The vessels are thrombosed, and extensive portions of the organ may be affected by true capillary phlebitis.
The lymphatics are dilated and distended with pus in animals which have resisted for some days.
If there is peritonitis, the entire floor of the abdominal cavity is affected, and sometimes the peritonitis is generalised.
The lesions in the other tissues and viscera are similar to those found in septicæmia and in general intoxication, such as injection of the capillary system, and interstitial extravasations of blood in the pleura, pericardium and other tissues.
Diagnosis. The diagnosis of septic metritis is not very difficult, though something more is required than simple observation of external signs. From the clinical standpoint it is of no great importance to distinguish between the various forms or to determine the responsibility of microorganisms for the infection. In every case the practitioner must utilise all the means at his disposal.
Prognosis. The prognosis is extremely grave, and death almost invariably occurs when treatment is not early undertaken.
Treatment. Treatment should be prompt and energetic. Infection of the genital organs being the cause of the symptoms, it is against this that remedies should be directed. The parts should first be thoroughly washed out with boiled water at the body temperature. A stiff drainage tube about 6 feet in length is passed to the base of the uterus and connected at its free end with a reservoir of liquid, which can be raised so as to obtain sufficient pressure. During this operation the animals should be placed with the front limbs higher than the hind.
When the liquid injected returns perfectly clear, antiseptics may be employed. Strong solutions containing mercury, carbolic acid, lysol or creolin should be avoided, partly because of their toxic action, but principally because they cause irritation and violent expulsive efforts.
A 25 per cent. hydroxyl solution gives surprisingly good results. A 1 in 2,000 iodine solution (iodine 15 grains, potassium iodide 1 drachm, warm water 4 pints) is also of very great service.
As the first irrigations are difficult to carry out thoroughly, it is often advisable to cleanse the parts directly by means of a large disinfected sponge, which should be passed over the whole surface of the mucous membrane and into the depressions of the uterus, thus directly removing septic liquids. Thereafter irrigation will be easier and more efficacious.