Prognosis. Since the disease is rarely diagnosed until it has reached an advanced stage, it usually progresses steadily to a fatal issue. If, however, it can be detected at an earlier stage, it may be palliated, or held in abeyance, for a length of time varying with the extent of the lesions. As it is very largely a disease of meat producing animals and as the subject is at first in a condition of marked obesity, it can usually be turned over to the butcher without material loss.
Treatment. If the disease has resulted from the inbred propensity to fattening, the family that shows the disposition must be subjected to a somewhat different regimen, open air exercise must take the place of confinement in warm stables, a rather bare pasturage is valuable for herbivora, and a restricted diet in which the oleaginous, saccharine, and amylaceous constituents do not predominate, is strongly indicated. Crossing with a strange male having many of the desirable qualities of the herd, but which is more vigorous may be resorted to. When the secretion of urine becomes scanty an abundance of pure water, or a diet of succulent grass or roots or ensilage or even small doses of alkaline diuretics may be resorted to. Any source of arsenic or phosphorus poisoning should be cut off, and as an antidote to phosphorus, oil of turpentine may be given in small doses. This agent may, indeed, replace the alkalies as a diuretic, bringing in an element of tone for the mucosa which is not to be despised. Or balsam of copaiba or buchu leaves may be substituted.
When the small white kidney (granular, fatty) results from chronic nephritis, the prevention and treatment would be as for that disease. Little hope is to be entertained of entire restoration to health.
AMYLOID KIDNEY. LARDACEOUS OR WAXY KIDNEY.
This condition of the kidney has been found in the ox (Gerlach) and dog (Rabe, etc.). There are usually similar degenerative lesions in the liver, pancreas, intestines and other organs. It is usually a concomitant of some chronic wasting disease (chronic nephritis, tuberculosis, etc.).
Morbid Anatomy. The kidney is usually enlarged, pale and on section waxy or glistening. Soaked in dilute compound tincture of iodine it shows spots of a walnut or mahogany brown color. The glomeruli are well marked and show the earlier changes, later the tubes do so excepting the epithelium. The latter is swollen, granular, fatty.
Symptoms. There may have been those of chronic nephritis. Rabe has noticed in dogs dropsy of the limbs, ascites, emaciation, anorexia, followed by uræmia, coma, weakness, vomiting, and if the kidney alone was affected great lowering of temperature (35.9°C). With hepatic complication there was greater weakness, giddiness, and higher temperature (39.6°C). Urine is usually increased (in man albuminous) and the casts have shown the anyloid reaction. They tend to be fatty or finely granular. Casts may, however, show anyloid reaction when the kidney, post mortem, does not (Jaksch).
Diagnosis from Bright’s disease is often impossible.
Treatment is essentially the same as in chronic nephritis, and is not hopeful.
Trasbot recommends KI 3 to 7 grs., or tinct of iodine 3 drops for shepherd dog. Ol. terebinth and alkaline diuretics are also commended.