Chapter 14

The kidney of the ox (Pl. IX, fig. 1) is a compound organ made up of 15 to 25 separate lobules like so many separate kidneys, but all pouring their secretion into one common pouch (pelvis) situated in an excavation in the center of the lower surface. While the ox is the only domesticated quadruped which maintains this divided condition of the kidney after birth, this condition is common to all while at an early stage of development in the womb. The cluster of lobules making up a single kidney forms an ovoid mass flattened from above downward, and extending from the last rib backward beneath the loins and to one side of the solid chain of the backbone. The right is more firmly attached to the loins and extends farther backward than the left. Deeply covered in a mass of suet, each kidney has a strong outer, white, fibrous covering, and inside this two successive layers of kidney substance, of which the outer is that in which the urine is mainly separated from the blood and poured into the fine, microscopic urinary ducts. (Pl. X, fig. 1) These latter, together with blood vessels, lymph vessels, and nerves, make up the second, or internal, layer. The outer layer is mainly composed of minute globular clusters of microscopic, intercommunicating blood vessels (Malpighian bodies), each of which is furnished with a fibrous capsule that is nothing else than the dilated commencement of a urine tube. These practically microscopic tubes follow at first a winding course through the outer layer (Ferrein's tubes), then form a long loop (doubling on itself) in the inner layer (Henle's loop), and finally pass back through the inner layer (Bellini's tubes) to open through a conical process into the common pouch (pelvis) on the lower surface of the organ. (Pl. X, figs. 1, 2, 3.)

The tube that conveys the urine from the kidney to the bladder is like a white, round cord, about the size of a goose quill, prolonged from the pouch on the lower surface of the kidney backward beneath the loins, then inward, supported by a fold of thin membrane, to open into the bladder just in front of its neck. The canal passes first through the middle (muscular) coat of the bladder, and then advances perceptibly between that and the internal (mucous) coat, through which it finally opens. By this arrangement in overfilling the bladder this opening is closed like a valve by the pressure of the urine, and the return of liquid to the kidney is prevented. The bladder (Pl. IX, fig. 2) is a dilatable, egg-shaped pouch, closed behind by a strong ring of muscular fibers encircling its neck, and enveloped by looped, muscular fibers extending on all sides around its body and closed anterior end. Stimulated by the presence of urine, these last contract and expel contents through the neck into the urethra. This last is the tube leading backward along the floor of the pelvic bones and downward through the penis. In the bull this canal of the urethra is remarkable for its small caliber and for the S-shaped bend which it describes in the space between the thighs and just above the scrotum. This bend is attributable to the fact that the retractor muscles are attached to the penis at this point, and in withdrawing that organ within its sheath they double it upon itself. The small size of the canal and this S-shaped bend are serious obstacles to the passing of a catheter to draw the urine, yet by extending the penis out of its sheath the bend is effaced, and a small, gum-elastic catheter, not more than one-fourth of an inch in diameter, may with care be passed into the bladder. In the cow the urethra is very short, opening in the median line on the floor of the vulva about 4 inches in front of its external orifice. Even in her, however, the passing of a catheter is a matter of no little difficulty, the opening of the urethra being very narrow and encircled by the projecting membranous and rigid margins, and on each side of the opening is a blind pouch (canal of G‰rtner) into which the catheter will almost invariably find its way. In both male and female, therefore, the passing of a catheter is an operation which demands special skill.

_General symptoms of urinary disorders._--These are not so prominent in cattle as in horses, yet they are of a similar kind. There is a stiff or straddling gait with the hind legs and some difficulty in turning or in lying down and rising, the act causing a groan. The frequent passage of urine in driblets, its continuous escape in drops, the sudden arrest of the flow when in full stream, the rhythmic contraction of the muscles under the anus without any flow resulting, the swelling of the sheath, the collection of hard, gritty masses on the hair surrounding the orifice of the sheath, the occurrence of dropsies in the limbs under the chest or belly, or in either of these cavities, and finally the appearance of nervous stupor, may indicate serious disorder of the urinary organs. The condition of the urine passed may likewise lead to suspicion. It may be white, from crystallized carbonate of lime; brown, red, or even black, from the presence of blood or blood-coloring matter; yellow, from biliary coloring matter; frothy, from contained albumin; cloudy, from phosphates; glairy, from pus; it may also show gritty masses from gravel. In many cases of urinary disorder in the ox, however, the symptoms are by no means prominent, and unless special examination is made of the loins, the bladder, and the urine the true nature of the malady may be overlooked.

DIURESIS (POLYURIA, DIABETES INSIPIDUS, EXCESSIVE SECRETION OF URINE).

A secretion of urine in excess of the normal amount may be looked on as disease, even if the result does not lead to immediate loss of condition. Cattle fed on distillery swill are striking examples of such excess caused by the enormous consumption of a liquid feed, which nourishes and fattens in spite of the diuresis; the condition is unwholesome, and cattle that have passed four or five months in a swill stable have fatty livers and kidneys, and never again do well on ordinary feed. Diuresis may further occur from increase of blood pressure in the kidneys (diseases of the heart or lungs which hinder the onward passage of the blood, the eating of digitalis, English broom, the contraction of the blood vessels on the surface of the body in cold weather, etc.); also from acrid or diuretic plants taken with the feed (dandelion, burdock, colchicum, digitalis, savin, resinous shoots, etc.); from excess of sugar in the feed (beets, turnips, ripe sorghum); also from the use of frozen feed (frosted turnip tops and other vegetables), and from the growths of certain molds in fodder (musty hay, mow-burnt hay, moldy oats, moldy bread, etc.). Finally, alkaline waters and alkaline incrustations on the soil may be active causes. In some of these cases the result is beneficial rather than injurious, as when cattle affected with gravel in the kidneys are entirely freed from this condition by a run at grass, or by an exclusive diet of roots or swill. In other cases, however, the health and condition suffer, and even inflammation of the kidneys may occur.

_Treatment._--The treatment is mainly in the change of diet to a more solid aliment destitute of the special, offensive ingredient. Boiled flaxseed is often the best diet or addition to the wholesome dry food, and, by way of medicine, doses of 2 drams each of sulphate of iron and iodid of potassium may be given twice daily. In obstinate cases 2 drams ergot of rye or of catechu may be added.

BLOODY URINE (RED WATER, MOOR ILL, WOOD ILL, HEMATURIA, HEMAGLOBINURIA).

This is a common affection among cattle in certain localities, above all on damp, undrained lands and under a backward agriculture. It is simply bloody urine or hematuria when the blood is found in clots, or when under the microscope the blood globules can be detected as distinctly rounded, flattened disks. It is smoky urine--hemaglobinuria--when neither such distinct clots nor blood disks can be found, but merely a general browning, reddening, or blackening of the urine by the presence of dissolved, blood-coloring matter. The bloody urine is the more direct result of structural disease of the kidneys or urinary passages (inflammation, stone, gravel, tumors, hydatids, kidney worms, sprains of the loins), while the stained urine (hemaglobinuria) is usually the result of some general or more distinct disorder in which the globules are destroyed in the circulating blood and the coloring matter dissolved in and diffused through the whole mass of the blood and of the urine secreted from it. As in the two forms, blood and the elements of blood escape into the urine, albumin is always present, so that there is albuminuria with blood-coloring matter superadded. If from stone or gravel, gritty particles are usually passed, and may be detected in the bottom of a dish in which the liquid is caught. If from fracture or severe sprain of the loins, it is liable to be associated not only with some loss of control of the hind limbs and with staggering behind but also with a more or less perfect paralysis of the tail. The bloodstained urine without red globules results from specific diseases--Texas fever (Pl. XLVII, fig. 3), anthrax, spirillosis, and from eating irritant plants (broom, savin, mercury, hellebore, ranunculus, convolvulus, colchicum, oak shoots, ash privet, hazel, hornbeam, and other astringent, acrid, or resinous plants, etc.). The Maybug or Spanish fly taken with the feed or spread over a great extent of skin as a blister has a similar action. Frosted turnips or other roots will bring on the affection in some subjects. Among conditions which act by the direct destruction of the globules in the circulating blood may be named an excess of water in that fluid; the use of water from soils rich in decomposing vegetable matter and containing alkaline salts, particularly nitrites; and the presence in the water and feed of the ptomaines of bacteria growth; hence the prevalence of "red water" in marshy districts and on clayey and other impervious soils, and the occurrence of bloody urine in the advanced stages of several contagious diseases. Some mineral poisons--such as iodin, arsenic, and phosphorus taken to excess--may cause hematuria, and finally the symptoms may be merely the result of a constitutional predisposition of the individual or family to bleeding. In some predisposed subjects, exposure of the body to cold or wet will cause the affection.

The specific symptom of bloody or smoky water is a very patent one. It may or may not be associated with fever, with the presence or absence of abdominal tenderness on pressure, with a very frothy state of the milk or even a reddish tinge, with or without marked paleness of the mucous membranes, and general weakness. When direct injury to the kidneys is the immediate cause of the disease the urine will be passed often, in small quantity at a time, and with much straining. When there is bloodlessness (a watery blood) from insufficient nourishment, fever is absent and the red water is at first the only symptom. When the active cause has been irritant plants, abdominal tenderness, colics, and other signs of bowel inflammation are marked features.

_Treatment._--Treatment varies according as the cause has been a direct irritant operating on a subject in vigorous health or a microbian poison acting on an animal deficient in blood and vigor. In the first form of red water a smart purgative (1 pound to 1-1/2 pounds Glauber's salt) will clear away the irritants from the bowels and allay the coexistent high fever. It will also serve to divert to the bowels much of the irritant products already absorbed into the blood and will thus protect the kidneys. In many such cases a liberal supply of wholesome, easily digestible feed will be all the additional treatment required. In this connection demulcent feed (boiled flaxseed, wheat bran) is especially good. If much blood has been lost, bitters (gentian, one-half ounce) and iron (sulphate of iron, 2 drams) should be given for a week.

For cases in which excess of diuretic plants has been taken, it may be well to replace the salts by 1 to 2 pints of olive oil, adding 1 ounce of laudanum and 2 drams of gum camphor; also to apply fomentations or a fresh sheepskin over the loins. Buttermilk or vinegar, one-half pint, or sulphuric acid, 60 drops in a pint of water, may also be used frequently as injections. In cases caused by sprained or fractured loins, inflamed kidneys, stone or gravel, the treatment will be as for the particular disease in question.

In hematuria from anemia (watery blood), whether from insufficient or badly adjusted rations or from the poisonous products of fermentations in impervious or marshy soils, the treatment must be essentially tonic and stimulating. Rich, abundant, and easily digestible feed must be furnished. The different grains (oats, barley, wheat, bran, rye) and seeds (rape, linseed, cotton seed) are especially called for and may be given either ground or boiled. As a bitter, sulphate of quinin, one-half dram, and tincture of chlorid of iron, 2 drams, may be given in a pint of water thrice a day. In some cases 1 or 2 teaspoonfuls of oil of turpentine twice daily in milk will act favorably.

In this anemic variety prevention is the great need. The drainage and cultivation of the dangerous soils is the main object. Until this can be accomplished young and newly purchased cattle not yet inured to the poisons must be kept from the dangerous fields and turned on only those which are already drained naturally or artificially. Further, they should have an abundant ration in which the local product of grass, hay, etc., is supplemented by grain or other seeds. Another point to be guarded against is the supply of water that has drained from marshes or impervious soils, rich in organic matter, as such water is charged with nitrites, ptomaines, etc., which directly conduce to the disorder. Fence out from all such waters and supply from living springs or deep wells only.

ALBUMIN IN THE URINE (ALBUMINURIA).

In bloody urine albumin is always present as an important constituent of 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.