Diai'iiosis. 



569 



to feel the end of the cystlike body and, with very few excep- 

 tions, there is no change in the shape of the abdomen or m the 

 position of the area of dnlness in different positions of the ani- 

 mal. The loops of the intestines do not permit of any change 

 of position of the large growth at all or only after some tmie. 

 In the larger animals rectal examination fnrnishes valnable 

 evidence for the exclusion of tumors or pregnancy. Retention 

 of the urine is almost always observed in cases of distension of 

 the bladder. Exploratory puncture is negative when there is a 

 tumor. In cases of cystic ovary a viscid liquid containing 

 ciliated epithelium is withdrawn and in hydro- or pyrometra the 

 liquid is generally turlnd or puslike and putrid. The differen- 

 tial diagnosis of ol)esity is 

 easy, because alteration of the 

 position of the animal does 

 not affect the shape of the ab- 

 domen and extensive areas of 

 dulness are lacking. Of course, 

 the negative result of explora- 

 tory puncture requires an ex- 

 planation. 



The presence of liquid in 

 the peritoneum is not diagnos- 

 tic of ascites, because the 

 same condition is met with in 

 serous peritonitis and as a re- 

 sult of rupture of the bladder. 

 The differential diagnosis of 

 acute peritonitis is easy on 

 account of the pain on pres- 

 sure on the abdominal wall, 

 the elevation of temperature 

 and the rapid course of the 

 disease. It is more difficult to 

 exclude the possibility of 

 chronic peritonitis. The symp- 

 toms so closely resemble each 

 other that a well-founded di- 

 agnosis can be based on the examination of the liquid obtained 

 by puncture in cases where the primary disease and the manner 

 of development of the condition are not known. Contrary to 

 what is the case with the transudate (see page 565) the exudate 

 is turbid, contains a large proportion of albumin (more than 

 3.5 per cent); its specific gravity is rather high (above 1,016) 

 and it contains fibrin and is comparatively rich in white blood 

 corpuscles. In cases of rupture of the bladder, the bladder is 

 found to be empty and the expired air, the skin and the liquid 

 obtained bv puncture smell of urine. 



It is often difficult to discover the inmiediate cause of the 

 ascites. As a general rule simple ascites is due to some dis- 



Fit,'. 76. The distension of the pelvic and 



neighboring portion of the abdomen due 



to ascites, the animal being held up in a 



sitting position. 



