Diagnosis. Prognosis. Treatment. 423 



to differentiate the various forms of intestinal displacement, 

 since the treatment is the same in all three forms. Incarcerated 

 external hernia may be recognized on the basis of the symptoms 

 of closure of the intestines in connection with the local signs; 

 hence an examination of the inguinal ring and of the scrotum 

 should always be made whenever there are colicky pains, par- 

 ticularly in stallions. Changes of position and internal strangu- 

 lation niay be confounded with those types of intestinal obtu- 

 ration (impaction) which cause almost continual pain and ten- 

 derness upon pressure in well defined places of the abdominal 

 cavity (see page 382). Similar symptoms have occasionally 

 been observed in cattle in obturation of the bowel by blood 

 coagula. Aside from the result of rectal exploration, the con- 

 tinuous absence of general symptoms and anamnestic points 

 frequently furnish sufficient diagnostic data. Obstruction of 

 the urethra by calculi in male cattle is distinguished from in- 

 testinal strangulation by the following features: Urination 

 ceases in obstruction of the urethra, but not thj defecation 

 which goes on undisturbed, the patients exhibit peculiar pulsat- 

 ing motions of the urethra in the region of the intestines, rectal 

 exploration in the inguinal regions is negative and one can only 

 feel the urinary bladder in the shape of a flat cylindrical, thick 

 tumor, lying exactly in the median line. 



Prognosis. The prognosis is unfavorable if rectal or oper- 

 ative correction of the intestinal strangulation can, for some 

 reason or other, not be accomplished, because spontaneous re- 

 covery occurs only very exceptionally if at all, and medicinal 

 treatment has no influence whatever upon the affection. The 

 operative procedure is determined preferably by the species of 

 the patient, also by the duration of the train of symptoms, the 

 general condition of the animal, the condition of the constrict- 

 ing body, and by the question whether reposition can be ac- 

 complished per rectum or only by a laparotomy. The prognosis 

 is most favorable in cattle, even in such cases where a laparot- 

 omy is necessary. (Hoffmann observed losses only in 5% out 

 of 185 cases.) 



Dogs likewise stand the operation of laparotomy well. The 

 presence of a secondary peritonitis or of grave disturbances of 

 the general condition very much diminish the chances of oper- 

 ative procedure, and these are abolished completely if symp- 

 toms of collapse (unconsciousness, pale mucosa, subnormal 

 temperature, unrecognizable pulse, paralytic weakness) and 

 high fever in horses are already present. Exploratory puncture 

 may furnish certain data of prognostic value ; if a putrid smell- 

 ing fluid is obtained from the abdominal cavity there is no more 

 hope of saving the animal. 



Treatment. The nature and the manner of the origin of 

 the affection determine the fact that only operative procedure 



