RUPTURE OF THE BLADDER 413 



in the diagnosis of rupture. Passing the catheter will reveal 

 the empty bladder. Examination by performing laparotomy 

 should be done as early as possible in all cases where rupture 

 is suspected. 



Prognosis. After the development of general symptoms 

 of collapse, subnormal temperature, etc., the condition is 

 considered unfavorable. In cases of rupture where the 

 diagnosis is established early, or, in accidental cutting 

 through the walls of the bladder during surgical operations, 

 the prognosis is quite favorable, provided prompt treatment 

 is given. 



Treatment. Medical. It is always advisable to administer 

 stimulants at once. Strychnin in small doses (0.001). 



Surgical. Prompt surgical treatment is absolutely essen- 

 tial for a successful termination. 



The animal should be properly prepared for laparotomy 

 (see Laparotomy), and the operation begun as soon as 

 possible. The abdominal cavity should be emptied of all 

 the retained urine, by flushing thoroughly with normal salt 

 solution, which should be repeated two or three times to be 

 sure that all the urine is removed. Locate the wound in the 

 bladder and suture with interrupted and Lembert stitches. 

 A milliner's needle will be found to be the best suturing needle. 

 Place the stitches quite close together. Suture the abdominal 

 wound in the usual manner. The after-treatment consists 

 in placing the animal in a warm place and using stimulants 

 for the first ten to twelve hours. Thoroughness in treating 

 these cases will often bring excellent results. 



Wounds of the bladder, such as gunshot wounds, injury 

 by compression without complete rupture, puncture by 

 fragments of bone, etc., are found in the dog, and their 

 seriousness depends upon the degree of injury. In very 

 small punctured wounds and small bullet wounds, aside from 

 the symptoms of cystitis, and stiffness, no serious com- 

 plications set in and the animals make prompt recoveries. 

 In the other forms when urine escapes into the peritoneal 

 cavity and some hemorrhage takes place, the case will soon 

 assume serious complications. (See Rupture of the Bladder.) 



