272 Surgical Diseases and Surgery of the Dog 



of purulent matter which finds vent at the vaginal outlet. Under 

 normal conditions pathogenic bacteria are constantly present 

 throughout the vaginal canal, but the uterine cavity remains free, 

 being protected by the mucus at the cervix. At times, howerer, 

 especially when vaginitis occurs, microorganisms gain entrance and 

 originate an inflammatory disturbance of the mucosa. It is rather 

 remarkable that it arises most commonly as a chronic process in 

 virgin females of advanced age. This I have found to be almost 

 invariably the case, and Froehner has made similar observations. 

 Should the cervical mucosa swell sufficiently to occlude the lumen, 

 which it very often does, the matter is retained, gradually increases 

 in amount, and forms a septic retention cyst. This condition is 

 known as pyometra. From pyometra secondary septic endo- 

 carditis is prone to result. 



In chronic cases the wall of the uterus is extremely thickened, 

 the microorganisms present being very numerous and often located 

 deep in the tissues. In one instance the diseased organ when sub- 

 mitted to microscopic examination, exhibited a microorganism, 

 which in shape and size resembled the ordinary diplococcus lanceo- 

 latus of human pneumonia, which is found under normal conditions 

 in the mucous passages of the dog. 



Symptoms and Diagnosis. When the cervical canal is patent, 

 the vagina presents an injected and swollen appearance, and the 

 discharge, which may be purulent, sanguineous or ichorous, takes 

 place more or less constantly, but more particularly after locomotion 

 or any expulsive effort of the abdominal muscles, such as accom- 

 panies defecation. The animal usually licks the vulva a great deal. 

 Abdominal palpation is painful. In the early stages of pyometra 

 there is little change in outward manifestations, and the disease 

 process may continue for some weeks, the abdomen all the while 

 enlarging, until finally the appetite becomes capricious, fails alto- 

 gether, and thirst and vomiting set in, accompanied by emaciation. 

 The symptom of vomiting is always indicative of grave toxemia. 

 By this time the abdomen is very much enlarged, and by careful 

 palpation the two distended cornua may be made out on either side 

 of the floor of the abdomen. The alteration in the contour of the 

 abdominal wall partakes somewhat of a bilateral uniformly cylin- 

 drical tense swelling, as contrasted with the pyriform outline of a 

 cross section of the trunk in dropsical effusion of the peritoneum. 



