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 1½ 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].)