Causes: acrid diuretics, loss of kidney, catheterization, dermatitis,
burns, traumas, overexertion. Lesions: enlarged, blood-gorged kidney,
red or black, petechiated. Symptoms: stiff, arched, tender loins,
tardy, dragging of hind limbs, urine passed often, clear to bloody,
albuminous, anorexia, nausea, vomiting, diarrhœa, dullness, stupor.
Treatment: stop cause, give emetic, laxative, in surgical cases
antiseptic, for cantharides, camphor, bromides, vegetable food. Warm
clothing or building.
_Causes._ This comes most commonly from the ingestion of acrid or
diuretic agents, saltpeter, turpentine oil, cantharides and, according
to Cadeac, various essential oils including oil of mustard. It takes
place in the remaining kidney after the one has been extirpated, or had
its functions abolished by disease or urethral obstruction. Again,
surgical operations on the urinary organs, even the simple passing of a
catheter, will cause sympathetic renal congestion. Extensive acute
dermatitis, and burns of the skin may have a similar sequence.
Falls, kicks, blows, or crushing beneath a wheel or otherwise are
additional causes.
Finally violent overexertion as in coursing, causes congestion with
albuminuria, and blood globules and even casts in the urine. This is
common to the human athlete, who undergoes a violent and continued
overexertion, race and draught horses, and dogs.
_Lesions._ When congestion is produced experimentally by cantharides the
kidneys are found to be enlarged and the cortex gorged with blood so
that it has a deep red or blackish port wine hue, with here and there
spots of ecchymosis. The veins, capillaries and glomeruli are especially
congested, and the epithelial cells of the convoluted tubes have become
laterally distended, so that they approximate to a globular form. A
loose coagulum containing blood globules may be found in the capsule of
the glomerulus and in the convoluted tubes.
_Symptoms._ These are arching and stiffness of the loins, a tardy,
dragging movement of the hind limbs and tenderness of the loins. The
urine may be scanty or in excess, and tends to be passed frequently, in
small quantities and with evidence of pain. It may be clear, pinkish or
bloody, and shows albumen and frequently casts, and blood globules or
small clots. There is some impairment of appetite, and, in severe cases,
nausea and vomiting, with, it may be, diarrhœa, nervous depression,
dullness and stupor. When due to poison or other transient cause the
symptoms improve when this factor has been stopped.
_Treatment._ When due to poison taken by the stomach this must be
stopped, and the stomach and bowels evacuated by an emetic (ipecacuan)
and laxative (sodium sulphate). Appropriate treatment must be made in
case of burns or skin eruptions. When surgical cases are due to
infection rather than simple shock or sympathetic irritation, antiseptic
injections of the bladder are indicated. In all cases alike a warm bath
is an important adjunct. When irritation is due to cantharides, it may
be calmed by camphor, 2 grains every three or four hours. Other anodynes
may be given as required. Rest is essential and, as appetite is
recovered, a moderate amount of amylaceous puddings. A warm building or
comfortable clothing is desirable.