CYSTIC CAL CU LI I N THE D OG: A RESUME . Bv FRED. C. MAHON, M. R.C.V.S. Southamp ton. THE URINE o F T H E
D oc .
I s the re anythin g which can go t o pr o\·e a tendency ·O·\:ring t o h::.emal o r chemical chan g es, b a ct~rial invasion , or, indirectly, mode o f li\·in g, pro perti es in food a nd chemi cal chan g es to brin g· a bout the form a ti o n of renal or cysti c calculi in dog s. Many cases occur in thi s a nima l, o ft un suspected durin g life. yet found on makin g post-mortem. examinations? Durin g the past yea r I have had four ma rked in stan ces. bu t select th e fo ll owin g to illustrat e my po int . Hist ory.-My pati ent was a fi eld spaniel , ag ed 3 year s•. He had o nly bee n a f.ew week s in h1s o wne r 's care , but from the fir st day was noti ce d to have difficulty at time s t o micturate freely or natura lly, to pa ss bl oo d occa sionally, have a capriciou s a ppetite, to shive r in o rdin at ely . st ragglin g g ait a t times, fickle- if one can call it so-behavi our, being excited one moment , mmose the next . Some th ne e weeks after purcha se my services were re qui siti oned and I wa s asked f·or a dia g nos is. After ca refu l examination of the penis, te st icles, passin g of catheter, r·e ctal examination, &c ., I diagnosed cystic calcu li, and favoured, however, renal trouble-ulc.erati•on of kidney (pelvi s) of some time standin g-and calculi . Po st-mortem examination showed no rena l calculi, but an ulcerated bladder, both kidney s intensely inflamed, wlth sixty-thnee calculi of various sizes·, shape, and colouring . A rou g h sket ch of a few pr omi scuously chos•en will serve to illustrate the case m ore forcibly . F urthermore, the g astro-inte stinal omentum showed intense inflammation. The linin g membrane of the ga stro-intestin al tract wa s remarkably fre e from con s·esti on , as one would expect . Th ePe wa s hcemorrha g ic effu sion onto abdominal cavity, heart so ft, and a few h::.e mo rrha g ic infa rcts vo be seen , with se r ou = effusion int o the pe·l""ic ardial sac.
tfte Dog: a R esume.
The bladder was ruptured for about It in ., edges jagged, dark coloured, and severa l pyramidal-shaped calculi driVIen together and protruded through the muscles of the bladder, and serous cov·erings into the abdominal cavity. On carefully dissecting the penis the following sa li ent le sions w:el!"·e s hown: A few inches from the prepuce marked ulceration of the urethra, with enlargement a nd ulc.e ratio n of the prostat e glands, and commencing ulceration of the " os peni s ." Th e testicles were apparently healthy . Reviewing di seases of the urino-ge nital syst em , may I all ud e to (1) cystic calculi; (2) renal; (3) pyeliti s (:inflammation o f the bladder); (4) pustular erosions in urethra, g lan s penis, kidneys of the dog. This brings one to a wide sphere, where scope is given one to reason as to the causation of the many ailments peculiar to the dog. His life-history tends to produce so many of the se conditions, and the facilities aff 01rded by climatic changes, dirt, connection with bitches suffering often from nnereal disea ses render him, with the cat, the mo st subject to diseases affecting the organs above enumerated. Bacterial Immsiou.-I take as my standpoint as regard s microbic mischief the part played by Bacillus coli , or.d inarily a normal inhabitant of the infesbnal canal of i:he dog, and the g rave pos sibiliti es of it s takin g on a virulent sta ge due to climatic . cliet.e tic, and other changes. For examp le, take inflammation of t he kidneys, and the deposit very often as a seque l of grav,el ; the urine tin ged with blood , with mucus accompanyin g the same , access of the B. co li fro m ulceration of the parts, and its subsequent entrance into the circulatory system. Wou ld not the se condition s start the formation of calculi in the peh·is of the kidney, de scend into the bladder. and afford the re sult s I found to a marked extent in my spaniel patient ? CYSTI C C ALC ULI.
The se may and are undoubtedly cau sed by the use of hard water (or water co ntainin g lim e) fo r drinking purp oses, es epcially where a n anim al as t he horse is \Yorked fo r hours at a s tretch, and not g iven an opportunity to u·pinate. Thi s pe rt ain s to the horse. Re lative to th e cl og , he ha s access to everything and a nything, and fo,rtunately e scapes by virt ue, not of anyt hing
The Veterinary Journal.. peculiar 111 his dige stive or urinary apparatus, but by organisms minimizin g or neutrali zing the germs he swa ll ows when dninking fr om polluted streams , &c. TH E RAPEUTIC S .
VA CC INE.
Therapeutic oppoTtunities for g onococcu s vaccine arise when dealin g with cystic, renal , and g enital diseases of the dog an d bitch , especially in cases of staphylococcus invasio n of the urinary tract. This wa s in stanced by Wri g ht (Proc. Roy. Soc. j![,e d.), "Vaccine Therapy Debate," 1910, vol. iii , where he favoured an a ss ociation between thi s infection and calculus formation s in the human subject , with the suggestion advanced by Walters in the same vo lume to the effect that the lowered resistance to stap hylococcu s manifests itself in diabetes by the tendency to carbuncle, &c., which may rather be a cause than a result of diabetes. Beside the cystic calculi in the case of the spaniel, I found fonT in the urethral canal post mortem, v·e ry sharp edges t·o tl"iangular-shaped formation s, and which, injuring the urethral membrane, caused the di s charg~e with urine of the blood noticed by owner and mys·elf. As regard s treatment, death resulted so qurickly that I used but few, but had opportunity of g iving several dos~es of adrenalin, both hypodermically a nd by the m outh. The do g's app-etite was gone, a haggard appeaTance, straggling ga it, mara smus rapid, and death •on fourth day after ent
Cystic (.:a!cu!i ,·n tlte Dog-: a R esume.
more intere stin g cases are to be found in the di sea ses of the dog -orr r-equire more capeful thoug ht, car-e in hand lin g and mixed the rapeutic and vaccine treatmen t than t hose o f the r ena l, cyst ic, and ge nerative o r ga ns ri n both the d og and bit ch. In conc lusion, may I again add th e long-standing lesio ns, the newly fo rm ed ulceration s of the urethra, the commencin g necrosis o f the " os penis " appe ar to c·on vince one that the who le trouble a rose fr om the p-enis and travelled u pward s in this ca se, and that t he r enal condit ions were only sequ elc.e? Unfort una tely, want of time and fa ciliti es fo r invest igation a re lacking in dog practice to ve ry many , but I ventu re to add we know but litt le truly o f m any a ilments of the clo g; in fact, are o nly jus t commen cin g, as it were, t'O t o uch up o n di sea ses unknown a nd unreco g ni zed hith e rto . See Ve ter inary N utcs . January, 19 16, and "Wi lh a m Scott, F.R .C .V.S., of Bridgwatrm·, " The Bacillu s co li co mmunis in Vete rinary P r act ice. " He says : " O ne can eas ily und erstand the prominent part the B. co li would take in di seas-e s o f the kidneys. T hey are o ften the seat of B. coli in vas ion s. In the female , particularly after partunition, the infection is u rogre ni c in o ri g in , a nd this point is rath er sub stantiated by the fa ct: in practice one s·eld om ge t s specific bacterial in vasions of the kidney s in the male, unless they are of hc.ema t oge nic or igi n. Co lon vacc in e is now being tri-ed for metriti s, rrenal , cy sti c, and uret hral affectira,ns, al so in en teriti s, in wh ich dis.ease in the horse a nd dog I tru st at a futur-e date t o record my expe ri ence:>, and vacc in e tJreatment. a s I hoJd strongly that B. co li a nd ot her o rganis m s are the cau se of enteriti s in the ma jority of case s ." THERAPEUTIC S .
Bo th rn human sub ject s a nd in canine practice. " P iperaza ine " (B urro ug hs. Wellcome and Co .) , 5 gr. , tablo id form, t o be g iven afte r a m ea l has bee n tried with m arked success. It is cla imed that thi s drug act s as a depre ssant in some ca ses, therefo r e it is advocated. and I ge ner a lly u se 2-gT. cl oses at fir st, and 0 Tad u ally in crea se to 5 g r. It is further claim ed for thi s ag·e nt that it is be lieved to be a sbro nge r so lvent of uri c aci d than any sa lt of li thi u m. For th e latter dru g it iSI be li eved th at it s admi ni strat ion form ~
The Veterinary '.Journal.
soluble urate s, therdo1re it plays a g reat part in hum an medicine . and especially in go ut and uric acid calculus . I have used th is alternated with adrenalin in old patients suffering from incon tinence of urin e and sabulou s deposits in the same, with amelioration of the graver symptom s. Potass;ium citrate is al so strongly recommended for patient s suffe·r.ing from blo•ody urine with uric acid depo sit s , and should he u seful in canine practice. In many cases of sabulou s deposit s in the bladder mineral acids, as nitro-hydrochloric acid dilutum , m my experience affo·rde d reli e f and prolonged life materially .
Selecteb tlrticle. A STAi\DARD METHOD OF TESTING ANTISEPTICS FOR WOUN DS. WITH SOME RESULTS. Bv W. D'ESTE EMERY, M.D.Lorw., M.R.C.S.Er.;G., L.R.C. P.LoND. Captai11 , R.A .;Jf. C. ( T. r : ) ; Director of the Laboratories, King's Coll1re /:los pita!. ONE -o·f the mo·st as ton ish•ing medical fa cts in connect ion with the War is that there is no sort of agree ment as to the best method of treating s.e pti c wound s. Are we to use antiseptics at a ll ? And if so, what ant ise ptic? An impartial observer might come to the conclu sion that the best treatment depended on the locality . In France , he mi g ht say , wound s do be st without any ant iseptic at all: in England, especi ally in the Midland s, Dakin' s anti se ptic is the best; wherea s, when we cro.ss the Tweed, there is nothin g t o compa re with eusol. The fact is . of course, that good result s a.r•e obta in ed by all methods (why thi s is the case I shall di scu ss in a sub sequent paper), and that th e skill of th e surgeo n is of much g reater importance than the parti cular form o f lotion he happen s to be enamoured of for th e moment. I think we may lay ·down the ge neral propositi on t hat if a wound is properly clea nsed and properly drained at a suffi ciently ea.rly per iod, th ere oug ht to be no deat hs from sepsis. I am speakin g exc lu sively o f \\·o und s as I have se·e n them in France. But thi s doc s n ot absolve us from th e duty of te stin g a ll methods o f t reatll11ent whi ch may be ap pli ed s ub sequ ently to t hi ~ surg ica l toilet of the wound, for so me may g·i,·e u s qui cker a nd more