By James Law, F. R. C. V. S.,

Diseases of the Urinary Organs.

Formerly Professor of Veterinary Science, etc., in Cornell University.

Uses of the Urinary Organs.

The urinary organs constitute the main channel through which are excreted the nitrogenous or albuminoid principles, whether derived directly from the feed or from the muscular and other nitrogenized tissues of the body. They constitute, besides, the channel through which are thrown out most of the poisons, whether taken in by the mouth or skin or developed in connection with faulty or natural digestion, blood-forming, nutrition, or tissue destruction; or, finally, poisons that are developed within the body, as the result of normal cell life or of the life of bacterial or other germs that have entered the body from without. Bacteria themselves largely escape from the body through the kidneys. To a large extent, therefore, these organs are the sanitary scavengers and purifiers of the system, and when their functions are impaired or arrested the retained poisons quickly show their presence in resulting disorders of the skin and connective tissue beneath it, of the nervous system, or other organs. Nor is this influence one-sided. Scarcely an important organ of the body can suffer derangement without entailing a corresponding disorder of the urinary system. Nothing can be more striking than the mutual balance maintained between the liquid secretions of the skin and kidneys during hot and cold weather. In summer, when so much liquid exhales through the skin as sweat, comparatively little urine is passed, whereas in winter, when the skin is inactive, the urine is correspondingly increased. This vicarious action of skin and kidneys is usually kept within the limits of health, but at times the draining off of the water by the skin leaves too little to keep the solids of the urine safely in solution, and these are liable to crystallize out and form stone and gravel. Similarly the passage, in the sweat, of some of the solids that normally leave the body, dissolved in the urine, serves to irritate the skin and produce troublesome eruptions.

Prominent Causes of Urinary Disorders.

A disordered liver contributes to the production under different circumstances of an excess of biliary coloring matter which stains the urine; of an excess of hippuric acid and allied products which, being less soluble than urea (the normal product of tissue change), favor the formation of stone, of taurocholic acid, and other bodies that tend when in excess to destroy the blood globules and to cause irritation of the kidneys by the resulting hemoglobin excreted in the urine, and of glycogen too abundant to be burned up in the system, which induces saccharine urine (diabetes). Any disorder leading to impaired functional activity of the lungs is causative of an excess of hippuric acid and allied bodies, of oxalic acid, of sugar, etc., in the urine, which irritate the kidneys, even if they do not produce solid deposits in the urinary passages. Diseases of the nervous system, and notably of the base of the brain and of the spinal cord, induce various urinary disorders, prominent among which are diabetes, chylous urine, and albuminuria. Certain affections, with imperfect nutrition or destructive waste of the bony tissues, tend to charge the urine with phosphates of lime and magnesia and endanger the formation of stone and gravel. In all extensive inflammations and acute fevers the liquids of the urine are diminished, while the solids (waste products), which should form the urinary secretion, are increased, and the surcharged urine proves irritant to the urinary organs or the retained waste products poison the system at large.

Diseases of the heart and lungs, by interfering with the free, onward flow of the blood from the right side of the heart, tend to throw that liquid back on the veins, and this backward pressure of venous blood strongly tends to disorders of the kidneys. Certain poisons taken with the feed and water, notably that found in magnesian limestone and those found in irritant, diuretic plants, are especially injurious to the kidneys, as are also various cryptogams, whether in musty hay or oats. The kidneys may be irritated by feeding green vegetables covered with hoar frost or by furnishing an excess of feed rich in phosphates (wheat bran, beans, peas, vetches, lentils, rape cake, cottonseed cake) or by a privation of water, which entails a concentrated condition and high density of the urine. Exposure in cold rain or snow storms, cold drafts of air, and damp beds are liable to further disorder an already overworked or irritable kidney. Finally, sprains of the back and loins may cause bleeding from the kidneys or inflammation.

The right kidney, weighing 23-1/2 ounces, is shaped like a French bean, and extends from the loins forward to beneath the heads of the last two ribs. The left kidney (Pl. VIII) resembles a heart of cards, and extends from the loins forward beneath the head of the last rib only. Each consists of three distinct parts—(a) the external (cortical), or vascular part, in which the blood vessels form elaborate capillary networks within the dilated globular sacs which form the beginnings of the secreting (uriniferous) tubes and on the surface of the sinuous, secreting tubes leading from the sacs inward toward the second, or medullary, part of the organ; (b) the internal (medullary) part, made up in the main of blood vessels, lymphatics, and nerves extending between the notch on the inner border of the kidney to and from the outer vascular portion, in which the secretion of urine is almost exclusively carried on; and (d) a large, saccular reservoir in the center of the kidney, into which all uriniferous tubes pour their secretions and from which the urine is carried away through a tube g (ureter), which passes out of the notch at the inner border of the kidney and which opens by a valve-closed orifice into the roof of the bladder just in front of its neck. The bladder is a dilatable reservoir for the retention of the urine until the discomfort of its presence causes its voluntary discharge. It is kept closed by circular, muscular fibers surrounding its neck or orifice, and is emptied by looped, muscular fibers extending in all directions forward from the neck around the blind anterior end of the sac. From the bladder the urine escapes through a dilatable tube (urethra) which extends from the neck of the bladder backward on the floor of the pelvis, and in the male through the penis to its free end, where it opens through a pink, conical papilla. In the mare the urethra is not more than an inch in length, and is surrounded by the circular, muscular fibers closing the neck of the bladder. Its opening may be found directly in the median line of the floor of the vulva, about 4-1/2 inches from its external opening.

General Symptoms of Disease.

These apply especially to acute inflammations and the irritation caused by stone. The animal moves stiffly on the hind limbs, straddles, and makes frequent attempts to pass urine, which may be in excess, deficient in amount, liable to sudden arrest in spite of the straining, passed in driblets, or entirely suppressed. Again, it may be modified in density or constituents. Difficulty in making a sharp turn, or in lying down and rising with or without groaning, dropping the back when mounted or when pinched on the loins is suggestive of kidney disease, and so to a less extent are swelled legs, dropsy, and diseases of the skin and nervous system. The oiled hand introduced through the rectum may feel the bladder beneath and detect any overdistention, swelling, tenderness, or stone. In ponies the kidneys even may be reached.

Examination of the Urine.

In some cases the changes in the urine are the sole sign of disease. In health the horse's urine is of a deep amber color and has a strong odor. On a feed of grain and hay it may show a uniform transparency, while on a green ration there in an abundant white deposit of carbonate of lime. Of its morbid changes the following are to be looked for: (1) Color: White from deposited salts of lime; brown or red from blood clots or coloring matter; yellow or orange from bile or blood pigment; pale from excess of water; or variously colored from vegetable ingredients (santonin makes it red; rhubarb or senna, brown; tar or carbolic acid, green). (2) Density: The horse's urine may be 1.030 or 1.050, but it may greatly exceed this in diabetes and may sink to 1.007 in diuresis. (3) Chemical reaction, as ascertained by blue litmus or red test papers. The horse on vegetable diet has alkaline urine turning red test papers blue, while in the sucking colt and the horse fed on flesh or on his own tissue (in starvation or abstinence during disease) it is acid, turning blue litmus red. (4) Organic constituents, as when glairy from albumen coagulable by strong nitric acid and boiling, when charged with microscopic casts of the uriniferous tubes, with the eggs or bodies of worms, with sugar, blood, or bile. (5) In its salts, which may crystallize out spontaneously, or on boiling, or on the addition of chemical reagents.

Albuminous urine in the horse is usually glairy, so that it may be drawn out in threads, but its presence can always be tested as follows: If the liquid is opaque, it may be first passed through filter paper; if very dense and already precipitating its salts, it may be diluted with distilled water; add to the suspected liquid acetic acid drop by drop until it reddens the blue litmus paper; then boil gently in a test tube; if a precipitate is thrown down, set the tube aside to cool and then add strong nitric acid. If the precipitate is not dissolved, it is albumen; if dissolved it is probably urate or hippurate of ammonia. Albumen is normally present in advanced gestation; abnormally it is seen in diseases in which there occurs destruction of blood globules (anthrax, low fevers, watery states of the blood, dropsies), in diseases of the heart and liver which prevent the free escape of blood from the veins and throw back venous pressure on the kidneys, in inflammation of the lungs and pleuræ, and even tympany (bloating), doubtless from the same cause, and in all congestive or inflammatory diseases of the kidneys, acute or chronic.

Casts of the uriniferous tubes can be seen only by placing the suspected urine under the microscope. They are usually very elastic and mobile, waving about in the liquid when the cover glass is touched, and showing a uniform, clear transparency (waxy) or entangled circular epithelial cells or opaque granules or flattened, red-blood globules or clear, refrangent oil globules. They may be even densely opaque from crystals of earthy salts.

Pus cells may be found in the urine associated with albumen, and are recognized by clearing up, when treated with acetic acid, so that each cell shows two or three nuclei.