But if, in spite of such treatment, the incontinence persists, it is better, from an economic standpoint, to treat the urinary eczema with astringents, etc., and quickly to fatten the animal.
EVERSION OF THE BLADDER.
Eversion of the bladder only occurs in female animals after difficult parturition. The viscus is turned completely inside out, as occurs in eversion of the uterus, the base of the bladder becoming invaginated in the cavity of the bladder itself, and afterwards passing into the urethra and vagina. The bladder thus becomes totally displaced, and appears between the lips of the vulva, resting on the inferior commissure, and forming a mass the size of an orange.
Eversion cannot occur unless the ligaments of the bladder have become relaxed, stretched or ruptured. Expulsive efforts and the pressure of the intestinal mass complete the process, the peritoneum and peri-vasicular layers of connective tissue being torn.
Diagnosis. The diagnosis of eversion of the bladder presents no difficulty. The everted mass appears to have a narrow neck opposite the meatus, and is seen to form a reddish, unctuous mass. The mucous membrane now forms the external coat and appears covered with mucus so long as inflammation does not occur.
The urine continually escapes from the ureters (which open on the surface of the mucous membrane) as it is formed, and flows away by the lower commissure of the vulva. The vulva is half open, and the prominence formed by the bladder projects beyond it.
Prognosis. The prognosis is grave, because reduction is difficult, and may be accompanied by rupture of the organ; also because even in favourable cases it is invariably followed by acute cystitis.
Treatment. Treatment is confined to reduction. Before attempting this, measures must be adopted to prevent straining, either by passing a rope round the animal’s body, thus causing it to flex the vertebral column, or by puncturing the rumen or performing tracheotomy. The open hand is then applied to the surface of the swelling, which is gently compressed and thrust in turn through the meatus and urethra. The portions nearest to the urethra should first be returned. It is sometimes necessary to use both hands, and even to employ a catheter with a large round head, to reduce the eversion effectually. After reduction a truss or vulval clamp should be applied. Subsequent treatment consists in the administration of sedatives—e.g., laudanum, mucilaginous drinks, barley-water, pellitory, etc.
HÆMATURIA.
Hæmaturia, i.e., the passage of blood-stained urine, is in itself only a symptom, which may accompany very varying conditions, such as the congestion peculiar to the early stages of nephritis, traumatic lesions of the kidneys, ulceration of the uriniferous tubules, or of the pelvis of the kidney, lesions of the ureters, bladder, etc., etc. The term, therefore, does not indicate a disease, but nevertheless in bovine practice the term hæmaturia has acquired a special significance.