DISEASES OF THE URINARY ORGANS
GENERAL DISCUSSION.--The urinary apparatus is composed of two glands, the
kidneys and an excretory apparatus that carries the excretion of the
kidneys to the outside.
The kidneys are situated in the superior region of the abdominal cavity
(sublumbar) above the peritoneum, and to the right and left of the median
line. They are highly vascular glands, somewhat bean-shaped and of a deep
red color. These glands are capable of removing from the blood a fluid that
is essentially different in composition and which, if retained in the
blood, would be harmful or poisonous to the body tissues.
The kidney excretions are carried from the pelvis of the kidneys by the
right and left ureters. These canals terminate in the bladder, an
oval-shaped reservoir for the urine. This organ is situated in the
posterior portion of the abdominal cavity and at the entrance to the pelvic
cavity. Posteriorly, it forms a constricted portion or neck. It is here
that the urethra originates. This canal represents the last division of the
excretory apparatus. In the female, the urethra is short and terminates in
the vulva. In the male it is long and is supported by the penis.
The urine secreted by the kidneys is a body excretion, and consists of
water, organic matter and salts. The nitrogenous end-products, aromatic
compounds, coloring matter, and mucin form the organic matter. The
nitrogenous end-products and aromatic compounds are urea, uric and hippuric
acids, benzoic acid and ethereal sulfates of phenol and cresol. The salts
are sulfates, phosphates and chlorides of sodium, potassium, calcium and
magnesium. The organic and inorganic matter varies with the ration.
The quantity of urine secreted within a given time varies in the different
species and at different times in the same individual. In the horse the
quantity secreted in twenty-four hours varies from twelve to fifteen pints;
in cattle from ten to forty pints; in sheep from one-half to one and
three-quarter pints. The normal color of the urine varies. In the horse it
is yellow or yellowish-red; in cattle and sheep yellowish; and in the dog a
straw yellow. The specific gravity varies with the quantity secreted and
the ration fed. When the quantity of urine secreted is above the average,
the specific gravity is usually low.
THE NECESSITY OF EXAMINING THE URINE.--In diseases of the urinary
apparatus, a careful examination of the urine is very necessary in order to
be able to form a correct diagnosis. In domestic animals it is impractical
to attempt to determine the exact amount of urine passed within a certain
time, but we can make a general estimate of the quantity passed by
carefully observing the animal and noting the condition of the bedding in
the stall. The sample of urine to be examined is best taken from urine
collected at different periods during the day. We should note its color and
consistency. The different substances in the urine can be determined only
by determining the specific gravity, testing with certain chemical reagents
and by making a microscopic examination of the sediment. Normal urine from
the horse may be turbid or cloudy and more or less slimy, because of the
presence of mucin. This is less true of other species. In disease the color
of the urine may be changed to a pale yellow, red or brown. For example, in
congestion of the kidneys the urine is light in color and rather
transparent; in southern cattle fever it may be red; and in azoturia it may
be brown.
EXCESSIVE URINATION.--The horse is the most common sufferer from excessive
secretion of urine. The most common _causes_ are musty feeds, such as hay,
grain and shipped feeds. New oats, succulent feeds and acrid plants may
sometimes cause it. In the fall of the year, when the season is changing
from warm to cool weather and the horse eliminates less water from the body
by way of the skin, the kidneys may become more active and the quantity of
urine secreted be greatly increased. This, however, is a normal
physiological condition and should not be confused with this disease.
The first _symptom_ noted is the frequent passing of a large quantity of
urine. The animal drinks more water than usual and the appetite is poor.
Dulness and a weak, emaciated condition are prominent symptoms. Death
occurs unless the cause of the disease is removed. If the poisonous
substance has been acting for some time, it is difficult to cure the
animal.
This disease can be _prevented_ by eliminating spoiled feeds from the
ration fed to animals in our care. Early in the attack the necessary
attention to the ration and the feeding of a clean, nourishing ration is
sufficient to correct the disease. The quantity of water drunk by the
animal should be limited. Complete rest is indicated. Laxatives, stimulants
and tonics should be given if necessary.
NEPHRITIS.--Congestion and inflammation of the kidneys commonly occur in
mixed and specific infectious diseases, such as septicaemia, pyaemia and
influenza. The toxic effect of spoiled feeds, impure drinking water, and
irritating drugs like cantharides and turpentine may so irritate the
kidneys as to cause them to become inflamed. Chilling of the skin and
nervousness or extreme fear may sometimes cause a congestion of these
organs. Inflammation of the kidneys is a common complication of azoturia.
Irritation from parasites should be included among the causes of this
disease.
The _symptoms_ vary in the different stages of the disease. During the
period of active congestion the quantity of urine secreted is increased.
The scant secretion of urine, dark in color and thick or turbid, is
suggestive of an inflammation of the kidneys. The animal moves stiffly, the
back may be arched, urination is painful and the urine is passed in very
small amounts. The appetite is irregular or suppressed, the pulse strong at
first but later small and weak, and the body temperature is elevated. On
making a rectal examination we find the bladder empty and the kidneys
enlarged and sensitive.
When the kidneys become so badly diseased that they can no longer perform
their function of separating from the blood the nitrogenous end-products of
digestion, uraemic poisoning occurs. In this later stage of the disease the
animal staggers about if moved, and finally goes down in the stall and is
unable to get up. Death is usually preceded by convulsions and coma.
_The prognosis_ is very unfavorable, death occurring in the majority of
cases. In azoturia of horses and in infectious diseases, the inflammation
is nearly always acute. The color of the urine, its high specific gravity
and the small quantity passed are valuable symptoms to consider in the
recognition of this disease. Chronic inflammation generally develops slowly
and may not give rise to any very prominent symptoms at first.
_The preventive treatment_ of nephritis consists in careful nursing of
animals affected with acute infectious diseases, a clean water supply and
avoiding the feeding of spoiled feeds. The _curative treatment_ is largely
careful nursing. The animal should be given comfortable, well-ventilated
quarters and complete rest. Chilling of the skin should be especially
guarded against by protecting the body with heavy blankets and applying
roller bandages to the limbs when necessary. The diet must be of such a
nature as not to increase the work of the kidneys. For the first few days
the animal should receive very little feed or water. Later a sloppy diet of
sweet milk, green feed and mashes should be fed. Such purgatives as aloes
and Glauber's salts are indicated at a very early stage in the disease. We
must encourage the elimination of waste products by way of the skin in the
larger animals by vigorous rubbing, blanketing and the administration of
such drugs as pilocarpine. If the animal becomes weak, general and heart
tonics may be given.
CYSTITIS.--Inflammation of the bladder is not an uncommon disease of
horses. It is commonly _caused_ by retention of the urine, calculi in the
bladder and chilling of the body. Irritating drugs that are eliminated from
the body in the urine, and infection of the bladder by germs may cause it.
_The symptoms_ are usually marked. The inflammation is characterized by
more or less pain, depending on the degree of the inflammation, and
frequent passing of urine. Only a small amount of urine is passed at each
attempt, and in severe inflammation it may contain pus or blood. Colicky
pains sometimes occur. The pain is usually manifested by a stiff,
straddling gait and tenderness when pressure on the bladder is made by
introducing the hand into the rectum or vagina, and pressing over the
region of the bladder. General symptoms, such as elevation in body
temperature and irregular appetite, may be manifested.
_The treatment_ should be first directed at removing the cause. If a cystic
calculus is present in the bladder it should be removed. If the retention
of the urine is caused by some local condition, and this is very often the
case in nervous, well-bred animals, this must first be corrected. It is
best to feed green and soft feeds, such as bran mash and chopped hay, and,
if the animal will take them, gruels. A physic of castor or linseed oil
should be given occasionally. It is very necessary that the animal be kept
quiet. Comfortable, clean quarters and a good bed should be provided.
Whenever necessary the animal should be blanketed. The medicinal treatment
consists in irrigating the bladder with antiseptic solutions, and
administering drugs that when eliminated by way of the urine may change its
composition and render it less irritating. The following mixture may be
given: potassium chlorate two ounces, salol one-half ounce, and powdered
nux vomica one ounce. This mixture may be divided into sixteen powders. One
of the powders should be given with each feed.
RETENTION OF THE URINE.--This may be due to a variety of _causes_. In the
ox and ram, small calculi collect in the S-shaped curvature of the urethra,
or at its terminal extremity. In the horse, cystic calculi are more common
than urethral. In cattle and hogs, fatty secretions from the inflamed
lining membrane of the sheath of the male may accumulate, and obstruct the
flow of urine from the anterior opening. The giving of feed rich in salts,
concentrated urine resulting from feeding of too dry a ration, insufficient
exercise and inflammation of the bladder are the direct causes of calculi.
Compression of the urethra by growths or tumors, strictures of the urethra,
distended bladder, spasm of the neck of the bladder in nervous animals,
paralysis of the bladder and injuries to the penis are common causes of
retention of the urine.
_The early symptoms in ruminants_ are not usually recognized until a day or
two after retention of the urine has occurred. The symptoms are then quite
marked. The animal acts dull, refuses to eat, rumination is stopped, and
there is a constant effort to urinate, as indicated by the raising of the
tail and rhythmical contractions of the urinary muscles just below the
anus. Urine may dribble from the sheath or the flow may be completely
suppressed. The odor of urine may be marked.
_Horses show symptoms_ of abdominal pain. The animal may move about the
stall, lie down and get up again, or make unsuccessful attempts to urinate.
On examination the bladder is found to be greatly distended with urine. In
the horse the retention is recognized at an earlier period than in
ruminants, because of the prompt, decided symptom of pain.
Retention of the urine commonly terminates in rupture of the bladder in
ruminants. When this occurs, the symptoms of pain are less evident. Death
occurs from uraemic poisoning and peritonitis. The outcome is less
favorable in ruminants than in solipeds.
_Inflammation of the sheath_ can be readily recognized because of the local
swelling.
_The following lines of treatment_ are recommended: A ration or feed that
favors the formation of calculi should not be fed to animals; inflammation
of the sheath should receive prompt treatment--this consists in irrigating
the part with warm, soapy or alkaline water, followed by an antiseptic
wash; we may attempt to work the urethral calculi forward and out of the
S-curve in the urethra; if this is unsuccessful, urethrotomy for their
removal may be attempted.
The retention of the urine in horses, because of spasm or paralysis of
certain muscles, may be treated by passing the catheter. Sometimes
spreading litter under the horse and keeping it quiet may induce it to
urinate. Hot packs over the region of the back may be used. The treatment
for calculi is entirely surgical. The operation for the removal of cystic
calculi in the horse, although difficult, is followed by good results.
QUESTIONS
1. Describe the urinary apparatus.
2. Give the composition of the urine and quantity secreted in the different
animals.
3. State method of determining quantity and composition of urine secreted
by different domestic animals.
4. Give the causes and treatment of excessive urination.
5. Give the causes and treatment of congestion and inflammation of the
kidneys.
6. Give the causes of cystitis; symptoms; treatment.
7. Give the causes and treatment of retention of the urine.