Vulvar Diseases 813 



the infections and of the purulent exudates, the precipitated 

 urinary salts and other debris, by the use of physiologic salt 

 solution, or other neutral fluid followed by non-irritant anti- 

 septics (iodoform, bismuth) suspended in bland oil or in- 

 corporated in suppositories of wax or low-melting paraffin. 



7. Vulvar Diseases 



The vulva of the mare not infrequently suffers from in- 

 juries during parturition which lead later to important 

 infections. Parturient hematoma of the vulva are common. 

 Usually the blood clots are submucous and, when opened, 

 heal without serious infection. Not all cases terminate so 

 fortunately. When parturient abrasions are severe, infec- 

 tion of an important type is always to be feared and should 

 be anticipated by taking proper antiseptic measures. It is 

 highly important when, following abortion, the fetal mem- 

 branes are retained and lie in contact with parturient abras- 

 ions, that special precautions should be taken as in retained 

 fetal membranes in cows, and everything possible done to 

 avoid serious bacterial invasion. 



Twice I have observed vulvar gangrene in the mare fol- 

 lowing dystocia when the fetus was in the anterior presenta- 

 tion, dorso-sacral position, and the two posterior limbs ex- 

 tended underneath the body, engaged beneath the fetal chest 

 within the maternal pelvis. This caused the fetus to become 

 tightly jammed in the pelvis, where it pressed upon the in- 

 ternal pudic vessels and apparently caused a pressure or 

 anemia necrosis, leading, in one case, to rapid sepsis and 

 death. In the other case the gangrene caused vulvar atresia 

 and prevented breeding. Since in each instance the dystocia 

 developed at night and was not discovered until morning, 

 the perilous pressure upon the soft parts had been continued 

 for a long period of time. When such injuries occur, the vet- 

 erinarian should anticipate vulvitis by means of warm 

 douches with massage, and such other measures as may sug- 

 gest themselves in the particular case. It is to be remem- 

 bered that fatal gangrene is at least possible, and, while 

 probably preventable by the application of vigorous anti- 

 septic measures, is not ordinarily curable. 



