STONE IN THE BLADDER 201 



bulbus cavernosum. The incision must be made down on the catheter, 

 which has been previously inserted as far up as possible. The higher op- 

 eration must never be attempted unless this latter precaution is taken, as 

 it is almost impossible to find the urethra unless the sound is in it. 



Another mode of operation is to introduce a catheter into the penis 

 until it reaches the obstruction, and by means of a tape looped around 

 the free end of the penis it is drawn away from the prepuce, which is 

 held back ])y an assistant, and then cut down on the end of the catheter; 

 the catheter is pulled back a short distance, but not entirely, and the 

 penis bent over, and by means of a small pair of blunt forceps the stone 

 can be removed; when this is accomplished pass the catheter into the 

 bladder and wash out any calculi that may still remain in the bladder 

 or urethra; by means of a small hose attach the catheter to a syringe and 

 inject the bladder full of tepid water. 



In the bitch the operation is much more simple. The urethra is 

 opened by means of a thin tenotome introduced on a grooved director 

 and the opening enlarged, and then the forceps passed into the opening, 

 the stone crushed, and the bladder washed out. It is generally necessary 

 to introduce one finger into the rectum to guide the stone into the forceps 

 before it can be grasped. Great care must be taken in such an operation 

 to avoid crushing the tissues. In the bitch there is no after-treatment 

 necessary. 



Cystotomy. — Laprocystotomy, or cutting through the abdominal 

 wall is the only mode permissible on the dog, lithotripsy being pro- 

 hibited on account of the size and anatomy of the urethra of the dog. 



Laprocystotomy, cystotomy suprapubica: Preparatory to the op- 

 eration the urine is removed from the bladder and the bladder washed 

 out with a 2 per cent, solution of boracic acid, the tissues in the neighbor- 

 hood of the incision thoroughly cleansed and disinfected, the animal is 

 put under ether and an incision is made in front of the pul^is parallel 

 with the prepuce and directly on the median line (in the bitch cut 

 directly on the linea alba); make an incision about 5 to 8 cm. long, 

 take up the hemorrhage by means of absorl)ent cotton, then draw 

 out the bladder, surround it with cotton compresses and an incision 

 about 1 to 3 cm, is made in the bladder and by means of a pair of 

 forceps the stone removed, if the stone is incysted it should be scraped 

 out; the bladder is then washed out with boracic acid solution, the 

 wound stitched with carbolized catgut, the muscular and serous coats 

 are sewed with the edges turned inward, the stitches must be put very 

 close together as distention with urine causes the very elastic bladder to 

 open and allow the escape of urine into the peritoneal cavity; return the 

 bladder after having first cleansed it with boracic acid solution, and 

 the abdominal wall closed and the wound covered bv a bandage. As 



