made a special study of that portion of pathological anatomy.
In general, whatever may be the nature, age and seat of tumors, ablation
or destruction by caustics is the only efficacious mode of treatment. For
benign growths, the interference of the surgeon varies according to the
clinical character of the neoplasm and the region it occupies. It is pru-
dent to leave alone indolent, stationary or slowly progressing tumors loca-
ted in regions where they give rise to no inconvenience. If they are,
however, well pedunculated, they can be removed with the ecraseur or a
non-extensible ligature. If they are small and do not spread at their base,
the red-hot iron or potential caustics (potash, chloride of zinc, arsenious
5l8 VETERINARY SURGICAL THERAPEUTICS.
or mineral acids) are sufficient to destroy them. When they are wide and
flat or intimately implanted in the tissues so that their removal is to be
made with the bistoury, one must carefully weigh the possibility of com-
plications following the interference. Serious and even fatal accidents
may occur from bloody exeresis of a benign and painless neoplasm which
did not trouble the patient and might never have caused serious incon-
venience. Should there be an oversight in the operation, septicaemia may
occur from the wound made by the removal of an old neoplasm, whose
slow growth as well as clinical manifestations positively indicated its
benignity. Therefore, for these tumors, abstention ought to be the general
rule. Let us remark, however, that tumors which may have remained
benign for a long time, may at a given time rapidly enlarge and spread ;
as soon as this transformation takes place, they evidently return to the
category of the malignant tumors and must be treated as such. Pedun-
culated tumors of mucous membranes easily explored (nose, rectum,
vagina) should be removed with the ecraseur or torn off with the fingers.
During the last few years, the prophylaxis of cancer has been much
talked about ; but we have seen that, aside from heredity, there are no
positive etiological data to admit it. It has been believed that cancer is
more common in man since meat has entered in a greater proportion
into general alimentation ; hence the advice to eat less meat and a greater
proportion of vegetables â€” a piece of advice which could be put in practice
with dogs and cats if facts justified it. The relative frequency of can-
cerous growths among subjects affected with arthritis has suggested the
use of arsenical or alkaline substances, either as therapeutic agents of the
" neoplastic diathesis " or ,as prophylactic medication of carcinosis. Up
to the present time nothing proves the real efficacy of these means.
At all times the cure of malignant tumors has been tried by the use of
a great variety of applications and by a no less varied assortment of in-
ternal medications. Chlorate of potassium in powder or in saturated solu-
tion seems to be effective against some epithelial growths ; some results
have been obtained in cases of cancroids of the skin or the tegument of
natural openings, but they fail with the epithelial growth of mucous mem-
branes. If papillomas of the mouth in dogs and the growth of the lip of
the cat, improperly called "cancroid," do ordinarily submit to the action
of chlorate of potash, it is known that those growths are exceptions to the
general law of the persistency of neoplasms ; after a variable length of time
almost always the ulceration of the cat's lip stops in its growth and heals ;
in the same manner the warts of the buccal mucous membrane of dogs
shrink and disappear; it is rarely necessary to treat them actively.
Against the ulcerated epithelial tumors of the lips, aniline colors can be
tried, in particular the solution of methylene blue ; treatment recom-
mended for man by Mosetig-Moorhof and Darier.'
Arsenical preparations (Fowler solution, arsenious acid) and iodine,
recommended against sarcomas and lymphadenomas, have but little efficacy.
We have often used them without the slightest advantage. Iodide of
potassium has never produced a satisfactory change in the growth of
neoplasms ; it rather seems to stimulate their growth by the disturbances
it gives rise to. As local applications, or to be taken internally, a number
of compound mixtures, " antineoplastic " plants have been recommended,
all without the slightest use. Electricity, which has given some success-
ful results in the therapeutics of the uterine tumors of women, has not
been much used in veterinary practice.
Some microbian inoculations have also been proposed for cancer.
Among these it has been said that the streptococcus of erysipelas injected
into sarcomas and carcinomas could arrest the process and bring on re-
covery, the tumors becoming affected with fatty degeneration and disap-
pearing. We know also that this result has taken place spontaneously
without those injections. Bacteriotherapeutics seems to have succeeded
only in cases of such nature.
At the present time the only rational therapeutics of malignant tumors
is extii-pation. To obtain all that it can give, it must be radical and early.
To make it radical, one must bear in mind that almost all these growths
are surrounded by a zone infiltrated with neoplastic elements, though no
alteration manifest to the naked eye can be observed in them. When
secondary tumors are already developed round a diffused primitive
neoplasm, the latent zone of infection may at times be very wide and
then the ablation must be quite extensive. If the skin is more particularly
the seat of this neoplastic infiltration this extends deeply into the con-
nective lamellae on the surface of the aponeurosis and into the thickness
of all the tissues of that region. Independently of this zone of infection
which surrounds the tumor, there is another formed by the blood vessels
and the surrounding lymphatic glands ; the latter is almost always rapidly
overrun with the neoplasms of epithelial origin ; often it is already infected
when exploration fails to reveal any alteration ; most often, however, the
lymphatic vessels show small nodosities here and there along their length,
and their collecting glands are hypertrophied and indurated. In such
cases the removal of the growth must necessarily be completed by that of
the infected lymphatic structure. Numerous are the mammary neoplasms
of sluts that demand such extensive removals. The trouble must be fol-
lowed up in the groin to its roots. Some of the diseased glands cannot
be reached ; operation is then powerless to bring about recovery. It is
I Mosctig-Moorhoff^ Darier; Semaine Medicale, 1894, pp. ?28 and 238,
220 VETERINARY SURGICAL THERAPEUTICS.
the same for old tumors of the mouth, of the nasal cavities, for those of
the testicle, the anus or the rectum. For a greater reason, when the
tumor is already more or less generalized, when the patient is weak, in a
cachectic condition, interference is forbidden, as not only would the
operation be a failure, but it would accelerate the progress of the
Interference is also to be forbidden when the neoplasm, located in
some regions, has extended far into the subcutaneous layers. In sluts and
female cats, ulcerated mammary tumors are found which have invaded the
entire thickness of the abdominal wall, and whose removal could not be
performed without removing a large portion of this wall.
Then, again, there are tumors which, though circumscribed and of small
extent and depth, and not involving the lymphatics, do not justify ex-
tirpation : these noli me tangere recidivate immediately, develop more
rapidly, and are endowed with a more marked infecting power than pre-
vious to the interference. The seat of the neoplasm sometimes imposes
abstention from operation ; animals affected with malignant tumors of
the mouth, of the sinuses, the larynx, the oesophagus, or the rectum
must not be operated on. The prognosis is sometimes aggravated by the
age, and by some morbid conditions (albuminuria, cardiac affections,
Once decided upon, the operation must be performed with all anti-
septic care. If the tumor is ulcerated, it should be disinfected with a
strong solution of chloride of zinc, the suppurating surface should be
curetted as well as the fistulous tracts, if they exist. For ablation, the
bistoury will be preferred ; it is better than any other instrument, because
it will permit a total and methodical excision. The large blood vessels
should be obliterated with forceps and ligatures, and the hemorrhages
of capillaries should be arrested with actual cauterization. In dangerous
parts, a careful dissection will allow one to avoid the arteries, veins and
important nerve branches yet unaltered. With some tumors, enucleation
with the blunt probe or the finger is advantageous where connective layers
exist. No neoplastic nucleus should be allowed to remain ; all invaded
lymphatic glands or vessels should be taken off.
Excise all that is morbid, all that seems diseased ; remove the im-
mediately surrounding layer, which is often affected with neoplastic ele-
ments to a depth, at times, a centimeter thick, and only stop when sound
tissue is reached. Such is the rule, which must be strictly observed. In
leaving a suspicious cutaneous fragment, or a piece of doubtful tissue, re-
lapse is to be feared. After carefully cleaning the wound and com-
pleting the hemostasis with actual cautery, it should be dusted with
iodoform, or a mixture of tannin and iodoform, its edges brought together
with separated sutures, and the whole covered with a coat of collodion or
with a dressing.
In every case, if possible, and even if the solution of continuity has to
be large, complete extirpation should be made at one sitting. There are
cases when successive interferences are necessary to remove a neoplasm in
its entirety, and then there remains, in some parts of the large wound,
small spots of repullulation which demand another surgical operation
with the bistoury or the actual cautery. Quite often in sluts, notwith-
standing the total removal of mammary tumors, another interference is
necessary after a variable length of time ; and even then the patient cannot
Although we possess a certain number of observations on radical cures
of neoplasms which histology had declared incurable, it is, nevertheless,
true that the recidivity of malignant tumors is the general rule.
Let us now consider the special methods of treatment of the various
kinds of tumors.
Fibromas, which are to be placed among the most benign growths, re-*
cidivate but very rarely after removal, and when they do they affect the
structure of sarcomas. Some retrogressions are also explained by errors
of diagnosis : carcinomas or sarcomas which had undergone fibrous trans-
formation or growth were mistaken for simple fibromas. The ablation
of fibromas is ordinarily done with the bistoury : if the wound remaining
is small, first-intention cicatrization is possible. When the tumor is
pedunculated, the ecraseur or elastic ligature can be used. The slow
action of this latter, the putrefaction which takes place in the tumor
before its complete section, and the fetid odor coming from it are objec-
tionable ; for these reasons it is advantageous to combine ligature with
excision ; twenty-four or thirty-six hours after the application of the ligature
the tumor is cut ofif close to the ligature and the stump left to its
spontaneous slough. Sometimes the actual or the thermo cautery are used
also. Some sessile diffused fibromas may also be destroyed by actual or
Circumsaibed myxomas are treated by total removal with the bistoury
or ecraseur; sometimes they are torn off with the fingers. Diffused
myxomas demand a careful dissection of the roots which extend into
muscular spaces. The former rarely recidivate, the latter more com-
monly. When they do, the new growth ordinarily offers the structure of
a sarcoma. For small animals, if a myxoma of a leg returns, amputation
is better than a second removal.
When lipomas are large and troublesome they are removed with the
bistoury. The operation is very simple for circumscribed, but rather
222 VETERINARY SURGICAL THERAPEUTICS.
difficult for dififused, lipomas. If the tumor is voluminous, an elliptical
cutaneous flap is removed with it. Union by first intention or sutures
with drainage, according to the extent of the wound, complete the removal.
Papillomas are generally not serious. They are destroyed with the
bistoury or the ecraseur (ligature with silk threads) when well peduncu-
lated, or repeated cauterization of nitric acid. Radical recovery of
warts and cutaneous growths require ordinarily the removal of a portion
of the skin where they are implanted. Papillomas of the mucous mem-
branes (vulva, vagina, uterine neck) are treated with excision ; some-
times they return and require being operated upon again after a variable
length of time (weeks or months) ; but even in these cases radical recovery
is not rare.
For cysts two methods can be employed : (i) Extirpation of the growth ;
(2) evacuation of its contents, and local application of agents to promote
the granulating inflammation of the walls of the cyst, the obliteration of
its cavity, and the shrinking of the walls of the sac.
Extirpation with the bistoury is the surest and quickest way, and ought
to be used whenever the operation can be performed easily and without
danger. Elastic ligature is advantageous for some pedunculated cysts.
The other mode of interference includes several ways. For serous and
most mucous cysts, the evacuation of the contents by a capillary puncture
and the injection into the cavity of an irritating fluid (pure or diluted
tincture of iodine, a strong carbolic solution) are at times sufficient ;
after the injection, especially if before the removal of the injected fluid
the tumor has been kneaded by the surgeon, the wall of the sac has be-
come inflamed and vascular, a sero-fibrinous exudation takes place ;
then gradually this serosity is absorbed, the walls of the sac retreat and
the cavity disappears. The free incision of the wall of the cyst is another
process which brings on recovery in a dififerent manner : the cystic mem-
brane, then exposed, loses its epithelium, suppurates, is covered with
granulations which fill the cavity, thus constituting a more or less volumin-
ous mass of embryonic tissue which afterwards becomes organized and
contracts. Multiple punctures and capillary or tubular drainage bring on
the same result ; sometimes recovery is slow, but it can be stimulated
with irritating injections into the cavity. Deep cauterization, which also
gives good results, is especially advised when the walls of the cyst are
thickened by previous unsuccessful treatments.
Sarcomas require early, entire removal, which even does not insure
against their return. Still, recovery in numerous cases follows a single
well-performed operation. When this is performed for sarcoma of soft
parts, one must bear in mind that the fibrous capsular sheet, which ordi-
narily isolates the morbid tissue, is part of the neoplasm and envelops it
entirely. An iodoform dressing with or without drainage should follow.
We have found no especial efificacy in arsenious acid ; its so-called specific
action on sarcomatous elements remains to be demonstrated. If there
is a relapse, interference must be renewed as early as possible. Sar-
comas of bones almost always return, even when resection extended be-
yond the limits of the neoplasm. In the case of small animals affected
with sarcomas of the legs amputation is advised. Melanotic iiitnors should
be operated upon only when they give rise to functional disturbances, in-
terfere with deglutition, micturition, defecation, or with the work of
With epitheliomas and carcinomas, radical and early removal is also
the only treatment likely to arrest the disease ; but interference is to take
place only when the entire excision of the growth and ganglionary sur-
roundings is possible. One should remove the neoplasm, the surround-
ing latent zone of infection, the indurated glands and those that are sus-
picious, and also the lymphatic vessels connected with the tumor. The
excision should always be made freely, including even healthy structure ;
the edges of the wound should then be broup;ht together by suture and
an iodoform dressing, with or without drainage, be applied. Ulcerated
epithelial tumors on the toes of dogs, ordinarily yield only to amputation
on the metacarpal region ; excision only of the diseased toe is insufficient.
When total ablation is not possible, it is useful, in some cases, for in-
stance where there is ulceration, to make a partial excision in order to
facilitate the cleaning of the wound and relieve the pain (dog), but absten-
tion is the rule. Interference is always to be forbidden in diffuse cancers,
enormous multiple growths and in cases when infection is of generalized
The removal of enchondromas and osteomas should be performed only
when the disease progresses rapidly and causes functional disturbances.
Enchondroma of soft parts rarely returns after complete extirpation ; that
which develops in the superficial layers of bones is scraped off. If there
is a relapse and the growth affects a bone of a leg, amputation is required
in the case of small animals. Osteomas which cause no pain or interfer-
ence are left alone.
With lymphadenomas abstention is the rule. The tumor returns in a
short time or new ones develop in other regions. In supposed cases of
cures of lymphadenomas by surgical interference, it is probable that the
ailment had been given a wrong name. Internal arsenical treatment,
recommended for lymphadenia, is powerless in domestic animals.
For myomas and neuromas which are painful and interfere with func-
tions, extirpation must be attempted if not too difficult. Tumors de-
veloping on the nerves afterneurolomyarenot true neuromas, but chronic
224 VETERINARY SURGICAL THERAPEUTICS.
inflammatory neoformations, which are at times accompanied with great
pain or lameness, and must be resected. In general they can be avoided
by giving to the wound of operation all the conditions required for immedi-
ate cicatrization ; their return is prevented in the same way.
DISEASES SPECIAL TO EACH TISSUE.
SKIN AND CELLULAR TISSUE.
EXCORIATIONS â€” CORES â€” STICKFASTS.
We shall say nothing of hj-uised or ordinary cutaneous wounds. Their
treatment requires no special attention.
Excoriations, so frequently observed during the warm season on the
parts of the body which carry the various pieces of harness, are ordinarily
made by their direct action upon the skin moist with perspiration ;
the epidermis adheres to the harness, becomes loose, and the Malpighian
and papillary layers of the skin are exposed. The uncomfortable itching
following gives rise to repeated rubbing on the part of the animal, and be-
comes the frequent cause of complications when the lesion exists on the
withers, the neck or the poll.
Very simple attention is necessary to obtain cicatrization. The injured
region should be relieved of the pressure of the harness ; if this is on an
animal whose work can be stopped, it should be left for a few days in the
stable ; if it has to be kept at work, the saddle or the collar should be
chambered or padded on each side of the injuring part of the harness
to relieve the pressure. That removed, the excoriation becomes covered
with a yellowish or brownish scab and rapidly cicatrizes. In case the
lesion is extensive and looks bad, recovery may be accelerated by antisep-
tic lotions or epithems, or applications of vaseline or glycerine. Cocained
vaseline can be used if the itching is very great.
The skin of the regions which are the seat of pressure or repeated rub-
bings â€” surfaces on horses which carry the harness, on cattle the yoke, and
the plantar cushion of a dog's paws â€” present sometimes circumscribed epi-
dermic neoformations moreor less elevated, with irregular edges, analogous
in their pathogeny to the corns of men ; they are called cores. Surround-
226 VETERIXARV SURGICAL THERAPEUTICS.
ing them the hairless skin is covered with a dry, horny, hard and irregular
patch, which results from the hypertrophy of the horny layer of the
epidermis. Generally, the deep face of this core is fiat, the mucous layer
and the dermis remain intact or slightly altered ; it is possible, however,
that the papillary coat is involved in old and extensive cores, and that
they remain even after the removal of the cause that has produced them.
Except in rare cases, cores of our large animals are painless, and do not
interfere with their use. It is not so with those of the paws of dogs ;
they have deep roots, which consume the papillae, thin the dermis, and
give rise ordinarily to severe lameness.
Cores due to the harness, most commonly giving rise to no serious im-
pediment, are not treated ; it is, however, important to prevent the in-
crease of the trouble by improving the condition of the harness, with new
padding, for instance. Painful cores must be relieved of all pressure.
The thinning of the epidermic plate with the bistoury, and applications of
vaseline, glycerine or salicylic collodion are ordinarily used. Cauterization
with mineral acid or the excision of the cutaneous spot is seldom necessary.
In dogs, the cores of the paws are treated with paring, warm baths,
and the repeated applications of salicylic collodion.
On the surfaces where the skin is much pressed by certain pieces of
harness (saddle, collar, surcingle), spots of dry gangrene may develop,
of which we have already spoken in the article on Gangrefie, and which
are known as stickfasts. This expression does not apply to epidermic
growths, but, on the contrar}', to lesions of necrotic order.
Their pathogeny is known ; badly padded or improperly fitting har-
ness presses hard on the skin and promotes a permanent ischsemia and cel-
lular disturbance, which end in mortification of a more or less extensive
cutaneous spot, generally circular in shape. If the pressure continues,
the tegumentary spot, which is necrosed, dried and hardened, transmits it
to the tissues underneath, which in turn become successively necrosed ;
thus is explained the formation of the deep stickfasts of the withers, of
the neck, and of the poll, accidents that we shall consider later.
The sloughing of the mortified skin takes place as in all cases of limited
dry gangrene. It rarely requires more than twelve or fifteen days, when
the necrosis does not extend beyond the subcutaneous connective tissue.
The wound heals by granulation.
Stickfasts are prevented by watching the condition of the harness and
its paddings. As soon as the mortification sets in, its spreading is pre-
vented by removing the pressure made on the spot ; the animal should,
according to the case, be kept out of work for a certain length of time, or
the harness should be so altered as to prevent any further mischief.
Though this may often be sufficient, it is better to accelerate the cure by
the application upon the diseased part of vaseline simple, or mixed with
an antiseptic substance (cresyl, carbolic or boric acid). If there is pain,
cocaine preparations should be used.
To stimulate the sloughing of the stickfast, vesicating preparations
(simple blister, mercurial or bi-iodide of mercury ointment) are often
used. These agents stimulate the progress of the inflammation, and
noticeably relieve the pain when it is great. The sloughing completed,
cicatrization of the wound follows soon afterwards. At times a certain
sensitiveness remains in the region where it took place ; this gradually
diminishes, and its disappearance can be hastened by a slight blister.
On the superior border of the neck, on the surface of the implantation
of the hair of the mane, there appears sometimes, after an eruption of
acne, a certain number of Httle necrotic spots on the superficial layer of
the skin. These have their seat principally in the bottom of the cutane-
ous folds that are found in some horses at the boundaries of the neck and
the withers. They are very painful during the time required for their
elimination (Bouley and Nocard).
These miliary necrotic spots of the neck are generally found in animals
that are badly kept. Their skin is generally covered with a greasy sub-
stance, irritating, and formed of epidermic detritus, dust and fluid exuda-