300 DISEASES OF THE UTERUS 



Puerperal septicemia should be differentiated from acute and 

 chronic metritis which can be made by a careful examination 

 of the patient. 



Prognosis. The prognosis is unfavorable, most cases ter- 

 minating fatally. Mild cases often recover; more severe 

 ones may recover if treatment can be applied early. 



Treatment. Medical. In cases of marked collapse, sub- 

 normal temperature, etc., stimulants, such as aromatic 

 spirits of ammonia, spirits of camphor, oil of camphor, or 

 strychnin should be administered early. 



Surgical. As local applications in the form of irrigation 

 with antiseptics have proved unsatisfactory, an early opera- 

 tion is advised. Before operating obviously the genital 

 tract should be flushed with antiseptics. The animal should 

 be anesthetized and operated as in chronic metritis. (See 

 Chronic Metritis.) Care must be exercised in preventing 

 infection of the serous membrane of the abdominal cavity. 

 The stump of the uterus should be inverted and thoroughly 

 disinfected before it is returned to the abdominal cavity. 



The after-treatment is very important, and prompt 

 remedial agents (stimulants) should be administered. 



Irrigation of the vagina should be done at regular intervals 

 to control local infection. Normal salt solution should be 

 used in cases of collapse following the operation. It is best 

 injected intraperitoneally (250 to 500 c.c.). 



EVERSION OF THE UTERUS. 



Prolapse. Inversion of the Uterus. 



Eversion of the uterus is not common in the small, multip- 

 arous animals, particularly in the dog and cat. The small 

 uterus and long cornua present an anatomical arrangement 

 which tends to prevent eversion except in rare instances. 



It is occasionally observed in the bitch following parturi- 

 tion. The eversion in most cases consists of an invagination 

 of the anterior extremity of the cornu into the succeeding 

 portion, and should the process continue, it will appear at 

 the vulva or even project outside. In most cases the pro- 

 lapsed portion will consist of one cornu and a portion of the 



