health the horse's urine is of a deep amber color and has a strong odor.
On a feed of grain and hay it may show a uniform transparency, while on
a green ration there in an abundant white deposit of carbonate of lime.
Of its morbid changes the following are to be looked for: (1) _Color_:
White from deposited salts of lime; brown or red from blood clots or
coloring matter; yellow or orange from bile or blood pigment; pale from
excess of water; or variously colored from vegetable ingredients
(santonin makes it red; rhubarb or senna, brown; tar or carbolic acid,
green). (2) _Density_: The horse's urine may be 1.030 or 1.050, but it
may greatly exceed this in diabetes and may sink to 1.007 in diuresis.
(3) _Chemical reaction_, as ascertained by blue litmus or red test
papers. The horse on vegetable diet has alkaline urine turning red test
papers blue, while in the sucking colt and the horse fed on flesh or on
his own tissue (in starvation or abstinence during disease) it is acid,
turning blue litmus red. (4) _Organic constituents_, as when glairy from
albumen coagulable by strong nitric acid and boiling, when charged with
microscopic casts of the uriniferous tubes, with the eggs or bodies of
worms, with sugar, blood, or bile. (5) _In its salts_, which may
crystallize out spontaneously, or on boiling, or on the addition of
chemical reagents.
[Illustration: PLATE VIII.
LONGITUDINAL SECTION THROUGH KIDNEY.]
[Illustration: PLATE IX.
MICROSCOPIC ANATOMY OF KIDNEY.]
[Illustration: PLATE X.
MICROSCOPIC ANATOMY OF KIDNEY.]
Albuminous urine in the horse is usually glairy, so that it may be drawn
out in threads, but its presence can always be tested as follows: If the
liquid is opaque, it may be first passed through filter paper; if very
dense and already precipitating its salts, it may be diluted with
distilled water; add to the suspected liquid acetic acid drop by drop
until it reddens the blue litmus paper; then boil gently in a test tube;
if a precipitate is thrown down, set the tube aside to cool and then add
strong nitric acid. If the precipitate is not dissolved, it is albumen;
if dissolved it is probably urate or hippurate of ammonia. Albumen is
normally present in advanced gestation; abnormally it is seen in
diseases in which there occurs destruction of blood globules (anthrax,
low fevers, watery states of the blood, dropsies), in diseases of the
heart and liver which prevent the free escape of blood from the veins
and throw back venous pressure on the kidneys, in inflammation of the
lungs and pleurae, and even tympany (bloating), doubtless from the same
cause, and in all congestive or inflammatory diseases of the kidneys,
acute or chronic.
Casts of the uriniferous tubes can be seen only by placing the suspected
urine under the microscope. They are usually very elastic and mobile,
waving about in the liquid when the cover glass is touched, and showing
a uniform, clear transparency (waxy) or entangled circular epithelial
cells or opaque granules or flattened, red-blood globules or clear,
refrangent oil globules. They may be even densely opaque from crystals
of earthy salts.
Pus cells may be found in the urine associated with albumen, and are
recognized by clearing up, when treated with acetic acid, so that each
cell shows two or three nuclei.
DIURESIS (POLYURIA, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF
URINE).
This consists in an excessive secretion of a clear, watery urine of a
low specific gravity (1.007) with a correspondingly ardent thirst, a
rapidly advancing emaciation, and great loss of strength and spirit.
_Causes._--Its causes may be any agent--medicinal, alimentary, or
poisonous--which unduly stimulates the kidneys; the reckless
administration of diuretics, which form such a common constituent of
quack horse powders; acrid diuretic plants in grass or hay; new oats
still imperfectly cured; an excess of roots or other very watery feed; a
full allowance of salt to animals that have become inordinately fond of
it; but, above all, feeding on hay, grain, or bran which has not been
properly dried and has become musty and permeated by fungi. Thus hay,
straw, or oats obtained in wet seasons and heating in the rick or stack
is especially injurious. Hence this malady, like coma somnolentum
(sleepy staggers), is widespread in wet seasons, and especially in rainy
districts.
_Symptoms._--The horse drinks deep at every opportunity and passes urine
on every occasion when stopped, the discharge being pale, watery, of a
low density, and inodorous; in short, it contains a great excess of
water and a deficiency of the solid excretions. So great is the quantity
passed, however, that the small amount of solids in any given specimen
amounts in 24 hours to far more than the normal--a fact in keeping with
the rapid wasting of the tissues and extreme emaciation. The flanks
become tucked up, the fat disappears, the bones and muscles stand out
prominently, the skin becomes tense and hidebound, and the hair erect,
scurfy, and deficient in luster. The eye becomes dull and sunken, the
spirits are depressed, the animal is weak and sluggish, sweats on the
slightest exertion, and can endure little. The subject may survive for
months, or may die early of exhaustion. In the slighter cases, or when
the cause ceases to operate, a somewhat tardy recovery may be made.
_Treatment_ consists in stopping the ingestion of the faulty drugs,
poisons, or feed, and supplying sound hay and grain free from all taint
of heating or mustiness. A liberal supply of boiled flaxseed in the
drinking water at once serves to eliminate the poison and to sheathe and
protect the irritated kidneys. Tonics like sulphate or phosphate of iron
(2 drams morning and evening) and powdered gentian or Peruvian bark (4
drams) help greatly by bracing the system and hastening repair. To these
may be added agents calculated to destroy the fungus and eliminate its
poisonous products. In that form which depends on musty food nothing
acts better than large doses of iodid of potassium (2 drams), while in
other cases creosote, carbolic acid (1 dram), or oil of turpentine (4
drams), properly diluted, may be resorted to.
SACCHARINE DIABETES (DIABETES MELLITUS, GLYCOSURIA, OR INOSURIA).
This is primarily a disease of the nervous system or liver rather than
of the kidneys, yet, as the most prominent symptom is the sweet urine,
it may be treated here.
_Causes._--Its causes are varied, but resolve themselves largely into
disorder of the liver or disorder of the brain. One of the most
prominent functions of the liver is the formation of glycogen, a
principle allied to grape sugar, and passing into it by further
oxidation in the blood. This is a constant function of the liver, but in
health the resulting sugar is burned up in the circulation and does not
appear in the urine. On the contrary, when the supply of oxygen is
defective, as in certain diseases of the lungs, the whole of the sugar
does not undergo combustion and the excess is excreted by the kidneys.
Also in certain forms of enlarged liver the quantity of sugar produced
is more than can be disposed of in the natural way, and it appears in
the urine. A temporary sweetness of the urine often occurs after a
hearty meal on starchy feed, but this is due altogether to the
super-abundant supply of the sugar-forming feed, lasts for a few hours
only, and has no pathological significance. In many cases of fatal
glycosuria the liver is found to be enlarged, or at least congested, and
it is found that the disorder can be produced experimentally by agencies
which produce an increased circulation through the liver. Thus Bernard
produced glycosuria by pricking the oblong medulla at the base of the
brain close to the roots of the pneumogastric nerve, which happens to be
also the nerve center (vasomotor) which presides over the contractions
of the minute blood vessels. The pricking and irritation of this center
leads to congestion of the liver and the excessive production of sugar.
Irritation carried to this point through the pneumogastric nerve causes
saccharine urine, and, in keeping with this, disease of the pancreas has
been found in this malady. The complete removal of the pancreas,
however, determines glycosuria, the organ having in health an inhibitive
action on sugar production by the liver. The same result follows the
reflection of irritation from other sources, as from different ganglia
(corpora striata, optic thalami, pons, cerebellum, cerebrum) of the
brain. Similarly it is induced by interruption of the nervous control
along the vasomotor tracts, as in destruction of the upper or lower
cervical sympathetic ganglion, by cutting the nervous branch connecting
these two, in injury to the spinal marrow in the interval between the
brain and the second or fourth dorsal vertebra, or in disease of the
celiac plexus, which directly presides over the liver. Certain chemical
poisons also cause saccharine urine, notably woorara, strychnia,
morphia, phosphoric acid, alcohol, ether, quinia, chloroform, ammonia,
arsenic, and phlorizin.
_Symptoms._--The symptoms are ardent thirst and profuse secretion of a
pale urine of a high density (1.060 and upward), rapid loss of
condition, scurfy, unthrifty skin, costiveness or irregularity of the
bowels, indigestion, and the presence, in the urine, of a sweet
principle--grape sugar or inosite, or both. This may be most promptly
detected by touching the tip of the tongue with a drop. Sugar may be
detected simply by adding a teaspoonful of liquid yeast to 4 ounces of
the urine and keeping it lightly stopped at a temperature of 70 deg. to 80 deg.
F. for 12 hours, when the sugar will be found to have been changed into
alcohol and carbon dioxid. The loss of density will give indication of
the quantity of sugar transformed; thus a density of 1.035 in a urine
which was formerly 1.060 would indicate about 15 grains of sugar to the
fluid ounce.
Inosite, or muscle sugar, frequently present in the horse's urine, and
even replacing the glucose, is not fermentable. Its presence may be
indicated by its sweetness and the absence of fermentation or by
Gallois's test. Evaporate the suspected urine at a gentle heat almost to
dryness, then add a drop of a solution of mercuric nitrate and evaporate
carefully to dryness, when a yellowish residue is left that is changed
on further cautious heating to a deep rose color, which disappears on
cooling and reappears on heating.
In advanced diabetes, dropsies in the limbs and under the chest and
belly, puffy, swollen eyelids, cataracts, catarrhal inflammation of the
lungs, weak, uncertain gait, and drowsiness may be noted.
_Treatment_ is most satisfactory in cases dependent on some curable
disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a
run at pasture in warm weather, or in winter a warm, sunny, well-aired
stable, with sufficient clothing and laxatives (sulphate of soda, 1
ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may
benefit. To this may be added mild blistering, cupping, or even leeching
over the last ribs. Diseases of the brain or pancreas may be treated
according to their indications. The diet should be mainly albuminous,
such as wheat bran or middlings, peas, beans, vetches, and milk. Indeed,
an exclusive milk diet is one of the very best remedial agencies. It may
be given as skimmed milk or butter-milk, and in the last case combines
an antidiabetic remedy in the lactic acid. Under such an exclusive diet
recent and mild cases are often entirely restored, though at the expense
of an attack of rheumatism. Codeia, one of the alkaloids of opium, is
strongly recommended by Tyson. The dose for the horse would be 10 to 15
grains thrice daily. In cases in which there is manifest irritation of
the brain, bromid of potassium, 4 drams, or ergot one-half ounce, may be
resorted to. Salicylic acid and salicylate of sodium have proved useful
in certain cases; also phosphate of sodium. Bitter tonics (especially
nux vomica one-half dram) are useful in improving the digestion and
general health.
HEMATURIA (BLOODY URINE).
_Cause._--As seen in the horse, bloody urine is usually the direct
result of mechanical injuries, as sprains and fractures of the loins,
lacerations of the sublumbar muscles (psoas), irritation caused by stone
in the kidney, ureter, bladder, or urethra. It may, however, occur with
acute congestion of the kidney, with tumors in its substance, or with
papilloma or other diseased growth in the bladder. Acrid diuretic plants
present in the feed may also lead to the escape of blood from the
kidney. The predisposition to this affection is, however, incomparably
less than in the case of the ox or the sheep, the difference being
attributed to the greater plasticity of the horse's blood in connection
with the larger quantity of fibrin.
The blood may be present in small clots or in more or less intimate
admixture with the urine. Its condition may furnish some indication as
to its source; thus, if from the kidneys it is more liable to be
uniformly diffused through the urine, while as furnished by the bladder
or passages clots are more liable to be present. Again, in bleeding from
the kidney, minute, cylindrical clots inclosing blood globules and
formed in the uriniferous tubes can be detected under the microscope.
Precision also may be approximated by observing whether there is
coexisting fracture, sprain of the loins, or stone or tumor in the
bladder or urethra.
_Treatment._--The disease being mainly due to direct injury, treatment
will consist, first, in removing such cause whenever possible, and then
in applying general and local styptics. Irritants in feed must be
avoided, sprains appropriately treated, and stone in bladder or urethra
removed. Then give mucilaginous drinks (slippery elm, linseed tea)
freely, and styptics (tincture of chlorid of iron 3 drams, acetate of
lead one-half dram, tannic acid one-half dram, or oil of turpentine 1
ounce). If the discharge is abundant, apply cold water to the loins and
keep the animal perfectly still.
HEMOGLOBINURIA (AZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS).
Like diabetes, this is rather a disease of the liver and blood-forming
functions than of the kidney, but as prominent symptoms are loss of
control over the hind limbs and the passage of ropy and dark-colored
urine, the vulgar idea is that it is a disorder of the urinary organs.
It is a complex affection directly connected with a plethora in the
blood of nitrogenized constituents, with extreme nervous and muscular
disorder and the excretion of a dense reddish or brownish urine. It is
directly connected with high feeding, especially on highly nitrogenized
feed (oats, beans, peas, vetches, cottonseed meal), and with a period of
idleness in the stall under full rations. The disease is never seen at
pasture, rarely under constant daily work, even though the feeding is
high, and the attack is usually precipitated by taking the horse from
the stable and subjecting it to exercise or work. The poisoning is not
present when taken from the stable, as the horse is likely to be
noticeably lively and spirited, but he will usually succumb under the
first hundred yards or half mile of exercise. It seems as if the
aspiratory power of the chest under the sudden exertion and accelerated
breathing speedily drew from the gorged liver and abdominal veins
(portal) the accumulated store of nitrogenous matter in an imperfectly
oxidized or elaborated condition, and as if the blood, surcharged with
these materials, were unable to maintain the healthy functions of the
nerve centers and muscles. It has been noticed rather more frequently in
mares than horses, attributable, perhaps, to the nervous excitement
attendant on heat, and to the fact that the unmutilated mare is
naturally more excitable than the docile gelding.
Lignieres has found in hemoglobinuria a streptococcus which produced
nephritis, bloody urine, and paraplegia in experimental animals,
including horses.
_Symptoms._--In the milder forms this affection may appear as a lameness
in one limb, from indefinite cause, succeeding to some sudden exertion
and attended by a dusky-brown color of the membranes of the eye and nose
and some wincing when the last ribs are struck. The severe forms come on
after one or two days of rest on a full ration, when the animal has been
taken out and driven one hundred paces or more: The fire and life with
which he had left the stable suddenly give place to dullness and
oppression, as shown in heaving flanks, dilated nostrils, pinched face,
perspiring skin, and trembling body. The muscles of the loins or haunch
become swelled and rigid, the subject moves stiffly or unsteadily,
crouches behind, the limbs being carried semiflexed, and he soon drops,
unable to support himself. When down, the body and limbs are moved
convulsively, but there is no power of coordination of movement in the
muscles. The pulse and breathing are accelerated, the eyes red with a
tinge of brown, and the urine, if passed, is seen to be highly colored,
dark brown, red, or black, but it contains neither blood clots nor
globules. The color is mainly due to hemoglobin and other imperfectly
elaborated constituents of the blood.
It may end fatally in a few hours or days, or a recovery may ensue,
which is usually more speedy and perfect if it has set in at an early
stage. In the late and tardy recoveries a partial paralysis of the hind
limbs may last for months. A frequent sequel of these tardy cases is an
extensive wasting of the muscles leading up from the front of the stifle
(those supplied by the crural nerve) and a complete inability to stand.
_Prevention._--The prevention of this serious affection lies in
restricting the diet and giving daily exercise when the animal is not at
work. A horse that has had one attack should never be left idle for a
single day in the stall or barnyard. When a horse has been condemned to
absolute repose on good feeding he may have a laxative (one-half to 1
pound Glauber's salt), and have graduated exercise, beginning with a
short walk and increasing day by day.
_Treatment._--The treatment of the mild cases may consist in a laxative,
graduated daily exercise, and a daily dose of saltpeter (1 ounce).
Sudden attacks will sometimes promptly subside if taken on the instant
and the subject kept still and calmed by a dose of bromid of potassium
(4 drams) and sweet spirits of niter (1 ounce). The latter has the
advantage of increasing the secretion of the kidneys. Iodid of potassium
in one-half ounce doses every four hours has succeeded well in some
hands. In severe cases, as a rule, it is desirable to begin treatment by
a dose of aloes (4 to 6 drams) with the above-named dose of bromid of
potassium, and this latter may be continued at intervals of four or six
hours, as may be requisite to calm the nervous excitement. Fomentations
with warm water over the loins are always useful in calming the
excitable conditions of the spinal cord, muscles, liver, and kidneys,
and also in favoring secretion from the two latter. On the second day
diuretics may be resorted to, such as saltpeter one-half ounce, and
powdered colchicum, one-half dram, to be repeated twice daily. A
laxative may be repeated in three or four days should the bowels seem to
demand it, and as the nervous excitement disappears any remaining
muscular weakness or paralysis may be treated by one-half dram doses of
nux vomica twice a day and a stimulating liniment (aqua ammonia and
sweet oil in equal proportions) rubbed on the torpid muscles.
During the course of the disease friction to the limbs is useful, and in
the advanced paralytic stage the application of electricity along the
line of the affected muscles. When the patient can not stand he must
have a thick, soft bed, and should be turned from side to side at least
every twelve hours. As soon as he can be made to stand he may be helped
up and even supported in a sling.
ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS.
Inflammations of the kidneys have been differentiated widely, according
as they were acute or chronic, parenchymatous or tubal, suppurative or
not, with increased or shrunken kidney, etc. In a work like the present,
however, utility will be consulted by classing all under acute or
chronic inflammation.
_Causes._--The causes of inflammation of the kidneys are extremely
varied. Congestion occurs from the altered and irritant products passed
through these organs during recovery from inflammations of other organs
and during fevers. This may last only during the existence of its cause,
or may persist and become aggravated. Heart disease, throwing the blood
pressure back on the veins and kidneys, is another cause. Disease of the
ureter or bladder, preventing the escape of urine from the kidney and
causing increased fullness and tension in its pelvis and tubes, will
determine inflammation. Decomposition of the detained urine in such
cases and the production of ammonia and other irritants must also be
named. In elimination of bacteria through the kidney, the latter is
liable to infection with consequent inflammation. The advance of
bacteria upward from the bladder to the kidneys is another cause. The
consumption in hay or other fodder of acrid or irritant plants,
including fungi, the absorption of cantharidine from a surface blistered
by Spanish flies, the reckless administration of diuretics, the presence
of stones in the kidney, exposure of the surface to cold and wet, and
the infliction of blows or sprains on the loins, may contribute to its
production. Liver disorders which throw on the kidneys the work of
excreting irritant products, diseases of the lungs and heart from which
clots are carried, to be arrested in the small blood vessels of the
kidney, and injuries and paralysis of the spinal cord, are additional
causes.
_Symptoms._--The symptoms are more or less fever, manifest stiffness of
the back and straddling gait with the hind limbs, difficulty in lying
down and rising, or in walking in a circle, the animal sometimes
groaning under the effort, arching of the loins and tucking up of the
flank, looking back at the abdomen as if from colicky pain, and
tenderness of the loins to pinching, especially just beneath the bony
processes 6 inches to one side of the median line. Urine is passed
frequently, a small quantity at a time, of a high color, and sometimes
mixed with blood or even pus. Under the microscope it shows the
microscopic casts referred to under general symptoms. If treated by
acetic acid, boiling and subsequent addition of strong nitric acid, the
resulting and persistent precipitate indicates the amount of albumen.
The legs tend to swell from the foot up, also the dependent parts
beneath the belly and chest, and effusions of liquid may occur within
the chest or abdomen. In the male the alternate drawing up and
relaxation of the testicles in the scrotum are suggestive, and in small
horses the oiled hand introduced into the rectum may reach the kidney
and ascertain its sensitiveness.
_Treatment_ demands, first, the removal of any recognized cause. Then,
if the suffering and fever are high, 2 to 4 quarts of blood may be
abstracted from the jugular vein; in weak subjects or unless in high
fever this should be omitted. Next relieve the kidneys so far as
possible by throwing their work on the bowels and skin. A pint of castor
oil is less likely than either aloes or salts to act on the kidneys. To
affect the skin a warm stall and heavy clothing may be supplemented by
dram doses of Dover's powder. Pain may be soothed by dram doses of
bromid of potassium. Boiled flaxseed may be added to the drinking water,
also thrown into the rectum as an injection, and blankets saturated with
hot water should be persistently applied to the loins. This may be
followed by a very thin pulp of the best ground mustard made with tepid
water, rubbed in against the direction of the hair and covered with
paper and a blanket. This may be kept on for an hour, or until the skin
thickens and the hair stands erect. It may then be rubbed or sponged off
and the blanket reapplied. When the action of the bowels has been
started it may be kept up by a daily dose of 2 or 3 ounces of Glauber's
salt.
During recovery a course of bitter tonics (nux vomica 1 scruple, ground
gentian root 4 drams) should be given. The patient should also be
guarded against cold, wet, and any active exertion for some time after
all active symptoms have subsided.
CHRONIC INFLAMMATION OF THE KIDNEYS.