Acrid diuretics, by mouth or skin, microbian infection, retention of
urine, urethral calculus, parasites, spasm, enforced suspension of
micturition, unclean catheter, adjacent infection, chill. Lesions:
hyperæmia of mucosa, thickening, vascular distention, clouding of
epithelium, muco-purulent secretion, alkaline fermentation, ammonia,
liquefaction of cells, erosion. Symptoms: Slight fever, stiff,
straddling gait, urine scanty, cloudy, alkaline, penis or clitoris
semi-erect, smearing of tail or prepuce. Crystals of triple phosphate.
Treatment: Antiseptics, boric or salicylic acid, gum arabic,
astringent antiseptics, laxatives, flax seed, slippery elm, anodynes,
diluents, piperazine, drainage, rest, restricted laxative diet,
warmth, avoid stimulants.
_Causes._ Cystitis is caused in all animals by irritant diuretics like
cantharides, copaiba, or oil of turpentine given by the mouth or applied
to an extensive cutaneous surface. It is an error, however, to conclude
with Williams that this is the sole cause. The very existence of calculi
virtually implies bacterial infection, and fermentation. The presence of
free ammonia in the urine usually implies fermentation, and fermentation
must be looked upon as practically synonymous with microbian invasion.
That bacteria may be present without serious injury is undoubted. The
protective power of the healthy mucosa is very great. But when the
mucosa is weakened, microbes that would otherwise be harmless, find a
ready infection atrium, and triumph over the weakened tissues. Hence
retention of urine and overdistension of the bladder as in urethral
calculus, blocking of the urethra by a parasite, spasm of the sphincter
vesicæ, compulsory retention as in the mare in harness, the dog kept
indoors, or in railway car on a long journey, or in mares so travelling,
may become the occasion of cystitis. Even in cases in which no microbe
is present at first, this reaches the bladder by the introduction of an
unclean catheter, or by extension from an uretheritis, vaginitis or
metritis, or even from a peritonitis, or infected urachus. Or the
infection may descend from a suppurating kidney. Another occasion of
microbian invasion is the congestion which attends on exposure to cold.
_Lesions._ Hyperæmia of the cystic mucosa, with dilation and tortuous
deviations of the larger vessels, thickening of the membrane, and
distension and clouding of the epithelial cells, with a thick covering
of tenacious mucus containing epithelial, pus, or white blood cells. As
the disease advances epithelium is desquamated abundantly, and
degenerates with production of free nuclei and pus. Along with these are
microbes, usually the bacillus coli communis, and various cocci. In the
fully established disease there is liable to be alkaline fermentation,
and the liberated ammonia dissolves the epithelial cells, leading to
extensive desquamation and raw granulating surfaces, so that the disease
tends to run in a vitiating circle, the alkali dissolving the epithelium
and increasing the microbian development and fermentation, which in its
turn produces an increasing quantity of ammonia.
_Symptoms._ There is slight hyperthermia or none, stiff or straddling
gait, frequent passage of urine in small quantities and cloudy, or
straining without passage, the penis or clitoris is semi-erect, eversion
of the lips of the vulva is frequent, and the bladder is tender (through
prepubian wall, vagina or rectum). If a finger is inserted into the
bladder in the mare the thickening of the walls can often be recognized.
The urine often contains precipitated crystals of ammonio-magnesian
phosphate, and even clots of blood. It has an alkaline reaction even in
herbivora.
_Treatment._ The danger centres around the bacteridian fermentations,
and a main object must be to disinfect the bladder. This will be all the
more effectual if the lotions used are of an acid reaction. Thus boric
acid or salicylic acid in 3 per cent. solution, injected after
evacuation of the bladder and repeated a number of times a day may soon
establish a healthy action. If the bladder is especially irritable a
boiled weak solution of gum arabic will form a suitable medium. Other
antiseptics are often used as creosote (0.5:100), carbolic acid (3:100),
chloride of zinc (3:100), chlorate of potash (3:100), mercuric chloride
(1:5000), silver nitrate (0.5:100), or astringents are often better:
PbA, ZnSO_{4} tannic acid, ferri chloridi in dilute solution so as not
to cause pain.
The bowels should be kept open by an occasional saline laxative, pain
moderated by codeine, and abundance of pure water and a laxative diet
enjoined. Linseed tea, and infusions of slippery elm or marsh mallow
have long been employed, and by soothing and relaxing the bowels they
act favorably on the urinary mucosa. Stimulants of the urinary track
like buchu, uva ursi or copaiba in small doses, or antiseptics like
creosote, boric acid, salicylic acid, piperazine, are available in
slight cases or when the acute symptoms have subsided somewhat. With
prior infection of the kidneys, the latter may be used. Constant
drainage may be necessary to avoid distension.
Perfect rest is absolutely essential, a restricted laxative diet, and a
careful avoidance of cold, and stimulants.
When urine is retained it should be removed with a thoroughly aseptic
catheter.
In case of blood clots in the bladder, wash out with a boiled normal
salt solution.