Prolapse or Evorsion of the Bladder 855 



by the hand to make sure that all parts of the walls are straight- 

 ened out. 



The prognosis of prolapse of the rectum in the mare during 

 parturition is highly unfavorable. In other animals the prog- 

 nosis is more favorable. 



13. Prolapse or Eversion of the Bladder. 



Eversion of the bladder may occur in any animal, but has been 

 noted chiefly in the mare, though it has also been recorded in 

 the cow and sow. The very wide urethral opening of the bladder 

 of the mare tends to make the eversion of the organ in that ani- 

 mal more probable, because more room is afforded through 

 which the organ may pass. 



The eversiou of the bladder may occur at any time immedi- 

 ately prior to, during, or following labor. When prolapse occurs 

 prior to the expulsion of the fetus, the integrity of the organ may 

 be endangered during the passage of the fetus through the vulva. 

 The accident does not constitute any great impediment to the 

 expulsion of the fetus, but greatly imperils the integrity of the 

 organ and the life of the patient if the fetus passes over the pro- 

 lapsed organ. When eversion occurs after the passage of the 

 fetus, the danger to the patient is less. 



The causes of eversion of the bladder are chiefly the exalted 

 intra-abdominal pressure due to expulsive efforts, the relaxed 

 and weakened state of the circular muscles of the urethra, and 

 in the mare, the very large urethral opening. 



The symptoms of eversion of the bladder are of such a char- 

 acter as to render diagnosis easy and clear in the majority of 

 cases. A tumor appears, which is somewhat pear-shaped and 

 has its attachment on the median line of the floor of the vulva, 

 at the point where the urethra normally exists. In eversion the 

 urethral opening has disappeared, 'and its place has been taken 

 by the everted organ. The tumor varies in size, according to 

 its degree of congestion, which is largely dependent upon the 

 duration of the eversion. If the eversion is recent, or if it has 

 not protruded beyond the vulva to any great extent, or has not 

 been seriously abraded or injured, it presents a fresh mucous 

 surface, and upon either side near the neck of the tumor may be 

 observed the two uretral openings, from which urine escapes 

 drop by drop, or sometimes in small jets during an expulsive 



