PERITONITIS 253 



symptoms, and is very persistent. The vomitus consists 

 mainly of mucus, food particles, bile, and, if severe, of fecal 

 matter. 



There is complete loss of appetite noted early in the course 

 of the disease. The urine is decreased in quantity, highly 

 colored, and contains a large amount of indican. There is 

 often severe straining as if to urinate (tenesmus vesicae). 



In the early stages there is diarrhea followed later by 

 constipation with considerable tympany. In the very early 

 stages the temperature in the dog and cat is elevated (104- 

 106° F.). The temperature, however, remains high for only 

 a few hours when it drops rapidly and becomes subnormal 

 (96-100° F.). In small animals the temperature in perito- 

 nitis is usually normal or subnormal. 



The pulse is rapid, small, hard and often wiry. In the 

 later stages the pulse becomes very weak, irregular, and 

 finally imperceptible. The extremities grow cold, the 

 mucous membranes cyanotic, and there is every evidence of 

 a deficient heart action. 



Effusion of fluid (ascites) is usually present except in some 

 of the more acute cases which are rapidly fatal. The per- 

 cussion sound is flat, the area of dulness shifting as the 

 patient's position is changed. A friction sound may be 

 present in the early stages, but due to the effusion which 

 forms early, soon disappears. 



In some cases of peritonitis, due to severe septic infection 

 (rupture of abscesses), the course is very rapid and the 

 general symptoms of toxemia are the only ones noticed. 

 Peritonitis following rupture of the stomach or bowel, from 

 severe injury, such as being run over, kicks, etc., runs a very 

 rapid course. General weakness, coldness of the extremities, 

 and coma may be the only symptoms noted. 



The symptoms of circumscribed peritonitis are similar to 

 those of diffuse, except that they are so mild at times as 

 to be overlooked. 



Course.— The acute, diffuse peritonitis usually terminates 

 in death. The most intensive forms usually produce death 

 in thirty-six to seventy-two hours; however, most commonly 

 death results in five to eight days. Some of the milder cases 



