156 DISEASES OF THE PERITONEUM 



yellow fluid may be drawn off. The specific gravity of the 

 fluid is about 1012 and the albumin about 2 to 4 per cent. 

 There is usually no fever. If a large quantity of fluid is 

 present it may press the diaphragm forward and interfere 

 with the action of the lungs, inducing dyspnea. Usually 

 there are also symptoms of the primary disease present (heart 

 bruits, albuminuria, examination of blood). Often associated 

 with ascites are hydrothorax, hydropericardium, and ana- 

 sarca (speaks for heart lesions). If the portal system alone is 

 involved (cirrhosis of the liver) only ascites may be present. 



Diagnosis.— In large animals, unless the ascites is marked 

 (abdominal distention), due to the tenseness of the abdominal 

 walls, it may be overlooked. Obviously any condition which 

 enlarges the abdomen might be mistaken for it. Therefore 

 pregnancy, dropsy of the fetal membranes in cows, distention 

 of the bladder, urine accumulation (ruptured bladder in ox), 

 and the rare cystic ovary or tumors (dogs) should be thought 

 of. In large animals rectal exploration (pregnancy, distended 

 bladder) is helpful in diagnosis. An explorative puncture 

 can be employed in cases of doubt. It not only reveals the 

 presence but the character of the fluid (transudate, exudate, 

 urine, etc.). The determination of the primary disease is 

 often difficult, especially when a lung or liver disease, as the 

 symptoms are vague. 



Prognosis. — Unless due to feeds too rich in water or hydre- 

 mia the prognosis in ascites is bad. The primary disease, of 

 which it is merely a symptom, is usually incurable. 



Treatment. — Treatment is generally unsatisfactory. In 

 case it is due to food too rich in water or too high an altitude 

 (brisket disease of Colorado cattle), placing the patients on 

 dry food or bringing them to lower levels are curative. In 

 large animals medicinal treatment rarely pays. Diuretics, 

 such as digitalis (fid. ext. 5j) or theobroma (5ij), may be 

 tried. Arecalin (gr. j) or pilocarpin (gr. v) are recommended 

 if the heart will stand them. A good purge of aloes (3vj) or 

 Glauber salts (lb.j) is useful. 



Tapping the abdomen is advisable when dyspnea is dis- 

 tressing the patient. The operation may be repeated several 

 times provided the patient eats and is allowed ample nourish- 



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