864 Veterinary Obstetrics 



there be present, within the bladder, a calculus or tumor, the 

 danger to the viscus would be very great. Should the floor of 

 the vagina and the upper wall of the bladder become very severely 

 contused, and the two adhere, there might well occur a sloughing 

 of the injured portions, and eventually an artificial communication 

 between the bladder and the vagina. Chronic purulent cystitis, 

 see page 900, which is not a very rare disease in the mare, fol- 

 lowing vaginitis and other maladies, should not be mistaken for 

 vesico-vaginal fistula. 



The handling of vesico-vaginal fistula should be based upon 

 general surgical principles, adjusted to each individual case. 

 The fistula cannot be overcome unless the urethra remains open. 

 In such a lesion, as a general rule, there would be, in addition, 

 a chronic, purulent cystitis, with an accompanying precipitation 

 of the urinary salts upon the walls of the bladder, causing the 

 latter to become very greatly thickened and paretic, while they 

 give to the finger the sensation of being covered with fine sand 

 which has formed into crusts. This condition needs be overcome 

 by repeated irrigations with warm water, wuth possibly very mild 

 anti.septics as recommended on page 900. 



16. Hematoma of the Vulva. 



During or about the period of parturition, there occasionally 

 appear in the vulva more or less extensive hematoma, due to the 

 rupture of blood ves.sels, causing a hemorrhage beneath the 

 mucous membrane in the loose connective tissue. 



The date of their appearance varies. In one instance w^e noted 

 a hematom of considerable size in a mare, following parturition, 

 in which no dystokia had occurred so far as was known. In a 

 .second instance we noted the development of a hematom which 

 contained about }4 pound of coagulated blood, in a mare not yet 

 due to foal. In this animal there had been a somewhat severe 

 colic, which had continued for 18 or 20 hours with some tjanpany, 

 but she had not rolled violently and it was not known that she 

 had received any injury. The owner had made a manual ex- 

 ploration of the vagina, but apparently had done nothing which 

 might cause the hematom to form. The great vascularity of the 

 part just prior to parturition tends to favor such lesions upon 

 very slight provocation. In one of these cases the hematom oc- 



