RETENTION OF URINE IN THE BLADDER 415 



in which case the symptoms of pain will disappear for a time 

 until peritonitis and uremia develop. If the bladder ruptures 

 symptoms of uremia will develop in a few hours. (See 

 Uremia.) 



In the dog the distention of the bladder will produce a 

 noticeable increase in size of the abdominal cavity. Careful 

 palpation will reveal the distended movable bladder. When 

 rupture occurs the fluid will be detected free in the abdominal 

 cavity. In such case puncturing the a"bdominal wall w r ith an 

 exploring trocar will reveal the presence of urine. Care 

 should be observed, however, to determine whether the 

 fluid is in the cavity or still in the bladder, as the distended 

 bladder can extend well forward in the abdominal cavity. 



Diagnosis. The symptoms should be noted carefully. If 

 the patient shows colic, frequent micturition, with small quan- 

 tities of urine passed, a careful and thorough examination 

 of the urinary organs should be made. As retention of urine 

 in most cases is secondary to some disease of the urinary, 

 organs, a careful examination should be made to determine 

 the' primary condition. The examination may include 

 puncturing the abdominal walls, laparotomy, rectal or vaginal 

 exploration. 



Prognosis. The prognosis depends principally upon the 

 possibility of relieving the primary condition, and whether 

 or not the bladder is still intact. In case of rupture it is 

 unfavorable, especially when symptoms of uremia are present. 



Treatment. The treatment must be directed toward 

 removing the causes. In cases of paralysis of the walls of 

 the bladder, it is advisable to remove the urine as early as 

 possible. This can be done in most cases by catheterization. 

 Small doses of strychnin (0.001, dog) are recommended to 

 give tone to the walls of the bladder. 



In spasms of the sphincter vesica 1 , catheterization may be 

 tried; if unsuccessful,, puncture the bladder and remove a 

 portion of the urine. A small dose of morphin will overcome 

 the spasmodic contraction, allowing the urine to flow out. 



In case an obstruction to the outflow of urine exists, treat- 

 ment must be applied to remove it. 



House-broken dogs should be allowed to run out of doors 

 at regular intervals to avoid extreme distention. 



