation period of about 30 days. This strain
has now been kept alive for the past three years by " passaging " through suscep¬
tible dogs, and in the course of this work, much useful information has been
gained concerning the pathogenicity of P. gibsoni infection for country-bred dogs.
This will form the subject of a separate paper to be prepared in collaboration with
Messrs. P. R. Krishna Iyer, M. K. Sreenivasan and J. Idnani, Veterinary Inspectors
at this Institute, who have been good enough to carry out the subinoculations for
the present writer and have kept careful protocols of about 50 dogs that have so
far been used in this work.
358 THE INDIAN JOURNAL OF VETERINARY SCIENCE AND ANIMAL HUSBANDRY [III, IV.
The present note records the results of transmission experiments carried out
upon only five dogs, two of which died from causes other than P. gibsoni infection,
whilst the remaining three duly developed the infection. In view of the small
number of experiments carried out and of the fact that no special precaution was
adopted to prevent the animals from contracting a natural infection, the results
reported in this note must be regarded as of a tentative character until further work
has been done, under more controlled conditions, to confirm these findings.
The writer desires to acknowledge his grateful thanks to Mr. F. Ware,
F.R.C.V.S., I.V.S., Director of the Imperial Institute of Veterinary Research,
Muktesar, for his kind encouragement and for granting every facility in the
prosecution of this investigation.
FEEDING OF TICKS ON DOGS.
At the outset it was realized that one of the fundamental difficulties
that hampered the progress of investigations of this kind was the lack of a
suitable method of feeding ticks (particularly the larval forms) on dogs. Patton
(l.c.) and Rao (l.c.) have not indicated the methods adopted by them in feeding
their ticks, but Rao mentions having recovered 30 nymphs in one instance, 20 in
another and 30 in a third, and from this one would gather that the number of
nymphs which he failed to recover was not small, for ticks, as a rule, bring forth
a considerable progeny.
In his work on the transmission of malignant jaundice of dogs through the
agency of R. sanguineus, Christophers [1907] enclosed his experimental animals
(" pups of medium size") in cages of iron which were kept surrounded with sheets of
muslin to enable any engorged ticks to be readily seen and collected. A similar
type of cage is also recommended by Patton and Cragg [1913] for feeding
R. sanguineus, the cage being provided underneath with a tray to catch the
urine or faeces of the enclosed animal. The ticks to be fed are dropped upon a
quantity of straw placed inside the cage, care being taken first to remove the
underpan in order to avoid any of the ticks getting drowned in the urine which may
have collected in it. The dog is taken outside when required to feed and
the cage is cleaned once a day by removing all faeces, urine and soiled straw, whilst
the removal of such ticks as have lodged themselves between the bars of the cage
is effected by bumping the cage over a piece of white cloth placed upon the
floor.
In his work upon the life-history of R. sanguineus, Nuttall [ 1913-14] enclosed
his dogs in a barrel-shaped metal cage " placed horizontally upon an insulated- stand,
one end of the barrel being open but guarded by a metal grating, a similar grating
serving as a floor for the animal to stand upon ". The" cage was searched daily,
VECTOR OF CANINE PIROPLASMOSIS DUE TO P. GIBSONI
359
a sheet of white paper being laid upon the floor of the cage to show up any engorg-
ed ticks that might have dropped upon it.
It is obvious that the foregoing methods, although serviceable in their own
way, entail an amount of attention which it is not always possible to afford in the
midst of other laboratory duties and, moreover, it was repeatedly observed in the
course of trials carried out at this Institute that some loss of ticks was inevitable
when they were fed by any of the methods described above. An intensive series
of experiments was therefore undertaken with a view to devising a method that
would not only effect a substantial saving in time but would also ensure the reco-
very of every single tick on the completion of its feed upon its host. Both these
conditions were found capable of being satisfied to a very large extent in the method
which is to be described presently and which is now adopted at this Institute as a
routine method for feeding ticks on dogs.
The method, which represents essentially a modification of one recommended
by Nieschulz and Wawo-Roentoe [ 1930 ], has for its object the confinement of the
ticks to a circumscribed area on the body of the host until the completion of their
feed. In the original method, as devised by Nieschulz and Wawo-Roentoe, the
ticks were kept confined under a cloth-cover (" Batistdecke " ) fixed on to the skin
of the host by means of collodion. To prevent the cloth-cover from being damag-
ed by the dog, the latter was made to wear a collar made of stiff carton (of. Muller
and Glass [ 1926 ], who, too, recommend the use of similar collars for dogs) and
to ensure further security, the hind legs were kept wrapped in a quantity of padding
( " umwickelt" ). Experience at this Institute has shown, however, that collodion
is not quite the type of adhesive that can be depended upon to keep the cloth-cover
intact for the requisite period. In this respect, a much superior adhesive was
found in the substance known as " Chatterton's Compound ", which is procurable,
in the form of sticks, from all leading chemists in India (our own supply of this
material was obtained from Messrs. Smith, Stanistreet and Co., Calcutta). The
material is melted before use and is best applied with a small spatula or a glass rod
flattened at one end. Some tests carried out at this laboratory showed that
Chatterton's Compound was practically insoluble in alcohol, but that it dissolved
slowly in chloroform, ether and xylol, so that any of these solvents may be used
in detaching cloth-covers fixed by means of this adhesive. It was, however,
found more convenient in practice gently to peel off the cover, although this
caused a certain amount of temporary pain to the dog. When used alone,
Chatterton's Compound was found sometimes to have a fatal effect upon such
of the ticks as got stuck in this material along the margin of the cloth cover, so
that it was eventually found to be a good plan to effect the initial fixation by
means of collodion and to apply a layer of Chatterton's Compound only along the
E