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This test is delicate, and will detect 1/1000 of a milligramme, but it is not quantitative. Persons using these preparations may suffer from catarrhal symptoms, rashes on the neck, ears, and face, thirst, nausea, pain in stomach, vomiting, headache, perhaps peripheral neuritis and loss of patellar reflex.
In young and rachitic animals outdoor exercise and a good nutritive ration for the subject are indicated. Hypophosphites in assimilable form may be beneficial, and vesication of the patellar region contributes to recovery. Where extreme luxation is present in both stifles, the prognosis is unfavorable.
Sudation and restlessness are manifested and the subject presents a clinical picture of distress and fear of a painful ordeal. In some cases of this kind, complete recovery takes place by the time animals are five or six years of age. One should avoid keeping such subjects in narrow stalls. Preferably patellar desmotomy should be performed that relief may be obtained at once.
Because of immobilization of the stifle and hock joints in upward luxation, the subject can walk only by hopping on the sound leg and then the extremity is flexed, allowing the anterior portion of the fetlock to drag on the ground. Such cases may be styled momentary luxation, whether they are due to a weakened condition of the patellar ligaments or spasmodic contraction of the crural muscles.
The subject becomes more lame and eventually is rendered incapable of service. Upon manipulation of the patellar region, one is impressed with the fact that hyperesthesia does not exist in proportion to the pain manifested during locomotion. In some cases a gelatinous swelling is present and may be detected by palpating between the straight ligaments of the patella.
Traction is exerted upon the rope and at the same time force is directed against the stifle joint to produce further extension if possible, so that the straight patellar ligaments may relax sufficiently to allow the patella to be dislodged from its position upon the inner trochlear lip. Failing in this manner of procedure, the affected animal is to be cast and anesthetized with chloroform.
Also, some practictioners report cases of patellar luxation and refer to pseudo-luxations, without clearly defining the conditions which constitute pseudo-luxation. This has contributed to the extant cause of misconception as to actual differences between luxation and conditions simulating dislocation.
Möller states that moderate exercise or work stimulates the establishment of collateral circulation. Massage per rectum is condemned as dangerous by Cadiot. Fracture of the Patella. Etiology and Occurrence. Patellar fractures are rarely met with in the horse but may be caused by falls and heavy contusions. Violent muscular contraction, it is said, may also bring about the same condition.
DR CROTTHERS: I have examined the patient's urine. It is albuminoid. Salivation is insufficient, the patellar reflex intermittent. DR PUNCH COSTELLO: The fetor judaicus is most perceptible. His moral nature is simple and lovable. Many have found him a dear man, a dear person. He is a rather quaint fellow on the whole, coy though not feebleminded in the medical sense.
In cases of habitual luxation, unless the ligaments are so lax that the patella may be displaced laterally over the inner as well as the outer trochler rims, division of the inner straight patellar ligament will correct the condition. This desmotomy has been advocated by Bassi, and good results in appropriate cases have been reported by Cadiot, Merillat and Schumacher.
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