646 PROLAPSE AND INVERSION OF THE URINARY BLADDER. 



to suture it, to prevent recurrence and to guard against the passage 

 of urine into the abdominal cavity. 



For* retroflexed bladder in the dog, with no great difficulty in 

 urinating, a laxative diet should be prescribed. If retention occur, 

 enemas of oil or warm water should be given ; while reposition of 

 the bladder may be effected by raising the dog's hind quarters and 

 applying light pressure to the swelling. A finger inserted in the 

 rectum may prove of much assistance in the necessary manipulations. 

 If the bladder is much distended, it must be punctured — using a 

 fine hollow needle — and the urine drawn off ; afterwards further 

 efforts at reduction should be tried. 



When the bladder becomes inverted, the first point is to effect 

 reposition before the mucous membrane is much altered. After 

 expelling the peritoneal fluid from the inverted bladder by pressure 

 and cleaning the prolapsed part, the animal may be placed with the 

 hind-quarters high and a twitch applied ; but operation under 

 anaesthesia in the recumbent position should be preferred. The 

 urethra is sometimes so wide that the displaced bladder can be passed 

 through it with the hand, but should it prove too narrow, a blunt 

 stick, well rounded off at one end to prevent injury to the bladder, 

 may be employed. Lonnecker employs a probang for this purpose. 

 The hand or stick is placed on the base of the bladder and the latter 

 gently pushed through the urethra. By injecting a lukewarm fluid 

 like boric acid lotion, diluted alum lotion (1 to 5 per cent.) or tannin 

 (1 to 2 per cent.), recurrence may be prevented and inflammatory 

 reaction checked ; such solutions also favour contraction of the 

 urethra. By slow exercise, pressure on the loins, or by administering 

 an anodyne, straining and possible recurrence may be obviated. 



Lonnecker replaced an inversion, but as it reappeared five days later 

 he sewed up the orifice of the urethra, grasping and raising the mucous 

 membrane with the left hand, and passing a lead wire through it, after 

 which recovery took place. Holgen successfully effected reposition five 

 weeks after the first appearance ; probably the bladder was not continuous] y 

 e.\ posed. The same applies to the case related by Degive, in which 

 reposition or reversion was successful fourteen days after the viscus first 

 protruded. 



As a rule, however, the surface of the mucous membrane is so 

 much injured during prolonged exposure as to become necrotic, 

 in which case reposition is contra-indicated, and amputation of the 

 bladder offers the only chance of recovery. Though this certainly 

 deprives the animal of the natural reservoir for the urine, which, 

 therefore, flows continuously or is discharged in small quantities 



