Part 48

The treatment of cystitis in cattle does not differ materially from that of the horse.

The hæmorrhagic form demands prevention by drainage, cultivation and the use of phosphates to the soil.

CYSTITIS IN DOGS.

The special symptoms in dogs are uneasiness and frequent changes of place. The patient passes urine often in small quantity, and with whines or cries. He walks slowly and stiffly with the back arched, and compression of the abdomen and especially of the prepubian region is painful to a marked degree. The tense elastic bladder may often be distinctly felt through the abdominal walls. The inflamed bladder is liable to paresis and paralysis with great overdistension, and aggravation of the general symptoms, the eyes sunken, and dullness, stupor and coma betraying uræmic poisoning. Some claim rupture of the bladder as is so common in the ox.

In the main, treatment is as for the horse. Rest, warm bath, or fomentations, catheterism with aseptic catheter, draw urine through hypodermic nozzle in prepubian region. Antiseptics: boric or salicylic acid by the mouth and bladder. Laxatives, and plenty of water are important. Free access to open air where the animal can urinate, is very essential. In chronic cases, buchu, copaiba, balsams, or piperazine may be employed. Mustard blister. Electricity. Small doses of belladonna to give tone to the bladder.

ATONY AND PARALYSIS OF THE BLADDER.

Causes. This comes usually from troubles of innervation. Paraplegia, dorsal and lumbar fractures with injury to the spinal cord, brain lesions, hæmoglobinuria with effusion pressing on the cystic plexus, overdistension of the viscus, from cervical spasm, urethral stricture or calculus or parasite (strongylus gigas), acute or chronic cystitis. In dogs it may come from obstruction by enlarged prostate. Polypus blocking the cervix and chronic disease of the walls of the organ are additional causes.

Symptoms. More or less complete retention of the urine. The bladder cannot be completely emptied except by powerful contractions of the abdominal muscles. Habitually it may escape in drops, or in jets at intervals during exercise. Palpation will show overdistended bladder as a tense, elastic mass. But as overdistension may occur without paralysis, no case can be certainly diagnosed without catheterization to show that the urethra is free.

When the paralysis affects the cervix, the urine escapes continually and trickles down the insides of the hips in mares, or from the sheath in males.

Diagnosis demands catheterism and rectal examination.

Complication. Cystitis by retention. Infection by catheter.

Treatment. Corresponds to causes. These corrected, use aseptic catheter often. After extreme distension empty partially, or inject a few ounces of borax or boric acid solution. Thus avoid collapse and inflammation, and secure antisepsis. Give tone by a course of strychnia, (ergot, belladonna), mustard blister; turpentine in small doses. Better electricity, 1 pole in bladder, 1 on pubic symphysis. Apply for 5 minutes.

TUMORS OF THE BLADDER.

Recorded cases of sarcoma (Mauri), carcinoma (Cadeac, Hink, Friedberger), and tuberculosis can be adduced. Papilloma is perhaps as frequent as any of the above. The author has treated two cases of papilloma in mares complicated with multiple small calculi and gravel. Treatment is exclusively surgical and in the mare with the widely dilatable urethra this is sometimes possible through that channel. In the same animals diagnosis may be accomplished by introducing the finger into the urethra and bladder. In other females and males, vaginal or rectal palpation must be resorted to.

VESICAL PARASITES.

Eustrongylus gigas. Dog, horse, man. Trichosoma plicata. Dog. Œstrus Hemorrhoidalis. Mare.

SPASM OF NECK OF BLADDER.

Spasm of the cervix vesicæ has been doubted, save as the result of local inflammation, yet it not uncommonly takes place in horses and other animals in connection with irritation attendant on the retention of urine during work, or in dogs during a period passed indoors. Trouble and suffering continues, with ineffectual efforts to micturate, but practically complete relief is secured by catheterization or by a spontaneous abundant discharge. The neurosis which leads to it is produced or aggravated at times by enlarged prostate, or lesions in the urethra. Intense fear may cause it.

Treatment. Remove cause. Give antispasmodics, valerian, musk, bromides, chloral hydrate, opium, stramonium, hyoscyamus, codeine, etc., may be given as injections or suppositories. For the horse spread the litter and soothe by whistle or song. Or use the catheter and correct any local irritation.

RUPTURE AND LACERATION OF THE BLADDER.

This occurs most commonly in oxen from obstruction of the urethra by a calculus. Similar obstruction in the horse causes most acute symptoms, calling for immediate relief, and rupture is a comparatively rare occurrence. Pench mentions a case resulting from a fall during an attack of colic, and with a full bladder. It has happened during lithotrity, or lithotomy, and even during parturition. Perforation by parasites has been noted and in one case by an osseous tumor of the pubic symphysis. In horses a fatal result is prompt, in cattle from 6 to 48 days.

Treatment surgical.

EVERSION OF THE BLADDER.

This is really invagination into the female urethra and bladder. It has only been seen in mares, and then by reason of the extreme dilatability of the urethra. A pyriform, red, perhaps rugose tumor shows between the lips of the vulva, during straining. It is covered by mucosa, and on its upper surface near to its neck are two small orifices from which urine oozes or comes in jets during active expulsive efforts. It soon becomes muco-purulent on the surface, and even excoriated. Urine escaping continuously trickles down the thighs with much fœtor. It occurs especially during violent expulsive efforts as in parturition or constipation.

Treatment essentially surgical consists in uniform compression to expel blood and exudate followed by the pushing of the fundus through the bladder and urethra. The more recent the case, the easier is the process. Pressecq claims to have cured an obstinately recurring case, by cauterizing the urethra up to the cervix vesicæ with a round iron rod an inch in diameter. The resulting loss of substance, with the neoplasia and constriction effectually prevented renewed eversion even during parturition. Other veterinarians have successfully excised the bladder, but this entailed incontinence and constant offensive soaking of the thighs with urine.

HERNIA OF THE BLADDER.

This is commonly seen in the mammalian female in connection with rupture of the floor of the vagina during dystokia. It has also been observed without such lesion in both male and female dogs and horses, the bladder forming a cystocele of the vagina, or bulging between the anus and the ischium.

Diagnosis is confirmed by careful palpation through the rectum. The folding of the bladder backward obstructs the exit of urine.