856 Veterinary Obstetrics 



effort. If not much swollen, the bladder may remain almost or 

 completely hidden, especially when the animal is standing, to 

 become exposed when the patient is lying down or straining. 



It is to be differentiated chiefly from hernia of the bladder 

 through a rent in the vaginal floor, and from hematoma or tu- 

 mors in the vagina or vulva. In rupture of the vaginal 

 floor with hernia of the bladder, the peritoneal surface of the 

 bladder remains external, and the ureters, still emptying inside 

 the organ, may cause it to become distended with urine. The 

 rupture in the vaginal floor is recognizable. The urethra is 

 present in its normal position on the vulvar floor, and through it 

 the finger or a catheter may be passed into the herniated organ. 

 Ths. mucous surface of the (fWifrfefl? bladder, is external, and the 

 ureters open upon the external surface. The viscus does not 

 become dilated with urine, and the meatus urinarius is absent. 



In the handling of eversion of the bladder, the organ should first, 

 be thoroughly cleansed by wa.shiug with a non-irritant fluid, 

 such as a normal saline solution. The organ should be examined 

 and proper attention given to any injuries. If any perforations 

 of the walls of the organ exist, these should be carefully closed 

 by means of sutures, so applied that the peritoneal surfaces of 

 the lips of the wounds are brought into contact. If a portion 

 of the wall of the organ has been severely lacerated or contused 

 or has become so badly infected or otherwise damaged that its 

 recovery cannot well be expected, the damaged portion should 

 be removed and the edges of the wound brought together, thus 

 amputating as much of the organ as may be necessary. In such 

 an operation it is essential to preserve the outlet of each ureter. 



After due preparation the organ is to be returned into its 

 normal position, through the urethral opening. The operation 

 is usually not difiicult, especially if the organ has not been long 

 everted. Grasping the organ in the hollow of one or both hands, 

 the operator should press firmly and evenly over the entire mass 

 until it gradually returns into its position. The operation can- 

 not generally be carried out hastily. Firm and evenly applied 

 pressure with the hands gradually forces the blood out of the 

 organ, and reduces its volume, until finally, when the engorge- 

 ment has largely disappeared, the organ is usually returnable 

 through the urethal opening. 



