HEMATURIA.
Symptoms of different lesions of kidneys and constitutional states, of poisoning by irritant plants, common on moors and in woods. In puerperal cow fed on turnips raised on mucky, unreclaimed, sour lands. Bacteria. Toxins. Anæmia. Poor wintering. Limed new soils. Symptoms: in plethoric, congested mucosæ, vascular tension, hurried breathing, colics, straining, red urine; in vegetable irritants, depression, weakness, coldness, trembling, stiffness behind, scanty red or black urine, diarrhœa, constipation; in anæmia, poverty, debility, red urine, pink tinge in milk, emaciation, hidebound, anorexia, colics. Chronic or intermittent. Lesions: in plethoric, congested enlarged kidney, without softening; in irritant poisons, congestion also of throat, stomachs, intestines, liver with hæmorrhagic extravasations; in anæmia, kidneys pale, flaccid, hydroæmia, liver enlarged, softened, reddish liquids in serous cavities. Treatment: avoid the injurious soils, drain, cultivate, feed products of such soils with other food, oleaginous or saline laxatives, antiferments, tonics, astringents, flax seed, farinas.
The passage of blood or blood elements in the urine.
Causes. A symptom of a variety of diseases, producing lesions of the secreting structures of the kidneys; acute congestion, tumors, calculi, parasitism. Also as a manifestation of diseases of distant organs—hæmoglobinuria, southern cattle fever, anthrax, poisoning by irritant diuretics, wounds of the bladder, pelvic fracture with injury to bladder or urethra, cystitis with varicose cystic veins, etc.
Among the irritant plants charged with producing the affection are the young shoots of oak, ash, privet, hornbeam, alder, hazel, dogberry, pine, fir, and coniferæ, generally. Also ranunculus, hellebore, colchicum, mercuriales annuus, asclepias vincetoxicum, broom, etc. The disease is common in spring in cattle turned out too early to get good pasturage and which, it is alleged, take to eating the swelling buds and young shoots of irritant plants.
The disease has occurred mostly in woods and wild lands and has accordingly been vulgarly named the wood evil, (maladie de bois, holzkrankheit), and moor ill.
In England, as occurring in the puerperal cow, Cuming, of Ellon, attributes it to a too exclusive diet of turnips. His analysis showed that turnips contained 10% sugar and 1 to 1½% vegetable albumen. The sugar is held to stimulate unduly the milk secretion, but fails to supply the nitrogenous materials needful to form it, and the cow is speedily rendered anæmic, with solution of the blood globules or of the hæmatin and its excretion by the urine. No attempt was made to produce hæmaturia by an exclusive or excessive diet of sugar, and cows fed on turnips grown on well drained lands never suffered from the disease.
Williams says that urine in such cases had a strong odor of rotten turnips. This argues not an anæmia determined by sugar, but rather an intestinal fermentation, perhaps superinduced by ferments introduced along with the turnips. Add to this the notorious fact that the offending turnips are usually such as are grown on wild, damp, undrained, swampy, or mucky lands, and we have the suggestion of a bacteridian poison, or a toxic product of bacteria. Williams and Reynal practically agree on the point that the common hæmaturia is the result of anæmia. It has long been noticed that the herds which suffer from the affection are those which have come out of the winter in low condition, the victim is the poor man’s cow, and the symptoms are most likely to appear when turned into the fields in spring before the pastures have come up. The anæmic condition of the carcasses is quoted in support of this view, but perhaps without making sufficient account of the extraordinary destruction of blood globules during the progress of the malady.
Pichon and Sinoir see in the liming of soils and the production of larger crops, a cause of anæmia in the rank and aqueous growth of the meadows, and their overstocking in order to eat them down, or to consume their products. They found that an abundant artificial feeding was the most efficacious mode of treatment.
Reynal, who endorses this view, tells us that in the anæmic and liquid blood the globules become smaller and can pass more readily through the walls of the vessels. But this is exactly the opposite effect from what we see when the blood is diluted with water. The globules in such a case are distended and enlarged, and may finally have their protoplasm and hæmatin dissolved and diffused through the liquid. If the blood globules are shrunken, then we must look for a cause very different from anæmia.
Reynal further assures us that plethora is a common cause of hæmaturia in cattle. “Under the prolonged influence of a very assimilable diet, the blood becomes more plastic, circulates with difficulty in the capillaries, and may even rupture them, with a resulting capillary renal hæmorrhage, and bloody urine.” He further intimates that this occurs especially in spring after the animals have been turned out on very rich pastures, and that in Normandy certain pastures of unusual richness are notorious for producing hæmaturia.
Apart from the fact that the rich grasses of spring produce at first intestinal congestion, and diarrhœa, with consequent disorder of the liver and kidneys, this spring affection on particular pastures suggests some special poison in the pasture as the unknown cause of the disease.
In all forms alike of this affection the nature of the soil appears to have a preponderating influence. It is the disease of the woods, and waste lands, of damp and undrained lands, of dense clays, of lands underlaid by clay or hard pan, of lands rich in vegetable humus, or vegetable moulds the decomposition of which has been hastened by the application of quicklime.
Pottier, Salomé, Wiener, and Reynal especially testify to the prevalence of hæmaturia on soils that are either dense and impermeable, or that have a subsoil of clay or hardpan.
The disease has not been traced to any definite microbe nor toxin, but there is much to suggest the necessity for inquiry in that line. The special susceptibility of animals that may be plethoric on the one hand, or in low condition on the other, would be entirely in keeping with such a view, as the debility or derangement of health would lay the system open to attack.
Symptoms. In the plethoric animal there are congested mucosæ, full, strong pulse, forcible heartbeats, full veins, accelerated breathing, colicy pains, dullness, straining frequently and the discharge of thick, red or bloody urine.
If from irritant buds and shoots, or plants, there is more depression, weakness, fever, dry skin, staring coat, coldness of the surface, tremblings, stiffness or weakness of the hind limbs, diarrhœa, followed by constipation, frequent straining and the passage of colored urine with pain. In violent cases the expulsion of bloody urine may be excessive, and the cow may die in 24 hours. From irritant plants however the quantity of urine is liable to be small, but frequently passed.
As occurring irrespective of plethora or irritants there may be at first only poor condition and debility with the passage of blood. A pink tinge may show on the froth in the milk pail, and a red precipitate on its bottom. If not anæmic at the outset they soon become so, and the pulse which was at first bounding becomes small and weak, the heart palpitates, the red mucosæ become pale. The subjects become tucked up, emaciated, weak, rough coated, the skin adherent to the bones, and the appetite and rumination impaired or lost. Sometimes colics are present.
In the milder anæmic forms it may continue for months before it causes death. In such cases it may prove intermittent.
Morbid Anatomy. In the hæmaturia of plethora the kidneys are large, congested and of a dark red, but, preserve their normal consistency and texture.
In the form associated with ingestion of irritant plants, there is congestion of the pharynx, stomachs, and intestines with hæmorrhagic spots, congestion of the liver, violent congestion of the kidneys which are of a blackish red color, and enlarged to perhaps twice the normal size, with hæmorrhagic exudations, the convoluted tubes filled with fibrinous exudate and blood globules, the pelvis red and like the bladder containing some reddish urine. The vesical mucosa may be black.
In anæmic cases the kidneys are pale, flaccid and colorless, with a reddish liquid in the pelvis and bladder. The vascular system is comparatively empty, and the blood, thin, and watery, and often coagulates loosely or not at all. As noted by Herland globules are greatly reduced in numbers and size, and often crenated or partially broken down. Slight serous effusions in the serous membranes are common. The liver is softened and enlarged, the lacteals have reddish contents, and the ingesta are dark colored.
Treatment. Preventive. Avoid hæmaturia pastures and the fodder grown on such lands. Drain and cultivate such soils. When animals must feed on the products of such soils supplement the food by grain, oil cake, cotton seed meal, etc. Avoid stagnant waters draining from such soils.
Therapeutic Treatment. Give oleaginous or saline laxative to clear out poisons and ferments from the bowels and may add an antiferment (salol, salicylic acid, carbolic acid, turpentine oil, chlorate of potash, sulphites or hyposulphites), no matter if diarrhœa is present. Follow with tonics (copperas, chloride of iron) and stimulant antiseptics (ol. terebinth, potass. chlorate), and sound food. Flax seed, linseed meal, farinas. Bitters may be added (gentian, quinine, quassia). As a calmative, camphor (2 to 4 drs.) 2 or 3 times a day has proved useful.
In case of nephritis treat as for that affection.
Weiner lauds empyreumatic oil and oil of turpentine with camphor.
In chronic cases, nourishing food with change of locality and water are very important.
A course of iron tonics should wind up the treatment.