290 Sv,rgical Diseases and Surgery of the Dog 



but in a hernia of long standing it may become thickened and some- 

 times adherent to the contained organs or neighboring tissues. Dif- 

 ferential diagnosis lies between it and neoplasms and abscesses. 



Treatment. It has already been remarked that a hernia con- 

 stitutes an ever-present menace to life. It naturally follows that 

 such a lesion should always be remedied at the earliest possible 

 opportunity. The owner must be informed of the possible termi- 

 nations and of the advisability of submitting the animal to treatment. 

 Treatment of hernia should be operative in all cases, there being no 

 more danger to the animal from opening the peritoneal cavity in 

 this manner than there is in any other abdominal section, provided 

 due care be exercised to avoid wounding blood-vessels and punctur- 

 ing viscera. The operation is termed Herniotomy. It is advisable 

 to deprive the animal of all food for two or three days prior to 

 operation and to administer an active purgative. 



The fundamental principles governing operative measures for 

 either form are: reduction of the contents, dissettion and complete 

 extirpation of the sac, and closure of the opening in the abdominal 

 wall, whether accidental or natural, by suture. The technic is as 

 follows : The animal being hoppled in the most convenient position 

 and anesthetised, an incision is made in the skin directly over the 

 protrusion. The subjacent fascia is next cautiously dissected until 

 the sac is reached, and the dissection continued until the latter is 

 completely enucleated. To distinguish the sac, when it is not ad- 

 herent to the surrounding connective tissue, it may be picked up 

 between the index finger and thumb when the intestine will slip 

 away, leaving the sac alone in the grasp. In a hernia of some du- 

 ration it is recognized by its whitish appearance, but if strangulated 

 it may be of dark-reddish color and not easily discernible. Some 

 writers, evidently borrowing from the principles of human surgery 

 where the possibility of infecting the peritoneal cavity always has to 

 be considered, advise that the contents be reduced without or before 

 opening the sac. I am a firm believer in opening the sac at the 

 outset, being no more fearful of any probability of inducing peri- 

 tonitis than I am when performing simple celiotomy. With an open 

 sac the operator can see what he has to handle, can see whether 

 adhesions have formed at the neck to interfere with reduction, and 

 can see whether any organs need to be extirpated. I have in mind a 

 few instances where the operation was needlessly prolonged for 



