In case the disease has progressed to absolute obstruction, with the bladder ready to rupture any moment, no time must be lost in opening into the urethra with a sharp knife over the bony arch under the anus, where the pulsations are seen in urinating. This incision is best made in the median line from above downward, but in the absence of a skillful operator a transverse incision with a sharp knife over the bone in the median line until the urine flows with a gush is better than to let the patient die. Considerable blood will be lost and the wound will heal tardily, but the ox will be preserved. Then the slitting and cleansing of the sheath can be done at leisure, as described above. If the bladder is ruptured, the case is hopeless.
INFLAMMATION OF THE SHEATH AND PENIS FROM BRUISING.
This also is an affection of work oxen, caused by the pressure and friction of the sling when the animals are held in stocks for shoeing. This crushing of both sheath and penis for half an hour or more leads to the development, some hours later, of a hard, hot, and painful swelling, extending from the scrotum as far as the opening of the sheath. Fever sets in, with dry muzzle, red eyes, hard, full, rapid pulse, accelerated breathing, and elevated temperature. The ox stands obstinately with his hind legs drawn apart and urine falling drop by drop from the sheath. Appetite and rumination are suspended. In twenty-four hours there may be indications of advancing gangrene (mortification), the swelling becomes cold, soft, and doughy; it may even crack slightly from the presence of gas; a reddish brown, fetid liquid oozes from the swelling, especially around the edges, and if the animal survives it is only with a great loss of substance of the sheath and penis.
Prevention.—The prevention of such an injury is easy. It is only necessary to see that the slings do not press upon the posterior part of the abdomen. They must be kept in front of the sheath.
Treatment.—Treatment, to be effective, must be prompt and judicious. Put around the patient a strap with soft pads in contact with the affected parts, constantly soaked in cold water for at least 24 hours. A pound or two of Epsom salt in 4 quarts of hot water should also be given. The second day the parts may be washed with 1 quart of witch-hazel (extract), 2 drams sugar of lead, and 1 ounce laudanum, or the cold-water irrigations may be continued if the active inflammation persists. In case the swelling continues hard and resistant, it may be pricked at the most prominent points to the depth of one-third of an inch with a lancet first dipped in dilute carbolic acid, and the whole surface should be washed frequently with some antiseptic solution.
When softening occurs in the center of a hard mass and fluctuation can be felt between two fingers pressed on different parts of such softening, it should be freely opened to let out the putrid pus, and the cavity should be syringed often with antiseptic solution.
In bad cases extensive sloughs of dead skin, of the whole wall of the sheath, and even of the penis, may take place, which will require careful antiseptic treatment. The soaking of the urine into the inflamed and softened tissue and the setting up of putrefactive action not only endanger great destruction of the tissues from putrid inflammation, but even threaten life itself from a general blood poisoning (septicemia). Every case should have skillful treatment to meet its various phases, but in the severe ones this is most urgently demanded.