DIFFICULT PARTURITION {DYSTOKIA) 309 



necessitate to be remedied before the first pup can be 

 delivered. Tiiis is especially the case in the bulldog and 

 other short-nosed breeds, the wedge shape of the head of 

 the longer-nosed varieties being much more likely to force 

 their way through. In dealing with a stricture, it is better to 

 avoid the use of the knife if possible, the stricture being 

 forcibly broken down with the fingers or with a specially- 

 designed speculum or pair of forceps. Further details of 

 surgical treatment are given on p. 305. 



Uterine inertia is a most troublesome condition to deal 

 with, and the tendency is unquestionably hereditary. It is 

 most commonly met with in bitches with heavy litters, and 

 in those whose puppies, through accidental or other causes, 

 have died in uiero. It sometimes happens that there are no 

 labour pains at all, or it may be that two or three puppies 

 have been safely delivered, and the labour pains have then 

 entirely ceased. In such cases no time should be lost in 

 using every endeavour to get the puppies away. Ergotine 

 (gr. xV to gr. i.) should be given hypodermically, or the liquid 

 extract of ergot (iT|_x. to Tji.) given by the mouth, and 

 repeated in half an hour, and then every hour for three or 

 four times. The flanks and abdomen should be massaged, 

 and hot solution of some non-irritating antiseptic (such as 

 boracic acid, grs. v. to f,i.) injected into the uterus in order 

 to stimulate contraction. Attempts may be made with long 

 forceps to reach a fcetus, but this must always be done very 

 cautiously, as there is great risk of including the wall of the 

 uterus in the forceps. If after five or six hours (or some 

 reasonable time, determined at the discretion of the prac- 

 titioner in charge of the case), no labour pains can be 

 induced and no puppies can be got away, the only course 

 open in order to save the bitch lies in laparotomy. Some- 

 times this will be all that is necessary, manipulation with 

 the hand being sufficient to pass the fcetus towards the 

 pelvic outlet ; but in other cases either Ctesarean section 



