Puerperal Tetanus 909 



The prognosis of the disease is generally highly favorable, and 

 is parallel to the prognosis of the endometritis. In fact the 

 two diseases are inseparably bound up together, so that their 

 prognosis and handling are essentially identical. Like laminitis 

 from other causes, so puerperal laminitis is largely a disease of 

 the draft animal. The prognosis will depend to a degree upon 

 the size of the patient. The gravity of the disease increases 

 with the weight of the animal. 



The handling of the endometritis we have already discussed 

 on page 874, and it is only essential at this time to consider the 

 local treatment of the laminitis. There are two plans for hand- 

 ling the inflammation of the feet, each of which has its devotees 

 — hot and cold applications. 



We distinctly prefer the application of cold, either in the form 

 of water or of ice, and that the application be continuous and 

 ample. If the animal is recumbent or can be induced to remain 

 recumbent, so much the better, because it relieves the feet from 

 the weight of the patient. In the recumbent animal, cold water 

 is not readily applied, and consequently one may most con- 

 veniently apply ice poultices, renewing them frequently in order 

 to maintain constant refrigeration. If the animal can readily 

 stand, and will do so, it should be placed in a bath of cold water, 

 the temperature of which may be reduced to a low point by the 

 frequent addition of ice. The cold water bath should extend up 

 to or above the fetlocks, and the floor of the bath should be of 

 some yielding substance, so that the entire plantar surfaces of 

 the feet may contribute to the support of the weight. The shoes 

 should be removed in order to prevent the sinking of the os 

 pedis, or the dropping of the sole may be still better prevented 

 by the application of special padded shoes, and the weight dis- 

 tributed equally over the entire plantar surface of the hoof. 



The internal treatment and the handling of the uterus, which 

 have already been discussed on page 875, are quite as important 

 as the local applications to the feet. 



10. Puerperal Tetanus. 



In discussing the question of retained placenta in the sheep on 

 page 811, and of prolapse of the uterus on page 827, we have 

 alluded to the rare occurrence of tetanus as a complication. We 

 observed one case of tetanus following retained placenta in a cow. 



