LACTEAL FISTULA 133 



The milk tube is now removed and the cow allowed 

 to get up. 



In recent cases this bandage may be removed at the 

 end of ten days or two weeks, when the fistula is 

 usually entirely healed. In chronic cases three to four 

 weeks should elapse before removing the bandage. 

 The removal of the bandage is facilitated by first satu- 

 rating with alcohol, after which it may be unwound 

 gently. If the layer in contact with the teat sticks 

 tenaciously it should merely be saturated with alcohol 

 and then allowed to drop off of its own accord, a thing 

 it will do after a few days. 



The above is not an ideal or very scientific perform- 

 ance, but "it works" every time if the bandaging is 

 correctly done. 



In our hands, classical surgical procedures have been 

 failures in this condition. 



Lacteal fistulas resulting from meddling with a rudi- 

 mentary teat or from a rudimentary teat which has 

 begun to leak can only be cured by direct surgical 

 interference. 



In such cases the cow is cast, and the region of the 

 fistula is thoroughly cleansed with soap and warm 

 water, and rinsed with antiseptic solutions. The 

 mouth of the opening or fistula is then swabbed thor- 

 oughly dry with cotton and a local anesthetic injected. 

 The rudimentary duct is now grasped on one side of 

 its edge with rat-tooth forceps and dissected loose from 

 the wall of the teat or udder. A new hold is repeat- 

 edly taken with the forceps, around the entire circum- 

 ference of the duct, and the duct dissected inward to 

 a distance of at least half an inch. Great care must be 

 taken not to prick through the duct with the point or 

 edge of the knife. 



