148 Surgical Diseases and Surgery of the 'Dog 



Symptoms and Diagnosis. Ascites is recognized by the gradual 

 enlargement of the abdomen together with a sinking in of the flank 

 and the acquirement of a pronounced concavity by the vertebral 

 column. A wave or fluctuation of the contained fluid may be per- 

 ceived by placing the hand on one side of the abdominal wall and 

 tapping the side opposite. Percussion gives rise to a tympanitic 

 sound superiorly where the intestines are floating, and a dull one in- 

 feriorly. In very chronic cases there may be edematous swellings 

 of the abdominal wall, prepuce, and extremities. It is important to 

 differentiate from hydro- and pyometra. In these latter conditions 

 the outlines of the bicornate uterus can generally be made out, 

 percussion always calls forth a dull sound and fluctuation is imper- 

 ceptible. Differential diagnosis from such condition as chyle-cyst 

 is extremely difficult, but this form occurs with suddenness. As- 

 cites is occasionally confounded with other conditions. It is dis- 

 tinguished from the enlargement of gestation by palpation, and from 

 dbesity by palpation and negative results attending aspiration. 



Differential diagnosis between the various causative factors is 

 comparatively easy in some cases, while in others it is almost an 

 impossibility. There is little difficulty in diagnosing pericarditis, 

 pleuritis, and valvular lesions, by auscultation, but when the condi- 

 tion is the result of primary inflammatory changes, or secondary to 

 lesions of the abdominal cavity, the fluid must be first drawn off 

 to make palpation of value. If much emaciation or cachexia is 

 present, malignant tumor or tuberculosis may be suspected. To 

 differentiate between the two latter diseases, tuberculin should be 

 employed. 



The prognosis must be guided by the causative factors present. 

 Only when the condition is idiopathic of simple peritonitis or is de- 

 pendent on the simple forms of hydrothorax or hydropericardium, 

 or compression of the portal vein by benign neoplasms, may any per- 

 manent amelioration be expected by eradication of the primary cause. 

 With these few exceptions, treatment can give but temporary relief. 



Treatment. Diuretics and saline purgatives are employed to 

 lessen the amount of fluid. A case is on record of apparent recov- 

 ery by the daily internal administration of pilocarpine hydrochlorate. 

 Cadiot and Breton favor the employment of this drug. Paracentesis 

 is a more certain and rapid method and is employed when the dis- 

 tension and dyspnea are very considerable, but with the exceptions 



