690 PROLAPSE OF THE UTERUS. 



Such invagination may remain after prolapse if the uterus and 

 its cornua are not completely returned. In mares, the interior 

 portion of the displaced uterus is sometimes strangulated in the 

 cervix uteri, generally producing a fatal issue. A similar accident 

 has been seen in cows. 



In any case, prolapse of the uterus presupposes elongation of 

 the uterine ligaments, and therefore the factors predisposing to 

 prolapse of the vagina predispose to this condition. They consist- 

 in too high a position of the fore-limbs, repeated pregnancy, &c. ; 

 the immediate causes are generally uterine inertia with non-occurrence 

 of post-part um contraction, severe straining and excessive labour 

 pains. Retention of the after-birth is one of the chief, partly because 

 the cervix then remains open for a long time, partly because the 

 manipulation necessary to remove the fcetal membranes favours 

 inversion. Violent interference during parturition may also give 

 rise to it. Relaxation of the cervix is the second necessary condition ; 

 the disease is therefore rare, except soon after parturition. 



Symptoms. As already remarked, incomplete prolapse, i.e. 

 inversion of a portion of the uterus, is seldom directly observed, 

 though it sometimes causes metritis and death ; usually, however, 

 it may be detected by introducing the hand into the vagina. 



In complete prolapse of the uterus, a swelling, covered by mucous 

 membrane, and similar to that in prolapsus vaginae, appears beyond 

 the vulva. In cows, it resembles a half-filled sack ; in mares, its 

 form is more cylindrical, the organ sometimes reaches as far down- 

 wards as the hocks ; the surface is not infrequently covered by the 

 fcetal membranes, but in the cow, if the membranes have already 

 been removed, the cotyledons, which have a mushroom-like form, 

 will be exposed. The surface gradually dries, and often becomes 

 soiled and wounded. In swine, the prolapsed uterus is not infrequently 

 bitten by the other occupants of the sty. 



The prognosis is most favourable in cows, provided the uterus 

 is not injured and has not been exposed more than three or four hours. 

 Violet estimates the mortality in the mare at 68 per cent., and in the 

 cow at 13 per cent., while of 123 cases in mares and cows, mentioned 

 by Stockfleth, 83 recovered, 20 died and 20 were destroyed. 

 Reposition, though certainly not easy, is yet generally possible, 

 and if not, the animal's life can, . as a rule, still be saved by 

 amputation. In other animals, and particularly in mares, the 

 condition is grave and often fatal. Fenner, however, saved a mare 

 after suturing a wound about 4 inches in length, involving the mucous 

 and muscular coats. Korner removed the uterus in a mare by ligature, 



