422 DISEASES OF THE BLADDER 



passed. Attention is usually called to the case by the con- 

 stant dribbling of urine. 



Examination of the bladder is necessary to determine the 

 presence of the calculus. This may be made either by digital 

 examination through the rectum, by abdominal palpation, 

 or by laparotomy. (See Examination of Bladder.) 



Prognosis. Cases when taken early before systemic dis- 

 turbances make their appearance from absorption of urine, 

 etc., are favorable. However, the local disturbances in the 

 bladder produced by the calculi should be taken into con- 

 sideration, for sometimes serious alterations difficult to heal 

 will be found in the mucosa. 



Treatment. Surgical treatment is the only satisfactory 

 method of removing calculi from the bladder. In the male 

 animal the following procedure has been found to be the most 

 efficient. 



The animal is prepared for operation by being given an 

 anesthetic, placed on the table in the dorsal position, and 

 the field of operation just anterior to the pubis and lateral 

 to the penis shaved and disinfected. The incision should 

 be 2 to 3 inches in length, so that the bladder can be exposed. 

 After exposing the bladder it should be well protected with 

 gauze to prevent urine from flowing into the cavity when 

 incised. The incision is made through the walls of the 

 bladder where bloodvessels show the fewest anastomoses. 

 It should be of sufficient size to remove the calculus. After 

 the removal of the calculus the mucosa of the bladder should 

 be examined for smaller stones or deposits, and if any are 

 found they should also be removed with a blunt curette. 

 The mucosa is then swabbed with gauze saturated in an anti- 

 septic solution. The wound in the bladder is sutured with 

 a double row of sutures bringing the serous coats in direct 

 approximation. The sutures should be placed close together 

 to prevent the urine escaping until adhesion takes place. 

 The laparotomy wound is closed and protected in the usual 

 manner. In the female two methods are employed: 



(a) The animal, well hoppled, is placed in the ventral 

 position on the table. A vaginal speculum is used to dilate 

 the vagina. A grooved director is inserted into the urethra 



