Part 30

Some horses, and especially mares, show an irritability of the bladder and nerve centers presiding over it by frequent urination in small quantities, though the urine is not manifestly changed in character and no more than the natural quantity is passed in the twenty-four hours. The disorder appears to have its source quite as frequently in the generative or nervous system as in the urinary. A troublesome and dangerous form is seen in mares, which dash off and refuse all control by the rein if driven with a full bladder, but usually prove docile if the bladder has been emptied before hitching. In other cases the excitement connected with getting the tail over the reins is a powerful determining cause. The condition is marked in many mares during the period of heat.

An oleaginous laxative (castor oil 1 pint) will serve to remove any cause of irritation in the digestive organs, and a careful dieting will avoid continued irritation by acrid vegetable agents. The bladder should be examined to see that there is no stone or other cause of irritation, and the sheath and penis should be washed with soapsuds, any sebaceous matter removed from the bilocular cavity at the end of the penis, and the whole lubricated with sweet oil. Irritable mares should be induced to urinate before they are harnessed, and those that clutch the lines under the tail may have the tail set high by cutting the cords on its lower surface, or it may be prevented from getting over the reins by having a strap carried from its free end to the breeching. Those proving troublesome when "in heat" may have 4-dram doses of bromid of potassium, or they may be served by the male or castrated. Sometimes irritability may be lessened by daily doses of belladonna extract (1 dram), or a better tone may be given to the parts by balsam copaiba (1 dram).

DISEASED GROWTHS IN THE BLADDER.

These may be of various kinds, malignant or simple. In the horse I have found villous growths from the mucous membrane especially troublesome. They may be attached to the mucous membrane by a narrow neck or by a broad base covering a great part of the organ.

Symptoms.--The symptoms are frequent straining, passing of urine and blood with occasionally gravel. An examination of the bladder with the hand in the rectum will detect the new growth, which may be distinguished from a hard, resistant stone. In mares, in which the finger can be inserted into the bladder, the recognition is still more satisfactory. The polypi attached by narrow necks may be removed by surgical operation, but for those with broad attachments treatment is eminently unsatisfactory.

DISCHARGE OF URINE BY THE NAVEL, OR PERSISTENT URACHUS.

This occurs only in the newborn, and consists in the nonclosure of the natural channel (urachus), through which the urine is discharged into the outer water bag (allantois) in fetal life. At that early stage of the animal existence the bladder resembles a long tube, which is prolonged through the navel string and opens into the outermost of the two water bags in which the fetus floats. In this way the urine is prevented from entering the inner water bag (amnion), where it would mingle with the liquids, bathing the skin of the fetus and cause irritation. At birth this channel closes up, and the urine takes the course normal to extra-uterine life. Imperfect closure is more frequent in males than in females, because of the great length and small caliber of the male urethra and its consequent tendency to obstruction. In the female there may be a discharge of a few drops only at a time, while in the male the urine will be expelled in strong jets coincidently with the contractions of the bladder and walls of the abdomen.

The first care is to ascertain whether the urethra is pervious by passing a human catheter. This determined, the open urachus may be firmly closed by a stout, waxed thread, carried with a needle through the tissues back of the opening and tied in front of it so as to inclose as little skin as possible. If a portion of the naval string remains, the tying of that may be all sufficient. It is important to tie as early as possible so as to avoid inflammation of the navel from contact with the urine. In summer a little carbolic-acid water or tar water may be applied to keep the flies off.

EVERSION OF THE BLADDER.

This can occur only in the female. It consists in the turning of the organ outside in through the channel of the urethra, so that it appears as a red, pear-shaped mass hanging from the floor of the vulva and protruding externally between its lips. It may be a mass like the fist, or it may swell up to the size of an infant's head. On examining its upper surface the orifices of the urethra maybe seen, one on each side, a short distance behind the neck, with the urine oozing from them drop by drop.

This displacement usually supervenes on a flaccid condition of the bladder, the result of paralysis, overdistention, or severe compression during a difficult parturition.

The protruding organ may be washed with a solution of 1 ounce of laudanum and a teaspoonful of carbolic acid in a quart of water, and returned by pressing a smooth, rounded object into the fundus and directing it into the urethra, while careful pressure is made on the surrounding parts with the other hand. If too large and resistant it may be wound tightly in a strip of bandage about 2 inches broad to express the great mass of blood and exudate and diminish the bulk of the protruded organ so that it can be easily pushed back. This method has the additional advantage of protecting the organ against bruises and lacerations in the effort made to return it. After the return, straining may be kept in check by giving laudanum (1 to 2 ounces) and by applying a truss to press upon the lips of the vulva. (See Eversion of the womb.) The patient should be kept in a stall a few inches lower in front than behind, so that the action of gravity will favor retention.

CALCULI AND INSTRUMENT FOR REMOVAL.]

INFLAMMATION OF THE URETHRA (URETHRITIS, OR GLEET).

This affection belongs quite as much to the generative organs, yet it can not be entirely overlooked in a treatise on urinary disorders. It may be induced by the same causes as cystitis (which see); by the passage and temporary arrest of small stones, or gravel; by the irritation caused by foreign bodies introduced from without; by blows on the penis by sticks, stones, or by the feet of a mare that kicks while being served; by an infecting inflammation contracted from a mare served in the first few days after parturition or one suffering from leucorrhea; by infecting matter introduced on a dirty catheter, or by the extension of inflammation from an irritated, bilocular cavity filled with hardened sebaceous matter, or from an uncleansed sheath.

Symptoms.--The symptoms are swelling, heat, and tenderness of the sheath and penis; difficulty, pain, and groaning in passing urine, which is liable to sudden temporary arrests in the course of micturition, and later a whitish, mucopurulent oozing from the papilla on the end of the penis. There is a tendency to erection of the penis, and in cases contracted from a mare the outer surface of that organ will show more or less extensive sores and ulcers. Stallions suffering in this way will refuse to mount or, having mounted, will fail to complete the act of coition. If an entrance is effected, infection of the mare is liable to follow.

Treatment in the early stages consists in a dose of physic (aloes 6 drams) and fomentations of warm water to the sheath and penis. If there is reason to suspect the presence of infection, inject the urethra twice daily with borax 1 dram, tepid water 1 quart. When the mucopurulent discharge indicates the supervention of the second stage a more astringent injection may be used (nitrate of silver 20 grains, water 1 quart), and the same may be applied to the surface of the penis and inside the sheath. Balsam of copaiba (1 dram daily) may also be given with advantage after the purulent discharge has appeared.

Every stallion suffering from urethritis should be withheld from service, as should mares with leucorrhea.

STRICTURE OF THE URETHRA.

This is a permanent narrowing of the urethra at a given point, the result of previous inflammation, caused by the passage or arrest of a stone, or gravel, by strong astringent injections in the early nonsecreting stage of urethritis, or by contraction of the lining membrane occurring during the healing of ulcers in neglected inflammations of that canal. The trouble is shown by the passage of urine in a fine stream, with straining, pain, and groaning, and by frequent painful erections. It must be remedied by mechanical dilatation, with catheters just large enough to pass with gentle force, to be inserted once a day, and to be used of larger size as the passage will admit them. The catheter should be kept perfectly clean and washed in a borax solution and well oiled before it is introduced.

URINARY CALCULI (STONE, OR GRAVEL).

These consist in some of the solids of the urine that have been precipitated from the urine in the form of crystals, which remain apart as a fine, powdery mass, or magma, or aggregate into calculi, or stones, of varying size. (See Pl. XI.) Their composition is therefore determined in different animals by the salts or other constituents found dissolved in the healthy urine, and by the additional constituents which may be thrown off in solution in the urine in disease. In this connection it is important to observe the following analysis of the horse's urine in health:

Water 918.5 Urea 13.4 Uric acid and urates .1 Hippuric acid 26.4 Lactic acid and lactates 1.2 Mucus and organic matter 22.0 Sulphates (alkaline) 1.2 Phosphates (lime and soda) .2 Chlorids (sodium) 1.0 Carbonates (potash, magnesia, lime) 16.0 ----- 1000.0

The carbonate of lime, which is present in large quantity in the urine of horses fed on green fodder, is practically insoluble, and therefore forms in the passages after secretion, and its microscopic rounded crystals give the urine of such horses a milky whiteness. It is this material which constitutes the soft, white, pultaceous mass that sometimes fills the bladder to repletion and requires to be washed out. In hay-fed horses carbonates are still abundant, while in those mainly grain-fed they are replaced by hippurates and phosphates--the products of the wear of tissues--the carbonates being the result of oxidation of the vegetable acids in the feed. Carbonate of lime, therefore, is a very common constituent of urinary calculi in herbivora, and in many cases is the most abundant constituent.

Oxalate of lime, like carbonate of lime, is derived from the burning up of the carbonaceous matter of the feed in the system, one important factor being the less perfect oxidation of the carbon. Indeed, Fuestenberg and Schmidt have demonstrated on man, horse, ox, and rabbit that under the full play of the breathing (oxidizing) forces oxalic acid, like other organic acids, is resolved into carbonic acid. In keeping with this is the observation of Lehmann, that in all cases in which man suffered from interference with the breathing oxalate of lime appeared in the urine. An excess of oxalate of lime in the urine may, however, claim a different origin. Uric and hippuric acids are found in the urine of carnivora and herbivora, respectively, as the result of the healthy wear (disassimilation) of nitrogenous tissues. If these products are fully oxidized, however, they are thrown out in the form of the more soluble urea rather than as these acids. When uric acid out of the body is treated with peroxid of lead it is resolved into urea, allantoin, and oxalic acid, and Woehler and Frerrichs found that the administration of uric acid not only increased the excretion of urea but also of oxalic acid. It may therefore be inferred that oxalic acid is not produced from the carbonaceous feed alone but also from the disintegration of the nitrogenous tissues of the body. An important element of its production is, however, the imperfect performance of the breathing functions, and hence it is liable to result from diseases of the chest (heaves, chronic bronchitis, etc.). This is, above all, liable to prove the case if the subject is fed to excess on highly carbonaceous feeds (grass and green feed generally, potatoes, etc.).

Carbonate of magnesia, another almost constant ingredient of the urinary calculi of the horse, is formed the same way as the carbonate of lime--from the excess of carbonaceous feed (organic acids) becoming oxidized into carbon dioxid, which unites with the magnesia derived from the feed.

The phosphates of lime and magnesia are not abundant in urinary calculi of the horse, the phosphates being present to excess in the urine in only two conditions--(a) when the ration is excessive and especially rich in phosphorus (wheat, bran, beans, peas, vetches, rape cake, oil cake, cottonseed cake); and (b) when, through the morbid, destructive changes in the living tissues, and especially of the bones, a great quantity of phosphorus is given off as a waste product. Under these conditions, however, the phosphates may contribute to the formation of calculi, and this, above all, is liable if the urine is retained in the bladder until it has undergone decomposition and given off ammonia. The ammonia at once unites with the phosphate of magnesia to form a double salt--phosphate of ammonia and magnesia--which, being insoluble, is at once precipitated. The precipitation of this salt is, however, rare in the urine of the horse, though much more frequent in that of man and sheep.

These are the chief mineral constituents of the urine which form ingredients in the horse's calculi, for though iron and manganese are usually present it is only in minute quantities.