itis offers no difficulty. In the very early stages,
however, it may, as we have already indicated, be mistaken for the oncoming
of Enteritis, Lymphangitis, or even Pneumonia. The paddling of the feet
may help us. If this is absent, however, nothing but a most careful
examination, or, if necessary, the withholding of our opinion until the
following visit will prevent a blunder being made.

Even when well established, laminitis has been mistaken for paralysis,
for tetanus, for rheumatic affections of the loins, or even for some
undiscovered affection of the muscles of the arms and chest. This latter is
no doubt suggested to the uninitiated by the reluctance the animal shows to
move the muscles _apparently_ of that region, and led the older writers to
give to the disease its name of 'Chest-founder.' It is only fair to add,
however, that these blunders in diagnosis are nearly always committed by
persons without a veterinary training.

Thus warned, the veterinary surgeon of average ability should have no
difficulty in establishing a distinction between the diseases we have
enumerated as likely to be confounded with it, and the one this chapter is
describing.

The prognosis in laminitis should, in our opinion, always be guarded. No
advice given in a work of this description can be of any real use, for
every case must be judged entirely on its merits. The severity of
the symptoms, the cause of the attack, the complications, and the
idiosyncrasies of the patient, have all to be taken into account. These the
veterinarian must be left to judge for himself.

_Treatment_.--The treatment of acute laminitis in its early stage must be
based upon the fact that we have to deal with a congested state of the
circulatory apparatus of the whole of the keratogenous membrane. This fact
was well enough known to the older veterinarians. It is not surprising,
therefore, to learn that jugular phlebotomy was at once resorted to as the
readiest means of relieving the overcharged vessels of their blood. As a
matter of fact, bleeding from the jugular is still advocated by modern
authorities. We cannot say, however, that we unhesitatingly recommend it.
Mechanically, of course, the removal of a large quantity of blood is
bound to result in a lowering of the pressure in the vessels. The effect,
however, is but transient. Blood removed in this way is again quickly
returned to the vessels so far as its fluid matter is concerned, and the
pressure, remo