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
The _symptoms_ are by no means clear, unless the injury result from
external traumatism, or when it can be detected by rectal exploration.
There may be blood staining of the urine, stiffness of the loins,
lameness in one hind limb, tenderness of the lumbar vertebræ and of
their transverse processes on pinching, frequent straining to pass
urine, a disposition to remain recumbent, pain and groaning when rising,
or when turned in a narrow circle. Under rectal examination the blocked
ureter may sometimes be recognized, its cystic end shrunken and empty,
up to the seat of obstruction, and its renal end, from the
hypersensitive seat of obstruction forward, full, rounded, elastic and
firm. If the ureter has been ruptured, it may be impossible to
distinguish it, but the presence of urine free in the peritoneum may be
detected through the rectum as it may often be through the abdominal
walls. Sometimes the urine infiltrates the subperitoneal connective
tissue, and forms a pasty swelling on the loin or flank. In either case
a hollow needle inserted will draw off a liquid having an urinous odor.
That this urine has escaped in front of the bladder may be safely
inferred from the continued discharge of urine by the urethra and by the
absence of cystic swelling, heat and tenderness. If the kidney can be
reached by rectal exploration it is felt to be firm and resistent up to
the period of rupture of the ureter.
In case of obstruction by calculus, crystals and even small calculi may
be passed in the urine, there is usually a history of previous attacks
of renal colic, and the suffering is manifestly extreme. In case of
worms (strongylus gigas) the use of the centrifuge on the urine, may
possibly secure in the sediment specimens of its ova. The existence of
tumors or tubercles can usually be clearly made out.
_Treatment_ will be as varied as the lesion. Simple ureteritis may be
met by wet compresses, sinapisms, and internally by balsams and
anodynes. Calculi and parasites may be passed with some aid perhaps from
fomentations, antispasmodics, and diluents. Obstinate cases can only be
successfully met by surgical interference. The resulting wounds in the
ureter, like ruptures, perforating ulcers and strictures may be met by
Van Hook’s “_lateral implantation_”: the divided cystic end of the
ureter is ligatured and on the cystic side of the ligature a
longitudinal incision is made, large enough to admit the divided
extremity of the renal portion, and through each of the two sides of
this last a fine ligature is passed; these ligatures are then passed
into the lumen of the cystic portion of the ureter through its
longitudinal incision and brought outward through its walls; next the
renal end is inserted into the incision in the cystic end and the two
are firmly sewed together by the two ligatures. When a small portion of
an ureter must be excised it may sometimes be possible to save a
valuable animal by such an expedient.
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