the blood, and in congested and inflamed kidneys it is present as a part of
the inflammatory exudate. Apart from these, albumin in the urine represents
in different cases a variety of diseased conditions of the kidneys or of
distant organs. Among the additional causes of albuminuria may be named:
(1) An excess of albumin in the blood (after easy calving with little loss
of blood and before the secretion of milk has been established, or in cases
of sudden suppression of the secretion of milk); (2) under increase of
blood pressure (after deep drinking, after doses of digitalis or broom,
after transfusion of blood from one animal to another, or in disease of the
heart or lungs causing obstruction to the flow of blood from the veins);
(3) after cutting (or disease) of the motor nerves of the vessels going to
the kidneys, causing congestion of these organs; (4) violent exertion,
hence long drives; the same happens with violent, muscular spasms, as from
strychnia poisoning, lockjaw, epilepsy, and convulsions; (5) in most fevers
and extensive inflammations of important organs, like the lungs or liver,
the escape of the albumin being variously attributed to the high
temperature of the body and disorder of the nerves, and to resulting
congestion and disorder of the secreting cells of the kidneys; (6) in burns
and some other congested states of the skin; (7) under the action of
certain poisons (strong acids, phosphorous, arsenic, Spanish flies,
carbolic acid, and those inducing bloody urine); (8) in certain conditions
of weakness or congestion of the secreting cells of the kidneys, so that
they allow this element of the blood to escape; (9) when the feed is
entirely wanting in common salt, albumin may appear in the urine
temporarily after a full meal containing an excess of albumin. It can also
be produced experimentally by puncturing the back part of the base of the
brain (the floor of the fourth ventricle close to the point the injury to
which causes sugary urine). In abscess, tumor, or inflammation of the
bladder, ureter, or urethra the urine is albuminous.
It follows, therefore, that albumin in the urine does not indicate the
existence of any one specific disease, and except when from weakness or
loss of function of the kidney cells, it must be looked on as an attendant
on another disease, the true nature of which we must try to find out. These
affections we must exclude one by one until we are left to assume the
noninflammatory disorder of the secreting cells of the kidney. It is
especially important to exclude inflammation of the kidney, and to do this
may require a microscopic examination of the sediment of the urine and the
demonstration of the entire absence of casts of the uriniferous tubes. (See
"Nephritis," p. 123.)
To detect albumin in the urine, the suspected and frothy liquid must be
rendered sour by adding a few drops of nitric acid and then boiled in a
test tube. If a solid precipitate forms, then a few more drops of nitric
acid should be added, and if the liquid does not clear it up it is albumin.
A precipitate thrown down by boiling and redissolved by nitric acid is
probably phosphate of lime.
_Treatment._--Treatment is usually directed to the disease on which it is
dependent. In the absence of any other recognizable disease, mucilaginous
drinks of boiled flaxseed, slippery elm, or gum may be given, tannic acid,
one-half dram twice daily, and fomentations or even mustard poultices over
the loins. When the disease is chronic and there is no attendant fever
(elevation of temperature), tonics (hydrochloric acid, 6 drops in a pint of
water; phosphate of iron, 2 drams, or sulphate of quinin, 2 drams, repeated
twice daily) may be used. In all cases the patient should be kept carefully
from cold and wet, a warm, dry shed, or in warm weather a dry, sunny yard
or pasture being especially desirable.
SUGAR IN URINE (DIABETES MELLITUS).
This is a frequent condition of the urine in parturition fever, but as a
specific disease, associated with deranged liver or brain, it is
practically unknown in cattle. As a mere attendant on another disease it
demands no special notice here.
INFLAMMATION OF THE KIDNEYS (NEPHRITIS).
This has been divided according as it affects the different parts of the
kidneys, as: (1) Its fibrous covering (perinephritis); (2) the secreting
tissue of its outer portion (parenchymatous); (3) the connective tissue
(interstitial); (4) the lining membrane of its ducts (catarrhal); and (5)
its pelvis or sac receiving the urine (pyelitis). It has also been
distinguished according to the changes that take place in the kidney,
especially as seen after death, according to the quantity of albumin in the
urine, and according as the affection is acute or chronic. For the purpose
of this work it will be convenient to consider these as one inflammatory
disease, making a distinction merely between the acute and the chronic or
of long standing.
The _causes_ are in the main like those causing bloody urine, such as
irritant and diuretic plants, Spanish flies applied as a blister or
otherwise, exposure to cold and wet, the presence of stone or gravel in the
kidneys, injuries to the back or loins, as by riding one another, the
drinking of alkaline or selenitic water, the use of putrid, stagnant water,
of that containing bacteria and their products, the consumption of musty
fodder, etc. (See "Hematuria," p. 119.)
The length of the loins in cattle predisposes these parts to mechanical
injury, and in the lean and especially in the thin, working ox the kidney
is very liable to suffer. In the absence of an abundance of loose,
connective tissue and of fat, the kidneys lie in close contact with the
muscles of the loins, and any injury to them may tend to stretch the kidney
and its vessels, or to cause its inflammation by direct extension of the
disease from the injured muscle to the adjacent kidney. Thus, under
unusually heavy draft, under slips or falls on slippery ground, under
sudden unexpected drooping or twisting of the loins from missteps or from
the feet sinking into holes, under the loading and jarring of the loins
when animals ride one another in cases of "heat," the kidneys are subject
to injury and inflammation. A hard run, as when chased by a dog, may be the
occasion of such an attack. A fodder rich in nitrogenous or flesh-forming
elements (beans, peas, vetches (_Vicia sativa_), and other leguminous
plants) has been charged with irritating the kidneys through the excess of
urea, hippuric acid, and allied products eliminated through these organs
and the tendency to the formation of gravel. It seems, however, that these
feeds are most dangerous when partially ripened and yet not fully matured,
a stage of growth at which they are liable to contain ingredients
irritating to the stomach and poisonous to the brain, as seen in their
inducing so-called "stomach staggers." Even in the poisoning by the seeds
of ripened but only partially cured rye grass (_Lolium perenne_), and
darnel (_Lolium temulentum_), the kidneys are found violently congested
with black blood; also, in the indigestions that result from the eating of
partially ripened corn or millet some congestion of the kidneys is an
attendant phenomenon.
Cruzel says that the disease as occurring locally is usually not alone from
the acrid and resinous plants charged with inducing hematuria, but also
from stinking camomile (_Anthemis cotula_) and field poppy when used in the
fresh, succulent condition; also from the great prevalence of dead
caterpillars on the pasture, or from dead Spanish flies in the stagnant
pools of water. The fresh plants are believed to be injurious only by
reason of a volatile oil which is dissipated in drying. In the case of the
stagnant water it may be questioned whether the chemical products of the
contained ferments (bacteria) are not more frequently the cause of the evil
than the alleged Spanish flies, though the latter are hurtful enough when
present.
Inflammation of the kidneys may further be a form or an extension of a
specific contagious disease, such as erysipelas, rinderpest, septicemia, or
even of poisoning by the spores of fungi. Rivolta reports the case of a cow
with spots of local congestion and blood staining in the kidney, the
affected parts being loaded with bacteria. Unfortunately he neither
cultivated the bacteria nor inoculated them, and thus the case stands
without positive demonstration that they were the cause of disease.
In certain cases the _symptoms_ of nephritis are very manifest, and in
others so hidden that the existence of the affection can be certainly
recognized only by a microscopic examination of the urine. In violent cases
there is high fever, increase of the body temperature to 103∞ F. and
upward; hurried breathing, with a catching inspiration; accelerated pulse;
dry, hot muzzle; burning of the roots of the horns and ears; loss of
appetite; suspended rumination; and indications of extreme sensitiveness in
the loins. The patient stands with back arched and hind legs extended
backward and outward, and passes water frequently, in driblets, of a high
color and specific gravity, containing albumin and microscopic casts. (Pl.
XI, fig. 5.) When made to move, the patient does so with hesitation and
groaning, especially if turned in a narrow circle; when pinched on the
flank just beneath the lateral bony processes of the loins, especially on
that side on which the disease predominates, it flinches and groans. If the
examination is made with oiled hand introduced through the last gut
(rectum), the pressure upward on the kidneys gives rise to great pain and
to efforts to escape by moving away and by active contractions of the
rectum for the expulsion of the hand. Sometimes there is a distinct
swelling over the loins or quarter on one or both sides. In uncastrated
males the testicle on the affected side is drawn up, or is alternately
raised and dropped. In all there is a liability to tremors of the thigh on
the side affected.
In some severe cases colicky pains are as violent as in the worst forms of
indigestion and spasms of the bowels. The animal frequently shifts from one
hind foot to the other, stamps, kicks at the belly, frequently looks
anxiously at its flank, moans plaintively, lies down and quickly gets up
again, grinds its teeth, twists its tail, and keeps the back habitually
arched and rigid and the hind feet advanced under the belly. The bowels may
be costive and the feces glistening with a coat of mucus, or they may be
loose and irritable, and the paunch or even the bowels may become distended
with gas (bloating) as the result of indigestion and fermentation. In some
animals, male and female alike, the rigid, arched condition of the back
will give way to such undulating movements as are sometimes seen in the act
of coition.
The disease does not always appear in its full severity; for a day, or even
two, however, there may be merely loss of appetite, impaired rumination, a
disposition to remain lying down, yet when the patient is raised it
manifests suffering by anxiously looking at the flanks, shifting or
stamping of the hind feet, shaking of the tail, and attempts to urinate,
which are either fruitless or lead to the discharge of a small quantity of
high-colored or perhaps bloody urine.
In some recent slight cases, and in many chronic ones, these symptoms may
be absent or unobserved, and an examination of the urine is necessary to
reach a safe conclusion. The urine may contain blood, or it may be cloudy
from contained albumin, which coagulates on heating with nitric acid (see
"Albuminuria," p. 121); it may be slightly glairy from pus, or gritty
particles may be detected in it. In seeking for casts of the uriniferous
tubes, a drop may be taken with a fine tube from the bottom of the liquid
after standing, and examined under a power magnifying 50 diameters. If the
fine, cylindroid filaments are seen they may then be examined with a power
of 200 or 250 diameters. (Pl. XI, fig. 5.) The appearance of the casts
gives some clue to the condition of the kidneys. If made up of large,
rounded or slightly columnar cells, with a single nucleus in each cell
(epithelial), they imply comparatively slight and recent disease of the
kidney tubes, the detachment of the epithelium being like what is seen in
any inflamed mucous surface. If made up largely of the small, disk-shaped
and nonnucleated red blood globules, they imply escape of blood, and
usually a recent injury or congestion of the kidney--it may be from
sprains, blows, or the ingestion of acrid or diuretic poisons. If the casts
are made of a clear, waxy, homogeneous substance (hyaline), without any
admixture of opaque particles, they imply an inflammation of longer
standing, in which the inflamed kidney tubules have been already stripped
of their cellular (epithelial) lining. If the casts are rendered opaque by
the presence of minute, spherical granular cells, like white blood
globules, it betokens active suppuration of the kidney tubes. In other
cases the casts are rendered opaque by entangled earthy granules (carbonate
of lime), or crystals of some other urinary salts. In still other cases the
casts entangle clear, refrangent globules of oil or fat, which may imply
fatty degeneration of the kidneys or injury to the spinal cord. The
presence of free pus giving a glairy, flocculent appearance to the urine is
suggestive of inflammation of the urinary pouch at the commencement of the
excretory duct (pelvis of kidney) (Pl. IX, fig. 1), especially if
complicated with gritty particles of earthy salts. This condition is known
as pyelitis. In the chronic cases swelling of the legs or along the lower
surface of chest or abdomen, or within these respective cavities, is a
common symptom. So, also, stupor or coma, or even convulsions, may
supervene from the poisonous action of urea and other waste or morbid
products retained in the blood.
_Treatment._--In the treatment of acute nephritis the first consideration
is the removal of the cause. Acrid or diuretic plants in the feed must be
removed, and what of this kind is present in the stomach or bowels may be
cleared away by a moderate dose of castor or olive oil; extensive surfaces
of inflammation that have been blistered by Spanish flies must be washed
clean with soapsuds; sprains of the back or loins must be treated by
soothing fomentations or poultices or by a fresh sheepskin with its fleshy
side applied on the loins, and the patient must be kept in a narrow stall
in which it can not turn even its head. The patient must be kept in a warm,
dry building, so that the skin may be kept active rather than the kidneys.
Warm blanketing is equally important, or even mustard poultices over the
loins will be useful. Blisters of Spanish flies, turpentine, or other agent
which may be absorbed and irritate the kidneys must be avoided. The active
fever may be checked by 15 drops tincture of aconite every four hours or by
one-third ounce of acetanilid. If pain is very acute, 1 ounce of laudanum
or 2 drams of solid extract of belladonna will serve to relieve. When the
severity of the disease has passed, a course of tonics (quinin, 2 drams, or
gentian powder, 4 drams, daily) may be given. Diuretics, too, may be given
cautiously at this advanced stage to relieve dropsy and give tone to the
kidneys and general system (oil of turpentine, 2 teaspoonfuls; bicarbonate
of soda, 1 teaspoonful, repeated twice a day). Pure water is essential, and
it should not be given chilled; warm drinks are preferable.
In the chronic forms of kidney inflammation the same protection against
cold and similar general treatment are demanded. Tonics, however, are
important to improve the general health (phosphate of iron, 2 drams;
powdered nux vomica, 20 grains; powdered gentian root, 4 drams, daily). In
some instances the mineral acids (nitric acid, 60 drops, or
nitrohydrochloric acid, 60 drops, daily) may be used with the bitters.
Mustard applied to the loins in the form of a thin pulp made with water and
covered for an hour with paper or other impervious envelope, or water
hotter than the hand can bear, or cupping, may be resorted to as a
counterirritant. In cupping, shave the loins, smear them with lard, then
take a narrow-mouthed glass, expand the air within by smearing its interior
with a few drops of alcohol, setting it on fire and instantly pressing the
mouth of the vessel to the oiled portion of the skin. As the air within the
vessel cools it contracts, tending to form a partial vacuum, and the skin,
charged with blood, is strongly drawn up within it. Several of these being
applied at once, a strong derivation from the affected kidneys is obtained.
In no case of inflamed or irritable kidney should Spanish flies or oil of
turpentine be used upon the skin.
PARASITES OF THE KIDNEY.
As the kidney is the visual channel by which the bacteria leave the system,
this organ is liable to be implicated when microphytes exist in the blood,
and congestions and blood extravasions are produced. In anthrax, southern
cattle fever (Texas fever), and other such affections bloody urine is the
consequence. Of the larger parasites attacking the kidney may be specially
named the cystic form of the echinococcus tapeworm of the dog, the cystic
form of the unarmed or beef tapeworm of man, the diving bladderworm--the
cystic form of the marginate tapeworm of the dog, and the giant strongyle--
the largest of the roundworms. These give rise to general symptoms of
kidney disease, but the true source of the trouble is likely to be detected
only if the heads or hooklets of the tapeworm or the eggs of the roundworm
are found on microscopical examination of the urine.
TUMORS OF THE KIDNEY (HYPERTROPHY OR ATROPHY).
The kidney may be the seat of cancerous or simple tumors, and it may be
unnaturally enlarged or reduced in size, but though there may be signs of
urinary disorder the true nature of the disease is seldom manifest until
after death. The passing of blood and of large multi-nucleated cells in
the urine (to be detected under the microscope) may betray the existence of
an ulcerated cancer of the kidney. The presence of cancerous enlargement of
(superficial) lymphatic glands may further assist and confirm the decision.
RETENTION OF URINE.
Inability to pass urine may come from any one of three conditions--first,
spasm of the neck of the bladder; second, paralysis of the body of the
bladder; third, obstruction of the channel of outlet by a stone (calculus)
(see Pl. XI) or other obstacle.
In _spasm of the neck of the bladder_ the male animal may stand with the
tail slightly raised and making rhythmical contractions of the muscle
beneath the anus (accelerator urinÊ) (see Pl. IX, fig. 2), but without
passing a drop of liquid. In the female the hind legs are extended, widely
parted, and the back is arched as if to urinate, but the effort is vain. If
the oiled hand is introduced into the rectum or vagina in the early stages
of the affection, the bladder may be felt beneath partially filled, but not
overdistended with liquid, and its neck or mouth firm and rigid. In the
more advanced stages of the affection the organ is felt as a great, tense,
elastic bag, extending forward into the abdomen. In this condition the
overdistended muscular coat of the bladder has lost its power of
contraction, so that true paralysis has set in, the muscle closing the
mouth of the sac alone retaining its contractile power.
In _paralysis of the body of the bladder_ attention is rarely drawn to the
urinary disorder until the bladder has been distended to full repletion and
is almost ready to give way by rupture and to allow the escape of the
contained liquid into the abdomen. Overdistention is the most common cause
of the paralysis, yet it may occur from inflammation of the muscular wall
of the bladder, or even from injury to the terminal part of the spinal
marrow. In this last condition, however, the tail is liable to be
powerless, and the neck of the bladder may also be paralyzed, so that the
urine dribbles away continuously.
_Causes._--Among the causes of spasm of the neck of the bladder may be
named the lodgment of small stones or gravel, the feeding on irritant
diuretics (see "Bloody urine," p. 119, or "Nephritis," p. 123), the
enforced retention of urine while at work or during a painful or difficult
parturition. The irritation attendant on inflammation of the mucous
membrane of the bladder may be a further cause of spasms of the neck, as
may also be inflammation of the channel (urethra) back of the neck.
Extensive applications of Spanish flies to the skin, the abuse of
diuretics, and the occurrence of indigestion and spasms of the bowels are
further causes. So long as spasmodic colic is unrelieved, retention of
water from spasm of the neck of the bladder usually persists.
_Treatment._--Treatment depends largely on the cause. In indigestion the
irritant contents of the bowels must be got rid of by laxatives and
injections of warm water; Spanish-fly blisters must be washed from the
surface; a prolonged and too active exertion must be intermitted. The spasm
may be relaxed by injecting one-half ounce of solid extract of belladonna
in water into the rectum or by a solution of tobacco. Chloroform or ether
may be given by inhalation, or chloral hydrate (1 ounce) may be given in
water by the mouth. Fomentations of warm water may be made over the loins
and between the thighs, and the oiled hand inserted into the rectum may
press moderately on the anterior part of the bladder, which can be felt as
an elastic fluctuating bag of an oval shape just beneath.
All other measures failing, the liquid must be drawn off through a tube
(catheter). This is, however, exceedingly difficult, alike in male and
female, and we can not expect an amateur to succeed in accomplishing it. In
the cow the opening into the bladder is found in the median line of the
floor of the generative entrance, about 4 inches in front of the external
opening, but it is flanked on either side by a blind pouch, into which the
catheter will pass, in ninety-nine cases out of a hundred, in the hands of
any but the most skilled operator. In the bull or steer the penis, when
retracted into its sheath, is bent upon itself like the letter S, just
above the scrotum and testicles (see Pl. IX, fig. 2), and unless this bend
is effaced by extending the organ forward out of its sheath it is quite
impossible to pass a catheter beyond this point. When, however, by the
presentation of a female, the animal can be tempted to protrude the penis,
so that it can be seized and extended, or when it can be manipulated
forward out of the sheath, it becomes possible to pass a catheter of small
caliber (one-third inch or under) onward into the bladder. Youatt advised
laying open the sheath so as to reach and extend the penis, and others have
advocated opening the urethra in the space between the thighs or just
beneath the anus, but such formidable operations are beyond the stock
owner. The incision of the narrow urethra through the great thickness of
muscular and erectile bleeding tissue just beneath the anus is especially
an operation of extreme delicacy and difficulty. Drawing the liquid through
the tube of an aspirator is another possible resort for the professional
man. The delicate needle of the aspirator is inserted in such cases through
the floor of the vagina and upper wall of the bladder in the female, or
through the floor of the rectum (last gut) and roof of the bladder in the
male, or finally through the lower and back part of the abdominal wall,
just in front of the bones of the pelvis (pubic bones), thence through the
lower and anterior part of the bladder near its blind anterior end. After
relief has been obtained the administration of belladonna in 2-dram doses
daily for several days will tend to prevent a recurrence of the retention.
When the body of the bladder has become benumbed or paralyzed by
overdistention, we may seek to restore its tone by doses of one-half a dram
of powdered nux vomica repeated daily, and by mustard plaster applied over
the loins, on the back part of the belly inferiorly, or between the thighs.
Small doses (2 drams) of balsam of copaiba are sometimes useful in
imparting tone to the partly paralyzed organ.
INCONTINENCE OF URINE (PALSY OF THE NECK OF THE BLADDER).
This may occur from disease or injury to the posterior part of the spinal
cord or from broken back, and in these cases the tail, and perhaps the hind
limbs, are liable to be paralyzed. In this case the urine dribbles away
constantly, and the oiled hand in the vagina or rectum will feel the
half-filled and flaccid bladder beneath and may easily empty it by
pressure.
_Treatment._--Treatment is only successful when the cause of the trouble
can be remedied. After these (sprains of the back, etc.) have recovered,
blisters (mustard) on the loins, the lower part of the abdomen, or between
the thighs may be resorted to with success. Two drams of copaiba or of
solid extract of belladonna or 2 grains Spanish flies daily may serve to
restore the lost tone. These failing, the use of electric currents may
still prove successful.
URINARY CALCULI (STONE OR GRAVEL).