Text book of veterinary medicine, Volume 3 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 3 (of 5)
Law, James
Veterinary medicine
Unlike hypertrophy, this is constantly the result of a pathological
process. So long as a normal functional activity of the secreting
elements is carried on, such parts must maintain their size and healthy
characters. But with the compression of such secreting elements
(glomeruli and convoluted tubes) by a hyperplasia of connective tissue,
by pressure from without or from the damming back of the urine in the
pelvis and tubes, the secretory elements are absorbed and removed, and
the final result is a general atrophy. If such atrophy appears in both
kidneys at once it can only be very partial in extent, as extreme
atrophy of both, with loss of their secretory function, would entail
poisoning and death from the retained urinary products. The comparative
frequency of the disease may be inferred from the reports of the numbers
of specimens found by Barrier and Moussu in old horses in the dissecting
rooms. The latter observed a dozen cases in a single winter, other
examples are recorded by Cadeac (horse), Soula (swine) and Trasbot (in
various animals).
_Causes._ The most common source of the condition is the occurrence of
chronic productive inflammation. The new product in such cases, if not
pus, or a growth that rapidly passes into fatty or granular
degeneration, or into gangrene, tends to form tissue of a low
organization, especially fibrous. The resulting increase of the fibrous
trabeculæ, in undergoing subsequent contraction necessarily compresses
the secretory tissue and the final result is a visible and, it may be,
extreme wasting. Hence any slowly advancing productive inflammation is
liable to result in absorption and removal of the kidney parenchyma, and
distinct atrophy of the gland.
Again the obstruction of the ureter by a calculus in the pelvis which
falls into the infundibuliform entrance, or a stone arrested at any part
of the duct (or even of the urethra) or by worms, hydatids, cysts or
tumors, throws back on the kidney the secreted urine, which distending
the pelvis and uriniferous tubes leads to direct compression and
absorption of the secretory parenchyma. Direct compression of the kidney
by an adjacent tumor will act in a similar manner. Retention cysts by
their gradual increase and augmenting pressure cause absorption of the
gland tissue.
The blocking of individual uriniferous tubules by minute calculi, which
is so often seen in cattle, kept on dry feeding in winter, is a cause of
partial nephritis, and absorption, as noted by Röll.
A somewhat rare cause of atrophy is the diminution of the blood supply
by arteritis and embolism of the renal artery, or by pressure of tumors
on that vessel. Arteritis and blocking suggests at once the possible
agency of the strongylus (sclerostoma) armatus in the horse. Trasbot
records a striking instance of compression of the renal artery and
kidney by an enormous sublumbar melanoma. This occurred in an aged horse
and led to atrophy.
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