PERITONITIS 153 



Symptoms. — As peritonitis is nearly always secondary, its 

 symptoms are preceded by those of the primary disease 

 (colics, metritis, septicemia). 



In acute diffuse peritonitis the following symptoms are 

 present: abdominal pain (colic) is prominent especially 

 toward the end. The patient usually does not roll or even 

 lie down as in colic. The gait is stiff, the animal moving as 

 one piece, avoiding short turns, and in peritonitis following 

 castration the hind legs are advanced in abduction, the animal 

 walking, in a straddled fashion. The abdominal wall is tense 

 and in many instances bloating is present. Sensitiveness is 

 not so marked in horses but in some cases pain is evinced by 

 manual pressure. 



The pulse is rapid (80), irregular and hard ("serous mem- 

 brane" pulse), often "wiry." Tbe respirations are increased, 

 shallow and of the costal type. With increasing bloating or 

 accumulation of abdominal exudate, the dyspnea becomes 

 more marked. The temperature is usually high (108° to 

 109° F.) but of no particular type. 1 The conjunctiva is highly 

 reddened in the early stages but later becomes "muddy" or 

 even cyanotic. The peristalsis is suppressed and usually there 

 is obstinate constipation with tenesmus. The urine is voided 

 at frequent intervals under symptoms of strangury. 



The general condition of the patient is that of great prostra- 

 tion. The facial expression is anxious, and the body often 

 covered with a cold sweat. Forced movements are not un- 

 common (walking in a circle, etc.). 



On rectal examination at times the surface of the peri- 

 toneum may be felt roughened. 



Diagnosis. — The sudden development, the fever, serous 

 membrane pulse, bloating, stiff gait, obstinate constipation, 

 and colicky pains form characteristic symptoms of peritonitis, 

 especially if they follow a primary disease or operation (colic, 

 castration) to which peritonitis can be a sequela. Most valu- 

 able is the finding of the rough and sensitive peritoneal sur- 

 face on rectal examination. 



Confusion with "colics" due to acute dilatation of the 

 stomach, tympanites, displacements of bowel or gastro- 



1 In rare instances in perforative peritonitis (sepsis!) it is subnormal. 



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