198 Surgical Diseases and Surgery of the Dog 



pouches, pruritis manifested by licking or dragging the anus along 

 the floor, is a constant symptom. The usual form, — the external 

 incomplete fistula or rather sinus, — gives vent to a purulent dis- 

 charge. A true complete fistula may discharge fecal matter. The 

 probe should next be brought into use, to definitely determine the 

 exact course of the tract, but it must be remembered that should the 

 probe reach the lumen of the rectum, in the majority of cases it is 

 because it has passed through the normal excretory orifice, and 

 that this does not indicate the presence of a complete true fistula. 

 The probe and the speculum will always serve for making a differ- 

 ential diagnosis. 



Treatment. In discharging anal pouches treatment must be 

 directed towards promoting a healthy secretory surface within the 

 gland, and for this purpose injections of solutions of nitrate of 

 silver or tincture of iodine as indicated under Suppuration of the 

 Anal Pouches should be employed through the abnormal tract until 

 the latter heals, which it usually does before long. In true fistula 

 the object is to destroy the wall of the tract. A grooved director 

 is passed through the fistula tract till its extremity projects within 

 the lumen of the gut, and it is manipulated so that its extremity is 

 pushed out through the anus. All the tissues intervening between 

 the director and the ano-rectal canal are then divided, and the wall 

 of the tract, including ramifications, curetted. Internal incomplete 

 fistula is treated in a similar manner, but it must first be converted 

 into the complete form, and to accomplish this the anus must be 

 dilated with a speculum. 



Where the condition is dependent upon some other disease 

 or lesion, treatment must vary accordingly. Neoplasms must be 

 extirpated. 



Following the operation the wound should be irrigated if 

 found necessary. If the sphincter has been necessarily divided, 

 incontinence is thereby created, but this only lasts for a certain 

 length of time until reunion of the fibers has taken place. 



HEMORRHOIDS. PILES. 



The typical hemorrdoidal condition is a very rare complaint. 

 It is often confounded with the very common condition of enlarged 

 and suppurating anal pouches. Old dogs of sedentary habits oc- 

 casionally suffer. 



