244 CANINE AND FELINE SURGERY 



a size, it ma}- be washed out of the urethra \\ith the next 

 outflow of urine. In large dogs a pair of long thin urethral 

 forceps can be passed up the urethra, and the stone crushed 

 or removed intact, but this is rendered impossible in small 

 patients on account of the narrowness of the groove in the 

 bone of the penis. It is ah\a}'s \\-orth while, before deciding 

 upon urethrotom^^ to \.r\ whether manipulation and careful 

 pressure upon the bladder between the ball of the thumb 

 and the fingers will not remove the obstruction. This is 

 especially the case in the cat, and the end of the urethra 

 should first be carefully squeezed and picked out. For this 

 purpose, on account of the small size of the opening, a fine 

 probe or a thin wire (such as the stylet of the catheter), if 

 used cautiouslv, improvises very \\&A. 



If, bj' mischance, during manipulation the bladder does 

 rupture, the operator has warning of it in the sudden collapse, 

 and perhaps attempt at vomiting, of the patient. Immediateh- 

 previous to that he has probably heard or felt it go, the 

 bursting making a distinct ' popping ' sound, and the collapse 

 of the structure in the hand being very sudden. In the event 

 of such an accident, the only chance lies in immediate 

 laparotomy (see p. 158), suture of the rent in the bladder wall 

 (see p. 259), and careful swabbing out of the abdominal cavity 

 with antiseptics. The chance of success, on account of the 

 patient's condition, is a ver}- slender one ; otherwise, under 

 healthy circumstances, the bladder wall heals well when 

 sutured, and even if urine does escape into the abdomen, a 

 fatal result does not necessarily follo\\' (see p. 297). 



Operation. — If external manipulation fails to give relief, 

 and the above-mentioned accident has not occurred, the 

 surgeon must choose between puncture of the bladder or 

 urethrotomy. 



Puncture of tlie Bladder. — This operation is most com- 

 monly done in cats and the smaller varieties of dogs in 

 which it is impossible to pass the catheter. It is performed 



