the extreme narrowness of its mouth. The protrusion of the bladder,
however, through a laceration sustained in calving, in the floor of the
vagina and its subsequent protrusion through the vulva, is sometimes met
with. In this case the protruding bladder contains urine; this can never be
the case in a real eversion, in which the inner surface of the bladder and
the openings of the ureters are both exposed outside the vulva. The
presence of a bag containing water, which is connected with the floor of
the vagina, will serve to identify this condition. If the position of the
bladder in the vulva renders it impracticable to pass a catheter to draw
off the urine, pierce the organ with the nozzle of a hypodermic syringe, or
even a very small trocar and cannula, and draw off the water, when it will
be found an easy matter to return the bladder to its place. The rent in the
vagina can be stitched up, but as there would be risk in any subsequent
calving it is best to prepare the cow for the butcher.
RUPTURE OF THE BLADDER.
This has been known to occur in protracted parturition when the fetus
finally passed while the bladder was full. The symptoms are those of
complete suppression of urine and tenderness of the abdomen, with a steady
accumulation of liquid, and fluctuation on handling its lower part. If the
hand is introduced into the vagina it is felt to be hot and tender, and
perhaps slightly swollen along its floor. As a final test, if the lower,
fluctuating part of the abdomen is punctured with a hypodermic needle, a
straw-colored liquid of a urinous odor flows out. The condition has been
considered as past hope. The only chance for recovery would be in opening
the abdomen, evacuating the liquid, and stitching up the rent in the
bladder, but at such a season, and with inflammation already started, there
would be little to hope for.
RUPTURE OF THE WOMB.
When the womb has been rendered friable by disease rupture may occur in the
course of the labor, but much more frequently it occurs from violence
sustained in attempting assistance in difficult parturition. It is also
liable to occur during eversion of the organ through efforts to replace it.
If it happens while the calf is still in the womb, it will usually bleed
freely and continuously until the fetus has been extracted, so that the
womb can contract on itself and expel its excess of blood. Another danger
is that in case of a large rent the calf may escape into the cavity of the
abdomen and parturition become impossible. Still another danger is that of
the introduction of septic germs and the setting up of a fatal inflammation
of the lining membrane of the belly (peritoneum). Still another is the
escape of the small intestine through the rent and on through the vagina
and vulva, so as to protrude externally and receive perhaps fatal injuries.
In case of rupture before calving, that act should be completed as rapidly
and carefully as possible, the fetal membranes removed, and the contraction
of the womb sought by dashing cold water on the loins, the right flank, or
the vulva. If the calf has escaped into the abdomen and can not be brought
through the natural channels, it may be permissible to fix the animal and
extract it through the side, as in the CÊsarian section. If the laceration
has happened during eversion of the womb it is usually less redoubtable,
because the womb contracts more readily under the stimulus of the cold air
so recently applied. In case the abdomen has been laid open it is well to
stitch up the rent, but if not, it should be left to nature, and will often
heal satisfactorily, the cow even breeding successfully in after years.
Rupture of the floor of the vagina has been already referred to as allowing
the protrusion of the bladder. Laceration of the roof of this passage is
also met with as the result of deviations of the hind limbs and feet upward
when the calf lies on its back. In some such cases the opening passes clear
into the rectum, or the foot may even pass out through the anus, so that
that opening and the vulva are laid open into one.
Simple, superficial lacerations of the vaginal walls are not usually
serious, and heal readily unless septic inflammation sets in, in which case
the cow is liable to perish. They may be treated with soothing and
antiseptic injections, such as carbolic acid, 1 dram; water, 1 quart.
The more serious injuries depend on the complications. Rupture of the
anterior part of the canal, close to the mouth of the womb, may lead to the
introduction of infecting germs into the cavity of the abdomen, or
protrusion of the bowel through the rent and externally, either of which
may prove fatal. If both these conditions are escaped the wound may heal
spontaneously. Rupture into the bladder may lead to nothing worse than a
constant dribbling of the urine from the vulva. The cow should be fattened
if she survives. Rupture into the rectum will entail a constant escape of
feces through the vulva, and, of course, the same condition exists when the
anus as well has been torn open. I have successfully sewed up an opening of
this kind in the mare, but in the case of the cow it is probably better to
prepare her for the butcher.
CLOTS OF BLOOD IN THE WALLS OF THE VAGINA.
During calving the vagina may be bruised so as to cause escape of blood
beneath the mucous membrane and its coagulation into large bulging clots.
The vulva may appear swollen, and on separating its lips the mucous
membrane of the vagina is seen to be raised into irregular rounded
swellings of a dark-blue or black color, and which pit on pressure of the
finger. If the accumulation of blood is not extensive it may be reabsorbed,
but if abundant it may lead to irritation and dangerous inflammation, and
should be incised with a lancet and the clots cleared out. The wounds may
then be sponged twice a day with a lotion made with 1 dram sulphate of
zinc, 1 dram carbolic acid, and 1 quart water.
RETAINED AFTERBIRTH.
The cow, of all our domestic animals, is especially subject to this
accident. This may be partly accounted for by the firm connections
established through the fifty to one hundred cotyledons (Pl. XIII, fig. 2)
in which the fetal membranes dovetail with the follicles of the womb. It is
also most liable to occur after abortion, in which preparation has not been
made by fatty degeneration for the severance of these close connections. In
the occurrence of inflammation, causing the formation of new tissue between
the membranes and the womb, we find the occasion of unnaturally firm
adhesions which prevent the spontaneous detachment of the membranes. Again,
in low conditions of health and an imperfect power of contraction we find a
potent cause of retention, the general debility showing particularly in the
indisposition of the womb to contract, after calving, with sufficient
energy to expel the afterbirth. Hence we find the condition common with
insufficient or innutritious feed, and in years or localities in which the
fodder has suffered from weather. Ergoted, smutty, or musty fodder (Pl. V),
by causing abortion, is a frequent cause of retention. Old cows are more
subject than young ones, probably because of diminishing vigor. A temporary
retention is sometimes owing to a too rapid closure of the neck of the womb
after calving, causing strangulation and imprisonment of the membranes.
Conditions favoring this are the drinking of cold (iced) water, the eating
of cold feed (frosted roots), and (through sympathy between udder and womb)
a too prompt sucking by the calf or milking by the attendant.
_Symptoms._--The symptoms of retention of the afterbirth are usually only
too evident, as the membranes hang from the vulva and rot away gradually,
causing the most offensive odor throughout the building. When retained
within the womb by closure of its mouth and similarly in cases in which the
protruded part has rotted off, the decomposition continues and the fetid
products escaping by the vulva appear in offensively smelling pools on the
floor and mat together the hairs near the root of the tail. The septic
materials retained in the womb cause inflammation of its lining membrane,
and this, together with the absorption into the blood of the products of
putrefaction, leads to ill health, emaciation, and drying up of the milk.
_Treatment._--Treatment varies according to the conditions. When the cow is
in low condition, or when retention is connected with drinking iced water
or eating frozen feed, hot drinks and hot mashes of wheat bran or other
aliment may be sufficient. If along with the above conditions, the bowels
are somewhat confined, an ounce of ground ginger, or half an ounce of black
pepper, given with a quart of sweet oil, or 1-1/2 pounds of Glauber's salt
in at least 4 quarts of warm water, will often prove effectual. A bottle or
two of flaxseed tea, made by prolonged boiling, should also be given at
frequent intervals. Other stimulants, like rue, savin, laurel, and
carminatives like anise, cumin, and coriander, are preferred by some, but
with very questionable reason, the more so that the first three are not
without danger. Ergot of rye, 1 ounce, or its extract, 1 dram, may be
resorted to to induce contraction of the womb. The mechanical extraction of
the membranes is, however, often called for; of this there are several
methods. The simplest is to hang a weight of 1 or 2 pounds to the hanging
portion, and allow this, by its constant dragging and by its jerking effect
when the cow moves, to pull the membranes from their attachments and to
stimulate the womb to expulsive contractions. It frequently happens that
the afterbirth is only loosely adherent to the womb and its removal is
effected if but a slight amount of traction on it is exerted. This can be
determined by seizing the dependent part of the afterbirth between two
sticks and rolling it up on them until they lie against the vulva; then, by
careful traction, accompanied with slight jerking movements from side to
side, the womb is stimulated to expulsive contractions and the afterbirth
is wound up more and more on the sticks until finally its last connections
with the womb are severed and the remainder is expelled suddenly en masse.
It is quite evident that neglected cases with putrid membranes are poor
subjects for this method, as the afterbirth is liable to tear across,
leaving a mass in the womb. During the progress of the work any indication
of tearing is the signal to stop and proceed with greater caution or
altogether abandon the attempt in this way.
The following method (that with the skilled hand) is the most promptly and
certainly successful. For this the operator had better dress as for a
parturition case. Again, the operation should be undertaken within
twenty-four hours after calving, since later the mouth of the womb may be
so closed that it becomes difficult to introduce the hand. The operator
should smear his arms with carbolized lard or vaseline to protect them
against infection, and particularly in delayed cases with putrid membranes.
An assistant holds the tail to one side, the operator seizes the hanging
afterbirth with the left hand, while he introduces the other along the
right side of the vagina and womb, letting the membranes slide through his
palm until he reaches the first cotyledon to which they remain adherent. In
case no such connection is within reach, with the left hand gentle traction
is made on the membranes until the deeper parts of the womb are brought
within reach and the attachments to the cotyledons can be reached. Then the
soft projection of the membrane, which is attached to the firm
fungus-shaped cotyledon on the inner surface of the womb, is seized by the
little finger, and the other fingers and thumb are closed on it so as to
tear it out from its connections. To explain this, it is necessary only to
say that the projection from the membrane is covered by soft, conical
processes, which are received into cavities of a corresponding size on the
summit of the firm, mushroom-shaped cotyledon growing from the inner
surface of the womb. To draw upon the former, therefore, is to extract
its soft, villous processes from within the follicles or cavities of the
other. (Pl. XIII, fig. 2.) If at times it is difficult to start this
extraction it may be necessary to get the finger nail inserted between the
two, and once started the finger may be pushed on, lifting all the villi,
in turn, out of their cavities. This process of separating the cotyledons
must be carefully conducted, one after another, until the last has been
detached and the afterbirth comes freely out of the passages. I have never
found any evil result from the removal of the whole mass at one operation,
but Shaack mentions the eversion of the womb as the possible result of the
necessary traction, and in cases in which those in the most distant part of
the horn of the womb can not be easily reached, he advises to attach a cord
to the membranes inside the vulva, letting it hang out behind, and to cut
off the membranes below the cord. Then, after two or three days' delay, he
extracts the remainder, now softened and easily detached. If carefully
conducted, so as not to tear the cotyledons of the womb, the operation is
eminently successful; the cow suffers little, and the straining roused by
the manipulations soon subsides. Keeping in a quiet, dark place, or driving
a short distance at a walking pace, will serve to quiet these. When the
membranes have been withdrawn, the hand, half closed, may be used to draw
out of the womb the offensive liquid that has collected. If the case is a
neglected one, and the discharge is very offensive, the womb must be
injected as for leucorrhea.
INFLAMMATION OF THE VAGINA (VAGINITIS).
This may occur independently of inflammation of the womb, and usually as
the result of bruises, lacerations, or other injuries sustained during
calving. It will be shown by swelling of the lips of the vulva, which,
together with their lining membrane, become of a dark-red or leaden hue,
and the mucous discharge increases and becomes whitish or purulent, and it
may be fetid. Slight cases recover spontaneously, or under warm
fomentations or mild astringent injections (a teaspoonful of carbolic acid
in a quart of water), but severe cases may go on to the formation of large
sores (ulcers), or considerable portions of the mucous membrane may die and
slough off. Baumeister records two cases of diphtheritic vaginitis, the
second case in a cow four weeks calved, contracted from the first in a
newly calved cow. Both proved fatal, with formation of false membranes as
far as the interior of the womb. In all severe cases the antiseptic
injections must be applied most assiduously. The carbolic acid may be
increased to one-half ounce to a quart, or chlorin water, or peroxid of
hydrogen solution may be injected at least three times a day. Hyposulphite
of soda, 1 ounce to a quart of water, is an excellent application, and the
same amount may be given by the mouth.
LEUCORRHEA (MUCOPURULENT DISCHARGE FROM THE PASSAGES).
This is from a continued or chronic inflammation of the womb, or the
vagina, or both. It usually results from injuries sustained in calving or
from irritation by putrid matters in connection with retained afterbirth,
or from the use of some object in the vagina (pessary) to prevent eversion
of the womb. Exposure to cold or other cause of disturbance of the health
may affect an organ so susceptible as this at the time of parturition so as
to cause inflammation.
_Symptoms._--The main symptom is the glairy, white discharge flowing
constantly or intermittently (when the cow lies down), soiling the tail and
matting its hairs and those of the vulva. When the lips of the vulva are
drawn apart the mucous membrane is seen to be red, with minute elevations,
or pale and smooth. The health may not suffer at first, but if the
discharge continues and is putrid the health fails, the milk shrinks, and
flesh is lost. If the womb is involved the hand introduced into the vagina
may detect the mouth of the womb slightly open and the liquid collected
within its cavity. Examination with the oiled hand in the rectum may detect
the outline of the womb beneath, somewhat enlarged, and fluctuating under
the touch from contained fluid. In some cases heat is more frequent or
intense than natural, but the animal rarely conceives when served, and, if
she does, is liable to abort.
_Treatment._--Treatment with the injections advised for vaginitis is
successful in mild or recent cases. In obstinate ones stronger solutions
may be used after the womb has been washed out by a stream of tepid water
until it comes clear. A rubber tube is inserted into the womb, a funnel
placed in its raised end, and the water, and afterwards the solution,
poured slowly through it. If the neck of the womb is so close that the
liquid can not escape, a second tube may be inserted to drain it off. As
injections may be used chlorid of zinc, one-half dram to the quart of
water, or sulphate of iron, 1 dram to the quart. Three drams of sulphate of
iron and one-half ounce ground ginger may also be given in the feed daily.
INFLAMMATION OF THE WOMB (METRITIS, INFLAMMATION OF WOMB AND ABDOMEN, OR
METROPERITONITIS).
Inflammation of the womb may be slight or violent, simple or associated
with putrefaction of its liquid contents and general poisoning, or it may
extend so that the inflammation affects the lining membrane of the whole
abdominal cavity. In the last two cases the malady is a very grave one.
_Causes._--The causes are largely the same as those causing inflammation of
the vagina. Greater importance must, however, be attached to exposure to
cold and wet and to septic infection.
_Symptoms._--The symptoms appear two or three days after calving, when the
cow may be seen to shiver, or the hair stands erect, especially along the
spine, and the horns, ears, and limbs are cold. The temperature in the
rectum is elevated by one or two degrees, the pulse is small, hard, and
rapid (70 to 100), appetite is lost, rumination ceases, and the milk
shrinks in quantity or is entirely arrested, and the breathing is hurried.
The hind limbs may shift uneasily, the tail be twisted, the head and eyes
turn to the right flank, and the teeth are ground. With the flush of heat
to the horns and other extremities, there is redness of the eyes, nose, and
mouth, and usually a dark redness about the vulva. Pressure on the right
flank gives manifest pain, causing moaning or grunting, and the hind limbs
are moved stiffly, extremely so if the general lining of the abdomen is
involved. In severe cases the cow lies down and can not be made to rise.
There is usually marked thirst, the bowels are costive, and dung is passed
with pain and effort. The hand inserted into the vagina perceives the
increased heat, and when the neck of the womb is touched the cow winces.
Examination through the rectum detects enlargement and tenderness of the
womb. The discharge from the vulva is at first watery, but becomes thick,
yellow, and finally red or brown, with a heavy or fetid odor. Some cases
recover speedily and may be almost well in two days; a large proportion
perish within two days of the attack, and some merge into the chronic form,
terminating in leucorrhea. In the worst cases there is local septic
infection and ulceration, or even gangrene of the parts, or there is
general septicemia, or the inflammation involving the veins of the womb
causes coagulation of the blood contained in them, and the washing out of
the clots to the right heart and lung leads to the blocking of the vessels
in the latter and complicating pneumonia. Inflammation of the womb and
passages after calving are always liable to these complications, and
consequently to a fatal issue. Franck records three instances of rapidly
fatal metritis in cows, all of which had been poisoned from an adjacent cow
with retained and putrid afterbirth. Others have had similar cases.
_Treatment._--Treatment in the slight cases of simple inflammation does not
differ much from that adopted for vaginitis, only care must be taken that
the astringent and antiseptic injections are made to penetrate into the
womb. After having washed out the womb a solution of chlorid of lime or
permanganate of potassium (one-half ounce to 1 quart of water), with an
ounce each of glycerin and laudanum to render it more soothing, will often
answer every purpose. It is usually desirable to open the bowels with 1-1/2
pounds of Glauber's salt and 1 ounce of ginger in 4 quarts of warm water,
and to apply fomentation of warm water or even mustard poultices or
turpentine to the right flank.
In the violent attacks with high temperature and much prostration, besides
the salts agents must be given to lower the temperature and counteract
septic poisoning. Salicylate of soda one-half ounce, or quinia 2 drams
every four hours will help in both ways, or ounce doses of hyposulphite of
soda or dram doses of carbolic acid may be given as often until six doses
have been taken. Tincture of aconite has often been used in 20-drop doses
every six hours. If the temperature rises to 106∞ or 107∞ F., it must be
met by the direct application of cold or iced water to the surface. The
animal may be covered with wet sheets and cold water poured on them
frequently until the temperature in the rectum is lowered to 102∞ F. In
summer the cow may be allowed to dry spontaneously, while in winter it
should be rubbed dry and blanketed. Even in the absence of high temperature
much good may be obtained from the soothing influence of a wet sheet
covering the loins and flanks and well covered at all points by a dry one.
This may be followed next day by a free application of mustard and oil of
turpentine. When the animal shows extreme prostration, carbonate of ammonia
(1 ounce) may be given to tide over the danger, but such cases usually
perish.
In this disease, even more than in difficult and protracted parturition or
retained placenta, the attendants must carefully guard against the
infection of their hands and arms from the diseased parts. The hand and arm
before entering the passages should always be well smeared with lard
impregnated with carbolic acid.
MILK FEVER (PARTURITION FEVER, PARTURIENT APOPLEXY, OR PARTURIENT
COLLAPSE).
This disease is not only peculiar to the cow, but it may be said to be
virtually confined to the improved and plethoric cow. It further occurs
only at or near the time of calving. Indeed, these two factors, calving and
plethora, may be set apart as preeminently the causes of this disease. It
is the disease of cows that have been improved in the direction of early
maturity, power of rapid fattening, or a heavy yield of milk, and hence it
is characteristic of those having great appetites and extraordinary power
of digestion. The heavy milking breeds are especially its victims, as in
them the demand for the daily yield of 50 to 100 pounds of milk means even
more than a daily increase of 2 to 3 pounds of body weight, mainly fat. The
victims are not always fat when attacked, but they are cows having enormous
powers of digestion, and which have been fed heavily at the time. Hence the
stall-fed, city-dairy cow, and the farm cow on a rich clover pasture in
June or July are especially subject. The condition of the blood globules in
the suffering cow attests the extreme richness and density of the blood,
yet this peculiarity appears to have entirely escaped the notice of
veterinary writers. I have never examined the blood of a victim of this
disease without finding the red-blood globules reduced to little more than
one-half their usual size. Now, these globules expand or contract according
to the density of the liquid in which they float. If we dilute the blood
with water they will expand until they burst, whereas if solids, such as
salt or albumin, are added they shrink to a large extent. Their small size,
therefore, in parturition fever indicates the extreme richness of the
blood, or, in other words, plethora.
Confinement in the stall is an accessory cause, partly because stabled
cattle are highly fed, partly because the air is hotter and fouler, and
partly because there is no expenditure by exercise of the rich products of
digestion.