From wounds, calculus, parasites, infection, injuries in parturition. Symptoms: in wounds of ureter. Course: danger of infection of kidney or bladder. Treatment: for calculus, antispasmodics, anodynes, fomentations, for parasites arsenious acid, for catarrhal conditions, balsams, buchu, salicylates, etc. Operation. Uretero-vaginal fistula.
This may arise from the passage of a rough calculus, from wounds of the ureter sustained in kicks and blows or by being run over by wheels (dogs, cats), it may be due to the blocking of the tube by a parasite such as strongylus gigas, echinococcus, etc., or it may be the result of extension of an infectious inflammation backward from the kidney or forward from the bladder. Again it may be the result of a lesion of the ureter in cases of dystokia.
The symptoms are obscure but there is likely to be frequent straining and passage of urine, tenderness of the loins, all the more significant if confined to one side, lameness or halting on the corresponding hind limb, and on examination through the rectum the swollen and tender cord representing the ureter may be recognizable. In case of calculus or other obstruction the ureter may be felt to be swollen, elastic and tender back to a slight nodular, painful, firm swelling at the seat of obstruction.
Course. In all such cases there is always danger of inflammation (infections or otherwise) of the kidney with degeneration and loss of structure and function, the organ being reduced to a simple urinous cyst (hydronephrosis). In some cases, however, the obstruction (calculus, parasite) may escape into the bladder and a recovery follow. Slight infections, too, may improve and advance to complete convalescence.
Treatment will depend much on the causative factor: Calculus must be treated by anodyne antispasmodics, and fomentations, and in case of relief by measures calculated to prevent its formation anew: parasites may be treated by arsenious acid, oil of turpentine, and other parasiticides which are secreted by the kidneys: catarrhal and infected conditions may be met by balsams, buchu, salicyclic acid and even peppers. In case of calculus which does not give promise of passing, even a surgical operation may be thought of, especially in the smaller house animals.
In rupture of the ureter in dystokia the walls of the womb or vagina have usually suffered, and a recovery with a ureterouterine or uretero-vaginal fistula is not unknown.
ACUTE CATARRHAL CYSTITIS.
Acrid diuretics, by mouth or skin, microbian infection, retention of urine, urethral calculus, parasites, spasm, enforced suspension of micturition, unclean catheter, adjacent infection, chill. Lesions: hyperæmia of mucosa, thickening, vascular distention, clouding of epithelium, muco-purulent secretion, alkaline fermentation, ammonia, liquefaction of cells, erosion. Symptoms: Slight fever, stiff, straddling gait, urine scanty, cloudy, alkaline, penis or clitoris semi-erect, smearing of tail or prepuce. Crystals of triple phosphate. Treatment: Antiseptics, boric or salicylic acid, gum arabic, astringent antiseptics, laxatives, flax seed, slippery elm, anodynes, diluents, piperazine, drainage, rest, restricted laxative diet, warmth, avoid stimulants.
Causes. Cystitis is caused in all animals by irritant diuretics like cantharides, copaiba, or oil of turpentine given by the mouth or applied to an extensive cutaneous surface. It is an error, however, to conclude with Williams that this is the sole cause. The very existence of calculi virtually implies bacterial infection, and fermentation. The presence of free ammonia in the urine usually implies fermentation, and fermentation must be looked upon as practically synonymous with microbian invasion. That bacteria may be present without serious injury is undoubted. The protective power of the healthy mucosa is very great. But when the mucosa is weakened, microbes that would otherwise be harmless, find a ready infection atrium, and triumph over the weakened tissues. Hence retention of urine and overdistension of the bladder as in urethral calculus, blocking of the urethra by a parasite, spasm of the sphincter vesicæ, compulsory retention as in the mare in harness, the dog kept indoors, or in railway car on a long journey, or in mares so travelling, may become the occasion of cystitis. Even in cases in which no microbe is present at first, this reaches the bladder by the introduction of an unclean catheter, or by extension from an uretheritis, vaginitis or metritis, or even from a peritonitis, or infected urachus. Or the infection may descend from a suppurating kidney. Another occasion of microbian invasion is the congestion which attends on exposure to cold.
Lesions. Hyperæmia of the cystic mucosa, with dilation and tortuous deviations of the larger vessels, thickening of the membrane, and distension and clouding of the epithelial cells, with a thick covering of tenacious mucus containing epithelial, pus, or white blood cells. As the disease advances epithelium is desquamated abundantly, and degenerates with production of free nuclei and pus. Along with these are microbes, usually the bacillus coli communis, and various cocci. In the fully established disease there is liable to be alkaline fermentation, and the liberated ammonia dissolves the epithelial cells, leading to extensive desquamation and raw granulating surfaces, so that the disease tends to run in a vitiating circle, the alkali dissolving the epithelium and increasing the microbian development and fermentation, which in its turn produces an increasing quantity of ammonia.