670 Veterinary Obstetrics 



uterus is to be lifted out of the abdominal cavity in the same 

 manner. After the organ has been exposed, the utero-ovatian 

 arteries and all visible arteries in the broad ligaments should be 

 securely ligated, and a firm ligature of silk placed around the 

 cervix or vagina. The entire uterus, horns, and ovaries should 

 then be excised, and the vaginal stump securely detained out- 

 side the wound. 



In order to prevent the escape of the putrid contents of the 

 uterus in the neighborhood of the wound, it is best to apply a 

 double ligature to the cervix or vagina and sever the organ be- 

 tween the two. The vaginal stump should be thoroughly 

 disinfected, by drying it first with sterile gauze and then 

 thoroughly cauterizing the mucous membranes with the thermo- 

 cautery or nitrate of silver. Tincture of iodine thoroughly 

 applied to the stump, while it is held outside the wound until the 

 alcohol has evaporated, may also suffice. The stump of the 

 vagina is then to be allowed to return into the abdominal cavity. 

 If infection of the peritoneal cavity is feared, it may be irrigated 

 with normal salt solution in the hope of mechanically cleansing it. 



Sometimes partial hysterectomy is preferable to the preceding. 

 In irreducible torsion of the uterus or transverse rupture of the 

 uterus from torsion the uterine cavity may not be safely 

 closed as in hysterotomy, nor completely amputated, because of 

 adhesions. A portion of the organ may then be excised and the 

 margins of the stump securely fixed to the margins of the ab- 

 dominal incision, thus affording exterior drainage for the sup- 

 purating uterine cavity. 



Prognosis. The prognosis of hysterotomy and hysterectomy 

 is generally unfavorable, though it is gradually becoming more 

 successful in veterinary practice, as veterinarians become better 

 acquainted with anaesthesia and asepsis. It is most favorable 

 in small domestic animals, in^ which incidentally there is less 

 susceptibility to infection, although perhaps the main considera- 

 tion is that of the size of the animal and the practicability of 

 proper confrol of the wound after the operation. Keller re- 

 cords the operation of hysterotomy in 10 bitches, with recovery 

 of 8 of the mothers, or 80 %. In 8 out of these 10 cases, some or 

 all of the fetuses were saved. In the other cases the fetuses were 

 dead at the time when the operation was undertaken. 



