846 Veterinary Obstetrics 



occur at the seat of the sutures, which may readily involve the 

 general surface of the uterus. 



The prognosis of amputation of the uterus varies in 

 different animals, and under different conditions. In the mare it 

 is usually unsuccessful. In the cow it is a fairly successful 

 operation, if undertaken indue season and carried out with proper 

 care. In the smaller domestic animals it is usually quite success- 

 ful, especially in the sow and carnivora. 



Technic. Before proceeding with amputation, the entire 

 prolapsed organ is to be carefully cleansed and disinfected, and 

 placed upon a sheet of sterile gauze or other material, where it 

 may be well protected during the operation. As far as possible, 

 the blood accumulated in the organ should be forced back into 

 the circulatory system by compression with the bandage of 

 Coquelet as, described on page 836, or by other means. 



Great care should also be taken that other viscera are not in- 

 cluded in the operation. The bladder may extend out into the 

 prolapsed organ, and be caught or damaged in the operation. 

 Very frequently a loop of intestine projects out into the peritoneal 

 sac of the prolapsed organ, and numerous instances have oc- 

 curred where veterinarians have carelessly ligated the organ and 

 included the intestine, causing the death of the patient. In order 

 to safely determine whether any viscera extend into the cavity 

 of the prolapsed organ, the veterinarian should incise the uterine 

 wall under aseptic precautions, and insert a finger or his hand 

 into its peritoneal cavity. 



Amputation is to be carried out by the ligation or suturing 

 of the entire organ. Some operators advise that it be 

 ligated in parts, while others strongly insist that the organ 

 should be ligated in toto. The latter is the usual cu.stom, 

 and probably the best. The material for the ligature may vary 

 according to availability in a given case. One of the best and 

 most satisfactory materials is silk tape, which is soft and very 

 strong, so that it will admit of being drawn very tight. Others 

 use a heavy cord of almost any character, and some veterinary 

 obstetrists advise the use of a moderately thick and strong pure- 

 gum tubing. 



In the larger domestic animals, the ligature should usually be 

 placed about the cervix of the uterus, near to the external os, 

 while in the smaller multiparious animals, in which generally 



