242 Surgical Diseases and Surgery of the Dog 



the organ. The incision is made of sufficient length to effect de- 

 livery of the largest body present, and the edges of the wound 

 caught with hemostatic forceps. It is a good plan to apply the 

 sutures without, of course, tying them, before making the incision, 

 as it insures more accurate alignment being' made than is afterwards 

 possible, owing to the tendency of the organ to contract under the 

 stimulus of the knife. Encysted calculi, i. e., calculi embedded in 

 the mucosa, are removed by scraping with the scoop. All calculi 

 being removed, the interior of the organ is flushed with a warm 

 antiseptic or saline solution and the wall closed as described under 

 cystorraphy. 



LITHOLAPAXY. 



The technic of this operation in the male is as follows: 

 Administer a general anesthetic and secure the animal in the dorsal 

 position with the hind legs drawn forward. Pass the catheter to 

 the bladder, draw off the urine and inject a quantity of antiseptic 

 or saline solution sufficient to distend the viscus. Open the urethra 

 as in urethrolithotomy, making the incision in the perineum at the 

 level of the ischial arch. Withdraw the catheter and introduce a 

 lithotrite of suitable size through the wound and cautiously pass it 

 through the prostatic urethra into the interior of the bladder. Turn 

 the shaft of the instrument so that the blades will point towards the 

 roof of the organ which is now undermost, and wait a few moments 

 until currents generated by the passage of the instrument have sub- 

 sided. Draw back the male blade and manipulate it until the stone 

 is caught. It may be necessary to turn the blades to either side. 

 Then lock the instrument and crush the body by screwing. Sudden 

 cessation of resistance indicates that either the stone has slipped 

 away from the grasp or it has been pulverized. Repeat the crushing 

 process until no stones of any size remain and then proceed to evacu- 

 ate. The latter part of the operation is accomplished with a bulb in- 

 strument, know as the evacuator, by which a suction effect is pro- 

 duced. In the absence of the instrument the next best means to em- 

 ploy is irrigation with the catheter. Leave the urethral wound open 

 to heal by cicatrization as in urethrolithotomy. In the female the 

 operation is more practicable provided the stones are of very 

 moderate size. It is conducted as follows: Anesthetise and secure 

 the animal in either position. Dilate the vagina with a speculum. 



