Retained Placenta in the Coiv 807 



Copious irrigation of the uterine cavity, within a few hours after 

 calving, washes away placental debris, fetal fluids and retained 

 blood clots, stimulates uterine involution, and greatly favors the 

 spontaneous expulsion of the membranes. 



The irrigating fluid should be at least as warm as the uterine 

 cavity, but not of appreciably higher temperature, and should be 

 of soft water or softened by the addition of soda bi-carbonate, to 

 which may be added 0.6% of salt. 



The irrigation should be begun as early as convenient after 

 calving, and may be repeated every 4 to 6 hours. The irriga- 

 tion is to be carried out under antiseptic precautions, and very 

 gently. When the horse stomach tube we have advised is used 

 for irrigation, the properly lubricated end can be pushed forward 

 gently, and with some rotary motion, through the vagina and 

 into the uterine cavity, usually without inserting the hand, thus 

 avoiding the manual introduction of infection. The tiibe is 

 rigid enough to be reasonably subject to external direction, and 

 pliable enough to obviate any danger of wounding the genital 

 tract. 



The prognosis of retained placenta is exceedingly variable, 

 but must always be cautious. Whenever the afterbirth can be 

 completely removed manually within 24-48 hours after calving, 

 the prognosis is highly favorable. It must, however, depend 

 upon the state of the uterus itself, and upon the general vigor of 

 the animal. If the uterus is highly inflamed and paretic, the out- 

 look is always serious. 



In our experience, the most serious ca.ses have usually been 

 those where some part}' has unsuccessfully attempted to remove 

 the membranes, and has merely succeeded in tearing away the 

 major portion of the chorion, leaving many of the fetal placentae 

 still firmly attached to the cotyledons, and naturally leaving many 

 of the cotyledons themselves more or less seriously injured. 

 When this has been done, and severe straining follows, accom- 

 panied \yy a high temperature and loss of appetite, we have found 

 the disea.se highly fatal. On the other hand, the uterine walls 

 may be very intensely inflamed, firm, paretic, and yet recovery 

 occur. Pomayer has emphasized the value, in this disease, of 

 the degree of leucocytosis in the uterine walls. It is, he says, 

 the number of leucocytes which exist in the uterine walls, or 



