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This article was published in 1937
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THE STOMACH TUBE AND WORM MEDICATION
Mr. ROY STEWART, B.V.Sc.
Note.—Mr. Stewart delivered his lecture which he prepared from an article in "Veterinary Medicine" (Chicago), and which was set out in the form of question and answer as printed below:—
Questions by Dr. J. R. Stswart
Answers by Or. G. Lichtenstern, Rotthalmunster, Germany.
Restraint
Q.: What restraint do you use (a) for foals six months old; (b) for yearlings; and (c) for horses?
A.: In the horse breeding section of Rotthalmunster, the horses are farm-raised, and therefore gentle; moreover, the horses presented for treatment are, as a rule, in advanced stages of sickness. and consequently no restraint is needed for the passing of the stomach tube.
Q.: Do you use a crush?
A.: If the horse should prove to be uncontrollable, or if the attendants are too feeble to manage the horse, then the horse is put into a chute or squeeze.
Q.: How do you prevent the animal from (a) rearing; (b) striking; and (c) throwing himself?
A.: Horses suffering from illness do not rear, strike or throw themselves when handled; if the horse is unruly, one may put hobbles on the front legs.
Q.: Do you use a twitch?
A.: When the horse is very unruly, a twitch is used.
Q.: Do you tie the front legs down tightly to the ground?
A.: Ordinarily the raising of one leg is sufficient to restrain the horse. However. if necessary, a stock may be used for restraint.
The Stomach Tube.
Q.: Do you pass the stomach tube through (a) the nose; (b) the mouth; and if so, do you use a gag?
A.: We pass the stomach tube through the nose exclusively.
Q.: Describe the length of the tube, its external and internal diameter.
A.: Our stomach tube is about four meters in length. The external diameter is about one and one-eighth inches; the internal diameter is about five-eighths of an inch. Thus, the thickness of the wall of the tube is about one fourth inch.
Q.: How long will it take a quart of mixed oils, such as paraffin, castor or linseed, to run down the tube into the stomach?
A.: With the tube just described, one half-minute is required. If greater speed is wanted, a syringe may be used.
Q.: Is the composition of the tube rubber, or rubber reinforced with canvas, like a garden hose?
A.: The stomach tube we use is distributed by the firm, H. Hauptner, Berlin, Germany. The tube is of rubber made by a special process. It contains no canvas.
Q.: Describe the degree of stiffness and flexibility.
A.: The flexibility of the tube may be compared to that possessed by a willow. The tube should be neither too hard nor too soft.
Q.: What is the nature of the end inserted? Is it just rounded smooth, or has it an enlarged end like a bulb or olive?
A.: The end inserted is rounded smooth.
Q.: Do you use a funnel, and if so, do you pass the tube first, or is the funnel fixed in the tube before you start?
A.: The outer end of the tube is connected with a vessel having a capacity of five quarts.
Q.: Do you pass the tube right down into the stomach, and if so, how do you know when it is in the stomach?
A.: We do not pass the tube into the stomach.
Q.: What measurements or computations do you use before you start on a horse of a given size to determine how far you are to pass the tube to be sure it has travelled far enough to be sure it has entered the stomach?
A.: No measurements or computations are necessary because the passing of the tube can be observed from the outside.
Q.: How far down the esophagus do you pass the tube?
A.: The tube is passed just a trifle beyond the aperture of the chest.
Q.: What measures do you adopt to prevent the tube being pulled out of the esophagus should the horse suddenly throw his head up, down or sideways.
A.: An Attendant keeps the tube in position by pressing the tube and nasal ala between thumb and fingers.
Q.: What length of the tube is free outside the body?
A.: This varies with the length of the neck and the length of the tube.
Method of Inserting the Tube.
Q.: Where do you stand in relation to the horse?
A.: The operator should stand always on the same side on which the tube is inserted through the nose.
Q.: What method do you adopt to aid or ensure the horse swallowing the tube?
A.: The head of the horse must be bent downward slightly. The tube must be lubricated. The stomach tube is inserted with the concave side of the coil as the underside: when the tin of the tube has about reached the larynx, the tube is then rotated 180 so that the concave side of the coil is now the upper side. This will prevent the tube from entering the larynx and will aid it in gliding into the pharynx and down the esophagus.
Q.: How do you determine that the tube is in the esophagus and not in the trachea; that is, what are the signs that it is in the esophagus?
A.: The tube can be seen in the jugular groove, gliding down the esophagus. When in the esophagus, the tube does not glide easily but offers a certain resistance. The contact of the tube with the esophageal wall causes a spasm which lasts from one to three minutes, before the muscles of the wall relax again, at the termination of which the tube has to be pushed down further at once. When the tube is in the esophagus, it is difficult to blow air into the tube. On putting the ear to the tube, if one hears regurgitating sounds, this is a sign that the tube is in the esophagus.
Q.: Is the tube easier to insert into the esophagus or into the trachea?
A. When the tube enters the trachea it glides down very easily, but the course cannot be observed from the outside. Cough is a symptom indicating that the tube is in the trachea.
Q.: If the tube at times enters the trachea, what procedure do you adopt to overcome this difficulty and prevent a repetition of this happening?
A.: The tube is to be pulled back and care is taken that the head of the horse is kept slightly bent upon the neck and that the concave side in the coil of the tube is directed upward.
Q.: Does the tube ever bend round behind the soft palate and enter the mouth and so fail to enter the esophagus at all? If so, how do you recognise this happening and what precaution do you adopt to prevent this occurring?
A.: When the tube bends over and enters the mouth, it will not become visible in the jugular groove and it cannot be pushed further down, This occurrence may be prevented by using a more flexible tube or by changing to the other nostril. Expedient use of the bending of the tube may be made in cases where it is desirable to dislodge a foreign body (carrot, apple,etc.) which has become lodged behind the vellum.
TREATMENT OF PARASITES IN HORSES BY MEANS OF THE STOMACH TUBE.
Questions by Dr. J. R. Stewart, Rushcutters Bay, Sydney, Australia.
Answers compiled from U.S. Department of Agriculture Bulletins.
Assuming you have now passed the tube to the prescribed position as mentioned before and have adopted the precaution described to ensure that the tube is correctly placed, describe the actual operation of dosing for bots.
Q.: What medicament do you use to eliminate bot larvae?
A.: Carbon disulphide.
Q.: Give dosage for (a) a foal six months old, thoroughbred; (b) a foal 12 months old, thoroughbred; (c) a two-year-old thoroughbred; and (d) a horse four years of age or upward, thoroughbred.
A.: The dosage of the medicament is 6 cc. for each 250 pounds of body weight (six drams for a horse weighing 1,000 pounds). Animals should he fasted for 18 hours before treatment.
Q.: Do you give the medicament (a) alone; (I)) diluted with any liquid, and if so, what liquid?
A.: Alone, undiluted.
Q.: Do you give any liquid immediately before or after the medicament, and if so, describe in detail and state quantities.
A.: The horse should be fasted for 18 hours before treatment. The use of oils or purgatives in combination with, or following, the treatment, is likely to be detrimental.
Q.: After dosing one horse, do you wash, disinfect or sterilize the tube before inserting into the next horse? And if so, describe the procedure.
A.: The tube is cleaned and rinsed in cold water, except when used in a horse with an infectious disease. In the latter case, the tube is sterilized in live steam.
Q.: What medicament do you use for the removal of worms?
A.: Carbon disulphide against Ascaris equorum, oil of turpentine against tapeworms, oil of chenopodium against strongylus species and against Oxyuris equi, carbon tetrachloride against Habronema.
Q.: Give prescription and dosage for (a) a foal six months of age, thoroughbred; (b) a foal 12 months of age, thoroughbred; (c) two-year-old thoroughbred; and (d) a horse four years and upward, thoroughbred.
A.: Carbon disulphide is given in a dose of 6cc. for each 250 pounds of body weight. Oil of turpentine is given in a dose of 60 cc. (in capsules), followed every second day by 30 cc. until live or six doses have been given. Oil of chenopodium is given in a dose of 4 cc. for each 250 pounds of body weight.
Q.: Do you give any liquid just prior to or immediately following the worm prescription?
A.: With the carbon disulphide treatment the animal should be fasted for 18 hours before treatment. Purgatives should not be given. In the case of oil of turpentine treatment, the last dose (of 30 c.c.) is immediately preceded or followed by one purgative dose of raw linseed oil. In the case of oil of chenopodium treatment, the animal should be fasted for 36 hours before treatment. One liter of linseed oil is given immediately preceding or following the antheimintic. Raw linseed oil may produce excessive purgation, and a substitute of castor oil and neutral oil may be used as follows:
Weanlings: Castor oil, four to six ounces; neutral oil, one pint.
Yearlings and two-year-olds: Castor oil, six to eight ounces; neutral oil, one pint.
Three-year-olds and older: Castor oil, eight to 10 ounces; neutral oil, one-and-one-half pints.
Q.: If whilst in the middle of the actual dosing the horse perchance performed some unaccountable gyration, such as throwing himself (a) what do you do; (b) what happens to the medicament?
A.: The stomach tube must be pulled out at once. Any medicament in the tube may be retained there by placing the thumb over the aperture in the free end.
Q.: As regards feeding, do you adopt mashing, and if so how many?
A.: The feeding of mashes is not required.
Q.: Do you employ starvation, and if so, how long?
A.: In the case of carbon disulphide, carbon tetrochloride and oil of chenopodium treatment, fasting for 18 to 36 hours, as stated, is required.
Q.: What after-care is required? What do you do immediately after treatment? Do you keep the animal away from food for several hours, and if so, for how long?
A.: Water as well as feed should be withheld for five to six hours after treatment.
Q.: Do you give water or feed first, i.e., do you allow a drink before feeding or do you insist upon feeding before watering?
A.: The individuality of the case must he taken into consideration.
Q.: Does the bot medicament cause purging?
A.: No.
Q.: Does the worm treatment cause purging, and if so, of what duration and how long before it starts?
A.: Carbon disulphide does not cause purgation; the aacarids usually come away on the second and third day, but may continue to be expelled for several days. Carbon tetrachloride causes purgation.
Q.: How long before the bots or worms begin to appear in the manure?
A.: The hots will be found in the feces in maximum number on the third day, and continue to pass for 17 days or even longer. Ascarids usually come away on the second and third day, but may continue to do so for several days.
Q.: Advise the risk of (a) death; (b) illness as a result of the medication. Describe methods adopted to (a) prevent; (b) overcome such happenings.
A.: The risks are as follows: Carbon disulphide is a volatile, inflammable liquid and should be kept away from fires or open flames. Oil of chenopodium is dangerous for pregnant mares; it is contraindicated in febrile conditions and in weak or debilitated animals. Carbon tetrachloride should be substituted.
Q.: What degree of efficiency does the method and treatment obtain?
A.: The degree of efficiency of the above-named drugs varies between 90% and 100%.
Q.: At what intervals must medication be repeated to ensure removal of all the bots and the great proportion of worms?
A.: This depends on the efficiency obtained with the drugs, and on the constitution of the horse, and the time at which treatment is given. Thirty days should intervene. No fast rule can be laid down.
Q.: How often should worm or bot treatment be repeated?
A.: It is customary to treat horses twice a year for the removal of ascarids and strongyles. One treatment for bots in late January or in February is sufficient. If given in December, It should be repeated in February or early March. (Dates changed to conform to to season in the Northern Hemisphere).