174 DISEASIJS OF THE PERITONEUM 



Symptoms. — As peritonitis is neaily always secondary its 

 symptoms are preceded by those of the primary disease 

 (colics, metritis, septicemia). 



In acute, diffuse peritonitis the following symptoms are 

 present: Abdominal pain (colic) is prominent especially 

 toward the end. The patient usually does not roll or even 

 lie down as in colic. The gait is stiff, the animal moving as 

 one piece, avoiding short turns, and in peritonitis following 

 castration the hind legs are advanced in abduction, the animal 

 walking in a straddled fashion. The abdominal wall is tense 

 and in many instances bloating is present. Sensitiveness is 

 not so marked in horses but in some cases pain is evinced on 

 manual pressure. 



The pulse is rapid (80), irregular and hard ("serous mem- 

 brane" pulse), often "wiry." The respirations are increased, 

 shallow and of the costal type. With increasing bloating or 

 accumulation of abdominal exudate, the dyspnea becomes 

 more marked. The temperature is usually high (108° to 109° 

 F.) but of no particular type.^ The conjunctiva is highly 

 reddened in the early stages but later becomes "muddy" or 

 even cyanotic. The peristalsis is suppressed and usually 

 there is obstinate constipation with tenesmus. The urine is 

 voided at frequent intervals under symptoms of strangury. 



The general condition of the patient is that of great prostra- 

 tion. The facial expression is anxious, and the body often 

 covered with a cold sweat. Forced movements are not 

 uncommon (walking in a circle, etc.). 



On rectal examination at times the surface of the peri- 

 toneum may be felt roughened. 



Diagnosis. — ^The sudden development, the fever, serous, 

 membrane pulse, bloating, stiff gait, obstinate constipation, 

 and colicky pains form characteristic symptoms of peritonitis, 

 especially if they follow a primary disease or operation (colic, 

 castration) to which peritonitis can be a sequel. Most 

 valuable is the finding of the rough and sensitive peritoneal 

 surface on rectal examination. 



Confusion with "colics" due to acute dilatation of the 



1 In rare instances in perforative peritonitis (sepsis!) it is subnormal. 



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