876 Veterinary Obstetrics 



should be coatinued until the water is expelled clear and odor- 

 less. This may require a total of six to ten gallons. 



The plan outlined is mechanical cleansing, in contradistinc- 

 tion to chemical disinfection. The enormous volume of viru- 

 lently infective discharges is quite beyond the power of any or- 

 dinary disinfectant to overcome. If the discharges can be me- 

 chanically removed, the aim of the surgeon is fully accomplished 

 in so far as that is concerned. The walls are still infected and 

 inflamed, and will quickly secrete more discharges. We cannot 

 disinfect the walls ; any antiseptic capable of doing this would 

 likewise irritate, injure or destroy the uterine tissues. 



The paretic uterine walls do not contract, and the fluid must 

 either be forced out by the contraction of the abdominal walls or 

 must be siphoned out through the irrigation tube. The uterine 

 cavity should be left empty, except that ^ oz. of powdered iodo- 

 form may be introduced in a gelatine capsule, the capsule opened, 

 and the powder scattered over the surface. 



The irrigation should be repeated one to three times daily, ac- 

 cording to indications. Improvement is indicated by decreased 

 discharge, disappearance of fetor, and a gradual change from the 

 dirty-grayish, flocculent, semi-fluid mass to a transparent, odor- 

 less mucus. At the same time the hard, thickened walls of the 

 uterus soften and become thinner, the mucosa recovers its normal 

 consistence, the walls contract, the uterine cavity decreases and 

 the walls come in contact. These changes mark convalescence, 

 and warrant the gradual cessation of irrigation. 



The strength of the patient may be advantageously supported 

 by a free allowance of alcohol or nitrous ether in the drinking 

 water. An ordinary sized mare may take two to four ounces of 

 either drug, and the dose may be repeated frequently. She may 

 take either of them at the rate J^ to i oz. per hour for 24 con- 

 secutive hours. Quinine may also be administered in large 

 (ounce) doses, once or twice daily if fever is present. 



The handling of the concurrent laminitis will be discussed 

 while dealing separately with that affection. 



The prognosis of acute endo-metritis is highly favorable. 

 Properly handled, over 90% recover promptly and completely. 

 The mare usually remains fertile. 



