192 PATHOLOGY OF PREGNAXCY. 



will follow the everted vagina, and a spontaneous reduction can no 

 longer take place, while manipulation increases the straining. This is 

 in reality now a case of ijrolcqMiis uteri, and an examination of the 

 voluminous mass may lead to the detection of some portion of the foetus 

 in its midst. Not only this, but the prolapsus of vagina and uterus 

 will, in all probability, produce displacement of the bladder, and when 

 this is distended with urine it will gravely complicate the case and 

 render reduction more difficult. 



According to Cox,i Sheep, when heavy in Lamb, frequently evert a 

 double fold of the vaginal mucous membrane. This happens when 

 they are in a recumbent position, and it is in some animals of such 

 frequent occurrence as to cause excoriation and ulceration. 



Tkeatment. — This prolapsus, in the majority of cases, does not appear 

 to cause the slightest inconvenience to the animal, and offers no obstacle 

 to parturition — indeed, it has been noted that such Cows calve more 

 easily than others ; neither does it predispose to chronic eversion of the 

 vagina, as has often been supposed. After calving, the vaginal tumour 

 disappears without any treatment being required. But if treatment is 

 necessary, the first thing to be done, should the floor of the stall be lower 

 behind than in front, is to level it, or even raise it a little behind. This 

 may be readily accomplished by means of the litter. The diet may 

 also require attention, giving that which contains sufficient nutriment 

 in small bulk ; constipation should be guarded against or remedied. 

 This treatment will be sufficient in the majority of cases. In others, a 

 bandage, to be hereafter described, may be required, and especially if 

 the tumour is liable to become soiled and irritated when the animal is 

 lying. 



In serious cases, when the tumour is large and the Cow strains, and 

 spontaneous reduction does not occur in the standing position, the mass 

 must be returned. This is readily enough accomplished ; but it some- 

 times happens that reduction does not prevent a continuation of the 

 straining, and even with the bandage the everted vagina again appears. 

 This is due to the mucous membrane, which, not having been properly 

 smoothed down when introduced into the pelvic cavity, is ridged, and 

 these rugae give rise to an uncomfortable sensation, and induce expul- 

 sive efforts. 



It is necessary, therefore, in reducing the part, to cleanse it well with 

 tepid water, and to smooth the vaginal mucous membrane by gentle 

 pressure forward as far as the cervix uteri, in order to efface any folds 

 which may excite uneasiness. After this the bandage may be applied 

 with a view to keeping the vulva closed, until its labia have retracted 

 somewhat. Wire sutures through these have been recommended, but 

 they are very rarely required. 



In very exceptional instances, we may have not only complete pro- 

 lapsus vaginae, but also, as has been said, partial protrusion of the 

 uterus itself. Then the case is very serious, owing to the excessive 

 straining and the weight and bulk of the foetus, which has to be 

 returned beyond the inlet of the pelvis. 



But in the majority of cases reduction may be successful, and appar- 

 ently desperate cases may be saved by the exercise of patience and tact. 

 The Cow must be made to stand, with the hind quarters as high as 

 possible, and to prevent straining the loins should be pressed upon 

 ' Veterinary Journal, vol. i., p. 267. 



