338 DISEASES OF THE THYROID GLANDS 



important means of making the differentiation between the 

 various forms of goiter. 



Prognosis. In parenchymatous goiter most cases recover. 

 The glands grow smaller until of normal size or near it, and 

 any general symptoms disappear. However, in cases where 

 the glands are enormously enlarged and symptoms of cretin- 

 ism and myxedema are present the prognosis is not favorable. 

 A recurrence of this form of goiter, while rare, is always 

 probable. 



Treatment. lodin medication both externally and inter- 

 nally has proved to be of great value. Some remarkable 

 results have been obtained in the rapidity and degree of 

 reduction after its use. For internal administration it has 

 been definitely proved that small doses give the best results. 

 The dose should be regulated somewhat according to the age 

 and size of the animal. One-fourth grain, 0.016 of potassium 

 iodid for puppies, or 0.05-0.08 for older animals, given 

 once daily, has given the best results. When given in large 

 doses there is danger of too rapid depletion of the body and 

 paralysis of the heart. These small doses should be continued 

 daily for one to three weeks. For external application color- 

 less tincture of iodin may be applied. Where staining the 

 hair does not matter the regular tincture should be employed. 

 An application can be made daily, or every second day. 

 Thyroid extract (0.15 daily) has been used with excellent 

 results. Surgical interference has not proved successful 

 in relieving this form of goiter. Complete unilateral 

 thyroidectomy might be tried in case one gland is 

 enormously enlarged and the other nearly normal. The 

 operation is performed under general anesthesia and strict 

 antiseptic precautions. The gland is dissected out carefully 

 and multiple ligation of the pedicle is necessary so that the 

 tissue will not retract and allow the ligature to slip off. The 

 gland is then removed about ^ inch from the ligature and the 

 wound packed with antiseptic gauze for a few days. The 

 ligature is then removed cautiously and the wound covered 

 with an antiseptic dusting power. It is very important that 

 the wound be kept free from infection during the first few 

 days, and the ligature kept in position to avoid fatal hemor- 

 rhage. 



