Definition. In cattle on low damp lands, acrid plants, sprain, blow,
calculus, from purulent nephritis, in anæmia. Symptoms: of nephritis,
soiling of tail or prepuce, albumen, pus or blood in urine, lameness,
unilateral or bilateral, lumbar swelling, in small animals
fluctuation, history. Lesions: abscesses around kidney, under capsule,
intercommunicating. Treatment: as in purulent nephritis.
Suppuration in the connective tissue between the kidney and its capsule
is seen in cattle in low condition, on damp, unimproved soils like
undrained river bottoms and estuaries, abounding in acrid and diuretic
plants. Even among such animals it is rare and has probably a directly
exciting cause in a sprain or blow on the loins, or the presence and
movement of a renal calculus. It may extend from suppurations in the
substance of the kidney and to such extension the weak or anæmic
condition materially contributes. In man, in which such conditions have
been more frequently observed, a weak or cachectic condition is
considered as an essential accessory factor along with the traumatic
lesion (R. Harrison). Similar conditions may be expected to bring about
perinephritis in any one of our domestic animals. The author has
observed it especially on the low lands on the banks of the Ouse in
Yorkshire, England.
_Symptoms._ These are mainly those of nephritis in general, shivering,
stiff movement in the hind limbs, straddling, frequent passage of urine,
straining, difficulty in lying down and rising, tenderness of the loins,
dropping when mounted, groaning when turned in a short circle. If the
suppuration communicates with the pelvis of the kidney there may be, in
females, soiling of the tail, and in males of the prepuce. Blood may be
passed with the urine, and pus cells and albumen are found when it is
examined. If one kidney only is affected, there is lameness in the
corresponding hind limb, the special feature being inability to extend
it backward. A swelling on the one side of the loins, and beneath the
lumbar transverse processes just posterior to the last rib, is likely to
be a marked symptom, and if this persists and is especially prominent at
one point, an exploratory incision or puncture will detect the presence
of the pus. Fluctuation can rarely be detected, yet in small animals
with very flaccid abdomen, the swollen, tender kidney and even
fluctuation should be detected at times. The history of the case, the
low, damp pasturage, the access to acrid plants, the alimentation with
hay or grain covered with cryptogams, the fact of an injury and the low,
weak, anæmic condition of the animal should contribute to a satisfactory
diagnosis.
_Lesions._ In bovine kidneys affected in this way we have found general
inflammation and exudation around the entire kidney and inside the
capsule, with numerous small abscesses, in many instances communicating
with each other. They may extend through the capsule and invade
surrounding organs.
_Treatment._ In the treatment of cases of this kind the general
principles of therapeutics for nephritis are about all that can be
attempted in the lower animals. Fomentations over the loins are
especially desirable as a means of relieving the suffering, and
moderating inflammatory action. To the same end is the allowance of
plenty of pure water as a diluent. Then the various agents that
antagonize suppuration may be thought of, and some one selected for use.
Beside the antisuppurants already mentioned one may use copiaba, cubebs,
or turpentine in small doses, salicylates, or the sulphide or sulphite
of calcium. Surgical interference by puncture or incision and antiseptic
irrigation can only be thought of when the abscess is single and
circumscribed; never when the whole periphery of the organ is involved.
In the latter case the only rational surgery would be the desperate
resort of the removal of the entire kidney.